Massachusetts. State Board of Charity.

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Different groups are assigned to the trades which are selected
for them by the superintendent after consultation with parents
and a study of the individual. Boys are put to painting, black-
smithing, carpentering, or the different branches of farming,
as they seem most qualified. While it is not possible to make
a finished tradesman in the time usually spent at the school, it
is possible to make a boy sufficiently efficient in his particular
branch to make him valuable in his trade. But if nothing more
were done with these boys than to develop in them habits of
industry and healthful living the school would be doing a most
useful work.

The minimum age limit of admission is fifteen, and there-
fore all the boys are above school age; but there are among
them some illiterates and many who are backward. These have

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Part I.] GENERAL WORK OF THE BOARD. 45

their deficiencies supplied in the schoolroom. Exercises in
composition and penmanship for all the boys are parts of the
educational program, and a taste for good books is encouraged
in a practical way.

Recreation in the form of outdoor sports is an important
factor in the system of training, and the school baseball and
football teams not only are the media for healthful enjoyment,
but they also provide a natural avenue of contact with the world
outside the school by competitive series with teams from
neighboring towns and schools.

During the year the boys gave a minstrel show and repeated
it in near-by towns. The band is an important feature in en-
tertainment and has played for the open-air concerts in the
town.

While there are always infractions of the rules necessitating
recourse to punishment, the spirit of graduates of the school
may jtistly be gathered from the fact that there is an alumni
association which holds an annual reunion in Boston in the
winter and a field day at the school in summer. Large numbers
are in attendance at each.

Out of an appropriation of $68,230 a total of $68,229.79
was expended for the maintenance of this institution. Of the
amount expended $28,007.84 was for salaries, wages, and labor;
all other expenses, $40,221.95. Weekly per capita cost of
maintenance, computed on expenses less sales and refunds from
maintenance, $7,173. Total receipts from all sources other
than the State treasury, $193.15. Net cost of maintenance to
the Commonwealth, $68,036.64. Ratio of daily average num-
ber of persons employed to daily average number of inmates,
1 to 4. For detailed analysis of receipts and expenditures,
see pp. 69-80.

The year closed with one stone and concrete cottage for 30
boys practically completed, and another of the same type in proc-
ess of construction. In addition, several minor improvements
have been effected, namely, moving and remodelling a small
house for a cottage tenement, building two silos and a chicken
house, extending sidewalks and water-pipe connections, and the
extension of sewer beds.

The Trustees ask this year for the following four items of ex-

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46 STATE BOARD OF CHARITY. [P. D. 17.

tension and permanent improvement, all of which are approved
by this Board: —

L Central building, providing chapel, schoolrooms, central
offices, fireproof vaolt, and assembling and exercising
rooms $90,000 00

2. Heating and furnishing and equipping cottage for 30

boys, now being built 3,000 00

3. Two cottages for 30 boys each and attendants, and for

furnishing, heating, and equipping the same . 49,000 00

4. Moving, relocating, and making repairs on large hay

bam 1^50 00

$143,550 00

Of these requests, the second supplies an omission in last
year's appropriation, while the fourth seeks to eliminate a dan-
gerous fire risk by removing an old Shaker bam now located
in the centre of the institution group. The central building is
a vital necessity in the housing, discipline and constructive pur-
pose of this institution. Makeshift acc(»nmodations thus far
found in the buildings of the old " settlement '* are so far out-
grown by the rapid increase in court ccnnmitments that proper
school, chapel, and assembly provisicm is no longer available
without a central building. The structure as planned would
house the administrative officers in addition.

The two cottages asked for are planned after thorou^ study
of requirements and methods in economical housing and efficient
care, discipline, and treatment. They represent the least
amount of extension in the capacity of the school necessary to
meet the pressure of numbers.

Ikdustrial School por Girls, Laitcaster.
Amy F. Everall, Superintendent.
Total valuation of plant, real and personal, $363,043.71.
Normal capacity of plant, 312. Value per unit of capacity,
$1,163.60.

Provides custodial care and industrial training for delinquent
girls under twenty-one years of age. Only girls under seven-
teen may be committed.

