%images;]>LCRBMRP-T1901Report of the Freedmen's Hospital to the Secretary of the Interior : Austin M. Curtis: a machine-readable transcription.Collection: African-American Pamphlets from the Daniel A. P. Murray Collection, 1820-1920; American Memory, Library of Congress.Selected and converted.American Memory, Library of Congress.

Washington, 1994.

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91-898264Daniel Murray Pamphlet Collection, 1860-1920, Rare Book and Special Collections Division, Library of Congress.Copyright status not determined.
0001

REPORTOF THEFREEDMEN'S HOSPITALTO THESECRETARY OF THE INTERIOR.AUSTIN M. CURTIS,SURGEON IN CHIEF.1899.

WASHINGTON:GOVERNMENT PRINTING OFFICE.1899.

0002

FREEDMEN'S HOSPITAL.BOARD OF VISITORS.GEORGE W. EVANSJOHN J. DARBY, M.D.WILLIAM T. PIERSON.MEDICAL AND SURGICAL STAFF.Surgeon in chief: AUSTIN M. CURTIS, A.M., M.D.First Assistant Surgeon: WILLIAM A. WARFIELD, M.D.CONSULTING STAFF.Gynecologist: J. TABER JOHNSON, M.D.Physician: THOMAS B. HOOD, M.D.Obstetrician: THOMAS C. SMITH, M.D.VISITING STAFF.Physician: JOHN BRACKETT, M.D.; G.N. PERRY, M.D.; F.E. MAXCY, M.D.; C.L. ALLEN, M.D.; S.R. WATTS, M.D.; THOMAS MARTIN, M.D.; ROBERT R. BROWN, M.D.Surgeons: E.A. BALLOCH, A.M., M.D.; N.F. GRAHAM, M.D.Obstretrician: JOHN R. FRANCIS, M. D.Gynecologists: F.J. SHADD, M.D.; CHARLES I. WEST, M.D.Ophthalmologist and Otologist: E. OLIVER BELT, M.D.; Assistant: ROBERT S. LAMB, M.D.Bacteriologist: W.W. ALLEGER, M.D.Pathologists: D.S. LAMB, M.D.; J.M. LAMB, M.D.OUT-PATIENT DEPARTMENT.JOHN W. MITCHELL, M.D.; A.W. TANCIL, M.D.; E. OLIVER BELT, M.D.S.R.WATTS, M.D.; F.J. SHADD, M.D.; C.B. PURVIS, M.D.; E.D. WILLISTON, M.D.; W.H. HUGHES, Jr., M.D.; C.I. WEST, M.D.INTERNES.J.J. ROBINSON, M.D.; W.E. MACKEY, M.D.; GRANT G. BROWN, M.D. J.H. HUTTON, M.D.; Directress of Training School, SARAH C. EBERSOLE; Pharmacist, ROBERT B. TYLER, M.D., Phar. D.; Assistant Pharmacist, M. FLORES; Matron, ANNIE A. SEAMS; Clerk, H. KUDZU; Assistant Clerk, HATTIE M. CURTIS. 0003Freedmen's Hospital Report, 1899.

THE FREEDMEN'S HOSPITAL--HOWARD UNIVERSITY MEDICAL SCHOOL AND ADMINISTRATIVE BUILDING

00043

REPORT OF THE FREEDMEN'S HOSPITALWASHINGTON, 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 00054in 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 00065

THE FREEDMEN'S HOSPITAL--ENTRANCE

00065from 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 00076practical 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 00087accomplishment 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 admitted255289128172,012 Births191100192 Patients in hospital July 1, 1898827266148 Stillbirths22Total in hospital26430 1,0759832,374--------------------------------Patients discharged250299348542,067 Deaths519668170 Stillbirths22Total discharged22530 1,0309222,259--------------Remaining July 1, 189994561115---------------Treated in out-patient department146472,7081,8784,779Revisits for last three quarters2,593 Prescriptions compounded8,901 Emergencies8012308114514 Operations368238146428 Refused admission47713041225 Revisits to emergency department890 Patients treated in hospital and dispensary.410773,783 2,8617,131

