water which now costs ten cents for one thousand gallons would be purchased for seven cents. The six inch main would also furnish ample water for protection from fire, which the present does not.

The Independence hospital also needs aid to finish and furnish the kitchen and building. It will not require a large amount of money to make this important department complete and of sufficient capacity to meet the wants of the institution. The improvements contemplated by the Superintendent are absolutely necessary, and your Committee hopes he will not be prevented in making them for want of funds.

The laundry department at Independence is also very incomplete and inconvenient, subjecting the officers to much inconvenience and rendering the work in this important department much more imperfect and laborious than it should be. The laundry improved as desired and contemplated, the necessity for doing any part of the washing for patients in the wards, as now has to be done, can be entirely done away with, much to the advantage of all concerned. The wards should be homes to the patients and not wash-houses nor laundries; hence the necessity for the most ample provisions for this work being done exclusively in one apartment, separate from the living rooms of the patients.

A new coal shed is among the important wants of the hospital at Independence. The present shed is worn out and practically useless as a place of storage for coal. Twice during the past year spontaneous combustion took place, and a great number of tons of coal had to be thrown out of the shed in order to get at the fire. The combustion was caused by moisture from the plank in the floor resting on the ground, as also we think from the coal becoming wet from the leaky roof. The same thing is likely to occur in these sheds at any time, entailing a loss in coal, and endangering a still greater loss by communicating fire to the main structure.

TILING.

There are many acres of land on the Independence farm practically useless, but which with proper drainage by tiling could be made productive and valuable-the best land in the farm. It is not economy for the State to let this land lie, as it has for years, practically useless when more land is so badly needed. The Superintendent contemplates tiling and thus reclaiming all this wet land and making it available for the needs of the institution. We trust no short-sighted policy on

part of our legislature will prevent his doing this at the earliest possible day.

The Superintendent of the Independence hospital is also desirous to complete changes to supply low-pressure steam heating. These are necessary from an economical stand-point and should be made.

PIANOS AND BILLIARD TABLES.

A request for funds to supply an asylum for the insane with pianos and billiard tables may seem strange to the average citizen who knows little or nothing of the plans, aims and operations of these institutions. What we have said elsewhere concerning the amusement of patients applies with equal force to music and games. In the convalescent and hopeful minds these are never ending sources. of amusement and entertainment. It must be remembered that there are in every institution of this character a large number of patients of highly cultivated minds, some of them musical experts, and all of them lovers of music, while the average patient finds in music a rich source of amusement and pleasure. The curative influence of music upon some classes of insane persons need not be enlarged upon, as since the days of Saul and Jonathan the good effects of music upon diseased intellects have been acknowledged. Playing billiards and other games are a prolific source of pleasure and amusement, especially in winter, to a large class of patients, and serve to make the hospital a home. Billiards is a favorite game with many of these patients, and the good effects of this and kindred amusements cannot be ignored. Your Committee is convinced that pianos and billiard tables are not among the things which could be dispensed with without harm; but rather that more of them should be in every hospital for the insane, as they, with other amusements, have a very salutary influence and are especially serviceable and beneficial during the long winter days and evenings, when outdoor exercise or work is impracticable. In summer the patients have croquet, base ball, lawn tennis and other outdoor sports; but in winter, billiards and kindred games, with music, reading, etc., must be their principal sources of amusement. Without them, the minds of many must be practically dormant, and the good effects of treatment by exercise, etc., outdoors must be in a great measure lost during the winter. Money spent for these things is as well spent as for any other purpose in the treatment and care of the insane, and there should be no narrow-guage policy concerning them.

In addition to what we have already mentioned, your Committee desires to call attention to the need of elevators in our hospitals, especially for the female wings. Many of the patients in the upper wards have physical ailments, peculiar to their sex, which are greatly aggravated by walking up and down stairs. They are obliged to ascend and descend several flights of tiresome steps each time they leave their wards for work or outdoor exercise. It is a question in the minds of your Committee if the injury caused by this does not more than counteract, in many cases, the good results expected from outdoor work or exercise. The cost of elevators would be small, but the good results from them would be great.

Another thing your Committee would suggest is the removal of the morgue at Independence from its present locality. It is now situated directly under the dining room of ward "C." It does not require a very wide stretch of imagination to anticipate what might be the results from the presence of dead bodies here for any length of time, as in the case of autopsies or intricate scientific examinations. To avoid the possibilities of any bad results from this source, we recommend that a suitable place, outside the hospital proper, be prepared for the morgue.

