Tag Archives: History

1893 State Hospital Cadavers

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For those of you looking for ancestors buried in Anonymous Graves at Unmarked State Hospital and Custodial Institution Cemeteries, you may never find them.

Chapter 661, Laws 1893. Sec. 207. CADAVERS.
“The persons having lawful control and management of any hospital, prison, asylum, morgue or other receptacle for corpses not interred, and every undertaker or other person having in his lawful possession any such corpse for keeping or burial may deliver and he is required to deliver, under the conditions specified in this section, every such corpse in their or his possession, charge, custody or control, not placed therein by relatives or friends, in the usual manner for keeping or burial, to the Medical Colleges of the State authorized by law to confer the degree of Doctor of medicine and to any university of the State having a medical preparatory course of instruction and the professors and teachers in every such college or university may receive any such corpse and use it for the purpose of medical study. No corpse shall be so delivered or received if desired for interment by relatives or friends within forty-eight hours after death, or if known to have relatives or friends; or of a person who shall have expressed a desire in his last illness that his body be interred, but the same shall be buried in the usual manner. If the remains of any person so delivered or received shall be subsequently claimed by any relative or friend, they shall be given up to such a relative or friend for interment. Any person claiming any corpse or remains for interment as provided in this section may be required by the persons, college, university or officer or agent thereof, in whose possession, charge or custody the same may be to present an affidavit stating that he is such relative or friend, and the facts and circumstances upon which the claim that he is such relative or friend is based, the expense of which affidavit shall be paid by the persons requiring it. If such person shall refuse to make such affidavit, such corpse or remains shall not be delivered to him but he shall forfeit his claim and right to the same. Any such medical college or university desiring to avail itself of the provisions of this section shall notify such persons having the control and management of the institutions and places heretofore specified, and such undertakers and other persons having any such corpse in their possession, custody or control in the county where such college or university is situated, and in any adjoining county in which no medical college is situated, of such desire, and thereafter all such persons shall notify the proper officers of such college or university whenever there is any coipse in their possession, custody or control, which may be delivered to a medical college or university under this section, and shall deliver the same to such college or university. If two or more medical colleges located in one county are entitled to receive corpses from the same county or adjoining counties, they shall receive the same in proportion to the number of matriculated students in each college. The professors and teachers in every college or university receiving any corpse under this section shall dispose of the remains thereof, after they have served the purposes of medical science and study, in accordance with the regulations of the local board of health where the college or university is situated. Every person neglecting to comply with or violating any provision of this section, shall forfeit to the local board of health where such non-compliance or violation occurred, the sum of twenty-five dollars for every such non-compliance or violation, to be sued for by the health officer of such place, and when recovered to be paid over, less the costs and expenses of the action, to such board for its use and benefit.”
SOURCE: Contributions From The Pathological Institute Of The New York State Hospitals, Volumes I and II, 1896-1897, State Hospital Press, Utica, New York, 1898, Pages 127-128.

Rochester State Hospital – Rochester, NY

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Rochester State Hospital, formerly Monroe County Insane Asylum
Rochester, Monroe County, New York
1600 South Avenue

The history of the Rochester State Hospital is a little confusing because the lines blur between the Alms House and the Insane Asylum which would later be known as the Rochester State Hospital. Four structures stood on the same tract of land, facing South Avenue, between Elmwood and Highland Avenues, in the Town of Brighton. None of these structures remain. The original Monroe County Poor House or Alms House was built in 1826. The Work House was built in 1853 at the cost of $22,707.60 and contained ninety-two cells for men, women, and occasionally children. In 1865 and again in 1868, fires broke out and the buildings were replaced. In 1869, new brick buildings were constructed. At some point the Work House was renamed, the Penitentiary. Before county “Insane Asylums” the “insane” were kept in jails and county poor houses, separated from the other inmates and usually in chains or handcuffs. The first buildings of the Monroe County Insane Asylum were opened in the spring of 1857. It is at this point that the lines become blurred because the official year of the opening of the asylum is 1863.

