years of maintenance. It will also provide additonal accommodations, as above.

If the legislative committee herein recommended for the investigation of the "County Support" system is appointed, we respectfully suggest that it be given authority over this subject also.

COUNTY SUPPORT.

We again feel it our duty to renew the recommendation made in a previous report:

"That in case of all institutions under charge of the Board of Control where the inmates are lodged and fed by the state, except the state prison and reformatory, the counties from which such inmates are sent or received respectively shall be required to pay into the state treasury toward the support of such inmates, upon such commitment being made or inmate received, and annually thereafter, the sum of seventy-five dollars, an amount which is approximatly one-half of the per capita current expense of such support. At the present time the state assumes the entire burden of supporting these dependent people, which fact furnishes an inducement for sending to the public institutions persons who only require care and attention, who cannot be benefited by treatment and who could be properly provided for in their own families or community. In the state hospitals, for instance, the numbers have become. so great that those who are amenable to treatment, and for whom there is some hope of restoration to health are deprived of proper room and attention by the great influx of mere custodial cases."

Many of our sister states have had such law in force for many years, and judging from the official reports therefrom, experience justifies their continuance. Statistics will also confirm that the direct expense to any one locality under the proposed system will be far less than the indirect expense incurred under the present one.

Another very important reason why this forward step should be taken is so many other states are on this basis that a constant effort is being made by residents of such states to turn Minnesota into a dumping ground for public charges.

We have a case in point now on our hands. In Illinois relatives, if able, must pay for the care of insane or feeble-minded. A brother in that state having an epileptic brother likely to become insane sends him. to a sister in Minnesota to make it his home (?). He remains here fifteen months, information of insanity is filed against him, and he is sent to one of our hospitals to be cared for at the expense of the state. The brother in Illinois is relieved of all expense and nothing material has been added to the liability of the sister here. We attempt to deport

him under our law to the state from whence he came, but that state says: "No! He left here fifteen months ago; he has lost his residence here; you have had him long enough to gain a residence under your laws, so don't send him here." If we do send him there under that prohibition the person so taking him will likely be arrested and fined or imprisoned. Counties should be empowered to reimburse their treasuries for expenses so paid from individuals or estates legally liable for such maintenance under our present statute when able to do so. This would cause no greater burden to such individuals or estates than is now imposed for other support, and would only enforce a moral obligation which at large number of our people are willing and anxious to discharge without compulsion, if permitted to do so.

Space will not permit us to further emphasize the importance of this question or the necessity for its investigation by the legislature. We believe there are few, if any, subjects to be considered of greater importance to the State than this. We respectfully suggest that a special committee be appointed to carefully look into the merits of this recommendation and report at the coming session.

SELF-SUPPORTING DEPARTMENT FOR INSANE.

The attention of the Board has frequently been called to the fact that the establishment of such an institution is a necessity, and many individual cases have come to our knowledge during the past five years where, had such an institution been in operation, it would have not only fulfilled the humane requirements of the case, but would have proved a great saving to the State, as well.

Many people have relatives or friends committed to our hospitals for the insane who would not only be willing to pay all expenses incidental to their care and treatment, but feel grieved that they are not permitted to do so. Others not only wish to pay the usual expenses, but also to have better accommodations than can possibly be had at the regular hospitals.

The establishment of such an institution would in nowise affect the character of the general hospitals and asylums, patients there receiving the same care and treatment as now. It would, however, permit those who are able and willing to do so to assume the entire expense of commitment, care and support of their friends, and would constitute a great saving to the state.

We are aware that there is some prejudice against the system, but if the establishment of such an institution will save the state directly and counties indirectly all cost of maintenance of the people there committed, we see no good reason why such action should not be taken. We believe the subject well worthy of consideration.

BUILDINGS FOR THE INSANE.

We have at the State Asylums at Anoka and Hastings 576 men and 109 women, the former about to be increased to 600 and the latter to 120. An additional cottage for women is now being built at each of the asylums, which, by crowding, will accommodate 120 more or 240 in all.

The erection of Nurses' Dormitories at the Fergus Falls and St. Peter Hospitals and the probable provision for one at the Rochester Hospital by the coming Legislature will give us additional room for women patients, which is much needed at all the hospitals.

At the present time there are at the Rochester Hospital 537 women patients, originally designed for 400. At St. Peter Hospital, 509 women, originally designed for 375. At Fergus Falls Hospital, 675 women, originally designed for 600. From the present situation it will be readily seen that they are greatly overcrowded on the women's side at all of the hospitals. But as we are soon to transfer 120 women to Anoka and Hastings, as the quarters vacated by the nurses when moved into their dormitories will be utilized for women patients, and as the Hospital at Rochester has an appropriation for the extension of the Main Building to connect with West Detached Ward, which will be built early in the spring and will accommodate a still larger number of women, we hope to be able to take care of what we have and the natural increase for the coming two years. If, however, no provision is made at the coming session of the Legislature for additional cottages for women at Anoka and Hastings, and it is left for the Legislature of 1909 to provide for them, it will be three years before we can expect to have such additional quarters ready for occupancy. This delay would undoubtedly cause great inconvenience and hardship and if possible should be provided for.

