Open Collections

BC Sessional Papers

ANNUAL REPORT OF THE PUBLIC HOSPITAL FOR THE INSANE OF THE PROVINCE OF BRITISH COLUMBIA FOR THE YEAR… British Columbia. Legislative Assembly 1911

Item Metadata

Download

Media
bcsessional-1.0064403.pdf
Metadata
JSON: bcsessional-1.0064403.json
JSON-LD: bcsessional-1.0064403-ld.json
RDF/XML (Pretty): bcsessional-1.0064403-rdf.xml
RDF/JSON: bcsessional-1.0064403-rdf.json
Turtle: bcsessional-1.0064403-turtle.txt
N-Triples: bcsessional-1.0064403-rdf-ntriples.txt
Original Record: bcsessional-1.0064403-source.json
Full Text
bcsessional-1.0064403-fulltext.txt
Citation
bcsessional-1.0064403.ris

Full Text

 ANNUAL   REPORT
-OF  THE-
PUBLIC HOSPITAL FOR THE INSANE
—OF  THE-
PROVINCE OF BRITISH COLUMBIA
—FOR  THE-
YEAR   1910.
PRINTED BY AUTHORITY OF
THE LEGISLATIVE ASSEMBLY OF BRITISH COLUMBIA.
VICTORIA, B. C :
Printed by Richard Wolfenden, I.S.O., V.D., Printer to the King's Most Excellent Majesty,
1911. I   ' ■ "•■ •'
sa* _**     "»»:
sf-^AiffV; <s.  1 Geo. 5
Public Hospital for the Insane.
G 3
REPORT
PUBLIC   HOSPITAL   FOR   THE   INSANE.
1910.
To His Honour the Honourable Thomas Wilson Paterson,
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 1910.
HENRY ESSON YOUNG,
Provincial Secretary.
Provincial Secretary's Office,
January, 1911. G 4
Public Hospital for the Insane.
1911
OFFICERS
-:o:-
Medical Superintendent:
C. E. DOHERTY, M. D., C. M.
Assistant Medical Superintendent:
JAMES G. McKAY, M. D., C. M.
Bursar:
GOWAN S. MACGOWAN.
Analyst :
F. P. HUGHES.
Assistant Bursar:
T. H. CAMBRIDGE.
Matron :
MARIA FILLMORE.
Steward and Store-keeper:
R. REES.
Engineer:
W. F. JOHNSTON.
R. LENNIE.
Chaplains:
E. MAILLARD, O. M. I.
Chief Male Attendant:
GILBERT MATHEWSON.
Matron and Chief Female Attendant:
MARIA FILLMORE.
Carpenter :
THOMAS CORMACK.
Plasterer and Mason :
EDWARD FITZGERALD.
Farmer:
E. B. STINCHCOMBE.
Gardener :
W. T. L. HOUSE.
Tailor :
W. F. BEGGS.
Laundryman :
J.   HARGIE.
Shoemaker:
D. McQUARRIE. 1 Geo. 5
Public Hospital for the Insane.
G 5
REPORT
OF  THE
Medical Superintendent of the Public  Hospital for the Insane,
New Westminster, B. C.
For the Year Ending 31st December,  1910.
Public Hospital for the Insane,
New Westminster, B. C, January,  1911.
The Honourable
The Provincial Secretary,   Victoria, B. C.
Sir,—I have the honour to submit herewith the Thirty-ninth Annual Report of the
Public Hospital for the Insane at New Westminster for the year 1910. The report embraces
a full account of the operations of the Institution, together with a record of the movements of
the Hospital population and a detailed account of all revenues and expenditures for the year.
The work of this Department has been progressive and has, with the increased facilities
at our command, given results which I trust will be satisfactory to yourself and to the other
Honourable Members of the Cabinet.
In order to facilitate a more ready comprehension of the data given in the tabulated
portion of the report, the following resume and summary is presented : At the close of the year
the number of patients under our care was 700, of whom 523 were men and 177 were women.
The admissions for the year were 284 ; of these, 220 were men and 64 were women, an increase
of admissions over the previous year of 52. Of the admissions, 128 were suffering from a first
attack, 23 were suffering from a second attack, and 17 from a third attack. In 112 cases it
was impossible to ascertain the number of attacks, but it is more than probable that a portion
of these were cases recurring.
Of those admitted, 102 were married, 5 were in the widowed state, 165 had never been
married, while in 8 cases it was impossible to ascertain the civil state.
In religion, 210 were Protestants of various denominations, 49 were Roman Catholics,
4 were heathens, and in 17 cases the religion could not be ascertained.
The total number of discharges for the year was 166. Of these, 84 were discharged
recovered, 70 were discharged as improved, and 12 were discharged as unimproved. None
were discharged as not insane. The percentage of recoveries, computed on the number
admitted during the year, is 30 per cent.
In the classification of our mental cases, you will notice that the same forms as last year
were used. Of late much has been written and said about the classification of mental
disorders, but after due consideration by our medical staff, we have found it advisable to
adhere to the classification of Krseplin, a classification which we consider not weighed down
with unnecessary complications and technicalities, and one which so simplifies statistics that
an extensive text is made unnecessary.
Dementia prsecox and manic depressive conditions predominate as formerly, while general
paralysis also plays an important part.    I wish particularly  to call your attention to the G 6
Public Hospital for the Insane.
1911
number of idiots admitted during the past year, and also to the extremely young age of many
of this class admitted. The increasing number of children coming into the care and custody
of this Hospital is a matter of much concern ; with our present facilities, we are unable to
properly classify and segregate them, so that due regard may be given to their individual
claims, and the comfort and well-being of other patients. These children necessarily have
to be assigned to such locations in the Hospital as the character of our equipment and
accomodations permit.
Without desiring at all to avoid the responsibility incident to caring for this class of
patients, I would strongly advise that one wing of the present Hospital be given over entirely
to this class of patients, as soon as the new Hospital at Coquitlam is completed. Nothing but
dissatisfaction can result from the mingling of children and adults ; the difference in their
ages, the very nature of their mental disabilities unfit them from the standpoint of science,
discipline and the principles of classification to be grouped together.
Treatment.
The officers and nurses, both male and female, have given faithful and efficient attention
to their several duties. I have in past reports attempted to dwell upon the taxing nature of
these duties and the conditions under which they are performed. Institution life is a life
apart; it may have the seeming advantage of much quiet, of freedom from the stress and strain
of the struggle in the outside world, but in its place, I can assure you, there is a strain equally
as great, if not greater, in the never-ending responsibility, a part of which every employee
must bear. In accepting such huge responsibility, it is our duty, as medical officers and heads
of the Hospital, to also guard against the ever present danger of following the lines of least
resistance and getting into a routine and mechanical performance of daily duty. There is, I
am glad to be able to say, a vigour and spirit in the life of this Hospital which in no small
way you yourself, in your efforts as Provincial Secretary, have been responsible for. The great
interest you have always shown, not only in the management of the Hospital but also in the
results of its treatment, has been a great source of encouragement to me, and I can assure you
that it behoves us all not only to be earnest and diligent in providing the best physical
conditions for our patients, but also to be ever mindful of our duty in doing what is practicable
for promoting their cure.
Hydrotherapy.
The splendid effects to be derived from the appropriate use of this method of treatment
have been quite evident during the year, and, in my opinion, no other means of treatment can
compare with hydrotherapy in reducing motor restlessness and exerting beneficial and soothing
reflex influence in states of agitation, anxiety, and depression.
Mr. Beaton has again handled this Department to our entire satisfaction, the attached
table showing exactly the amount of work  done in our bath-rooms.    During my trip East,
early in the year,  I had occasion  to visit  the  hydrotherapeutic  departments  of  several
hospitals, and in none of them did I see the acutely insane handled with better system and
success than is being done by our Mr. Beaton.    During the past year the following work was
done in the different hydrotherapeutic departments :—
3,357 warm full baths ;
4,129 rain and needle shower-baths ;
659 steam cabinet baths, followed by massage ;
60 prolonged continuous baths in maniacal cases ;
56 patients have been treated electro-therapeutically ;
6 have been treated by vibration method. 1 Geo. 5
Public Hospital for the Insane.
G 7
Amusement.
A form of treatment for our patients which cannot be overlooked is found in affording
them means of amusement. We have availed ourselves of such resources as were at our
command in entertaining and amusing our patients, so as to divert them from their vagaries,
and awaken in them an appreciation of the normal or healthful side of life.
The usual weekly dances or concerts have been given throughout the year; the patients
w-ho take part in these dances look forward to them and speak of them as a weekly treat,
which they very much appreciate. Many who do not dance find pleasure and diversion
watching those who do, and in listening to the music furnished by the Hospital orchestra.
Next year we hope to have in operation our new campus, with its baseball diamond,
tennis courts, and bowling green, features which should prove very beneficial, both to the
physical and mental health of our patients.
Pathological Laboratory.
The special work in our laboratory has been going on in a systematic and thorough
manner. Mr. Hughes has been compiling valuable statistics for the Institution, not least
among which are the interesting and valuable series of physio-chemical experiments upon the
quantitative elimination and determination of the chlorides and phosphates in the urine of our
patients as a whole, with a view of confirming the findings recently advanced as to its relation
to existing insanity. The conclusions arrived at are given in this report only in part, but will
be submitted to your Department in full when completed at a later date.
Increase of. Tuberculosis.
I wish here to say a few words in connection with the great increase of tuberculosis
noticed among the insane of the Province; while this increased proportion is no doubt, to
a certain extent, due to our increased facility for exact diagnosis, still the matter is a very
serious one, and one for which special provision will have to be made in the near future.
In computing the amount of tuberculosis from our autopsies, the percentage has been
reckoned as fairly as possible; the common adhesions of the apices of the lungs and pleurisy
with or without effusion, have not been considered as of tubercular origin. Those which have
shown substantial evidence of the existence of the disease have alone been counted. With
these ideas in view, the percentage computation figures of 12 per cent, of tuberculosis was
found in eighteen autopsies in this Institution.
It is not with any hope of presenting anything new that I offer these statistics for your
consideration, but only that we may keep before our minds a question that is surely of the
utmost importance to our Institution, and one that seems to me to need immediate attention in
provision of means for special isolation and care. When so earnest endeavours are being
made by the energetic Health Department of our Province to control the spread of this
scourge among the general public, it seems highly important to recognise the danger and to
make proper provision for the restraint of the disease with those who are directly under our
supervision and control. The difficulty of controlling the habits of the insane is known
chiefly to those who are concerned with their care; but when we see tuberculous patients in
wards daily with a receptacle for sputum at their bedsides, who yet prefer, in spite of the
utmost care on the part of the nurses, to expectorate on the floor, or into the bed linen, one
is at once convinced of the double difficulty in combating this dreadful disease in our insane
colony. I would respectfully suggest that a special pavilion for the treatment of this disease
be built at Coquitlam in the very near future. G 8
Public Hospital for the Insane.
1911
Improvements.
New   Westminster.
Much work, both on grounds and buildings, has been done during the past year; everything within and without the buildings is in excellent repair, while the grounds, under the
care of our efficient gardener, Mr. House, have been much admired. The excellent taste and
splendid system exhibited in this Department have been a great source of pleasure to me.
Colony Farm.
At Colony Farm great energy was displayed in the work of clearing and underdraining.
Connected with the Coquitlam Institution are some thousand acres of land, and in the
management and laying out of this large area we have in mind, both for the present and the
future, the accomplishment of three general results : First, the pleasure and health of the
insane population of British Columbia ; secondly, the providing of employment to a large class
of patients who will be benefited by regular work in the open air; thirdly, the great economy
to be effected by utilising the help provided in producing most of the requirements of the
Institution in fruit, flowers, vegetables, and farm and dairy products. Already the lowland
of the farm has been completely cleared and underdrained, while, with the exception of some
fifteen acres, it has also received its first ploughing or breaking, and there can be no doubt
that, within two years, this will be one of the very best farms in the Province. The new
dairy and hay-barns and also the farm cottage have been completed, and will be occupied very
shortly after the New Year.
I wish to take this opportunity of congratulating the Government upon the recent
appointments to the more important positions at Colony Farm. It would be impossible to
expect good results from the farm, unless we had at its head men of experience, ability, and
integrity. In the appointment of Mr. E. B. Stinchcombe as chief gardener, the Government
has placed at the head of this very important department a man who has been in the service
as chief farmer at the New Westminster Institution for the past fifteen years, and a man whose
ability is well known.
Mr. Duncan Montgomery, as chief farmer, should give splendid satisfaction; he is well
and favourably known throughout the Province as one of its very best agriculturalists and
stockmen, having been manager of the Pemberton Stock Farm for some ten years, where he
established a very enviable reputation.
In the promotion of Mr. J. B. Pumphrey to the position of steward and chief attendant,
the Government has secured a man for this dual post who has been well tried and who has
made abundantly good.
Expenditure.
In the matter of expenditure, our per capita cost of maintenance was $184.43. This is a
very low rate when you take into consideration the following facts : First, the increased price
of nearly every article of necessity furnished the patients; secondly, the increased salaries
paid to employees; and, thirdly, the new expenditure in the amusement of patients.
When you take into consideration that in this expenditure of $184.43 per patient, we
include not only the food, clothing, bedding, laundry, and tobacco of each patient, but also the
cost of overseeing, treatment, the heat and light furnished, as well as the amusement of each
patient, I think no fault can be found.
I can remember a few years ago, when the question of increased salaries for employees
came up for discussion and when, notwithstanding the willingness of the Government to see
that the Hospital employees were well paid, the argument set up against it was that it would
be impossible for this Hospital to show a comparison which would appear at all favourable
