Report of the Board of Trustees of the Northern Michigan Asylum at Traverse City June 30, 1892.

Report of the Board of Trustees of the Northern Michigan Asylum at Traverse City June 30, 1892.

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, 1892. 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: Robert Smith & Co., State Printers and Binders.

30 June 1892

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.

PDF.

English.

Document.

TCSH0020

Traverse City, Grand Traverse County, Michigan.

REPORT

BOARD OF TRUSTEES

NORTHERN MICHIGAN ASYLUM
CITY
JUNE 30, 1892

BY AUTHOEITY

LANSING
ROBERT SMITH & CO., STATE PttlNTERS AND BINDERS
1892

OFFICERS OF THE NORTHERN MICHIGAN
ASYLUM.

TRUSTEES.
THOS. T . BATES,
.
_
_
_
.
H. H. NOBLE,
.
.
_ . .
_
VARNUM B. COCHRAN, _
_
.
LORIN ROBERTS, .
_
H . C . DAVIS,
- C. L. WHITNEY, . . . . . . >

_

_

_

-

. . -r.
_ -.
_
.
.
_
_
-'
- - - . .
_ .
.
.

TRAVERSE CITY.
ELK RAPIDS.
MARQCETTE.
TRAVERSE CITY.
TRAVERSE CITY.
MUSKEGON.

RESIDENT OFFICERS:
JAMES D. MUNSON, M. D.,
..
C. G. CHADDOCK, M. D.,
.
G. C. CRANC.ALL, M. D., )
A. S. ROWLEY, M. D.,
[
M. ROCKWELL, .M..D.,,

_

_ • , _

_

_ MEDICAL SUPEBI^TENDBNT.
Assr. MEDICAL, SUPERINTENDENT.

-

.

. ACT. ASST. PHYSICIANS

NON-RESIDENT OFFICERS.
J . P . C . CHURCH, .
W. P. MANTON, M. D., _

_

.
.

.
_

.
.

.

.
_
.
.
STEWARD.
DETROIT, MICH., GYNECOLOGIST.

ACTING CHAPLAIN:
REV. D. COCHLIN,

.

_

_

TRAVEESE CITY.

TREASURER:
C. A. CRAWFORD,

TRAVERSE CITY.

G R O U N D S LOOKING N O R T H .

EEPOET OF THE BOAED 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 30, 1892, and also the reports of the medical
superintendent, treasurer, and steward.
The period has been quite free from accidents to patients. It has
not been marked by the introduction of especially new methods of treatment, although every effort has been made to keep pace with new measure of care and to extend the benefits of the Institution as widely as
possible. Much administrative work has been necessitated by reason of
additional buildings and the many minor improvements that have been
required and that have had for their sole objects increased benefit to
patients and greater usefulness of the Institution.
Seventeen regular meetings of the board have been held. As heretofore, monthly inspections of the Institution by a committee of trustees
have been made. These visitations, from suggestions to which they gave
rise relative to care of patients and the business operations of the
hospital, have been especially useful.
Apart from a quite severe outbreak of influenza last winter, the health
of the patients has been usually good. No deaths were directly due to
the influenza, although secondarily it led to consumption, heart failure,
and death in a few cases. The death of Mr. Olsen, which is detailed in
the superintendent's report, is the only accident that has ever occurred
here. We are glad to be able to report that the Institution has ever been
found in good order, patients kindly and skillfully cared for, and the
strictest attention given to its business management.
The number of patients under treatment during the period was, males
585, females 456; total 1,041. The number of patients admitted was,
males 208, females 146: total 354. Of this number 304 were admitted at
county expense as follows: Alpena 12, Antrim 9, Arenac 4, Alcona 1,
Baraga 3, Benzie^, Charlevoix 1, Clare i, Crawford 1, Cheboygan 4, Chippewa 4, Delta 3, Dickinson 2, Emmet 9, Gogebic 12, Grand Traverse 7,
Gratiot 9, Houghton 37, Isabella 6, losco 4, Iron 4, Keweenaw 2, Lake 4,
Leelanaw 2, Luce 1, Mackinac 7, Manistee 7, Marquette 25, Mason 1,
Mecosta 6, Menominee 23, Midland 6, Missaukee 4, Muskegon 21, Montcalm 16, Newaygo 7, Oceans 4, Ogemaw 3, Ontonagon 1, Osceola 9,
Oscoda 1, Roscommon 3, Shiawassee 1, Schoolcraft 4, and Wexford 5.
Twenty-seven (non-residents) were admitted at State expense, 2 at State
military, and 21 at private expense. Twenty-five had been confined in
county houses, and 95 in jails; 23 had been in other asylums; 43 were
said to have been destructive; 60 had attempted or threatened suicide; 59

6

NOKTHERN MICHIGAN ASYLUM.

were homicidal or had threatened homicidal assaults; 5 had been treated
in hospitals; and 42 had been confined or restrained at home. The number confined in jails previous to admission was very large, and was in part
due, no doubt, to the fact that they had to be so cared for until vacancies
could be made for them at the Asylum. Of the 354 patients admitted
only 64 could be considered as primarily curable; the remainder were
either suffering from organic nervous disease, or belonged to the degenerate class—all essentially incurable. The degenerate class of the
insane, as it relates to crime and lunacy, is little understood by the general
public. How many appreciate the fact that nearly one-half of all patient's
admitted are primarily incurable because of inherited psychical or nervous defects? This fact should give rise to careful inquiry of the means
requisite to prevent the increase of this class. Doubtless if sufficient
room had existed, the admissions for the period would have considerably
exceeded 400. Notwithstanding the fact that accommodations for 100
patients have been supplied during the period, yet for some months past
have patients been denied admission to the hospital for want of room. At
the present time quite a number are being temporarily cared for in jails.
We have regretted this condition, and to accommodate the counties have
not only crowded the Asylum to the fullest limits, but have favored the
discharge of patients to the custody of friends whenever it was deemed
safe.
The net increase of patients for each biennial period since the opening
of the Asylum has been as follows: From 1886 to 1888, 148; from 1888 to
1890, 131; from 1890 to 1892, including 60 patients awaiting admission,
183; total for 6 years, 459.
The number of patients discharged during the period was, males 150,
females 81; total 231, of which 66 were recovered, 71 improved, 9 unimproved, and 85 died. Of the total number of patients discharged recovered from the organization of the Institution ten per cent have been readmitted, and of those discharged improved twenty-two per cent have been
returned. Of the total number of patients discharged as recovered and
improved 331 are at home and self-supporting so far as known. This
number represents twenty-three per cent of the total number of individuals
treated in the hospital from its opening.
The daily average number of patients was for the period 765. The
number of weeks spent in the Asylum by patients was 79,979f; this was
an increase of 48 in the daily average and 15,533f weeks' board over the
last preceding period.
The rate charged for the maintenance of each patient per day was 49
cents for the first and 48 cents for the last year of the period. This was a
decrease of one cent per day over the first half, and two cents per day
over the last half of the preceding period.
There were under treatment June 30, 1892, at State expense 584, at
county expense 205, at State military expense 2, and at private expense 19
patients. At the close of the period Alpena county was supporting 6
patients, Arenac 2, Antrim 5, Alcona 1, Baraga 3, Benzie 4, Charlevoix 1,
Clare 3, Cheboygan 3, Chippewa 3, Delta 2, Dickinson 2, Emmet 4, Grand
Traverse 3, Gratiot 5, Gogebic 7, Houghton 29, Isabella 4, losco 3, Iron 3,
Kalkaska 1, Lake 2, Leelanaw 3, Luce 1, Mackinac 3, Manistee 4, Mecosta
5, Midland 4, Marquette 17, Menominee 15, Missaukee 2, Montcalm 9,
Muskegon 16, Newaygo 5, Oceana 4, Ogemaw 1, Osceola 7, Oscoda 1, Roscommon 2, Schoolcraft 3, Shiawassee 1, and Wexford 5.

CONVALESCENT WARD FOR MEN.
(ALCOVE).

REPORT OF THE BOARD OF TRUSTEES.

7

There were 152 persons employed by the Institution June 30, 1892 in
the positions and at the salaries as shown by the schedule accompanying
this report.
IMPROVEMENTS.

Besides the completion of a cottage for males, the description of which
accompanied our last report, many important additions and improvements
hare been effected during the period. Among the most essential we may
mention the removal of the carriage barn from in front of the cottages for
men to the south boundary of ihs farm, and the paving of the farm barnyard with cedar blocks to make it passable for stock during the fall and
spring months.
The heater at the east cottage became so defective and dangerous that it
was replaced with a steam heating apparatus last fall. The cost of this
repair including boiler, radiators, piping, fixtures, brick, necessary labor,
etc., was about $400.
A small slaughter-house was erected on the farm in 1890. Thus far very
few cattle have been offered for sale, owing doubtless to the fact that the
excessive drought of 1891 forced the sale of nearly all cattle in this region
We hope to be able, in the near future to slaughter a large proportion of
the meat used by the Institution.
Owing to a great increase of work, and to the fact that the washers in
use had to be taken out for repairs, a new metallic washer was placed in
the laundry, at a cost of $385.
A bread mixer and a cake mixer were added to the bakery. These
machines have proved very helpful in the work of these departments.
FARM AND GARDEN.

The farm has been greatly improved, and that portion lying in front of
the buildings has been reclaimed and has become profitable for general
agricultural purposes. The garden has been enlarged and, as may be seen
by consulting the farm report, has yielded a profit to the Institution.
A great hinderance to the successful cultivation of flowers and early
garden plants, has been experienced from having no place to care for the
former in winter, or for propagating plants in early spring. So much loss
was known to result from this cause that, after most careful consideration,
it was decided to construct a greenhouse. This structure was authorized
in December, 1891, and built in accordance with plans and specifications
prepared by Mr. C. L. Whitney. It was finished March 1, 1892, at a cost
of about $1,800. A brief description of the greenhouse may be of value.
It consists of three buildings-arranged on the ridge-and-furrow plan, each
22x96 ft. A shed 66x14 ft. extends across its south end, which contains
the heating apparatus, coal bins, work benches, and shelving for storage
purposes. The walls were constructed of cedar posts set 4 ft. apart,
planked inside and out, and then covered with tarred paper and sided with
-|in. siding outside, and sheeted inside with -|in. material. These walls are
strong and warm, and at the same time not expensive. The roof has
permanent sash bars set 14 inches apart, fitted with second quality doublethick glass. The sash bars do not meet at the ridge, but fit into a deck 16
inches wide; this deck contains the ventilation openings. One of the
houses is arranged in the ordinary way with benches on its sides and

8

NORTHERN MICHIGAN ASYLUM.

through its center, the others have a core of earth in their centers instead
of benches for holding the soil. They are warmed by a Furman No. 8
•water heater. There are two 2 inch outflow pipes for each house, and each
pipe divides at the far end of the house into four 1| returns. Although
the heater has not had the trial of midwinter weather, yet no fears are
entertained that its heating capacity is not ample. Thus far the greenhouse has more than met our expectations. From the first it has raised
many vegetables, and afforded abundant space for the propagation of
flowers and plants for early transplanting into the lawn and garden. We
feel assured that the outlay involved in its construction will be quite
repaid this year by garden produce that could not have been otherwise
successfully cultivated, to say nothing of the enhanced beauty of the
grounds which it has assured.
A root cellar 60x30 ft. was built last fall at a cost of $500. Still the
Asylum is in need of this kind of storage room. Roots grown for the
stock and part of the vegetables raised on the farm had to be buried.
This was not a satisfactory way to secure these crops, and it was found
difficult to get them out fronn under a great depth of snow, or to open a
pit without having more or less damage result from frost.
Besides these improvements, many others of minor importance, such as
construction of fences, laying of drains, building sidewalks and driveways,
have been accomplished.
The receipts from the farm during the period were $21,664.49, and the
disbursements $18,162.91; the latter includes outlay for tile, fencing,
shrubbery, and plants, horses, work cattle, farm machinery, etc., also the
maintenance of teams employed in hauling fuel for the Asylum.. If the
undeveloped state of the farm is taken into consideration, the financial
results obtained from it during the period were quite satisfactory.
ADDITION TO EAST COTTAGE.

This building, originally a farm residence, was fitted up a few years ago
for patients, but it was found too small for their economical care. The
pressure for admissions having become so great, it was 'decided to increase
its capacity from 12 to 24 beds. The extension is finished, and its cost,
including furniture, was $1,000. The room thus made was much needed
by the district, but will only afford it temporary relief.
SPECIAL APPROPRIATION, $15,000.

This appropriation was passed by the last legislature for the erection
and furnishing of a cottage for fifty women patients. In general arrangement it is like the cottages previously built; it differs only in having
fewer but larger dormitories. It is warmed by steam and lighted by
electricity, and is ventilated by a series of flues commencing at the floors
of the various rooms and passing to the open air above the roof. It is
supplied with water for domestic purposes from the Asylum well, and its
fire protection will be derived from the reservoir now in process of construction. This cottage is finely located just north of the main building,
and affords a pleasant outlook upon Grand Traverse bay and upon the
Asylum grounds. Mr. C. M. Prall, our foreman of construction, prepared
the plans and supervised its construction, and Mr. Wm. Bauld, engineer,
superintended the plumbing, heating, and lighting. Our thanks are

REPORT OF THE BOARD OF TRUSTEES.

9

extended to these gentlemen for the satisfactory manner in which they
completed the work. The cost of this cottage was as follows:
Lumber
Stone, and cut stone
Lime and cement
Lumber and door frames
Heating, pipe and
Iron columns
Brick
Sewer and traps
Nails and hardware
Window guards
Mantels/.
Beds, mattresses, etc
Chairs, wardrobes, etc
Curtains, etc
Silver-plated ware
Range and fittings __•
Paint
. _.
Locks._

fittings

.

Total

$5,594 63
753 38
396 76
2,199 68
1,700 58
90 00
2,245 82
109 66
190 13
83 68
90 00
617 74
354 16
"
15 12
91 00
17995 •
82 37
127 66
$14,922 32

The small balance on hand to the credit of this fund will be required to
complete the ventilation of the building.
SPECIAL APPEOPRIATION, $2,000.

This appropriation was made by the last legislature for enlarging the
electric light plant of the Asylum. After careful deliberation a contract
was entered into with the Edison General Electric Company in September,
1891, for one Edison dynamo, having a capacity of 540 lamps of 16 candle
power, one Ampere meter for indicating the number of lamps burning at
any time, one pressure indicator for indicating the exact electric pressure
on the lamps, and one Armington & Sims horizontal automatic cut-off 60
horse power engine, including foundation Jaox, starting valves, lubricators,
wrenches, oil cups and belt, all in place for the sum of $1,750 in cash and
one small Armington & Sims engine and one 100-Edison dynamo previously in use by the Asylum. The Edison company fully met the conditions of the contract, and the machinery put in by them has given excellent satisfaction. The following is an itemized account of the expenditures made from this appropriation:
One 540-lamp dynamo, and one 60-h. p. engine and
accessories, complete in place
$1,750 00
Labor, lime and cement, lumber, electrical supplies.250 00
Total-.

-$2,000 00
SPECIAL APPBOPBIATION, $6,000.

This was passed by the last legislature for the construction of a reservoir and making connections between the same and the Asylum fire
mains and hydrants for fire protection. The trustees feel that the object
2

10

NORTHERN MICHIGAN ASYLUM.

hoped to be attained by means of this appropriation—additional fire protection for the buildings—is of the greatest importance. The greatest
care has been taken to secure an ample supply of water and to make the
fire service mains and their connections of the most durable character,
that in the emergency of fire they may not fail. It was necessary, in
order to control the source of the water supply, to purchase, at a cost of
$225, 2J acres of land adjoining the State property on the west. This
tract is really one vast spring and yields a constant supply of the purest
water. The site of the reservoir joins it on the east, and is 100 feet above
the ground level of the Asylum buildings. The reservoir will be 225 feet
in length and 135 feet in width on the east' and 145 feet on the west side.
It will have a depth of 9| feet and will hold about 2,000,000 gallons. The
west, north, and a portion of the south sides will be natural embankments;
the east side and the remaining portion of the south will be constructed of
stone and gravel. A stone settling basin, 12xl2x4| feet, will be constructed west of the reservoir, through which the water must pass before
entering the reservoir. A 6-inch pipe, controlled by a gate valve, will
lead from this basin, through which the incoming water can be diverted if at
any time it is necessary to free the basin from sand or other material, or to
effect repairs in other parts of the works. The two effluent pipes begin in a
large steel tank, which is solidly anchored to a stone foundation in the
reservoir. Each effluent is controlled by a gate valve. These pipes pass
through the east wall of the reservoir, after which they unite, and a single
8-inch cast pipe is continued to the service mains, stand pipes and hydrants
of the Asylum buildings, and to the fire pump, or both, at the will of the
engineer. The work on the reservoir is progressing as rapidly as possible.
The service connections have been made at the buildings, and new mains
have been laid where necessary and new hydrants placed. The number
of new hydrants is 5—2 for the North Cottage, 1 at the north end of the
main building, 1 between Cottages "A" and " B," and 1 in the rear of the
boiler house. Much of the labor on the reservoir has been by patients,
and if it had not been for this labor, the appropriation would not have
been sufficient to have completed it. The work will be finished in about 90
days, and it will be a great element of safety to the institution and its
inmates from the danger of fire. The expenditures thus far made from
this appropriation are as follows:
Labor
. _ _ _ $417 65
Land, conveyancing, etc
230 25
Stone
'
399 97
Lime and cement
250 00
Pipe, hydrants, and
fittings
2,740 64
Effluent tank and valves..
23050
$4,269 01
SPECIAL APPROPRIATION, $3,500.

This appropriation was passed by the last legislature to repair roofs and
gutters of the Asylum. As soon as it becomes available, Mr. D. Ered
Charlton, of the firm of Charlton and Gilbert, architects, Marquette, Mich.,
was invited to examine the building and report on the condition of its
roofs and gutters and present plans for the correction of defects found in

EEPORT OF THE BOARD OF TRUSTEES.

