To the Ohio Board of Administration, Columbus, Ohio.

GENTLEMEN:-I have the honor to submit the thirty-ninth report of the Athens State Hospital for the fiscal year ending November 15, 1914. On November 16, 1913, the beginning of the year, there were present in the hospital 725 men and 667 women-a total of 1,392, and there were 11 visiting-8 men and 3 women, making the total enrollment 1,403 -733 men and 670 women. There were admitted during the year, 190 men and 127 women-a total of 317, of which number 185 men and 122 women were regularly committed by the Probate Court, and 5 men and 5 women were admitted under the Voluntary Commitment Act, thus the grand total under treatment during the year was 1,720, of which 923 were men and 797 were women. Of these patients, 270 were discharged172 men and 98 women. Of the removals, 118 were discharged as recovered-73 men and 45 women; 27 as improved-19 men and 8 women; 6 as unimproved-3 men and 3 women, and 119 died-77 men and 42

women.

The percentage of recoveries based upon the admissions for the year is 38.4% for men and 35.4% for women-an average of 36.9%.

The percentage of deaths based upon the total number under care is 8.9% for men and 5.3% for women-an average of 6.8%.

The daily average resident for the year was 1,398—an increase of 13 over last year, and there were present on November 15, 1914, 736 men and 694 women- -a total of 1,432, which is far in excess of the population at the time of any previous report. As a partial explanation of this it will be noted that there were 28 more admissions this year.

Considering the psychoses in the admissions, dementia praecox still leads. This form of insanity comprises over 30% of all the admissions for the year.

Manic-depressive is second with almost 16%; the other principal psychoses range as follows: Senile dementia 14%, toxic psychoses 10%, involution melancholia 9.5%, general paralysis of the insane 8.2%, paranoia and paranoid states 1%.

There are several variations from last year's report, which are more or less significant. Table No. 3 shows 16 cases of morphinism against 4 last year. This is due to the strict enforcement of the laws restricting the sale of narcotics and the consequent commitment of the habitues to the institution.

Fewer alcoholics were admitted this year-less than 5% as compared with 7.3% last year and 10% the year previous.

The number of cases of general paralysis of the insane received, indicate a gradual increase in the prevalence of this malady, with the continuation of the ratio of men to women of 4 to 1.

The wide variance in the age at which the individual is affected is interesting to know. One youth of 17 was admitted presenting all of the typical symptoms, while another patient had reached the age of 58 before the disease manifested itself.

We have had no epidemics during the year, and the general health of the household has been good. It is exceptional to have a case of acute psychoses succumb. The mortuary is greatly made up of an accumulation of bed-ridden terminal cases, mostly paretics, and the accession of senile cases necessarily ending in death.

During the month of December, 1913, as a prophylactic measure, all the employes and patients in the hospital were vaccinated. The great majority of these responded well, the reaction being positive and complete, and I am pleased to state that there were no serious untoward effects following, in any instance. The procedure is now a routine practice, new employes and patients being vaccinated as they come to the institution.

The total amount disbursed during the year for maintenance was $182,157.88, which makes the per capita cost based upon the daily average resident-1,398-and the above amount, $130.29. This is an increase of $3.61 over last year, but owing to the fact that there has been a change in the classification of accounting, an exact comparison is hardly possible.

The value of the products consumed from the farm and garden during the year, including the production of milk and pork is $20,555.88, which is equivalent to a per capita cost of $14.70, making the gross per capita cost $144.99.

The ministers of the various denominations in Athens, have conducted religious services in the chapel as in the past. Memorial day was duly observed by a short service in the chapel after which those in attendance marched to the hospital cemetery where all the soldiers' graves were decorated with flowers.

Recent acquisitions have been made to our library, which now contains over one thousand volumes of fiction, history and science. Twice each week patients are permitted to come to the library and exchange books. The popularity of this diversion has resulted in its becoming one of the principal hospital features.

The hospital orchestra continues to render music for the dances, moving picture shows and other entertainments, and contributes very greatly to the pleasure of the patients.

Last winter another victrola was purchased and placed on rubber tire trucks to facilitate its being taken to any department in the hospital. New and up-to-date records have been added from time to time, and I am pleased to state that the two victrolas now in use have afforded the patients an inestimable amount of pleasure.

Athens

In August a moving picture machine was installed in the amusement hall, since which time picture shows have been held weekly. This form of entertainment is growing in interest and always brings out a large attendance. The weekly dances have been conducted as in the past.

The Fourth of July was again a day of pleasure for the patients. It was celebrated on the lawn where various field sports interspersed with selections by the hospital orchestra were enjoyed. Prizes for the successful contestants were given, which encouraged a spirited, but friendly rivalry. While the athletic events were in progress, refreshments consisting of fruit, cake and lemonade were served the patients.

MEDICAL WORK.

There has been no change in the medical staff during the period of this report.

In May, Dr. W. H. Vorbau, resigned to enter private practice in Columbus, but after a month's absence returned to the hospital service.

Nothing new has been instituted in the way of treatment. Drugs are gradually being placed further in the background and we are prescribing more hydrotherapy and diversional occupation than ever before.

Special attention is given the care and treatment of tubercular patients and the detection of incipient cases. The segregation of these patients in a suitable environment with appropriate diet and medication, has been productive of much good. Not only have many cases apparently recovered or shown a complete arrest of the tuberculous process, but there has been a gradual decrease in the mortality rate during the past three years. In 1912 the percentage of deaths from tuberculosis was 2.2%, in 1913, 1.6% and the current year, 1.5%.

All patients whose physical condition will permit, are encouraged to engage in some light employment. The large farm in connection with the hospital together with the dairy and the numerous other industries afford splendid opportunities for diversified employment for all the patients. We continue the policy of employing an industrial teacher for the women patients. The class is made up of both willing and unwilling workers since by such combination, I believe, more satisfactory results can be obtained. A display of their handiwork was publicly exhibited at the state fair and articles sold in the sum of $150.00. The proceeds go toward maintaining the class with new material and providing entertainment for the patients. Also, many useful and ornamental articles have been made for the hospital, not to mention the therapeutic benefit derived from the employment of the class, which is inestimable.

It is our policy to give the patients as much privilege and liberty as