Report of the Board of Trustees of the Northern Michigan Asylum at Traverse City June 30, 1900.

Report of the Board of Trustees of the Northern Michigan Asylum at Traverse City June 30, 1900.

Asylums--Michigan--Traverse City--History.

Psychiatric hospitals.

Report of the Board of Trustees of the Northern Michigan Asylum for the biennial period ending June 30, 1900. This report includes the reports of the medical superintendent, treasurer and steward.

Board of Trustees of the Northern Michigan Asylum at Traverse City.

Original document held by Traverse Area District Library.

Lansing: Wynkoop Hallenbeck Crawford Co., State Printers.

30 June 1900

State of Michigan.

This document is in the public domain.

See other reports from the Board of Trustees in the "Traverse City State Hospital" Digital Collection.

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English.

Document.

TCSH0016

Traverse City, Grand Traverse County, Michigan.

REPORT

BOARD OF TRUSTEES

ASTIB
TRAVERSE CITY
JUNE 30, 1900

BY AUTHORITY

1900
WYNKOOP HALLENBECK CRAWFORD CO. OF LANSING, MICH.
STATE PRINTERS

OFFICERS OF THE NORTHERS MICHIGAN ASYLUM.

TRUSTEES.

H. C. DAVIS,
OHAS. F. BACKUS,
THOS. T. BATES,
W . W . CUMMER,
JOHN MAYWOOD,
H. D. CAMPBELL,

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TRAVERSE CITY.
- DETROIT.
TRAVERSE CITY.
.
. CADILLAC.
BAD AXE.
- TRAVERSE CITY.

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RESIDENT OFFICERS.

JAMES D. MUNSON, M. D.,
A. S. EOWLEY, M. D.,
G. L. NOYES, M. D.,
1
F. P. LAWTON, M. D., I
C. A. GOOD, M. D.,
>
J. F. CANAVAN, M. D.,

MEDICAL SUPERINTENDENT.
ASST. MEDICAL SUPERINTENDENT.
ASSISTANT PHYSICIANS
HYSiciANh.

•

NON-RESIDENT OFFICERS.

C. L. WHITNEY,
W. P. MANTON, M. D.,
THEO. KLINGMANN, M. D.,

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REV. D . COCHLIN,

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STEWARD.
DETROIT, MICH., GYNECOLOGIST.
ANN ARBOR, PATHOLOGIST.

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CHAPLAIN.

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TRAVERSE CITY.

TREASURER.

J . T . HANNAH,

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TRAVERSE CITY.

NORTHERN MICHIGAN ASYLUM.

REPORT OF THE BOARD OF TRUSTEES.

To the Governor and Legislature of the State of Michigan :

In accordance with the provisions of the law, the trustees of the
Northern Michigan Asylum have the honor to submit their report
for the biennial period ending June 80, 1900, and also the reports of
the medical superintendent, treasurer and steward.
Eighteen regular meetings of the board have been held. Monthly inspections of the asylum, as heretofore, have been made by a visiting
committee of the trustees.
It affords us great pleasure to speak of the excellent condition of the
asylum and of the general well being of the patients. Aside from organic diseases, the hospital has been measurably free from sickness
and exempt from epidemics and serious accidents of any kind.
We would also bear witness to the efficiency with which the officers
and all others in the employ of the institution have performed their
duties. The period has been an active one in improving and enlarging
the institution, farm, etc., all of which will be fully detailed in connection with this report.
Prom the beginning of the period until the opening of the new hospital
for men in March, 1900, the asylum was unable to receive all patients for
whom treatment was desired, and as a result many curable patients
have become incurable while awaiting treatment. During the years in
which the asylum wras able to care for all cases the number of recoveries
was comparatively large, but during the last two years preference was
given to the admission of those patients who had developed dangerous
tendencies or who had become burdens on their friends by reason of
degraded habits. • The recent cases were thus deprived of asylum care,
and the cures for the period have consequently been few. The average
duration of the asylum life of an insane individual is said to be about
ten years. The cost of maintenance of each insane person is about f 175
per year; so it is clear that from an economic standpoint only it is
greatly to the advantage of the State to provide ample room, to the end
that the insane may have the advantage of prompt medical treatment.
The number of patients under treatment during the period was:
Males, 708; females, 568; total, 1,276. The number of patients admitted
was: Males, 156; females, 111; total, 267. Of this number there were
admitted at county expense as follows:

NOETHEEN MICHIGAN ASYLUM.
Alpena
Antrim
Arenac
Alcona
Benzie
Oharlevoix
Clare
Crawford
Cheboygan
Emmet
Gladwin
Grand Traverse
Gratiot
Isabella
losco
Ionia
Kalkaska
Lake ..

6

Leelanau

6 Manistee
fi Mason
S Mecosta

Midland
Missaukee
Moutcalm
Montmorencv
Muskegon
7 Newaygo
1 Oceana
19i Ogemaw
..
4
2
1
1

°0

4

Otsego
Presqae Isle

00

Wexford

Non-resident State
Permanent State
Military State
Private.

(>
12

.

8
8
6
3
22
8
27
4
9
3
9
2
2
8
H

1
9

Of the 267 patients admitted:
9 had been confined in county houses.
47 had been confined, in jails.
20 had been treated in other asylums.
37 were said to have been destructive.
23 had attempted or threatened suicide.
63 were homicidal or had made homicidal assaults.
50 had been confined or restrained at home.

i.

From this it is found that over thirty per cent of the number admitted
had been either homicidal or suicidal; and further, it may be seen that
but few cases were suffering from acute insanity.
As compared with the preceding period, there was a small decrease
in the number of patients admitted—267 against 306 for the former
period. Two years ago there were about thirty patients awaiting admission; at the present time about forty, nearly all of whom are women.
The net gain in patients under treatment in the hospital has been 41,
owing largely to the opening of the new hospital for men.

COST OF MAINTENANCE.

The cost of maintenance of patients, apart from medical supplies,
nursing, food, fuel, furniture, etc., includes ordinary repairs to buildings,
farm improvements, walks, fences, care of grounds, replacing of furniture, machinery, etc. In fact, all expenses, save those of salaries of
officers, clothing, and such damages as patients do to buildings or
furniture, are included in the rate charged for maintenance. As stated
in our last report, if the rate charged for maintenance did not include
all of these items of expense, each Legislature would be called upon
for appropriations to meet them, which would necessitate delay, and

REPORT OF THE BOARD OF TRUSTEES.

7

the cost of repairs would be increased by secondary damages incident
to neglect of repairs. Prompt attention to needed repairs will in the
long run effect a great saving.
The cost of maintenance per patient per day for the last fifteen years
has been as follows:
Eighteen hundred eighty-five, fifty-three cents; 1886, fifty-three cents;
1887, fifty-two cents; 1888, fifty-one cents; 1889, fifty cents; 1890, fortynine cents; 1891, forty-nine cents; 1892, forty-eight cents; 1893, fortyeight cents; 1894, forty-seven cents; 1895, forty-six cents; 1896, forty^
four cents; 1897, forty-two cents; 1898, forty-two cents; 1899, forty-four
cents. The rate has been fixed for 1900 at forty-four cents per day.
The net increase of patients for each biennial period since the opening
of the institution has been as follows: From 1886 to 1888, 148; from
1888 to 1890, 131; from 1890 to 1892, 123; from 1892 to 1894, 150; from
1894 to 1896, 53; from 1896 to 1898, a decrease of 4; from 1898 to 1900,
an increase of 41.
The number of patients discharged during the period was: Males,
123; females, 103; total, 226. Of this number 18 were discharged recovered, 92 improved, 20 unimproved, and 96 died. The percentage of
recoveries on the total number under treatment was 1.4; on the number
admitted in 1898-9, 9; and 1899-1900, 5.
The death rate was 39 per thousand in 1898-9, and in 1899-1900 44 per
thousand.
The readmissions for the period were: Males, 15; females, 19; total,
34. The readmissions from the beginning have been: Males, 109;
females, 94; total, 203, and the total number of admissions, 2,844, therefore represents but 2,641 individuals.
The daily average number of patients was 1,018.9. The number of
"weeks spent in the institution by patients was 106,261.28. This shows
an increase of 13.5 in the daily average, and of 1,360.28 weeks' board
over the last preceding period.
On June 30, 1900, there were 917 patients under treatment at State
expense, 120 at county, and 13 at private expense. Since House Enrolled Act No. 329, Laws of 1899, became operative, a much larger
number of patients are supported by the State. We believe that it
would be more advantageous if all patients became wards of the State
from the time of commitment, and that it should be a part of the duty
of the asylum to send an attendant to accompany the patient to the
asylum after notification by the probate judge to do so. Ordinarily
one attendant would be able to bring a patient alone from his home,
saving in this way more than half the cost of the conveyance of the '
patient to the hospital, as is necessitated by the existing law.
There were 229 persons employed by the asylum on June 30, 1900, in
the positions and at the wages given in the schedule accompanying this
report.

NORTHERN MICHIGAN ASYLUM.

IMPROVEMENTS.

The permanent improvements hare not been extensive. The most
important are those in connection with the clearing of the farm and
development of the grounds, the extending of steam mains from the
central plant to the cottages for men, and the replacing of one steam
boiler. Formerly the cottages for men were warmed by separate heating systems in each building—a dangerous and expensive method. The
saving in fuel during the last winter, using central heating, nearly
covered the cost of putting in the new system. Early in the winter of
1899, a boiler which had been in use for a number of years became damaged to such an extent that it was not believed to be worth repairs.
As this boiler supplied the steam for heating the cottages, there was no
alternative but to replace it. Consequently a contract was made with
Wickes Brothers, of Saginaw, Mich., for a Wood water-tube boiler of
150 horse-power capacity, to cost |2,250. This boiler was installed and
ready for operation in February, 1899, and has proved very efficient.
A large number of minor repairs were required in connection with the
heating plant, water mains, closets, etc. Nearly all of the large steam
pipes in the general kitchen had to be replaced, as well as many others
in various parts of the main building. In the course of the next few
years nearly all of the steam pipes will have to be renewed.

THE FARM, GARDEN AND GROUNDS.

The real estate owned by the asylum comprises 628 acres, of which
195 acres are forest, timber belts,, parks, lawns and grounds, 35 acres
stump lands in process of development, and 398 acres under cultivation.
Another year will find all land not reserved for park and forest ready
for use.
The results from the farm and garden have been satisfactory during
the past two years. The value of crops and proceeds from the stock
amounted to $51,554.02, while the total disbursements on account of the
farm were f33,269.49. A portion of the latter were for permanent improvements and the cost of maintenance and care of carriage and
express teams employed by the institution. To the disbursements should
be added the value of farm products used in the production of milk,
meat, etc., $5,198.15, making ~a total running cost of $38,467.64, which
leaves a balance in favor of the farm of $13,086.38. To this should be
added the value of the permanent improvements, the machinery bought,
and the increased value of stock and farm. A detailed statement of
farm products and their value, and of the farm disbursements, will be
found in the Steward's report.

REPORT OP THE BOARD OF TRUSTEES.

THE STOCK.

The herd of Holsteins has been increased. Two years since there
were 53 thoroughbreds and a few graded animals. Now there are 81
thoroughbreds and 13 grades. The average number of cows during the
period was 44—49 the first and 39 the second year, the amount of milk
the second year being greater than that of the first. The total amount
of milk for the period was 1,091,331 pounds, an average of 34 pounds a
day for each cow. Compared with the preceding period (that of 1897-8)
the improvement in the herd is noticeable, as there has been a net gain
of 8 pounds a day for each cow. In 1896 we stated that by careful
selection the herd could be brought up to an average of 35 pounds a
day. In 1897 the herd gave an average of 25 pounds; in 1898, 30 1-5; in
1899, 35 1-5, while for the six months of 1900 the average has been 38
pounds per day. This shows what careful selection will do for a herd.
In addition to the herd of cows, steers have been fattened, keeping
20 to 30 on hand most of the time. This practice protects the institution from sudden scarcity and furnishes a better quality of beef than
can usually be obtained, and withal is a source of considerable profit.
From the beginning it has been our effort to render the farm of the
greatest use. Apple, peach, plum, cherry orchards and vineyards were
planted and small fruits of all kinds cultivated. Further than this, nutbearing trees, walnut, butternut, hickory, pecan and chestnut were
planted in large numbers. Also especial attention has been given to
gardening, all with the ultimate aim of furnishing abundant fruits and
garden products to the patients.

THE PATHOLOGICAL LABORATORY OF THE MICHIGAN ASYLUMS.

Two years ago, through the efforts of the Eegents of the University
and the Joint Board of Trustees of the Asylums, a pathological laboratory for the Michigan asylums for the insane was established at the
University, the work to be carried on under the direction of the chair
of Pathology at the University, the pathologist to be appointed by the
asylums on nomination by the University authorities, and his necessary
traveling expenses and salary of $500 a year to be paid by the several
asylums by equal assessments. This department has now five laboratories—one at each hospital, and a central laboratory at the University,
all of which are under the direction of the pathologist. The pathological staff consists of five memjbers, who give nearly their whole time to
This work, which consists of clinical investigation and pathological
anatomy. There is one assistant at each asylum, one at the central
laboratory, and the pathologist. The duties of the assistants at the
hospitals relate to pathological, clinical and laboratory work, the tak:
ing of special histories of cases selected by the superintendent and
2

HOSPITAL FOR ACUTE INSANE-(MEN)-

10

NORTHERN MICHIGAN ASYLUM.

pathologist as suitable for special study, and of making careful, systematic clinical examinations. This includes bacteriological examinations, urine analysis, blood examinations, etc. Careful records are
kept of all work for future reference.
The work in the central laboratory consists in the study of special
cases, experimental pathology, comparative anatomy and pathology.
Monthly meetings of the pathological staff are held at the various
asylums and at the central laboratory. The object of the meetings is
that each assistant may become familiar with the work at the various
asylums and at the central laboratory, and to bring the asylums in
closer relation with each other.
The work thus far accomplished by this department has, aside from its
scientific importance, been of great value in the development of more
accurate methods of clinical observation and investigation of diseased
conditions coming under observation, and of applying more scientific
treatment for the relief of such conditions. The expense attending the
work of this department has been modest, but if it is to be continued
and made highly practical, a law should be enacted providing for the
appointment and compensation of a pathologist and for the necessary
expenses of the assistant pathologists. In view of the importance of
the work, we would most respectfully recommend to your honorable
body that this department be given legal existence.

SPECIAL APPROPRIATION—$20,000.

This appropriation was made by the last Legislature (see Act 121,
Public Acts of 1899) for "the erection of one male hospital for the
acutely insane, to accommodate fifty patients, and complete in every particular." Although the act was given immediate effect, the money
did not become available until February, 1900. With the consent, however, of the Auditor General the board commenced the building in
August, 1899, meeting payments on contracts for material, labor, etc.,
from the general fund of the asylum. By this means the building was
well under way at the beginning of the present year and was ready
for occupancy March 13, 1900. The estimates upon which this appropriation was made were prepared in October, 1898, before the advance
took place in the price of building material. Although every possible
item of cost was eliminated in the construction of the new hospital,
its cost complete, ready for use, will exceed slightly the appropriation,
but it is believed that a sufficient saving can be made in the companion building for women to make up the deficiency. The stress for
room in the asylum district was so urgent jt became imperative to finish
the building.
The new hospital for men is especially arranged for the treatment of
curable cases. The floor space is ample, and there are sufficient single
rooms to meet the needs of quite varied mental conditions as well as
individual preferences of patients. It is believed better results will be

REPORT OF THE BOARD OF TRUSTEES.

11

obtained by the separate care and treatment of recent cases than has
heretofore been possible. Patients can now be received, treated and
discharged without coming in contact with chronic cases. The building
is constructed of stone and brick, and it is finished throughout in pine
and hardwood. The heating and ventilation are from plans approved
by the State Board of Corrections and Charities and the State Board
of Health. The hospital is finely located just south of Cottage B and
has a pleasing outlook over Grand Traverse Bay, the city, the asylum
grounds and the surrounding country. The accompanying photograph
will give a general idea of the building. The cost of the hospital was as
follows:
Wages
Stone and brick
Lime, cement, tiling, etc
Lumber, shingles, frames
Hardware and iron
Heating apparatus
Plumbing, electric light
Furniture, bedding, etc

fixtures

$7,310 67
4,849 21
885 80
3,544 85
647 31
1,089 15
707 92
898 15
$19,933 08
•

On June 30, 1900, there remained in the hands of the treasurer to the
credit of this appropriation, f 66.94.

SPECIAL APPROPRIATION—$20,000.

This appropriation was passed by the last Legislature "for the erection of one women's hospital for the acutely insane, to accommodate
fifty patients, and complete in every particular." The general arrangement of this hospital is similar to that of the building for men above
described. It is, however, one foot narrower and four feet shorter;
this was thought necessary in order to reduce the cost somewhat. Owing to a more favorable location, the basement walls will
cost less than those of the building for men, so that with the slight
reduction in size and the lessened cost of material in the women's building we believe that the two hospitals can be finished complete within
the appropriations made for them. The building was commenced in
April, and the brick work is finished and the roof nearly on at the
present time; and it will be ready for occupancy about the 1st of November, 1900. It is beautifully located just north of the main building.
The disbursements on account of this appropriation have been as
follows:
........................................................
Stone, brick, lime and cement
................
'
....................
Lumber and shingles
.............................................
Heating apparatus
...........
..........................
............
Furniture and bedding
...........................................

$3,060 81
3,362 42
1,594 99
638 48
492 50
$8,149 20

12

NORTHERN MICHIGAN ASYLUM.

On June 30, 1900, there remained in the hands of the treasurer to the
credit of this appropriation, |11,850.80.
Special appropriation, home for nurses
Special appropriation, fireproof vault
Special appropriation, pathological laboratory

|5,450 00
1,200 00
1,500 00

Work on these buildings has not been commenced, although it will be
in the near future and they will be completed during the present year,
with the exception possibly of the home for nurses. On comparing thn
estimates prepared for the nurses' home, as presented to the State
Board of Corrections and Charities in October, 1898, with present prices
of material, it is found that the appropriation will not be sufficient to
complete it, if constructed as originally planned. This building will
not be commenced until the others are finished, in order that any balances remaining from the other appropriations may be transferred to
this building fund, as provided by the act. If it is found it cannot
be built within the appropriation, work upon it will be deferred until
after your honorable body can act and an additional appropriation
passed for its completion. At the present cost of material about f 1,500
additional^will be needed to build and furnish the home as contemplated
by the plans.

SPECIAL APPROPRIATION—$2,000.

This appropriation was made by the last Legislature for the purchase
of forty acres of land from Hon. Perry Hannah. When the survey of this
tract was made it was found to contain 41.13 acres, or 1.13 acres more
than provided for by the act of purchase. T,he 1.13 acres was paid for
from the general fund of the institution, and the State entered into
possession of the property in June, 1900. This land adjoins the asylum
farm on the south, is well located, and is a valuable addition to the
asvlum domain.

SPECIAL APPROPRIATION—$500.

