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I



ANNUAL REPORTS



OFFICERS OF STATE



STATE OF INDIANA,



AND OF THE



TRUSTEES AND SUPERINTENDENTS OF THE SEVERAL BENEVOLENT, RE-
FORMATORY AND EDUCATIONAL INSTITUTIONS, AS REQUIRED
BY LAW TO BE MADE TO THE GOVERNOR,



YEAR ENDING OCTOBER 31, 1888.






I



)IANAPOLIS :

WM. B. BUEFORD, CONTRACTOR TOR STATE PRIN,TING AND BINDING.
1889.






PRKKACK.



STATE OF INDIA.NA,

Office of Secretaby of State,

Indianapolis, May, 1889.

In accordance with the requirements of an act, approved February 3, 1853,
(Ist G. & H., p. 538), the several administrative officers of the State and the
Trustees and Superintendents of the Benevolent, Eeformatory and Educational
Institutions thereof, have submitted to the Governor, and filed in the Executive
Department the reports required of them for the fiscal year ending October 31,
1886, and the calendar year ending December 31, 1886, respectively, which have
been entered of record in the order of their reception, and delivered to the Secre-
tary of State for publication under the order of the Board of Commissioners of
Public Printing and Binding.

Sixteen hundred copies of reports are now bound and issued to the officers and
persons designated by law to receive them. The usual number of copies of each
report have also been bound in pamphlet form, and delivered to the responsible
officer or Si^erintendent of each Institution for distribution in such manner as
they may deem for the best interests of the State.

CHAKLES A. BOOKWALTEE,

Clerh Bureau Publie Printing.



CONTKNTS,



FIRST VOLUME.

Governors' Messages.

Governor Reprieves and Pardons, 1887-88.

Secretary of State.

Auditor of State.

Attorney-General.

Treasurer of State.

State Mine Inspector.

State Coal Oil Inspector.

Fish Commissioner.

Indiana University.

Purdue University.

State Normal School.

Soldiers' Orphans' Home.

SECOND VOLUME.

Hospital for Insane.

Institution for Deaf and Dumb.

Institution for the Blind.

Institute for Feeble-Minded Youth.

Reformatory for Girls and Women's Prison.

Reform School for Boys.

State Prison South.

State Prison North.



if



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I



FORTIETH ANNUAL REPORT



Trustees and Superintendent



lilANi OOSPITAL FOR THE INSANE



FISCAL YEAR ENDING OCTOBER 3L 1888,



TO THE C3-OVER,lSrOK.



INDIANAPOLIS:

WM. B. BVJRFORD, CONTRACTOE FOR STATE PRINTING AND KIKDING.

1889



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STATE OF INDIANA, ^

Executive Mansion, j-

December 28, 1888. J

Received, examined by the Governor and referred to the Auditor of State for
verification of the financial statement.



OFFICE OF AUDITOR OF STATE, "l^
IndianapoI/IS, January 8, 1889. j

The financial statement of the within report, so far as it relates to money
drawn and paid into the Treasury, has been examined by me and fonnd correct.

BRUCE CARR,

Auditor of State.



January 8, 1889.

Returned by the Auditor of State with above certificate, and transmitted to
the Secretary of State for publication upon the order of the Board of Com-
missioners of Public Printing and Binding. PIERRE GRAY,

Private Secretary.



Filed in the oflSce of the Secretary of State of the State of Indiana January
8, 1889. CHARLES F. GRIFFIN,

Secretary of State.



OFFICERS OF THE INSTITUTION.



TRUSTEES.

THOS. H. HARRISON, M. D., President.
PHILLIP M. GAPIN, Treasurer.
B. H. BURRELL, Secretary.



SUPERINTENDENT.

THOS. S. GALBRAITH, M. D.



ASSISTANT PHYSICIANS — MALE DEPARTMENT.

A. J. THOMAS, M. D.
E. C. REYER, M. D.



ASSISTANT PHYSICIANS — FEMALE DEPARTMENT.

SARAH STOCKTON, M. D.
C. H. WILES, M. D.



MATRON.

ELIZABETH GALBRAITH.



PRIVATE SECRETARY.

FRED. C. HEEB.



RECORD CLERK.

EVA M. SMITH.



BOOK AND STOREKEEPERS.

J. S. HALL,

WM. H. WILHELM, Assistant.

H. L. HYDE, Assistant.



DRTJGGI.ST.