00098

Table showing diagnosis, number treated, and result when discharged from the hospital.Diagnosis.White. Colored. Cured. Im-Unim-NotDied. Total.M. F. M. F.proved. proved. treated. Abortion1714317Adenitis:Tubercular,cervical18659115 Inguinal,simple.310741620 Inguinal,specific2 8 155111 Alcoholism91 143159 1227 Abscess:Alveolar13314Of axilla333216 Of breast111 Of vulva333 Of chest333 Of scalp111 Retropharyngeal111 Ischio-rectal.122825 Tubo-overian111 Of liver111 Psoas111 Appendicitis2112 Atrophy of leg111 Anourism:Femoral111 Popliteal111 Aortic111 Amenorrhoea74127 Antiflexionof uterus111 Anchyloglossia111 Asthma:Bronchial311415 Cardiac51 2199 Arthritis:Tubercular, ofknee111 Of elbow111 Bronchitis:Acute33 95 14414856101215 Chronic37145211 Capillary111Burn:Face and body222 Hand25167 Leg21213 Face (powder)2133 Arm223 Arm, face and body11133 Carcinoma of-- Stomach13314 Uterus82314 Liver4155 Bladder111 Rectum111 Breast2112 Congestion and cedema of lungs111 Conjunctivitis51426 Chancre, hunterian222 Chancroids3441117 Catarrh:Gastric42336 Nasal111 Cataract624318 Cephalalgia1233216 Condylomata111 Cystitis, acute 232527 Coryza4314 Convulsions,infantile222 Concussion of brain3123 Constipation.22134 Calculus:Vesical1122 Vesical and vesico-rectal fistula111 Cyst: Peritoneal111 Mesenteric1111 Sebaceous2133 Diabetes,insipidus111 Dyspepsia1 221315 Diarrhoea5315319 DeliriumTremens111 Dysmenorrhoea73317 Dysentery111

00109

Debility,senile2613339 Diphtheria141112 Epilepsy4114Endo-cervieitis1339113 Epithelioma ofcervix uteri111 Eczema15516 Embolism,cerebral11112 Exhaustion:Heat12213 Nervous13314Ectopicpregnancy111 Ectopicpregnancy andrupture of tube111 Epistaxis23415 Empyemia1122 Erosion ofcervix uteri222Elongation ofcervix uteri111Endometritis1135914 Epididymitis334116Epithelioma ofbreast111 Fever:Typhoid437 21491362 Typhoid with perforation111 Febricula11133Intermitting malaria216297813192 Remitting malarial12133206228 Puerperal8448 Foreign body in--Eye111 Throat21213 Nose111 Ear111 Furunculosis12123 Frost bite of--Fingers16257Feet1232121426 Fistula:In ano152718 Urethral2112 Fracture of--Tibia and fibula(middle third)222 Tibia and fibula,compoundcomminuted111Fibula (lowerthird)2112 Ulna (middlethird)222Humerus (upperthird)13314 Condyles ofhumerus111 Anatomical neckof humerus111 Fifth metatarsal111 Ribs12213 Patella111 Clavicle(sternal end)2112 Externalmalleolus2112Pott's1 1133 Colles's111 Femur (lowerthird)1122 Skull, compound111 Inferior maxilla2112 Goitre111 Gastritis:Acute41 6612517 Chronic111123 Gonorrhoea26737515Gangrene of foot421416 Gastralgia17628Gastro-enteritis12213 Granulations,exuberant111 Hysteria1277310Haemorrhoids,external275 1012114 Heart:Mitralinsufficiency112 12107825Mitral stenosis111 Aorticinsufficiency433317 Hypertrophy12123 Hydrocele1344 Hernia,inguinal254127 Hystero-epilepsy222