11

them. Architect G. W. Lloyd had previously examined and reported to
the board the condition of the roofs, and submitted plans for the correction of the difficulties existing in them. The plans submitted by these
architects for these much needed repairs are very similar. The following
is Mr. Charlton's report:
Marquette, Mich., August 6, 1891.
To the Hon. Board of Trustees of the Northern Michigan Asylum, Traverse Gity,
Mich.:
GENTLEMEN—At the request of Dr. James D. Munson, Mr. Charlton of our firm visited
the Asylum at Traverse City with a view of examining into the defects of the roofs
and gutters of that building, and we respectfully submit the following report on the
same:
Mr. Charlton has made a careful examination of the whole of the roofs of the Asylum and finds lhat the same are in a very deplorable condition—a true example of what
our severe winters will do to a building when it is not designed especially for this snowbelt region. We do not consider that the defects in the roof have anything to do with
bad workmanship, as everything about the building shows that the work was well done,
but the trouble is entirely due to the fact that the snow has no chance to slide off, and
consequently, after continuous freezing and thawing, it forms a barrier of ice. At the
eaves this causes the water to back up under the slates and find its own way down
inside the building, which fact can be seen in nearly all the rooms.
The main cause of the snow not being able to slide off is attributable: First, to the
gutters; Secondly, to the way in which they are formed; Thirdly, to the number of
small gables in close proximity to one another, which narrow up the discharge at the
eaves and so wedge up the snow practically to the point of a V; and Fourthly, to a too
flat pitch of the roof, especially at the points " A, A" on the plan (also see section at
same point, sheet three). The effects of the above defects are to be seen all around
the buildings, especially so at points marked " H, H, H " on plan (sheet 1), where the
water, having backed in behind the cornice and run down on the outside of the walls,
has destroyed portions of the brick and stone work.
This state of affairs, if allowed to go on , will soon cause disintegration of the entire
walls and make the buildings unsafe, and consequently unfit to live in. To remedy
these existing defects and to make the buildings permanently water proof, is a matter
of no small undertaking or expense, but these defects can be remedied for a time in a
comparatively simple manner.
It has been our experience in the upper peninsula of Michigan (and we take it that
the winter in your location is similar), that the only permanent roofing material is copper. This metal although far more expensive in the first place, becomes the most
economical in the end on account of it never requiring to :be repaired or painted, which
is not so with slate or iron. The items of continual painting or repairing these two
materials will soon run up the expense of the first cost. Whereas, with copper, if
roperly put on, it will last as long as the buildings. Therefore we beg to recommend
rst, as a permanent water tight roof, that you discard the slate and cover with sheet
copper as shown in sketch sheet 2, and do away with all gutters, allowing the snow and
water to have a free discharge over the eaves. The cost of such a roof we would estimate at about $30.00 per square.
As this method may not meet with your approval on account of a considerable immediate outlay, we beg to recommend another method which we feel confident will overcome the present defects and will give a water-tight roof as long as kept in repair. It
would consist in doing away entirely with all gutters, and covering the roof from the
eaves up to the top of the valleys formed by main roofs and roofs of small dormer
gables, with the best tin plate double locked and soldered. We submit detail drawings (sheet 3) showing how to extend roof over cornice, and the necessary changes to
be made.
There is one particularly bad place in the center building where the tower passes
through the roof, and two small gables on each side of tower come very closely
together; in fact, they are so arranged as to make the sliding of snow practically an
impossibility. We have endeavored to correct this defect by extending pitch of. small
gable up to the tower, and slating the front fact vertically (see elevation and sketch
sheet 4).
TKis we think will entirely overcome the difficulty, and will not mar the symmetry of
the present design.
We noticed that the roof at "A, A" on plan, sheet one, has two pitches as shown in sec-

S
1

12

NORTHERN MICHIGAN ASYLUM.

tion (sheet 3) and that the one on the west side is a very low pitch. We would recommend that the east pitch be extended high enough so as to make the west pitch to
coincide.
We also noticed that the main part of roof over engine house is very flat, in
fact, far too flat for slate. We would recommend that tin plate be substituted for
slate.
The system of cooling the underside of roofs by means of openings in the soffit of
cornices and the top of roofs, is of no value whatever if the gutters are to be done
away with. We would prefer that these holes be entirely closed up, and that spaces
be left to admit the warm air which is in the attic, into the space which the gutters now
occupy, as it will keep the tin plate slightly warm and so permanently free from ice and
snow, and assist in causing the snow to slide off. This is a very important detail
to the satisfactory correction of defects, and we particularly beg to call your attention
to it.
We noticed that there are side stoops at points " H, H " on plan; these being directly
under the discharge of valleys are dangerous, for large icicles must necessarily be formed
there in winter, and the steps probably covered with ice. We would recommend as a
convenience and a safeguard that the stoop roof be extended at least to cover the steps,
and that an extension of same roof be made at right angle to same, far enough along
main wall to cover entrances to area ways.
Regarding the drip from the roofs, it occurred to us that should it effect the growth
of the sod near the buildings, that trouble could be overcome by making a pavement
all round the buildings about three feet wide, of good sized cobble stones such as we
understand can be picked up in large quantities on the lake shore. This will be better
than cement or stone as the water will drain through them to better advantage.
As to the drip causing dampness in the foundation walls, you need have no fear of
this in such a soil as these buildings are on.
Before closing this report, we would wish to call your attention to the fact that there
is no drip cut in any of the stone sill and belt courses around the building. This
should undoubtedly be done, as this constant running of water down the surface of
the brick leaves dirty black streaks, and must in time cause injury to them. By
dripping all the projecting courses, a great deal of damage may be avoided and the
building will keep clean.
Respectf uly submitted,
CHARLTON & GILBERT, Architects.

After careful consideration the board approved Mr. Charlton's plans,
but the season was too far advanced (1891) to safely open up the roofs.
The almost incessant rains of this season have thus far rendered it utterly
impracticable to begin the work. We may say that we are only a waitingsuitable weather to commence the work. It is very essential that it
should be completed before winter to save the building from further
damage. This appropriation remains in the hands of the treasurer of
the Asylum, and in the State treasury but will immediately be used as
far as it will go in these repairs. We would further invite your attention to this matter, as we deem it of importance, that an appropriation
of sufficient amount should be made to put the roofs in secure condition.
NEEDS OF THE ASYLUM.

The trustees would respectfully recommend for your careful consideration the purchase of additional land for the uses of the Asylum. If the
cottage system is to be extended to meet the requirements of the district
in the care of its insane, it will be necessary to secure grounds upon
which to locate them. The city is reaching out to the Asylum, and Seventh street is at present partially occupied with residences to Elmwood
avenue, only a short distance from the Institution. At least twenty acres
of land adjoining the Asylum property on the north, and west of Elmwood avenue, should be purchased. This would secure to the Institution
a site for one or more additional cottages for women, and also secure that

REPORT OF THE BOARD OP TRUSTEES.

13

which seems to us of first importance—privacy of the grounds. This
land has not yet been placed in the market, but when it is, doubtless it
will immediately be taken for residence sites'. It will be very undesirable
to have dwellings so close to our line, as will surely result if the State
fails to purchase this ground.
We would also recommend the purchase of 120 acres of land adjoining
the Asylum farm on the south. A portion of this tract is low and heavily
wooded, but the remaining portions are high and will afford excellent sites
for cottages for men. Eighty acres of this tract are owned by Hon. E,.
Goodrich, and the remaining by Hon. Perry Hannah, of Traverse City.
The 20 acres to the north can be purchased for $200 per acre; the 120 on
the south for $62.50 per acre. Our judgment is for the State to secure
this property, not only for additional sites for cottages, but for extending
farm as well. We can only utilize about 275 of the 400 arcres that are
now owned, and with the patient labor at our command we can profitably
cultivate a very much larger tract. This land can now be purchased at
reasonable rates, but it will soon pass into small holdings and beyond the
reach of the Asylum.
The accompanying map shows the location of the lands.
ADDITIONAL ACCOMMODATIONS.

As the State is pledged to care for the insane, it is only a question
whether additional provisions for their care shall be made by the construction of cottages in connection with the existing asylums, as has been
the policy of the State for a number of years past, or to establish a new
institution. We believe, that for some years to come, proper provisions can
be more economically provided by the cottage system. It is true, however,
that some modifications will be required in the arrangement of such
structures to fully meet the requirements of certain classes of patients.
The cottages now in use are for the quiet, cleanly, and able-bodied—all
upon the open-door system. There is a limit in the proportion of this
class of patients to those that cannot enjoy such liberties. In future
cottages will need to be adapted to the care of an intermediate class,
which will necessarily increase the per capita cost of the structures.
Since the organization of this institution appropriations to the amount of
$78,500 have been made to increase its capacity. This sum has provided
accommodations for 270 patients, or a per capita cost of about $300. As
compared with the main building, this would be about one-fourth of the
cost per bed. We feel that it is impossible to erect suitable cottages for
less than $300 per bed, and that $350 per bed will be nearer the true cost.
Additional provisions will be required in this Asylum district for 250
patients during the next three years. During the period just closed there
has been an increase in patients under treatment of 123, and if to this
number is added 60 applications now on file, it brings the increase up to
186, or a yearly average of a little over 90. During the period accommodations were supplied for 100 patients, so that 23 have been crowded into
the hospital during the period. Should the legislature make provisions
for three years on a basis of 80 patients per year, all such additional room
would be taken by June, 1895, and it would then be nearly two years more
before the next succeeding legislature could make necessary appropriations and buildings gotten ready for occupancy. We deem it to the highest economical interests of the State that such provisions be made, that

14

NOETHEEN MICHIGAN ASYLUM.

the insane shall not be distressed by lack of care awaiting asylum accommodations. So far as our knowledge extends, we find it cheaper for the
counties to maintain their insane in asylums than to care for them in
county houses. We have been informed that during the last few months
the expense of caring for certain patients in county houses has been three
or four times as much as the charges for their care would have been here.
As additional accommodations must be provided, we would respectfully
ask for an appropriation of $75,000 for the erection and complete equipment on the Asylum grounds of two cottages for men. for 75 patients each
and one for women for 100 patients, to be granted by your honorable
body; two of these buildings, one for men and one for women, to be erected
in 1893-4 and the remaining one in' 1894-5.
FAEM BAEN.

We would respectfully request that an appropriation of $2,500 be made
for the construction of a barn 40x80 feet for general farm purposes. The
barn rooni of the Institution is totally inadequate to meet its needs, and
farm utensils, hay and grain can only be partially cared for. As the Institution needs to store hay and straw in large quantities, it is essential to
have a suitable place, also proper facilities for the care of wagons, farm
machinery, etc., during the winter season.
UNIFOEM CLASSIFICATION OF ACCOUNTS.

The uniform system of classification of accounts for State institutions,
as required by law, has worked satisfactorily. The new method, however,
is not essentially different, so far as it relates to the asylums, from the one
previously in use. We would suggest a modification relative to the
method of keeping farm accounts. It is required that the institution purchase from the farm at market rates its products, charging them to the
proper departments and giving the farm credit for them. The difficulty
simply lies in the method of making the transfers. It has always been
the practice to charge up to the institution all these products, but not to
make transfers in voucher form. We would suggest that this part of the
law be amended, and that the institution be simply required to make
monthly reports of farm receipts and disbursements to the Auditor General, and at the end of the year submit a report to the Auditor General
including the totals of these receipts and disbursements on farm account
for the year.
EECEIPTS AND DISBUESEMENTS.

The total receipts of the Asylum from July 1, 1890, including cash on
hand to the credit of the general fund and special appropriation for
detached cottage for males, were $159,388.83; and the total disbursements
for that fiscal year, including amounts expended of special appropriation,
were $139,308.
The total receipts of the Asylum for the fiscal year ending June 30,
1892, including balance on hand, officers' salaries, $9,211.94, and $24,500
from special appropriations, have been $214,149.81; and the total disbursements for the same period, including the amounts expended of officers'

S9!?:

COTTAGE FOR WOMEN.

INTERIOR

COTTAGE

FOR

WOMEN

RESERVOIR, PATIENTS AT WORK

REPORT OF THE BOARD OF TRUSTEES.

15

salaries, $9,211.94, and of special appropriations, $21,029.18, have been
$184,020.38.
There was at the close of the fiscal year June 30, 1892, $26,658.61 in
the hands of the treasurer to the credit of the " Current Expense Fund"
of the Asylum, and $3,4,70.82 to the credit of " Special Appropriations."
ILLUSTRATIONS.

The accompanying views will give some idea of the Asylum and its
grounds. Friends of patients, and others, will doubtless be interested in
them.
In conclusion we would call your attention to the crowded condition of
the Hospital, and to the distress that comes to patients, their friends, and
even communities, from the lack of room. We would respectfully ask that
the insane, and their just needs, receive your earliest consideration, that
prompt means for their relief may be afforded.
In May, 1891, Dr. W. A. Stone resigned to accept the position of Assistant Superintendant at the Michigan Asylum at Kalamazoo. While we
were sorry to lose his very efficient services, yet we were pleased with his
promotion, and feel assured that the Trustees of the Michigan Asylum
could not have secured a more valuable officer. In June, 1891, Dr. I. L.
Harlow resigned to enter into private practice in Brooklyn, N. Y. He
carried with him the .best wishes of all. In June of the same year Dr.
A. S. Rowley, of Kalamazoo, was invited to take the position made vacant
by Dr. Stone, and in July Dr. M. Rockwell, of Three Rivers, that made
vacant by the resignation of Dr. Harlow.
In August, 1890, Dr. Walter P. Manton, of Detroit, was appointed
gynecologist to the Asylum.
The trustees are glad to refer to the efficient manner in which the medical superintendent has preformed the multifarious and important duties
constantly devolving upon him. His watchful care and personal supervision have been apparent in every department of the Institution, and to him
is due in great measure the success of the work undertaken. Acknowledgments are also due to the medical staff for the manner in which they
have performed their several duties.
THOS. T. BATES,
H. H. NOBLE,
LORIN ROBERTS,
VARNUM B. COCHRAN,
H. C. DAVIS,
C. L. WHITNEY,
Traverse City, June 30, 1892.
Trustees.

TREASURER'S REPORT.

ABSTRACTS
OP ACCOUNTS CURRENT OF THE RECEIPTS AND DISBURSEMENTS AT THE NORTHERN
MICHIGAN ASYLUM, ON ACCOUNT OF CURRENT EXPENSES FOR
THE FISCAL YEAR ENDING JUNE 30, 1891.

THE STATE OF MICHIGAN, In account with C. A. Crawford, • Treasurer of Northern
Michigan Asylum for month ending July 31, 1890.
By balance on hand July 1,1890
Cash from State Treasury:
Account of Officers'salaries
Cash from earnings of Institution

$17,084 70
_.

2,139 04
31,400 I

$50,623 82

DEBITS.

To disbursements:
Account of officers'salaries
Account of detached cottage No. 2
Account of current expense
Balance on hand to new account

$2,13904
943 28
7,622 79
39,918 71

$50,623 82

THE STATE OP MICHIGAN, In account with G. A. Crawford, Treasurer of Northern,
Michigan Asylum for month ending August 31, 1890.
By balance on hand August 1,1890
Cash from earnings of Institution

To disbursements:
Account of detached cottage No. 2
Account of current expense
Balance on hand to new acconnt

$39,918 71
1,702 71

_

$545 49
8,047 34
33,028 59

$41,621 42

$41,621 42

17

TREASURER'S REPORT.

THE STATE OF MICHIGAN, In account with C. A. Crawford, Treasurer of Northern
Michigan Asylum for month ending September 30, 1890.
By balance on hand September 1,1890.
Cash from earnings of Institution

$33,028 59
1,108 45

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

$15,012 79
19,124 25

$34,137 04

$34,137 04

THE STATE OP MICHIGAN, In account with C. A. Crawford, Treasurer of Northern
Michigan Asylum, for month ending October 31, 1890.
CREDITS.
By balance on hand October 1,1890__
Cash from State Treasury:
Account of officers' salaries
Cash from earnings of Institution

__

$19,124 25
2,565 82
31,755 :

$53,445 33

DEBITS.

To disbursements.
Account of officers' salaries
Account of detached cottage No. 2
Account of current expense.
Balance on hand to new account

$2,565 82
425 45
10,148 58
40,305 •'"

$53,445 33

THE STATE OF MICHIGAN, In account with C. A. Craioford, Treasurer of Northern
Michigan Asylum, for month ending November 30, 1890.
CREDITS.
By balance on hand November 1,1890
Cash from earnings of Institution.__

To disbursements:
Account of detached cottage No. 2
Account of current expense
Balance on hand to new account

_

$40,305 48
1,63477

$42 51
15,894 87
26,002 87

$41,940 25

$41,940 25

THE STATE OF MICHIGAN, In account with C. A. Craivford, Treasurer of Northern
Michigan Asylum, for month ending December 31, 1890.
By balance on hand December 1,1890
Cash from earnings of Institution

$26,002 87
353 13

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

$12,940 13
13,415 87

$26,356 00

$26,356 00

18

NORTHERN MICHIGAN ASYLUM.

THE STATE OF MICHIGAN, In account with C. A. Craivford, Treasurer of Northern
Michigan Asylum, for month ending January 31, 1891.
CREDITS.
By balance on hand January 1,1891
Cash from State Treasury:
Account of officers'salaries
Cash from earnings of Institution

$13,415 87
2,412 50
33,746 30

$49,574 67

DEBITS.

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

$2,412 50
*9,239 49
37,922 68

THE STATE OP MICHIGAN, In account with C. A. Crawford, Treasurer of Northern
Michigan Asylum, for month ending February 28,1891.
CREDITS.

By balance on hand February 1,1891...
Cash from earnings of Institution

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

_

$37,922 68
5,04836

-

$42,971 04

DEBITS.

$9,463 45
33,507 59

_..

$42,971 04

THE STATE OP MICHIGAN, In account with C. A. Crawford, Treasurer of Northern
Michigan Asylum, for month ending March 31,1891.
By balance on hand March 1,1891
Cash from earnings of Institution

_

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

$33,507 59
522 61

$34,030 20

$9,300 67
24,729 53
$34,030 20

THE STATE OP MICHIGAN, In account with C. A. Crawford, Treasurer of Northern
Michigan Asylum, for month ending April 30,1891.
By balance on hand April 1,1891
Cash from State Treasury:
Account of officers' salaries
Cash from earnings of Institution

$24,729 53
.._

2,412 50
32,597 78

$59,739 81

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

__

__

$2,412 50
11,220 77
46,106 54

$59,739 81

TREASURER'S REPORT.