This appropriation was granted by the last Legislature for an addition to the asylum library. Much care has been given to the selection
of books and an order has been placed for about 250 volumes. Further
purchases will be made in the near future as fast as the books can be
selected. There remained to the credit of this fund in the hands of the
treasurer June 30, 1900, $484.28.

REPORT OF THE BOARD OF TRUSTEES.

13

NEEDS OF THE ASYLUM.

We would respectfully ask of your honorable body an appropriation;
of $3,860 to continue the repairs to the roofs and gutters of the asylum
buildings. The roof over the administration building is in very bad
condition and must be replaced. Much damage has already been done
to the building, and if further is to be prevented repairs must be provided for at once. Many of the gutters have been badly broken by
accumulations of snow and ice, and there has been much wetting of
walls both outside and inside of the building. These damages are becoming worse from year to year, and means should be provided for their
prompt repair. Many gutters have been filled and then roofed with
copper, which has permanently corrected the defects as far as the repairs
have been extended.

INCREASED ACCOMMODATIONS.

The new building completed and the hospital under construction will
no more than meet the requirements of the asylum district to the close
of the present year, and to care for all the insane of the district for the
next two years will require additional room for fifty patients of each
sex. During the last three years the asylum has been constantly overcrowded and unable to promptly care for patients for whom application
was made, and as a result patients have been too often kept waiting
until their mental illness had become incurable. With ample room, at
least fifty per cent of recent cases recover, while if treatment is delayed
by want of accommodations, the majority of curable become incurable
cases. The experience of the asylum for the past year has been in
proof of this statement. Out of the 146 cases admitted there were only
seven recoveries, while had there been sufficient room for their prompt
reception, no doubt a much larger number would have been discharged
recovered. This entails to many patients the most distressing of all
misfortunes—chronic mental disease—and also entails a great financial
loss to the State. Our State constitution declares that "institutions for
the benefit of those inhabitants who are deaf, dumb, blind or insane,
shall always be fostered and supported." We would respectfully recommend to your honorable body that an appropriation of $21,367 be made
for an additional cottage for fifty men, and $21,367 for an additional
cottage for women, in connection with this asylum and for this asylum
district.

HOSPITAL FOR TUBERCULOUS WOMEN PATIENTS.

Perhaps one of the most pressing needs of the asylum is provision
for the separate care and treatment of the tuberculous insane.
Tuberculosis is a very frequent cause of death of asylum inmates, and

14

NORTHERN MICHIGAN ASYLUM.

although every effort has been made for a number of years to lessen
infection, yet there has been no great decrease in the death rate from
this cause. This is due to the fact that not only new cases are being
admitted, but patients within the hospital become infected, and that
overcrowding is the rule, which, besides directly increasing the possibility of infection, brings about a condition of low vitality strongly predisposing to phthisis.
From 1885 to the present time 20 per cent of all deaths in the Northern
Michigan Asylum were caused by tuberculosis. The lowest death rate
during any biennial period was 14 and the highest 29 per cent of all
deaths. During the last fifteen years the deaths from tuberculosis to
1,000 of asylum population were as follows:
1885-6, 7 to
1887-8, 16 to
1889-90, 8 to
1891-2, 10 to

1,000.
1,000.
1,000.
1,000.

1893-4, 15.6
1895-6, 10.6
1897-8, 6 to
1899, 7.8 to

to 1,000.
to 1,000.
1,000.
1,000,

Average for 15 years, 10.12 to 1000.

According to Crookshank, all the asylums of England and Wales for
the year 1897 gave 14.6 deaths to 1,000; all the Scottish, 10.4 to 1,000,
and the London County Asylums, 9.8 deaths to 1,000 of asylum population. The average for the English asylums in 1897 was 10.17 to 1,000
of asylum population.
According to statistics gathered by Dr. Arthur H. Harrington from
sixty-seven American asylums for the five years ending January, 1900,
the deaths from tuberculosis were 14.8 per cent of the total number of
deaths in these sixty-seven asylums. His statistics further show that
in the New England States the death rate from tuberculosis of the
whole number of deaths in all institutions heard from was 11.9 per cent;
in the Middle States, 13.5; in the West and Southwestern States, 15.2,
and in the Southern States, 20 per cent. He further shows that the
percentage of deaths from tuberculosis in individual asylums varied
from less than 5 per cent to over 60 per cent.
It is now almost undisputed by sanitarians that tuberculosis is an
infectious disease. If it is true that tuberculosis is several times more
frequent in asylums than in the general population, then a grave duty
rests upon the State to especially provide for its consumptive insane,
in order to lessen suffering and death and to reduce the possibility of
infection of the non-tubercular, both patients and nurses, to a minimum.
The general arrangement of our asylums promotes rather than prevents
the diffusion of disease germs. As Crookshank well says, "Surely it
would be difficult to find institutions which afford such opportunities
for the dissemination of disease germs as do our asylums. ^Consider a
community existing under conditions that preclude for many adequate
exercise in the open air; spending long hours in overcrowded day rooms
and dormitories; a community of filthy and careless habits and already
phthisical in proportion of from 15 to 25 per cent. * * * Nowhere,
save in asylums, are there such aggregations of tubercular persons
whose malady is complicated by persistently uncleanly habits." In
order to prevent the non-tubercular insane from infection by the tuberculous and to carry out modern curative treatment, we would respect-

REPORT OF THE BOARD OF TRUSTEES.

15

fully ask an appropriation of $12,067 for a hospital to be erected on
the asylum grounds for the care and treatment of fifteen women patients.
Such a building should be complete within itself, with day rooms, sun
rooms, piazzas, baths, kitchen and laundry. Every means should be
provided for the sterilization of clothing, bedding, etc., and for open
air, light, and judicious work and exercise. We cannot too strongly
urge upon your honorable body the value of such a provision for the
asylum. Nearly all asylum officers are urging separate buildings for
the care of the tuberculous insane. Several states in particular have
made provision for the proper isolation and care of such cases. Dr.
Harrington says that at the Lancaster County Asylum, England, where
separate buildings were constructed a few years ago, the death rate
from consumtion has been reduced nearly one-half, and that "Dr. A. B.
Beattie, of the Southern Illinois Hospital, writes me that a separate
cottage was constructed a few years ago for tuberculous female patients.
Since that time the number of tuberculous female patients has been
markedly reduced." Orookshank says, "It will be urged against any
such scheme as this (the building of separate hospitals) that the expense would * * * be prohibitive, but the initial expense of erecting these asylum sanitaria for individual or grouped asylums would be
little more than the cost of provision for the inevitable increase in the
number of lunatics that in every case has to be faced."

NEW BOILER.

An appropriation of f2,850 is respectfully requested of your honorable
body for the purchase and installation of a 150 horse-power water-tube
boiler for the central heating plant of the institution. The asylum
now has four boilers of 650 horse-power aggregate capacity, but the
two new buildings added during the past year will draw heavily ut)on
them. In winter there is no boiler in reserve, and should accident
occur it might leave the institution in a most unfortunate condition.
Further, if the appropriations requested for two additional cottages be
granted, at least one of them should be heated from the central t> ant,
not only for economic reasons but because it lessens greatly the danger
of fire. In this case an additional boiler would be imperative. We
would respectfully ask your honorable body to give this appropriation
careful consideration, as it is a matter of the utmost importance to the
institution.

ADDITIONAL LAND.

An appropriation of $3,200 is requested for the purchase of forty acres
of land. This tract corners into the asylum farm on the southeast and
access to it is by a road crossing a portion of the asylum grounds. It
is within the city, is growing in value, and should be acquired by the

16

NORTHERN MICHIGAN ASYLUM.

State to prevent its sale into small lots and encroachment upon the
asylum frontage. The asylum farm, apart from parks, roadways, etc.T
contains about 400 acres under cultivation. Within a year the farm
will be fully reclaimed, after which the men patients will have comparatively little work that they can do. The farm is yearly yielding a
greater profit, and as a business proposition we would urge not only
the purchase of this land but that of other adjoining tracts, until all
has been acquired that can be profitably worked by the institution.
The minimum amount of land required for asylums is thought to be one
acre for each patient. The asylum farm has a total acreage of 628, and
the number of patients will reach 1,100 before the close of this period.
Prom this it may be seen that the asylum has less than one-half acre
under cultivation for each patient. Therefore, we would strongly urge
the purchase of this land. Lands that fifteen years ago could have
been purchased at from f25 to f65 per acre are now worth from f50 to
$600 per acre. It would be wise to purchase needed land at as early
a date as possible, as each year adds to the value of acreage adjoining
the asylum.

RECEIPTS AND DISBURSEMENTS.

The total receipts of the asylum for the fiscal year ending June 30,,
1899, including cash on hand to the credit of the general fund and officers' salaries, were f208,333.56; and the total disbursements for the
same period, including amount of officers' salaries, were $184,524.05.
The total receipts of the asylum for the fiscal year ending June 30,
1900, including cash on hand to the credit of the general fund and
officers' salaries, were $262,237.75; and the total disbursements for the
same period, including amount of officers' salaries, amounts expended
special appropriations male hospital, female hospital, fire-proof vault,
nurses' building, forty.acres of land, library and pathological laboratory, were $224,083.94!
There was at the close of the biennial period ending June 30, 1900,
$38,153.81 in the hands of the treasurer, $26,351.18 of which amount wasto the credit of the current expense account, and the balance, $11,802.63,
unexpended balances to the credit of special appropriations account.

OFFICERS.

In August, 1899, Hon. L. Roberts' term of office as trustee expired,
Mr. Roberts had been connected with the board for a period of twelve
years and for the last two years was its president. Mr. Roberts ever
took the greatest interest in the institution and showed great devotion
to its welfare. In his retirement from the board he carried with him
the kindest regards, not only of his associates on the board, but of the
officers and all connected with the asylum.

REPORT OP THE BOARD OP TRUSTEES.

17

In August, 1899, Hon. H. D. Campbell, of Traverse City, was appointed
to succeed Mr. Roberts. Mr. Campbell brings to the board a varied and
ripe business experience, and doubtless will make a very valuable
trustee.
In August, 1899, Hon. C. F. Backus, of Detroit, was reappointed. Mr.
Backus' reappointment was a just recognition of his services to the
institution.
In September, 1898, Dr. May Fonda Nadeau was appointed assistant
physician on the staff.
She resigned January 1, 1900, to engage in
private practice.
In June, 1899, Drs. J. F. Canavan and D. L. Harris were appointed
internes. Dr. Harris resigned his position in September to accept a
position at the Worcester Hospital for the Insane, at Worcester, Mass.
In April, 1900, Dr. Canavan was appointed to the staff.
In May, 1900, Dr. Minta Proctor Kemp, of Sault Ste. Marie, accepted
an appointment as assistant physician on the medical staff. She will
begin her duties in July, 1900.
We would respectfully invite inspection of the asylum and its methods. We would especially ask you to investigate the needs of the
institution, and would also invoke your aid in furthering the care of
the insane.
Dr. J. D. Munson, the medical superintendent, has been in charge of
the institution since the date of opening, fifteen years ago. To his
efficient management, not only as a medical, but as an executive officer,
is very largely due the success and excellent reputation the institution
has attained. The board of trustees again express in the most cordial
manner their high regard for him and their appreciation of his valuable
services. We also desire to thank the entire medical staff for their
faithful work and untiring efforts for the good of the institution and the
comfort and well being of the patients. The steward, Mr. C. L. Whitney, who has so thoroughly proved himself a capable and efficient
official, is also entitled to the thanks of this board for the good work
he has done. And the faithful and painstaking work of the attendants
and employes of the asylum is fully appreciated by the board.
H. C. DAVIS,
T. T. BATES,
W. W. CUMMER,
JOHN MAYWOOD,
C. F. BACKUS,
H. D. CAMPBELL,
Trustees.
Traverse City, June 30, 1900.
3

T R E A S U11E R ' S R E P 0 R T.
ABSTRACTS
OF ACCOUNTS CURRENT OF THE RECEIPTS AND DISBURSEMENTS AT THE NORTHERN
MICHIGAN ASYLUM, ON ACCOUNT OF CURRENT EXPENSES FOR THE
FISCAL YEAR ENDING JUNE 30, 1899.

THE STATE or MICHIGAN, In account with J. T. Hannah, Trensurcr of Northern
Michigan Asylum, for month ending July 31, 1898.
By balance on hand July 1,1898
Cash from State treasury:
Account of officers' salaries
Cash from other sources

-

2,462 50
2,935 80

'—

$2,462 50
10,139 90
19,478 74

$32,081 14

DEBITS.

To disbursements:
Account of officers' salaries
Account of current expense
Balance on hand to new account

$32,081 14

THE STATE OF MICHIGAN, In account mill J. T. Hannah, Treasurer of Northern
Michigan Asylum, for month ending August 31, 1898.
CREDITS.

By balance on hand August 1,1898
Cash from State treasury:
Account current expenses
Cash from other sources

To disbursements:
Account current expense
Balance on hand to new account

$19,478 74
25,211 42
2,208 20

$46,898 36

DEBITS.
$15,008 47
31,889 89

THE STATE OF MICHIGAN, In account with J. T. Hannah, Treasurer of Northern
Michigan Asylum, for month ending September 30, 1898.
CREDITS.
By balance on hand September 1,1898
Cash from State treasury:
Account of current expenses
Cash from other sources

$31,889 89
12,605 69
380 06

$44,875 64

DEBITS.

To disbursements:
Account current expenses
Balance on hand to new account

$11,921 34
32.954 30

$44,875 64

REPORT OF THE TREASURER.

19

THE STATE or MICHIGAN, In account with J. T. Hannah, Treasurer of Northern
Michigan Asylum, for month ending October 31, 1898.
By balance on hand October 1,1898...
Cash from State treasury:
Account of officers' salaries
Account of current expenses
Cash from other sources

$32,954 30
2,428 81
11,331 93
2,761 64
$49,476 08

To disbursements:
Account of officers' salaries
Account of current expenses
Balance on hand to new account
$49,476 68

.THE STATK OF MICHIGAN, In account teith J. T. Hannah, Treasurer of Northern
Michigan Asylum, for month ending November 30, 1898.
CREDITS.

By balance on hand November 1,1898.
Cash from State treasury:
Account current expenses
Cash from other sources

$33,789 11
11,331 93
663 04

$45,784 08

To disbursements:
Account of current expenses...
Balance on hand to new account..

$18,847 18
26,936 90
5,784 08

THE STATE OF MICHIGAN, In account with J. T. Hannah, Treasurer of Northern
Michigan Asylum, for month ending December 31, 1898.
By balance on hand December 1, 1898..
Cash from State treasury:
Account of current expenses....
Cash from other sources

$26,936 90
11,331 91
1,245 34
$39 614 15

To disbursements:
Account of current expenses ...
Balance on hand to new accoimt..

$16,972 42
22,541 73
$39,514 15

THE STATE OF MICHIGAN, In 'account with J. T. Hannah, Treasurer of Northern
Michigan Asylum, for month ending January 31, 189'J.
By balance on hand January 1,1899 .
Cash from State treasury:
Account of officers' salaries
Account of current expenses...
Cash from other sources

2,587 50
17,939 35
5,753 74
$48,822 32

To disbursements:
Account of officers' salaries
Account of current expenses —
Balance on hand to new account - -

$2,587 50
10,571 22
35,603 60
$48,822 32

20

NORTHERN MICHIGAN ASYLUM.

THE STATE OF MICHIGAN, In account with J. I. Hannah, Treasurer of Northern
Michigan Asylum, for month ending February 28, 1859.
By balance on hand February 1,1899
Cash from State treasury:
Account of current expenses
Cash from other sources

To disbursements:
Account of current expenses
Balance on hand to new account

$35,663 60
13,035 95
312 00

$14,590 49
34,415 06

$49 Oil 55

$49,011 55

THE STATE OF MICHIGAN, In account with J. T. Hannah, Treasurer of Northern
Michigan Asylum, for month ending March HI, 1899.
By balance on hand March 1,1899
Cash from State treasury:
Account of current expenses
Cash from other sources

$34,415 00
13,045 95
776 45
$48,237 46

To disbursements:
Account of current expenses
Balance on hand to new account

$15,366 78
32,870 68
$48,237 4B

THE STATE OF MICHIGAN, In account with J. X. Hannah, Treasurer of Northern
Michigan Asylum, for month ending April SO, 1S99.
By balance on hand April 1, 1899
Cash from State treasury:
Account of officer's salaries
Account current expenses
Cash from other sources

$32,870 68
2,662 50
11,078 79
4,400 46
$51,072 43

To disbursements:
Account of officers' salaries
Account of current expenses
Balance on hand to new account

$2,662 50
16,087 09
32,322 84
$51,072 43

THE STATE OF MICHIGAN, In account n-ilh J. T. Hmmah, Treasurer of Northern
Michigan Asylum, for month ending May 31, 1899.
By balance on hand May 1,1899
Cash from State treasury:
Account of current expenses
Cash from other sources

$32,322 84
11,087 63
683 36
$44,093 83

To disbursements:
Account of current expenses
Balance on hand to new account

$17,058 88
27,034 95
$44,093 83

REPORT OF THE TREASURER.

21

THE STATE OF MICHIGAN, In account with J. T. Hannah, Treasurer of Northern Michigan Asylum, for month ending June 30, 1899.
J!y balance on hand June 1,1899
Cash from State Treasurer:
Account of current expenses
Cash from other sources

$27,034 95
11,078 77
250 00

To disbursements:
Account of current expenses
.Balance on hand to new account

$14,554 21
23,809 51
$38,3(8 72

SUMMAEY.
THE STATE OF MICHIGAN, In account with J. T. Hannah, Treasurer of Northern Michigan Asylum, for fiscal year ending June 30, 1899.
]>y balance on hand July 1,1S98
Cash from State Treasurer:
Account of officers' salaries
Account of current expenses
Cash from other sources

$26,682 84
10,141 31
149,079 32
22,430 09

To disbursements:
Account of officers' salaries
Account of current expenses
Balance on hand to new account

$10,141 31
174,382 74
23,809 51

$208,333 56

$208,333 5(>

22

NORTHERN MICHIGAN ASYLUM.

ABSTRACTS
OF ACCOUNTS CURRENT OF THE RECEIPTS AND DISBURSPiMENTS AT THE NORTHERN
MICHIGAN ASYLUM, ON ACCOUNT OF CURRENT EXPENSES FOR THE
FISCAL YEAR ENDING JUNE 30, 1900.

THE STATE OF MICHIGAN, In account Kith J. T. Hannah, Treasurer of Northern
Michigan Asylum, for month ending July 31, 1899.
By balance on hand July 1, 1890
Cash from State treasury :
Account of officers' salaries
Cash from other sources

To disbursements:
Account of officers' salaries
Account of current expenses
Balance on hand to new account

$23,809 51
2,647 75
2 , 540 49

$2,647 75
10,410 17
15,939 83

$28,997 75

$28,997 75

THE STATE OF MICHIGAN, In account with J. T. Hannah, Treasurer of Northern
Michigan Asylum, for month ending August 31, 1899,
By balance on hand August 1, 1S99
~Cash from State treasury :
Account of current expenses
Cash from other sources

$15,939 83
25,378 65
3,625 00
$44,943 48

To disbursements ;
Account Female Hospital for Acute Insane
Account of Male Hospital for Acute Insane
Account of current expenses
Balance on hand to new account

$296 37
1,726 78
11,301 52
31,618 81

THE STATE OF MICHIGAN, In account u-ith J, T. Hannah, Treasurer of Northern
Michigan Asylum, for month ending September 30, 1899.
By balance on hand September 1, 1899
Cash from State treasury :
Account of current expenses
Cash from other sources
To disbursements :
Account Male Hospital for Acute Insane
Account of current expenses
Balance on hand to new account

$31,618 81
12 , 689 32
922 25

$2,529 14
11,526 30
31,174 94

$45,230 38

$45,230 .

