REPORT OF THE FREEDMEN's HOSPITAL WASHINGTON, D.C., September 1, 1899.

SIR: I have the honor to herewith submit the annual report for the fiscal year ending June 30, 1899.

Since my last annual report many changes have been made in the conduct of affairs and the general management of this institution, thereby establishing a higher order of efficiency. A new system of bookkeeping has been introduced in each department; also new statistical methods in both the in-patient and out-patient department of the hospital.

PATIENTS. The number of in-patients treated during the year was 2,374. The number of out-patients treated was 4,779. The total number of patients treated within the wards and dispensary was 7153. Admission to the hospital was denied to 225, who were not eligible under the rules governing the admission of patients. Twenty-five of the deaths recorded occurred within forty-eight hours after admission, due to the fact that many patients are brought to the hospital in a dying condition. Four hundred and twenty-eight surgical operations have been performed, including some of the most difficult known to science, with only 5 deaths, showing a percentage of only 1.16. The death rate of all causes has been 7.11. Excluding the cases admitted in moribund and those dying in the consumptive wards, the death rate is only 4.25.

The classified report of cases treated, however, which follows in the tabulated summary, speaks for itself. The record for the year, both in surgical operations performed and medical care given to the patients, reflects credit upon the institution.

IMPROVEMENTS AND ALTERATIONS. Among the improvements made since the last report, none have better justified the expenditure than the introduction of an intercommunicating telephone system, which was put into operation early in the fiscal year just closed. Its usefulness as a means of better dispatching the business of the hospital and of offering to the public a more efficient service is inestimable.

The out-patient department has received considerable attention during the past year, to the extent that the classification of disease has been carefully tabulated; also a card system introduced, whereby the revisit of each patient and the diagnosis of each case are accurately kept. The number of cases applying for treatment is constantly increasing. During the past year about 2,000 more cases were treated than 0005 4in the previous year. The present accommodations, consisting of one room 12 by 18 feet, are inadequate and totally unfit for such work. It is necessary to treat men, women, and children, and all classes of diseases, in this one room, under the most unfavorable circumstances.

In my last report the propriety of establishing a children's ward was urged. It is a pleasure therefore to announce that one of the wards is now being altered for the accommodation of children. The plans embrace 12 beds, 2 isolating rooms for suspected contagious diseases, occurring among them, a surgical dressing room, a diet kitchen, and other appointments necessary to a children's department. This work will be completed in a few weeks, and the hospital will be in a position to give succor and care to many of that portion of humanity who apply for treatment.

A room for examining patients who apply for admission has been fitted up and made sufficient to meet the present demands. Its equipment has proven very advantageous. Since its existence three patients applying, having been discovered to have smallpox, it was possible under the circumstances to properly isolate them in this room, until the health department removed them. Heretofore there was no room for examination, and it was necessary to admit to the ward before examination. Many other improvements of minor importance were made during the year.

NEEDS. It becomes necessary to reiterate the plea for new and modern hospital buildings. During the past year there has been ample illustration of the depressing condition which confronts the inmates, who occupy such ill-adapted frame buildings and the pressing and urgent necessity of more substantial brick structures. The present frame structures are so dilapidated and exposed that it is practically impossible to heat them, especially during such severe weather as was experienced last winter, when cold air and snow found easy access to the wards through the many crevices that are beyond repair. It is necessary to rely wholly on stoves to furnish such heat as can be secured, and some of the wards remain cold, damp, and moldy through quite a period in spite of the 500 tons of coal consumed. After escaping the dangers of winter, the perils of summer come. During one of the recent storms the frame buildings narrowly escaped destruction. Some of them visibly swayed and rocked, while a portion of one was completely demolished. It was only through the self-sacrificing devotion of the nurses and their remarkable presence of mind that a frightful panic was averted among the poor and helpless sufferers. A fire starting among these inflammable structures would find splendid fuel for a fearful conflagration that would result in indescribable injury and death.

The board of visitors to the Freedmen's Hospital, in referring to the needs of this institution in their report to the Secretary of the Interior, dated June 24, 1898, expressed themselves very forcibly concerning the immediate and urgent need of new buildings. Among other things they said, “These buildings are frame structures, built on the old army barracks plan of more than thirty years ago, and are wholly unfitted for modern hospital purposes. These buildings are not connected, and in all kinds of weather—winter and summer—convalescent patients are compelled to expose themselves in going to their meals in the dining room in the kitchen building. Further than this, the diet for the patients who are unable to leave their beds must be carried on trays 0006 5

THE FREEDMEN's HOSPITAL—ENTRANCE

0006 5from the kitchen, through the grounds, to the different wards. No means exist for properly heating, lighting, or ventilating the wards. In case of fire the buildings could not resist rapid destruction, and in any emergency it would be impossible to remove all the sick and helpless from the wards before the flames devoured the buildings and inmates.”

These illustrations and citations are given with the hope that they may convey some conception of the menacing conditions which confront so worthy a charity. It is proper in this connection to state that some of these buildings are more than 25 years old, and the expenditures made necessary for constant repairs and renovations in an effort to maintain them in a proper condition for hospital work would build at least one modern building of two wards.

From a hospital point of view the out-patient department should be adequately equipped for the treatment of medical and surgical diseases, diseases of the eye, ear, nose, and throat, and diseases of women, in order to give the proper care to all suffering and needy poor who apply. Area ways could be excavated around the basement and four rooms could then be properly constructed in addition to the one room which is in use at present. This would materially facilitate the reception and prompt care of the many dispensary cases. It would further give better opportunity for observation of all cases and assist in better classification. Under these circumstances the out-patient department would receive proper treatment under the most favorable conditions, thus preventing their subjection to the depressing effect of witnessing the treatment of those in pain and suffering.

