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During the year the diet of the patients in the Asylum has been somewhat improved, and a larger supply of clothing given to them. By this means, their comfort has been increased, and it is believed their health also has been materially benefited.

I would suggest for the improvement of the Asylum, an increased number of attendants, as we have now but four, and I would advise also the introduction of water-closets in the older half of the building.

After six years' continued service here, Miss Helen M. Marsh, M. D., presented her resignation, May 27, and it was accepted upon the appointment of her successor, July 14. She very soon went to Europe for purposes of investigation and study, taking with her the best wishes of her patients and associates in this Institution. In their behalf, I take this occasion to acknowledge our indebtedness to her faithfulness and skill.

Dr. George E. Putney was appointed first assistant physician, July 14. He is a graduate of the Harvard Medical School, and has had experience as a physician in the Boston City Hospital. Dr. E. Q. Marston was appointed second assistant physician at the same time. He is also a graduate of the Harvard Medical School, and has had experience in private practice. Both of these gentlemen have come to us through the introduction and recommendation of their former instructors, and those best acquainted with their professional character. They have applied themselves with zeal and industry to the work of the Institution.

The nurses in the Hospital and attendants upon the insane are worthy of praise for faithful attention to their arduous duties.

We are indebted to Dr. Moses G. Parker of Lowell for valuable counsel and assistance in the treatment of diseases of the eye and ear.

To Dr. W. W. Godding of Taunton a word of thanks is also due for professional advice rendered with regard to the insane.

For myself, I beg leave to express to you, and to the Superintendent, my appreciation of the unvarying confidence which has been extended to me in the work to which I have been assigned.

The accompanying tables of statistics are herewith also submitted.

Very respectfully,
Your obedient servant,
W. H. LATHROP,
Resident Physician.

State Almshouse, Tewksbury, October 1, 1876.

Statement No. 1.

Births and Still-births.

Statement No. 2.

Statistics relating to Children under One Year Old when Admitted.

1. Children with Mothers.

Discharged during the year, 92 Died during the year, 17 Remaining in Institution, September 30, 1876, 18 Total, 127

2. Children without Mothers (Foundlings).

Ages when Admitted.

Length of Time spent in the Institution.

(MISSING PAGES 34 and 35)

Statement No. 5.

Time spent in the Institution by Sane Inmates who have Died.

DEATHS OF INSANE.

Statement No. 6.

Time spent in Asylum by those who have Died.