when set alongside statistics from eastern hospitals.    Now, with increased salaries, with better  1 Geo. 5
Public Hospital for the Insane.
G 9
amusement, and with the increased cost of living, our per capita cost is one of the lowest in
the history of the Hospital, and not only compares most favourably with eastern hospitals but
is 30 per cent, less than that of New York State hospitals, facts which go to prove that well-
paid, intelligent help is in the end the most economical.
In the matter of salaries, I would like the Government to take into its consideration the
question of advanced salaries for married attendants; these men, while living at home and
maintaining a house, receive salaries similar to single men who have quarters provided by the
Hospital. A married man, raising a family and providing his own living quarters, should be
entitled to at least $10 per month in excess of that received by single men. If you can see
your way go favourably consider this favour for the married attendants, I will promise that no
material difference will be noticeable in next year's per capita cost.
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
351.55
340.90
374.57
419.24
490.80
526.85
563.33
$ 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,'26I 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
66,052 76
63,342 07
66,596 69
74,874 64
90,269 49
96,586 32
103,900 44
|616 00
1873	
1874	
487 98
491 20
1875	
360 77
1876	
344 91
1877 	
1878	
1879	
1880	
373 26
382 93
268 63
232 32
1881	
226 62
1882  	
1883	
237 02
242 75
1884	
243 20
1885	
284 54
1886	
259 42
1887 	
216 70
1888	
204 72
1889	
1890	
1891	
219 60
223 13
181 50
1892	
1893  	
187 80
193 36
1894	
178 25
1895	
193 83
1896	
186 67
1897	
191 75
1898	
214 38
1899	
242 52
1900	
244 00
1901	
205 54
1902	
186 59
1903	
178 65
1904	
187 89
1905	
185 80
1906 	
177 79
1907	
178 59
1908	
183 92
1909	
1910	
183 32
184 43 G 10
Public Hospital for the Insane.
1911
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..
1904..
1905..
1906..
1907..
1908..
1909..
1910..
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
87 43
92 17
88 76
89 18
90 93
94 27
95 97
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
18
69 43
72 91
72 62
66
65
61
13
57
86
60
01
54
09
53
15
48 47
49
17
53 41
48
43
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
03
33
49
88
41
20
02
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
6 85
5 99
5 16
5 81
6 61
8 16
7 87
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
17 84
17 93
15 92
19 82
17 63
13 02
21 32
Furniture.
$15 55
21 59
28 36
25 45
17 90
20 75
7 20
6 39
6 00
5 55
4 54
4 26
4 14
3 90
3 72
3 88
3 11
4 13
4 00
3 40
3 35
3 39
2 98
2 51
2 56
2 95
2 76
2 50
2 15
3 25
4 13
3 24
4 48
3 83
3 57
3 02
4 56
2 78
2 02
Medicines.
$10 18
74
78
73
86
74
16
6 31
3 63
2 56
49
24
77
93
59
93
09
07
29
89
80
69
43
10
63
86
12
73
1 71
1 07
1 20
1 91
1 57
1 79
84
1 15
Miscellaneous.
$49 30
32 16
25 81
30 51
24 93
19 52
21 82
7 40
3 34
5 34
61
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
9 18
9 76
10 02
10 72
13 23
10 84
7 67
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
187 89
185 80
177 79
178 59
183 92
183 32
184 43 1 Geo. 5
Public Hospital for the Insane.
G 11
a
•73
N
a
a
_o
a,
O
-3  to
eg  u
*Q  o
d>
h-1
bc-^ d
H.      %      (D
3.0. a
3
NCJH^©MOTfI^H05rtMmL0Q0rtlOTflO01i0^I-(0^
^h^h        IOtlHiOiOOD^«IOOO©OI
oicMo^coa:oiooioofOio
o o
o o
00 Ci
oooooooooh«MHiowffi«m
tocNcoootMi'^co^aO'-^i'^Ttir^cococoioo
rt H d a>
-S rt S n
iOrt<HOOXI^^01XCD>OH^^X(NtOOiOCCNaC«0:0©iOiOOQOiOt-'«ONQ'*aiO:l'^
^^N(^Q0r^^c0(>lHmciWi0^i0^r^l^l^c0TrOr^iHTt<or^0iO^WW(NO^0:cDO
CD^(rOQOrHCO'QLOQ^(^^iO«^OOt^lO'HOO:XO(NCJM^O'*iOin^03t--'CCOO
0'lX01CCW05©C'llOOfCCOCOiOO:o:(N©LOI>^QTt(^CW^©«'*KWOCOIOCOWI005
LQr>0)OCC^CDWCONHr-b.NiO^©0©©OCOr^l>LOTtllOT|fiacOCOO^H^U'3Tt(^0
r/"i   —I   -"^   r**i   ^-^   »-—   ^^   r-r\   ti~\   *r-\   i^_   rv^   ^^   ^r^   **^  ^^,   z^n   t--^, rO   l
rHOiMOMCCO^-HWr-tCHXOOiOiOOiiffiC
(»H?:woi--QcoLOioNC,;o©ma)Cj^©iooot
.1   ti.)   l_U   S.M   l_M   <J-J   "J-i   1-*J   *••>  ^»'<   •'»   I- —   ^'    ^J '   «. — ■■•>
ph .-T ci f-T Of rH ci CO CO CO CO ■* SO iO rf
es
3
a
o
0
=3
IS
o
uj
a
3
=i
<|
en
H
i-l
H
S>
-C
NOlHiOCOHNiOOOfONOH^^^ocOHOOOCO^MCO^OOXCOOlHCDOOiffi
OTt>*<©C^^^I>OOONif5HFH(N©©i>CiMrH00003(NI>COWH-^MiHOO^'#cO'*iOO
W(>17:00ClNW^«WfflC«CD0S©OTt'O<NCJO^O(N(NOH^C0O«W0JLCiL'Jt;.Tf»O
rHr-HrHr-trHCOCNrHl—ii-H.—l^ir-l HHH(M!MCO(MlOOI>rHCO'*i:ifCC01>CO^OCO^O
F-i
T3
+J
Ci
a
3
+^
[XI
OJ
rw
0
^
Ml
3r-l
N
HOWCD©0®^i>
wOcoi^^^Hcoi^(Ni»i>(>icoc-ic»co>cciOir:aiOGoo«ixi>a)(^co
Ha0WMNHb.^HMQlOh.«lO$00MCiICJO)b'(»tO'rtlO>-il>^fflt:
IO-H©'fl-.OrHOO-'-IQOTHaiHO'-HOTfrHp:iCQlS(NN(NI>t-CW
CO CO oi *r
CD ZD ir~ *0
CI CM Tf -
-Tea ph.
P4
O
K
9
J*
-P
a
o
m
xcoo^N^ooMoccwooii-CMoiMOTtir'OiffiiM^HfNaiooiwoi'HC-HioiOH
«^^Q0i^l0CD«©^i0OC00iHFH01«'!fiW:OI>W'*CDl>C0aOl001(NH©«ioaDO
r-ifM(MK(Nrt««^t^l>^^^COtOOXGOO(M
^C^^OO:«OXl0^^i^^X05^NW^COXCOiOOiOCO^^|>H001^lOLO^NHO:
xiQoci^rHMiocii^xxK'^ocxxiHi^ciiO'^ooooiXOHi-iaiHajrHiro^HCDi'CiiN
(NcoofoocDH^occ^o:^^^^o«ooih'Oj'-iFiaiOiW(^o:i>oi003cciioiTHxr-'
85N«W«ONHH«COWWW«m^P5LOt-»^iOI^i> ©^O^lq^h x (NI>n»'*003'*011N'#
^ pH rH rH pH ci ^i ci Oi Ci Ci Ci Ci i-H Ci" CO" *# t^
Nx>*o©cow^X(N^HrHoo5^o^^cDOi>ai"vDxair;r-icocDcc(>iaiccowirc^i>
COtOLOHHmKJOOlOOOlfl'tfffiOMXNOsOHH^oiOfflOlOffiQHfMO^QKHHN
OiHHCCCO«nO©>CtO©0©«0©0(NWXrtXtDl>fMOHuOCD--01J>»0»OOHO»OC
COCO^I^X^^OlQQrtlLOQtNQOOCDHOlX&lrH^O^fOriCDOXCOCKi^XWNXX
NQWb'XQMTl*Oi^iO«Oi(Jlff)05050>0 0«0^«005NX^OiWJ(NlO--«'if!OU0 01
i^iOt^rHrH(N«01l^O«H«W^OJaaONfflOO>40«(NQWCSW^«D«W'*05<NCD^
OOXWCNhtJhOWXO 0_W CQ « CO « O O X l> O X (NX i« O mt>OJMl>Tj*(MniOCOO
HHr-lrHrHrnrH(N(N(N(N(N(NCQCQCOCQ^^IfJ
(NCQTf<lO©l>XQOHO]CO^in©|>XQO^(>]CQ^iCiCt--X010HQ-lCQTt<»0©b-XffiO
i>h-hr>M^t-i>GOXxcoxxciDcoX'a!ai©o:oo50ffio:C!050ooooooooOrt
XXXXXXXXXXXXXXXXXXXXXXXXXXXXQOiaOOiG&QOlOiQOJ _/
G 12                               Public Hospital
FOR  THE
Insane.
1911
The amount of revenue co
and our Bursar, Mr. Macgowan
the very close attention given t<
paid into the Government Agen
1873	
1874	
1875  	
Revei
lected at this ofi
, and his assista
3 this important
t.
$1,440 99
680 00
1,342 60
730 31
799 91
479 42
867 38
1,433 04
614 99
505 18
298 24
98 35
TOE.
ace during
nt, Mr. Ca
feature.
1892
1893
1894
1895
1896
1897
1898
1899
1900
1901
1902
1903
1904
1905
the past year sett
mbridge, are to be
In all $26,137.38
up a new
congratu
was collec
.   $2,418
1,585
2,709
4,409
3,741
3,816
4,003
4,769
6,893
12,800
10,926
13,639
.   15,004
16,613
19,058
20,753
25,807
25,845
26,137
,356 25
1 68
46 72
10 00
94 50
30 42
2 00
112 56
37 50
31 32
235 10
record,
ated on
ted and
43
40
53
23
71
80
79
04
33
76
23
64
22
lc
42
35
83
65
38
1876	
1877	
1878.	
1879	
1880	
1881	
1882	
1883 '	
1884	
1885	
1886	
1887	
1888	
1889	
50 00
720 59
750 00
220 00
599 24
761  15
Garden Peod
1906
1907
1908
1909
1910
uce—Frui
1890	
1891	
Apples	
T.
43,400 lb
24
584
100
1,350
507    ,
20    ,
2,814
1,200    ,
522    ,
2,351     ,
13,286 lb
3,008    .
113    i
71    i
1,214
3.         $1
$1
s.       $1
$2
Plums    	
Raspberries	
Strawberries	
Total
Pork (dressed) used at
ii    sold alive  	
Home Farm Produce.
Institution	
,958 05
,660 75
150 00
345 64
73 45
71 00
424 90
Chickens, dressed....
Ducks,             ii     ....
Eggs, dozen	
Total
,725 74 1 Geo. 5
Public Hospital for the Insane.
G 13
Garden Produce—Vegetables.
Beets  8,868 lbs. $    88 68
Beans, French  322    „ 16 10
Carrots  9,059    „ 90 59
Cabbage  5,569    ■■ 22 67
Cauliflower  160    „ 16 60
Celery  116 doz. 34 80
Corn, sweet  409    „ 81 80
Cucumbers  2    n 50
Leeks  650 lbs. 32 50
Lettuce  244 doz. 85 40
Onions  594 lbs. 17 82
Parsnips  15,950    „ 159 50
Peas, green  3,910    ., 234 60
Potatoes  4,420    >, 44 20
Radishes  1,520 bunches    60 80
Rhubarb  1,604 lbs. 80 20
Spinach ,  1,873    „ 93 65
Tomatoes, ripe  100    ,. 15 00
ii        green    . 32    n 1 60
Turnips ,  10,069    „ 100 69
Total  $1,277 70
Colonv Farm—Vegetables.
Cabbage  2    tons $   160 00
Potatoes  55      i, 1,320 00
Carrots  26      „ 520 00
Parsnips  3      n 60 00
Beets  &    ii 10 00
Mangolds  5      ., 110 00
Turnips  121    „ 250 00
Apples .  15    boxes 15 00
Field peas  5    tons 175 00
Wheat  3      ,, 96 00
Oats, hay  40      „ 720 00
Butter  110    lbs. 33 00
Total , $3,469 00
It is pleasing to have this opportunity of expressing my gratitude and appreciation of all
the courtesies that have been extended to the Hospital and its patients by their numerous
friends in the Province. To those who have taken part and assisted us in our musical entertainments, or have supplied us with magazines or papers, we are very grateful. Our thanks
are especially due to the publishers of numerous newspapers for their kindness in furnishing
regularly and gratuitously copies of their publications.
To all the officers and employees of the Hospital who have so loyally and faithfully
performed their duties and made possible the success the Institution has attained, too much
cannot be said in praise and appreciation. Their work is performed under conditions of trial
and self-denial that are hardly appreciated by the public, except perhaps those who have by
personal experience or otherwise been brought into contact with insane persons. G 14
Public Hospital for the Insane.
1911
I am especially thankful to yourself and to the other Honourable Members of the Cabinet
for the helpful advice, assistance, and kind consideration that has so materially lightened the
burden of the administration of the affairs of the Hospital.
I have the honour to be,
Sir,
Your obedient servant,
C. E. DOHERTY,
Medical Superintendent.
LABORATORY   REPORT.
Laboratory of Hospital for Insane,
New Westminster, B. O, December 31st, 1910.
The Medical Superintendent,
Public Hospital for Insane, New Westminster, B. C.
Sir,—I have the honour to submit, herewith, the Annual Report of this Laboratory for the
year ending December 31st, 1910.
Out of a total of forty-one deaths, autopsy has been performed upon eighteen bodies; the
pathological and microscopical findings of which will be found appended hereto.
Twenty-two gross specimens from the autopsies have been preserved for museum purposes ;
a list of them is also appended.
On admission of each patient, the blood and urine are subjected to examination, and also
during residence if specially indicated. Sputa, stomach contents, etc., have also been examined
in certain cases. Tables are appended which will show at a glance the number and results of
these various examinations.
On the completion of each investigation, the report is carefully and systematically placed
on file, so that we are rapidly compiling valuable statistics on our work, while each report can
be turned to at any future time, to demonstrate the clinical course or termination of the
individual case. It is, perhaps, needless to say that it is only from the statistics compiled from
the study of each patient, and the similarity or vagaries existing between two or more cases
suffering with the same form of insanity, that the latest theoretical methods for diagnosis have
been based upon; the work done, in only one or two cases, no matter how thorough it may
be, bears no weight whatever in attempting to establish any authentic deductions, or to refute
any theory already established.
The milk and water supplied to this Hospital have been submitted to analysis at least
weekly, and food supplies when suggested. The results of these analyses are given in tables
appended hereto.
Pathology.
At each autopsy sections are taken from various organs, hardened, cut, stained, and
examined microscopically, in order to ascertain the degree of degenerative changes, if any,
existing. 1 Geo. 5
Public Hospital for the Insane.
G 15
The cerebro-spinal fluid is taken from each fatal case and put through a series of chemical,
bio-chemical, and bacteriological tests, together with inoculation experiments on animals. So
far, our results do not allow us to offer any opinion or make any suggestions, but we are
systematically working and recording our findings, with the hope that some definite conclusion
may be arrived at in the near future.
Of late the question has arisen as to whether we can say " Without syphilis there is no
general paresis," or otherwise. Numerous papers have been read and published on this vexed
question; in one, a well-known worker claims that general paresis cannot occur without
previous syphilis, while another investigator states that there is not yet sufficient proof to
warrant the syphilis-etiology theory of general paresis. The principal arguments on both
sides are:—
Syphilis-etiology  Theory.
For.
1. The Wassermann reaction occurs in 100
per cent, of all cases of general paresis and
syphilis.
2. The Argyll-Robertson pupil occurs only
in these two diseases.
3. The anatomical changes in these two
diseases are similar.
4. These two diseases are much less common in females than in males.
5. A history of hereditary syphilis is nearly
always given in cases of juvenile general
paresis.
6. It has never been known for a case of
general paresis to contract a chancre.
7. Cases of general paresis inoculated with
syphilis give negative results.
8. The fifteen-year period between the two
diseases.
9. Signs of having had, or a history of
syphilis, is given with about 80 per cent, of
cases of general paresis.
10. The infiltrative changes i» the two
diseases are similar.
Against.
1. The Wassermann reaction is not biologically specific, occurring in some cases of scarlet
fever, leprosy, and sleeping sickness.
2. Only a very small percentage of syphi-
litics develop general paresis.
3. The Treponema pallidum has never been
demonstrated in general paresis.
4. Where syphilis is widespread among the
natives of parts of Africa and India general
paresis is unknown.
5. The scarcity of general paresis in India
and China, where syphilis has existed for
thousands of years.
6. Many cases of cerebral syphilis yield to
antisyphilitic treatment.
7. Anti-syphilitic treatment does not affect
the course of general paresis.
8. The long interval between syphilis and
general paresis, and our limited knowledge of
protozoal evolutions.
9. No signs of having had, nor a history o*
syphilis, can be obtained in about 20 per cent-
of cases of general paresis.
10. Infiltrative changes in other chronic
inflammatory conditions are similar.
The Wassermann reaction is the strongest presumptive evidence yet produced in favour
of the luetic origin of general paresis. That this reaction occurs in a few cases of scarlet
fever, sleeping sickness, and leprosy is claimed to be no more argument against its specificity
than that the typhoid agglutination reaction of Widal occurs in cases of icterus and ptomaine
poisoning, and is explained as being merely a phenomenon of interaction between lipoids.
As is well-known, typhoid serum plus bacillus typhosus will bind complement. It is
perfectly just to surmise that a syphilitic serum plus the syphilitic inciter will also bind
complement. Wassermann thought that, in the absence of culturable organisms, extracts from
the liver of syphilitic foetuses will admirably fulfill all the functions of a specific antigen.
When tried in the actual test, this really proved of great efficiency. A few years later its
specificity was fundamentally shaken, for investigators found that sera undoubtedly non-syphilitic were capable of binding complement when brought in contact with the extracts from G 16
Public Hospital for the Insane.
1911
syphilitic livers. It was also shown that extracts from non-syphilitic organs, and substances
whose composition does not in the least justify the appellation of antigen, were capable of
deviating complement when brought in contact with specific sera.
From all the evidence brought forward during the last two years, we are probably
justified in concluding that:—