During the year 563 cases have been under care. This total



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Part I.l GENERAI. WORK OF THE BOARD. 47

number of cases is 16 more than in 1912 and 32 more than ia
1911. The number in the school at the beginning of the year
was 299 ; admissions during the year, 264 ; discharged, includ-
ing all persons going out of the school, 258 ; remaining Novem-
ber 30, 1913, 305. The largest daily census was 332 ; smallest,
288 ; daily average, 308.

The list of causes of admission in the 264 cases received
during the year was as follows : common night walker, 2 ; de-
linquency, 2; delinquent child, 5; disorderly conduct, 1; dis-
obedient, 2-; drunkenness, assault and battery, 1; fornication,
10 ; idle and disorderly, 6 ; idle and lascivious, 1 ; idle, vagrant
and vicious, 2 ; idleness, 13 ; larceny, 8 ; lewdness, 10 ; lewd and
lascivious, 2; lewd, wanton and lascivious, 1; returned from
place or parole, 75; returned from hospital, 11; returned for
visit to the school, 32 ; runaways, 1 ; stubbornness, 64 ; stubborn
and disobedient, 2 ; imnatural act, 1 ; vagrancy, 2 ; vicious and
wanton, 1 ; waywardness, 2 ; witnessing at court, 7.

Of the 258 girls discharged or released during the year, 3
ran away ; 188 were released on parole to relatives or to families
for employment ; 7 went to witness in court ; 24 from visiting
the school; 2 to temporary place; 2 to board; 19 were trans-
ferred to other institutions, not penal ; 8 were sent to other in-
stitutions, penal; and 4 became of age at the school and were
thereby discharged.

This school receives girls up to the age of seventeen years,
who are committed by the court or transferred by the State
Board of Charity as delinquents. There are an administration
building, a chapel, a small hospital, a storehouse, dairy and
farm buildings, and ten cottages. One of these cottages is in
the town of Bolton, a mile and a half from the school, and is
used as a disciplinary house for those girls who get along badly
in the main school.

Twenty-nine of the 188 girls paroled last year went imme-
diately to parents or relatives. One hundred and fifty were
placed at work for wages. An examination of the records of
the 119 girls who passed out of the care of the parole depart-
ment of the past year shows that of 72 it could be said that
their conduct was good; of 9 it was bad; and of 19 it was
unknown. In 19 cases it was impossible to classify. Thus 60



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48 STATE BOARD OF CHARITY. [P. D. 17.

per cent, are known to be taming out well, while less than one-
tenth are known to have conducted themeelves badly.

The proportion of girls of low mental grade has increased,
although this condition promises some degree of alleviation soon
through the opening of additional buildings at the Wrentham
State School. This relief is only temporary, however, and the
often reiterated arguments for removal of the feeble-minded
from the Industrial School still remain unanswerable from the
point of view of the interests of the normal as well as the
feeble-minded girL

During the year a grading system based on merit has been
introduced and is proving successful. The new girl is first
placed in the receiving cottage and from there transferred to
the first grade. She is promoted to the honor grade if her con-
duct warrants it, and in this grade she is entitled to many
highly valued privileges. If her conduct is not good she may
be sent from the first grade to the second grade where she loses
all privileges. A girl in the honor class may by misconduct
also suffer transfer to the second grade. There are two monthly
entertainments, one for the honor grade and one for the first
and honor grades combined. These entertainments are a great
aid to good conduct, as they are highly esteemed breaks in the
routine.

Another innovation during the year is the rearrangement of
the schedule of studies. Formerly classes were confined to the
afternoon, but at present there are morning sessions as well.
The class hours are from 9 a.m. to 11.45 a.m. and from 2 p.m.
to 4.50 P.M., and all girls are enabled to have one daily period
in the classroom and one of industrial training.

All the girls are assembled at 8.30 a.m. for short exercises
in the chapel, from which they start on their program for the
day.

Discipline at the school has greatly improved, as indicated
by the fact that there were but two runaways for the entire
year.

Many improvements have been made in the buildings and
grounds and have been the means of providing healthful out-
door exercise for the girls, whose physical condition has been
very good for the year.

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Parti.] GENERAL WORK OF THE BOARD. 49

The most important and helpful material improvement is the
installation of electric lighting, displacing the oil lamps which
have been for years a potential danger to life and property. A
new and efficient telephone ^stem has been completed, and
Fisher cottage has been prorided with a new heating system.

