Reports of the Board of Directors and Superintendents of the State Hospital for the Insane at Morganton, Goldsboro and Raleigh |
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REPORTS OF THE BOARD OF DIRECTORS AND OF THE SUPERINTENDENTS OF THE STATE HOSPITALS FOR THE INSANE AT RALEIGH, GOLDSBORO AND MORGANTON NORTH CAROLINA FOR THE TWO YEARS ENDING NOVEMBER 30, 1918 RALEIGH Edwards & Broughton Printing Co. State Printers 1918 BOARD OF DIRECTORS OF THE STATE HOSPITALS OF NORTH CAROLINA Joseph G. Brown, President Wake County Term expires April, 1923. A. E. Tate - Guilford County Term expires April, 1919. P. B. McKinne Franklin County Term expires April, 1921. B. B. Adams Johnston County Term expires April, 1921. R. R. Clark Iredell County Term expires April, 1923. W. H. Williams Beaufort County Term expires April, 1919. C. A. Woodard . . . . ' Durham County Term expires April, 1919. *C. P. Matheson Alexander County Term expires April, 1921. J. W. Thompson Wayne County Term expires April, 1923. *Died during the year and succeeded by J. H. Giles, Burke County. Term expires April, 1921. LETTER OF TRANSMITTAL Raleigh, N. C, December 21, 1918. To His Excellency, T. W. Bickett, Governor of North Carolina. Sir:—On behalf of the Board of Directors of the State Hospitals of North Carolina, I beg to submit herewith the reports of the superintendents, show-ing in detail all the operations at each 'hospital for the two years beginning December 1, 1916, and ending November 30, 1918. The institutions and the State suffered a great loss in the death of Mr. Charles P. Matheson, an 'honored and useful member of this Board and a gentleman of sterling character. Your special attention is called to the fact that a deficit is shown at each institution. It is a source of gratification that this deficit is not larger as, because of war conditions throughout the entire period, the price of labor and of supplies of every kind have been excessively high. Two years ago the directors of the three 'hospitals asked for increased appropriations, basing their request on the advanced prices then prevailing. The General Assembly thought best to curtail the amounts asked for, and did so. Prices continued to advance, and, 'dearly foreseeing that the appro-priations would be inadequate, the directors, in person and by letter, in May, 1917, called the matter to the attention of yourself and your Council of State. After due consideration the directors were advised to make t'he available funds go as far as possible and wihen they were exhausted to call upon you for further instructions. This course was followed and every possible economy was practiced. Rooms were kept empty because funds were not sufficient to support the present population. There are now empty rooms sufficient to accommodate at Morganton 100 and at Raleigh 110 additional patients. Because of lack of funds these rooms could not be used, although there were many applicants on the waiting list, and some unfortunately lying in the county jails. In October, 1918, your attention was again called to the lack of funds, and your Council of State authorized the directors to borrow for Goldsboro $30,000, for Raleigh $30,000, and for Morganton $60,000. The hospitals did not find it necessary to borrow quite so much, although at Morganton it was found necessary to leave some outstanding bills. Attention is called to these mat-ters in the various reports, and the General Assembly is asked to provide for these deficits in addition to their appropriation for maintenance for the next two years. The directors would suggest and most earnestly urge that authority be lodged in some one to provide for emergencies of this kind so that the direc-tors may not be called upon to assume personal responsibility for the support of these institutions or to ask the banks to make loans for wlhich there exists no authority. Your attention is further directed to the crying need for other permanent improvements, as indicated in the reports of the superintendents. The direc-tors are fully aware of the lack of funds sufficient to provide for all of the interests of the various institutions of the State, but the needs of the class Letter of Transmittal of patients served by these hospitals are of such a nature that they think it their duty to submit these matters for the careful consideration of yourself and of the General Assembly. There is a fund known as the "Receipts or Steward's Account," which comes from pay patients and other sources and which the various hospitals have been allowed to use. But for this fund it would have been impossible to have made as good a showing with the regular appropriations. In large institutions of this kind, as in smaller households, many unusual emergencies occur which cannot possibly be anticipated. This fund has been used judi-ciously, and detailed report is made thereof. It should not be interfered with. Messrs. Pullen, Henderson, McKinne & Co., a well-known firm of account-ants, have been employed to audit the books and accounts, and comparative statements have been inaugurated which it is believed will result in great good. Summary of the same will be found herein, and all per capita calcula-tions, comparisons, etc., will be found in the Auditor's report. The suggestions and requests found in these reports have been made after the most careful consideration of the Board, and are solely for the interests of the institutions and of the patients under their care. The directors wish to express their appreciation of the cordial support and hearty cooperation which they have always received at your hands. Very respectfully, Jos. G. Brown, President of the Board. REPORT OF THE STATE HOSPITAL AT RALEIGH, N. C. FOR THE TWO YEARS ENDING NOVEMBER 30, 1918 EXECUTIVE COMMITTEE Joseph G. Brown, Chairman B. B. Adams C. A. Woodard RESIDENT OFFICERS AND STAFF Albert Anderson, M.D Superintendent R. K. Adams, M.D -. Assistant Physician Charles L. Jenkins, M.D Assistant Physician Thomas M. Jordan, M.D Assistant Physician Miss Mary S. White Steward SUBORDINATE OFFICERS Miss Minnie Stamps Gosney Bookkeeper Miss Lillie Belle Goodwin Private Secretary to Superintendent Miss Myrtle Reams Superintendent of Nurses Miss Catherine White Matron Miss Annie J. Eagle Druggist T. A. Holliday Engineer Robert Green Carpenter James Adams Florist, Farmer and Gardener REPORT OF THE SUPERINTENDENT Mr. Joseph G. Brown, President, and Members of the Board of Directors of the State Hospital at Raleigh. Gentlemen:—Report of the work of this hospital for two years ending November 30, 1918, is herewith submitted: Statistical Summaey Insane Department Males Patients remaining November 30, 1916 481 Admitted during the past two years 208 Total number under treatment 689 Average daily population in hospital 538 Total number discharged 224 Restored 17 Improved 88 Unimproved 2 Died 117 Per cent of deaths on number treated Per cent of recoveries on number admitted Remaining 465 Epileptic Department Males Patients remaining November 30, 1916 88 Admitted during the past two years 39 Total number under treatment 127 Average daily population 90 Total number discharged 42 Discharged improved 13 Transferred to Main Building 3 Died 26 Per cent of deaths on number treated Total number remaining November 30, 1918 85 Females Total 556 1,037 205 413 761 1,450 618 1,156 231 455 17 34 142 230 1 3 71 188 .... 12 • • • • 4 530 995 Females Total 82 170 26 65 108 235 88 178 25 67 11 24 . . . 3 14 40 . . . 17 83 168 The statistical summary includes the Epileptic Department. There has been no suicide during this biennial period. There had been no epidemic of any disease until the influenza came in October and lasted until about the close of the year. Three hundred and seven cases, including all officers, employees, and patients, occurred in about thirty days, a little over ten cases a day. Of these, there were seventy-two employees and officers with only two deaths; the balance were patients—eighteen of whom died—making 2.7-9 per cent mor-tality among employees and officers and 7% per cent among patients. R. E. Chesnutt, our chief cook, was the first to die of pneumonia. No finer hero than he died in the trenches. He strictly considered his post of service as one of patriotic duty, and flatly refused more remunerative offers and stuck to his job with supreme loyalty. 8 State Hospital at Raleigh W. F. Christenbury, our dairyman, was the second one to die, and he died of the same disease—pneumonia following influenza. He, too, was faithful, efficient, and loyal to his work. Regular staff meetings have been held daily, at which reports from assist-ant physicians are received as to new cases and the condition of the sick. We have had most of our new patients examined and their histories taken and presented to the staff meeting. The large demands of war for doctors depleted our staff and we could not keep up with all the work as we have been accustomed. The work of our pathological department has been done by the State Laboratory of Hygiene since last May. We have had no dental work done at the hospital. There is decided need for this. There is greater need for providing dental work for tlhe mental sick than any other iclass, 'mostly because they cannot be sent outside of the institution in the large majority of cases. There have been very fine results obtained by many institutions where dental work was done. Many mentally sick cases have been restored to health by repairing the teeth. We mentioned in our report two years ago that the old closets of the main building should be replaced with new ones, suclh as were put in the new buildings. The repairs on the old closets and the waste water from defects of tlhe same justify an immediate change. Reference to estimate of the abso-lute needs of male and female sides of main building is made on another page. During recent years the condition of our steam boiler plant and heating system has reached a point where it has been impossible to heat the buildings with any degree of comfort, or even to prevent suffering among our patients in extremely cold weather. The additional buildings recently erected called for additional capacity, and the fuel consumed in an attempt to provide service was increasing at such a rapid rate that in the spring of 1918 it was found absolutely necessary to take some adequate steps to relieve the rapidly increasing difficulties along this line. As the problem presented many difficulties, owing to the large size of the plant as a whole, and the vast amount of heating equipment and complicated nature of the piping system which has accumulated through the various stages of enlargement for many years, it was considered advisable to secure the services of some engineer of experience in this class of work to plan and superintend the contemplated improvements. After careful investigation, Wiley & Wilson, consulting engineers of wide experience in this line of work, were employed in February, 1918, to perform this service. After making a very thorough survey and study of our conditions for several weeks, our engineers submitted a report which convinced us that the alterations would have to be extensive to be of permanent value, and that the expenditure of approximately $15,000 originally available for the work would only cover repairs to an inadequate equipment without reaching the desired results, and that it would be finally wasted, as a general rebuilding of the plant and remodeling of the equipment was inevitable. Among other things the investigations showed that the 750 horse-power boiler plant was connected to a chimney which was only large enough to produce proper draft for 300 horse-power; that the brick settings surround-ing the boilers were practically falling down; that the pipe connections and auxiliary boiler-rooul equipment were entirely inadequate and so far worn State Hospital at Raleigh 9 out that further repairs was a waste of money, and that serious breakdowns and interruptions of service were sure to continue until these items had been replaced by better equipment. The boiler-house was largely of temporary construction with large fire risk and not adequate to accommodate the increased capacity of equipment needed, and the elevations of the boiler-room floor and railway sidings were such that no adequate provision could be made for dumping and storage of fuel, a matter wnich has caused us much trouble and expense in the past. It was also found that the heating equipment in a number of the older buildings needed extensive repairs, and it was necessary to remove a large number of undersized and poorly insulated steam mains, many of which were laid underground and leaked so badly that their further use was out of the question. The improvements finally agreed upon and for Which plans and specifica-tions were prepared by our engineers covered the following: First. The remodeling of the power-house building and construction of coal dump and storage bins. Second. The ' construction of a new brick chimney of sufficient size to accommodate 1,000 horse-power steam-boiler capacity. Third. The installation of an additional steam boiler raising the boiler capacity to 900 horse-power total, and the rearrangement and resetting of all of the six 150 horse-power boilers. Fourth. The installation of entirely new power-house piping, boiler-feed pumps, and auxiliary equipment along modern lines. Fifth. The installation of new steam mains leading to the various build-ings, both for heating and power purposes, so far as these renewals were found necessary. Sixth. The remodeling of the heating equipment in the various buildings wlhere repairs or alterations were found necessary to provide satisfactory heating service. It was estimated that the above work would cost approximately $60,000. The available funds for this purpose being only about $15,000, it was decided to get permission from the North Carolina State Building Commission to use funds which had been appropriated for a new kitchen to devote to the re-modeling of our central power and heating plant. This matter was submitted to the North Carolina Building Commission on May 9th and their approval given, contracts being let at that time for remodeling of power-house, con-struction of chimney, and a number of other items (which, due to the war, would require considerable time to manufacture and deliver to the institu-tion). The plans for the power-plant piping and equipment, also remodeling of the entire steam-distributing system and heating apparatus in the buildings, were submitted to the contractors soon after this time, and bids received