J. C. JAMESON,

.J. M. TAYLOR, Assistant.



CHIEF ENGINEER.

EDWARD CAIN.



CHIEF CARPENTER.

T. F. COBB.



f:^TATE LIBRARY. r

ii«WANAPOLIS, INDIANA.



TRUSTEES' REPORT.



To Isaac P. Gray, Governor:

Sir — The Board of Trustees for the Indiana Hospital for the
Insane makes the following report for the fiscal year ending
October 31, 1888.

Estimated value of real estate $1,436,150 00

Value of personal property 198,858 61

Total $1,685,008 61

THE REVENUE.

For maintenance as per appropriation $260,000 00

Expended for maintenance 260,000 00

repairs.

For repairs as per appropriation $15,000 00

Expended for repairs 15,000 00

CLOTHING.

For clothing as per appropriation $12,000 00

Expended for clothing 12,000 00

The revenue from sales and donations during the year was
$838.65, which amount was properly turned over to the State
treasury.

The daily average number of patients during the year was
1,524.

The per capita expense for maintenance was $170.



STATISTICAL.

The following shows the per capita expense for the last ten
years :

In 1879 per capita expense of maintenance was |191 31

In 1880 per capita expense of maintenance was 184- 64

In 1881 per capita expense of maintenance was 184 97

In 1882 per capita expense of maintenance was 194 00

In 1883 per capita expense of maintenance w^s 194 00

In 1881 per capita expense of maintenance was 177 02

In 1885 per capita expense of maintenance was 173 43

In 1886 per capita expense of maintenance was 160 02

In 1887 per capita expense of maintenance was 169 68

In 1888 per capita expense of maintenance was 170 00

The yield of farm and garden products was very satisfactory.

Natural gas was put in the Institution during the month of
October, but not in time to effect the expense for fuel during
this fiscal year. The management contracted with the Indi-
anapolis Natural Gas Co. for a sufiicient supply, for the sum of
$11,000 per annum, to be paid in monthly installments.

It saves for the State annually the sum of $8,500, and is
much more convenient.

The buildings are in a high state of repairs, as well as the
grounds and gardens. Many growing trees have been added
to the groves, and the park was never so beautiful.

We are happy to say to your excellency that there has been
no fires or other accidents of importance during the year.
The institution is well guarded against fires in all its depart-
ments.

The per cent, of cures has continued high during the entire
year, which compares favorably with any other hospital in the
country.

The food and care of the patients are first-class, and as good
as can be obtained.

We call your special attention to the report of the Superin-
tendent, herewith submitted. It contains in detail the full
workings of the management.

The Superintendent and his subordinates have been faithful
and efficient in all their duties.



It is the opinion of the Board, in view of the large savings
in fuel, and other things necessary to maintenance, that the
sum of $260,000 annually will meet the requirements of the
Hospital for the coming biennial term. And that the sum of
$12,000 will meet the annual demands for clothing. Also that
the annual appropriation of $15,000 will keep the buildings
and premises in their present state of repairs.

The present laundry for the Department for Women is very
poor and insufficient, and must be replaced wHh a new one.
Especial attention is called to the report of the Superintendent
on this matter.

Respectfully submitted,

THOS. H. HARRISON, President.
BARTON H. BURRELL, Secretary.
PHILIP M. GAPEN, Treasurer.



SUPERINTENDENT'S REPORT.



To the Board of Trustees q/ the Indiana Hospital for the Insane :

Gentlemen — The Fortieth Annual report of the Indiana Hos-
pital for the Insane, for the fiscal year ending October 31, 1888,
is herewith respectfully submitted.



SUMMARY.

The general results, as indicated by the statistical tables, show
that at the beginning of the year the number of patients was
1,513 ; admitted during the year, 682 ; and discharged, 669.
The number discharged as recovered, was 312 ; as improved,
112; as unimproved, 118; as not insane, 7. Died, 116. The
daily average during the year, 1,524 ; the number of patients
at close of the year, 1,526. The per cent, recovered of the total
number treated during the year, was 45.75. The per cent, of
deaths of the whole number treated, was 5.28. By reference to
table No. IV, it will be seen that 16 patients died within one
month after admission. It might be stated in explanation,
that the majority of these cases were subjects of acute mania,
who had been treated at home under many disadvantages sev-
eral days, and in some instances, weeks, when they should have
been brought to the Hospital. The want of proper nourish-
ment, the excessive use of sedatives and narcotic drugs, and
the injudicious application of various methods of restraint, was,
no doubt, accountable for the exhausted condition of these pa-
tients. Several of them died within a few days, and in one
case a man died within three hours after reaching the Hospital.
Hence, if these practices continue to prevail, to any extent, our
death rate will always be an uncertain and variable quantity.



