<emph>Annual Report of the Board of Directors and the Superintendent of the North Carolina Insane Asylum, for the Year Ending November 30, 1884:</emph> Electronic Edition.

]> <emph>Annual Report of the Board of Directors and the Superintendent of the North Carolina Insane Asylum, for the Year Ending November 30, 1884:</emph> Electronic Edition. Insane Asylum of North Carolina Funding from the Institute for Museum and Library Services supported the electronic publication of this title. Text transcribed by Apex Data Services, Inc. Images scanned by Matt Kern Text encoded by Apex Data Services, Inc. and Melissa Meeks First edition, 2002 ca. 150K Academic Affairs Library, UNC-CH University of North Carolina at Chapel Hill, 2002.

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Annual Report of the Board of Directors and the Superintendent of the North Carolina Insane Asylum, for the Year Ending November 30, 1884. Insane Asylum of North Carolina 30 p. Raleigh, N.C.: Ashe & Gatling, Printers and Binders, Presses of Uzzell & Gatling. 1884. Call number C362.2 N87s 1851-1888 (North Carolina Collection, University of North Carolina at Chapel Hill)

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Library of Congress Subject Headings English Insane -- Commitment and detention -- North Carolina. Mentally ill -- Care -- North Carolina. Insane Asylum of North Carolina. State hospitals -- North Carolina -- Raleigh. Psychiatric hospitals -- North Carolina -- Raleigh. Insane Asylum of North Carolina -- Finance. Mentally ill -- Care -- North Carolina -- Raleigh. 2003-03-13, Celine Noel and Wanda Gunther revised TEIHeader and created catalog record for the electronic edition. 2002-11-12, Melissa Meeks finished TEI-conformant encoding and final proofing. 2002-03-21, Don Chalfant finished TEI/SGML encoding 2002-02-01, Apex Data Services, Inc. finished transcribing the text.

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ANNUAL REPORT OF THE BOARD OF DIRECTORS AND THE SUPERINTENDENT OF THE NORTH CAROLINA INSANE ASYLUM, FOR THE YEAR ENDING NOVEMBER 30, 1884. RALEIGH, N. C.: ASHE & GATLING, STATE PRINTERS AND BINDERS, PRESSES OF UZZELL & GATLING. 1884. BOARD OF DIRECTORS. DR. E. BURKE HAYWOOD, President, . . . . .Term expires March 1, 1889. PROF. JOHN B. BURWELL,. . . . .Term expires March 1, 1889. COL. ROBERT L. STEELE,. . . . .Term expires March 1, 1889. WILLIAM S. MASON, ESQ.,. . . . .Term expires March 1, 1887. A. J. TOMLINSON, ESQ.,. . . . .Term expires March 1, 1887. DR. W. M. B. BROWN,. . . . .Term expires March 1, 1887. RICHARD H. SMITH, ESQ.,. . . . .Term expires March 1, 1885 WILLIAM S. BATTLE, ESQ.,. . . . .Term expires March 1, 1885. WILLIAM S. HARRIS, ESQ.,. . . . .Term expires March 1, 1885. EXECUTIVE COMMITTEE. WILLIAM S. MASON, Chairman,E. BURKE HAYWOOD, M. D., RICHARD H. SMITH. OFFICERS. HON. JOHN M. WORTH,. . . . . .TREASURER ex-officio. PETER M. WILSON,. . . . .CLERK OF RECORDS. RESIDENT OFFICERS. EUGENE GRISSOM, M. D., L.L. D., . . . . . SUPERINTENDENT. FRANCIS T. FULLER, M. D., . . . . . FIRST ASSISTANT PHYSICIAN. SION H. ROGERS, M. D., . . . . . SECOND ASSISTANT PHYSICIAN. JOHN W. THOMPSON, . . . . . STEWARD. MRS. MARY A. LAWRENCE, . . . . . MATRON. SUBORDINATE OFFICERS. JAMES S. WEST, . . . . . ENGINEER. I. H. ROGERS, JR., . . . . . CHIEF MALE ATTENDANT. MRS. V. C. JONES, . . . . . CHIEF FEMALE ATTENDANT. REPORT OF THE BOARD OF DIRECTORS OF THE NORTH CAROLINA INSANE ASYLUM. TO HIS EXCELLENCY, THOMAS J. JARVIS, GOVERNOR OF NORTH CAROLINA:

SIR:—In behalf of the Board of Directors, I have the honor to submit the accompanying reports of the Superintendent and Treasurer of the North Carolina Insane Asylum for the year ending November 30th, 1884.

It is well known to alienists, that the sooner acute cases of insanity receive proper hospital treatment, the better their chances of recovery. Therefore, the Board of Directors are anxious to receive all acute cases as soon as possible. It will be seen from the Superintendent's report that the number of admissions exceed that of any preceding year. Our mortality has been small, being less than four per centum.