about June 25th. Owing to rapidly increased cost of material and labor since estimates were made on March 25th the total cost of the improvements ex-ceeded the estimates by $30,000 to $40,000. The matter was taken up with the Governor's Council and the State Building Commission and permission was given for us to proceed with the work, the funds to he supplied from our next year's building fund or by a special appropriation. The work has been pushed as rapidly as possible, but, owing to the unpre-cedented conditions resulting from the war and influenza epidemic, serious 10 State Hospital at Raleigh delays in getting material and shortage of labor have prevented its final com-pletion. The matter, however, has been handled in such a way as to prevent a serious interruption of the power or heating service. The building contractor remodeling the power-house died in October, and his wife, Who was his administrator, died soon afterwards, and this has been the cause of one of our most serious delays. This matter has been readjusted with a third administrator, and we hope to proceed with the completion of the unfinished details of the building and coal dump. The central plant is now in such shape that we are in position to furnish practically all the buildings with heat and prevent suffering among our patients, although up to the present time we have only three boilers in opera-tion. The other three boilers will be in operation by January 1st, and the improvements as a whole will be nearly completed. It will probably take a month to six weeks after January 1st to finish up all of the minor details and get the plant entirely finished and running in the most economical manner. It would have been impossible for us to get through this winter and take care of our patients without making the improvements above outlined, and the economy resulting from the improvements will abundantly justify the investment, notwithstanding the high cost of labor and material during the construction period, and to say nothing of the satisfactory nature of the service which will be obtained. A tabulation giving cost of the various items entering into the improve-ments as outlined can be furnished if desired, and While there may be some slight changes as the work progresses, it is not contemplated that any mate-rial increase will be required. Our farm and carpenter's departments have continued under the same head, with increased output and efficiency. The engineer's department has of necessity changed heads four times, mainly on account of the war. We are spending on this department all our building appropriation for three years as above outlined. The reports for all the departments are herewith submitted. They all show good results in production. In making our estimate for maintenance appropriation two years ago, we based our estimate on the best obtainable statistics as of October 1, 1916, which showed that the average price of food was 23.8 per cent higher than the average for the past eight years prior to that date. The Legislature failed to give the increased amount asked for, and we were unable to equip and open our new receiving building. Our usual number were sufficient to use all the maintenance fund and create a deficit of about $30,000. We began the biennial period with a deficit of more than $16,000. We have been able to live without larger deficit, as shown by auditor, by making large crops, saving all we make, and practicing strictest economy — "eating enough and wisely, and wasting none." By opening the new building and using all available space we can take about one hundred and ten additional patients. But we have about six hun-dred and thirty on the waiting list. Every mentally sick patient in the State ought to be provided for during the acute stage. Our plan, forced by lack of room, keeps many acute cases out till they become chronic life charges on the State. State Hospital at Raleigh 11 On account of the continued high prices, we must ask for $230 per capita for next two years, and with this amount we believe we can arrange to pro-cure sufficient help to properly care, treat, and feed 1,160 patients. We under-estimated the cost of building a kitchen and two congregate dining-rooms in our last report. We had plans made only for a kitchen, and the lowest bid was about $75,000. Each one of the dining-rooms would have cost nearly as much. At present prices our architect informs us that the kitchen would cost $100,000 and each dining-room $90,000, making a total of $280,000. Our large waiting list might be reduced considerably by adhering to a strict rule of rejecting the applications of many aged people who are bedridden, feeble, or dotards. These do not need the special equipment of a hospital as the mentally sick. Homes for incurables and invalids are the places for these. G Ward building is one either to be condemned or thoroughly remodeled according to the opinion of a competent architect. As the effects of the war upon work, we would mention high cost of living, scarcity and restlessness of labor, producing our deficit, making it very difficult to keep up the usual sanitary condition in our wards and all other work on account of the short-age of help. To the clergy and a few Christian laymen of the city we owe our thanks for their service in conducting our Sunday morning worship. In the discharge of my official duties, I wish to personally thank the officers, employees, and patients for their assistance and support. My indebtedness to the Executive Committee, members of the Board, and members of the build-ing commissioners for their counsel and assistance in solving the many diffi-cult problems connected with the management of the institution is hereby tendered with sincerest appreciation. Respectfully submitted, Albert Anderson, Superintendent. 12 State Hospital at Raleigh Repairs named below are compulsory to the following wards: Female Department A, B, C, D, E, and F Wards Six bath tubs $ 360.00 Eighteen lavatories 360.00 Twelve commodes 600.00 Six sinks 90.00 J Ward Two commodes $ 100.00 Three lavatories 105.00 One sink 15.00 G Ward Three bath tubs $ 480.00 Pour commodes 200.00 Three lavatories ., 105.00 One dish sink in C. D. room 40.00 E. B. Ward Twelve commodes •....$ 600.00 Four bath tubs 240.00 Twelve lavatories 420.00 Four sinks 60.00 Tubercular Ward Two commodes $ 100.00 Two lavatories 70.00 Three toilets in female courtyard 500.00 Total $4,445.00 Needed on Male Side Sixteen commodes $ 800.00 Eight lavatory bowls 280.00 Two or three toilets in male courtyard 500.00 Total $1,580.00 Female $4,445.00 Male 1,580.00 Amount together $6,025.00 Appropriations For 1,160 patients, 1919 $266,800.00 For 1,160 patients, 1920 , 266,800.00 State Hospital at Raleigh 13 TABLE No. 1 Showing the Number of Admissions and Discharges (Including Cures, Im-proved, Unimproved, and Deaths) for Each Year Since the Opening of the Hospital. CO o 03 H < Discharged Date 73 cd Bu CD > O a a CD uu CD CD a CO a o T3 CD >O a S • r-t a CD p o H Mc 'S 'cS a CD 1856 » 90 96 57 83 76 61 44 41 40 . 41 65 85 72 27 27 44 43 50 44 42 44 52 42 45 56 49 50 53 106 97 95 74 80 93 75 88 93 97 92 137 160 182 190 169 192 143 163 141 187 151 143 208 137 237 487 336 262 324 372 316 274 222 191 5 15 26 22 23 21 17 9 14 9 15 13 18 7 7 9 14 17 13 16 11 13 14 14 17 10 16 17 27 41 17 17 37 52 30 45 57 46 50 62 96 99 115 105 119 100 150 55 121 15 113 11 160 6 239 31 293 41 280 5 106 7 27 3 10 7 11 22 4 2 4 7 1 4 5 7 3 4 5 9 6 8 5 6 8 11 4 7 3 5 43 16 12 36 2 14 9 17 10 12 17 3 7 12 10 6 4 3 5 1 10 12 2 5 6 3 2 3 2 55 2 46 25 230 16 214 2 7 9 10 23 8 15 21 27 45 14 21 17 7 9 8 8 13 16 14 9 15 19 13 29 23 17 9 11 24 20 8 18 25 26 24 21 28 19 41 44 28 27 53 31 41 33 28 29 16 28 45 41 43 55 64 110 69 82 77 90 79 109 10 38 51 50 73 47 42 41 55 74 47 52 53 19 22 31 55 41 39 40 29 39 54 33 60 38 56 132 62 86 101 30 80 87 79 81 94 91 75 114 159 145 161 168 154 147 186- 105 240 77 154 75 209 60 324 123 467 127 423 115 432 105 350 80 1857 6 9 7 25 14 8 7 7 19 14 13 11 2 2 9 14 5 2 5 3 3 10 2 I 18 63 9 9 28 3 11 1 16 2 4 138 1858 141 185,9 . 170 186b 179 1861 . 193 1862 . _ 195 1863 195 1864 189 1865 147 1866 - 165 1867 198 1868 . 217 1869 225 1870 . 232 1871 . 245 1872 . 233 1873 . 242 1874 247 1875 249 1876 264 1877 278 1878 266 1879 277 1880 273 1881 284 1882 278 1883 199 1884 . 243 1885 . 254 1886 248 1887 292 1888 292 1889 298 1890 . 294 1891 . 301 1892 300 1893 . 288 1894 3 4 5 8 3 4 1 1 1 4 8 2 4 5 7 5 4 9 13 4 6 3 305 1895 328 1896 2 329 1897. 364 1898 393 1899 2 390 1900.. 424 1901 . . 420 1902 77 29 5 1 8 1 4 3 397 1903 . 433 1904 ... . 380 1905 . 454 1906 . . 441 1907 . 3 6 574 1908 3 1 9 13 3 6 1 4 2 3 11 8 2 1 502 1909. 677 1910.... 842 1911 1,055 1912. . 850 1913 . 1,057 1914 . . 994 1915 1,195 1916 . 1,037 1917... . 1,154 1918 995 Total 7,833 3,056 1,023 154 58 464 2,042 6,817 14 State Hospital at Raleigh TABLE No. 2 Showing Movements of Population foe the Past Two November 30, 1918. Males Patients remaining November 30, 1916 481 Admitted during the past two years 208 Total number under treatment 689 Average daily population in hospital 538 Total number discharged 224 Restored 17 Improved 88 Unimproved 2 Died 117 Per cent of deaths on number treated Per cent of recoveries on number admitted Remaining 465 Fears Ending Females Total 556 1,037 205 413 761 1,450 618 1,156 231 455 17 34 142 230 1 3 71 188 12 4 530 995 TABLE No. 2—EPILEPTIC Showing Movements of Population for the Past Two November 30, 1918. Males Patients remaining November 30, 1916 88 Admitted during the past two years 39 Total number under treatment during 2 years 127 Average daily population , . . 90 Total number discharged 42 Discharged improved 13 Transferred to main building 3 Died 26 Per cent of deaths on number treated Total number remaining November 30, 1918 85 Years HiNDING Females Total 82 170 26 65 108 235 88 178 25 67 11 24 oO 14 40 17 83 168 TABLE No. 3 Showing Form of Insanity of Those Admitted During the Past Two Years. Males Females Total Epilepsy Dementia praecox Manic depressive Constitutionally defective Senile dementia Dipsomania Pellagra Pseudo-bulbopalsy Imbecile Toxic Paresis Drug addiction Traumatic 44 26 70 40 29 69 57 102 159 20 6 26 19 12 31 4 4 6 21 27 1 .... 1 4 .... 4 4 .... 4 5 1 6 3 4 7 2 .... 2 State Hospital at Raleigh 15 Table No. 3 — Continued Males Females Total Puerperal 1 1 Chorea 1 1 Hysteria 1 1 208 205 413 TABLE No. 4 Showing Duration of Insanity of Those Admitted During the Past Two Years. Males Females Total Not to exceed 1 month 30 43 73 From 1 to 3 months 34 27 61 From 3 to 6 months 27 24 51 From 6 to 12 months 17 14 31 From 1 to 2 years 26 27 53 From 2 to 3 years 14 18 32 From 4 to 5 years 15 14 29 From 5 to 10 years 12 22 34 From 10 to 20 years 23 11 34 From 20 to 30 years 5 2 7 From 30 to 40 years 5 3 8 208 205 413 TABLE No. 5 Showing Supposed Cause of Insanity of Those Admitted During the Past Two Years. Males Females Total Unknown 78 67 145 Fright 1 1 2 Heredity 10 12 22 111 health 20 26 46 Pellagra 6 17 23 Domestic trouble 2 22 24 Puerperal 7 7 Drug habit 5 3 8 Whiskey 9 9 Overwork 7 3 10 Menopause 5 5 Senility 1 1 2 Financial trouble 2 1 3 Syphilis 1 1 2 Epilepsy 30 19 49 Grief 2 8 10 Love affair 2 1 3 Worry over war 5 1 6 Traumatism 9 2 11 Masturbation 10 .... 10 Cigarettes 1 .... 1 Religion 7 6 13 208 205 413 16 State Hospital at Raleigh TABLE No. 6 Showing Age When Admitted During Past Two Years. Males Females Total 21 14 35 54 55 109 49 59 108 41 36 77 24 31 55 15 9 24 1 1 2 .... 1 1 From 10 to 20 years, From 20 to 30 years, From 30 to 40 years, From 40 to 50 years, From 50 to 60 years From 60 to 70 years, From 70 to 80 years, From 80 to 90 years 208 205 413 TABLE No. 7 Showing Number of Attacks of Those Admitted During the Past Two Years. Males Females Total First attack 142 128 270 Second attack '. 21 22 43 Third attack 8 13 . 21 Fourth attack 11 8 19 Fifth attack 2 2 Several attacks '. . . . 26 32 58 208 205 413 TABLE No. 8 Showing Occupation of Those Admitted During Past Two Years Males Females Total Housewife Domestic None Teacher Clerk Farmer Merchant Civil engineer .... Laborer Mechanic Shoemaker Railroad conductor Druggist Fisherman Policeman Blacksmith Insurance agent . . Editor Carpenter Contractor Butcher 32 4 7 96 3 2 32 2 1 1 1 1 1 1 1 1 3 1 1 102 61 32 3 102 61 64 7 7 96 3 2 32 2 1 1 1 1 1 1 1 1 3 1 1 State Hospital at Raleigh 17 Table No. 8 — Continued Males Females Total Mill operator 11 4 15 Student . 3 3 6 Tobacconist 2 .... 2 Lawyer 1 .... 1 208 205 413 TABLE No. 9 Showing Civil Condition of Those Admitted During the Past Two Years. Males Females Total Single 107 66 173 Married 96 121 217 Widowed .' 5 18 23 208 205 413 TABLE No. 10 Showing Residence of Those Admitted During the Past Two Years. Males Alamance 4 Anson 3 Beaufort 7 Bertie Bladen 8 Burke 1 Brunswick 1 Buncombe 1 Camden Carteret 2 Caswell 1 Chatham 3 Cleveland 1 Columbus 1 Craven 2 Cumberland 9 Dare 1 Duplin 3 Davidson Durham 7 Edgecombe 8 Franklin 7 Forsyth 1 Gaston 3 Guilford 1 Granville 8 Greene Cabarrus Halifax 4 Harnett 6 Henderson 1 2 Females Total 2 6 .... 3 2 9 3 3 2 10 1 2 1 2 1 2 1 1 5 7 2 3 5 8 .... 1 8 9 4 6 8 17 .... rl 3 6 1 1 7 14 .... 8 5 12 .... 1 1 4 2 3 3 11 2 2 2 2 2 6 6 12 1 18 State Hospital at Raleigh Table No. 10 — Continued Haywood . . . Hoke Hyde , Iredell , Johnston Jones Jackson Lee Lenoir Martin Macon McDowell . . . Moore ....... Mecklenburg Montgomery . Mitchell Nash New Hanover Northampton Onslow Orange Pamlico Pasquotank . Pender Person Pitt Robeson ..... Rowan Rockingham . Sampson Scotland Surry Stokes Tyrrell Transylvania Vance Wake Swain Warren Washington . Wayne ...... Wilson Wilkes Yancey Males Females Total 2 .... 2 .... 4 4 .... 1 1 1 1 2 4 7 11 1 1 2 1 .... 1 2 3 5 6 2 8 2 .... 2 .... 2 2 .... 1 1 6 4 10 1 1 2 .... 3 3 2 .... 2 6 6 12 5 5 10 2 1 3 2 3 5 4 6 10 1 3 4 3 .... 3 3 1 4 2 1 3 2 4 6 7 10 17 .... 1 1 2 1 3 3 5 8 4 4 8 1 .... 1 1 .... 1 1 .... 1 .... 1 1 9 2 11 14 22 36 .... 1 1 3 1 4 1 1 2 6 7 13 4 5 9 .... 1 1 .... 2 2 208 205 413 State Hospital at Raleigh 19 TABLE No. 11 Showing Nativity of Those Admitted During the Past Two Years. Males Females Total Serbia 1 .... 1 Virginia 2 1 3 Mississippi 1 .... 1 Alabama 1 .... 1 Mexico 1 1 South. Carolina 5 3 8 North Carolina 195 200 395 Kentucky 1 .... 1 Germany 1 .... 1 Tennessee 1 .... 1 208 205 413 TABLE No. 12 Showing Form of Insanity of Those Recovered During the Past Two Years. Males Females Total Manic depressive 11 14 25 Involutional melancholia 2 2 4 Toxic 1 1 Drug habit 1 .... 