and since that time has been a subject of record by explorers and historians. The structure is built of the material known as cajonthat is, puddled clay molded into walls and dried in the sun, and of perishable character.

The Casa Grande Ruin Reservation is located in Pinal County, Ariz., and embraces the S., SW. 4. SW. 4, SE. sec. 9; NW. 4, W. §. NE., NE., SW. and NW. 4, SE. 4 sec. 16, T. 5 S., R. 8 E., Gila and Salt River meridian. The lands embraced therein were reserved from settlement by Executive order dated June 22, 1892, under authority of an act of Congress approved March 2, 1889. By this act $2,000 was appropriated for the repairing and preservation of the ruin, and was expended in removing débris, supplying underpinning to the walls, filling cavities, and fixing in place wooden and iron braces as supports. These repairs the custodian, Frank Pinkley, who resides on the reservation, states are in excellent condition, but the appropriation was not sufficient to fully provide for the preservation of the ruin.

At the present time it is stated there is need of renewing the lintels over doors and windows. The floors of the building having been destroyed by fire, the walls have been unsupported for their entire height, and becoming weatherworn near the ground need proper underpinning in places to keep them standing. The northeastern and southeastern corners of the ruin have fallen, but the remaining walls are standing with a fair degree of stability, and if properly preserved will remain intact for several generations.

At the last session of Congress $2,000 was appropriated for repairs to this ruin. Specifications for the work are now in course of preparation, and before the close of the fiscal year it is believed that the work of strengthening the building will be completed. An additional appropriation is desirable in order that a roof of asphalt or corrugated iron can be placed over the structure, and the ruin be inclosed by a barbed-wire fence in order to more effectively exclude trespassers.

ELEEMOSYNARY INSTITUTIONS.

The act of Congress entitled "An act to establish a board of charities for the District of Columbia," approved June 6, 1900 (31 Stat.. 664), provides, among other things, that said board of charitiesshall visit, inspect, and maintain a general supervision over all institutions, societies, or associations of a charitable, eleemosynary, correctional, or reformatory character, which are supported in whole or in part by appropriations of Congress made for the care or treatment of residents of the District of Columbia; and no payment shall be made to any such charitable, eleemosynary, correctional, or reformatory institution for any resident of the District of Columbia who is not received and maintained therein pursuant to the rules established by such board of charities, except in the case of persons committed by the courts, or abandoned infants needing immediate

are.

The Attorney-General on the 12th of October, 1900, in construing this act, held that the Government Hospital for the Insane, Freedmen's Hospital, the Columbian Institution for Deaf and Dumb, and the Washington Hospital for Foundlings, created by prior laws and placed under the supervision of the Secretary of the Interior, came within the terms of said act of June 6, 1900, and that—

with the exception that the board of charities is given the general supervision of these institutions and, under the order of the District Commissioners, the power of investigation, with the duty of submitting a report and recommendations to Congress, the powers and duties of the Secretary of the Interior are unchanged by the act of June 6, 1900, and remain the same as before its enactment.

Attention has been directed in previous annual reports to the fact that a divided supervision or control over the class of institutions enumerated, especially where the lines of division are uncertain and not easily understood, would have a tendency to embarrass the immediate management of each institution and to detract materially from the desired standard of excellence. I therefore renew the recommendation heretofore made in this matter that as to each of said institutions the authority, etc., of the Board of Charities be transferred to the Secretary of the Interior, or the authority and responsibility of the Secretary of the Interior be transferred to the Board of Charities.

Considering the character and purpose of each institution and the extent of the supervisory authority of the Secretary of the Interior over the same prior to the passage of the above-mentioned act, prob ably the best results could be obtained if the administration of the affairs of the Government Hospital for the Insane, Freedmen's Hospital, and the Washington Hospital for Foundlings were placed exclusively under the supervision of the Secretary of the Interior.

During the first session of the Fifty-seventh Congress a bill (H. R. 10372), copy of which is hereto appended, page 229 (Exhibit N), in accord with the above recommendations, passed the House of Representatives on the 24th of February, 1902, and it is to be hoped that it will receive early and favorable consideration in the Senate.