19

THE STATE OF MICHIGAN, In account with C. A. Crawford, Treasurer of Northern
Michigan Asylum, for month ending May 31, 1891.
CREDITS.
By balance on hand May 1,1891
Cash from earnings of Institution.__

$46,106 54
51662

-

$46,623 16

DEBITS.

'To disbursements:
Account of current expense
Balance on hand to new account _.

$16,426 86
30,196 20

$46,623 16

'THE STATE OF MICHIGAN, In account with C. A. Crawford, Treasurer of Northern
Michigan Asylum, for month ending June 30, 1391.
CREDITS.
By balance on hand June 1,1891
Cash from earnings of Institution

$30,196 20
1,918 C6

$32,114 26

DEBITS.

ffo disbursements:
Account of current expense
Balance on hand to new account

$12,033 43
20,08083

$32,114 26

THE STATE OP MICHIGAN, In account with C. A. Crawford, Treasurer of Northern
Michigan Asylum, for fiscal year ending June 30, 1891.
CEEDITS.
By balance on hand July 1, 1890..
Cash from State Treasury:
Account of officers' salaries
Cash from earnings of Institution __ _ __

. . ....

....

. $17,08470
9,529 86
142,30413

$168,918 69

DEBITS.

'.To disbursements:
Account of officers' salaries
Account of detached cottage No. 2
Accountof current expense
Balance on hand to new account

__

_

. . .

$9,529 86
1,956 73
137,351 27
20,080 83

$168,918 I

20

NORTHERN MICHIGAN ASYLUM.

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, 1892.

THE STATE OP MICHIGAN, In account with C. A. Crawford, Treasurer of Northern
Michigan Asylum, for month ending July 31,1891.
CREDITS.
By balance on hand July 1,1891
Cash from State Treasury:
Account of officers'salaries
Cash from earnings of Institution __.

_. $20,080 83
-

2,231 89
36,82811

-

.$59,140 83

DEBITS,

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

_

$2,231 89
14,893 57
42,015 37

.__

$59,140 83

THE STATE OP MICHIGAN, In account with C. A. Crawford, Treasurer of Northern
Michigan Asylum, for month ending August 31, 1891.
OEEDITS.
By balance on hand August 1,1891._
Cash from State Treasury:
Accountof reservoir
Account of detached cottage No. 3
Accountof roof repairs, main building
Cash from earnings of Institution
__..

To disbursements:
Account of reservoir
Accountof detached cottage No. 3
Accountof current expense
Balance on hand to new account
-

__

$42,015 37
_

_..

_

6,000 00
3,400 00
1,500 00
86077

"553,776 14:

DEBITS.

-

-

--

$321 22
183 38
12,258 13
41,01341

-

.$53,776 14

THE STATE OP MICHIGAN, In account with C. A. Crawford, Treasurer of Northern
Michigan Asylum,, for month ending September 30,1891.
OEEDITS.
By balance on hand September 1,1891.
Cash from earnings of Institution

To disbursements:
Acconntof detached cottage No. 3
Accountof roof repairing
Accountof reservoir
Accountof electric light dynamo
Accountof current expense
Balance on hand to new account

$41,013 41
56531

$41,578 72

DEBITS.

_
_. '
__.

$1,166 57
85 35
309 00
17 40
13,527 90
26,472 50

$41,578 72:

TREASURER'S REPORT.

21

THE STATE OP MICHIGAN. In account with C. A. Crawford, Treasurer of Northern
Michigan Asylum, for month ending October 31, 1891.
CBEDITS.

By balance on hand October 1,1891..
Cash from State Treasury:
Account of officers' salaries
Account of electric light dynamo
Account of detached cottage No. 3
Cash from earnings of Institution

To disbursements:
Account of officers's salaries
Account of detached cottage No. 3
Account of reservoir
Account of electric light dynamo
Account of current expense
Balance on hand to new account.

$26,472 50
2,305 05
2,000 00
6,600 00
35,504 94
DEBITS.

$72,882 49
•-

.----

$2,305 05
6,477 86
132 09
68 56
12,886 59
51,012 34

3
$72,882 49

THE STATE OP MICHIGAN, In account with C. A. Crawford, Treasurer of Northern
Michigan Asylum, for month ending November 30, 1891.
CEEDITS.

By balance on hand November 1,1891
Cash from earnings of Institution .„ -

To disbursements:
Accountof detached cottage No. 3
Account of reservoir
Accountof electric light dynamo
Accountof current expense
Balance on hand to new account

$51,012 34
1,85489

,

$32,867 23

DEBITS.

..
•_

_

'-.

$1,626 44
169 78
88 37
18,083 27
32,899 37

$52,867 23

THE STATE OP MICHIGAN, In account with C. A. Crawford, Treasurer of Northern
Michigan Asylum, for month ending December 31, 1891.
CBEDITS.

By balance on hand December 1, 1891
Cash from State Treasury:
Accountof detached cottage No. 3
Cash from earnings of Institution

$32,899 37
.... ...

To disbursements:
Account of detached cottage No. 3
Account of reservoir
Account of electric light dynamo
Accountof current expense
Balance on hand to new account

5,000 00
1,70941

._

__
___

$2,778 87
2,755 21
86 58
12,285 31
21,70281

$39,608 78

" 78

THE STATE OF MICHIGAN, In account with C. A. Crawford, Treasurer of Northern
Michigan Asylum, for month ending January 31, 1892.
CREDITS.
By balance on hand January 1,1892
Cash from State Treasury:
Accountof officers' salaries
Cash for earnings of Institution ...

$21,702 81
_

__

.........

2,337 50
36,65752

$60,697 83

22

NORTHERN MICHIGAN ASYLUM.

To disbursements:
Accountof officers' salaries..
Account of detached cottage No. 3
Accountof reservoir
Accountof electric light dymamo
Accountof current expense
Balance on hand to new account

_

_

$2,337 50
1,653 05
20 50
1,789 09
10,870 72
44/17697

$60,697 &S

THE STATE OP MICHIGAN, In account with C. A. Crawford, Treasurer of Northern
Michigan Asylum, for month ending February 29, 1892.
CEEDITS.
By balance on hand February 1,1892
Cash from earnings of Institution.__
*

$44,076 97
3,44498

.

To disbursements:
Accountof detached cottage No. 3
Accountof current expense
Balance on hand to new account

...

$734 94
8,967 32
37,819 69

-

$47,521 95

$47,521 95

THE STATE OP MICHIGAN, In account with C. A. Crawford, Treasurer of Northern
Michigan Asylum, for month ending March 31, 1892.
OEEDITS.
By balance on hand March 1,1892
Cash from earnings of Institution...

To disbursements:
Accountof detached cottage No. 3
Accountof current expense
Balance on hand to new account.._

„

._

$37,819 69
5,30392

-

$43,123 61

DEBITS.

_

__

$301 21
11,027 25
31,79515

$43,123 61

THE STATE OP MICHIGAN, In account with C. A. Crawford, Treasurer of Northern
Michigan Asylum, for month ending April 30,1892.
OEEDITS.
By balance on hand April 1,1892
Cash from State Treasury:
Accountof officers'salaries
Cash from earnings of Institution

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

_
^

_

_

$31,795 15
2,337 50
34,7&6 98

$68,919 63

DEBITS.

_

$2,337 50
13,301 08
53,28105

$68,919 68

THE STATE OP MICHIGAN, In account with C. A. Crawford, Treasurer of Northern
Michigan Asylum, for month ending May 31, 1892.
CEEDITS.
By balance on hand May 1,1892
Cash from earnings of Institution

$53,281 05
1,295 71

$54,576 76:

TREASURER'S REPORT.
To disbursements:
Account of reservoir
Account of current expense
Balance on hand to new account

__

__

.__

__ -

$153 11
15,020 47
39,403 18

$54,576 76

THE STATE OP MICHIGAN, In account with G. A. Crawford, Treasurer of Northern
Michigan Asylum, for month ending June 30,1892.
CREDITS .
By balance on hand June 1, 1892
.
Cash from earnings o f Institution _„ _ _ _ _ _ _

$39,403 18
1,544 5 0

_ _ _ _ _

$40,947 68

DEBITS.

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

-

-

__

- ..

$160 60
10,657 65
30,12943

$40,947 68

THE STATE OF MICHIGAN, In account with G. A. Crawford, Treasurer of Northern
Michigan Asylum, for fiscal year ending June 30, 1892.
CBEDITS.
By balance on hand July 1,1891
Cash from State Treasury:
Account of officers'salaries
Account of detache_d cottage No. 3___
Account of reservoir
Account of repairing roof
Account of electric light dynamo
Cash from earnings of Institution

$20,080 83
.

9,21194
15,000 00
6,000 00
1,500 00
2,000 00
160,357 04

$214,149 81

DEBITS.

To disbursements:
Account of office*'salaries—
Account of detached cottage No. 3
Account of reservoir,
Account of repairing roof
Account of electric light dynamo
Account of current expense
Balance on hand June 30,1892

__ __

_ _

_

__ _

$9,211 94
14,922 32
4,021 51
85 35
2,000 00
153,779 26
30,129 43

$214,149 81

We have carefully examined the accounts of C. A. Crawford, Treasurer
of the Northern Michigan Asylum, for the biennial peried ending June 30,
1892, and have compared the same with the books and vouchers; and verified the same by a further comparison with the books of the Steward and
hereby certify to the entire correctness of them.
LOKIN ROBEETS,

C. L. WHITNEY,
THOS. T. BATES,
Auditing Committee.

STEWARD'S EEPOET
FOR THE BIENNIAL PEEIOD ENDING JUNE 30, 1892.

ANALYSIS
OF RECEIPTS AND DISBURSEMENTS FROM JULY 1, 1890, TO
JUNE 30, 1892.

EBCBIPT8.
State—tor maintenance, etc., of patients __
Counties—for maintenanc, etc., of patients
Private patients
Sundry receipts, interest, etc., miscellaneous
Special appropriations:
Officers' salaries
Cottages for females...
__
._
Reservoir..
Repairing roofs
Electric light dynamo, etc
_

$201,813 03
90,404 16
6,632 57
3,811 41

_
_

18,741 80
15,000 00
6,000 00
1,500 00
2,000 00
$345,902 97

DISBURSEMENTS.
No. 1.—Attendants' salaries and wages
No. 2.—Provisions, food:
Meat and
Butter
Flour
Sugar
Tea
Coffee _ _
_
Miscellaneous
No. 3.—Clothing
No. 4.—Laundry:
Wages
Starch and Indigo
Soda, etc., soap making
Gasoline
Oil
Coal
Irons
Tubs and washing machines
Stoves..
_

_
_.

_

$37,679 56
j» 20,347 93
10,406 82
7,322 58
1,851 85
...
4,663 01
21,065 87

_

_

_
_.

_

$5,602 25
427 81
515 57
7981
15 00
2,664 65
5 17
521 19
38 71

_
_

_
—

.

_

103,337 62
26,529 81

9,870 16

HEATING AND VENTILATING.

No. o.—Heating:
Wages...
Coal...
Radiators, stoves and pipes
New boilers and
No. 6.—Light:
Wages
__
Oil.
Coal
Wicking
Electric lamps and

$55,838 48
fish

„

$3,812 17
9,940 17
244 85
2,359 65

fittings

_.

;
fixtures

__

_

$2,689 71
93 76
5,36245
1 10
890 76

16,356 8*

8,537 78

STEWARD'S REPOET.
DISPENSARY.

No. 7.—Medical supplies:
Druggist's wages
Drags
Books
Medicine cups
Instruments
__
Charts

$370
2,664
89
29
105
7

70
08
20
35
61
75

$1,805
818
612
406
98
275
25
I

00
86
05
76
50
63
25
00

$3,266 69

OFFICE, ETC.

No. 8.—Stationery, printing, etc.:
Printing and blanks...
Stationery, ink, etc.
Typewriter
ileotal of telephones..
Numbering machine
Official seal

. 3,572 05

AMUSEMENTS.

No. 9.—Amusements and Instruction:
Games.
Music for dances.
Fair tickets
Circus tickets
Theatricals
Books
Hymnals

$73 75
199 00
1000
25 00
7 25
41 26
13 80

No. 10.—Household supplies:
Paper
Dry goods
Crockery ___
Soap
Utensils
_
Carpets
Clocks..
_
Scales
Hardware, brooms and mops.
Sewing machine
Stove castings
Miscellaneous

$229 65
1,495 48
716 00
441 50
676 42
413 23
10 23
68 05
433 94
77 07
8 08
61 24

370 06

4,633 86

FUBNITURE AND STORES.

No, 11.—Furniture and bedding:
Wages.
Hardware and utensils.
Brooms, brushes and mops .
Crockery
Furniture, seats, beds, etc...
Dry goods
Soap
Carpets and rugs
Paper
Bedding, sheeting, etc

$1,081 40
529 !
438 83
456 34
1,663 56
3,357 71
267 85
232 07
112 82
1,794 05

Fire protection:
Watchman's wages..
Hose
_
Kitchen and bakery:
Wages
Utensils and"hardware.._
Soap
Stoves and castings
Coal

65987
..
._-

__
__.

-

$4,186 65
27587
12 15
219 86
872 05

Greenhouse and grounds:
Wages
Pipes and hose
_
Sickles, mowers.
_
Seed
--

$299 53
55 70
25 34
12 04

Out buildings:
Wages
Barn moving..

$282 40
100 00

Telephones:
Rental of phones .
Batteries, etc

9,932 49

$107 98
312 81
21 69

5,566 58

392 61
382 40

442 48

26

NORTHERN MICHIGAN ASYIA/M.
RENEWALS AND ADDITIONS.

No. 12. — Improvements and repairs:
Wages_______________________________________________________________________________$8,307 01
Hardware, pipes, etc
---------------------------------------------------------------2,790 64
Varnish, oil and paints_____________________________________________________________1,839 73
Brick, lime and cement_____________________________________________________________855 37
Lumber_____________________________________________________________________________2,117 73
Coal_________________________________________________________________________________420 70
Glass_______________________________________________________________________________346 71
Belting ______________________________________________________________________________ 7 26
Tile
.
.
.
174 15
Stone________________________________________________________________________________180 00
-$17,039 30
No. 13. —Tools and machinery:
Bread mixer ___ ... ... _ ...... ... ._ ..... ___ „ .................. ____ ........ $539 50
Belting_________________________________________________.........._
..................
80 91
Boiler purge ...___________ _ . _ . _ _ ...________________. .________ _ _47 50
Shafting _________________________________ ....... ____________________________________ 53 58
Gaskets, valves
_
...........................
..
............
________
8130
Lubricating oil__________________________......._ ...... . .. ...... . ........ _____ ..... _.
109 90
Tools
76 51
-989 20
No. 14. — Farm, garden, stock and grounds:
Wages_____________........________..........________________________________________$4,385 21
Implements, etc_____________________________________________________________________833 40
Veterinary ......................... ______ ._________....._____________________________43 50
Feed and hay_____.........._________________________________________________________10,894 35
Paris green and plaster ...____________________________________________________________44 80
Seeds ...... __________________________________________________________ 54556
Tile..... ...... ____________________________________________________ 14358
Stock ________________ ........ ______ ....... ___________________________________________ 637 25
Blacksmithing and repairs ______ .................. _________ ........ ________________ 504 41
Draining.. .
___________
_________________
5684
Horsehire...
.............
...._________________________________________1500
Threshing ____________ ............................ ____________________________________ 6 00
Flower-pots and boxes ............ ___________ ..... ____________________________ ---- 5117
Grease.
.......
______________________________________
1 84
-18,162 91
No. 15. — Freight and transportation:
Miscellaneous charged back_____________________________.......... ........... ______ $415 70
Superintendent's traveling expenses_______________________________________________158 14
Steward's traveling expenses___________________________........._ ................. .
119 00
-692 Si
Water distribution:
Wages
$519 16
Coal
____
421 84
Oil
7 76
-948 7ft
No. 16. — Miscellaneous:
Patients' expenses home____________________________________________________________$461 80
Undertaker's expenses___________________________________________________. __________ 316 60
Miscellaneous charged back________________________________________________________2,744 03
Expenses of elopement_____________________________________________________________66 80
Refunded money __
18 51
-3,607 74
Special appropriations :
Officers' salaries ... ......... ______ ...... ..............._______________________..........________18,741 80
Detached cottage for males _ . _ __________________________________________________________1,956 73
Cottage for females_________________________........_________________________________........_. 14,922 32
Repairing roofs___________________._________________________________________________________8535
Reservoir.
..............
_______
4,021 50
Electric light dynamo _____ ................... ........________________________............______2,000 00
Total ...... .

..

.. ..

...

... _ ...... . . . . . .

.- $332,85824

27

STEWARD'S REPORT.
Farm and garden products for the biennial period ending June 30, 1892.
Quantity.
889
17
993
444
1,400
86
4
50
4,698
12,550
4,600

Price.

Articles.
Asparagus, bunches Apples, bushels
Beets, bushels. _.
Beef, pounds

._

_
._

.

.

.

.

..

. __

40
60
10
02?
03 S
05

Cabbage, heads
11

U

Cauliflower, bushels
..
_
19
u
heads
3,100
Carrots, bushels-.
566
159
295
Cucumbers, bushels.. ... ..
VA

..

.

351
318
20
324
14
13
12
12
170
8
193
8
825
1,456

11
u
Kohl Eabi, bushels

2,272
96
177
203
4,360
28,629
13,095
37,783
214
41

...

$19 98 )
8400J

$89 90
8 50
248 25
103 98

34 40)
240?

36 80
5 00

470 46 ?
230 00 }

700 48

25
08
25
30
1 00)
2 OOf

4
248
141
47

40
25
05
03
7 00

140 40 )
79 50f

8 00
13 00
10 00
20
100

104 00 )
156 00 f120 00 )
34 00)
8 00 J

75)
00 J
50 j
705

252 75
189 20
298 00
219 90
1 00
9 72
98 00
380 00
42 00

bushels.

u

u

U

41

11

11

11

11

8 00
8 00)
3 00 f
16
14
10

.

.

.

..

_.

.

11

11

11

11

11

11

11

11

11

515
736
3,251
3,191

04, )
64 C
27 )
80 5

100 ;

428 75 ?
51 75)

60
60s)
35 t
30 f
2flJ

1,363 201

05
04
05'/2
60
60

1,431
523
2,078
128
24

75
37

50
SO
20

(I

249 06

10 (
06)

03)

"

VA

32
3,340
2,626
50
3

.

ti
11

307
152
162
264
12
72
• 625
1,300

...