In the Eastern Division of the State, comprising fifty-six counties assigned to the North Carolina Insane Asylum, there are eight hundred and fifty white insane. This Asylum cannot accommodate more than two hundred and fifty patients. Our wards are constantly crowded with patients, five-sixth of whom are chronic cases. It is therefore evident, that only a few of the acute cases outside can be received, and that room for them can be obtained only by the discharge of the cured or the removal of the harmless incurables. Very often the friends of the insane postpone making application for their admission until they have become chronic and almost hopeless cases. If they are admitted, they add to the number of incurables, and prevent the reception of the acute cases from their counties, and if postponed or rejected, are the innocent cause of unmerited censure of the Board by their friends, who do not discriminate between acute and chronic cases of insanity, but very naturally think that all indigent insane are the wards of the State and should be provided and cared for by it.

The returning of harmless incurables to their counties of settlement, in obedience to Section 2260 of the Code of North Carolina, is often attended with delay from some of the sheriffs neglecting their duty, and when done, causes in many instances great distress and suffering to the unfortunate persons sent and trouble and expense to their families and friends, who are often unable to bear it.

Therefore, the Board of Directors respectfully request of the Legislature to make an appropriation to increase the hospital accommodation for the insane in this district, either by the purchase of a building that could be made suitable for such a purpose, or by adding to the buildings of the North Carolina Insane Asylum, thus enabling them to rescue from the dreadful state of chronic insanity many who are fast approaching that almost hopeless condition. They also respectfully request, that in their wisdom, they will so amend Sections 2260 and 66 of the Code of North Carolina, as to relieve them of the burden of keeping the harmless incurables when ordered to be transferred to their counties of settlement.

The expenditures for the Asylum for the last two years have been greater and the improvements and repairs much more extensive than were anticipated. The result of this is a debt which the biennial appropriation was insufficient to pay, as will fully appear in the statements contained in the Superintendent's reports for 1883 and 1884.

For the purpose of paying this indebtedness, supporting the Asylum and making such purchases and repairs as the necessities of the next two years will require, the same or nearly the same appropriation will be necessary for two years.

We also recommend that the law should clearly define the beginning and end of the fiscal year in the use of appropriations for this Asylum.

I have the honor to be, Very respectfully, Your obedient servant, E. BURKE HAYWOOD, M. D., President of the Board of Directors. SUPERINTENDENT'S REPORT. TO THE BOARD OF DIRECTORS OF THE NORTH CAROLINA INSANE ASYLUM:

GENTLEMEN:—It is my privilege to present to you the report of the history and operations of this institution for the twenty-ninth year of its existence.

In order to facilitate compliance with the law upon the subject of the admission of patients to the institution, and for the convenience of the public, the following rules and forms have been adopted by the Board, in accordance with the provisions of Chap. 2, Vol. II, of the Code of North Carolina:

THE NORTH CAROLINA INSANE ASYLUM, RALEIGH, N. C., ..... ..... 188...

The dividing line established according to law, between the North Carolina Insane Asylum at Raleigh and The Western North Carolina Insane Asylum at Morganton, runs from the Virginia line south with the Western boundary lines of Rockingham, Guilford, Randolph, Montgomery and Richmond counties to the South Carolina line. All applications from counties west of said line to be made to Western Asylum.

The following rules have been adopted by the Board of Directors of the North Carolina Insane Asylum:

1. All applications now on file, to be renewed under the new Act of the General Assembly and recorded as received, stating name, date, county and what disposition is made of the same, and the correspondent of the applicant notified.

2. All admissions to be in the interest of the institution, merits of the case and the protection of society.

3. Acute cases, with good prospects of cure, to be admitted promptly on application, making room by discharge, if necessary, of some comparatively harmless and incurable case, from the same or some other county.

4. All other applications to be referred to the Board of Directors or Executive Committee, with such information pertaining to the same as may be of service to said committee in deciding as to the admission of the case. Such admissions to be regulated, as far as practicable, by the population, in such manner as to equalize the benefits of the institution among the various counties.

5. Each admission or rejection of an applicant to be a matter of record in a special book, and signed by two or more members of said Board or Committee.

6.No patient need be brought to the Asylum without previous notice of acceptance by the Board of Directors or Executive Committee.

By order of the Board of Directors:

EUGENE GRISSOM, Superintendent. (FORM OF COMMITTAL). AFFIDAVIT TO PROCURE EXAMINATION OF AN INSANE PERSON. STATE OF NORTH CAROLINA, ..... County.

The undersigned, residing in said county, makes oath that he has carefully examined ....., the alleged lunatic, and believes ..... to be an insane person, and to be, in the opinion of the undersigned, a fit subject for admission into an Insane Asylum.

Dated ..... day of ..... 188 ... ....., Affiant.

Subscribed and sworn to before me, ....., Justice of the Peace.

N. B.—Upon the coming of such alleged insane person before such Justice, as provided in section 17 of the Law to Incorporate the Insane Asylums of the State, ratified February 20, 1883, if the Justices shall so determine, they shall render the following judgment of committal:

(Every part of the following forms is required by law to be filled).