1 Psychoneurosis 2 1 3 17 17 34 TABLE No. 13 Showing Duration of Insanity of Those Recovered During the Past Two Years. Males Females Total From 1 to 3 months 1 1 2 From 3 to 6 months 1 2 3 From 6 to 12 months 4 9 13 From 1 to 3 years 10 5 15 From 3 to 5 years 1 .... 1 17 17 34 TABLE No. 14 Showing the Cause of Death of Those Who Died During the Past Two Years. Males Females Total Acute cardiac dilatation 1 2 3 Carcinoma of nose 1 .... 1 Carcinoma of tongue 1 .... 1 Carcinoma of stomach 1 1 2 Carcinoma of breast 1 1 Pulmonary tuberculosis 6 7 13 Peritonitis 2 2 Exhaustion from epilepsy 22 9 31 20 State Hospital at Raleigh Table No. 14 — Continued Lobar pneumonia Broncho-pneumonia Dysentery Cardio-renal disease Angina pectoris Parenchymatous nephritis Pseudo-bulbar palsy (Edema of the glottis Concussion of the brain , Erysipelas Influenza , Status epilepticus , Heat stroke , Pulmonary oedema , Apoplexy , Pulmonary abscess , Exhaustion from senile dementia Exhaustion from depressive insanity. Exhaustion from dementia praecox. . , Pellagra Septicaemia Paresis Intestinal obstruction Aortic regurgitation Wales Females Total 3 1 4 4 2 6 1 .... 1 4 3 7 1 .... 1 1 .... 1 1 .... 1 .... 1 1 1 .... 1 1 .... 1 11 5 16 3 1 4 1 .... 1 .... 1 1 6 .... 6 .... 1 1 18 9 27 5 .... 5 7 3 10 11 18 ' 29 .... 1 1 5 2 7 .... 1 1 1 .... 1 117 TABLE No. 15 71 188 Showing the Form of Insanity of Those Who Died During the Past Two Years. Males Manic depressive insanity 11 Involutional melancholia 1 Senile dementia 25 Epilepsy 33 Dementia pra&cox 20 Psychosis following pellagra 10 Imbecile 3 Toxic psychosis 1 Paresis 8 Idiot 3 Huntington's chorea Traumatic psychosis 1 Pseudo-bulbar palsy 1 Females Total 13 24 1 2 16 41 16 49 10 30 11 21 2 5 .... 1 1 9 .... 3 1 1 • 1 117 71 188 4 3 7 10 5 15 21 13 34 29 22 51 25 12 37 19 13 32 9 3 12 State Hospital at Raleigh 21 TABLE No. 16 Showing the Age at Death of Those Who Died During the Past Two Years. Males Females Total From 15 to 20 years From 20 to 30 years From 30 to 40 years From 40 to 50 years From 50 to 60 years From 60 to 70 years From 70 to 80 years 117 71 188 TABLE No. 17 Showing Length of Time Spent in Hospital of Those Who Died During the Past Two Years. Males Females Total From 1 to 4 weeks 3 From 1 to 3 months 10 From 3 to 6 months 4 From 6 to 12 months 9 From 1 to 3 years 32 From 3 to 5 years 25 From 5 to 10 years 17 From 15 to 20 years 10 From 20 to 30 years 5 From 30 to 40 years 2 4 7 7 17 4 8 10 19 14 46 6 31 16 33 6 16 3 8 1 3 117 71 188 TABLE No. 18 Showing Residence of Those Remaining in Hospital Males Females Total Alamance 14 12 26 Allegthany Alexander Anson Ashe Beaufort Bertie Bladen Burke Brunswick Buncombe Camden Catawba Carteret Caswell Caldwell Chatham Chowan . . 1 1 1 .... 1 5 .... 5 2 .... 2 10 4 14 12 3 15 14 10 24 1 2 3 8 2 10 2 2 4 2 1 3 1 1 2 10 3 13 8 5 13 1 1 2 8 3 11 2 2 4 22 State Hospital at Raleigh Table No. 18 — ^Continued Males Cleveland 2 Columbus 8 Cherokee . Craven 5 Cumberland 23 Currituck 2 Cabarrus 3 Dare 1 Davie Duplin 10 Davidson Durham 20 Edgecombe 10 Franklin 10 Forsyth 2 Gates 1 Gaston 2 Guilford .' 2 Granville 6 Greene 2 Henderson 1 Halifax 12 Harnett 6 Hertford 3 Haywood 3 Hoke 1 Hyde 3 Iredell 4 Johnston 12 Jones 4 Jackson 1 Lee 4 Lenoir 6 Martin 5 Macon McDowell 3 Moore 9 Mecklenburg 1 Montgomery 1 Madison 2 Mitchell 3 Nash 6 New Hanover 14 Northampton 3 Onslow 4 Orange 5 Pamlico 4 Pasquotank 10 Pender 4 Females Total 1 3 5 13 1 1 5 10 14 37 3 5 3 6 2 3 1 1 9 19 1 1 26 46 10 20 10 20 .... 2 4 5 1 3 4 6 9 15 19 21 .... 1 11 23 9 15 2 5 1 4 5 6 4 7 2 6 15 27 3 7 1 2 5 9 8 14 9 14 1 1 1 4 21 30 4 5 2 3 3 5 .... 3 9 15 25 39 11 14 12 16 6 11 7 11 10 20 1 5 State Hospital at Raleigh 23 Perquimans . Person Polk Pitt Robeson Rowan Randolph . . . Rockingham Richmond . Rutherford . Sampson . . . Stanly Scotland Surry Stokes Tyrrell Transylvania Union Vance Wake Warren .... Washington . Wayne Watauga . . . Wilson Wilkes Yancey Table No. 3L8 — Continued Males Females 3 4 19 19 2 1 2 1 2 10 1 5 2 2 2 11 35 7 26 6 1 1 Total 3 7 11 8 27 . . . . 9 28 1 3 2 3 2 4 1 2 2 7 17 1 2 5 10 4 6 1 1 1 3 1 1 2 7 18 33 68 10 17 4 4 8 34 1 1 6 12 1 2 1 2 465 530 995 CARPENTER'S REPORT Dr. Albert Anderson, Superintendent. Sir:—I respectfully submit to you the report covering the work in the car-penter's department for the period from November 30, 1916, to November 30, 1918. We lhave kept in repair all wagons, carts, binders, 'harrows, and all other machinery and tools used in the farming department. We have also kept up the repairs of the bedsteads, the springs being put on in our own shop. The patients have made all the mattresses except those bought for the two new buildings. All filling for the mattresses has been properly sterilized. The mattresses are all made by patients under my supervision. We have kept in repair all cthairs and furniture used in the building with the exception of chairs bought for the Nurses' Home and Receiving Building. No chairs have been bought for the institution in the past five years. This has been brought about by repairs done on old chairs. All the necessary repairs, such as windows, panes, sashes, and other repairs of general nature have been done in spite of the fact that the carpenter's department has been short of labor. We have also made enough brooms for the needs of the hospital. Most of the broom-<corn used was grown on the farm. The handles are used over and over again, and as the brooms are made by a patient, we were able to supply the needs of the institution at a very small expenditure. We have dug the graves, made coffins, and prepared for burial all bodies buried in the hospital cemetery. We have also kept in repair the shoes and harness. This work was done by patients. , I submit the following to show the scope of the work that has been done: Carpenter's Report for Year Ending November 30, 1917 Two small houses at Oaks Colony $ 100.00 Steps and platform at male congregate dining-room 30.00 Moving and repairing summer house 35.00 Calf barn 1,500.00 Shingling two houses at Dr. Jenkins . 30.00 Roofs on corn crib and stables 35.00 Roof over rooms at brick cottage 30.00 Pigeon run and room at brooder 60.00 Moving bins from store-room to brooder 10.00 Screening and bars at Nurses's Home 125.00 Clothes racks and bins at Receiving Building 35.00 Putting up wood-saw, extending shafting, pulleys, shed, and fence... 85.00 Eight long new dining tables for Receiving Building 80.00 Four long canning tables for Cannery 40.00 Repairing foundation sawmill carriage 25.00 Sawed 10,000 feet lumber 175.00 Two new doors, two dooMrames and work on Dr. Adams' rooms, Center Building 75.00 State Hospital at Raleigh 25 Made seven new wagon bodies $ 70.00 Made one new wagon hay flat 9.00 Partition, swinging doors, and windows at engine-room 125.00 Bricking up partition between boiler-room and engine-room 75.00 Platform at shop for motors 10.00 Cedar chest 20.00 Stock-room at carpenter's shop 15.00 Bull-pen and house at dairy 110.00 Cement walks from old building to Receiving Building and in front of Nurses' Home , 325.00 Two new screen doors, male T. B 8.00 Made 953 stick handle brooms at 70c 667.10 Repaired 1,325 pairs shoes at $1 1,325.00 Renovated and made 321 mattresses at $6 1,926.00 Run pipe-line from Cannery to shop 20.00 The above work (except the cement work) was done with two employees, with the assistance of five patients. Carpenter's Report for the Year Ending November 30, 1918 Built salt-room $ 20.00 Plastered and ceiled room at dairy residence 65.00 Cement top on male colony 35.00 Pour wagon flats with iron wheel protectors 40.00 Potato barn ". 2,430.26 Made 268 mattresses at $6 1,608.00 Made 1,152 brooms at 70c 806.40 Repaired 1,200 pairs shoes at $1 1,200.00 Repaired roofs and down-spouts 650.00 Repaired bridge across Rocky Branch 50.00 Cement walk from Receiving Building to Nurses' Home 702.00 Sawed about 25,000 feet lumber 685.00 Repaired room at brick cottage 65.00 Made 515 potato crates 257.50 Made 72 concave benches, total length 479 feet 143.70 There are quite a number of repairs and some needed construction work that I would respectfully call your attention to. Lack of funds with which to purchase necessary material, added to our in-ability to secure competent help, has prevented us from doing this work. You will note that many of the items call for a rather large expenditure, but they all are absolutely necessary if the building is to be kept in good con-dition and properly cared for. I would recommend that the following things be done: Plastering and painting $2,500.00 Wrought iron window-guards in the male department 1,500.00 Receiving porches in the 7th, 8th, 9th, and 10th wards 600.00 Receiving floor on 9th ward 100.00 Locks for rooms in main building 450.00 Farm machinery building for housing farm machinery 3,000.00 Ice room 750.00 Courtyard fence, both male and female departments 1,500.00 Floor and ceiling Erwin building 300.00 Respectfully submitted, Robert Green. ENGINEER'S REPORT FOR THE TWO FISCAL YEARS ENDING NOVEMBER 30, 1918 Dr. Albert Anderson, Superintendent State Hospital, Raleigh, N. C. My Dear Sir:—I herewith submit the report of Engineer's Department for the two years ending November 30, 1918'. In addition to the regular daily repair work incident to running the institution, the following changes, im-provements, and new installations are noted: Replaced one 30 horsepower steam engine in carpenter's shop with one motor, the engine still being used in driving the mills. Replaced steam power in machine shop with 5 horsenpower motor. Installed two other motors, one each in Cannery and Bakery. Replaced the old belt-driven washing machines in Laundry with 6 niotor-driven machines. These machines are up-to-date and work automatically. Installed one motor to drive extractors and dry-room. Replaced three old body ironers with two new bodying pressers. We have overhauled and put in good condition two ammonia compressors; put in new condensing coil'in No. 2 Ice Plant and 48 new ice cans; installed new water closet and bath tub in Laundry dormitory; installed new water closet at Female Epileptic Colony; installed new range at Female Epileptic Colony. Repaired ranges at Oaks and Male Epileptic Colonies. Removed old steril-izer from Laundry and installed the same at carpenter's shop, connecting up with steam, and it is now used for sterilizing mattresses and materials. In-stalled one W. C. Meadows Mill Co.'s wheat mill. Now have under construction new boiler-house, boiler settings, new smoke-stack, heating system with adjacent coal bins, and for detail report of the same, see report of Superintendent. Respectfully submitted, T. A. Holiday, Engineer. REPORT OF CLOTHING SUPERVISOR FOR 1917-1918 1917 1918 Aprons 842 510 Bonnets 57 180 Bed pads 38 407 Burial robes 24 33 Belts 58 36 Bolsters 3 .... Corset covers 37 35 Chemises 527 578 Curtains, pairs 240 82 Chair covers 26 32 Caps 120 97 Clothes bags 69 175 Collars 18 14 Dresses 598 654 Dress shirts 22 14 Drawers, pairs 467 694 Gowns 275 298 Garters, pairs 10 16 Ice-bags 14 .... Kimonas 7 4 Mattress ticks 321 268 Napkins 71 59 Night-shirts 147 44 Overalls, pairs 318 566 Pants, pairs 4 18 Petticoats 403 422 Pillow-ticks 38 18 Pillow-cases 1,729 1,520 Rompers, pairs 110 124 Sheets 2,567 1,634 Shirt waists 31 28 Suits, boys 2 .... Suspenders .... 756 Shirts 954 929 Table-cloths 52 114 Towels 350 323 Underbodies 26 16 Wrappers 3 .... Bandages, rolls 304 Hose, pairs (darned) 1,437 1,702 Garments remodeled 218 96 Garments mended 45,850 52,200 Garments marked 26,219 29,318 Average number of workers per day: Sewing room, ladies 20 Mending and marking room, ladies 22 Laundry, men 7 Respectfully submitted, Mrs. B. L. Chesnutt, Clothing Supervisor. FARMER'S REPORT Products of Farm, Garden, and Dairy for the Year 1917 Asparagus—44% bushels at $2 $ 89.00 Apples—146 bushels at $1 146.00 Beans, lima, dry—20 bushels at $3 60.00 Beans, lima, green—52 bushels at $3.20 166.40 Beans, snap—1,167 bushels at $1 1,167.00 Beef—8,062 pounds at 13c 1,048.06 Butter—1,095 pounds at 40c 438.00 Beets—346 bushels at 60c 207.60 Corn—4,875 bushels at $2 , 9,750.00 Cabbage—28,469 heads at 7c 1,988.83 Collards—20,000 heads at 5c 1,000.00 Cantaloupes—45,79 6 at 5c 289.80 Corn, ensilage—455 tons at $3.50 1,692.50 Corn, stover—55 tons at $10 , 550.00 Carrots—78 bushels at 75c 58.50 Cucumbers—183 bushels at 60c 109.80 Chickens—582 pounds at 20c 116.40 Chickens, spring—49 pounds at 25c 12.25 Dewberries—1,486 quarts at 10c 148.60 Eggs—1,248 dozen at 40c 499.20 Fodder—23 tons at $20 460.00 Grapes—139 bushels at $1.25 173.75 Hay, alfalfa—85 tons at $25 2,125.00 Hay, miscellaneous—52 tons at $25 1,300.00 Leeks—153 bushels at 60c 91.80 Lettuce—3,060 heads at 5c 153.00 Milk—36,479 gallons at 40c 14,591.60 Mutton—372 pounds at 20c 74.40 Manure—1,750 loads at $1 1,750.00 Okra—152 bushels at 50c 76.00 Onions—133 bushels at 85c 113.05 Peas, dry—400 bushels at $1.50 550.50 Peas, English—134 bushels at $3.20 428.80 Pepper—42% bushels at 80c 34.00 Peaches—748 bushels at $1.15 860.20 Plums—7% bushels at $1 7.50 Pork—33,500 pounds" at 20c 6,700.00 Potatoes, sweet-—3,800 bushels at $1 3,800.00 Potatoes, Irish—403 bushels at $1.50 604.50 Parsnips—28 bushels at 75c 21.00 Radishes—38y2 bushels at 60c 23.10 Roasting ears—1,096 dozen at 20c 219.20 Salads—1,675 bushels at 50c 887.50 Salsify—183 bushels at 60c 109.80 Squashes—547 bushels at 50c 273.50 State Hospital at Raleigh 29 Squabs—59- pairs at $1 $ 59.00 Strawberries—3,625 quarts at 10c 362.50 Tomatoes—823 bushels at 60c 493.80 Turnips—756 bushels at 40c 302.40 Watermelons—2,816 at 6c 168.96 Vegetable eggs—2,305 at 5ic 115.25 Green rye and clover—70,800 pounds at 30c. cwt 212.40 Wheat—1,100 bushels at $2 2,200.00 Wheat straw—20 tons at $10 200.00 Wood—400 cords at $5 2,000.00 Sales 896.30 Horses—two 600.00 Total $ 62,576.75 Broom-corn—2,000 pounds at 20c 400.00 Respectfully submitted, James Adams. Products of Farm, Garden, and Dairy for the Year 1918 Asparagus—58 bushels at $2 $ 116.00 Apples—85% bushels at $1.25 107.18 Beans, Lima, dried—25 bushels at $3 75.00 Beans, Lima, green—60 bushels at $3.20 192.00 Beans, snaps—1,240 bushels at $1 1,240.00 Beef—4,578 pounds at 20c 915.60 Butter—2,544 pounds at 50c 1,272.00 Broom-corn—2,500 pounds at 18c 450.00 Beets—420 bushels at 60c 252.00 Corn—5,000 bushels at $2 10,000.00 Cabbage—18,036 heads at 8c 1,442.88 Collards—23,000 heads at 5c 1,150.00 Cantaloupes—9,782 at 5c 489.10 Corn, ensilage—375 tons at $3.50 1,312.50 Corn stover—34 tons at $10 340.00 Carrots—20 bushels at 75c 15.00 Cucumbers—74 bushels at 60'C 44.40 Chickens—1,151 pounds at 25c 287.75 Chickens, spring—1,022 pounds at 30c 306.60 Dewberries—512 quarts at 12c 61.44 Eggs—2,658 dozen at 50c 1,329.00 Fodder—21 tons at $20 420.00 Grapes—91 bushels at $1.25 113.75 Hay, alfalfa—65 tons at $25 1,625.00 Hay, miscellaneous—48 tons at $25 1,200.00 Leeks—53 bushels at 70c 37.00 Lettuce—573 heads at 5c 28.65 Milk—44,305 gallons at 60c 26,583.00 Mutton—412 pounds at 25c 102.00 Manure—1,580 loads at $1.25 1,975.00 Okra—112 bushels at 60c 67.20 30 State Hospital at Raleigh Oats—^576 bushels at $1.25 $ 720.00 Onions—128 bushels at $1 . 