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Suicide

Tertiary syphilis

Paralysis



Switzerland

Germany

Massachusetts

United States

Pennsylvania ...

Maine

Portugal

Maine

France

Germany

Austria

Ireland

Tennessee

Italy

Western Island..

Ireland .

Canada '

Austria

Ohio

Wisconsin

Virginia

France

Mexico

Germany

Ireland

Switzerland

New Hampshire -

Mexico

Ireland

California

Ireland

China

Mexico

Ohio

Massachusetts

Ireland

Virginia

New York

Missouri

New York

Ireland

England

Prussia

Missouri

France

Utah

Pennsylvania

Sweden

Germany

Maryland

Belgium

Germany

France

Canada

Ireland

China

Ireland

Ireland

New York

Ireland



28
68
80
58
64
53
30
74
55
63
58
54
50
50
31
46
55
35
43
32
55
58
31
48
Unknown
62

43 i
37
38
20
47
33
49
49
32
58
83
67
28
76
81
65
55
57
38
26
77
41
50
40
60
31
70
■ 48
36
49
43
49
44
43



43

Table I — Continued.



Cause of Death.



Nativity.



Age.



March, 1884
March, 18S-4
March, 1884
March, 1884
March, 1884
Marcn, 1884
March, 1884
April, 1884-
April, 1884.
April, 1884-
April, 1884.
April, 1884.
Mav, 1884.
May, 1884-
Mav, 1884-
May, 1884-
May, 1884.
Mav, 1884-
May, 1884.
May, 1884.
■June, 1884.
June, 1884-
Juue, 1884.
June, 1884.
June, 1884.
June, 1884.
June, 1884-



Epilepsy

Consumption

Tabes niesenterica

Organic disease of brain

Epilepsy

Epilepsy

Paralysis

Cancer of rectum

Consumption

Nephritis

Acute delirious mania _.

Abscess of the lungs

Maniacal exhaustion

Organic disease of brain

Maniacal exhaustion

Organic disease of brain

Paralysis

Chronic diarrhQ3a

Paralysis

Maniacal exhaustion

Cerebral effusion

Paralysis

Epilepsy

Maniacal exhaustion

Paresis

Paralysis

Consumption



Ireland

France

Massachusetts

Mexico

Ireland

Missouri

Ireland

Mexico

Ireland

Germany

Germany

Pennsylvania

China

Massachusetts

China

Ireland

Chili

Ohio -

Tennessee

China

Ohio ._

China

California

Germany

Ireland

Tennessee

China



36


1




66





i


34


1




53




i


82


i




43





i


48


1





63





1


54




1


37




1


52







26







31






55







49







67







50







52






68







27







69







Unknown







31







25




1


40







54







38





1



TABLE J.



Hecapitulatio'ii of Cause of Death of Eighty -seven Patients during the Year from July 1, 1883, <o

Jicbj 1, 1884.



Cause of De.vth.



Consumption

Paralysis

Maniacal exhaustion

Organic disease of brain

Epilepsy

Senile decay

Marasmus

Apoplexy

Suicide

Acute delirious mania

Atrophy

All other causes

Totals



Males.


Females.


11


6


15


1


5


3


5


2


4


1


4




2


2


3




2




1


I


1


1


14


3


67


20



17
16
8
7
5
4
4
3
2
2
2
17

87



44

The following table shows the movement of patients in the asylum
from its foundation to July 1, 1884:



GENERAL STATISTICS.

NUMBER OF ADMISSIONS, RECOVERIES, DEATHS, ETC.



Years.



il

O CD

2-0-






1851 ...

1852 ...

1853 ...

1854 ...

1855 ...

1856 ...

1857 ...

1858 ...

1859 ...

1860 ...

1861 ...

1862 ...

1863 ...

1864 ...

1865 ...

1866 ...

1867 ...

1868 ...

1869 ...

1870 ...

1871 ...

1872 ...

1873 ...

1874 ...

1875 ...

1876 ...

1877 ...

1878 ...

1879 ...

1880 ...

1881 ...

1882 ...
188:5 ...
1884 ...

