{"@context":{"@language":"en","AIPUUID":"https:\/\/open.library.ubc.ca\/terms#identifierAIP","AggregatedSourceRepository":"http:\/\/www.europeana.eu\/schemas\/edm\/dataProvider","AlternateTitle":"http:\/\/purl.org\/dc\/terms\/alternative","CatalogueRecord":"http:\/\/purl.org\/dc\/terms\/isReferencedBy","Collection":"http:\/\/purl.org\/dc\/terms\/isPartOf","Creator":"http:\/\/purl.org\/dc\/terms\/creator","DateAvailable":"http:\/\/purl.org\/dc\/terms\/issued","DateIssued":"http:\/\/purl.org\/dc\/terms\/issued","DigitalResourceOriginalRecord":"http:\/\/www.europeana.eu\/schemas\/edm\/aggregatedCHO","FileFormat":"http:\/\/purl.org\/dc\/elements\/1.1\/format","FullText":"http:\/\/www.w3.org\/2009\/08\/skos-reference\/skos.html#note","Genre":"http:\/\/www.europeana.eu\/schemas\/edm\/hasType","Identifier":"http:\/\/purl.org\/dc\/terms\/identifier","IsShownAt":"http:\/\/www.europeana.eu\/schemas\/edm\/isShownAt","Language":"http:\/\/purl.org\/dc\/terms\/language","Provider":"http:\/\/www.europeana.eu\/schemas\/edm\/provider","Publisher":"http:\/\/purl.org\/dc\/terms\/publisher","Rights":"http:\/\/purl.org\/dc\/terms\/rights","SortDate":"http:\/\/purl.org\/dc\/terms\/date","Source":"http:\/\/purl.org\/dc\/terms\/source","Title":"http:\/\/purl.org\/dc\/terms\/title","Type":"http:\/\/purl.org\/dc\/terms\/type","Translation":"http:\/\/purl.org\/dc\/terms\/description"},"AIPUUID":[{"@value":"843ab899-4206-48aa-b5cb-9e78f76cc84b","@language":"en"}],"AggregatedSourceRepository":[{"@value":"CONTENTdm","@language":"en"}],"AlternateTitle":[{"@value":"PUBLIC HOSPITAL FOR THE INSANE.","@language":"en"}],"CatalogueRecord":[{"@value":"http:\/\/resolve.library.ubc.ca\/cgi-bin\/catsearch?bid=1198198","@language":"en"}],"Collection":[{"@value":"Sessional Papers of the Province of British Columbia","@language":"en"}],"Creator":[{"@value":"British Columbia. Legislative Assembly","@language":"en"}],"DateAvailable":[{"@value":"2014-12-12","@language":"en"}],"DateIssued":[{"@value":"[1911]","@language":"en"}],"DigitalResourceOriginalRecord":[{"@value":"https:\/\/open.library.ubc.ca\/collections\/bcsessional\/items\/1.0064403\/source.json","@language":"en"}],"FileFormat":[{"@value":"application\/pdf","@language":"en"}],"FullText":[{"@value":" ANNUAL   REPORT\n-OF  THE-\nPUBLIC HOSPITAL FOR THE INSANE\n\u2014OF  THE-\nPROVINCE OF BRITISH COLUMBIA\n\u2014FOR  THE-\nYEAR   1910.\nPRINTED BY AUTHORITY OF\nTHE LEGISLATIVE ASSEMBLY OF BRITISH COLUMBIA.\nVICTORIA, B. C :\nPrinted by Richard Wolfenden, I.S.O., V.D., Printer to the King's Most Excellent Majesty,\n1911. I   ' \u25a0 \"\u2022\u25a0 \u2022'\nsa* _**     \"\u00bb\u00bb:\nsf-^AiffV; <s.  1 Geo. 5\nPublic Hospital for the Insane.\nG 3\nREPORT\nPUBLIC   HOSPITAL   FOR   THE   INSANE.\n1910.\nTo His Honour the Honourable Thomas Wilson Paterson,\nLieutenant-Governor of the Province of British Columbia.\nMay it please Your Honour :\nThe  undersigned   respectfully  submits  herewith  the Annual Report  of the  Medical\nSuperintendent of the Public Hospital for the Insane for the year 1910.\nHENRY ESSON YOUNG,\nProvincial Secretary.\nProvincial Secretary's Office,\nJanuary, 1911. G 4\nPublic Hospital for the Insane.\n1911\nOFFICERS\n-:o:-\nMedical Superintendent:\nC. E. DOHERTY, M. D., C. M.\nAssistant Medical Superintendent:\nJAMES G. McKAY, M. D., C. M.\nBursar:\nGOWAN S. MACGOWAN.\nAnalyst :\nF. P. HUGHES.\nAssistant Bursar:\nT. H. CAMBRIDGE.\nMatron :\nMARIA FILLMORE.\nSteward and Store-keeper:\nR. REES.\nEngineer:\nW. F. JOHNSTON.\nR. LENNIE.\nChaplains:\nE. MAILLARD, O. M. I.\nChief Male Attendant:\nGILBERT MATHEWSON.\nMatron and Chief Female Attendant:\nMARIA FILLMORE.\nCarpenter :\nTHOMAS CORMACK.\nPlasterer and Mason :\nEDWARD FITZGERALD.\nFarmer:\nE. B. STINCHCOMBE.\nGardener :\nW. T. L. HOUSE.\nTailor :\nW. F. BEGGS.\nLaundryman :\nJ.   HARGIE.\nShoemaker:\nD. McQUARRIE. 1 Geo. 5\nPublic Hospital for the Insane.\nG 5\nREPORT\nOF  THE\nMedical Superintendent of the Public  Hospital for the Insane,\nNew Westminster, B. C.\nFor the Year Ending 31st December,  1910.\nPublic Hospital for the Insane,\nNew Westminster, B. C, January,  1911.\nThe Honourable\nThe Provincial Secretary,   Victoria, B. C.\nSir,\u2014I have the honour to submit herewith the Thirty-ninth Annual Report of the\nPublic Hospital for the Insane at New Westminster for the year 1910. The report embraces\na full account of the operations of the Institution, together with a record of the movements of\nthe Hospital population and a detailed account of all revenues and expenditures for the year.\nThe work of this Department has been progressive and has, with the increased facilities\nat our command, given results which I trust will be satisfactory to yourself and to the other\nHonourable Members of the Cabinet.\nIn order to facilitate a more ready comprehension of the data given in the tabulated\nportion of the report, the following resume and summary is presented : At the close of the year\nthe number of patients under our care was 700, of whom 523 were men and 177 were women.\nThe admissions for the year were 284 ; of these, 220 were men and 64 were women, an increase\nof admissions over the previous year of 52. Of the admissions, 128 were suffering from a first\nattack, 23 were suffering from a second attack, and 17 from a third attack. In 112 cases it\nwas impossible to ascertain the number of attacks, but it is more than probable that a portion\nof these were cases recurring.\nOf those admitted, 102 were married, 5 were in the widowed state, 165 had never been\nmarried, while in 8 cases it was impossible to ascertain the civil state.\nIn religion, 210 were Protestants of various denominations, 49 were Roman Catholics,\n4 were heathens, and in 17 cases the religion could not be ascertained.\nThe total number of discharges for the year was 166. Of these, 84 were discharged\nrecovered, 70 were discharged as improved, and 12 were discharged as unimproved. None\nwere discharged as not insane. The percentage of recoveries, computed on the number\nadmitted during the year, is 30 per cent.\nIn the classification of our mental cases, you will notice that the same forms as last year\nwere used. Of late much has been written and said about the classification of mental\ndisorders, but after due consideration by our medical staff, we have found it advisable to\nadhere to the classification of Krseplin, a classification which we consider not weighed down\nwith unnecessary complications and technicalities, and one which so simplifies statistics that\nan extensive text is made unnecessary.\nDementia prsecox and manic depressive conditions predominate as formerly, while general\nparalysis also plays an important part.    I wish particularly  to call your attention to the G 6\nPublic Hospital for the Insane.\n1911\nnumber of idiots admitted during the past year, and also to the extremely young age of many\nof this class admitted. The increasing number of children coming into the care and custody\nof this Hospital is a matter of much concern ; with our present facilities, we are unable to\nproperly classify and segregate them, so that due regard may be given to their individual\nclaims, and the comfort and well-being of other patients. These children necessarily have\nto be assigned to such locations in the Hospital as the character of our equipment and\naccomodations permit.\nWithout desiring at all to avoid the responsibility incident to caring for this class of\npatients, I would strongly advise that one wing of the present Hospital be given over entirely\nto this class of patients, as soon as the new Hospital at Coquitlam is completed. Nothing but\ndissatisfaction can result from the mingling of children and adults ; the difference in their\nages, the very nature of their mental disabilities unfit them from the standpoint of science,\ndiscipline and the principles of classification to be grouped together.\nTreatment.\nThe officers and nurses, both male and female, have given faithful and efficient attention\nto their several duties. I have in past reports attempted to dwell upon the taxing nature of\nthese duties and the conditions under which they are performed. Institution life is a life\napart; it may have the seeming advantage of much quiet, of freedom from the stress and strain\nof the struggle in the outside world, but in its place, I can assure you, there is a strain equally\nas great, if not greater, in the never-ending responsibility, a part of which every employee\nmust bear. In accepting such huge responsibility, it is our duty, as medical officers and heads\nof the Hospital, to also guard against the ever present danger of following the lines of least\nresistance and getting into a routine and mechanical performance of daily duty. There is, I\nam glad to be able to say, a vigour and spirit in the life of this Hospital which in no small\nway you yourself, in your efforts as Provincial Secretary, have been responsible for. The great\ninterest you have always shown, not only in the management of the Hospital but also in the\nresults of its treatment, has been a great source of encouragement to me, and I can assure you\nthat it behoves us all not only to be earnest and diligent in providing the best physical\nconditions for our patients, but also to be ever mindful of our duty in doing what is practicable\nfor promoting their cure.\nHydrotherapy.\nThe splendid effects to be derived from the appropriate use of this method of treatment\nhave been quite evident during the year, and, in my opinion, no other means of treatment can\ncompare with hydrotherapy in reducing motor restlessness and exerting beneficial and soothing\nreflex influence in states of agitation, anxiety, and depression.\nMr. Beaton has again handled this Department to our entire satisfaction, the attached\ntable showing exactly the amount of work  done in our bath-rooms.    During my trip East,\nearly in the year,  I had occasion  to visit  the  hydrotherapeutic  departments  of  several\nhospitals, and in none of them did I see the acutely insane handled with better system and\nsuccess than is being done by our Mr. Beaton.    During the past year the following work was\ndone in the different hydrotherapeutic departments :\u2014\n3,357 warm full baths ;\n4,129 rain and needle shower-baths ;\n659 steam cabinet baths, followed by massage ;\n60 prolonged continuous baths in maniacal cases ;\n56 patients have been treated electro-therapeutically ;\n6 have been treated by vibration method. 1 Geo. 5\nPublic Hospital for the Insane.\nG 7\nAmusement.\nA form of treatment for our patients which cannot be overlooked is found in affording\nthem means of amusement. We have availed ourselves of such resources as were at our\ncommand in entertaining and amusing our patients, so as to divert them from their vagaries,\nand awaken in them an appreciation of the normal or healthful side of life.\nThe usual weekly dances or concerts have been given throughout the year; the patients\nw-ho take part in these dances look forward to them and speak of them as a weekly treat,\nwhich they very much appreciate. Many who do not dance find pleasure and diversion\nwatching those who do, and in listening to the music furnished by the Hospital orchestra.\nNext year we hope to have in operation our new campus, with its baseball diamond,\ntennis courts, and bowling green, features which should prove very beneficial, both to the\nphysical and mental health of our patients.\nPathological Laboratory.\nThe special work in our laboratory has been going on in a systematic and thorough\nmanner. Mr. Hughes has been compiling valuable statistics for the Institution, not least\namong which are the interesting and valuable series of physio-chemical experiments upon the\nquantitative elimination and determination of the chlorides and phosphates in the urine of our\npatients as a whole, with a view of confirming the findings recently advanced as to its relation\nto existing insanity. The conclusions arrived at are given in this report only in part, but will\nbe submitted to your Department in full when completed at a later date.\nIncrease of. Tuberculosis.\nI wish here to say a few words in connection with the great increase of tuberculosis\nnoticed among the insane of the Province; while this increased proportion is no doubt, to\na certain extent, due to our increased facility for exact diagnosis, still the matter is a very\nserious one, and one for which special provision will have to be made in the near future.\nIn computing the amount of tuberculosis from our autopsies, the percentage has been\nreckoned as fairly as possible; the common adhesions of the apices of the lungs and pleurisy\nwith or without effusion, have not been considered as of tubercular origin. Those which have\nshown substantial evidence of the existence of the disease have alone been counted. With\nthese ideas in view, the percentage computation figures of 12 per cent, of tuberculosis was\nfound in eighteen autopsies in this Institution.\nIt is not with any hope of presenting anything new that I offer these statistics for your\nconsideration, but only that we may keep before our minds a question that is surely of the\nutmost importance to our Institution, and one that seems to me to need immediate attention in\nprovision of means for special isolation and care. When so earnest endeavours are being\nmade by the energetic Health Department of our Province to control the spread of this\nscourge among the general public, it seems highly important to recognise the danger and to\nmake proper provision for the restraint of the disease with those who are directly under our\nsupervision and control. The difficulty of controlling the habits of the insane is known\nchiefly to those who are concerned with their care; but when we see tuberculous patients in\nwards daily with a receptacle for sputum at their bedsides, who yet prefer, in spite of the\nutmost care on the part of the nurses, to expectorate on the floor, or into the bed linen, one\nis at once convinced of the double difficulty in combating this dreadful disease in our insane\ncolony. I would respectfully suggest that a special pavilion for the treatment of this disease\nbe built at Coquitlam in the very near future. G 8\nPublic Hospital for the Insane.\n1911\nImprovements.\nNew   Westminster.\nMuch 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\ncare of our efficient gardener, Mr. House, have been much admired. The excellent taste and\nsplendid system exhibited in this Department have been a great source of pleasure to me.\nColony Farm.\nAt Colony Farm great energy was displayed in the work of clearing and underdraining.\nConnected with the Coquitlam Institution are some thousand acres of land, and in the\nmanagement and laying out of this large area we have in mind, both for the present and the\nfuture, the accomplishment of three general results : First, the pleasure and health of the\ninsane population of British Columbia ; secondly, the providing of employment to a large class\nof patients who will be benefited by regular work in the open air; thirdly, the great economy\nto be effected by utilising the help provided in producing most of the requirements of the\nInstitution in fruit, flowers, vegetables, and farm and dairy products. Already the lowland\nof the farm has been completely cleared and underdrained, while, with the exception of some\nfifteen acres, it has also received its first ploughing or breaking, and there can be no doubt\nthat, within two years, this will be one of the very best farms in the Province. The new\ndairy and hay-barns and also the farm cottage have been completed, and will be occupied very\nshortly after the New Year.\nI wish to take this opportunity of congratulating the Government upon the recent\nappointments to the more important positions at Colony Farm. It would be impossible to\nexpect good results from the farm, unless we had at its head men of experience, ability, and\nintegrity. In the appointment of Mr. E. B. Stinchcombe as chief gardener, the Government\nhas placed at the head of this very important department a man who has been in the service\nas chief farmer at the New Westminster Institution for the past fifteen years, and a man whose\nability is well known.\nMr. Duncan Montgomery, as chief farmer, should give splendid satisfaction; he is well\nand favourably known throughout the Province as one of its very best agriculturalists and\nstockmen, having been manager of the Pemberton Stock Farm for some ten years, where he\nestablished a very enviable reputation.\nIn the promotion of Mr. J. B. Pumphrey to the position of steward and chief attendant,\nthe Government has secured a man for this dual post who has been well tried and who has\nmade abundantly good.\nExpenditure.\nIn the matter of expenditure, our per capita cost of maintenance was $184.43. This is a\nvery low rate when you take into consideration the following facts : First, the increased price\nof nearly every article of necessity furnished the patients; secondly, the increased salaries\npaid to employees; and, thirdly, the new expenditure in the amusement of patients.\nWhen you take into consideration that in this expenditure of $184.43 per patient, we\ninclude not only the food, clothing, bedding, laundry, and tobacco of each patient, but also the\ncost of overseeing, treatment, the heat and light furnished, as well as the amusement of each\npatient, I think no fault can be found.