We have little authentic information relative to the institution population prior to 1903. The United States Census Bureau in its report of 1904 on the insane in hospitals shows that in 1903 there were 140,312 patients, of which number 47,078, or 34.3 per cent, were of foreign birth. The percentage of foreign born in state hospitals in various parts of the country at that time were as follows:— New York 46.9 per cent Massachusetts 42.0 " " New Jersey 39.5 " " Pennsylvania 30.9 " " District of Columbia 36.7 " " Connecticut 35.4 " " Michigan 43.5 " " Illinois 41.6 " " Wisconsin 50.9 " " Minnesota 63.5 " " North Dakota 68.4 " " South Dakota 49.9 " " Montana 57.8 " " Nevada 63.1 " " In 1912 an investigation was made of the foreign born in the New York state hospitals. As a result of the census taken, it was found that of 31,624 patients, 13,728, or 43.4 per cent, were foreign born. Of this number 4,487 had been naturalized and 9,241, or 29.2 per cent of the total hospital population were aliens. At the Manhattan State Hospital in New York City, out of a total of 4,570 patients 2,526 were foreign born and only 708 had been naturalized. The Central Islip State Hospital at the same time had 4,438 patients. Of this number 2,803 were foreign born and only 891 were naturalized citizens. Thus, at the Manhattan State Hospital 39.8 per cent and at the Central Islip State Hospital 43.1 per cent of the patients were aliens. It was shown that the average hospital residence of the insane in the state was 9.85 years. Based on the maintenance expenditures for 1912 it was estimated that the cost to New York for caring for its 9,241 aliens in the state hospitals was $2,579,902.78 per year, and for their entire hospital residence, over twenty-five million dollars.[73] Of the first admissions to the New York hospitals for the eight years beginning October 1, 1904, and ending September 30, 1910, 46.2 per cent were foreign born. The citizenship of the first admissions for this same period is shown by the following table:— _Year_ _Aliens_ 1905 28.4 per cent 1906 31.4 " " 1907 32.6 " " 1908 33.9 " " 1909 33.4 " " 1910 33.0 " " 1911 32.9 " " 1912 29.3 " " It was also shown that 14.7 per cent of the aliens admitted in 1905 had been in the United States less than three years, in 1906, 18.7, in 1907, 21.8, in 1908, 20.1, in 1909, 18.1, in 1910, 15.5, in 1911, 14.9 and in 1912, 18.1 per cent. The birthplace and citizenship of first admissions to the New York state hospitals since 1912 is shown in the following table:— _Year_ _Foreign born_ _Aliens_