With an appropriation of $78,500, a total of $81,553.34
was expended for the maintenance of this institution. Of the
amount expended, $35,761.10 was for salaries, wages, and
labor; all other expenses, $45,792.24. Weekly per capita cost
of maintenance, c(Hnputed on expenses, less sales and refunds
from maintenance, $5,061. Total receipts from all sources
other than the State treasury, $285.22. Net cost of mainte-
nance to the Commonwealth, $81,268.12. Ratio of daily aver^
age number of persons employed to daily average number of
inmates, 1 to 4.4. For detailed analysis of receipts and ex-
penditures, see pp. 69-80.

The central school building, for which an appropriation of
$40,000 was made last year, is under way and will be ready
for occupancy during the current year.

The Trustees make the following requests for special appro-
priations, all of which, excepting the fifth, are approved by this
Boird: —

1« 'Hig^-preesare water eyetem connecting with town water

supply for fire protection $5,340 00

2. Snrvey of school gronnds, showing exact location of all

buildings, undergronnd water and sewer pipes and
underground wires and conduits, and for outline plan
of entire premises establishing boundaries . • . 500 00

3. Completing sidewalks 800 00

4. Piggery building . . . . . . . . 1,700 00

5. Finishing off a part of second story and for building

an outside open-air sun and sleeping porch upon in-
firmary buOding 1,950 00

6. Unit of central steam-heating S3rstem and for connection

with infirmary, schod building and chapel, and for
steam-heating system in infirmary, and for complet-
ing steam-heating system in chapel, and removing two
furnaces from the infirmary and installing them in
other buildings to replace worn-out furnaces . . 11,500 00

$21,790 00

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50 STATE BOARD OF CHARITY. [P. D. 17.

The first three items represent good economies. The first
would provide fire protection which is not now adequately sup-
plied. High pressure is ready at hand ; the appropriation would
merely provide necessary connections. , The survey of grounds
is an essential at all institutions. The completion of sidewalks
represents the end of an improvement that has been in progress
for some time.

The institution stands in great need of a central heating plant.
The request would provide the first unit of such a system.

The item for finishing off a part of the second story of the
infirmary and for the construction of a small addition thereto
is disapproved by this Board, on the ground that ^^in the
opinion of this Board it is inadvisable to finish off the attic
of this building for the care of infirmary patients, and inex-
pedient to impair the capacity of the existing infirmary to the
extent that must be done in building stairways to meet the new
improvement."

MASSACHUSETTS HOSPITAL SCHOOL.
John E. Fish, M.D., Superintendent.

Total valuation of plant, real and personal, $316,072.13.
Normal capacity of plant, 270. Value per unit of capacity,
$1,170.64.

Provides care and schooling for crippled and deformed chil-
dren.

During the year 295 cases, representing the same number
of separate children, have been under care. This total is 25
more than in 1912, and 32 more than in 1911.

On December 1, 1912, there were 238 children in the school.
FiJly-seven new cases were admitted and 45 discharged during
the year. The maximum number at any one time was 257,
the minimum, 202, and the daily average, 235.83, an increase
of 7.27 over the preceding year. The average age at time of
admittance was seven years and eleven months.

All of the children admitted were certified by physicians as
being physically unsuitable for instruction in the public schools.
Twenty-six of these were cases of bone tuberculosis, 17 of
various forms of paralysis, 14 of rickets, malnutrition, and de-
formities.



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Part 1.1 GENERAL WORK OF THE BOARD. 51

The new admissions have been of a higher mental grade and
more amenable to orthopcedic treatment than the average of
those formerly admitted. This condition is probably due to
better classification of applications and more knowledge and
confidence on. the part of the public in the schooL At the out-
set it was necessary to admit a number of children from alms-
houses and other institutions, a large proportion of whom proved
to be mentally deficient It is interesting to note, also, that as
the institution grows the number of girls among the new ad-
missions increases, which is another indication of the growth
of public confidence in the school.

Twenty-four out of the 45 discharges during the year had
been brought to a condition where they were capable of self-
support or could be classed with normal children. Kine of the
discharges were feeble-minded and unable to take advantage
of the opportunities offered by the school. Seven were released
reluctantly, due to insistent pressure on the part of parents. In
one case a hopelessly paralyzed boy was discharged after he
had been taught to read, enabling him to enjoy practically the
only pleasure of which he was capable. There were two deaths
during the year.