128.00 Peas, dry—600 bushels at $2 1,200.00 Peas, English—1,421 bushels at $3.20 454.50 Pepper—76 bushels at 80c 60.80 Peaches—436 bushels at $1.25 545.00 Plums—12 bushels at $1 12.00 Pork—25,000 pounds at 25c 6,250.00 Potatoes, sweet—3,500 bushels at $1.25 4,375.00 Potatoes, Irish—236 bushels at $1.50 354.00 Parsnips—12 bushels at $1 12.00 Radishes—34 bushels at 80c 27.20 Roasting ears—1,475 dozen at 20'c 295.00 Salads—1,025 bushels at 60c 615.00 Salsify—163 bushels at 65c 105.95 Squashes—448 bushels at 50c 224.00 Squabs—172 pairs at $1 172.00 Strawberries—3,523 quarts at 12c 422.76 Soja beans—25 bushels at $2.40 60.00 Tomatoes-^1,041 hushels at 60<c 624.60 Turnips—625 bushels at 50c , 312.50 Watermelons—3,925 at 8c 314.00 Vegetable eggs—648 at 5c 32.40 Green rye and clover—65,750 pounds at 30c 197.25 Wheat—1,450 bushels at $2.20 3,190.00 Wheat straw—25 tons at $10 250.00 Wood—350 cords at $5.50 1,925.00 Mules—1 team •. 600.00 Sales 2,451.55 Rye—10 bushels at $2.20 22.00 $ 79,502.56 Respectfully submitted, James Adams. MATRON'S REPORT FOR THE YEAR ENDING NOVEMBER, 1917 CANNED VEGETABLES AND FRUITS Beans 9,717 quarts Tomatoes 5,055 quarts Okra 88 quarts Soup mixture 1,696 quarts Peaches 4,268 quarts Pears 5,472 quarts Apples 968 quarts PICKLES AND PRESERVES Sweet pickle 14 quarts Sour pickle 51 quarts Pepper hash. 50 quarts Preserved pears 26 quarts Preserved peaches 21 quarts Preserved grapes 30 quarts Jelly 67 quarts DRIED VEGETABLES Apples 621 quarts Pears 483 quarts Beans 162 quarts Okra 48 quarts Potatoes 24 quarts ' Beets ! 48 quarts Carrots 12 quarts Cabbage 48 quarts MISCELLANEOUS Lard 2,246 pounds Butter 1,095 pounds Soap 8,417 pounds Wine 5 gallons Tomato catsup 16 quarts Respectfully submitted, Miss Katherine White. FOR THE YEAR ENDING NOVEMBER, 1918 Beans 15,062 quarts Tomatoes 7,651 quarts Peaches 3,342 quarts Apples 268 quarts 32 State Hospital at Raleigh Butter beans 164 quarts Corn 67 quarts Onions 44 quarts Grape jelly 41 quarts Grape juice 6 quarts Lard 2,682 pounds Butter 2,540 pounds Soap 9,625 pounds Respectfully submitted, Miss Katherine White. FINANCIAL EXHIBITS FOR BIENNIAL PERIOD, DECEMBER 1, 1916, TO NOVEMBER 30, 1918 Dr. Albert Anderson, Superintendent State Hospital for the Insane, Raleigh, N. C. Dear Sir:—Herewith I beg to submit in six exhibits the biennial report of the Steward, covering the period December 1, 1916, to November 30, 1918, giving a record of receipts and disbursements for maintenance, permanent improvements, and source and disposition of institutional cash receipts, along with the status of all funds as of November 30, 1918, and detailed reconcilia-tion of accounts with State Treasurer. Exhibit A — Maintenance Account GENERAL STATEMENT Receipts— Appropriation, State of North Carolina. December 1, 1916, to November 30, 1917 $207,500.00 December 1, 1917, to November 30, 1918 207,500.00 $415,000.00 Other Receipts. Lightning insurance 510.00 Fire insurance collected 199.50 709.50 Total receipts $415,709.50 Disbursements— Per audited vouchers for maintenance. (See detailed Exhibits B and C.) December 1, 1916, to November 30, 1917 $210,711.67 December 1, 1917, to November 30, 1918 217,648.98 Total disbursed for period $428,360.65 Add deficiency in maintenance close of period No-vember 30, 1916 (see biennial report of that date) , 13,790.43 Total against receipts $442,151.08 Deficiency to date, November 30, 1918 $ 26,441.58 (See Exhibit E for proof of above by reconciliation of accounts with State Treasurer.) 34 State Hospital at Raleigh Exhibit B — Maintenance Account DISBURSEMENTS BY MONTHS December 1, 1916, to November 30, 1917. Audited vouchers issued as follows: December, 1916 $ 16,180.82 January, 1917 15,124.22 February, 1917 14,885.84 March, 1917 18,610.12 April, 1917 20,206.90 May, 1917 18,230.43 June, 1917 18,223.79 July, 1917 . 16,796.91 August, 1917 19,329.64 September, 1917 16,521.11 October, 1917 21,841.27 November, 1917 14,760.62 $210,711.67 December 1, 1917, to November 30, 1918. December, 1917 $ 19,148.51 January, 1918 15,166.09 February, 1918 20,971.02 March, 1918 18,819.62 April, 1918 17,945.95 May, 1918 17,303.79 June, 1918 15,085.01 July, 1918 21,408.40 August, 1918 15,843.40 September, 1918 17,993.48 October, 1918 20,298.03 November, 1918 '. 17,665.68 217,648.98 Total for the two years maintenance $428,360.65 State Hospital at Raleigh 35 'O "* CO CM "* o CO >o t^ CO r^ CO CO ^H CO Oi 00 _ -*l CM UO lO O Oi O0 T-H CD CO * cr> O * 00 1*1 CO OS 03 O CO •o <* CO 00 CO CO o fa CM O CO 00 CO 00 IO oo I- o oo f Oi CO T-H CO 0. -V co OTj CM 1*1 t-- Oi CO CM CO CM ^< CM r— r^ I- t^ Oi CO CO CO CO CO !>. o CO CD 00 CM t^ T-H O >o t^. t^ CO Oi t-H CO 1*1 !>• io t>- f-H 1-H T-H T-H 10 co T-H T-H T-H T-H CM T-H «> CM »? CM T-H O0 CM t-- o I- * CO CM O >o T-H CO O0 IO CO O 00 >~ ' CM f l>- "*! Co CO Oi CD CO CO IO Oi CM l~ 10 b- CO > t—i 00 o * O0 00 I>- T-H O 00 CO OS OS ir~ CO 00 CO »o o 00 1*< t>. 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Sh* O o3 Pa CD OX© T5 d 03 CO CD TTH > U CD CO CO '> Oi CD '"I ^ I-H & • 0) « S3 0-3 2 CO CO a "co > O 2 fa bfi d +a o o a a e3 03 co A M 3 a a fa fa CD -H> O ^§ CD w f-, co CD C '3 T3 od T— 1 BQ N a CD co CD co d CD a fa Q a »H c3 CD s ft >iH P fa .CD 'fH '08 CQ CO "3 •T^ H Oi <]j CD f-i O ~ 03 3 GO CO a "to '> TH >H CD 3 fa f"a O° . >H fa a t * o3 CQ +;> fa bO fa 13 d »h CD a a X X fa fa . CD CD w FH CQ CD a "3 Xi a HH CQ Sh 'o3 a CD CQ CD CO a CD aX fa Q 13 a S3 a 03 43 a CD s a '3 cr fa CQ 'Eh "3 CO a • tH CQ TTH CO "3 4J O CO fa s fa fa fa Ph fa CO fa O fa fa fa fa fa 36 State Hospital at Raleigh Exhibit D — Permanent Improvement Appropriations receipts Approp?*iations— December 1, 1916, to November 30, 1917. Unexpended appropriation (see biennial report November 30, 1916) $ 4,848.45 December 1, 1917, to November 30, 1918. Through N. C. State Bonds 70,000.00 $ 74,848.45 disbursements December 1, 1916, to November 30, 1917 December, 1916, per audited voucher $ 4,848.45 December 1, 1917, to November 30, 1918. April, 1918, per audited vouchers 2,100.00 May, 1918, per audited vouchers 4,889.08 June, 1918, per audited vouchers 9,204.64 July, 1918, per audited vouchers 9,061.15 August, 1918, per audited vouchers 6,462.84 September, 1918, per audited vouchers 7,436.09 October, 1918, per audited vouchers 12,563.04 November, 1918, per audited vouchers 9,981.75 Total disbursements for two years $ 66,547.04 Balance available permanent improvement appropriations, November 30, 1918 $ 8,301.41 State Hospital at Raleigh 37 Exhibit E — Reconciliation With State Treasurer institution's rooks Credits to State Treasurer— December 1, 1916. Deficiency maintenance fund (Exhibit A) $ 13,790.43 Balance per. imp. fund (Exhibit D) 4,848.45 Net overdraft, December 1, 1916 $ 8,941.98 Add vouchers, issued-—Maintenance. December 1, 1916, to November 30, 1917 (Ex. B) . .$210,711.67 December 1, 1917, to November 30, 1918 (Ex. B) . . 217,648.98 Vouchers issued, permanent improvements. December 1, 1916, to November 30, 1917 (Ex. D) . . 4,848.45 December 1, 1917, to November 30, 1918 (Ex. D) . . 61,698.59 Total credits to State Treasurer $503,849.67 Charges to State Treasurer— Appropriations. Dec. 1, 1916, to Nov. 30, 1917—maintenance $207,500.00 Dec. 1, 1917, to Nov. 30, 1918—^riaintenanee 207,500.00 Dec. 1, 1916, to Nov. 30, 1917—^er. imp 70,000.00 Lightning insurance deposited, 1917 510.00 Fire insurance deposited, 1918 199.50 Total charges to State Treasurer $485,709.50 Balance overdrawn or due State Treasurer as of November 30, 1918 18,140.17 Of above vouchers the following are outstanding (have not been presented) : Number 942 (November, 1917 ) $ .47 Number 365 7.15 Number 751 144.50 Vouchers for November, 1918, audited and ready for delivery 27,647.43 27,799.55 Balance per Treasurer's books (to our credit November 30, 1918) $ 9,659.38 »i 38 State Hospital at Raleigh Steward's Institutional Receipts Fund receipts Sources— Pay patients $ 18,603.84 $ 26,805.38 Board of officers 320.26 308.08 Arts and crafts and shoe shop 131.65 154.90 Sale of wood 258.95 1,748.75 Sale of hides 303.35 167.05 Sale of junk and barrels 357.66 " 249.52 Fines 209.87 287.04 Refund, investigation expense 402.75 Interest on deposits - 94.27 511.65 Miscellaneous . . 1,905.59 1,016.92 $ 22,588.19 $ 31,249.29 SUMMARY STEWARD'S INSTITUTIONAL RECEIPTS FUND Receipts— Balance in bank December 1, 1916 $ 12,002.15 Receipts Dec. 1, 1916, to Nov. 30, 1917 (as above).. 22,588.19 Receipts Dec. 1, 1917, to Nov. 30, 1918 (as above) . . 31,249.29 $ 65,839.63 Disbursements— From Dec. 1, 1916, to Nov. 30, 1917 (as detailed in this exhibit) $ 19,869.54 From Dec. 1, 1917, to Nov. 30, 1918 (as detailed in this exhibit) 21,516.09 41,385.63 Balance on hand Nov. 30, 1918 $ 24,454.00 State Hospital at Raleigh 39 DISBURSEMENTS December 1, 1916, to November 30, 1917 Purpose— Nurses' Home, balance on contract $ 4,524.86 Repairs and repair materials 2,740.88 Furniture and furnishings 2,907.28 Farm implements and animals 2,290.00 Electric supplies, etc 1,398.19 Construction supplies 620.83 Delivery truck 1,710.00 Dryer 1,200.00 Traction engine 775.00 Furnace stoker 898.65 Lock contract 500.00 Receiving building 194.55 Miscellaneous 109.30 December 1, 1917, to November 30, 1918 Piir})ose— Plumbing and plumbing supplies $ 4,359.86 Equipment, ice plant and laundry 6,077.34 Repairs and repair material 1,769.61 Furniture and furnishings 529.66 Farm implements and animals 1,744.08 Electrical supplies, etc 161.56 Office fixtures and supplies 308.30 Automobile and gas tank 1,314.33 Potato house 1,611.06 Cement walk 702.45 Musical instruments and music 246.00 Coal 2,597.44 Miscellaneous 94.40 $ 19,869.54 21,516.09 Total disbursements—two years $ 41,385.63 (See summary opposite.) REPORT OF THE STATE HOSPITAL AT GOLDSBORO, N. C. FOR THE TWO YEARS ENDING NOVEMBER 30, 1918 EXECUTIVE COMMITTEE State Hospital, Goldsboro, N. C. J. W. Thompson, Chairman Col. W. H. Williams P. B. McKinne OFFICERS W. W. Faison, M.D '. Superintendent W. C. Linville First Assistant Physician Clara E. Jones, M.D Second Assistant Physician P. L. Whelpley, M.D Clinical Director B. R. Lacy Treasurer, Ex Officio J. W. Bryan Steward Mrs. J. W. Bryan Steward's Clerk W. D. Williams Engineer Mrs. Mamie Herring Housekeeper Miss Luna P. Bridgers Assistant Housekeeper H. S. Toler Storekeeper Miss Martha Newell Seamstress D. H. Newell Farmer SUPERINTENDENT'S REPORT Goldsboro, N. 0., December 18, 1918. To the Board of Directors of the State Hospital at Goldsboro. Gentlemen:—I herewith submit a report of the operations of this institu-tion for the two years ending November 30, 1918. Males Females Total Number on roll November 30, 1916 380 625 1,005 Number admitted 242 304 546 Total number treated 622 929 1,551 Total number removed 246 312 558 Number on roll November 30, 1918 376 617 993 Number present November 30, 1918 368 594 962 Percentage of cures on number received .... .... 31 Percentage of deaths on number treated .... 11.78 We have had no serious epidemic, but, owing to the large number of patients admitted with pellagra, many of them in the last stage, and living only a short time after admission, our percentage of death was larger than usual. I regret to have to report that a male patient, while assisting in moving a car on our spur track, was accidently run over by the car and died from the injuries received; and, also, that a female patient committed suicide by hang-ing herself at night in her room. She had been in the hospital less than a month, and during this time had shown no suicidal tendencies. Of the 5,783 admissions to this institution since it was opened August 1, 1880, this is the second suicide to be reported. IMPROVEMENTS AND REPAIRS The following are the most important improvements and repairs: A steel tower with two water tanks of 115,000-gallon capacity was erected and is now in use. A cannery 36 x 40 feet has been built and equipped with all necessary con-veniences. There was an addition to the kitchen, and a room for preparing vegetables was built. There is now under construction a building for the accommodation of ninety patients which, we hope, will be completed in the spring. A new system of pipe lines for supplying the above building and, also, the tubercular and epileptic buildings with water and heat is also under con-struction. Our spur track was relaid with seventy-fivenpound rails, and a new trestle and coal-chute were built. See Engineer's report for a detailed account of improvements and repairs. FARM, GARDEN, AND DAIRY Estimated net value of farm, garden, and dairy products (1917) . . $ 26,303.73 Estimated net value of farm, garden, and dairy products (1918) . . 28,785.42 Estimated net value of farm, garden, and dairy products (1917-1918) $ 55,089.15 44 State Hospital at Goldsboro LABOR During the period embraced in this report, and especially during the last year, it has been impossible to keep sufficient help to carry on the work to the best interest of the institution. FINANCES For the maintenance of this institution for the two years, 1917 and 1918, the Legislature appropriated $245,000. The appropriation was entirely inade-quate, and it was only by practicing the strictest economy that the deficit was not greater than $23,470.07. Per capita cost of maintenance for 1917 $ 132.59 Per capita cost of maintenance for 1918 147.576 NEEDS FOR THE NEXT TWO YEARS For maintenance for 980 patients (1919) $153,125.00 For maintenance for 1,000 patients (1920) 156,250.00 For deficit for 1917 and 1918 23,470.07 For completing and furnishing new building 35,650.00 In conclusion, I wish to thank the Board, officers, and employees for their generous and loyal support in conducting the affairs of the institution. Respectfully submitted, W. W. Faison, Superintendent. State Hospital at Goldsboro 45 TABLE No. 1 Showing Movement of Patients for the Period of Two Years Ending November 30, 1918. 