ADMINISTRATION.

An earnest effort has been made during the period embraced
by this report, to improve the efficiency of the Hospital service
in all its departments. With that end in view some changes
have been made, a few of which may be mentioned.

Men and their wives are no longer employed as attendants in
the Department for Men. The plan was found by experience
to be impracticable, and was, therefore, abandoned. Aside from
the common difficulty of finding a man and wife possessing
qualifications suitable for the important duties of attendants on
the insane, the natural and inevitable tendency to collusion of
man and wife in shielding each other from detection in neglect
of duty, seemed so great as to absolutely prevent the enforce-
ment of that degree of discipline that is essential to satisfactory
management in a hospital of this kind. However, the idea of
having the kindly and refining influence of women in the male
wards has not been abandoned; the plan has only been changed.
Instead of wives as attendants, widow women of suitable age
and experience are employed. These are known as female at-
tendants in the Department for Men, each having three wards
on the same floor assigned to them. The doors between these
wards are left open when practicable.

It is the duty of these women to attend to the decorating and
house-heeping of their wards, repair the clothing and see that
the patients are properly served at meals, and above all, to see
that they are kindly treated by the male attendants. The con-
stant presence of kind-hearted and conscientious women in the
male wards, gives additional assurance that no harsh or cruel
treatment of patients can occur without detection.

NIGHT WATCH.

The night watch service in the Department for Women has
been increased. We now have three night watches in the
wards, in addition to a night nurse who has charge of the in-
firmary ward. By this division of the work each ward is
visited about every thirty-five or forty minutes during the
night. It is gratifying to state that during the past year 1,189
patients have been treated in this department alone, many of
whom were acute melancholic cases, with marked suicidal
tendencies, and no accident of any importance has occurred.



10



STUPEFYING DRUGS.



Without going into detail of the professional work of the
hospital, which would be evidently out of place in a report of
this kind, I may say that we have not found it necessary to re-
sort to such remedies as the hydrate of chloral and the bromide
of potassium with that frequency and liberality that formerly
prevailed here. By comparing the drug requisitions for the
present year with those of previous years I find that the
amount of these drugs used has been reduced fully one-third.

GYNECOLOGY.

In applications for the admission of women to the hospital,
uterine disease is frequently assigned as the cause of insanity
by the attending physician, and the number of single women
admitted, having a history of menstrual irregularities, is suffi-
ciently great to lead to the supposition that derangements of
the sexual system in the female plays an important part in the
production of the various forms of insanity.

As to the cause of insanity in young and single women ad-
mitted to the hospital during the past year, the family histories
are not given with sufficient accuracy in all of the cases to
enable us to form definite conclusions. But from the records
obtained and our own observation, it seems probable that
heredity is the chief cause. In young persons faulty organi-
zation has laid the ground work in most cases where we find
slight shock, bitter disappointment or other adverse agency
acting as the disturbing cause to develop insanity.

In married women who have gone through the ordeal of
childbirth, a different class of causes may be suspected to be
present. Several years ago Dr. Emmet made the statement
that about thirty-three per cent, of all the women who had
borne children and suffered from any form of uterine disease
had laceration of the cervix. Since that time numerous ob-
servers, skilled in gynecological practice, have fully verified
his conclusions as to the frequency of this injury. While pro-
fessional opinion of to-day may not entirely sustain the ex-
treme views first entertained of the pathological significance
of this lesion, there is a general unanimity of sentiment as to
its serious character. When we consider the intimate anatom-
ical relations existing between the uterus and every other



11

organ of the female organization through the intricate ramifi-
cations of the sympathetic nervous system, it is only reason-
able to conclude that an. injury that destroys to any consider-
able degree the integrity and symmetry of that central organ,
may, by sympathetic and reflex action, pervert and destroy the
normal physiological relations that should exist between all the
organs of the body to such an extent as to lead to disturbed
nutrition and general impairment of the health.