Removed to contagious hospital001110

Hypertrophy of-Prostate1122 Tonsils1111 Eyelids11112 Cervix uteri111 Haemorrhage,cerebral25521012 Hepatitis1122 Herpes zoster111 Hernia:Ventral111 Strangulated111 inguinalUmbilical111 Indigestion,intestinal1699716 Ingrown toenail1122Influenza41831671125Iritis12123 Intestinalobstruction111 Infected--Hand22 15681725 Leg12123 Arm111 Foot1233 Laryngitis11112 Lumbago56138112 Luxation of-Femur111Elbow111 Coccyx111 Radius111 Humerus222 Lipoma ofback222 Laceration ofcervix uteri3123 La Grippe27 52491261 Marasmus333 Myalgia14325 Miscarriage444 Migrain111 Menorrhagia84318 Meningitis:Tubercular111 Cerebro-spinal19241712 Myelitis2133 Metritis111 Mastitis2112 Nephritis:Acuteinterstitial 221415 Chronicinterstitial 295142916 interstitialAcuteparenchymamatous24336 Chronicparenchy-matous222Neurasthenia12312216 Necrosis ofTibia1122Ulna2112 Inferiormaxilla222Neuralgia:Facial22 1214117 Ovarian111Orchitis5325 Ovaritis85218Onychia111Pleurisy:Acute13314 Chronic111 Chronic witheffusion111 Peritonitis14325 Phimosis174318 Pteryguim121113Painfulcicatrix ofshoulder111 Pneumonia:Lobar11229615 Lobular16342410 Prematurebirth2577 Prolapse ofUterus2112Phlegmon:Prepatellary111 Of arm111 Of leg111 Pyosalpinx85218 Pyosalpinx,double111 Placenta,retained444

001211

Poisoning:Kerosene111 Carbolic acid112Opium22Potts disease11Pericarditis211 Pleurodynia312Pregnancy11881711818 Rupture ofurethra andurinaryintiltration11 Rupture ofurethra11Retroversion ofuterus11Retroflexionof uterus321Rheumatism:Acutearticular1530 1419381159 Chronicarticular351618 Acute muscular 913511132123 Strabismus:External334 Internal113 Sciatica22Syphilis12 182014176341 Stricture,urethral2815611Subluxation of-Ankle697815Shoulder21144 Wrist141336 Inferiormaxilla333 Septicaemia1233 Synovitisof knee21123 Salivation,mercurial111 Sunstroke11112 Singultus2112 Sarcoma ofthigh111Sclerosis of-Spinal cord111 Liver111 Suppuratingstumps2112 Supernumeraryfingers111Tuberculosis:Pulmonary442 3525342281 Miliary158212023 Of chest andribs111 Of hip joint1122 Tubercularosteo-myelitisof femur111 Tonsilitis:Acute5411 Follicular1011111Tinea capitis1233Tetanus1122 Torticollis111 Tumor:Submucousfibroid ofuterus6426 Multiplefibroids ofuterus111 Fibroid andpyosalpinx111 Fibro-myomaof uterus222Fibro-cysticof uterus3123 Fatty, ofknee111Fatty, ofshoulder1111 Thrombus,cerebral111 Ulcer of-Leg216 148194132 Cornea111 Stomach222 Uraemia31113 Varicoseveins1233 Vertigo133437 Wounds of--Scalp,incised216251520 Face,incised211121214 Leg, incised241257 Hand,incised32 7621618 Liver,incised111 Penis111 Scalp,lacerated132 47 12155974 Hand,lacerated117341721 Arm,lacerated3147 lacerated2574 Chest, stab32145

001312

Wounds of-Arm, stab333 Thigh, stab3123Leg, punctured4444812 Arm, punctured5235 Face, punctured 12 255 Arm, contused26 21910 Leg, contused31134 Scalp,contused1027 1193948 Penis andscrotum,gunshot111 Leg, gunshot16437 Shoulder,gunshot31224 Arm andabdomen,gunshot1111 Arm,granulated223437 Leg,granulated1122Foot,granulated111--- -- ---- --------- ---------------Total255 30 1,030 9221,088808126451702,237

Table showing the number of surgical operation. White. Colored.Operations. Diagnosis. M. F. M. F.Total. Cured.Im- Unim- Diedproved. proved. Amputation of-FingersSupernumerary111FingersGangrene777 FeetGangrene and1344necrosisHandGangrene and111septicinfection1HandCicatricial de-111 formityToesNecrosis777ThighTubercular111 osteomyelitisArmdo111BreastCarcinoma3321Arm, upper Tubercular111thirdosteomyelitisAlexander's Retroverted111operationand prolapseduterusAspiration Hydrocele333Coeliotomy Dermoid cyst111 of ovaryDoIncised wound.111of abdomen andliver. liverDoMultiple fib-111roids ofuterusDoStrangulated111inguinalherniaDoMyofibroma of444uterusDoAppendicitis,111general septicperitonitis.2DoMyoma and pyo-111salpinx, rightDoFibroid and111 pyosalpinx,leftDoVentral hernia111DoEctopic preg-111nancy withrupture 3DoEctopic preg-111nancy (tubalabortion)DoIntestinal111obstructionDoFoecal fistual111DoPyosalpinx,double111DoPyosalpinx2211DoCystic degene- ration of ovary111DoRecto-vesical fistula111DoCystic ovary pyosalpinx andadherent tubes333CaesareanPregnancy withsectiondeformed pelvis113Curettment. Endometritis8871DoRetained pla-cental tissue555DoMembranousdysmenorrhoea2211Circmumson. Phymosis777Colpotomy,posterior Pelvic abscess222Colporrhapy Rectocele111DilationStenosis ofcervix uteri111Extirpation Cervical adenitis22431DoTubercularcervical ade-nitis174 211722DoInguinal ade-nitis333DoSebaceous tumor of scalp2244