PATHOLOGICAL ROOM. Bacteriology and pathology play a necessary and important role in successful diagnosis and treatment of diseases. These new methods of scientific investigation, so widely introduced throughout all well-regulated hospitals in the world, have fully demonstrated their usefulness, and this hospital should be abreast with others in furnishing every modern facility for doing such work. There is an urgent need for a pathological laboratory, which should be considered as essential to hospital results as an operating room.

In my last report extended reference was made to the inconvenience incident to the dual management of this hospital, and it was recommended that the honorable Secretary of the Interior request Congress to place the hospital management and finances under the absolute control of the Department of the Interior. Reference was also made to the unhealthy condition of the Government reservation opposite the hospital grounds, with suggestions as to how it might be improved and made a healthful and beautiful park. The necessity of establishing a ward for and authorizing the admission of pay patients was also urged. I desire to reiterate all the former report said on these subjects and renew the recommendations with regard to each.

INTERNES AND NURSES. While the charity service of this hospital is always its primary object, the possibilities and progress of modern medicine and surgery have brought it into other relations with the public. For this reason it is a cause of profound gratitude that this institution is enabled, while administering to the sick and alleviating suffering, also to exert lasting influence through its interne system and nurse-training school for the 0007 6practical cultivation of useful and scientific men and women. Since the internes have been exempted from the classified service the method of selection is from those doctors who make application and are graduates from a regular school of medicine. Four are appointed who have passed a satisfactory examination given by the hospital authorities and whose record has been satisfactory during their college course, and also who appear best fitted for practical work. The internes and externes chosen for the coming year represent the following medical schools, viz: Long Island Medical College, New York; Leonard Medical College, Raleigh, N.C.; Rush Medical College, Chicago, Ill.; Meharry Medical College, Nashville, Tenn., and Howard University Medical College, Washington, D.C. The appointment of two externes in addition to the four internes has been conducive to a higher order of service. This has been attested in the out-patient department, where during the clinic hours these externes are utilized as dispensary clerks, thus relieving the visiting physician of much extraneous work necessary in the treatment and classification of the cases. They have also proven valuable adjuncts to the internes as assistants in the general ward work of the hospital.

The work of the training school for nurses is steadily gaining recognition, as evidenced by the large number of graduates who are constantly employed in private nursing, which clearly demonstrates the value of such training as a practical working basis for young colored women. New fields are also opening, so that the graduates from the school are filling positions as superintendents of nurses to the number of eight in various hospitals recently established in different parts of the country. The annual number of applicants for admission to the training school is constantly increasing, thus permitting a more careful selection of higher grade applicants. Many of the nurses are graduates of normal schools and seminaries, holding teachers certificates. Such women elevate the standard of the training school for obvious reasons, and notably increase the good care and nursing received by the inmates of the hospital, which is the primary object of the training school in connection with hospital nursing.

THE BOARD OF VISITORS. It is an extreme pleasure that the opportunity is offered to express my warm appreciation of the admirable services rendered by the board of visitors. It is to their untiring efforts and activity in connection with every department of the hospital equipment, as also to their vigilance and complete confidence in its usefulness, that the present efficiency and success of the institution are so largely due. Their personal interest in its welfare has made it possible for me to put into execution the many reforms deemed best for the good of the hospital. It is to be hoped that the progress, which has received such impetus from them, will continue until Freedman's Hospital, beneath whose charitable roof so much is being done to alleviate the sufferings of humanity and through whose doors the worthy poor always find a welcome, shall stand in the very highest rank, presenting an architecture with all the facilities which modern science offers.

In the founding and maintenance of Freedmen's Hospital, the Government manifests its practical sympathy for the most unfortunate and helpless members of a much-persecuted race, and at the same time encourages the development of negro genius in the broad field of medical investigation and practice in a way that is impossible of 0008 7accomplishment by any other such institution known in this country. Whatever changes time and the wisdom of the legislative branch of our Government may make in the charities of the District of Columbia, there can be no difference of opinion among those citizens most interested in the general welfare of the negro race as to the utility and propriety of continuing Freedmen's Hospital separate and distinct from and independent of any large and general scheme which might be proposed as a substitute for the lesser plants now in operation. Whatever might be said in favor of the unification of all the charities in the District under one head—and there is much to be said in its favor—it is still clear to all observant men that the 90,000 colored residents of Washington and the ambitious negro youths of the country would not receive the same amount of help and encouragement from one general hospital that is now afforded by this plant.

It is to be hoped that Congress can be induced to view this matter in the light of the superior benefits which accrue therefrom to so large a number of an oppressed race; that it will consider how many trained doctors and nurses are scattered all through the United States, blessing the communities in which they reside, as a result of the experience gained in this hospital, and which experience would have been inaccessible to the great majority of them had not the doors of Freedmen' Hospital been open to them, and that it will soon add to the permanence and growing usefulness of this unique institution by the erection of such modern buildings as will stand for an enduring monument of the National Government's friendly attitude toward a loyal, though unfortunate, class of citizens.

I herewith append the tabulated statistics of the hospital for the year ending June 30, 1899.

Respectfully submitted. A.M. Curtis, Surgeon in Chief. Hon. Ethan A Hitchcock, Secretary of the Interior.