Total
Amount.

40\5 (
u
u

Lumber, feet
64,380
73,331
ti
11
50,000
20,320 7-16
22,799
300
2,025
368
69
168

$0 10
50
25
04i/2
06

Amount.

10
081
05 1
03 f
02)
15)
05 f
01)
01
75
60

1,052 45 [
J
45 )
80 [
06 )
40 )
605

153 50 )
45 60 |
26 401
1
49 31 j"
J
35 2 2 )
26 26)
37 50)
1 805

1,251 68
6,443 13
SO 00
480 50
62 16
2,415 65

4,033 31
153 00
199 10
32 40

75 71

61 48
39 30

28

NORTHERN MICHIGAN ASYLUM.
Farm and garden products.—CONTINUED.

Quantity.

Price.

Articles.

$0 06
05
20
50

268
42
40
16
5
30
5
2
7H
27,117
101
28
SO
55
100
312
905
475
350

u

ii

1*

11

(I

It

"

pounds.

It

II

II

II

Total

ii

. .

11

„

, _.

__

Total
Amount.

$16 08 )
2 10 S
8 00)

$18 18

8 oo y

16 00

2 50
2 50
6 00)
400J

12 50*1
75 00 (
38 00 J

125 50

8 00)
01 ]
1 00

293 67 I
101 00)

394 67

1 00
20
1 00
25

Turnips, bushels
11

__

Amouut.

10
1 50
2 00
1 25

28
16
55
25

CO1)
00 (
(Xlf
00 ,)

124 00

31 20
1,357 50 ~)
950 00^
437 50 )

2,745 00

31 20

$21,664 49

J. P. C. CHURCH,
Steward.

SUMMARY OF INVENTORY.

Summary of Inventory Northern Michigan Asylum, June 30, 1892.
Heal estate, farm and grounds...
_
Buildings....
__
_.
Stock on farm..
Farm and garden produce
_
Vehicles and barn
Farm implements
Administration building
"
diningrooma
Trustees1 parlor, corridor and reception rooms
Matron's room
"
" stock __ __
Pathological laboratory ._
Dispensary. _
Medical office
.
.. .
Steward's office
Library.
Chapel
Wards
Cottage A .
B
"
C
"
East
General kitchen
_
Special kitchen
Bakery....
Meat shop
Laundry
Engineer's department
Carpenter shop
Stores—Dry goods and clothing
Notions, hardware and miscellaneous
Crockery
Groceries and provisions
Furnitureand
Store silverware
Total

____•_.._
fixtures
_
_

fixtures
...

_.
.

...

..
-..
..--

..._

........

..-,_-...
...

_
__._

. . .

...
—.

fixtures

$24,19646
542,804 47
3,997 50
11,662 09
634 64
880 46
2,622 70
627 05
501 13
79 44
547 77
673 40
818 54
816 48
339 17
436 03
809 25
31,66642
2,151 25
1,896 34
2,395 18
74394
2,89367
481 39
83507
281 16
2,262 15
1,962 28
654 83
5,911 96
1,018 52
144 33
2,726 18
134 45
25 48
$650,621 18

KEPOBT OF MEDICAL SUPEEiNTEIsrDENT.

To the Hoard 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, 1892.
The movement of population has been as follows:
for tlie Biennial Period.
Males.

Patients.

Discharged

-.

Discharged, recovered

_

_

_

.

_.

_ _ _ _

Died

.-

Females.

Total.

877
208

310
146

687
354

585
150

456
81

1,041
231

435

375

810

43
43
5
59

23
28
4
26

66
,/a -H• -985

<-

/

t

$ "

From the Beginning.
Males. Females.

Patients.
Total admitted
Discharged recovered
improved
Died

.
.

Total discharged
Remaining under treatment June 30, 1892

.
_

-

._

Total.

830

654

1,484

122
120
IS
136

79
94
11
96

201
214
29
232

896

280

676

435

373

810

The net gain of patients during the period has been 123.
The smallest number of patients under treatment in any one day was
685; the largest number was 811.
The death rate upon the whole number under treatment for the year

REPORT OP MEDICAL SUPERINTENDENT.

31

ending June 30, 1891, was 4.2 per cent; for the year ending June 30,
1892, 5 per cent.
The following table will show the sex, age, form of mental disease and
cause of death in those discharged died:
TABLE II.
Sex.

Mate.
Male
Male

Age
fifi

Male

64
31
27
34

Female __
Male
Male
Male
Male

4fi
4S
45
52
55

41
Male
98
Male
Female . 55
23
Male
47
Male

Form of Disease.

Nativity.
(rprmany

Finland
New York..

L

New York

B.II, Senility
B. II, Dementia
B. 11, Syphilitic
.
A. I, Melancholia
B. II, General Paralysis
C. I. Neurasthenia
A. 11, Dementia
A. II, Dementia
G. II, Paranoia
C. I, Epilepsia _

Sweden,
Germany
New York
New York

Cause of Death.
Organic Brain Disease.
Organic Brain Disease.
Paretic Seizure,
,.. -

C. Ill, Imbecility
C. I, Epilepsia
C. I, Epilepsia
A. II, Delusional,

Michigan,

Male.
Male
Male,
Male
Male

47 Ireland .
, » B. I, Chronic
45
B. II, General Paralysis
7fi Newfoundland . , B. II, Senility
W
B. II, General Paralysis
flO Canada
C. II, Periodical .
..

Female
Female _ _
Male
Male

75
(?)
67
(?)
45

Male...
Male
Male
Male
Male

74
58

New York

^
67
56

Vermont .

Female -_ 67
54
Male
44
Male
90
Female
40
Male
Male
Male—
Male
Male

63
6P
40

33
76

Female... 40
f;9
Male
41
Male
30
Female

33

Male
Male
Male
Male

Unknown
New York. . _ _
Unknown

65
(?)
58
43
'50

70
65
(?)

»
3]

Senility
Delusional
Dementia ...
General Paralysis

. B. II, Senility

Germany
Canada .

B. II, Senility..
tf
_ r C. II, Periodical
___. B. II, General Paralysis

Illinois...
Michigan

-. -. B. II, General Paralysis
C. I, Epilepsia .
_

Germany
Finland
Unknown
Ohio

Unknown
Michigan
Michigan. _

Exhaustion.
Cardiac Disease.
Meningeal Hemorrhage.
Bright' s Disease.
Phthisis Pulmonalis.
Paretic Seizure.
Strangulated Hernia.
Paretic Seizure.
Bright's Disease.
Bright's Disease.
Ovarian Tumor.
Paretic Seizure.
Erysipelas.
Dysentery.
Phthisis Pulmonalis.
Paretic Seizure.

. Paretic Seizure.
Epileptic Seizure.

B. II, General Paralysis
B. I, Chronic
B. II, General Paralysis
C. I, Epilepsia
A. II, Delusional

Paretic Seizure.

B. II, Dementia
B. II, Dementia
C. II, Periodical

Organic Brain Disease.
Organic Brain Disease.
Exhaustion.

B. II, Organic

Female- fi8 New York
4S
Male
34 Finland
Male
Male, _. 30 Michigan
Female . 48 Canada
Male
Male.
Male
Female., Male_._

B. II,
A. II,
A. II,
B. II,

Exhaustion.

. , _ Phthisis Pulmonalis.
Phthisis Pulmonalis.
Cardiac Disease.

.

B. II, Senility

Organic Brain Disease.

A. 11, Dementia
B. II, General Paralysis.
A. II, Delusional

Dysentery.
Paretic Seizure.
Cardiac Disease.

B. II, Organic
B. II, Organic

B right's Disease.
Bright's Disease.

B. II, General Paralysis
B. II, Delirium Grave..

_ Paretic Seizure.
.... Exhaustion.

32

NORTHERN MICHIGAN ASYLUM.
TABLE II.—CONTINUED.

Sex.

Age

Male
Male
Male
Male
Female--

26
59
58
42
42

Nativity.
Sweden

Ohio
Canada _
34 Ireland
44
37 New York

Male..-.
Male
Male
47
Male
Female- 75
Female —
Male
Female.. .
Male
Female —

71
39
25
60
44

Female—
FemaleMale
Male ...
Female-

34
58
54
35
61

Female—
Male. -.
Male
Female...
Male

f'l

38
R5
20
32

Form of Disease.
0. 1, Neurasthenia
B. 11, Senility
C. II, Paranoia

B. II, Senility
Massachusetts
Massachusetts
C. II, Paranoia
New York
C. I, Epilepsia
B. 11, Organic
New York
Michigan
Ireland _
B. II, General Paralysis
England
Belgium
B. 11, General Paralysis
Ohio
A. I, Mania
C. I, Epilepsia
Canada .
Wisconsin
B. II, General Paralysis
New York. _. ._ A. II, Delusional.
A. I, Mania
Unknown
.. C. I, Epilepsia
Canada .
A. II, Dementia

Cause of Death.
Phthisis Pulmonalis.
Organic Brain Disease.
Bright's Disease.
Paretic Seizure.
Phthisis Pulmonalis.
Phthisis Pulmonalis.
Paretic Seizure.
Phthisis Pulmonalis.
Paretic Seizure.
Organic Brain Disease.
Cardiac Disease.
Bright's Disease.
Status Epilepticns.
__ _ Organic Brain Disease.
Cardiac Disease.
Paretic Seizure.
Cardiac Disease.
Paretic Seizure.
._ __ Phthisis Pulmonalis.
Cardiac Disease.
Paretic Seizure.
Phthisis Pulmonalis.
Traumatism.
Cardiac Disease.
Pernicious Anaemia.

It may be interesting to observe that no death occurred from simple
acute insanity, and from the table it may be found that death was due to
Bright's disease in 8; cardiac disease in 9; dysentery in 2; epileptic
seizure in 1; erysipelas inl; exhaustion in 6; meningeal hemorrhage in 1;
organic brain disease in 12; ovarian tumor in 1; paretic seizure in 21;
pernicious anaemia in 1; phthisis pulmonalis in 16; pulmonary oedema in
1; status epilepticus in 2; stragulated hernia in 1; traumatism in 2.
During the period many post-mortem examinations were made. Some
of these were exceptionally interesting. The following will briefly
describe a few of the most important:
Mr. J. J., age 55, native of Finland, suffering from organic brain
disease, was admitted December 9, 1890. About two years previous to
admission he received a blow on the head from a falling tree. After the
injury he was delirious for several weeks, and for a year after the delirium
subsided he was confused, restless, irritable, and inclined to wander away
from home in an aimless manner. When received his physical health was
good, but he was much demented. As a rule he was a quiet and comfortable patient, doing considerable work so long as his health would permit.
When admitted the vision of the left eye was very imperfect and gradually failed until it was entirely lost. After a few months the right eye
began to fail and was much impaired at time of death. During the last
few weeks of his life there was evident failure of the coordinating function, and the dementia rapidly increased. There was also partial deafness
of right ear. The morning of October 22, 1891, he had a series of five
convulsive seizures during three hours, dying in a comatose state.
Autopsy held a few hours after death revealed the following condition:
The calvarium was very thick, membranes adherent along longitudinal
sinus and in regions of softened areas of left frontal lobe. The arachnoid.

INTERIOR

I N F I R M A R Y FOR

WOMEN

INTERMEDIATE

WARD

FOR

WOMEN

REPORT OF MEDICAL SUPERINTENDENT.

.

33

space was considerably distended with fluid. The convolutions were not
well developed. There was softening of the anterior thirds of all the
frontal convolutions and the middle of the inferior temporal convolutions
of the left side, the middle of first and anterior portion of the second
frontal convolutions, parts of the middle temporal convolution and nearly
all of the occipital lobe of right cerebral hemisphere, the inferior surface
near median line and small spots along the external margin of the right
lobe of the cerebellum.
The softened areas were of a brownish yellow
color and the tissue much shrunken and disorganized. There was atrophy
of the left optic nerve and partial atrophy of both optic tracts. The lateral ventricles were very much distended with
fluid.
,
Mr. H. H., age 31, native of Finland, suffering from organic brain dis.ease, was admitted August 4, 1890. He was a powerfully built man, weighing 180 pounds, though quite feeble, having the appearance of one who
had been ill for some time. The expression of his countenance was blank
and unintelligent. As he could not speak English, and only incoherently
in his own language, little could be learned of his mental condition except
by his actions. He seemed very actively hallucinated, especially at night,
being restless and noisy. There were several scarification scars along both
sides of spine, along courses of both sciatic nerves, and along course of
right brachial nerve. The heart was feeble and irregular, pulse 84, and
there was a marked mitral regurgitant murmur. The knee reflexes were
diminished, coordination very imperfect, and fibrilary twitching of face
and tongue. His vision, poor at first, failed rapidly until on the sixth day
after admission he could not discern objects, though he could digtinguish
a window from the wall. An ophthalmascopic examination showed some
small spots of retinal hemorrhage in both eyes, but the retinal lesions
were not sufficient to account for the impairment of vision. He became
more restless and disturbed from day to day until the evening of August
30, when he gradually sank into a comatose state, dying the following
day. The autopsy held twenty-four hours after death showed the calvarium to be quite normal, dura adherent along longitudinal sinus, and some
bulging of arachnoid with fluid. The membranes and brain were very
anaemic. An irregular tumor, two and one-half by one and one-half
inches, was found involving the optic nerves, the optic commissurej the
anterior portion of optic tracts, the olfactory nerves, the anterior portion
of crura cerebri, the anterior portion of corpus striatum of right side and
a part of both anterior lobes. The growth was closely adherent to and
involved the bony structures underneath. The outer portion of the tumor
was soft and much disorganized, but the center was firm and had a brownish mottled appearance when cut. A microscopical examination of the
growth showed it to be syphilitic. Many of the small vessels were completely occluded by the thickening of the tunica intima.
Mr. E. G., age 61, blacksmith, admitted to Michigan Asylum, January
9, 1882, transferred here December 7, 1885. He was always impulsive, and
had been intemperate for years. When about 45 he began to have occasional attacks of petit mal, becoming gradually demented. His physical
health was very good, and for two years and a half he worked at his trade
in the shop. During May, 1888, he suffered from acute rheumatism, and
in January, 1890, had a severe attack of influenza which left him quite
feeble. His heart troubled him often during the summer, and an examin5

34

NORTHERN MICHIGAN ASYLUM.

ation showed the area of dullness much enlarged, extending considerably
to right of sternum, apex beat heard to left of mammary lines, a systolic
and diastolic murmur, and no normal second sound. He became very
much jaundiced and was at times cyanotic, but continued to work a little
until October, 1890, when he failed rapidly. There was marked venous
congestion. The lower limbs and the abdomen became very cedematous.
He could not retain food. Bloody stools and sputum were noticeable for
some time preceding death, showing the extreme congestion of the mucous
tracts. He had a convulsion October 28, dying soon after. Autopsy, held
a few hours after death, showed a very much dilated heart, with considerable hypertrophy of left ventricle. There was some inflammatory thickening of mitral and tricuspid valves with marked insufficiency, the latter
being due more to dilatation than to the lesions of the valves. The anterior
and right posterior aortic valves were much thickened, and near the center of each was an oval opening about seven m. m. in diameter. The left
posterior valve had a thickened spot corresponding in position to the openings in the other valves. There were some vegetations on the mitral and
aortic valves and along the arch of the aorta. The thoracic and abdominal viscera were very much congested.
Mrs. E. D., age 4A, suffering from mania, admitted to Michigan Asylum
December 23, 1879, transferred here December 10,1885. When received
here her physical health was good, but she was somewhat demented. She
remained very comfortable and was quite industrious. During the winter
and spring of 1892 her physical health gradually failed as a result of
imperfect circulation. An examination of the heart showed the area of
dullness much increased. The apex beat was heard in sixth intercostal
space to the left of mammary line. There were loud systolic and diastolic murmurs heard best at apex and over pulmonary valves. The systolic murmur was loudest and completely replaced the second sound.
Both external jugulars were distended and positive pulsation was noticed.
The liver dullness extended as low as the umbilicus. There was no jaundice. She was very cyanotic for several hours previous to her death,
which occurred April 28, 1892. Autopsy held ten hours after death
revealed a much dilated heart. The pericardium was also much distented
with fluid and impeded the action of the left lung. There was thickening
and insufficiency of aortic valves. There was also imperfect action of the
other valves due rather to distention than to any disease of the valves.
Vegetations were noticed on aortic valves and along the arch of aorta.
The liver was enlarged, and the gall bladder, which was full of a transparent glairy mucus, contained eight gall stones, one of which was lodged
in the duct at mouth of bladder. All the thoracic and abdominal viscera
were congested.
Mrs. M. D., age 67, suffering from organic brain disease. She had
rheumatic fever in December, 1889, since which time she had shown mental symptoms. When admitted, her physical health was poor. She was
restless, confused, intensely hallucinated and demented. Heart enlarged,
loud, regurgitant mitral murmur heard at apex. The pulmonary second
sound accentuated. The temporal and radial arteries showed atheromatous change. She was considerably jaundiced. There was noticeable
tremor of head and hands, gait uncertain, speech tremulous and indistinct, conversation incoherent. Sept. 29, 1890, she had a seizure which

CONVALESCENT WARD FOR W O M E N
(ALCOVE)

REPORT OP MEDICAL SUPERINTENDENT.

