GENTLEMEN:—The biennial report of this Hospital from June 30th, 1924, to June 30th, 1926, is submitted as follows:

STATISTICAL SUMMARY Table No. 1   Male Female Total Patients remaining June 30, 1924 651 671 1,322 Admitted during last two years (insane) 565 471 1,036 Admitted during last two years (criminal insane) 78 6 84 Total number under treatment 1,294 1,148 2,442 Average daily population —— —— 1,474.5 Restored (insane) 61 84 145 Improved (insane) 327 174 501 Unimproved (insane) 19 30 49 Transferred (insane) 8 1 9 Not insane 2 0 2 Died (insane) 109 101 210 Discharged and transferred (criminal insane) 15 1 16 Died (criminal insane) 3 2 5 Total number discharged and dead 544 393 937 Per cent of deaths on number treated 8.6 8.8 8.7 Per cent of recoveries and improved of number admitted 68 54 61 Remaining June 30, 1926 750 755 1,505

Our reports on the medical work for two years cover four departments—the insane, epileptic, inebriate and the criminal insane.

The doctors of my staff have submitted the following reports:

(See Dr. Adams' report.)

(See Dr. Ashby's report.)

(See Dr. Brackin's report.)

(See Dr. Jordan's report.)

(See Dr. Young's report.)

The work of our general hospital service has been satisfactory. The necessary surgical operations have been done by different members of our Advisory Board of Surgeons very promptly when called.

Our requests for new buildings and reasons for making them are set out fully in our transmittal letter to Budget Bureau.

We wish again to express our appreciation to the Advisory Board of Doctors for responding so promptly to our call whenever we have work for them to do.

SIR:—Pursuant to your request, I submit herewith the report for the Male Department, covering the biennial period from June 30th, 1924 to June 30th, 1926.

The general health of the patients in this department has been good. There has been no epidemic diseases. Vaccination against typhoid and smallpox has been carried out. A few cases of psychosis following encephalitis have been treated with tryparsamide and a few cases of dementia præcox have been treated by the production of an aseptic meningitis by the intraspinal injection of sterile horse serum. Sulpharsphenamine, neosalvarsan bismuth and mercury (both intramuscularly and intravenously) have been employed in the treatment of syphilis. I had hoped during this biennium to treat some cases of paresis with malaria, but have experienced difficulty in securing proper malarial parasites. This work, however, will be carried out during the coming biennial period. There were two suicides during the biennial period. One of these occurred in the Main Building and the other occurred at the Hospital Building.

On April 10th, 1926, about 1:40 P. M., fire broke out in the roof of the Sixth Ward and destroyed the First, Second, Third, Fourth, Fifth and Sixth Wards and the northern end of the Seventh, Eighth, Ninth and Tenth Wards. The Eleventh Ward was also so badly damaged that it cannot be used until extensive repairs can be made. The patients are being cared for on the porches of the Seventh, Eighth, Ninth and Tenth Wards and on the parts of these wards not destroyed by the fire. Some patients were transferred to Oaks Colony and some were taken home by relatives.

Even after the burned building has been rebuilt, the Male Department will still need additional buildings. There has been no building in the Male Department for housing patients since the Seventh, Eighth, Ninth and Tenth Wards were built about twenty years ago. I would make the following recommendations: A Receiving Building with a capacity of 75 to 100 patients, a building for untidy patients to care for 150, and a building for inebriates and drug addicts. The inebriates and drug addicts are now cared for on the wards with the insane. Table One of the statistical report will show that we have admitted more male patients than females, which will show the necessity for a Receiving Building for men, a building of this type having already been provided for the female patients.

On January 1st, 1925, the Criminal Insane building was opened, the Legislature having passed an act that patients of this type should be cared for in this institution instead of the State's Prison. The building was too small due to inadequate appropriation and as soon as the patients were transferred from the State's Prison the building was so crowded as to necessitate the placing of beds in the halls. During the past biennial period the building has been enlarged and its capacity slightly more than doubled. For this building I would recommend an occupational therapy teacher and amusements from time to time such as moving pictures.

The functions of a State Hospital should be:

1. To receive as many worthy cases as possible.

2. To restore as many patients as possible to society.

3. To accomplish the two above objects as economically as is compatible with good treatment.

With these objects in view, I think the Male Department has made a creditable showing. By referring to Table One of the Statistical Report you will note that more men have been admitted and discharged than women, and by comparison of the payrolls you will note that this has been accomplished very economically.