Summary for fiscal year 1898-99. White. Colored. Total. M. F. M. F. Patients admitted 255 28 912 817 2,012 Births 1 91 100 192 Patients in hospital July 1, 1898 8 2 72 66 148 Stillbirths 22 Total in hospital 264 30 1,075 983 2,374 ———————————————— Patients discharged 250 29 934 854 2,067 Deaths 5 1 96 68 170 Stillbirths 22 Total discharged 225 30 1,030 922 2,259 ——- —— ——- Remaining July 1, 1899 9 45 61 115 ——- ——- ——- Treated in out-patient department 146 47 2,708 1,878 4,779 Revisits for last three quarters 2,593 Prescriptions compounded 8,901 Emergencies 80 12 308 114 514 Operations 36 8 238 146 428 Refused admission 47 7 130 41 225 Revisits to emergency department 890 Patients treated in hospital and dispensary.410 77 3,783 2,861 7,131

0009 8

Table showing diagnosis, number treated, and result when discharged from the hospital. Diagnosis. White. Colored. Cured. Im- Unim- Not Died. Total. M. F. M. F. proved. proved. treated. Abortion 17 14 3 17 Adenitis: Tubercular, cervical 1 8 6 5 9 1 15 Inguinal, simple. 3 10 7 4 16 20 Inguinal, specific 2 8 1 5 5 1 11 Alcoholism 9 1 14 3 15 9 1 2 27 Abscess: Alveolar 1 3 3 1 4 Of axilla 3 3 3 2 1 6 Of breast 1 1 1 Of vulva 3 3 3 Of chest 3 3 3 Of scalp 1 1 1 Retropharyngeal 1 1 1 Ischio-rectal.1 2 2 8 2 5 Tubo-overian 1 1 1 Of liver 1 1 1 Psoas 1 1 1 Appendicitis 2 1 1 2 Atrophy of leg 1 1 1 Anourism: Femoral 1 1 1 Popliteal 1 1 1 Aortic 1 1 1 Amenorrhoea 7 4 1 2 7 Antiflexion of uterus 1 1 1 Anchyloglossia 1 1 1 Asthma: Bronchial 3 1 1 4 1 5 Cardiac 5 1 2 1 9 9 Arthritis: Tubercular, of knee 1 1 1 Of elbow 1 1 1 Bronchitis: Acute 3 3 95 144 148 56 10 1 215 Chronic 3 7 1 4 5 2 11 Capillary 1 1 1 Burn: Face and body 2 2 2 Hand 2 5 1 6 7 Leg 2 1 2 1 3 Face (powder) 2 1 3 3 Arm 2 2 3 Arm, face and body 1 1 1 3 3 Carcinoma of— Stomach 1 3 3 1 4 Uterus 8 2 3 1 4 Liver 4 1 5 5 Bladder 1 1 1 Rectum 1 1 1 Breast 2 1 1 2 Congestion and cedema of lungs 1 1 1 Conjunctivitis 5 1 4 2 6 Chancre, hunterian 2 2 2 Chancroids 3 4 4 1 1 1 7 Catarrh: Gastric 4 2 3 3 6 Nasal 1 1 1 Cataract 6 2 4 3 1 8 Cephalalgia 1 2 3 3 2 1 6 Condylomata 1 1 1 Cystitis, acute 2 3 2 5 2 7 Coryza 4 3 1 4 Convulsions, infantile 2 2 2 Concussion of brain 3 1 2 3 Constipation. 2 2 1 3 4 Calculus: Vesical 1 1 2 2 Vesical and vesico-rectal fistula 1 1 1 Cyst: Peritoneal 1 1 1 Mesenteric 1 1 1 1 Sebaceous 2 1 3 3 Diabetes, insipidus 1 1 1 Dyspepsia 1 2 2 1 3 1 5 Diarrhoea 5 3 1 5 3 1 9 Delirium Tremens 1 1 1 Dysmenorrhoea 7 3 3 1 7 Dysentery 1 1 1

0010 9

Debility,senile 2 6 1 3 3 3 9 Diphtheria 1 4 1 1 1 2 Epilepsy 4 1 1 4 Endo-cervieitis 13 3 9 1 13 Epithelioma of cervix uteri 1 1 1 Eczema 1 5 5 1 6 Embolism, cerebral 1 1 1 1 2 Exhaustion: Heat 1 2 2 1 3 Nervous 1 3 3 1 4 Ectopic pregnancy 1 1 1 Ectopic pregnancy and rupture of tube 1 1 1 Epistaxis 2 3 4 1 5 Empyemia 1 1 2 2 Erosion of cervix uteri 2 2 2 Elongation of cervix uteri 1 1 1 Endometritis 1 13 5 9 14 Epididymitis 3 3 4 1 1 6 Epithelioma of breast 1 1 1 Fever: Typhoid 4 37 21 49 13 62 Typhoid with perforation 1 1 1 Febricula 1 1 1 3 3 Intermitting malaria 21 62 9 78 13 1 92 Remitting malarial 12 13 3 20 6 2 28 Puerperal 8 4 4 8 Foreign body in— Eye 1 1 1 Throat 2 1 2 1 3 Nose 1 1 1 Ear 1 1 1 Furunculosis 1 2 1 2 3 Frost bite of— Fingers 1 6 2 5 7 Feet 1 23 2 12 14 26 Fistula: In ano 1 5 2 7 1 8 Urethral 2 1 1 2 Fracture of— Tibia and fibula (middle third) 2 2 2 Tibia and fibula, compound comminuted 1 1 1 Fibula (lower third) 2 1 1 2 Ulna (middle third) 2 2 2 Humerus (upper third) 1 3 3 1 4 Condyles of humerus 1 1 1 Anatomical neck of humerus 1 1 1 Fifth metatarsal 1 1 1 Ribs 1 2 2 1 3 Patella 1 1 1 Clavicle (sternal end) 2 1 1 2 External malleolus 2 1 1 2 Pott's 1 1 1 3 3 Colles's 1 1 1 Femur (lower third) 1 1 2 2 Skull, compound 1 1 1 Inferior maxilla 2 1 1 2 Goitre 1 1 1 Gastritis: Acute 4 1 6 6 12 5 17 Chronic 1 1 1 1 2 3 Gonorrhoea 2 6 7 3 7 5 15 Gangrene of foot 4 2 1 4 1 6 Gastralgia 1 7 6 2 8 Gastro- enteritis 1 2 2 1 3 Granulations, exuberant 1 1 1 Hysteria 1 2 7 7 3 10 Haemorrhoids, external 2 7 5 10 1 2 1 14 Heart: Mitral insufficiency 1 12 12 10 7 8 25 Mitral stenosis 1 1 1 Aortic insufficiency 4 3 3 3 1 7 Hypertrophy 1 2 1 2 3 Hydrocele 1 3 4 4 Hernia, inguinal 2 5 4 1 2 7 Hystero- epilepsy 2 2 2