1 Moribund, general exhaustion at operation.2 Shock, moribund, general peritonitis 4 days.3 Moribund, collapse, and profound shock at operation.001413

ExcisionExternal haemo- rrhoids5166DoIngrown toenail2133DoLipoma of back222DoPterygium1122DoHypertrophy of tonsil1 122Enterectomy Instestinaland enter- obstructionandorrhaphy gangrene of gut111Enucleation Cataract22431Halstead's Carcinoma ofoperationbreast223Incision Alveolar abscess1122DoCellulitis of foot111DoInfected hand1455DoSuppuratinginguinal ade-nitis3331DoFissure of rectum111DoIschio-rectal abscess12144DoParonychia3144DoAnchylo- glossia111DoFuruncle223IncisionPrepatellaryand drain- phlegmon111ageDoProstaticabscess111IncisionFistula in ano113163and curett-ment.DoCellulitis ofarm111Incision Hydrocele111and packingLitigation. Varicose veins111DoAneurism of femoral artery111DoAneurism of pop- liteal artery111Mastoidec- Mastoiditis2211tomyParacen-Effusion intesispericardium111DoHydroperito-1566 neumDoHydrothorax3312Perineorr-. Lacerated peri-haphyneum38 3838Perineorr- Lacerated peri-haphy and eum and cervixtracheol-uteri2211orrhaphyProstato- Prostatic ab-tomy, per- scess and per-inealineal infil-111tration of urine.RadicalStrangulatedcureinguinal222herniaDoInguinial her-222 niaReduction Dislocation of111 humerusDoDislocation of111femurDoFractured of111tibia and fibu-la compoundDoFracture of111femur, lowerthirdDoColle's frac-111tureDoFracture of111femur, upperthirdDoFracture of fi-222bula, middlethirdDoFracture of111humerus, upperthirdDoFracture of111clavicleDoFracture of111anatomicalneck of hu-merus.DoFracture of111tibia andfibula, comp-ound commin-ted.DoFracture of1344ulua, upperthirdDoFracture of111patellaDoPott's frac-11133ureDoFracture of2211inferior max-illaSuturingIncised wou-216220155nds of scalpDoIncised wou-2111 14212nds of faceDoIncised wou- 327618216nds of handDoLacerated1324712 745915wounds ofscalpDoLacerated wou-117321174nds of handDoLacerated wou- 2577nds of legDoLacerated wou-3312nds of thighTenotomyExternal23166strabismusUrethroto-. Ruptured ure-222my external thraDoStructure of222urethraUrethroto-. do555my, inter-nalTrephining. Tetanus (anti-111 of skulltetanic seruminjection).1VaginalCystic ovary111coeliotomy and salpin-gitisDoRetroversion of111uterus, withadhesions.Whitehead's Haemorrhoids222operation-- -- --- --- ------------Total3882381464283358085

Had convulsions, period of forty-eight hours before operation, great exhaustion.001514

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. July4321147February119626 August11362774March928542 September11223642April220325 October73281553May6226842 November6117731June62451669 December12126645-- -- --- --- ---January518418Total8012308114514 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 vulgaris9211 Adenitis:Cervical314 Tubercularcervical28634 Inguinal1122629 Submaxillary11 Anaemia1283665 Amenorrhoe16233 Atrophy of opticnerve22 Angina pectoris11 Asthma:Bronchial52 403582 Cardiac44 Aphasia314 Ascaridies11 Abscess:Hepatic11 Alveolar18211 Ischiorectal11 Alcholism47516 Adenoma ofbreast33 Abortion33 Amblyopia322 Astigmatism3912 Bronchitis:Acute9337187538 Chronic412773204

