]> <emph>Biennial Report of the State Hospital at Raleigh, Raleigh, N.C., from July 1, 1924, to June 30, 1926:</emph> Electronic Edition. State Hospital (Raleigh, N.C.) 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 Tampathia Evans Text encoded by Apex Data Services, Inc. and Melissa Meeks First edition, 2002 ca. 167K Academic Affairs Library, UNC-CH University of North Carolina at Chapel Hill, 2002.

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 Biennial Report of the State Hospital at Raleigh, Raleigh, N.C., from July 1, 1924, to June 30, 1926. State Hospital (Raleigh, N.C.) 42 p. Raleigh Bynum Printing Company 1926 Call number C362.2 N87s 1914/16-1936/38 (North Carolina Collection, University of North Carolina at Chapel Hill) Biennial Report of the State Hospital at Raleigh, N.C., from July 1, 1924, to June 30, 1926 also includes a section entitled "Report on Audit for the Fiscal Year Ended June 30, 1926" that was not digitized.

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 Library of Congress Subject Headings English State hospitals -- North Carolina -- Raleigh. Psychiatric hospitals -- North Carolina -- Raleigh. State Hospital (Raleigh, N.C.). Mentally ill -- Care -- North Carolina -- Raleigh. Mentally ill offenders -- Care -- North Carolina -- Raleigh. 2003-03-13, Celine Noel and Wanda Gunther revised TEIHeader and created catalog record for the electronic edition. 2002-12-03, Melissa Meeks finished TEI-conformant encoding and final proofing. 2002-05-10, Harris Henderson finished TEI/SGML encoding 2001-11-01, Apex Data Services, Inc. finished transcribing the text.

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 BIENNIAL REPORT OF THE STATE HOSPITAL AT RALEIGH RALEIGH, N. C. FROM JULY 1, 1924, TO JUNE 30, 1926 RALEIGH BYNUM PRINTING COMPANY STATE PRINTERS 1926

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BOARD OF DIRECTORS OF THE STATE HOSPITAL AT RALEIGH, NORTH CAROLINA C. FELIX HARVEY,President......Lenoir CountyTerm expires April 1, 1929 A. L. JAMES........Scotland CountyTerm expires April 1, 1929 DR. J. C. BAUM......Currituck CountyTerm expires April 1, 1929 H. R. DWIRE......Forsyth CountyTerm expires April 1, 1929 JUDGE W. S. O'B. ROBINSON......Wayne CountyTerm expires April 1, 1929 DR. LESLIE B. EVANS......Bertie CountyTerm expires April 1, 1929 JOS. G. BROWN......Wake CountyTerm expires September 24, 1929 MRS. MARSHALL P. WILLIAMS......Duplin CountyTerm expires September 24, 1929 DR. THURMAN D. KITCHEN......Wake CountyTerm expires September 24, 1929

EXECUTIVE COMMITTEE JOSEPH G. BROWN, Chairman C. FELIX HARVEY A. L. JAMES

RESIDENT OFFICERS AND STAFF ALBERT ANDERSON, M.D...............Superintendent R. K. ADAMS, M.D.......................Assistant Physician JULIAN W. ASHBY, M.D.............Assistant Physician H. B. BRACKIN, M.D...................Assistant Physician T. M. JORDAN, M.D....................Assistant Physician T. L. YOUNG, D.D.S........................................Dentist MISS MARY S. WHITE...........................Stewardess

SUBORDINATE OFFICERS MISS WESLEY JORDAN....................................Bookkeeper MISS LILLIE B. GOODWIN..............Steno. to Board and Private Secy. to Supt. MRS. PATTIE BRADSHAW, R.N..........Superintendent of Nurses MRS. R. B. HALL............................Matron MISS ANNIE J. EAGLE....................Druggist H. L. MARLOW............................Engineer R. M. BROWN................................Carpenter JAMES ADAMS............................Florist, Farmer and Gardener

LETTER OF TRANSMITTAL His Excellency, GOV. A. W. MCLEAN, RALEIGH, N. C. MY DEAR SIR:

I have the honor to submit herewith the report of Dr. Albert Anderson, Superintendent of the State Hospital for the Insane, at Raleigh, North Carolina, covering the operations of the Hospital from July 1, 1924 to June 30, 1926, together with a copy of the audit made by Hon. Baxter Durham, Auditor.

