Of the 456 first admissions within the year, 53 were discharged as recovered.

The daily average of patients was 853.5. The largest number present at any one time was 900; the smallest, 787. In addition to the 85 discharged as recovered, 68 were discharged as much improved, and 64 as improved. Of the recoveries, 18 had acute melancholia, and 27 acute mania; 32 of them had been insane less than one month before admission, 14 less than three months, 8 less than six months, and 6 less than a year. Among the deaths 19 were from general paralysis, 27 from senile dementia, and 6 from phthisis. Among the probable causes of insanity in persons admitted during the year, intemperance is assigned in 117 cases, heredity in 83, senility in 37, and epilepsy in 29.

It is about twenty years since the buildings of this Hospital were first occupied. They were erected to accommodate 400 patients, and from time to time additions have been made to provide for about 400 more, giving a nominal capacity of 800. The present average, however, is considerably over that number.

This Institution entered last year upon a work so radically different from anything hitherto attempted by any State Institution that the experiment was looked upon with general interest. We allude to the establishment of a trainingschool for medical internes, which has proved even more successful than was expected by its originators. Four internes thus far have taken a course of study, two of them being considered sufficiently trained to take the places of two regular assistants who resigned. Other State Hospitals are following this example, which was first set in the State by the McLean Hospital.

A re-classification of the patients has been made since the transfer of about 200 chronic cases to the Medfield Asylum; and all of the recent cases, as well as those in which the disease is still in a transition state, have been grouped upon the first two floors, where they can be easily observed. The whole work of the Institution has been very thoroughly and carefully systematized under the immediate direction of Dr. Meyer, the pathologist; and large results are expected in the not distant future, both in the way of the scientific study

of insanity, and in the immediate effect of the new system upon the patients, who are more or less made aware that they are being treated individually and their several cases made the object of special study. All this is in keeping with the high standard which has been almost invariably maintained here from the beginning. Plans for the early opening of a training-school for nurses have been under consideration for some time, and it is hoped that it will not be long before they are carried out. The building of a nurses' home is also in contemplation.

Under the appropriation made by the last Legislature, work has begun upon two buildings for infirmary wards, one for each sex. With the completion of these buildings there will be a slight addition to the capacity of the Institution, and, it is claimed, much gain in the ability of the management to classify and care for the acutely sick.

The Trustees will ask the Legislature for an appropriation of about $60,000 to meet the expense for an addition, to contain a new kitchen, and accommodations for the outside help; and an appropriation of about $20,000 for a nurses' home.

THE TAUNTON LUNATIC HOSPITAL.
(Opened, 1854.)

Trustees: William C. Lovering, of Taunton, Chairman; Henry R. Stedman, M.D., of Boston, Secretary; Ruth S. Murray, of New Bedford; Susan E. Learoyd, of Wakefield; Oakes A. Ames, of North Easton; Milton Reed, of Fall River; Gerard C. Tobey, of Wareham.

Classification of discharges: Recoveries of Insane, 73; Deaths, 112; Discharged by transfer, 142; Other removals, 122; Total, 449.

Of the 346 first admissions within the year, 43 were discharged as recovered.

The daily average of patients was 795.8. The largest number present at any one time was 845; the smallest, 754. In addition to the 73 discharged as recovered, 54 were discharged as much improved and 37 as improved. Of the recoveries, 20 had acute melancholia, and 16 acute mania; 27 of them had been insane less than one month before admission, 20 less than three months, 54 less than six months,

and 4 less than a year. The whole duration of insanity in 79 per cent of those who recovered did not exceed one year. Among the deaths 5 were from general paralysis, 18 from senile dementia, and 12 from phthisis. Among the probable causes of insanity in persons admitted during the year, intemperance is assigned in 68 cases, heredity in 29, senility in 20, and epilepsy in 20.

In common with the other Hospitals, this Institution has been greatly benefited by the opening of the Medfield Asylum, and the removal of patients thereto; the effect upon the remaining inmates being very noticeable. Some structural changes have been made, greatly to the convenience and comfort of the inmates, especially the completion of the new chapel and the opening of bay-windows in one of the wings devoted to the care of women. The medical work here is always of a very high order. An excellent pathological laboratory has been fitted up, and a pathologist is expected to begin work early in the Spring. It is worthy of note that it is more than ten years since a suicide occurred here. The number of patients employed in the sewing-room, the brush shop, and on the wards, has been larger than in previous years; and it is safe to say that this Hospital is in advance of the rest in the matter of diversity of occupation for its inmates. The training-school for nurses has been in operation two years. Another year has been added to the course of study, and the full course for graduation is now three years. Hereafter all the attendants will be required to be members of the school for two years at least.

It is but justice to this Institution to say that, on account of its geographical situation, which allows but a limited number of private patients, and these at a very slight increase over their actual cost, very careful financiering is required to avoid calling upon the State for a special appropriation for current

expenses.

In the matter of kind and sympathetic treatment of the patients, and in its general good order and management, the Hospital continues in a most satisfactory condition.

The Trustees will ask for an appropriation of $2,000 for completing the bay-window in the west wing, and for necessary repairs in that wing.

THE NORTHAMPTON LUNATIC HOSPITAL.

(Opened, 1858.)

Trustees: William D. MacInnes, of Pittsfield, Chairman; Sarah M. Butler, of Northampton, Secretary; Adams C. Deane, M.D., of Greenfield; Sarah A. Woodworth, of Chicopee; Lyman D. James, of Williamsburg; Elisha Morgan, of Springfield; Alvan Barrus, of Goshen.