Those discharged capable of self-support were competent to
take up the following occupations : clerical and telephone opera-
tor, 1 boy; steam laundry assistants, 2 boys; cook and domestic
work, 2 girk; messenger, 1 boy; carpentry and woodworking
machines, 1 boy; cobbling and leather work, 1 boy; farming
and gardening^ 2 boys. Five of this number were graduated
from the grades and received the school diploma. The others
recovered before finishing the school course, or were beyond
compulsory school age, and were better adapted for suitable
employment than for further academic instruction.

During the year another schoolroom has been opened and an
additional teacher employed. The average time for instruction
in the school remains the same, one and one-half hours daily.
All the school work is done in the open air, the windows in the
two inside rooms being kept constantly open except when the
weather forbids, and the outdoor rooms are in service during
the entire year.

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52 STATE BOARD OF CHARITY'. [P. D. 17.

The assembly hall has added greatly to the comfort, enter-
taimnent, and education of the children since its opening, and
has been the scene of many enjoyable gatherings in addition to
its use as a chapel for various religious exer^uses. The children
have given a number of plays, a minstrel show, and musical
entertainments, while the brass band has given a number of
concerts. There is also among the girls a guitar and mandolin
club formed during the year, which promises additional enjoy-
ment and instruction to the girls. The library which is con-
nected with the assembly hall is open daily, and is very generally
used imder the supervision of one or another of the teaching
staff. Plans are now being made to coordinate the use of the
library with the school work.

Recreation in the open is one of the great factors in the up-
building of the health of these children; this feature has been
further emphasized during the year.

The close of this year shows the practical completion of the
school as contemplated by the act of establishment passed in
1904. The girls' cottage now under construction will provide
acconmiodations for 30, meeting the requirements of the act.
The original appropriation was $300,000, and it is expected
that provision for 300 children will be made within the appro-
priation. The school has developed slowly because of its experi-
mental nature, and every new step while carefully thou^t out,
was tentative, the purpose in the Trustees' minds being to build
up an institution that would develop health, self-reliance and
capacity for some degree, at least, of self-support in the chil-
dren, and not have it become a mere repository for the crippled
and physically handicapped. As the years go on this purpose
appears to be measurably accomplished, and the numbers who
go out from the school able to take part in the ordinary activi-
ties of life gradually increase.

Out of an appropriation of $73,614, a total of $68,807.94
was expended for the maintenance of this institution. Of the
amount expended, $30,283.37 was for salaries, wages, and
labor; all other expenses, $38,524.57. Weekly i)er capita cost
of maintenance computed on expenses less sales and refunds
from maintenance, $5,583. Total receipts from all sources other
than the State treasury, $39,720.42. Net cost of maintenance

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Part I.] GENERAL WORK OF THE BOARD. 53

to the Commonwealth, $29,087.52. Ratio of daily average num-
ber of persons employed to daily average number of inmates,
1 to 3.3. For detailed analysis of receipts and expenditures,
see pp. 69-80.

The Trustees ask this year for $2,700 for the purchase of cows
and dairy equipment. The new cow bam is now ready for oc-
cupancy. The request is approved by the Board.

THE STATE TUBERCULOSIS SANATORIA.

The Board's supervision of tuberculosis hospitals covers the
Rutland, Lakeville, North Reading and Westfield State sana-
toria, and the tuberculosis wards at the State Infirmary. The
four separate institutions are administered by one Board of
Trustees, the Trustees of Hospitals for Consumptives.

During the year these four institutions treated 2,287 cases,
with a combined normal capacity of 951 patients, and a daily
average population of 904.01.

Of the total number cared for, 872 were in residence at the
beginning of the year. The 1,415 admissions during the year
were offset by the 1,351 discharges, leaving 936 on November
80, 1913.

Of the 1,415 cases admitted, 232 were classed as incipient;
482 as moderately advanced; 676 as advanced; 8 as non-tuber-
cular ; and 17 as imdetermined. Seven hundred and sixty-three
were males ; 652 females.

The discharges were classified as follows: disease arrested,
356; condition improved, 402; condition not improved, 221;
non-tubercular, 8 ; died, 236 ; unclassified because of shortness
of stay, 128. Thus 758, or 56.1 per cent, of all the discharged
cases that were considered were sent away either with the disease
apparently arrested or with condition improved. The corre-
sponding percentage for last year was 63.3.