REPORT OF THE TREASURER.

23

THE STATE OF MICHIGAN, In account witli J. T. Hannah, Treasurer of Northern
Michigan Asylum, for month ending October 31, 1899.
CREDITS.
By balance on hand October 1,1899
Cash from State treasury:
Account of officers' salaries
Account of current expenses
Cash from other sources

$31,174 94
2,887 50
12,483 96
3,035 26

$49,581 66

DEBITS.

To disbursements:
Account of officers' salaries
Account Female Hospital for Acute Insane
Account Male Hospital for Acute Insane
Account current expenses
Balance on hand to new account

$2,887 50
225 00
3,630 23
20,066 07
22,172 86

THE STATE OF MICHIGAN, In account with J. T, Hannah, Treasurer of Northern
Michigan Asylum, for month ending October 31, 1899.
CREDITS.
By balance on hand November 1,1899
Cash from State treasury:
Account of current expenses
Cash from other sources

$22,172 86
12,483 96
814 88
-

$35,471 70

DEBITS.

To disbursements:
Account of nurses' building
Account fire-proof vault
Account Female Hospital for Acute Insane
Account Male Hospital for Acute Insane
Account current expenses
Balance on hand to new account

$330 59
40 85
424 38
0,371 26
12,774 55
16,530 07

$35,471 70

THE STATE OF MICHIGAN, In account with J. T. Hannah, Treasurer of Northern Michigan Asylum, for month ending December 31, 1899.
CREDITS.
Balance on hand December 1,1899
Cash from State treasury:
Account current expenses
Cash from other sources

$16,530 07
12,483 94
862 34
$29,876 35

To disbursements:
Account of nurses' building
Account Female Hospital for Acute Insane
Account Male Hospital for Acute Insane
Account current expenses
Balance on hand to new account

DEBITS.

$152 95
1,475 03
2,051 29
15,810 43
10,386 65
$29,876 35

THE STATE OF MICHIGAN, In account Kith J. T. Hannah, Treasurer of Northern Michigan Asylum, for month ending January 31, 1900.
CREDITS.
By balance on hand January 1,1900
Cash from State treasury:
Account of officers' salaries
Account Male Hospital for Acute Insane
Account current expenses
Cash from other sources
To disbursements:
Account of officers' salaries
Account Female Hospital for Acute Insane
Account Male Hospital for Acute Insane
Account of current expenses
Balance on hand to new account

$10,380 65
2,827 50
20.000 00
20,780 30
3,836 33
DEBITS.
$2,827 50
23 75
2,479 18
13,334 56
39,165 79
$57,830 78

24

NORTHERN MICHIGAN ASYLUM.

THE STATE OP MICHIGAN, In account witli J. T. Hannah, Treasurer of Northern Michigan Asylum, for month ending February 3S, 1900.

By balance on hand February 1, 1900.
Cash from State treasury:
Account current expenses
Cash from other sources
To disbursements:
Account Female Hospital for Acute Insane
Account Male Hospital for Acute Insane
Account current expenses
Balance on hand to new account

$39,105 79
14,658 93

1,184 26
DEBITS.

$271 06
1,098 53
13,926 12
39,712 67
$55,008 98

THE STATE OF MICHIGAN, In account with J. T. Hannah, Treasurer of Northern
Michigan Asylum, for month ending March 31, 1900.
By balance on hand March 1, 1900
'Cash from State treasury:
Account of library
Account of 40 acres of land
Account Female Hospital for Acute Insane ..
Account current expenses
Cash from other sources

500
2,000
5,000
14,658
418

00
00
00
93
91
$62,290 51

DEBITS.

To disbursements:
Account of Female Hospital for Acute Insane
Account of Male Hospital for Acute Insane
Account current expenses
Balance on hand to new account.

$546 50

1,012 15
16,673 55
44.058 31
$62,290 51

THE STATE OF MICHIGAN, In account with J. T. Hannah, Treasurer of Northern
Michigan Asylum, for month ending April 30, 1900.
By balance on hand April 1, 1900..
"Cash from State treasury:
Account of officers' salaries...
Account current expenses —
Cash from other sources

$44,058 31
2,002 50
12,535 35
3,004 40
$02,200 56
DEBITS.

To disbursements;
Account of officers' salaries
Account of Female Hospital for Acute Insane
Account current expenses
Balance on hand to new account

$2,002 50

306 94
19,770 10
39,521 02
$62,200 56

THE

STATE OF MICHIGAN, In account with J. T. Hannah, Treasurer
Michigan Asylum, for month ending May 31, 1900.

By balance on hand May 1,1900
Cash from State treasury:
Account Female Hospital for Acute Insane...
Account current expenses
Cash from other sources
To disbursements:
Account of Pathological Laboratory
Account of 40 acres of land
"
Account of fire-proof vault
Account Female Hospital for Acute Insane.
Account current expenses
Balance on hand to new account

Northern

$39,521 02
15,000 00
12,535 35
980 58
$68,030 95

$37 50
2,000 00

37 50
1,348 82
17,913 96
46,699 17
$68,038 95

REPORT OP THE TREASURER.

-0

THE STATE OF MICHIGAN, In account with J. T. Hannah, Treasurer of Northern
Michigan Asylum, for month ending June 30, 1900.
By l>alaiice on hand June 1,1900
"Cash from State treasury:
Account current expenses
Cash from other sources

$40,699 17
12,535 35
514 25

$59,748 '

"DEBITS.

To disbursements:
Account of library
Account of Female Hospital for Acute Insane
Account current expenses
Balance on hand to new account

$15 72
3,2(15 25
18,313 99
•3S,153 81
$59,748 77

SUMMARY.
THE STATE OF MICHIGAN, In account with J. T. Hannah, Treasurer of Northern
Michigan Asylum, for fiscal year ending June 30, 1900.
CREDITS.
By balance on hand July 1,1899
"Cash from State treasury:
Account of officers' salaries
Account Female Hospital for A.cute Insane
Account Male Hospital for Acute Insane
Account library
Account 40 acres of land.
Account current expenses
Cash from other sources

$23,809 51
10,965 25
20,000 00
20,000 00
500 00
2,000 -00
163,224 04
21,738 95
2,237 75

To disbursements:
Account officers' salaries
Account Female Hospital for Acute Insane.
Account Male Hospital for Acute Insane...
Account library
Account 40 acres of land
Account nurses' building
Account tire-proof vault
Account pathological laboratory
. Account current expenses
"
Balance on hand to new account

$10,965 25

8.183 70
19,898 56

15 72
2,000 00

483 54
78 35
37 50
182,421 32
38,153 81

We have carefully examined the accounts of J. T. Hannah, Treasurer
of the Northern Michigan Asylum, for the biennial period ending June
30, 1900, and have compared the same with the books and vouchers; and
verified the same by further comparison with the books of the steward
and hereby certify to the entire correctness of them.
W. W. CUMMBE,
THOS. T. BATES,
H. D. CAMPBELL,
Auditing Committee.

STEWARD'S

REPORT

FOR THE .BIENNIAL PERIOD ENDING JUNE 30, 1900.
ANALYSIS
OF RECEIPTS AND DISBURSEMENTS FOR THE BIENNIAL PERIOD
ENDING JUNE 30, 1900.

RECEIPTS.

Maintenance, etc.. of State patients
Maintenance, etc., of county patients
Maintenance, etc., of private patients
Farm
Sundry accounts

$301,320 75
44,360 19
5,642 34
1,374 60
3,774 52

SPECIAL AITKOPRIATIOKS:
Officers' salaries
Male hospital
Female hospital
Forty acres land
Library

SALARIES ASP WAGES
FOOD :
Meat and
Butter
Flour
Coffee
'tea
Sugar
Miscellaneous

LAUNDRV :
Wages
Tubs
Baskets
Soap making
Machinery
Blue
Irons
Marking ink
Starch
HISATING :
Wages
Coal
Charcoal
LIGHT :
Wages
(Globes
Oil
Electric supplies
Lamps

,

21,100 56
20,000 00
20,000 00
2,000 00
500 00

DISBURSEMENTS.
,.
fish

..

$420,078 98

;

$39,519 l(i
18,359 51
8,836 08
4,007 88
2,534 63
7,517 40
21,472 46

$4,812 87

2 20
82 43
870 86
248 31
18 82
48 19
7 10
260 39
6,351 17

$2.587 61
23,618 36
22 46

26,228 43

$2.380 81
2
58
585
113

52
42
66
08
3,140 49

REPORT OF THE STEWARD.
MEDICAL SUPPLIES:
Drugs and Instruments
STATIONERY AND PRINTING :
Stamps
Telephones
Printing
Stationery
Ledger
Letter
Treasurer's expenses
Ink
Directory
Typewriter supplies

$4,697 92
$363 00
121 25
626 30
422 69
15 50
5 40
35 50
14 85
3 00
5 10

files

AMUSEMENT AND INSTRUCTION :
Games
Music
Fireworks
Entertainments
Circus tickets
Musical entertainment
Sheet music
Books, music
Books, medical
Flags and bunting

'.

HOUSEHOLD SUPPLIES:
Dry goods
Brooms
Hardware
Crockery
Pictures
Soap
Carpet
Sewing machines
Utensils
Mops
Badges
Ladder
Insect powder
Paper
Baskets
Chambers
Stoves
Brushes
Refrigerator
Toilet paper

$51 8(>
31 84
59 92
115 00
82 05
25 00
4 05
10 40
145 54
22 92
$3,447 16
817 98
935 86
1,106 55
52 90
1,146 50
16 46
45 50
941 81
35
4 20
90
32 65
148 73
11 42
76 55
166 79
3 93
28 61
233 02

FURNITURE AND BEDDING :
Dry goods
Sheeting
Bedding
Blankets
Furniture
Carpet
Seats
Mattresses
IMPROVEMENTS AND REPAIRS:
"Wages
Brick
,
Iron and pipe
Hardware
Paint
Glass
Lime and cement
Lumber
Boiler
Iron gates
Cistern
Hose
Radiators
Slate
Registers
Emery wheel
Castings
Rope
Wall paper
!
Inspection boilers
Stone
Lightning rods
Pipe covering
Tile

27

$91 04
5 40
5,578 97
213 78
465 70
631 48
19 01
25 75

fittings

*

'

$23,594 20
•• 990 97
4,447 93
1,360 72
1,716 70
130 12
2,146 97
1,114 32
93 33
114 !I2
14 44
«3 71
25 95
33 07
235 63
1 93
123 11
74 88
92 09
66 84
14 9(i
701 60
726 50
32 20

1,612 59

548 58

9,216 87

7,031 73

37,918 09

28

NORTHERN MICHIGAN ASYLUM.

TOOLS AND MACHINERY :
Tools
............................................................................
Engine
fittings
.................................................................
Valves
..........................................................................
...............................................................................
......................................................................

Oil
Machinery

Steam traps
Drill stand
lioiler repairs

292 70
324 88 I

....................................................................
.....................................................................
...................................................................

Boilers
Elevator

12 00
74 00
18 55

..........................................................................
.......................................................................

Belting
.........................................................................
Kelt lace
........................................................................
Steam charts
..................................................................
Saws
.............................................................................
Ladders (extension)
............................................................
Plumbers' pot
...................................................................
Clutch
...........................................................................
Gauge
...........................................................................
Shafting......................
.
.................................................
Packing
.........................................................................
FARM, GARDEN, STOCK AND Giio us i>s:
Wages
..........................................................................
Implements and repairs
.......................................................
Straw
............................................................................
Manure
........................................................................
Flower pots

Hose and sprinklers
Horses
Bull

Pigs and steers
Feed

Blacksmithing
Harness
Tile

2,364 99
1,228 90

12 47
3 50
6 00
7 25
20 00
6 00
23 7G
10 70
24 87
23 38
-

.....................................................................

44 62

170 76
425 00

.............................................................................

75 00

.................................................................

..................................................................
........................................................................

.......................................

Chicken
Plant boxes
Glass
Land
Trees
Registration of land
Veterinary
Paris green
Plants and seed
Dynamite
( 'attle markers
Land plaster

'.

.

,

$4,906 67

$15,333 72
774 86
346 34
632 21

..........................
..................................
..........................................................................

...........................................................

Registry of stock
Tobacco stems .............
Herd books
Hay

$361 42
22 13
69 07

4 , 579 42
................

7,539 62

387 32
162 36

......................................

663 07

...............................................................
....................................................
......................................................................

.............................................................................

........................................................................
...................................................................
............................................................................
.............................................................................
............................................................................
............................................................
.......................................................................
.....................................................................
.................................................................
.......................................................................
..................................................................
....................................................................

35 00
92
20 00

3 00
1120
13 W)
56 50 .
206 89
1 40
150 38
25 60
363 > 6
176 69
6 25
95 74
-

FREIGHT AND TRANSPORTATION :
Superintendent's expenses to board meetings, etc
............................
Steward's expenses purchasing supplies
.......................................
Physician of the staff; expenses attending the Pathological meetings
......
MISCELLANEOUS :
Undertaker's expenses
.........................................................
Expenses elopement
............................................................
Amount eharged'back
..........................................................
Expenses Home
.................................................................
Refunded money
...............................................................
Refunded money to Auditor General
..........................................
Miscellaneous
...................................................................

966 16

$206 35
216 30
74 39
$168 50
59 16
256 (14
261 76
172 18
2,031 25
2,288 64

SPECIAL APPROPRIATIONS :
Officers' salaries
...............................................................................
Male hospital
........................
........................................................
Female hospital
...............................................................................
Forty acres land
..............................................................................
Library
..................................................................................
.....
Nurses"' building
..............................................................................
Pathological laboratory
.......................................................................
Fire-proof vault
..............................
................................................

:

33,269 49

497 04

5.240 53
21,106 56
19,933 06
8,149 20
2,000 00
15 72
483 54
37 50
78 35
$408,607 99

REPORT OF THE STEWARD.

29

DISBURSEMENTS AND RECEIPTS FOR FARM, GARDEN, STOCK AND
GROUNDS FOR THE BIENNIAL PERIOD ENDING JUNE 30, 1900.

DISBURSEMENTS.

Wages
Implements and repairs
Straw
Manure
Flower pots
Hose sprinklers
Horses

:

Bull

Pigs ami steers
Feed
Blacksmithing
Harness
Tile
Registry of stock
Tobacco stems
Herd books
Hay
Chicken
1'lant lioxes.
(Hass
:
Land
Trees
Registration of land
Veterinary
Paris green
Plants and seeds
Dynamite
Cattle markers
Land plaster
Total

$15,333 72
774 80
346 34
632 21
44 62
170 76
425 00
75 00

:

:

4,579 42
7,539 62
387 32
162 36
663 07
35 00
92
20 00
966 16
3 00
11 20
13 80
56 50
206 89
' 1 40
150 38
25 60
3<;5 66
176 69
6 25
95 74
$33,269 49

NORTHERN MICHIGAN ASYLUM.
RECEIPTS.

Quantity.

U

i.t

u

(t

1.

U

U

t!

1.

((

Price.

Amount.

4 225

$0 10

$422 50

03

25

$15 75

135

50

67 50

3

1 60

$4 80

370

80

$296 00

949
91 T
34"
4

9Q

$189 80

40

13 60

53 930
1 462
3 245
13 596

it

U

it

U

08
08 a
08£
081

1 155 65

til1'

50

$306 00

12 000
10 152
3 686

03

$300 00
184 30

10

05
00

4,705

20
50

$941 00
30 00
3 50

02

$487 10

50
1 00
2 00

$163 00
187 00
5 00

287
290
70

05
06
08

$14 35
17 40
5 60

1,323

05

$00 15

520

10

$52 60

48

10

101

12
12$

$4 80
12 12
4 75

40
U

(I

24,355

it

U

,(

U

326
187
2£

38
32

it
tl

401
198
366
128 1
40
*>
38
56^
58|

it
il

U

i.

U

U

120 01

60

1 00
2 00

$3'' 00
10 00

12

$48 20
24 75
47 58
17 97
6 00

12£
13
14
15
10
17
18
20

Total .

3'>

6 46

10 14
11 75

173 17

u

u

((

14

11

U

58WV
7£
27l
10-JJ39"
59
189T

4 00
4 00
4 00
4 00
6 00
4 00
5 00
5 00

16
40

1 00
1 25

$10 00
50 00

321
24f

7 00
8 00

$2 250 50
198 00

$^32
30
110
42
234
230
94
37

20
00
66
20
00
00
50
50

31

REPORT OF THE STEWARD.
HECEirTS.— Continued.
Quantity.

Price.

Amount. '•

Lettuce, pounds

6,595
350
4,650

$0 10
12
15

$659 50

Logs, feet

9,910

5 00

I 58

12

05

$0 60

8,231

15

$1,234 65

Mints, dozen
Mangels, bushels

42 00
697 50

$1,399 00

Melons, water, pounds
"
"
musk,
"

j
I

3,540
900
2,175
585

01
02
02
03

$35
18
43
17

Milk, pounds

|1,075,933

02

$21,518 66

Oats, bushels
Onions, bushels

Total.

40
00
50
55

450

30

$135 00

7,250

998
662
272

02
04
40
50
75

$145 00
39 92
264 80
136 00
6 00

14

1 00

$14 00

2

1 00

65

1 00

49 58
00
1,234 85

114 45

21,518 66
135 00

591 72

Plums,

"

Pears,

"

|
I
!

Peaches,

"

I

14 00
$65 00

Peas,

"

5CO

80

$448 00

Peppers

"

21

1 00

$21 00

Parsnips, "

1,050

25
40
50

$262 50

Potatoes, "

10,751

I

182
202

Pumpkins, pounds
loads
"
tons

i

Pork, pounds
"

"

1,350
1G
38

i

7,801

$61 70
35 50
4 00

391

20
25
30

$78 20
239 00
15 00

0 00

$51 00

1,161

07

$81 27

I

150

05

$7 50

i

2,850
306
65j
20

08
1 20
1 30
1 60

$228 00

112

50

$56 00
60 00

30

05
10

3,300
2,775
26

01
02
15 00

956
50

Rye, tons

83

Raspberries, quarts

Salsify, dozen
"

Summer savory, dozen
Squash, pounds
tons

100

I

436 30

2,687 75

425 50

468 06

01
02
04

1,775
100

Ruta-baga,«. bushels

»

$1,990 60

39,812

0,170

l

Strawberries, quarts
"
bushels
"
"
"
"

$13 50
32 00
380 00

$9 14
614 40
236 85

Rhubarb, bunches

,

$2,687 75
01
2 00
10 00

21 00

72 80
101 00

02
04
05

I
:

Sage, bushels

448 00

457
15,360
" 4.737

Radishes, bushels
"
"
"
"
;

2 00
65 00

2,458 66

860 39

101 20

332 20
51 00
81 27
7 50

367 20
85 15
32 00
712 35
116 00
$1 50 i
2 50 j
4 00
$33 00
55 50
390 00
478 50

32

NORTHERN MICHIGAN ASYLUM.
HECEIPTS.—Concluded.
Quantity.