Totals



13
124
160
202
214
210
206
i 244
■ 276



50
108
150
168
126

81
112
112



13
16
15
17
20
22



248


123


21


54


198


154


34


33


301


127


14


65


252


105


17


47


219


101


25


82


268


93


15


82


279


131


13


62


313


125


14


89


387


146


13


134


482


225


16


159


562


221


36


156


523


245


36


176


506


240


33


188


401


185


19


152


524


209


46


178


615


259


71


181


414


252


60


172


201


83


30


100


219


80


19


106


106


58


16


100


114


40


9


72


149


64


16


92


179


71


11


93


258


68


10


86


264


113


22


87


9,631


4,421


733


2,940



10 i

14

12

12

12

27

12

9
10
15
22
23
12
12
23
26
18

7

7

7

4

1
11

6
11

322



62

103

134

162

172

188

273

370

417

416

499

583

581

632

693

769

853

920

1,047

1,090

1,123

1,156

1,224

1,302

1,214

1,195

1,202

1,127

1,116

1,102

1,095

1,184

1,215



51
61
76
84
67
127
43
33
33
68
78



31



1,432



13

130

222

305

348

382

378

432

549

618

615

717

751

802

849

911

1,006

1,156

1,335

1,482

1,570

1,596

1,524

1,680

1,839

1,716

1,415

1,414

1,308

1,241

1,265

1,281

1,353

1,448



217



46.15
40.32
67.50
74.00
78.50
60.00
39.32
45.90
40.58
49.59
77.77
42.19
41.67
46.12
34.70
46.95
40.00
37.73
46.68
39.32
46.84
47.43
46.13
39.88
41.95
61.26
41.29
36.53
54.71
35.08
36.24
39.67
26.35
42.80



7.69

7.69

5.40

6.89

5.20

6.02

7.33

7.41

8.91

8.73

5.36

9.06

6.26

10.22

9.66

6.81

8.80

11.59

11.91

10.55

11.21

11.78

9.97

10.59

9.84

10.03

7.06

7.49

7.64

5.80

7.19

7.27

6.35

6.01



45



TABLE FIRST.



Shoioing Account of Articles Consumed and Current Expenditures in the Asylum for the Year

ending with June 30, 1884.



Values.



Flour.

Meat

Sugar

Tea

Syrup

Potatoes

Butter

Coffee

Lard

Fish .

Poultry and eggs

Beans and peas

Rice and cracked wheat

Cornmeal and middlings

Fruit

Vegetables

Salt

Vinegar

Small groceries

Soap and potash

Drugs and medicines

Liquors

Tobacco

Dry goods

Clothing and hats

Shoes and leather

Blankets

Bedding

Furniture and crockery

Hardware

Brooms and brushes

Fuel

Gas and oil

Books and stationery

Grain and feed

Castings, pipe, and iron

Garden tools and seeds

Paints, oil, and glass

Lumber

Building materials and repairs.

Discharged patients

Returned escapes

Payroll and wages

Miscellaneous



Total .



$9,551


00


24,724


57


5,015


12


1,156


37


663


92


3,517


68


6,894


26


1,344


32


181


19


890


79


414


26


954


94


864


00


504


10


758


00


229


58


117


32


164


89


1,346


62


1,159


36


1,799


77


541


75


1,305


43


1,758


01


5,282


11


2,655


88


2,131


45


1,375


26


1,025


68


1,185


24


335


99


15,688


10


1,918


28


332


79


2,783


76


1,242


04


396


61


147


93


683


57


2,182


06


281


25


172


20


74,279


68


1,848


76


$181,805


89



46

TABLE SECOND.
Showing the Cost of the different Departments for the Year ending vnth June 30, 1884.



Depabtments— 1883-1884.



Cost.



Male kitohen and dining-room .$35,570 05

Male department . • 50,387 20

Female kitchen and dining-room 18,669 86

Female department 31,963 30

Bakery \ 10,592 02

Laundry and engine-room i 5,713 07

Farm, garden, and dairy ; 6,162 61

Repairs and improvements 3,013 56

Medical Superintendent j 5,571 19

First Assistant Physician 1 4,300 02

Sesond Assistant Physician i 4,230 56

Miscellaneous | 5,632 45

Total \ $181,805 89

i



TABLE THIRD.
Shovnng tlie Cost of Extraordinary Expenditures for the Year ending June 30, 1884.



Articles.



Cost.



Wagon and harness

Furniture and repairs, residence Medical Superintendent
Teams and labor, filling slough and plowing field

Total



$235 00

611 52

1,025 50



.•?1.872 02



TABLE FOURTH.
Averages.



Months.



>


>


i-2.g


>e g










h^'=^


1 g.


*< 5- c




! "3




1 Q c-


■ &


1 s %


1 ^



P a



o O

t c
OS.









Julv, 1883 .- 1,179

August, 1883 1,187

September, 1883 1,197

October, 1883 1,199

November, 1883.-. 1,203

December, 1883 1,205

January, 1884.. 1,211

February, 1884 1 1,223

March, 1884 ! 1,225

April, 1884 ' 1,228

Mav, 1884 I 1,235

June, 1884 1,238

Yearly average 1,211




$12 34
12 31
12 63

12 62
14 41

13 35
13 46

11 76

12 46

11 87

12 42
10 67

$12 52



47

TABLE FIFTH.
Sliowing Products of the Farm, Garden, and Dairy, for the Year ending with June 30, 1884.