Assembling the children at Westfield has progressed rapidly.
The new children's ward with accommodations for 60 patients
has been completed and is now occupied.

The after-care and following up of discharged patients in-
augurated a year ago has been carried on with increasing vigor
during the year just closed. This work forms an essential part
of the educational purpose of the sanatorium.



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54 STATE BOARD OF CHARITY. [P. D. 17.

Separate report is not made upon the tuberculosis department
of the State Infirmary. It is considered under the general head-
ing of the State Infirmary, at p. 30 ante. The four separate
sanatoria follow : —

Rutland State Sanatorium, Rutland.
Elliott Washburn, M.D., Superintendent.

Total valuation of plant, real and personal, $366,710.03.
Normal capacity of plant, 354. Value per unit of capacity,
$1,600.87.

Provides hospital care and treatment for persons afflicted with
pulmonary tuberculosis.

During the year 794 cases have been under care, representing
the same number of separate individuals. This total is 74 less
than in 1912 and 87 less than in 1911. Of the whole number,
345 were in residence at the beginning of the year. The re-
maining 449 were admitted under the following classification,
based upon the ascertained progress of the disease: incipient,
161, or 35.86 per cent.; moderately advanced, 212, or 47.22
per cent. ; advanced, 63, or 14.03 per cent ; found to be non-
tubercular, 6; not determined, 7. Of the new cases, males
numbered 225; females, 224.

The discharges numbered 438, namely, 223 males and 215
females, classified according to conditions as follows: disease
arrested, 161, or 36.7 per cent.; improved, 145, or 33.1 per
cent.; not improved 58, or 13.2 per cent; non-tubercular, 5;
died, 36, or 8.2 per cent; unclassified because of shortness of
stay, 33, or 7.5 per cent.

The average daily census was 348. The average for 1912 was
346. Average duration of stay of patients, two hundred and
fifty-four days. The corresponding average for 1912 was two
hundred and twenty-seven days.

With an appropriation of $183,000, a total of $188,076.55
was expended for the maintenance of this institution, creating
a deficit of $5,076.55. Of the amount expended, $67,116.08
was for salaries, wages, and labor; all other expenses, $120,-
960.47. Weekly per capita cost of maintenance computed on
expenses less sales and refunds from maintenance, $10,125.
Total receipts from all sources other than the State treasury.

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PartL] GENERAL WORK OF THE BOARD. 55

$41,667.03, Net cost of maintenance to the Commonwealth,
$146,409.52. Ratio of daily average ntunber of persons em-
ployed to daily average number of inmates, 1 to 1.73. For de-
tailed analysis of receipts and expenditures, see pp. 69-80.

On September 29 Dr. Bartlett, superintendeht since June,
1910, resigned, and was succeeded by Elliott Washburn, M.D.

On March 17 fire broke out in the engine room, probably
caused by defective insulation, and damaged the electrical ma-
chinery and the interior of the engine room to the extent of
$5,000. Fortunately, the plant was not crippled beyond tem-
porary repair, so that the patients suffered no hardship.

An improvement of importance during the year has been the
completion of the new horse bam. The total expended out of
appropriations for special purposes was $9,457.05. The Trus-
tees this year ask for appropriations for special purposes as fol-
lows: —

1. Watchman's dectrie clock system $480 00

2. Removing old bam 600 00

3. New poultry houses 1,000 00

4. Water supply 35,000 00

$37,080 00

Items 1 and 2 are important for the safety of the patients, the
first by insuring protection while the institution sleeps, the sec-
ond by removing a fire risk. The third item represents normal
expansion of the poultry farm. The last results from study by
the Trustees and this Board of the advisability of an inde-
pendent water supply, and arises out of conditions of financing
the present supply, which are increasingly unfavorable to the
Commonwealth.

NoETH Beading State Sanatokium, Nobth Beading.
Carl C. MacCobison, M.D., Superintendent.

Total valuation of plant, real and personal, $156,202.52.
Normal capacity of plant, 174. Value for unit of capacity,
$897.71.

Provides hospital care and treatment for persons afflicted with
pulmonary tuberculosis.



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