11

tt

'

"'

. • ) ^™, 1

f399i{

it
u

Amount.

10
3i
3"

$3 50
4 00
5 00

$35 00

15
11
50

04
50
50
1 00
1 00
2 00

$0 60

140J

259J
llj
89

ttu

Price.

50

Total.

14 00

15 00
5 50
140 25
259 25
22 50
$44 50

860
1 138
131 .',
54

15
20
30
40

$129
227
39
21

00
(10
45
60

214
1 , 16''
600
737

07
08

98
9G
00
70

417 C5

u
u

u
u

10

$14
92
54
73

50

70

$35 00

CO
193
44
158
80

1 50
1 25
1 00
2 00
2 25

09

935 {J4

u
u
a

u
u
u

$90
241
44
316
180

00
25
00
00
00
871 25

$50,360 07

(.'. L. WHITNEY,
Steward.

SUMMARY.

Summary of Inventory, Northern Michigan Asylum, June 30, 1900.
Farm and grounds
Buildings
Stock on farm
Produce from farm and garden
Farm implements and barn
Administration building
Pathologic laboratory
Dispensary: Stock and
library and chapel
Wards
Cottage A
B
C
D
E
F and G
I
Kitchen and bakery
Laundry
Engine room and work shops
Stores: Furniture and
"
Groceries and provisions
"
Boots and shoes
"
Dry goods
"
Crockery
''
Steel enameled ware
'•
Silver plated ware
"
Notions
"
Hardware and miscellaneous
"
Clothing and furnishings
"
Meats

fixtures
fixtures

fixtures

•• ••

-

.

Total

$43,960 00
641,350 00
7,358 00
50,366 07
3,833 01
7,264 34
856 00
980 62
1,123 55
29,079 50
2,042 76
1,927 73
2,066 94
3,360 47
933 32
4,071 82
2,497 04
4,934 83
4,872 39
2,982 03
371 15
7,264 74
1,267 48
5,378 94
374 25
109 92
74 01
1,676 00
696 26
4,205 30
475 97
$837,755 04

Corrections of Summary.
Farm implements and barn
Administration building
Wards
Cottage B
Cottage E
Cottage F. & G
Cottage 1
Kitchens and bakery
Engine room and work shops
Stores: furniture and
"
groceries and provisions
"
notions
Total

fixtures

:

fixtures

f 3,822 91
7,494 34
29,133 78
1,927 63
944 32
4,070 82
2,493 60
4,919 03
2,984 53
378 IB
7,263 74
1,676 65
$838,02843

REPORT OF THE MEDICAL SUPERINTENDENT.
To the Board of Trustees :

Gentlemen—As required by law, I have the honor to submit the following report of the principal operations and events of the asylum for
the biennial period ending June 30, 1900.
The movement of population has been as follows:
TABLE I.—For (lie Triennial period.
Patients.

Males. Females. Total.

Died

552
156

457
111

1,009
267

708
123

568
103

1,276
226

585

465

1,050

9
44
15
55

9
48
5
41

18
92
20
96

I

From the 'beginning.
Males. Females. Total.

Patients.
Total admitted

.

1,265

2,844

347
87
339

155
308
83
244

655
170
583

1 004

790

1 794

585

465

1 050

1,589
931

Died

386

On June 30, 1898, there remained under treatment 1,009 patients, and
on June 30, 1900, 1,050, an increase of 41 patients during the period.
There are about 40 cases awaiting admission, giving a net gain of
about 80 patients in this asylum district during the period just closed.

REPORT OF THE MEDICAL SUPERINTENDENT.

35

The number of admissions, 267, was not as large as for the preceding
biennial period, owing probably to the fact that many were denied admission from lack of accommodations in the asylum.
The smallest number of patients under treatment on any one day was
1,000; the largest number, 1,050.
The death rate for the year ending June 30, 1899, was 3.8 per cent,
and for the year ending June 30, 1900, 4.5 per cent.
The following table will show the sex, age, form of mental disease
and cause of death in each of those who died:
TABLE II.
Sex.

Age.

Female . . .
Male
Male
Female —
Female ....
Male
Male
Male
Female —
Female ....
Male
Male
Male
Male
Male
Female —
Male
Male
Female ....

67
64
CO
70
48
62
32
72
40
73
24
40
34
50
53
53
54
38
72

Male
Female ....
Female. . . .
Female ....
Male
Female —
Male
Female ....
Male
Male
Male
Female —
Female ....
Female —
Male
Female —
Male
Female —

38
41
39
58
41

Male
Female
Female —
Female. . . .
Male
Male
Male
Female —
Male
Female . . .
Male
Female. . . .
Male

24
54
52
69
54

27
63
58
53
43
71
54
36
33
61
73
34
44
72

88
41
55
29
36
29
47
46

Form of disease.

Nativity.

Ohio
New York
Michigan
Canada
Norway
Unknown
Unknown
Unknown
Michigan
Pennsylvania
Canada
Michigan
New York
Canada

Germany
New York
New York
Ohio .
Michigan
Holland
Maine
Michigan
New York
Ireland
Norway
Michigan
Missouri
Canada
Canada
Wisconsin
Maine
Michigan.
New York
France
Germany
New York
Michigan
Wisconsin
Michigan
Michigan
Michigan
Michigan
Scotland
New York
New York

B II Senility B. IT, Senility
B II Senility

B. IT,
B. II,
B. II,
C. I
C. TI,
B II

General paralysis
General paralysis
General paralysis
Epilepsia
Paranoia
Senility.

B. II, General paralysis
A. II, Dementia
B. II, General paralysis
B. II, Senility
C. II, Paranoia
B II Senility.
C. I, Neurasthenia
B. II, General paralysis
B. II, General paralysis
A. II, Dementia
B. 11, General paralysis
A. II, Dementia
C. T, Kpilepsia
C. II,
A. I,
B. II,
B. II,

Paranoia
Mania
Senility
General paralysis

B.
C.
B.
C.
C.

General paralysis
Epilepsia
Senility
Paranoia
Epilepsia

II,
I,
II,
II,
I,

Cause of death.
Cardiac disease.
Paretic seizure.
Exhaustion.
Exhaustion.
Oedema of lungs.
Dysentery.
Dysentery.
Tuberculosis.
Brain tumor.
Paretic seizure.
Exhaustion.
Status epilepticus.
Paretic seizure.
Paretic seizure.
Paretic seizure.
Exhaustion.
Exhaustion.
Peritonitis.
Tuberculosis.
Cardiac disease.
Paretic seizure.
Paretic seizure.
Cardiac disease.
Bright's disease Paretic seizure.
Exhaustion.
Exhaustion.
Bright's disease.
Pneumonia.
Exhaustion.
Cardiac disease.
Paretic seizure.
Tuberculosis.
Paretic seizure.
Paretic seizure.
Leukaemia splenic.
Pysemia.
Tuberculosis.
Tuberculosis.
Cerebral haemorrhage.
Pneumonia.
Pneumonia.
Status epilepticus.
Cancer.
Cerebral haemorrhage.
Cardiac disease.
Paretic seizure.
Paretic seizure.
Status epilepticus.
Paretic seizure.
Tuberculosis.
Cardiac disease.
Cancer.
Suffocation.

36

NORTHERN MICHIGAN ASYLUM.
TABLE II.—CONCLUDED.
Sex.

Age.

Female —
Male
Female —
Female —
Female —
Male
Male
Female —
Male
Female —
Male
Female. . . .
Male
Female —
Male
Male
Female —
Male
Male
Male

64
43
54
70
52

Nativity.

\irginia
Ohio
Switzerland
Canada
Unknown

Form of disease.

Paranoia
Paranoia
Paranoia
Delusional
General paralysis
Senility
Senility
Mania
Senility

79

Ireland
Unknown
Germany
Ohio
Norway
Canada
Ireland
Unknown
Germany
Canada
Germany
Unknown
England

G. II,
C. II,
C. II,
A. II,
B. II,
B. II
B. II,
A. I,
B. II,
A. II,
A. I,
A. II,
A. II,
B. II,
B. II,
B. II,
B. II,
B. II,

Dementia
Mania
Dementia
Delusional
Senility
General paralysis
General paralysis
General paralysis
Senility

56
71
70
58
38

Michigan

A. II, Delusional

Canada
Finland

B. II, Senility
A. II, Dementia
A. I, Melancholia

61
20
52
79
26
33
45
52
50
84
55
47

Male
Male
Female. . . .
Female —
Female — 20
Female .... 83
Female — 79
48
Male
Female — 28
Female —
50
Male
37
Male
26
Male
Female. . . . 52
Female
! 48
Male
*
Male
Male

Unknown
Canada
Poland
Michigan
Ohio
Unknown
Unknown

B. II,
C. I,
C. II,
C. I,

General paralvsis
Epilepsia
Paranoia
Epilepsia

B.
B.
B.
B.

Senility
Senility
Senility
General paralysis

II,
II,
II,
II,

Cause of death.
Cardiac disease.
Tuberculosis.
Tuberculosis.
Exhaustion.
Tuberculosis.
Paretic seizure.
Cardiac disease.
Pneumonia.
Exhaustion.
Exhaustion.
Cardiac disease.
Tuberculosis.
Tuberculosis.
Endocarditis.
Tuberculosis.
Tuberculosis.
Pneumonia.
Paretic seizure.
Paretic seizure.
Paretic seizure.
Cardiac disease.
Cardiac disease.
Peritonitis,
Cardiac disease.
Pneumonia.
Tuberculosis.
Tuberculosis.
Pneumonia.
Peritonitis.
Tuberculosis.
Status epilepticus.
Paretic seizure.
Enteritis.
Peritonitis.
Tuberculosis.
Tuberculosis.
Cerebral haemorrhage.
Cerebral hsemorrhage.
Cerebral haemorrhage.
Cardiac disease.
Exhaustion.
Paretic seizure.

Summary.
Males. Females.
General par alysis
Pulmonary tuberc
Cardiac disc
Bndocarditi
Exhaustion
Pneumonia
Status epile aticus
Oedema of 1ungs.
Cerebral ha .morr
Brain tumoi
Splenic leuk aemia
Chronic ent eritis
Bright's dis
Total

15
9
10
7
2
2
2
3
2

1
1
1

I

3
1
2
5

20
18
13
}
2
12

5
2
1

7
4

1
3

2
4
5

1
1

2
55

Total.

41

1
1
1
1
1
2
96

REPORT OF THE MEDICAL SUPERINTENDENT.

37

As compared with the preceding two years, the death rate from
phthisis, general paralysis and cardiac disease was greater, while from
other causes it was slightly less. From all causes combined the death
rate was slightly greater than for the previous period. Although constant care has been exercised for several years to prevent the spread
of tuberculous infection among our patients, yet there was a marked
increase in this disease in the hospital during the past year. Every
effort has been made to separate the tuberculous from the non-tuberculous, and yet in a crowded asylum it is almost impossible to completely
isolate them.
Several autopsies were made during the year, and the following observations are abstracted from the notes of the most interesting:
A. K., female, admitted November 23, 1894, aged 44. Suffered from
paranoia following delusions of persecution and hypochondriasis. She
was constantly agitated and scolded continually. It was impossible to
determine exactly her mental condition because her words were never
intelligible. In June, 1897, it was noted that she had some laryngitis.
Her power of vocalization gradually failed until her death on September 10, 1898, the cause being asphyxiation. Autopsy revealed a much
enlarged larynx containing a large papilloma growing on the anterior
laryngeal wall between the vocal cords. Numerous smaller papillomata were situated under the vocal cords, all the growths so nearly
filling the lumen of the larynx as to admit the passage only of a small
probe. Microscopically, the growths presented the characteristics of
soft papilloinata. The post-mortem findings other than the laryngeal
ones were as follows: Heart fibroid, ante-mortem clots in right auricle
and right ventricle. Liver enlarged, spleen small, sclerotic. Eight
kidney displaced downward. Eight ovary atrophic; left cystic, small.
M. S., male, admitted December 2,1895, aged 76. Suffering from senile
dementia. During the entire period of residence in the asylum he was
a most offensive and filthy patient. His last illness was brief and
characterized by much embarrassed respiration and heart action. There
were evidences of consolidation in the left lung and much abdominal
tenderness. He seemed to be in profound shock, and died suddenly.
The post-mortem findings were as follows: Brain atrophic in frontal and
parietal regions. Gyri thin and pointed with fissures gaping. Left
lung retracted; pleuritic adhesions over lower left lobe; hemorrhagic
infarct 4 inches in diameter in right middle lobe, infarct showed dilated,
distorted and ruptured blood vessels with extravasation of red cells,
leucocytes and epithelial cells. Liver normal. Spleen had numerous
large fibrous tuberculae running into splenic substance; small blood
vessels atheromatous; blood spaces and content considerably increased.
Kidneys showed microscopically chronic interstitial nephritis. Stomach
distended and enlarged, with very thin walls; capacity seven pints.
Jejunum and ileum slightly contracted in places. Sigmoid flexure and
upper rectum thickened and lumen contracted to size of 1 inch diameter.
Peritoneum diffusely spotted with small accumulations of what seemed
to be carbon. Abdominal cavity contained no fluid. At the median
line in the mesentery close to the transverse colon was a round body
1 inch in diameter, which was encapsulated and contained a soft, dark
brown homogeneous mass; the microscope showed this to be degenerated
blood contained in a well vascularized fibrous capsule.

38

NORTHERN MICHIGAN ASYLUM.

B. E. B., male, admitted to the Michigan Asylum April 27, 1892, transferred to the Northern Michigan Asylum January 9, 1896. Aged 49.
Suffering from chronic chorea characterized by irregular movements,
disturbance of speech and dementia, all of which conditions were progressive. The chorea was of the hereditary origin. He died of exhaustion on December 17, 1898. Autopsy revealed a thick skull with
dura adherent. The convexity of the brain and membranes presented
appearances of chronic meningo-encephalitis; base normal, vessels
slightly atheromatous. Brain as a whole atrophied; gyri small; sulci
wide and gaping; motor and frontal regions most atrophic; ependyma
normal; medulla and pons normal. Microscopical examination of the
entire nervous system showed no evidence of primary inflammation or
involvement of the supporting framework of the system. There were
throughout the cortex overwhelming evidences of involvement of ganglion cells, most marked in the motor and frontal regions, cell degeneration being of the common form.
M. J., female, admitted September 8, 1896, aged 70. Suffering from
senile dementia with brain tumor. Eemained in bed during entire residence in the asylum. Her legs and arms were paretic; she was unable
to feed herself, and was extremely filthy in habits. She was practically
helpless, and her memory poor; was blind, and the sense of taste abolished. She died October 30, 1898. Autopsy revealed the skull cap to
be very thin; in several places along the superior longitudinal sinus
it was almost perforated, and directly beneath these places were several
very large pacchionian bodies. Dura moderately thickened and very
adherent to skull cap anteriorly and to the brain anteriorly at the base.
In removing the brain the frontal lobes seemed hard and 'unyielding
and were found to be quite atrophic. A hard, unyielding tumor occupied
part of both frontal lobes. Viewed from above the tumor could not be
seen unless the hemispheres were separated, and from below it appeared
to take the place of the brain substance, merging gradually into apparently normal cerebral tissue. The tumor was hard, dense, uniformly
white in appearance, and did not bleed on being cut. Left lung normal;
slight hypostatic congestion of lower lobe of right lung. Heart small,
valves normal, and sub-pericardial fat very much increased. Liver
greatly enlarged. Great omentum and mysentery loaded with fat. Gall
bladder distended, about six inches in length, and at the neck a large
gall stone about the size of a dove's egg was found tightly enclosed
and could not be removed; by pressure a small amount of bile could
be squeezed out of the duct. Gall bladder filled with a dark, pultaceous,
semi-fluid mass, very disagreeable in odor, though not fetid. Spleen
slightly enlarged, very flabby. Intestines apparently normal, with the
exception of some very large dilated arteries and a few small ecchymoses. Kidneys small; capsule not adherent; cortex slightly atrophic;
fatty capsule enormously increased. Apparently a double ureter existed
for a short distance, and in each kidney a small duct entered above the
hilum. A microscopical examination of the tumor showed it to be a
spindle-celled sarcoma.
J. F. A. B., male, admitted May 25, 1886, aged 58. Suffering from
paranoia, and otherwise presented no unusual mental characteristics.
About six months before death he complained of pains in the chest and

REPORT OF THE MEDICAL SUPERINTENDENT.

39

abdominal region. He also had considerable trouble with his stomach
and intestines; his bowels moved with difficulty, and albumin was found
in the urine. His heart was found to be enlarged, with roughening of
the mitral valve, and the lungs were slightly congested. A paracentesis
was performed on the right side, extracting about six quarts of fluid,
and later on the left, removing about four quarts. He died suddenly
February 15, 1900. The autopsy revealed a slight amount of fluid in
pleural cavities, the right containing about six ounces soft, friable, redjelly blood clot. Lungs extensively colored by deposit of carbon, and
in several areas near the apices, which were somewhat retracted and
fibrous, a distinct interstitial pneumonia had resulted from the deposit.
Pleura thickened; dense pleuritic adhesions over right lower lobe.
Lungs, diagnosis—anthracosis, interstitial pneumonia, emphysema.
Right heart and pulmonary vein enormously dilated, full of fluid blood;
left heart empty, firmly contracted. Valves soft, pliable; no lesion.
Large amount of fat beneath pericardium. Heart weighed 24 ounces.
Coronary vessels markedly atheromatous. Left ventricle on anterior
side reduced in thickness to from one-eighth inch to one-quarter inch,
presenting the appearance of white fibrous tissue; opposite side fully
one inch thick in places; endocardium, particularly over fibrous area,
greatly thickened and uniformly white; coronary artery, though thickened, remaining open. Right ventricle moderately hypertrophied. Sections from the coronary arteries showed walls much thickened; adventitia thick and hyalin in appearance, with blood vessels thick-walled,
large, and numerous; medial coat thickened; fenestrated membrane of
Henley traceable nearly all the way around, but on one side becoming
lost, and from this part of the vessel wall there arose a distinct elevation made up of a mass of spindle-shaped cells and much intercellular
substance, which mass greatly reduced the size of lumen of the vessel,
making it more or less three cornered; endothelial coat thickened,
rough; diagnosis—endarteritis obliterans. Sections from thickened
hypertrophied wall of left ventricle showTed heart muscle to be quite
normal, though fatty degeneration in some cells and in areas beginning
fibroid degeneration, and sections from heart wall revealed marked fat
infiltration and degeneration, also strand of heart muscle separated by
fat and fatty degeneration in many cells. A. greatly thickened endocardium and marked degeneration of muscular tissue was revealed by a
cross section of a muscular column of left ventricle, and the proliferation of fibrous tissue is well shown by section from left ventricle
near fibroid area, the narrow bands of fibrous tissue found in the heart
being greatly enlarged and increased so that muscle cells and fibrous
tissue appear in about equal proportion. Some muscle cells greatly
enlarged, with pale nucleus, the chromatic elements of the nuclei appearing as coarse granules. Some heart cells stained deeply, were vacuolated, and their protoplasm granular, in places comparatively large
masses of fat to be seen separating the cell; blood vessels numerous,
walls thickened, full of blood, and at one place quite a large capillary
hemorrhage. A section through the thin, fibrous wall of anterior surface of left ventricle shows the following: The narrow way of section
is the entire thickness of this part of heart wall. From within outwTard, endocardium thickened, thin layers of muscle cells, and greatly

40

NOETHEBN MICHIGAN ASYLUM.

thickened pericardium. Muscular wall reduced to narrow layer of
from three to twenty or more heart muscle cells in thickness; some of
the cells appear normal, others contain vacuoles—the evidences of fatty
degeneration, which alcohol absorbed out. Many of the cells while
retaining their shape somewhat, were more or less irregular, without
nuclei and granular. In one part there was a capillary hemorrhage
between pericardium and muscular coat. In places fibrous tissue so
increased as to form whole wall of heart, no muscle cell remaining;
in other areas only a single heart muscle cell to be found. Fibrous
tissue hyalin in character, containing comparatively few nuclei. Diagnosis: Fibroid heart; fatty degeneration of heart muscle. Liver and
spleen normal. Liver weighed three pounds eleven ounces; spleen,
8.5 ounces. Kidneys, capsules thickened; cortex slightly atrophic; many
glomeruli obliterated, others show extensive proliferation of cells of
Bowman's capsule. In certain areas connective tissue markedly proliferated, tubules irregular, misshapen, small; in other areas tubules
large and dilated. Epithelium lining the tubules swollen and protoplasm granular. Some tubules filled with granular detritus, staining
light red with eosin, and between collecting tubules connective tissues
also increased. Walls of blood vessels thickened and hyalin. Several
small cysts found between cortex and medulla. Diagnosis: Chronic
diffuse interstitial nephritis.
The following table will show the form of insanity in the patients
admitted during the biennial period, and also from the beginning of the
hospital:

TABLE III.
For the
biennial period.