According to W.H. McIntosh: In 1856, “there were thirty-seven insane confined in thirteen cells [in the alms house]. These cells were low, unventilated, and unwholesome, and in dimensions but four and a half by seven feet. In this small space were crowded as many as four persons, some of whom, wild and raving, were chained and handcuffed. There was no out-yard, and no guards to stoves to prevent self-inflicted injury. It was resolved to erect a permanent and convenient building especially for the insane. It was constructed at a cost of somewhat over three thousand dollars, during 1856 and 1857.” (1) The Monroe County Insane Asylum opened in the spring of 1857 to accommodate forty-eight people and was under the supervision of Colonel J.P. Wiggins and wife. An additional wing to house the superintendent and employees was completed in October 1859 at a cost of $26,791.57. Because of the lack of room, several patients still remained in the Poor House. In 1870, an additional wing was constructed to accommodate twenty-five more patients. In 1871, the number of inmates rose to one hundred. In 1872 an entirely new, main building was constructed with forty-one rooms at the cost of $18,000, and with various improvements close to $50,000. Dr. M.L. Lord was the warden and physician beginning in 1868.

According to the 1872 Proceedings of the Board of Supervisors of the County of Monroe: “Your Committee in tracing back the history of Monroe County Insane Asylum to 1863, when, by an act of the Legislature, it was made a separate institution from the County Alms House, find that the whole number of inmates supported at that institution during the year was sixty-three. The number of inmates now in that institution have increased to 137, and has more than doubled during the last nine years…” (3, page 18).

The Alms House – In 1860, a building, “was set apart for the infirm old men.” (1) George E. McGonigal was the Superintendent, and Dr. Azel Backus was the physician. On February 28, 1872, a building committee was appointed for a new almshouse to be built at the cost of $59,600. “The almshouse was located midway between the insane asylum and the penitentiary, and fifty feet south. The architect employed was J.R. Thomas. The entire cost of the work was $72,948.44.” (1) In late 1872, the new Monroe County Alms House was completed and opened. It was built in front of the old and at some point thereafter, the original poor house was torn down.

The Insane Asylum – The State of New York purchased the land and the buildings of the Monroe County Insane Asylum for $50,000 bringing it into the State Care system. On July 1, 1891, it was renamed, Rochester State Hospital. Dr. Eugene H. Howard was the first Superintendent and served in that position for several years. (2) The Rochester State Hospital was torn down in the 1960s to make way for The Al Sigl Center. Rochester State Hospital faced South Avenue, the address was 1600 South Avenue. The Al Sigl Center faces Elmwood Avenue, the address is 1000 Elmwood Avenue.

So it appears that in 1857 a separate building was constructed for the sole purpose of becoming the Monroe County Insane Asylum. In 1863, by an act of the New York State Legislature, the asylum was officially separated from the alms house. In late 1872, the NEW Alms House was opened. In that same year, an entirely NEW main building was constructed for the Insane Asylum complete with a Mansard Roof. If you look at the sketch of these three buildings (W.H. McIntosh’s book of 1877), you can see that all three are separate but they stand side by side, three in a row: Far left, Penitentiary; Center, Alms House; Far right, Insane Asylum.

Work House, County Infirmary, Insane Asylum 1877

Work House, County Infirmary, Insane Asylum 1877

There is an interesting map that was drawn in 1984 during an excavation of Highland Park that shows the footprints of the original wood frame and brick buildings. At this time, the remains of approximately 900 people were discovered. (4) In April 2013, while researching the history of the poor house and the asylum, I came across the “Chaplain’s Report” from 1872 which stated that the unmarked cemetery, “familiarly known as the ‘bone yard,” was “an enclosed lot of the public farm in the rear of the penitentiary.” (3) This cemetery was located behind the old Penitentiary and was used to bury the inmates of the Penitentiary, Alms House, and Insane Asylum from 1826 until January 8, 1873 when the County Board of Supervisors directed the Superintendents of the Penitentiary and of the County Poor, “to discontinue the burial of paupers or criminals in the old burying ground attached to the penitentiary, and to have the remains of all such interred in Mount Hope cemetery.” (3) The county board of supervisors of 1872 were well aware that this cemetery existed but apparently, it was never recorded. Perhaps the document concerning this cemetery hasn’t been discovered yet. The Remember Garden in Highland Park marks the location of this long forgotten cemetery.

Map of Penitentiary, Poorhouse, Asylum

Map of Penitentiary, Poorhouse, Asylum

305 bodies were interred at Mount Hope Cemetery in 1985. The remaining bodies (approximately 600) (4) were left in the ground at Highland Park. The picture below shows a man preparing the ground for the monument that was or will be placed in memory of these original inmates. There is NO monument in Mount Hope Cemetery for the inmates of The Monroe County Insane Asylum / Rochester State Hospital, most of whom were buried in anonymous, unmarked graves in Section Y. If bill S2514-2013, which was introduced to the New York State Legislature by Senator Joseph Robach, becomes a law, then these people will no longer be anonymous.