1. The weight of evidence is in favour of syphilis as an essential cause of general paresis,
and, if a history of the disease is not obtained, we are probably justified in supposing, either
that the infection has been so slight as to escape notice, or that it was inherited.
2. Alcohol, trauma, and other factors merely play the part of lowering the general
resistance, as they do to any disease.
3. Whether the occurrence of general paresis, after syphilis, is determined by a
constitutional predisposition, by a special form of virus, or by the incidence of some other
factors, is not yet clear.
4. General paresis must still be regarded as a metasyphilitic disease rather than a true
syphilis.
In addition to the above routine work, many miscellaneous examinations of sections,
smears, etc., have been made as aids to diagnoses.
Gross Specimens Added to Museum.
1. Brain, cerebral haemorrhage.
2. Lung, tubercular cavities.
3. Lung, collapsed and tubercular nodules.
4. Brain, convolutional atrophy.
5. Kidney, carcinoma.
6. Liver, portal cirrhosis.
7. Kidney,  cortical cysts.
8. Brain, dilatation of ventricles.
9. Liver, nutmeg.
10. Coecum, perforation.
11. Brain, convolutional atrophy.
12. Lung, anthracosis.
13. Heart, sclerosis of valves.
14. Uterus and ovaries, cystic.
15. Heart, chlorosis.
16. Suprarenals, fatty degeneration.
17. Liver, fatty degeneration.
18. Kidney, pelvis dilated.
19. Lung, tubercular.
20. Intestine, tubercular.
21. Sternum, fracture of.
22. OEsophagus and trachea, laryngeal obstruction from piece of impacted, regurgitated,
and unmasticated meat.
Summary of Autopsy Reports.
1. Manic Depressive Insanity :
2531. F. T. S., female, set. 36, married, housewife, first admission. Duration of
psychosis, about two years.    Cause of death, general debility.  1 Geo. 5
Purlic Hospital for the Insane.
G 17
Clinical Report.—Admitted 22nd December, 1909. From history received, psychosis
had existed for about two years prior to her admission ; first noticed by her reserved manner
and refusing to meet her old friends. Later on she developed persecutory delusions, and
gradually deteriorated physically. Physical examination ; poorly nourished, mucus membranes
pale, skin d^', tongue coated, showing slight tremors; pupils dilated but equal, and react to
light and accommodation, although they are rather sluggish ; patellar reflexes diminished •
examination of lungs negative; examination of heart shows a mitral murmur, but no cardiac
enlargement. From the time of her admission patient gradually became more and more
stupid, until finally it was necessary to rouse her to give nourishment, and during the last
fifteen days she remained in a state of coma, from which she could be aroused with great
difficulty, and could only take a small amount of nourishment. Died suddenly about fifteen
minutes after taking a cup of beef tea on 25th January, 1910.
Pathological Report.—Permission for a complete autopsy could not be obtained. Slight
oedema of lower limbs ; no marks on body ; sordes on teeth and lips. Cranial bones compact;
tenacious adhesions of the dura to the skull and arachnoid over the parietal verices ; dura
thickened and tough ; diffuse opacity of the arachnoid ; no marked increase of subdural
or subarachnoidean fluid; pia adherent generally, but most marked in frontal lobes.
Brain—weight, 1,256 grms.; some cedema of convolutions most marked in frontal lobes.
Heart—weight, 238 grms. ; moderate sclerosis of the aortic valve ; no atheroma of aorta.
Left lung—weight, 540 grms.; normal.
Microscopical Report.—Moderate chromatolytic changes in some of the nerve cells;
central canal of the cord filled with proliferated epithelial cells; round cell infiltration of the
dura, completely occluding some of the vessels and perivascular spaces, and all of the
perivascular spaces more or less filled with them. Cerebro-spinal fluid negative to Noguchi
test.
2. General Paralysis :
2396. Male, set. 52, single, carpenter, first admission. Duration of psychosis, ten months.
Cause of death, peritonitis.
Clinical Report.—Admitted 29th May, 1909, from the Provincial Gaol, where he was
serving a term for vagrancy; has marked delusions of grandeur and is unsteady in his gait.
Sent to the infirmary ward ; physical examination showed skin moist, well nourished, tongue
furred and tremorous; pupils react slightly to accommodation, but not to light; radial
arteries sclerosed; patellar reflexes absent; marked Rhomberg present; examination of heart
and lungs negative. From the time of his admission until the 1st January, 1910, patient
showed a steady progression in paresis, but at this time developed symptoms of appendicitis,
temperature running about 101-102, pulse rapid, tenderness over McBurney's point, rigidity
over all right abdomen. These symptoms gradually disappeared during the next few weeks,
but patient's physical condition deteriorated rapidly, and on attempting to get out of bed
patient collapsed, dying about five hours later on 26th March, 1910.
Pathological Report.—Abdomen distended and tympanitic.    Cranial bones cancelleous ;
dura adherent over the frontal and parietal bones; diffuse opacity of the arachnoid which is
more or less adherent to the brain substance ; marked increase of subdural and subarachnoidean
fluid.    Brain—weight, 1280 grms. ; consistency firm; ventricles dilated; ependyma granular
throughout; basal vessels atheromatous ; posterior columns of the cord gray.    Lungs—weight,
left  449 grms. ; right 510 grms. j  costal  cartilages ossified;  extensive  pleuritic  adhesions
throughout both pleural cavities; lower lobe of right lung semi-solid and almost in a condition
of red hepatization ; anthracosis of both lungs.    Heart—weight, 354 grms ; moderate sclerosis
2 G 18
Public Hospital for the Insane.
1911
of the aortic and mitral valves ; muscles firm and numerous ; whitish streaks throughout the
substance; moderate amount of epicardial fat; arterio-sclerosis and atheromatous degeneration
of the arteries. Spleen—weight, 283 grms.; splenic artery large, tortuous, thickened and
atheromatous. Liver—weight, 1,417 grms. ; firm adhesions to diaphragm; pale and
commencing nutmeg in appearace. Kidneys—weight, left 130 grms.; right 150 grms.; pale
in colour, numerous cortical cysts; considerable pelvic fat; capsule strips readily; pelves
dilated; ureters dilated and distended with urine. Pancreas—weight, 106 grms. Thyroid
gland—weight, 27 grms. Peritoneal cavity contains about 800 c. c. bloody serous fluid;
peritoneum red and intensely congested, most marked in the lower part and on right side;
small intestines distended with gas; caecum distended and slightly gangrenous; mesenteric
and retroperitoneal glands not enlarged ; caecum contained several old perforations which had
become walled off from peritoneal cavity by a fibrous tissue growth, attached to csecum and
mesentery ; caecum and about 4 feet of the small intestine intensely congested ; appendix
thickened and congested but empty.
Microscopical Report.—Extensive chromatolytic changes in the nerve cells ; proliferation
of the ependyma epithelium ; sclerosis of the posterior columns of the cord and of the posterior
roots and ganglia. Chronic myocarditis ; moderate arterio-sclerosis and irregular atheromatous
degeneration of the arteries. Extensive diffuse nephritis, the arterio-sclerotic and parenchymatous changes predominating. Fatty degeneration of the pancreas. Tendency to cystic
dilatation of many of the thyroid gland vesicles. Intense engorgement of the liver with some
cirrhosis.
S. General Paralysis :
2545.    A. R., male, aet. 60, married, first admission.    Cause of death, general paresis.
Clinical Report.—Admitted 9th January, 1910, with marked symptoms of advanced
paresis. Physical examination ; fairly well nourished ; tongue clean and tremorous; tremors of
facial muscles; pupils irregular and sluggish ; Rhomberg present ; writing characteristic of a
paretic; patellar reflexes exaggerated, otherwise physical examination negative. Patient's
condition rapidly deteriorated until the time of his death on 16th April, 1910.
Pathological Report.—Cranial bones thin and compact; dura moderately adherent to the
cranial bones; numerous vascular connections of the dura to the arachnoid ; diffuse opacity
of the arachnoid ; great increase of subdural and subarachnoidean fluid. Brain—weight, 1,346
grms. ; general atrophy of the convolutions; granulations of the fourth ventricle; moderate
atheromatous degeneration of the basal vessels; ventricles dilated and distended with fluid.
Heart—weight, 314 grms. ; right ventricle dilated and contains a pinkish looking coagulum
more or less firmly adherent to the endocardium ; sclerosis of the margins of the mitral valves
and in the bodies of the aortics; moderate atheromatous degeneration of the arteries.
Lungs—weight, left 238 grms.; right 320 grms. ; some firm pleuritic adhesions in left pleural
cavity; no fluid; lungs slightly doughy in consistency, ooze considerable frothy fluid on
section; subpleural pigmentation. Spleen—weight, 140 grms. ; moderately firm on section.
Liver—weight, 1,574 grms.; oozes considerable blood on section; cut surface of a mottled
yellowish red colour showing areas of fatty degeneration. Kidneys—weight, left 138 grms.;
right, 142 grms.; several cortical cysts; moderately firm on section; pale in colour; pelvis
dilated ; pelvic mucosa congested ; capsule strips readily.    Other abdominal organs normal.
Microscopical Report.—Extensive diffuse chromatolytic changes in the nerve cells;
extensive perivascular round cell infiltration, practically occluding some of the vessels •
numerous hyaline bodies in the choroid plexus. Moderate sclerosis of the blood-vessels.
Many vesicles of the thyroid gland filled with proliferated epithelial cells. Engorgement of
the liver.    Hyperplasia of the malpighian bodies of the spleen.    Chronic diffuse nephritis. 1 Geo. 5
Public Hospital for the Insane.
G 19
Jf.  General Paralysis :
1066. A. McD., male, aet. 49, married, farmer, first admission. Cause of death, general
paralysis.
Clinical Report.—Admitted 16th August, 1900, with delusions of grandeur which had
extended over some time prior to his admission; had shown a tendency to squander his
earnings and on this account was committed. During the first few years of his residence
patient showed little, if any, change, and then became dirty in habits, apparently losing all
control of his bladder ; speech affected until in the latter stages he was unable to articulate,
and during the last two years was confined to his bed, having had slight seizures at intervals
during that time, from which he apparently made a perfect recovery each time. During the
last few days he had numerous seizures which were the immediate cause of his death on
19th May, 1910.
Pathological Report.—Scalp thick ; cranial bones compact and ^-inch thick ; dura adherent
over the frontal and parietal bones, with numerous vascular connections to the arachnoid ;
diffuse opacity and increased thickness of the arachnoid, with adhesions to the brain
substance; large quantity of subdural and subarachnoidean fluid. Brain—weight, 1,380
grms.; atrophy of the convolutions of both frontal lobes ; extensive atheromatous degeneration
and thickening of the basal vessels; ventricles extremely dilated and distended with fluid,
there being a layer of tissue of only about 1 cm. in thickness between the inner surface of the
ventricles and the external surface of the cerebral hemispheres, particularly over the parietooccipital region ; septum lucidum very thin and absent at the posterior portion ; foramina of
Munroe 1 cm. in diameter; ependyma granular throughout; choroid plexus cystic. Thorax
and abdomen not examined.
Microscopical Report.—Extensive chromatolytic changes in the nerve cells with diffuse
staining; intense round cell infiltration of the pia, and more or less of the pial prolongations
into the brain substance; many hyaline bodies in the choroid plexus.
5. General Paralysis :
2630.    A. McL, male, set. 60, first admission.    Cause of death, general paralysis.
Clinical Report.—Admitted 22nd May, 1910; physical examination negative; condition
fair ; shows pronounced symptoms of paresis, and during his residence in hospital was confined
to his bed, having no control over his sphincters. Patient's condition rapidly failed until the
time of his death on 18th November, 1910.
Pathological Report.—Cranial bones compact; dura firmly adherent generally; increase
of subdural and subarachnoidean fluid; opacity of arachnoid. Brain—weight, 1,234 grms.;
general atrophy of the convolutions; moderate atheromatous degeneration of the basal vessels
with thickening of most; ventricles dilated and distended with fluid. Heart—weight, 320
grms.; sclerosis of the mitral and aortic valves ; moderate atheromatous degeneration of the
arteries. Lungs—weight, left 220 grms.; right 315 grms.; considerable subpleural
pigmentation. Spleen—weight, 132 grms.; moderately firm on section. Liver—weight,
1,462 grms.; oozes considerable blood on section, and is of a mottled yellowish-red colour,
showing areas of fatty degeneration. Kidneys—weight, left 125 grms.; right 132 grms.;
moderately firm on section ; capsules adherent; considerable pelvic fat. Other abdominal
organs normal.
6. Melancholia :
2128.    F. P., male, aet. 52, married, miner, first admission,
obstruction from impacted, regurgitated and unmasticated food.
Cause of death, laryngeal G 20
Public Hospital for the Insane.
1911
Clinical Report.—Admitted 19th March, 1908; very depressed. From history received
psychosis extended back a year or so. Physical examination ; patient poorly nourished ; skin
sallow ; otherwise negative. During his residence patient never brightened up at any time,
gradually becoming more demented ; on one occasion made an attempt to strangle himself, but
was found before any damage was done. On November 3rd, 1910, patient bolted a large piece
of meat, which became impacted in his oesophagus ; being unable to remove this, it was forced
down with tube into stomach, and patient was taken to the ward and put in charge of a special,
and appeared to be perfectly normal. About twenty minutes later he regurgitated the piece
of meat, which became impacted in the larynx, causing his death before assistance could be
had.
Pathological Report.—Rather poorly nourished. Brain not examined. Heart—weight,
300 grms.; several sclerotic patches in the epicardium; moderate sclerosis of the mitral and
aortic valves. Lungs—weight, left 320 grms.; right 340 grms.; extensive subpleural
pigmentation ; bronchial glands enlarged and deeply pigmented. The larynx occluded above
the thyroid cartilage by a mass in the oesophagus, which proved to be a piece of meat; the
oesophagus below the obstruction is dilated but empty ; stomach empty. Spleen—weight,
65 grms.; firm on section; capsule thick and rough. Liver—weight, 1,250 grms.; firm
adhesions to the diaphragm; firm on section. Kidneys—weight, left 155 grms.; right 145
grms.; moderately firm on section ; cortex pale ; medulla deep-red colour ; considerable pelvic
fat; capsule strips readily. Prostate enlarged, the middle lobe projecting into the neck of
the bladder.
7. Melancholia :
2542. S., aet. 25, Hindoo, single, farmer, first admission. Cause of death, tuberculosis
of lungs.
Clinical Report.—Admitted 6th January, 1910. Physically his health prior to admission
was poor; on examination patient was emaciated, skin dry and hot; examination of lungs
found both very markedly involved; otherwise physical examination negative. The consolidation rapidly increased and patient died in three days on 9th January, 1910.
Pathological Report.—Fairly well nourished. Cranial bones hard, but not thickened ;
dural adhesions over parietal verices. Brain—weight 1,435 grms. Lungs—weight, left 916
