I by training others at great expense of time and patience. strongly recommend that they be paid adequate salaries, which salaries should not be below those of well-trained stenographers in the State civil service, and these salaries should increase according to the regular schedule for stenographers in the civil service. The scientific work in the serological department consisted in further investigations of the principles underlying the Wassermann reaction, studies which Dr. Morse embodied in lectures. given at the Psychiatric Institute. He was prevented from publishing these by his enlisting in the national service. In the chemical department the work was as follows: Two cases of general paralysis have been examined by analysis of uniform samples of the entire hemisphere, cerebellum, spinal cord, cortex and corpus callosum. Compared with the normal, the central nervous system in this disease is subject to a series of decided chemical changes involving principally certain lipoids such as the phosphatides. This indicates a destruction of the unsaturated lipoids to which belong lecithin and cephalin. There is considerable increase in the extractives (water soluble) which compensates for the loss of the lipoids, whereas the proteins are changed very little. The different parts of the central nervous system in general paralysis are affected differently, in the sense that the cerebrum exhibits the most striking chemical changes, the cerebellum approaches it only in a measure, while the spinal cord shows the least change. Again the cortex of the cerebrum shows more pronounced changes than the corpus callosum. These findings confirm in a general way those obtained by a few other investigators. These two cases of general paralysis will be reported in greater detail in a paper to be published in the Psychiatric Bulletin. A similar study was made on three cases of alcoholic Korsakoff psychosis. An analysis of uniform samples was made of the entire hemisphere, cerebellum and spinal cord. In one case the gray matter (cortex) and white matter (corpus callosum) were also examined. Compared with the normal, the central nervous system in this disease shows consistent variations, although not to the same extent as was found in general paralysis. The phos phatides, for example, which were found to be most affected in general paralysis, have been found to be little changed in Korsakoff psychosis. The sulfatides appear to have undergone the greatest change. Whether or not this is typical for Korsakoff psychosis requires further confirmation and will be carefully followed in other cases studied. In the continuation of the work on the chemistry of the central nervous system the following problems are receiving special attention (1) Perfecting the method for the oxidation of nerve tissue for the determination of sulfur and phosphorus. The direct oxidation method (using a Parr Illium bomb) is being substituted for the older fusion method. By this new method a great saving of time and reagents is accomplished. (2) Metabolic products of the nervous system. Working out of methods for the identification and study of the organic extractives present in the water soluble fraction. This is a rough index of the metabolic activity going on in the tissues. Analyses and calculations of the two additional cases of Korsakoff psychosis, and of one case of dementia praecox, are nearing completion. In the last part of the period reported, that is, since the time that Dr. Morse went to Washington, Miss Mathilde Koch, who has been doing the work on brain chemistry just detailed, has also taken over the carrying out of the routine Wassermann tests. Tempting as it might be, I purposely refrain from making any suggestions as to the further development of the work of the Institute, because I feel that this work is now in the hands of my extremely competent successor, who will and should develop the work along lines of his own. Aside from the changes in the personnel which I have mentioned above in connection with the war, the only fact to record is that Dr. Lon O. Weldon resigned in September, 1916, and that his place was taken by Dr. Thomas J. Heldt. In conclusion I wish to take this occasion to express, not only to you but to your predecessors, my deepfelt indebtedness for the helpful spirit which the Commission invariably showed toward the work of the Institute. I also wish to give expression to the appreciation which I and my colleagues feel toward the super intendents and staffs of the various hospitals for the co-operation which we continuously received from them during the entire time that I was director. All this and the friendships which I formed during my work in the State, together with the splendid opportunities for a thorough study of mental diseases that the position afforded, made the seven and a half years of my connection with the Psychiatric Institute the most enjoyable part of my professional career. Respectfully yours, Santa Barbara, Cal., January 1, 1918. AUGUST HOCH. REPORT OF THE BUREAU OF DEPORTATION To the State Hospital Commission: I beg to submit herewith the annual report of the Bureau of Deportation for the fiscal year ending June 30, 1917. Through the efforts of this department during the year the State has been relieved of the care and maintenance of 320 patients; 52 aliens and 268 nonresidents. Of this number 270 were removed from the hospitals after commitment. The remaining 50 were removed to their places