That laceration of the cervix is the initial lesion, the start-
ing point from which emanates many of the ills that make
woman's life miserable and unhappy, there can be no doubt.
Subinvolution, displacements of various kinds, sterility, and
enlarged ovaries, anemia and perverted nervous sensation are
only a few of the long list of ailments that might be enumer-
ated as resulting from this injury. The diagnosis of pelvic
disease in insane patients is attended with more or less diffi-
culty. The perverted action of the nervous system, the irreg-
ular manifestations of the reflex phenomena causes the sub-
jective symptoms to be so varied as to be of little value in esti-
mating physical conditions.

The operation for laceration of the cervix has been per-
formed eleven ti^nes in the hospital during the past year, and
no unfavorable result has followed the procedure in any in-
stance. The general health of the patients operated on has
uniformly improved. The improvement, of course, was more
marked in recent cases. In a few of the cases the operation
was followed by such a marked change for the better in the
patient's mental condition as to lead to the inference that in
these cases the lacerated cervix was a prominent etiological
factor in the production of insanity. However, the number of
cases operated on are, as yet, too few, and the time they have
been under observation not sufficiently prolonged to warrant
us in more than suggesting the possibility of such relation.

OVARIAN TUMOR.

Ovariotomy was done in one case as a last resource. The
presence of a large accumulation of acitic liquid somewhat ob-
scured the diagnosis, but laparotomy revealed a malignant
tumor of considerable size, of the right ovary, which was re-
moved. The patient rallied from the operation fairly well, but
succumbed to peritonitis two days later.



12

VISITORS.

It is a matter of observation that visitors to the hospital are
gradually increasing from year to year. The number of vis-
itors during the past year is probably unprecedented in the
history of the Hospital. This can be accounted for to some
extent by the fact that several months of that period Indian-
apolis had a presidential candidate, and was the center of at-
traction for the numerous visiting delegations from the various
counties of Indiana, as well as from cities and towns of neigh-
boring States. In order to accommodate these visitors we did
not hold strictly to the hours that are usually allotted to that
purpose, but allowed them access to the wards during the
morning as well as the afternoon.

We have been especially particular to give visitors free ac-
cess to the Hospital, and have gone to some pains to explain
the system of management to those who seemed interested in
such matters. As a rule, visitors seemed well pleased with the
condition in which they found the wards of the Hospital.
However, persons would occasionally appear possessed of a
morbid curiosity to see patients in cells bound with chains, or
other implements of torture, and when told that they had al-
ready seen the most disturbed patients, that we had no cells, in
fact, no patients under restraints, they would look incredulous
and disappointed.

It has been our custom to permit relatives of patients to
visit them on Sundays, but I am of the opinion that this privi-
lege should be extended to those only, who for some particular
reason, can not make their visits on other days of the week.
The patients appreciate the systematic observance of Sunday,
and the officers, together with the other employes, should be
allowed some of the blessings of rest and quiet on that day, in
common with other people.

In view of the fact that the Hospital grounds are being over-
run on Sundays by visitors and sight-seers, who, by their per-
sistent encroachments, are rapidly converting the beautiful
lawns and avenues, which were designed exclusively for the
benefit of the patients, into the purposes of a public park, I
would suggest that the public be excluded from the grounds on
Sundays, and that the Street Car Company be required to stop
their cars at the outside gate on that day, or, if that is not
practicable, ask them to remove their tracks entirely from the
Hospital grounds.



13



SALARIES.



The salaries paid male attendants is entirely too low. It has
been a matter of surprise to me that we could obtain as good a
class of young men for attendants as we do for the small sum
of $20 per month. The wages of attendants should be graded
in accordance with their general usefulness and the duties re-
quired of them. It seems to me that $30 per month would only
be fair compensation for the services of a first-class attendant.
If the wages were advanced to this amount, young men would
seek the position, and, once employed, contentment would fol-
low, and they would be more likely to remain longer in the ser-
vice of the hospital than they usually do. Forbearance, kind-
ness and exhaustless patience are essential qualifications in an
attendant on the insane. These qualifications are not acquired ;
they must be inherited. Then by continuous service, a degree
of tact and skill in the control of patients, is attained that
makes their services invaluable.

The salary allowed the Superintendent is not at all adequate
to the duties and responsibilities pertaining to that position.
When the statutes were enacted, several years ago, limiting
the Superintendent's salary to $2,000 per annum, the Hospital
had a capacity for about four or five hundred patients. Since
that time the institution has been greatly enlarged, a new build-
ing, the Department for Women, has been added having a
capacity for 850, giving the Hospital an aggregate capacity for
1,500 patients. Of course, the duties of the Superintendent have
been correspondingly increased, and yet his salary remains un-
changed.