From
the beginning.

Form of insanity.
OD
O

3
£
8
5

5
6

a

13
11

d. Hallucinatory delirium (primary coni T Q««™ri 0 ™-

( a» Delusional insanitv (dementia mono-

I. Developed on the neuroses
C. Incident to the degenerate brain 4 TT
„, f/11
.,,
Ji. «„.•.,
i nmaiy
torms
1 III. Arrest of development
Total

I a" -^-C11^e
1 b. Chronic
^ a I,-!-*\'| syP
11111^10
b _ 0 e neral paralysis
J c. Dementia from gross brain lesions (ap-

-j °; Hypochondria .'.
j<; b.
Reasoning insanitv
c _ paranoia
{ *• Imbecility

!! i" !

169
76

146
73
1

315
149
1

13

10

23

211
138
1
2
6
24

356
250
30
60
14
159

13

1
2

15

145
112
29
58
8
135

8
15

5
8
1

13
23
1

68
81
7

31
62
8

9!)
143
15

12

21
11

s

111
124

120
29
6
70

231
29
14
194

2
9

C I Toxic falcohol omuml
1
•
B. Incident to the normal and the
ripp-pTipraf-p
hrain
J
degenerate Drain
II. Symtomatic of organic disease of the

3
$

"5

! ! ! ! ! ! I.!

3
9

1

77. .. .77. 8

15

4

19

11 ;

7

18

59

73

132

45

32

77

332

204
4

536
4

14

0

20

36

89
1

156

111

1,255

2,844

53
1

267 1,589

42

NORTHERN MICHIGAN ASYLUM.

Of the 267 patients admitted during the period, only 24, or about 9
per cent, were classified in the primary group. Of the remaining cases,
3 were suffering from secondary delusional insanity, 9 from terminal
dementia, 1 from syphilitic insanity, 15 from general paralysis, 13 from
dementia incident to gross brain lesions, 23 from senile dementia, 1 from
delirium grave, 33 from constitutional neurasthenia, 11 from hysteria,
19 from epilepsy, and the balance from the primary forms of mental
impairment incident to a degenerate brain. This is the smallest percentage of primary, or curable, cases admitted during any biennial
period in the history of the asylum. It would seem that some effort
should be made to spare the asylums from the care of the senile, epileptic and imbecile. Would it not be wise if the Legislature would enlarge
the institution at Lapeer sufficiently to care for the epileptics and imbeciles now confined in our institutions? The asylums are not especially
fitted for the care and treatment of epileptics, nor for the feeble minded.
If these patients could be cared for elsewhere, additional room at the
asylum would not be needed for a number of years. Ten per cent of
the admissions from the beginning have been epileptic and feeble minded.
Both can be better cared for, and a.t less expense, in colonies than in
asylums for the insane. This is the experience of those states and
countries where separate care for these classes has been established.

SURGICAL WORK.

During the period quite a number of minor operations were performed, viz., harelip, uterine curetage, removal of polyps, hemorrhoids,
slight injuries, etc.; and several of greater import, such as the removal
of the appendix, ovarian cysts, malignant tumors, diseased bone; and
operations on the urethra, etc. No deaths resulted from these operations,
and the results were uniformly good so far as relief of the physical
suffering of the patients was concerned. It has been the aim of the
staff to give surgical aid to all, even when only small prospect of relief
existed. Surgery among the insane, as a general rule, is not highly
satisfactory, but with few exceptions we have experienced little difficulty in the after-care of the patients.

MEDICAL WORK.

Clinical laboratory methods have been used more than during any
previous period. Qualitative and quantitative analyses have been made
of the urine of a large number of patients, especially in epileptics.
The results of these investigations were not entirely negative. In 3
the amount of urea excreted was excessive, less than normal in 6, and
normal in 9; in 11 the amount of uric acid was increased, less than normal in 4, and normal in 1; in 2 the amount of chlorides was increased,

EEPORT OF THE MEDICAL SUPERINTENDENT.

43

less than normal in 6, and normal in 10; in 1 the amount of phosphates
was increased, less than normal in 15, and normal in 2. Indican was
present in 6 cases.
These analyses were made without reference to the occurrence of
seizures—some before, some after, and some between fits. No doubt
the metabolic functions are deranged in epilepsy, and Krainsky's experiments would seem to point to the storing' in the system of a certain
toxin (carbamate of ammonium), which he believes produces the spasms
in epilepsy.
The frequent presence of indican is not only interesting from a pathological standpoint, but affords valuable therapeutic indications. This
coloring matter is obtained from indol, which is produced as the result
of the action of intestinal bacteria on albumin. The indol is absorbed,
transformed into indoxyl in combination with sulphuric acid, and
eliminated in the urine as indican. An excess of indican in the blood
indicates putrefaction of the albumin in the intestine; hence it is present when there is prolonged stagnation of the intestinal content in the
ileum. In the cases in which it was present, benefit was obtained from
careful regulation of the diet in connection with the use of intestinal
antiseptics.
Your attention is called to these investigations simply to show that
with accurate methods of examination in any given disease more correct means of treatment may be adopted. If we may regard a toxin
as an important factor in the causation of epilepsy, a much more hopeful view may be entertained of its curability.
During the period many blood examinations were made, and only
in a few cases was there not found some abnormal condition. These
examinations are of the highest value. In the cases with negative
results the labor is not entirely lost, since the efforts are directed to
some other line of investigation. It is of immense importance in the
mentally diseased to determine at *s early a time of the disease as
possible the hemoglobin percentage, the nature of the anemia, if existing, etc. Perhaps no scientific work is of greater value in the treat,
ment of insane states than that which leads to a thorough knowledge
of the condition of the blood.
Bacteriological examinations have been mostly limited to tuberculous
cases, although work has been done in connection with other diseases.
After the laboratory is finished, these clinical investigations can be
greatly extended. Newer methods of research afford many advantages
to the staff, the chief of which is accuracy in diagnosis, and the enthusiasm which scientific investigation of diseased conditions excites. The
asylum is gradually becoming a hospital, in the true sense of the word,
in which every case is carefully studied. We believe the day has
passed when patients can be treated successfully from surface symptoms alone, even by the most experienced physician in mental diseases,
without the aid of laboratory methods. Psychic phenomena likewise
must be studied, as far as possible, by instruments of precision. Advances in nervous and mental pathology, bacteriology, and in physiological chemistry, have been astonishing during the past few years,
and the tests for the discovery of diseased conditions are so numer

44

NORTHERN MICHIGAN ASYLUM.

ous that if they were all applied to every ease a large staff would be
required.
Much original work has been accomplished in the asylum's laboratory
at Ann Arbor, and several papers detailing the more important results
have been published by the pathologist and his staff. While a step
forward has been made in the medical work during the period, yet we
feel that we are only at the beginning of what ought to be done. The
medical staff is too small if much more additional work is to be undertaken. We believe that internes could be added to the staff—men
thoroughly trained in technic, and who would be glad to serve at comparatively small pay for the experience and knowledge they might gain
in this special field. ]STo one appreciates better than myself the interest you have taken in this work, and your constant efforts to advance
it, and if the medical officers could be relieved of much that is purely
routine, and their efforts directed more to clinical methods, the hospital would advance another step.
During the last two years the number of tuberculous patients has
increased. Some of these were infected at the time of their admission,
but the distressing fact remains that the majority have developed the
malady within the hospital. A thorough examination was made of all
the patients to determine the amount of phthisis in the asylum. In
the doubtful cases, and in those in which the bacillus did not appear,
tuberculin was used. The results showed that there were 29 patients
in various stages of the disease. These patients were living in various
parts of the institution—some in crowded wards, where the danger
of infection was great. In order to protect the non-tuberculous, and to
afford opportunity for better care and treatment of infected women,
a ward on the north wing was assigned especially for such cases. The
hall was thoroughly renovated, carpets and draperies removed, and
antiseptic measures established.
No new cases have developed ^p the institution since, and several
have greatly improved. It may be interesting to state that two cases
in which tuberculosis had been found several years before, died from
intercurrent diseases, and the post-mortem examination showed that
in each instance lung cavities had existed, but had healed, and that
at the time of death no evidence of tuberculous disease existed in any
of their organs.
The medical work, including the taking of histories, making of records of morbid conditions, requires a vast amount of time; in fact, the
present staff cannot accomplish all the research work required. It
is to be hoped that our present Legislature will give this matter careful consideration and increase the appropriations for officers' salaries,
so' that the staff may be increased in number to an extent that each
patient may be given the benefit of exact scientific work. We believe
that the laboratory work can be performed by medical internes, but
that the treatment of patients and the direction of their care, etc.,
should be performed by experienced men, as is. the practice in the
best general hospitals of our great cities. We appreciate your efforts
in promoting and making practical the asylum's laboratory in connection with the University ^)f Michigan. The work thus far accomplished
by this department has been of value, especially during the last year.

45

REPORT OF THE MEDICAL SUPERINTENDENT.

In my experience there has never been so much accomplished, nor
so much enthusiasm in our field of work. We fully believe that if this
department can be placed upon a permanent basis, untold value will
follow to the insane, to say nothing of the research work that can be
accomplished, to the credit of the State. No one but a physician can
fully appreciate the value of the discoveries of the lesions of the
neurone that have been recently made, and the asylums should be able
to keep pace with the best scientific investigators. We trust the coming Legislature will establish and fully equip the asylum's laboratory
at the Universitv.

IMPROVEMENTS AND REPAIRS.

These have been detailed in your report, so that we need not reiterate
them in this connection. I may say, however, that the farm is nearly
reclaimed, and that the great expense attending it will soon be over.
Possibly in one respect we may regret that this work is so nearly
finished". It has been a great field for the labor of patients, and in the
near future there will need to be established other lines if the occupation of patients is to be continued. T,here is no doubt, from a curative
standpoint, of the value of well-adapted labor for patients, especially
for the able-bodied insane. I may say that it has ever been our aim
under your direction to keep every department of the institution in
perfect repair and in the highest state of efficiency.
The following are the usual statistical tables:

TABLE IV.—Degree of heredity.
For the biennial period.

From the beginning.

Males. Females. Total. Males. Females.
2
6
15

10
2
9

8

12
8
24
-16

14
2
54
55

17
1
50
14

104
69

156

111

267

8

To tal

31

To till.

21
71

52
103
57

18
87
38
131
67

30
158
90
234
124

91
35
372
'787

112
35
390
377

203
70
762
1,164

1,255

2,844

1,589

46

NORTHERN MICHIGAN ASYLUM.
TABLE V.—Occupation of those admitted.
For the biennial period.
Males. Females.

Baker

4

.

Cook

From the beginning.

Total.

4
6
25
3
1
6
60

14
8

3

1

4

5

6
5

11
9
1

2
3

5
4
1

3

5

8

1

1
2
8
1

2
1

1

8
1

1

3

41

54

1

2

17

33

87

419

Florist
1
1

Miller
Milliner
Miner

.. .

1

43

26

69

1
1

1

2
1

1
2
1

1
3

4

1

1

4
648
5
2
18
13
2
6
0

.
2

1

3

1

1
1
1

69
3
2
38

1
1

Soldier

Tailor

4

12
6
5
26
12

1

2
1

12
6

1

1

4
8
7
3
3
88

1

Sailor
--

4
1

1
3
3
2

1
1
23

9
1

1

Total

1
9
3
1
1

156

1
1

1
1
32
1
1

111

267

3
1

1,689

4
9
5
39
11
1

8
101

112
2

112

1
14
1
323

1
1
31
1
742

}
1

1

1
1

Total.

4

3
1
1

1

Males. Females.

2
55
1
276
3
4
18
1
7
16
9
1
39
6
2

3

i

3
56
K
924
8
6
36
1
20
2
22
12
1
108
9
2

1

i^
80
I
1
11
4
1
2

5
3
3
17
10
1
11
2

17
9
8
43
22
1
23
8

3
9
21

7
17
28
3
3
217
1
5
1

3
42
1
2
1

129
1
2

1,255

2,844

47

REPORT OF THE MEDICAL SUPERINTENDENT.
TABLE VI.—Nativity of patients admitted.
For the biennial period.
Males. Females.
Africa

From the beginning.

Total.

Males. Females.
1

. -.
23

42
4

20

2
1

4
1

67
4

8
1

1
15
1
1

65
126
13
83
7

30
107
9
57
2

5
3
1

17
8
4

8
..._..

19

1
4

2

1
7

Holland
Italy

1

1
1

3
2

2

2

50
1

41

91
1

3

5

8

293
4
2
31
1
3
3

10
1

9

19
1

152

7

5

12

1
65

2

5

7

5

3

8

1

1
1
1

1
1

6

37
12
3
131
19

4
396

3
15
1
38
4

4
35
2
105
8

Wales

28

6

34

Total

156

111

267

1,589 1

1
2

39
16
41
4
12
9
1
572
5

34
1

2
65
2
3
4

1
1
120
1
68

1
272
3
1
133

30
11
1
1
94

6T
23
1
4
225

11
1

30
1
1
16
1

9
1

1
2

95
233
22
140
9

5
1
279
1

1

3
6
3
18
2
124

1
1

178

3

5
4

Ohio

1

18
1
218

Total.

2
9
1
15
64

5
15
4
33
2
188

1,255

2,844

RECAPITULATION.

Total

146
87
34

1,212
1,444
188

267

2,844

4

48

NORTHERN MICHIGAN ASYLUM.
TABLE VII.—Clinical groups.
For the biennial period.

From the beginning.

Males. Females. Total. Males. Females. Total.
8
5

Phthisical

..

Post-febrile

35
117
88
89
102

11
117
21
107
341

10
65
19
6
291

21
182
40
113
632

177
1
111
17
1

237
4
17
15

414
5
128
32
1

24
12
84

20
165
19
64

44
165
31
148

4
6
10
3

42
35
75
101

15
8
14
107

57
43
89
268

267

1,589

1,255

2,844

15
15

4

19

51

37

88

14

20
1
2
1

34
1
14
1

3
*
0

7
3
25

3

Senile . .
Syphilitic
Toxic
Total

6
64

22
1
35
83
38

8
11
4
22

12

13
116

r>3

6
4
7

17

o

2
3
8
3

.. .

2
3
2

111

156

TABLE VIII.—Duration of disease previous to admission.
For the biennial period.
Males. Females.

Total

Total.

From the beginning.
Males. Females. Total.

21
14
5

1
17

20
15
8
1
9

41
29
13
2
26

257
152
96
21
178

210
121
83
25
105

467
273
179
46
283

8
11
2
14
63

10
10
10
7
15

24
21
12
21
78

249
140
138
78
280

208
149
161
74
119

457
289
299
152
399

156

111

267

1,589

1,255

2,844

REPORT OF THE MEDICAL

49

SUPERINTENDENT.

TABLE IX.—Civil condition.
For the biennial period.
Males. Females.
53
66
12
9
16

Single

Total.

75
20
8
4
4

128
86
20
13
20

From the beginning.
Males. Females.
616
787
76
29

Total.

844
257
115
28
11

1,460'

1,255

2,844

1,044
191
57
92

81

Total

156

267

111

1,589 i

TABLE X.—Age of patients.
For the biennial period.
Males. Females.
16 to
21 to
26 to
31 to

20
25
30
35

36 to
41 to
46 to
51 to

40
45
50
55

56 to 60
61 to 70

1

.

'
..

..

Total . . . . . . .

Total.

From the beginning.
Males. Females.

11

Total.

9
so

20
147
303
415
369

200
175
102
81

192
136
*77

392
311
216
158

11
17
9
29

63
100
44
122

59
04
24
47

122
164
68
169

267

1,589

1,255

2,844

5
13
29
19

10
7
18
11

1
IS
20
47
30

87
188
234
182

11
17
8
8

16
8
10
10

27
25
18
18

1
14
6
25

10
3
3
4

156

111

115
181
177

50

NORTHERN MICHIGAN ASYLUM.
TABLE XI.—Probable exciting cause.
For the biennial period.

From the beginning".

Males. Females. Total.
B
1
3
16

1

Males. Females.

6
3
3
23
3

2
7
3
JJ

3
16
19

14
15

2

64
18

Total.

35
26

88
59
37
98
26

9
21
122
3
27

17
64
71
5
18

26
85
193
8
45

7
119
189
13
g

16
193
13

23
312
193
15
22

17
12
12
168

1
50
15
15
168

41
37
63

2

Fright
Ill-health

...

11
8

3

80

41
8

2

2

o
1
7

Phthisis

5
1
•

33 '
3
3

7

22
16
1
22

3

4
2

15
3
40
1

7

19

156

111

8

Total . . . .

1

22
19
9
59

1
22

4
46

13

10

30
66

34
18

6

5

64
84
4
11

22
3
B9
1

64
37
462
147

52
6
310
15

116
43
772
162

1,589

1,255

2,844

267

51

REPORT OF THE MEDICAL SUPERINTENDENT.
TABLE XII.—Eesidence of patients admitted.
For the biennial period.
Males. Females.

Clare

From the beginning.
!
Males. Females.