Articles.



Amouut.



Beets, pounds

Tomatoes, pounds

Turnips and carrots, pounds

Beans and peas, pounds

Pumpkins and squash, pounds

Other vegetables, pounds

Corn and cucumbers, dozens

Cabbage, pounds

Onions, pounds

Lettuce, cauliflower, and celery, dozens

Peppers and okra, pounds

Apples, pears, and plums, pounds

Grapes, pounds

Egg and oyster plant, dozens

Parsnips, pounds

Pork, pounds

Milk, gallons

Eggs, dozens

Turkeys and chickens

Wood, cords

Beef, pounds

Hay, tons

Fodder, tons



,205
,185
,260
27f)
357
,363
575
099
,907
371
267
129
553
439
.032
,162
757
310
73
60
370
50
10



TABLE SIXTH.
Shoiuing Stock Sold for the Year ending loith June 30, 1884.



Stock.



Number, i Price.



Calves . .


4
38

1
1


$34 50


Hogs


225 00


One cow . _.


70 00


One bull


40 00










$369 50



TABLE SEVENTH.
Shotoing Stock on Hand June 30, 1884.



Cows i 40

Bull 1

Yearlings 7

Young calves 18

Hogs : 62



48

SEWERAGE.

The grounds prepared by the State Engineer for the distribution of
sewage, under the system adopted by your Board last Fall, has not
yet been set to the proper grasses, but, with this exception, the work
is successfully completed and in admirable order. The old sewers,
from which there was a continuous exhalation of disagreeable and
deleterious gases, have been thoroughly flushed and purified with
disinfectants. They have also been bulkheaded in several places and
the upper portions adjacent to the buildings filled in with fresh earth.
The atmosphere in and around the buildings has by this means been
relieved of impurities heretofore existing, and the sanitary condition
much improved.

THE DAIRY.

The dairy has not been enlarged to the capacity intended, owing to
the impossibility, last Spring, of putting in a sufficient acreage of
alfalfa and other grasses to supply food for a larger number of cattle.
The daily product for several months past has been about one hundred
and twenty gallons of milk. This has been a very agreeable addition
to the usual fare of the patients and attendants, but the quantity is
not enough to reduce, perceptibly, the general expenses. The land
now partially prepared for the cultivation of grasses will in the future,
it is hoped, produce an ample supply of fodder for one hundred head
of cattle. From this number a dairy of sixty cows can be maintained
throughout the year, the product of which will materially lessen the
expense now incurred in the purchase of meats.

THE SEWING ROOM.

During the past year a sewing room, in rear of the amusement hall
of the female building, has been provided, properly furnished, and
placed under the supervision of the seamstress. By this arrangement
the making and mending of all wearing apparel of the female patients
have been brought more directly under the inspection of the Matron,
thereby saving much of the waste incidental to the irregular and
imperfect manner of performing such work in the wards.

THE NEW LAUNDRY.

By permission of your Board a new laundry has been erected at
the female department. This building is now completed in accord-
ance with the contract, and the machinery will, in a few weeks, be in
place and ready for work. This was a much needed improvement.
The old laundry was inadequate for the purposes intended, and its
close proximity to the male department rendered it impossible to give
the female patients while at work the requisite seclusion and protec-
tion from frequent annoyances by the male patients and visitors. It
will also enable the employes to exercise a more eff'ective supervision
of the clothing of the several wards of both departments of the
institution.

AMUSEMENTS.

The weekly dances, inaugurated last Fall, and continued unin-
terruptedly, except for a short time during the warmest period of the



49

Summer, have contributed largely to the enjoyment of the patients.
They have also derived much satisfaction and benetitfrom the morn-
ing and afternoon rides in the asylum carriage. Such amusements
and recreations not only agreeably break the monotony of asylum
life, but are highly beneficial in the treatment of the insane; and it
is a matter of regret that the appropriations for the maintenance of
the asylum are so limited that suitable recreation grounds, and other
healthful means of enjoyment and exercise, cannot be more liberally
provided.

NEEDED IMPROVEMENTS.

