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The somewhat monotonous life at the island may be varied by an occasional visit to the city on passes. These passes can be obtained after a residence of three months, but only on a record for good behavior. They entitle the holder to an absence of from one to seven days. As a rule no one can get a pass oftener than once in three months.

The hospital, although a part of the almshouse, is of sufficient importance in itself to be considered a separate institution. The total number of patients in 1897 was 387 men and 573 women. Of these, 305 men and 409 women were admitted during the year, and 297 men and 426 women were discharged. The largest number at any one time was 281, and the smallest, 233. Besides those treated in the hospital, 883 were treated as out-patients. Among the diseases treated were, in the hospital: General debility, 65; senile debility, 91; rheumatism, 38; phthisis, 96; tuberculosis, 4; typhoid fever, 4; alcoholism, 23; epilepsy, 19; dementia, including senile, 34; bronchitis, 29; pneumonia, 13; venereal diseases, 64; and, in the outpatient department: Rheumatism, 39; alcoholism, 16; debility, 71; and venereal, 23. The other ailments treated would exhaust the nomenclature of diseases. The insane are transferred to some hospital for the insane, but cases of mild dementia are retained. Twenty-three cases of insanity were transferred during 1897.

In a hospital of this description the death rate must necessarily be very great. The morgue, which is a separate building, is seldom if ever free from dead bodies. Not infrequently it contains six or seven. About half are claimed by relatives or friends; the rest being buried on the island. The hospital is under the care of a medical superintendent with three assistants. There is a visiting medical and surgical staff. Connected with the hospital is a training school for nurse attendants. The course requires one year and includes general medical, minor surgical, maternity, and infant nursing. Instruction is given by means of lectures and text books, and teaching by the bedside in the regular performance of duties. The first graduating exercises were held in September, 1896; at which time seven pupils received diplomas. There are at present 25 in the school.

The idea that an almshouse hospital should be conducted differently from other hospitals would seem to be fast disappearing. And it should disappear; as the last report of the Long Island almshouse well says: "Whether dependent or independent, sick persons should receive the best possible care, and it is better economy as well as better humanity to insist that the standard of this hospital should be as good as that of any other."

One of the greatest needs of the Long Island hospital is that of a separate building for both men and women suffering from tuberculosis, who now are kept in open ward. There is need also of an isolation ward for other contagious diseases. Among the rules and regulations for Long Island are the following:

Inmates immediately upon their arrival at the almshouse, unless excused by a physician, must take a bath and change their citizens clothing for a full outfit of institution clothes. Inmates will not be allowed to wear any of their own clothing while in the institution except by express permission of the Superintendent, and all money must be given to the Superintendent for safe keeping.

Inmates must rise at 5.15 A. M., and retire at 8 P. M., at which time all lights must be turned down. The gong will be sounded at those hours.

The regular hours for labor will be from 7 to 11.45 A. M., and from to 4.45 P. M. Hours for meals will be breakfast, 6 A. M.; dinner, 12 M.; supper, 5 P. M.

Smoking is prohibited within 1,500 feet of any building, or in the building outside of the regular smoking rooms.

Inmates are forbidden, except on business, to enter the barn or other out-buildings, or to loiter about them or the wharves.

Inmates must be bathed at least once a week, and cleanliness both in person and in habits will be enforced. Male inmates must be at their bedside at 11 A. M., and female inmates at 2.30 P. M., every Sunday to undergo inspection of clothing.

Profane, obscene and impertinent language, disorderly or insubordinate conduct, talking in the dormitories after retiring, wilful destruction of institution property, annoying cranky or feeble-minded inmates are strictly prohibited. Inmates must perform such work as may be assigned to them faithfully and well, and obey the orders of their officers and rules of the institution cheerfully and promptly. Leave of absence will be granted to males on Monday; to females on Wednesday.

Dr. L. F. Wentworth, the superintendent, although still a young man, has had considerable and varied institutional experience. Before coming to Long Island he had been assistant physician at the Brattleboro, Vermont, insane asylum, assistant superintendent of the state insane asylum, Topeka, Kansas, superintendent of the state insane asylum at Osawatomie, Kansas, and in the service of the Massachusetts state board of lunacy and charity. He entered upon the duties of his present position in April, 1897.