THE GOVERNMENT HOSPITAL FOR THE INSANE.

The annual report of the board of visitors shows that no untoward incidents have occurred during the year, and that the affairs of the hospital have continued to be satisfactory. The health of the people at the institution has been ordinarily good, with the exception of a few cases of typhoid fever during the fall of 1901. The water supply and the milk supply of the hospital were bacteriologically examined, but no evidence of infection from those sources was found.

The number of patients in the hospital at the beginning of the year was 2,176; there were admitted during the year 686, the largest num

ber in the history of the hospital, making a total under treatment of 2,862. During the year there were 177 deaths; 248 were discharged recovered, 98 improved, 20 unimproved, 3 not insane, leaving on the records at the close of the year 2,316. Of those received during the year, 297 were from the Army and Navy and Marine-Hospital Service, and 389 from civil life. Of the latter, 285 were cases of indigent patients, residents of the District of Columbia, and 51 were nonresidents, admitted by order of the district courts. The recoveries number 248, or 36.15 per cent of the admissions, and the deaths 177, or 6.18 per cent of the whole number under treatment and 8.06 per cent of the average number resident.

The training school for nurses continues to do good service, a class of 30 having been graduated May 23, 1902. Most of the graduates remain in the service of the institution and are performing satisfactory service. Twelve female nurses are employed in the male hospital wards with satisfactory results. The nursing and care of the patients is receiving special attention, and there has been a steady improvement in the equipment of the hospital wards.

With the completion of the additional buildings authorized by Congress, and now being erected, the facilities for the special-care cases will be further enlarged. The improvements under way at the commencement of the last fiscal year have been satisfactorily completed. The old stable building has been removed and its location made into a lawn, enhancing the appearance of the park in the rear of the main building. Work has commenced on the reconstructing of the roads and walks of this portion of the grounds, and a considerable number is already completed. A new gas machine has been installed in the laundry and a ward for 40 colored female patients has been opened with satisfactory results in the old laundry building.

The constantly increasing number of patients has necessitated the erection of a temporary frame building to accommodate 120 male patients. It is hoped that these accommodations will tide over the institution until the completion of the buildings of the extension now under contract without much increase in inconvenience from overcrowding, which is highly undesirable, not to say hazardous. The new kitchen for the group of attached buildings has been completed and is in successful operation; the service of food to the general dining room adjoining, which seats about 600 patients, has been greatly improved. Plans and specifications for the new heating and power plant for the hospital, for an administration building, for an additional kitchen for the Toner group of buildings, including three of the new cottages, have been prepared and approved by the Department, and it is hoped that the work thereon will be commenced early in the fall.

In the pathological department during the year 92 post-mortem

examinations were made-about the usual proportion out of 177 deaths. The work in this branch has been greatly facilitated and made much more interesting and valuable by the synopsis of the clinical histories required to be sent with each case for examination. During the past year many very interesting cases have been examined and recorded for future study and many valuable specimens and photographs have been added to our collection. Two of the cases were of tumor of the brain, which have been added to the pathologist's work on intracranial growths, now numbering 29. The special work for the year has been the preparation of this work for publication. It will consist of 29 tumors and 1 aneurism of cerebral artery, illustrated by 28 plates and 62 microscopic drawings.

The clinico-pathological branch has been kept busy in the various lines of study. During the year 385 examinations of blood have been made. Of these, 288 were for the presence of the malarial parasite, with positive results in 95 cases. Thirty were for Widal's reaction in typhoid fever; the test was positive in 14 cases. Sputum examinations have been made in 93 cases, with the discovery of tubercle bacilli in 38 cases. Other examinations were in cases of essential anæmias, etc. Eight hundred and forty-six examinations of urine have been made, all new admissions being examined, and in clinical cases for records and confirmation of diagnosis. In cases coming to autopsy these urinary analyses are always consulted, and the conclusions reached are compared with the actual condition of the organs at the time of death.

