has improved, and there is now little or no arbitrary interference by officials having no special knowledge of the subject. A Nurses' Home and the employment of a larger number of nurses of a more competent class are still needed improvements.

Paid Employees in Wards of Hospitals.—We are pleased to be able to report further progress during the year in substituting paid and responsible employees for irresponsible workhouse prisoners in the wards of hospitals, as required by the law establishing a separate Department of Charities, re-enacted in the Charter. Prisoners were employed in certain of the wards of Bellevue Hospital until early in the present year, since which time paid helpers have been provided for all the wards. The employment of paid helpers inevitably met with some opposition on the part of officials accustomed to the former system, but this opposition has steadily decreased, and now many of those who were most strongly in favor of prison labor are most outspoken in their praise of the new plan. A better grade of employees is secured as the matter becomes better understood, and the results are correspondingly more satisfactory. Prisoners are still employed to some extent in the Almshouse hospitals, and for a few hours per day as scrubbers in the Metropolitan Hospital.

Food and other Supplies.—It is the general testimony of visitors, employees, and others that on the whole the quality and amount of food provided for the inmates of the various institutions has been better during the past year than before. There was a serious cut in February last which, however, was soon remedied in considerable measure. There have been many evidences of a more efficient oversight over the distribution of food supplies.

There has been a serious lack of clothing all through the year, as also of minor supplies, and especially of shoes and other articles bought of the penal institutions.

Bellevue Hospital.-Of the four new buildings erected in 1897-a laundry and boiler house, an isolating pavilion, a pavilion for erysipelas cases and a morgue-three were not occupied until late in 1898, and one is still unoccupied. The

new laundry, occupied in October, 1898, from which so much was hoped, is not considered adequate to the needs of the institution. The pavilion intended as an isolating pavilion was unoccupied until October, 1898, when the erysipelas patients were removed thither from the Dock House. The new pavilion for erysipelas patients is still unoccupied. The new morgue was first used in November, 1898. There have been no male workhouse prisoners at Bellevue Hospital during the year, although the number of "unpaid helpers " sent from the City Lodging House, and many of them returning there to sleep, has increased. Paid helpers have been employed in all the wards since early in the year. Female prisoners are still employed in the laundry and elsewhere in the Hospital, though not in the wards. Steel ceilings are gradually replacing the old-fashioned plastering. The Babies Ward in the Marquand Pavilion is too small and in other ways is not suited to its present uses.

A large number of soldiers were received at Bellevue during the summer and autumn, and the number of deaths among them was very small.

Gouverneur Hospital.-The new building, begun in May, 1897, makes but slow progress. At the date of this report the walls are not yet completed. The overcrowding of course continues. The general condition of the Hospital and the care of the patients have been as satisfactory as was possible in such crowded quarters.

Harlem Hospital.-Harlem Hospital has suffered greatly during the year from overcrowding. The recommendation of a new site was withdrawn by the Charities Commissioners in December, 1897, and owing to the debt limit of the city having been reached, no funds are available for the erection of a new hospital, but it is hoped that temporary relief will be provided at an early date, either by the lease of a building on the adjoining property, or by the erection of an addition over the laundry building. The crematory for burning ward dressings and dry refuse has been very satisfactory.

Fordham Hospital.-A new building, erected on the site leased by the city last year, was completed in August, and the patients were removed from the old hospital to the new on Sep

tember 1st. The new building proved in many ways but illy adapted to its purpose, and its location, as pointed out in our last report, is very unfortunate. Nevertheless, the patients are more comfortable here than in their former quarters. The lease of this site and the construction thereon of a new building by the former city administration, cannot be approved, from either a humanitarian or a business point of view.

City Hospital.-The two new water towers, containing lavatories and bath rooms, which were begun in March, 1897, and were nearing completion at our last report, were not finally ready for use till late in September, 1898. The small rooms opening off the wards, formerly used as bath-rooms, are now being fitted up as dining-rooms for the patients.

