The course consisted of daily lectures, clinical conferences, examinations of patients, laboratory exercises and reviews of literature conducted by the institute staff as follows: Psychiatry: Drs. Kirby and Cheney. Clinical conferences: Drs. Kirby and Cheney. Neuro-anatomy and Neuro-pathology: Drs. Dunlap and Stevenson. Bacteriological problems in psychiatry: Dr. Kopeloff. Endocrine glands and body development: Dr. Gibbs. We were fortunate in being able to secure for a series of special lectures a number of physicians from New York City who presented interesting discussions of the topics listed below: The Physical Basis of Behavior: Dr. C. B. Davenport. The Attitude of the Internist Toward Functional Symptoms: Dr. N. B. Foster. A Classification of Neuroses and Psychoses Based on Their Predominant Affective Mechanisms: Dr. E. J. Kempf. Psychopathic Personality: Dr. Bernard Glueck. A Modern Conception of Epilepsy: Dr. L. Pierce Clark. Other lectures and clinics given by members of the Institute staff during the year included the following: A regular course of lectures in psychiatry with clinical demonstrations for the third year class of Cornell University Medical College, by Drs. Kirby and Cheney. A course of lectures in medical psychology for the third year class at the Cornell University Medical College, by Dr. MacCurdy. Advanced instruction in clinical psychiatry for the fourth year students at Cornell University Medical College, by Drs. Kirby and Cheney. The regular course in neuro-pathology for students at the Univer sity and Bellevue Hospital Medical College, by Dr. Dunlap. A clinic for the Eugenics Class of Cold Spring Harbor was given at the Institute on August 5, 1921, by Dr. Cheney. Two lectures on alcoholism and drug addiction were given at the New School for Social Research, February 1 and 6, 1922, by Dr. Kirby. Three lectures on the benign emotional psychoses were given at the New School for Social Research, April 6, 10 and 13, 1922, by Dr. Kirby. Dr. Robert King, pathologist, Central Islip State Hospital, spent four weeks in May and June, 1922, at the Institute for a course of instruction in Wassermann technique. INTERHOSPITAL MEETINGS Two meetings were arranged during the year, one for the physicians of the down-State hospitals being held at Hudson River March 16 and 17, 1922, and one for the physicians of the up-State hospitals being held at Utica March 23 and 24, 1922. Both meetings were well attended and a series of interesting papers was presented by members of the staffs of the Institute and the various hospitals. A full account of the meetings and a list of the papers read will be found in the State Hospital Quarterly for May, 1922. COMMUNICATIONS The following is a list of scientific contributions, addresses and discussions made during the year by members of the institute staff: "Guides for History Taking and Clinical Examination of Psychiatric Cases," a handbook for physicians by Dr. Kirby. Published November, 1921, by the Utica State Hospital Press. "How May the Medical Staffs of the State Hospitals be Strengthened?" by Dr. Kirby. Read at the Quarterly Conference, St. Lawrence State Hospital, June 3, 1922. Published in the State Hospital Quarterly, August, 1922. "Restraint and Seclusion," by Dr. Kirby, a discussion at the Quarterly Conference, Albany, March 9, 1922. Published in the State Hospital Quarterly, May, 1922. "The Mental Symptoms of Epidemic Encephalitis," by Dr. Kirby. A discussion at the Brooklyn Neurological Society, October, 19, 1921. "Psychoanalysis and the General Practitioner," by Dr. Kirby. Discussion at the Harlem Medical Society, January 4, 1922. "Spirochaetes in General Paralysis," by Dr. Dunlap. Read at the Interhospital Meetings at Hudson River and Utica, March, 1922. To appear in the Archives of Neurology and Psychiatry. "Two Recent Improvements in Staining Spirochaetes," by Dr. Stevenson. Published in the Archives of Neurology and Psychiatry, March, 1922. "Spirochaete Stain in Multiple Sclerosis," by Dr. Stevenson. Submitted for publication in the Archives of Neurology and Psychiatry. "The Stabilizing of Brain Tissue During Fixation," by Dr. Stevenson. Submitted for publication in the Archives of Neurology and Psychiatry. "Chemical Investigations of the Central Nervous System Under Normal and Pathologic Conditions," by Miss Koch. Published in the Archives of Neurology and Psychiatry, April, 1922. "A Study in Basal Metabolism in Dementia Praecox and Manicdepressive Psychoses," by Dr. Gibbs and Miss Lemcke. Submitted June 1, 1922, for publication in the Archives of Internal Medicine. "The Prognosis of Involution Melancholia," by Dr. MacCurdy, based partly on the work of the late Dr. Hoch. Read at the meeting of the American Psychiatric Association, Boston, Mass., June, 1921. Published in the Archives of Neurology and Psychiatry, January, 1922. "Belief and Mental Adjustment," by Dr. Harrington. Published in the Journal of Nervous and Mental Diseases, September, 1921. "Studies in the Fractional Method of Gastric Analysis Applied to the Psychoses," by Dr. Kopeloff. Read at the Brooklyn Neurological Society, October, 1921. Published in the Journal of the American Medical Association, February, 1922, under title: "Individual Variation as Influencing the Rehfuss Fractional Method of Gastric Analysis: Preliminary Communication." Also as a monograph entitled: "The Fractional Method of Gastric Analysis as Applied to the Psychoses," in the State Hospital Quarterly, May, 1922. "A Simple Method for Anaerobic Cultivation in Petri Dishes," by Drs. Kopeloff and Morse. Read November 15, 1921, American Public Health Association Meeting. Published in the Journal of the American Public Health Association, Vol. 12, No. 2, February, 1922. "The Bacterial Content of the Stomach as Influenced by the Saliva," by Dr. Kopeloff. Read at the Society for Experimental Biology and Medicine, December 21, 1921. Abstracted in Proceedings Society Experimental Biology and Medicine, Vol. 19, No. 3, 1921. "Bacteriologic Studies in the Fractional Method of Gastric Analysis," by Dr. Kopeloff. Read at the Society for American Bacteriologists, December 29, 1921. Published in the Journal of Infectious Diseases, June, 1922. "Variations