The Board of Directors appreciates the coöperation and support accorded it by you and the Council of State at all times, and especially your prompt response to its appeal for assistance when confronted by the emergency arising from the destruction of the West Wing of the Hospital last spring.

Very truly yours, C. F. HARVEY, President Board of Directors. SUPERINTENDENT'S REPORT MR. C. FELIX HARVEY, President, and Members of the Board of Directors of the State Hospital at Raleigh:

GENTLEMEN:—The biennial report of this Hospital from June 30th, 1924, to June 30th, 1926, is submitted as follows:

STATISTICAL SUMMARY Table No. 1   Male Female Total Patients remaining June 30, 1924 651 671 1,322 Admitted during last two years (insane) 565 471 1,036 Admitted during last two years (criminal insane) 78 6 84 Total number under treatment 1,294 1,148 2,442 Average daily population —— —— 1,474.5 Restored (insane) 61 84 145 Improved (insane) 327 174 501 Unimproved (insane) 19 30 49 Transferred (insane) 8 1 9 Not insane 2 0 2 Died (insane) 109 101 210 Discharged and transferred (criminal insane) 15 1 16 Died (criminal insane) 3 2 5 Total number discharged and dead 544 393 937 Per cent of deaths on number treated 8.6 8.8 8.7 Per cent of recoveries and improved of number admitted 68 54 61 Remaining June 30, 1926 750 755 1,505

Our reports on the medical work for two years cover four departments—the insane, epileptic, inebriate and the criminal insane.

The doctors of my staff have submitted the following reports:

(See Dr. Adams' report.)

(See Dr. Ashby's report.)

(See Dr. Brackin's report.)

(See Dr. Jordan's report.)

(See Dr. Young's report.)

The work of our general hospital service has been satisfactory. The necessary surgical operations have been done by different members of our Advisory Board of Surgeons very promptly when called.

Our requests for new buildings and reasons for making them are set out fully in our transmittal letter to Budget Bureau.

We wish again to express our appreciation to the Advisory Board of Doctors for responding so promptly to our call whenever we have work for them to do.

Governor McLean appointed the following physicians of the State on our Advisory Board:

Dr. T. M. Green Wilmington Dr. J. F. Highsmith Fayetteville Dr. J. P. Monroe Charlotte Dr. Foy Roberson Durham Dr. Hubert A. Royster Raleigh Dr. C. A. Woodard Wilson Dr. W. W. Green Tarboro Dr. Hubert Haywood, Jr Raleigh Dr. T. C. Johnson Lumberton Dr. Chas. O'H. Laughinghouse Greenville Dr. W. B. McNider Chapel Hill Dr. E. J. Wood Wilmington Dr. R. S. Beam Lumberton Dr. J. J. Murphy Wilmington Dr. S. D. McPherson Durham Dr. Jas. Parrott Kinston Dr. Louis West Raleigh Dr. J. B. Wright Raleigh Dr. T. M. West Fayetteville Dr. Julian Baker Tarboro Dr. W. D. James Hamlet Dr. R. L. Pittman Fayetteville Dr. J. V. McGougan Fayetteville Dr. H. M. Baker Lumberton Dr. Jos. Tayloe Washington Dr. R. D. V. Jones New Bern Dr. T. D. Kitchin Wake Forest

I am giving below a report from the Architect, C. C. Hook, and of Wiley & Wilson, our Heating Engineers, covering all the work done in the last two years.

(See report of Wiley & Wilson.)

(See report of Chas. C. Hook.)

Our Auditor's report gives the details of money spent in our building program.

In conclusion, I wish again to express my sincere thanks to the members of our Board for the great sacrifices they have made in serving this Institution and the fine spirit of coöperation they have given us in the management of the business affairs and building program of this Institution for the last two years.

The officers and employees of this Institution have been loyal and trustworthy and have striven to promote the welfare and care of our patients in every possible way.

