The opportunities for schooling and work, and the probabilities of having simple care and treatment continued after the patient is discharged, are matters of no little importance, and should be carefully weighed in teaching the child while a patient here and in determining the time for discharge.

If a boy or girl comes to us at the age of twelve, having spent five or more years in bed, or in a chair, the problem of the child's future should be studied, while he is still a patient. It may be a case which will require three years of treatment before all the resources of surgery have been exhausted and at the end of that time, he may be discharged, let us say, in a condition to get about with a brace on one leg and the assistance of a cane. He will then be fifteen years of age. The mental training, the education, he has received here should have been directed in view of the way in which he must spend the next few years. Will he be able to continue at school, or must he become a wage earner? If the latter, what will he find most readily at hand which he can undertake? The probability of a child's receiving care after discharge is frequently a determining factor in selecting an operation or in designing a brace. When we know that our instructions will be followed out, we can safely undertake a line of treatment, which would prove useless or worse under other conditions.

These and other similar matters we have taken up to the best of our ability, but we now feel that we should have a staff-officer whose duty it would be to obtain information about the patient's probable future and relieve us of the correspondence between parents and relatives, which is becoming an onerous, but necessary part of the work. Formal and brief letters to parents in reply to their inquiries about their child, are not likely to keep nourished the parental love, which long absence may otherwise diminish. This officer whom we would call " Investigator" would also help in the question of adoption, which even now arises from time to time and will become more important when the hospital is completed. The intimate personal knowledge of the patient which the "Investigator " would share with the entire staff, would tend to make all efforts in the child's behalf, more vigorous and more earnest and more helpful on the part of everyone.

Last year we gave 52,664 days of hospital treatment, which would be 157,992 meals to patients. We served meals to an average of about fifty employees. Our food cost $24,975.84. The diet for many of our children needs to be selected with care, and more expensive articles are sometimes needed than would be were this an insti

tutional home, and not a hospital. This is well recognized, and our requests for extra latitude in buying necessary articles not usually allowed at State institutions are readily granted. With a completed plant, we feel that poultry and dairy products should be fully provided from our own farm. This will probably be an economy, but even at a slight increased expense, will be of great value in securing foods pure, wholesome and fresh. This year we used 68,777 quarts of milk, 4,167 pounds of butter, and 607 pounds of cheese. The milk has been tested monthly for butter fats and varies but little from 3.5 to 4. We have paid an average price of 12 cents per quart. At the suggestion of the State Board of Health we are requesting an appropriation from the Legislature for the purchase and installing of a pasteurizing plant. With fresh milk from our own herd, this would not be necessary, and we believe that fresh milk from healthy cattle, kept in sanitary surroundings, is far superior for children, especially little ones below normal physically, than milk that has been pasteurized. We used 5,360 dozen eggs and 881 pounds of chicken. We have used our own products almost entirely for children requiring special diets. With the reconstruction of our poultry plant in connection with the recently acquired "Farm," we hope to supply all our poultry products. We used 6,013 pounds of pork products. As we have had insufficient cold storage facilities for the keeping of large supplies of meat, we have not attempted to raise hogs. More than half of this meat is used as fresh pork, and most of the rest as ham. It may be advisable to raise pigs when we can properly care for the meats. Of 490 bushels of potatoes used, we raised 398. With our additional farm land, we shall raise all our potatoes. Of other foodstuffs, we used 2,397 pounds of meat, 24,305 pounds of fish, and 30,190 pounds of farinaceous foods none of these can we supply. Of garden vegetables and fruits, we produced 369,534 pounds of vegetables and 1,260 pounds fruit. All of these can be increased with our increased acreage. Our per capita cost, including all expenditures, was $1.62 per day. The average per capita cost as reported by the United Hospitals fund of New York city, was for 1919, $3.50.

The growth of this hospital, the first State institution of its kind in the country, has been slow, but steady. Our friends have constantly increased, and we feel that our work, as seen in the results accomplished, has made our hospital one of the charitable enterprises of which citizens of New York State have cause to be proud. We are making it possible for citizens of moderate means to give their crippled children the costly treatment of orthopedic surgery: costly