grms.; right 1,070 grms.; left lung nodular and on section shows tubercular infiltration; some
hypostratic congestion posteriorly; bronchial mucosa congested ; bronchial glands enlarged and
pigmented. Right lung, firm pleuritic adhesions at apex and base; pleura thickened; a local
collection of purulent fluid in the apex; extensive diffuse, irregular, nodular infiltration, with
extensive degeneration and cavity formation ; portion of upper lobe underlying the purulent
collection is collapsed, airless and of a splenic-like consistency; bronchial mucosa swollen,
thickened, congested and covered with a viscid mucopurulent secretion; bronchial glands
enlarged, pigmented and caseate; some solid areas of lower lobe of a pneumonic appearance,
and on section ooze a bloody fluid with some intervening areas of a doughy character.
Microscopical Report:—Smears from both lungs show T. B. Portions of the lungs show
dense tubercular infiltration, with more or less degeneration; other portions show intense
engorgement of the vessels, with rupture of some and filling of the vesicles with blood; other
portions more or less emphysema; considerable perivascular and peribronchial pigmentary
infiltration;   chronic bronchitis and peribronchial consolidation;   hyperplasia of the lymph
follicles and tubercular infiltration of the bronchial glands.
8.  Terminal Dementia :
1268.    M.  E, male,
haemorrhage.
aet. 67, single, sailor, first admission.    Cause of  death,   cerebral  1 Geo. 5
Public Hospital for the Insane.
G 21
Clinical Report.—Admitted 7th July 1902 ; very well nourished ; showed a mark mental
deterioration and was almost imbecilic. This condition has existed from the time of his
admission until the time of his death on 2nd January, 1910. At various times has shown the
result of a severe malarial infection.
Pathological Report.—Emaciated ; cranial bones hard but not thickened ; tenacious dural
adhesions over parietal verices; increase of subdural fluid ; dura somewhat thickened and
tough ; opacity of arachnoid with some white spots and bands; pia generally adherent.
Brain—weight, 1,380 grms. ; vessels on left hemisphere of cerebrum congested and engorged;
small haemorrhage round left cerebellum, and rupture of one of the small arteries from the
basilar artery ; basilar artery shows marked sclerosis with atheromatous degeneration. Other
organs not examined.
Microscopical Report.—Moderate degenerative changes in the nerve cells ; central canal
of the cord filled with proliferated epithelial cells, which also infiltrate the surrounding central
gelatinous substance; extensive thickening of the dura and arachnoid by round cell accumulation involving the vascular spaces, extending into and through the cortex with thickening of
the vessel walls, particularly the media; in the cerebellum there is diffuse subpial haemorrhage
extending into, and infiltration of the cortex and underlying white matter; in other portions
the perivascular spaces and blood vessels show a leukocytic accumulation and infiltration.
9.  Terminal Dementia :
1571. A. G., male, Bet. 61, single, labourer, first admission. Cause of death, general
debility.
Clinical Report.—Admitted 27th November, 1904. Physical condition fair; inclined to
be aggressive and irrational in conversation ; some slight swelling on right hand and right
foot. During the first few years of his residence, showed but slight if any change in mental
condition, but from the early part of 1907 he gradually became more and more demented, with
periods of excitement; gait became spastic, and for several months prior to his death on 22nd
July, 1910, he was very unsteady and had to be confined to his bed the greater part of the
time.
Pathological Report.—Cranial bones thin and rather cancellous; extensive dural adhesions;
patchy opacity of the arachnoid; increase of subdural and subarachnoidean fluid. Brain—
weight, 1,180 grms.; general atrophy of the convolutions; more or less granulations of
opendyma throughout; moderate atheromatous degeneration of the basal vessels ; spinal dura
more or less firmly adherent to the vertebra, particularly to the first thoracic, which is very
prominent; beneath the adhesions to the latter is a necrotic cavity, the cord underlying it is
soft, the gray and white matter indistinguishable more or less throughout, more so in the
lower cervical and upper dorsal region, the gray matter being rather reddish in colour.
Sternum fractured between sixth and seventh ribs and a pocket of pus formed around broken
ends of bone ; intercostal muscles and pericardium engorged. Heart—weight, 510 grms. •
firm pericardial adhesions over the posterior surface of the right ventricle ; extensive hyper,
trophy ; large quantity of epicardial fat; sclerosis and some atheroma of the mitral valves,
with calcareous deposit in the body of the anterior nitral cusp; moderate arterio-sclerosis.
Lungs—weight, left 380 grms.; right 420 grms.; extensive anthracosis. Spleen—weight,
102 grms.; lower extremity lobulated; capsule thickened; malpighian bodies distinct;
moderately firm on section. Liver—weight, 1,630 grms.; numerous adhesions to the
diaphragm and of the gall bladder to the colon ; rather soft on section; oozes considerable
blood ; biliary staining about the biliary capillaries ; foci of whitish-yellow colour and somewhat softer in consistency.    Kidneys—weight, left 160 grms.; right 150 grms. ; a few subcap- G 22
Public Hospital for the Insane.
1911
sular cysts ; firm on section; cortex pale in colour; pyramids dark ; very little pelvic fat;
capsule tears the substance on removal, and surface has then a rough granular appearance.
Pancreas—weight, 136 grms. ; firm and nodular throughout.    Thyroid gland—weight, 90 grms.
Microscopical Report.—Diffuse staining and extensive chromatolytic changes of the nerve
cells; spinal cord more or less engorged, and almost complete destruction, showing only as a
granular debris-like formation. Chronic myocarditis; fatty infiltration of the right ventricle;
extensive atheromatous degeneration of the arteries. Great irregularity in size of the thyroid
gland vesicles, with many of the smaller ones filled with epithelial cells. Malpighian bodies
of the spleen dense and stain deeply. Chronic venous congestion of the liver. Extensive
diffuse nephritis.
10. Terminal Dementia :
1506. F. J., male, aet 81, single, labourer, first admission.    Cause of death, senility.
Clinical Report.—Admitted 5th April, 1904; quite depressed, due to his persecutory
delusions; physical examination negative. A few weeks after admission it was necessary to
feed him, as he absolutely refused to take any nourishment himself. This continued at
intervals until the early part of 1905, when his sight became very poor, and by January, 1906i
he was totally blind, due to senile cataract. From that time until the time of his death on
24th October, 1910, he at intervals became depressed, in which it was necessary to feed him
with tube. During the last few months patient lost control of his sphincters and rapidly
became emaciated.
Pathological Report.—Moderate oedema of the lower limbs. Cataracts of both eyes.
Scalp thick; cranial bones thick and cancellous; dura diffusely adherent throughout; diffuse
opacity of the arachnoid; increase of subdural and subarachnoidean fluid. Brain—weight,
1,390 grms.; basal vessels extensively atheromatous and calcareous; bony plates in the
anterior walls of the superior longitudinal sinus ; lateral ventricles dilated; large bony plate
size of half-dollar, with needle-like projections, firmly adherent to dura and right olfactory
peduncle, lying in longitudinal fissure between frontal lobes; choroid plexus cystic. Heart—
weight, 320 grms. ; sclerotic patches in the epicardium ; extensive fatty infiltration ; chronic
myocarditis; marked sclerosis of the mitral and aortic valves, with extensive calcareous
infiltration at the bases; extensive atheromatous degeneration of the arteries, with calcareous
infiltration and numerous foci of atheromatous ulceration. Lungs—weight, left 265 grms.;
right 230 grms. ; firm pleuritic adhesions in the right side; cicatrical contraction of the right
apex; calcareous nodules in both apices; dilatation of the marginal lobules; extensive
subpleural blackish pigmentation ; bronchial glands enlarged and pigmented. Liver—weight,
1,055 grms. ; rather soft in consistency. Kidneys—weight, left 155 grms.; right 180 grms.;
firm on section; dark red in colour, the pyramids more so than the cortex; moderate amount
of pelvic fat; capsule adherent, tearing the substance on removal. Spleen—weight, 110
grms.; firm on section; capsule thick and rough. Thyroid gland—weight, 60 grms.; firm
and rather lobular. Pancreas—weight, 80 grms.; splenic artery rigid, dilated, tortuous and
calcareous.
Microscopical Report.—Extensive degenerative changes in the nerve cells. Extensive
chronic myocarditis; extensive arterio-sclerosis and atheromatous degeneration, calcareous
infiltration and ulceration of the arteries. Chronic venous congestion of the liver and some
cirrhosis. Dilatation of some of the vesicles of the thyroid gland with cellular infiltration of
many of them.
11. Dementia Prcecox:
1725. W. T. B., male, set. 25, single, labourer, first admission. Cause of death,
tuberculosis of the lungs. 1 Geo. 5
Public Hospital for the Insane.
G 23
Clinical Report.—Admitted 7th February, 1906; fairly well nourished; very unkempt
in appearance (patient resembles twin brother in every way who was admitted about two
months ago); patient has been a typical dementia praecox case, going through the various
phases with marked regularity, and for several months previous to his death on 6th January,
1910, was in a semi-katatonic condition.
Pathological Report.—Emaciated. Cranial bones not thickened ; dural adhesions over
parietal verices; opacity of and a few white spots on arachnoid; subarachnoidean fluid
slightly increased. Brain—weight, 1,414 grms. ; slight convolutional atrophy of both frontal
lobes. Heart—weight, 255 grms.; muscle pale ; clot in left ventricle. Lungs—weight, left
821 grms., right 963 grms.; left lung adherent at apex; large tubercular cavity at apex, and
on section shows typical tubercular cavity formation and infiltration ; cavities full of foul-
smelling pus and "cheesey" matter. Right lung adherent at apex; typical tubercular cavity
formation at apex with infiltration of middle and upper lobe with pus and " cheesey " particles ;
nodular; pleura thickened; lower lobe congested. Liver—weight, 1,303 grms.; engorged;
capsule adherent. Spleen—weight, 141 grms.; malpighian bodies prominent; capsule
adherent. Kidneys—weight, left 148 grms., right 152 grms.; cortex pale and capsules
adherent. Intestines not ulcerated but somewhat congested for about 3 feet up small intestine
from caecum.    Some mesenteric glands enlarged and hard.
Microscopical Report.—Diffuse staining of the nerve cells with Nissl's soapy methylene-
blue ; atrophy frontal lobes. Extensive massive tubercular infiltration of the lungs; some
intervening emphysema, engorgement of the alveolar capillaries ; hyperplasia of the lymph
follicles, pigmentation and tubercular infiltration of the bronchia] glands. Extensive increase
of fibrous tissue in the thyroid gland, vesicles small and mostly filled with proliferated
epithelial cells, a circumscribed mass made up of epithelial cells arranged more or less into
alveoli, with a fibrous tissue framework carrying the blood-vessels, surrounded by a capsule of
fibrous tissue. Intense engorgement and fibrous tissue increase in the pituitary body.
Hyperplasia of the malpighian bodies of the spleen. Slight diffuse increase of fibrous tissue
in the pancreas.
12. Dementia Prcecox :
2261.    F. S., female, set. 22, single, servant, first admission.    Cause of death, chlorosis.
Clinical Report.—Admitted 26th September, 1908 ; impossible to obtain a history, as
patient is unable to speak English. Physical examination; skin moist; sallow ; feet and legs
puffy, also a symmetrical enlargement of the thyroid; mucous membranes pale; tongue
slightly coated ; otherwise physical examination negative. From the time of her admission
until September, 1909, patient did not show any change, either mentally or physically, but
during the next few months she became very anaemic, and was a typical case of chlorosis with
pulmonary murmur; was confined to bed and treated with Pil. Blauds Co. for three months
apparently making a perfect recovery, but in March, 1910, she again showed symptoms of
chlorosis which did not react to treatment, and she gradually failed until the time of her
death on 13th April, 1910.
Pathological Report.—Apparently well nourished, but extremely anaemic. Brain not
examined. On opening up body, not a drop of blood escaped. Considerable fat generally.
Heart—weight, 318 grms.; moderate amount of epicardial fat; moderate increase of
pericardial fluid; right side somewhat dilated; patent foramen ovale; right ventricle
contained a large serous clot of gelatinous consistency. Lungs—weight, left 645 grms.,
right 429 grms.; pale in colour; moderate congestion at margin of lower left lobe-
Liver—weight, 1,559 grms.; pinkish in appearance ; on section pale; capsule strips only with G 24
Public Hospital for the Insane.
1911
tearing of tissue. Spleen—weight, 134 grms.; dark-coloured on section and friable ; malpighian bodies prominent; capsule adherent. Kidneys—weight, left 162 grms.; right 162 grms.,
moderately adherent to the pirirenal tissues; firm on section and pale in colour; considerable
pelvic fat; capsule strips, but leaves a rough surface; suprarenals enlarged. Bladder
distended with urine. Large cyst in the left ovary, containing about 25 c. c. of clear serous
fluid; right ovary enlarged and in a fibrous condition; blood clot in uterus. Appendix three
inches long, and hanging into the pelvic cavity; mesenteric glands not enlarged, but
mesentery and omentum very fatty.
Microscopical Report.—Aortitis; hypoplasia of heart and aorta. Fatty changes in the
suprarenals.
IS. Dementia Prcecox :
2308.    E. A. O, male, set. 33, single, logger, first admission.    Cause of death, tuberculosis.
Clinical Report.—Admitted 5th January, 1909; psychosis extending back several
months prior to admission; physical examination negative. For a few months after his
admission he was depressed and delusional, refusing to do any work; but during the latter
part of 1909 he worked very well outside. In the early part of March, 1910, submaxillary
glands became enlarged, and he was put on 20 grains iodite, t. i. d., without any improvement. Later the right parotid became affected, and on the 4th June were both opened and
curetted. In the latter part of July examination of lungs showed them both affected, and
he was running an even temperature. About the 10th August patient complained of dull
pain over abdomen, with slight distension; this condition gradually became more marked,
until the time of his death on 28th October, 1910, when his abdomen was very much
distended, both lungs completely involved, and glands of neck still discharging.
Pathological Report.—Emaciated ; abdomen greatly distended and tympanitic. Cranial
bones moderately firm; dura moderately adherent; slight diffuse opacity of the arachnoid ;
slight increase of subarachnoidean fluid. Brain—weight, 1,220 grms. Heart—weight, 240
grms.; extensive hypertrophy; slight arterio-sclerosis. Lungs—weight, left 390 grms., right
385 grms.; left cavity full of clear yellowish fluid ; has several bands of fibrous adhesions ; left
lung collapsed, solid and airless; lower lobe firm on section and has a splenic-like appearance ■
upper lobe contains some abscess cavities filled with " cheesey" and calcareous material.
Right lung is doughy, of a boggy consistency; crepitation is decreased ; mottled light and