001615

Blepharitis17Bubo1611Cephalalgia4133508 Constipation6415613530 Chancre21315 Chancroids135137 Condylomata,specific347 Conjunctivitis:Purulent125917 Phlyctenular3221522 Catarrhal202545 Coeyza1322457 Cystitis:Acute320528 Chronic11314 Congestion of brain8210 Catarrh:Nasal221932 Gastric9312 Aural33 Carbuncle22 Cellulitis of arm628 Chorea246 Cataract, capsular11 Diarrhoea:Acute4181232 Chronic224 Dyspepsia21 5464121Dysmenorrhoe14950 Debility, senile4381961 Dysentery, acute6410 Diabetes insipidus11 Eczema:Papulosum2544096 Pustulosum120526 Epilepsy63743 Epistaxis1337 Epididymitis44 Empyema11Endocervictis34245 Endometritis167Enteritis8311 Erosion of cervix uteri33 Emphysema33 Frosted feet11213 Frosted hands22 Fistula in ano112 Furunculosis347 Flatulency11 Fever:Remitting malaria221234 Intermittingmalaria41935103 Gonorrhoae312214139 Glaucoma33 Gleet77 Gastralgia527 Gastritis:Acute13711 Chronic11 Glossitis acute11 Goitre simple123 Heart:Mitralinsufficiency83725Aorticinsufficiency157Hypertrophy246 Aortic stenosis16613 Myocarditis11 NervousPaipitation432Hemorrhagecerebal639Hemorrhoids:External16714 Internal11 Hysteria22224 Herpes1438 Hemicrania12214 Hydroperi-cardium11 Hydroperitoneum134

001716

Hyperthophy of--Tonsil1Prostate11 Prostate11 Hemorrhage, rectal33 Hernia, inguinal22 Iritis2321650 Influenza1315 Indigeston,intestinal1232552 Insomnia110415 Ingrown toe nail11 Keratitis91524 Lagrippe493382 Laryngitis:Acute1449Chronic123 Lumbago271239Lumbrocoides55 Locomotor ataxia314 Metritis178 Metorrhagia1717 Menorrhagia1616 Menopause(disorders of)33538Meningitis, acute325 Marasmus11 Myalgia13 391457 Myopia22 Mumps10717 Neuralgia: Facial 1191223 Ovarian99 Neurasthenia1192031 Nephritis:Acute242549 Chronic29736 Necrosis of tibia22 Ovaritis99 Orchitis2929 Odontalgia235 Otorrhoea325 Opthalmia,gonorrheal15 Otitis, media24410 Opacity, corneal516 Pleurisy:Chronic12416 Acute2201436 Pharyngitis:Acute19515 Chronic117110 Pneumonia123 Phlegmon of arm213 Pertussis123 Ptyalism33 Pregnancy1111 Phimosis77 Peritonitis123 Prolapsus, ani33 Pleurodynia9514 Pruritis99 Polypus, nasal11 Pericarditis33 Rheumatism:Acute, articular316751122 Acute, muscular99857164 Chronic, muscular1362057 Retroversion of1 uterus1Rhinitis1315 Syphilis:Primary51371053 Secondary4214474194 Tertiary637851 Sciatica314 Synovitis, acute246 Subluxation of ankle1010 Stomatitis538 Stricture of urethra279 Sclerosis of liver11 Tuberculosis:Pulmonary3210649160 Ankle joint11

001817

Tinea capitis322530 Tonsilitis:Acute116652120 Follicular1151026 Torticollis9514 Trachoma11 Ulcer:Chronic, of leg82836 Varicose1618 Urticaria325 Vertigo5712 Wounds:Shoulder,contused11 Arm, contused527 Back, contused369 Foot, contused1337--- -- ----- ----- ---- --- ----- --------Total11832 2,1311,43128557719810 2494,779Note.--Revisits to this department for last three quarters (no record report of first quarter)2,593 Prescriptions compounded8,901 Patients admitted to hospital from this department75

Table showing number of refusals.White. Colored.White. Colored. Month.Total. Month.Total.M. F. M.F.M.F.M.F. July1124February167 August1158March319316 September37515April2115422 October82 8523May214411 November101 19636June19515 December51023437---- -- -----January51 2413147713041225