Total.

2
1
5
1

4
5
1
2

6
6
6
S

49
31
12
6

3

4

7

1
11
15

2

2

4

23

1
1

1

1

19
7

2

1

3

32
15

'2

5

7
1

Delta

i

Glartwin .
Gratiot .

.

.

2
20
63
66
97

!)
8

3
11

12
20

4

1
4

5
4

24
25
2
10

18
7

7
1

25
8

25
18
8

j
3

2
7

12

Isle Royal

Kent
Lake

23
22
32

1
1
4

Total.

41
37
9
11
1

90
68
21
17
1

5
17
9
20

1
16
32
9
43

10
8
1
29
7

29
15
1
61
22

15
1
I

38
31
58
2
3

21
41
60
fiO
2

41
104
126
157
2

1
23
23

1
47
48
2
13

3
25
7
X
1
H

50
25
16
1
3
30
46

11

18
21
3
1
13

2

e
i

24

6

6

5
6

3
2

8
8

48
87
25
55
88

39
57
21
37
31

87
144
46
92
119

2

6
1

6
3

22
19

IB
3

(i

22
3

91
6

41
13
1
70
2

63
32
]
161
8

14
4
8

14

28
4
10
3

101
31
34
13
7

105
36
28
8
6

206
61
62
21
18

2
1

.

12

52

NORTHERN MICHIGAN ASYLUM.
TABLE XII.—CONCLUDED.
For the biennial period.
Males. Females.

From the beginning.

Total.

Males.

Females.

37
8

6

3

9

36

1
1

1
2

2
3

8
4
7
8

2

2

St Clair

3
7

4

1

2
20

7
1

State
Total

..

73
16
4
10
15

5
1

4
27
1

31

5
4

27
6
88
43

2
20
49

58
8
108
92

267

1,589

1,255

2,844

1

a

6

4
4

1

156

111

ESTIMATES OP THE SPECIAL

Total.

APPROPRIATIONS.

The following are the estimates of special appropriations requested by
the Board of Trustees of the asylum and submitted to the State Board
of Corrections and Charities for its approval:
To the State Hoard of Corrections and Charities :
GENTLEMEN—As required by section 2228, Compiled Laws of 1897, I
submit below estimates of special appropriations requested by the Board
of Trustees of the Northern Michigan Asylum for the erection and furnishing of two cottages—one for fifty men and one for fifty women;
for the purchase of one 150 horse-power boiler; a cottage for 15 tuberculous patients; for repairs to roofs and gutters of main building of the
asylum, and for the purchase of forty acres of land:
I. COTTAGE FOE FIFTY MEN PATIENTS.
a. Labor and Material:
650,000 brick at $5.50
80 cords rubble stone, on grounds, at $8.50
Cut stone
800 barrels lime at 90c
'.
50 barrels Portland cement at $2.40
60 doors, 94 windows (glazed), 55 transoms (glazed)
Head blocks, ash casing, ash bases, ash aprons, casings and stools
121 window frames
40,000 feet rough lumber at $10
35,000 feet matched lumber at $20
15,000 feet dressed pine
30.000 feet pine, inside work
5,200 yards plastering at 20c
1,600 yards painting at 25c

$3,575 00
080 00
350 00
720-00
120 00
600 00
250 00
250 00
400 00
700 00
180 00
750 00
1,040 00
400 00

EEPORT OF THE MEDICAL SUPERINTENDENT.
I. COTTAGE FOR FIFTY MEN PATIENTS.—Continued.
a. Labor and Material:
90,000 shingles at $2.50
Hardware, nails, locks, hinges, etc
Masons, carpenters and laborers
250 feet tile at 20c
65 wire window guards
17,000 feet, flooring at $25

53

$225 00
750 00
5,500 00
50 00
227 00
425 00
$17,192 00

b. Heating and Ventilating:
Iron, steam and water pipe, radiators—direct and indirect
Register faces and iron ventilating pipe
Two mantels and grates

1,250 00
150 00
110 00
$1,510 00

e. Furnishing:
Range and kitchen utensils
50 iron bedsteads
.*
50 woven wire mattresses
50 hair mattresses
60 dimnsr-room chairs
120 half chairs
Blankets, sheets, towels, dishes, etc
Stands, settees, etc

125 00
3°0 00
100 00
500 00
40 00
300 00
400 00
100 00
$1,865 00

d. Electric Lighting:
Wire fixtures, cut-outs, switches, lamps, etc
e. Plumbing:
Sinks, baths, water closets, sewer and sewer connections, etc

300 00
500 00
$21,367 00

II. COTTAGE FOE FIFTY WOMEN PATIENTS.
Estimates same as above.
III. BOILER.
One 150 horse power water tvibe boiler
Valves, steam pipe and labor

$2,500 00
350 00
$2,850 00

IV. REPAIRS TO ROOF OF MAIN BUILDING OF ASYLUM.
Replacing tin roof on administration building, 45 squares at $8 per square
Roofing 500 feet gutter and covering same with copper sheeting, erecting
scaffolds, labor, etc., at $7 per foot

380 00
3,500 00
$3,860 00

V. PAVILION FOR CONSUMPTIVES (15 WOMEN PATIENTS).
Labor and Material:
275,000 brick at $5
40 cords stone, in wall, at $12
63 windows at $12
25 windows at $5
28 doors and frames at $14
25,000 feet rough lumber at $12
50,000 shingles at $2.50
15,000 feet dressed lumber at $12
10,000 feet dressed lumber at $25
7,000 feet matched lumber at $25
10,000 feet pine lumber at $15
'
Cut-stone sills and water table. .
Carpenter work and labor

1,375 00
480 00
756 00
125 00
392 00
300 00
125 00
180 00
250 00
175 00
150 00
275 00
1.300 00

54:

NOETHEEN MICHIGAN ASYLUM.

V. PAVILION FOK CONSUMPTIVES.—Continued.
a. Labor and Material:
10,000 ft. maple flooring at $25..
2,800 yards plastering at 20c
1,000 yards painting at 25c
Hardware, nails and tin work
Lime and cement
Tile
floors
Woven wire window guards
Mason work and labor

$250 00
560 00
250 00
250 00
350 00
100 00
175 00
1,400 00
$9,218 00

b. Heating and Ventilating:
Iron, steam and water pipe, radiators—direct and indirect, boiler, etc. ..
Register faces and iron ventilating pipe
One mantel and grate
One sterilizer and laundry furniture

1,000
75
55
800

00
00
00
00

$1,930 00
c. Furnishing:
15 iron bedsteads
15 woven wire mattresses
15 hair mattresses
18 dining-room chairs
36 hall chairs
Blankets, sheets, towels, dishes, etc
Stands, settees, etc

:

90 00
30 00
150 00
12 00
72 00
120 00 .
45 00
$519 00

d. Electric Lighting:
Wire fixtures, cut-outs, switches, lamps, etc
e. Plumbing:
Water closets, sinks, baths, sewer and sewer connections

100 JO
300 00
$12,067 00

VI.
Forty acres of land

$3,200 00

All of which is respectfully submitted.
JAMES D. MUNSON,
Medical SuperintendentNorthern Michigan Asylum, September 11, 1900.

REPORT OF THE MEDICAL SUPERINTENDENT.

55

The following is the report of the State Board of Corrections and
Charities upon the above requests for special appropriations:

STATE OF MICHIGAN,
>
BOAKD OF CORRECTIONS AND CHARITIES, >
Lansing, October 29, 1900.
)
JAMES D. MUNSON, M. D., Medical Superintendent Northern Michigan Asylum, Traverse
City, Mich,.
DEAR SIB—Your communication to the State Board of Corrections and Charities,
submitting for its consideration and opinion the proposed appropriations for the
Northern Michigan Asylum for the years 1901 and 1902, was duly received.
The
asylum was visited and its "conditions and needs investigated." The Board has carefully considered the appropriations proposed, and respectfully submits herewith its
opinion of the same.
A cottage for fifty men patients-X^
~'
$21,367 00
A cottage for fifty women patients
21,367 00
The inhumane and illegal long confinement of the insane in jails, because of lack
of room in our State asylums, makes this request most reasonable; the amount asked
is, in the opinion of the State Board, none too great, and the item is approved.
One 150 horse-power boiler, connection and setting
$2,850 00
As a reserve, and with the demand for increased steam for heating additional buildings, a new boiler would seem a necessity; the cost for the boiler contemplated is
deemed reasonable and this item is approved.
Repairs to roof
$3,860 00
That this work should be continued for the preservation of this State property is
unquestionable. The amount asked is, as shown by your estimate, reasonable, and
is approved.
Pavilion for consumptives (15 women patients)
$12,067 00
While the State Board appreciates the fact that some such provision should be made
for the care of such patients, it does not approve of this building at the present time.
The State Board would, however, recommend that a sterilizer, for more general use,
he provided for and installed at the Northern Michigan Asylum, and that for this
purpose there be appropriated $1,000.
Land
$3,200 00
The State Board favors the purchasing of this land for the Northern Michigan
Asylum. The price ($3,200 for 40 acres) seems, however, exorbitant, and a strong
effort should be made to secure it at, less cost.
Yours respectfully,
L. C. STORES,
GEO. D. GILLESPIE,
Secretary.
Chairman.

CHAPEL SERVICES.

The chapel services continue to be a source of great comfort to
patients. Eegular services have been conducted by the chaplain, Rev.
D. Cochlin, assisted by Revs. W. K. Wright, C. T. Stout, A. A. Wall, and
W. T. Woodhouse. It is to be regretted that the institution has outgrown the capacity of the chapel. The chapel seats comfortably about
350 patients, and there should be room for at least 500. In the near
future steps will need to be taken to enlarge this building.

56

NORTHERN MICHIGAN ASYLUM.
ACKNOWLEDGMENTS.

The institution returns thanks to the editors of the following papers
for donations of their journals for the use of patients:
Alpena Argus.
Deaf Mute Mirror.
Michigan State Democrat.

Big Rapids Herald.
Grand Traverse Herald.
Traverse Bay Eagle.

Cheboygan Tribune.
Index and Review.
Triumphs of Faith.

We would also extend our thanks to C. L. Lockwood, general passenger agent Grand Rapids & Indiana railroad, for donations of papers
and journals. We are especially indebted to Mrs. Emily Arnold for
the donation of a large number of magazines. To all who have contributed in any way to the comfort and pleasure of patients, I would
return most sincere thanks.
I am under renewed obligations to the staff for many personal kindnesses. I cannot express too highly my appreciation of the work they
have accomplished, and of the enthusiasm they have shown in all that
pertains to the care of their charges.
I would again thank the Board of Trustees for the interest they have
taken in the institution, and for their earnest support in all that pertains to the discharge of my duties. We believe that during the biennial period just closed the hospital made progress in its medical work,
and we feel assured that it will continue.
All of which is respectfullv submitted.
JAMES D. MUNSON,
Medical Superintendent.
Traverse City, Michigan, Sept. 26, 1900.

OFFICERS AND EMPLOYES
OF THE NORTHERN MICHIGAN ASYLUM, AND THE WAGES OR
SALARIES PAID EACH, JUNE 30, 1900, AS REQUIRED
'BY SECTION 2, ACT 206, LAWS 1881.

Service.

Name.

Medical superintendent
<>

C. L. Whitney

a

Acting assistant physician..
Steward.:

T. H A Tregea
C M Frail
C.TC.Kenyon
C TJ Osborn
S. O. Howard
Byron Doty
HansTohler
Hattie Allen

Stenographer
Storekeeper
Telephone operator
Gardener

Hattie Booth

"

Lottie Bahlke

"

B. P. Burns.
Kittie Bliss
F J Benjamin

(i
ti
(i

a

a
(i
(i
It

D. Reid Butler
Maggie Clark
D. Cox

(|

11
11
.1
11

Period.

Rate.
$3,000 00
1,91X1 00
1,2"0 00
1,000 00
900 00

Per annum. Resident.

BO
1,600
250
600
1,200

00
00
00
00
00

Per month.
Per annum. Non-resident.

50
1,400
1,400
70
32

00
00
00
00
00

Per month.
Per annum.
Per month. Resident.

45
65
35
10
60

00
00
00
00
00

30
12
26
14
19

00
00
00
00
00

22
26
14
22
32

00
00
00
00
00

IS
34
20
22
19

00
00
00
00
00

14
12
22
26
19

00
00
00
00
00

16
3S
14
34
30

00
00
00
00
00

Xoii-resident.
Resident.
Cottage.
Resident.
Non-resident.
Resident.

Non-resident.
Resident.

Non-resident.
Resident.
Non-resident.

58

NORTHERN MICHIGAN ASYLUM.
OFFICERS AND EMPLOYES—CONTINUED.
Service.

Name.

C E Culbert
Hattie Colby

(i
4i
it
<(

tt

H -V Dotv

,t

„
it

Mayme Doran

Attendant
„

ci

„

E<*telle Fisher

Will f»oodell
L Hodge

Fred Hale

((
t(
ti
tt

It
II

00
00
00
00
00

U

14 00
i2 00
24 00
24 00
22 00

tt
tt
.t
tt

It
tt
It
tt

18
19
12
12

00
00
00
00

tt
It

It
tt
It

12
40
L>2
19
2ti

00
00
00
00
00

28
18
32
14
18

00
00
00
00
00

34 00

tt

tl

A E Knight
Libbie Kelley

l(

Effie Kent

[(

((
;(

((

u

tl

It
(t

Non-resident.

•'

Resident.

t.
K
.i

00
00
00
00
00

t(

"

22 00
10 00
14 00

18
34
19
19
2ti

[(

Non-resident-

tl

00
00
00
00
00

K

•'

ti.

14
28
19
14
32

it

tt

la oo

.1
((
l(

It

It

ie oo

00
00
00
00
00

K

Fer month. Resident.
. *'
'•
tt
tt
.1

30
18
14
22
26

if

E R Jacobie

$2(1
2»
22
24
12

it
(i
l(
(t

tt

Period.

Kate.

22
14
22
12
13

00
00
00
00
00

22
24
32
32
20

it

it

4k

41

l(

„

ti.

4t

((

ii

U

"
"
.(
u

tl

Non-residentResident.
tt
i

U

i

u

t

it
it,

:
.t

tl

't

,

,t
it
tl
tl
it

*i
iii
.t

00
00
00
00
00

it
;t
:;
tt

it
it
i'
(t

36
12
13
22
20

00
00
00
00
00

t<

(4

(i
.1

ti
ti

26
16
12
19
10

00
00
00
00
00

U
u

ti
tc

((

59

OFFICERS AND EMPLOYES.
OFFICERS AND EMPLOYES—CONTINUED.
Name.

Service.

t<

Fred McCarn .
J. H. McAllister
F G- North
E North .
. . . . .
V. A. Patrick
W S Purple
N Purple

tt

]t

l(

it

n

.1

„it
K
ii

Chas Stantield
Geo.H. Smith
(I

Bart Simmonds
Marie Smaltz
J Tuller
Floy Theobald

it

Attendant

n
4t

Wm Watson
Eunice Walsh
Emma Wiltshire
Ella Willis
Hattie Walsh
Thos Whitfield
Wm C Walker . . . .
Minnie Wall
Luella Wright
Geo. E. White
W. L. Wesson
Elsie Middle ton
H. W. Pierce
C.L. Shugart
F. D. McAvov
C J Leland "
R. F. Herkner
G-. Swan
W Swan

W.Bellaw
Chas Getchell
Ralph Thacker

tt

ii

;;
^i

li
((

Attendant

Watchman
Assistant laundryman

ii

i;

<*

*t

Kitchen assistant
U

1

a

:

n
a

i
t

Period.

Kate.
$lfi
20
26
2<i
32

00
00
00
00
00

18
32
34
18
19

00
00
00
00
00

26
24
22
24
31

00
00
00
00
00

24
22
12
12
26

00
00
00
00
00

14
12
3(i
16
20

00
00
00
00
00

28
12
18
26
28

00
00
00
00
00

12
12
26
32
24

00
00
00
00
00

16
22
10
22
19

OO'
00
00
00
00

32
53
45
45
28

00
00
00
00
00

1,100
60
30
22
19

00
00
00
00
00

18
45
65
35
20

00
00
00
00
00

18
15
14
IS
16

00
00
00
00
00

16
16
16
Hi
16

00
00
00
00
00

Per month. Resident.

Non-resident.
Resident.

Non-resident.
u
Per annum.
Per month.

Resident.

Non-resident.
Resident.

60

NORTHERN MICHIGAN ASYLUM.
OFFICERS AND EMPLOYES—CONCLUDED.
Name.

Service.

O. Armitage
J. Lotharius

Barnman
-. Fireman

L Hewett .
H Housler

W Ben ton

"W D Hollister
Geo A Grill
\ Fraser
F A Wright
J Quaife

1 75
1 FO
25 00
30 00
35 00
*;

ti

"

1 50
1 50
1 75
1 75
1 50
1 50
1 50
22 00
22 00
24 00

14

„
Armitatrp

F W Elliott
R Hadley

4(
(i

1 75
2 00
' 2 00
2 00
2 00
2
2
2
2

I
,

4

Nellie Plough

Laundry assistant
tt

ti

14

tt

tt

..
tt

50
25
25
'J5

2 25
2 25
1 50
1 50
10 00
10
10
10
10

00
00
00
00

ti

tt

ti

l(

n

n

ii

u

tt

a
it
l:

11
t(
it

U

(t

(C

.1

li
it

11
11

i:

a

it

u

(i

it

11
(
t
i
4

''2 00
1 50

S H McMichael
B Wilhelm

Per month. Cottage.
Non-resident.

30 00
22 00

44

F. Nagel
C. Swan

35 00
25 00
3 00
3 00
3 00
3 00
3 00
3 00
3 00
2 25

E Packard
C C Howard.
FrJ

Period.

$24 00
31 00
25 00
1 f>0
1 50

4(

W C Barnard

Rate.

tt
t.
ti
(i

ti

14

i.

44

it

41

11

11

U

tt

11

It

tt

t.

tl

t(

f(

tt

It

tt

1.

it

It

Per month. Resident.
ti
ti
it

tt
it
a.

LAWS GOVERNING THE ASYLUM.

The act organizing the asylums of Michigan and providing for the
admission, maintenance, and discharge of patients is known as Public
Act 135, Laws of 1885.
GOVERNMENT.

SEC. 10. Each board of trustees is hereby directed and empowered to establish such
by-laws as it may deem necessary and expedient for regu'atiiig the appointment and
duties of officers, attendants and ass'stants; for fixing the conditions of admission,
support and discharge of patients, and for conducting in a proper manner the business
of the institution under its charge; also to ordain and enforce a suitable system of
rules and regulations for the internal government, discipline and management of the
asylum. .
ADMISSION OF PATIENTS.

