The most productive cause of insanity, as shown by the returns, is intemperance, 84; the next is mental anxiety, 69; grief for loss of friends, &c., 69; then comes the loss of property, 67; religious excitement, 56; domestic difficulties, 45, and _unascertained_, 563! In 907 of the cases, insanity appeared before middle age, leaving 384 only developed after that period. The plan of detached cottages for a particular class of patients, continues to be an approved feature of the arrangements; and among the valuable improvements of the last year is the erection of a museum and reading-room on an eligible site. The building is 46 feet by 24, with a piazza, and the interior is furnished with interesting and valuable cabinets in natural science, as well as with newspapers, maps, periodicals, pamphlets, &c. On the interesting topics of society, instruction, and moral treatment, and the arrangements for heating and ventilation, much valuable information is furnished. The annual receipts and expenses are balanced with the sum of _twenty-six cents_, and the cost of each patient per week, including every thing, is $3 88. The amount expended on _free patients_ during the year is $7,666 88. This is unalloyed charity. 2. The State Hospital at Worcester, (Massachusetts,) under the care of Dr. Chandler, was overflowing with patients, though fifteen new rooms were added during the year. The average number for the year was 404, and the number of dormitories 360 only. The number of foreigners in the hospital at the close of 1842 was 34, at the close of 1847 it was 121, and at the close of 1848 it was 150! Dr. Chandler is of opinion, that it would not be judicious to enlarge the present hospital, but he would rather erect a new one, and separate the sexes. He thinks three small hospitals, in different sections of the State, would have some advantage over a large one. The whole number of patients admitted from January 1833, to November 30, 1848, is 3084, of whom 1433 were discharged cured, 416 improved, and 272 died. Of the patients admitted last year, 154 were under middle age, and 255 above, showing a very different result from that which we have stated above at the Pennsylvania hospital. Of the whole number received at Worcester, the cause of insanity in 322 cases is supposed to have been intemperance; in 266 domestic affliction; in 233 religious views, and in 161 self-abuse. Hereditary tendencies to insanity were traced in 691 cases. Fifteen hundred and sixty-one were single, one thousand two hundred and thirty-two married, one hundred and ninety-nine widows, and eighty-six widowers. Dr. C. thinks it very clear that the sympathies and motives to action, which the domestic relations supply, are all but indispensable to keep the whole system of mind and body in a healthful state. If we understand the report of the trustees, the cost to the State of each patient is $2 33⅓.