\nI can remember a few years ago, when the question of increased salaries for employees\ncame up for discussion and when, notwithstanding the willingness of the Government to see\nthat the Hospital employees were well paid, the argument set up against it was that it would\nbe impossible for this Hospital to show a comparison which would appear at all favourable\nwhen set alongside statistics from eastern hospitals.    Now, with increased salaries, with better  1 Geo. 5\nPublic Hospital for the Insane.\nG 9\namusement, and with the increased cost of living, our per capita cost is one of the lowest in\nthe history of the Hospital, and not only compares most favourably with eastern hospitals but\nis 30 per cent, less than that of New York State hospitals, facts which go to prove that well-\npaid, intelligent help is in the end the most economical.\nIn the matter of salaries, I would like the Government to take into its consideration the\nquestion of advanced salaries for married attendants; these men, while living at home and\nmaintaining a house, receive salaries similar to single men who have quarters provided by the\nHospital. A married man, raising a family and providing his own living quarters, should be\nentitled to at least $10 per month in excess of that received by single men. If you can see\nyour way go favourably consider this favour for the married attendants, I will promise that no\nmaterial difference will be noticeable in next year's per capita cost.\nTable A.\nShowing the average number of patients in residence each year, the total amounts spent for\nmaintenance and the per capita cost.\nYear.\nAverage number\nin residence.\nMaintenance\nexpenditure.\nPer capita\ncost.\n1872 (81 days)\t\n16.57\n16.07\n16.76\n27.42\n36.41\n34.61\n36.52\n38.17\n45.42\n47.18\n47.86\n48.73\n48.70\n54.67\n59.11\n73.55\n79.43\n71.30\n78.78\n119.87\n125.24\n133 92\n148.64\n162.97\n171.43\n188.91\n216.53\n226.44\n243.24\n269.56\n296.62\n332.23\n351.55\n340.90\n374.57\n419.24\n490.80\n526.85\n563.33\n$ 2,265 25\n7,841 94\n8,232 41\n9,892 38\n12,558 18\n12,917 17\n13,985 05\n10,253 72\n10,552 18\n10,691 76\n11,343 65\n11,829 11\n11,843 94\n15,555 87\n15,334 43\n15,945 22\n16,'26I 06\n15,657 79\n17,577 80\n21,757 03\n23,518 37\n25,904 98\n26,495 83\n31,587 89\n32,001 40\n36,224 76\n46,420 25\n54,917 45\n59,349 20\n55,406 08\n55,345 65\n59,353 57\n66,052 76\n63,342 07\n66,596 69\n74,874 64\n90,269 49\n96,586 32\n103,900 44\n|616 00\n1873\t\n1874\t\n487 98\n491 20\n1875\t\n360 77\n1876\t\n344 91\n1877 \t\n1878\t\n1879\t\n1880\t\n373 26\n382 93\n268 63\n232 32\n1881\t\n226 62\n1882  \t\n1883\t\n237 02\n242 75\n1884\t\n243 20\n1885\t\n284 54\n1886\t\n259 42\n1887 \t\n216 70\n1888\t\n204 72\n1889\t\n1890\t\n1891\t\n219 60\n223 13\n181 50\n1892\t\n1893  \t\n187 80\n193 36\n1894\t\n178 25\n1895\t\n193 83\n1896\t\n186 67\n1897\t\n191 75\n1898\t\n214 38\n1899\t\n242 52\n1900\t\n244 00\n1901\t\n205 54\n1902\t\n186 59\n1903\t\n178 65\n1904\t\n187 89\n1905\t\n185 80\n1906 \t\n177 79\n1907\t\n178 59\n1908\t\n183 92\n1909\t\n1910\t\n183 32\n184 43 G 10\nPublic Hospital for the Insane.\n1911\nTable B.\nShowing analysis of the per capita cost.\nYear.\n1872..\n1873..\n1874..\n1875..\n1876..\n1877..\n1878..\n1879..\n1880..\n1881..\n1882..\n1883..\n1884..\n1885..\n1886..\n1887..\n1888..\n1889..\n1890..\n1891..\n1892..\n1893..\n1894..\n1895..\n1896..\n1897..\n1898..\n1899..\n1900..\n1901..\n1902..\n1903..\n1904..\n1905..\n1906..\n1907..\n1908..\n1909..\n1910..\nSalaries.\n$279 38\n221 48\n231 10\n153 82\n143 34\n177 15\n176 16\n134 27\n111 84\n112 44\n121 51\n123 81\n124 02\n169 05\n159 03\n127 80\n118 34\n131 70\n121 54\n88 35\n94 25\n95 50\n87 76\n90 83\n89 13\n89 09\n94 68\n113 31\n116 04\n99 16\n87 47\n82 36\n87 43\n92 17\n88 76\n89 18\n90 93\n94 27\n95 97\nProvisions.\n$184 03\n166 81\n152\n10\n113\n40\n114 45\n126\n75\n124 23\n95\n10\n87\n71\n81\n14\n84\n52\n92 56\n90 64\n84\n33\n69 35\n59\n10\n60 47\n59\n11\n62 77\n54 79\n56 74\n53\n55\n57 07\n61\n15\n55\n93\n58\n18\n69 43\n72 91\n72 62\n66\n65\n61\n13\n57\n86\n60\n01\n54\n09\n53\n15\n48 47\n49\n17\n53 41\n48\n43\nClothing.\n$55 81\n14 55\n22 07\n13 98\n18 68\n20 69\n30 43\n3 25\n5 74\n6 86\n7 05\n6 03\n03\n33\n49\n88\n41\n20\n02\n83\n4 69\n5 43\n5 25\n9 90\n6 30\n8 36\n9 94\n8 31\n9 06\n10 12\n7 95\n8 58\n6 85\n5 99\n5 16\n5 81\n6 61\n8 16\n7 87\nFuel and\nLight.\n$22 44\n23 65\n23 98\n16 88\n22 75\n4 66\n13 94\n15 91\n14 06\n12 73\n12 30\n11 04\n12 43\n15 05\n16 20\n15 38\n13 90\n12 93\n17 31\n20 43\n20 53\n22 60\n18 83\n20 41\n20 29\n19 11\n21 82\n33 96\n32 10\n18 52\n15 25\n14 77\n17 84\n17 93\n15 92\n19 82\n17 63\n13 02\n21 32\nFurniture.\n$15 55\n21 59\n28 36\n25 45\n17 90\n20 75\n7 20\n6 39\n6 00\n5 55\n4 54\n4 26\n4 14\n3 90\n3 72\n3 88\n3 11\n4 13\n4 00\n3 40\n3 35\n3 39\n2 98\n2 51\n2 56\n2 95\n2 76\n2 50\n2 15\n3 25\n4 13\n3 24\n4 48\n3 83\n3 57\n3 02\n4 56\n2 78\n2 02\nMedicines.\n$10 18\n74\n78\n73\n86\n74\n16\n6 31\n3 63\n2 56\n49\n24\n77\n93\n59\n93\n09\n07\n29\n89\n80\n69\n43\n10\n63\n86\n12\n73\n1 71\n1 07\n1 20\n1 91\n1 57\n1 79\n84\n1 15\nMiscellaneous.\n$49 30\n32 16\n25 81\n30 51\n24 93\n19 52\n21 82\n7 40\n3 34\n5 34\n61\n82\n18\n95\n04\n81\n40\n46\n19\n81\n6 42\n10 20\n4 93\n5 93\n8 83\n10 20\n10 62\n8 80\n10 32\n6 77\n9 46\n9 93\n9 18\n9 76\n10 02\n10 72\n13 23\n10 84\n7 67\nTotal.\n$616 69\n487 98\n491 20\n360 77\n344 91\n373 26\n382 93\n268 63\n332 32\n226 62\n237 02\n242 75\n243 20\n284 54\n259 42\n216 78\n204 72\n219 60\n223 12\n181 50\n187 80\n193 36\n178 25\n193 83\n186 67\n191 75\n214 37\n242 52\n244 00\n205 54\n186 59\n178 65\n187 89\n185 80\n177 79\n178 59\n183 92\n183 32\n184 43 1 Geo. 5\nPublic Hospital for the Insane.\nG 11\na\n\u202273\nN\na\na\n_o\na,\nO\n-3  to\neg  u\n*Q  o\nd>\nh-1\nbc-^ d\nH.      %      (D\n3.0. a\n3\nNCJH^\u00a9MOTfI^H05rtMmL0Q0rtlOTflO01i0^I-(0^\n^h^h        IOtlHiOiOOD^\u00abIOOO\u00a9OI\noicMo^coa:oiooioofOio\no o\no o\n00 Ci\noooooooooh\u00abMHiowffi\u00abm\ntocNcoootMi'^co^aO'-^i'^Ttir^cococoioo\nrt H d a>\n-S rt S n\niOrt<HOOXI^^01XCD>OH^^X(NtOOiOCCNaC\u00ab0:0\u00a9iOiOOQOiOt-'\u00abONQ'*aiO:l'^\n^^N(^Q0r^^c0(>lHmciWi0^i0^r^l^l^c0TrOr^iHTt<or^0iO^WW(NO^0:cDO\nCD^(rOQOrHCO'QLOQ^(^^iO\u00ab^OOt^lO'HOO:XO(NCJM^O'*iOin^03t--'CCOO\n0'lX01CCW05\u00a9C'llOOfCCOCOiOO:o:(N\u00a9LOI>^QTt(^CW^\u00a9\u00ab'*KWOCOIOCOWI005\nLQr>0)OCC^CDWCONHr-b.NiO^\u00a90\u00a9\u00a9OCOr^l>LOTtllOT|fiacOCOO^H^U'3Tt(^0\nr\/\"i   \u2014I   -\"^   r**i   ^-^   \u00bb-\u2014   ^^   r-r\\   ti~\\   *r-\\   i^_   rv^   ^^   ^r^   **^  ^^,   z^n   t--^, rO   l\nrHOiMOMCCO^-HWr-tCHXOOiOiOOiiffiC\n(\u00bbH?:woi--QcoLOioNC,;o\u00a9ma)Cj^\u00a9iooot\n.1   ti.)   l_U   S.M   l_M   <J-J   \"J-i   1-*J   *\u2022\u2022>  ^\u00bb'<   \u2022'\u00bb   I- \u2014   ^'    ^J '   \u00ab. \u2014 \u25a0\u25a0\u2022>\nph .-T ci f-T Of rH ci CO CO CO CO \u25a0* SO iO rf\nes\n3\na\no\n0\n=3\nIS\no\nuj\na\n3\n=i\n<|\nen\nH\ni-l\nH\nS>\n-C\nNOlHiOCOHNiOOOfONOH^^^ocOHOOOCO^MCO^OOXCOOlHCDOOiffi\nOTt>*<\u00a9C^^^I>OOONif5HFH(N\u00a9\u00a9i>CiMrH00003(NI>COWH-^MiHOO^'#cO'*iOO\nW(>17:00ClNW^\u00abWfflC\u00abCD0S\u00a9OTt'O<NCJO^O(N(NOH^C0O\u00abW0JLCiL'Jt;.Tf\u00bbO\nrHr-HrHr-trHCOCNrHl\u2014ii-H.\u2014l^ir-l HHH(M!MCO(MlOOI>rHCO'*i:ifCC01>CO^OCO^O\nF-i\nT3\n+J\nCi\na\n3\n+^\n[XI\nOJ\nrw\n0\n^\nMl\n3r-l\nN\nHOWCD\u00a90\u00ae^i>\nwOcoi^^^Hcoi^(Ni\u00bbi>(>icoc-ic\u00bbco>cciOir:aiOGoo\u00abixi>a)(^co\nHa0WMNHb.^HMQlOh.\u00ablO$00MCiICJO)b'(\u00bbtO'rtlO>-il>^fflt:\nIO-H\u00a9'fl-.OrHOO-'-IQOTHaiHO'-HOTfrHp:iCQlS(NN(NI>t-CW\nCO CO oi *r\nCD ZD ir~ *0\nCI CM Tf -\n-Tea ph.\nP4\nO\nK\n9\nJ*\n-P\na\no\nm\nxcoo^N^ooMoccwooii-CMoiMOTtir'OiffiiM^HfNaiooiwoi'HC-HioiOH\n\u00ab^^Q0i^l0CD\u00ab\u00a9^i0OC00iHFH01\u00ab'!fiW:OI>W'*CDl>C0aOl001(NH\u00a9\u00abioaDO\nr-ifM(MK(Nrt\u00ab\u00ab^t^l>^^^COtOOXGOO(M\n^C^^OO:\u00abOXl0^^i^^X05^NW^COXCOiOOiOCO^^|>H001^lOLO^NHO:\nxiQoci^rHMiocii^xxK'^ocxxiHi^ciiO'^ooooiXOHi-iaiHajrHiro^HCDi'CiiN\n(NcoofoocDH^occ^o:^^^^o\u00abooih'Oj'-iFiaiOiW(^o:i>oi003cciioiTHxr-'\n85N\u00abW\u00abONHH\u00abCOWWW\u00abm^P5LOt-\u00bb^iOI^i> \u00a9^O^lq^h x (NI>n\u00bb'*003'*011N'#\n^ pH rH rH pH ci ^i ci Oi Ci Ci Ci Ci i-H Ci\" CO\" *# t^\nNx>*o\u00a9cow^X(N^HrHoo5^o^^cDOi>ai\"vDxair;r-icocDcc(>iaiccowirc^i>\nCOtOLOHHmKJOOlOOOlfl'tfffiOMXNOsOHH^oiOfflOlOffiQHfMO^QKHHN\nOiHHCCCO\u00abnO\u00a9>CtO\u00a90\u00a9\u00ab0\u00a90(NWXrtXtDl>fMOHuOCD--01J>\u00bb0\u00bbOOHO\u00bbOC\nCOCO^I^X^^OlQQrtlLOQtNQOOCDHOlX&lrH^O^fOriCDOXCOCKi^XWNXX\nNQWb'XQMTl*Oi^iO\u00abOi(Jlff)05050>0 0\u00ab0^\u00ab005NX^OiWJ(NlO--\u00ab'if!OU0 01\ni^iOt^rHrH(N\u00ab01l^O\u00abH\u00abW^OJaaONfflOO>40\u00ab(NQWCSW^\u00abD\u00abW'*05<NCD^\nOOXWCNhtJhOWXO 0_W CQ \u00ab CO \u00ab O O X l> O X (NX i\u00ab O mt>OJMl>Tj*(MniOCOO\nHHr-lrHrHrnrH(N(N(N(N(N(NCQCQCOCQ^^IfJ\n(NCQTf<lO\u00a9l>XQOHO]CO^in\u00a9|>XQO^(>]CQ^iCiCt--X010HQ-lCQTt<\u00bb0\u00a9b-XffiO\ni>h-hr>M^t-i>GOXxcoxxciDcoX'a!ai\u00a9o:oo50ffio:C!050ooooooooOrt\nXXXXXXXXXXXXXXXXXXXXXXXXXXXXQOiaOOiG&QOlOiQOJ _\/\nG 12                               Public Hospital\nFOR  THE\nInsane.\n1911\nThe amount of revenue co\nand our Bursar, Mr. Macgowan\nthe very close attention given t<\npaid into the Government Agen\n1873\t\n1874\t\n1875  \t\nRevei\nlected at this ofi\n, and his assista\n3 this important\nt.\n$1,440 99\n680 00\n1,342 60\n730 31\n799 91\n479 42\n867 38\n1,433 04\n614 99\n505 18\n298 24\n98 35\nTOE.\nace during\nnt, Mr. Ca\nfeature.\n1892\n1893\n1894\n1895\n1896\n1897\n1898\n1899\n1900\n1901\n1902\n1903\n1904\n1905\nthe past year sett\nmbridge, are to be\nIn all $26,137.38\nup a new\ncongratu\nwas collec\n.   $2,418\n1,585\n2,709\n4,409\n3,741\n3,816\n4,003\n4,769\n6,893\n12,800\n10,926\n13,639\n.   15,004\n16,613\n19,058\n20,753\n25,807\n25,845\n26,137\n,356 25\n1 68\n46 72\n10 00\n94 50\n30 42\n2 00\n112 56\n37 50\n31 32\n235 10\nrecord,\nated on\nted and\n43\n40\n53\n23\n71\n80\n79\n04\n33\n76\n23\n64\n22\nlc\n42\n35\n83\n65\n38\n1876\t\n1877\t\n1878.\t\n1879\t\n1880\t\n1881\t\n1882\t\n1883 '\t\n1884\t\n1885\t\n1886\t\n1887\t\n1888\t\n1889\t\n50 00\n720 59\n750 00\n220 00\n599 24\n761  15\nGarden Peod\n1906\n1907\n1908\n1909\n1910\nuce\u2014Frui\n1890\t\n1891\t\nApples\t\nT.\n43,400 lb\n24\n584\n100\n1,350\n507    ,\n20    ,\n2,814\n1,200    ,\n522    ,\n2,351     ,\n13,286 lb\n3,008    .\n113    i\n71    i\n1,214\n3.         $1\n$1\ns.       $1\n$2\nPlums    \t\nRaspberries\t\nStrawberries\t\nTotal\nPork (dressed) used at\nii    sold alive  \t\nHome Farm Produce.\nInstitution\t\n,958 05\n,660 75\n150 00\n345 64\n73 45\n71 00\n424 90\nChickens, dressed....\nDucks,             ii     ....\nEggs, dozen\t\nTotal\n,725 74 1 Geo. 5\nPublic Hospital for the Insane.\nG 13\nGarden Produce\u2014Vegetables.\nBeets  8,868 lbs. $    88 68\nBeans, French  322    \u201e 16 10\nCarrots  9,059    \u201e 90 59\nCabbage  5,569    \u25a0\u25a0 22 67\nCauliflower  160    \u201e 16 60\nCelery  116 doz. 34 80\nCorn, sweet  409    \u201e 81 80\nCucumbers  2    n 50\nLeeks  650 lbs. 32 50\nLettuce  244 doz. 85 40\nOnions  594 lbs. 17 82\nParsnips  15,950    \u201e 159 50\nPeas, green  3,910    ., 234 60\nPotatoes  4,420    >, 44 20\nRadishes  1,520 bunches    60 80\nRhubarb  1,604 lbs. 80 20\nSpinach ,  1,873    \u201e 93 65\nTomatoes, ripe  100    ,. 15 00\nii        green    . 32    n 1 60\nTurnips ,  10,069    \u201e 100 69\nTotal  $1,277 70\nColonv Farm\u2014Vegetables.\nCabbage  2    tons $   160 00\nPotatoes  55      i, 1,320 00\nCarrots  26      \u201e 520 00\nParsnips  3      n 60 00\nBeets  &    ii 10 00\nMangolds  5      ., 110 00\nTurnips  121    \u201e 250 00\nApples .  15    boxes 15 00\nField peas  5    tons 175 00\nWheat  3      ,, 96 00\nOats, hay  40      \u201e 720 00\nButter  110    lbs. 33 00\nTotal , $3,469 00\nIt is pleasing to have this opportunity of expressing my gratitude and appreciation of all\nthe courtesies that have been extended to the Hospital and its patients by their numerous\nfriends 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\nare especially due to the publishers of numerous newspapers for their kindness in furnishing\nregularly and gratuitously copies of their publications.\nTo all the officers and employees of the Hospital who have so loyally and faithfully\nperformed their duties and made possible the success the Institution has attained, too much\ncannot be said in praise and appreciation. Their work is performed under conditions of trial\nand self-denial that are hardly appreciated by the public, except perhaps those who have by\npersonal experience or otherwise been brought into contact with insane persons. G 14\nPublic Hospital for the Insane.\n1911\nI am especially thankful to yourself and to the other Honourable Members of the Cabinet\nfor the helpful advice, assistance, and kind consideration that has so materially lightened the\nburden of the administration of the affairs of the Hospital.\nI have the honour to be,\nSir,\nYour obedient servant,\nC. E. DOHERTY,\nMedical Superintendent.\nLABORATORY   REPORT.\nLaboratory of Hospital for Insane,\nNew Westminster, B. O, December 31st, 1910.\nThe Medical Superintendent,\nPublic Hospital for Insane, New Westminster, B. C.\nSir,\u2014I have the honour to submit, herewith, the Annual Report of this Laboratory for the\nyear ending December 31st, 1910.\nOut of a total of forty-one deaths, autopsy has been performed upon eighteen bodies; the\npathological and microscopical findings of which will be found appended hereto.\nTwenty-two gross specimens from the autopsies have been preserved for museum purposes ;\na list of them is also appended.\nOn admission of each patient, the blood and urine are subjected to examination, and also\nduring residence if specially indicated. Sputa, stomach contents, etc., have also been examined\nin certain cases. Tables are appended which will show at a glance the number and results of\nthese various examinations.\nOn the completion of each investigation, the report is carefully and systematically placed\non file, so that we are rapidly compiling valuable statistics on our work, while each report can\nbe turned to at any future time, to demonstrate the clinical course or termination of the\nindividual case. It is, perhaps, needless to say that it is only from the statistics compiled from\nthe study of each patient, and the similarity or vagaries existing between two or more cases\nsuffering with the same form of insanity, that the latest theoretical methods for diagnosis have\nbeen based upon; the work done, in only one or two cases, no matter how thorough it may\nbe, bears no weight whatever in attempting to establish any authentic deductions, or to refute\nany theory already established.\nThe milk and water supplied to this Hospital have been submitted to analysis at least\nweekly, and food supplies when suggested. The results of these analyses are given in tables\nappended hereto.\nPathology.\nAt each autopsy sections are taken from various organs, hardened, cut, stained, and\nexamined microscopically, in order to ascertain the degree of degenerative changes, if any,\nexisting. 1 Geo. 5\nPublic Hospital for the Insane.\nG 15\nThe cerebro-spinal fluid is taken from each fatal case and put through a series of chemical,\nbio-chemical, and bacteriological tests, together with inoculation experiments on animals. So\nfar, our results do not allow us to offer any opinion or make any suggestions, but we are\nsystematically working and recording our findings, with the hope that some definite conclusion\nmay be arrived at in the near future.\nOf late the question has arisen as to whether we can say \" Without syphilis there is no\ngeneral paresis,\" or otherwise. Numerous papers have been read and published on this vexed\nquestion; in one, a well-known worker claims that general paresis cannot occur without\nprevious syphilis, while another investigator states that there is not yet sufficient proof to\nwarrant the syphilis-etiology theory of general paresis. The principal arguments on both\nsides are:\u2014\nSyphilis-etiology  Theory.\nFor.\n1. The Wassermann reaction occurs in 100\nper cent, of all cases of general paresis and\nsyphilis.\n2. The Argyll-Robertson pupil occurs only\nin these two diseases.\n3. The anatomical changes in these two\ndiseases are similar.\n4. These two diseases are much less common in females than in males.\n5. A history of hereditary syphilis is nearly\nalways given in cases of juvenile general\nparesis.\n6. It has never been known for a case of\ngeneral paresis to contract a chancre.\n7. Cases of general paresis inoculated with\nsyphilis give negative results.\n8. The fifteen-year period between the two\ndiseases.\n9. Signs of having had, or a history of\nsyphilis, is given with about 80 per cent, of\ncases of general paresis.\n10. The infiltrative changes i\u00bb the two\ndiseases are similar.\nAgainst.\n1. The Wassermann reaction is not biologically specific, occurring in some cases of scarlet\nfever, leprosy, and sleeping sickness.\n2. Only a very small percentage of syphi-\nlitics develop general paresis.\n3. The Treponema pallidum has never been\ndemonstrated in general paresis.\n4. Where syphilis is widespread among the\nnatives of parts of Africa and India general\nparesis is unknown.\n5. The scarcity of general paresis in India\nand China, where syphilis has existed for\nthousands of years.\n6. Many cases of cerebral syphilis yield to\nantisyphilitic treatment.\n7. Anti-syphilitic treatment does not affect\nthe course of general paresis.\n8. The long interval between syphilis and\ngeneral paresis, and our limited knowledge of\nprotozoal evolutions.