Occupation of patients.White. Colored.White. Colored.Occupation.Total. Occupation.Total.M.F.M.F.M.F.M.F. Attorney112Druggist123 Actor11Dyer11 Athlete11Elecrtrician11 Butler33Engineer235 Bellman11Elevator boy11 Barber11617Farmer11 Boiler'maker11Fireman32632 Blacksmith257Fish dealer25 Bartender44Footman11BaseballGardener11 player11Glassblower13 Baker325Grocer11Brush Maker11Housekeeper459 Butcher527Hostler33Brick mason123Huckster55 Bootblack11Hotel keeper11 Basket maker11Hatter11 Carpenter10414HarnessContractor11maker11 Cook3 16928Ironworker11 Clerk113115Janitor112 Confectioner11Jockey33 Conductor11Laundress33 Coachman178Laborer54583637 Cooper111Latherer11 Canvasser101Lamplighter11 Domestic733743Laundryman11 Driver51722Lumberman11 Dressmaker55Lineman138 Dentist11Soldier24143

001918

Musician112Steward37 Mechanic325Sailor722 Messenger336Stenographer236 Miner112Steam titter615 Midwife11Shoemaker232 Maid11Stonecutter23 Manager111Seamstress33 Minister11Tinner314 Nurse1910Teacher1228 Newsboy1Teamster2164 News dealer21Unknown28856 Oyster dredger42Upholsterer12202 Painter88512Vender33 Pupil10222119Waiter14445 Porter1910Wall scraper11 Plasterer448Watchman11 Physician112Washerwoman33 Policeman112-- -- -- -----Paper hanger112Plumber11Press girl11Restaurantkeeper11Total255 28 912 8172,012

Nativity of patients.White. Colored.White. Colored. Nativity.M.F.M.F.Total.Nativity.M.F.M.F.Total. District ofIndiana11 Columbia587250 217532Iowa11 Virginia164 359367746Vermont11 Illinois235Connecticut123New York1836431NewWest Virginia26715Hampshire11 Maryland261154 164345Texas1225 Missouri2215Unknown43512Pennsylvania231 10751Holland11 Mississippi134Ireland22123 North Carolina225 2350Germany18523 Ohio448England10111 Kentucky628Italy33 Delaware2518Canada213 Arkansas224Switzer-California134land33 Massachusetts53210France55 Florida213WestGeorgia12113Indies77 South Carolina1 27331China11 Rhode Island11Russia22 Louisiana1113Austria11 Minnesota22Poland11 Alabama1214Scotland11 Michigan11SouthTennessee1618America22 Nebraska22Cuba11 New Jersey134Denmark11Corea11-- -- -- ------Total25528912 8172,012

Number admitted each year for past twenty-five years. YearNumberYearNumberYearNumber endingendingendingJune 30-June 30-June 30-187519018841,50918932,422 187631918851,79418942,801 187750018861,92318952,476 187851918872,01718962,596 187964218881,99718972,815 188081918892,07418982,355 188189218902,39418992,374 18821,10218912,37318831,37318922,331

002019
APPENDIX.

The following is the report of the training school for nurses, under the supervision of Miss Sarah C. Ebersole, directress of nurses:

The usual routine work has been pursued throughout the year. Graduating exercises were held May 3, 1899, at which time 17 nurses received their diplomas. There were 125 applications for admission to this department during the year. Seventy-nine were formally considered, 25 were admitted on probation, 19 were accepted and enrolled, and 3 have been dismissed for various reasons. There are 32 nurses, including probationers, enrolled in the school at present. The course of instruction has been conducted by the following lecturers on their respective subjects, viz:A.M. Curtis, A.M., M.D., general surgery and bandaging.E.A. Balloch, A.M., M.D., general surgery and bandaging.E.O. Belt, M.D., diseases of the eye and ear.N.R. Jenner, M.D., obstetrics and care of infants.J.R. Francis, M.D., diseases of children.J.M. Lamb, M.D., D.D.S., physiology.F.E. Maxey, M.D., hygiene and general medical nursing.J.W. Mitchell, M.D., materia medica.W.A. Warfield, M.D., anatomy.C.I. West, M.D., bacteriology and urinalysis.Prof. Louis J. Sanders, massage.Miss S.C. Ebersole, dietetics.

