BENEVOLENT INSTITUTIONS 37 



chusetts, Ohio, etc., such income covers less than 50 per cent 

 of the cost of maintenance; in 19 states it equals from 50 to 80 

 per cent of the cost of maintenance; in Indian Territory, 

 Nebraska, North Dakota, and Oklahoma it was, respectively 

 94.1, 89.3, 96.5, and 82.9 per cent of the cost; and in Utah and 

 Oregon the income actually exceeded the cost, the percentages 

 being 116.2 and 109.7. 



There is an apparent contradiction in describing hospitals 

 as benevolent institutions when the amount of money they 

 receive from pay patients is equal to or in excess of the cost of 

 maintenance ; but, in general, it should be remembered that to 

 a very large extent the moneys termed income do not represent 

 the personal contributions of the patients or their relatives and 

 friends, but the amounts collected from the public authorities 

 legally responsible for their support. Furthermore, the cost 

 of maintenance as given does not include improvements or 

 general equipment. A hospital may receive income, on ac- 

 count of patients, equal to or larger than the bare cost of 

 running it, yet deserve the appellation benevolent, because it 

 owes its existence to generous endowment, and because the 

 services of physicians and attendants are not reckoned among 

 the items of cost. 



Although the dispensaries differ from other institutions 

 in the respect that the persons frequenting them are occasional 

 visitors rather than inmates, they are too conspicuous a part of 

 the medical charity to be ignored. If certain out-patient 

 departments had been counted as separate institutions, which 

 would have been misleading, the total number of dispensaries 

 would have been augmented. Dispensaries that are mere 

 feeders to hospitals run for profit were excluded. 



For 27 states no dispensaries were reported. About two 

 thirds of the entire number (156) are found in California, 

 Illinois, Maryland, Massachusetts, New York, and Pennsyl- 

 vania. In other words, dispensaries as separate institutions 

 are peculiar to large urban centers. Only 11 were maintained 

 at public cost, and 17 were supported by churches, the re- 

 mainder (128) being under private control. 



From 33 dispensaries no statements were obtainable in 

 regard to the number of cases treated during 1904. The total 