\n9. No signs of having had, nor a history o*\nsyphilis, can be obtained in about 20 per cent-\nof cases of general paresis.\n10. Infiltrative changes in other chronic\ninflammatory conditions are similar.\nThe Wassermann reaction is the strongest presumptive evidence yet produced in favour\nof the luetic origin of general paresis. That this reaction occurs in a few cases of scarlet\nfever, sleeping sickness, and leprosy is claimed to be no more argument against its specificity\nthan that the typhoid agglutination reaction of Widal occurs in cases of icterus and ptomaine\npoisoning, and is explained as being merely a phenomenon of interaction between lipoids.\nAs is well-known, typhoid serum plus bacillus typhosus will bind complement. It is\nperfectly just to surmise that a syphilitic serum plus the syphilitic inciter will also bind\ncomplement. Wassermann thought that, in the absence of culturable organisms, extracts from\nthe liver of syphilitic foetuses will admirably fulfill all the functions of a specific antigen.\nWhen tried in the actual test, this really proved of great efficiency. A few years later its\nspecificity 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\nPublic Hospital for the Insane.\n1911\nsyphilitic livers. It was also shown that extracts from non-syphilitic organs, and substances\nwhose composition does not in the least justify the appellation of antigen, were capable of\ndeviating complement when brought in contact with specific sera.\nFrom all the evidence brought forward during the last two years, we are probably\njustified in concluding that:\u2014\n1. The weight of evidence is in favour of syphilis as an essential cause of general paresis,\nand, if a history of the disease is not obtained, we are probably justified in supposing, either\nthat the infection has been so slight as to escape notice, or that it was inherited.\n2. Alcohol, trauma, and other factors merely play the part of lowering the general\nresistance, as they do to any disease.\n3. Whether the occurrence of general paresis, after syphilis, is determined by a\nconstitutional predisposition, by a special form of virus, or by the incidence of some other\nfactors, is not yet clear.\n4. General paresis must still be regarded as a metasyphilitic disease rather than a true\nsyphilis.\nIn addition to the above routine work, many miscellaneous examinations of sections,\nsmears, etc., have been made as aids to diagnoses.\nGross Specimens Added to Museum.\n1. Brain, cerebral haemorrhage.\n2. Lung, tubercular cavities.\n3. Lung, collapsed and tubercular nodules.\n4. Brain, convolutional atrophy.\n5. Kidney, carcinoma.\n6. Liver, portal cirrhosis.\n7. Kidney,  cortical cysts.\n8. Brain, dilatation of ventricles.\n9. Liver, nutmeg.\n10. Coecum, perforation.\n11. Brain, convolutional atrophy.\n12. Lung, anthracosis.\n13. Heart, sclerosis of valves.\n14. Uterus and ovaries, cystic.\n15. Heart, chlorosis.\n16. Suprarenals, fatty degeneration.\n17. Liver, fatty degeneration.\n18. Kidney, pelvis dilated.\n19. Lung, tubercular.\n20. Intestine, tubercular.\n21. Sternum, fracture of.\n22. OEsophagus and trachea, laryngeal obstruction from piece of impacted, regurgitated,\nand unmasticated meat.\nSummary of Autopsy Reports.\n1. Manic Depressive Insanity :\n2531. F. T. S., female, set. 36, married, housewife, first admission. Duration of\npsychosis, about two years.    Cause of death, general debility.  1 Geo. 5\nPurlic Hospital for the Insane.\nG 17\nClinical Report.\u2014Admitted 22nd December, 1909. From history received, psychosis\nhad existed for about two years prior to her admission ; first noticed by her reserved manner\nand refusing to meet her old friends. Later on she developed persecutory delusions, and\ngradually deteriorated physically. Physical examination ; poorly nourished, mucus membranes\npale, skin d^', tongue coated, showing slight tremors; pupils dilated but equal, and react to\nlight and accommodation, although they are rather sluggish ; patellar reflexes diminished \u2022\nexamination of lungs negative; examination of heart shows a mitral murmur, but no cardiac\nenlargement. From the time of her admission patient gradually became more and more\nstupid, until finally it was necessary to rouse her to give nourishment, and during the last\nfifteen days she remained in a state of coma, from which she could be aroused with great\ndifficulty, and could only take a small amount of nourishment. Died suddenly about fifteen\nminutes after taking a cup of beef tea on 25th January, 1910.\nPathological Report.\u2014Permission for a complete autopsy could not be obtained. Slight\noedema of lower limbs ; no marks on body ; sordes on teeth and lips. Cranial bones compact;\ntenacious adhesions of the dura to the skull and arachnoid over the parietal verices ; dura\nthickened and tough ; diffuse opacity of the arachnoid ; no marked increase of subdural\nor subarachnoidean fluid; pia adherent generally, but most marked in frontal lobes.\nBrain\u2014weight, 1,256 grms.; some cedema of convolutions most marked in frontal lobes.\nHeart\u2014weight, 238 grms. ; moderate sclerosis of the aortic valve ; no atheroma of aorta.\nLeft lung\u2014weight, 540 grms.; normal.\nMicroscopical Report.\u2014Moderate chromatolytic changes in some of the nerve cells;\ncentral canal of the cord filled with proliferated epithelial cells; round cell infiltration of the\ndura, completely occluding some of the vessels and perivascular spaces, and all of the\nperivascular spaces more or less filled with them. Cerebro-spinal fluid negative to Noguchi\ntest.\n2. General Paralysis :\n2396. Male, set. 52, single, carpenter, first admission. Duration of psychosis, ten months.\nCause of death, peritonitis.\nClinical Report.\u2014Admitted 29th May, 1909, from the Provincial Gaol, where he was\nserving a term for vagrancy; has marked delusions of grandeur and is unsteady in his gait.\nSent to the infirmary ward ; physical examination showed skin moist, well nourished, tongue\nfurred and tremorous; pupils react slightly to accommodation, but not to light; radial\narteries sclerosed; patellar reflexes absent; marked Rhomberg present; examination of heart\nand lungs negative. From the time of his admission until the 1st January, 1910, patient\nshowed a steady progression in paresis, but at this time developed symptoms of appendicitis,\ntemperature running about 101-102, pulse rapid, tenderness over McBurney's point, rigidity\nover all right abdomen. These symptoms gradually disappeared during the next few weeks,\nbut patient's physical condition deteriorated rapidly, and on attempting to get out of bed\npatient collapsed, dying about five hours later on 26th March, 1910.\nPathological Report.\u2014Abdomen distended and tympanitic.    Cranial bones cancelleous ;\ndura adherent over the frontal and parietal bones; diffuse opacity of the arachnoid which is\nmore or less adherent to the brain substance ; marked increase of subdural and subarachnoidean\nfluid.    Brain\u2014weight, 1280 grms. ; consistency firm; ventricles dilated; ependyma granular\nthroughout; basal vessels atheromatous ; posterior columns of the cord gray.    Lungs\u2014weight,\nleft  449 grms. ; right 510 grms. j  costal  cartilages ossified;  extensive  pleuritic  adhesions\nthroughout both pleural cavities; lower lobe of right lung semi-solid and almost in a condition\nof red hepatization ; anthracosis of both lungs.    Heart\u2014weight, 354 grms ; moderate sclerosis\n2 G 18\nPublic Hospital for the Insane.\n1911\nof the aortic and mitral valves ; muscles firm and numerous ; whitish streaks throughout the\nsubstance; moderate amount of epicardial fat; arterio-sclerosis and atheromatous degeneration\nof the arteries. Spleen\u2014weight, 283 grms.; splenic artery large, tortuous, thickened and\natheromatous. Liver\u2014weight, 1,417 grms. ; firm adhesions to diaphragm; pale and\ncommencing nutmeg in appearace. Kidneys\u2014weight, left 130 grms.; right 150 grms.; pale\nin colour, numerous cortical cysts; considerable pelvic fat; capsule strips readily; pelves\ndilated; ureters dilated and distended with urine. Pancreas\u2014weight, 106 grms. Thyroid\ngland\u2014weight, 27 grms. Peritoneal cavity contains about 800 c. c. bloody serous fluid;\nperitoneum red and intensely congested, most marked in the lower part and on right side;\nsmall intestines distended with gas; caecum distended and slightly gangrenous; mesenteric\nand retroperitoneal glands not enlarged ; caecum contained several old perforations which had\nbecome walled off from peritoneal cavity by a fibrous tissue growth, attached to csecum and\nmesentery ; caecum and about 4 feet of the small intestine intensely congested ; appendix\nthickened and congested but empty.\nMicroscopical Report.\u2014Extensive chromatolytic changes in the nerve cells ; proliferation\nof the ependyma epithelium ; sclerosis of the posterior columns of the cord and of the posterior\nroots and ganglia. Chronic myocarditis ; moderate arterio-sclerosis and irregular atheromatous\ndegeneration of the arteries. Extensive diffuse nephritis, the arterio-sclerotic and parenchymatous changes predominating. Fatty degeneration of the pancreas. Tendency to cystic\ndilatation of many of the thyroid gland vesicles. Intense engorgement of the liver with some\ncirrhosis.\nS. General Paralysis :\n2545.    A. R., male, aet. 60, married, first admission.    Cause of death, general paresis.\nClinical Report.\u2014Admitted 9th January, 1910, with marked symptoms of advanced\nparesis. Physical examination ; fairly well nourished ; tongue clean and tremorous; tremors of\nfacial muscles; pupils irregular and sluggish ; Rhomberg present ; writing characteristic of a\nparetic; patellar reflexes exaggerated, otherwise physical examination negative. Patient's\ncondition rapidly deteriorated until the time of his death on 16th April, 1910.\nPathological Report.\u2014Cranial bones thin and compact; dura moderately adherent to the\ncranial bones; numerous vascular connections of the dura to the arachnoid ; diffuse opacity\nof the arachnoid ; great increase of subdural and subarachnoidean fluid. Brain\u2014weight, 1,346\ngrms. ; general atrophy of the convolutions; granulations of the fourth ventricle; moderate\natheromatous degeneration of the basal vessels; ventricles dilated and distended with fluid.\nHeart\u2014weight, 314 grms. ; right ventricle dilated and contains a pinkish looking coagulum\nmore or less firmly adherent to the endocardium ; sclerosis of the margins of the mitral valves\nand in the bodies of the aortics; moderate atheromatous degeneration of the arteries.\nLungs\u2014weight, left 238 grms.; right 320 grms. ; some firm pleuritic adhesions in left pleural\ncavity; no fluid; lungs slightly doughy in consistency, ooze considerable frothy fluid on\nsection; subpleural pigmentation. Spleen\u2014weight, 140 grms. ; moderately firm on section.\nLiver\u2014weight, 1,574 grms.; oozes considerable blood on section; cut surface of a mottled\nyellowish red colour showing areas of fatty degeneration. Kidneys\u2014weight, left 138 grms.;\nright, 142 grms.; several cortical cysts; moderately firm on section; pale in colour; pelvis\ndilated ; pelvic mucosa congested ; capsule strips readily.    Other abdominal organs normal.\nMicroscopical Report.\u2014Extensive diffuse chromatolytic changes in the nerve cells;\nextensive perivascular round cell infiltration, practically occluding some of the vessels \u2022\nnumerous hyaline bodies in the choroid plexus. Moderate sclerosis of the blood-vessels.\nMany vesicles of the thyroid gland filled with proliferated epithelial cells. Engorgement of\nthe liver.    Hyperplasia of the malpighian bodies of the spleen.    Chronic diffuse nephritis. 1 Geo. 5\nPublic Hospital for the Insane.\nG 19\nJf.  General Paralysis :\n1066. A. McD., male, aet. 49, married, farmer, first admission. Cause of death, general\nparalysis.\nClinical Report.\u2014Admitted 16th August, 1900, with delusions of grandeur which had\nextended over some time prior to his admission; had shown a tendency to squander his\nearnings and on this account was committed. During the first few years of his residence\npatient showed little, if any, change, and then became dirty in habits, apparently losing all\ncontrol of his bladder ; speech affected until in the latter stages he was unable to articulate,\nand during the last two years was confined to his bed, having had slight seizures at intervals\nduring that time, from which he apparently made a perfect recovery each time. During the\nlast few days he had numerous seizures which were the immediate cause of his death on\n19th May, 1910.\nPathological Report.\u2014Scalp thick ; cranial bones compact and ^-inch thick ; dura adherent\nover the frontal and parietal bones, with numerous vascular connections to the arachnoid ;\ndiffuse opacity and increased thickness of the arachnoid, with adhesions to the brain\nsubstance; large quantity of subdural and subarachnoidean fluid. Brain\u2014weight, 1,380\ngrms.; atrophy of the convolutions of both frontal lobes ; extensive atheromatous degeneration\nand thickening of the basal vessels; ventricles extremely dilated and distended with fluid,\nthere being a layer of tissue of only about 1 cm. in thickness between the inner surface of the\nventricles 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\nMunroe 1 cm. in diameter; ependyma granular throughout; choroid plexus cystic. Thorax\nand abdomen not examined.\nMicroscopical Report.\u2014Extensive chromatolytic changes in the nerve cells with diffuse\nstaining; intense round cell infiltration of the pia, and more or less of the pial prolongations\ninto the brain substance; many hyaline bodies in the choroid plexus.\n5. General Paralysis :\n2630.    A. McL, male, set. 60, first admission.    Cause of death, general paralysis.\nClinical Report.\u2014Admitted 22nd May, 1910; physical examination negative; condition\nfair ; shows pronounced symptoms of paresis, and during his residence in hospital was confined\nto his bed, having no control over his sphincters. Patient's condition rapidly failed until the\ntime of his death on 18th November, 1910.\nPathological Report.\u2014Cranial bones compact; dura firmly adherent generally; increase\nof subdural and subarachnoidean fluid; opacity of arachnoid. Brain\u2014weight, 1,234 grms.;\ngeneral atrophy of the convolutions; moderate atheromatous degeneration of the basal vessels\nwith thickening of most; ventricles dilated and distended with fluid. Heart\u2014weight, 320\ngrms.; sclerosis of the mitral and aortic valves ; moderate atheromatous degeneration of the\narteries. Lungs\u2014weight, left 220 grms.; right 315 grms.; considerable subpleural\npigmentation. Spleen\u2014weight, 132 grms.; moderately firm on section. Liver\u2014weight,\n1,462 grms.; oozes considerable blood on section, and is of a mottled yellowish-red colour,\nshowing areas of fatty degeneration. Kidneys\u2014weight, left 125 grms.; right 132 grms.;\nmoderately firm on section ; capsules adherent; considerable pelvic fat. Other abdominal\norgans normal.\n6. Melancholia :\n2128.    F. P., male, aet. 52, married, miner, first admission,\nobstruction from impacted, regurgitated and unmasticated food.\nCause of death, laryngeal G 20\nPublic Hospital for the Insane.\n1911\nClinical Report.\u2014Admitted 19th March, 1908; very depressed. From history received\npsychosis extended back a year or so. Physical examination ; patient poorly nourished ; skin\nsallow ; otherwise negative. During his residence patient never brightened up at any time,\ngradually becoming more demented ; on one occasion made an attempt to strangle himself, but\nwas found before any damage was done. On November 3rd, 1910, patient bolted a large piece\nof meat, which became impacted in his oesophagus ; being unable to remove this, it was forced\ndown with tube into stomach, and patient was taken to the ward and put in charge of a special,\nand appeared to be perfectly normal. About twenty minutes later he regurgitated the piece\nof meat, which became impacted in the larynx, causing his death before assistance could be\nhad.\nPathological Report.\u2014Rather poorly nourished. Brain not examined. Heart\u2014weight,\n300 grms.; several sclerotic patches in the epicardium; moderate sclerosis of the mitral and\naortic valves. Lungs\u2014weight, left 320 grms.; right 340 grms.; extensive subpleural\npigmentation ; bronchial glands enlarged and deeply pigmented. The larynx occluded above\nthe thyroid cartilage by a mass in the oesophagus, which proved to be a piece of meat; the\noesophagus below the obstruction is dilated but empty ; stomach empty. Spleen\u2014weight,\n65 grms.; firm on section; capsule thick and rough. Liver\u2014weight, 1,250 grms.; firm\nadhesions to the diaphragm; firm on section. Kidneys\u2014weight, left 155 grms.; right 145\ngrms.; moderately firm on section ; cortex pale ; medulla deep-red colour ; considerable pelvic\nfat; capsule strips readily. Prostate enlarged, the middle lobe projecting into the neck of\nthe bladder.\n7. Melancholia :\n2542. S., aet. 25, Hindoo, single, farmer, first admission. Cause of death, tuberculosis\nof lungs.\nClinical Report.