SIR:—I hereby submit the report of the Female Receiving Building:

Since the last biennial report three strong rooms have been added to the Female Receiving Building at a cost of about $1,800. This is the only expenditure that has been made to this building since its construction. The three additional rooms have increased the efficiency of the service but the present capacity is not sufficient and three strong rooms would materially increase our comfort. These rooms could be extended from the three rooms constructed two years ago and on the roof of these three rooms, and the three rooms previously mentioned, we should have a sun porch. This would give the patients at the Female Receiving Building the advantages of sunshine and fresh air which they do not at present enjoy in bad weather and winter, and which is a privilege granted to nearly all of the other patients. The expense of this addition should not exceed $6,000.

During the past biennial period we have been free from a great deal of sickness, but there was one epidemic of erysipelas which affected an attendant and four or five patients, all of whom recovered. There were no suicides during this period and twelve deaths. Most of these deaths occurred shortly after admission of the patients. Two of them dying one day after admission, another within four days and the longest period that any of these patients who died had been in the hospital was fifty-one days. There was also one death which occurred the day after the patient left the hospital after having been in our service for twelve days.

There has been a decided decrease in drug addiction patients. For the periods of 1924-1925, we admitted thirty patients; 1925-1926 seventeen patients who were drug addicts. On July 1st, 1924, there were in this service four patients diagnosed drug addiction; July 1st, 1926, only one patient of this class.

We are continuing to make a mental and physical examination of all patients as soon as possible after admission; and we are also vaccinating all patients against smallpox and typhoid fever.

The continuous baths and hot packs are being continued with benefit.

SIR:—I herewith submit the report of the Female Department, with the exception of the Receiving Building. There were 533 patients at the end of the biennial period.

SIR:—Herewith I hand you the biennial report of the Colonies in the department of my service:

Movement and condition of the population of Oaks Colony during the biennial period ending June 30th, 1926:

Number of patients in the institution at beginning of period 169 Number of patients admitted during period 155 Number of patients readmitted during period 15 Number of patients died during period 1 Number of patients escaped during period 47 Number of patients returned from escape 35 Number of patients at large 12 Number of patients transferred 85 Number of patients discharged 42 Number of patients remaining June 30th, 1926 199

All patients have been immunized against smallpox and typhoid fever. There have been no contagions or epidemics. The one death reported was due to heart disease. Examinations of and histories written for these received

The Dental Department, which has been under the direction of Dr. T. L. Young since April 21st, 1921, has completed a large amount of work during the past two years. All new patients are seen soon after they are admitted. All focal infection removed and teeth repaired.

The office is equipped with the Ritter outfit and Wappler X-ray machine.

The following table will show the work that has been done:

Patients seen 2,875 Extractions 2,559 Amalgam fillings 475 Cement fillings 483 Cleanings 1,131 Synthetic fillings 119 X-rays made 118 Plates made 45 Plates repaired 9 Bridges made 4

SIR:—In the past two years, ending with June, 1925, we have made provision for caring for fifty additional inmates in the Criminal Insane department and that building will now accommodate one hundred inmates. A wing was added to the original building and some changes made in the original building, thus giving us the space for the fifty additional beds and also providing a new dining room and serving room to care for the one hundred inmates, the former smaller dining room having been used for bedrooms by building partitions in same. The required number of shower baths and other toilet facilities were also added and two additional rooms for attendants in charge of this wing of the building.

We were successful in getting this project completed within the amount of the appropriation, and the plan is a very satisfactory one, having been arranged so that this wing may be extended in the future without destroying any part of the present building.

We took advantage of the ground floor space of the covered way leading from the Erwin Building to the dining room, and built into this space a strong-room wing for women, and provided ten additional strong rooms, well ventilated, lighted and heated; also an attendants' room and double continuous bathroom; the necessary toilet rooms, store-rooms, etc., were also provided and this piece of work is considered one of the best pieces of construction that we have. The utilization of the space under the covered way saved us about three thousand dollars, and this wing is entirely above the ground. This wing, also the Criminal Insane wing, are both of fireproof construction.