NORTH CAROLINA, ..... County.

Upon examination of ....., M. D., ..... and ....., we decide that ..... is insane, and no friend becoming bound, as the law directs, we adjudge and direct that said ..... be removed to “The North Carolina Insane Asylum” as a patient, and that a warrant issue accordingly.

....., J. P. ....., J. P. THE STATE OF NORTH CAROLINA, To the Sheriff or Constable of ..... County—Greeting:

WHEREAS, It has been made to satisfactorily appear to us, ..... and ....., Justices of the Peace of said county, that ....., citizen of the State, is an insane person, that ..... has a legal settlement in said county, and is a fit subject for an Insane Asylum, and that ..... being at large, is injurious to ..... and disadvantageous, if not dangerous to the community:

YOU ARE THEREFORE COMMANDED to take said ..... and convey ..... to the Insane Asylum of North Carolina, and there deliver ..... to the Superintendent thereof for safe keeping.

Given under our hands, this ..... day of ....., 188 ... ....., J. P. ....., J. P. NOTE.—The above warrant is to be issued under an Act of the General Assembly, ratified February 20, 1883, and should be filled up in every application. INTERROGATORIES TO BE ANSWERED BY COMPETENT WITNESSES.

QUESTION 1. What is the name of the patient? ANSWER. .....

QUES. 2. Is ..... white or colored? ANS .....

QUES. 3. What is ..... age? ANS. .....

QUES. 4. Is ..... married or single; and if married, for how many years? ANS .....

QUES. 5. What is the supposed cause of insanity? ANS. .....

QUES. 6. In what way is the disease exhibited? ANS. .....

QUES. 7. Has any medical treatment been pursued? If so, what kind and by whom? ANS .....

QUES. 8. How long has ..... been insane? Count from first symptoms and give all known symptoms from that time to this date. ANS .....

QUES. 9. Has the patient manifested any propensity to injure ..... or others? If so, what way and how often? ANS .....

QUES. 10. Has ..... been subject to epilepsy? ANS .....

QUES. 11. Has any of ..... ancestors been insane? If so, state what ancestors, and what was the character of their insanity. ANS .....

QUES. 12. Has ..... any family, and if so, what persons compose it? ANS .....

QUES. 13. Are any of them insane, and what is the character of such insanity? ANS .....

QUES. 14. What is the occupation of the patient? ANS .....

QUES. 15. How many attacks of mental disease has the patient had? ANS .....

QUES. 16. Are parents of the insane person related by blood? If so, what is the degree of relationship? ANS .....

QUES. 17. Has the patient property? If so, state in what such property consists, and what is the value thereof? ANS .....

QUES. 18. Is ..... under any forcible restraint? If so, what? ANS .....

QUES. 19. Has the patient received any aid from the county? If so, what? ANS .....

QUES. 20. Give NAME and post-office of the nearest relative or friend of the patient with whom the Superintendent of the Insane Asylum can correspond, as circumstances require, for the benefit of the patient. ANS .....

QUES. 21. Give any information in your possession, not embraced in the above questions, which may throw light on the mental or physical condition of the patient. ANS .....

..... ....., M D., ..... ..... ..... ..... ..... ..... Witnesses. STATE OF NORTH CAROLINA, ..... ..... County.

Before us, officers duly authorized to administer an oath, this ..... day of ....., 18..., came ....., M. D., ....., persons known to be reliable and creditable witnesses (one of whom is a physician), and make oath that the foregoing answers are true to the best of their knowledge and belief.

..... ..... ....., J. P. ..... ..... ....., J. P.

The total number of admissions since the opening of the Asylum on the 22d February, 1856, is 1,626; the total number of discharges for the same time, is 1,383; of whom 428 were cured; 210 improved; 296 unimproved; and 449 died; leaving now under treatment 243.

Upon the whole number of admissions, the percentage of discharges cured has been 26; of improved, 12; of unimproved, 18; of deaths, 27.

At the date of the last Annual Report, there were in the Asylum 96 males and 103 females. The admissions since have been 53 males and 53 females. The whole number under treatment during the year was 149 males and 156 females, making a total of 305.

There have been 25 males and 37 females discharged during the year; of these, 13 males and 13 females were cured; 2 males and 14 females improved; 4 males and 5 females unimproved; and 6 males and 5 females died.

Of the past year the following are the results:

1. The percentage of cures upon admission has been 24. 2. The percentage of deaths upon number under treatment has been 4.

Of the admissions during the year, the cause of disease is reported to have been mental in 29 cases, physical in 56 cases, and unknown in 21.

The form was Mania, Epileptic, Suicidal and Homicidal in 68 cases; Melancholia in 26; Dementia in 5; and other forms in 7 cases.

The average duration of disease previous to admission, is represented to have been about 3 years—many of them 10 to 20 years.

Of those recovered, the supposed cause of the disease was mental in 5 cases; physical in 15; and unknown in 6.

The form was Mania in 18 cases; Melancholia in 6 cases; Dementia in 1 case; and Monomania in 1 case.