\u2014Admitted 6th January, 1910. Physically his health prior to admission\nwas poor; on examination patient was emaciated, skin dry and hot; examination of lungs\nfound both very markedly involved; otherwise physical examination negative. The consolidation rapidly increased and patient died in three days on 9th January, 1910.\nPathological Report.\u2014Fairly well nourished. Cranial bones hard, but not thickened ;\ndural adhesions over parietal verices. Brain\u2014weight 1,435 grms. Lungs\u2014weight, left 916\ngrms.; right 1,070 grms.; left lung nodular and on section shows tubercular infiltration; some\nhypostratic congestion posteriorly; bronchial mucosa congested ; bronchial glands enlarged and\npigmented. Right lung, firm pleuritic adhesions at apex and base; pleura thickened; a local\ncollection of purulent fluid in the apex; extensive diffuse, irregular, nodular infiltration, with\nextensive degeneration and cavity formation ; portion of upper lobe underlying the purulent\ncollection is collapsed, airless and of a splenic-like consistency; bronchial mucosa swollen,\nthickened, congested and covered with a viscid mucopurulent secretion; bronchial glands\nenlarged, pigmented and caseate; some solid areas of lower lobe of a pneumonic appearance,\nand on section ooze a bloody fluid with some intervening areas of a doughy character.\nMicroscopical Report:\u2014Smears from both lungs show T. B. Portions of the lungs show\ndense tubercular infiltration, with more or less degeneration; other portions show intense\nengorgement of the vessels, with rupture of some and filling of the vesicles with blood; other\nportions more or less emphysema; considerable perivascular and peribronchial pigmentary\ninfiltration;   chronic bronchitis and peribronchial consolidation;   hyperplasia of the lymph\nfollicles and tubercular infiltration of the bronchial glands.\n8.  Terminal Dementia :\n1268.    M.  E, male,\nhaemorrhage.\naet. 67, single, sailor, first admission.    Cause of  death,   cerebral  1 Geo. 5\nPublic Hospital for the Insane.\nG 21\nClinical Report.\u2014Admitted 7th July 1902 ; very well nourished ; showed a mark mental\ndeterioration and was almost imbecilic. This condition has existed from the time of his\nadmission until the time of his death on 2nd January, 1910. At various times has shown the\nresult of a severe malarial infection.\nPathological Report.\u2014Emaciated ; cranial bones hard but not thickened ; tenacious dural\nadhesions over parietal verices; increase of subdural fluid ; dura somewhat thickened and\ntough ; opacity of arachnoid with some white spots and bands; pia generally adherent.\nBrain\u2014weight, 1,380 grms. ; vessels on left hemisphere of cerebrum congested and engorged;\nsmall haemorrhage round left cerebellum, and rupture of one of the small arteries from the\nbasilar artery ; basilar artery shows marked sclerosis with atheromatous degeneration. Other\norgans not examined.\nMicroscopical Report.\u2014Moderate degenerative changes in the nerve cells ; central canal\nof the cord filled with proliferated epithelial cells, which also infiltrate the surrounding central\ngelatinous 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\nthe vessel walls, particularly the media; in the cerebellum there is diffuse subpial haemorrhage\nextending into, and infiltration of the cortex and underlying white matter; in other portions\nthe perivascular spaces and blood vessels show a leukocytic accumulation and infiltration.\n9.  Terminal Dementia :\n1571. A. G., male, Bet. 61, single, labourer, first admission. Cause of death, general\ndebility.\nClinical Report.\u2014Admitted 27th November, 1904. Physical condition fair; inclined to\nbe aggressive and irrational in conversation ; some slight swelling on right hand and right\nfoot. During the first few years of his residence, showed but slight if any change in mental\ncondition, but from the early part of 1907 he gradually became more and more demented, with\nperiods of excitement; gait became spastic, and for several months prior to his death on 22nd\nJuly, 1910, he was very unsteady and had to be confined to his bed the greater part of the\ntime.\nPathological Report.\u2014Cranial bones thin and rather cancellous; extensive dural adhesions;\npatchy opacity of the arachnoid; increase of subdural and subarachnoidean fluid. Brain\u2014\nweight, 1,180 grms.; general atrophy of the convolutions; more or less granulations of\nopendyma throughout; moderate atheromatous degeneration of the basal vessels ; spinal dura\nmore or less firmly adherent to the vertebra, particularly to the first thoracic, which is very\nprominent; beneath the adhesions to the latter is a necrotic cavity, the cord underlying it is\nsoft, the gray and white matter indistinguishable more or less throughout, more so in the\nlower cervical and upper dorsal region, the gray matter being rather reddish in colour.\nSternum fractured between sixth and seventh ribs and a pocket of pus formed around broken\nends of bone ; intercostal muscles and pericardium engorged. Heart\u2014weight, 510 grms. \u2022\nfirm pericardial adhesions over the posterior surface of the right ventricle ; extensive hyper,\ntrophy ; large quantity of epicardial fat; sclerosis and some atheroma of the mitral valves,\nwith calcareous deposit in the body of the anterior nitral cusp; moderate arterio-sclerosis.\nLungs\u2014weight, left 380 grms.; right 420 grms.; extensive anthracosis. Spleen\u2014weight,\n102 grms.; lower extremity lobulated; capsule thickened; malpighian bodies distinct;\nmoderately firm on section. Liver\u2014weight, 1,630 grms.; numerous adhesions to the\ndiaphragm and of the gall bladder to the colon ; rather soft on section; oozes considerable\nblood ; biliary staining about the biliary capillaries ; foci of whitish-yellow colour and somewhat softer in consistency.    Kidneys\u2014weight, left 160 grms.; right 150 grms. ; a few subcap- G 22\nPublic Hospital for the Insane.\n1911\nsular cysts ; firm on section; cortex pale in colour; pyramids dark ; very little pelvic fat;\ncapsule tears the substance on removal, and surface has then a rough granular appearance.\nPancreas\u2014weight, 136 grms. ; firm and nodular throughout.    Thyroid gland\u2014weight, 90 grms.\nMicroscopical Report.\u2014Diffuse staining and extensive chromatolytic changes of the nerve\ncells; spinal cord more or less engorged, and almost complete destruction, showing only as a\ngranular debris-like formation. Chronic myocarditis; fatty infiltration of the right ventricle;\nextensive atheromatous degeneration of the arteries. Great irregularity in size of the thyroid\ngland vesicles, with many of the smaller ones filled with epithelial cells. Malpighian bodies\nof the spleen dense and stain deeply. Chronic venous congestion of the liver. Extensive\ndiffuse nephritis.\n10. Terminal Dementia :\n1506. F. J., male, aet 81, single, labourer, first admission.    Cause of death, senility.\nClinical Report.\u2014Admitted 5th April, 1904; quite depressed, due to his persecutory\ndelusions; physical examination negative. A few weeks after admission it was necessary to\nfeed him, as he absolutely refused to take any nourishment himself. This continued at\nintervals until the early part of 1905, when his sight became very poor, and by January, 1906i\nhe was totally blind, due to senile cataract. From that time until the time of his death on\n24th October, 1910, he at intervals became depressed, in which it was necessary to feed him\nwith tube. During the last few months patient lost control of his sphincters and rapidly\nbecame emaciated.\nPathological Report.\u2014Moderate oedema of the lower limbs. Cataracts of both eyes.\nScalp thick; cranial bones thick and cancellous; dura diffusely adherent throughout; diffuse\nopacity of the arachnoid; increase of subdural and subarachnoidean fluid. Brain\u2014weight,\n1,390 grms.; basal vessels extensively atheromatous and calcareous; bony plates in the\nanterior walls of the superior longitudinal sinus ; lateral ventricles dilated; large bony plate\nsize of half-dollar, with needle-like projections, firmly adherent to dura and right olfactory\npeduncle, lying in longitudinal fissure between frontal lobes; choroid plexus cystic. Heart\u2014\nweight, 320 grms. ; sclerotic patches in the epicardium ; extensive fatty infiltration ; chronic\nmyocarditis; marked sclerosis of the mitral and aortic valves, with extensive calcareous\ninfiltration at the bases; extensive atheromatous degeneration of the arteries, with calcareous\ninfiltration and numerous foci of atheromatous ulceration. Lungs\u2014weight, left 265 grms.;\nright 230 grms. ; firm pleuritic adhesions in the right side; cicatrical contraction of the right\napex; calcareous nodules in both apices; dilatation of the marginal lobules; extensive\nsubpleural blackish pigmentation ; bronchial glands enlarged and pigmented. Liver\u2014weight,\n1,055 grms. ; rather soft in consistency. Kidneys\u2014weight, left 155 grms.; right 180 grms.;\nfirm on section; dark red in colour, the pyramids more so than the cortex; moderate amount\nof pelvic fat; capsule adherent, tearing the substance on removal. Spleen\u2014weight, 110\ngrms.; firm on section; capsule thick and rough. Thyroid gland\u2014weight, 60 grms.; firm\nand rather lobular. Pancreas\u2014weight, 80 grms.; splenic artery rigid, dilated, tortuous and\ncalcareous.\nMicroscopical Report.\u2014Extensive degenerative changes in the nerve cells. Extensive\nchronic myocarditis; extensive arterio-sclerosis and atheromatous degeneration, calcareous\ninfiltration and ulceration of the arteries. Chronic venous congestion of the liver and some\ncirrhosis. Dilatation of some of the vesicles of the thyroid gland with cellular infiltration of\nmany of them.\n11. Dementia Prcecox:\n1725. W. T. B., male, set. 25, single, labourer, first admission. Cause of death,\ntuberculosis of the lungs. 1 Geo. 5\nPublic Hospital for the Insane.\nG 23\nClinical Report.\u2014Admitted 7th February, 1906; fairly well nourished; very unkempt\nin appearance (patient resembles twin brother in every way who was admitted about two\nmonths ago); patient has been a typical dementia praecox case, going through the various\nphases with marked regularity, and for several months previous to his death on 6th January,\n1910, was in a semi-katatonic condition.\nPathological Report.\u2014Emaciated. Cranial bones not thickened ; dural adhesions over\nparietal verices; opacity of and a few white spots on arachnoid; subarachnoidean fluid\nslightly increased. Brain\u2014weight, 1,414 grms. ; slight convolutional atrophy of both frontal\nlobes. Heart\u2014weight, 255 grms.; muscle pale ; clot in left ventricle. Lungs\u2014weight, left\n821 grms., right 963 grms.; left lung adherent at apex; large tubercular cavity at apex, and\non section shows typical tubercular cavity formation and infiltration ; cavities full of foul-\nsmelling pus and \"cheesey\" matter. Right lung adherent at apex; typical tubercular cavity\nformation at apex with infiltration of middle and upper lobe with pus and \" cheesey \" particles ;\nnodular; pleura thickened; lower lobe congested. Liver\u2014weight, 1,303 grms.; engorged;\ncapsule adherent. Spleen\u2014weight, 141 grms.; malpighian bodies prominent; capsule\nadherent. Kidneys\u2014weight, left 148 grms., right 152 grms.; cortex pale and capsules\nadherent. Intestines not ulcerated but somewhat congested for about 3 feet up small intestine\nfrom caecum.    Some mesenteric glands enlarged and hard.\nMicroscopical Report.\u2014Diffuse staining of the nerve cells with Nissl's soapy methylene-\nblue ; atrophy frontal lobes. Extensive massive tubercular infiltration of the lungs; some\nintervening emphysema, engorgement of the alveolar capillaries ; hyperplasia of the lymph\nfollicles, pigmentation and tubercular infiltration of the bronchia] glands. Extensive increase\nof fibrous tissue in the thyroid gland, vesicles small and mostly filled with proliferated\nepithelial cells, a circumscribed mass made up of epithelial cells arranged more or less into\nalveoli, with a fibrous tissue framework carrying the blood-vessels, surrounded by a capsule of\nfibrous tissue. Intense engorgement and fibrous tissue increase in the pituitary body.\nHyperplasia of the malpighian bodies of the spleen. Slight diffuse increase of fibrous tissue\nin the pancreas.\n12. Dementia Prcecox :\n2261.    F. S., female, set. 22, single, servant, first admission.    Cause of death, chlorosis.\nClinical Report.\u2014Admitted 26th September, 1908 ; impossible to obtain a history, as\npatient is unable to speak English. Physical examination; skin moist; sallow ; feet and legs\npuffy, also a symmetrical enlargement of the thyroid; mucous membranes pale; tongue\nslightly coated ; otherwise physical examination negative. From the time of her admission\nuntil September, 1909, patient did not show any change, either mentally or physically, but\nduring the next few months she became very anaemic, and was a typical case of chlorosis with\npulmonary murmur; was confined to bed and treated with Pil. Blauds Co. for three months\napparently making a perfect recovery, but in March, 1910, she again showed symptoms of\nchlorosis which did not react to treatment, and she gradually failed until the time of her\ndeath on 13th April, 1910.\nPathological Report.\u2014Apparently well nourished, but extremely anaemic. Brain not\nexamined. On opening up body, not a drop of blood escaped. Considerable fat generally.\nHeart\u2014weight, 318 grms.; moderate amount of epicardial fat; moderate increase of\npericardial fluid; right side somewhat dilated; patent foramen ovale; right ventricle\ncontained a large serous clot of gelatinous consistency. Lungs\u2014weight, left 645 grms.,\nright 429 grms.; pale in colour; moderate congestion at margin of lower left lobe-\nLiver\u2014weight, 1,559 grms.; pinkish in appearance ; on section pale; capsule strips only with G 24\nPublic Hospital for the Insane.\n1911\ntearing of tissue. Spleen\u2014weight, 134 grms.; dark-coloured on section and friable ; malpighian bodies prominent; capsule adherent. Kidneys\u2014weight, left 162 grms.; right 162 grms.,\nmoderately adherent to the pirirenal tissues; firm on section and pale in colour; considerable\npelvic fat; capsule strips, but leaves a rough surface; suprarenals enlarged. Bladder\ndistended with urine. Large cyst in the left ovary, containing about 25 c. c. of clear serous\nfluid; right ovary enlarged and in a fibrous condition; blood clot in uterus. Appendix three\ninches long, and hanging into the pelvic cavity; mesenteric glands not enlarged, but\nmesentery and omentum very fatty.\nMicroscopical Report.\u2014Aortitis; hypoplasia of heart and aorta. Fatty changes in the\nsuprarenals.\nIS. Dementia Prcecox :\n2308.    E. A. O, male, set. 33, single, logger, first admission.    Cause of death, tuberculosis.\nClinical Report.\u2014Admitted 5th January, 1909; psychosis extending back several\nmonths prior to admission; physical examination negative. For a few months after his\nadmission he was depressed and delusional, refusing to do any work; but during the latter\npart of 1909 he worked very well outside. In the early part of March, 1910, submaxillary\nglands 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\ncuretted. In the latter part of July examination of lungs showed them both affected, and\nhe was running an even temperature. About the 10th August patient complained of dull\npain over abdomen, with slight distension; this condition gradually became more marked,\nuntil the time of his death on 28th October, 1910, when his abdomen was very much\ndistended, both lungs completely involved, and glands of neck still discharging.\nPathological Report.\u2014Emaciated ; abdomen greatly distended and tympanitic. Cranial\nbones moderately firm; dura moderately adherent; slight diffuse opacity of the arachnoid ;\nslight increase of subarachnoidean fluid. Brain\u2014weight, 1,220 grms. Heart\u2014weight, 240\ngrms.; extensive hypertrophy; slight arterio-sclerosis. Lungs\u2014weight, left 390 grms., right\n385 grms.; left cavity full of clear yellowish fluid ; has several bands of fibrous adhesions ; left\nlung collapsed, solid and airless; lower lobe firm on section and has a splenic-like appearance \u25a0\nupper lobe contains some abscess cavities filled with \" cheesey\" and calcareous material.\nRight lung is doughy, of a boggy consistency; crepitation is decreased ; mottled light and\ndark-red in colour; cheesey nodules in apex; bronchial mucosa swollen and congested, the\nsmaller ones softened and filled with a mucopurulent fluid ; bronchial glands enlarged, more or\nless caseated, and infiltrated with calcareous material. Liver\u2014weight, 1,450 grms.; fatty and\noily on section; firm adhesions to diaphragm and stomach covered with a fibrino-plastic\nexudate. Spleen\u2014weight, 250 grms.; hyperplasia of the malpighian bodies. Kidneys\u2014\nweight, left 160 grms., right 160 grms.; enlarged; firm on section; pale in colour; cortex\nwidened; increased pelvic fat; capsule strips with difficulty and tears the kidney substance.\nPeritoneal 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\ndistended with gas, the stomach lying anterior to the transverse colon with the pylorus lying\nbeside the gall-bladder; typical tubercular ulcerations involving the whole canal from the\njejenum to the sigmoid colon ; extensive hyperplasia and caseation of the mesenteric glands .\nthe whole of the peritoneum covered with typical white tubercular nodules.