sistant Physician. The position of fourth assistant physician is at present vacant but is expected to be filled soon.

ILLINOIS.-The Department of Public Welfare, with the co-operation of the Cook County Commissioners, has opened the Juvenile Psychopathic Institute at the Cook County Psychopathic Hospital. An out-patient clinic will make examinations of children who may be brought by parents or guardians, sent by the County or Juvenile Courts, or by the Juvenile Detention Home. If longer examination or treatment is necessary the child may be admitted to the Institute for a period of 10 days or less. There are two wards, each having twelve beds, for the two sexes. After-care and follow-up work will be carried on with the assistance of the state parole officers, the probation officers of the courts, and the social agencies of Cook County.

The Department of Public Welfare has also established a state-wide plan of occupational therapy and has appointed Mrs. Eleanor Clarke Slagle as General Superintendent in charge of this work. A Superintendent of Occupational Therapy has been appointed to each of the state hospitals, who is a staff officer and has charge of the occupational activities in that institution. Assistants are provided and there is also provision for volunteers.

A Training School for Psychiatric Nursing has also been established at the Chicago State Hospital.

-Alton State Hospital, Alton.-The Alton State Hospital was founded in 1911 and the site comprises 1034 acres acquired at a cost of $200,000. The ultimate plans call for 50 buildings, of which 10 are completed and in use.

It is located in the southwestern section of the state and is designed to meet the needs of the rapidly expanding population of the Illinois territory adjacent to St. Louis.

A small colony of 35 working patients had been maintained in one of the principal farm buildings since 1914, but the institution was not really opened until July, 1917, when the new Department of Public Welfare took charge of the state charitable institutions. From that time its growth was rapid and on February 1 of the present year there were 640 patients present, mostly drawn from the other state hospitals.

The buildings are fire-proof throughout and are modern in every respect. The central utility buildings are capable of serving a population of 5000.

During the current year every effort will be concentrated on intensive farming. An extensive field of winter wheat has been supplemented by 50 acres of spring wheat, and there will be a large acreage of corn and other grains. It is expected that the yield will far exceed the needs of this institution and that through the interchange of institution commodities, sanctioned by the department, much produce will be sent elsewhere.

This is perhaps the only state hospital that has never had a bar, grating or netting on any window or door. Others have removed these evidences

of imprisonment, but this institution was built without them and in no future extension is it proposed to resort to them.

The radical change in environment experienced by patients not used to this unusual freedom resulted in numerous escapes, but as the attendant body becomes more thoroughly organized and greater vigilance is observed it is expected that these occurrences will cease or be reduced to the minimum.

-Chicago State Hospital, Chicago.-On October first there will be opened a Training School for Psychiatric Nursing to provide nurses for all of the Illinois state hospitals. Applicants must be between 20 and 35 years of age and shall have had, at least, the equivalent of four years of high school work. The first and third year work will be carried on at this hospital, the second year at a general hospital. Graduates will be entitled to state registration. The customary four months course for attendants will continue, and in addition, there will be a second year course with four months of lecture work, leading to certification as Charge Attendant.

A Superintendent of Occupational Therapy has been appointed who has two paid assistants, and from eight to 10 volunteer workers are sent to the hospital for periods of varying length as a part of their instruction, practice teaching, in the Henry B. Flavill School of Occupational Therapy, and also in connection with Red Cross training of those who have volunteered for service in government reconstruction work. At present work is being carried on in five wards with occupational classes in the mornings and gymnastics, dancing, and games in the afternoon. About 300 patients are being treated in this way.

It is expected that within a month or two alterations will have been completed in the old power plant which will then be used as an occupational center.

A new hospital car has been built by the Chicago Railways Company at a cost of $16,000, to be used for the transportation of patients from the Psychopathic Hospital to the state hospitals at Dunning, Elgin, and Kankakee. It has accommodation for 24 men patients, having seats for 20 and cots for four, and 14 women patients, 12 sitting and cots for two. The car has two toilet rooms. Doors are provided at the ends through which stretchers may be carried.

-Illinois Colony for Epileptics, Dixon.-The colony was opened for the reception of patients in May. It consists of 17 buildings on a tract of 1100 acres on Rock River, above Dixon. It is expected that eventually 2000 patients will be accommodated. Dr. Henry B. Carriel is Superintendent.

INDIANA.-Central Indiana Hospital for the Insane, Indianapolis.-During the summer this hospital was obliged to refuse the reception of patients and place them upon a waiting list. This was caused by the overcrowded condition of the hospital and the scarcity of labor. The number of patients is over 1500.

KENTUCKY. As a result of a survey conducted by Dr. Thomas H. Haines for the National Committee for Mental Hygiene a bill was passed by the legislature providing a training school and colony farm for feebleminded and epileptic persons.

MAINE.-Augusta State Hospital, Augusta.-This hospital has established a clinic for mental and nervous patients to be held each Wednesday in the City Hall, Portland. It will be open from 10 a. m. to 4 p. m.

MARYLAND.-Spring Grove State Hospital, Catonsville.-Governor Harrington approved an appropriation of $80,000 for the equipment and completion of the new psychopathic building at this hospital. It has been offered to the government for the use of soldiers and sailors suffering from mental and nervous diseases.

-Sheppard and Enoch Pratt Hospital, Towson.-At the 12th annual commencement of the Training School for Nurses of this hospital, held May 22, 1918, a portrait of the Physician-in-Chief and Medical Superintendent, Dr. Edward N. Brush, was presented to the hospital. Dr. William Rush Dunton, Jr., Senior Assistant Physician, made the presentation on behalf of over 350 friends of Dr. Brush, who had subscribed for the portrait, which had been painted by Mr. Thomas C. Corner, a Baltimore artist. Dr. Charles H. Riley, President of the Board of Trustees, accepted the portrait for the hospital.

