Engine for pumping water at Phelps & Barlow farms... The pumping at present is done by hand and an engine. would save time and labor. $300 00 Three hot-water generators (Dr. Tobin's)... 1,350 00 The ones at present in use are too small and are nearly worn out.. Cottage for engineer at water works.... 1,500 00 That the engineer may be near this plant in case of there being an accident or his being needed there in the night. Building new crib at river.... The one now in use has given out and it is very necessary that a new one should be substituted. Shed for housing dry lumber.. We have none at present and one should be provided for the purpose. Covering for steam pipe... Protection and economy. Fire-escape at north end of Ogden building.... Our present protection from fire is not sufficient, and in case of fire here the result might prove disastrous. For deficiency in maintenance.. Total 500 00 550 00 2,000 00 500 00 30,000 00 $68,350 00 ST. LAWRENCE STATE HOSPITAL. This hospital was partly built and opened for the reception of patients in 1890, being the seventh established in point of time. It is situated about three miles from the city of Ogdensburg, and is accessible by public stage. It has a total of 950 acres of land. The estimated value of its real estate, inclusive of buildings, on the 1st of October, 1891, was $1,400,000. The capacity of the hospital when completed in accordance with the original plans as required by the Legislature will be 1,500, at a per capita cost estimated by the architect not to exceed $1,150 The value of its personal property was $59,867.50. The number of acres of farm land under cultivation at that time was 500. The present capacity of the institution is given at 400, although accommodations are ready at the present time to bring the capacity up to 600 upon the purchase of the necessary furniture. The daily average number under treatment during the year ending September 30, 1891, was 227. This hospital is designed to represent in its structural arrangements the most advanced ideas of the present day in public hospital construction, and when completed will consist of a central hospital and administration building, together with a series of detached cottages or groups of buildings sufficiently varied in style of architecture and interior arrangement to fully meet the requirements of classification of its inmates. In designing the building the architect, Mr. I. G. Perry, has admirably succeeded in giving to them a tasteful and dignified solidity combined with durability, convenience, as well as compliance with modern sanitary requirements in the matter of heating, ventilation, plumbing, etc. The site for this hospital was wholly purchased by the State. Dr. Peter M. Wise is the medical superintendent; he was appointed in 1889. GENERAL OPERATIONS. State generally the operations of the hospital for the fiscal year ending September 30, 1891, giving the number and kind of buildings erected or completed during the year, or now in course of erection, extraordinary repairs to buildings, and other important improvements begun or completed during the year; also any new features in methods of management, together with a cursory review of the general results of the year. The first patients were received upon December 9, 1890. From that date and up to October 1, 1891, the close of the hospital year, there were 225 women and 241 men, or a total of 466 patients received. Of this number fifty-one were discharged-twenty-nine as recovered, ten as improved, seven as unimproved, five as not insane; and twentyeight died, leaving 387 patients remaining upon September 30, 1891. The daily average between December 9, 1889, and October 1, 1891, was 227 Of the 466 patients received during the year, 269 were transferred from alms-houses or county asylums. The remainder were committed under new certificates of insanity. In 128 of the admissions, the alleged duration of the insanity was under one year. Twenty-seven of the twenty-nine recoveries reported were from this number. CARE AND TREATMENT. State briefly your views on the care and treatment of the insane, with special reference to these points: 1. GENERAL CHARACTER OF MEDICAL TREATMENT. Medical treatment is furnished patients by the attending physicians on the ward, who look after their requirements. The visits are made regularly twice daily, mornings and afternoons, but in cases of sick requiring more frequent visitations, they are given as required. 2. Medicines, how prescribed, dispensed and how and by whom administered, whether by "single dose" system or otherwise ? Medicines are prescribed by recording in the prescription book or by prescription slips which are numbered to correspond to the number placed upon the bottle. All medicines are dispensed by the single dose system. 3. What class of medicines, if any, are kept on the wards and in whose custody kept? State if poisonous drugs of any kind are kept on the wards and what precautions are taken in the use of the same. No medicines are kept on the ward except in the case of some disinfectants, and they are kept under lock and key in charge of the head attendant. 