\nMicroscopical Report.\u2014Moderate diffuse chromatolytic changes in the nerve cells. Extensive tubercular consolidation of the lungs with areas of necrosis and softening. Hyperplasia\nof  the  mesenteric  and   bronchial glands  with tubercular infiltration.    Typical tubercular i\ni\ns 1 Geo. 5\nPublic Hospital for the Insane.\nG 25\ninfiltration of the intestinal walls with the hyperplasia of the lymph follicles. Extreme fatty\ndegeneration, venous congestion and tubercular, nodular infiltration of the liver. Tubercular\ninfiltration of the spleen.    Subacute diffuse nephritis.\n11\/.. Imbecility :\n1973.    C. D. W., female, set. 20, half-breed, first admission.    Cause of death, pneumonia.\nClinical Report.\u2014Admitted 22nd July, 1907; physical condition good; is a high-grade\nimbecile. During her residence in hospital patient would go a month at a time without\nspeaking. About 1st March patient developed a cough with gradual emaciation, and\nexamination of lungs showed both affected; from that time patient gradually failed until her\ndeath on 28th May, 1910.\nPathological Report.\u2014Emaciated. Brain not examined. Both pleural cavities obliterated\nby firm, dense adhesions; pericardium adherent to pleura generally; pleura thickened; lobes\nadherent. Right lung\u2014weight, 595 grms.; shows irregular areas of consolidation, with the\nintervening tissue cedematous and boggy ; the solid areas are dark-red in colour, splenic-like\nin appearance and consistency on section; there is no cavity formation or pus, but the whole\nlung is diffusely and irregularly nodular, many of which are caseous and creamy. Left\nlung\u2014weight, 506 grms.; collapsed and airless ; pale in colour on section; extensive diffuse,\nirregular, nodular infiltration, the nodules being caseous and creamy ; bronchial mucosa deeply\ncongested, swollen, softened and covered with a frothy, viscid secretion; bronchial glands\nenlarged, softened, and pigmented; tracheal glands and laryngeal mucosa congested;\nmediastinal glands enlarged, and some are^callous. Heart\u2014weight, 222 grms.; enlarged;\ncavities dilated; moderate quantity of epicardial fat. Spleen\u2014weight, 300 grms. ;\nrather soft and friable; bleeds considerably on section; malpighian bodies prominent.\nLiver\u2014weight, 1,750 grms.; foci of dull, yellowish-red colour; consistency softened.\nKidneys\u2014weight, left 130 grms., right 115 grms.; moderately firm on section ; pale in colour;\nsmall quantity of pelvic fat; in the cortex of the left is a small firm nodule, white centrally,\nsurrounded by a zone deeply injected, not encapsulated. Thyroid gland\u2014weight, 30 grms.\nOmentum adherent to the anterior pelvic wall from the posterior surface of the bladder near\nthe apex to the pelvic brim; rectum and uterus drawn over to the right half of the pelvic\ncavity and firmly bound by a mass of adhesions filling the whole pelvic cavity; extensive\ntubercular nodules scattered throughout the small intestine, most marked in the ileum,\nwhere there is also some ulceration ; diffuse enlargement of the mesenteric and retroperitoneal\nglands.\nMicroscopical Report.\u2014Chronic myocarditis. Diffuse miliary and chronic tubercular areas\nof 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\nepithelial cells more or less alveolated with a fibrous tissue stroma, circumscribed by a more\nor less deeply engorged fibrous capsule, cells resembling the cortical cells of the adrenals.\nChronic venous congestion, some fatty infiltration and some portal cirrhosis of the liver.\nIntense engorgement of the spleen and hyperplasia of the malpighian bodies. Typical\ntubercular infiltration of the intestines in all stages of formation and degeneration.\n15. Senile Dementia :\n2276.    J. E., male, aet. 76, widower, sea captain, first admission.    Cause of death, senility.\nClinical Report.\u2014Admitted 31st October, 1908, from the General Hospital in Vancouver,\nwhere he was said to be destructive and disturbed; was at once sent to the infirmary ward as\nhe was very feeble; physical examination shows marked senile changes in every way. This\ncondition gradually become more marked up until the time of his death on 12th January, 1910. G 26\nPublic Hospital for the Insane.\n1911\nPathological Report.\u2014Emaciated; both legs and arms reflexed. Scalp thin; cranial\nbones hard but not thickened ; extensive dural adhesions generally markedly over frontal\nlobes; dura thickened and tough; marked increase of subdural and subarachnoidean fluid ;\narachnoid slightly opaque and adherent to dura and pia ; hemispheres of cerebrum adherent on\ntheir mesial surfaces of the frontal lobes; pia thickened and generally adherent. Brain\u2014weight,\n1,265 grms.; basal vessels thickened and sclerotic with athermatous degeneration and\ncaseation ; clot in basilar artery; convolutional atrophy both frontal lobes. Heart\u2014weight,\n268 grms. ; muscle pale; pericardium and pericardial fluid normal; aortic and tricuspid valves\nsclerotic with atheromatous degeneration and caseation of coronaries; arterio-sclerosis with\nmarked atheromatous degeneration. Lungs\u2014weight, left 566 grms., right 680 grms.; firm\nadhesions to costal pleura on posterior surfaces of upper lobes, also middle right lobe; anthra-\ncosis of both. Liver\u2014weight, 1,643 grms.; atrophic cirrhosis; capsule adherent. Spleen\u2014\nweight, 255 grms. ; surface presents a mottled appearance; on section tough and capsule\nadherent. Kidneys\u2014weight, left 150 grms., right 154 grms. ; chronic diffuse nephritis.\nPeritoneal cavity and organs normal.\nMicroscopical Report.\u2014Extensive degenerative changes in the nerve cells ; numerous\nhyaline bodies in the choroid plexus. Chronic myocarditis; extensive arterio-sclerosis and\natheromatous degeneration and calcareous infiltration of the arteries. Interstitial increase of\nthe thyroid-gland with dilatation of some of the vesicles, and cellular infiltration of others.\nChronic cirrhosis of the liver. Extensive diffuse nephritis ; foci of round cell infiltration in\nthe adrenals.    Chronic pancreatitis.    Diffuse anthracosis.\n16. Senile Dementia :\n2361. W. R., male, aet. 79, single, carriage builder, first admission. Cause of death,\nsenility.\nClinical Report.\u2014Admitted 1st April, 1909 ; was restless and from history received had\ngiven considerable trouble prior to his admission to the Hospital; physical examination shows\na typical condition of a case of general senility, and during his residence in Hospital patient\ngradually deteriorated until the time of his death on 1st February, 1910.\nPathological Report.\u2014(Edema of left leg and commencing cellulitis. Cranial bones\ncompact; dura tenaciously adherent to inner surface of skull generally and to the arachnoid\nover parietal verices ; dura thickened and tough; arachnoid opaque and contained numerous\nplaques ; hemispheres adherent on their mesial surfaces of the frontal lobes. Brain\u2014weight,\n1,417 grms; basal vessels thickened and sclerosed with atheromatous degeneration; left\nposterior cerebral to the junction with the left posterior communicating very small, the\ncommunicating very large and apparently continues as the posterior cerebral; pituitary body\nsoft and friable. Heart\u2014weight, 318 grms. ; atheromatous degeneration and calcareous\ninfiltration of the aortic valve. Lungs\u2014weight, left 496 grms., right 567 grms. ; right lung\nfirmly adherent at apex ; anthracosis. Liver\u2014weight, 1,204 grms. ; firm on section ; moderate\ncirrhosis ; capsule adherent. Spleen\u2014weight, 92 grms.; small; adherent to diaphragm ; somewhat softened beneath the seats of the adhesions ; capsule thickened and adherent. Kidneys\u2014\nweight, left 184 grms., right 212 grms.; numerous cortical cysts; firmly adherent to the\nperirenal tissue; firm on section ; pale in colour; striation indistinct; pelves dilated ; capsule\nadherent and leaves a rough surface; considerable pelvic fat. Pancreas\u2014weight, 90 grms.;\nfirm on section. Thyroid gland\u2014weight, 43 grms, ; firm and rather lobular. A few of the\nmesenteric glands enlarged.    Ureters full and dilated with urine ; bladder distended with  1 Geo. 5\nPublic Hospital for the Insane.\nG 27\nMicroscopical Report.\u2014Extensive degenerative changes in the nerve cells; numerous\nhyaline bodies in the choroid plexus. Chronic myocarditis; extensive arterio-sclerosis and\natheromatous degeneration of the arteries. Cvstic dilatation of many of the thyroid gland\nvesicles.    Chronic venous congestion of the liver and some cirrhosis.\n17. Senile Dementia :\n2101.    J. A., male, aet. 67, single, moulder, first admission.    Cause of death, senility.\nClinical Report.\u2014Admitted 9th February, 1908; had marked symptoms of senile\ndementia, and was sent to the infirmary ward. During his residence in Hospital was confined\nto his bed the greater part of the time ; physical condition gradually deteriorated until the\ntime of his death on 11th April, 1910.\nPathological Report.\u2014Emaciated; first and second fingers and thumb of right hand\namputated. Cranial bones cancellus; dura diffusely adherent throughout; diffuse opacity\nof the arachnoid; increase of subdural and subarachnoidean fluid. Brain\u2014weight, 1,474\ngrms.; general atrophy of the convolutions; bony plates in the anterior walls of the superior\nlongitudinal sinus; numerous foci of softening scattered throughout the cortex and diffuse\nthrough the substance, varying in size and shape; extensive atheromatous degeneration of the\nbasal vessels; choroid plexus cystic. Lungs\u2014weight, left 425 grms., right 878 grms.; firm\npleuritic adhesions in both cavities; extensive anthracosis; some of the marginal lobules\ndilated; lower right lobe of a more or less solid consistency. Heart\u2014weight, 297 grms.;\nconsiderable epicardial fat; moderate sclerosis of the mitral and aortic valves ; moderate\natheromatous degeneration of the arteries. Thyroid gland\u2014weight, 62 grms.; both lobes\nenlarged. Spleen\u2014weight, 141 grms.; soft on section and friable; capsule firmly adherent.\nLiver\u2014weight, 1,616 grms.; firm on section; pale and somewhat nutmeg in appearance;\ncapsule firmly adherent; band-like adhesions to the diaphragm. Kidneys\u2014weight, left 148\ngrms., right jl62 grms.; firm on section; pale in colour; striation indistinct; considerable\npelvic fat; capsule strips readily.    Pancreas\u2014weight, 86 grms.\nMicroscopical Report.\u2014Extensive degenerative changes in the nerve cells ; numerous\nhyaline bodies in the choroid plexus. Moderate arterio-sclerosis and atheromatous degeneration\nof the arteries.    Cystic dilatation of many of the thyroid gland vesicles.\n18. Senile Dementia :\n2117.     G. G., male, aet. 75, single, sailor, first admission.     Cause of death, peritonitis.\nClinical Report.\u2014Admitted 4th March, 1908 ; physical examination shows senile changes.\nDuring his residence in hospital was a very willing worker, but his mental condition remained\nthat of a child. On August 28th, 1910, complained of severe pain in abdomen with marked\ntenderness; this condition never subsided, and during the last twenty-four hours had faecal\nvomiting and purging and died on the 3rd September, 1910.\nPathological Report.\u2014Well nourished ; nose disfigured, apparently result of old\nfracture; old scar right groin, result of operation for radical cure for hernia; foul-smelling\nfaecal matter oozing from mouth and nostrils'; abdomen distended and tympanitic. Cranial\nbones cancellous; some dural adhesions; diffuse opacity and increased thickness of the\narachnoid ; moderate increase of subdural and subarachnoidean fluid. Brain\u2014weight, 1,320\ngrms.; convolutions somewhat flattened ; basal vessels thickened; ventricles dilated and filled\nwith fluid. Lungs\u2014weight, left 680 grms., right 730 grms. ; extensive diffuse anthracosis.\nHeart\u2014weight, 320 grms. ; some sclerosis of aortic cusps; sclerosis of mitral and tricuspid\nvalves with atheromatous degeneration ; irregular patchy atheromatous degeneration of the\narteries. Liver\u2014weight, 1,300 grms.; dense adhesions to thediaphragm; firm on section;\nmottled nutmeg in appearance.    Spleen\u2014weight, 110 grms.; capsule thickened and rough; G 28\nPublic Hospital for the Insane.\n1911\nparenchyma soft and friable. Kidneys\u2014weight, left 160 grms., right 150 grms. ; firm on\nsection ; considerable pelvic fat; capsule adherent and leaves a rough surface. Peritoneum,\nomentum, and walls of intestines deeply congested, most marked in the lower part and in\nthe pelvis; a small quantity of yellowish, turbid fluid in the pelvic cavity ; numerous firm\nadhesions of the under surface of the liver to the underlying omentum and hepatic flexure\nof the colon ; omentum and intestines more or less cemented together by a fibrino-plastic\nexudate; mesenteric and retroperitoneal glands enlarged.\nMicroscopical Report.\u2014Considerable chromatolytic changes in the nerve cells ; numerous\nhyaline bodies in the choroid plexus and calcareous bodies in the pineal gland; round cell\ninfiltration of the pia and of the pial septa entering the brain-cortex, and of the perivascular\nspaces throughout the cortex. Slight chronic myocarditis; moderate arterio-sclerosis and\natheromatous degeneration.    Acute congestion of the omentum ; acute peritonitis.\nSputum.\nThe following table shows the number and nature of the examinations made:\u2014\nB. Tuber- Diplococcus\nculosis. Pneumoniae.\nSlides examined  80 8\nNumber of cases  16 4\nFound in  11 2\nNot found in  5 2\nAs there are, when working amongst the insane, several reasons why specimens of sputum\ncannot be obtained for examination in every case, some other method is required, especially to\nconfirm the diagnosis of tuberculosis.\nAs mentioned under the heading of \" Histology,\" the blood cannot be utilised, and where\nthe sputum cannot be obtained, and the examinations of stools and urine give only negative\nresults, the only apparent means of confirming the diagnosis is the use of \"tuberculin.\" At\none time we thought we had found an easy method, for in one case, where the sputum\ncould not be obtained, the pharynx was swabbed with a sterile cotton swab, and smears made\nfrom 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\nfound that this is not to be depended upon, some cases giving positive and some negative\nresults.\nFood Supplies.\nThe food supplies of the Hospital have been analysed at intervals and the milk weekly.\nThe following table shows the work done in this regard:\u2014\nChemical Bacteriological\nAnalyses. Examinations.\nMilk    45 26\nButter ,        2\nTea        3\nCoffee        2\nFlour       3\nOn no occasion has there been cause to condemn any of the articles supplied.\nThe Water Supply.\nNo better water could be desired than that supplied to this Institution. Chemical\nanalyses and bacteriological examinations have been conducted at least weekly, with the result\nthat it has always been favourably reported upon. I Geo. 5\nPublic Hospital for the Insane.\nG 29\nUrinalysis.\nThe following table will show the number of examinations made and the findings :\u2014\nTotal number of specimens examined    255\nCells:\nAlbumen   ,  7\nPhosphates     2\nCalcium oxalate  2\nUrobilin  130\nBlood\t\nPus\t\nEpithelial . . .\nFatty  \t\nHoemoglobin.\nMolds\t\nLeucin\t\nCasts :\nTyrosin        2\nSugar  3\nUrates  58\nMucin  11\nBile pigments  1\nHyalin  43\nEpithelial  12\nGranular  32\nBlood   ,  1\nFatty  2\nSpermatazoa  2\nHippuric acid  1\nA number of microscopical examinations of the urine from suspected tubercular patients\nhave also been made, with the idea that, when the tubercle bacillus could not be demonstrated\nin the sputum, or the sputum was not obtainable, the centrifugalised deposit from a large\nquantity of the urine may contain the organism, but we obtained negative results in nearly\nevery case.\nCorroborating last year's report, we still find that urates are present in the urine, in large\nexcess, in nearly all cases of manic depressive insanity during the excited period, and that\nthis excess of urates disappears as the excitement subsides. Also that this excess coincides,\nboth in its prevalence and decrease, to the leukocytosis found in the majority of these cases.\nHistology.\nUnder this heading a considerable amount of time has been appropriated in the making\nof red, white and differential enumerations of the blood corpuscles. The blood of all admissions\nis subjected to an examination, and also that of cases specially indicated during residence.\nThe number of counts made is given in the following table :\u2014\n269 red counts on 248 cases.\n270 white counts on 249 cases.\n113 differential counts on 107 cases.\nAs stated in our Report for 1909, and mentioned again under the heading of\n\" Urinalysis,\" the almost constant occurrence of a leukocytosis in our cases of manic depressive\ninsanity, during the period of excitement, together with a marked excess of urates in the\nurine, is steadily indicated in our records, and were it not that the excited condition of the\npatient affords sufficient evidence for diagnosis, this phenomenon could be used as an aid in\nthe majority of these cases. As it is, however, by keeping recurrent cases under continuous\nobservation, the period of excitement may generally be shortened, and the exhaustion following\nit lessened, by resorting to hydrotherapeutic measures as soon as it is noticed that the\nleukocytes are increasing in the individual case.