The following is the annual report of the physician at the county house. Ara Akuor, January aoth, 1891. To the Superintendent of the Poor, Washtenaw County : Gentlemen: In accordance with the usual custom, I herewith respectfully submit my annual report of the patients coming under my charge at the County House, forthe year 1890. Number of poor registered in Hospital Records who have received medical treatment. . 90 Number of poor subsequently prescribed for and for whom . medicines were dispensed. . .320 Number of surgical cases "12 „ , ,_ , f males .... c Number orcdeaths , , (. females. . . 4 Number examined for State institution 6 Total number of visits 67 Considering the above fatalitiés due chiefly to extreme oíd age, the sequence from disease alone is reduced to a minimum. Although perhaps well known to you, it is important to here state that the people cared for, are byfcno means ordinary in their character or condition. Many of them come here at the eleventh hour of their existence, diseased and discouraged with the strugglesj of life; and affected the more, therefore, by every change of atmosphere, there is need of wisdom and care in proper! y administering to their 'conditions. I take pleasure in stating, however, that this is being accomplished, notably in 'the women's wards and in the hospital, where the rooms and necessary appliances are kept rigorously clean and attractive under the excellent supervisión of the matron of the institution. It is true our idiotie and incurables need improved dormitories, yet I have no hesitancy in saying that they are kept clean and comfortable. In this connection also, I cannot speak too liighly of the material assistance afforded me by the healthy and properly prepared food supplied to the inmates; and above all, in the sanitary measures - so neeessary to the maintenance of health - daily enforcod by the energy and intelligence of the keeper in charge. Through the benevolence of certain citizens of Ann Arbor, a considerable number of books, pamphlets, etc, were contributed for the benefit of the inmates; a nucleus which I feel assured you will preserve, and I hope that further munificence will make it a still more valuable accession for the county poor. Respectfully, In medical charge of County House.