The following by-laws govern the admission of patients:
First, Indigent and pauper insane will be admitted upon orders granted by the
proper officers, in accordance with the laws of the State, and no indigent or pauper
insane persons shall be admitted without such authority;
Second. Pay patients (or private patients) can only be admitted to the asylum for
care and treatment upon compliance with the following requirements:
(a.) The certificates of two reputable physicians, under oath, appointed by the
judge of probate of the county where the alleged insane person resides, possessing the
qualifications required by Section 22, Public Act No. 135, Laws of 1885, as amended by
Act No. 220, Laws of 1889, and the certificate of the county clerk.
(b.) A bond in the sum of one thousand dollars, duly executed by two persons of
responsibility, to be approved by the Medical Superintendent, shall be delivered to the
Superintendent at the time of the admission of the patient, obligating the bondsman
to pay all the patient's expenses while in the Asylum.
(c.) An order from the judge of probate of the county of the patient's residence,
committing him (or her) to the Asylum as a private patient.
(d.) Pay for thirteen weeks' board and treatment must be made in advance of the
admission of the patient.

No patient shall be detained in the asylum after the medical superintendent shall determine that he is of sane mind.
Indigent insane persons are admitted on the orders of judges of probate, in accordance with the provisions of sections 23 and 24, Act 135,
Laws of 1885, as amended by Act 44, Laws of 1897; and further amended
by Act 173, Laws of 1899.

62

NORTHERN MICHIGAN ASYLUM.

SEC. 23. When a person not a pauper becomes insane, and no application be made
to admit such person to the asylum for the insane as a private patient, application
may be made in his behalf by any person conversant with the circumstances to the
judge of probate of the county where said insane person shall be at the time such
application is made, and said judge of probate shall immediately notify- such alleged
insane person of such application and of the time and place of hearing to be held
thereon, and shall also summon to appear before him at the same time the following'
persons, if known: The guardian, if such alleged insane person have a guardian; also
such relatives as are legally liable for the support of such person, which summons may
be served in any county of the State, and shall also notify any person having alleged
insane person in charge or custody, and shall also call two legally qualified physicians,
and, in his discretion, other credible witnesses, and also immediately notify the prosecuting attorney of the county and the supervisor of the township, or the supervisor
or alderman of the ward in which said insane person resides, if his residence is in said
application claimed to be in the said county, of the time and place of such hearing,
and upon receiving such notice such officers shall attend said examination and act in
behalf of said county, and said judge of probate may appoint a guardian ad litem
to represent such insane person upon said hearing, and said judge of probate shall
fully investigate the facts in the case and may summon a jury at his discretion. He
shall summon a jury whenever requested by such alleged insane person, or by any
relative legally liable for his support, or by the prosecuting attorney of the county,
such jury to consist of six residents of the county, and shall be selected and summoned in the same manner as juries are selected and summoned in justices' courts,
and either with or without the verdict of the jury, as the ease may be, shall determine the question of insanity, and also the question of indigence, but this decision
as to indigence shall not be conclusive; and if the judge of probate, after such hearing, shall certify that such person is adjudged to be insane and his estate insufficient
to support himself and his family, or if he has no family, himself, under the visitation
of insanity; or if it shall appear that his estate is sufficient, but no person will
execute the required bond or perform the required regulation to have such, person
admitted as a private patient, on his certificate under seal of the probate court of
said county, such person shall be admitted into the asylum and supported therein
at the expense of the county to which he belongs until he shall be restored to soundness of mind, if effected within two years, or until otherwise ordered; or at the .
expense of the State, if the judge of probate shall find that such insane person
has no legal settlement in any county in this State, or is unable to find from the
evidence where that settlement is. If it shall appear on said hearing to said judge
of probate that such insane person is indigent, and that he has relatives legally liable
for his support, said judge of probate shall also at the said hearing, or at some
adjourned day thereof, investigate fully as to the financial ability of such relatives
of said insane person as are legally liable for his support. If said judge of probate
shall be satisfied on such hearing that said insane person is indigent, and has relatives
legally liable for his support who are able to contribute to the support of such insane
person, he may make an order requiring the payment by such relatives of such sum
or sums as said probate judge may find they are reasonably able to pay, not exceeding, however, in all, the sum of two hundred dollars per year. Said order shall
require the payment of such sums to the county treasurer of such county, and may
require such payment to be made annually, semi-annually, or quarterly, as the said
judge may direct. Said probate judge shall furnish the said county treasurer of said
county a copy of such order, and it shall be the duty of the county treasurer to collect the sums therein named, to turn the same into the county treasury so long as
such.patient is a county charge, and when such patient becomes a State charge, to
pay over the moneys so collected by him quarterly to the State Treasurer. If such
relatives so ordered to pay shall neglect or refuse so to do, the county treasurer shall
notify the superintendents of the poor of said county, and also shall notify the
prosecuting attorney of the county of such neglect or refusal, and said prosecuting
attorney shall proceed, by action to be brought in the name of the county, to collect
such sum. If any person so ordered to contribute to the support of such insane
person shall at any time become unable to pay the sum so ordered, such person may
make application to the judge of probate by petition, setting forth the fact; said
judge shall hear the evidence thereon; upon the filing of such petition, the court shall
appoint a day of hearing thereon, and notice of such hearing shall be served on the

LAWS GOVERNING THE ASYLUM.

63

"prosecuting attorney of the county and supervisor of the township or ward in which
such insane person resides, which said notice shall be served not less than six days
before the day of hearing, and if satisfied that such person is no longer able to contribute such sum, may vacate or modify said order. The judge of probate in any
proceeding provided therein may request the presence of the prosecuting attorney, and
upon receiving such request, it shall be the duty of the prosecuting attorney to appear
in behalf of the county, and shall also have power to compel the attendance of witnesses and jurors, and shall file the certificates of the physicians taken under oath,
and other papers, in his office, and enter the proper orders in the journal of the
probate court in his office, and he may appoint a proper person or persons to take such
insane person to the asylum, who shall receive as pay for such services the sum of
three dollars per day, together with his necessary expenses, to be paid upon the
certificate of the judge of probate, under the seal of the probate court, by the county
treasurer of such county upon presentation to him, and out of the general fund of
such county, or any other fund available for that purpose. Whenever any person
is committed to the asylum on the order of the judge of probate under the provisions of this section, and it shall appear to said judge of probate on the hearing
thereon that such insane person has an estate, or if he has any income, annuity, or
pension, which is not sufficient to support him and his family, if he have one, under
the visitation of .insanity, and yet is sufficient to admit of the payment of something
thereto, and if it further appears to said judge of probate that such person has no
family, or that he has a family whose support and maintenance does not require the
whole of such estate, income, annuity, or pension, or if it shall appear to such judge
that such person has an estate sufficient to support himself, or if he have a family,
himself and family, under the visitation of insanity, but no person appears to execute
the requisite bond or perform the requisite regulations to have such person admitted
to the asylum as a private patient, then the said judge of probate may, on the first
• or on some subsequent day of hearing had. before him, wherein the parties interested
have been duly cited to appear, as hereinbefore provided, or duly cited otherwise,
make an order requiring the estate of such insane person, or the guardian or other
person having control of such estate, income, annuity, or pension, to pay the same
or such part thereof as said judge of probate shall determine, to the county treasurer of such county, to be by said treasurer turned into the county treasury while
such insane person is a county charge, and into the State treasury when such insane
person becomes a State charge, as hereinbefore provided.
If such guardian shall
neglect or refuse to pay over said money to the county treasurer as provided in said
order, the said judge of probate shall cite such guardian to appear before him, at
such time as he may direct, to render an accoimt of all moneys or other property in
his hands as such guardian, and on his failure to appear or render such account,
the said judge of probate may remove such guardian and appoint some other suitable
person in his place. The said judge of probate shall thereupon refer the matter to
the prosecuting attorney of said county, who shall enforce payment of the sums provided in said order by a proper action, in the name of the county. If it shall be
made to appear to the judge of probate at any time subsequent to the commitment
of any insane person to any of the asylums for the insane in this State as a.n indigent
patient, that such person has since such commitment become possessed of property,
or estate, or of an income, annuity, or pension, 'which ought in the whole or in part
to be used towards his support, and that the same is not wholly required towards
the support and maintenance of the family of such insane person, the judge of probate
shall inquire into the matter and make an order requiring the estate of such insane
person, or his guardian, or other person having control of such estate, income, annuity,
or pension, to pay so much or such a, part thereof as may appear to be proper towards
reimbursing the county or the State for the past sripport of such person, and such
part thereof towards his future support as may to him appear to be just and equitable;
and before making such order such judge of probate shall cause notice of such hearing to be served on the prosecuting attorney of the county, supervisor of the township or ward in which such insane person resided at the time of his commitment, and
to the guardian and relatives of such insane person, not less than six days before the
-day of hearing. The said judge of probate, pending any proceeding taken to commit
any insane person to any asylum in this State, may. if it shall appear upon the cartificato of two physicians to be necessary and essential so to do. commit such person
into the custody of the superintendents of the poor of said county, the sheriff of his

64

NORTHERN MICHIGAN ASYLUM.

county, or to the asylum of the district in which such insane person resides, to be
detained until such application can be heard "and determined: Provided, however,
That the period of such detention shall not exceed in all fourteen days, and all the
expenses thereof shall be paid by the county treasurer upon the certificate of the
judge of probate, under the seal of the probate court, out of the general fund of
said county, or any other fund available for that purpose. If the probate judge shall
at any such hearing find that the person is insane, but is not in indigent circumstances, he may make an order admitting such insane person to any asylum in this
State, public or private, as a private patient, if the requisite conditions therefor
are complied with. If the probate judge shall find such insane person a State charge,
as hereinbefore provided, he shall certify his findings upon the question of settlement to the Secretary of the State and to the med'cal superintendent of the asylum
to which said insane person has been sent, and the State shall become responsible for
the maintaining of said insane person. The judge of probate shall report the result
of his proceedings to the supervisors of his county, and shall also state in his report
all cases in which he had required by order, as hereinbefore provided, for payment
by relatives to the support of the insane person, or the application of his estate,
income, annuity, or pension, thereto, and the respective amounts so ordered to be paid.
The county treasurer shall also report to the board of supervisors the amounts collected by him on such order. It shall be the duty of the board of supervisors, at the
next annual meeting thereafter, to raise money requisite to meet the expenses of support accordingly. The order of the judge of probate may be in the following form:
STATE OF MICHIGAN, )
County of
J ssPROBATE COURT FOR SAID COUNTY.

At a session of the said probate court, holden at-the probate office in the
county of
on the
day of
, A. D. 190..
Present
judge of probate.
In the matter of
an insane person (or pauper).
This day having been assigned for hearing the petition now on file in this court,
alleging that
a
of
in said county (or that his residence is unknown), is
insane, and praying that the said
may be admitted
to the
asylum for the insane at
;
,
there to be supported at the expense of the county of
,'and having
notified the said insane person, and the other person's and officials required by law to be
notified, of the time and place of hearing said petition, and having filed the certificates, taken under oath, of
and
,.
two legally qualified pnysieians, and having taken the testimony of other credible
witnesses, and having inquired into h. . . settlement and having fully investigated the
facts in the case with
the verdict of a jury as to the question of insanity,
I, the judge of probate in and for said county, do find and adjudge that the said
is insane and is
indigent circumstances
(or pauper), (or, "and Ms estate is sufficient to support himself under the visitation
of insanity, but no person appears to give the necessary bond or to perform the necessary conditions to permit said
to be admitted to the
asylum as a private patient,") and certify and adjudge that the said
is insane, and that he has
acquired a legal settlement in said county (or that
he has not acquired a legal settlement in said county, but that he has a legal
residence in the county of
in said State, or that his legal residence
is unknown), and that his estate is
sufficient to support h. .. and B. .. family
under the visitation of insanity.
• It is therefore ordered that the said
be admitted to
said asylum and there supported at the expense of the county of
(or
State of Michigan) until restored to soundness of mind, if effected within one
year, and until otherwise ordered.
Judge of Probate.

LAWS GOVERNING THE ASYLUM.
I hereby appoint and direct
to the
asylum for the insane at
with full power and authority for that purpose.

65
to take said
,

• When any person is found to be insane, and in need of treatment at an insane asylum in this State, and the question of his indigency, residence, or legal settlement
cannot, for any reason, then be adjudicated, he shall, nevertheless, be committed to
the proper asylum, to be supported at the expense of the State until such question
can be properly adjudged; and if, upon the determination thereof, it shall be found
that any county in this State was legally liable for the support of such person, the
judge of probate shall certify such fact to the Secretary of State and to the superintendent of the asylum at which such person is detained, and the expense borne by the
State pending such determination shall be charged up to such county and paid by the
county treasurer out of the general fvmd into the State treasury.
SEC. 29. The rate of charge per week to be paid for the board and necessary treatment of all patients of the asylums who are residents of this State shall be annually
fixed by the trustees of the several asylums in joint session, and shall not exceed the
actual cost of support and attendance, exclusive of officers' salaries: but this provision
shall not be construed so as to prevent the furnishing of extra care and attendance
to patients by special contracts to parties chargeable therefor. At the close of each
quarter the medical superintendents of the asylums shall certify to the Secretary of
State the name, age and residence of all patients under treatment, the expense of
whose maintenance shall have been wholly paid by any county for the period of one
year, whether sucli period shall have been continuous or interrupted, and such patient
shall, from and after the close of such period of one year, be maintained by the Stats
until restored, or so long as may be deemed necessary by the board of trustees. No
person who has been committed to any asylum in the State and removed or discharged
temporarily, or otherwise, and has ieeh absent therefrom for a period of six months
or longer, shall be readmitted except upon a new adjudication as to his insanity; and
whenever an insane person shall have been maintained in any of the asylums for the
insane in this State at the expense of any county thereof for a period of two years,
whether such period shall be continuous or interrupted, and shall be discharged therefrom, temporarily or otherwise, and thereafter readmitted to any asylum within the
State, he shall not again be chargeable to any county, but to the State. If a State
patient shall be removed from an asylum on trial, and his friends be unable to defray
the expense of his return to the asylum in case such return becomes necessary, the
actual necessary expenses attending his return shall be defrayed by the State, the
asylum paying the same and rendering the account quarterly to the Auditor General, in
the same manner as other bills are rendered for the support of State patients. The
bills for the maintenance, clothing, and other charges of such patients shall be rendered
quarterly to the Auditor General in the same manner as bills are rendered to county
treasurers for the support of patients at county charge, and shall be paid by the
State Treasurer to the treasurers of the asylums in which the patients may be, on
the warrant of the Auditor General, out of any moneys belonging to the general fund.
The provisions of this act shall apply to the Wayne County Asylum as far as they may
be applicable and consistent with its organization.

Dependent or pauper insane persons are admitted on orders of judges
of probate, granted in accordance with the following section:
SBC. 26. The county superintendents of the poor of any county, or any supervisor of
any city OT town to which a person who shall become insane may be chargeable by
reason of being a pauper, shall make application to the probate judge of said county,
who shall proceed to inquire into the question of the insanity of said person, and for
the purpose of such inquiry shall call upon and may compel the attendance of one or
more legally qualified physicians, and such other witnesses as he may deem necessary,
and if satisfied of the insanity of said person, said probate judge shall make the same
certificate and order for admission into the insane asylum, and the same record and
report as are required to be made, by section twenty-three of this act, in the case of an
insane person in indigent circumstances.

66

NORTHERN MICHIGAN ASYLUM.

The form of order is the same as prescribed for indigent patients
under section 23.
Pay patients (or private patients) are admitted in accordance with
the following sections of Act 135, Laws of 1885, as amended bv Act 220,
Laws of 1899, Act No. 204, Laws of 1895, Act No. 120, Laws of 1897, and
Act 173, Laws of 1899.
SEC. 21. No person who is a resident of this State shall be held as a private patient
in any asylum, public or private, or in any institution, home or retreat, for the care or
treatment of the insane, except upon the certificates of two reputable physicians under
oath, appointed by the judge of probate of the county where such alleged- insane person resides to conduct an examination, and an order from said judge of probate setting
forth that the said person is insane and directing his removal to an asylum or institution for the care of the insane. When the relatives or friends of any insane person
shall make application in his behalf for an order admitting him to any asylum, public
or private, or to any institution, home or retreat for the care or treatment of the insane,
to the judge of probate of the county where he resides, the judge of probate shall
institute an inquest and take proofs as to the alleged insanity before granting such
order, and shall immediately notify such alleged insane person of such application and
of the time and place of hearing to be'held therein, and any relative or other person
having such alleged insane person in charge or custody shall likewise be notified of
said time and place of hearing, and the judge of probate may appoint a guardian ad
litem to represent such insane person upon such hearing, and shall fully investigate
the facts, and if the judge of probate shall deem it necessary, or if such alleged insane
person shall so demand, a jury of twelve freeholders having the qualifications required
of jurors in courts of record, shall be summoned to determine the question of insanity,
and whenever a jury is demanded the court shall proceed to the selection of such iurv
in the same manner as provided for the selection of a jury for the condemnation of land
for railroad purposes, and such jury shall determine the question of the sanity or
insanity of the alleged insane person, and the said judge of probate, pending such proceedings, if it shall appear to be necessary and essential so to do, such alleged insane
person may be placed in the custody of some suitable person, or may be moved to the
asylum of the district in which said insane person resides, or to any hospital, home or
retreat, to be detained until such application can be heard and determined:
Provided, however, That the period of such temporary detention shall not exceed
in all fourteen days, and all the expenses thereof shall be paid by the petitioner or out
of the estate of said alleged insane person. Such alleged insane person shall have the
right to be present at such hearing, unless it shall be made to appear to the judge of
probate, either by certificate of the medical superintendent of the asylum or the officers
in charge of such hospital, home, or retreat to which he may have been temporarily
committed, or by the certificate of two reputable physicans, that his condition is such
as to render his removal from the institution for that purpose, or his appearing at such
hearing, improper and unsafe. The said judge of probate shall, if satisfactory evidence
is adduced, showing the alleged insane person to be of unsound mind and in need of
care or treatment in an asylum, home, or retreat, grant an order for the commitment of
such insane person to such institution, there to be supported as a private patient.
Before making his order committing an insane person as a private patient to any of the
public asylums supported by this State, the judge of probate shall require the petitioner or friends of such insane person to enter into such bond for the support of such
insane person thereat as may be provided by the by-laws thereof, and to pay such sum
to the medical superintendent or treasurer thereof as an evidence payment towards his
support as such by-laws may require, which bond shall be signed by at least two sureties to be approved by such judge of probate, and said judge of probate, at the request
of the medical superintendent of the asylum in which any insane person may be committed as a private patient, may require such sureties to justify their responsibility
anew or order that a new bond be filed in the place and instead therefor.
The order of the judge of probate shall be substantially in the following form:

LAWS GOVERNING THE ASYLUM.