The duration before admission is represented to have been less than one year in 20 cases, and from 1 to 3 years in 6 cases.

The length of time under treatment in the Asylum was less than 1 year in 16 cases, and over 1 year in 10 cases, making on average of 7 or 8 months of treatment, except in cases at home on “probation,” not properly to be included.

Of the deaths, the cause of insanity was mental in 2 cases; physical in 5 cases; and unknown in 4. The duration before admission was 4 years, and length of time under treatment was 7½ years, the longest one 27 years, the shortest 3 days.

The cause of death was Heart Disease in 1 case; General Paresis in 1; Exhaustion from Chronic Mania in 3: Acute Mania in 1; Phthisis in 3; Chronic Dysentery in 1; and Inanition in 1 case.

For more than a quarter of a century, with accommodations for less than two hundred and fifty patients, this institution was the only hospital for the insane in a State which, for a great portion of that period, contained over a million of people.

When first opened, its records show that of the ninety admissions of its first year, only twelve per cent. had been suffering from disease for a shorter period than one year. From the very beginning chronic and incurable cases have largely occupied the wards, and a steady increase of insanity within our borders, with the great public and private injury inseparable therefrom, has marked every year of our history, because the means of arresting the progress of a calamity which may well be likened to the dry-rot of civilization, were totally inadequate.

After many urgent appeals, and as soon as circumstances seemed to indicate the practicability of the undertaking, a great step in advance was taken by the enlightened and humane legislators to whom we owe the excellent institutions now in operation at Morganton and Goldsboro.

It is a source of congratulation that so many of the insane can now be cared for by these Asylums, in addition to those who can receive treatment here. The final completion and thorough equipment of the new institutions will greatly contribute to the accommodations for the comfort and cure of suffering humanity, so long demanded by every interest of the State.

The economic questions involved in the care of the insane are of the most serious character. From the statistics of the tenth census (1880), we find the following startling facts, as tabulated below:

DATE. POPUL'N U. S. NO. INSANE. RATIO. 1860 31,443,221 20,042 1 to 1,308 1870 38,558,371 37,432 1 to 1,030 1880 50,155,783 91,997 1 to 545

If we could believe that these figures absolutely represented the increment of disease, unmodified by qualifications, we might well despair of a future so burdened by ever increasing liabilities for succeeding generations to discharge. But it is justly remarked by the collector of statistics of the “defective classes” (Rev. F. H. Wines), that “it is not possible to believe that there has in fact been any such increase of the defective classes as are indicated by the figures given in tables above. The inference is irresistible that either the enumeration in 1880 is excessive, or else it was incomplete in 1870 and the years previous.”

That the latter conclusion explains the enormous increase, in part, of the number reported, is perhaps true. Ten years ago, in relation to this subject, the following language may be found in my report:

“But it would seem that by far the prevailing reason for the great public demand for increase of accommodations for the insane, arises from the growth of public confidence in their curative and custodial work: and the better appreciation of insanity as a disease amenable, in a majority of cases, to prompt treatment; and, therefore, there is a greater willingness, and even eagerness, to bring forth the afflicted from their secluded retreats for appropriate treatment.”

The report of 1874 continues as follows: “From information in my possession, I have reason to believe that insanity, in this State, is largely on the increase. It is probable that there are in the State, in accordance with the statistics of other sections more accurately taken, not less than one case of insanity in every 1,000 of our population, or 1,071 cases. The census of 1870 gave 779 cases, but it is notoriously defective in this respect, from the evident reason of the dislike of families to register their insane members; and not unoften from their uncertainty or ignorance of the disease. It is possible that one-half of them may be taken care of by their friends, as chronic cases, and blessed with a share of comfort. But a large part are to-day languishing in jails and poor-houses, with equal rights to the enjoyment of the bounty of the State, with those who are now fortunate enough to be under her immediate protection.”

But if this were a matter of grave concern at that day, the problem now is one that may well task the best efforts of the statesman.

According to the last census, there was in North Carolina four years ago, a total population of 1,398,417, of which 867,242 were white, and 531,277 colored.

The total number of insane reported in the State is 2,028; of these 1,591 were white, and 437 colored.

The two Asylums for the white population, at Raleigh and at Morganton, now have under treatment about 450, leaving 1,141 without such care, and about 200 colored patients are in the Asylum at Goldsboro, leaving 219 colored unprovided for. To these must be added the increase of insane population for the last four years.

The present dividing line between the territory from which patients are sent to this institution, and to the Western Asylum, is so arranged as to place 56 counties, with a white population of 465,500, as patrons of this Asylum, and 40 counties, with a white population of 401,742, as patrons of the Western institution.

You are aware that this dividing line can be changed at any time by the concurrence of the directors of the two institutions.

It will be observed that the ratio of the white insane to the whole white population of the State is 1 to 545, being about the general ratio for the entire population of the Union.

If the proportion is alike in both sections of the State, there are 853 white insane persons east of said dividing line, and 738 west of the line.

