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To His Excellency, Honorable George K. Nash, Governor of Ohio:

SIR: The Board of Trustees of the Ohio Hospital for Epileptics presents for your consideration this chronicle of the thirteenth year of the institution's history, ending November 15, 1903. Our report is supplemented and amplified in certain particulars by that of the Superintendent, to which your attention is respectfully invited.

The two years of our trusteeship have been marked by a number of changes both in the personnel of the working force and in methods of administration. Of the wisdom of these changes we feel that most satisfactory evidence exists in the spirit of industry and harmony that pervades the whole institution, reflecting itself in each of the principal departments; and in the many improvements already effected, in progress, and in contemplation. We shall make brief mention of some of the improvements, leaving their more detailed consideration for the Superintendent's report.

In his annual statement closing the first year of his superintendency, November 15, 1903, Dr. Ohlmacher brings to the Board some figures of the business transactions conducted by himself and by the steward, Mr. Barnes, which we submit to you and to the public with particular pride. The detailed showing appears in the financial officer's report. It is the comparative exhibit, compiled with perfect accuracy from the records of the hospital, that makes the most significant showing. Here it appears that the net sum used for current expenses for the year 1903 has been $121,422.48, which is $9,962.09 less than for 1902, and $14,843.09 less than for 1901. Simultaneously with this marked reduction in current. expenses the daily average attendance of patients actually in the hospital has increased 44 over 1901, and 43 over 1902. On November 16, 1902, there were 866 patients actually in the institution; on this same date, 1903, the number is 929. What these figures mean will be seen by our per capita cost of maintenance. Basing this figure on the average daily attendance of actual inmates against total current expenses with officers' salaries and trustees' expenses, our per capita for 1903 is $168.19. This is $17.08 less than for 1902 based on the same factors, and $26.56 less than for 1901. Were the calculations based on the current expenses alone, even better results for 1903 would be obtained, since our expenditure in officers' salaries has been larger than in the previous years because of the increase through the new salary law. This table shows the various figures more fully:

What particularly pleases us is that this saving, comparatively so remarkable, has been effected without a penurious handling of the finances and during a period of high prices for commodities, especially as compared with 1901. We believe that our inmates enjoyed a standard of living of a superior grade and that they have had more amusements and recreations than ever before. We have augmented the number of our male and female employees, and wages have been advanced in each of the several departments as shown by the increase of $1,894.00 in the year's pay roll for male employees over that of 1902, and an increase of $1,228.00 in the female pay roll over that of 1901. A policy of reasonable economy, we believe, explains the excellent account made by the Superintendent and Steward, even in the face of marked advances in the cost of certain indispensable articles. Thus, while we are paying 35 cents a ton more for coal than in 1902, our coal bill is but $626.00 more, meaning that 1,065 tons less have been consumed. Our fuel and light as a whole cost us $1,088.00 more than for 1902, and $1,159.00 more than for 1901 because of the advance in the price of coal, gas, and coke. Our milk bill has advanced over $1,000.00 above that for 1901 and 1902, the larger consumption occasioned by an increased number of inmates explaining the difference. To offset these unavoidable advances, a study of the financial officer's statement will show that material reductions have been effected in such items as groceries, dry goods, canned goods, vegetables, drugs, clothing and underwear, moderate as compared with 1902 and more striking as compared with 1901. On the other hand, our expenditures for amusements are decidedly in advance of those for the preceding two years.

We are much impressed with the importance of the medical aspects in the management of the institution which were so prominently presented

Officers'

salaries

TABLE MAKING COMPARATIVE FINANCIAL EXHIBIT.

with

Trustees' expenses.

Per capita based on total

expenditures for current

expenses

salaries

and
with

expenses.

officers'

trustees'

Per capita based on net

current expenses and of

ficers'

salaries

with

trustees' expenses.

in Dr. Ohlmacher's last report, and we feel that these affairs are now going forward in a way that promises to fulfill the expectations concerning the institution which the medical profession of Ohio and of the country. at large entertains. The arguments for a hospital for acute medical and surgical cases, and for a separate morgue and laboratory building, together with a good equipment for them, meet our hearty approval, and we hope they will receive favorable consideration from the legislature. The plea for a recreation building is also one that we heartily endorse, feeling that our duty toward the afflicted entrusted to our care cannot meet the full medical requirements without providing liberally for their entertainment, recreation, and physical training. The Superintendent's plan of combining in one building the amusement and assembly hall, gymnasium and hydrotherapeutic establishment seems especially commendable.

