For the purpose of special fire protection, the following appropriations are recommended, in accordance with suggestions made by the State Fire Marshal:

Although the Commission was obliged to reduce the total of the hospital requests for buildings, extensions and miscellaneous improvements from $7,720,451.17 to $1,726,000.00 the sum of all hospital estimates shows a grand total of $15,222,290.17 as against the actual appropriation of $6,725,104.93 made by the Legislature for the hospitals for the year 1913-14.

The Commission would most earnestly urge upon the Legislature the allowance of a sufficient sum for construction purposes to permit a material reduction in the dangerous over-crowding of hospital wards which now prevails. No funds whatever were provided by the Legislature in 1914 for this purpose, and the special necessity of liberal appropriations during the coming year must be apparent to every member of the Legislature who has visited these institutions particularly to the Finance and Ways and Means sub-committees appointed during the year to inspect our hospital system. Even if all items in the foregoing list for additional accommodations for patients, nurses, and attendants were granted, a total of only 1100 additional beds would be previded, representing little more than the normal increase of a single year.

INSPECTIONS OF STATE HOSPITALS AND LICENSED

INSTITUTIONS

Despite a disabling illness of one of the Commissioners, the statutory inspections of all institutions for the insane within the State have continued throughout the year, and these have been supplemented by visits of its corps of inspectors. As usual, the medical inspector has made at least four visits to each institution, and, as shown in detail in his report which appears on page 256, his activities have found a wide scope.

Complaints, signed and unsigned, against the administration of hospitals or licensed private sanitariums have been promptly investigated either by the Commission or by the medical inspector and hearings under oath have been conducted in a number of cases during the year, reference to which will be found in Dr. Ryon's report included herewith.

At each State hospital the Commissioners have held conferences with boards of managers and superintendents as to build

ing operations, finances, and other administrative matters, and prompt investigation has been made of all complaints filed by patients or their friends. The Medical Commissioner has also reviewed the work of the nurses' training schools, the adequacy of medical and lay attendance on the wards, the daily routine of the ward work, the regularity of staff meetings, and has especially examined as to the physical well-being of the patients. Careful attention has been devoted to the procedure and facilities in each hospital in the active treatment of patients adınitted for the first time, and suggestions have been made looking to the most advanced study and treatment of this class. The case histories also have been examined to determine the active interest of physicians in each patient and a basis of comparison has thus been obtained.

It would seem appropriate at this point to place on record the Commission's recognition of the spirit of devotion and self-sacrifice manifested by the great majority of our hospital physicians. When the somewhat narrowing character of the medical work is considered, together with the discouraging outcome of treatment in the mass, not to mention the lack of a pension system to provide for disabled or superannuated physicians, it is not strange to find some of our most promising assistants leaving the State to accept positions in the Federal Marine Hospital service. The Commission can only renew its strong recommendation to the Legislature for authority to establish a strictly self-supporting pension system for the physicians of the State hospital service.

As his title indicates, the inspector of engineering and buildings keeps in touch with the technical and structural features of the hospital system. Attention is drawn to his report as well as that of the inspector of supplies which appear on pages 229 to 232, inclusive.

NEW LEGISLATION AFFECTING THE DEPARTMENT ESTABLISHMENT OF THE DEPARTMENT OF ARCHITECTURE Chapter 111 of the laws of 1914 established the State Department of Architecture, the functions of which are to some extent identical with those formerly possessed by the State Architect. As certain sections of the new law contain references to similar