Mount Hope Cemetery 11.2011

Mount Hope Cemetery 11.2011

“Work is now underway to install a monument in memory of the 305 Rochester poor house remains now interred in Mount Hope Cemetery. From the picture you can determine that the monument is in Section Y at the far west end. Note the Civil War plot, the Fireman’s monument and the Steam Gauge and Lantern Co. monument in the background. In July, 1984 when terracing land for a Highland Park addition, a bulldozer unearthed some human remains near the SE corner of Highland and South Ave. Investigation proved these burials were very old. It is believed they are from the Rochester poor house. The burials were not marked and the people were interred in the most simple wooden coffins. These remains underwent an examination prior to their reburial in Mount Hope Cemetery.” 11/2011

I have transcribed the earliest records: Names: Monroe County Poorhouse, Asylum, Penitentiary, Other Charities 1838 to 1860. If you believe that your ancestor was an inmate who lived and died at The Monroe County Insane Asylum / Rochester State Hospital you can search for them at the Rochester – Mt. Hope Cemetery Records online. Here is a brief description of what you will see if you decide to search the records for yourself: Under the heading “Residence,” a street name will be given with no specific address; or it will list the place where the person died such as: Insane Asylum, Asylum, County House, Jail, etc. (Be aware that there was an Asylum Street in the City of Rochester that as far as I know, had no connection with the Monroe County Insane Asylum). About 1891, you will start to see the words “Rochester State Hospital” under “Residence.” At some point in the 1900s, instead of listing the place of death as Rochester State Hospital the address has been given instead as “1600 South Avenue.” In some instances, the family of the deceased claimed the body and buried them in the family plot. In the case of pauper and indigent insane, the hospital buried them in unmarked, anonymous graves at Mount Hope Cemetery. Some unclaimed bodies were donated by state hospitals to state medical colleges for the advancement of medical science in which case no grave will be found.

SOURCES:

1 – McIntosh, W.H., History of Monroe County, New York; With Illustrations Descriptive Of Its Scenery, Palatial Residences, Public Buildings, Fine Blocks, and Important Manufactories, From Original Sketches By Artists Of The Highest Ability. Philadelphia: Everts, Ensign & Everts, 1877, Pages 45-47, Transcribed by L.S. Stuhler.

2 – Hurd, Henry Mills; Drewry, William Francis; Dewey, Richard; Pilgrim, Charles Winfield; Blumer, George Adler, The Institutional Care of the Insane in the United States and Canada, The John Hopkins Press, Baltimore, Maryland, 1916, Pages 199-200, Transcribed by L.S. Stuhler.

3. – Proceedings of the Board of Supervisors of the County of Monroe, for 1872, Rochester, N.Y., Steam Press of Curtis, Morey & Co., Union And Advertiser Office, 1872, Pages 18, 211, 212.

4. – Steckel, Richard H. and Rose, Jerome C., The Backbone of History: Health and Nurtrition in the Western Hemisphere, Cambridge University Press, 2002, Page 162.

Friends of Mt. Hope Cemetery – The Friends of Mount Hope Cemetery are a wonderful group of knowledgeable volunteers who will help you locate your loved one and provide you with all the information you need to locate the grave.

Facebook – Friends of Mt. Hope

USGenWeb Monroe County, NY – Mt. Hope Cemetery Tombstone Transcriptions

Records of the Rochester State Hospital

Photographs of Memorial to Residents of Almshouse, Insane Asylum & Penitentiary by L.S. Stuhler

History of Mount Hope Cemetery – McIntosh 1877

Rochester History – Life and Death in Nineteenth Century Rochester by Ruth Rosenberg-Naparsteck, pages 12 – 22.

1872 “Bone Yard” – The Remember Garden – Rochester, NY by L.S. Stuhler

1873 Monroe County Poor House

The Willard and Rochester State Hospital Connection by L.S. Stuhler

CLICK HERE TO VIEW THE VIDEO They’re Buried Where? by Seth Voorhees

The Inmates Of Willard 1870 to 1900  A Genealogy Resource by L.S. Stuhler

“Breakthrough For Medical Genealogy” by Judy G. Russell – HIPAA 2013

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Great article by Judy G. Russell, re-posted with permission. I have contacted the New York State Office of Mental Health asking their position on this new ruling. Hopefully, they will respond soon.

