at the Peoria State Hospital, the two costing $100,000. At the Kankakee State Hospital a building for a psychopathic hospital is nearly completed at a cost of $75,000, but an additional appropriation of $20,000 will be required to complete and furnish it. An appropriation of $25,000 for a similar building at the Elgin State Hospital was found insufficient, so that $15,000 was asked of the legislature. At Jacksonville State Hospital there are two psychopathic wards, one new and the other an old ward which has been refitted.

INDIANA.-Northern Hospital for Insane, Longcliff.-The improvements contemplated are a new local telephone system; new electric lighting and power plant; new plumbing in all old buildings, and a new $15,000 pathological building to be erected next summer.

Arts and crafts for female patients and out-door and in-door games for male patients have been proved and are proving a valuable branch of treatment.

IOWA.-Institution for Feeble-minded Children, Glenwood.-Two hundred acres of land has recently been purchased at a cost of $20,000, which makes the total acreage at present 870 acres. There is being constructed a new fireproof wing to the Boys' Custodial Building which it is estimated will cost $40,000. Additional reservoirs and other changes in the water system are being made at a cost of $10,000, and the total outlay for the completed water system will be $60,000.

The population of inmates is now 1206.

-Cherokee State Hospital, Cherokee.-Contract for a fire station 46 x 26 feet, one and one-half stories, will be let on or before the 31st inst.

A concrete tunnel, 6 x 5 feet 6 inches, and over a thousand feet in length is being constructed, through which all steam and water pipes, also electric wires will be carried from the main station to the psychopathic hospital now being completed.

A concrete underground root cellar, 110 feet long by 30 feet wide is being completed to afford additional room for vegetables of all kinds.

Much grading and road-making has been done during the summer and the work is still in progress.

All of the work, with the exception of the fire station, is being done by the institution, and for the most part with the patients' help.

MARYLAND.-Springfield State Hospital, Sykesville.-A new cottage for 75 women patients has been recently completed at a cost of $30,000.

The new private railroad connecting with the Baltimore & Ohio was recently completed at a cost of about $100,000. It is believed that it will effect a considerable saving in the hauling of coal and general supplies.

MISSOURI.-City Asylum, St. Louis.-The new additions to the St. Louis Insane Asylum are well under way in construction and will be completed

probably by June, 1910. As the completed plant will cost about one and one-quarter million, it should be one of the most modern and handsomest in this country. There is not a feature in modern construction which has been neglected. No expense has been spared in the material, and as a charity institution it should stand out as one of the ornaments of St. Louis and a beneficence of its people. Besides the two additional wings, which will accommodate 2000 patients, the cost of which is $962,000, there will be an isolation building for the disturbed insane, also a local power and heating plant for this institution, female hospital and poor house; also a threestory kitchen and a laundry with an equal number of stories. As the city charter is now being revised by a board of freeholders, it is advised that a receiving hospital be located on the same grounds as this institution, which will be under the control of a board of experienced alienists, at the same time be of service to not only the medical profession, but also to any citizen who cares to have the advice of this board; also that it be requisite in any court case where insanity is plead in defense. The alleged insane person shall be sent to this hospital and there remain until a decision is rendered by the board of alienists. All patients to be admitted to the general hospital on the affidavit of this board. This should make a complete system, as it will encompass a psychopathic hospital and building for the acute and disturbed insane and a general hospital.

-State Hospital No. 2, St. Joseph.-As a result of a disagreement between the board of managers of this hospital and the superintendent, Dr. W. F. Kuhn, the latter was summarily removed from office. Dr. Frederick A. Patterson, a member of the staff, was appointed acting superintendent. Resolutions of censure were adopted by the board, which claim that Dr Kuhn has been guilty of inattention and misconduct. /

NEW JERSEY.-New Jersey State Hospital at Trenton.-During the year a great many important improvements have been made.

The legislature during 1908 voted $111,000 for extraordinary improvements, which included the following: Replumbing, remodeling and the sanitation of the old building, at a cost of $50,000; tiling all bath rooms, toilets, etc., at a cost of $20,000. These improvements were very necessary, as the plumbing in this building had not been renovated since its construction 60 years ago.

This includes an equipment of a number of continuous baths for the treatment of excited patients on both wings of the hospital. Each equipment consists of four tubs, controlled by a central table, also electric thermometers which register when the water reaches 110°, or falls below 90°, so that patients are protected, even if an attendant is inclined to be careless. The hot water system has been further regulated by installing Tobey heaters, which control all hot water in the building, and prevent scalding patients through negligence.

In the bath rooms on the male wards the rain baths have taken the place

of the tubs. In the female wings both systems are installed, and in a large majority of the bath rooms shower baths alone are used.

A new up-to-date bakery has been installed, at a cost of $5000. Three new artesian wells were bored at a depth of from 250 to 280 feet deep, and an air pressure system installed for forcing water from these wells to the reservoir. Cost of same, $5000.

The Howard Night Watch System, with central clock and dial, has been installed at a cost of $1837. A complete telephone system, consisting of a central exchange and 80 stations, was installed by the Bell Telephone Company.

One open-air ward for female tuberculosis patients has been constructed, to accommodate 20 patients, at a cost of $3500.

The question of fire protection for the hospital has been carefully considered. All apparatus on the wards has been overhauled, and new fire mains and plugs constructed around the buildings. Nurses and attendants have been thoroughly instructed in using the apparatus, and weekly fire drills are held in the various wards.

The medical work has been entirely reorganized. The old case books have been displaced by a complete envelope system. Daily staff meetings are held at 8.30 a. m., at which all new cases are presented for discussion and diagnosis. The medical staff has been increased by three members, including one woman physician.