dark-red in colour; cheesey nodules in apex; bronchial mucosa swollen and congested, the
smaller ones softened and filled with a mucopurulent fluid ; bronchial glands enlarged, more or
less caseated, and infiltrated with calcareous material. Liver—weight, 1,450 grms.; fatty and
oily on section; firm adhesions to diaphragm and stomach covered with a fibrino-plastic
exudate. Spleen—weight, 250 grms.; hyperplasia of the malpighian bodies. Kidneys—
weight, left 160 grms., right 160 grms.; enlarged; firm on section; pale in colour; cortex
widened; increased pelvic fat; capsule strips with difficulty and tears the kidney substance.
Peritoneal cavity contains over 3,000 c. c. of clear yellowish fluid with masses of fibrin; adhesions between the omentum and coils of the intestines; stomach and intestines dilated and
distended with gas, the stomach lying anterior to the transverse colon with the pylorus lying
beside the gall-bladder; typical tubercular ulcerations involving the whole canal from the
jejenum to the sigmoid colon ; extensive hyperplasia and caseation of the mesenteric glands .
the whole of the peritoneum covered with typical white tubercular nodules.
Microscopical Report.—Moderate diffuse chromatolytic changes in the nerve cells. Extensive tubercular consolidation of the lungs with areas of necrosis and softening. Hyperplasia
of  the  mesenteric  and   bronchial glands  with tubercular infiltration.    Typical tubercular i
i
s 1 Geo. 5
Public Hospital for the Insane.
G 25
infiltration of the intestinal walls with the hyperplasia of the lymph follicles. Extreme fatty
degeneration, venous congestion and tubercular, nodular infiltration of the liver. Tubercular
infiltration of the spleen.    Subacute diffuse nephritis.
11/.. Imbecility :
1973.    C. D. W., female, set. 20, half-breed, first admission.    Cause of death, pneumonia.
Clinical Report.—Admitted 22nd July, 1907; physical condition good; is a high-grade
imbecile. During her residence in hospital patient would go a month at a time without
speaking. About 1st March patient developed a cough with gradual emaciation, and
examination of lungs showed both affected; from that time patient gradually failed until her
death on 28th May, 1910.
Pathological Report.—Emaciated. Brain not examined. Both pleural cavities obliterated
by firm, dense adhesions; pericardium adherent to pleura generally; pleura thickened; lobes
adherent. Right lung—weight, 595 grms.; shows irregular areas of consolidation, with the
intervening tissue cedematous and boggy ; the solid areas are dark-red in colour, splenic-like
in appearance and consistency on section; there is no cavity formation or pus, but the whole
lung is diffusely and irregularly nodular, many of which are caseous and creamy. Left
lung—weight, 506 grms.; collapsed and airless ; pale in colour on section; extensive diffuse,
irregular, nodular infiltration, the nodules being caseous and creamy ; bronchial mucosa deeply
congested, swollen, softened and covered with a frothy, viscid secretion; bronchial glands
enlarged, softened, and pigmented; tracheal glands and laryngeal mucosa congested;
mediastinal glands enlarged, and some are^callous. Heart—weight, 222 grms.; enlarged;
cavities dilated; moderate quantity of epicardial fat. Spleen—weight, 300 grms. ;
rather soft and friable; bleeds considerably on section; malpighian bodies prominent.
Liver—weight, 1,750 grms.; foci of dull, yellowish-red colour; consistency softened.
Kidneys—weight, left 130 grms., right 115 grms.; moderately firm on section ; pale in colour;
small quantity of pelvic fat; in the cortex of the left is a small firm nodule, white centrally,
surrounded by a zone deeply injected, not encapsulated. Thyroid gland—weight, 30 grms.
Omentum adherent to the anterior pelvic wall from the posterior surface of the bladder near
the apex to the pelvic brim; rectum and uterus drawn over to the right half of the pelvic
cavity and firmly bound by a mass of adhesions filling the whole pelvic cavity; extensive
tubercular nodules scattered throughout the small intestine, most marked in the ileum,
where there is also some ulceration ; diffuse enlargement of the mesenteric and retroperitoneal
glands.
Microscopical Report.—Chronic myocarditis. Diffuse miliary and chronic tubercular areas
of pneumonic consolidation. Tendency to cystic dilatation of the thyroid vesicles. Tubercular infiltration of the bronchial glands. Slight diffuse nephritis; in one kidney is a mass of
epithelial cells more or less alveolated with a fibrous tissue stroma, circumscribed by a more
or less deeply engorged fibrous capsule, cells resembling the cortical cells of the adrenals.
Chronic venous congestion, some fatty infiltration and some portal cirrhosis of the liver.
Intense engorgement of the spleen and hyperplasia of the malpighian bodies. Typical
tubercular infiltration of the intestines in all stages of formation and degeneration.
15. Senile Dementia :
2276.    J. E., male, aet. 76, widower, sea captain, first admission.    Cause of death, senility.
Clinical Report.—Admitted 31st October, 1908, from the General Hospital in Vancouver,
where he was said to be destructive and disturbed; was at once sent to the infirmary ward as
he was very feeble; physical examination shows marked senile changes in every way. This
condition gradually become more marked up until the time of his death on 12th January, 1910. G 26
Public Hospital for the Insane.
1911
Pathological Report.—Emaciated; both legs and arms reflexed. Scalp thin; cranial
bones hard but not thickened ; extensive dural adhesions generally markedly over frontal
lobes; dura thickened and tough; marked increase of subdural and subarachnoidean fluid ;
arachnoid slightly opaque and adherent to dura and pia ; hemispheres of cerebrum adherent on
their mesial surfaces of the frontal lobes; pia thickened and generally adherent. Brain—weight,
1,265 grms.; basal vessels thickened and sclerotic with athermatous degeneration and
caseation ; clot in basilar artery; convolutional atrophy both frontal lobes. Heart—weight,
268 grms. ; muscle pale; pericardium and pericardial fluid normal; aortic and tricuspid valves
sclerotic with atheromatous degeneration and caseation of coronaries; arterio-sclerosis with
marked atheromatous degeneration. Lungs—weight, left 566 grms., right 680 grms.; firm
adhesions to costal pleura on posterior surfaces of upper lobes, also middle right lobe; anthra-
cosis of both. Liver—weight, 1,643 grms.; atrophic cirrhosis; capsule adherent. Spleen—
weight, 255 grms. ; surface presents a mottled appearance; on section tough and capsule
adherent. Kidneys—weight, left 150 grms., right 154 grms. ; chronic diffuse nephritis.
Peritoneal cavity and organs normal.
Microscopical Report.—Extensive degenerative changes in the nerve cells ; numerous
hyaline bodies in the choroid plexus. Chronic myocarditis; extensive arterio-sclerosis and
atheromatous degeneration and calcareous infiltration of the arteries. Interstitial increase of
the thyroid-gland with dilatation of some of the vesicles, and cellular infiltration of others.
Chronic cirrhosis of the liver. Extensive diffuse nephritis ; foci of round cell infiltration in
the adrenals.    Chronic pancreatitis.    Diffuse anthracosis.
16. Senile Dementia :
2361. W. R., male, aet. 79, single, carriage builder, first admission. Cause of death,
senility.
Clinical Report.—Admitted 1st April, 1909 ; was restless and from history received had
given considerable trouble prior to his admission to the Hospital; physical examination shows
a typical condition of a case of general senility, and during his residence in Hospital patient
gradually deteriorated until the time of his death on 1st February, 1910.
Pathological Report.—(Edema of left leg and commencing cellulitis. Cranial bones
compact; dura tenaciously adherent to inner surface of skull generally and to the arachnoid
over parietal verices ; dura thickened and tough; arachnoid opaque and contained numerous
plaques ; hemispheres adherent on their mesial surfaces of the frontal lobes. Brain—weight,
1,417 grms; basal vessels thickened and sclerosed with atheromatous degeneration; left
posterior cerebral to the junction with the left posterior communicating very small, the
communicating very large and apparently continues as the posterior cerebral; pituitary body
soft and friable. Heart—weight, 318 grms. ; atheromatous degeneration and calcareous
infiltration of the aortic valve. Lungs—weight, left 496 grms., right 567 grms. ; right lung
firmly adherent at apex ; anthracosis. Liver—weight, 1,204 grms. ; firm on section ; moderate
cirrhosis ; capsule adherent. Spleen—weight, 92 grms.; small; adherent to diaphragm ; somewhat softened beneath the seats of the adhesions ; capsule thickened and adherent. Kidneys—
weight, left 184 grms., right 212 grms.; numerous cortical cysts; firmly adherent to the
perirenal tissue; firm on section ; pale in colour; striation indistinct; pelves dilated ; capsule
adherent and leaves a rough surface; considerable pelvic fat. Pancreas—weight, 90 grms.;
firm on section. Thyroid gland—weight, 43 grms, ; firm and rather lobular. A few of the
mesenteric glands enlarged.    Ureters full and dilated with urine ; bladder distended with  1 Geo. 5
Public Hospital for the Insane.
G 27
Microscopical Report.—Extensive degenerative changes in the nerve cells; numerous
hyaline bodies in the choroid plexus. Chronic myocarditis; extensive arterio-sclerosis and
atheromatous degeneration of the arteries. Cvstic dilatation of many of the thyroid gland
vesicles.    Chronic venous congestion of the liver and some cirrhosis.
17. Senile Dementia :
2101.    J. A., male, aet. 67, single, moulder, first admission.    Cause of death, senility.
Clinical Report.—Admitted 9th February, 1908; had marked symptoms of senile
dementia, and was sent to the infirmary ward. During his residence in Hospital was confined
to his bed the greater part of the time ; physical condition gradually deteriorated until the
time of his death on 11th April, 1910.
Pathological Report.—Emaciated; first and second fingers and thumb of right hand
amputated. Cranial bones cancellus; dura diffusely adherent throughout; diffuse opacity
of the arachnoid; increase of subdural and subarachnoidean fluid. Brain—weight, 1,474
grms.; general atrophy of the convolutions; bony plates in the anterior walls of the superior
longitudinal sinus; numerous foci of softening scattered throughout the cortex and diffuse
through the substance, varying in size and shape; extensive atheromatous degeneration of the
basal vessels; choroid plexus cystic. Lungs—weight, left 425 grms., right 878 grms.; firm
pleuritic adhesions in both cavities; extensive anthracosis; some of the marginal lobules
dilated; lower right lobe of a more or less solid consistency. Heart—weight, 297 grms.;
considerable epicardial fat; moderate sclerosis of the mitral and aortic valves ; moderate
atheromatous degeneration of the arteries. Thyroid gland—weight, 62 grms.; both lobes
enlarged. Spleen—weight, 141 grms.; soft on section and friable; capsule firmly adherent.
Liver—weight, 1,616 grms.; firm on section; pale and somewhat nutmeg in appearance;
capsule firmly adherent; band-like adhesions to the diaphragm. Kidneys—weight, left 148
grms., right jl62 grms.; firm on section; pale in colour; striation indistinct; considerable
pelvic fat; capsule strips readily.    Pancreas—weight, 86 grms.
Microscopical Report.—Extensive degenerative changes in the nerve cells ; numerous
hyaline bodies in the choroid plexus. Moderate arterio-sclerosis and atheromatous degeneration
of the arteries.    Cystic dilatation of many of the thyroid gland vesicles.
18. Senile Dementia :
2117.     G. G., male, aet. 75, single, sailor, first admission.     Cause of death, peritonitis.
Clinical Report.—Admitted 4th March, 1908 ; physical examination shows senile changes.
During his residence in hospital was a very willing worker, but his mental condition remained
that of a child. On August 28th, 1910, complained of severe pain in abdomen with marked
tenderness; this condition never subsided, and during the last twenty-four hours had faecal
vomiting and purging and died on the 3rd September, 1910.
Pathological Report.—Well nourished ; nose disfigured, apparently result of old
fracture; old scar right groin, result of operation for radical cure for hernia; foul-smelling
faecal matter oozing from mouth and nostrils'; abdomen distended and tympanitic. Cranial
bones cancellous; some dural adhesions; diffuse opacity and increased thickness of the
arachnoid ; moderate increase of subdural and subarachnoidean fluid. Brain—weight, 1,320
grms.; convolutions somewhat flattened ; basal vessels thickened; ventricles dilated and filled
with fluid. Lungs—weight, left 680 grms., right 730 grms. ; extensive diffuse anthracosis.
Heart—weight, 320 grms. ; some sclerosis of aortic cusps; sclerosis of mitral and tricuspid
valves with atheromatous degeneration ; irregular patchy atheromatous degeneration of the
arteries. Liver—weight, 1,300 grms.; dense adhesions to thediaphragm; firm on section;
mottled nutmeg in appearance.    Spleen—weight, 110 grms.; capsule thickened and rough; G 28
Public Hospital for the Insane.
1911
parenchyma soft and friable. Kidneys—weight, left 160 grms., right 150 grms. ; firm on
section ; considerable pelvic fat; capsule adherent and leaves a rough surface. Peritoneum,
omentum, and walls of intestines deeply congested, most marked in the lower part and in
the pelvis; a small quantity of yellowish, turbid fluid in the pelvic cavity ; numerous firm
adhesions of the under surface of the liver to the underlying omentum and hepatic flexure
of the colon ; omentum and intestines more or less cemented together by a fibrino-plastic
exudate; mesenteric and retroperitoneal glands enlarged.
Microscopical Report.—Considerable chromatolytic changes in the nerve cells ; numerous
hyaline bodies in the choroid plexus and calcareous bodies in the pineal gland; round cell
infiltration of the pia and of the pial septa entering the brain-cortex, and of the perivascular
spaces throughout the cortex. Slight chronic myocarditis; moderate arterio-sclerosis and
atheromatous degeneration.    Acute congestion of the omentum ; acute peritonitis.
Sputum.
The following table shows the number and nature of the examinations made:—
B. Tuber- Diplococcus
culosis. Pneumoniae.
Slides examined  80 8
Number of cases  16 4
Found in  11 2
Not found in  5 2
As there are, when working amongst the insane, several reasons why specimens of sputum
cannot be obtained for examination in every case, some other method is required, especially to
confirm the diagnosis of tuberculosis.
As mentioned under the heading of " Histology," the blood cannot be utilised, and where
the sputum cannot be obtained, and the examinations of stools and urine give only negative
results, the only apparent means of confirming the diagnosis is the use of "tuberculin." At
one time we thought we had found an easy method, for in one case, where the sputum
could not be obtained, the pharynx was swabbed with a sterile cotton swab, and smears made
from this, when stained and examined microscopically, demonstrated the presence of B. tuberculosis. Later another case also gave a positive result by this method, but we have since
found that this is not to be depended upon, some cases giving positive and some negative
results.
Food Supplies.
The food supplies of the Hospital have been analysed at intervals and the milk weekly.
The following table shows the work done in this regard:—
Chemical Bacteriological
Analyses. Examinations.
Milk    45 26
Butter ,        2
Tea        3
Coffee        2
Flour       3
On no occasion has there been cause to condemn any of the articles supplied.
The Water Supply.