35

resembled an epileptic attack. It affected only the right side. There
was conjugate deviation of eyes to right. From time to time she had
convulsive attacks, resembling the first and increasing in severity. When
very severe, both sides convulsed. She was now confused, irritable, and
destructive requiring much attention. The morning of Sept. 18, 1891,
she could not speak or swallow, and the entire right side was paralyzed.
She failed rapidly, dying Sept. 25, 1891. Autopsy held a few hours after
death showed the dura very adherent to skull along longitudinal sinus,
tearing when the calvarium was removed. The arachnoid contained about
three ounces of yellowish serous fluid. Brain shrunken and convolutions
flattened. Many of the cerebral vessels were atheromatous. There was a
thrombus of the left sylvian artery beginning just beyond origin of temporal branch, filling the artery for an inch. Beyond thrombus the artery
contained dark fluid blood. The cortex supplied by portion of occluded
vessel, beyond thrombus, was in an advanced stage of degeneration. The
lower portion of motor zone of left side was in early stage of degeneration.
Mr. J. B., age 43, suffering from epilepsy, admitted Dec. 22, 1887.
Physical health good. Somewhat demented. He was a short, fleshy individual. On evening of Sept. 25, 1891, at 11 o'clock P. M., he had a
severe convulsion, during which he fell from his bed, striking his abdomen
against the post of an adjoining bed. About two hours after the injury
he first complained of pain in abdomen, but said he was not very ill, and
at 5:30 A. M., he arose and dressed himself, sitting up for about an hour.
He suddenly became rapidly worse, soon passing into a cotamose state,
with the symptoms of shock. An examination of abdomen revealed an
ecchymotic area about six inches in length and one and one-half inches in
width immediately above and parallel to Pourpart's ligament, on the right
side. The outer portion of bruised area showed several small superficial
lacerations, apparently due to overstretching of skin. Pressure over injury
caused intense pain. A small amount of normal urine was drawn with
catheter. Patient died sixteen hours after injury. Autopsy six hours after
death showed abdominal walls unusually thick and fatty, about two pints
of bloody serum and feecal matter in the peritoneal canal, signs of developing peritonitis, and a longitudinal rupture an inch in length in illium
opposite its mesenteric attachment at a point about four feet from its
juncture with colon. The lacerated portion of intestine was directly
beneath external injury.
Mr. T. S., age 61, suffering from periodical insanity, had been in the
Topeka and Michigan asylums, from which latter institution he was transferred here Dec. 7, 1885. He had very extravagant religious delusions,
and at times was inclined to be irritable. He was discharged improved
July 1, 1887, and again admitted Sept. 8, 1890. When last received his
physical health was fair, the mental symptoms same as before. He soon
improved so that he could live on the convalescent hall. During his confinement here he suffered from Bright's disease. On Jan. 7, 1891, he complained of his kidneys and the penis was noticed to be swollen, but he
would not allow an examination at the time, and for a few days he seemed
better, going out daily with the walking party and maintaining that he
was^ feeling much better. Jan. 15 he complained seriously again, and
an examination of urine showed blood, pus, and albumen present. Jan.
16 an examination of the penis showed a solid body in the urethra,

36

NORTHERN MICHIGAN ASYLUM.

which he said he inserted about two weaks previous, and had lied to prevent its being discovered. He said he was trying to make an opening up
to the kidneys and the stick slipped so far in that he could not withdraw
it. The meatus was slit and with much difficulty a wooden rake tooth,
three inches long and one-half inch in diameter at large end, was removed.
The large end was nearest meatus. The left testicle was considerably
inflamed. There was also a severe cystitis, about a pint of decomposed
urine being drawn with catheter after removal of obstruction. For some
days there had probably not been complete excretion of urine. A movable fluctuating tumor, about six inches in diameter, was noticed in lumbar
region. Patient died Jan. 18. Autopsy, fifteen hours after death,
showed the left kidney cystic and very much distended, containing three
pints of bloody urine. There were a few small calculi in cysts. The
left ureter was not patent, though no calculus was discovered in it. A
little apparently normal kidney tissue was found in outer wall of some of
the cysts. The right kidney was twice the normal size and contained
some small pus cavities. The bladder was much congested.
Mr. J. B., age 50' (?), suffering from organic brain disease, was
admitted Aug. 7, 1891. He was feeble, walked with difficulty, coordination imperfect, vision poor, and hearing much impaired. He failed rapidly, dying Aug. 18, 1891. Autopsy, made a few hours after death,
showed the calvarium and outer membranes normal, considerable bulging
of arachnoid with a clear serous fluid. The vessels were in general atheromatous, and branches of both middle cerebral arteries were occluded.
The right hemisphere showed softening of middle temporal convolutions,
except anterior portions; supra marginal and supra parietal convolutions
nearly wasted, also anterior portions of occipital convolution. The left
hemisphere showed softening of angular gyrus, portions of middle and
inferior frontal convolutions, corpus striatum and lenticular nucleus.
Mr. A. M., age 63, transferred from Michigan Asylum Dec. 7, 1885.
He had had several attacks of alcoholic insanity. His physical health was
good. He was demented, but usually comfortable, though at times irritable
and noisy. In September, 1889, there were symptoms of heart disease, and
an examination showed aortic and mitral insufficiency with considerable
enlargement. His health failed gradually. During the summer of 1891
he had diabetes melitus, passing at times, according to quantitative examination, 5% of sugar. Urine also contained a little albumen, some hyaline
and granular casts. His limbs and abdomen became very oedematous, and
for several days preceding death there was venous stasis in small areas on
surface of lower limbs and body. The area of cardiac dullness was much
enlarged, no normal heart sounds could be distinguished, and there was a
marked venous pulse. He died July 10, 1891. Autopsy showed insufficiency of all the valves of the heart, with some hypertrophy of left ventricle.
The right heart was enormously dilated. There was thickening of the
aortic and mitral valves. The liver was considerably enlarged and there
was a general venous congestion. Kidneys did not show any lesions ascertainable by naked eye examination.
The following is an interesting case of death from traumatism due to
accidental causes.
Mr. H. P. O., age 50 (?), suffering from alcoholic insanity, admitted

REPORT OF MEDICAL SUPERINTENDENT.

37

June 22,1892. When received his temperature was normal, pulse regular,
not rapid, respiration normal except for wheezing due to congested and
swollen condition of throat. There were some small bruises on body and
limbs. He said his swollen neck was the result of being choked while in
jail. In the jail he had attempted suicide with twisted bedclothes about
his neck. After receiving a bath he drank some milk and went to bei?
quietly in a "shuttered" room. He slept during the entire night and arose
the next morning but little disturbed. He took food without much urging
during the day. Some of the time he was restless, requiring special attention. The evening of June 23 he retired quietly, as he had done on the
previous evening, and was soon apparently asleep. Not long after, the
attendants were attracted to his room by noise of a moving bed, and found
that he had barricaded the door with the bedstead and spring mattress.
By looking through transom over door they could see him holding
the slats which he had torn from the bedstead, and evidently inclined to
resist any effort that might be made to enter his room. He used violent
and very threatening language. The physician was at once called, and as
the patient was breathing with difficulty and seemed ill, it was deemed
best to secure control of him at once. Before entrance to the room could
be made, he had climbed upon the bedstead to strike, with the slat which
he held, at the electric lamp suspended from the ceiling of the room.
While endeavoring to strike the lamp he was heard to fall heavily. He
was easily controlled when the door was opened, and after being placed on
the bed soon became quiet. An examination revealed several ribs broken
on each side near sternal ends. The swollen condition of the neck, with
injury to the chest, made breathing very difficult, and he died the morning
of June 24 from failure of respiration and shock. Autopsy held six
hours after death showed second, third, fourth, fifth, and sixth ribs of the
right side, and the fifth, sixth, and sexenth ribs of the left side fractured
near the sternal ends. From all the circumstances connected with the
injury, it seemed very probable that he received it accidentally while alone
in the room, as those who had cared for him knew of no trouble which
might have caused it.

38

'4r

^
4

fl

•g.
K

a

8
R

^1

'3

I
^i- i

sc

M
I—)
(•H

H

m
&

TWL

-0IBK

""[BIJO^

IM
O

1
1
HH

a

1

eiscoi-t -#
W t—

GOOD

cotT-H UTJ

"

oo
CQSO

NORTHERN

*-!•«#

i
i

OJCO
cairs

i
'

TO

OO CO
INC-

^•l CD
rH CQ

^

2*4*

$3^

i£i-*^ i-f

i-H?a

^ a /

j

>.*J

cp

<N

i-ii-n-ieo
CO 1—1 0

05

oo
*O

rH

^5

Iffi

«v^N,
OsA4

!

^

?q

"T "*•

^^^^ 1;
^W

^**'

!

Ift

^H

Csl

OT ICi-l

M

\*

00

S ; -"
gco

t'V

v>.

t

i

!
i

]

j

N

^ v-^
i

:
;

' ; i

|j
'<)

{j

| "]

ii

i
o o * ^

]

£'S,

,», I »

o3
§

^

\

i

'

i

' '

A *^^-^l
'

'5

S

MICHIGAN ASYLUM.

-*

fl

O

'*
1^

J!|
sj^-S0^

*coS®^£

S^^S

S S S- S <*£ ^

rH »-t

ooeo co -^nos
t— iC 1C

«•:

1C

+>• a

^S S (M lH

^

ft

7^
o

S '

7^7 ^
«d

s
CO

§ §i

0
3

1 oI

a

a

ft

1

'C
1
^

•§•& 'g-a
'S

5 Is -s
c3 rQ

<8

r

,
'*——

J

S '

<D
0)

y

^

.s
S

Pj

£
1

'

-^v-^

aft
•«0
£

2
Q

.

,1
i—1
'

1
s
c?

(
C J

i
=1 >
00

c

-2C

l if* II .2 iHfii iifi |iii s^x
«^

d

3
'p«
o

d
o
-d
-^ •
§

-8a

Q

£
1

O

P

0

-4-1

3

3

tJ

§

1
0>

____ Y

S
O
•u
o
2
Q,'S

1S
as
CQ
h-i
'

«
£

i|Hi 1| II lir-ii itll l|i| |I
S a" « "d*

•§

d

""^

En

0
-a
o

& I-S

&
02

s0
8

g1
•a
Cn

"-T-"
S

^

BE

0'=

Sp

83

fc"

"

'eS

1

^O

S

t-t
0

a

1

*

Si
» §
ag
® j
""S o
•

fl
i—(

*

13

*

3
•
s
<'S

03

U^

cf
*—1

0

«5

i '

REPORT OF MEDICAL SUPERINTENDENT.

39

The above classification, adopted two years ago, has been clinically quite
satisfactory. To avoid, however, further use of the toxic factor, cases
heretofore placed in Group B I. are now classified without reference to
aetiology. While various toxic agents may be the exciting causes of mental derangement, yet the symptoms expressive of the latter do not necessarily differ from those of insanities arising from other causes. If this is
true, acute and chronic mental affections of toxic origin can just as well be
classified in other groups without violating the fundamental idea of the
classification, and obviate a special aetiological group in the scheme.
A glance at the table will suffice to show that out of the 354 admissions
during the period just closed, 64 acute and 57 secondary cases were assigned
to Group A ; 58 symptomatic of organic brain disease in Group B; and 167
in the several subdivisions of the degenerate Group C. In 38 of the 167
insanity developed upon the neuroses, and in the remainder, 129, it was but
the product or expression of an original, primary, degenerate, nervous constitution. The 64 cases of Group A, or 18% of the admissions, represent
all who suffered from simple, acute, idiopathic insanities, such as mania
and melancholia and their clinical varieties, primary confusional insanity,
etc. These patients were free from degenerative stigmata, and nothing
existed in their family or personal antecedents indicative of defective or
abnormal mental development. It is doubtless true that under stress, insanity may occur in individuals free from neurotic taint, but a careful study
leads to the belief that the number of such instances is small, as compared
to the number where defect is known to exist.
An inquiry into the termination of the insanity in these 64 cases, shows
that 70 per cent recovered, and of those remaining under treatment a
sufficient number will recover to increase this percentage to 80, or even
higher. Further, it may be observed that the causes which lead to the
mental failure in these individuals were mostly somatic—such as might
overtake the best mentally endowed. *
The 57 cases assigned to group A, as secondary or terminal, are not
without interest from a preventive standpoint. These were primarily
curable, but through various circumstances their treatment was delayed
until after their mental disease became chronic. These 57 cases represent
about 16 per cent of the admissions, and their fate affords a most urgent
plea of the necessity of early treatment of mental disease. It is clear
that, had prompt care been afforded them, 80 per cent would have been
rescued from mental death and the State relieved of the burden of their
support. Next to the indiscriminate marriage of the defective, nothing
tends more to swell the aggregate of our public charges than this indifference to, or neglect of early hospital treatment of this class of the insane.
Of the 354 patients, 82 per cent were incurable at the time of admission; 16 per cent suffered from terminal dementia, or secondary delusional
insanity; 18 per cent from organic brain diseases; and 50 per cent from
primary mental deterioration.
Without pursuing these statistics further, 'we would briefly call your
attention to the
DEGENERATE INSANE.

Under this designation is comprised all patients in whom mental disease was primary and had for its necessary, essential cause a hereditary
or acquired neuro-psychopathic constitution. Heredity of psychical

40

NORTHERN MICHIGAN ASYLUM.

peculiarities, defects, or diseases, is a well-known fact. " It influences
the internal conformation no less than the external structure. Nothing is
more undisputed than the heredity of form, size, and anomalies of the
osseous system; and universal every-day experience proves the heredity of
all the proportions of the cranium, thorax, etc,," and, "lastly, it regulates
the proportions of the nervous system" (Kibot).
This constitution may be acquired in early life through diseased conditions, fevers, acute brain affections, etc., or in later years by intemperance,
vicious habits, syphilis, etc. Intemperance of a parent is a potent cause
of nervous instability in the child, and as Ellis says, when insanity and
intemperance are combined in the parents, a rich and awful legacy of
degeneration is left to the offspring. We cannot doubt that the children
of the defective are more liable to be degenerate than those of normal
parentage. An individual coming into the world is not an isolated being,
dependent solely for his well being in life upon education, environment,
or opportunity, but inherently he bears the potentalities of his race; if
it is well endowed, it is not likely in his development he will deviate from
the average of mankind; if, on the contrary, it is diseased or imperfect,
he bears in latent form the germs of these defects or imperfections, which
only need slight cause to bring into full activity.
As the neuropathic taint may be slight or marked, so may the mental
products of the imperfect organic mechanism vary in character and content and be manifested by modified thought and conduct. At one end of
the scale genius may be found, at the other imbecility may exist. The
neuropathic constitution is occasionally characterized by an excessive or
one-sided development of talents, or by a vicious or imperfect development of character. As a rule, the primary mental activities of the degenerate unfold unequally and disproportionately, but almost invariably in
the direction of immediate or remote ancestral imprints. These tendencies may be intensified, modified, or transformed in the descendants,
according as the influence of parental selection, training, and environment
has been better or worse than in the ascendants. Doubtless in the neuropathic, morbid, mental, moral and instinctive feelings are as much physiological outgrowths, as are normal, mental, moral and instinctive aptitudes in
the healthy. Neurasthenic, hysterical, hypochondriacal, moral and paranoic insanities are but designations given to just so many symptom complexes developing in this class of patients. While their clinical features
differ widely, yet the underlying cause is for each the same, but of infinite
grades of intensity.
t
In the degenerate psychical stigmata or peculiarities of character and
disposition may be noted in childhood. Unusual emotionality, imaginativeness, inconsiderateness, untruthfulness, or reticence, sensitiveness,
slowness of thought and bodily action, effeminacy, uncontrolable outbursts
of passion, and imperative impulses and acts, are frequent. Mental
lacunes or deficiencies are not rare. Certain branches may be learned
very readily, while the individual is utterly unable to comprehend certain
others. Many of these qualities are common to all men, and, as Levinstein
Schlegel remarks, every individual has his idiosyncrasy of character. It
is the exaggerated form of these qualities that indicates a want of harmony
between external impressions and the mental reactions resulting from
them. Griesinger, in referring to individuals of this class, says, " They
are incapable of satisfying their emotional cravings by external actions,
dwelling in the realms of imagination. To them the world appears com-

REPORT OP MEDICAL SUPERINTENDENT.

41

mon, and they fancy themselves too good and too noble for its pursuits.
Thus are produced various modes of manifestation of the same fundamental state, which nevertheless agree generally in this—that the disproportion which exists between the reaction and the impression appears in
the higher degrees as extravagance and excess. The result is, that the
individual, with his whims and unusual modes of reaction, steps out of the
ordinary beaten path of humanity, and passes in the world as an original,
singular man." • • • • «They exhibit striking peculiarities—at one
time lowness of spirit, at another time enthusiasm; but they are always
changeable, always violent. The mode of reaction differs in such cases
from that of the average of mankind, and therefore seems freakish."
Unusual precocity has not been often noted in degenerates corning
under our observation. As a class they learn well to a certain time, after
which they show no special aptitude for instruction, and often in obedience
to vague impulses, wander from place to place and from occupation to
occupation. This tendency has been very frequently observed, and the
following is given as a most interesting example:
C. W. D., male, aged 36, was admitted May 18, 1891. History stated
that he had simply been wandering about, and people were afraid of him.
The day following admission he had a light convulsion, there being no '
premonitory symptoms. The effects of the convulsion passed away in a
few moments. From this time on he was a very pleasant patient, causing
no particular trouble. After being confined a month he was discharged.
The following is a brief outline of an autobiography of the patient:
" I was born in 1855. A few years later my father died, and at the age
of nine years I was sent to a reform school because of an innate tendency
to steal anything and everything I could get hold of, whether it was of
any value to me or not. I escaped from the reform school by tunneling
underneath the surrounding walls, and at the age of eleven had been
adjudged insane and sent to the S. G. asylum. Right here I might say that I
have had convulsions since I was six months old, brought about, it was
thought, by an injury received by being dropped from my sister's arms
upon the sidewalk at that age.
At 131 was removed from the S. G. institution by my brother and placed in
an Asylum. After a year's confinement I escaped, but was soon arrested for
vagrancy and petty thefts and sent to the workhouse at W. I served
my time, and then went to Detroit, Mich., and entered the service of the
U. S. navy. After two years of service I was discharged because of lack
of ability to do my work. From Detroit I went to Buffalo, then to Utica,
where I was again arrested and sent to the asylum. Here I remained
three months, and was discharged and sent to New York city. My love
for liquor again brought trouble, and I was sent to Blackwell's Island for
90 days. Here my mental condition was ascertained, and I was transferred to the Long Island asylum. After three months of confinement I
escaped and went to Philadelphia, Pa., where I secured employment on an
oyster dredge in Chesapeake bay. In six months my services were dispensed with, and I shipped on Str. Dongola for San Francisco, Cal. I
arrived in that city at the age of 16, was immediately discharged, and
before being on land a day I was arrested and sent to an asylum. My
discharge followed in three months, and I started by rail for Cedar Kapids, la., but drink again put me in an asylum at that place. In six months
I was released and sent to Burlington. I next worked on a farm for some
6

