$2,235,508.44 the previous year, and $2,095,288.69, the average the last five years.

Salaries, wages and labor amounted to $837,287.64, compared with $791,674.20 the previous year.

Food supplies cost $563,122.51, compared with $533,588.01. Clothing and clothing material cost $97,579.45, compared with $108,948.14.

Furnishings cost $90,436.70, compared with $86,279.92. Heat, light and power cost $208,003.93, compared with $202,589.05.

Repairs and improvements cost $139,043.03 (exclusive of labor), compared with $146,800.35.

Farm, stable and grounds cost $173,598.72, compared with $161,008.69.

Miscellaneous expenses cost $164,093.64, compared with $204,620.08.

Details of such expenses for each institution may be found in Table VI. of the Appendix.

INCREASE OF MAINTENANCE EXPENSES

over the previous year was $37,647.18, or 1.68 per cent. This is accounted for, in part, by an increase of patients cared for in these institutions. In 1907, 10,978 patients were cared for, compared with 10,545 the previous year, an increase of 433, or 4.11 per cent.

Shortening hours of labor, higher wages and higher prices of food and other supplies were the main factors in increasing

expenses.

The increase in salaries, wages and labor was $45,613.44. The hours of labor have been gradually shortened in response to an urgent public demand during the last five years, and have not yet been reduced to the average outside of institutions.

The increase in cost of food was $29,534.50. This increase is accounted for by increase in the number of persons fed and the higher prices of food supplies.

The decrease in cost of clothing and clothing material was $11,368.69. Prices of clothing were higher, but less clothing was bought; the stock on hand at the end of the year was

$3,979 less than at the beginning. Friends of patients furnish a variable amount from year to year.

The increase in cost of furnishings was $4,156.78. Higher prices account fully for this increase.

The increase in cost of heat, light and power was $5,414.89. The heating of new buildings for the accommodation of additional patients would more than account for this increase, but the stock of coal on hand at the end of the year was $12,926 less than at the beginning.

The decrease in cost of repairs and improvements was $7,757.31. Such expenditures vary from year to year, according to the needs in each case.

The increase in cost of farm, stable and grounds was $12,590.04. This was due to the very high prices of grain for stock.

Miscellaneous expenses decreased $40,526.43. Such decrease indicates that the greatest care was exercised to reduce the expenses of the year.

THE WEEKLY PER CAPITA COST

of maintenance averaged in these institutions $3.69, based on net expenses. Net expenses represent every expenditure from maintenance funds made on account of the institutions. They are the gross maintenance expenses, less receipts except for support of patients. Such receipts are income from sale of products, other earnings of the various departments, or repayments for articles purchased for the use of employees and sold to them at cost, e.g., clothing for nurses' uniforms, which is bought by the institution in order that the same material may be used and obtained at the lowest price.

This sum includes an average weekly expenditure of $0.24 for repairs and improvements, so that the net cost of maintenance, exclusive of depreciation charges, was $3.45.

In the insane hospitals the weekly cost averaged $4.22, compared with $4.15 the previous year, an increase of $0.07, or 1.68 per cent.

In the insane asylums the weekly cost averaged $3.65, compared with the same the previous year.

In the insane hospitals and asylums together the weekly cost

averaged $4.01, compared with $3.98 the previous year, an increase of $0.03, or 0.75 per cent.

The cost in hospitals and asylums fairly represents the average for all classes of the insane.

Further information in regard to weekly per capita cost for each institution will be found in Table VII. of the Appendix.

METHOD OF SUPPORT

of patients in such institutions is private, if the whole expense be paid from private resources; reimbursing, if a part be paid from private resources; and public, if the whole be paid by the State or municipality.

The insane are supported by the State so far as they become public charges.

With the same qualification, the feeble-minded and epileptic in public institutions and the inebriates at the Foxborough State Hospital are supported by municipalities if they have settlements therein, and by the State if there be no such settlement.

SUPPORT STATUS OF THE INSANE

on Oct. 1, 1907, and on the average for the year, is shown in the following tabulation:

It thus appears that 9,069 patients under public care, or 87.92 per cent., were State charges during the year, compared with 88.12 per cent. the previous year; that 482, or 4.67 per cent., were reimbursing, compared with 4.58 per cent. the previous year; and that 764, or 7.41 per cent., were private, compared with 7.30 per cent. the previous year.

The average weekly rate of private board was $5.36, compared with $5.68 the previous year; the average reimbursing rate was $3.01, compared with $2.95 the previous year.

THE CAPACITY FOR PATIENTS

in all the institutions Oct. 1, 1907, was 12,638, compared with 11,951 the previous year, an increase of 687 beds. The whole number of patients in them was 11,830, compared with 11,357 the previous year, an increase of 473. Hence there was an excess of provision for 808 patients, or 6.39 per cent.

Such excess is more apparent than real, since some 500 temporary beds are still made up nightly in corridors and day spaces, because the excess of day space over dormitory space, after allowing 100 square feet of floor area to each patient, justifies this number of additional beds. Such necessity is to be regretted, for reasons stated in previous reports, and should be obviated by the gradual addition of dormitory space for the reception of permanent beds proportionate to the day space.

Work was in progress at the close of the year or appropriations had been granted for 57 new beds for the insane, 160 beds for the feeble-minded, none for the epileptic; a total of 217 prospective beds, compared with 843 the previous year. If it be borne in mind that the average annual increase of these classes is not less than 500, and that an average of two years or more elapses before the occupancy of a building, after an appropriation has been made therefor, it will appear that the necessity exists for making appropriations for new provision, as recommended in the estimates later presented.

If there should be an unusual influx into institutions, as seems probable with diminishing activity in business, it is likely that overcrowding will supervene before such provision can become available.