Our capacity for accommodation is 250, which leaves at home, in the jails, and in the poor-houses of the Eastern Division not less than 603, and not many differing from that number also, in the Western Division.

It may be of interest to state that the ratio of the colored insane to the colored population is 1 to 1,215, and that about one-half of all the colored insane in the State are provided for in the Goldsboro institution.

Recurring to the white insane, the question of immediate importance is, what shall be done with the 600 directly dependent upon this institution, with their constantly increasing numbers.

The effort to send away our incurable and harmless cases, to make room for some of the acute and curable, is met with constantly recurring difficulties. From their families come indignant protests and bitter complaints of partiality. From the county officers we encounter indifference, reluctance, and frequently absolute refusal to send for the patients thus to be discharged, as provided in Section 2260 of the Code. The expense attending their removal at the cost of the institution also interferes in the execution of this sad, yet imperatively necessary choice of evils.

Account for it as we may, by reasoning from many ingenious suppositions, there remains the evident fact, that in round numbers there remains nearly one hundred thousand victims of insanity in the United States, of which we have two thousand, or about one-fiftieth, and there is the sad conviction within us, that this army of the stricken and helpless is constantly increasing.

A distinguished writer observes: “The number of the insane in the United States is greater than in any other country, except, perhaps, England.

“Comparative statistics of the disease in different countries demonstrate that insanity is a part of the price we pay for our Western civilization. It is comparatively unknown in the East. The immobility of the Oriental peoples, their systems of caste lead to an individual and national calm, the complete contrast of our ceaseless agitation. Contemplate for a moment our American life. The business of the country is an Atlantic of storm, which scarce knows repose. We buy, we sell, we tear down, we build up, we put girdles round the globe, as if our time were but an hour and eternal destiny hung upon these material issues. With our rapid successes, which will try the brain of the stoutest, and our as sudden reverses, toppling in a day the stateliest pile that energy and opportunity can rear, what must be the wear and tear of that central force, which is at once the driving-wheel and motive power of our business activity—the nervous system? Every day of the year somebody's brain reels.

“Splendid as is our civilization, insanity, and intemperance, its foremost proximate cause, are its dark shadows which follow its march with ever-deepening gloom wherever it goes. They appear at our firesides, at our altars, and in our most sacred seats, like the skeletons at the Egyptian feasts, as if to mock us.

These features of our Western life impose peculiar obligations. Man is the creature of society. It envelops him as an atmosphere, and he cannot escape its mutualities and responsibilites. No man liveth to himself, and no man dieth to himself. We are bound together in this community life, and not a member of the vast confraternity can be diseased, and the whole body not suffer. We take our civilization cum onere, and our society with all its obligations.”

These thoughtful expressions represent the sentiment of the best and wisest among us. Long ago, the declaration of Horace Mann, that the insane were the wards of the State, was stamped as an axiom by political economists. And if the insane are justly wards; if we may, as we do, take charge of their estates by legal process, to preserve them from dilapidation and waste, in the hands of proper and discreet guardians, can the State do less for their bodies than for their perishing property?

But if the State is to control the well-being of the insane, to restrain their liberty in order to protect her peaceful citizens from maniacal outrage, and to administer medical treatment to the end that the victim may be restored to the ranks of useful citizenship, on what principle can the line be drawn which surrounds one man with the comforts and appliances of modern science to contribute to his recovery, and consigns another to the poor-house or the jail—often well-nigh synonymous terms? This shocking inequality cries aloud, and its voice will necessarily come up in louder tones year after year from bereaved households and agonized victims.

It must inevitably occur, in the passage of a considerable part of our population, from the quiet and healthful pursuit of agriculture, to the excitements of the manufacturing and commercial pursuits now extending among us, that the tendency to insanity will be still more distinctly marked.

There is, perhaps, a sort of compensation in the fact that the rapidly increasing wealth of the State, through the developed activities of the people, will furnish additional means for the provision for treatment and cure.

It may be assumed that eventually, and the earlier the better, additional accommodations must be provided for the rapidly increasing number of insane. This involves the creation of additional institutions, or the extension of the facilities for treatment at the present institutions, either by wings added thereto or by semi-detached buildings in the adjacent grounds.

The first plan involves an expenditure unnecessary to the end in view, and is undesirable. The introduction of many improvements in asylum management and much labor-saving apparatus, and a more perfect system, of recent years, makes it much more practicable than was formerly the case, to care for a larger number of patients than it was customary to assemble together.

Economy of building expenditures should be carefully considered. The average cost of eighty asylums of the United States was $1,253.50 per capita, but as this includes some of very expensive architecture, the limit of reasonable expenditure has been regarded as about $1,000 per capita. The Eastern Asylum of this State cost $437.50 per capita, upon a basis of 160 patients. This has, however, been increased to a larger capacity.

It is probably altogether practicable to build additional accommodations in the form of detached buildings in the grounds of the present institutions, and certainly in the shape of wings to those now in use, for $500 per capita or less.