42

NOETHEEN MICHIGAN ASYLUM.

time, going 011 an occasional drunk. This mode of living became too
monotonous, and I started for Chicago, but liquor again stopped me in an
asylum. At the expiration of the usual period of confinement (six
months) I was released and went to Chicago, and soon found myself at
the workhouse, as a result of obtaining money under false pretenses. At
the expiration of my sentence I shipped on board the Str. Gordon Campbell for Detroit, where I secured employment; but the intense heat,
tegether with an unlimited amount of whisky, completely prostrated me
and I was sent to a hospital, where I was under medical treatment for
four months. After my discharge I went to New York city and shipped for
Liverpool. On our arrival in England I was sent to an asylum, until there
was an opportunity to return me to America. On my return I was sent to
government hospital. After I was discharged I started for Iowa, but
hired out to an Ohio farmer for whom I worked faithfully for one year.
At the expiration of that time I went to T., Ohio, with $140 in my pocket,
expecting to have a good time, but I was soon committed to the C. asylum.
It was one year before I was considered able to care for myself, and immediately on my discharge I went to Baltimore, thence to Charleston, near
which place I worked on a farm for two months, and was then married.
Through my wife I came into possession of a farm and $1,000 cash. For
six months everything went nicely, then my wife dying, took to drink, left
home, secured employment at Chesapeake Bay for a time. I next went to
Chicago, shipped to Buffalo, served four months' time at Buffalo workhouse, and then proceeded to New York city, but again returned to
Buffalo and shipped for Bayfield, Wis. My desire for liquor again prevailed and I soon found myself at Oshkosh asylum, where I remained for
18 months. After my discharge I went to M., and was again committed
to an asylum. I escaped, went to Chicago, thence to New York city, back
again to Wisconsin, and was sent again to Oshkosh asylum. After a stay
of two months I escaped, went to Chicago, shipped for Detroit, where I
passed the winter. The following spring I went to Toledo, shipped for
Chicago, and on arriving at that city, went ashore, got drunk, was discharged, and immediately started by rail for Ludington, Mich., but was
arrested at Niles and sent to Ionia prison and later was transferred to
Ionia asylum. On my release, which occurred in a year, I started for
Ludington a second time, but was arrested for drunkenness in Heed City
and sent to Ionia again. I served my time and made a third start for
Ludington. Reaching this place at last, I secured employment on a
lake steamer, but was finally put ashore at Muskegon, and then committed
to Pontiac asylum. Four months later I was in the government hospital,
and after nine months' rest returned to Chicago and worked on steamer
between Grand Haven and Chicago. Began drinking again, and this
time was committed to Michigan Asylum at Kalamazoo. Five months
later I was discharged. After a short visit among relatives I started for
Harrisburg, but before reaching my destination I was arrested and sent
to Harrisburg Asylum. Was confined a month, and then went to Baltimore, and from thence to Chicago, where I shipped to Ashland, Wis. At
the latter place I was discharged, went to Wisconsin Junction, and the
convulsions recurring, I was sent to Oshkosh Asylum again for the third
time. In three months went to Milwaukee, began drinking, was sent to
workhouse for 60 days. After serving my time I left for the Bast, and at
Erie, Pa., shipped for Duluth. Our vessel was run into off Whitefish
Point and sunk, two of the crew perishing. After spending three days

REPORT OF MEDICAL, SUPERINTENDENT.

43

in a life boat, I was taken aboard a steamer, which landed me at Chicago.
From here I went to Baltimore, was taken ill and spent some time in city
hospital. I then worked my way back to Menominee county, Mich., and
was engaged in a lumber camp for five months. Later I visited Traverse
City, was promptly arrested for drunkenness, fined, and ordered to
leave town. Went to E., got drunk, wandered in woods eleven days, and
returning to M., was committed to Northern Michigan Asylum."
It should be stated that this man never has convulsions except after
excessive use of liquor.
Tardive paranoiacs often manifest mental faculties of a high order, and
also patients who suffer from "fixed ideas," "morbid fears," etc., are
aften of good abilities. Aside from psychic stigmata, the degenerate
often present interesting physical abnormalities. A careful examination
of 40 consecutive cases of original paranoia admitted within the last biennial period, demonstrated that 29 were less in stature than the average,
and that in no patient was it above the average. In 12 the head was
asymetrical, brachycephalic in 24, dolichocephalic in 2, and mesocephalic
in 13. Facial asymetry existed in 13; the lower maxillary was irregular
in 15, upper in 4. The teeth were abnormally implanted in 10, high
arched or cleft palate in 11, saddle or half-saddle jaw in 4, Y-shaped jaw
in 3; ears, large, small, or misshapen, etc., in 16; irregularities of the eyes
in 6; hands abnormal in 4; absence of beard in men, 10; stammering in 1,
and left-handedness in 1. The highest cephalic index was 93, and the
lowest 73. No measurements of imbeciles are included in the above list.
The most striking of these stigmata are the shortness of stature, asymmetry of head and face, absence of beard, and the brachycephalism of the
patients. No attempt has been made to compare the patients upon whom
these investigations were made with a similar number of patients falling
in other clinical groups, yet it may be asserted that it would be impossible
to select from the remaining patients 40 others whose averge stature
would not attain the normal. Lombroso would teach us that many men
of genius have presented such physical abnormalities, but, however that
may be, these deformities are to be regarded as " correlations of something lying deeper in the structure of the brain;" they almost invariably
exist in the delinquent and the mental weakling.
Insanity may appear in this class of individuals at an early age, at nine
in one, and at thirteen in another of our cases, and if tardive paranoia is
excepted, manifestations of alienation are rarely delayed beyond the age
of puberty. In the majority of our original paranoiacs, insanity developed before the age of 20—a fact in itself most significant of taint, as the
idiopathic or pure insanities are never met with before the age of complete
adolescence.
In the degenerate, the insane manifestations may resemble almost any
known type, from simple depression to systematized ideas of persecution.
Some are intensely hallucinated, others may present delusions of grandeur, in still others there are fixed ideas, imperative conceptions, or any of
the so-called pathophobias. Fixed ideas referring to self are frequently
met with in hypochondriacal insanity, and those leading to " impulsions "
are common in paranoia. In degenerates very slight causes seem sufficient
to texhaust the physical and mental forces, and very frequently ensue
abrupt and very severe mental disorders. Constitutional neurasthenic
insanity is usually of a melancholy, emotional type, with tendency to suicide; great mental confusion, and even stupor are sometimes observed,

44

NORTHERN MICHIGAN ASYLUM.

and intense excitement, with hallucinations of a frightening nature, may
occur. They frequently suffer from " fixed ideas " or imperative conceptions. These are most interesting phenomena, not only from the intense
distress to which they give rise, but that the sufferer is fully conscious of
their true nature. These ideas intrude in the normal flow of thought and
cling with intense persistency in the consciousness of the patient. They
are distinguished from delusional ideas by the fact that the patient is conscious of their abnormality and constantly strives against them.
Morselli divides imperative conceptions into two groups.—First, simple
fixed ideas, in which the " obsessions " are purely psychic and without tendency to impulsions; and second, imperative ideas in which the obsessions
are accompanied by irresistible tendency.
Patients afflicted with the simple rudimentary forms of imperative conceptions are not often seen in asylums, but if the imperative conception
dominates the patient, or if impulsions to homicide, suicide, or other acts
of violence exist, their committment is necessary. Dr. Ireland well says,
" The fixed idea attracts to itself all the spontaneous attention, which
seems greater than usual, while the power of voluntary attention is diminished. If the insistent idea be pushed for a moment from the foreground
of consciousness by some exciting or urgent event, it speedily returns,
fatiguing the mind with its monotonous persistence. The person over
whom such ideas tyrannize recognizes that they have no real or relative
importance. They are like silly, uninvited guests, who interrupt everything and take up the attention which is not their due with their ceaseless
chattering. They are automatic in this sense, that they arise in the mind
without any exertion of the will, but they have nothing to do with unconscious cerebration, as Adriana has suggested, for, indeed, and overwrought
consciousness of their presence is the most distressing feature in the
case."
These imperative ideas may be the cause of the most varying degrees of
mental distress. Patients may moan and cry for hours in the vain attempt
to determine which of two or more very simple things to do, or wash
almost incessantly to.remove fancied contamination, or to be excited to
mental agony by attempts to remove or to put on a garment. Another
curious phenomenon of this type is the necessity experienced to touch
objects, to make signs, or to emit fixed phrases, in consequence of
uncontrolable impulses. Any attempt made to control them only tends to
bring on or heighten a mental paroxysm.
All forms of mental disturbance are possible in the degenerate.
Attacks of mania and of melancholia are common—differing only from
the idiopathic forms in a more abrupt onset, and the severity and shortness of the paroxysm. Each recurrent attack tends to greater severity of
the disease, and ultimately ends in dementia. Constitutional hypochondriacal neuroses are distinguished by their early development in life, by
their systemization, and by the absence of hallucinatory manifestations.
They are not dependent upon physical ill health, and are not secondary to
other mental diseases. They often present remissions, and while cure is
not attainable, they seldom end in deep dementia.
Original paranoiacs comprise a large proportion of the degenerate
insane, and present a most varying symptomatology. The insanity develops suddenly, with mental confusion, hallucinations, or with ideas of persecution or grandeur. There may be seen in this class mystic, erotic, or
intense religious delusions. Indeed, one of the principal characteristics

REPORT OF MEDICAL SUPERINTENDENT.

45

of this class of insane is the polymorphous nature of the concomitant
psychoses. A small group may not only feel themselves wronged and persecuted, but develop ideas of hatred against others, pursuing them in
every conceivable way, and even attempting violence upon them to avenge
fancied injuries. A patient erratic from youth develops the idea that he
has been robbed by a relative; he persecutes him with letters, threats of
prosecution, and finally with threats of killing. He is committed to the
asylum; soon after has a remission, and later escapes. He goes to a
neighboring city and does well for a few weeks. Then the idea develops
that the institution must pay him for time unjustly spent in it. He follows a demand for pay with murderous threats against the superintendent
if his wishes are not immediately complied with. This man is hallucinated at times, has delusions of grandeur at others, and again is hypochondriacal. Nearly all degenerates are masturbators, and many present sexual delusions. Some are sexual perverts. Many of the latter pass long
undiscovered unless a crime or a series of crimes exposes to view their
shocking degeneracy. Complete loss of moral sense is rare even in the
degenerate, yet there are individuals who, while showing no intellectual
impairment are lacking in this sense. A patient 18 years old, was born in
a county house. Her father was unknown; her mother died when she
was five. Then she was sent, reason unknown, to the School for Girls at
Adrian, where she remained until 16, She then returned to the poorhouse, and after a year went away with an old man and lived with him as
his wife. Together they went to M. where the man was arrested. She
then went with another man, who soon left her; and then with another, who
also soon abandoned her. Then she began to work as a domestic, but she
left her place of work and wandered about, resting in barns and deserted
buildings where she was accustomed to receive the male public. She says
she once burned a barn at the instigation of another. She has used
whisky. She never had hallucinations or delusions, and was never violent.
Her life in the asylum has been quiet. She is cheerful and pleasant in
manner, but will lie and steal. There has been since she came to the
hospital a distinct moral improvenent. When she first came she was
. perfectly self-satisfied, and seemed to have no respect for anything or anybody. Were she to leave her present surroundings and be thrown on her
own resources, undoubtedly there would soon be a return to the former
habits. There never were any manifestations of eroticism. Other examples could be given of this class of degenerates.
Primary paranoia must be distinguished from original paranoia. While,
as a rule, it is hereditary, it may be acquired. Its subjects present but
few physical stigmata, and many have been of more than average mental
ability during early life. It makes its appearance after adolescence and
never presents remissions in its course. It has a long prodromal stage in
which the patient struggles with vague, bewildering impressions, which
constantly haunt him; next hallucinations of hearing appear, and the
stage of persecution is soon attained. This period may last for years, to
be in turn followed by a period of delusions of grandeur, of power, of
wealth, that he is a great personage and has been imprisoned, abused, and
persecuted that others may enjoy the benefits of the position which rightfully belongs to him. We have a case, now in the stage of grandeur, who
insists that he is a prince of the " House of Hohenzollern," that he is the
rightful emperor of Germany, and that through the machinations of enemies he has been imprisoned here. The insanity of the primary paranoiac

NORTHERN MICHIGAN ASYLUM.
has but few stages, which are of unvarying kind and progress. The
insanity of the degenerate is " polymorphous." There may be depression
today, elation tomorrow. Remissions are frequent, but relapses are certain, every recurrent attack tending to greater severity. The onset is very
generally sudden. Delusions of grandeur may be first to appear, and
continue for years without being complicated with hallucinations or ideas
of persecution. We have a typical case. The patient, 18 years old at
time of admission, presented the grand air and ideas of a paretic. He
controls the election of presidents, is the author of legal works, and has
the notion that he has vast business enterprises, etc. There has been no
change in him during six years of asylum life. He is still grandiose in
all that he thinks and does.
I have made no attempt to describe any special form of degenerate
insanity. • The facts I wished to make appear in relation to the degenerate
are, the>early development of mental disorders, their psychical and physical stigmata, the essentially intermittent and periodic character of the
psychoses, that the delusions may be isolated and chronic as in true
paranoia, or affect every sphere of the intellectual and moral life, and that
they are transmitted from generation to generation.
This last fact is extremely important and teaches that the prevention of
insanity is largely a social' question and lies outside the domain of
practical medicine.
The following clinical description of a most fatal form of mental disease
was prepared by Dr. G. C. Crandall.
ACUTE DELIRIOUS MANIA (DELIRIUM GRAVE).

During the past six years we have received eight cases of acute delirious mania, some observations on which may be of interest. The following table shows some of the most important facts attending the previous
history of the patients, the duration and treatment of the disease, and the
result:
Sex.

Female
Male
Male Female
Female
Male..
Male
Male

..

Age.

38
45
43
52
21
43
45
31

Previous
roental
character.

Previous
attacks of
insanity.
Two
One

Neurotic. One .
Neurotic. One
Neurotic. . One
Unknown
One

Physical
health.

Exciting cause.

Poor ..
Poor
Fair..
Fright
Poor ..
Fright
Unknown Domestic trouble .
Unknown

Duration
of
disease.

Si
18
20
13
16
17
20

Kesult.

Died.
Died.
Died.
Died.
Recovered.
Died.
Died.
Died.

The patients had been very imperfectly cared for at home or in a county
jail an average of eight days previous to admission, and when received
were much exhausted physically, besides suffering intense delirium.
As a rule they were bruised on body and limbs, some having been tied
with ropes, others held by friends, while those who had been confined in
jail had the liberty of their cell. They were usually brought to the
Asylum in irons, or some form of restraint. With one exception they had
refused food, little or no nourishment having been administered. The
secretions were more or less deranged, and an examination of urine usually
revealed albumen and an excess of phosphates.

REPORT OF MEDICAL SUPERINTENDENT.

47

The mental condition of patients previous to attack was very unstable.
So far as known, each exhibited neurotic tendencies and had suffered from
one or more attacks of mental disease.
So far as could be ascertained, the physical health was also below par at
the beginning of the attack. The onset was invariably sudden; the
exciting causes being debilitating influences and mental excitement.
During the course of the disease the most prominent symptoms were
noisy delirium, with exciting delusions and hallucinations. Visions of
friends or enemies, of God or the Devil, of fire and of demons, as well as
peculiar sensory hallucinations, were common. The jargon, very characteristic of these patients, was usually incoherent and monotonous. When
awake they were almost constantly talking, f requ ently screaming as if startled
or frightened by their visions. Para-lucid intervals were observed, even
within a few hours of death, and often when apparently occupied by their
wildest thoughts they would answer questions quite coherently and take
water or medicine from the attendant. The facial expression was
extremely varied; sometimes the most silly grimaces would be noticed,
and again expressions of anger, of agony, or of deep despair. Other
motor symptoms most commonly observed were boring of head in pillow,
or rubbing it against the head-board of bed; turning of body, and wild,
indefinite movements of the limbs, occasionally striking at attendant or
some near object. Spitting was a very frequent and annoying symptom,
and as a rule they evinced a great desire to bite, chewing the bedding or
anything they could get in their teeth. Patients would often hold their
breath for short intervals, and sometimes breathe in a puffing manner.
Sordes collected on teeth, causing a marked fetor of breath.
They would usually take but little food voluntarily, making it necessary
in every case to administer nourishment mechanically. Milk and eggs
with sugar was the food usually given.
In the treatment of this disease, rest, seclusion so far as possible from
noise and light, plenty of liquid food, with careful attention to the
secretions, proved most beneficial.
By careful padding of limbs, patients could be securely fastened to mattress by sheets with less danger of injury than if held by attendants.
The temperature was of the adynamic type, the lowest being 98° and
the highest 103°, usually ranging from 99° to 102°. Sudden changes of
temperature were observed in some cases, and a sub-normal temperature
•was not uncommon, especially toward the end of the disease.
Medicinal treatment did not prove very satisfactory. As a sedative
large doses of sulfonal were most efficacious. Morphine was of no value,
and bromide and chloral did not act very favorably. Ergot was used in
three cases with apparent benefit. Constant cold applied to the head by
Letter's tubes in one case, beginning its use on ninth day, was of doubtful utility. Cracked ice and acidulated drinks seemed to relieve patients
and were usually willingly received. Antiseptic catharsis was used as
necessary.
In the fatal cases, toward the end the delirium became low and muttering, subsultus tendiuni was quite noticeable, and diarrhoea usually developed; the patient dying in a state of extreme exhaustion. In the more
prolonged cases there was a tendency for the bruises on the limbs to
develop into abscesses.
The advent of pneumonia in two instances hastened death. One
patient menstruated quite normally during the attack. The ave-age dura-

48

NORTHERN MICHIGAN ASYLUM.

tion of the disease was fifteen days. The recovered patient was several
weeks convalescing after the delirium subsided, but she quite regained her
normal mental condition.
Autopsy of the brain made in two of the cases showed the calvarium
normal, meninges considerably congested, and in one case adherent along
the longitudinal sinus, the lymph spaces somewhat distended, and some
congestion of the cerebral tissue.
Our abservations of acute or grave delirium point to the following
facts:
It is a distinct psychosis.
It is prone to attack individuals of an unstable nervous system.
Its onset is sudden, and persons when attacked are usually below par
physically.
The exciting causes are mental strain, mental excitement, and physical
exhaustion.
It runs a rapid course, with fever of adynamic type, and symptoms of
auto-intoxication.
Autopsy reveals no distinctive lesions.
TABLE III.—Clinical Groups.
For the Biennial Period.
Males.
Adolescence

_. _ „ -_

Brain disease

._

Climacteric. .