No better water could be desired than that supplied to this Institution. Chemical
analyses and bacteriological examinations have been conducted at least weekly, with the result
that it has always been favourably reported upon. I Geo. 5
Public Hospital for the Insane.
G 29
Urinalysis.
The following table will show the number of examinations made and the findings :—
Total number of specimens examined    255
Cells:
Albumen   ,  7
Phosphates     2
Calcium oxalate  2
Urobilin  130
Blood	
Pus	
Epithelial . . .
Fatty  	
Hoemoglobin.
Molds	
Leucin	
Casts :
Tyrosin        2
Sugar  3
Urates  58
Mucin  11
Bile pigments  1
Hyalin  43
Epithelial  12
Granular  32
Blood   ,  1
Fatty  2
Spermatazoa  2
Hippuric acid  1
A number of microscopical examinations of the urine from suspected tubercular patients
have also been made, with the idea that, when the tubercle bacillus could not be demonstrated
in the sputum, or the sputum was not obtainable, the centrifugalised deposit from a large
quantity of the urine may contain the organism, but we obtained negative results in nearly
every case.
Corroborating last year's report, we still find that urates are present in the urine, in large
excess, in nearly all cases of manic depressive insanity during the excited period, and that
this excess of urates disappears as the excitement subsides. Also that this excess coincides,
both in its prevalence and decrease, to the leukocytosis found in the majority of these cases.
Histology.
Under this heading a considerable amount of time has been appropriated in the making
of red, white and differential enumerations of the blood corpuscles. The blood of all admissions
is subjected to an examination, and also that of cases specially indicated during residence.
The number of counts made is given in the following table :—
269 red counts on 248 cases.
270 white counts on 249 cases.
113 differential counts on 107 cases.
As stated in our Report for 1909, and mentioned again under the heading of
" Urinalysis," the almost constant occurrence of a leukocytosis in our cases of manic depressive
insanity, during the period of excitement, together with a marked excess of urates in the
urine, is steadily indicated in our records, and were it not that the excited condition of the
patient affords sufficient evidence for diagnosis, this phenomenon could be used as an aid in
the majority of these cases. As it is, however, by keeping recurrent cases under continuous
observation, the period of excitement may generally be shortened, and the exhaustion following
it lessened, by resorting to hydrotherapeutic measures as soon as it is noticed that the
leukocytes are increasing in the individual case.
Estimation of the haemoglobin      269
n            colour index  240
n            blood coagulation time  6
n            specific gravity  4
n            alkalinity  4
Examination for bacillus tuberculosis  43 G 30
Public Hospital for the Insane.
1911
Rosenberger stated in 1908 that the B. tuberculosis could be demonstrated in the blood
of nearly all tuberculous patients. Investigations conducted since, however, show objections
to this assertion, for acid-fast bacilli were found in the centrifugalised deposit from distilled
water when fixed on the slide with albumen, and it has later been shown that it is only in
extremely rare cases that the bacillus of tuberculosis can be demonstrated in the blood, or
recovered from animals injected with the blood of tuberculous individuals, and our results go
to show that the latter is the more authentic.
The Significance of a Leukocytosis and Urat^mia in Manic Depressive Insanity.
Since the beginning of this Laboratory in October, 1908, a leukocyte and red-blood-cell
enumeration and an examination of the urine have been undertaken for each admission to
this Hospital.    Altogether, to date, the blood and urine from 509 cases have been examined.
From the commencement it was noticed that, in cases of manic depressive insanity, a
marked increase in the number of leukocytes was fairly constant, while the number of
erythrocytes and the percentage of haemoglobin had not necessarily decreased; also, where a
leukocytosis was evident, the urine showed a large excess of urates with generally hyaline and
granular casts, urobilin and epithelial cells.
This deviation from normal, both in the blood and in the urine, appearing so constantly
in these cases, more so than in other types of insanity, indicated an interesting study, while
no satisfactory explanation could be given for the coincidence. There is little or no literature
bearing on this subject, and even the few investigations recorded, as regards blood counts
in the insane, varying so much in the conclusions arrived at, it was deemed expedient to
investigate further, with a view to drawing some authentic conclusions from the statistics
compiled from the study of each individual case.
Before proceeding further, I wish to state that in using the term "leukocytosis," I accept
Cabot's definition of same, and this is adhered to throughout. Cabot says : "To my mind the
term (leukocytosis) is best used to mean : An increase in the number of leukocytes in the
peripheral blood over the number normal in the individual case, this increase never involving
a diminution in the polymorphonuclear varieties, but generally a marked absolute and relative
gain over the number previously present."
In most of the previous investigations recorded, the authors have omitted to mention the
relation of their counts to food, hot and cold baths, altitude above sea-level, menstruation,
etc. In all probability, the omission of this important data accounts for the wide variation
and conflicting results recorded. The blood counts made here have all been conducted, as far
as possible, under exactly similar conditions, in order to eliminate any error that may occur
statistically or clinically, from blood taken under conditions where it would vary from normal
(this condition not being due to the psychosis.) This institution being practically at sea-level,
and all the counts being made from peripheral blood taken from the finger at least two hours
after ordinary meals, and never immediately after or during a hot or cold bath, nor after a
considerable quantity of liquid has been taken, during menstruation or lactation, and all the
cases being well past the age of puberty, makes the results comparable.
The red and white cell enumerations have been made with a Thoma-Zeiss haemacytometer,
using Hayem's fluid for the reds, and a 0.33 per cent, acetic acid and gentian violet solution
for the whites. In the differential counts, Wright's stain has been used throughout, and for
the haemoglobin estimation a Fleischl's haemoglobinometer up to July; since then Tallquist's
haemoglobin scale has been employed as being more convenient,  1 Geo. 5
Public Hospital for the Insane.
G 31
In making the red counts, sixteen fields of sixteen small squares have been counted, then
the slide cleaned and the same number of squares counted in the second drop, and the average
from the total number calculated. In enumerating the leukocytes, the entire field of sixteen
large squares is counted in two drops, and the average calculated from the total. In making
the differential counts, at least 500 leukocytes are counted, and the percentage caculated.
The following table will show the results of the red and white counts, the figures, unless
otherwise specified, representing the first count made on admission. The cases have been
classified under the headings of the various forms of insanity in order to facilitate
comparison :—
Manic Depressive.
Sex.
Reds.
Whites.
Sex.
F
Reds.
Whites.
Sex.
M
Reds.
Whites.
M
3,680,000
10,640
4,080,000
5,600
5,360,000
7,200
F
4,048,000
18,720
M
4,320,000
6,400
M
4,550,000
11,200
F
3,870,000
11,640
M
4,340,000
18,240
M
4,538,000
9,280
F
4,098,400
14,800
F
3,775,200
21,200
M
4,866,000
10,560
M
4,800,000
9,360
M
4,754,000
11,420
F
4,182,000
14,360
F
4,300,000
14,380
F
4,332,000
12,420
F
4,238,000
14,440
M
4,624,000
12,000
M
4,700,000
14,260
M
4,600,000
11,280
M
4,428,000
11,460
M
4,600,000
12,580
F
4,430,000
7,240
M
4,824,000
13,240
F
4,450,000
5,460
M
4,768,000
11,800
F
4,460,000
13,420
F
4,600,000
12,840
M
4,880,000
11,620
M
4,842,000
7,680
M
4,886,000
7,260
M
4,620,000
10,440
F
3,868,000
12,260
M
4,764,000
9,380
M
4,728,000
17,420
M
4,866,000
12,800
M
4,886,000
21,200
F
4,100,000
15,200
M
4,800,000
7,260
F
4,380,000
13,640
M
4,868,000
11,280
F
4,400,000
14,260
M
4,680,000
10,220
M
4,748,000
13,200
F
4,300,000
6,600
M
4,800,000
12,200
M
5,100,000
8,280
F
4,480,000
13,200
F
4,400,000
9,200
F
4,460,000
8.300
M
5,120,000
6,800
M
4,800,000
7,300
M
4.960,000
11,600
M
4,826,000
8,200
F
4,250,000
13,000
F
4,320,000
10,200
F
4,400,000
8,300
M
4,860,000
15,320
F
4,480,000
7,300
F
4,018,000
15,160
M
4,828,000
12,260
M
4,912,000
10,640
F
3,760,000
13,480
M
4,900,000
14,120
M
4,710,000
13,320
M
4,900,000
9,700
M
4,612,000
11,620
F
4,220,000
12,300
M
4,860,000
11,200
F
4,630,000
11,220
M
4,920,000
8,420
F
4,280,000
12,460
M
5,116,000
9,400
M
4,868,000
11,400
M
5,020,000
9,920
F
4,200,000
13,100
F
4,400,000
13,140
M
4,760,000
11,600
F
4,230,000
10,200
M
4,760,000
10,800
F
4,610,000
8,800
M
4,040,000
13,200
F
4,340,000
12,600
F
4,346,000
12,260
F
4,300,000
12,160
M
4,820,000
14,360
M
4,800,000
10,600
M
4,700,000
10,300
M
4,746,000
12,100
M
4,912,000
11,260
M
4,816,000
14,700
M
4,926,000
12,420
M
4,938,000
13,420
M
4,860,000
13,140
M
4,600,000
12,580
F
4.400,000
9,740
F
4,312,000
9,000
F
4,460,000
14,260
M
4,760,000
11,200
M
4,760,000
10,000
F
4,048,000
14,440
F
4,510,000
8,860
F
4,620,000
15,200
M
5,360,000
7,200
F
4,430,000
13,180
M
5,210,000
11,200
F
4,450,000
13,420
M
4,882,000
11,340
M
4,920,000
9,380
Acute Mania.
M
F
4,866,000
4,230,000
21,200 *
18,380 *
M
F
4,780,000
4,080,000
18,600 ■
16,560 '
4,520,000
14,380
* Acute oases. G 32
Public Hospital for the Insane.
1911
Toxic Insanity.
Sex.
Reds.
Whites.
Sex.
M
Reds.
Whites.
Sex.
F
Reds.
Whites.
M
5,177,600
7,440
4,024,000
13,760
4,112,000
11,840
F
3,870,000
11,640
M
4,574,400
9,360
M
4,820,000
10,240
M
4,882,000
13,120
M
4,788,000
10,280
F
4,282,000
13,380
M
4,900,000
8,280
M
4,720,000
12,480
M
4,932,000
7,460
M
4,842,000
12,200
F
4,240,000
12,620
M
5,020,000
9,650
F
4,800,000
8,000
M
4,640,000
11,000
M
4,740,000
11,200
F
4,340,000
10,200
F
4,280,000
9,840-
F
4,350,000
8,680
F
4,580,000
11,620
M
5,018,000
10,620
F
4,500,000
10,240
M
5,060,000
8,800
F
4,712,000
11,400
M
4,712,000
11,600
F
4,830,000
12,380
M
4,740,000
9,200
F
4,216,000
12,400
M
4,690,000
10,200
M
4,960,000
10,280
M
4,460,000
12,220
M
4,800,000
8,800
M
4,680,000
9,680
M
4,960,000
9,640
M
4,912,000
12,200
F
4,276,000
11,200
M
4,820,000
7,280
F
4,216,000
13,210
Dementia Prjecox.
M
4,272,000
11,840 f
M
4,868,000
8,840
F
4,352,000
9,360
M
3,248,000
12,800
M
4,320,000
12,480 t
M
4,900,000
7,320
M
5,440,000
7,440
M
4,352,000
9,360
M
4,100,000
11,200
M
3,700,000
11,840
M
4,600,000
5,600
M
4,823,000
6,400
M
4,680,000
10,000
M
4,880,000
7,200
M
4,280,000
9,360
M
4,960,000
8,680
M
4,640,000
14,960 t
M
4,260,000
10,200
M
4,840,000
8,460
M
4,375,000
11,240
M
4,640,000
9,400
M
4,937,000
7,440
M
4,424.800
7,440
M
4,720,000
10,000
M
4,984,000
11,200
M
5,000,000
10,800
M
4,730,200
11,000
M
4,600,000
9,460
M
4,680,000
11,200
F
4,400,000
11,320
M
4,940,000
10,220
M
4,820,000
9,200
M
4,890,000
8,160
M
4,768,000
9,840
M
4,942,000
8,440
M
4,680,000
9,340
M
4,735,000
11,460
F
4,600,000
5,600
F
2,680,000
18,640 t
M
4,466,000
15,240
M
5,249,600
8,720
M
4,780,000
8,820
M
4,800,000
11,260
M
4,900,000
6,400
M
4,668,000
12,840
M
4,780,000
8,260
M
4,840,000
7,620
F
4,380,000
6,300
M
5,120,000
8,600
M
5,120,000
12,380
F
4,480,000
8,200
M
5,020,000
10,200
M
4,900,000
6,600
M
4,800,000
12,380
F
4,127,000
10,400
M
4,768,000
11,000
M
5,120,000
8,800
M
4,700,000
8,800
F
4,520,000
15,200
M
4,620,000
14,320
M
3,860,000
9,800 f
M
4,920,000
10,420
M
4,860,000
7,600
M
5,300,000
9,280
M
4,900,000
8,640
F
4,520,000
6,240
F
4,400,000
7,600
M
4,840,000
9,000
M
4,730,000
10,200
M
4,980,000
9,360
M
5,100,000
7,200
M
4,840,000
10.200
M
4,400,000
12,160
M
4,880,000
8,000
F
4,416,000
S,600
M
4,840,000
10,100
M
5,310,000
9,600
M
4,720,000
9,320
M
4,880,000
8,680
M
4,624,000
8,480
M
5,080,000
11,200
M
4,738,000
9,400
M
4,890,000
10,360
M
4,690,000
9,600
F
4,520,000
7,460
M
5,206,000
9,400
M
4,800,000
9,260 f
M
4,910,000
11,200
M
4,616,000
8,380
F
4,610,000
10,380
M
4,800,000
10,380
M
4,740,000
10,260
M
4,900,000
8,480
M
4,860,000
12,240
M
4,920,000
9,000
M
4,860,000
9,376
M
4,694,000
13,140
F
4,300,000
12,160 f
M
4,828,000
10,380
M
4,880,000
9,400
M
4,680,000
13,400
M
4,762,000
9,380
M
5,060,000
7,400
M
4,906,000
9,260
F
4,600,000
8,640
M
4,906,000
10,300 f
M
4,938,000
8,380 f
M
4,820,000
11,800
F
4,284,000
12,160
M
4,800,000
7,640
M
4,788,000
7,680
M
4,780,000
8,320
M
5,204,000
10,620
M
4,906,000
10,220
M
4,708,600
9,400
M
4,680,000
9,260
M
4,938,000
8,860 f
M
4,800,000
8,600
M
4,880,000
8,360 f
M
4,820,000
9,200
M
4,938,000
12,320
M
4,806,000
7,420
M
4,836,000
8,600
M
4,862,000
9,860 f
M
4,928,000
10,600
M
5,210,000
10,380
M
5,142,000
11,200
M
4,960,000
9,480
M
4,800,000
9,200
M
4,716,000
10,940
M
4,664,000
11,380
M
4,880,000
7,640
M
4,920,000
9,600
M
4,772,000
8,460
M
4,724,600
11,200
M
4,800,000
7,340
M
4,886,000
9,200
F
4,480,000
9,674 t
F
4,538,000
9,620
M
4,942,000
10,380
M
4,920,000
10,100
M
4,710,000
10,380
M
4,760,000
9,100 f
M
4,860,000
11,280
M
4,926,000
9,600
M
4,806,000
10,340
t Count made after patient had been in the hospital some time. 1 Geo. 5
Public Hospital for the Insane.
G 33
General Paresis.
Sex.
Reds.
Whites.
Sex.
Reds.
Whites.
4,800
Sex.
M
Reds.
Whites.
M
3,920,000
9,840
M
4,480,000
4,000,000
8,800
M
4,720,000
17,440
M
4,880,000
9,360
M
5,248,000
18,720
M
4,340,000
18,240
M
4,727,000
16,240
M
4,754,000
11,420
F
4,320,000
9,640
M
4,848,000
12,240
M
4,792,000
10,600
M
4,834,000
9,280
M
4,728,000
9,360
M
4,600,000
6,800
M
4,668,000
8,720
M
4,660,000
8,640
F
4,340,000
13,280
M
4,820,000
11,180
M
4,794,000
9,820
F
4,320,000
9,180
M
4,600,000
10,200
M
4,900,000
8,200
M
5,327,000
18,720 t
M
5,220,000
8,000
M
4,740,000
13,200
M
4,868,000
9,600
M
4,648,000
13,600
M
4,920,000
10,200
M
4,700,000
8,260
F
4,400,000
9,280
M
4,738,000
7,400
M
5,060,000
9,300 t
M
4,660,000
6,800
M
4,920,000
9,840 t
M
4,780,000
9,600
M
4,900,000
10,200
M
4,624,000
7,680
M
4,868,000
8,420
M
4,860,000
8,460
M
4,886,000
10,220
M
4,890,000
10,260
M
4,826,000
8,800
F
4,380,000
9,200 t
M
4,738,000
8,680 t
F
4,370,000
11,120
M
4,960,000
11,600
M
4,826,000
7,440
M
4,780,000
9,400
M
4,866,000
10,640
M
4,860,000
11,160
M
4,920,000
10,260
M
4,826,000
6,800
M
4,920,000
8,810 t
M
4,812,000
8,620 t
M
4,700,000
11,440
Paranoia.
M
2,400,000
16,800
M
4,620,000
10,560
M
4,225,000
8,080
M
4,352,000
9,360
M
5,656,000
13,680
M
5,240,000
7,200
Jvl
4,600,000
17,440
M
4,021,600
10,000
M
4,824,000
10,120
M
5,000,000
10,800
M
4,764,000
11,200
M
4,890,000
8,160
M
4,872,000
10,200
F
4,600,000
8,240
M
4,896,000
8,080
M
4,880,000
9,600
M
4,780,000
8,260
M
5,220,000
11,290
M
4,296,000
8 440
M
4,680,000
8,800
M
5,000,000
7,300
F
4,520,000
6,800
M
4,580,000
12,240
M
4,900,000
8,260
M
5,180,000
8,200
M
4,900,000
8,200
V
4,300,000
11,200
M
4,940,000
6,840
M
4,800,000
11,300
F
4,620,000
6,500
M
4,700,000
8,240
M
4,848,000
7,800
M
4,900,000
8,300
F
4,480,000
7,400
M
4,900,000
8,600
M
4,726,000
9,600
M
4,910,000
10,280
M
4,730,000
10,180
M
5,018,000
10,200
M
4,766,000
9,640
M
4,868,000
8,420
M
4,860,000
9,380
M
4,820,000
8,280 t
F
4,600,000
10,240
1V1
4,912,000
8,640 t
M
4,882,000
9,200
M
4,960,000
11,100
V
4,380,000
12,200
M
4,916,000
10,320
M
4,800,000
9,760
M
4,836,000
9,680
M
4,780,000
7,640
M
4,860,000
8,400 t
M
4,860,000
8,840
M
4,662,000
9,280
M
4,682,600
12,260
M
5,210,000
11,600
M
4,920,000
7,600
M
4,968,000
9,260
F
4,328,000
10,160
M
4,716,000
12,260
M
4,820,000
11,920
M
4,820,000
9,280 t
M
4,808,000
9,640 t
M
4,700,000
8,600
M
4,778,000
12,100
M