Breakthrough For Medical Genealogy

Posted on April 8, 2013 by Judy G. Russell One For Our Side

There’s been a major breakthrough in records access for those of us with family medical issues that we research in part through our genealogy.

Quietly, without much fanfare, the federal Department of Health and Human Services (HHS) has finally come around to understanding that closing medical records forever, even after the death of the person treated, isn’t the way to go.

It adopted a new set of rules earlier this year, effective just two weeks ago, that opens medical records 50 years after the patient’s death.

The change — first proposed nearly three years ago1 — came in an omnibus Final Rule adoption governing a vast array of issues under the federal Health Insurance Portability and Accountability Act (HIPAA) designed primarily to update personal privacy rules in light of technological changes in medical recordkeeping.2 The rule was adopted in January and became effective on March 26th.

As far back as 2003, archivists had complained to HHS about the old rule, under which personal health information was to be protected forever and only disclosed even after the patient’s death only if the legal representative of the estate authorized it.

In 2005, Stephen E. Novak of Columbia University had quoted from those earlier complaints in an HHS conference, explaining that “certain historical, biographical and genealogical works where the identity of the individual is the whole point could not be written, such as the Pulitzer Prize-winning A Midwife’s Tale, based on the late 18th and early 19th century diary of Maine midwife Martha Ballard.”3

Nancy McCall of the Johns Hopkins Medical Institutions told that same conference that “a number of state archives have acquired the records of defunct hospitals in their states and do not know whether they are covered entities. This is especially important for mental hospitals and TB hospitals that have closed.”4

All of those participating pleaded for clarity — and for access.

The new rule is, finally, the HHS response.

In its rulemaking, HHS recognized the problems inherent in “the lack of access to ancient or old records of historical value held by covered entities, even when there are likely few surviving individuals concerned with the privacy of such information. Archives and libraries may hold medical records, as well as correspondence files, physician diaries and casebooks, and photograph collections containing fragments of identifiable health information, that are centuries old. Currently, to the extent such information is maintained by a covered entity, it is subject to the Privacy Rule.”5

It noted that the “majority of public comment on this proposal was in favor of limiting the period of protection for decedent health information to 50 years past the date of death. Some of these commenters specifically cited the potential benefits to research. A few commenters stated that the 50-year period was too long and should be shortened to, for example, 25 years.”6

Based on its review and the public comments, HHS concluded:

We believe 50 years is an appropriate period of protection for decedent health information, taking into account the remaining privacy interests of living individuals after the span of approximately two generations have passed, and the difficulty of obtaining authorizations from a personal representative of a decedent as the same amount of time passes. For the same reason, we decline to shorten the period of protection as suggested by some commenters or to adopt a 100-year period of protection for decedent information.7

So, as of the 26th of March, HIPAA’s definition of “protected health information” expressly excludes information regarding “a person who has been deceased for more than 50 years,”8 and covered entities need only comply with HIPAA “with respect to the protected health information of a deceased individual for a period of 50 years following the death of the individual.”9

Now the fact that the federal government isn’t standing in the way doesn’t mean that all of us with family health issues can rush out and expect to be given immediate access to those old health records that may tell us so much about things we face today. The feds have never been the only player in the privacy game — state laws may also restrict access to health information.

But it’s a major breakthrough to have the federal government finally move out of the way of access to records of critical importance.

SOURCES

Tip of the hat to Ron Tschippert for alerting The Legal Genealogist to the rule adoption!

  1. Notice of proposed rulemaking, 75 Fed. Reg. 40868, 40874 (14 Jul 2010). ↩
  2. See “Modifications to the HIPAA Privacy, Security, Enforcement, and Breach Notification Rules Under the Health Information Technology for Economic and Clinical Health Act and the Genetic Information Nondiscrimination Act; Other Modifications to the HIPAA Rules,” 78 Fed. Reg. 5565 (25 Jan 2013), PDF version, U.S. Government Printing Office (http://www.gpo.gov/fdsys/ : accessed 7 Apr 2013). ↩
  3. Minutes, 11-12 January 2005, Subcommittee on Privacy and Confidentiality, National Committee on Vital and Health Statistics, HHS.gov (http://ncvhs.hhs.gov/ : accessed 7 Apr 2013). ↩
  4. Ibid. ↩
  5. “Modifications to the HIPAA … Rules,” 78 Fed. Reg. 5613-5614. ↩
  6. Ibid., 78 Fed. Reg. 5614. ↩
  7. Ibid. ↩
  8. 45 CFR §160.103. ↩
  9. 45 CFR §164.502(f). ↩