We are still holding in our mind the same objective that we have always held persistently; that is “to make our Institution equal to any and surpassed by none.”

Respectfully submitted, ALBERT ANDERSON, Superintendent. PROFESSIONAL REPORTS JULY 1st, 1926. DR. ALBERT ANDERSON, Superintendent, State Hospital, Raleigh, N. C.

SIR:—Pursuant to your request, I submit herewith the report for the Male Department, covering the biennial period from June 30th, 1924 to June 30th, 1926.

The general health of the patients in this department has been good. There has been no epidemic diseases. Vaccination against typhoid and smallpox has been carried out. A few cases of psychosis following encephalitis have been treated with tryparsamide and a few cases of dementia præcox have been treated by the production of an aseptic meningitis by the intraspinal injection of sterile horse serum. Sulpharsphenamine, neosalvarsan bismuth and mercury (both intramuscularly and intravenously) have been employed in the treatment of syphilis. I had hoped during this biennium to treat some cases of paresis with malaria, but have experienced difficulty in securing proper malarial parasites. This work, however, will be carried out during the coming biennial period. There were two suicides during the biennial period. One of these occurred in the Main Building and the other occurred at the Hospital Building.

On April 10th, 1926, about 1:40 P. M., fire broke out in the roof of the Sixth Ward and destroyed the First, Second, Third, Fourth, Fifth and Sixth Wards and the northern end of the Seventh, Eighth, Ninth and Tenth Wards. The Eleventh Ward was also so badly damaged that it cannot be used until extensive repairs can be made. The patients are being cared for on the porches of the Seventh, Eighth, Ninth and Tenth Wards and on the parts of these wards not destroyed by the fire. Some patients were transferred to Oaks Colony and some were taken home by relatives.

Even after the burned building has been rebuilt, the Male Department will still need additional buildings. There has been no building in the Male Department for housing patients since the Seventh, Eighth, Ninth and Tenth Wards were built about twenty years ago. I would make the following recommendations: A Receiving Building with a capacity of 75 to 100 patients, a building for untidy patients to care for 150, and a building for inebriates and drug addicts. The inebriates and drug addicts are now cared for on the wards with the insane. Table One of the statistical report will show that we have admitted more male patients than females, which will show the necessity for a Receiving Building for men, a building of this type having already been provided for the female patients.

On January 1st, 1925, the Criminal Insane building was opened, the Legislature having passed an act that patients of this type should be cared for in this institution instead of the State's Prison. The building was too small due to inadequate appropriation and as soon as the patients were transferred from the State's Prison the building was so crowded as to necessitate the placing of beds in the halls. During the past biennial period the building has been enlarged and its capacity slightly more than doubled. For this building I would recommend an occupational therapy teacher and amusements from time to time such as moving pictures.

The functions of a State Hospital should be:

1. To receive as many worthy cases as possible.

2. To restore as many patients as possible to society.

3. To accomplish the two above objects as economically as is compatible with good treatment.

With these objects in view, I think the Male Department has made a creditable showing. By referring to Table One of the Statistical Report you will note that more men have been admitted and discharged than women, and by comparison of the payrolls you will note that this has been accomplished very economically.

Respectfully submitted, R. K. ADAMS, M.D. RALEIGH, N. C., SEPTEMBER 20, 1926. DR. ALBERT ANDERSON, Superintendent, State Hospital, Raleigh, N. C.

SIR:—I hereby submit the report of the Female Receiving Building:

Since the last biennial report three strong rooms have been added to the Female Receiving Building at a cost of about $1,800. This is the only expenditure that has been made to this building since its construction. The three additional rooms have increased the efficiency of the service but the present capacity is not sufficient and three strong rooms would materially increase our comfort. These rooms could be extended from the three rooms constructed two years ago and on the roof of these three rooms, and the three rooms previously mentioned, we should have a sun porch. This would give the patients at the Female Receiving Building the advantages of sunshine and fresh air which they do not at present enjoy in bad weather and winter, and which is a privilege granted to nearly all of the other patients. The expense of this addition should not exceed $6,000.