, _, _ _

..

12

..

Puerperal
Phthisical
Post Febrile

.

Unascertained
Toxic
Neurotic
Total

17

. 8
99
26
6
8

18
1
18
4
55

26
100
44
10
61

23
61
105
101
1

13
46
6
138
2

36
107
111
239
3

9
124
15
9
7

76
124
24
23
20

5

4

6

10

14

4
13

18
13
1
1
3

67

9
1
19
9

20
3
47
26

28
15
121

24
3
81
16

52
18
202
33
1

2

5

78

2
59

27
137

26
78

3
1
2
59

8
1
28
137

208

146

354

830

11
2
28
17

.. .
_.

Total.

9
15

3

...

5

Females.

3
10

1

Traumatic
Idiopathic

Males.

5
6 .
5

„_

Total.

..

Epileptic
Neurasthenic

Females.

From the Beginning.

1

2
25

9
14
13

n
i

654

1,484

49

REPORT OF MEDICAL SUPERINTENDENT.
TABLE IV.—Nativity of Patients Admitted.
For the Biennial Period.

From the Beginning.

Males.

Females.

Total.

Males.

2
1
26

4
1
19

6
2
45

11
1
114

1

2

3

England
France
Finland

10
1
20
15

5

15
1
23
25

Holland

3
14

1
7

4
21

2

3
2

3
4

Canada .
Denmark .

_ ....

Italv
Illinois

3
10

1
1

1

2
1

36
1

36

72
1

3

4

7

19

1
14

1
33

5
4
2

4
2
3

Sr,otla.TiH

19
1
2

Virginia

2

Michigan
New Hampshire

New York-

_

Ohio
...
Pennsylvania
Poland

.
._

10

15
2
193
2
20

1
39
2
42
77

27
1
17
64

1
66
3
59
141

7
53
6
7
5

5
42
1
12
5

12
95
7
19
10

Total

1
4
1
112
1
1
17

1
1
2
4
119

1
1
2
6
5

17
1

231
1
1
34
1

91
1

1
65
1

3
3
1
156
2

9
6
5

1
30
20
8
2

35
14
6

1
'65
34
14
2

9
1
1

28
2
3

88
12
5

2

3

54
8
6
1
2

142
20
11
1
5

1

1

1

1

2

3
1
13

16

11

27

4
1
9
1
35

7
2
22
1
64

208

146

354

830

654

Vermont
Wisconsin
Wales

Total.

4
1
79
2
10

1

Massachusetts

Females.

3
3

29

1,484

BEO APITUL ATION :

Total

137
190
27

577
843
64

354

1,484

In answer to the almost daily inquiry " what proportion of your patients
are foreign-born?" we may state that our district has a population of
700,000, of which about one-third are foreign-born. Fifty-seven per cent
of all the admissions have been from the latter; or, in other words, 33 per
cent of our population furnishes 57 per cent of our patients.
7

50

NORTHERN MICHIGAN ASYLUM.
TABLE V.—Civil Condition of Patients Admitted.
For the Biennial Period.
Males.

Married
Single
Widowed,.
Oivorced
Unascertained

_. _

Total

Females.

From the Beginning.

Total.

Males.

Females.

Total.

75
108
9
3
13

107
22
16
1

182
130
25
4
13

315
437
35
9
34

455
128
56
13
2

770
565
91
22
3ft

208

146

354

830

654

1,484

TABLE VI.—Occupation of those Admitted.
For the Biennial Period.
Males.

Females.
1
1

Baker .
Blacksmith
Butcher
Baker

5
2
2

Cabinet maker
Cook
Editor

34

Fisherman

1
1
114
1
3
2

Miller

1
7
1
1
37
1

Total

_

. _-.

5
2
2
1
7

4

1
1
71
1
1
1
4

29
1
2
1
1
1

143
2
5
1
3
1

5

1

6

8
1
1
4

19
1
4
5
1
2

1

1

Tailor
Unascertained

1
1

11
3
1
1
1

Sailor
Soldier

Total.

1

3
1
1
2
2

1
2
2

4
3
1
2
4

2
9

1
35

3
44

208

146

354

From the Beginning.
Males.

1
16
5
3
19
2
2
8
185
1
1
3
382
2
8
9
2
1
12
51
3
19
3
4
7
1
1
2
9
12
8
2
4
1
4
35
2
830

Females.
1
1

Total.

7
77
2

1
1
1
25
6
6
34
2
2
1
52
17
1
1
343
3
1
1
39
3
532
5
18
1
12
6
3
20
3
81
1
4
41
3
5
10
1
1
3
1
12
25
13
2
13
1
11
112
4

654

1,484

9
1
3
15
1
52
9
1
1
158
3
39

150
3
10
1
3
4
2
8
3
30
1
1
22
1
3
1
1
3
13
5
9

INTERIOR

COTTAGE

FOR

MEN

EEPORT OF MEDICAL SUPEEINTENDENT.

51

TABLE VII.—Duration of Disease Previous to Admission-.
For the Biennial Period.
Males.

4
Under two months
Five months and under 9

- ..

One year and nnder 2
Two years and under 5
Five years and under 10
Ten years and under 20
Twenty years and over

.
_

.

..
_ __

Total

Females.

From the Beginning.

Total.

Males.

Females,

Total.

88
19
20
1
21

24
14
13
4
11

60
33
33
5
32

113
67
54
14
102

89
57
42
12
62

202
124
96
26
164

32
16
15
12
36

20
14
23
7
16

52
30
38
19
52

164
98
91
39
88

116
98
96
41
41

280
196
187
80
129

208

146

354

830

654

1,484

TABLE VIII.—Probable Exciting Causes.
For the Biennial Period.
Males.

Brain disease
Congenital defect.

Domestic infelicity.

_ _
_ .

__

Fright
111 health

Females.

Total.

Males.
9
12
13
23

1
4

2
1

3
5

2

2

4

1
1
6

1
1
12

2
2
18

3

1

4

13
28
2

11
1

Overwork

Prolonged lactation.

5
4
65
2
13

4
21
47
5
7

9
25
112
7
20

24
29
2

4
64
124
7
1

9
101
2
1

13
165
126
8
1

2
3

2
3

22

22

5
1
1

8
5
5
125
3

13
6
6
125
3

3

2
1
1
6
4

5
1
4
10
25

3

3

1

4

3
4
21

7
7
124
6

9
2
75

16
9
199
6

3
23
17
295
108

20
4
202
8

3
3
43
21
497
116

208

146

354

830

654

1,484

Senility.
Traumatism
Unascertained
Vicious Habits
Total

.35
6

Total.

,11
•,8

Previous attacks
Syphilis

Females.

44
18
13
34
8

Nostalgia

Pubescence-

From the Beginning.

52

NORTHERN MICHIGAN ASYLUM.
TABLE IX.—Residence of patients admitted.
For the biennial period.

From the beginning.

Comity.
Males.

Females.

5
5
. 3

7
5
1
1

2
1
3

Chippewa
Delta
Emmet
Gogebic

Alpena.
Arenac
Baraga..
Benzie,.
Gharlevoix
Clare
Crawford
Clinton..

Gratiot

. _.

,

_

Males.

Females.

12
10
4
1

25
13
4
3

23
19
3
3
1

48
32
7
6
1

2
2
1
2
1

3
4
2
5
1

7
3
12
12
5

8
5
12
4
6

10
8
24
16
11

8
3
2
5

1
1
1
2
4

1
4
4
4
9

13
9
20
18

1
12
5
8
10

1
25
14
28
2»

1
5
5
8

1
7
3
4

2
12
8
12

1
11
25
27

1
1
10
22
30

1
2
21
47
57

49
1
10

125
1
25
1
25

I

.

Total.

28

15

38

76

Isabella

3

4

7

losco

2

3

5

15
1
15

Iron

3

1

4

2

2

1
3

3

3
2

1
4
6

4
17
3

12
12
5

6
7
6

2
2
7
1
1

8
9
13
1
1

4
3
1
7
8

7
11
7
27

5
13
1
11
22

12
24
1
18
46

6
1
2
7
3

25
1
8
24
6

67
9
28
59
11

41
9
28
22
20

108
18
56
81
31

4
9
8
2

4
21
20
7

4
53
46
15

1
7
56
40
22

1
11
109
86
37

2
2

4
3
1
9

15
7
3
17
5

14.
6
6
25
3

29
13
9
42
8

1

2
2
5
3

5

2
2
10
3

Kent

Mason

19

2
1
1
5

4

1

Schooleraft
Wexford

Totals

10

Total.

1
1

2

4
3
2
23

3

208

3
1

14
18
5
56

1
21

6

4
6
2
29

13

15
89
5
69

146

354

830

654

1,484

53

REPORT OF MEDICAL SUPERINTENDENT.
TABLE X.—Age of patients admitted.
For the biennial period.

From the beginning.

Males.

Females.

16 to 20
21 to 25
26 to 30
31 to 35

15
31
32
25

1
12
12
22
24

1
27
43
54
49

7
44
98
120
107

4
35
63
102
94

11
79
161
222
201

36 to
41 to
46 to
51 to
56 to

40
45
50
55
60

19
19
10
8
10

20
11
11
6
6

39
30
21
14
16

112
94
45
44
30

91
75
61
35
20

203
169
106
79
50

61 to 70

8
5
26

13

21
5
34

40
18
71

36

8

33

76
23
104

208

146

354

830

654

1,484

Unascertained
Total

Total.

Males.

Females.

Total.

TABLE XI.—Degree of heredity.
From the beginning.

Paternal and maternal

:

_ _-

Paternal remote
Maternal remote

None. _ ._
Unascertained
Total

...

For the biennial period.

Males.

Females,

Total.

Males.

7
12
6
13
7

1
10
1
12
8

8
22
7
£5
15

12
42
2!6
50
21

10
40
16
63
27

22
82
42
113
48

15
5
20
123

11
1
29
73

26
6
49
146

46
15
151
467

58
20
180
240

104
35
331
707

354

830

654

1,424

208

146

Females.

Total.

OCCUPATION OF PATIENTS.

The monthly average of male patients engaged in outside labor has
been 30 per cent, and in inside work and in various duties in connection
with the grounds, 28 per cent. The average for women has been about
55 per cent. The labor of men has been such as the development of a
new farm and the construction of new buildings would naturally necessitate. In the construction of the cottages nearly all the common labor
was done by patients, and some assisted in the carpentry. The excavation for basements, trenches for water pipes and sewers, the sorting and
handling of bricks, drawing of sand, carrying mortar, lumber, etc.,
were well done by them. A few years ago it would have been thought
hazardous to entrust patients with tools that might in their hands be
dangerous, such as axes, shovels, picks, etc., but as time has gone
our fears have been partially allayed, and today over 30 per cent of the
men are regularly using various kinds of implements in ditching, stump

54

NORTHERN MICHIGAN ASYLUM.

pulling, fencing, road making, chopping, and general farm work. Those
who work regularly in the open air soon grow hearty and strong, and seldom make trouble in any way. Attempts to escape are rare, and altercations, violent outbursts, or threatened assaults, are extremely uncommon.
The majority soon become interested in the work, and take much pride in
the accomplishment of a given improvement. I regret that we cannot
have outside occupation for the women. With regular, well-directed
labor, much of the restlessness and irritability of patients disappear.
Only with good physical health can good mental health be enjoyed, and
open-air life with suitable work is a most potent, if not the most valuable
curative means at our command.
CHAPEL SERVICES.

Chapel services have been conducted by the chaplain, Rev. D. Cochlin,
assisted by Kev. Mr. Chase and Eev. Mr. Powell, and others. These services have been very largely attended, and have been a source of much
comfort to our people.
PLANS OF NORTH COTTAGE.

As required by law, the plans of the cottage for females were submitted
to the State board of health and the State board of corrections and charities for approval, and the following are their reports on the same:
LANSING, July 17, 1891.
JAMES D. MUNSON, M. D., Medical Superintendent Northern Michigan Asylum,
Traverse City, Michigan:
DEAK DOCTOR—The board of corrections and charities, after its examination at
your Institution on the llth inst. of the plans for the fitting and furnishing of one
cottage building for patients, which was provided for by Act 167 of the laws of 1891,
find that such plans are entirely satisfactory to it, and I am instructed to certify such
fact to you, which I take pleasure in now doing. Yours very truly,
L. C. STORRS.
Secretary.
PLANS FOR COTTAGE FOR FIFTY FEMALE PATIENTS AT NORTHERN ASYLUM
FOR INSANE.

MICHIGAN STATE BOARD OF HEALTH,
OFFICE OF SECRETARY, LANSING, MICHIGAN, Aug. 29, 1891.
A special meeting of the State board of health, to examine the plans for the
cottage for fifty female patients, was called to be held at the Asylum in Traverse City,
August 17 and 18,1891. It was understood that if, by reason of service on committees
to visit other localities, it was found not practicable for all members to be there
August 17 or 18, so many as could do so should reach there at that time and soon as
practicable thereafter. It was also voted that those who actually visited the Asylum,
and examined the plans, were authorized to express the view of the board.
The undersigned, the president, a member, and the secretary of the State board of
health, having visited the Asylum at Traverse City, and examined the site and the
plans for the cottage for fifty female patients, respectfully report that the site and
the plans are approved.
During the examination of the plans, a few suggestions were made by members of
this board, one being that in the instances (two rooms for attendants in second story)
in which no fresh air inlet was marked on the plans, provision be made for such air
supply, also for foul air outlets, and for indirect instead of direct radiation, not relying
entirely upon the entrance of air through transoms and windows.
(Signed)
JNO. AVERY,
FRANK WELLS,
HENRY B. BAKER.

REPORT OF MEDICAL, SUPERINTENDENT.

oo

ACKNOWLEDGMENTS.

The following papers have been donated to our patients by their
respective editors:
Big Rapids Herald.
Heimlandet.
Three Rivers Tribune.
Triumphs of Faith.
Traverse Bay Eagle.
Cheboygan Tribune.
Grand Traverse Herald.

Pontiac Gazette.
Alpena Argus.
Torch Lake Times.
Michigan State Democrat.
Deaf Mute Mirror.
Menominee Democrat.
The Index.

This kindness has been deeply appreciated by our people.
We are greatly indebted to C. L. Lockwood, Esq., Gen. Pass. Agt., G.
R. & I. R. R., for the regular weekly donation of a large number of papers
and journals. Likewise our thanks are due to Mr. J. W. Milliken. Mr. S.
Anderson, and Hon. T. T. Bates, of Traverse City, and Mrs. Albert
Crane, of Grand Rapids, for donations of papers and magazines.
I would most earnestly thank the officers, chiefs of departments, and
the attendants for their efforts in behalf of patients and success of the
Institution, and my thanks are due and most sincerely extended to you,
gentlemen of the board, for many acts of personal kindness and for aid
ever given to me in the discharge of my duties.
We may look back to the period just closed as an important one in the
history of the Asylum, and we trust that the coming period may be as
useful in the cause of the insane.
Respectfully submitted,
JAMES D. MUNSON,
Medical Superintendent.
Traverse City, Michigan, June 30, 1892.

OFFICERS AND EMPLOYES
OF THE NORTHERN MICHIGAN ASYLUM, AND THE WAGES OR SALARIES
PAID TO EACH, JUNE 30, 1892, AS REQUIRED BY SECTION 2,
ACT 206, LAWS OF 1881.

Service.

Name.

C. G Chaddock
G. C. Crandall
A 8. Rowley
M. Rockwell
Rev. D. Cochlin
J. P. C. Church
C. A. Crawford
T. H. A. Tregea
Wm. H Bauld
C M. Prall
S G. Howard
W. Pen.nin.gton
E. C. Kent
May Botsford
Wm. Attwood

$3,000
1,500
1,000
800
800

00
00
00
00
00

250
1,500
500
1,200
110

00
00
00
00
00

110
55
40
30
30

00
00
00
00
00

10
45
24
27
65

00
00
00
00
00

"
<i

40
26
80
20
15

00
00
00
00
00

„
"
[<
i'
it

15
18
18
13
18

00
00
00
00
00

11

U

(I
tl

Ik
11

«t
K
(i
it
t(

21
13
18
86
18

00
00
00
00
00

30
15
15
15
15

00
00
00
00
00

22
20
18
12
12
26
12
12
28
28

Medical Superintendent
Ass't Medical Supt.
Assistant Physician
<t
u
Chaplain
Steward
Treasurer.
Accountant
Stenographer.
Druggist
Clerk
Telephone operator
Supervisor
_

_

Gardener
Watchman

K

K. Clark

Time.

Rate.

t(
"
'•

C. F. Deuel

u

J. S. Decker

*i

TUlie Drainer

M

C. D. Edwards **

tl

Ella Faxon

14

Chas. Fletcher

tl

is

It

il

H

_.

1

_

Per annum. Resident.
14

It

il

U

11

11

Non-resident.
u

"

Per month.

u

"

"
Resident.
Non-resident.
Resident.

«
ti

4*
ti

u

u

it

(1

"

Non-resident.

"

Resident.

U

il

tl

U

U

.1

U

4(

il

U

tt
11

tl
U

Non-resident.
Resident.
u

u

U
U
U

it
((
It

00
00
00
00
00

,(
U

U
41

00
00
00
00
00

U

a
u

n
(-•

U

44

41

u

u

(.

«

It

U

It

tl

OFFICERS AND EMPLOYES.
OFFICERS AND OTHER EMPLOYES.—CONTINUED.
Name,
Minnie Flint
Wm. Ferguson
W.A.Griffith"
F. M. Hale
Belle Hale
L. Hnsted
Ida Hickok
W. D. Hollister „
M. Hollister
S. Houghton
C. Horn beck

Service.

Rate.

