To the Honorable Board of Trustees of the Waupaca County Insane Asylum:

GENTLEMAN: It is with pleasure that I present my sixth annual report for the fiscal year ending June 30, 1908, of the medical, surgical and sanitary condition of the asylum and premises.

The general health of the patients has been fully up to the average. During the year I have made 105 visits at which time I have found it necessary to treat the afflicted ones for lymphadenitis, nephritis, cystitis, gastritis, gastric ulcer, erysipeias, anasarca, conjunctivitis diarrhea, papilloma, gastrimenorrhagia, enervation, jaundice, arthritis, dermatitis, anemia, prurigo, erythema nodosun, hernia, neuralgia, periostitis, eczema, lithemia, coccygodynia, prostates, tachycardia, catarrah, pneumonia, influenza, lumbago, torticollis, phlebitis, bronchitis, gastralgia, asthma, ozen, submaxillary adenitis, besides various neauralgias, nervous and disturbed conditions common to this class of patients. The surgery for the year has been light, a few cases ulcer abcess and varix; two cases of burns, not severe; one incision of the foot, while chopping wood, one broken arm by throwing a baseball wile engaged in a game of catch. The burns among the epileptic patients have been reduced in number by the use of radiator shields. The mortality list is as follows: John Schluens, aged 48 died of uremic coma complicating tuberculosis; Minnie Ziegenhagen, age 51, died of marasmus; George Crossman, age 80, died of pneumonia; Simeon Carley, age 68, died of sudden heart-failure during an epileptic seizure.

Sanitation has received especial attention and every effort has been made to keep it up to the highest standard. Strictest cleanliness has been enforced throughout the premises as well as in the preparation of food and drink. To avoid all possible tubercular or other infection from the dairy, a frequent source of disease, the heard has been thoroughly tested by the state veterinarian and found practically immune.

In slaughtering most careful precautions are taken to avoid diseased meat and the same cleanliness is observed as elsewhere. The careful selections of the herd, the feed and care of them, clean stables and well drained yards has done much to lessen the danger of infection from this source.

The clothing and bedding of the patients has been suitable and ample. The hall of the third floor, heretofore of little practical value, has been converted into a dormitory with sixteen beds, ample fire escape, and other necessary appointments for the use of the more trusty patients employed in the farm labor.

Besides the practical side of the management of affairs, which is always important, the no less important consideration of comfort, entertainment and amusement has been properly cared for. Invalid chairs for those in need of them, lawn swings, etc. have bee provided, while attendants and employed have joined with the management in trying to alleviate the pangs and mental torture of the unfortunate ones.

The asylum, however, is not to be considered altogether a hall of gloom. Many of the patients are cheerful and seem to be happy and contented, making friendships among themselves and often taking much interest in their surroundings, joining in the same amusements and entertainments, reading and discussing various topics. This state of mind is encouraged as being conducive to their best welfare and every endeavor is put forth to make the institution homelike.

In closing I wish to thank the Trustees, Superintendent and Matron for their help and courtesies extended to me in my work at all times in the past.

Respectfully submitted
E. H. Jones, Physician