Removed to contagious hospital 0011 10

Hypertrophy of- Prostate 1 1 2 2 Tonsils 1 1 1 1 Eyelids 1 1 1 1 2 Cervix uteri 1 1 1 Haemorrhage, cerebral 2 5 5 2 10 12 Hepatitis 1 1 2 2 Herpes zoster 1 1 1 Hernia: Ventral 1 1 1 Strangulated 1 1 1 inguinal Umbilical 1 1 1 Indigestion, intestinal 1 6 9 9 7 16 Ingrown toe nail 1 1 2 2 Influenza 4 18 3 16 7 1 1 25 Iritis 1 2 1 2 3 Intestinal obstruction 1 1 1 Infected— Hand 2 2 15 6 8 17 25 Leg 1 2 1 2 3 Arm 1 1 1 Foot 1 2 3 3 Laryngitis 1 1 1 1 2 Lumbago 5 6 1 3 8 1 12 Luxation of- Femur 1 1 1 Elbow 1 1 1 Coccyx 1 1 1 Radius 1 1 1 Humerus 2 2 2 Lipoma of back 2 2 2 Laceration of cervix uteri 3 1 2 3 La Grippe 2 7 52 49 12 61 Marasmus 3 3 3 Myalgia 1 4 3 2 5 Miscarriage 4 4 4 Migrain 1 1 1 Menorrhagia 8 4 3 1 8 Meningitis: Tubercular 1 1 1 Cerebro-spinal 1 9 2 4 1 7 12 Myelitis 2 1 3 3 Metritis 1 1 1 Mastitis 2 1 1 2 Nephritis: Acute interstitial 2 2 1 4 1 5 Chronic interstitial 2 9 5 1 4 2 9 16 interstitial Acute parenchyma matous 2 4 3 3 6 Chronic parenchy- matous 2 2 2 Neurasthenia 1 2 3 1 2 2 1 6 Necrosis of Tibia 1 1 2 2 Ulna 2 1 1 2 Inferior maxilla 2 2 2 Neuralgia: Facial 2 2 1 2 1 4 1 1 7 Ovarian 1 1 1 Orchitis 5 3 2 5 Ovaritis 8 5 2 1 8 Onychia 1 1 1 Pleurisy: Acute 1 3 3 1 4 Chronic 1 1 1 Chronic with effusion 1 1 1 Peritonitis 1 4 3 2 5 Phimosis 1 7 4 3 1 8 Pteryguim 1 2 1 1 1 3 Painful cicatrix of shoulder 1 1 1 Pneumonia: Lobar 1 12 2 9 6 15 Lobular 1 6 3 4 2 4 10 Premature birth 2 5 7 7 Prolapse of Uterus 2 1 1 2 Phlegmon: Prepatellary 1 1 1 Of arm 1 1 1 Of leg 1 1 1 Pyosalpinx 8 5 2 1 8 Pyosalpinx, double 1 1 1 Placenta, retained 4 4 4