Graduates of 1899.Banks, Effie PaulineIndianapolis, Ind. Browne, Agnes MatildaMeyersdale, Pa. Coleman, Georgia AnnaColumbus, Ga. Dismond, S. MatthewLynchburg, Va. Francis, Bertha ACincinnati, Ohio. Hairston, Lula CWinston, N.C. Henry, Lillian MLynchburg, Va. Hodge, Carrie EvaDanville, Va. Hendrick, Eliza RobertaWarrenton, N.C. Hankins, Mintha CarolynCleveland, Ohio. Keemer, Jessie ESpringfield, Ohio. McEwen, Irene OMobile, Ala. Rich, AnnaNew York City, N.Y. Scott, Helen ViolaRock Hill, S.C. Thompson, IsabellaMobile, Ala. Wilson, Emma CMontgomery, Ala. Williams, Almira ElizabethLansingbury, N.Y.

List of graduates and their present occupations and whereabouts. 1896.Name.OccupationResidence. Ashton, Luci VSuperintendent of nurses,Kansas City, Mo.Douglas Hospital.Blackburn, N.LPrivate nursePhiladelphia, Pa. Burke, JuliaNow Mrs. PhillipsJacksonville, Fla. Fleetwood, Sara IPrivate nurseWashington, D.C. Foust, Isabella LdoWinston, N.C. Gibson, Katherine CdoWashington, D.C. Green, Anna MdoNew York, N.Y. Owens, Laura AdoWashington, D.C. Price, LetitiaNow Mrs. BlairDo. Ricks, Antoinette MPrivate nurseCleveland, Ohio. Robinson, Annie BSuperintendent and matron,Charlotte, N.C.Good Samaritan Hospital.Shorter, Sarah AHead nurse, McDonoughNew York, N.Y.Hospital.Simms, Annie AMatron, Freedmen'sWashington, D.C.Hospital.Smith, GertrudePrivate nurseDo. Tyler, Elizabeth WdoNorthampton, Mass.

002120

1897Coombs, Annie RPrivate nurseWashington, D.C. Caldwell, Amanda JdoCharlotte, N.C. Griffin, G. JosephinedoWashington, D.C. Green, LucilledoSt. Paul, Minn. Haithcock, AdadoWashington, D.C. King, Annie CdoAmherst, Mass. Rollins, Willie MdoWashington, D.C. Smith, S. MaydoTroy, N.Y. Thompson, Dell RNow Mrs. DavisVienna, Va. Thomas, Annie MPrivate nurseWashington, D.C. Underhill, Katherine PNow Mrs. MotenDo. Webb, Evangeline L.MNurse, Clarke UniversityAtlanta, Ga. Warner, Florence APrivate nurseNorthampton, Mass. Young, Lola E.MdoPhiladelphia, Pa.

1898.Bennett, Florence APrivate nurseBaltimore, Md. Bannister, Carrie JdoWashington. D.C. Carter, Edith MdoNew Rochelle, N.Y. Cabaniss, Martha EdoFalls Church, Va. Davis, Annie MillerdoShelbyville, Tenn. Ennis, Sarah JHospital nurseSantiago de Cuba. Geder, IsabellaPrivate nurseBinghamton, N.Y. Gaines, Mary RdoBaltimore, Md. Hurlong, Mary AdoCharleston, S.C. King, Carrie MNow Mrs. ForemanSyracuse, N.Y. Russell, Ruby EPrivate nurseCharlottesville Va Robinson, Amelia AHospital nurseBattlecreek, Mich. Stanton, PriscillaMarriedPittsburg, Pa. Sunby, Lillie MayPrivate nurseWashington D.C. Valentine, J. EllaSuperintendant and matron,St. Louis, Mo.Provident Hospital.Whitson, Clara EPrivate nurseRhinecliff, N.Y.1899.

Banks, Effie PPrivate nurseBaltimore, Md. Browne, Agnes MdoMeyersdale, Pa. Coleman, Georgie AStill in school.Dismond, S. MatthewDo. Francis, Bertha APrivate nurseNashville, Tenn. Hairston, Lula CdoWinston, N.C. Henry, Lillian MdoLynchburg, Va. Hodge, Carrie MdoWashington, D.C. Hendrick, Eliza RStill in school. Hankins, Mintha CDo. Keemer, Jessie EPrivate nurseWashington, D.C. McEwen, Irene OdoMobile, Ala. Rich, AnnaPhysician's assistantNew York, N.Y. Scott, Helen VPrivate nurseRock Hill, S.C. Thompson, IsabelladoMobile, Ala. Wilson, Emma CStill in school. Williams, Almira EDo.