67

STATE, OF MICHIGAN, )
County of
J SS"
At a session of the probate court for the county of
holden at tlie probate
office in the
of
, on the
day of
, in
the year one thousand nine hundred and
Present
Judge of Probate.
In the matter of
an alleged insane person.
To the Medical Superintendent of the Northern Michigan Asylum:
Having received the certificates of
and
duly qualified
medical examiners in insanity, appointed by this court, by whom
•
of
an alleged insane person, was personally visited and examined,
and after notifying the said
of the proceedings to be taken in h . . .
case, and having taken the testimony of
credible witnesses, and having fully investigated the facts in the case with
the
verdict of a jury, as to the question of insanity, I, the judge of probate in and for
said county, do find that the said
is insane and a fit person for
care and treatment in the Northern Michigan Asylum.
It is therefore ordered that the said
be removed
to the Northern Michigan Asylum, there to be supported as a private patient.
Judge of Probate.
STATE OF MICHIGAN, )
County of
) ss"
I HEREBY CERTIFY, That the foregoing is a true copy of the original order and certificate made by said court.
IN WITNESS WHEREOF, I have hereunto set my hand and affixed the seal of the probate court at
this
day of
Judge of Probate.
In all cases of proceedings arising under this act, any person aggrieved by any order,
sentence, decree or denial of a judge of probate, may appeal therefrom to the circuit
court for the same county, by filing a notice thereof with the judge of probate within
ten days from the date of the act appealed from, with his reasons for such appeal,
together with such bond as is hereinafter required, and by giving notice of said appeal
to the relatives of the appellant, or person having such alleged insane person in charge,
or guardian ad lit em, with his reasons therefor, in such manner as the probate court
shall direct, at least fourteen days before the same shall be brought on for trial in the
circuit court, and within thirty days after such appeal is taken, filing in the circuit
court to which the appeal is taken a certified copy of the record or proceedings
appealed from, and of the notice and reasons for such appeal and of the bond on appeal
filed in the probate court, and of the order directing notice to the relatives of the
appellant, together with evidence that notice has been given to the relatives of the
appellant or person having such alleged insane person in charge, or guardian ad liteni,
according to the order of the probate court: Provided, however, That in all cases
where any person has been adjudged insane under the provisions of this act within
two years next prior to the time when this act shall take effect, he or she, within
sixty days from the time when this act shall take effect, may appeal therefrom, to the
circuit court for the same county by giving the notice and bond provided for in this
section, and by otherwise complying with the requirements of this section as to giving
notice of appeal with reasons therefor and filing evidence of service thereof and filing
in the circuit court to which the appeal is taken certified copies of the proceedings
and act appealed from in the probate court. All such cases shall be tried in the circuit court the same as other appeals from probate court. The party appealing shall
at the time of filing notice thereof, file with the judge of probate a bond running to
the judge of probate of said county, for the vise and benefit of any person who shall
be injured by the allowance of such appeal in such penalty and with such- surety or
sureties as the judge of probate may approve, conditioned for the diligent prosecution of such appeal and the payment of all such damages and costs as shall be awarded

68

NORTHERN MICHIGAN ASYLUM.

to any person on account of allowance of such appeal in case the person appealing shall
fail to obtain a reversal of the decision so appealed from, and any person injured by
the allowance of such appeal shall have a right of action upon such bond in case the
decision so appealed from is not reversed: Provided, further, The judge of probate
shall, if it be made to appear to his satisfaction necessary and proper so to do. either
because such person is so insane as to be in urgent need of treatment or dangerous to
himself, his friends, or the public, grant an order for the commitment of such insane
person to such institution pending the hearing and determination of such appeal.
SEC. 22. It shall not be lawful for any physician to certify to the insanity of any
person for the purpose of securing his admission to an asylum, unless said physician
be of reputable character, a graduate of some incorporated medical college, a permanent resident of the State, registered according to law, not related by blood or
marriage to the alleged insane person nor to the person applying for such certificate,
and shall have been in the actual practice of his profession for at least three years; and
such qualifications shall be certified to by the clerk of the county in which such physician resides. No certificate of insanity shall be made except after a personal examination of the party alleged to be insane; and it shall not be lawful for any physician to
certify to the insanity of any person for the purpose of committing him to any asylum
of which the said physician is either a trustee, the superintendent, proprietor and
officer, or a regular professional attendant. The county clerk's certificate of qualification, of which there shall be one for each certifying physician, shall be in the following
form:
STATE OF MICHIGAN,
County of
I hereby certify that
of
is personally known to me as a reputable
physician, and is possessed of the qualifications required by section 22 of Act 135 of
the Session Laws of 1885, as amended and now in force, and that, as appears by his
oath-on file in my office, he is a graduate of
medical college, and that he has
been in the practice of medicine for a period of
years, and is registered according to law.
[L.S.]

,

County Clerk.

The following blanks have been adopted for the admission of private
patients, with the exception of the order of the probate judge, which is
quoted above:
APPLICATION FOE ADMISSIOX.

To Hon
Countv of

•

Judge of Probate for the
in the State of Michigan:

of
in said county, respectfully shows that
who is a resident of the
of
in said county, is insane and in need of asylum treatment. Ihat said petitioner will
furnish a bond with sufficient sureties to the Treasurer of the Northern Michigan
Asylum at Traverse City, to guarantee payment of the expense of the maintenance and
care of the said
in said asylum.
That the petitioner is
and is
well acquainted with the pecuniary circumstances of said
and makes this application in behalf of said
that he may be
admitted, on the certificate of said judge of probate, in the Northern Michigan Asylum,
and there supported at private expense, according to the provisions of Act No. 220, of
the Laws of 1889.
Dated

19.

LAWS GOVERNING THE ASYLUM.

09

STATE or MICHIGAN, }
County of
j'ss'
the above named applicant,
being duly sworn, says that the above application by him signed, is true, as he verily
believes.
Subscribed and sworn to before me this
day of
..A. D. 19.. .
Judge of Probate.
APPOINTMENT OF MEDICAL EXAMINEES.
STATE OF MICHIGAN, )
County of.. .:
( SSAt a session of the probate court ior said county of
held at the
probate office in the
of
on the
day of
, in the year one thousand nine hundred and
Present
Judge of Probate.
In the matter of
an alleged insane person.
Application having been made to this court for an order for the admission of
said alleged insane person to the Northern Michigan Asylum as a private patient,
and
two reputable physicians, qualified medical examiners in insanity, are hereby appointed
to examine said alleged insane person, as to such alleged insanity.
Judge of Probate.
BOND.
Know all men by these presents. That we ............ and ............ in the county
of .......... are held and firmly bound unto
................
treasurer of the Northern
Michigan Asylum, at Traverse City, and his successors in office, in the sum of ons
thousand dollars, for the payment of which we jointly and severally bind ourselves,
our heirs, executors and administrators by these presents.
WHEREAS,
.............
of the ........... of ........... in. the countv of
...........
an insane person, has been admitted as a patient into the Northern Michigan Asylum,
at Traverse City.
Now. therefore, the condition of this obligation is that if the said obligors shall pay
the treasurer of said asylum the sum of .......... . .dollars and ............ cents per
week, for the care and board of said insane person so long as ...... shall continue in
said asylum, with such extra charges as may be occasioned by ...... requiring more
than ordinary care and attention, and also provide ...... with suitable clothing, and
pay for all such necessary articles of clothing as shall be purchased for ...... by Lne
steward of the asylum, a. statement of which, by the steward, shall be taken as conelusive, and is hereby agreed to by the undersigned, and remove ...... '....whenever
the room occupied by ....... sha'll be required for a class of patients haying preference
by law, and also pay for all damages that ...... may do to the furniture or other
property of said asylum, and for reasonable charges in case of elopement, and funeral
charges in case of death ; such payments for board and clothing to be made quarterly,
and at the time of removal, then this obligation to become void, otherwise to remain
in force.
Sealed with our seals and dated the
....................
day of
..................
in the year 19 . . .
[L. S.]

Signed and sealed in the presence of
......................................
I HEREBY CERTIFY, That I am personally acquainted with
.....................
and
.....................
signers of the above bond, and consider either of them fully
responsible for the prompt discharge of its obligations.

70

NORTHERN MICHIGAN ASYLUM.

STATE or MICHIGAN,
County of..
and
of the
in said county,
sureties named in the within and foregoing bond, being duly sworn, depose and say
that they are each worth in unincumbered property not exempt from execution vinder
the laws of this State, the sum of one thousand dollars after payment of all just debts,
claims and liabilities.
Subscribed and sworn to before me, this

day of

Notary Public in and for

19...
County, Mich.

PHYSICIAN'S CERTIFICATE.
STATE OF MICHIGAN, )
County of
J ss'
In the Probate Court for said County.
In the matter of the application of
in behalf of
an alleged
insane person, praying that he may be admitted into the Northern Michigan Asylum.
I
a permanent resident of
in the county aforesaid, being a graduate of
and
having practiced as a physician
years, hereby certify under oath, that on the
day of
, 10. . ., acting under the direction and by
the appointment of the Hon
judge of probate for the county of
, I personally visited and examined
of
a1
aged
years, by
occupation a
and2
, and that the said
is insane, and a proper person for care and treatment,
under the provisions of section 21, of Act No. 135, of the Session Laws of 1885, and
acts amendatory thereto.
I further certify, That I have formed this opinion upon the following grounds, viz.:
[Here insert delusion, insane conduct or other evidences of insanity.]

And I further certify and declare, That I am not related by blood or marriage to
said insane person, or to the person applying for this certificate, and that I am not a
trustee, the superintendent, proprietor and officer, or a regular professional attendant
of the Northern Michigan Asylum, and that my qualifications as a Medical Examiner
in Insanity1 have been duly attested and certified by
clerk of
county.
(Signed)
., M. D.
Sworn to and subscribed before me, this
day of
19...
Judge of Probate.
Male or female.
- Married, single, widowed or divorced.
1

LAWS GOVEBNING THE ASYLUM.

71

COUNTY CLERK'S CERTIFICATE OF QUALIFICATION.*
STATE OF MICHIGAN, )
County of
\'
I hereby certify, That
of
!*
is personally known to ,me as a reputable physician, and is
possessed of the qualifications required by section 22, of Act No. 135, of the Session
Laws of 1885., as amended and now in force, and that as appears by his oath on file
in my office, he is a graduate of
Medical College, and that he
has been in the practice of medicine for a period of
years, and is registered
according to law.
County Clerk.

Patients are transferred from private to county charge in compliance
with.the provisions of the following section:
SEC. 24. When any insane person in indigent circumstances shall have been maintained by his friends in the asylum as a private patient for three months, and the
superintendent of the asylum shall certify that he is insane and requires further treatment, the judge of probate, on application by the friends of such patient, shall
determine the question of indigence, and also investigate the estate, income, annuity,
or pension of such insane person and the ability of his relatives legally liable for his
support, according to the provisions of the preceding section, with or without further
evidence of insanity, as in his discretion he may think best, and if the indigence be
established, he shall make an order authorizing the admission of such patient into the
asylum as a county or State charge according to the provisions of the preceding section,
together with such other orders for the application of the estate, income, annuity, or
pension of such insane person to his support, and for the payment to the county
•treasurer for his support by relatives legally liable therefor, as is provided in the preceding section, and shall certify the same to the Secretary of State if he or she is made
a State charge, and shall report the same to the board of supervisors, if he or she is
made a county charge as required by the preceding section, and the patient, as in other
cases of indigence, shall be supported at the asylum at the expense of the State or of
the county to which he or she may belong, as provided in the preceding section, until
restored, or if a county charge, for a period of not exceeding two years.

Insane members of the Michigan Soldiers' Home can be committed to
the insane asylums according to the provisions of Act No. 47, Laws of
1895.
Indigent patients can be committed to private asylums within the
State in accordance with the provisions of section 1945d of Third Howell's Annotated Statutes of Michigan, as amended by section 4, Public
Acts No. 84, Laws of 1895.
THE REMOVAL OF PATIENTS TO THE ASYLUM.

In conveying a patient to the asylum, do not deceive him. Truth
should not be compromised by professing a visit to the institution, and,
on arrival, suggesting to the patient the idea of staying, when his admission has already been decided upon; nor should patients be induced to
come and "stay a few days to see how they like it," under the impression
*See Public Act No. 220, Laws of 1889.

72

NORTHERN MICHIGAN ASYLUM.

that they can leave at pleasure. This course not only destroys confidence in friends, but also in the officers of the asylum, by giving
patients an impression that they are parties to the deception.
Hemoval to the asylum should never lie attempted when the patient is
much prostrated or laboring under severe bodily illness, and qfire should be
taken that the excitement attendin'g acute mental disease be not mistaken for
physical strength.

The attention of county officers is particularly directed to the requirements of the following section in reference to a female attendant, clothing, etc.:
SEC. 35. All town and county officers sending a patient to the asylum, shall, before
sending him, see that he is in a state of perfect bodily cleanliness, and is comfortably
clothed and provided with suitable cnanges of raiment as prescribed in the by-laws of
the asylum, and shall provide a female attendant, of reputable character and mature
age, for a female patient or patients, unless accompanied by her husband, father,
brother or son. Any person or officer who shall bring a female patient to the asylum
in violation of the last preceding provision of this section, or who shall under the provisions of law, or otherwise, bring or accompany any patient to the asylum, and not in
due time deliver him into the lawful care and custody of the proper officers of the
asylum, taking his receipt therefore, provided lie be admitted, or who shall willfully
leave, abandon, neglect or abuse such patient, either in going to or returning from the
asylum, shall be deemed guilty of a misdemeanor, and on conviction shall be liable to
a fine not exceeding two hundred and fifty dollars, or to imprisonment not exceeding
one year, or to both, in the discretion of the court before which the conviction shall be
had.
REMOVAL OF UXEECOVEBED PATIEXTS.

An unrecovered patient may be removed from the asylum in accordance with the following by-law adopted by the board of trustees, January t
18, 1888:
An unrecovered patient supported at private or county expense may
be .allowed to leave the asylum on trial, with the.approval of the medical
superintendent, under the charge of a guardian, relative, or friends, and
may be received back without the formality of a new order; provided,
that the period of absence be not longer than six months.
It is necessary, however, that in each instance a new bond be furnished
upon the return of the patient.
Indigent or pauper patients may be removed from the asylum in
accordance with section 33, Act Xo. 177, Laws of 1897. In accordance
with section 38 of the same act, superintendents are, when the asylum is
overcrowded, empowered to discriminate in the reception of patients,
favoring those that are most in need of asylum care and treatment. .
CLOTHING.

As friends of patients are often in doubt as to what articles of clothing it is necessary to provide, the following suggestions are made:
Male patients require 3 new shirts, 1 new and substantial coat and
vest, 2 pairs pantaloons, 3 pairs socks, 2 pairs drawers, 2 undershirts,
1 hat or cap, 1 cravat, 3 collars, 6 handkerchiefs, 1 pair of shoes or boots,
1 pair slippers, 1 overcoat.
Female patients should have 3 calico dresses, 3 chemises, 3 pairs draw-

LAWS GOVERNING THE ASYLUM.

73

ers, 4 pairs hose, 3 night dresses, 3 cotton flannel skirts, 6 handkerchiefs,
4 collars, 1 pair shoes, 1 pair slippers, 1 shawl or cloak, 1 hat, hood or
nubia, 4 aprons.
The outfit should be liberal when circumstances permit. As nearly
all the patients go regularly into the open air each day, it is desirable
that they be furnished with clothing of a character to enable them to go
comfortably in all weather, and also to appear at little social gatherings. When desired, articles of clothing, etc., will be furnished at the
institution. Jewelry should not be brought with patients. // such
articles are left in their possession the asylum cannot be responsible for
their safe keeping.
CORRESPONDENCE.
All letters concerning patients, from individuals haying the right to
make inquiry, will be answered at once; and friends are promptly
advised of any severe illness, accident, or event of moment or interest.
The postoffice and telegraphic addresses of one correspondent in each
case are recorded, to whom such communications are sent. Letters
are frequently received to which replies cannot be mailed, for the reason
that the postoffice address is not clearly given. A little care on the
part of friends will often save them disappointment and the asylum
unmerited censure. Information concerning inmates will not be given
to casual visitors, except at the written request of friends.
MEDICAL HISTORT.

Application for admission 'should be made before the patient is brought
to the asylum, and the following facts should be furnished when possible,
in reference to his case:
1. Please state the name, residence, age, nativity, civil condition,
occupation, education, and religion.
2. Give facts pertaining to family history.
3. Speak of any physical peculiarities or defects, of the habits as a
child, and later as an adult; state the temperament, disposition and
.tastes; the success in business; if addicted to the use of liquor, opium or
tobacco; if the patient has any vicious habits.
4. State if the patient has ever had convulsions, or any previous
attack of insanity, the age at time of attack, its character, duration,
and the treatment employed; if sent to an asylum, state where, and the
result of treatment. Give the particulars of subsequent atacks.
5. State the supposed cause or causes of the attack, also any facts
that will throw light upon the case.
6. State the date of the first indication of any change in the usual
condition, habits, disposition, or temper of the patient. What was the
change? What was the physical condition? Give the subsequent history of the attack, and the treatment employed.
7. Give full particulars of every attempt to injure self or others;
whether in any way destructive, or careless and uncleanly in habits.
8. If it has been necessary to use restraint or confinement, state in
what form and for how long a time.
9. Give present condition. Physically—whether in usual health, or
10

74

NORTHERN MICHIGAN ASYLUM.

feeble and emaciated; pulse, respiration, appearance of pupils, whether
equally dilated. Voice, whether natural, or if there is any unnatural
hesitancy or stammering while speaking; appetite, sleep, digestion, hearing, sight; if there is any evidence of paralysis, or loss of power or of
control of muscles.
Mentally—if excited or quiet, pleasant or moody and irritable, the
character of the delusions, how occupied during the day,
10. Give name and address of attending physician.
If the case will admit of delay, blanks for this history will be furnished
on application.
Idiots are especially excepted by law from the benefits of the asylum and
cannot under any circumstances be received.

All correspondence in reference to patients may be addressed to Dr.
James D. Munson, Northern Michigan Asylum, Traverse City.

INDEX

INDEX

Additional land
Addition to library
Accounts, classification of
Accounts, current
Acknowledgments
Additional land
Additional buildings, recommendations for
Admission of private patients
Admission of indigent and pauper patients. .
Admissions and discharges
Age of patients. Table
Appropriations, report on
Civil conditions. Table
Clinical groups. Table
Classification. Table
Correspondence
Cost of maintenance
Clothing
Chapel services
Duration of disease. Table
Deaths, causes, etc
Estimates of special appropriations
Exciting causes. Table
Farm and garden products
Farm and garden
Fire proof vault
Form of diseased Table
Government of the asylum
Heredity. Table
..Home for women nurses
Hospital for curable patients
Hospital for tuberculous women patients
Improvements
Increased accommodations
Inventory, summary of
Medical work
Medical history
Movement of population. Tables
Nativity of patients. Table
Names of officers and employes, etc
Needs of the asylum
.,
New boiler
Officers

*

,

.'
'

rage.
12-15
12
26
IS
56
15, 54-55
13
66
61-65
5-7
49
55
49
48
41
73
6
72
55
48
35
52
50
30-31-32
g
12
41
61
45
12
10-11
13, 53-55
8-45
13
33
42
73
34
47
57
13
15, 53-55
16

78

INDEX.

Occupations. Table
Pathological laboratory of the Michigan asylum
Pathological work
Report of trustees
,
Report of treasurer
Report of medical superintendent
Report of steward
Report of auditing committee
Report of State Board of Corrections and Charities
Removal of patients to asylum
Repairs to roof
Receipts and disbursements
Residence of patients. Table
Special appropriations
Support of patients by counties
Stock
Surgical work

Page.
46
9
12
5
18
34
26
25
55
71
13, 53-55
16-26
51
10-11-12
6
9
42