Attendant
«
,,
"
u

11
u

,1
It
(i

I*
it

[

Merta Huff
E. Hiatt

(
I
I
1
u
u
u

Etta Ingalls
D. W. Kelley
L. Kelley
Nellie Kent
Ord Knight

It

C. J. Oren
E. Sargent
J. Shivel
M. V. Smith
B. Shriner
M. Shigley.
V. Shigley
L. Smaltz __J
Z. D. Kule
W- Rogers.,

00
00
00
00
00

24
15
22
20
19

Per month. Resident.
u
u

u
u

{(

U

00
00
00
00
UO

t(

U

28
34
20
24
22

00
00
00
00
00

u
u

U

(t

28
13
22
19
Ib

00
00
00
00
00

41

'it

22
15
IS
16
30

00
00
00
00
00

u

u

(i

U

tl

It

20
25
22
22
24

tt

u

U

11

u
u

u
u
f

u
u

it

U

U

tt

It

.

it

U

u

u

t(

U

it

tl

K

00
00
00
00
00

tl

It

It
tt
it

It
u
tt

tt

4i

24 00
16 00
12 00
18 00
21 00

tl

*t«

u
tt

tt
li

26
15
18
19
20

00
00
00
00
00

tt

it
tt
u
u
.1
u
u
u
it

30
20
22
18
19

00
00
00
00
00

w
it
it
u
u

«

"
(I

(,

Thornton Miller.
Mabelle McDonald
Myrta McDonald _
Niel McLarty
.
K. Middleton
L. A. Welling
. . _
Fred North
E. North
H. W. Pierce
W. S. Purple
V. A. Patrick
_ .
John Pfeifer
L. Revolt
S. Richter

$12
10
22
12
26

U

u

[,

Lizzie Law
R. N. Longwell
J. Magill

Time.

u

u
u
tt
u
((

Adm'n Building

{[

u
ti

tt
u

((

Adm'n Building

_

_

U

tt

tt

It

tt

tt

tt

u
a
tt

u
tt
u

t!

t(

tt
tt
tt

tt
tt
tt

it

it

26
14
24
26
22

00
00
00
00
00

tl
tt
tt
tt
It

(i
tt
ii
il

It

19
12
10
12
22

00
00
00
00
00

tt
tt

(I
tl

tl
It

tt
t

19
26
26
18
13

00
00
00
00
00

tl

tt

(I
tt
tt
It

It

22
10
22
22

00
00
00
00

>
t
t

11
It

t
t

u
tt

t
t

58

NORTHERN MICHIGAN ASYLUM.
OFFICERS AND OTHT5B EMPLOYBS.-CoNTiNUED.
Name.

B. Warner
H. Walsh
E. Walsh
M. A. Watson
S. E. McCool
F. Dumbrille
I. Cook
F.E.Warner

Service.

u

"

Cook
Kitchen assistant
it
4i

B. Canute E. Herkner
F. Harper
L. Irish
J. .Rattenbury
E. Franklin
H. A. Van Antwerp
F. Wilhelm
N. Harris
M Daggett
C. W. Button
W. Travis
E. Fleming

U
I*

it

U

Kitchen d'groom

_.

Assistant baker..
Butcher

__ .

FirPTnan
I*

J. Thomas -..
H. Butler
L. Thomas
D. Elliott
M. Harris M. lies
L. Yack .
S. Miller
L. Mort
M. Irish ....
E. Irish
C. Ohateey
T. Yack
E. Ferguson. _
H. Wiifcins
F. Bondron, Sr.
F. Bondron, Jr.
A. Hyde _
S. H. McMichael
John King
E. H. Wood
S. Holmes

Laundryman
((

it

11

t(

u

u

U

it

II

11

u

u

11

U

U

tl

tl

11

U

11

It

>«

tl

14

u

f(

Painter
Laborer

Time.

Bate.

__ .

$28
20
23
22
50
30

00
00
00
00
00
00

20
18
IS
18
18
18

00
00
00
00
00
00

18
12
60
25
18

00
00
00
00
00

40
20
12
55
30

00
00
00
00
00

25
25
34
25
18

00
00
00
00
00

Per month. Resident.
U

I!

(1

l(

it

u

11

11

11

(1

U

(4

It

41

11

U

41

11

(t

tl

u
it

•

''
"

it
:i

Non-resident.
Resident.

u

ti

11

11

t

(I

'

Resident.

I

14

41

11

14

It

14

tl

13 00
12 00
13 00
13 00
13 00

14

U

13
12
13
13
13

00
00
00
00
00

11

12
15
30
25
25

00
00
00
00
00

25 00
2 50
2 00
1 75
1 75

It

11

11

41

U

11

11

U

(1

41
(1

14
'

It

11

11

. 41

t(

u

(t

11

it

11

It

it

It

U

11

U

tl

11

11

41

11

.

CORRESPONDENCE.

o9

Tke following correspondence relating to proposed appropriations for
this institution is respectfully submitted:
NOBTHEBN MICHIGAN ASYLUM, [
Traverse City, Mich., Aug. 21, 1892. }
HON. Li. O. STORES, Secretary State Board Corrections and Charities:
DEAR SIR—I submit below appropriations that the Board of Trustees of the Northern
Michigan Asylum will request of the coming Legislature. It seems like too great an
undertaking to prepare plans and submit detailed estimates of the cost of cottages
without knowing whether the Legislature will appropriate money for their construction
or not. The buildings proposed are similar to those we now have, and will cost:_$300
per bed completely furnished. I should be glad to have your Board visit here and
determine that the buildings requested by the Board of Trustees are proper and right,
if the insane of our district are to be provided with sufficient accommodations for their
care and treatment. The following will give the aggregate of each appropriation:
Two cottages for males, 75 patients each, $45,000.
One cottage for 100 women, $30,000.
Land, 140 acres, $10,250. The lands adjoin the asylum property, the tract north being
especially desirable. It is not yet in the market, but as soon as it is, it will be sold into
small holdings and will, from dwelling and other buildings being erected, become a
source of much concern to the asylum; and, moreover, it will be necessary to buy this
land if the State is to have a proper location for an additional female cottage.
For a farm barn, $2,500.
Yours very truly,
JAMES D. MUNSON,
Lansing, Michigan.
Medical Superintendent.

BOABD OF COBBECTIONS AND CHAEITIES, )
Lansing, Michigan, October 4,1892.
}
JAMES D. MUNSON, M. D., Medical Supt. Northern Michigan Asylum, Traverse City
Michigan:
DEAR SIR—Your communication to the State Board of Corrections and Charities,
submitting for its consideration and opinion the proposed appropriations for your
institution, for the years 1893-4, was duly received. We visited the Northern Michigan
Asylum as required, September *-30, 1892, and " investigated the condition and needs of
the same." We have carefully considered the appropriations proposed, and respectfully
submit herewith our opinion of the same.
Two cottages for males, 75 patients each, $45,000.
One cottage for 100 women, $30,000.
The experience of the past warrants the providing for large additional room for the
insane, and that without delay. If the plan followed by the State for the past twelve
years is to be continued, namely, the constant enlarging of the present asylums, the
expectancy of which is, to say the least, doubtful, you will, in our opinion, need all the
provision which the appropriation asks for, and require the amount stated. If such
plan is to continue, we favor the appropriation.
Land, 140 acres, $10,250. This land is composed of two lots. First, twenty acres
adjoining the asylum property on the north, which will cost $4,000. The Board considers, for reasons already stated in your letter, that it is especially desirable that the
State should own it, and favors such appropriation. The additional tract valued at
$6,250 will, in the opinion of this Board, be needed if the contemplated room is provided for 175 additional inmates. If such cottages are provided for, we would favor the
appropriation for this land.
Farm barn, $2,500. A large and convenient farm barn will doubtless be needed in
the near future, as the land belonging to the institution is fast being cleared up, and is
becoming very productive. The demand for it will be even greater should additional
land be purchased. This Board, however, is of the opinion that a barn of requisite
size, and in every way suitable, can be constructed for $2,000, and would therefore favor
an appropriation for a farm barn of $2,000.
Yours respectfully,
GEO. D. GIL/LESPIE,
L. C. STORES, Secretary.
Chairman.

APPENDIX

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 regulating the appointment and
duties of officers, attendants and assistants; 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 person 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 bondsmen 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 the following section:
SEC. 23. When a person in indigent circumstances and not a pauper becomes insane,
application may be made in his behalf to the judge of probate of the county where he
resides; 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 in the
discretion of the judge of probate any relative, or other person having said alleged
insane person in charge or custody, shall likewise be notified of said time and place of
hearing; and shall also call two legally qualified physicians and other credible witnesses

62

NORTHERN "MICHIGAN ASYLUM.

and also immediately notify the prosecuting attorney of his county, and the supervisor
of the township or the supervisor or alderman of the ward in which said insane person
resides, of the time and place of such hearing, whose duty it shall be to attend the
examination and act in behalf of said county; and said judge of probate shall fully
investigate the facts in the case, and either with or without the verdict of a jury at his
discretion, as to the question of insanity, shall decide the case as to his indigence, but
this decision as to indigence shall not be conclusive; and if the judge of probate certifies that satisfactory proof has been adduced, showing him to be insane and his estate
insufficient to support him and his family or, if he has no family, himself, under the
visitation of insanity, on his certificate under the seal of the probate court of said
county, he shall be admitted into the asylum, and supported there at the expense of
the county to which he belongs, until he shall be restored to soundness of mind, if
effected in two years, and until otherwise ordered; and the judge of probate shall in
no case grant such -certificate until fully satisfied of the indigence of such insane person. The judge of probate in such case shall 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 order in the journal of the probate
court in his office; and he may appoint a proper person or persons to conduct such
insane person to the asylum, who shall receive pay for expenses and services, in the
discretion of said judge, the same as any other officer. The judge of probate shall
report the result of his proceedings to the supervisors of his county, whose duty it
shall be, at the next annual meeting thereafter, to raise money requisite to meet the
expenses of support accordingly.

The provisions of this section secure the benefits of the Institution to a
class by far more numerous than any other in this State, who, though
possessed of some property, find it insufficient to meet the expenses of
treatment and the support of the family at the same time. The form of
order arranged in accordance with the requirements of this section, copies
of which may be procured at the Asylum, is as follows:
STATE OF MICHIGAN, /
County of
}
At a session of the probate court for the county of
holden at the probate office in the
of
on the
day of
in the year one thousand eight hundred and
Present
, Judge of Probate.
In the matter of
, an indigent insane person ;
This day having been assigned for hearing the petition, now on file in this court, of
alleging that
, a resident of
in said county,
is insane, and praying that said
may
be admitted to the Northern Michigan Asylum at Traverse City, there to be supported at
the expense of the county of
. and having duly notified the said
_
, also
refative_-of the said
, also
prosecuting attorney for said county, and
supervisor of
in which said insane person resides, of the time and place of hearing said petition, and
having filed the certificates, taken under oath, of
and
two legally qualified physicians,
and having taken the testimony of
credible witness_-_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
and indigence, I, the judge of probate, in and for said county, do find that said
is in indigent circumstances, and certify that satisfactory proof has
been adduced showing the said
to be
insane; that he has
acquired a legal settlement in said county of
and that h
estate is insufficient to support h
and h
family under the
visitation of insanity.
And it appearing to the court that said
under and
according to the provisions of Sec. 23 of Public Act 135, laws of 1885, is entitled to
admission into the Northern Michigan Asylum, at Traverse City.
It is ordered that the said
be supported in said

LAWS GOVERNING THE ASYLUM.

63

Aeylum at the expense of the county of
until restored
to soundness of mind, if effected within two years, and until otherwise ordered.
Judge of Probate.
STATE OF MICHIGAN, /
County, \I hereby certify that the foregoing is a true copy of the original order and certificate
made by me.
In testimony whereof, I have hereunto set my hand and affixed the seal of the
Probate Court, at
this
day
of
, A. D. 18
I hereby appoint and direct
said

Judge of Probate.
to conduct
to the Northern Michigan Asylum.
Judge of Probate.

Indigent insane patients having no legal settlement in any county of the
State of Michigan, can be committed to the Asylum, as non-resident State
patients, in accordance with the provisions of Sec. 25, Act No. 135, Laws
of 1885, as amended by Act No. 62, Laws of 1887.
Dependent or pauper insane persons are admitted on orders of judges
of probate granted in accordance with the following section:
•
SEC. 26. The county superintendents of the poor of any county, or any supervisor
of any city or 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.

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 by Act 220,
Laws of 1889.
SECTION 21. No person shall be admitted or 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. No person shall be held in confinement in any such asylum or institution
for more than fourteen days without such certificates and order. The judge of probate
shall institute an inquest and take proofs as to the alleged insanity, before granting
such order; and said judge may, in his discretion, call a jury of six persons in each
case to determine the question of (insanity) sanity. Said jury shall be summoned and
empanelled in accordance with the law governing justices' courts. The said judge of
probate shall, if satisfactory evidence is adduced showing the alleged insane (person),
persons to be of unsound mind and in need of care or treatment in (an) any asylum,
home, or retreat, grant an order for the removal of such insane person to such
institution, there to be supported as a private patient. If from any cause such inquest
has not been held previous to the admission of such alleged insane person to the
asylum, it shall be the duty of the medical superintendent forthwith to notify the
judge of probate of the county in which said person resides of the fact of his admission
to the asylum. Immediately upon the receipt of such notification, the judge of probate
shall hold an inquest, and take proofs as to alleged insanity, such hearing to be held
within two weeks following the date of said insane person's admission to the asylum.

fi4

NORTHERN MICHIGAN ASYLUM.

Said judge shall direct that two qualified medical examiners in insanity investigate the
mental condition of said alleged insane per-on and may, in his discretion, subpoena
other witnesses. It shall be the duty of the medical superintendent to reta_in such
alleged insane person under his care until such matter is determined by the judge of
probate, and an order received from said judge for his care and treatment, unless the
said medical superintendent shall determine that he is not a proper person to be so
held; and in case the judge of probate shall deem it advisable to have the alleged
insane person present at the inquest, and his condition shall be such as to render his
removal from the institution for that purpose proper and safe, it shall be the duty
of the medical superintendent to produce such person under his own charge, or that
of a competent attendant.
SECTION 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 pupose 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 OP 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.
[L.S.]
County Clerk.

The following blanks have been adopted for the admission of private
patients:
V

JUDGE OF PEOBATE'S OEDEE.
STATE or MICHIGAN, /
County of
i>
At a session of the Probate Court for the County of
holden at the probate
office in the
of
, on the
day of ±
, in the year one thousand
eight 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 arid 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.

LAWS GOVERNING 'THE ASYLUM.

65

STATE OP MI_°HIGAN,^ j gg_
I HEREBY OEETIPY, That the foregoing is a true copy of the original order and
certificate made by said Court.
IN TESTIMONY WHEREOF, I have hereunto set my hand and affixed the Seal of
the Probate Court, at__________________this________________day of ____________
A. D. 18 ______
________________________________ Judge of Probate.
APPLICATION FOE ADMISSION.

To Hon
----------------------------------------------------Judge of Probate for the
County of____________________, in the State of Michigan:
The application of_________________________________________________________of the
________________________________________
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: That 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 petitioner is ___________________________________________________________
________________________________________________________ and is ___________________
well acquainted with the pecuniary circumstances of said ____________________________
and make 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
STATE OF MICHIGAN, )
County of
J8*

18.—

the above named appplicant,
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 o f \
A. D. 18
/
Judge of Probate.
APPOINTMENT OF MEDICAL EXAMINEES.
STATE OF MICHIGAN, j
County of
. $ ss'
At a session of the Probate Court for said County of
held at the probate
office in the
of
, on the
day of
, in
the year one thousand eight 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 one thousand dollars, for the payment of which we jointly and severally bind ourselves, our
heirs, executors and administrators by these presents.

9

66

NORTHERN MICHIGAN ASYLUM.

WHEREAS,
of the
of
in the county 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 maybe 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 the steward of
the Asylum, a statement of which, by the steward, shall be taken as conclusive, and is
hereby agreed to by the undersigned, and remove
whenever the room occupied
by
shall be required for a class of patients having 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 18
. s.l

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.

PHYSICIANS' CERTIFICATE,
^County ^ICHIG^N' I 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 NOBTHEKN 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
,18
, 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
.
and 2
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 delusions, 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
Insanity* have been duly attested and certified by
Clerk of
'.
County.
(Signed)
M. D.
Sworn to and subscribed before me, this
day of
18
Judge of Probate.
1 Male or Female.
2 Married, single, widowed or divorced.

LAWS GOVERNING THE ASYLUM.

67

COUNTY CLERK'S CERTIFICATE OF QUALIFICATION.*
STATE OP 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.

*See Public Act No. 220 Laws of 1889.

Patients are, transferred from private to county charge in compliance
with the provisions of the following section:
SEC. 24. When an 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 such indigence, according to the provisions of the preceding
section, with or without further evidence of the insanity, as in his discretion he may
think best, and if the indigence be established, he shall make a certificate authorizing
the admission of said patient into the asylum as a county charge, and the report to the
supervisors required by the preceding section; and the said patient, as in other cases of
indigence, shall be supported at the asylum at the expense of the county until restored
or for a period not exceeding two years.
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
that they can leave at pleasure., This course not only destroys confidence in frends, but also in the officers of the Asylum by giving patients
an impression that they are parties to the deception.
Removal to the Asylum should never be attempted when the patient is
much prostrated or laboring under severe bodily illness, and care should
be taken that the excitement attending 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 changes 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 officer of the
asylum, taking his receipt therefor, provided he be admitted, or who shall wilfully

68

NORTHERN MICHIGAN ASYLUM.

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 j to both in the discretion of the court before which the conviction
shall be had.
EEMOTAL OF UNESCOVEEED PATIENTS.

An unrecovered patient may be removed from the Asylum in accordance with the following by-law adopted by the Board of Trustees, Jan.
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 friend, and
may be received back without the formality of a new bond or order,
provided, that the period of absence be not longer than six months.
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 shoes or boots, 1 pair slippers, 1 overcoat.
Female patients should have 3 calico dresses, 3 chemises, 3 pairs drawers,
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. If such articles are left in
their possession the Asylum cannot be responsible for their safe keeping.
COEEESPONDENCE.

All letters concerning patients, from individuals having 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 disappqintment and the Asylum unmerited censure. Information concerning inmates will not be given to casual visitors, except at
the written request of friends.
MEDICAL HISTORY.

Application for admission should be made before the patient is brought

LAWS GOVERNING THE ASYLUM.

69

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 usp 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 attacks.
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 eondition, 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
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.