There are some objections to the use of detached buildings recapitulated in my report of 1874. Candor, however, impels me to qualify the statements therein made by reference to the later experience of some institutions which report satisfactory results from this plan of building, both in economy of management and success of treatment, and especially the latter.

I need not dwell upon the obvious economy of erecting additional wings to this institution, whereby, with only the necessary room and appliances for the personal accommodation of the patients, within a reasonable number, the present administrative buildings and machinery for cooking, washing, lighting, heating, ventilating and water supply, with very moderate additions, would suffice, together with the same grounds and farm, and the same staff of officers, with the necessary addition of attendants and employees; thus making a vast annual saving of expenditure. It is no small consideration, in addition, that this is also by far the most speedy method of affording a remedy for the evils which have been discussed in this report.

IMPROVEMENTS AND REPAIRS FROM DECEMBER 1st, 1883, TO NOVEMBER 30th, 1884.

The Arcade has been repaired. Large iron rods have been put in from arch to arch.

The Steward's house has been completed at an additional cost of $420.84, making the total cost $2,223.38.

The plastering in the kitchen, store-room, bakery, dairy, boiler-house and laundry, has been patched and whitewashed, and the stucco on kitchen repaired. Three half low-down grates have been put up.

Engineer's house has been re-shingled.

One No. 2 Troy Laundry Machine has been added to the wash-house machinery.

One hundred and twenty feet five-inch bronze cornice has been put up in Fourth Ward dining and sitting-rooms.

Five sitting-room tables, with clustered stools, have been put in the Ward sitting-rooms, and also two sitting-room tables, without stools.

The old fences have been removed from around the male and female court yards, and 258 panels close fence have been put up between the front grounds and the back yard.

Four hundred panels fence around the grounds have been repaired.

A new floor put in the air-duct.

Two sheds 16×18, for tools and wagons, have been built.

One Tise's well fixture put over well at Steward's house.

IMPROVEMENTS IN ENGINEER'S DEPARTMENT.

A new corrugated iron roof, new doors and windows complete, one new furnace for retort, with connecting pipe and two new rosin kettles, have all been put up at gas-house.

One steam radiator put in male night attendants' room.

One new hand pump put in well near female wing.

Two dozen registers put in wards.

FINANCES.

In accordance with the provisions of chapter 60, laws of North Carolina, session of 1883, ratified January 31, 1883, and recapitulated in sections 2272 and 3360 of The Code of North Carolina, our fiscal year and accounts for the last two years closed on the 30th day of November of each year. Our biennial appropriation was made subsequent to the passage of said act of Assembly, as will be seen by reference to chapter 419, Acts of 1883, ratified March 12th, 1883. The Legislature would hardly have made an appropriation for any but the years recognized by law.

The following exhibits and accompanying statements show the expenses in detail for the fiscal year, and with them is my Annual Report of last year for the entire two years' appropriation:

EXPENSES FROM DECEMBER 1ST, 1883, UP TO NOVEMBER 30TH, 1884, BOTH DATES INCLUSIVE. SUBSISTENCE. IMPROVEMENTS AND REPAIRS. TOTAL. December $ 3,858 51 $ 1,946 16 $ 5,804 67 January 3,911 96 1,908 11 5,820 07 February 3,426 78 477 62 3,904 40 March 4,825 05 227 21 5,052 26 April 3,953 58 832 44 4,786 02 May 5,002 14 555 50 5,557 64 June 4,633 68 208 08 4,841 76 July 4,597 43 422 30 5,019 73 August 3,308 99 78 57 3,387 56 September 3,139 08 90 04 3,229 12 October 3,592 41 740 65 4,333 06 November 662 16 465 98 1,128 14 $ 44,911 77 $ 7,952 66 $ 52,864 43

STATEMENT. Expenditures from December 1st, 1883, to November 30th, 1884 $ 52,864 43 Balance of appropriation for 1883-'84, $50,207 41 Cash paid to Treasurer by John W. Thompson, Steward, for amounts collected of sundry persons in 1884, 288 72 50,496 13 Overdrawn $ 2,368 30

EXPENDITURES UPON IMPROVEMENTS AND REPAIRS FROM DECEMBER 1ST, 1883, TO NOVEMBER 30TH, 1884. Lumber, building material, mouldings, tables, doors, sash, blinds, &c. $ 2,305 81 Paints, painting material, glass, &c. 180 84 Hardware, &c. 548 98 77 days carpenters' work 146 95 173 days painting 284 75 53¾ days mason work 121 18 147½ days helpers' work 82 25 Services of Architect and Superintendent on Arcade work, 15 days, at $5 per day 75 00 On water-works 2,663 21 One laundry machine and pulley 207 43 Iron roof and fixtures for gas-house 317 89 Lime, cement, plaster, &c 253 20 One pump and fixtures 37 83 One Tise's well fixture 15 00 Freight on material 45 07 Hauling material, rubbish, &c. 101 50 Medical instruments. . . . . 88 90 Register faces and smoke plates for gas 48 23 Bronze cornice and fixtures 46 05 Rock pillars under bridge at Rocky Branch 104 40 Retorts, castings, &c. 238 86 Brass knobs, with plates and screws 29 33 $ 7,952 66

Two thousand four hundred and forty-two dollars and seventy-seven cents of the above was paid for building material, hardware, paints, lime and cement used in the improvement and repairs of 1883.