COMPLAINTS AND CHARGES FILED BY PATIENTS.

Your Committee has carefully and thoroughly investigated all complaints or charges made orally or by letter, from patients, as to bad treatment received from officers or attendants. In a few instances we have found just cause for these complaints, but the greater portion of them were imaginary. In our investigations of these cases we have always found the Superintendents ready and willing to afford us the best opportunities and the largest liberty, with no attempt to conceal anything or excuse any dereliction of duty on part of attendants or employes. And in all cases where the cause of complaint was found to have foundation in fact, we have found the officers ready and willing to adopt the suggestions and recommendations of your Committee for the removal of all sources of dissatisfaction among patients. As regards causes for complaint of harsh or unjust treatment from any of the patients, your Committee is glad to say that they are the exception and not the rule in the management of the institutions. They result, as a rule, from the impossibility of the Superintendents having constant personal supervision over every in

dividual attendant in every ward, and the impossibility of at all times getting attendants and employes adapted to the care and treatment of insane persons. Prompt dismissal quickly follows every case of harshness, unkindness or any act savoring of abuse of patients by any employe. Your Committee is deeply impressed with the importance of securing competent attendants for the wards. They should be persons of mature age and judgment, endowed with a decided tact, if not a love, for the work. We are aware of the difficulty of securing such attendants, especially at the wages paid, but we are convinced that if really competent persons were offered inducements sufficient to retain their services from year to year, many of the causes of complaint would be removed. To this end the appropriations should be sufficiently large to pay competent persons fair salaries. It may be economy on part of the State to secure and retain cheap attendants for these unfortunate wards, but it is not in the interests of humanity. Your Committee would earnestly urge reform in this particular.

SPECIAL ATTENDANTS FOR THE SICK.

We would also urge the necessity for more liberal provisions for special wards and special trained nurses for the care of the very sick, day and night. This important matter has not been entirely neglected, but the plans and provisions are not as thorough and complete as they should be. The appropriations for the current expenses of the institutions should be sufficiently large to meet any ordinary expense for this service.

CONFINING INSANE PERSONS IN JAIL.

As a result of our familiar personal intercourse with the patients, your Committee is deeply impressed with the gross injustice and positive harm perpetrated by incarcerating insane persons in the county jails and in city prisons pending their examination, or their being sent to the hospital. The impressions made are baneful and lasting. Many of them are impressed with the belief that they have committed some crime for which they have been put in jail. This impression they carry with them to the hospital, and in many cases is intensified on their arriving there, they fully believing that the hospital is a prison, and that they have been put there as a punishment for crime. It requires no argument to show the pernicious

effects of this treatment, and the barrier it may prove in effecting mental restoration. Your Committee cannot admit that there are any number of insane persons whom it is necessary to place in jail for safe keeping; and yet it is the common practice for officers, and often relatives and friends, to place them there, and it is a common practice for officers en route to the asylum who are obliged to stop in a city over night, to make a train in the morning, to place the insane persons in their charge in jail during the night, that they, the officers, may be relieved of the care and sleep in a hotel. But few, if any, insane persons requiring restraint, require any more than can be had in a room in a private house or a hotel. And yet the mildest cases are often put in prisons greatly to their hurt. Placing insane persons in jail is barbarous, cruel and hurtful, and it should be made a penal offense for any officer, or other person, to put a person adjudged insane in prison pending their being sent to the hospital.

ANOTHER PERNICIOUS PRACTICE.

Another pernicious practice much in vogue with friends and officers in the commitment of insane persons to the asylums, is to deceive them as to where they are going. They tell them they are going for a ride on the cars, to visit friends; that the hospital is a hotel, where they will only remain over night, etc., etc. But few persons are so badly demented on being taken to an asylum as to not soon realize that they have been deceived, and this knowledge adds greatly to their mental irritation, and often severely interferes with the beneficial effects of treatment. On all commitment papers furnished by the officers of the hospitals there is a note advising persons in charge of insane people not to deceive them in regard to where they are going and what they are going for; and your Committee, from having heard the stories of patients as to this deception, and seen its effects upon them, would insist that its practice be aban. doned.

TRIAL BY JURY.

While your Committee has never found a patient in our asylums we did not think was technically insane at least, or who was not legally placed there, we have been impressed by conversations with patients concerning the manner of their commitment, with the importance of a more thorough investigation in some cases, for the sat