in Aliquot Fractions of Gastric Contents," by Dr. Kopeloff. Read at the Society for Experimental Biology and Medicine, January 18, 1922. Published in the Archives of Internal Medicine, July 15, 1922. "Is the Stomach a Focus of Infection in the Functional Psychoses?" by Dr. Kopeloff. Read at the New York Neurological Society, March 7, 1922, and Interhospital Meetings, Hudson River State Hospital, March 16; Utica State Hospital, March 23, 1922. To be published in the American Journal of Medical Sciences, 1922. "Studies in the Therapeutic Effect of Bacillus Acidophilus Milk and Lactose," by Drs. Kopeloff and Cheney. Read at the Society for Experimental Biology and Medicine, May 17, 1922. Published in the Journal of the American Medical Association, August 19, 1922. "Studies in Focal Infection: Its Presence and Elimination in the Functional Psychoses," by Drs. Cheney and Kopeloff. Read at the American Psychiatric Association, June 8, 1922, at Quebec, Canada. Published in the American Journal of Psychiatry, October, 1922. "The Interpretation of Serological Findings," by Dr. Morse. Published in the State Hospital Quarterly, November, 1921. "Mathematical Analysis Relations in the Wassermann Reaction," by Dr. Morse. Published in the Proceedings of the Society for Experimental Biology and Medicine, Vol. 19, pp. 17-21, 1921. "A Multiple Pipette: Description of a New Apparatus," by Dr. Morse. Read at the meeting of the Society of American. Bacteriologists, Philadelphia, December 27, 1921. "The Mathematical Analysis of Immune Reactions," by Dr. Morse. Read at the meeting of the Society of American Bacteriologists, Philadelphia, December 29, 1921. OTHER ACTIVITIES The director, as a member of the Federal Board of Hospital Consultants, has been called frequently to Washington in reference to government policies and plans for the care and treatment of ex-service men, particularly neuro-psychiatric cases. Frequent conferences have been held with the Federal authorities regarding plans for the development and operation of the United States Veterans Neuro-psychiatric Hospital, No. 81, Bronx, New York City. The hospital was opened for the reception of patients in April, 1922. The following examinations were arranged and held for the State Civil Service Commission by the Examining Committee of which the director is chairman: Senior assistant promotion examination, written July 16, 1921, oral, September 21 and 22, 1921. Superintendent and medical inspector, written examination, December 10, 1921, oral examination, January 23 and 24, 1922. During July and August, 1921, the director made a visit to the Battle Creek Sanitarium and the Mayo Clinic at Rochester, Minn. A study was made of the diagnostic and treatment methods employed at these clinics with special reference to possible applications in psychiatric work. It is a pleasure to express my thanks to my associates and all others connected with the Institute for their cordial cooperation and faithful performance of duty. I also desire to express my appreciation of the assistance given in various aspects of our work by the superintendent, clinical director, and other officers of the Manhattan State Hospital. I am especially grateful for the interest which the Commission has taken in the work of the Institute and for their encouragement in our effort to further the development of the scientific and medical work in the State hospital system. Very respectfully, GEORGE H. KIRBY, Director. REPORT OF THE MEDICAL EXAMINER To the State Hospital Commission: The Medical Examiner respectfully submits herewith the annual report of the Bureau of Deportation, New York State Hospital Commission, for the year ending June 30, 1922. It is with mixed emotions that I approach the matter in handregret that, comparatively speaking, the results accomplished are so meagre pleasure that they are no worse -- surprise that they are, all things considered, so good. Owing to the exigencies of the situation created by the desire of the Legislature for economy, the work of this bureau was carried on by the medical examiner without a deputy for ten months, with but one transportation agent, one stenographer and an interpreter, for most of the year. An additional transportation agent was supplied for two months and another stenographer for one month. The motive of the Legislature, we may be sure, is not open to question and we may very properly say that the economic results show conclusively the unwisdom of their action. In fact, this bureau could properly use, and with distinct advantage to the State, more rather than fewer employees for only the great efficiency and unusual devotion to duty of the small part of the efficient machine which was left us, permitted the results which our tabulation shows. SUMMARY During the fiscal year the Federal immigration authorities removed from the State through our intervention 172 aliens, many less than could have been removed had the Congress supplied sufficient funds for employees at Ellis Island. As a matter of fact, insufficiency of funds compelled an enforced vacation without pay of 25 per cent of their force, so that while on March 1, there were only 88 unserved warrants in cases certified by this office, on June 30, there were 232 still to serve. One hundred and ninety-five aliens, in the country more than five years, were repatriated at their own request or that of friends or relatives, a somewhat better showing than the year before, but not as large a number as desired to go, the number being kept down by increased difficulties in procuring passports and our own limited force. The State paid all expenses involved in repatriating 89 of the number and the aliens or their friends and relatives paid all or a part of the expenses for 106. If we assume that the average cost of repatriation in a given case is $150 (a very conservative estimate), it can readily be seen that the negotiations of the Medical Examiner's Office in New York City saved the State the expenditure of about $16,000. Friends and relatives furnished funds for the return to other States of 168 of the 353 nonresidents who were taken to their homes or to the authorities from the observation ward at Bellevue Hospital. |