Included in cost of milk and beef, respectively. Repairs to dairy and new fencing are charged against cost of milk and beef, respectively. This item does not include the transportation of patients; nor are beds, bedding, drugs, and other sup plies from the purveying depot in Washington included in this account. This item is the value of their rations which are properly charged under "Ration." If we eliminate the cost of repairs, renewals of equipment, and new construction our net cost per patient per day is $1.5468. This figure is of no interest except to compare our cost with that of other institutions which do not reckon these items. Institutional care of the advanced tuberculous is very expensive, If the laity were properly instructed and the profession sufficiently skilled, all tuberculosis would be diagnosed in incipiency and prolonged sanatorium treatment seldom needed. It is evident, however, that we must continue for a time, at least, to treat patients The money derived from refunds is turned into the general maintenance account Public Health Service, and that from the sale of hides, etc., to the general account of the Secretary of the Treasury. suffering from the end results of tuberculosis, and for such institu tional care is necessary. The ration is seen in the above table to amount to $0.6068 per day. If beef had been counted at contract price ($0.1175 per pound by carcass) the cost of ration would have been $0.6901. Repairs and renewals of equipment, to which might also be added the salaries and rations of carpenters, plumbers, and painters, is a large item of expense, and always will be at this station, where there are over 30 buildings, all of which are old and 91 cheaply constructed tent houses. The coldest winter in the history of the station increased the expense for fuel, which amounted to $9,166.59 for coal used in the power plant and ranges, and $5,111.60 for wood used in tent houses and other quarters. The item, $4,856.29, for nursing is expended almost entirely in the infirmary, only $581.47 of this amount being expended in the nursing of ambulatory patients. Some economy has been effected by the burning of sawdust and chips in the power plant, 142 cubic yards having been collected on the grounds, and by the making of 900 gallons of soft soap for use in the kitchens. Effort has been made to compare the cost of treatment at this sanatorium with that at similar institutions, and a list of all the large sanatoria from which data on this subject could be secured is appended. Cost of maintenance per patient per day in 58 representative sanatoria, 1912. Cost of maintenance per patient per day in 53 representative sanatoria, 1912-Continued. 140 per cent advanced. 275 per cent advanced. Information obtained from annual report of sanatorium. NOTE. In all cases where the source of information is not given, data was furnished in letter from superintendent of sanatorium. The Farm. The farm and dairy have been operated at a small profit during the year. This profit could have been increased at will by raising the price of any of the products, such as eggs, above the contract price. As a matter of fact, the farm is indispensable to the successful operation of the sanatorium. The item "Labor loaned sanatorium" covers many exigencies of sanatorium administration calling for additional help; in the same way alternate Sunday relief was afforded employees of the sanatorium. The alfalfa produced on the farm, 131 tons, and the ensilage and other forage are not recorded as a farm credit, as these were all consumed in the production of milk and beef. Milk has been credited at cost of production, as we have no contract price on this article. It would be practically impossible to buy bottled milk from a tuberculin tested pure bred Jersey herd at any price in this locality. Herd report. The present number of cattle is just about sufficient to furnish the station with beef, veal, and milk. It is also all the range will accommodate. In this neighborhood about 20 acres per head is allowed pasturage on a large scale, and according to this estimate our range is overstocked, but the Government range is superior to the average grazing land in this region, and, with some additional watering facilities, will probably accommodate our present number of cattle without risk of loss in good seasons. The losses were due chiefly to starvation and exhaustion from traveling long distances to water and were not greater than the usual losses from these causes at other ranches in this neighborhood. Large loss from blackleg among the young stock was prevented by thorough vaccination. At the present time we are threatened with great shortage of grass, owing to an unusually dry summer. Cattlemen in the southwest are endeavoring to dispose of large numbers of their cattle for this reason. All dairy cows were given the customary biennial tuberculin test, with negative results. No case of tuberculosis has yet been found among the dairy or range herds at this station. |