During the past biennial period we have been free from a great deal of sickness, but there was one epidemic of erysipelas which affected an attendant and four or five patients, all of whom recovered. There were no suicides during this period and twelve deaths. Most of these deaths occurred shortly after admission of the patients. Two of them dying one day after admission, another within four days and the longest period that any of these patients who died had been in the hospital was fifty-one days. There was also one death which occurred the day after the patient left the hospital after having been in our service for twelve days.

There has been a decided decrease in drug addiction patients. For the periods of 1924-1925, we admitted thirty patients; 1925-1926 seventeen patients who were drug addicts. On July 1st, 1924, there were in this service four patients diagnosed drug addiction; July 1st, 1926, only one patient of this class.

We are continuing to make a mental and physical examination of all patients as soon as possible after admission; and we are also vaccinating all patients against smallpox and typhoid fever.

The continuous baths and hot packs are being continued with benefit.

Respectfully submitted, J. W. ASHBY, M.D. RALEIGH, N. C., SEPTEMBER 17, 1926. DR. ALBERT ANDERSON, Superintendent, State Hospital, Raleigh, N. C.

SIR:—I herewith submit the report of the Female Department, with the exception of the Receiving Building. There were 533 patients at the end of the biennial period.

ILLNESS:

All cases of physical illness were sent to the Hospital Building except during the influenza epidemic when it would not take care of all. The general health of the patients has been good except for influenza during January and February, 1926. There were about 150 cases of influenza on this service during that time. Most of the cases had a high elevation of temperature and quite a number had complications. The most frequent complications were pneumonia and otitis media. Very few cases were fatal. We have had no cases of contagious disease. There has been no sudden deaths and no suicides. No serious accident has happened.

 TREATMENT:

The warm continuous baths have been used for excited and noisy patients with good results. Neutral wet packs have been used very extensively for noisy and excited patients with benefit to the patient.

 PROGRESSIVE NOTES:

All patients on this service have had a complete physical examination during this period and a record of the abnormalities found put in their folder. All patients have also had notes made of their mental condition and a record of it made in their folder.

 REPAIRS:

During the past biennial period G-ward, K-ward, and Female dining room have been painted. No other repairs have been made except ones necessary in an institution of this kind.

 NEW BUILDING:

There has been one ward built on this service. It has ten rooms and is for violent and excited patients. Two continuous bath tubs were installed on this ward.

 RECOMMENDATIONS:

We are in need of a building for noisy and untidy patients. At the present time G-ward, which accommodates 100, is being used for same but its location is bad for this type of patients. It is on the main drive of hospital grounds and all visitors can see these untidy patients on the porch and hear their profane and obscene language. My suggestion is to build a building for 100 untidy and noisy patients, in the pines across from E. B., away from the road and use G-ward for higher type of patients.

The Female tubercular building needs a floor and some additional rooms. It stays full all the time and some tubercular patients have to be kept on wards with other patients. My suggestion would be to change the room being used for a dining room, and not suitable for such, into single rooms and build a dining room.

Respectfully submitted, H. B. BRACKIN, M.D. DR. ALBERT ANDERSON, Superintendent, State Hospital, Raleigh, N. C.

SIR:—Herewith I hand you the biennial report of the Colonies in the department of my service:

Movement and condition of the population of Oaks Colony during the biennial period ending June 30th, 1926:

Number of patients in the institution at beginning of period 169 Number of patients admitted during period 155 Number of patients readmitted during period 15 Number of patients died during period 1 Number of patients escaped during period 47 Number of patients returned from escape 35 Number of patients at large 12 Number of patients transferred 85 Number of patients discharged 42 Number of patients remaining June 30th, 1926 199

All patients have been immunized against smallpox and typhoid fever. There have been no contagions or epidemics. The one death reported was due to heart disease. Examinations of and histories written for these received

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not already so treated. Notations of condition of patients have been recorded and filed from time to time.

On account of the sudden influx of patients from Main Building following fire, Oaks Colony was, and is now, very much congested, and the number of idle patients, due either to feebleness or too mentally disturbed to send out, have added considerably to the problem of oversight, yet these conditions have been met by only an addition of one caretaker to usual force of attendants.