of residence prior to commitment, 47 being from the Psychopathic Ward of Bellevue Hospital. In view of existing conditions I consider these results quite gratifying. During the year the Immigration Department deported only 27 aliens; less than 7 per cent of the number deported under normal conditions. There were none deported since January, 1917. From July 1, 1916, to March 15, 1917, no funds were available for the repatriation of aliens or removal of nonresidents and, when funds became available, repatriations were no longer possible, in spite of the fact that many requests for repatriation had been made by friends and relatives of alien patients. Within the past year circumstances materially affecting the Bureau's work, which necessitated readjustments, have arisen. First, the new Immigration Law, which extends the period. for deportations from three to five years and is retroactive, has brought within its scope many aliens not previously considered deportable. Following the enactment of this law a survey of all alien patients in the State hospitals was made and those affected thereby are being reported by medical certificate to the Commissioner of Immigration for investigation and such action as may be considered proper. Second, the reciprocity agreements relative to nonresident insane made by your Commission with departments of similar jurisdiction in the States of Massachusetts, Rhode Island, Wisconsin, Ohio, Michigan, Illinois and California. These agreements have given us a definite basis upon which to determine a residence with its resultant responsibilities and have proven a decided success with some of the states. DEPORTABLE ALIENS AND THEIR MAINTENANCE It has long been known that the State of New York has a large number of alien insane maintained at a high per capita cost to the State, and since the European war has made deportations through the Immigration Department impossible, this has been even more apparent. It has already been pointed out that during the past year less than 7 per cent of the usual number of deportations have been effected; consequently the State has been compelled to bear the burden of maintenance of the remaining 93 per cent and at a greatly increased per capita cost. On June 30, 1917, there were 416 deportable aliens in the State hospitals on whom warrants of arrest had been served. Besides these there were 216 under investigation, a large percentage of whom will undoubtedly be ordered deported. Also, prior to this date, many aliens reported by us, who had been ordered deported, were discharged from the hospitals and at present it is impossible to estimate the number of these cases who will again become public charges and what percentage of them will have passed the deportable period before readmission. Since January 1, 1914, there has been no Government fund available to reimburse the State for the maintenance of deportable aliens. Prior to that time, however, the State was reimbursed at the rate of $1 per day, from the date of service of the warrant of arrest to the date of removal from the hospital, for all aliens who were deported by the Federal authorities. Although this payment for maintenance was of some assistance and a step in the right direction, it was not fully satisfactory, for the reason that in many cases the payments covered only a relatively short portion of the patient's hospital residence. After several years of investigation of such cases I have reached the conclusion that the only satisfactory solution of the situation is that the maintenance of all aliens, admitted to State institutions, within the deportable period, should be paid by the Federal Government, not only for the time while under investigation by the Immigration Department, but for the entire duration of hospital residence. This conclusion seems justified because the condition is one over which the individual State has no control, all aliens being admitted under Federal inspection. The State of New York is especially concerned in this matter because of the proportionately large number of such cases always in its hospitals, the principal reason being that more than 28 per cent of all immigrants are destined to New York State. Another cause is that New York city, being the largest seaport, attracts the emigrant as well as the immigrant, with the result that many aliens, after being in this country for a few weeks or months or possibly years, come to New York for the purpose of returning to their native lands. Some of these come here in a demented state and are taken into custody while awaiting the time to sail, while others come here solely for treatment. The result is that such cases, who have never lived in New York State, are maintained by the State for an indeterminate period. It has happened that an alien already under warrant of deportation, who never lived in New York, has come here and become a public charge upon this State and I have in mind also the case of a Philippino who, immediately upon his arrival in the city of New York, coming directly across the United States, was taken into custody as an insane man and still remains a public charge in a State hospital. This case was reported to the Immigration Department, but, because he is a Philippino, no action could be taken. Another important fact as regards the deportable alien is that, as a group, the average age is much less than that of the native born patient; therefore, everything being equal, it must be expected |