1917 1918 Totals ' Male Female Total Male Female Total Male Female Total Remaining Nov. 30, 1918 380 113 493 36 6 10 3 3 54 112 625 142 767 45 8 9 5 1 70 138 1,005 255 1,260 81 14 19 8 4 124 250 Admitted 129 510 38 3 5 5 3 80 134 162 793 54 1 15 4 1 99 174 291 1,303 92 4 20 9 4 179 308 242 622 74 9 15 8 6 134 246 304 929 99 9 24 9 2 169 312 546 Total under treatment Discharged, recovered Discharged, much im-proved 1,551 173 18 Discharged, improved. . Discharged, unimproved.. Discharged, eloped . Died Total removed . ._ 39 17 8 303 558 Percentage of cures on number received 31 Percentage of deaths on number treated 11.78 Males Females Total Number on roll November 30, 1918 377 617 994 Number present November 30, 1918 368 594 962 Daily average on roll, 1917 1,015 Daily average present, 1917 963 Daily average on roll, 1918 1,004 Daily average present, 1918 954 46 State Hospital at Goldsboro TABLE No. 2 Showing the Cause of Death. Male Pellagra 15 Pulmonary tuberculosis Cerebral hemorrhage Paresis Exhaustion from dementia Exhaustion from mania Status epilepticus Interstitial nephritis Diabetes mellitis Acute nephritis Pyonepihritis Uremia Mitral insufficiency of the heart . . Mitral regurgitation of the heart. Aortic regurgitation of the heart. Fatty degeneration of the heart . . Pat embolism of the heart Hydro-pericarditis Aneurism of the abdominal aorta. Arteriosclerosis Lobar pneumonia Auto-intoxication Cancer of duodenum Cancer of the uterus Softening of the brain Influenza . . . Oholio cystitis Sudden, no known cause Shock from injury Typhoid fever Diabetic gangrene Pyo-salpingitis Chronic diarrhea Tuberculosis of the pancreas Intestinal tuberculosis Carbuncle Exopthalmic goitre Hypostatic pneumonia Erysipelas Phlebitis Acute indigestion Suicide 1911 Female 24 13 6 2 4 1 2 Male 12 14 5 4 2 7 17 2 1918 Female 44 17 4 Total 95 50 22 12 4 18 30 7 2 1 1 1 8 2 2 1 1 1 1 2 3 3 1 2 1 3 1 4 1 2 2 1 9 1 1 1 1 1 1 1 1 1 Total 54 70 80 99 303 State Hospital at Goldsboro 47 TABLE No. 3 Showing Cause of Insanity as Given by Application. Male Unknown 56 Pellagra 4 Not stated 7 Religious excitement 6 Epilepsy 7 Worry 5 111 health 1 Heredity 3 Domestic trouble 3 Syphilis 4 Fever 2 Men Grief Female trouble Injury 3 Imbecile 4 Puerperal Apoplexy Influenza War Senility 1 Anger Overwork 3 Nervousness 1 Masturbation 2 Indigestion Thinks they are conjured Intemperance 1 Measles Menopause Total 113 1917 Female 72 10 6 3 1 6 3 3 5 2 3 1 5 2 1 4 3 Male 58 3 8 3 11 8 9 3 8 2 1918 Female 69 12 13 8 1 10 3 9 2 1 4 12 5 3 4 4 1 142 129 162 Total 255 29 34 20 20 29 16 18 8 16 8 1 9 14 13 8 8 4 9 5 4 1 5 2 2 1 1 1 2 546 48 State Hospital at Goldsboro TABLE No. 4 Showing Psychosis of Patients Admitted Male Manic depressive 29 Psychosis with pellagra 13 Psychosis with epilepsy 11 Psychosis with syphilis 11 Dementia prsecox 17 Allied dementia precox 4 Infective exhaustive ". . 8 Senile psychosis 5 Alcoholic psychosis 3 Traumatic psychosis 2 Undifferentiated depression Psychosis with idiocy 1 Psychosis with drugs 1 Constitutional inferiority and psycho-neurosis 8 Total 113 917 1918 Female Male Female Total 70 25 64 188 30 10 31 84 1 17 6 35 2 21 2 36 14 29 28 88 10 7 16 37 6 11 1 26 6 2 6 19 . . . . 1 4 . . 1 . . 3 1 2 2 5 . . 3 . . 4 1 2 15 142 129 162 546 TABLE No. 5 Showing Duration of Insanity on Admission Male Less than 1 month 33 From 1 to 3 months 19 From 3 to 6 months 9 From 6 to 12 months 11 From 1 to 2 years 9 From 2 to 3 years 4 From 3 to 4 years 8 From 4 to 5 years 1 From 5 to 10 years 5 From 10 to 20 years 3 Unknown • 11 Total 113 1917 Female 42 29 12 8 16 7 4 2 5 2 15 1918 Male Female 45 23 14 13 7 10 3 2 5 2 5 60 26 20 11 9 Total 180 97 55 43 41 29 21 5 19 16 40 142 129 162 546 TABLE No. 6 Showing Social Relation 1917 1918 Male Female Male Female Total Single 66 39 77 52 234 Married 37 86 46 95 264 Widowed 6 14 4 13 37 Divorced 2 .. 2 2 6 Not stated 2 3 . . . . 5 113 142 129 162 546 State Hospital at Goldsboro 49 TABLE No. 7 Showing Duration of Residence in Hospital of Those Cured Male Less than 3 months From 3 to 6 months 1 From 6 to 12 months 26 From 1 to 2 years 6 From 2 to 3 years 2 From 3 to 5 years From 5 to 10 years From 10 to 20 years 1 Total 36 1917 Female 1 4 15 18 7 1918 Male Female 4 20 9 3 1 1 5 23 16 6 1 2 1 Total 1 14 84 49 18 2 3 2 45 38 54 173 TABLE No. 8 Showing Duration in Hospital of Those Who Died 1917 1918 Male Female From 1 to 5 days 3 From 5 to 30 days 6 8 From 1 to 3 months 13 8 From 3 to 6 months 4 1 From 6 to 12 mpnths 8 1 From 1 to 2 years 6 13 From 2 to 3 years 3 9 From 3 to 4 years 3 4 From 4 to 5 years 3 From 5 to 10 years 6 10 From 10 to 15 years 1 7 From 15 to 20 years 2 From 20 to 30 years 2 From 30 to 40 years 2 1 Total 54 70 80 Male 1 6 10 11 8 9 10 12 1 8 2 1 1 Female 3 12 17 5 11 8 6 4 7 16 3 4 2 1 Total 7 32 48 21 28 36 28 23 11 40 13 6 5 5 99 303 TABLE No. 9 Showing Age When Admitted 1917 Male Female From 5 to 10 years 1 From 10 to 20 years 18 11 From 20 to 30 years 42 52 From 30 to 40 years 19 30 From 40 to 50 years 16 27 From 50 to 60 years 10 12 From 60 to 70 years 4 8 From 70 to 80 years 3 2 From 80 to 90 years , Total 113 142 4 1918 Male Female Total 1 1 3 32 16 77 37 58 189 22 41 112 23 18 84 10 19 51 4 4 20 . . 2 7 1- 1 129 162 546 REPORT OF THE CLINICAL DIRECTOR The patients have been given a careful physical and mental examination as soon after their arrival as expedient, and as complete a history as possible has been written of each one and filed for convenient reference. In many instances the admission papers contain very little reliable information con-cerning the patient, and the patient's condition precludes the obtaining of any information Whatever from them concerning their past history. In most of such cases we have been materially assisted by our attendants who bring the cases to the Hospital, as they have freely cooperated and shown considerable aptitude in obtaining valuable information from friends, relatives, etc., of the patients, which has enabled us to compile a history of such cases. The Wasserman test has been made in every new and old suspected case so far as possible to do so. In all, 262 patients were thus tested during the past year. We found it more expedient to have this work done at the State Laboratory of Hygiene. Salvarsan has been administered about fifty times to selected cases with generally good results, and very gratifying results in six cases. We admin-istered it from one to eight times per patient. Post-mortems were held on all occasions where the cause o'f death was ob-scure. Eleven autopsies were held during the past year and a record of them written and filed for reference. The following work was done in the pathological laboratory during the past year: Urinalysis 620 Sputum examinations 102 Feces examinations 14 Blood examinations for malaria 92 Blood counts 10 Urethral and vaginal discharges examined 11 Body parasites examined 12 Gastric contents examined 4 Total 865 Dr. F. L. Whelpley, Clinical Director. STEWARD'S REPORT For the Biennial Period From December 1, 1916, to November 30, 1918 1916 Dec. 1. Legislative appropriation for support for 1917 $120,000.00 31. Less vouchers for December $ 11,734.30 1917 Jan. 31. Less vouchers for January 7,772.27 Feb. 28. Less vouchers for February 9,208.42 Mar. 31. Less vouchers for March 14,181.67 Apr. 30. Less vouchers for April 8,052.63 May 31. Less vouchers for May 8,056.65 June 30. Less vouchers for June 14,218.79 July 31. Less vouchers for July '. 7,440.63 Aug. 31. Less vouchers for August 8,601.31 Sept. 30. Less vouchers for September 11,239.70 Oct. 31. Less vouchers for October 18,919.55 Nov. 30. Less vouchers for November 8,256.20 127,682.52 Deficit in appropriation for 1917 $ 7,682.52 Appropriation for permanent improvements 16,708.00 May 31. Less vouchers for May $ 1,006.04 June 30. Less vouchers for June 2,272.15 July 31. Less vouchers for July 365.75 Sept. 30. Less vouchers for September 164.00 Oct. 31. Less vouchers for October 5,769.00 9,576.94 Nov. 30. Balance permanent improvement fund $ 7,131.06 Receipts and Disbursements December 1, 1017, to 'November 30, 1918 1917 Dec. 1. Legislative appropriation for support for 1918 $125,000.00 Deficit in appropriation for 1917 7,682.52 $117,317.48 Treasury balance December 1, 1916 (Auditor) 273.61 Net support fund for 1918 $117,591.09 31. Less vouchers for December $ 13,997.59 1918 Jan. 31. Less vouchers for January 9,815.10 Feb. 28. Less vouchers for February , 14,430.44 Mar. 31. Less vouchers for March 8,459.32 Apr. 30. Less vouchers for April 9,942.04 May 31. Less vouchers for May 16,050.44 June 30. Less vouchers for June 7,966.84 July 31. Less vouchers for July 8,073.06 Aug. 31. Less vouchers for August 24,129.97 52 State Hospital at Goldsboro Sept. 30. Less vouchers for September $ 12,591.62 Oct. 31. Less vouchers for October 9,221.57 Nov. 30. Less vouchers for November 6,383.17 $141,061.16 Deficit in support fund for 1918 $ 23,470.07 (Deficit covered by notes in Wayne Nat. Bank.) Receipts and Disbursements Permanent. Improvement Fund, December 1. 1917, to November 30, 1918 1917 Dec. 1. Balance on hand $ 7,131.06 1918 Nov. 12. Appropriation 19,845.06 $ 26,976.12 Jan. 31. Less vouchers for January $ 3,797.26 Feb. 28. Less vouchers for February 48.74 Mar. 31. Less vouchers for March 302.59 Apr. 30. Less vouchers for April 176.29 May 31. Less vouchers for May 39.55 July 31. Less vouchers for July 1,800.00 Oct. 31. Less vouchers for October 966.63 Nov. 30. Less vouchers for November 18,845.06 25,976.12 Balance permanent improvement fund $ 1,000.00 Receipts and Disbursements New Building Fund, December 1, 1917, to November 30, 1918 1918 May 31. Appropriation $ 8,000.00 Aug. 31. Appropriation 10,000.00 Nov. 30. Appropriation 5,302.00 $ 23,302.00 May 31. Less vouchers - for May $ 12.60 June 30. Less vouchers for June 2,528.80 July 31. Less vouchers for July 1,225.34 Aug. 31. Less vouchers for August 3,709.23 Sept. 30. Less vouchers for September 3,193.57 Oct. 31. Less vouchers for October 6,589.09 Nov. 30. Less vouchers for November 3,224.11 20,482.74 Balance new building fund $ 2,819.26 Statement of Population 1917 1918 Average number patients on roll. . 1.015 1,004 Average number patients present 963 954 Average number patients at work 415 401 Annual per capita cost 132.59 147.576 Daily per capita cost .363 .404 State Hospital at Goldsboeo 53 Summary of Receipts and Disbursements on Local Cash Account 1916 Dec. 1. Balance on hand $ 540.12 1917 Nov. 30. Received from all sources 14,287.36 Total cash $ 14,827.48 Less cash paid 11,228.63 Dec. 1. Balance on hand $ 3,598.85 1918 Nov. 30. Received from all sources 14,843.38 Total cash $ 18,442.23 Less cash paid 17,603.53 Dec. 1. Balance on hand $ 838.70 Classification of Expenditures from Support Fund 1917 1918 Salaries, services, labor $ 28,828.19 $ 30,814.92 Provisions, subsistence, food supplies 53,330.45 46,025.17 Furniture, furnishings, clothing, etc 11,111.85 14,367.63 Fuel, lights, and water ." 9,621.34 14,306.14 Freights, express, postage, stationery, etc 9,442.01 13,602.42 Drugs, medicine, physicians' supplies 635.16 623.99 Incidentals, repairs, miscellany 8,726.39 9,654.71 Farm expenses, utensils, provender, etc 5,987.13 11,666.18 Total expenditures for support $127,682.52 $141,061.16 Expenditures for permanent improvements 9,576.94 25,976.12 Expenditures for new building 20,482.74 Grand total $137,259.46 $187,520.02 Classification of Receipts and Disbursements on Local Cash Account 1916 Dec. 1. Balance $ 540.12 1917 Nov. 30. Receipts: Earnings 7,983.32 Board 632.48 All others 5,671.57 Total $ 14,827.48 1917 Nov. 30. Paid: Salaries, services, labor $ 989.61 Incidentals, miscellaneous 6,606.27 Farm expenses 3,632.75 11,228.63 $ 3,598.85 54 State Hospital at Goldsboro Classification of Receipts and Disbursements on Local Cash Account 1917 Dec. 1. Balance $ 3,598.85 1918 Nov. 30. Receipts : Earnings 7,311.96 Board 1,056.70 All others 6,474.72 Total $ 18,442.23 Paid: Salaries, services, labor $ 370.40 Food supplies 4,299.12 Incidentals, miscellaneous 4,678.04 Farm expenses 8,255.97 17,603.53 Balance $ 838.70 Statement of Dairy Account, 1917 By beef killed and calves and hides sold, etc $ 580.30 By 27,385 gallons milk at 32y2c 8,900.12 $9,480.42 To paid for feed $2,891.50 To wages of dairyman 540.00 To wages and board of helper 300.00 3,731.50 Net value of dairy products '. $5,748.92 Statement of Dairy Account, 1918 By beef killed and calves and hides sold, etc $ 964.93 By 28,776% gallons milk at 37y2c 10.771.09 $ 11,736.02 To paid for feed $4,333.23 To wages of dairyman 595.00 To wages and board of helper 351.33 5,279.56 Net value of dairy products $ 6,456.46 Respectfully submitted, J. W. Bryan, Steward.. ENGINEER'S BIENNIAL REPORT Dr. W. W. Faison, Superintendent State Hospital at Goldsooro, N. C. Dear Sir:—I beg to submit herewith a report of the Engineering Depart-ment for the year ending November 30, 1917. This report will be brief and, I fear, incomplete, owing to the fact that my predecessor, Mr. Hardesty, was hurriedly called away by the Government before he had time to make a report of the work done during the year prior to the time of his departure. I desire to state just here that I found the plant and work, as a whole, in excellent condition when I took charge of it September 15th, showing plainly the care and attention that had been given it prior to that time. The most important improvements and repairs made during the year are as follows: A new trestle and coal chute have been built, the two stave silos moved to a more suitable place and put in a first-class condition, porches added to six tenant houses. Two rooms were added to the gardener's house. A cannery 36 x 40 feet was built and equipped with cement sinks, steam cookers, hot and cold water, and with all other conveniences necessary for an up-to-date cannery. We have under construction at the present time a steel tank and tower for water, with a total capacity of 115,000 gallons, which, when complete, will give much better water service and fire protection. Respectfully submitted, T. Miller White, Engineer in Charge. ENGINEER'S REPORT (1918) Dr. W. W. Faison, Superintendent State Hospital, Golclsboro. N. C. I herewith submit my report as Engineer, covering the brief period of my employment. I took charge of the plant August 29, 1918. During this time there has been no new work done in the way of additions to the machinery, so my work has been confined to the upkeep and repairs of the machinery and equipment. The principal items of repair have been leveling up the boilers, building concrete steps to Aycock building, renewing two motors, repair of boiler feed line and boiler feed pump, putting in one piston and plunger in ammonia pump, overhauling one hydraulic pump. I have recalked the suction line from the river to the pumping station; put in one heating coil in the vegetable house; overhauled heating coils on two fans; riveted