Due to the fact that a large part of the population at Oaks Colony is employed upon the farm, opportunities for escape are multiplied. It is very gratifying to record, however, that the number of escapes during this biennium have been decreased above 40% over what occurred during previous two-year period.

At Oaks Colony an increased number of properly heated and ventilated strong rooms are needed to meet the needs of present population. There should also be an increased number of single rooms wherein a noisy patient might be kept over night, otherwise a dormitory of thirty or more patients will be broken of their rest at times for a whole night.

RECOMMENDATIONS:

All strong rooms, bath and toilet rooms should be screened against flies. Dining-room floor should be repaired. Bath-room floors should be of cement and arranged to drain properly.

 MALE EPILEPTIC COLONY

MOVEMENT and condition of population at the Male Epileptic Colony:

Number of inmates in institution at beginning 88 Number of inmates admitted during term 182 Number of inmates died during term 14 Number of inmates discharged during term 46 Number of inmates escaped during term 26 Number of inmates returned during term 15 Number of inmates at large during term 11 Number of inmates transferred during term 14 Number of inmates remaining at term 185

There have been no contagions. Mild epidemics of influenza occurred during early months of 1926. No deaths, however, from this cause. All patients have been immunized against smallpox and typhoid fever. The prevailing cause of death has been exhaustion from epilepsy. One death was from pneumonia. Examinations, mental and physical, of all new patients have been made and their histories written. Notations of condition have been made and recorded from time to time. With more than double the population of the previous biennium we have experienced only three more deaths this period than the former report. On first and third wards we have had repairs during this biennium of cement floors and wood wainscote, which has enabled cleanliness to be maintained with less labor. Notwithstanding population has increased 100% and more, our caretakers have only been increased 25% in number.

NEEDS:

More properly ventilated and heated strong rooms and single bedrooms are necessary for carefully handling and safeguarding present population.

 FEMALE EPILEPTIC COLONY

MOVEMENT and condition of the population of the Female Epileptic Colony:

Number of inmates in institution beginning of term 90 Number of inmates admitted during term 106 Number of inmates died during term 11 Number of inmates discharged during term 11 Number of inmates escaped during term 1 Number of inmates returned during term 1 Number of inmates at large during term 0 Number of inmates transferred during term 5 Number of inmates remaining at end of term 164

There have been no contagions. Mild epidemic of influenza occurred during the early months of 1926. No deaths, however, from this cause. All patients have been immunized against smallpox and typhoid fever. The prevailing cause of death has been exhaustion from epilepsy. Two patients died from exhaustion from pellagra. Two patients committed suicide. With a population increased by 117% during the biennium there has been but one escape against four during the previous biennium, and the caretakers have only been increased by one. Examinations of all new patients have been made and their histories written, with notations of changes from time to time filed. Notwithstanding the population doubled during the biennium and the fact that there were two suicides as against one in the previous biennium, there was exactly the same number of deaths, as of the previous period.

REPAIRS:

On A and C wards during this period we have had new wooden floors and cement wainscote, which enables cleanliness to be maintained with less labor.

 NEEDS:

More properly ventilated and heated strong rooms and single bedrooms are necessary for carefully handling and safeguarding the population.

 A WORD ABOUT THE EPILEPTIC PROBLEM IN OUR STATE:

It will be noted from the foregoing report that as soon as space was available, that in two years' time as many patients were admitted as had been gathered together during the fourteen years that the State had undertaken to provide for that class of defectives. Of course, when there was no space there could be no admissions. Now there is no space again; Male Colony completely full, and Female Colony with less than twenty empty beds.

Among the new admissions are a number of children, fifteen years and less of age. Many applications for children have been rejected, for the policy has been to provide for the more urgent, those who being so mentally upset that to be refused would mean lying in jail. The children admitted cannot enter public school. The conclusion is, from the above facts, that if the State meets its obligations to this class of the afflicted more room for the epileptic is an absolute necessity. Because a child is afflicted with epilepsy it should not be denied the educational opportunities that would enable him to enjoy at least the three R's in educational advantage. Again, it is agreed by all, that the more intelligent use and appreciation of any organ the less deterioration there will be—the brain is no exception to this.