The old wooden floors of the Seventh Ward were entirely removed and replaced with re-enforced concrete. Concrete floors were also placed in certain parts of the Epileptic Colony building for men where the old wooden floors had decayed. New tile floors were laid in the serving rooms adjacent to the dining rooms for women and men.

We awarded contracts July 15th for the rebuilding of that portion of the building that was destroyed by fire on the 10th day of April. The building is now in course of construction, and at the suggestion of Governor McLean, who deemed it wise to take advantage of the overhead expense in connection with building operations, we enlarged the building and instead of rebuilding for two hundred seventy-five, which was the number of inmates in the burnt portions, we have provided for one hundred additional, or three hundred seventy-five. Our contract provides that this entire project must be completed not later than the 15th day of May, 1927, and that part designated as the rear dormitory, which is a part of this project, will be completed by the 15th of October, this year. This project is to be one of the best in the State. The building will be fireproof, and the plans were given most careful consideration, and I conferred with several of the Nation's competent authorities in reference to the building before preparing the working plans.

After consulting with the Superintendent as to the urgent needs of the Hospital, I have advised as follows: (See letter of transmittal to Budget Bureau.)

MADAM:—I hereby respectfully submit to you a report of the work done in the Matron's Department from June 30th, 1924, to June 30th, 1926:

We have, besides keeping up the regular daily duties of the Kitchen, Bakery and Center Building, made the following:

  1925 1926 Total Butter 7,521 pounds 6,438 pounds 13,959 pounds Lard 4,264 pounds 4,290 pounds 8,554 pounds Strawberry preserves 68 gallons gallons 68 gallons Plum jelly 28 gallons gallons 28 gallons Peach preserves 202 gallons 246 gallons 448 gallons Grape jelly 34 gallons 54 gallons 88 gallons Peach pickle 45 gallons 48 gallons 93 gallons Apple jelly 18½ gallons 68 gallons 86½ gallons Watermelon rind preserves 30 gallons 128 gallons 158 gallons Watermelon rind pickle 37 gallons 98 gallons 135 gallons Pear preserves 235 gallons 128 gallons 363 gallons Grape preserves 25 gallons 48 gallons 73 gallons Apple preserves 18 gallons gallons 18 gallons Cucumber pickle 60 gallons gallons 60 gallons Tomato pickle gallons 48 gallons 48 gallons Pear sweet pickle gallons 25 gallons 25 gallons Cucumbers in brine 20 barrels barrles 20 barrels Beans 5,789 gallons 5,438 gallons 11,277 gallons Apples 3,050 gallons 718 gallons 3,768 gallons Peaches 739 gallons 88 gallons 827 gallons Pears 1,245 gallons 333 gallons 1,578 gallons Tomatoes 211 gallons 2,060 gallons 2,271 gallons Okra gallons 285 gallons 285 gallons

With the aid of patients in the spring of 1925 we painted the entire Kitchen, including the five Dining Rooms in Kitchen, Vegetable Room and Diet Kitchen. In the spring of 1925 we painted the Meat Room, Broom Room, Vegetable Room, Supply Room, Diet Kitchen and varnished all the furniture, office fixtures and chairs in Center Building, also painted and enameled all beds in Center Building.

MADAM:—We hereby submit to you the biennial report of the Occupational Therapy Departments, male and female:

FEMALE DEPARTMENT: No. of Articles Made Aprons, child's, embroidered 87 Aprons, ladies', embroidered 124 Aprons, laides', hemmed 211 Broom holder, raffia 9 Boudoir caps, embroidered 8 Baby's bedquilt, tufted 1 Baby's bedquilt, embroidered 1 Baby's kimona, embroidered 1 Baby's sack, embroidered 1 Baby's cap, crocheted 4 Baby's slip, embroidered 1 Baby's bib, embroidered 36 Baby's bibs, with crochet 6 Bird cages of soda straws 61 FEMALE DEPARTMENT—Continued No. of Articles Made Bedquilt, patchwork 4 Baby baskets, reed 15 Baby baskets, lined 15 Baskets, reed, large 22 Baskets, reed, small 31 Baskets, waste 22 Baskets, flower 35 Baskets, fruit 7 Baskets, raffia 5 Baskets, pine needle 4 Baskets, reed, doll 6 Bag, laundry, embroidered 12 Bag, canvass and raffia 1 Curtains, appliqued 2 Curtains, hemstitched 24 Curtains, embroidered 4 Cats, rag 5 Centerpieces, embroidered 36 Centerpieces, with crochet 112 Centerpieces, appliqued 2 Centerpieces, with tatting 6 Chairbacks, embroidered 6 Costume, party 2 Crocheted centerpiece 1 Crocheted inserts 13 Doll bed sheets 2 Doll bed spread 1 Doll bed pillow case 1 Doilies with tatting 31 Doilies with crochet 125 Doilies, hemstitched 62 Dolls, rag 5 Doilies, picoted 8 Dolls dressed 8 Doilies, embroidered 40 Dogs, rag 7 Flowers, paper 129 Flowers, waxed 129 Gown with crochet 1 Gown with tatting 1 Handkerchiefs, hemstitched 22 Handkerchiefs, with tatting 19 Hamper, reed 1 Lace, crocheted (yards) 97 Luncheon set, embroidered (pieces) 223 Luncheon set, with crochet (pieces) 416 Luncheon set, with tatting (pieces) 7 Luncheon set, hemstitched 156 Lampshade base, reed 1 Lampshade, lined 1 Masks, face 125 Medallions, crocheted 229 Medallions, tatting 155 Napkins, hemstitched 94 Napkins, embroidered 36 Napkins, hemmed 123 Napkins, picoted 79 Pillow cases, hemstitched 16 Pillow cases, embroidered 50 Pillow cases, with crochet 43 FEMALE DEPARTMENT—Continued Pillow cases, hemmed 49 Pillow cases, with tatting 46 Pillows, sofa 13 Pillow tops, embroidered 16 Pillow tops, handpainted 4 Pin cushions 8 Rugs, braided 32 Rugs, hooked 53 Rugs, woven 132 Rugs, crocheted 9 Rugs, repaired 1 Scarfs, hemstitched 293 Scarfs, with crochet 56 Scarfs, with tatting 19 Scarfs, embroidered 100 Sunbonnets, small 10 Towels, hemstitched 118 Towels, embroidered 93 Towels, with crochet 72 Towels, hemmed 78 Towels, with tatting 6 Trays, pine needle 2 Trays, reed, serving 40 Trays, with glass 13 Trays, handpainted 12 Trays, coaster 29 Table cloths, hemstitched 2 Table cloths, appliqued 1 Table cloths, embroidered 15 Tatting edge (yards) 230 Tatting insertion (yards) 5 Vases, reed 87 Total 5,030 MALE DEPARTMENT: No. of Articles Made Baskets, waste 19 Baskets, medicine 3 Baskets, small souvenir 88 Baskets, large 31 Baskets, varnished 241 Boxes, plain wooden 3 Boxes, cedar, small 7 Boxes, window 31 Boxes, window, painted 31 Boxes, knife, wooden 2 Boxes, knife, reed 4 Bookcase, of spools 1 Bread board 1 Butter molds 3 Brooms (made since April 10, 1926; prior to this date did not make them in this Dept.) 1,040 Brooms, whisk 150 Brooms, round 76 Chairs, caned 513 Chairs, painted 205 Chairs, varnished 196 Doll bedstead 1 Ferris wheel 1 Fernery, reed (painted) 1 Hose reels 2 MALE DEPARTMENT—Continued No. of Articles Made Hampers, reed 4 Lampshades, reed 16 Lamp bases, reed 8 Lamp bases, varnished 8 Lampshades, varnished 16 Mattresses made 1,135 Napkin rings, reed 116 Napkin rings, varnished 73 Pillows made 236 Picture frames 36 Reed toy sunshades 45 Reed toy sunshades, varnished 31 Reed serving trays 13 Rugs, woven 30 Rolling pins 3 Repairs reed table 1 Repaired loom 1 Repaired rug frame 1 Repaired mat frame 1 Repaired milk churn 1 Repaired hinges on cedar chest 1 Repaired clocks 8 Screen, three panel 1 Screen, painted 1 Settee caned 2 Settee cushions 2 Settee cover 2 Settee sofa pillows 2 Settee painted 1 Stools caned, small 137 Stools caned, large 23 Stools, frames 160 Stools varnished 106 Stools painted 49 Tables, card (wood) 3 Tables, cedar 1 Tree racks 3 Total 4,928 Total number of articles made in Male Department 4,928 Total number of articles made in Female Department 5,030 Grand total 9,958 Entertainments given 6