The employment of paid help throughout this Hospital is more and more satisfactory to the authorities of the Hospital and of the training school. The gas supply has been even more inadequate than before. It is a positive cruelty to allow serious surgical operations to be performed in a building so badly lighted as this. The greatest need of the City Hospital is an electric lighting plant. The contract for new floors and ceilings, executed in January, 1898, was decided to be illegal, but it is understood that these very much needed improvements will be made from the appropriation for repairs. The waiting room of the Maternity Ward is sadly in need of new floors and other repairs.

The Special Committee on the employment of epileptics sent two teachers weekly, from November until May, to instruct the epileptic patients in various industries.

Almshouse. The census of the Almshouse has averaged from 200 to 300 higher than during the preceding year, though but slightly in excess of the census during 1896. The completion of the six dormitory pavilions materially relieved the overcrowding, though some of the inmates still sleep upon beds made up on the floor. The wooden shed, known as the smoking shed dormitory, though still in use as a dormitory, is very much less overcrowded than last year. The new kitchen was occupied in March, and is one of the most important improvements of the year. The enlarged dining-rooms and the water towers attached to the

main building were also very desirable improvements. The steam-heating apparatus proved wholly inadequate until late in December, 1897. A great deal of suffering and no doubt considerable illness were caused thereby. Stoves were placed in some of the more exposed wards. At the close of the year the apparatus was so far improved that it had become possible to keep the buildings warm, though this could not be done if adequate ventilation were provided.

While the sleeping quarters for the nurses employed in the Almshouse hospitals are as unsatisfactory as ever, the nursing has somewhat improved through more harmonious relations with the general administration of the institution. Some classification of the Almshouse inmates, based upon the general character of their former lives, is very desirable.

Metropolitan Hospital.-The Metropolitan Hospital received no new buildings from the bond issue. Numerous minor repairs and alterations were made during the year, but new floors, a passenger elevator and water towers are greatly needed. The management of the Hospital is always a subject of favorable comment. The proportion of operative cases has greatly increased during the past two or three years.

Randall's Island Institutions.-The city institutions on Randall's Island include the Infants' Hospital, the Children's Hospitals, and the Schools and Asylum for the Feeble-minded.

Our report of the Infants' Hospital a year ago was of a thoroughly disorganized and demoralized institution in which the death rate was very high, reaching the almost incredible figure of 98 per cent. among such of the foundlings as were not adopted or transferred to other institutions during the year.

It is with extreme satisfaction that we now report that the Infants' Hospital from being one of the worst institutions in the Department, has become one of the best. The former Superintendent of all the institutions on the Island was again placed in charge of the Infants' Hospital in November, 1897. In March, 1898, a very competent Supervising Nurse was appointed, a step which our Committee had been strongly urging since the preceding June. The number of wet-nurses was increased from less

than 10 to more than 40. In April an admirable sterilizer was given to the institution by Mr. Nathan Straus.

During the summer new floors were laid throughout the institution, and new and modern plumbing replaced the obsolete plumbing that had so long been a source of danger to the lives of the inmates. Finally, in co-operation with a Joint Committee of the Association for Improving the Condition of the Poor and this Association, the experiment has been made of boarding in carefully selected families in the country a number of the children, mostly foundlings, for whom wet-nurses cannot be provided at the institution.

The death rate among the various classes of children in the Infants' Hospital according to the official reports for the years ending October 1st, 1896, 1897, and 1898, has been as follows:

Several facts make the death rate of 1898, as compared with that of 1897, somewhat less striking than the above table would indicate. The children of the wet-nurses employed in the institution are, according to a system that has long been in use, included among the "orphan" children. During the past year, for the first time, a considerable number of children having contagious diseases have been transferred to North Brother's Island. Making due allowance for these facts, however, there has been a most remarkable improvement in the management of this institution during the year-an improvement which has resulted in the saving of many lives and the relief of much suffering. For these commendable results great credit is due to the Hon. Commissioner of Public Charities, John W. Keller, as well as to the Superintendent of the Institution, Mrs. M. C. Dunphy, and the Supervising Nurse, Miss Agnes Sheridan.

The Children's Hospitals, for children between two and sixteen years of age, which were under a divided administration during the previous year, were placed wholly under the charge of the present Superintendent in November last. The reports from these institutions are always of scrupulous cleanliness and per