Tests of the usual clinical character have been conducted with very satisfactory results, and the scope of the work is rapidly increasing; the equipment is sufficient and the work is thereby greatly facilitated; all that seems to be required now is increased laboratory space.

The board of visitors in discussing the legislative needs of the hospital state that

Your attention is also respectfully called to the necessity for amending the law relating to the disposition of pensions of patients who have been admitted to the hospital from the National Homes for Disabled Volunteer Soldiers who have no dependent relatives. The law now provides that in all such cases the pension shall be paid to the superintendent for the support of the patient and be credited to the general support appropriation without regard to the amount. When these pensions are credited to the general fund of the hospital they can not be used for the special benefit of the patient, and as the regular charge for board is $5 per week, the pension in some instances exceeds this amount. In all cases it is desirable that at least a portion of the pension should be available for special use of the patient for small purchases which the hospital can not ordinarily supply. It is therefore recommended that the law be so amended as to permit all pensions of patients to be paid to the superintendent while the pensioners are inmates of the hospital, and that he be authorized to use the pension, under regulations established by yourself, for the benefit, first, of any dependent relatives under the law, and second, for the patient himself, the regular charge for board alone being credited to the general fund of the hospital in such cases as may be determined to be proper. The law should also

authorize the disposition of such funds accruing from this source in case of decam pensioners which are unclaimed, and of which a considerable amount is n = accumulated.

This board is also impressed with the necessity for amendment to the law reg.. ting commitment to the hospital and the discharge of patients therefrom. It ju ticularly important that authority be given the superintendent to grant trial vien before discharge to such patients as are believed to be in condition to warrant it, an also to discharge to the custody of friends such as can be safely cared for out-dea hospital and who can not be further benefited by hospital treatment.

In my last annual report I called attention to similar recommendations submitted by the board of visitors, and recommended tit legislation be enacted by Congress along the lines indicated. Sab sequently, in April of 1902, I prepared and transmitted to the Senate and House Committees on Pensions, respectively, a draft of bill copy of which is hereto appended, pages 229, 230 (Exhibit O) in relation to the payment and disposition of pension moneys due to inmates of the Government Hospital for the Insane. I earnestly recommend that this measure be enacted into law at the earliest practicable date.

In discussing the matter of the change in the law relative to disburs ment of moneys for the Government Hospital for the Insane, I state! in my last annual report that

After the decease of the former superintendent a committee was appointest examine his books and accounts as a disbursing agent of the institution. In report ing thereon, after referring to the fact that his accounts were found to be correst balanced, and closed, and so reported by the accounting officers of the Treasury, the state, referring to the matter of the disbursements of the institution, that

"Your committee are of the opinion, however, that the best interests of the pu1service would be subserved if the disbursement of the appropriations for the hospita was taken therefrom and placed under the direct supervision of the Secretary of 11Interior, to be disbursed by the disbursing officer of the Department of the Intery on vouchers properly certified by the superintendent of the hospital, and approves by the Secretary of the Interior. One of the principal reasons advanced why niet a change should be made is that the superintendent of the hospital is now the p chasing officer, the receiving officer, the disbursing officer-three offices in one. act of March 3, 1855 (sec. 4837, Rev. Stat.), made him a special disbursing ager Under existing United States Treasury regulations he is required to render b accounts monthly, and no advance of funds is allowed him in any month in exce his bond. On the contrary, the disbursing officer of the Department is required t render his accounts only quarterly, and is not confined to the limit of his botl advances from the Treasury, so that money could always be promptly ob'ained trea the Treasury for the payment of the bills of the hospital upon presentation of san • Under the present condition of affairs it has often occurred that persons selling go alo and supplies to the hospital, expecting to receive cash when such have been r* nished, have been compelled to wait weeks and months for payment. This cert tion of affairs should not be tolerated by the Department for a moment. Busi methods prevail in every other branch of the Department of the Interior, and r creditors are promptly paid their bills on presentation of the same. Such shon f the rule with the bills against the Hospital for the Insane. The merchant sells goods to the hospital at a trifle above cost, expecting to receive promptly cash pat ment for the same. Failure to so pay him frequently results in serious embarrassme to his business."