EXPENDITURES UPON WATER-WORKS FROM DECEMBER 1ST, 1883, TO NOVEMBER 30TH, 1884. Work on reservoir, digging ditch, building trestle and laying pipes. . . . . $1,357 32 Cement, oil, &c.. . . . . 421 12 Land purchase. . . . . 326 00 Registering deed. . . . . 1 75 Bricks. . . . . 237 30 Buggy hire. . . . . 55 75 Iron pipes. . . . . 16 57 Lumber. . . . . 27 25 Surveys, estimates, writing deed, &c.. . . . . 112 00 Hauling sand and lumber. . . . . 48 50 Tools and iron. . . . . 11 70 One valve. . . . . 37 95 Tools for pipes. . . . . 5 00 One slush pump. . . . . 5 00 $2,663 21

The repairs upon the wings, wards and outside premises and water-works were necessarily much more extensive than was anticipated, and a wise economy would suggest the completion of the same improvements in the centre building.

Among the purchases to be made is a new boiler at the pump-house, in place of the old one, now almost worn out by twenty-eight years' use, and a duplicate for Cameron pump. The gas-works are not completed, and the heating apparatus will need repairs.

The same or nearly the same appropriation will be needed for the next two years to meet current expenses, make necessary repairs and pay off indebtedness.

To Rev. Mr. Smedes, Rev. Dr. Marshall, Rev. Dr. Atkinson, Rev. Mr. Gwaltney and Rev. Mr. Norman we are indebted for ministerial services.

Respectfully submitted,

EUGENE GRISSOM. RALEIGH, December 1st, 1884. APPENDIX.

TABLE No. 1. Showing the number of Admissions and Discharges (including cures, improved, unimproved and deaths) and those remaining for each year since the opening of the Asylum, February 22, 1856. DATE. Admissions. DISCHARGES. Remaining. Cured. Improved. Unimproved. Deaths. Total. 1856 90 5 3 0 2 10 80 1857 96 15 10 6 7 38 138 1858 57 26 7 9 9 51 141 1859 82 22 11 7 10 50 176 1860 76 23 2 25 23 73 179 1861 61 21 4 14 8 47 193 1862 44 17 2 8 15 42 195 1863 41 9 4 7 21 41 195 1864 40 14 7 7 27 55 180 1865 41 9 1 19 45 74 147 1866 65 15 4 14 14 47 165 1867 85 13 5 13 21 52 198 1868 72 18 7 11 17 53 217 1869 27 7 3 2 7 19 225 1870 29 7 4 2 9 22 232 1871 44 9 5 9 8 31 245 1872 43 14 9 14 18 55 233 1873 50 17 6 5 13 41 242 1874 44 13 8 2 16 39 247 1875 42 16 5 5 14 40 249 1876 44 11 6 3 9 29 264 1877 52 13 8 3 15 39 278 1878 42 14 11 10 19 54 266 1879 45 14 4 2 13 33 277 1880 56 17 7 7 29 60 273 1881 49 10 3 2 23 38 284 1882 50 16 5 18 17 56 278 1883 53 17 43 63 9 132 199 1884 106 26 16 9 11 62 243 Total 1,626 428 210 296 449 1,383 243

TABLE NO. 2. Total number of Admissions and Discharges since the opening of the Institution, February 22, 1856. MALES. FEMALES. TOTAL. Admissions 908 708 1,626 Discharges 784 599 1,383 Remaining 124 119 243

TABLE NO. 3. Admissions and Discharges for the year ending November 30, 1884. MALES. FEMALES. TOTAL. Patients in Asylum November 30, 1883 96 103 199 Received 53 53 106 Under treatment 149 156 305 Discharges 25 37 62 Remaining 124 119 243

TABLE NO. 4. Discharges, classified for the year ending November 30, 1884. MALES. FEMALES. TOTAL. Cured 13 13 26 Improved 2 14 16 Unimproved 4 5 9 Died 6 5 11 Total 25 37 62