THOS. M. JORDAN, Physician in Charge. DENTAL REPORT—JUNE 30TH, 1924, TO JUNE 30TH, 1926. DR. ALBERT ANDERSON, Superintendent, State Hospital, Raleigh, N. C.

The Dental Department, which has been under the direction of Dr. T. L. Young since April 21st, 1921, has completed a large amount of work during the past two years. All new patients are seen soon after they are admitted. All focal infection removed and teeth repaired.

The office is equipped with the Ritter outfit and Wappler X-ray machine.

The following table will show the work that has been done:

Patients seen 2,875 Extractions 2,559 Amalgam fillings 475 Cement fillings 483 Cleanings 1,131 Synthetic fillings 119 X-rays made 118 Plates made 45 Plates repaired 9 Bridges made 4

REPORT OF ENGINEERS DR. ALBERT ANDERSON, Superintendent, State Hospital, Raleigh, N. C.

SIR:—In accordance with your request, we are giving you below a statement of the extent and cost of mechanical equipment work which has been done at your institution under our plans and supervision, and completed within the last two years; the work which is now in progress; and also the estimated cost of future improvements, which we consider necessary to complete your central plant steam-heating system, provide adequate electric generating equipment, domestic hot water distributing mains, and to safeguard your city water supply system and provide better fire protection.

The estimates for new work include cost of heating equipment for the contemplated new buildings and other minor items, all of which are discussed under the various headings.

MECHANICAL EQUIPMENT WORK COMPLETED DURING THE LAST TWO YEARS

The mechanical equipment work completed under our plans and supervision during the last two years is as follows:

1924— Extension of hot water heating mains to the Male Tubercular Building, which was moved to a new location. Cost of this work $935.00 1924— Installation of new 8-in. exhaust steam supply main from power house to center of main building, to utilize the exhaust or waste steam in the heating system. Cost of this work $3,314.61 1924— Installation of high-pressure steam connections to new cooking equipment in three kitchens at the Colony Buildings. Cost of this work $632.50 1924— Installation of steam heating equipment in new Criminal Insane Building. Cost of this work $5,867.40 1924— Installation of heating equipment in Superintendent's residence, together with connecting mains from central heating plant. Cost of this work $4,375.00 1925— Installation of heating equipment in Steward's residence, independent plant. Cost of this work $1,160.50 1925— Installation of heating equipment in new addition to Criminal Insane Building and Strong Rooms. Cost of this work $2,992.00 1925— Installation of two new 250 h. p. water tube boilers, together with pipe connections and auxiliaries to take the place of three old boilers removed. Cost of this work $26,763.73

MECHANICAL EQUIPMENT WORK NOW IN PROGRESS

The mechanical equipment work now in progress under our plans and supervision is as follows:

Installation of two new 350 h. p. water tube boilers with pipe connections, forced draft equipment and necessary auxiliaries. Cost of this work$41,597.60
These boilers are being installed to take the place of three old boilers and provide additional boiler capacity, sufficient to supply steam to the Colony Group of the buildings, when connecting mains can be installed for this purpose. Heating, ventilating and domestic hot water supply equipment for new West Wing, North and Rear Dormitories, recently destroyed by fire. Cost of this work$31,710.80New underground hot water heating mains extending from power house to Male Tubercular Building and Seventh Ward, on one side, and from power house to Female Tubercular Building and Erwin Building on the other side, also domestic hot water mains leading along the same lines, all of which are to take the place of present mains which have rusted out and have to be renewed. This work is being done by your own repair department as renewals, and the estimated cost is$11,000.00

For Recommendations and Estimates for Future Mechanical Equipment Work, see letter of transmittal to Budget Bureau.

Respectfully submitted, WILEY & WILSON, Consulting Engineers. REPORT OF ARCHITECT DR. ALBERT ANDERSON, Superintendent, State Hospital, Raleigh, N. C.