In the original asylum building a more perfect system of heating
the wards is needed. The stoves now used for that purpose are
insufficient for the comfort of the patients, besides being more expen-
sive and dangerous than any modern means of accomplishing that
object. The south wing of this building requires a new roof. The
central projection, in which are located the sixth ward, the attendants'
dining room and a dining hall for about 180 patients, the kitchen,
and the storeroom, is, in its present dilapidated condition, unfit for
use, and requires thorough remodeling. Provision should also be
made for the delivery of food to this building from the new kitchen.
The estimated cost of these improvements, by the architects, Percy and
Hamilton, is $25,000, and an appropriation of this amount should be
asked therefor.

RECOMMENDATION FOR A NEW ASYLUM.

The new brick building now being erected under the appropriation
by the Legislature, approved March 9, 1883, will, if no unforeseen cause
of delay should occur, be ready for the reception of patients about
the first of December next. The construction of this building was
recommended by Dr. Shurtleff in his report for 1882, to relieve the
crowded condition of the asylum, to provide for the increase of the
insane during the two following years, and for the better accommo-
dation of the inmates of the old wooden structure known as the cot-
tage ward, built in 1869 only for temporary use.

Of the 1,250 patients now under our care, 134 are in this wooden
structure and 160 are sleeping on the corridor floors of the other
wards of the asylum, making a total of 294 to be provided for by the
new building. This number is nearly or quite equal to its full capac-
ity, and the usual increase will very soon again fill the asylum to its
present .overcrowded condition, unless some provision for its relief is
made by the Legislature. The fact that during the fiscal year ending
June 30, 1884, 764 patients were admitted to this and to the Napa-
Asylum, and the large number of inmates now at the latter institu-
tion in excess of its capacity for accommodation, are additional and
urgent reasons for immediate legislation to provide another asylum
for the care of the rapidly increasing insane of the State.

The frequent delivery of patients shackled as criminals, has been a
subject of remonstrance by myself and other officers of the institu-
tion, but this reprehensible practice on the part of Sheriff's and their
deputies still continues, and in most instances without the slightest
cause for such severity and indignity. I tall your attention to this

matter, in the hope that some remedy for this evil may be provided

410



50

by the proper autliorities, so that those who are so unfortunate as to
require the restraining care of an asylum, shall be humanely treated
while in charge of the executive officers of the several counties of the
State.

And finally, I desire to express my obligations and thanks to you
for your wise and efficient coiiperation in the management of this
great responsibility; to Drs. Langdon and Mays for their skillful and
untiring devotion to the matters under their immediate charge; and
to the officers and employes generally for the faithful discharge of
their respective duties.

W. T. BROWNE,

Medical Superintendent.

State Insane Asylum, Stockton, Cal., October 1, 1884.



APPENDIX.



THE SEWAGE QUESTION IN CALIFORNIA.



REPORT



State Engineer, Wm. Ham, Hall,



Board of Directors of the Stockton Insane ' Asylum



SEWERAGE FOR THE INSTITUTION IN THEIR CHARGE.



REPORT.



Office of the State Engineer, California, |
Sacramento, August 30, 1883. j

The Honorable Board of Directors of the Stockton Insane Asylum :

Gentlemen: The question of sewerage for your institution natu-
rally divides itself into two parts:

The First — What shall be done with the sewage matter ?

The Second — By means of what works and appliances shall it be
disposed of ?

The ultimate determination of each of these questions involves a
consideration of the other, but the study must commence with the
first mentioned.

This report is divided into five parts; the first four being devoted
to the first question above mentioned, and the last one to the second
question, as follows:

Part 1 — The Pollution of Rivers and Estuaries.

Part 2 — The Application of Sewage to Land.

Part 3 — The Artificial Treatment of Sewage.

Part 4 — The Disposal of the Asylum Sewage.

Part 5 — The Sewage Works Proposed at the Asylum.

In submitting this paper I do not apologise for requiring so much
of your time as it will take to read a long report, because I am im-
pressed with the magnitude of the subject, and with a sense of the
fact that we are about to take a step which will be looked to as hav-
ing been a precedent, when in the future this sewage disposal ques-
tion shall have attracted as much attention here as it has in older
countries; and I feel that it is our duty as officers of the State to
leave behind a record of the fact that we have looked deeper than
the surface of the matter, and tried, at least, to start aright.
Very respectfully, your obedient servant,

WM. HAM. HALL,

State Engineer.



WHAT IS TO BE DOjVE WITH SEWAGE!



PART I.— THE POLLUTION OF RIVERS AND ESTUARIES.



THE EFFICIENCY OP SEWERAGE WORK.

Every sewerage proposition must be considered from the standpoint
of efficiency as well as from that of cost.

To be efficient such a system must effect the final disposition of the
sewage matter in a way unobjectionable alike to the locality sewered,
to other localities, and the public generally.