4,836,400
10,100
M
4,930,000
10,200
M
4,910,000
8,620
M
4,926,000
9,280
M
4,826,000
9,640 t
Senile Dementia.
M
4,132,000
7,300
M
4,600,000
10,400
M
4,740,000
10,380
M
4,266,400
16,240
M
4,420,000
12,300
M
4,174,000
10,560
F
2,700,000
10,000
M
4,748,000
8,260
M
4,800,000
9,300
F
3,840,000
9,800
F
4,160,000
7,200
M
4,660,000
7,420
M
4,600,000
8,600
M
4,600,000
8,400
F
3,800,000
6,200
M
4,532,000
9,420
t Count made after patient had been in hospital some time. G 34
Public Hospital for the Insane.
1911
Terminal Dementia.
Sex.
Reds.
Whites.
Sex.
M
Reds.
Whites.
Sex.
Reds.
Whites.
M
5,160,000
12,400
4,920,000
7,820
M
4,812,000
13,680
M
4,575,200
13,120 t
F
4,422,000
12,260
M
4,620,000
11,400
F
4,520,000
8,080
F
4,400,000
7,440
M
4,784,000
7,400
M
4,800,000
8,260
M
3,467,000
13,240 t
F
4,400,000
9,340
M
5,020,000
9,650
F
4,470,000
10,000
M
4,780,000
11,220
M
4,800,000
8,620
M
4,400,000
8,620
M
4,740,000
8,660
F
4,360,000
9,400
M
4,860,000
10,600
M
4,880,000
9,300
F
4,480,000
10,260
M
4,980,000
11,100
F
4,290,000
12,600
M
4,920,000
8,800
M
5,200,000
10,400
M
5,216,000
10,420
M
4,880,000
9,640
M
4,928,000
7,620 t
t'
4,612,000
9,640
M
4,862,000
7,280
F
4,410,000
6,840
M
4,860,000
8,080 +
M
4,846,000
8,820 t
M
4,730,000
9,080
M
4,940,000
7,640
M
4,900,000
9,200
M
4,920,000
7,860
M
4,936,000
10,200
F
4,600,000
10,380
M
4,800,000
8,660
M
4,700,000
12,600
M
4,740,000
11,200
M
4,938,000
8,980 t
M
4,880,000
9,280 t
M
4,892,000
9,600
M
4,762,000
9,600
Melancholia.
F
4,400,000
10,000
F
2,875,000
14,125 *
M
3,960,000
13,760 *
F
4,120,000
16,800 *
M
4,900,000
11,840
F
4,240,000
12,230
F
4,549,000
11,840
M
4,780,000
21,200 *
V
4,520,000
6,580
F
4,400,000
10,140
F
4,460,000
7,200
F
4,600,000
8,600
M
4,800,000
14,260 *
M
4,650,000
8,420
F
4,520,000
10,240
F
4,400,000
8,340
M
4,700,000
8,600
F
4,420,000
6.280
M
4,800,000
13,100
F
4,086,000
15,120
M
4,680,000
12,280 *
F
4,500,000
9,240
M
4,900,000
9,600
M
4,746,000
10,460
M
4,802,000
10,600
M
4,862,000
11,000
F
4,416,000
8,600 +
M
4,912,000
14,100 *
F
4,340,000
12,280
M
4,910,000
12,280
M
4,740,000
8,280 t
M
4,884,000
9,600 t
F
4,460,000
13,140 *
F
4,460,000
10,180
M
4,912,000
13,620 *
M
4,728,000
15,160 *
Epilepsy.
M
M
F
4,800,000
4,842,000
4,276,000
7,320
12,460
11,000
F
M
M
3,155,200
5,210,000
4,860,000
18,080
12,300
11,620
M
F
4,530,000
4,716,000
16,480
10,400
Inbecility ani
Idiocy.
M
F
4,649,600
4,760,000
14,320
10,000
M
F
4,842,000
4,190,000
12,460
11,200
F
M
4,300,000
4,660,000
8,680
7,400
Organic Dementia.
M
M
M
4,824,000
4,527,000
4,720,000
13,120
4,960 t
6,800 t
M
M
M
4,176,000
4,520,000
4,827,000
3,280
8,680
9,200 t
M
M
4,320,000
4,660,000
13,680 t
12,400 t
Tetany.
F
F
4,974,000
4,960,000
14,960
15,240 t
F
4,949,600
17,440 t
F
4,916,000
18,400 t
* Acute cases. t Count made after patient had been in the hospital some time.
Under the heading of Manic Depressive Insanity will be found the results of 110 counts
in 110 cases: Acute mania, 5; toxic insanity, 40; dementia praecox, 132 and 14 recounts ;
paranoia, 65 and 6 recounts; general paresis, 49 and 7 recounts; senile dementia, 40
and 7 recounts; melancholia, 33 and 3 recounts; epilepsy, 8; imbecility and idiocy, 6;
organic dementia, 4 and 4 reco unts; tetany, 1 and 3 recounts. 1 Geo. 5
Public Hospital for the Insane.
G 35
Our records go to show that in nearly all cases of manic depressive insanity there is a
leukocytosis, while the erythrocytes (in size, appearance, and number) and the haemoglobin may
be normal, or practically so. Estimation of the colour index has also been systematically made,
but so far has offered no information.
Most observers say that a leukocytosis is not always an increase in the total number of
leukocytes in the body, but is often the result of chemotaxis or thermotaxis, the cells being
attracted to the periphery and out of the internal organs. Many investigators have shown
that there are two types of leukocytoses—(1) The first appearing and disappearing suddenly
and only of short duration; such are caused by cold baths. (2) When a leukocytosis is
prolonged, as in suppuration, etc.
In the former, the sudden appearance and short duration of the leukocytosis does not
allow time for the production of new cells, and it is probable that the increase of white cells
in the peripheral blood is coincident with a decrease in the number usually stored in the
pulmonary capillaries and elsewhere, while the total number of white corpuscles in the body
remains the same. In the latter, the production of leukocytes undoubtedly does take place,
and they are turned into the blood stream much more rapidly than when a pathological
condition does not exist, and in these cases the total number of leukocytes in the body is more
or less increased over normal for the individual case.
In poorly nourished persons the white enumeration may be low (3,000), while a high
count would denote, ordinarily, a pathological condition. On the other hand, there are well
nourished, healthy persons with whom a white count seldom falls below 10,000.
As regards the differential count, we shall have to make some average, and we will take
the normal number of polymorphonuclears as from 50 to 75 per cent. ; this is allowing a wide
margin and should cover practically all classes not suffering with any pathological condition ;
the count of polymorphonuclear leukocytes being a fair measure of the soundness and vigour of
the person's metabolism. All our cases of manic depressive insanity that have exhibited a
leukocytosis have been within these limits, and have never shown a diminution in the number
of polymorphonuclears, but always a marked absolute and relative gain.
The leukocytosis is shown most markedly during the excited period, but, on the
disappearance of this phenomenon, the leukocytes gradually diminish to normal. This period
may be from a few days to a few weeks, and the length of time prior to admission it is often
impossible to ascertain, but is, in all probability, at least several days. This would seem to
indicate that leukocytes are formed and turned into the circulation faster than under normal
conditions ; consequently, the total number of leukocytes in the body is increased over normal.
Cabot suggests that possibly the leukocytosis of acute delirium and acute mania come
under the heading of " toxic leukocytosis." Fisher (Amer. Jour. Insan., 1903) comes to the
conclusion that in cases of maniacal insanity " a leukocytosis is an almost constant accompaniment" and she believes that it is a result of " psychomotor activity."
It was also noticed during the course of our investigation that whenever a leukocytosis
was determined, the urine nearly always contained a large excess of urates. This excess
cannot be due to fermentation wholly, as the specimens were generally examined too closely
following the voiding for fermentation to take place; but, the longer the urine stands, the
heavier the precipitate of urates, up to a certain point. In most of these cases also hyaline
casts, granular casts, epithelial cells and urobilin were found, while in two cases positive
Ehrlich's diazo reactions were obtained. No clinical symptoms of a febrile condition
were evidenced, and repeated serum agglutination reactions and sputum examinations were
negative.    The urates were generally deposited in the form of amorphous sodic urate, but the G 36
Public Hospital for the Insane.
1911
" hedge-hog " crystals of ammonium urate were also frequently detected, and occasionally some
of the " whetstone " and irregular crystals of uric acid. It is generally understood that the
acid urates or bi-urates (MHC5H2N403) are very sparingly soluble, and exist in the urine
only after it has undergone ammoniacal fermentation. They are known pathologically as
components of gouty excretions in the tissues, but it is questionable if they ever exist
physiologically in the blood or tissues. The quadri-urates (MHC5H2N403, H2C5H2lSr403) are
more soluble than the bi-urates, and are specially the physiological combinations of uric acid.
They exist normally in the urine and probably also in the blood, and it may be that all the
morbid phenomena due to uric acid arise from secondary changes in the quadri-urates,
In healthy urine of feeble acid reaction the quadri-urates dissolve unchanged, but the solution
undergoes gradual but complete decomposition, with ultimate separation of the whole of the
uric acid in a free state. This change is retarded in normal urine by the salts and colouring
matters present (urea has no influence), occurring with greater facility the larger the proportion
of free acid there is present.
The decomposition of sodium quadri-urate under the influence of water can be conveniently
observed by filtering off the buff or brick-red coloured sediment, washing it thoroughly with
cold rectified spirit, and drying it at blood heat. When the quadra-urate thus purified is
mixed with a considerable volume of water it is speedily disintegrated, a portion passing into
solution in combination with the bases, and the remainder falling as an insoluble precipitate
of crystalline uric acid. The change is readily observed under the microscope, by intimately
mixing a particle of the purified deposit on a glass slide with a drop of water and protecting
the mixture with a covering-glass. In the course of ten minutes, ovoid crystals of uric acid
make their appearance and grow and multiply, till in the course of half an hour the entire
field is thickly studded with crystals ; the process continuing, provided that water be added
as required, until the amorphous substance is entirely replaced by crystals of uric acid
Crystals of the sodium bi-urate simultaneously formed are never observed, since this salt is
liberated in the gelatinous form.
The quadri-urates readily assume a gelatinous form. If a 5 per cent, solution of sodium
phosphate be heated to boiling with excess of uric acid and the liquid filtered hot, the filtrate
sets to a jelly on cooling. This jelly, after being pressed between blotting paper to free it
from mother liquor, exhibits the characteristic behaviour of a quadri-urate, being rapidly
decomposed by water with copious formation of crystals of uric acid. On keeping in a moist
condition, gelatinous sodium quadri-urate gradually passes into a crystalline condition, and
then appears under the microscope in radiating spheres, exactly similar to the spheres so
common in serpents' and birds' urine.
The salts of the formula M2C5H2N403, called " neutral" or " normal" urates, dissolve
readily in water, and are exclusively laboratory products, not being met with in the animal
system under either healthy or pathological conditions.
It is of interest to note that the only apparent cause for this excess of urates in the urine
is a disturbance of the general nutrition characterised by a uric acid diathesis. It is highly
improbable that the excess of urates is the immediate causation of the leukocytosis (uric acid
being present in the blood in leukaemia), while if the suggestion that the urataemia is caused
by a disturbance of the general nutrition be entertained, this would coincide with similar
causation for the leukocytosis.
While the abatement of mental excitement and an increase in body weight are generally
incidental with mental improvement in this class of cases, the earlier stages of the improvement may generally be much more closely observed by the diminution in the number of
leukocytes in the peripheral blood, and the gradual reduction of urates in the urine, for those 1 Geo. 5
Public Hospital for the Insane.
G 37
individuals who evidence these characteristics, and who are the large majority under this
heading of insanity. Whether the excess of urates in the urine has any bearing on the
maniacal condition or not has not yet been determined, but uric acid probably does act on
the nerve centres, and that it does produce headaches, as in gout and epilepsy, is an
established fact. In our cases, apparently, the urates did not pass into the insoluble crystalline
condition, but, the reaction of the urine being always acid, were excreted before they reached
the insoluble stage.
Two cases of manic depressive insanity were kept under observation after admission, and
after the first period of excitement had subsided, and their leukocytes and urine were normal,
with a view to ascertaining how long before the excited period was manifest (in case of a
recurrence) the leukocytes would commence to increase and urates be excreted in the urine in
excess.
Case 1 ; a male ; on admission patient's leukocyte count was 14,380, reds 4,928,000,
urates present in excess in the urine. Three weeks after admission blood and urine were
normal, whites 8,480, reds 4,932,000. Some two months later the leukocytes increased to
9,200, 11,320, 12,800, 12,960, 13,520, and 14,180; the urates gradually increased in the urine
until it appeared muddy, and the patient at this stage was very excited and restless, while
sleep could only be induced by means of hydrotherapeutic measures and hypnotics. As the
excitement subsided, so his leukocytes decreased again to 8,260, reds 4,868,000, and the urine
cleared up.
Case 2 ; also a male; the white count on admission was 14,840, reds 5,210,000, urates
present in laige excess in the urine. Within seventeen days from patient's admission his
blood and urine were normal, whites 7,860, reds 5,020,000. Three months after admission it
was noticed that his leukocytes were on the increase 9,400, 11,600, 13,420, 15,600, and urates
appeared in increasing quantity in the urine. At the time when the 15,600 count was made,
patient was very excited and restless and would not sleep without hypnotics. As his
excitement subsided so his leukocytes decreased to 8,400, and the urates gradually disappeared
from the urine.
Conclusions.
1. We are hardly justified in saying that any of the cases suffered with anaemia due to
the psychosis.
2. The leukocytosis is probably due to exhaustion induced by maniacal excitement, loss of
sleep, and malnutrition ; for although poorly nourished persons generally give a low leukocyte
count, those undergoing the first stages of starvation generally show a marked increase of
leukocytes.
3. The excitement accompanying manic depressive insanity does not cause a decrease, in
the number or size of the erythrocytes, or of the haemoglobin.
4. A decrease in the number of leukocytes to normal (for the individual case), the
disappearance of urates from the urine, and an increase in body weight are generally incidental
with mental improvement in this class of cases.
5. A urataemia is incidental with a leukocytosis  in these cases.
6. Recurrent periods of excitement can be foretold and hydrotherapeutic or other measures
taken, before the maniacal symptoms are evident, in order to shorten the period and lessen
the exhaustion following the attack of excitement.
I have the honour to be,
Sir,
Your obedient servant,
F. P. HUGHES. G 38
Public Hospital for the Insane.
1911
STATISTICAL   TABLES.
Table No. 1.
Showing the operations of the Hospital for the year 1910, in summary form.
Movement of Population New
Westminster asylum.
Remaining in residence here, Dec.
31st, 1909	
Discharged on probation, and still
out, Deo. 31st, 1909 	
Escaped, but not discharged, Dec.
31st, 1909 	
Total under treatment here,
31st, 1909	
Admitted during the year :—
By ordinarj' forms   .
By urgency forms	
By order of court	
By return from escape, 1910...
From Yukon Territory	
Total  under treatment   for   year
1910 at New Westminster	
Discharged during the year :-
As not insane	
As recovered	
As improved	
As unimproved	
Total	
Other discharges :—
Discharged on probation and
still out, Dec. Slst, 1910	
Escaped, but not yet discharged
Died	
Remaining under treatment   Jan.
1st, 1911	
"3
to
'3
2
Br
O
Total.
8
s
0>
"3
o
3V9
157
536
6
12
18
9
0
9
394
169
563
2(15
63
268
4
0
4
0
0
0
4
0
4
7
1
8
—
	