0012 11

Poisoning: Kerosene 1 1 1 Carbolic acid 1 1 2 Opium 2 2 Potts disease 1 1 Pericarditis 2 1 1 Pleurodynia 3 1 2 Pregnancy 1 188 171 18 18 Rupture of urethra and urinary intiltration 1 1 Rupture of urethra 1 1 Retroversion of uterus 1 1 Retroflexion of uterus 3 2 1 Rheumatism: Acute articular 15 30 14 19 38 1 1 59 Chronic articular 3 5 1 6 1 8 Acute muscular 9 13 5 11 13 2 1 23 Strabismus: External 3 3 4 Internal 1 1 3 Sciatica 2 2 Syphilis 1 2 18 20 14 17 6 3 41 Stricture, urethral 2 8 1 5 6 11 Subluxation of- Ankle 6 9 7 8 15 Shoulder 2 1 1 4 4 Wrist 1 4 1 3 3 6 Inferior maxilla 3 3 3 Septicaemia 1 2 3 3 Synovitis of knee 2 1 1 2 3 Salivation, mercurial 1 1 1 Sunstroke 1 1 1 1 2 Singultus 2 1 1 2 Sarcoma of thigh 1 1 1 Sclerosis of- Spinal cord 1 1 1 Liver 1 1 1 Suppurating stumps 2 1 1 2 Supernumerary fingers 1 1 1 Tuberculosis: Pulmonary 4 42 35 25 34 22 81 Miliary 15 8 2 1 20 23 Of chest and ribs 1 1 1 Of hip joint 1 1 2 2 Tubercular osteo-myelitis of femur 1 1 1 Tonsilitis: Acute 5 4 1 1 Follicular 10 1 11 11 Tinea capitis 1 2 3 3 Tetanus 1 1 2 2 Torticollis 1 1 1 Tumor: Submucous fibroid of uterus 6 4 2 6 Multiple fibroids of uterus 1 1 1 Fibroid and pyosalpinx 1 1 1 Fibro-myoma of uterus 2 2 2 Fibro-cystic of uterus 3 1 2 3 Fatty, of knee 1 1 1 Fatty, of shoulder 1 1 1 1 Thrombus, cerebral 1 1 1 Ulcer of- Leg 2 16 14 8 19 4 1 32 Cornea 1 1 1 Stomach 2 2 2 Uraemia 3 1 1 1 3 Varicose veins 1 2 3 3 Vertigo 1 3 3 4 3 7 Wounds of— Scalp, incised 2 16 2 5 15 20 Face, incised 2 11 1 2 12 14 Leg, incised 2 4 1 2 5 7 Hand, incised 3 2 7 6 2 16 18 Liver, incised 1 1 1 Penis 1 1 1 Scalp, lacerated 13 2 47 12 15 59 74 Hand, lacerated 1 17 3 4 17 21 Arm, lacerated 3 1 4 7 lacerated 2 5 7 4 Chest, stab 3 2 1 4 5

0013 12

Wounds of- Arm, stab 3 3 3 Thigh, stab 3 1 2 3 Leg, punctured 4 4 4 4 8 12 Arm, punctured 5 2 3 5 Face, punctured 1 2 2 5 5 Arm, contused 2 6 2 1 9 10 Leg, contused 3 1 1 3 4 Scalp, contused 10 27 11 9 39 48 Penis and scrotum, gunshot 1 1 1 Leg, gunshot 1 6 4 3 7 Shoulder, gunshot 3 1 2 2 4 Arm and abdomen, gunshot 1 1 1 1 Arm, granulated 2 2 3 4 3 7 Leg, granulated 1 1 2 2 Foot, granulated 1 1 1 —- — —— —- ——— —- —- — —- —— Total 255 30 1,030 922 1,088 808 126 45 170 2,237

Table showing the number of surgical operation. White. Colored. Operations. Diagnosis. M. F. M. F. Total. Cured. Im- Unim- Died proved. proved. Amputation of- Fingers Supernumerary 1 1 1 Fingers Gangrene 7 7 7 Feet Gangrene and 1 3 4 4 necrosis Hand Gangrene and 1 1 1 septic infection1 Hand Cicatricial de- 1 1 1 formity Toes Necrosis 7 7 7 Thigh Tubercular 1 1 1 osteomyelitis Arm do 1 1 1 Breast Carcinoma 3 3 2 1 Arm, upper Tubercular 1 1 1 third osteomyelitis Alexander's Retroverted 1 1 1 operation and prolapsed uterus Aspiration Hydrocele 3 3 3 Coeliotomy Dermoid cyst 1 1 1 of ovary Do Incised wound. 1 1 1 of abdomen and liver. liver Do Multiple fib- 1 1 1 roids of uterus Do Strangulated 1 1 1 inguinal hernia Do Myofibroma of 4 4 4 uterus Do Appendicitis, 1 1 1 general septic peritonitis.2 Do Myoma and pyo- 1 1 1 salpinx, right Do Fibroid and 1 1 1 pyosalpinx, left Do Ventral hernia 1 1 1 Do Ectopic preg- 1 1 1 nancy with rupture 3 Do Ectopic preg- 1 1 1 nancy (tubal abortion) Do Intestinal 1 1 1 obstruction Do Foecal fistual 1 1 1 Do Pyosalpinx, double 1 1 1 Do Pyosalpinx 2 2 1 1 Do Cystic degene- ration of ovary 1 1 1 Do Recto-vesical fistula 1 1 1 Do Cystic ovary pyosalpinx and adherent tubes 3 3 3 Caesarean Pregnancy with section deformed pelvis 1 1 3 Curettment. Endometritis 8 8 7 1 Do Retained pla- cental tissue 5 5 5 Do Membranous dysmenorrhoea 2 2 1 1 Circmumson. Phymosis 7 7 7 Colpotomy, posterior Pelvic abscess 2 2 2 Colporrhapy Rectocele 1 1 1 Dilation Stenosis of cervix uteri 1 1 1 Extirpation Cervical adenitis 2 2 4 3 1 Do Tubercular cervical ade- nitis 17 4 21 17 2 2 Do Inguinal ade- nitis 3 3 3 Do Sebaceous tumor of scalp 2 2 4 4

1 Moribund, general exhaustion at operation. 2 Shock, moribund, general peritonitis 4 days. 3 Moribund, collapse, and profound shock at operation. 0014 13