However, I have no doubt that the same generous liberality,
which prompted our people to build such magnificent struc-
tures as our present Hospital buildings for the care and treat-
ment of our unfortunate insane, will in due time inspire them
to make the necessary provision for paying the Superintendent
a reasonable salary, an amount at any rate commensurate with
his duties and responsibilities. If the salaries paid at similar
institutions, of less magnitude, be taken as a criterion in this
matter the salary of the Superintendent of this Hospital ought
to be $3,500 per annum.



14



SUBSISTENCE.



All articles of food supplied to the Hospital are first deliv-
ered at the store-house, where they are carefully examined by
the Steward and Storekeeper. On the delivery of meats and
poultry the butcher is required to assist in the inspection.
These officers are instructed not to accept any articles of food
that fall below the standard, in quality, as specified in our pur-
chasing contracts. Our refrigerators, for the preservation of
meat, butter and other articles that are liable to deteriorate,
seem about as perfect as they could be made. Our chief cooks
are instructed to examine closely all food supplies delivered to
them, and to reject every article that is of inferior grade, or
about which they have any suspicion of impurity.

When the food reaches the tables, ready to be served to the
patients, it is again inspected by the dining-room stewards,
physicians or supervisors. Therefore, it does not seem reason-
able that all these officers could be deceived about the quality
of the food served to the patients. Their testimony, as to the
satisfactory quality and quantity of the food, is a matter of
record in the Hospital from day to day. The dietary list is va-
ried from time to time, to accord with the season, and to avoid
monotony. The list given below was followed with slight va-
riation during September.

BILL OF FARE.

[General diet for patients.]
SUNDAY.

Breakfast — Oatmeal mush, milk, potatoes, bread, butter,
cofl:ee.

Dinner — Corn beef, bread, boiled cabbage, tomatoes, pickles.
Supper — Bread, butter, cake, peaches, tea.

BILL OF FARE.

[General diet for patients.]
MONDAY.

Breakfast — Fried bread, oat meal, coffee, bread, butter.
Dinner — Roast beef, gravy, bread, potatoes, hot slaw, bread
pudding, buttermilk.

Supper — Hot biscuits, apple sauce, tea, bread, butter.



15
BILL OF FARE.

[General diet for patients.]
TUESDAY.

Breakfast — Fried ham, milk gravy, corn cakes, coifee, bread,
butter, molasses.

Dinner — Mutton, stewed tomatoes, corn, potatoes, bread,
apples.

Supper — Boiled rice, milk, peaches, tea, bread, butter. .

BILL OF FARE.

[General diet for patients.]
WEDNESDAY.

Breakfast — Beef steak, gravy, potatoes in jackets, colfeey
bread, butter.

Dinner — Beans, bacon, boiled cabbage, corn bread, pickles,
apple pie, buttermilk.

Supper — Hot rolls, baked apples, tea, bread, butter.

BILL OF FARE.

[General diet for patients.]
THURSDAY.

Breakfast — Beef stew, oat meal, coft'ee, bread, butter.
Dinner — Boiled ham, potatoes, turnips, apple dumplings,
bread.

Supper — Boiled rice, milk, sugar, bread, butter, tea, grapes.

BILL OF FARE.

[General diet for patients.]
FRIDAY.

Breakfast — Boiled eggs, fried potatoes, coffee, bread, butter.
Dinner — Fried fish, mashed potatoes, hot slaw, buttermilk,
bread, butter.

Supper — Crackers, cheese, apple sauce, tea, bread, butter.



16
BILL OF FARE.

[General diet for patients.]
SATURDAY.

Breakfast — Fried bacon, gravy, potatoes in jackets, coffee,
bread, butter.

Dinner — Roast beef, gravy, stewed tomatoes, fried onions,
potatoes, bread.

Supper — Bread and milk, hominy, tea, bread, butter.

EXTRA SPECIAL DIET.

Selections from the following articles of food are made in
addition to the general bill of fare, for special cases, by the
physicians, when they have reason to believe that a change of
fare is needed, and where unusual quantities of any particular
kind of food seems to be indicated.

Apples, baked, stewed or roasted; bananas, oranges, beef
tea, beef extract, ceraline, in various styles; chocolate, cocoa,
chicken, boiled, stewed, roasted or served in soup ; eggs, boiled,
fried or poached on toast ; various kinds of jellies, maccaroni,



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