SIR:—In the past two years, ending with June, 1925, we have made provision for caring for fifty additional inmates in the Criminal Insane department and that building will now accommodate one hundred inmates. A wing was added to the original building and some changes made in the original building, thus giving us the space for the fifty additional beds and also providing a new dining room and serving room to care for the one hundred inmates, the former smaller dining room having been used for bedrooms by building partitions in same. The required number of shower baths and other toilet facilities were also added and two additional rooms for attendants in charge of this wing of the building.

We were successful in getting this project completed within the amount of the appropriation, and the plan is a very satisfactory one, having been arranged so that this wing may be extended in the future without destroying any part of the present building.

We took advantage of the ground floor space of the covered way leading from the Erwin Building to the dining room, and built into this space a strong-room wing for women, and provided ten additional strong rooms, well ventilated, lighted and heated; also an attendants' room and double continuous bathroom; the necessary toilet rooms, store-rooms, etc., were also provided and this piece of work is considered one of the best pieces of construction that we have. The utilization of the space under the covered way saved us about three thousand dollars, and this wing is entirely above the ground. This wing, also the Criminal Insane wing, are both of fireproof construction.

The old wooden floors of the Seventh Ward were entirely removed and replaced with re-enforced concrete. Concrete floors were also placed in certain parts of the Epileptic Colony building for men where the old wooden floors had decayed. New tile floors were laid in the serving rooms adjacent to the dining rooms for women and men.

We awarded contracts July 15th for the rebuilding of that portion of the building that was destroyed by fire on the 10th day of April. The building is now in course of construction, and at the suggestion of Governor McLean, who deemed it wise to take advantage of the overhead expense in connection with building operations, we enlarged the building and instead of rebuilding for two hundred seventy-five, which was the number of inmates in the burnt portions, we have provided for one hundred additional, or three hundred seventy-five. Our contract provides that this entire project must be completed not later than the 15th day of May, 1927, and that part designated as the rear dormitory, which is a part of this project, will be completed by the 15th of October, this year. This project is to be one of the best in the State. The building will be fireproof, and the plans were given most careful consideration, and I conferred with several of the Nation's competent authorities in reference to the building before preparing the working plans.

After consulting with the Superintendent as to the urgent needs of the Hospital, I have advised as follows: (See letter of transmittal to Budget Bureau.)

Respectfully submitted, CHAS. C. HOOK, Architect. STATISTICAL SUMMARY

Table No. 1   Male Female Total Patients remaining June 30, 1924 651 671 1,322 Admitted during last two years (insane) 565 471 1,036 Admitted during last two years (criminal insane) 78 6 84 Total number under treatment 1,294 1,148 2,442 Average daily population —— —— 1,474.5 Restored (insane) 61 84 145 Improved (insane) 327 174 501 Unimproved (insane) 19 30 49 Transferred (insane) 8 1 9 Not insane 2 0 2 Died (insane) 109 101 210 Discharged and transferred (criminal insane) 15 1 16 Died (criminal insane) 3 2 5 Total number discharged and dead 544 393 937 Per cent of deaths on number treated 8.6 8.8 8.7 Per cent of recoveries and improved of number admitted 68 54 61 Remaining June 30, 1926 750 755 1,505

