of the Hospital by Messrs. Bushnell & Co., given evidence of its entire adequacy to furnish 50,000 to 80,000 gallons per diem, nearly filling the three-inch conduit pipe by which it was brought to the reservoir in the premises. It now, however, showed seriously and suddenly the effects. of the unprecedented drouth of the past season, and indeed of the past two years, during which the whole country had suffered from a very scanty rain fall. The "Kimball spring," situated upon the same range of hills, and a little farther north, and upon which many families had been accustomed to depend, showed the same falling off, as did all wells and streams in this region.

There is a possibility that our spring may have wasted itself to some extent in other and new channels of its own finding, as occasionally happens with springs opening in a gravelly and porous soil; but there cannot, I think, be any reasonable doubt that this failure was to be attributed largely, if not wholly, to the unparalleled dryness of the preceding seasons. Through the month of February the water from the spring was reduced to a stream scarcely more than sufficient to feed the boilers, to say nothing of the thousands of gallons daily needed to keep in cleanliness and order an institution with more than 200 inmates, including patients and employees.

Through the month of March, and after the frost was well out of the ground, the flow increased slightly, but not enough to warrant me, as medical officer, in commencing the reception of inmates-too much hazard being incurred by filling such an establishment with patients, and endangering their comfort and health by subjecting them to the chances of a precarious water supply with its attendant train of disease and disaster. We have many warnings against such imprudence in the sad experiences of other hospitals in this and other countries, whose fate it has been to see their inmates swept off in appalling numbers by the pestilential vapors which are sure to be bred in hot weather, when perfect cleanliness cannot be maintained, and when the sewers and soil pipes of every kind cannot be kept free and constantly washed by running water.

This source of delay kept our doors closed, much against our will and desire, through the month of March. By the first of April we commenced, with some trepidation, to receive inmates, and began rapidly to fill up. In the latter part of the month, however, it was found necessary to commence hauling water from the river to eke out our scanty supply, and two teams were constantly kept employed in this manner for nearly two months. Even then we were obliged to use water with great economy, and it rapidly became apparent that some other source of this essential element must be found.

Vol. IV-3

Here appears the wisdom of the act of the General Assembly, approved April 16, 1869, requiring the commissioners in the location of this institution to have special regard to the following conditions :

First-There shall be at easy command upon the premises an unfailing supply of pure water, sufficient for bathing, steam heating apparatus, sewerage, and all purposes for a household of 300 persons.

Second-There shall be complete natural facilities for sewerage into some unfailing stream of water.

In the light of our experience, these provisions seem to receive new emphasis, demonstrating still more clearly the truth which has long been known but too little acted upon-that it is unwise, nay suicidal, to locate an institution of this character where it cannot have ready communication with an abundant stream of living water, which will prove a certain reliance when all other sources fail. Had it not been for the wise choice made by the Commissioners in the location of this building, we might now be laboring under the embarrassment for the want of good and abundant water, which is so keenly felt by many of the public charitable institutions of this State.

The wise and prompt decision of your Board in acting upon your convictions when it became evident that water must be secured from some more abundant source, brought with it speedy and permanent relief. Happily, good water in unlimited quantity was within comparatively easy reach, in the Fox river, flowing within 800 yards of our front, and early in May the laying of a three-inch iron pipe to the river, was commenced, and all connections made so that water was supplied to the building by July 1.

The Pump House, which was completed by the latter part of September, is situated upon the river bank, in direct connection with the reservoir of supply. It is a substantial and convenient structure, built of brick, including space sufficient for storage of coal, and planned to meet all the demands of the institution present and prospective. The reservoir is 24 feet in diameter, in the clear, and 15 feet deep. It has a capacity of 44,000 gallons. Its walls are of stone masonry, two feet thick, laid up dry. Embarrassment for want of water is no longer known to us, and the water is not only abundant but of a very clear and pure quality, being supplied in about equal parts by a spring opened in the operation of digging, and by the water of the river, which filters in through an embankment of clear gravel, some fifteen feet in width.

INCREASED WATER STORAGE.

The requirements of the Hospital, when completed, will undoubtedly render necessary additional provision for the storage of water at the building. This can be effected at any time during the coming two years, by the construction of a reservoir adjacent to the one now in use, hav

ing a capacity of from 4,000 to 4,500 hhds., which added to the present one, will give us storage room for near 6,000 hhds. or 378,000 gallons, a supply equal to the demands of the institution, when full (allowing 100 gallons per diem for each patient,) for over one week. The economy of this provision is evident, when we reflect that it takes nearly 150 lbs. of coal at each pumping to generate the steam necessary for merely putting in motion the water from the river to the building, to say nothing of the time and labor of one man while this is being effected. When once established, however, the proportion of coal necessary to continue this stream unbroken for 10 hours, is something less than four times that expended in first generating the power. The present reservoir having only a capacity of 80,000 gallons, or two days' supply for 400 inmates, exclusive of employees, it would necessitate the use of the pump every second day at a loss of 150 lbs. of coal. In having storage for four times this quantity, the pump, which is capable of raising 110 to 120 gallons per minute, would fill both reservoirs in 57 hours, giving us from 7 to 8 days supply with the consequent saving in time and labor of one man for 4 days, besides the considerable item of from 1,600 to 1,800 lbs. of coal. Viewed wholly in its economical light, therefore, the wisdom of making this provision would seem unquestionable.