galvanized iron duct. I have overhauled filter tank and put in new pipes and fittings and cleaned out the reservoir. A brick foundation has been built under portions of the walls of the engine-room, and also under the fire-escape at Miller building, to prevent settling of the walls. During the year, under my predecessor, the water tank and tower were completed and put in service. An addition to the kitchen was made, and a room for preparing vegetables was built. Our spur track was relaid with seventy-five-pound rails. Respectfully submitted, W. D. Williams, Engineer. THE FARMER'S REPORT Farm Products of 1917 To Dr. W. W. Faison, Superintendent of State Hospital at Goldsboro, N. C. I respectfully submit the following report for the year 1917: 100,000 pounds alfalfa at $1.25 $ 1,250.00 600 barrels corn at $7.50 4,500.00 635 bushels cotton seed at $1.10 695.50 10 bushels cowpeas at $2.50 25.00 25,410 pounds clover at 75c 190.07 240 tons ensilage at $4 960.00 186 bushels garden peas (eaten) at 50c 93.00 374 bushels garden peas (sold) at $1.50 561.00 206 bushels Irish potatoes at $1 206.00 9,303 pounds lint cotton at 29c 2,697.87 5,010 pounds oat straw at $1 50.10 2,225 bushels oats at 80c 1,780.00 68,125 pounds oat straw (threshed) at 40c 272.50 400 pounds pea hulls at 25c 1.00 72,300 peavine hay at $1 723.00 332 bushels peanuts at $1.25 415.00 8,900 pounds peanut vines at 50c 44.50 61 bushels rye at $1.50 91.50 29,414 pounds rye straw at 40c 117.66 145 bushels snap beans at 50c 72.50 1,420 bushels sweet potatoes at 60c 852.00 54,600 pounds soja beans at 2c 1,092.00 99,461 pounds vetch and grain at $1 994.61 77 bushels wheat and vetch at $1.50 115.50 5,550 pounds wheat and vetch straw mixed at 40c 22.20 500,000 pounds corn stover at 40c 2,000.00 40 tons corn stover in ensilage at $8 320.00 6,000 pounds grass hay at 75c 450.00 Total value farm products $ 20,596.01 Garden Products of 1917 586 bushels apples at 50c $ 293.00 180 bunches asparagus at 10c 18.00 1,119 quarts apples (canned) at 10c 111.90 35 bushels beets at 50c 17.50 165 quarts beets (canned) at 15c 24.75 275 bushels cucumbers at 50c 137.50 235 barrels cabbage at $1 235.00 9,000 heads collards at 2%c 225.00 400 bushels cantaloupes at 50c 200.00 58 State Hospital at Goldsboro 1 bushel crab apples at $1 $ 1.00 55 bushels dewberries at $2 110.00 2,872 quarts dewberries (canned) at 15c 430.80 3 bushels figs at $2 6.00 40 bushels grapes at $1 40.00 300 bushels green peas at 50c 150.00 18 barrels kraut at $4 72.00 1,200 heads lettuce, at 4c 48.00 670 bushels leeks at 50c 335.00 1,200 bushels lima beans at 50c 600.00 30 bushels okra at 50c 15.00 135 bushels onion heads at 75c 101.25 16 bushels peppers at $1 16.00 1,052 quarts peaches (canned) at 20c 210.40 85 bushels peaches at $1 85.00 1 bushel plums at $1 1.00 2 buslhels (pecans at $4 8.00 6 stands popcorn at $1 6.00 6 bushels parsley at 50c 3.00 750 bushels rutabagas at 25c 187.50 6 bushels radishes at 75c 4.50 250 bushels squash at 50c 125.00 5 bushels sage at 50c 2.50 120 bushels salad onions at 50c 60.00 125 bushels strawberries at $2 250.00 616 quarts strawberries (canned) at 15c 92.40 304 bushels snap beans at 50c 152.00 750 bushels spring salad at 50c 375.00 175 quarts soup mixture at 15c 26.25 163 busbels tomatoes at $1 163.00 2,750 quarts tomatoes (canned) at 15c 412.50 1,584 bushels turnips at 25c 396.00 2,450 watermelons at 5c 122.50 600 bunches celery at 10c 60.00 100 stands green corn at $1 100.00 530 pints corn (canned) at 10c 53.00 32 bushels garden peas at 50c 16.00 713 pints garden peas (canned) at 10c 71.30 8 bushels salsify at 50c 4.00 83 hogs sold 2,809.65 7,850 pounds pork (killed) at 22y2 c 1,766.25 Total value garden products $ 10,750.45 Expenses of Farm and Garden for 1917 Salary of farmer $ 600.00 Salary of gardener 540.00 Wages and board of laborers 1,191.79 Feed for team 1,920.00 Implements and repairs 730.45 Fertilizers •. 4,424.71 State Hospital at Goldsboro 59 Seeds and plants $ 816.89 Feed and hogs 153.50 Bagging and ties 64.50 Truck baskets 60.00 Miscellaneous 289.81 Total expenses $ 10,791.65 Total value of farm products 20,596.01 Total value of garden products 10,750.45 Total value of farm and garden products $ 31,346.46 Net value of farm and garden products 20,554.81 Net value of dairy products , 5,748.92 Total net value of farm, dairy, and garden products $ 26,303.73 Dr. W. W. Faison, Superintendent of State Hospital at Goldsboro, N. C. I respectfully submit the following report for year of 1918: Farm Products of 1918 26,555 pounds alfalfa hay at $1.50 $ 398.32 614 barrels corn at $8 4,912.00 1,250 bushels cotton seed at $1 1,250.00 31 bushels cowpeas at $2.50 77.50 6,890 pounds clover at $1 68.90 325 tons ensilage at $5 1,625.00 168 bushels garden peas (sold) 142.82 665 bushels Irish potatoes at $1 665.00 120 bushels Irish potatoes (fall crop) at $1.50 180.00 20,000 pounds lint cotton at 26c 5,200.00 2,625 bushels oats at 80c 2,100.00 91,500 pounds oat straw at 40c 366.00 1,240 pounds pea hulls at 40c 4.96 103,055 pounds peavine hay at $1.25 1,288.18 200 bushels peanuts at $1.25 250.00 8,700 pounds peanut vines at 50c 43.50 61 bushels rye at $1.50 91.50 8,000 pounds rye straw at 40c 32.00 271 baskets beans (sold) 313.65 1,510 bushels sweet potatoes at $1 1,510.00 390 bushels soy beans at $3 1,170.00 79,900 pounds grain and vetch at $1 799.00 85 bushels wheat and vetch at $2 170.00 9,955 pounds wheat vetch straw at 40c 39.82 298 bushels wheat at $2 596.00 34,480 pounds wheat straw at 40c 137.92 440,000 pounds corn stover at 50c 2,200.00 31,000 pounds crab grass hay at $1 310.00 150 bushels garden peas at 50c 75.00 Total value farm products $ 26,017.07 60 State Hospital at Goldsboro Garden Products of 1918 250 bushels apples at 75c $ 187.50 202 bunches asparagus at 10c 20.20 50 bushels beets at 50c 25.00 203 bushels cucumbers at 50c 101.50 500 barrels cabbage at $1 500.00 23,850 heads collards at 2y2c 596.25 370 bushels cantaloupes at 50c 185.00 40 bushels dewberries at $2.50 100.00 3 bushels grapes at $2 6.00 225 bushels green peas at 50c 112.50 1,000 heads lettuce at 40'c 40.00 308 bushels leeks at 50c 154.00 800 bushels lima beans at 50c ' 400.00 20 bushels okra at 75c 15.00 65 bushels onion heads at $1 65.00 2 bushels peppers at $1 2.00 52 bushels peaches at $2 104.00 6 bushels plums at $1 6.00 2y2 bushels pears at $4 10.00 6 stands popcorn at $2 12.00 452 barrels rutabagas at $1 452.00 5 bushels radishes at 75c 3.75 284 bushels squashes at 50c 142.00 2 bushels sage at 50c 1.00 288 bushels salad onions at 50c 144.00 68 bushels strawberries at $2 136.00 270 bushels snap beans at $1 270.00 1,128 bushels spring salad at 50c 564.00 108 bushels tomatoes at $1 108.00 494 quarts tomatoes (canned) at 15c 74.10 1,975 barrels turnips at $1 1,975.00 2,090 watermelons at 10>c 209.00 25 stands green corn at $1.25 31.25 5 bushels salsify at 50c 2.50 5 bushels carrots at 50c 2.50 82 head of hogs 3,119.89 10,000 pounds pork (killed) at 22y2 c 2,250.00 Total value of garden products $ 12,226.94 Total value of farm products 26,017.01 Value of farm and garden products $ 38,144.01 Expenses of Farm and Garden for 1918 Salary of farmer $ 598.33 Salary of gardener 454.56 Salary of miller and feeder 224.00 Wages and board of laborers 1,002.31 Feed for team 2,170.00 Implements and repairs 1,070.75 State Hospital at Goldsboro 61 Fertilizers $ 6,090.94 Seeds and plants 1,540.62 Feed 1,369.50 Bagging and ties 50.95 Truck baskets 67.50 Miscellaneous 1,175.59 Total expenses $ 15,815.05 Total value of farm and garden products 38,144.01 Total value of dairy products 6,456.46 Total value of farm, dairy, and garden products $ 44,500.47 Total expense of farm, dairy, and garden products 15,815.05 Net value of farm, garden, and dairy products $ 28.785.42 D. H. Newell, Farmer. SEAMSTRESS'S REPORT Dr. W. W. Faison, Superintendent. Dear Sir:—I hereby submit a report of the work done in the sewing-room and on the wards for the year ending November 30, 1917. Articles Made and Mended in Sewing-Room Aprons 154 Bed-ticks 186 Bread covers for bakery 4 Bodies 669 Bonnets 22 Bed cases 1 Capes 123 Caps 6 Chemises 1,467 Curtains 23 Coats (made) " 245 Coats (mended) 3 Combination suits 63 Drawers 1,441 Dresses 1,004 Flannel shirts 331 Flannel skirts 18 Gowns 120 Indestructible dresses 409 Ironing sheets 12 Laundry bags 7 Laundry rack covers 2 Milk cloths 24 Mangle roller cover 4 Mangle apron ( mended ) 1 Meat covers for kitchen 2 Overalls 2 Pants 632 Pillows 145 Pillow-cases 691 Pillow-ticks 146 Protectors for hands and feet 8 Sheets 1,212 Shirts 835 Skirts 909 Sleeves, pairs 7 Sleeves (mended ) 19 Sleeved skirts 7 Shirt waists 23 Shrouds ' 72 Towels 349 State Hospital at Goldsboro 63 Tops and linings for quilts 37 Tray cloths 8 Table-cloths 6 Total 12,151 Articles Made and Mended on the Wards Quilts (made) 334 Sheets, burlap (made) 18 m Total 352 Articles Mended on Wards Aprons 7 Bed-ticks 112 Blankets 33 Bodies 141 Combination suits 281 Chemises 434 Coats 286 Drawers 2,887 Dresses 935 Flannel shirts 812 Flannel skirts 210 Gowns 297 Pants 3,392 Pillow-cases 21 Sheets 177 Shirts 3,388 Skirts 585 Vest 1 Total articles made and mended on wards 14,371 Total articles made and mended in sewing-room 12,151 Total articles made and mended in wards and sewing-room 26,522 Respectfully submitted, Miss Martha Newell, Seamstress. Dr. W. W. Faison, Superintendent. Dear Sir:—I hereby submit my report of the work done in the sewing-room and on the wards for the year ending November 30, 1918. Articles Made in the Sewing-Room Aprons 148 Bed-ticks 169 Bodies 957 Bonnets , 13 64 State Hospital at Goldsboro Bed-cases 5 Burlap spreads 20 Caps 24 Curtains (pairs) : 77 Chemises 1,197 Coats 143 Combination suits 16 Combination drawers 24 Chair cushions 2 Cases for automobile curtains 3 Covers for kitchen cabinet 4 Canopies for beds 13 Covers for cream separator 1 Dresses 768 Gowns 60 Ironing sheets 32 Indestructible dresses 215 Laundry hags 4 Mangle covers 1 Night-shirts ". 34 Outing shirts 364 Pants • 502 Pillow-cases - 1,194 Pillow-ticks 2 Pillows 160 Potato-peeler covers 1 Sheets 1,395 Shirts 715 Skirts 1,357 Shirt waists 56 Shrouds Ill Stretchers 2 Suspenders 130 Table-cloths 22 Towels 21 Tool bag 1 Tray cloths 26 Window shades 4 Total garments made in sewing-room 9,993 Articles Made on Wards Quilts 288 Articles Mended on Wards Bodies 250 Blankets 20 Bed-ticks 114 Combination suits 221 Coats 245 Chemises ". 700 State Hospital at Goldsbobo 65 Drawers 1,600 Flannel shirts 581 Pants 1,921 Pillow-cases 100 Shirts 2,118 Sheets 214 Sleeves 14 Skirts * 900 Dresses 600 Total garments made and mended on wards 9,886 Total garments made in sewing-room 9,993 Articles made and mended in sewing-room and wards 19,879 Respectfully submitted, Miss Martha Newell, Seamstress HOUSEKEEPER'S REPORT Dr. W. W. Faison, Superintendent. I hereby submit my report as housekeeper for the year 1917 as follows: Apple Jelly 28 quarts Apple preserves 8 quarts Crab-apple jelly 6 quarts Crab-apple preserves 21 quarts Fig preserves 3 quarts Grapes, spiced 25 quarts Plum preserves 12 quarts Peach preserves 15 quarts Peach sweet pickles 9 quarts Pear preserves 8 quarts Pear sweet pickles 9 quarts Pear marmalade 8 quarts Tomato sweet pickles 8 quarts Peppers stuffed 3 quarts Pepper relish 19 quarts Cucumber pickles 16 bbls. Dewberries, canned , : 16 quarts Butter 3,267 lbs. Lard 2,274 lbs. Sausage 1,760 lbs. Soap 30,000 lbs. Respectfully submitted, Mrs. Mamie Herring, Housekeeper. Miss Luna Bridgers, Assistant Housekeeper. Dr. W. W. Faison, Superintendent. I hereby submit my report as housekeeper for the year 1918 as follows: Apple jelly 8 quarts Apple preserves 10 quarts Blackberry jelly 4 quarts Blackberry jam 3 quarts Chow-chow 16 quarts Cucumber pickle, sweet 16 quarts Cucumber pickle, sour 20 bbls. Pear marmalade 16 quarts Pear preserves 20 quarts Pear sweet pickle 16 quarts Peach sweet pickle 36 quarts Pear preserves 7 quarts Plum preserves 15 quarts State Hospital at Goldsboro 67 Butter 294 lbs. Lard 818 lbs. Sausage 680 lbs. Soap 30,000 lbs. Respectfully submitted, Mrs. Mamie Herring, Housekeeper. Miss Luna Bridgers, Assistant Housekeeper. REPORT OF THE STATE HOSPITAL AT MORGANTON, N. C. FOR THE TWO YEARS ENDING NOVEMBER 30, 1918 i EXECUTIVE COMMITTEE A. E. Tate, Chairman R. R. Clark J. H. Giles OFFICERS John McCampbell, M.D Superintendent F. B. Watkins, M.D. , ' Assistant Physicians M. A. Griffin, M.D. r P. M. Scroggs Steward Vacancy Matron SUPERINTENDENT'S REPORT The Honorable Board of Directors. Gentlemen:—In compliance with the law I am herewith submitting a re-port of the operation of the Hospital for the biennial period ending November 30, 1918, together with the customary statistical tables. It will be noted from Table No. 1 that we had under treatment during the two years 2', 105 patients, and that 95 men and 97 women have been discharged as recovered. Based upon admissions, the recovery rate for men was 37.6 per cent, and for women 30.7 per cent. During 1917 59 men and 65 women died, making the death rate for that year 6.7 per cent. During 1918 73 men and 82 women died, giving an annual death rate of 8.6 per cent. This was the highest death rate recorded in the history of the institution, and was due, in a great measure, to the epidemic of influenza which prevailed in the Hospital during October and November of this year, afflicting more than 500 patients and resulting in 29 deaths. The employees were affected in even a greater proportion, there being approximately 100 stricken with the disease, and one nurse died from it. Five suicides have occurred during the period. The circumstances attend-ing same were reported to the executive committee of the Board of Directors at the time of occurrence. In each instance the coroner was notified, but in no case did he hold an inquest. One homicide occurred. A male patient, who had been in the Hospital for eight months without showing any dangerous propensities or giving expression to any delusions, one day while out with a working party picked up an axe and struck an inoffensive patient in the back of the neck, producing a wound which caused death in a few minutes. We have been very much hampered in the work of the Hospital owing to lack of support funds. The estimate in our report to the last General As-sembly was made without knowledge of the tremendous advance which was to take place in the price of all commodities and the price of labor as well, and was far too low to meet the vital needs of running expenses, and the appro-priation when finally made was $25,000 less than we asked for. Consequently, after practicing