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During the year 1901-02, at the suggestion of the State Board of Charity, five new buildings were added, -- an administration building, a recreation hall, a large dining-room and two new wards, -- thus increasing the capacity of the institution to two hundred and fifty beds. In consequence of the larger number of patients, a second medical assistant for the regular service was appointed at this time.

By statutes enacted in June, 1903, chapter 445, and under chapter 75 of Resolves of 1904, after a careful study of the question by the State Board of Charity, provision was made for the addition of "four brick cottages," two to be used as general wards, one as a possible "probation ward" and another as an "infirmary" for twenty or thirty patients who might require special nursing during severe illness. These wards were completed in 1905, with the exception of one spoken of as a "probation ward," which, owing to the unexpected expense of establishing a new heating plant, was omitted. The infirmary was finished later. The capacity was thus increased to about three hundred and eighty beds.

At this time, in 1905, the expense per capita was 18.83 per week, as against 19.36 in 1904.

In 1904 the Boston office was removed from 181 Tremont Street to the Out-Patient Department of the Massachusetts General Hospital, the duty of examining patients for admission falling upon the resident assistant physicians of the Sanatorium, instead of the attending physicians. Examining offices were also established in Worcester, Lowell, Springfield, Fall River and Pittsfield, special examiners having been appointed to these positions.

In 1905 two women members of the Board of Trustees were appointed, making the number seven in all.

In the same year, at the suggestion of the State Board of Charity, an out-patient department was established at the Sanatorium, for the benefit of patients who were boarding in the surrounding farm-houses but not connected with the Sanatorium. Two local physicians in Rutland kindly consented to take charge gratuitously of this department; but thus far, according to the Superintendent, in his eleventh annual report (1907), their services have not been in such demand as was at first thought would be the case, there being on an average only eight or ten calls weekly. Most of the work of this department now consists of laryngeal examinations and treatments done by the assistant physicians in the Sanatorium.

In 1906 the Trustees decided to change the form of administration by abolishing the positions of attending physicians, and by placing the whole medical department under the charge of a Medical Superintendent and his assistants. Following this decision, Dr. E. O. Otis of Boston (who had been chosen to fill the place of Dr. Bowditch after the latter's withdrawal on January I, 1906) and Dr. H. C. Clapp ceased to be attending physicians and were made consulting physicians, to serve without salary. Dr. Frederick L. Hills was also chosen as Medical Superintendent, in the place of Dr. Walter J. Marcley, who resigned to take charge of the Minnesota Sanatorium.

The cost per capita during this year again increased to $9.38, largely due, doubtless, to the general increased cost of living everywhere. In 1907 this cost was increased to $10.07, probably due to the same cause as before.

The report for 1904 contains an interesting statement as to the effect of the Sanatorium upon adjacent real estate values and upon the health of the native population of Rutland. On the assessor's books the total valuation of the town in 1904 was $704,183; in 1895, before the Sanatorium acquired any land, it was 1518,180, -- a gain of $186,000. The number of deaths from tuberculosis (exclusive of those who came to the town to be treated for the disease) for the whole time since patients were first received, viz., 1899 to 1904, inclusive, -- six years, -- was eight; for the six years immediately preceding (1893 to 1898 inclusive), eleven; for six years 1887 to 1892 inclusive, eleven; for six years 1881 to 1886 inclusive, fourteen. The town has thus averaged for the last twenty-four years two deaths per year from tuberculosis in a population averaging about one thousand. During the six years previous to 1904, with increased population, the deaths from this cause were less than before.

A table of comparative results expressed in percentages during the first eight years of the Sanatorium is hereby appended. It is taken from the tenth annual report of November 30, 1906.

Comparison of Percentages in the First, Second, Third, Fourth, Fifth, Sixth, Seventh and Eighth Years.