\nEstimation of the haemoglobin      269\nn            colour index  240\nn            blood coagulation time  6\nn            specific gravity  4\nn            alkalinity  4\nExamination for bacillus tuberculosis  43 G 30\nPublic Hospital for the Insane.\n1911\nRosenberger stated in 1908 that the B. tuberculosis could be demonstrated in the blood\nof nearly all tuberculous patients. Investigations conducted since, however, show objections\nto this assertion, for acid-fast bacilli were found in the centrifugalised deposit from distilled\nwater when fixed on the slide with albumen, and it has later been shown that it is only in\nextremely rare cases that the bacillus of tuberculosis can be demonstrated in the blood, or\nrecovered from animals injected with the blood of tuberculous individuals, and our results go\nto show that the latter is the more authentic.\nThe Significance of a Leukocytosis and Urat^mia in Manic Depressive Insanity.\nSince the beginning of this Laboratory in October, 1908, a leukocyte and red-blood-cell\nenumeration and an examination of the urine have been undertaken for each admission to\nthis Hospital.    Altogether, to date, the blood and urine from 509 cases have been examined.\nFrom the commencement it was noticed that, in cases of manic depressive insanity, a\nmarked increase in the number of leukocytes was fairly constant, while the number of\nerythrocytes and the percentage of haemoglobin had not necessarily decreased; also, where a\nleukocytosis was evident, the urine showed a large excess of urates with generally hyaline and\ngranular casts, urobilin and epithelial cells.\nThis deviation from normal, both in the blood and in the urine, appearing so constantly\nin these cases, more so than in other types of insanity, indicated an interesting study, while\nno satisfactory explanation could be given for the coincidence. There is little or no literature\nbearing on this subject, and even the few investigations recorded, as regards blood counts\nin the insane, varying so much in the conclusions arrived at, it was deemed expedient to\ninvestigate further, with a view to drawing some authentic conclusions from the statistics\ncompiled from the study of each individual case.\nBefore proceeding further, I wish to state that in using the term \"leukocytosis,\" I accept\nCabot's definition of same, and this is adhered to throughout. Cabot says : \"To my mind the\nterm (leukocytosis) is best used to mean : An increase in the number of leukocytes in the\nperipheral blood over the number normal in the individual case, this increase never involving\na diminution in the polymorphonuclear varieties, but generally a marked absolute and relative\ngain over the number previously present.\"\nIn most of the previous investigations recorded, the authors have omitted to mention the\nrelation of their counts to food, hot and cold baths, altitude above sea-level, menstruation,\netc. In all probability, the omission of this important data accounts for the wide variation\nand conflicting results recorded. The blood counts made here have all been conducted, as far\nas possible, under exactly similar conditions, in order to eliminate any error that may occur\nstatistically or clinically, from blood taken under conditions where it would vary from normal\n(this condition not being due to the psychosis.) This institution being practically at sea-level,\nand all the counts being made from peripheral blood taken from the finger at least two hours\nafter ordinary meals, and never immediately after or during a hot or cold bath, nor after a\nconsiderable quantity of liquid has been taken, during menstruation or lactation, and all the\ncases being well past the age of puberty, makes the results comparable.\nThe red and white cell enumerations have been made with a Thoma-Zeiss haemacytometer,\nusing Hayem's fluid for the reds, and a 0.33 per cent, acetic acid and gentian violet solution\nfor the whites. In the differential counts, Wright's stain has been used throughout, and for\nthe haemoglobin estimation a Fleischl's haemoglobinometer up to July; since then Tallquist's\nhaemoglobin scale has been employed as being more convenient,  1 Geo. 5\nPublic Hospital for the Insane.\nG 31\nIn making the red counts, sixteen fields of sixteen small squares have been counted, then\nthe slide cleaned and the same number of squares counted in the second drop, and the average\nfrom the total number calculated. In enumerating the leukocytes, the entire field of sixteen\nlarge squares is counted in two drops, and the average calculated from the total. In making\nthe differential counts, at least 500 leukocytes are counted, and the percentage caculated.\nThe following table will show the results of the red and white counts, the figures, unless\notherwise specified, representing the first count made on admission. The cases have been\nclassified under the headings of the various forms of insanity in order to facilitate\ncomparison :\u2014\nManic Depressive.\nSex.\nReds.\nWhites.\nSex.\nF\nReds.\nWhites.\nSex.\nM\nReds.\nWhites.\nM\n3,680,000\n10,640\n4,080,000\n5,600\n5,360,000\n7,200\nF\n4,048,000\n18,720\nM\n4,320,000\n6,400\nM\n4,550,000\n11,200\nF\n3,870,000\n11,640\nM\n4,340,000\n18,240\nM\n4,538,000\n9,280\nF\n4,098,400\n14,800\nF\n3,775,200\n21,200\nM\n4,866,000\n10,560\nM\n4,800,000\n9,360\nM\n4,754,000\n11,420\nF\n4,182,000\n14,360\nF\n4,300,000\n14,380\nF\n4,332,000\n12,420\nF\n4,238,000\n14,440\nM\n4,624,000\n12,000\nM\n4,700,000\n14,260\nM\n4,600,000\n11,280\nM\n4,428,000\n11,460\nM\n4,600,000\n12,580\nF\n4,430,000\n7,240\nM\n4,824,000\n13,240\nF\n4,450,000\n5,460\nM\n4,768,000\n11,800\nF\n4,460,000\n13,420\nF\n4,600,000\n12,840\nM\n4,880,000\n11,620\nM\n4,842,000\n7,680\nM\n4,886,000\n7,260\nM\n4,620,000\n10,440\nF\n3,868,000\n12,260\nM\n4,764,000\n9,380\nM\n4,728,000\n17,420\nM\n4,866,000\n12,800\nM\n4,886,000\n21,200\nF\n4,100,000\n15,200\nM\n4,800,000\n7,260\nF\n4,380,000\n13,640\nM\n4,868,000\n11,280\nF\n4,400,000\n14,260\nM\n4,680,000\n10,220\nM\n4,748,000\n13,200\nF\n4,300,000\n6,600\nM\n4,800,000\n12,200\nM\n5,100,000\n8,280\nF\n4,480,000\n13,200\nF\n4,400,000\n9,200\nF\n4,460,000\n8.300\nM\n5,120,000\n6,800\nM\n4,800,000\n7,300\nM\n4.960,000\n11,600\nM\n4,826,000\n8,200\nF\n4,250,000\n13,000\nF\n4,320,000\n10,200\nF\n4,400,000\n8,300\nM\n4,860,000\n15,320\nF\n4,480,000\n7,300\nF\n4,018,000\n15,160\nM\n4,828,000\n12,260\nM\n4,912,000\n10,640\nF\n3,760,000\n13,480\nM\n4,900,000\n14,120\nM\n4,710,000\n13,320\nM\n4,900,000\n9,700\nM\n4,612,000\n11,620\nF\n4,220,000\n12,300\nM\n4,860,000\n11,200\nF\n4,630,000\n11,220\nM\n4,920,000\n8,420\nF\n4,280,000\n12,460\nM\n5,116,000\n9,400\nM\n4,868,000\n11,400\nM\n5,020,000\n9,920\nF\n4,200,000\n13,100\nF\n4,400,000\n13,140\nM\n4,760,000\n11,600\nF\n4,230,000\n10,200\nM\n4,760,000\n10,800\nF\n4,610,000\n8,800\nM\n4,040,000\n13,200\nF\n4,340,000\n12,600\nF\n4,346,000\n12,260\nF\n4,300,000\n12,160\nM\n4,820,000\n14,360\nM\n4,800,000\n10,600\nM\n4,700,000\n10,300\nM\n4,746,000\n12,100\nM\n4,912,000\n11,260\nM\n4,816,000\n14,700\nM\n4,926,000\n12,420\nM\n4,938,000\n13,420\nM\n4,860,000\n13,140\nM\n4,600,000\n12,580\nF\n4.400,000\n9,740\nF\n4,312,000\n9,000\nF\n4,460,000\n14,260\nM\n4,760,000\n11,200\nM\n4,760,000\n10,000\nF\n4,048,000\n14,440\nF\n4,510,000\n8,860\nF\n4,620,000\n15,200\nM\n5,360,000\n7,200\nF\n4,430,000\n13,180\nM\n5,210,000\n11,200\nF\n4,450,000\n13,420\nM\n4,882,000\n11,340\nM\n4,920,000\n9,380\nAcute Mania.\nM\nF\n4,866,000\n4,230,000\n21,200 *\n18,380 *\nM\nF\n4,780,000\n4,080,000\n18,600 \u25a0\n16,560 '\n4,520,000\n14,380\n* Acute oases. G 32\nPublic Hospital for the Insane.\n1911\nToxic Insanity.\nSex.\nReds.\nWhites.\nSex.\nM\nReds.\nWhites.\nSex.\nF\nReds.\nWhites.\nM\n5,177,600\n7,440\n4,024,000\n13,760\n4,112,000\n11,840\nF\n3,870,000\n11,640\nM\n4,574,400\n9,360\nM\n4,820,000\n10,240\nM\n4,882,000\n13,120\nM\n4,788,000\n10,280\nF\n4,282,000\n13,380\nM\n4,900,000\n8,280\nM\n4,720,000\n12,480\nM\n4,932,000\n7,460\nM\n4,842,000\n12,200\nF\n4,240,000\n12,620\nM\n5,020,000\n9,650\nF\n4,800,000\n8,000\nM\n4,640,000\n11,000\nM\n4,740,000\n11,200\nF\n4,340,000\n10,200\nF\n4,280,000\n9,840-\nF\n4,350,000\n8,680\nF\n4,580,000\n11,620\nM\n5,018,000\n10,620\nF\n4,500,000\n10,240\nM\n5,060,000\n8,800\nF\n4,712,000\n11,400\nM\n4,712,000\n11,600\nF\n4,830,000\n12,380\nM\n4,740,000\n9,200\nF\n4,216,000\n12,400\nM\n4,690,000\n10,200\nM\n4,960,000\n10,280\nM\n4,460,000\n12,220\nM\n4,800,000\n8,800\nM\n4,680,000\n9,680\nM\n4,960,000\n9,640\nM\n4,912,000\n12,200\nF\n4,276,000\n11,200\nM\n4,820,000\n7,280\nF\n4,216,000\n13,210\nDementia Prjecox.\nM\n4,272,000\n11,840 f\nM\n4,868,000\n8,840\nF\n4,352,000\n9,360\nM\n3,248,000\n12,800\nM\n4,320,000\n12,480 t\nM\n4,900,000\n7,320\nM\n5,440,000\n7,440\nM\n4,352,000\n9,360\nM\n4,100,000\n11,200\nM\n3,700,000\n11,840\nM\n4,600,000\n5,600\nM\n4,823,000\n6,400\nM\n4,680,000\n10,000\nM\n4,880,000\n7,200\nM\n4,280,000\n9,360\nM\n4,960,000\n8,680\nM\n4,640,000\n14,960 t\nM\n4,260,000\n10,200\nM\n4,840,000\n8,460\nM\n4,375,000\n11,240\nM\n4,640,000\n9,400\nM\n4,937,000\n7,440\nM\n4,424.800\n7,440\nM\n4,720,000\n10,000\nM\n4,984,000\n11,200\nM\n5,000,000\n10,800\nM\n4,730,200\n11,000\nM\n4,600,000\n9,460\nM\n4,680,000\n11,200\nF\n4,400,000\n11,320\nM\n4,940,000\n10,220\nM\n4,820,000\n9,200\nM\n4,890,000\n8,160\nM\n4,768,000\n9,840\nM\n4,942,000\n8,440\nM\n4,680,000\n9,340\nM\n4,735,000\n11,460\nF\n4,600,000\n5,600\nF\n2,680,000\n18,640 t\nM\n4,466,000\n15,240\nM\n5,249,600\n8,720\nM\n4,780,000\n8,820\nM\n4,800,000\n11,260\nM\n4,900,000\n6,400\nM\n4,668,000\n12,840\nM\n4,780,000\n8,260\nM\n4,840,000\n7,620\nF\n4,380,000\n6,300\nM\n5,120,000\n8,600\nM\n5,120,000\n12,380\nF\n4,480,000\n8,200\nM\n5,020,000\n10,200\nM\n4,900,000\n6,600\nM\n4,800,000\n12,380\nF\n4,127,000\n10,400\nM\n4,768,000\n11,000\nM\n5,120,000\n8,800\nM\n4,700,000\n8,800\nF\n4,520,000\n15,200\nM\n4,620,000\n14,320\nM\n3,860,000\n9,800 f\nM\n4,920,000\n10,420\nM\n4,860,000\n7,600\nM\n5,300,000\n9,280\nM\n4,900,000\n8,640\nF\n4,520,000\n6,240\nF\n4,400,000\n7,600\nM\n4,840,000\n9,000\nM\n4,730,000\n10,200\nM\n4,980,000\n9,360\nM\n5,100,000\n7,200\nM\n4,840,000\n10.200\nM\n4,400,000\n12,160\nM\n4,880,000\n8,000\nF\n4,416,000\nS,600\nM\n4,840,000\n10,100\nM\n5,310,000\n9,600\nM\n4,720,000\n9,320\nM\n4,880,000\n8,680\nM\n4,624,000\n8,480\nM\n5,080,000\n11,200\nM\n4,738,000\n9,400\nM\n4,890,000\n10,360\nM\n4,690,000\n9,600\nF\n4,520,000\n7,460\nM\n5,206,000\n9,400\nM\n4,800,000\n9,260 f\nM\n4,910,000\n11,200\nM\n4,616,000\n8,380\nF\n4,610,000\n10,380\nM\n4,800,000\n10,380\nM\n4,740,000\n10,260\nM\n4,900,000\n8,480\nM\n4,860,000\n12,240\nM\n4,920,000\n9,000\nM\n4,860,000\n9,376\nM\n4,694,000\n13,140\nF\n4,300,000\n12,160 f\nM\n4,828,000\n10,380\nM\n4,880,000\n9,400\nM\n4,680,000\n13,400\nM\n4,762,000\n9,380\nM\n5,060,000\n7,400\nM\n4,906,000\n9,260\nF\n4,600,000\n8,640\nM\n4,906,000\n10,300 f\nM\n4,938,000\n8,380 f\nM\n4,820,000\n11,800\nF\n4,284,000\n12,160\nM\n4,800,000\n7,640\nM\n4,788,000\n7,680\nM\n4,780,000\n8,320\nM\n5,204,000\n10,620\nM\n4,906,000\n10,220\nM\n4,708,600\n9,400\nM\n4,680,000\n9,260\nM\n4,938,000\n8,860 f\nM\n4,800,000\n8,600\nM\n4,880,000\n8,360 f\nM\n4,820,000\n9,200\nM\n4,938,000\n12,320\nM\n4,806,000\n7,420\nM\n4,836,000\n8,600\nM\n4,862,000\n9,860 f\nM\n4,928,000\n10,600\nM\n5,210,000\n10,380\nM\n5,142,000\n11,200\nM\n4,960,000\n9,480\nM\n4,800,000\n9,200\nM\n4,716,000\n10,940\nM\n4,664,000\n11,380\nM\n4,880,000\n7,640\nM\n4,920,000\n9,600\nM\n4,772,000\n8,460\nM\n4,724,600\n11,200\nM\n4,800,000\n7,340\nM\n4,886,000\n9,200\nF\n4,480,000\n9,674 t\nF\n4,538,000\n9,620\nM\n4,942,000\n10,380\nM\n4,920,000\n10,100\nM\n4,710,000\n10,380\nM\n4,760,000\n9,100 f\nM\n4,860,000\n11,280\nM\n4,926,000\n9,600\nM\n4,806,000\n10,340\nt Count made after patient had been in the hospital some time. 1 Geo. 5\nPublic Hospital for the Insane.\nG 33\nGeneral Paresis.\nSex.\nReds.\nWhites.\nSex.\nReds.\nWhites.\n4,800\nSex.\nM\nReds.\nWhites.\nM\n3,920,000\n9,840\nM\n4,480,000\n4,000,000\n8,800\nM\n4,720,000\n17,440\nM\n4,880,000\n9,360\nM\n5,248,000\n18,720\nM\n4,340,000\n18,240\nM\n4,727,000\n16,240\nM\n4,754,000\n11,420\nF\n4,320,000\n9,640\nM\n4,848,000\n12,240\nM\n4,792,000\n10,600\nM\n4,834,000\n9,280\nM\n4,728,000\n9,360\nM\n4,600,000\n6,800\nM\n4,668,000\n8,720\nM\n4,660,000\n8,640\nF\n4,340,000\n13,280\nM\n4,820,000\n11,180\nM\n4,794,000\n9,820\nF\n4,320,000\n9,180\nM\n4,600,000\n10,200\nM\n4,900,000\n8,200\nM\n5,327,000\n18,720 t\nM\n5,220,000\n8,000\nM\n4,740,000\n13,200\nM\n4,868,000\n9,600\nM\n4,648,000\n13,600\nM\n4,920,000\n10,200\nM\n4,700,000\n8,260\nF\n4,400,000\n9,280\nM\n4,738,000\n7,400\nM\n5,060,000\n9,300 t\nM\n4,660,000\n6,800\nM\n4,920,000\n9,840 t\nM\n4,780,000\n9,600\nM\n4,900,000\n10,200\nM\n4,624,000\n7,680\nM\n4,868,000\n8,420\nM\n4,860,000\n8,460\nM\n4,886,000\n10,220\nM\n4,890,000\n10,260\nM\n4,826,000\n8,800\nF\n4,380,000\n9,200 t\nM\n4,738,000\n8,680 t\nF\n4,370,000\n11,120\nM\n4,960,000\n11,600\nM\n4,826,000\n7,440\nM\n4,780,000\n9,400\nM\n4,866,000\n10,640\nM\n4,860,000\n11,160\nM\n4,920,000\n10,260\nM\n4,826,000\n6,800\nM\n4,920,000\n8,810 t\nM\n4,812,000\n8,620 t\nM\n4,700,000\n11,440\nParanoia.\nM\n2,400,000\n16,800\nM\n4,620,000\n10,560\nM\n4,225,000\n8,080\nM\n4,352,000\n9,360\nM\n5,656,000\n13,680\nM\n5,240,000\n7,200\nJvl\n4,600,000\n17,440\nM\n4,021,600\n10,000\nM\n4,824,000\n10,120\nM\n5,000,000\n10,800\nM\n4,764,000\n11,200\nM\n4,890,000\n8,160\nM\n4,872,000\n10,200\nF\n4,600,000\n8,240\nM\n4,896,000\n8,080\nM\n4,880,000\n9,600\nM\n4,780,000\n8,260\nM\n5,220,000\n11,290\nM\n4,296,000\n8 440\nM\n4,680,000\n8,800\nM\n5,000,000\n7,300\nF\n4,520,000\n6,800\nM\n4,580,000\n12,240\nM\n4,900,000\n8,260\nM\n5,180,000\n8,200\nM\n4,900,000\n8,200\nV\n4,300,000\n11,200\nM\n4,940,000\n6,840\nM\n4,800,000\n11,300\nF\n4,620,000\n6,500\nM\n4,700,000\n8,240\nM\n4,848,000\n7,800\nM\n4,900,000\n8,300\nF\n4,480,000\n7,400\nM\n4,900,000\n8,600\nM\n4,726,000\n9,600\nM\n4,910,000\n10,280\nM\n4,730,000\n10,180\nM\n5,018,000\n10,200\nM\n4,766,000\n9,640\nM\n4,868,000\n8,420\nM\n4,860,000\n9,380\nM\n4,820,000\n8,280 t\nF\n4,600,000\n10,240\n1V1\n4,912,000\n8,640 t\nM\n4,882,000\n9,200\nM\n4,960,000\n11,100\nV\n4,380,000\n12,200\nM\n4,916,000\n10,320\nM\n4,800,000\n9,760\nM\n4,836,000\n9,680\nM\n4,780,000\n7,640\nM\n4,860,000\n8,400 t\nM\n4,860,000\n8,840\nM\n4,662,000\n9,280\nM\n4,682,600\n12,260\nM\n5,210,000\n11,600\nM\n4,920,000\n7,600\nM\n4,968,000\n9,260\nF\n4,328,000\n10,160\nM\n4,716,000\n12,260\nM\n4,820,000\n11,920\nM\n4,820,000\n9,280 t\nM\n4,808,000\n9,640 t\nM\n4,700,000\n8,600\nM\n4,778,000\n12,100\nM\n4,836,400\n10,100\nM\n4,930,000\n10,200\nM\n4,910,000\n8,620\nM\n4,926,000\n9,280\nM\n4,826,000\n9,640 t\nSenile Dementia.\nM\n4,132,000\n7,300\nM\n4,600,000\n10,400\nM\n4,740,000\n10,380\nM\n4,266,400\n16,240\nM\n4,420,000\n12,300\nM\n4,174,000\n10,560\nF\n2,700,000\n10,000\nM\n4,748,000\n8,260\nM\n4,800,000\n9,300\nF\n3,840,000\n9,800\nF\n4,160,000\n7,200\nM\n4,660,000\n7,420\nM\n4,600,000\n8,600\nM\n4,600,000\n8,400\nF\n3,800,000\n6,200\nM\n4,532,000\n9,420\nt Count made after patient had been in hospital some time. G 34\nPublic Hospital for the Insane.\n1911\nTerminal Dementia.\nSex.\nReds.\nWhites.\nSex.\nM\nReds.\nWhites.\nSex.\nReds.\nWhites.\nM\n5,160,000\n12,400\n4,920,000\n7,820\nM\n4,812,000\n13,680\nM\n4,575,200\n13,120 t\nF\n4,422,000\n12,260\nM\n4,620,000\n11,400\nF\n4,520,000\n8,080\nF\n4,400,000\n7,440\nM\n4,784,000\n7,400\nM\n4,800,000\n8,260\nM\n3,467,000\n13,240 t\nF\n4,400,000\n9,340\nM\n5,020,000\n9,650\nF\n4,470,000\n10,000\nM\n4,780,000\n11,220\nM\n4,800,000\n8,620\nM\n4,400,000\n8,620\nM\n4,740,000\n8,660\nF\n4,360,000\n9,400\nM\n4,860,000\n10,600\nM\n4,880,000\n9,300\nF\n4,480,000\n10,260\nM\n4,980,000\n11,100\nF\n4,290,000\n12,600\nM\n4,920,000\n8,800\nM\n5,200,000\n10,400\nM\n5,216,000\n10,420\nM\n4,880,000\n9,640\nM\n4,928,000\n7,620 t\nt'\n4,612,000\n9,640\nM\n4,862,000\n7,280\nF\n4,410,000\n6,840\nM\n4,860,000\n8,080 +\nM\n4,846,000\n8,820 t\nM\n4,730,000\n9,080\nM\n4,940,000\n7,640\nM\n4,900,000\n9,200\nM\n4,920,000\n7,860\nM\n4,936,000\n10,200\nF\n4,600,000\n10,380\nM\n4,800,000\n8,660\nM\n4,700,000\n12,600\nM\n4,740,000\n11,200\nM\n4,938,000\n8,980 t\nM\n4,880,000\n9,280 t\nM\n4,892,000\n9,600\nM\n4,762,000\n9,600\nMelancholia.\nF\n4,400,000\n10,000\nF\n2,875,000\n14,125 *\nM\n3,960,000\n13,760 *\nF\n4,120,000\n16,800 *\nM\n4,900,000\n11,840\nF\n4,240,000\n12,230\nF\n4,549,000\n11,840\nM\n4,780,000\n21,200 *\nV\n4,520,000\n6,580\nF\n4,400,000\n10,140\nF\n4,460,000\n7,200\nF\n4,600,000\n8,600\nM\n4,800,000\n14,260 *\nM\n4,650,000\n8,420\nF\n4,520,000\n10,240\nF\n4,400,000\n8,340\nM\n4,700,000\n8,600\nF\n4,420,000\n6.280\nM\n4,800,000\n13,100\nF\n4,086,000\n15,120\nM\n4,680,000\n12,280 *\nF\n4,500,000\n9,240\nM\n4,900,000\n9,600\nM\n4,746,000\n10,460\nM\n4,802,000\n10,600\nM\n4,862,000\n11,000\nF\n4,416,000\n8,600 +\nM\n4,912,000\n14,100 *\nF\n4,340,000\n12,280\nM\n4,910,000\n12,280\nM\n4,740,000\n8,280 t\nM\n4,884,000\n9,600 t\nF\n4,460,000\n13,140 *\nF\n4,460,000\n10,180\nM\n4,912,000\n13,620 *\nM\n4,728,000\n15,160 *\nEpilepsy.\nM\nM\nF\n4,800,000\n4,842,000\n4,276,000\n7,320\n12,460\n11,000\nF\nM\nM\n3,155,200\n5,210,000\n4,860,000\n18,080\n12,300\n11,620\nM\nF\n4,530,000\n4,716,000\n16,480\n10,400\nInbecility ani\nIdiocy.