	
220
64
284
614
233
847
16
0
15
599
233
832
0
0
0
60
24
84
50
18
58
12
2
14
122
44
166
16
9
25
7
0
7
27
12
39
172
65
237
172
65
237
■"
427
168
695
Movement op Population
at Vernon.
Remaining in residence at Vernon,
Dec. 31st, 1909	
Discharged on probation and still
out, Dec. 31st, 1909	
Escaped, but not discharged, Dec.
31st, 1909	
Total under treatment at New
Westminster, Dec. Slst, 1909	
Total under treatment, New Westminster and Vernon, Dec. 31st,
1909	
Admitted during year
Total under treatment New Westminster and Vernon for year 1910
Admitted to Vernon from New
Westminster	
Total treated in Vernon for year
1910	
Discharged on probation, Vernon..
Discharged, improved, Vernon	
Died at Vernon	
Less Vernon patients in residence
Dec. 31st, 1910	
Remaining   in   residence at   New
Westminster, Dec. Slst, 1910....
0
o    o
79
Total.
64
563
280
907
237
670
76
Total number of cases admitted since opening .
ii H n       discharged      	
it h M      died	
Remaining under treatment January 1st, 1911
Male.  Female.   Total
1,128
500
1,514
607
Male. Female. Total.
2,151 670 2,821
1,628 493 2,121
523
177
700
Daily average population during the year  563
Maximum number present any one day, December 22nd  597
Minimum h ii m January 4th          534
Percentage of discharges on admissions (deaths excluded)..   ,  59.2
11 recoveries on admissions         31
11 deaths on whole under treatment..       4.5 1 Geo. 5
Public Hospital for the Insane.
G 39
Table No. 2.
Showing in summary form the operations of the Hospital since its inception.
EC
a
a
'en
m
s
■ri
<
Discharges.
m
<u
A
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
26
27
28
39
57
40
41
Number resident at
the close of each
year.
CD
Ol
IS
CD
U
o
c
M
u
CD
XI
a
3 .
C T3
03 ®
O 03
£^
18
31
26
48
54
49
54
54
58
61
55
57
59
71
88
102
103
123
152
166
175
179
213
224
228
246
285
327
356
377
413
466
480
505
552
666
765
816
896
Percentage of recoveries to admissions.
Percentage of discharges to admissions (deaths excluded).
Percentage of deaths
to whole number
under treatment.
Year.
03
U
03
>
O
CD
CD
M
1
10
4
3
11
4
7
4
5
5
3
4
2
5
10
15
12
14
17
19
17
14
13
29
23
20
27
31
38
40
30
38
46
43
36*
48
68*
73+
84
CD
O CD
<\  o
o
CD
u
CD
to
OS
CD
U
O
CD
O
1872	
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
115
123
150
221
230
232
280
0
2
3
3
4
3
1
0
3
1
1
4
0
6
5
6
5
6
4
10
18
19
11
25
8
13
32
27
20
31
37
26
33
43
43
56
77
82
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
321
348
388
461
507
536
595
0
5
13
3
3
5
7
....
'"2"
10
5
11
5
18
17
6
12
29
2
7
32
18
13
24
26
27
38
27
43
73
46
29
48
0
2
5.55
66.66
33.33
10.34
50.00
28.57
43.75
22.22
29.41
38.46
42.85
50.00
20.00
25.00
37.03
41.66
46.15
34.15
32.69
38.77
32.69
31.81
16.25
46.77
35.93
27.03
33.33
30.69
33.63
34.78
24.79
27.34
40.00
33.33
23.03
21.30
28.30
31.00
30.00
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
62.61
61.78
52.06
41.20
53.90
64.60
59.28
5.55
1873	
16.12
1874	
11 53
1875	
20 83
1876	
9.35
1877	
6 12
1878	
16 16
1879	
14.81
1880	
8.62
1881	
8.19
1882	
3.63
1883	
1884	
5.26
3.33
1885	
6.94
1886	
6.81
1887	
4.80
1888	
2.87
1889	
3.25
1890 	
7 64
1891	
11.69
1892	
6.95
1893	
7.60
1894	
8.92
1895	
1896	
8.92
3.94
1897	
5.69
1898 .........
1899	
6.66
6.42
1900	
1901	
8.14
6.63
1902	
6.06
1903	
5.57
1904	
5.42
1905	
5.34
1906	
5.04
1907	
5.08
1908	
7.44
1909	
6.40
1910	
4.57
f Three not insane.
t One not insane. G 40
Public Hospital for the Insane.
1911
Table No. 3.
Showing the number of admissions, discharges, and deaths in 1910.
Months.
January.. ..
February ..
March.
April	
May	
June	
July	
August ....
September .
October ...
November..
December..
Total
Admissions.
Male.     Female.     Total.
25
16
10
11
18
20
11
25
22
22
23
13
216
64
30
21
16
13
18
27
19
31
31
25
31
18
280
Discharges.
Male.     Female.     Total
1
0
5
2
1
4
12
13
10
3
10
61
122
1
0
0
0
0
11
1
1
14
44
2
0
5
2
1
15
17
19
15
4
11
75
166
Deaths.
Male.     Female.
29
3
2
0
1
3
0
1
1
0
0
0
1
12
Total.
9
3
5
4
4
0
4
1
1
4
3
3
41
Table No. 4.
Showing the civil state of patients admitted during 1910.
Civil State.
Male.
Female.
Total.
148
58
3
0
7
216
17
44
2
0
1
165
102
5
0
8
Total	
64
280
Table No.  5.
Showing the religious denominations of those admitted in 1910.
Religious Denominations.
Atheist	
Apostolic faith   	
Baptists	
Buddhists	
Christian Science	
Congregationalist	
Episcopalian	
Free Church	
Greek Church	
Heathen	
Jews	
Lutheran	
Methodist	
Mohamedan	
Nonconformist	
Plymouth Brethren...
Presbyterian	
Protestant 	
Roman Catholic	
Shintoists	
Unknown	
None	
Total
Male.
Female.
1
0
1
0
6
6
3
0
3
0
0
1
10
6
1
1
4
0
2
0
2
0
17
5
11
6
3
0
0
2
1
0
31
12
58
17
43
6
2
0
15
2
2
0
216
64
Total.
1
1
12
3
3
1
16
2
4
2
2
22
17
3
2
1
43
75
49
2
17
2
280  1 Geo. 5
Public Hospital for the Insane.
G 41
Table No. 6.
Showing the degree of education of those admitted during 1910.
Degree of Education.
Superior	
Common school	
Could read and write .
None	
Unknown	
Total
Male.
Female.
4
2
139
56
36
3
8
2
29
1
216
64
Total.
6
195
39
10
30
280
Table No. 7.
Showing the nationality of those admitted during 1910.
Nationality.
Austria	
Chili	
China	
Denmark	
England	
Finland	
Germany	
Greece	
India	
Ireland	
Italy	
Japan 	
Jersey (Channel Island) ..
Newfoundland	
Norway	
Mexico	
Russia	
Saxony 	
Scotland	
Spain  	
Sweden	
Switzerland!	
United States.   	
Wales   	
Canada:—
Alberta	
British Columbia	
Manitoba	
New Brunswick	
Nova Scotia	
Ontario	
Prince Edward Island.
Quebec	
Saskatchewan	
Unknown	
Total      216
Male.
6
1
4
1
48
4
6
1
4
15
2
5
1
2
6
1
4
1
22
1
7
1
24
2
1
6
2
5
2
21
1
8
1
. 0
Female.
0
0
0
0
14
1
0
0
0
5
0
0
0
1
0
0
0
0
9
0
4
0
13
2
0
1
2
1
0
8
0
1
0
2
64
Total.
1
4
1
62
5
6
1
4
20
2
5
1
3
6
1
4
1
31
1
11
1
37
4
1
7
4
6
2
29
1
9
1
2
280 G 42
Public Hospital for the Insane.
1911
Table No. 8.
Showing what districts contributed patients during 1910.
Plane of residence at time of committal.
Male.
Female.
Total.
1
1
2
1
1
1
3
1
1
3
1
1
1
1
4
1
2
1
1
1
1
1
"io'
24
1
1
1
1
i
l
2
1
1
1
1
1
1
1
3
1
3
1
1
3
1
1
Elko    	
1
1
3
1
1
4
3
1
1
1
1
11
3
1
1
1
1
2
4
15
1
3
1
2
1
3
Fort Steele    	
1
Field	
1
4
3
Gold Hill ;	
1
1
1
1
14
4
1
2
1
1
Merritt	
2
2
4
19
2
3
Port Haney	
1
2
2
4
1
1
4
1
2
1
1
1
1
1
1
1
1
1
1
1
2
1
1
1
26
1
82
4
1
1
1
1
1
Steveston 	
1
1
2
1
1
1
36
1
106
4
1
2
1
1
2
7
216
2
8
64
280 1 Geo. 5
Public Hospital for the Insane.
G 43
Table No. 9.
Showing the occupation of those admitted during 1910.
Occupation.
Agent	
Accountant	
Baker	
Blacksmith	
Bricklayer	
Butcher     	
Carpenter	
Cooper	
Cabinet-maker	
Chemist	
Clerk	
Cook	
Civil Engineer	
Contractor	
Customs Officer	
Domestic	
Doctor	
Dental Mechanic	
(Marine) Engineer.
(Stationary) Engineer..
Expressman 	
Farmer	
Fireman	
Furrier	
Foreman	
Fisherman	
Housekeeper	
Housewife	
Indian Agent	
Labourer	
Lawyer	
Logger	
Merchant	
Mill-hand	
Milliner	
Miner	
Machinist	
Messenger-boy	
Musician	
None	
Painter	
Pensioner	
Printer	
Plasterer 	
Pile-driver	
Prostitute	
Real Estate Agent	
Remittance-man	
Salesman	
Sailor	
Sea Captain   	
Stone-mason	
Student-at-Law	
Teamster	
Tailor	
Traveller	
Watchmaker	
Waiter	
Unknown	
Total.
Male.
2
1
4
3
4
1
14
1
1
1
1
....
1
2
....
1
1
5
1
20
1
1
2
2
1
74
1
9
1
1
"l5
2
1
1
4
5
1
1
1
1
i
i
l
2
2
1
1
1
2
2
1
1
9
216
Female.
3
44
64
Total.
2
1
4
3
4
1
14
1
1
1
1
4
1
1
2
7
1
1
1
5
1
20
1
1
2
2
3
44
1
74
1
9
1
1
1
15
2
1
1
8
5
1
1
1
1
1
1
1
1
2
2
1
1
1
2
2
1
1
9
280 G 44
Public Hospital for the Insane.
1911
Table No. 10.
Showing the ages of those admitted during 1910.
Age.
Male.
Female.
Total.
0
1
5
6
6
8
9
7
5
2
5
6
0
2
1
1
64
1
7
29
30
39
32
13
19
18
12
8
4
3
2
0
12
»      20 to 25    a    	
35
a      25 to 30     //    	
36
a      30 to 35    ;/    .          	
47
»       35 to 40     n    	
41
it      40 to 45     //    	
20
24
20
17
60 to 65     ,i        	
14
4
a      70 to 75    ,/    	
5
v       75 to 80     a    	
3
a      80 to 85     a                                           	
1
Total	
216
280
Table No. 11.
Showing the number of attacks in those admitted during 1910.
Number of Attacks.
Male.
Female.
Total.
First 	
96
14
5
3
0
98
0
216
32
9
5
3
1
14
0
64
128
23
Third	
10
Fourth	
6
Eighth	
1
112
0
Total	
280
Table No. 12.
Showing the alleged duration of attack prior to admission.
Duration of Attack.
Male.
Female.
Total.
27
40
18
11
10
11
8
2
1
88
15
12
9
2
4
3
1
3
1
14
42
52
27
13
,i       6 to 12     //     	
14
14
</       5 to 10     n   	
9
5
/;         10 tO 15        ii      	
2
102
Total	
216
64
280 1 Geo. 5
Public Hospital for the Insane.
G 45
Table No. 13.
Showing statistics of heredity in those admitted during 1910.
Heredity.
Male.
Female.
3
3
0
4
35
19
Total.
16
13
2
13
105
67
19
16
2
17
140
86
Total	
216
64
280
Table No. 14.
Showing the alleged existing causes of attack of insanity.
Alleged Cause.
Business worry	
Christian Science study ,
Cerebral tumor	
Childbirth	
Cocaine	
Domestic worry	
Depression  	
Death of husband	
Drugs	
Epilepsy	
Exposure	
Fall	
Gunshot wound	
Heredity	
Injury to head	
Intemperance (alcoholic)	
Kidney trouble	
Loss of memory	
Masturbation	
Money trouble    	
Overstudy	
Overwork	
Pregnancy 	
Religion	
Religious mania	
Senility	
Stomach trouble	
Sunstroke	
Seclusion	
Strong medicine	
Spiritualism 	
Solitude	
Typhoid fever	
Unnatural life	
Venereal disease	
Women    	
Poor health	
Unstated but suspected heredity in majority of casee.
Total	
Male.
1
1
3
1
1
3
1
14
1
1
2
154
216
Female.
40
64
Total.
1
1
1
5
1
2
1
1
1
3
3
2
2
4
1
15
1
1
6
1
2
3
3
3
1
3
1
2
4
1
1
4
1
1
1
1
2
194
280 G 46
Public Hospital for the Insane.
1911
Table No. 15.
Showing the state of bodily health on admission during 1910.
Bodily Condition.
In average bodily health ...
In reduced health	
In greatly reduced condition
Total	
Male.
Female.
167
38
11
44
15
5
216
64
Total.
211
53
16
280
Table No. 16.
Showing the form of mental disorder in those admitted during 1910.
Form of Disorder.
Acute mania 	
Melancholia	
Mania, depressive condition
Dementia prascox	
Dementia organic	
General paralysis	
Epileptic insanity	
Toxic insanity	
Senile dementia.	
Terminal dementia	
Imbecility and idiocy	
Paranoia	
Not insane	
Total	
Male.
Female.
1
7
9
37
22
58
9
1
1
24
1
3
2
19
1
11
4
16
3
4
3
35
8
1
216
64
Total.
1
16
59
67
2
25
5
20
15
19
7
43
1
280
Table No. 17.
Showing the number allowed out on probation, and results during 1910.
Results.
Discharged recovered ..
n improved ..
n unimproved
Returned to hospital. ..
Still out at close of year
Total.
Male.
Female.
60
24
50
18
12
2
3
5
16
9
58
141
Total.
84
68
14
8
25
199 1 Geo. 5
Public Hospital for the Insane.
G 47
Table No. 18.
Showing alleged duration~of insanity prior to admission in those discharged during 1910.
Duration of Insanity.
Male.
Female.
7
12
6
4
3
3
2
7
Total.
15
22
12
6
1
3
2
1
4
56
22
34
18
„    2 a   3       n     	
6
5
3
6
4
Over 3                «         	
6
63
Total	
122
44
166
Table No. 19.
Showing length of residence of those remaining under treatment in 1911, and those who
were discharged during the year 1910.
Length of residence.
Of those
under
treatment
January  1st,
1911.
Of those
discharged
recovered
in 1910.
Of those
discharged
improved
in 1910.
Of those
discharged
unimproved
during
1910.
Of those
discharged
not insane
during
1910.
16
35
20
20
25
17
28
23
83
64
40
34
23
29
28
8
19
37
24
10
12
13
11
10
6
5
9
14
2
10
4
9
9
9
7
4
2
9
3
8
2
2
1
1
1
1
4
4
1
2
„       2 to   3      a      	
„       3 to   4      a         	
n       9 to 12      a
„       2 to   3      a
2
a       3 to   4      a
a       6 to   7      «              	
n      7 to   8      n
ii       8 to   9      n
n       9 to 10      »
a     10 to 15      a                   .....
1
»     15 to 20      a
n     20 to 25      n
Total
595
84
68
14 G 48
Public Hospital for the Insane.
1911
Table No. 20.
Records of death for the year 1911.
Register
No.
1,268
1,725
2,278
2,468
2,542
1,766
2,276
2,531
1,422
2,361
2,527
2,470
2,516
2,396
296
2,587
2,158
2,101
2,261
2,545
2,213
1,513
1,066
1,335
1,973
2,655
2,652
2,579
1,571
2,689
2,117
2,681
1,506
2,308
2,704
2,128
2,630
2,215
2,706
2,431
1,921
Initials.
M. E.
T. B.
F. J. C.
A. Y. M.
S.
E. S. M. C.
J. E.
L. S.
R. 0.
W. R.
E. M. M.
C. W.
J. K.
J. R.
J. W.
G. T. E.
E. L. H.
J. A.
F. S.
A. R.
J. C. S.
M. S.
A. McD.
C. A. L.
C. D. W.
T. O'C.
D. W.
W. McM.
A. G.
F. B.
G. G.
B. L.
F. J.
E. A. C.
J. B.
F. P.
A. Mel.
F. L.
J. R. S.
J. L.
C. H.
Sex.
Age.
Time in Hospital.
M.
Years.
Months.
5
Days.
26
69
7
M.
24
3
10
30
M.
60
1
2
2
F.
16
3
25
M.
F.
25
38
4
2
3
8
M.
77
1
2
12
F.
36
1
3
M.
52
6
5
13
M.
78
10
1
F.
50
1
24
F.
45
6
28
M.
41
3
12
M.
52
9
25
M.
70
21
8
27
M.
44
1
2
M.
37
1
11
2
M.
67
2
2
3
F.
24
1
8
19
M.
47
3
7
M.
13
1
9
18
F.
61
6
2
14
M.
49
9
9
4
F.
49
7
4
13
F.
39
2
10
7
M.
F.
M.
51
30
45
15
24
6
5
M.
60
5
7
26
F.
M.
33
75
6
12
2
6
M.
48
2
15
M.
75
6
6
29
M.
33
I
9
24
M.
28
2
12
M.
52
2
16
M.
60
5
26
M.
70
2
4
9
M.
74
3
10
M.
45
1
4
18
F.
56
3
8
9
Certified Cause.
Cerebral haemorrhage.
Tuberculosis of lung.
General paralysis.
Epileptic exhaustion.
Tuberculosis of lungs.
General debility.
Senility.
General debility.
Paresis.
Senility.
General debility.
Senility.
General paralysis.
Peritonitis.
Heart disease.
General paralysis.
Exhaustion of dementia.
Senility.
Chlorosis.
General paresis.
Tuberculosis.
Cerebral haemorrhage.
General paralysis.
Epileptic exhaustion.
Pneumonia.
General paresis.
Pulmonary tuberculosis.
General paralysis.
General debility.
Maniacal exhaustion.
Peritonitis.
General paralysis.
Senility.
Tuberculosis.
Cerebral haemorrhage.
Laryngeal   obstruction   from
impacted, regurgitated and
unmastieated food.
General paralysis.
Senility.
Senility.
General paralysis.
Peritonitis. 1 Geo. 5
Public Hospital for the Insane.
G 49
Table No. 21.
Work done by Patients during the year 1910.
Carpenter...
Farmer	
Gardener ...
Engineer....
Kitchen ....
Laundry ....
Painter	
Plasterer....
Shoemaker...
Tailor	
Ward work..
Porter	
Baker	
Plumber ....
Laboratory..
Dining-room
Scullery
Gate	
Colony Farm.
Carpenter	
Farmer	
Dining-room	
Engineer	
Kitchen	
Stable	
Painter	
General work	
Slashing and cutting wood.
Mason	
664 days.
10,489
2,680
1,595
1,924
3,609
1,126
462
259
665
54.331
1,079
920
299
292
5,897
1,992
365
348
3,309
661
293
607
832
213
1,037
4,046
62
Table No. 22.
Articles made by Female Patients.
Aprons      103
Blouses    	
Dresses, gingham  36
a         serge  9
Handkerchiefs  244
Napkins, table  48
Pillow-slips  437
Drawers (pairs)
Doilies	
Dusters	
Mats, rag	
Neckties	
Skirts	
Sheets .
Tablecloths	
Petticoats	
Cushions	
Window curtains (pairs)
Sash n a
Sofa covers	
Chemises	
371
21
12
4
34
96
Towels, bath..
//        roller.
a       tea ...
a tray ..
Bedside rugs ..
Table covers ..
Pillow-shams. .
Bureau covers.
Articles made for Nurses.
Aprons
67
78
Dresses ,
Repairs for Nurses.
Aprons       246       Dresses
Caps	
4
24
36
231
30
246
18
355
130
121
66
12
6
44
6
38
185 G 50
Public Hospital for the Insane.
1911
Mending done for Female Patients.
Aprons      305
Blankets  200
Blouses  294
Chemises  496
Drawers (pairs)  314
Dresses, gingham  561
w         serge   421
n        night  295
Hose (pairs)  3,702
Pillow-slips ...
Sheets	
Skirts	
Spreads, bed . .
Tablecloths ...
Ticks, bed
Towels, bath .
«        roller
Vests, under .
Mending done for Male Patients.
Aprons  56
Blankets  228
Coats  210
Drawers  1,563
Jumpers  56
Overalls  258
Pants (pairs)  698
Pillow-slips      223
Sheets  294
Shirts, duck...
w under .
Socks (pairs) . .
Spreads, bed . .
Tablecloths ...
Ticks, bed . ..
Towels, bath..
» roller.
Vests	
Report of Tailoring Department.
Stock :—
340 pairs pants	
366 coats 	
216 vests 	
16 suits 	
15 canvas blankets	
60 bed ticks	
71 pillow ticks	
24 night shirts	
12 jumpers	
13 overalls	
26 new collars and shirts .
Repairs	
Total stock work.
Uniforms :—
69 suits	
53 pair pants	
Total uniform work.
$ 965 65
2,188 65
464 50
183 70
78 60
101 00
24 85
30 00
9 00
9 75
2 60
12 70
14,071 00
|1,474 00
354 83
$1,828 83
Total Uniforms      $1,828 83
//     Stock      4,071 00
a     Repairs  14 69
Grand total
,914 52
New work :—
New shoes, men's,
a    slippers, men's,
a   slippers, women's
Repairs :—
Men's shoes,
//     slippers,
Women's shoes,
« slippers,
Miscellaneous work	
Total	
Work done by Shoemaker.
22 pairs.
46   i,    .
4    ,i    .
420    „    .
128    -/    .
38   ii    .
$155 00
115 50
10 00
462 95
116 52
26 75
5 25
$ 38 85
180
203
625
165
187
113
156
111
454
1,941
1,880
5,044
223
191
155
186
136
144
.$930 82 1 Geo. 5
Public Hospital for the Insane.
G 51
Preserves put up.
Red currants  62 quarts.
Black     a           60 a
Blackberries   28 »
Peaches         25 »
Plums 110 „
Gooseberries       65 //
Rhubarb  63 »
Raspberries  68 n
Pears   60 »
Crab-apple  35 n
Strawberries   130 a
Pickles.
Tomato 250 quarts.
Jelly.
Apple   15 quarts.
Red currant   12     //
Black currant       25     n
ADMINISTRATION   BUILDING
FRONT ELEVATION
VICTORIA, B. C.:
Printed by Richabd Wolfenden, I.S.O., V.D., Printer to the King's Most Excellent Majesty.
1911. 

Cite

Citation Scheme:

        

Citations by CSL (citeproc-js)

Usage Statistics

Share

Embed

Customize your widget with the following options, then copy and paste the code below into the HTML of your page to embed this item in your website.
                        
                            <div id="ubcOpenCollectionsWidgetDisplay">
                            <script id="ubcOpenCollectionsWidget"
                            src="{[{embed.src}]}"
                            data-item="{[{embed.item}]}"
                            data-collection="{[{embed.collection}]}"
                            data-metadata="{[{embed.showMetadata}]}"
                            data-width="{[{embed.width}]}"
                            async >
                            </script>
                            </div>
                        
                    
IIIF logo Our image viewer uses the IIIF 2.0 standard. To load this item in other compatible viewers, use this url:
http://iiif.library.ubc.ca/presentation/cdm.bcsessional.1-0064403/manifest

Comment

Related Items