All forms of mechanical restraint have been abolished since January, 1908, and resulted in great improvement in the treatment and care of the patients. Although this practice has been established in the hospital since its opening, the change was made with very little inconvenience, and nothing has occurred to warrant the return to any form of restraint.

An up-to-date operating room, with facilities for all emergencies, has been established.

A consulting staff of II outside physicians and surgeons has been appointed, and give much assistance to the regular hospital physicians.

Dormitories for the admission of acute and excited cases have been established on both the male and female wings; also in the annex, dormitories for the old and feeble patients, with better classification of such patients, has been possible.

In the past year a marked increase in the efficiency of the laboratory has been apparent. Additional apparatus, for which an appropriation of $1000 was granted by the last legislature, has been installed, and has proved of considerable advantage to that work.

There is a noted increase in the number of autopsies performed in the hospital. Seventy-five autopsies have been performed, 63 of which were regular hospital cases, the others being performed at the various hospitals, or obtained from other sources.

The work performed has been of a rather widely varying nature. In addition to the regular hospital clinical and pathological examinations, frequent sanitary and bacteriological analyses have been made of the hospital water and milk supplies.

Following the typhoid epidemic of two years ago, repeated bacteriological examinations for the detection of chronic bacillus carriers were made, both at the hospital laboratory and the Research Laboratory of the New York Health Department.

The nursing staff has been increased about 20 per cent, so that now the proportion is one nurse to nine patients.

Seven hundred and fifty books have been added to the general library for the use of the patients. The medical library has been increased to 550 volumes.

Mr. Henry Veghte was appointed librarian of the medical library, and his knowledge of foreign languages is of much assistance to the staff.

Trial visits of discharged patients has been extended from one to four months, and has proved of considerable advantage, and has been received with satisfaction by the friends of the patients.

-New Jersey State Hospital at Morris Plains.-There has been a steady increase in the insane population during the past six months, the census on August 28 being 2050-the greatest number ever under treatment in the institution.

A number of much needed improvements have been completed, among which is the equipment of both the Main Building and the Dormitory Building with spiral fire escapes. These are very efficient and insure the rapid escape of all patients in case of fire or accident.

The last legislature appropriated $2500 for the installation of new toilets, bath-tubs and plumbing in the Administration Building. This work has been completed. $15,000 was appropriated for a cold storage plant. The work on this improvement has not been completed, but the probabilities are that the plant will be in operation before the end of the year.

The location of the store-room was changed on August 15, 1909, to the basement of the south side of the Dormitory Building, as the part of the Main Building formerly used for that purpose was much too small for efficient work being done in that department.

The Nurses' Cottage, destroyed by fire in November, 1907, has been completely renovated and refurnished and was reopened in April of this year.

The board of managers, at a regular meeting held at the hospital on August 12, 1909, reaffirmed their confidence in Dr. B. D. Evans, the medical director, and resented some recent newspaper attacks by the passage of the following resolution:

"WHEREAS, Our attention has been called to an attack, indirectly and by inuendo, on Dr. B. D. Evans, medical director of this institution, because of his connection with a recent case in the New York courts, and

"WHEREAS, We have intimate personal knowledge individually and as a board of Dr. Evans' ability and appreciate the prominent position this institution has attained through his efforts, be it

"Resolved, That the board of managers of the State Hospital extend to Dr. Evans this assurance of our belief in his integrity and honesty of purpose."

NEW YORK.-According to various reports, the Lunacy Commission is having trouble in securing a site for the new hospital which is to be established on Long Island. It was said that a site of 548 acres, 75 per cent of which was tillable land, had been secured at Greenvale, but a later report stated that owing to opposition of those resident in the neighborhood that this site had been abandoned and a new one selected at Farmington. Here again opposition was met with and it will be necessary to find another site. Options have been secured on about 550 acres of land in Westchester County, near Yorktown, on which it is presumed will be established the new asylum which shall take the place of the one now on Ward's Island. -Manhattan State Hospital.-The following is the list of improvements made since the issue of the last half-yearly summary:

A new boiler has been installed in the hospital steamboat, "Wanderer." The addition to the west stable carriage room has been completed. The alterations to the cupola of the Verplanck Building, occupied by night nurses, have been finished.

New brass feed lines have been installed to the boilers in the west power house.

A new hot water tank has been purchased and erected in the basement of the main building for men, replacing one worn out.

Another tent has been purchased and put up at the camp for tuberculous

men.

An estimate has been allowed by the Lunacy Commission for renewals to the foundation of the store-house and the contract has been awarded for overhauling and enlarging the ice plant and insulating the cold storage rooms. This work is to be done during the coming winter.

A house providing additional accommodations for the medical staff, arranged for two families, is in course of construction, the work being done by extra mechanics employed by the hospital under direction of the hospital departments. The house is expected to be ready for occupancy this fall.

Material and labor have been allowed by the Commission under legislative appropriation for changing the electric lighting plant to a complete three-phase system.

The contract for the renewal of steam lines in the east building and the men's home, east, has been awarded and the work is now well under way. The Lunacy Commission has allowed money for the purchase of a fiftyfoot gasoline launch to take the place of the electric launch Evelyn" and the steamboat "Mermaid," recently sold. This boat is now being constructed and will be delivered in a few weeks.

Five hundred barrels of cement, with other material and labor necessary, have been allowed for the construction of sidewalks.

Material for fly screens for the tubercular camps has been purchased. A new hot water tank, supplying the hydrotherapeutic equipment of Ward 26, has been installed in the basement, replacing the old tank, now worn out.

A new float and some new piles, with other alterations, have been installed at the city dock.