\nM\nF\n4,649,600\n4,760,000\n14,320\n10,000\nM\nF\n4,842,000\n4,190,000\n12,460\n11,200\nF\nM\n4,300,000\n4,660,000\n8,680\n7,400\nOrganic Dementia.\nM\nM\nM\n4,824,000\n4,527,000\n4,720,000\n13,120\n4,960 t\n6,800 t\nM\nM\nM\n4,176,000\n4,520,000\n4,827,000\n3,280\n8,680\n9,200 t\nM\nM\n4,320,000\n4,660,000\n13,680 t\n12,400 t\nTetany.\nF\nF\n4,974,000\n4,960,000\n14,960\n15,240 t\nF\n4,949,600\n17,440 t\nF\n4,916,000\n18,400 t\n* Acute cases. t Count made after patient had been in the hospital some time.\nUnder the heading of Manic Depressive Insanity will be found the results of 110 counts\nin 110 cases: Acute mania, 5; toxic insanity, 40; dementia praecox, 132 and 14 recounts ;\nparanoia, 65 and 6 recounts; general paresis, 49 and 7 recounts; senile dementia, 40\nand 7 recounts; melancholia, 33 and 3 recounts; epilepsy, 8; imbecility and idiocy, 6;\norganic dementia, 4 and 4 reco unts; tetany, 1 and 3 recounts. 1 Geo. 5\nPublic Hospital for the Insane.\nG 35\nOur records go to show that in nearly all cases of manic depressive insanity there is a\nleukocytosis, while the erythrocytes (in size, appearance, and number) and the haemoglobin may\nbe normal, or practically so. Estimation of the colour index has also been systematically made,\nbut so far has offered no information.\nMost observers say that a leukocytosis is not always an increase in the total number of\nleukocytes in the body, but is often the result of chemotaxis or thermotaxis, the cells being\nattracted to the periphery and out of the internal organs. Many investigators have shown\nthat there are two types of leukocytoses\u2014(1) The first appearing and disappearing suddenly\nand only of short duration; such are caused by cold baths. (2) When a leukocytosis is\nprolonged, as in suppuration, etc.\nIn the former, the sudden appearance and short duration of the leukocytosis does not\nallow time for the production of new cells, and it is probable that the increase of white cells\nin the peripheral blood is coincident with a decrease in the number usually stored in the\npulmonary capillaries and elsewhere, while the total number of white corpuscles in the body\nremains the same. In the latter, the production of leukocytes undoubtedly does take place,\nand they are turned into the blood stream much more rapidly than when a pathological\ncondition does not exist, and in these cases the total number of leukocytes in the body is more\nor less increased over normal for the individual case.\nIn poorly nourished persons the white enumeration may be low (3,000), while a high\ncount would denote, ordinarily, a pathological condition. On the other hand, there are well\nnourished, healthy persons with whom a white count seldom falls below 10,000.\nAs regards the differential count, we shall have to make some average, and we will take\nthe normal number of polymorphonuclears as from 50 to 75 per cent. ; this is allowing a wide\nmargin and should cover practically all classes not suffering with any pathological condition ;\nthe count of polymorphonuclear leukocytes being a fair measure of the soundness and vigour of\nthe person's metabolism. All our cases of manic depressive insanity that have exhibited a\nleukocytosis have been within these limits, and have never shown a diminution in the number\nof polymorphonuclears, but always a marked absolute and relative gain.\nThe leukocytosis is shown most markedly during the excited period, but, on the\ndisappearance of this phenomenon, the leukocytes gradually diminish to normal. This period\nmay be from a few days to a few weeks, and the length of time prior to admission it is often\nimpossible to ascertain, but is, in all probability, at least several days. This would seem to\nindicate that leukocytes are formed and turned into the circulation faster than under normal\nconditions ; consequently, the total number of leukocytes in the body is increased over normal.\nCabot suggests that possibly the leukocytosis of acute delirium and acute mania come\nunder the heading of \" toxic leukocytosis.\" Fisher (Amer. Jour. Insan., 1903) comes to the\nconclusion that in cases of maniacal insanity \" a leukocytosis is an almost constant accompaniment\" and she believes that it is a result of \" psychomotor activity.\"\nIt was also noticed during the course of our investigation that whenever a leukocytosis\nwas determined, the urine nearly always contained a large excess of urates. This excess\ncannot be due to fermentation wholly, as the specimens were generally examined too closely\nfollowing the voiding for fermentation to take place; but, the longer the urine stands, the\nheavier the precipitate of urates, up to a certain point. In most of these cases also hyaline\ncasts, granular casts, epithelial cells and urobilin were found, while in two cases positive\nEhrlich's diazo reactions were obtained. No clinical symptoms of a febrile condition\nwere evidenced, and repeated serum agglutination reactions and sputum examinations were\nnegative.    The urates were generally deposited in the form of amorphous sodic urate, but the G 36\nPublic Hospital for the Insane.\n1911\n\" hedge-hog \" crystals of ammonium urate were also frequently detected, and occasionally some\nof the \" whetstone \" and irregular crystals of uric acid. It is generally understood that the\nacid urates or bi-urates (MHC5H2N403) are very sparingly soluble, and exist in the urine\nonly after it has undergone ammoniacal fermentation. They are known pathologically as\ncomponents of gouty excretions in the tissues, but it is questionable if they ever exist\nphysiologically in the blood or tissues. The quadri-urates (MHC5H2N403, H2C5H2lSr403) are\nmore soluble than the bi-urates, and are specially the physiological combinations of uric acid.\nThey exist normally in the urine and probably also in the blood, and it may be that all the\nmorbid phenomena due to uric acid arise from secondary changes in the quadri-urates,\nIn healthy urine of feeble acid reaction the quadri-urates dissolve unchanged, but the solution\nundergoes gradual but complete decomposition, with ultimate separation of the whole of the\nuric acid in a free state. This change is retarded in normal urine by the salts and colouring\nmatters present (urea has no influence), occurring with greater facility the larger the proportion\nof free acid there is present.\nThe decomposition of sodium quadri-urate under the influence of water can be conveniently\nobserved by filtering off the buff or brick-red coloured sediment, washing it thoroughly with\ncold rectified spirit, and drying it at blood heat. When the quadra-urate thus purified is\nmixed with a considerable volume of water it is speedily disintegrated, a portion passing into\nsolution in combination with the bases, and the remainder falling as an insoluble precipitate\nof crystalline uric acid. The change is readily observed under the microscope, by intimately\nmixing a particle of the purified deposit on a glass slide with a drop of water and protecting\nthe mixture with a covering-glass. In the course of ten minutes, ovoid crystals of uric acid\nmake their appearance and grow and multiply, till in the course of half an hour the entire\nfield is thickly studded with crystals ; the process continuing, provided that water be added\nas required, until the amorphous substance is entirely replaced by crystals of uric acid\nCrystals of the sodium bi-urate simultaneously formed are never observed, since this salt is\nliberated in the gelatinous form.\nThe quadri-urates readily assume a gelatinous form. If a 5 per cent, solution of sodium\nphosphate be heated to boiling with excess of uric acid and the liquid filtered hot, the filtrate\nsets to a jelly on cooling. This jelly, after being pressed between blotting paper to free it\nfrom mother liquor, exhibits the characteristic behaviour of a quadri-urate, being rapidly\ndecomposed by water with copious formation of crystals of uric acid. On keeping in a moist\ncondition, gelatinous sodium quadri-urate gradually passes into a crystalline condition, and\nthen appears under the microscope in radiating spheres, exactly similar to the spheres so\ncommon in serpents' and birds' urine.\nThe salts of the formula M2C5H2N403, called \" neutral\" or \" normal\" urates, dissolve\nreadily in water, and are exclusively laboratory products, not being met with in the animal\nsystem under either healthy or pathological conditions.\nIt is of interest to note that the only apparent cause for this excess of urates in the urine\nis a disturbance of the general nutrition characterised by a uric acid diathesis. It is highly\nimprobable that the excess of urates is the immediate causation of the leukocytosis (uric acid\nbeing present in the blood in leukaemia), while if the suggestion that the urataemia is caused\nby a disturbance of the general nutrition be entertained, this would coincide with similar\ncausation for the leukocytosis.\nWhile the abatement of mental excitement and an increase in body weight are generally\nincidental 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\nleukocytes in the peripheral blood, and the gradual reduction of urates in the urine, for those 1 Geo. 5\nPublic Hospital for the Insane.\nG 37\nindividuals who evidence these characteristics, and who are the large majority under this\nheading of insanity. Whether the excess of urates in the urine has any bearing on the\nmaniacal condition or not has not yet been determined, but uric acid probably does act on\nthe nerve centres, and that it does produce headaches, as in gout and epilepsy, is an\nestablished fact. In our cases, apparently, the urates did not pass into the insoluble crystalline\ncondition, but, the reaction of the urine being always acid, were excreted before they reached\nthe insoluble stage.\nTwo cases of manic depressive insanity were kept under observation after admission, and\nafter the first period of excitement had subsided, and their leukocytes and urine were normal,\nwith a view to ascertaining how long before the excited period was manifest (in case of a\nrecurrence) the leukocytes would commence to increase and urates be excreted in the urine in\nexcess.\nCase 1 ; a male ; on admission patient's leukocyte count was 14,380, reds 4,928,000,\nurates present in excess in the urine. Three weeks after admission blood and urine were\nnormal, whites 8,480, reds 4,932,000. Some two months later the leukocytes increased to\n9,200, 11,320, 12,800, 12,960, 13,520, and 14,180; the urates gradually increased in the urine\nuntil it appeared muddy, and the patient at this stage was very excited and restless, while\nsleep could only be induced by means of hydrotherapeutic measures and hypnotics. As the\nexcitement subsided, so his leukocytes decreased again to 8,260, reds 4,868,000, and the urine\ncleared up.\nCase 2 ; also a male; the white count on admission was 14,840, reds 5,210,000, urates\npresent in laige excess in the urine. Within seventeen days from patient's admission his\nblood and urine were normal, whites 7,860, reds 5,020,000. Three months after admission it\nwas noticed that his leukocytes were on the increase 9,400, 11,600, 13,420, 15,600, and urates\nappeared in increasing quantity in the urine. At the time when the 15,600 count was made,\npatient was very excited and restless and would not sleep without hypnotics. As his\nexcitement subsided so his leukocytes decreased to 8,400, and the urates gradually disappeared\nfrom the urine.\nConclusions.\n1. We are hardly justified in saying that any of the cases suffered with anaemia due to\nthe psychosis.\n2. The leukocytosis is probably due to exhaustion induced by maniacal excitement, loss of\nsleep, and malnutrition ; for although poorly nourished persons generally give a low leukocyte\ncount, those undergoing the first stages of starvation generally show a marked increase of\nleukocytes.\n3. The excitement accompanying manic depressive insanity does not cause a decrease, in\nthe number or size of the erythrocytes, or of the haemoglobin.\n4. A decrease in the number of leukocytes to normal (for the individual case), the\ndisappearance of urates from the urine, and an increase in body weight are generally incidental\nwith mental improvement in this class of cases.\n5. A urataemia is incidental with a leukocytosis  in these cases.\n6. Recurrent periods of excitement can be foretold and hydrotherapeutic or other measures\ntaken, before the maniacal symptoms are evident, in order to shorten the period and lessen\nthe exhaustion following the attack of excitement.\nI have the honour to be,\nSir,\nYour obedient servant,\nF. P. HUGHES. G 38\nPublic Hospital for the Insane.\n1911\nSTATISTICAL   TABLES.\nTable No. 1.\nShowing the operations of the Hospital for the year 1910, in summary form.\nMovement of Population New\nWestminster asylum.\nRemaining in residence here, Dec.\n31st, 1909\t\nDischarged on probation, and still\nout, Deo. 31st, 1909 \t\nEscaped, but not discharged, Dec.\n31st, 1909 \t\nTotal under treatment here,\n31st, 1909\t\nAdmitted during the year :\u2014\nBy ordinarj' forms   .\nBy urgency forms\t\nBy order of court\t\nBy return from escape, 1910...\nFrom Yukon Territory\t\nTotal  under treatment   for   year\n1910 at New Westminster\t\nDischarged during the year :-\nAs not insane\t\nAs recovered\t\nAs improved\t\nAs unimproved\t\nTotal\t\nOther discharges :\u2014\nDischarged on probation and\nstill out, Dec. Slst, 1910\t\nEscaped, but not yet discharged\nDied\t\nRemaining under treatment   Jan.\n1st, 1911\t\n\"3\nto\n'3\n2\nBr\nO\nTotal.\n8\ns\n0>\n\"3\no\n3V9\n157\n536\n6\n12\n18\n9\n0\n9\n394\n169\n563\n2(15\n63\n268\n4\n0\n4\n0\n0\n0\n4\n0\n4\n7\n1\n8\n\u2014\n\t\n\t\n220\n64\n284\n614\n233\n847\n16\n0\n15\n599\n233\n832\n0\n0\n0\n60\n24\n84\n50\n18\n58\n12\n2\n14\n122\n44\n166\n16\n9\n25\n7\n0\n7\n27\n12\n39\n172\n65\n237\n172\n65\n237\n\u25a0\"\n427\n168\n695\nMovement op Population\nat Vernon.\nRemaining in residence at Vernon,\nDec. 31st, 1909\t\nDischarged on probation and still\nout, Dec. 31st, 1909\t\nEscaped, but not discharged, Dec.\n31st, 1909\t\nTotal under treatment at New\nWestminster, Dec. Slst, 1909\t\nTotal under treatment, New Westminster and Vernon, Dec. 31st,\n1909\t\nAdmitted during year\nTotal under treatment New Westminster and Vernon for year 1910\nAdmitted to Vernon from New\nWestminster\t\nTotal treated in Vernon for year\n1910\t\nDischarged on probation, Vernon..\nDischarged, improved, Vernon\t\nDied at Vernon\t\nLess Vernon patients in residence\nDec. 31st, 1910\t\nRemaining   in   residence at   New\nWestminster, Dec. Slst, 1910....\n0\no    o\n79\nTotal.\n64\n563\n280\n907\n237\n670\n76\nTotal number of cases admitted since opening .\nii H n       discharged      \t\nit h M      died\t\nRemaining under treatment January 1st, 1911\nMale.  Female.   Total\n1,128\n500\n1,514\n607\nMale. Female. Total.\n2,151 670 2,821\n1,628 493 2,121\n523\n177\n700\nDaily average population during the year  563\nMaximum number present any one day, December 22nd  597\nMinimum h ii m January 4th          534\nPercentage of discharges on admissions (deaths excluded)..   ,  59.2\n11 recoveries on admissions         31\n11 deaths on whole under treatment..       4.5 1 Geo. 5\nPublic Hospital for the Insane.\nG 39\nTable No. 2.\nShowing in summary form the operations of the Hospital since its inception.\nEC\na\na\n'en\nm\ns\n\u25a0ri\n<\nDischarges.\nm\n<u\nA\n1\n5\n3\n10\n5\n3\n8\n8\n5\n5\n2\n3\n2\n5\n6\n5\n3\n4\n12\n20\n13\n14\n19\n20\n9\n14\n19\n21\n29\n25\n25\n26\n26\n27\n28\n39\n57\n40\n41\nNumber resident at\nthe close of each\nyear.\nCD\nOl\nIS\nCD\nU\no\nc\nM\nu\nCD\nXI\na\n3 .\nC T3\n03 \u00ae\nO 03\n\u00a3^\n18\n31\n26\n48\n54\n49\n54\n54\n58\n61\n55\n57\n59\n71\n88\n102\n103\n123\n152\n166\n175\n179\n213\n224\n228\n246\n285\n327\n356\n377\n413\n466\n480\n505\n552\n666\n765\n816\n896\nPercentage of recoveries to admissions.\nPercentage of discharges to admissions (deaths excluded).\nPercentage of deaths\nto whole number\nunder treatment.\nYear.\n03\nU\n03\n>\nO\nCD\nCD\nM\n1\n10\n4\n3\n11\n4\n7\n4\n5\n5\n3\n4\n2\n5\n10\n15\n12\n14\n17\n19\n17\n14\n13\n29\n23\n20\n27\n31\n38\n40\n30\n38\n46\n43\n36*\n48\n68*\n73+\n84\nCD\nO CD\n<\\  o\no\nCD\nu\nCD\nto\nOS\nCD\nU\nO\nCD\nO\n1872\t\n18\n15\n12\n29\n22\n14\n16\n18\n17\n13\n7\n8\n10\n20\n27\n36\n26\n41\n52\n49\n52\n44\n80\n62\n64\n74\n81\n101\n113\n115\n121\n139\n115\n123\n150\n221\n230\n232\n280\n0\n2\n3\n3\n4\n3\n1\n0\n3\n1\n1\n4\n0\n6\n5\n6\n5\n6\n4\n10\n18\n19\n11\n25\n8\n13\n32\n27\n20\n31\n37\n26\n33\n43\n43\n56\n77\n82\n16\n14\n19\n32\n35\n38\n36\n41\n48\n48\n49\n49\n51\n61\n66\n77\n82\n100\n117\n123\n135\n133\n162\n164\n171\n203\n221\n234\n258\n284\n311\n349\n321\n348\n388\n461\n507\n536\n595\n0\n5\n13\n3\n3\n5\n7\n....\n'\"2\"\n10\n5\n11\n5\n18\n17\n6\n12\n29\n2\n7\n32\n18\n13\n24\n26\n27\n38\n27\n43\n73\n46\n29\n48\n0\n2\n5.55\n66.66\n33.33\n10.34\n50.00\n28.57\n43.75\n22.22\n29.41\n38.46\n42.85\n50.00\n20.00\n25.00\n37.03\n41.66\n46.15\n34.15\n32.69\n38.77\n32.69\n31.81\n16.25\n46.77\n35.93\n27.03\n33.33\n30.69\n33.63\n34.78\n24.79\n27.34\n40.00\n33.33\n23.03\n21.30\n28.30\n31.00\n30.00\n5.55\n80.00\n33.33\n26.89\n63.63\n78.57\n62.50\n27.77\n29.41\n61.54\n57.14\n62.50\n60.00\n25.00\n59.25\n55.55\n69.23\n46.34\n44.23\n46.94\n51.92\n72.72\n40.00\n64.51\n75.00\n37.83\n49.38\n62.37\n57.52\n52.17\n50.41\n53.96\n62.61\n61.78\n52.06\n41.20\n53.90\n64.60\n59.28\n5.55\n1873\t\n16.12\n1874\t\n11 53\n1875\t\n20 83\n1876\t\n9.35\n1877\t\n6 12\n1878\t\n16 16\n1879\t\n14.81\n1880\t\n8.62\n1881\t\n8.19\n1882\t\n3.63\n1883\t\n1884\t\n5.26\n3.33\n1885\t\n6.94\n1886\t\n6.81\n1887\t\n4.80\n1888\t\n2.87\n1889\t\n3.25\n1890 \t\n7 64\n1891\t\n11.69\n1892\t\n6.95\n1893\t\n7.60\n1894\t\n8.92\n1895\t\n1896\t\n8.92\n3.94\n1897\t\n5.69\n1898 .........