MASSACHUSETTS.-By an act of legislature the Commission on Mental Diseases is empowered to make contracts with the federal government for the support of soldiers and sailors who become mentally ill and cannot be properly cared for at the army post or naval station or hospital where they may happen to be. These may be received by the superintendent of any state hospital upon the written application of the officer in charge.

-Gardner State Colony, East Gardner.-The fourth annual cattle show and fair was held at this hospital on September 10 and 11. The first date was for the benefit of the patients, the second for the general public, of whom about 1800 attended. The proceeds, about $500, were contributed to the Gardner Chapter of the American Red Cross. There was but little change in the program each day. There were midway attractions, flying horses, athletic games, band concerts, a baseball game, contests of draft horses, threshing demonstrations, and parades. This last had more than 30 features. By visiting this fair the public becomes familiar with the aims and results of this institution and with the care of the insane in Massachusetts as a whole.

MICHIGAN.-On March 28, 1918, the supreme court of this state declared the act of legislature of 1913 which authorized the sterilization of mentally defective inmates of public institutions to be unconstitutional, as it was class legislation.

-Kalamazoo State Hospital, Kalamazoo.-This hospital has furnished its quota for army service, a trustee, five assistant physicians, and 54 nurses, attendants and employees having enlisted.

The institution, with the co-operation of the probate courts and charity organizations, conducts monthly clinics in Kalamazoo, Grand Rapids, Jackson, and Lansing. Calls for service of this kind have come from several places outside of this hospital district. The work has not yet been authorized by the state. It was inaugurated by this hospital two years ago, the counties where the clinics are held bearing all expenses.

Excepting the State Psychopathic Hospital at Ann Arbor, which started a clinic in Detroit shortly after the work was begun by this institution, no other state hospital of Michigan holds mental clinics. They have met with public approval and have become an important part of hospital service.

The hospital is also making mental tests of prostitutes who are under the surveillance of the State Board of Health as a war measure. About 100 such examinations have been made.

Occupational therapy is being developed more than ever and the recreation of patients will soon be placed in trained hands.

MINNESOTA.-Rochester State Hospital, Rochester.-An outbreak of typhoid fever is reported as having occurred recently at this hospital, 12 patients and one nurse being ill. Thirteen hundred patients and all of the employees have been inoculated against typhoid.

NEW JERSEY.-New Jersey State Hospital at Morris Plains.—Because of new legislation enacted during the last session of the New Jersey legislature a State Board of Charities and Corrections has been appointed, with general control over all state institutions, including the state hospitals. The board employs a salaried commissioner with necessary deputies. The effect upon the state hospitals has been to do away with the dual form of management which had been in effect since 1885, and they now are under a chief executive officer. Dr. Britton D. Evans who was Medical Director under the old régime for 26 years, was elected Chief Executive Officer and Medical Superintendent of The New Jersey State Hospital at Morris Plains. This step aided greatly in facilitating the work in the institution. There is better co-operation and numerous readjustments have been possible.

In the men's department of the Main Building several bath rooms have been refitted with tile walls and floors, and shower baths have been installed. In connection with the dairy a bottling room is being built. Material is on hand for the construction of a fire-proof garage and the work of digging for the foundation has begun. At the Dormitory Building new floors and plumbing are being placed in all toilets and bath rooms. This is of an impervious character and will prevent water from leaking from one room to another with consequent disintegration of the masonry. All departments of the hospital are short of help and this condition is a serious one.

The convict and criminal insane have been transferred to a specially erected custodial building in connection with The New Jersey State Hospital at Trenton.

The new classification recommended by the National Committee for Mental Hygiene and the American Medico-Psychological Association has been adopted for use at this hospital at the beginning of the hospital year, July 1.

NEW YORK.-The New York State Prison Commission has appointed a Committee on Mental Disease and Delinquency to make inquiries leading to future legislation for psychiatric facilities for the state penal and reformatory institutions.

A recent law created a State Commission on Feebleminded. Dr. Walter B. James of New York City has been appointed chairman. The other members are the Fiscal Supervisor of State Charities and the Secretary of the State Board of Charities.

The State Hospitals Commission calls attention to the fact that owing to resignations of nurses and attendants to enter government service there is at present a shortage of 1000 in the nursing staff. As it has been arranged with the federal government that the New York state hospitals will receive all mental cases arising in citizens of the state who are in army or naval service, the situation may eventually be more serious than it is at present. Every effort is being made to induce men who are ineligible for military duty to enter training as attendants, and the commission is providing a shorter training course of six months.

-Binghamton State Hospital, Binghamton.-The most important development at the hospital during the past six months has been the loss of many employees resulting from calls made by the United States Army and Navy, and the better inducements in the way of wages offered by commercial enterprises in the business world. These causes have led to a shortage of more than 100 employees much of the time, and this shortage has in turn necessitated the closing of one of the hospital buildings containing four wards, a small ward in another building and the summer camp.

On May 1, 50 women patients were received by transfer from the Central Islip State Hospital, and on June 28, 20 men patients were received from the Matteawan State Hospital, to relieve the crowded conditions of those hospitals; the transfers from the Matteawan State Hospital were in all cases patients whose offences prior to commitment to the criminal asylum were of mild character.

May 21, the Binghamton Academy of Medicine held a meeting in the hospital assembly hall, at which papers and clinical material were presented by members of the hospital medical staff.

On July 2, the graduation exercises of the school of nursing were held in the assembly hall; the graduating class numbered five.

On September 10, the Twenty-seventh Annual Field Day was held on the hospital grounds; of special interest were the facts in connection