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On this list 247 names were duplicated, making the actual number of children treated 612, the actual death rate then being 25.82 per cent. instead of 18.39 based on 158 deaths and 859 admissions.

IDIOTS.

The large number of idiots heretofore cared for on Randall's Island has been reduced during the year by transfers to State care. The enlargement of accommodations at Rome gave opportunity to receive all the non-epileptic idiots, but the others are forced to remain under care of the city because the Custodial Asylum does not receive idiots afflicted with epilepsy. It is suggested that the scattered groups of this class of defectives now maintained by the city in its three almshouses be combined on Randall's Island.

The new pavilion F, which was finished last year at a cost of $40,000, has been opened during the year and has accommodation for 100 of these idiots. Their quarters are so much better than heretofore that the rebuilding of pavilion F is a decided advantage.

Formerly these defectives had dormitories heated by stoves; now the new steam plant furnishes ample heat and there are no stoves in use. This is in the line of greater safety. Not only was there danger of fire destroying the buildings as a consequence of the use of stoves, but the patients were always in danger of burning themselves even though each stove was protected by wire guards.

The new pavilion has outside stairs which serve as fire-escapes, but unfortunately these outside stairs are of wood.

THE FEEBLE-MINDED.

In addition to the unteachable idiots on the island, there are large numbers of the feeble-minded under care. Schools are provided and instruction given to them in such things as sewing, basket-making, tailoring, tinsmithing, the making of shoes and rugs, as well as in gardening and similar out-of-door pursuits. A strong effort is made by the superintendent to increase the

light industries suitable for this class, as well as to develop their powers through instruction in the common English branches.

The school on the island has to provide instruction not only for the feeble-minded but also for the children of normal mind sent to the Children's Hospital. As the latter are seldom on the island for any great length of time, the task of the teacher is exceedingly difficult so far as their instruction is concerned, but with the feeble-minded the several industries thrive and the children take pleasure in their work.

EPILEPTICS.

There are a large number of epileptic children on the island beside those included in the idiot class. All the epileptics who can be benefited by the transfer should be sent to Craig Colony, and it would be well were a definite plan adopted by which those suffering from double defects, as idotic epileptics or epileptic feeble-minded, could be transferred to a suitable institution.

NEEDS.

Many new trees have been set out on the grounds during the past year, and this plan of providing fruit and shade should be continued, as in all probability Randall's Island will always remain the seat of some of the large public charities of the city.

One special need is that a nurses' home be provided for this system of hospitals. In 1899 the Board of Estimate and Apportionment appropriated $15,000, which amount was deemed insufficient. There may be use for a larger sum, but the need of a nurses' home grows greater from year to year, and the necessary steps should be taken to provide such a building.

There is need of a crematory for the several institutions on the island. Doubtless one could be built which would serve as a destructor for the House of Refuge and the children's institutions, and the expense could be divided equitably.

A new ice house is required and also a better dormitory for the male help employed. Necessarily there are a number of

men who work upon the island, and these should be properly housed. A good dormitory should be provided for them.

One other improvement greatly needed is a better shelter on the dock at One Hundred and Twentieth street. To this dock all visitors to the island go and wait until a boat is able to convey them across. In stormy weather women and children are exposed, and a shelter of some kind, large enough to accommodate the crowd which makes use of the dock, should be provided. Then a steam launch is a necessity as a ferry between the island and the dock. At present the transfer is made by open rowboat. When it is remembered that hundreds of infants are taken to the hospital on the island, and that numbers of sick children must be transferred, it will be apparent that protection should be provided. The cost of a steam launch will not be very great, but even if such a ferry were to cost $5,000 or $6,000 the money would be well spent if it save the lives of some of the children whose death may be traced to exposure.

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