TABLE NO. 5. SHOWING CIRCUMSTANCES OF EACH CASE RECEIVED. DATE OF ADMISSION. SEX. SOCIAL RELATION. DISEASE. Number. Year. Month. Day. Male. Female. Age. Single. Married. Widowed. No. Attack. Supposed Cause DURATION BEFORE ADMISSION. FORM. Suicidal. Hereditary. RESIDENCE. No. Admissions. Year. Mos. Days. 1 1883 December 2 ..... Female. 26 ..... Married. ..... 3 Heredity ..... 3 ..... Mania Suicidal. Hereditary. Nash 2 2 1883 December 6 ..... Female. 28 Single. ..... ..... 1 Ill Health ..... 8 ..... Melancholia ..... ..... Montgomery 1 3 1883 December 6 Male. ..... 19 Single. ..... ..... 3 Heredity and injury 5 ..... ..... Mania ..... Hereditary. Montgomery 1 4 1883 December 7 Male. ..... 40 ..... Married. ..... 1 Unknown 10 ..... ..... Mania ..... ..... Brunswick 1 5 1883 December 11 Male. ..... 27 Single. ..... ..... 1 Masturbation 7 ..... ..... Imbecility ..... ..... Washington 1 6 1883 December 12 ..... Female. 50 ..... Married. ..... 1 Unknown ..... 3 ..... Melancholia ..... ..... Richmond 1 7 1883 December 13 ..... Female. 39 ..... Married. ..... 1 Domestic trouble 5 ..... ..... Mania ..... ..... Hyde 1 8 1883 December 14 Male. ..... 60 ..... Married. ..... 1 Unknown ..... 1 ..... Mania ..... ..... Richmond 1 9 1883 December 14 Male. ..... 31 Single. ..... ..... 1 Disappointment ..... 8 ..... Mania ..... ..... Johnston 1 10 1883 December 19 ..... Female. 66 Single. ..... ..... 1 Disappointment 2 ..... ..... Mania ..... ..... Jones 1 11 1883 December 22 ..... Female. 66 ..... ..... Widowed. 4 Unknown ..... 3 ..... Mania ..... ..... Moore 2 12 1883 December 23 ..... Female. 22 Single. ..... ..... 1 Disappointment 2 ..... ..... Mania ..... ..... Durham 1 13 1883 December 23 Male. ..... 23 ..... Married. ..... 1 Religious excitement 1 ..... ..... Melancholia ..... ..... Columbus 1 14 1883 December 26 Male. ..... 43 ..... Married. ..... 1 Unknown ..... ..... 6 Mania ..... ..... Johnston 1 15 1883 December 27 Male. ..... 22 Single. ..... ..... 1 Attack of fever 10 ..... ..... Mania ..... ..... Columbus 1 16 1883 December 28 Male. ..... 42 ..... Married. ..... 5 Mental shock ..... 1 ..... Mania ..... Hereditary. Pitt 1 17 1884 January 10 ..... Female. 27 Single. ..... ..... 1 Religious excitement ..... 4 ..... Mania ..... ..... Pitt 1 18 1884 January 11 ..... Female. 40 ..... Married. ..... 1 Exhaustion and sorrow ..... 11 ..... Melancholia Suicidal. Hereditary. Richmond 1 19 1884 January 11 Male. ..... 28 Single. ..... ..... 2 Epilepsy 2 ..... ..... Epileptic Mania ..... ..... Orange 1 20 1884 January 11 Male. ..... 38 ..... Married. ..... 1 Business trouble ..... ..... 10 Mania ..... ..... Wilson 1 21 1884 January 15 Male. ..... 34 Single. ..... ..... 1 1 ..... 4 ..... Dipsomania ..... ..... Robeson 1 22 1884 January 24 ..... Female. 44 ..... Married. ..... 1 Loss of sleep ..... 6 ..... Mania Suicidal. ..... New Hanover 1 23 1884 January 27 ..... Female. 30 Single. ..... ..... 1 Unknown 5 ..... ..... Mania ..... ..... Moore 1 24 1884 January 31 ..... Female. 56 ..... Married. ..... Unk. Heredity 8 ..... ..... Mania ..... Hereditary. Guilford 1 25 1884 February 4 Male. ..... 28 ..... Married. ..... 1 Heredity ..... 4 ..... Melancholia ..... Hereditary. Randolph 1 26 1884 February 4 ..... Female. 42 Single. ..... ..... 1 Unknown 7 ..... ..... Mania ..... ..... Durham 1 27 1884 February 5 Male. ..... 31 ..... Married. ..... 1 Religious excitement 3 1 ..... Mania ..... ..... Duplin 1 28 1884 February 8 ..... Female. 23 Single. ..... ..... 1 Heredity ..... 1 ..... Mania ..... Hereditary. Onslow 1 29 1884 February 8 ..... Female. 22 Single. ..... ..... 3 Menstrual trouble ..... 2 ..... Mania ..... ..... Guilford 1 30 1884 February 8 ..... Female. 42 Single. ..... ..... 2 Uterine disease ..... ..... 21 Mania ..... ..... Wayne 2

DATE OF ADMISSION. SEX. SOCIAL RELATION. DISEASE. Number. Year. Month. Day. Male. Female. Age. Single. Married. Widowed. No. Attack. Supposed Cause DURATION BEFORE ADMISSION. FORM. Suicidal. Hereditary. RESIDENCE. No. Admissions. Year. Mos. Days. 31 1884 February 13 Male. ..... 60 ..... Married. ..... 1 Intemperance 2 ..... ..... Mania ..... ..... Rockingham 1 32 1884 February 13 ..... Female.