Before speaking further of needed improvements, the more important of those already accomplished will be briefly alluded to. Our plans for expanding the institution by adopting the true colony idea of small independent houses have been put in execution. At our special meeting on April 23, 1903, we awarded to the lowest bidders, Caldwell & Drake & Company, contracts for five cottages and the farm house; the contract price being $68,998.00. Because of a technical error a special letting was required for one additional small cottage, which was awarded June 9, 1903, to Caldwell & Drake & Company, again the lowest bidders, the consideration being $9,133.00. Of the wisdom of the plan of future growth by small independent houses there is absolutely no question in our minds; in fact, had we not voluntarily adopted the idea, some modification of it would have been compelled because of the capacity of the central dining rooms having been reached. A series of unavoidable delays retarded the start upon the new buildings, and progress towards their completion has not been entirely satisfactory, chiefly on account of the great difficulty in obtaining material and in effecting prompt freight delivery. However, the work has advanced sufficiently to give some idea of the architectural and artistic beauty of the group of men colonists' 'houses set about the spur of the hill overlooking Mill Creek Valley. These handsome little houses, even in their unfinished state, give ample promise of fulfilling our prediction of a year ago that they would tend to inaugurate a new era of construction in the institutions of Ohio and adjoining States. For the care of the better class of patients they will offer a happy combination of homelike features and artistic settings quite unknown at present in the state hospitals of the western and middle United States. For its peculiar purpose of affording suitable habitation for thirty or forty working patients, the farm house promises to satisfy our requirements. The new cottage for women, in which we plan to place our younger girls, presents a number of improvements over the older cottages, though, on account of its proximity to the somber stone. buildings of the older group, we have aimed to make it depart but little

from them in color and style. The three buildings whose completion and furnishing were announced last year are now in use, the remaining ward in the cottage for men ("Cottage H") having been opened in July. Extensive alterations and repairs have been made on the steam lines radiating from the power station to the buildings on the main campus, but even with these alterations we must soon renew the steam mains in the principal tunnels. A new 231 H. P. Babcock and Wilcox boiler with Dutch oven furnace and boiler feed-pump has been obtained and placed in operation. A two-phase alternating 150 K. W. generator of the very latest and most approved type, direct connected to a 230 H. P. high-speed single-cylinder automatic engine, together with a 10 K. W. direct connected exciter set, and switchboard panel, has been successfully installed. The small stable which we propose ultimately to use as a tool house has been built; and the burned industrial building repaired as far as the available funds would permit. With the money made available by an emergency' appropriation, our fire protection has been improved-fire extinguishers, standpipes, extensions to unprotected buildings, additional hose, hosereels, ladders, and firemen's equipment have been procured. Another emergency appropriation has provided us with a new and sanitary slaughterhouse built of brick with cement floors and side walls, with abundant water supply, good drainage, fences, and new scales.

Under the skillful direction of Mr. Barnes our newly acquired farm has been much improved by under-drainage, and by a course of treatment directed to revitalizing the considerably impoverished soil. We believe that the saving effected by the additional farm products from this land already makes itself perceptibly felt in our current expenses, and as the farm responds to the scientific handling accorded it this influence will become more evident. A new floor, new beams, and a new steel ceiling have been added to the amusment hall and female serving room, necessitated by the damage wrought by steam from the warming table. The lifelessness of the older stone buildings has been relieved by painting with appropriate colors the window frames, doors, porches, etc.; and the roofs and valleys of all the buildings have been repainted and the walls and ceilings of a number of the old buildings have been tinted in water colors. A very marked improvement of the main grounds has been effected by the year's grading and planting. An extensive orchard of cherry trees, apple trees and peach trees has been set out on the hillsides of our grounds, together with shrubs and plants of blackberries, raspberries, and strawberries.

The foregoing are in brief some of the features of the year's showing submitted to us by the Superintendent in his annual statement. We would now bring to your notice Dr. Ohlmacher's report of our needs for the ensuing two years which we shall, with your sanction, present to