The condition as to accommodations for men at the hospitals is far worse. At Rochester they have 551 men confined in quarters originally intended for 400; at St. Peter 445, where but 350 were intended; and at Fergus Falls 840 men, where but 700 were intended; making in all an excess of 386 at the three hospitals. The transfer of the 24 hereinbefore referred to to the asylums will reduce this number to 362. To these must be added the probable increase for three years, 150, a grand total of men unprovided for 512. By crowding to the limit humanity and state respect will allow (it is now beyond these limits) the hospitals can take care of an additional number in present quarters as follows: St. Peter, 50; Rochester, 50; Fergus Falls, 100; leaving 312 men to be provided for during the coming three years.

That it is the first and paramount duty of the State to provide for these people needs no argument, nor will we advance any. We recommend the appropriation of $200,000 for the erection and equipment of two

cottages for men at each of the asylums. one-half available August 1, 1907, and one-half available August 1, 1908.

If the recommendation made herein, for the establishment of detention hospitals is adopted, we believe no further appropriation for increased accommodations for the insane need be made at the coming session. If not, then an appropriation for $100,000 should be made, to be available August 1, 1908, for one additional cottage for men and one for women to be erected at Anoka and Hastings.

BULLETINS OF SCIENTIFIC AND CLINICAL WORK.

The original framers of the Board of Control Law evidently intended that this should be one of its most important works. It provides (see Sec. 15, Chap. 122, Laws 1905; also Sec. 1874, Revised Laws of Minnesota) that:

"It shall encourage and urge the scientific investigation for the treatment of insanity and epilepsy by the medical staffs of the insane hospitals and asylums and School for Feeble-Minded, and from time to time shall publish bulletins and reports of scientific and clinical work done in said institutions."

It also provided that the annual expense therefor should not exceed five hundred dollars.

The opportunities for scientific research at the institutions named are so abundant and the results to be obtained so valuable in the study of the all-important subjects of insanity, epilepsy and idiocy that it seems almost improvidence on the part of the state to allow them to go by year after year without taking advantage of the same.

The carrying on of this class of work, if results are to be valuable, calls for the constant employment of a competent bacteriologist wh can devote his whole time and attention to it. The medical staffs a the institutions do not have the time to devote to this class of work, and if such staffs were increased in numbers so that it might be done by them, the cost would far exceed that of the plan proposed. The work also involves the preparation of a laboratory and its equipment with the necessary scientific apparatus to properly carry on the work. This should be in connection with one of the hospitals for insane to which other institutions can from time to time furnish such specimens and information as may be available.

We earnestly recommend that an appropriation of five thousand dollars be made for the purpose outlined, or, in the event that the Legislature in its wisdom cannot see its way clear to take this action, that the Board of Control be empowered to carry on the work outlined herein, the expense therefor to be apportioned among and paid from the

current expense appropriations of the six institutions named herein, the aggregate amount to be expended not to exceed the sum of five thousand dollars annually.

THE CARE OF DANGEROUS AND CRIMINAL INSANE.

The constantly increasing numbers of these classes in our institutions warrant us in calling your special attention thereto. They are a constant menace to other inmates, and, as well, to those who are responsible for their safe-keeping. Their recovery being hopeless, humane provisions should be made for their safe and constant custody.

There are now about 70 of these classes in the Prison and the three Hospitals for the Insane and School for Feeble-Minded. It is conceded. that the Prison is not a proper place for them, and also that it is unsafe. to attempt to care for them at the Hospitals where there are necessarily so many opportunities for escapes or injury to other patients or attend

ants.

We recommend the construction of a building for the detention of the classes in question, the necessary legislation to make legal commitments and transfers thereto, and a sufficient appropriation to maintain it. We believe it should be near and under the jurisdiction of one of the Hospitals for the Insane, and that speedy action is imperative.

The room vacated by these people in the institutions where now cared for could be utilized for new admissions; hence very little, if any, additional expense will be incurred by the separation, while great good will be accomplished and other inmates more efficiently protected.

SURGICAL OPERATIONS.

It often becomes necessary that surgical operations be performed. upon inmates of state institutions to save life or health, and in some cases great haste is necessary. It has been the policy of the Board not to permit such operations unless approved by the relatives of the patients. In some cases such relatives cannot be located; in others, when located, they exhibit a heartless degree of indifference not to be expected under 3uch circumstances. Whether the Board has a legal right to approve operations under such circumstances is questionable. We therefore recommend that a law be passed requiring the Superintendents of state institutions to report to the Board all cases where major surgical operations are, in their opinion, necessary, stating briefly the reasons why and probable results of delay in performing the same, in which report the Assistant Superintendent shall concur; that upon the approval of the Board of Control the operation may be performed.