CIRCULAR OF INFORMATION SENT APPLICANTS.The Freedmen's Hospital Training School for Nurses is established to give a two years' course of training to women who desire to enter the profession of nursing.

Applicants may be received at any time during the year when there is a vacancy. Those wishing to obtain this course of instruction must apply to the surgeon in chief of the Freedmen's Hospital, and printed instructions will be furnished respecting the personal information to be given by applicants. Letters of application should be accompanied by a statement from a clergyman testifying to good moral character, and from a physician certifying to sound health and unimpaired faculties. Applicants must be between twenty-one and thirty-five years of age, of at least average height and physique, and must give satisfactory evidence of a general fitness of disposition and temperament for the work of nursing. It has been the practice of the hospital to appoint only unmarried colored women (this term includes widows). Upon the recommendation of the superintendent of the nurses and the approval of the surgeon in chief, they will be received one month on probation. During the month of trial and previous to being accepted as a pupil in the school, the applicant 0022>must be prepared for an examination in reading, penmanship, simple arithmetic, English dictation. The examination is to test the applicant's ability to read all well, to write legibly and accurately, to understand arithmetic as far as fract and per cent, and take notes of lectures. This amount of education is [?] for a member of the school, but applicants are reminded that women [?] education and cultivation will be preferred.

During the probationary month, board, lodging, and laundry work are provided by the school. The probationer provides her own dress.

The training-school authorities reserve the right to terminate the connection of pupil with the school at any time in case of misconduct, inefficiency, or neglect duty. Those who prove satisfactory are accepted as pupils after signing a written agreement to remain at the school for two years, including the probationary month and during that time to obey the rules of the school and hospital and to be subordinate to the authorities governing the same. Pupils reside at the home and serve assistant in various departments of the hospital for the full two years. They also expected to perform any duty assigned to them by the superintendent of [??].

After the month of probation pupils are required, when on duty, to wear the [??] prescribed by the hospital, which is a blue gingham, simply made, with white [??] and cap and linen collar and cuffs. Probationers are not allowed to wear this dress.

In addition to their board and lodging, and a reasonable amount of laundry [??] the nurses will be provided with uniforms, the necessary note and text-books, a [??] five dollars ($5) per month. This sum is not given as pay for services render it being considered that their education during that time is a full equivalent their services.

The day nurses are on duty from 7.30 a.m. to 7.30 p.m., with an hour off for dinner and additional time for exercise or rest. The pupils have a right to one-half Sunday and are often given a half day in the week. A vacation of two weeks allowed each year during the summer. In sickness the pupils are cared for grateously, but the time lost must be made up.

The course of instruction is given by visiting and resident physicians and surgeon at the bedside of the patients and by the superintendent and head nurse. A regular course of lectures, recitations, and demonstrations is also given with examination at stated periods. When the full term of two years is ended the nurses receive, they pass the examination and are otherwise satisfactory, a diploma certifying the course of training and practice. Questions to be answered by candidates.(1) Name in full.(2) Are you a single woman or widow?(3) If a widow, have you children; how many; their age; how are they provided for?(4) Are you otherwise free from domestic responsibility, so that you are not liable to be called away during the two years' course? (5) Your present occupation or employment.(6) Your former employment, if any.(7) Your age on last birthday.(8) Date and place of birth.(9) Height.(10) Weight.(11) In what schools and places were you educated; and state what your advantages have been.(12) Have you ever been in any other hospital or training school? (13) Are you strong and healthy, and have you always been so (14) Are your sight and hearing good?(15) Have you any physical defects?(16) Have you any tendency to pulmonary complaint?(17) Have you ever had any uterine disease?(18) The names in full of two persons to be referred to, not relatives; and state how long each has known you, if previously employed; one of these must be the last employer.(19) Have you read and do you clearly understand the regulations? Contract signed by pupil nurses on entering the school. Washington, D.C.,----, 189----.I, ------------------------------, the undersigned, do hereby agree to remain two years, from date, a pupil of the above-named institution, and promise during that time to obey the rules of school and hospital and to be subordinate to the authorities governing the same.