Excision External haemo- rrhoids 5 1 6 6 Do Ingrown toe nail 2 1 3 3 Do Lipoma of back 2 2 2 Do Pterygium 1 1 2 2 Do Hypertrophy of tonsil 1 1 2 2 Enterectomy Instestinal and enter- obstruction and orrhaphy gangrene of gut 1 1 1 Enucleation Cataract 2 2 4 3 1 Halstead's Carcinoma of operation breast 2 2 3 Incision Alveolar abscess 1 1 2 2 Do Cellulitis of foot 1 1 1 Do Infected hand 1 4 5 5 Do Suppurating inguinal ade- nitis 3 3 3 1 Do Fissure of rectum 1 1 1 Do Ischio-rectal abscess 1 2 1 4 4 Do Paronychia 3 1 4 4 Do Anchylo- glossia 1 1 1 Do Furuncle 2 2 3 Incision Prepatellary and drain- phlegmon 1 1 1 age Do Prostatic abscess 1 1 1 Incision Fistula in ano 1 1 3 1 6 3 and curett- ment. Do Cellulitis of arm 1 1 1 Incision Hydrocele 1 1 1 and packing Litigation. Varicose veins 1 1 1 Do Aneurism of femoral artery 1 1 1 Do Aneurism of pop- liteal artery 1 1 1 Mastoidec- Mastoiditis 2 2 1 1 tomy Paracen- Effusion in tesis pericardium 1 1 1 Do Hydroperito- 1 5 6 6 neum Do Hydrothorax 3 3 1 2 Perineorr-. Lacerated peri- haphy neum 38 38 38 Perineorr- Lacerated peri- haphy and eum and cervix tracheol- uteri 2 2 1 1 orrhaphy Prostato- Prostatic ab- tomy, per- scess and per- ineal ineal infil- 1 1 1 tration of urine. Radical Strangulated cure inguinal 2 2 2 hernia Do Inguinial her- 2 2 2 nia Reduction Dislocation of 1 1 1 humerus Do Dislocation of 1 1 1 femur Do Fractured of 1 1 1 tibia and fibu- la compound Do Fracture of 1 1 1 femur, lower third Do Colle's frac- 1 1 1 ture Do Fracture of 1 1 1 femur, upper third Do Fracture of fi- 2 2 2 bula, middle third Do Fracture of 1 1 1 humerus, upper third Do Fracture of 1 1 1 clavicle Do Fracture of 1 1 1 anatomical neck of hu- merus. Do Fracture of 1 1 1 tibia and fibula, comp- ound commin- ted. Do Fracture of 1 3 4 4 ulua, upper third Do Fracture of 1 1 1 patella Do Pott's frac- 1 1 1 3 3 ure Do Fracture of 2 2 1 1 inferior max- illa Suturing Incised wou- 2 16 2 20 15 5 nds of scalp Do Incised wou- 2 11 1 14 2 12 nds of face Do Incised wou- 3 2 7 6 18 2 16 nds of hand Do Lacerated 13 2 47 12 74 59 15 wounds of scalp Do Lacerated wou- 1 17 3 21 17 4 nds of hand Do Lacerated wou- 2 5 7 7 nds of leg Do Lacerated wou- 3 3 1 2 nds of thigh Tenotomy External 2 3 1 6 6 strabismus Urethroto-. Ruptured ure- 2 2 2 my external thra Do Structure of 2 2 2 urethra Urethroto-. do 5 5 5 my, inter- nal Trephining. Tetanus (anti- 1 1 1 of skull tetanic serum injection).1 Vaginal Cystic ovary 1 1 1 coeliotomy and salpin- gitis Do Retroversion of 1 1 1 uterus, with adhesions. Whitehead's Haemorrhoids 2 2 2 operation — — —- —- —- —- — — — Total 38 8 238 146 428 335 80 8 5

Had convulsions, period of forty-eight hours before operation, great exhaustion. 0015 14

Table showing work done in obstetrical department. Note.—There were three pairs of twins.

Table showing number of emergencies. White. Colored. White. Colored. Month. Total. Month. Total. M. F. M. F. M. F. M. F. July 4 32 11 47 February 1 19 6 26 August 11 36 27 74 March 9 28 5 42 September 11 2 23 6 42 April 2 20 3 25 October 7 3 28 15 53 May 6 2 26 8 42 November 6 1 17 7 31 June 6 2 45 16 69 December 12 1 26 6 45 — — —- —- —- January 5 1 8 4 18 Total 80 12 308 114 514 Note .—There were 897 revisits to this department, of which 703 were males and 194 females.

Table showing number treated in out-patient department . Medical. Surgical. Gynecolog- ical. Disease. White. Colored. White. Colored. M. F. M. F. M. F. M. F. W. C. Acne vulgaris 9 2 11 Adenitis: Cervical 3 1 4 Tubercular cervical 28 6 34 Inguinal 1 1 22 6 29 Submaxillary 1 1 Anaemia 1 28 36 65 Amenorrhoe 1 62 33 Atrophy of optic nerve 2 2 Angina pectoris 1 1 Asthma: Bronchial 5 2 40 35 82 Cardiac 4 4 Aphasia 3 1 4 Ascaridies 1 1 Abscess: Hepatic 1 1 Alveolar 1 8 2 11 Ischiorectal 1 1 Alcholism 4 7 5 16 Adenoma of breast 3 3 Abortion 3 3 Amblyopia 3 2 2 Astigmatism 3 9 12 Bronchitis: Acute 9 337 187 538 Chronic 4 127 73 204

