Sobel, Dr. Nathan, medical interne in Kings Park State Hospital, resigned September 30, 1918, in order to take up a course of training in general medicine in one of the New York hospitals. Sperber, Dr. Irving, was appointed medical interne in Manhattan State Hospital, December 1, 1918. Spradley, Dr. J. Brutus, medical interne in Binghamton State Hospital, resigned December 20, 1918, to accept a position. in a general hospital in Rome, N. Y. Steckel, Dr. Harry A., of the Medical Corps, United States Army, returned to his duties as assistant physician in Kings Park State Hospital, May 7, 1919. Stough, Dr. Dowling B., Jr., medical interne in Binghamton State Hospital, resigned March 1, 1919, to take up his residence in Arkansas. Stout, Dr. E. G., having purchased an interest in Craig House, Beacon, N. Y., resigned as acting first assistant physician, Utica State Hospital, June 30, 1919. Swierat, Dr. John V., medical interne in Kings Park State Hospital, was promoted to assistant physician, July 1, 1918, and called to military duty at Fort Oglethorpe, Georgia, July 6, 1918. Szeto, Dr. Henry C., appointed medical interne in Manhattan State Hospital, July 1, 1918; was promoted to assistant physician, November 1, 1918. Taddiken, Dr. Paul G., superintendent of St. Lawrence State Trenkle, Dr. Henry L., appointed assistant physician in Hudson River State Hospital, July 9, 1918, resigned August 31, 1918, to take a position as physician-in-charge at Sanford Hall; was reappointed at Hudson River State Hospital, May 15, 1919. Vaux, Dr. Charles L., senior assistant physician in Central Islip State Hospital, returned from military service April 4, 1919. Veeder, Dr. Willard H., senior assistant physician in Rochester State Hospital, received a commission as captain in the United States Medical Reserve Corps and was detailed to the army laboratories at Yale University, October 12, 1918. Vermilyea, Dr. Sidney C., assistant physician in Hudson River State Hospital, was granted leave of absence to enter the military service in which he was commissioned as first lieutenant in the Medical Reserve Corps; died November 2, 1918, from wounds received with the A. E. F. Wearne, Dr. Raymond G., assistant physician in Willard State Hospital, was transferred to Brooklyn State Hospital and promoted to senior assistant physician, September 1, 1918. Worden, Dr. Rollin D., was appointed medical interne in Kings Park State Hospital, March 10, 1919. Worthing, Dr. Harry J., assistant physician in St. Lawrence State Hospital, who had been overseas on military duty, returned to the hospital, April 3, 1919. Wright, Dr. William W., clinical director in Manhattan State Hospital, resigned August 22, 1918, having been appointed first assistant physician in Buffalo State Hospital. RETIREMENT FUND The fiscal year just closed proved to be a favorable one for the retirement fund of the State hospital officers and employees. The retirement reserve fund on June 30, 1919, was $319,137.80 as compared with $251,809.06 at the end of the previous year. The increase was $67,328.74, or 26.73 per cent. Since the establishment of the fund on July 1, 1912, 333 employees and one officer have been retired on annuities. Forty-eight of these annuities were subsequently canceled by death or otherwise, leaving a total of 286 annuities in force on June 30, 1919. The average annuity granted is $386.93 and the average service of the officers and employees retired is 26.06 years. Through the conservative management of the Retirement Board, the fund is on a firm financial basis and there is every indication that it will prove ample to meet every just claim made upon it. EMERGENCY ADMISSIONS In order to insure the proper care of patients prior to commitment in sections of the State where psychopathic hospitals are lacking, the Insanity Law provides that emergency cases may be admitted to State hospitals on the certificate of two medical officers or at the written request of a health officer. These cases are discharged at the expiration of ten days if not regularly committed within that time. The emergency cases of the fiscal year numbered 558 and were distributed among the hospitals as follows: The voluntary admissions to the State hospitals, which had steadily increased for several years past, suffered a decline in 1919 there being a total of 402 voluntary cases, as compared with 490 in 1918 and 452 in 1917. The 402 cases were classified as follows: First admissions, males 94, females 103, total 197; readmissions, males 95, females 110, total 205. In 53 cases the mental condition of the voluntary patients made commitment necessary. Tables showing the voluntary admissions for each of the State hospitals and the psychoses of the voluntary cases are given in the statistical section of this report, page 269. PREVENTION OF MENTAL DISEASE During the recent war two opposing influences were at work; the one tending to increase mental disease, the other tending to lessen it. The war gave rise to great mental stress which, although most severe on the soldiers who went to the front and participated in the fighting, was felt by almost the entire population. The excitement, anxiety and grief as well as the mental conflicts caused by the war were undoubtedly precipitating factors in many cases of mental disease. Among soldiers the neuroses were the most common mental disorders but cases of dementia praecox and manicdepressive insanity were not infrequent. The intense study given the war neuroses has thrown new light on the whole subject of the causation, course and treatment of all forms of these disorders. In order to safeguard the health of the American army, the liquor traffic was restricted during the war and strenuous efforts were made to check the spread of venereal disease. The action. thus taken has had considerable influence in lessening mental disease. The effects of the reduced consumption of alcohol is seen in the decrease in the number of cases of alcoholic psychoses among first admissions to the civil State hospitals from 594 in 1917 to 354 in 1918, and to 269 in 1919. More time must elapse before the effects of the campaign against syphilis will be reflected in our hospital admissions as the onset of syphilitic psychoses does not usually occur until several years after the primary infection. If the efforts made by Federal and State health authorities to check venereal disease are maintained, there can be no doubt that in the course of a few years the new cases of general paralysis and cerebral syphilis will be much reduced. It is believed that the mental clinics established at the principal centers of population in the State will check the development of many incipient cases of mental disorder. These clinics suffered a decline during the war but are now being restored and will be more active during the coming year than ever before. The beginning of more fundamental work is seen in the widespread movement for the teaching of mental hygiene in the schools and for the general dissemination of correct information concerning the preservation of mental health. There are some indications that the rate of incidence of insanity is not at present increasing but the matter cannot be definitely determined before the 1920 census of population is published. MENTAL CLINICS The mental clinics of the State hospitals, which during the past three years have become important agencies in the prevention of mental disease, suffered temporary decline during the period of intense war and during the influenza epidemic. At the close of the fiscal year, however, the regular schedule, with few exceptions, had been restored and it is anticipated that the coming year will witness substantial progress in this field of work. A summary of the reports of the out-patient departments shows that a total of 7,203 visits were made to clinics held by the State hospitals during the year. Of these, 2,628 were first visits and 4,575 return visits. Paroled patients made 5,102 visits and discharged patients 265, and other patients who had no previous connection with the hospitals, 1,836. Of the latter, 1,088 were first visits. Of the 7,203 visits, 1,532 were made for advice or treatment, 517 for advice concerning others and 5,154 to report progress and consult with physicians. A movement is under way for the establishment of joint mental clinics through the co-operation of the State Department of Health, the State Education Department, the State Commission for Mental Defectives, the State Board of Charities, the State Probation Commission, the State Commission of Prisons and this Commission. It is felt that such a joint clinic should be located at each of the principal centers of population of the State. The functions of the joint clinic would include the following: Examination of retarded and psychopathic school children. Examination of juvenile delinquents, and adult delinquents whose behavior indicates mental disease or defect. Treatment of persons having incipient nervous or mental disease. Treatment of syphilitic patients. Giving advice and help to discharged or paroled patients of State hospitals. Giving support and encouragement to delinquents paroled or placed on probation by courts or penal institutions. A statistical report of the visits made to the clinics held last |