Classification of discharges: Deaths, 73; Removals, 28; Total, 101.

The daily average of patients was 741.95. The largest number present at any one time was 999; the smallest, 557. Among the deaths 4 were from general paralysis, 10 from senile dementia, and 7 from phthisis. Among the probable causes of insanity in persons admitted during the year, intemperance is assigned in 39 cases, heredity in 38, senility in 16, and epilepsy in 53.

All of the buildings of this Institution are now completed and occupied, patients having been received by transfer from the other State Institutions to the number of nearly one thousand, and the Asylum is practically full; the result being no little relief to the Hospitals. The difficulty in the matter of the water supply has been remedied by the introduction of water from Farm Pond in Sherborn. Some of the buildings first erected already show marks of inferior material and poor construction, and repairs and alterations upon them have been made almost continuously since their occupation.

The advantages of the cottage plan are already evident in this Institution. Among them may be mentioned the increased opportunity for getting patients out of the wards, the greater amount of air and sunlight obtainable in the rooms, and the opportunity for exercise afforded the patients, who are able to go out to the dining-rooms for each meal.

The Trustees ask for special appropriations of $15,000 to increase the present engine room, and of $25,000 to provide for the prospective deficiency in the current expenses of the Hospital, the income of the last year being far from sufficient

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to meet the expenses. They suggest that the per capita price per week to be paid by the Commonwealth for the support of State patients, established by law at $2.80 a week, be raised to $3.25, as is the case in the other State Institutions; but in the judgment of the Board it is advisable to try the experiment of an entire year with the full complement of patients, before considering the question of any change in this matter.

THE MASSACHUSETTS HOSPITAL FOR DIPSOMANIACS AND INEBRIATES, Foxborough.

Trustees: Edward Cowles, M.D., of Belmont, Chairman; Anna Phillips Williams, of Boston; Robert H. Richards, of Boston; Benjamin H. Hartwell, M.D., of Ayer; J. G. Pinkham, M.D., of Lynn.

Of the 265 cases committed during the past year, 241 were first commitments; 18, second commitments; 5, third commitments, and one a fourth commitment. Of the patients committed, six were between 70 and 80 years of age; nine between 60 and 70; thirty-nine between 50 and 60; seventy-seven between 40 and 50; forty-five between 35 and 40; forty-three between 30 and 35; thirty-one between 25 and 30; and fourteen between 20 and 25. The weekly per capita cost has been gradually reduced from $11.18 in 1893 to $8.41 in 1894, $7.00 in 1895, $6.32 in 1896, and $6.11 for the last official year.

There has been a decided improvement in the character of persons sent to the Hospital within the last year. Methods for the improvement of the physical condition of the patients and for scientific training have been continued, and good

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results have followed. Improvements in the grounds outside the Hospital have been made, and arrangements have been completed whereby intractable and untrustworthy patients can be given out-door air and exercise in an enclosed yard.

The Trustees are still considering a remedy for the elopements of patients on parole. It appears that the larger portion of those who elope are either morally degenerate or mentally weak, and in either case unable to resist the temptation offered by the opportunity for escape.

The last Legislature passed the following Act:

[CHAPTER 474.]

AN ACT RELATIVE TO ESCAPES AND DISCHARGES FROM THE MASSACHUSETTS HOSPITAL FOR DIPSOMANIACS AND INEBRIATES.

Be it enacted, etc., as follows:

SECTION 1. If a person held in the Massachusetts Hospital for Dipsomaniacs and Inebriates escapes therefrom, or from the grounds or premises thereof, he may be arrested and returned thereto by any officer authorized to serve criminal process in any county in the Commonwealth, or by any officer or employee of said Hospital. It shall be the duty of the superintendent of police of Boston, the city marshals and chiefs of police of other cities, and the chief of police of every town having such an officer, upon written information from the superintendent of said Hospital of such an escape, to cause the person so escaping to be arrested and returned to said Hospital, if he is within such city or town.

SECTION 2. The Board of Trustees of the Massachusetts Hospital for Dipsomaniacs and Inebriates are hereby authorized, whenever in their judgment a patient has been long enough in the hospital to enable them to form an opinion as to whether or not the treatment would benefit him, to finally discharge such patient. SECTION 3. This act shall take effect upon its passage. [Approved June 8, 1897.

The Board recommends that the laws regarding this Institution be farther amended so as to provide,—(1) that the State Board shall have the same authority to discharge patients therefrom that it has to discharge inmates of the State Lunatic Hospitals; (2) that the State Board shall prescribe the form of certificates to be used in committing persons to the Hospital; (3) that the Hospital authorities

shall be informed more specifically of the history of each patient at the time of commitment. These recommendations are all in accordance with those contained in the Report of the Commission on the Charitable and Reformatory Interests and Institutions of the Commonwealth, made to the Governor in February last.

The Trustees will ask the Legislature for an appropriation to erect a building to contain a chapel, gymnasium, library, reading-room, etc., at an estimated cost of $30,000; and also a building, with an enclosed garden, for receiving and custodial wards, to accommodate twenty or twenty-five patients, at an estimated cost of $20,000. They will also ask for a maintenance appropriation to meet part of the current expenses of the ensuing year.

THE MASSACHUSETTS SCHOOL FOR THE FEEBLE-MINDED, Waltham.

Trustees appointed by the Governor: Elizabeth E. Coolidge, of Boston; John S. Damrell, of Boston; Frank G. Wheatly, M.D., of Abington; William W. Swan, of Brookline, Secretary; Erskine Warden, of Waltham; Francis Barnes, M.D., of Cambridge.

Trustees appointed by the Corporation: Samuel Eliot, of Boston, President; Eliot C. Clarke, of Boston; John Cummings, of Woburn; Samuel Hoar, of Concord; Chas. F. Wyman, of Cambridge; George G. Tarbell, M.D., of Boston. WALTER E. FERNALD, M.D., Superintendent.