The question of efficiency in sewerage systems has received very
much attention within the past few years.

European centers of population, and outlying districts as well, have
been thoroughly shaken in their social structures by this sewage
question, and are yet earnestly considering it.

And even in the comparatively young communities of our Eastern
States such sanitary matters occupy a prominent place in the minds of
the thinking people of all leading cities and suburban neighborhoods,
and have received fitting recognition at the hands of professional and
scientific men.

As the result of this activity of practice, observation, and thought,
there is a fund of experience for us to contemplate.

The professional man who undertakes to look beyond the surface
of this subject, finds at his command a library of recorded experiences
and facts, which are multiplying so rapidly that there is no branch
of applied science at this time more progressive than that known as
Sanitary Engineering.

No questions in this connection have received more earnest atten-
tion than those of the efficiency of the disposal of sewage; first, by
mingling it with the w^aters of streams and tidal estuaries; and second,
by applying it to land; and, as auxiliary to each or both of these,
tJiird, the question of the artificial treatment of sewage matter to ren-
der it more easy of efficient final disposal by the other mentioned
methods.

The sewage to be dealt with at your institution is simply fouled
water — that is, it is " water carried," and not " middenstead " matter.

The object of all sewerage work in dealing with this class of .sewage
must be to return the water to its natural state of purity, and to change
to harmless, if not useful, forms, the other constituent parts of the
substance treated.



58

THE POLLUTION OP WATERS.

The practice of the disposal of sewage by mingling it with the waters
of rivers, tidal estuaries, etc., has been upheld upon the theory that
running waters soon purify themselves; that the organic matters
become changed in character, and other objectionable parts so far dis-
persed or altered as to lose appreciable influence upon the human
senses and all harmful effect upon the human system.

It was alleged that the particles of the organic (animal and vege-
table) parts of noxious matters, being dispersed by mingling with
comparatively large bodies of water when dumped into a river or
estuary, were brought in contact with the combined or dissolved
oxygen of the air in the water, or of the air over the water, by the
rolling or boiling motion of the current, and thus oxidized — a change
equivalent in its effect to burning.

The theory appeared to be well founded. A number of instances
were cited where the waters of streams polluted by sewage, appar-
ently cleared themselves by running a few miles. Others were brought
forward where clear water streams polluted by peaty matter, and ren-
dered dark and opaque by the vegetable organic matter held in solu-
tion, became clear after running similarly short distances. These
changes it was said were due to oxidation of the animal matter in the
one case, and the vegetable matter in the other; and, hence, that the
waters were purified.

And it was argued that contact with air under these conditions of
mingling with water, having this effect of oxidizing organic matter
in these cases, it would have such effect in all cases, and, hence, the
mingling of sewage with running or tide agitated waters was not a
vicious and objectionable practice.

So well grounded has this theory appeared, and so strong were the
interests involved in its favor, that in JEngland, " until recently, san-
itary engineers have done their best to remove sewage matter from
towns into rivers in obedience to legislative requirements." (Bailey
Denton, Lectures, etc., p. 248.)

But for years there has been the most violent opposition to this
" pernicious and disgusting practice," throughout Western Europe,
but more especially in England, where the subject has been forced to
the front in ways that could not be ignored, and where the form of
laws and social organization appears to have allowed wider range to
the discussion than it attained in the other countries.

But facts soon proved that the theory of self-purification of river
waters was at fault. Some streams of no less but greater volume,
receiving no more or perhaps less sewage, did not purify their waters
as was alleged of others, and inquiry developed the fact that by no
means all peaty waters become pure in their onward flow.

And, most perplexing of all, it was observed that streams which for
years had received sewage matter without much apparent detriment
to their waters, became foul to every sense, within a comparatively
short space of time, and without any considerable increase in the
amount of sewage led into them.

The subject now assumed a serious form. Great sewerage works
had been carried out, immense manufactories located and operated,
and all depending for efficiency upon the privilege of a free outfall
for sewage into the tidal or inland waterways of the country.

The battle now became fierce. Sanitarians generally, and towns



59

located low down on the streams, protested against the pollution of
the waters by town sewage and manufacturing offal at points above.

The property owners C'rate payers," so called in English litera-
ture — really non-resident landlords in many instances) in towns
where sewerage works had been constructed leading the sewage into
the streams, as well as those in other towns which desired to con-
struct works on this principle, together with the manufacturers gen-
erally, who were for getting rid of their offal waters in the easiest way
to avoid further expense to themselves, vigorously opposed interfer-
ence with existing practices.

The fight now became a war very similar to the struggle which has
gone on in this State between the hydraulic miners and the farmers



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