1880 Sickness – U.S. Federal Census – IPUMS USA

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IPUMS USA stands for: Integrated Public Use Microdata Series (Census Microdata For Social And Economic Research). I found this invaluable website in 2009 when I was transcribing the names of the Willard Asylum patients from the U.S. Federal Censuses. This particular page lists the common diseases found in the United States in 1880 and was re-printed from the IPUMS USA website. I hope you will take the time to check it out for yourself. It is a wonderful resource!

IPUMS-USA is a project dedicated to collecting and distributing
United States census data. Its goals are to:

  • Collect and preserve data and documentation
  • Harmonize data
  • Disseminate the data absolutely free!

1880 Sickness on Day of Enumeration Codes

The SICKNESS variable captures the self-reported health condition which kept the individual from working on the day of enumeration. The first two digits designate the general category of illness, while the second two designate the specific illness within the category. The 1880 Census contained five other questions reporting those considered insane, idiotic, maimed, blind or deaf. These five extra categories are included in SICKNESS to capture the extra detail which was sometimes provided in these separate variables. The general categories are as follows:

Sickness Terminology

The terminology relating to sicknesses found in the census manuscripts presented a mixture of precision and vagueness. At the time the 1880 census was taken, bacteriology was a recent development. Nonetheless, many illnesses were readily identifiable through physical symptoms. Measles, for example, seem to have offered little difficulty in lay diagnostics, nor did malaria (referred to as malaria, ague, remittent fever, intermittent fever, or bilious fever) or typhoid fever (typhoid, gastric fever or enteric fever).

Other seemingly precise diagnoses were not as well defined as one might imagine. Chronic nephritis was still commonly used to describe that which caused general or localized edema. “Chronic nephritis” includes, therefore, not only those cases so specified, but also “dropsy,” “Bright’s disease,” and “gout,” besides the spelling variations relating specifically to the kidney. Rheumatism and paralysis were still used as symptomatic descriptions of conditions rather than as clinical diagnoses. The designation of “rheumatism” appears to have included any condition which prohibited free movement, such as rheumatoid arthritis, coxalgia (scrofula, or tuberculosis of the joints) and syphilis, while “paralysis” included conditions which preclude movement or the control of movement, such as traumatic injury, stroke, metabolic disorders or syphilis.

Use of the Sickness Variable

Since the intent of the sickness question was to ascertain whether individuals were prevented from carrying out their normal activities due to sickness or disability, the response rates underreport illness in the population in two ways.

First, sickness among children will be underrepresented since most children did not have jobs or obligations outside the home. The Census Office did even not include those under the age of 15 when they tabulated the sickness data. Sickness rates for young children produced from the IPUMS 1880 sample are extraordinarily low and should be treated with caution.

The second underreporting of sickness is due to the failure to include those illnesses which limit as well as those that prevent regular activities, as was done for later censuses. A difference, therefore, in morbidity rates between race categories does not necessarily indicate an absolute difference in the prevalence or incidence of disease. It could instead indicate a difference in the perception of illness, tolerance thereof, or the ability or necessity to keep on with one’s activities in spite of it.

Users should also keep in mind the limitations inherent in self-diagnosis as well as possible biases related to nineteenth-century medical terminology and the general understanding of diseases. It may be impossible, for example, to determine the true incidence of pulmonary tuberculosis in a given population because of the potential for misdiagnosis between tuberculosis and various diseases of the respiratory system, such as bronchitis.