0016 15

Blepharitis 1 7 Bubo 16 1 1 Cephalalgia 4 1 33 50 8 Constipation 6 4 156 135 30 Chancre 2 13 15 Chancroids 1 35 1 37 Condylomata, specific 3 4 7 Conjunctivitis: Purulent 1 2 5 9 17 Phlyctenular 3 2 2 15 22 Catarrhal 20 25 45 Coeyza 1 32 24 57 Cystitis: Acute 3 20 5 28 Chronic 11 3 14 Congestion of brain 8 2 10 Catarrh: Nasal 2 21 9 32 Gastric 9 3 12 Aural 3 3 Carbuncle 2 2 Cellulitis of arm 6 2 8 Chorea 2 4 6 Cataract, capsular 1 1 Diarrhoea: Acute 4 18 12 32 Chronic 2 2 4 Dyspepsia 2 1 54 64 121 Dysmenorrhoe 1 49 50 Debility, senile 4 38 19 61 Dysentery, acute 6 4 10 Diabetes insipidus 1 1 Eczema: Papulosum 2 54 40 96 Pustulosum 1 20 5 26 Epilepsy 6 37 43 Epistaxis 1 3 3 7 Epididymitis 4 4 Empyema 1 1 Endocervictis 3 42 45 Endometritis 1 6 7 Enteritis 8 3 11 Erosion of cervix uteri 3 3 Emphysema 3 3 Frosted feet 11 2 13 Frosted hands 2 2 Fistula in ano 1 1 2 Furunculosis 3 4 7 Flatulency 1 1 Fever: Remitting malaria 22 12 34 Intermitting malaria 4 1 93 5 103 Gonorrhoae 3 122 14 139 Glaucoma 3 3 Gleet 7 7 Gastralgia 5 2 7 Gastritis: Acute 1 3 7 11 Chronic 1 1 Glossitis acute 1 1 Goitre simple 1 2 3 Heart: Mitral insufficiency 8 37 25 Aortic insufficiency 15 7 Hypertrophy 2 4 6 Aortic stenosis 1 6 6 13 Myocarditis 1 1 Nervous Paipitation 4 3 2 Hemorrhage cerebal 6 3 9 Hemorrhoids: External 1 6 7 14 Internal 1 1 Hysteria 2 22 24 Herpes 1 4 3 8 Hemicrania 12 2 14 Hydroperi- cardium 1 1 Hydroperitoneum 1 3 4

0017 16

Hyperthophy of— Tonsil 1 Prostate 1 1 Prostate 1 1 Hemorrhage, rectal 3 3 Hernia, inguinal 2 2 Iritis 2 32 16 50 Influenza 1 3 1 5 Indigeston, intestinal 1 23 25 52 Insomnia 1 10 4 15 Ingrown toe nail 1 1 Keratitis 9 15 24 Lagrippe 49 33 82 Laryngitis: Acute 1 4 4 9 Chronic 1 2 3 Lumbago 27 12 39 Lumbrocoides 5 5 Locomotor ataxia 3 1 4 Metritis 1 7 8 Metorrhagia 17 17 Menorrhagia 16 16 Menopause (disorders of) 3 35 38 Meningitis, acute 3 2 5 Marasmus 1 1 Myalgia 1 3 39 14 57 Myopia 2 2 Mumps 10 7 17 Neuralgia: Facial 1 1 9 12 23 Ovarian 9 9 Neurasthenia 1 1 9 20 31 Nephritis: Acute 24 25 49 Chronic 29 7 36 Necrosis of tibia 2 2 Ovaritis 9 9 Orchitis 29 29 Odontalgia 2 3 5 Otorrhoea 3 2 5 Opthalmia, gonorrheal 1 5 Otitis, media 2 4 4 10 Opacity, corneal 5 1 6 Pleurisy: Chronic 12 4 16 Acute 2 20 14 36 Pharyngitis: Acute 1 9 5 15 Chronic 1 1 7 1 10 Pneumonia 1 2 3 Phlegmon of arm 2 1 3 Pertussis 1 2 3 Ptyalism 3 3 Pregnancy 11 11 Phimosis 7 7 Peritonitis 1 2 3 Prolapsus, ani 3 3 Pleurodynia 9 5 14 Pruritis 9 9 Polypus, nasal 1 1 Pericarditis 3 3 Rheumatism: Acute, articular 3 1 67 51 122 Acute, muscular 9 98 57 164 Chronic, muscular 1 36 20 57 Retroversion of 1 uterus 1 Rhinitis 1 3 1 5 Syphilis: Primary 5 1 37 10 53 Secondary 4 2 144 74 194 Tertiary 6 37 8 51 Sciatica 3 1 4 Synovitis, acute 2 4 6 Subluxation of ankle 10 10 Stomatitis 5 3 8 Stricture of urethra 2 7 9 Sclerosis of liver 1 1 Tuberculosis: Pulmonary 3 2 106 49 160 Ankle joint 1 1

0018 17

Tinea capitis 3 22 5 30 Tonsilitis: Acute 1 1 66 52 120 Follicular 1 15 10 26 Torticollis 9 5 14 Trachoma 1 1 Ulcer: Chronic, of leg 8 28 36 Varicose 1 6 1 8 Urticaria 3 2 5 Vertigo 5 7 12 Wounds: Shoulder, contused 1 1 Arm, contused 5 2 7 Back, contused 3 6 9 Foot, contused 1 3 3 7 —- — ——- ——- — — —- —- — —- ——- Total 118 32 2,131 1,431 28 5 577 198 10 249 4,779 Note.—Revisits to this department for last three quarters (no record report of first quarter) 2,593 Prescriptions compounded 8,901 Patients admitted to hospital from this department 75