the strictest economy, and in some cases enduring privations, we have been compelled to incur a debt of approximately $75,000. The Board of Directors, acting under instructions of the Governor and his Council, has borrowed $55,000, and the balance of this amount is represented by outstand-ing bills. The per capita cost for the past year was $216, and would have been con-siderably more had the advance in wages to nurses, attendants, and other employees, Which we were compelled to make, been in effect for the entire year. We estimate that for the ensuing two years a per capita allowance of $230 will be necessary for anything like the proper care of our unfortunate charges. By opening the new dormitory for women, which has stood vacant for the past two years, our present capacity will be 1,440 patients, and for their sup-port at the above-mentioned rate per capita we will need for support during 1919 $331,200'. In order to meet the ever-increasing demands for the admis-sion of patients there should be constructed, during the coming year, a build- 72 State Hospital at Mokganton ing to accommodate at least 100 men, bringing the population up to 1,540, which at the same -rate would require an appropriation of $344,200 for 1920, and in addition $75,000 to cover notes and outstanding hills, representing the deficit for the last biennial period. Owing to the inadvisability of marketing the bonds authorized by the last General Assembly for additional improvements to the Hospital during the stress of war times, funds for that purpose were unavailable, and even had they been available there was no need for increased 'capacity without means of supporting the additional population. However, the time has come when steps should be taken looking to enlargement and improvements as provided for by this bond issue, and the immediate needs are for a building for men with a capacity of not less than 100 beds and a new refrigerating plant to replace our old one, which is too small and practically worn out from its more than twenty years of use. Out of the appropriation made two years ago for enlargement and improve-ment there will be available, during next year, $100,000, and this amount will doubtless meet the actual needs in that direction for the present, leaving nothing to be considered beyond the appropriation for maintenance. There are two vacancies on the medical staff caused by the resignation of Dr. Wan. R. Griffin, who left this service in last March to go into private work, and the resignation of Dr. Houck, which occurred last April. The de-mands of the Army for medical officers has been such that it has been impos-sible to fill these vacancies. The routine work of the Hospital has been kept up very well indeed con-sidering the shortness of working forces in practically every department, and our success in this direction has been due, in a great measure, to the loyalty and industry of those remaining with us, and to them I desire to express my sincere appreciation for their efforts and fidelity. Respectfully submitted, John McCampbell. State Hospital at Mokganton 73 TABLE No. 1 Showing Movement of Patients for the Period of Two Years Ending November 30, 1918. 1917 1918 Totals M. F. Total M. F. Total M. F. Total Remaining November 30, 1916-.- 654 132 881 170 1,535 Admitted 302 122 146 268 254 316 570 Total under treatment 78b 49 28 4 1 59 1,051 55 44 2 65 1,837 104 72 6 1 124 767 46 21 1 73 1,031 42 40 4 82 1,798 88 61 5 155 908 95 49 5 1 132 1,197 97 84 6 147 2,105 Discharged as recovered 192 Discharged as improved 133 Discharged, not improved. 11 Discharged as not insane .. 1 Died 279 Total removed 141 166 307 141 168 309 282 334 616 Remaining November 30 645 885 1.530 626 863 1,489 TABLE No. 2 Showing the Ages of Those Admitted and Those Removed During the Period of Two Years Ending November 30, 1918. Removed Admitted Recovered Impioved Not Improved Not Insane Died M. F. M. F. M. F. M. F. M. F. M. F. 10 to 20 years . .. 21 63 42 42 40 40 6 18 85 85 66 20 36 6 5 28 20 14 17 11 2 22 30 20 15 7 1 2 25 9 4 5 4 6 16 21 22 10 9 2 14 22 24 25 43 2 4 20 to 30 years .. 3 1 1 1 2 1 1 16 30 to 40 years 23 40 to 50 years ._ . 29 50 to 60 years . . 27 60 up 1 47 Unknown . 1 1 1 Totals 254 316 95 97 49 84 5 6 1 132 147 74 State Hospital at Morganton TABLE No. 3 Showing Duration of Insanity Before Admission of Those Admitted and Those Removed During the Period of Two Years Ending November 30, 1918. Removed Admitted Recovered Improved Not Improved Not Insane Died M. F. M. F. M. F. M. F. M. F. M. F. Less than 1 month. ._ 57 44 37 22 28 16 11 10 4 1 24 67 63 51 28 31 15 16 12 7 6 20 21 29 9 12 2 5 8 4 1 4 23 23 19 11 6 4 4 3 8 10 9 3 4 3 3 4 11 24 19 15 5 4 3 2 1 15 18 17 15 13 13 16 8 7 2 8 19 1 month and less than 3 . . 3 1 1 21 3 months and less than 6_ 24 6 months and less than 12 1 1 14 1 year and less than 2 16 2 years and less than 3 _ _- 11 3 years and less than 5 14 5 years and less than 10 .-. 2 15 10 years and less than 20 7 20 ano up I 1 Unknown 1 1 1 1 5 Totals 254 316 95 9'/ 49 84 5 6 1 132 147 TABLE No. 4 Showing Alleged Causes of Insanity as Shown in the Commitment Papers of Those Admitted During the: Period of Two Years Ending November 30, 1918. Male Abcess of brain 1 Accidental killing of two sons Acute Bright' s Acute indigestion 1 Advanced age 1 Age 1 Alcoholism 1 Alcoholism and excessive dissipation 1 Alcoholism and exposure 1 Alcoholism and pellagra 1 Always physically and mentally weak Amenorrhea Approach of puberty Bad health • 1 Bad health, masturbation and work 1 Bible study Bilious attack 1 Biliousness, toxemia, amenorrhea Birth of child Blow on head 3 Breach of promise Bug in ear 1 Cerebral and bodily exhaustion Change of life Change of life and uterine trouble Chronic rheumatism • 1 Female Total 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 2 1 1 1 1 1 1 4 4 3 1 1 1 1 1 3 3 1 1 1 State Hospital at Moeganton 75 Table No. 4 — Continued Male Church difficulties 1 Cigarettes, war work and worry 1 Climacteric and uterine disease Congenital Convulsions when a child 1 Deceases, children and war Death of child Death of husband Death of son , Declining health Delicate constitution Dementia prsecox 1 Desertion by husband Desertion by wife • 1 Desertion by son who left her alone with one grandchild Disappointment in love 1 Disease, worry over having pellagra Dissatisfied after death of wife 1 Dissipation and lues 1 Dismenorrhea Distracted by Holiness sect Domestic worries 1 Domestic worries or lactation Drafted in army 1 Drafting of son 3 Drinking whiskey 1 Exposure and suppression of menses Falling on ground 1 Failure to collect loan 1 Father alcoholic habitue Family troubles • 2 Fear of loss of employment 1 Fear of tuberculosis . Female derangement Female trouble Financial affairs 1 Financial affairs and bad health 1 Financial loss • Financial trouble and protracted meeting General breakdown 1 General rundown condition Grippe and pneumonia 1 Grief over death of grandchild Grief over death of mother 1 Hard fall 1 Has child two months old Heredity 3 Heredity and financial embarrassment 1 Heredity and masturbation 1 Heredity and Pellagra Heredity and religious excitement Holiness meeting 1 Historectomy High blood pressure 111 health 5 111 health and cigarettes 1 111 health and jealousy 111 health and worry 1 111 health and worry over boys in army 1 Impaired health 1 female Total 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 2 1 1 1 1 1 1 2 1 1 1 1 1 1 1 1 1 1 1 1 2 5 1 1 1 1 1 1 1 1 3 1 1 1 1 1 4 4 1 1 1 1 1 1 1 1 1 * 1 1 1 1 1 1 1 7 10 1 1 1 1 1 1 1 1 1 1 1 13 18 1 1 1 2 3 1 1 76 State Hospital at Morganton Table No. 4 — Continued Male Insomnia 1 Indigestion . 2 Indigestion and bad health 1 Indigestion and female trouble Indigestion and rheumatism Indigestion and worry 1 Influenza 2 Inherited * Injury to head 1 Injury to eye 1 Jealous of husband and Bible study Kidney trouble La grippe 1 Loss of child and worry Love affair 1 Low state of health Mastoid operation 1 Masturbation 2 Masturbation and indigestion, heredity 1 Masturbation and religion 1 Masturbation, disease of the heart, liver and kidneys 1 Measles 2 Meddling of neighbors : . . Melancholia 2 Meningitis 1 Menopause Menopause and war Menstrual irregularities Morphine and illness of daughter 1 Morphine 1 Miscarriage Mumps 1 Mutism 1 Nervous breakdown followed by poor health Nervousness 2 Nervousness at time she conceived last child Nervousness or general breakdown Nervousness or love affair Neurasthenia 2 Not stated 13 Operation Opium 1 Overwork and bad health 1 Overwork and childbirth • Overwork, teaching Overheat 1 Overwork 3 Paralysis 3 Paranoia • 1 Pellagra 3 Pellagra and womb trouble Poor health Poor health, nervous strain and operation 1 Pregnancy Pregnancy and childbirth Puerperal Rapid childbirth and overwork Recurrence 1 Religion 4 Religion and love affair ernale Total 1 1 3 1 1 1 1 1 1 1 oO 1 1 1 2 1 1 1 1 1 1 1 1 1 1 1 1 1 2 1 1 1 1 3 1 1 1 3 1 2 2 1 1 1 1 1 1 1 1 1 1 1 1 5 7 1 1 1 " 1 1 1 1 3 9 22 1 1 1 2 1 1 1 1 1 1 2 5 3 1 17 20 1 1 4 4 1 1 3 3 1 1 6 6 1 1 1 2 8 12 1. 1 State Hospital at Morganton 77 Table No. 4 — Continued Male Religious crank 1 Religious craze • 1 Religious excitement 3 Religious problems 2 Revival 2 Rundown health 1 Self-abuse 1 Senility Sickness and death of son-in-law Specific 2 Spinal disease 2 Son burned to death 1 Study over religion Stroke on the head 1 Taking off morphine 1915 1 Toxemia Tonsillotomy Trouble over parents' death Tumor of brain . 1 Typhoid fever 2 Typhoid fever and operation 1 Typhoid fever and pneumonia when young Unknown 113 Uremia following confinement Use of morphine and cocaine 1 Utero-ovarian, excited by menopause Whiskey and morphine 1 Want of care after childbirth War and Bible reading Weak mind Working in mill and run down health Worry 1 Worry and dope Worry about family condition, fear of poverty Worry and ill treatment by husband Worry over ancestry 1 Worry over condition in life Worry over condition of county 1 Worry over family affairs and overwork Worry over ill health Worry over daughter's leaving home • Worry over law suit Worry over loss of friend Worry over line and corner 1 Worry over past Worry over sickness of wife 1 Worry over son leaving home Worry over neighbor's remarks and church affairs Worry over Avar 2 Worry over brother going to war Female Total 1 1 2 3 1 3 2 1 1 4 4 1 1 2 2 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 117 230 1 1 1 1 1 1 1 1 1 1 1 1 1 1 2 3 1 1 1 1 1 1 1 1 1 1 2 2 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 3 1 1 78 State Hospital at Morganton TABLE No. 5 Showing Deaths for the Period of Two Years Ending November 30, 1918. No. 5553 6145 6700 5608 6744 6663 6531 6341 3017 3444 6741 6743 6701 159 5106 6613 2148 5762 6240 6628 6124 3281 6580 6767 6541 133 6740 6206 5985 5625 539 3228 6684 6395 870 6063 3510 6685 978 6820 6642 6799 6819 Male. 3557 6696 3306 5639 5349 5498 Sex Female- Female- Male Female. Female. Male Female. Female. Female. Female. Male Female. Female. Male Female. Male Female. Female- Fern ale- Male Male Female. Female, Female. Female. Female_ Male Female. Female- Male Female. Female. Male Male Male Female- Male Male.... Male. Male. Female. Female. Male Male Female- Male Male Female. . Age 23 32 57 58 40 71 45 46 53 35 73 49 50 81 57 40 29 31 59 18 37 53 81 42 66 37 20 26 69 66 67 34 74 69 20 61 48 57 74 27 53 64 60 61 61 61 Duration of Insanity Before Admission mos yr mo mos mos mos yrs mos yrs mo. 16 d. yrs mos yrs yrs yrs yrs 5 yrs Many years_ 3 yrs 5 mos. 18 d.. 15 d 3 yrs 1 yr 1 mo 1 yr 12 yrs 2 mos 3 yrs 3 yrs 6 mos 2 yrs 2 mos. 2 d. 7 mos 3 or 4 yrs. 1 mo 3 yrs 2 mos 3 mos 5 mos Not given. 6 mos.- 3 mos.. 11 mos. 8d..- 4 mos. 5 mos. 3 mos. 21 d... 47 7 mos. Hospital Residence Date of Death 4 yrs. 4 mos. 18 d. 1 yr. 11 mos. 28 d. 1 mo. 21 d. 4 yrs. 1 mo. 15 d. 6 d. 3 mos. 4 d. 8 mos. 12 d. 1 yr. 5 mo. 15 d. 14 yrs. 8 mos. 12 d. 13 yrs. 2 mos. 27 d. 1 mo. 20 d. 17 d. 2 mos. 2 d. 34 yrs. 3 mos. 22 d. 6 yrs. 4 mos. 10 d. 5 mos. 24 d. 3 yrs. 1 yr. 2 yrs. 6 mos. 16 d. 3 mos. 13 d. 9 mos. 27 d. 5 mos. 15 d. 1 mo. 25 d. 13 yrs. 10 mos. 19 d. 7 mos. 25 d. 15 d. 9 mos. 7 d. 34 yrs.' 6 mos. 2 d. 1 mo. 29 d. 1 yr. 11 mos. 24 d. 2 yrs. 6 mos. 22 d. 4 yrs. 1 mo. 19 d. 30 yrs. 11 mos. 28 d. 14 yrs. 1 mo. 20 d. 4 mos. 14 d. 1 yr. 28 yrs. 2 yrs. lo yrs. 4 mos. 15 d. 8 mos. 19 d. 5 mos. 3 d. 2 mos. 12 d. 4 mos. 26 d. 27 yrs. 10 mos. 13 d. bd. 7 mos. 21 d. 28 d. 11 d. 13 yrs. 4 d. 5 mos. 14 d. 14 yrs. mos. 25 d. 4 yrs. 3 mos. 8 d. 5 yrs. 9 mos. 26 d. Dec. Dec. Dec. Dec. Dec. Dec. Dec. Dec. Dec. Dec. Dec. Dec. Dec. Dec. Dec. Dec. Jan. Jan. Jan. Jan. Jan. Jan. Jan. Jan. Jan. Jan. Jan. Jan. Jan. Feb. Feb. Feb. Feb. 3-17 3-17 6-17 8-17 8-17 8-17 9-1/ 10-17 14-17 14-17 18-17 18-17 20-17 20-17 24-17 28-17 1-18 6-18 6-18 6-18 11-18 13-18 16-18 16-18 22-18 25-18 2o-l» 28-18 29-18 4-18 8-18 9-18 10-18 Feb. 16-18 Feb. 17-18 Feb. 21-18 Feb. 21-18 Feb. 25-18 Mar. 7-18 Mar. 21-18 Mar. 22-18 Mar. 23-18 Mar. 25-18 Mar. 25-18 Mar. 31-18 April 6-18 April 13-18 April 13-18 Cause of Death 5 yrs. mos. 2 d. April 15-18 Pneumonia (tubercular). Cardio-renal disease. Exhaustion of dementia. Tuberculosis. Pellagra. Facial erysipelas. Cardio-renal disease. Pellagra. Acute ascending myelitis. Pellagra. Facial erysipelas. Pellagra . Exhaustion of dementia. Chronic interstitial nephritis. Locomotor ataxia. General paralysis of the in sane. Apoplexy. Chronic myocarditis. Acute myocarditis. Exhaustion of dementia and diarrhea. Pneumonia. Cellulitis and senility. Pellagra. General peritonitis. Epilepsy. Chronic myocarditis. Pulmonary tuberculosis Pellagra. Facial erysipelas. Tuberculosis. Entero-colitis. General paralysis of the in-sane. Chronic myocarditis. Apoplexy. Pulmonary tuberculosis. Facial and general erysipelas. Chronic valvular heart dis-ease. Facial erysipelas. Chronic valvular heart dis-ease. Exhaustion of dementia. Exhaustion from diarrhea. General paralysis of the in-sane. Enteritis with diarrhea. Exhaustion of dementia. Cardiac disease. Cardio-renal disease. Chronic parenchymatous ne-phritis. Apoplexy. State Hospital at Morganton 79 Table No. 5 — Continued No. Sex Age Duration of Insanity Before Admission Hospital Residence Date of Death Cause of Death. 6502 Female.. 48 2 mos 1 yr. 1 mo. 27 d. April 16-18 Exhaustion of dementia. 6715 Male Female. . 18 41 10 d. . 2 yrs. 5 mos. 22 d. 6 mos. 11 d. April 17-18 April 18-18 Exhaustion of dementia. 6083 2 mos Pulmonary tuberculosis. 6647 Male 61 8 mos 8 mos. 7 d. April 19-18 Chronic valvular heart dis- 6818 Male 62 4 mos. 15 d.. 1 mo. 9 d. April 23-18 ease. Acute enteritis with diarrhea. 