\n1899\t\n6.66\n6.42\n1900\t\n1901\t\n8.14\n6.63\n1902\t\n6.06\n1903\t\n5.57\n1904\t\n5.42\n1905\t\n5.34\n1906\t\n5.04\n1907\t\n5.08\n1908\t\n7.44\n1909\t\n6.40\n1910\t\n4.57\nf Three not insane.\nt One not insane. G 40\nPublic Hospital for the Insane.\n1911\nTable No. 3.\nShowing the number of admissions, discharges, and deaths in 1910.\nMonths.\nJanuary.. ..\nFebruary ..\nMarch.\nApril\t\nMay\t\nJune\t\nJuly\t\nAugust ....\nSeptember .\nOctober ...\nNovember..\nDecember..\nTotal\nAdmissions.\nMale.     Female.     Total.\n25\n16\n10\n11\n18\n20\n11\n25\n22\n22\n23\n13\n216\n64\n30\n21\n16\n13\n18\n27\n19\n31\n31\n25\n31\n18\n280\nDischarges.\nMale.     Female.     Total\n1\n0\n5\n2\n1\n4\n12\n13\n10\n3\n10\n61\n122\n1\n0\n0\n0\n0\n11\n1\n1\n14\n44\n2\n0\n5\n2\n1\n15\n17\n19\n15\n4\n11\n75\n166\nDeaths.\nMale.     Female.\n29\n3\n2\n0\n1\n3\n0\n1\n1\n0\n0\n0\n1\n12\nTotal.\n9\n3\n5\n4\n4\n0\n4\n1\n1\n4\n3\n3\n41\nTable No. 4.\nShowing the civil state of patients admitted during 1910.\nCivil State.\nMale.\nFemale.\nTotal.\n148\n58\n3\n0\n7\n216\n17\n44\n2\n0\n1\n165\n102\n5\n0\n8\nTotal\t\n64\n280\nTable No.  5.\nShowing the religious denominations of those admitted in 1910.\nReligious Denominations.\nAtheist\t\nApostolic faith   \t\nBaptists\t\nBuddhists\t\nChristian Science\t\nCongregationalist\t\nEpiscopalian\t\nFree Church\t\nGreek Church\t\nHeathen\t\nJews\t\nLutheran\t\nMethodist\t\nMohamedan\t\nNonconformist\t\nPlymouth Brethren...\nPresbyterian\t\nProtestant \t\nRoman Catholic\t\nShintoists\t\nUnknown\t\nNone\t\nTotal\nMale.\nFemale.\n1\n0\n1\n0\n6\n6\n3\n0\n3\n0\n0\n1\n10\n6\n1\n1\n4\n0\n2\n0\n2\n0\n17\n5\n11\n6\n3\n0\n0\n2\n1\n0\n31\n12\n58\n17\n43\n6\n2\n0\n15\n2\n2\n0\n216\n64\nTotal.\n1\n1\n12\n3\n3\n1\n16\n2\n4\n2\n2\n22\n17\n3\n2\n1\n43\n75\n49\n2\n17\n2\n280  1 Geo. 5\nPublic Hospital for the Insane.\nG 41\nTable No. 6.\nShowing the degree of education of those admitted during 1910.\nDegree of Education.\nSuperior\t\nCommon school\t\nCould read and write .\nNone\t\nUnknown\t\nTotal\nMale.\nFemale.\n4\n2\n139\n56\n36\n3\n8\n2\n29\n1\n216\n64\nTotal.\n6\n195\n39\n10\n30\n280\nTable No. 7.\nShowing the nationality of those admitted during 1910.\nNationality.\nAustria\t\nChili\t\nChina\t\nDenmark\t\nEngland\t\nFinland\t\nGermany\t\nGreece\t\nIndia\t\nIreland\t\nItaly\t\nJapan \t\nJersey (Channel Island) ..\nNewfoundland\t\nNorway\t\nMexico\t\nRussia\t\nSaxony \t\nScotland\t\nSpain  \t\nSweden\t\nSwitzerland!\t\nUnited States.   \t\nWales   \t\nCanada:\u2014\nAlberta\t\nBritish Columbia\t\nManitoba\t\nNew Brunswick\t\nNova Scotia\t\nOntario\t\nPrince Edward Island.\nQuebec\t\nSaskatchewan\t\nUnknown\t\nTotal      216\nMale.\n6\n1\n4\n1\n48\n4\n6\n1\n4\n15\n2\n5\n1\n2\n6\n1\n4\n1\n22\n1\n7\n1\n24\n2\n1\n6\n2\n5\n2\n21\n1\n8\n1\n. 0\nFemale.\n0\n0\n0\n0\n14\n1\n0\n0\n0\n5\n0\n0\n0\n1\n0\n0\n0\n0\n9\n0\n4\n0\n13\n2\n0\n1\n2\n1\n0\n8\n0\n1\n0\n2\n64\nTotal.\n1\n4\n1\n62\n5\n6\n1\n4\n20\n2\n5\n1\n3\n6\n1\n4\n1\n31\n1\n11\n1\n37\n4\n1\n7\n4\n6\n2\n29\n1\n9\n1\n2\n280 G 42\nPublic Hospital for the Insane.\n1911\nTable No. 8.\nShowing what districts contributed patients during 1910.\nPlane of residence at time of committal.\nMale.\nFemale.\nTotal.\n1\n1\n2\n1\n1\n1\n3\n1\n1\n3\n1\n1\n1\n1\n4\n1\n2\n1\n1\n1\n1\n1\n\"io'\n24\n1\n1\n1\n1\ni\nl\n2\n1\n1\n1\n1\n1\n1\n1\n3\n1\n3\n1\n1\n3\n1\n1\nElko    \t\n1\n1\n3\n1\n1\n4\n3\n1\n1\n1\n1\n11\n3\n1\n1\n1\n1\n2\n4\n15\n1\n3\n1\n2\n1\n3\nFort Steele    \t\n1\nField\t\n1\n4\n3\nGold Hill ;\t\n1\n1\n1\n1\n14\n4\n1\n2\n1\n1\nMerritt\t\n2\n2\n4\n19\n2\n3\nPort Haney\t\n1\n2\n2\n4\n1\n1\n4\n1\n2\n1\n1\n1\n1\n1\n1\n1\n1\n1\n1\n1\n2\n1\n1\n1\n26\n1\n82\n4\n1\n1\n1\n1\n1\nSteveston \t\n1\n1\n2\n1\n1\n1\n36\n1\n106\n4\n1\n2\n1\n1\n2\n7\n216\n2\n8\n64\n280 1 Geo. 5\nPublic Hospital for the Insane.\nG 43\nTable No. 9.\nShowing the occupation of those admitted during 1910.\nOccupation.\nAgent\t\nAccountant\t\nBaker\t\nBlacksmith\t\nBricklayer\t\nButcher     \t\nCarpenter\t\nCooper\t\nCabinet-maker\t\nChemist\t\nClerk\t\nCook\t\nCivil Engineer\t\nContractor\t\nCustoms Officer\t\nDomestic\t\nDoctor\t\nDental Mechanic\t\n(Marine) Engineer.\n(Stationary) Engineer..\nExpressman \t\nFarmer\t\nFireman\t\nFurrier\t\nForeman\t\nFisherman\t\nHousekeeper\t\nHousewife\t\nIndian Agent\t\nLabourer\t\nLawyer\t\nLogger\t\nMerchant\t\nMill-hand\t\nMilliner\t\nMiner\t\nMachinist\t\nMessenger-boy\t\nMusician\t\nNone\t\nPainter\t\nPensioner\t\nPrinter\t\nPlasterer \t\nPile-driver\t\nProstitute\t\nReal Estate Agent\t\nRemittance-man\t\nSalesman\t\nSailor\t\nSea Captain   \t\nStone-mason\t\nStudent-at-Law\t\nTeamster\t\nTailor\t\nTraveller\t\nWatchmaker\t\nWaiter\t\nUnknown\t\nTotal.\nMale.\n2\n1\n4\n3\n4\n1\n14\n1\n1\n1\n1\n....\n1\n2\n....\n1\n1\n5\n1\n20\n1\n1\n2\n2\n1\n74\n1\n9\n1\n1\n\"l5\n2\n1\n1\n4\n5\n1\n1\n1\n1\ni\ni\nl\n2\n2\n1\n1\n1\n2\n2\n1\n1\n9\n216\nFemale.\n3\n44\n64\nTotal.\n2\n1\n4\n3\n4\n1\n14\n1\n1\n1\n1\n4\n1\n1\n2\n7\n1\n1\n1\n5\n1\n20\n1\n1\n2\n2\n3\n44\n1\n74\n1\n9\n1\n1\n1\n15\n2\n1\n1\n8\n5\n1\n1\n1\n1\n1\n1\n1\n1\n2\n2\n1\n1\n1\n2\n2\n1\n1\n9\n280 G 44\nPublic Hospital for the Insane.\n1911\nTable No. 10.\nShowing the ages of those admitted during 1910.\nAge.\nMale.\nFemale.\nTotal.\n0\n1\n5\n6\n6\n8\n9\n7\n5\n2\n5\n6\n0\n2\n1\n1\n64\n1\n7\n29\n30\n39\n32\n13\n19\n18\n12\n8\n4\n3\n2\n0\n12\n\u00bb      20 to 25    a    \t\n35\na      25 to 30     \/\/    \t\n36\na      30 to 35    ;\/    .          \t\n47\n\u00bb       35 to 40     n    \t\n41\nit      40 to 45     \/\/    \t\n20\n24\n20\n17\n60 to 65     ,i        \t\n14\n4\na      70 to 75    ,\/    \t\n5\nv       75 to 80     a    \t\n3\na      80 to 85     a                                           \t\n1\nTotal\t\n216\n280\nTable No. 11.\nShowing the number of attacks in those admitted during 1910.\nNumber of Attacks.\nMale.\nFemale.\nTotal.\nFirst \t\n96\n14\n5\n3\n0\n98\n0\n216\n32\n9\n5\n3\n1\n14\n0\n64\n128\n23\nThird\t\n10\nFourth\t\n6\nEighth\t\n1\n112\n0\nTotal\t\n280\nTable No. 12.\nShowing the alleged duration of attack prior to admission.\nDuration of Attack.\nMale.\nFemale.\nTotal.\n27\n40\n18\n11\n10\n11\n8\n2\n1\n88\n15\n12\n9\n2\n4\n3\n1\n3\n1\n14\n42\n52\n27\n13\n,i       6 to 12     \/\/     \t\n14\n14\n<\/       5 to 10     n   \t\n9\n5\n\/;         10 tO 15        ii      \t\n2\n102\nTotal\t\n216\n64\n280 1 Geo. 5\nPublic Hospital for the Insane.\nG 45\nTable No. 13.\nShowing statistics of heredity in those admitted during 1910.\nHeredity.\nMale.\nFemale.\n3\n3\n0\n4\n35\n19\nTotal.\n16\n13\n2\n13\n105\n67\n19\n16\n2\n17\n140\n86\nTotal\t\n216\n64\n280\nTable No. 14.\nShowing the alleged existing causes of attack of insanity.\nAlleged Cause.\nBusiness worry\t\nChristian Science study ,\nCerebral tumor\t\nChildbirth\t\nCocaine\t\nDomestic worry\t\nDepression  \t\nDeath of husband\t\nDrugs\t\nEpilepsy\t\nExposure\t\nFall\t\nGunshot wound\t\nHeredity\t\nInjury to head\t\nIntemperance (alcoholic)\t\nKidney trouble\t\nLoss of memory\t\nMasturbation\t\nMoney trouble    \t\nOverstudy\t\nOverwork\t\nPregnancy \t\nReligion\t\nReligious mania\t\nSenility\t\nStomach trouble\t\nSunstroke\t\nSeclusion\t\nStrong medicine\t\nSpiritualism \t\nSolitude\t\nTyphoid fever\t\nUnnatural life\t\nVenereal disease\t\nWomen    \t\nPoor health\t\nUnstated but suspected heredity in majority of casee.\nTotal\t\nMale.\n1\n1\n3\n1\n1\n3\n1\n14\n1\n1\n2\n154\n216\nFemale.\n40\n64\nTotal.\n1\n1\n1\n5\n1\n2\n1\n1\n1\n3\n3\n2\n2\n4\n1\n15\n1\n1\n6\n1\n2\n3\n3\n3\n1\n3\n1\n2\n4\n1\n1\n4\n1\n1\n1\n1\n2\n194\n280 G 46\nPublic Hospital for the Insane.\n1911\nTable No. 15.\nShowing the state of bodily health on admission during 1910.\nBodily Condition.\nIn average bodily health ...\nIn reduced health\t\nIn greatly reduced condition\nTotal\t\nMale.\nFemale.\n167\n38\n11\n44\n15\n5\n216\n64\nTotal.\n211\n53\n16\n280\nTable No. 16.\nShowing the form of mental disorder in those admitted during 1910.\nForm of Disorder.\nAcute mania \t\nMelancholia\t\nMania, depressive condition\nDementia prascox\t\nDementia organic\t\nGeneral paralysis\t\nEpileptic insanity\t\nToxic insanity\t\nSenile dementia.\t\nTerminal dementia\t\nImbecility and idiocy\t\nParanoia\t\nNot insane\t\nTotal\t\nMale.\nFemale.\n1\n7\n9\n37\n22\n58\n9\n1\n1\n24\n1\n3\n2\n19\n1\n11\n4\n16\n3\n4\n3\n35\n8\n1\n216\n64\nTotal.\n1\n16\n59\n67\n2\n25\n5\n20\n15\n19\n7\n43\n1\n280\nTable No. 17.\nShowing the number allowed out on probation, and results during 1910.\nResults.\nDischarged recovered ..\nn improved ..\nn unimproved\nReturned to hospital. ..\nStill out at close of year\nTotal.\nMale.\nFemale.\n60\n24\n50\n18\n12\n2\n3\n5\n16\n9\n58\n141\nTotal.\n84\n68\n14\n8\n25\n199 1 Geo. 5\nPublic Hospital for the Insane.\nG 47\nTable No. 18.\nShowing alleged duration~of insanity prior to admission in those discharged during 1910.\nDuration of Insanity.\nMale.\nFemale.\n7\n12\n6\n4\n3\n3\n2\n7\nTotal.\n15\n22\n12\n6\n1\n3\n2\n1\n4\n56\n22\n34\n18\n\u201e    2 a   3       n     \t\n6\n5\n3\n6\n4\nOver 3                \u00ab         \t\n6\n63\nTotal\t\n122\n44\n166\nTable No. 19.\nShowing length of residence of those remaining under treatment in 1911, and those who\nwere discharged during the year 1910.\nLength of residence.\nOf those\nunder\ntreatment\nJanuary  1st,\n1911.\nOf those\ndischarged\nrecovered\nin 1910.\nOf those\ndischarged\nimproved\nin 1910.\nOf those\ndischarged\nunimproved\nduring\n1910.\nOf those\ndischarged\nnot insane\nduring\n1910.\n16\n35\n20\n20\n25\n17\n28\n23\n83\n64\n40\n34\n23\n29\n28\n8\n19\n37\n24\n10\n12\n13\n11\n10\n6\n5\n9\n14\n2\n10\n4\n9\n9\n9\n7\n4\n2\n9\n3\n8\n2\n2\n1\n1\n1\n1\n4\n4\n1\n2\n\u201e       2 to   3      a      \t\n\u201e       3 to   4      a         \t\nn       9 to 12      a\n\u201e       2 to   3      a\n2\na       3 to   4      a\na       6 to   7      \u00ab              \t\nn      7 to   8      n\nii       8 to   9      n\nn       9 to 10      \u00bb\na     10 to 15      a                   .....\n1\n\u00bb     15 to 20      a\nn     20 to 25      n\nTotal\n595\n84\n68\n14 G 48\nPublic Hospital for the Insane.\n1911\nTable No. 20.\nRecords of death for the year 1911.\nRegister\nNo.\n1,268\n1,725\n2,278\n2,468\n2,542\n1,766\n2,276\n2,531\n1,422\n2,361\n2,527\n2,470\n2,516\n2,396\n296\n2,587\n2,158\n2,101\n2,261\n2,545\n2,213\n1,513\n1,066\n1,335\n1,973\n2,655\n2,652\n2,579\n1,571\n2,689\n2,117\n2,681\n1,506\n2,308\n2,704\n2,128\n2,630\n2,215\n2,706\n2,431\n1,921\nInitials.\nM. E.\nT. B.\nF. J. C.\nA. Y. M.\nS.\nE. S. M. C.\nJ. E.\nL. S.\nR. 0.\nW. R.\nE. M. M.\nC. W.\nJ. K.\nJ. R.\nJ. W.\nG. T. E.\nE. L. H.\nJ. A.\nF. S.\nA. R.\nJ. C. S.\nM. S.\nA. McD.\nC. A. L.\nC. D. W.\nT. O'C.\nD. W.\nW. McM.\nA. G.\nF. B.\nG. G.\nB. L.\nF. J.\nE. A. C.\nJ. B.\nF. P.\nA. Mel.\nF. L.\nJ. R. S.\nJ. L.\nC. H.\nSex.\nAge.\nTime in Hospital.\nM.\nYears.\nMonths.\n5\nDays.\n26\n69\n7\nM.\n24\n3\n10\n30\nM.\n60\n1\n2\n2\nF.\n16\n3\n25\nM.\nF.\n25\n38\n4\n2\n3\n8\nM.\n77\n1\n2\n12\nF.\n36\n1\n3\nM.\n52\n6\n5\n13\nM.\n78\n10\n1\nF.\n50\n1\n24\nF.\n45\n6\n28\nM.\n41\n3\n12\nM.\n52\n9\n25\nM.\n70\n21\n8\n27\nM.\n44\n1\n2\nM.\n37\n1\n11\n2\nM.\n67\n2\n2\n3\nF.\n24\n1\n8\n19\nM.\n47\n3\n7\nM.\n13\n1\n9\n18\nF.\n61\n6\n2\n14\nM.\n49\n9\n9\n4\nF.\n49\n7\n4\n13\nF.\n39\n2\n10\n7\nM.\nF.\nM.\n51\n30\n45\n15\n24\n6\n5\nM.\n60\n5\n7\n26\nF.\nM.\n33\n75\n6\n12\n2\n6\nM.\n48\n2\n15\nM.\n75\n6\n6\n29\nM.\n33\nI\n9\n24\nM.\n28\n2\n12\nM.\n52\n2\n16\nM.\n60\n5\n26\nM.\n70\n2\n4\n9\nM.\n74\n3\n10\nM.\n45\n1\n4\n18\nF.\n56\n3\n8\n9\nCertified Cause.\nCerebral haemorrhage.\nTuberculosis of lung.\nGeneral paralysis.\nEpileptic exhaustion.\nTuberculosis of lungs.\nGeneral debility.\nSenility.\nGeneral debility.\nParesis.\nSenility.\nGeneral debility.\nSenility.\nGeneral paralysis.\nPeritonitis.\nHeart disease.\nGeneral paralysis.\nExhaustion of dementia.\nSenility.\nChlorosis.\nGeneral paresis.\nTuberculosis.\nCerebral haemorrhage.\nGeneral paralysis.\nEpileptic exhaustion.\nPneumonia.\nGeneral paresis.\nPulmonary tuberculosis.\nGeneral paralysis.\nGeneral debility.\nManiacal exhaustion.\nPeritonitis.\nGeneral paralysis.\nSenility.\nTuberculosis.\nCerebral haemorrhage.\nLaryngeal   obstruction   from\nimpacted, regurgitated and\nunmastieated food.\nGeneral paralysis.\nSenility.\nSenility.\nGeneral paralysis.\nPeritonitis. 1 Geo. 5\nPublic Hospital for the Insane.\nG 49\nTable No. 21.\nWork done by Patients during the year 1910.\nCarpenter...\nFarmer\t\nGardener ...\nEngineer....\nKitchen ....\nLaundry ....\nPainter\t\nPlasterer....\nShoemaker...\nTailor\t\nWard work..\nPorter\t\nBaker\t\nPlumber ....\nLaboratory..\nDining-room\nScullery\nGate\t\nColony Farm.\nCarpenter\t\nFarmer\t\nDining-room\t\nEngineer\t\nKitchen\t\nStable\t\nPainter\t\nGeneral work\t\nSlashing and cutting wood.\nMason\t\n664 days.\n10,489\n2,680\n1,595\n1,924\n3,609\n1,126\n462\n259\n665\n54.331\n1,079\n920\n299\n292\n5,897\n1,992\n365\n348\n3,309\n661\n293\n607\n832\n213\n1,037\n4,046\n62\nTable No. 22.\nArticles made by Female Patients.\nAprons      103\nBlouses    \t\nDresses, gingham  36\na         serge  9\nHandkerchiefs  244\nNapkins, table  48\nPillow-slips  437\nDrawers (pairs)\nDoilies\t\nDusters\t\nMats, rag\t\nNeckties\t\nSkirts\t\nSheets .\nTablecloths\t\nPetticoats\t\nCushions\t\nWindow curtains (pairs)\nSash n a\nSofa covers\t\nChemises\t\n371\n21\n12\n4\n34\n96\nTowels, bath..\n\/\/        roller.\na       tea ...\na tray ..\nBedside rugs ..\nTable covers ..\nPillow-shams. .\nBureau covers.\nArticles made for Nurses.\nAprons\n67\n78\nDresses ,\nRepairs for Nurses.\nAprons       246       Dresses\nCaps\t\n4\n24\n36\n231\n30\n246\n18\n355\n130\n121\n66\n12\n6\n44\n6\n38\n185 G 50\nPublic Hospital for the Insane.\n1911\nMending done for Female Patients.\nAprons      305\nBlankets  200\nBlouses  294\nChemises  496\nDrawers (pairs)  314\nDresses, gingham  561\nw         serge   421\nn        night  295\nHose (pairs)  3,702\nPillow-slips ...\nSheets\t\nSkirts\t\nSpreads, bed . .\nTablecloths ...\nTicks, bed\nTowels, bath .\n\u00ab        roller\nVests, under .\nMending done for Male Patients.\nAprons  56\nBlankets  228\nCoats  210\nDrawers  1,563\nJumpers  56\nOveralls  258\nPants (pairs)  698\nPillow-slips      223\nSheets  294\nShirts, duck...\nw under .\nSocks (pairs) . .\nSpreads, bed . .\nTablecloths ...\nTicks, bed . ..\nTowels, bath..\n\u00bb roller.\nVests\t\nReport of Tailoring Department.\nStock :\u2014\n340 pairs pants\t\n366 coats \t\n216 vests \t\n16 suits \t\n15 canvas blankets\t\n60 bed ticks\t\n71 pillow ticks\t\n24 night shirts\t\n12 jumpers\t\n13 overalls\t\n26 new collars and shirts .\nRepairs\t\nTotal stock work.\nUniforms :\u2014\n69 suits\t\n53 pair pants\t\nTotal uniform work.\n$ 965 65\n2,188 65\n464 50\n183 70\n78 60\n101 00\n24 85\n30 00\n9 00\n9 75\n2 60\n12 70\n14,071 00\n|1,474 00\n354 83\n$1,828 83\nTotal Uniforms      $1,828 83\n\/\/     Stock      4,071 00\na     Repairs  14 69\nGrand total\n,914 52\nNew work :\u2014\nNew shoes, men's,\na    slippers, men's,\na   slippers, women's\nRepairs :\u2014\nMen's shoes,\n\/\/     slippers,\nWomen's shoes,\n\u00ab slippers,\nMiscellaneous work\t\nTotal\t\nWork done by Shoemaker.\n22 pairs.\n46   i,    .\n4    ,i    .\n420    \u201e    .\n128    -\/    .\n38   ii    .\n$155 00\n115 50\n10 00\n462 95\n116 52\n26 75\n5 25\n$ 38 85\n180\n203\n625\n165\n187\n113\n156\n111\n454\n1,941\n1,880\n5,044\n223\n191\n155\n186\n136\n144\n.$930 82 1 Geo. 5\nPublic Hospital for the Insane.\nG 51\nPreserves put up.\nRed currants  62 quarts.\nBlack     a           60 a\nBlackberries   28 \u00bb\nPeaches         25 \u00bb\nPlums 110 \u201e\nGooseberries       65 \/\/\nRhubarb  63 \u00bb\nRaspberries  68 n\nPears   60 \u00bb\nCrab-apple  35 n\nStrawberries   130 a\nPickles.\nTomato 250 quarts.\nJelly.\nApple   15 quarts.\nRed currant   12     \/\/\nBlack currant       25     n\nADMINISTRATION   BUILDING\nFRONT ELEVATION\nVICTORIA, B. C.:\nPrinted by Richabd Wolfenden, I.S.O., V.D., Printer to the King's Most Excellent Majesty.\n1911. ","@language":"en"}],"Genre":[{"@value":"Legislative proceedings","@language":"en"}],"Identifier":[{"@value":"J110.L5 S7","@language":"en"},{"@value":"1911_09_G1A_G51","@language":"en"}],"IsShownAt":[{"@value":"10.14288\/1.0064403","@language":"en"}],"Language":[{"@value":"English","@language":"en"}],"Provider":[{"@value":"Vancouver : University of British Columbia Library","@language":"en"}],"Publisher":[{"@value":"Victoria, BC : Government Printer","@language":"en"}],"Rights":[{"@value":"Images provided for research and reference use only. For permission to publish, copy or otherwise distribute these images please contact the Legislative Library of British Columbia","@language":"en"}],"SortDate":[{"@value":"1911-12-31 AD","@language":"en"},{"@value":"1911-12-31 AD","@language":"en"}],"Source":[{"@value":"Original Format: Legislative Assembly of British Columbia. Library. Sessional Papers of the Province of British Columbia","@language":"en"}],"Title":[{"@value":"ANNUAL REPORT OF THE PUBLIC HOSPITAL FOR THE INSANE OF THE PROVINCE OF BRITISH COLUMBIA FOR THE YEAR 1910.","@language":"en"}],"Type":[{"@value":"Text","@language":"en"}],"Translation":[{"@value":"","@language":"en"}],"@id":"doi:10.14288\/1.0064403"}