PROVISION AGAINST FIRE.

Another and important reason which may be urged in favor of increased water storage, has been forcibly suggested to us in the recent burning of the Northern Ohio Asylum for the Insane-the second institution which that State has lost by fire within a period of four years. Calamities of this kind should certainly admonish us to make all possible provision against a like occurrence by having an abundance of water always in store, upon the premises, to meet any emergency, however great. Hydrants should be stationed at the most convenient point of proximity to each wing, for which proper hose should be kept always at hand, placed both outside in the grounds and inside on the stair cases. These should be connected both with the ordinary supply and with the tanks, and the pipes so arranged that the water may be played by steam power. Recognizing this importance of prompt provision against fire, your Board, early in the spring, authorized the purchase of 450 feet, two and four-ply rubber hose, 250 feet of which have been placed upon reel in the boiler room, ready for instant connection with a "Knowles "" pump, by which means a stream an inch and a quarter in diameter may be thrown in any direction, to, a distance of over 260 feet. The 200 feet of two-ply is placed upon the stair-way in the third story, a point about midway of the north wing, and connected with a fire plug coming off from the main delivery pipe from the tank above. Attachment can also be made at this point with three-inch supply pipe coming directly from

the engine room, so that should the tank become exhausted, the main reservoir and pump can be brought into requisition, and a continuous stream maintained for hours. The hose can be distributed from this point in any direction, reaching to either extremity of the wing or down. the stair-way to the basement. Similar provision, when made for each story of the present and future wings, (hose being alone required for the present one) with perhaps additional appliances in the central building, together with a system of hydrants upon the grounds, will place us in a position free from any ordinary danger on account of fire, and prove the best possible insurance to the State.

ADMISSION OF PATIENTS.

For more than a year previous to the opening of the Hospital, applications from all sections of the northern half of the State were coming in from friends of patients and from various county authorities, these latter making application for numbers of insane, ranging from two to ten, contined in their alms-houses and jails. The most urgent and needy of these cases were admitted, such discrimination as was practicable being exercised when it was impossible to receive more than a small part of the whole number. Filling up in this way, we acquired a very large preponderance of chronic cases. Many of those admitted had been previously treated in Jacksonville, and discharged as incurable. The average duration of the disease in the cases received during the first four months, was as high as six years, while in those received in the second four months it was only two years. To afford some slight relief to the Cook County Asylum, we received 13 male and 8 female patients from that institution, besides admitting many cases from the county at large. We also received by transfer from Jacksonville, on the 2d day of July, 40 patients, 32 males and 8 females, belonging to the northerly counties of the State. Having but one wing completed and yet being compelled to admit both sexes, we have devoted the first and second floors to male patients, and reserved the third for females. This involves very incomplete classification especially of our female patients, for whom we have but four wards, while there are but seven for the males, whereas the unanimous voice of those who have had the largest experience in the treatment of the insane, demands that there shall not be less than eight distinct divisions for each sex, as is clearly set forth in section VII. of the "Propositions" enunciated nearly 20 years ago by the Medical Superintendents of American Institutions for the Insane, which proposition reads as follows: "VII. Every hospital having provision for two hundred or more patients, should have in it at least eight distinct wards for each sex, making sixteen classes in the entire establishment." And supplementary to this is an additional declaration made in 1866, which reads as follows: "The facilities of classification

or ward separation possessed by each institution, should equal the requirements of the different conditions of the several classes received by such institution, whether these different conditions are mental or physical in their character."

This imperfection and incompleteness of classification is one of the many powerful arguments in favor of the earliest possible completion of this building, which will be dwelt upon at greater length however in another portion of this report.

GENERAL NEED OF INFORMATION.

It is extremely desirable that the public should become generally informed of the immense advantages of prompt action in placing the insane under proper treatment at the very outset of their malady. In a large majority of the cases here received we are obliged to regret that the most favorable time for treatment is already past when the patients present themselves. A more general diffusion of knowledge in the public mind, both of the nature of insanity and of the management of the institutions where it is treated, will, without doubt, dispel many fears and prejudices now entertained, and result in the promptest possible action of those interested. The universal experience of hospitals of this character is to the effect that of cases admitted within the first three months 70 to 80 per cent. are restored, while after one year has elapsed only 30 to 40 per cent. recover.

Insanity is a disease like other diseases, but it affects the man at his most vital and vulnerable point, and its issue is a matter of graver concern than that of ordinary physical disease. It can be most wisely and efficiently treated in hospitals built especially for that purpose, and by physicians of special skill and experience in its management, who have at command all the resources which science and charity combined have placed in our hands.

Not only is the individual thus a great gainer, but the State is profited at the same time, for the difference in actual cost between treating cases at once and after months have passed away, is considerable. In the first place those treated within the first year require fully one-half less time for their restoration; they then return to the community and become producers and self-supporters, while those who only receive tardy treatment have far less chance of recovery, require an indefinitely prolonged sojourn at the hospital if they do recover, and if they do not they remain for life a burden to themselves and the State as well.

EXPEDIENCY OF EARLY COMPLETION.

In endeavoring to bring together the considerations which I believe should actuate the policy of the State in reference to this institution I am sensible that the simple truth, if rightly presented and fully com