4. Extra diet for sick and feeble, stating variety provided, by whom ordered and the method of insuring its reaching those for whom it was ordered. Extra diet is prescribed by the physician by a written order to the several cooks in charge of the kitchens, and a report is weekly rendered stating extra diet that has been issued, and such report must be signed by the cook and countersigned by the steward. It is also subject to examination by the attendant and any lapse can be recognized. The following is a list of extra diet to which are added such articles as may be deemed necessary by the physician. The physicians are not limited in the matter of extra diet: Milk, eggs, toast, porridge, mush, oysters, beef, chicken, mutton, corn starch, tapioca, arrowroot, farina, rice, cracked wheat, custard, apples, jelly and canned fruits. 5. Artificial feeding or forced alimentation; state the rule of practice as to (a) methods of feeding; (b) on whose order and by whom done; (c) usual length of time permitted to elapse after a patient refuses to eat before feeding is resorted to; (d) how often the feeding process is usually repeated in a given case during the day or twenty-four hours; (e) forms in which foods are forcibly administered. Forced alimentation is practiced: (a) By the nasal feeding tube and the ordinary esophageal tube, the food being propelled by an ordinary syringe or pumped, or by gravitation. (b) It is done upon the order of the superintendent and by the assistant medical officer. (c) The length of time permitted to elapse after the patient refuses to eat before feeding is resorted to depends entirely upon the vitality of the patient, and the necessity for nourishment. Usually forcible feeding is practiced upon the third or fourth day after the refusal of food. (d) In ordinary cases the feeding process is repeated twice during the day, but in extreme cases it is repeated at intervals of six hours, or as often as required. (e) Foods are selected that can be administered in a liquid form, and those that have the physiological elements that seem to be required by the patient, milk being the basis, unless contra-indicated. MORAL TREATMENT. 1. State the facilities provided and methods in vogue for the entertainment and diversion of patients, including (a) amusement hall, its location, capacity, kind of entertainments for which it is adapted, and whether used for religious worship; (b) variety and average frequency of entertainments given therein; (e) band of music, and, if so, whether composed of patients or employes, or both, or whether hired for the occasion; (d) number and kind of musical instruments provided for the use of patients, exclusive of those used by the band; (e) from what fund are amusements maintained or provided; (f) average number of patients who attend entertainments, and if a record of the number is kept; (g) frequency and denomination of religious worship and average number of patients who attend such worship and compensation paid to clergymen; state approximately the number of patients of Roman Catholic faith and what provision, if any, is made for their spiritual requirements, including amount of compensation paid for the same; (h) rule as to arrangement for attention to the spiritual needs of the seriously sick and dying; (2) green-houses, if any, and estimated cost of same, to what extent, approximately, are flowers and foliage plants supplied to the wards, and what class of wards are so supplied; (j) generally, the extent to which the wards are supplied with pictures, bric-a-brac and other ornaments, also song birds, if any, and if these things are supplied to any extent to the "disturbed wards;" (k) Have you a patients' library, and, if so, the number of volumes contained therein, and, approximately, the number of patients who indulge in reading books; how is the library maintained? () State approximately the number of newspapers, magazines, etc., that are taken or received for patients' use; (m) practice as to taking patients out of doors for exercise; are disturbed patients regularly taken out and how frequently? (n) Has your hospital a base-ball club, and, if so, what proportion of it is composed of patients; (0) state any other means of amusement or diversion provided for patients. There are no facilities provided by the State for congregate entertainment and diversion of patients; therefore, (a) No amusement hall being provided, it is necessary to use a day room in the infirmary for any entertainments that we may have, which I can report with a great deal of emphasis is a matter of considerable embarrassment and inconvenience, and is an actual injury to many patients occupying those rooms. (b) In the room mentioned above there is one evening in the week devoted to a social party with dancing for patients between the hours of 7.30 and 9.30 P. M. We have had also, by the erection of a temporary stage at one end of the room, an occasional concert and reading. (c) Music for dances is provided by a female patient playing the piano and two male employes playing the violin. No music has been hired for these occasions. (d) One piano. (e) There is no fund for amusements and no money has been expended for this purpose. (f) The average number of patients attending entertainments is 128. A record of the number is kept. (g) Religious service is held in the day-room mentioned above at 3 P. M. on Sunday of each week. The average number of patients attending such worship is about 120. No compensation is paid to |