Sickness on Day of Enumeration

01 Infectious Disease

01 01 Typhoid Fever
01 02 Typhus Fever
01 03 Malaria
01 04 Smallpox
01 05 Measles
01 06 Scarlet Fever
01 07 Whooping Cough
01 08 Diphtheria
01 09 Cholera
01 10 Dysentery
01 11 Erysipelas
01 12 Chicken Pox
01 13 Mumps
01 14 Rheumatic Fever
01 15 Fevers (not elsewhere classified)
01 16 Meningitis

02 Chronic Disease

02 01 Rickets
02 02 Tumors (not elsewhere classified)
02 03 Rheumatism
02 04 Scurvy
02 05 Diabetes
02 06 Anaemia
02 07 Alcoholism
02 08 Hydrocephalis

03 Tuberculosis

03 01 Pulmonary Tuberculosis
03 02 Potts Disease
03 03 White Swelling
03 04 Tuberculosis, other organs
03 05 Disseminated Tuberculosis

04 Venereal Disease

04 00 Venereal Disease (not elsewhere classified)
04 01 Syphilis
04 02 Gonorrhea

05 Cancer

05 01 Cancer of Stomach, Liver
05 02 Cancer of Breast
05 03 Cancer of Skin
05 04 Cancer (not elsewhere classified)

06 Diseases of the Nervous System

06 01 Migraine, Headache
06 02 Fainting, Vertigo
06 03 Locomotor Ataxia
06 04 Cerebral Hemorrhage
06 05 Paralysis
06 06 Convulsions
06 07 Chorea
06 08 Epilepsy
06 09 Neuralgia, Neuritis
06 10 Other Nervous System Disorder
06 11 Eye Disease
06 12 Ear Disease

07 Diseases of the Circulatory System

07 01 Pericarditis
07 02 Organic Heart Disease
07 04 Functional Disorders of the Heart
07 05 Disease of Arteries
07 06 Disease of Veins
07 07 Lymphatic System
07 09 Hemorrhages

08 Diseases of the Respiratory System

08 01 Influenza, Cold
08 02 Acute Bronchitis
08 03 Chronic Bronchitis
08 04 Pneumonia
08 05 Pleurisy
08 06 Pulmonary Congestion
08 07 Asthma
08 08 Other Respiratory

09 Diseases of the Digestive System

09 01 Throat
09 02 Ulcers
09 03 Dyspepsia
09 04 Other Stomach
09 05 Diarrhea, Enteritis
09 06 Colic
09 07 Hernias, Obstruction
09 08 Other Intestinal
09 09 Atrophy of Liver
09 10 Other Liver
09 11 Disease of Spleen

10 Diseases of the Genito-Urinary Tract

10 01 Chronic Nephritis
10 02 Other Kidney
10 03 Urinary Tract Calculi
10 04 Disease of Bladder
10 05 Disease of Urethra
10 08 Inflammation, Prostate Gland
10 11 Strangury

11 Conditions of the Puerperal State

11 01 Pregnancy
11 02 Childbirth
11 03 Puerperal Septicemia
11 04 Illness After Childbirth
11 05 Other Puerperal
11 06 Miscarriage

12 Illnesses Unique to Women

12 01 Menstruation
12 02 Menopause
12 03 Uterine Ailment
12 04 Other Female

13 Diseases of the Skin and Adnexa

13 01 Furuncle
13 02 Acute Abcess
13 03 Hemorrhoids
13 04 Other Skin Disease

14 Diseases of the Skeletal System

14 01 Leg, Ankle, Foot
14 02 Hip
14 03 Back or Spine
14 04 Dental
14 05 Necrosis

15 Congenital Malformation

15 01 Congenital Malformation
15 02 Merasmus
15 03 Other Congenital Conditions

16 Diseases and Debility of Old Age

16 01 Feebleness
16 02 Senility

17 General Debility

17 01 Chronic Illness (not elsewhere classified)
17 02 Poisoned

18 Ill-Defined Sicknesses

18 01 Unspecified Illness
18 02 Incomplete Information
18 03 Miscellaneous

21 Mental Disease, Insanity

21 00 Melancholy
21 01 Mania
21 02 Hysteria
21 03 Nerves
21 04 Dementia
21 05 Insane (not elsewhere classified)

22 Mental Retardation, Idiocy

22 00 Idiotic

23 Traumatic Injury, Maimed

23 00 Maimed
23 01 Burns
23 02 Gunshot Wounds
23 03 Accidents
23 04 Injury to Leg, Ankle
23 05 Injury to Hip
23 06 Injury to Arm, Hand
23 07 Injury, Ribcage
23 08 Injury to Back, Spine
23 09 Amp or Missing Limbs
23 10 Other
23 11 Other Fractures
23 12 One Eye

24 Vision Impairment, Blind

24 00 Blind

25 Aural Impairment, Deaf

25 00 Deaf

26 00 Dumb

98 00 Illegible

99 00 Not applicable

99 99 Missing”