Table showing number of refusals. White. Colored. White. Colored. Month. Total. Month. Total. M. F. M. F. M. F. M. F. July 1 1 2 4 February 1 6 7 August 1 1 5 8 March 3 1 9 3 16 September 3 7 5 15 April 2 1 15 4 22 October 8 2 8 5 23 May 2 1 4 4 11 November 10 1 19 6 36 June 1 9 5 15 December 5 10 23 4 37 — — — — —- January 5 1 24 1 31 47 7 130 41 225

Occupation of patients. White. Colored. White. Colored. Occupation. Total. Occupation. Total. M. F. M. F. M. F. M. F. Attorney 1 1 2 Druggist 1 2 3 Actor 1 1 Dyer 1 1 Athlete 1 1 Elecrtrician 1 1 Butler 3 3 Engineer 2 3 5 Bellman 1 1 Elevator boy 1 1 Barber 1 16 17 Farmer 1 1 Boiler'maker 1 1 Fireman 3 26 32 Blacksmith 2 5 7 Fish dealer 2 5 Bartender 4 4 Footman 1 1 Baseball Gardener 1 1 player 1 1 Glassblower 1 3 Baker 3 2 5 Grocer 1 1 Brush Maker 1 1 Housekeeper 4 5 9 Butcher 5 2 7 Hostler 3 3 Brick mason 1 2 3 Huckster 5 5 Bootblack 1 1 Hotel keeper 1 1 Basket maker 1 1 Hatter 1 1 Carpenter 10 4 14 Harness Contractor 1 1 maker 1 1 Cook 3 16 9 28 Ironworker 1 1 Clerk 11 3 1 15 Janitor 1 1 2 Confectioner 1 1 Jockey 3 3 Conductor 1 1 Laundress 3 3 Coachman 1 7 8 Laborer 54 583 637 Cooper 1 1 1 Latherer 1 1 Canvasser 10 1 Lamplighter 1 1 Domestic 733 743 Laundryman 1 1 Driver 5 17 22 Lumberman 1 1 Dressmaker 5 5 Lineman 1 38 Dentist 1 1 Soldier 24 14 3

0019 18

Musician 1 1 2 Steward 3 7 Mechanic 3 2 5 Sailor 7 2 2 Messenger 3 3 6 Stenographer 2 3 6 Miner 1 1 2 Steam titter 6 1 5 Midwife 1 1 Shoemaker 2 3 2 Maid 1 1 Stonecutter 2 3 Manager 1 1 1 Seamstress 3 3 Minister 1 1 Tinner 3 1 4 Nurse 1 9 10 Teacher 1 2 2 8 Newsboy 1 Teamster 2 1 6 4 News dealer 2 1 Unknown 28 8 56 Oyster dredger 4 2 Upholsterer 1 2 20 2 Painter 8 85 12 Vender 3 3 Pupil 10 2 22 119 Waiter 1 44 45 Porter 1 9 10 Wall scraper 1 1 Plasterer 4 4 8 Watchman 1 1 Physician 1 1 2 Washerwoman 3 3 Policeman 1 1 2 — — — — —- Paper hanger 1 1 2 Plumber 1 1 Press girl 1 1 Restaurant keeper 1 1 Total 255 28 912 817 2,012

Nativity of patients. White. Colored. White. Colored. Nativity. M. F. M. F. Total. Nativity. M. F. M. F. Total. District of Indiana 1 1 Columbia 58 7 250 217 532 Iowa 1 1 Virginia 16 4 359 367 746 Vermont 1 1 Illinois 2 3 5 Connecticut 1 2 3 New York 18 3 6 4 31 New West Virginia 2 6 7 15 Hampshire 1 1 Maryland 26 1 154 164 345 Texas 1 2 2 5 Missouri 2 2 1 5 Unknown 4 3 5 12 Pennsylvania 23 1 10 7 51 Holland 1 1 Mississippi 1 3 4 Ireland 22 1 23 North Carolina 2 25 23 50 Germany 18 5 23 Ohio 4 4 8 England 10 1 11 Kentucky 6 2 8 Italy 3 3 Delaware 2 5 1 8 Canada 2 1 3 Arkansas 2 2 4 Switzer- California 1 3 4 land 3 3 Massachusetts 5 3 2 10 France 5 5 Florida 2 1 3 West Georgia 12 1 13 Indies 7 7 South Carolina 1 27 3 31 China 1 1 Rhode Island 1 1 Russia 2 2 Louisiana 1 1 1 3 Austria 1 1 Minnesota 2 2 Poland 1 1 Alabama 1 2 1 4 Scotland 1 1 Michigan 1 1 South Tennessee 1 6 1 8 America 2 2 Nebraska 2 2 Cuba 1 1 New Jersey 1 3 4 Denmark 1 1 Corea 1 1 — — — — —— Total 255 28 912 817 2,012

Number admitted each year for past twenty-five years. Year Number Year Number Year Number ending ending ending June 30- June 30- June 30- 1875 190 1884 1,509 1893 2,422 1876 319 1885 1,794 1894 2,801 1877 500 1886 1,923 1895 2,476 1878 519 1887 2,017 1896 2,596 1879 642 1888 1,997 1897 2,815 1880 819 1889 2,074 1898 2,355 1881 892 1890 2,394 1899 2,374 1882 1,102 1891 2,373 1883 1,373 1892 2,331