Table No. 2 SHOWING THE NUMBER OF ADMISSIONS AND DISCHARGES (INCLUDING CURES, IMPROVED, UNIMPROVED AND DEATHS) FOR EACH YEAR SINCE THE OPENING OF THE HOSPITAL Date Admissions Discharged Remaining     Cured Improved Transferred Not Insane Unimproved Deaths Total   1856 90 5 3 —— —— —— 2 10 80 1857 96 15 10 —— —— 6 7 38 138 1858 57 26 7 —— —— 9 9 51 141 1859 83 22 11 —— —— 7 10 50 170 1860 76 23 22 —— —— 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 55 189 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 27 7 4 —— —— 2 9 22 232 1871 44 9 5 —— —— 9 8 31 245 1872 43 14 9 —— —— 14 8 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
Table No. 2—Continued Date Admissions Discharged Remaining     Cured Improved Transferred Not Insane Unimproved Deaths Total   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 27 16 —— —— 9 11 62 243 1885 97 41 12 —— —— 9 24 86 254 1886 95 17 36 —— —— 28 20 101 248 1887 74 17 2 —— —— 3 8 30 292 1888 80 37 14 —— —— 11 18 80 292 1889 93 52 9 —— —— 1 25 87 298 1890 75 30 17 —— —— 16 26 79 294 1891 88 45 10 —— —— 2 24 81 301 1892 93 57 12 —— —— 4 21 94 300 1893 97 46 17 —— —— —— 28 91 288 1894 92 50 3 —— —— 3 19 75 305 1895 137 62 7 —— —— 4 41 114 328 1896 160 96 12 —— 2 5 44 159 329 1897 182 99 10 —— —— 8 28 145 364 1898 190 115 6 —— —— 3 27 161 393 1899 169 105 4 —— 2 4 53 168 390 1900 192 119 3 —— —— 1 31 154 424 1901 143 100 5 —— —— 1 41 147 420 1902 163 150 1 —— 1 1 33 186 397 1903 141 55 10 —— 8 4 28 105 433 1904 187 121 12 77 1 —— 29 240 380 1905 151 15 2 29 4 8 16 77 454 1906 143 113 5 5 3 2 28 154 441 1907 208 11 6 3 6 4 45 75 574 1908 137 160 3 3 2 —— 41 209 502 1909 237 6 2 1 3 5 43 60 677 1910 487 239 3 9 11 7 55 324 842 1911 336 31 2 13 8 5 64 123 1,055 1912 262 293 55 3 2 4 110 467 850 1913 324 41 2 6 —— 9 69 127 1,057 1914 372 280 46 1 1 13 82 423 994 1915 316 5 25 4 —— 4 77 115 1,195 1916 274 106 230 —— —— 6 90 432 1,037 1917 222 7 16 —— —— 3 79 105 1,154 1918 191 27 214 —— —— —— 109 350 995 1919 245 2 48 —— —— 5 59 114 1,126 1920 182 8 209 1 —— 1 51 270 1,069 1921 286 1 8 —— —— 2 73 84 1,253 1922 (7 months) 198 77 140 36 —— 19 37 309 1,160 1922-1924 865 156 275 8 4 57 203 703 1,322 1924-1926 1,120 145 501 25 2 49 215 937 1,505 Totals 10,729 4,442 2,201 224 64 597 2,680 9,198 ——

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Table No. 3SHOWING FORM OF INSANITY OF THOSE ADMITTED DURING PAST TWO YEARS   Male Female Total Epilepsy 115 101 216 Dementia præcox 81 93 174 Manic depressive 61 117 178 Senile dementia 45 21 66 Psychoneurosis 2 10 12 Pellagra 2 4 6 Drug addict and alcoholism 190 43 233 Undiagnosed 10 3 13 Defective mental development 10 24 34 Exhaustive psychosis 0 1 1 Toxic psychosis 6 1 7 Constitutional psychopathic inferiority 7 1 8 Involutional melancholia 8 32 40 Syphilis 1 0 1 Paresis 6 1 7 Cerebral hemorrhage 1 0 1 Traumatic psychosis 3 1 4 Psychosis (type undetermined) 3 0 3 Encephalitis 3 1 4 Idiocy 2 1 3 Tabes 1 0 1 Huntington's chorea 2 0 2 Psychosis following influenza 3 0 3 Psychosis following paralysis 1 3 4 Diabetis melitus 1 0 1 Multiple sclerosis 0 1 1 Post infectious psychosis 0 1 1 Puerperal psychosis 0 5 5 Not insane 1 6 7 Totals 565 471 1,036

Table No. 4 SHOWING DURATION OF INSANITY OF THOSE ADMITTED DURING PAST TWO YEARS   Male Female Total Not to exceed 1 month 45 49 94 1 to 3 months 49 51 100 3 to 6 months 39 41 80 6 to 12 months 40 52 92 12 to 24 months 51 43 94 2 to 3 years 26 24 50 3 to 5 years 70 41 111 5 to 10 years 69 63 132 10 to 20 years 59 46 105 20 to 30 years 19 12 31 30 to 40 years 9 3 12 40 to 50 years 2 0 2 50 to 60 years 0 1 1