3738 Male 44 4 yrs 12 yrs. 3 mos. 27 d. April 24-18 Pellagra. 5079 Female.. 73 7 d 6 yrs. 9 mos. 5 d. April 29-18 Erysipelas. 6582 Female.. Male 74 48 19 d 20 yrs. 11 mos. 9 d. 8 mos. 14 d. May 3-18 May 4-18 Exhaustion of dementia. 2192 6 yrs. .. Apoplexy. 6854 Male Male 38 60 20 d 26 yrs. 13 d. mojs. 11 d. May 8-18 May 10-18 Pellagra. 1290 6 mos.. Strangulation (suicide). 6871 Female. . Female- 53 62 21 d... 26 yrs. 6d. 10 mos. 5 d. May 21-18 May 28-18 Exhaustion of dementia. 1183 Not given... Exhaustion of dementia. 6872 Female. . 43 2 mos 16 d. June 1-18 Exhaustion of dementia. 6217 Male 74 6 mos.. 2 yrs. 3 mos. 27 d. June 12-18 Acute enteritis with diarrhea. 6845 Female- 64 4 mos 1 mo. 28 d. June 15-18 Cellulitis of neck. 6897 Male 35 3 mos. 7 d. June 25-18 Asphyxiation (suicide). 4486 Female.. 31 7 mos 8 yrs. 10 mos. 25 d. June 26-18 Pellagra. 6851 Female- 56 20 yrs 2 mos. 4 d. June 27-18 Huntington's chorea. 5618 Male 24 12 yrs 4 yrs. 7 mos. 8 d. June 30-18 Pulmonary tuberculosis. 4833 Female- 28 5 mos -. 7 yrs. 8 mos. 22 d. July 2-18 Acute enteritis. 5793 Female— 59 3 yrs. 6 mos. 25 d. July 3-18 Bright's disease. 6900 Female- 60 2 yrs 14 d. July 4-18 Exhaustion of dementia. 6846 Female.. 80 3 yrs 2 mos. 18 d. July 5-18 Acute enteritis. 6880 Female.. 87 5 yrs . .. 1 mc. 5 d. July 7-18 Gangrene of foot. 6906 Female- 44 Not given 10 d. July 10-18 Acute endocarditis. 223 Male 59 3 mos 34 yrs. mos. 10 d. July 10-18 Acute enteritis with diarrhea. 5951 Male 26 1 yr 3 yrs. 28 d. July 12-18 July 17-18 July 18-18 Pulmonary tuberculosis. 6893 Female.. Male 23 47 1 mo. . 17 yrs. 1 mo. 3 d. 3 mos. 26 d. Pellagra. 2757 1 mo. 10 d... Exhaustion of dementia. 6915 Male 72 3 or 4 yrs 14 d. July 25-18 Cardio-renal disease. 5537 Male 55 4 yrs. 6 mos. 5 yrs. 1 mo. 8 d. July 27-18 Apoplexy. 5993 Male 55 7 mos 3 yrs. 16 d. July 29-18 Pellagra. 5549 Male 45 2 mos .. 5 yrs. 21 d. Aug. 5-18 Apoplexy. 4583 Male 44 5 mos 8 yrc. 6 mos. 15 d. Aug. 5-18 Lobar pneumonia. 6940 Female.. 35 3 mos 15 d. Aug. 13-18 Pellagra. 5199 Female . 71 28 d 6 yrs. 8 mos. 5 d. Aug. 16-18 Chronic myocarditis. 6441 Male 39 6 mos lyr. 8 mos. 17 d. Aug. 17-18 Chronic gastro-enteritis. 6949 Male 38 9d 10 d. Aug. 21-18 Exhaustion of mania. 3330 Male 59 1 mo. 12 d... 14 yrs. 4 mos. 28 d. Sept. 10-18 Apoplexy. 4066 Female.. 46 3 mos.. 11 yrs. 14 d. Sept. 19-18 Cardio-ienal disease. 4752 Female.. 30 8 yrs. 1 mo. 17 d. Sept. 19-18 Cardio-renal disease. 6880 Male 30 4 mos:... .. . 4 mos. 20 d. Sept. 23-18 Exhaustion of dementia. 4440 Female.. 38 Several yrs. . 9 yrs. 3 mos. 29 d. Sept. 23-18 Spleno-medullary leukemia. 6159 Female.. 27 2 mos. 14 d._ 2 yrs. 9 mos. 14 d. Oct. 3-18 Acute endocarditis. 6526 Female.. 59 5 mos— .. lyr. 6 mos. 18 a. Oct. 4-18 Pellagra. 5805 Female.. 36 3 yrs. 8 mos. 23 d. Oct. 4-18 Pellagra. 6636 Male 32 Not gi\en_._ 1 yr. 2 mos. 9 d. Oct. 5-18 Chronic valvular heart dis- 6213 Male 35 2 yrs 2 yrs. 7 mos. 25 d. Oct. 6-18 ease. Exhaustion of dementia. 4374 Female.. 35 9 yrs. 8 mos. 22 d. Oct. 8-18 Pellagra. 6000 Male 46 6 mos 3 yrs. 2 mos. 19 d. Oct. 9-18 General paralysis cf the in- 4368 Female.. 36 8 yrs. 9 yrs. 9 mos. 9 d. Oct. 14-18 sane. Cardio-renal disease. 6816 Male 32 Not given... 7 mos. 3 d. Oct. 16-18 Pellacia. 1846 Female.. 70 7 mcs... _ . 24 yrs. 11 mos. 18 d. Oct. 16-18 Carcinomia of uterus. so State Hospital at Morganton Table No. 5 — Continued No. 2422 5086 4919 5927 1615 2867 6672 3568 5663 6766 1082 6165 1837 19 3597 5856 6925 6988 5289 2778 6112 2826 3728 6865 6982 1455 1688 4648 7002 6001 6376 932 2779 5507 4348 3084 3375 3531 6087 581-6 6985 207 5544 5064 6468 3158 6924 5642 6128 5979 Sex Age Female.. 53 Female.. 34 Male 25 Female.. 65 Female.. 51 Female.. 69 Male 26 Male 72 Female.. 44 Male 30 Male 49 Male 69 Male 34 Male 40 Male 66 Male 36 Male 40 Female.. 30 Male (?) Male 35 Male 58 Female. 36 Female. . 50 Female. . 53 Male 35 Male 33 Male 42 Female.. 43 Male 28 Female.. 17 Female.. 65 Female. . 35 Male 61 Female.. 44 Male 36 Female.. (?) Male 49 Female.. 60 Male 27 Male 73 Female.. 33 Female.. 44 Male 67 Female.. 24 Female.. 57 Female.. 22 Male 52 Female.. 34 Female.. 40 Female.. 64 Male 30 Duration of Insanity Before Admission 7 mos. 14 d.. 12 yrs 1 yr. 8 mos 3 mos 2 yrs. 6 mos 1 yr 4 mos.. 1 yr. 6 mos 5 yrs 1 mo. 15 d._ 1 yr 5- yrs 9 yrs 3 yrs 1 yr 2 yrs 3 mos 7d 1 mo. 15 d.. 1 mc. 10 d... 1 mo 5 mos 4 mos ... 2 yrs 2 yrs 6 mos 6 mos 3 yrs 7d 2 yrs 4 mos 1 yr 1 mo 15 yrs Not given. . 3 yis 6 yrs 1 yr 3 or 4 yrs... 1 yr._ 5 mos 5 yis 1 yr 4 yrs 9 yrs 3 yrs 5 yrs 1 yr... 2 yrs 2 yrs Hospital Residence 20 yrs. 1 mo. 7d. 2 mos. 19 d. 9 mos. 9 d. 5d 7 yrs 7 yrs 3 yis. 5 mos. 24 yrs. 3 mos. 25 d. 16 yrs. 9 mos. 5 a. . 1 yr. 1 mo. 18 d. 24 d. 13 yrs. 4 yrs. 27 yrs, 2 yrs 35 yrs, 13 yrs 3 yrs 6 yrs. 17 yrs. 3 yrs. 12 yrs. 6 mos. 7 mos. 10 mos. 10 mos. 10 mos. 23 yrs. 6 mos. 4 mos. 6 mos. 3 mos. 6 mos. 5 mos. mos. 7 mos. 10 mos. 6 mos. 16 d. 23 d. 29 d. 28 d. 2d. 21 d. 27 d. 10 d. 24 d. 19 d. 24 d. 27 6. 17 d. 3 d. 20 d. 22 d. 4d. 1 mo. 8 d. 25 yrs. 7 mos. d. 23 yrs. 10 mos. 1 d. 8 yrs. 7 mos. 18 d. 9 d. 3 yrs. 2 yrs. 28 jrs. 17 yrs. 5 yrs. 9 yrs. 15 yrs. 14 yrs. 13 yrs. 3 yrs. 3 yrs. 34 yrs. 1 yr. 7 yrs. 3 mos. 2 mos. 11 mos. 6 mos. 7 mos. 11 mos. 5 mos. 5 mos. 9 mos. 1 mo. 9 mos. 1 mo. 8 mos. 7 mos. 4 mos. 28 d. 25 d. 26 d. 7d. 2 d. 22 d. 17 d. 4d. 29 d. 13 d. 28 d. 16 d. 9d. 4 d. 28 d. 1 yr. 10 mos. 17 d. 15 yrs. 3 mos. 12 d. 4 mos. 11 d. 4 yrs. 10 mos. 14 d. 3 yrs. mos. 9 d. 3 yrs. 4 mos. 28 d. Date of Death Oct. Oct. Oct. Oct. Oct. Oct. Oct. Oct. Oct. Oct. Oct. Oct. Oct. Oct. Nov. Nov. Nov. Nov. Nov. Nov. Nov. Nov. Nov. Nov. Nov. 16-18 18-18 19-18 24-18 24-18 25-18 27-18 27-18 28-18 29-18 29-18 30-18 30-18 30-18 2-18 4-18 5-18 6-18 7-18 8-18 10-18 11-18 11-18 11-18 11-18 Nov. 11-18 Nov. 13-18 Nov. 16-18 Nov. 16-18 Nov. 17-18 Nov. Nov. .Nov. Nov. Nov. Nov. Nov. Nov. Nov. Nov. Nov. Nov. Nov. Nov. Nov. 18-18 19-18 21-18 21-18 21-18 22-18 22-18 22-18 22-18 22-18 24-18 24-18 24-18 25-18 26-18 Nov. 26-18 Nov. 27-18 Nov. 27-18 Nov. 27-18 Nov. 28-18 Nov. 30-18 Cause of Death , Cardio-ienal disease. Pellagra. Exhaustion of dementia. Acute enteritis. Acute enteritis. Exhaustion of melancholia. Influenza pneumonia. Chronic valvular heart dis ease. Broncho-pneumonia. Influenza pneumonia. Pellagra. Acute enteiitis with diarrhea. Influenza pneumonia. Influenza pneumonia. Apoplexy. Exhaustion of dementia. Apoplexy. Pellagra. Influenza pneumonia. Influenza pneumoriia. Influenza pneumonia. Influenza pneumonia. Exhaustion of dementia. Influenza pneumonia. General paralysis of the in-sane. General paralysis of the in-sane. Influenza pneumonia. Pellagra. Influenza pneumonia. Exhaustion of mania follow ing influenza. Pellagra. Influenza pneumonia. Influenza pneumonia. Influenza pneumonia. Influenza pneumonia. Influenza pneumonia. Influenza pneumonia. Cardio-renal disease. Influenza pneumonia. Cardio-renal disease. Influenza pneumonia. Exhaustion of mania. Cardio-renal disease. Pellagra. Chronic valvular disease of heart. Pellagra. Influenza pneumonia. Chronic endocarditis. Influenza pneumonia. Chronic endocarditis. Influenza pneumonia. State Hospital at Morganton 81 TABLE No. 6 Showing the Occupation of Those Admitted During the Period of Two Years, Ending November 30, 1918. Assistant Register of Deeds 1 Banker 2 Blacksmith 1 Bookkeeper 1 Business man 1 Butcher 1 Carpenter 5 Carpenter and soldier 1 Carpenter's wife • 1 Clerk 1 Clerk in postoffice 1 Cigarette factory operative 1 Commercial agent 1 Conductor • 1 Conductor and switchman 1 Contractor . . . 1 Cotton mill operative 18 District passenger agent 1 Domestic 25 Driver 1 Engineer 1 Farmer 128 Farmer and blacksmith 1 Farmer and carpenter 1 Farmer and laborer 1 Farmer and street car conductor • 1 Farmer's daughter 2 Farmer's son 1 Farmer's wife 7 Farming and housekeeping 1 Fire insurance 1 Fireman on railroad • 1 Foundry worker 1 Furniture factory operative 1 Harness maker 1 Home 1 Horse doctor • 1 Housekeeper 60 Housekeeper at hotel • 1 Housemaid 1 Housewife 98 Housewife and storekeeper 1 Housework 21 Insurance • 1 Laborer • 15 Laundress 1 Loom fixer 1 Lumberman 1 Machinist • 2 Mechanic 2 Merchant • 2 Merchant's wife 1 Mill hand 5 Mill operative • 6 Mill operative and carpenter 1 Miner 1 Minister 3 82 State Hospital at Morganton Table No. 6 — Continued. Mother 1 Music teacher 1 None • 44 Not stated 23 Office writing • 1 Painter 1 Paper hanger 2 Physician 3 Policeman 1 Printer 2 Public works 1 Raised on farm 1 Saleslady 2 Salesman • 2 Salesman and farmer 1 Sawmilling • 1 School boy 1 School girl 2 School teacher 2 Seamstress 2 Shoemaker 1 Soldier 1 Stationery engineer ., 1 Stenographer 4 Student 1 Telegraph operator 2 Textile worker 2 Trained nurse 1 Transfer man 1 Typesetter 1 Wage hand 2 Water boy 1 Weaver in cotton mill 1 Wife 1 Work in hotel 1 TABLE No. 7 Showing Civil Condition of Those Admitted During the Period of Two Years Ending November 30, 1918. Male Female Total Married 145 197 342 Single 94 93 187 Widowed 11 24 35 Divorced 2 2 Not stated 2 2 4 Totals ! 254 316 570 FINANCIAL STATEMENT From December 1, To appropriation for 1917 1916, to November 30, 1917. Dr. $ 20,753.86 22,987.20 20,789.06 $ 237,500.00 To overdrawn vouchers of 1917 25,291.52 Cr. red for: $ 262,791.52 By vouchers issued and appro\ December, 1916 _ $ January, 1917 February, 1917 - - _ - _ - - _ - - - - Total for first quarter 64,530.12 March, 1917 $ 21,494.79 20,265.18 21,806.97 April, 1917. May, 1917 Total for second quarter 63,566.94 June, 1917 $ 19,714.64 25,316.08 19,596.42 July, 1917 August, 1917 _ Total for third quarter 64,627.14 September, 1917 $ 20,992.80 22,600.17 26,474.35 October, 1917 November, 1917 . . . . . . . 70,067.32 $ 262,791.52 84 State Hospital at Morganton Financial Statement—Continued. From December 1, 1917, to November 30, 1918. Dr. To appropriation for 1918 To amount borrowed from banks Cr. By vouchers issued and approved for: December, 1917... January, 1918 February, 1918 Total for first quarter. March, 1918. April, 1918.. May, 1918... Total for second quarter. June, 1918 July, 1918 August, 1918 Total for third quarter. September, 1918. October, 1918 November, 1918. Total for fourth quarter. Recapitulation To appropriation for 1917. To appropriation for 1918. To cash borrowed By vouchers for 1917. By vouchers for 1918. 20,172.93 20,776.19 19,915.80 24,616.15 21,924.94 18,126.85 27,314.43 21,720.46 27,691.69 24,135.21 19,874.10 20,939.73 $ 262,791.52 267,208.48 $ 530,000.00 237,500.00 55,000.00 $ 292,500.00 $ 60,864.92 64,667.94 76,726.58 64,949.04 $ 267,208.48 237,500.00 237,500.00 55,000.00 $ 530,000.00 State Hospital at Morganton 85 CLASSIFIED EXPENDITURES From December 1, 1916, to November 30, 1918. Salaries, superintendent and physicians. Salaries, office force Salaries, and general labor Salaries and farm labor.. Bacon Beef.. Pork Hams and sausage Poultry... Fish and oysters Butter and oleo Eggs.... Flour Corn meal. Hominy and oat flakes Rice Cheese.. Crackers Molasses and syrup Coffee and tea Sugar Salt Lard and compound Baking powder and yeast Spices and vinegar... Fruits Vegetables.. Tobacco Soap, starch, and blueing Stamps and stamped envelopes. Stationery and piinted blanks.. Telegrams and telephone rent... Dry goods and notions Ready-made clothing Hosiery Shoes Shoe findings and leather Hats and caps... Furniture Bedding Carpets and matting Brooms and dusters Crockery and tinware Kitchen utensils Coal Wood Ilium inating oil Gasoline, candles, and matches. Drugs and liquors. Surgical instruments. Medical literature Extra physicians and sundries. . Amusements Ministerial services Directors' expenses. Travelling expenses 9, 4, 46, 11. 36, 13, 1, 1. 4, 2, 16, 4, 1, 1, 16, 2, 2, 7, 12, 175.81 101.37 228.93 735 .99 971 .42 722 .48 44.11 244 .96 562.13 480.85 465 .00 041 .07 203 .51 388 .86 525.36 248 .28 170.79 209 .03 209 .31 671.12 071 .70 275 .65 676 .04 900 .41 208 .54 348 .40 251 .76 802 .50 108 .49 425 .00 300 .22 189 .70 898.65 820 .76 445 .42 201 .40 429 .03 579 .36 17.55 144 .82 45.00 403 .49 829 .33 1.15 563.21 1, 37.35 400 .04 610.81 8.41 28.00 114.56 195.13 212.48 838.81 246.15 1918 7,830.08 4,484.78 57,933.73 11,678.07 36,229.69 13,877.54 581 .45 1,218.31 3.10 5,517.90 2,148.77 17,897.16 4,023.70 1,049.25 1,082.17 2.80 128.12 3,551.77 1,205.82 2,578.73 310.40 960.84 985 .06 267 .24 1,017.36 2,285.83 3,624.62 1,970.91 600 .00 312.47 157 .06 11,951.21 3,214.12 912.07 3,221.80 103 .50 10,556.93 725 .94 1,524.52 11,556.91 1,538.50 14.85 789 .74 1,084.02 2.72 16.59 105 .72 186 .48 162 .48 1,295.57 223 .58 86 State Hospital at Morganton Classified Expenditures—Continued. Freight on foods Freight on dry goods and notions Freight on furniture Freight on fuel Freight on drugs.. Freight on farm supplies Freight on repairs Express Fertilizer Seeds and plants Corn, bran, and oats Forage Horses and mules... New Machineiy and implements Machine parts Electric fittings Lubricating oils Ammonia Wagon paits and repairs.. Farm implements, parts and repairs. Blacksmith expenses... Lime and cement Paints, oils, glass, and putty Sundries Lumber and nails 1917 2,081.25 344 .62 233 .04 13,407.49 20.57 511.14 501 .53 137 .06 2,569.01 1,258.75 3,176.25 3,655.31 69.00 253 .05 1,656.22 710.00 336 .52 58.24 14.30 354.15 157.26 6.75 1,087.94 1,164.27 % 262,791.52 1918 1,883.50 166 .33 292 .58 16,499.42 13.45 226 .62 165.21 90.31 823 .75 1,155.93 1,156.10 5,287.63 130 .80 2,283.96 414 .44 216.63 28.20 383.61 41.48 23.10 533 .48 625 .89 64.08 $ 267,208.48 State Hospital at Morganton 87 STEWARD'S REPORT OF SPECIAL FUND From December 1, 1916, to November 30, 1918. Dr. To balance brought forward To receipts support and maintenance. Board officers families. County claims „.. Sale of drugs Shops Green house Farm and garden Calves and pigs Hides Barrels, sacks, and boxes Store room Coal Sundiies Totals. Cb. By paid returning escaped patients By paid County claims, patients to hospital. Woman's building Gas tank, range and pay rolls V/i ton truck.. New barn Pay rolls for repairs Calves and freight Farm tractor Vouchers for support Total disbursements- Balance carried over. 1917 51.03 829 .05 3,834.31 3,291.84 2,253.32 % 10,259.55 $ 10,685.62 1918 $ 10,117.97 $ 10,685.62 3,540.96 5,404.05 295 .00 78.61 1,023.36 366.59 8.61 23.42 80.00 33.88 96.02 85.00 129 .52 101.18 80.00 285 .07 2,820.74 936.65 169 .84 192.92 42.01 31.74 428.17 692.97 2,112.97 3,816.55 $ 20,945.17 % 22,734.25 48.67 24.92 3,975.45 4,440.01 2,106.15 3,037.53 1,392.25 5,002.03 20,027.01 2,707.24 88 State Hospital at Morganton REPORT OF FARM AND GARDEN From December 1, 1917, to December 1, 1918. Hay pounds Green hay pounds Fodder .bundles Tops bundles E