The internes are daily in attendance upon surgical and obstetrical cases and can not be permitted to do post-mortem work. There is a great need in this city for a hospital (which may with propriety be added to this one) where women may have treatment for hysteria and allied nervous disorders, especially when these diseases are consequent upon or connected with those peculiar to females. Many women are great sufferers from hysteria, insomnia, and neurasthenia. They are not subjects for a hospital like this, nor are they to be confined in an asylum for the insane. They need rest, seclusion, and moral management, as well as proper treatment to promote a cure. It is beyond our ability to provide for this class in the present building. They prove to be unsatisfactory cases, and have a demoralizing effect upon other patients who are fit subjects for this hospital. They in turn are unduly excited or influenced by the usual and unavoidable scenes in a hospital where surgical cases abound. It is earnestly recommended that you may give this matter your attention. In the event of the erection of a new building for surgical work, a part of the present structure could be appropriated to this class of cases.

It affords us great pleasure to again allude to the growth in popularity of the hospital and its increased usefulness as evidenced by the increasing number of patients, especially in the private rooms.

Drs. Bovée and King, the obstetricians, recommended the construction of two (so called) "delivery rooms," and a room where examinations, dressings, etc., can be made, all of which may be built adjacent to, but separate from, the present cottage, and connected with it by a closed corridor. Such rooms, separated from the lying-in rooms, and supplied with suitable appurtenances for artificial delivery and obstetrical operations, they said, are a part of every well-appointed lying-in hospital. The beds and operating table should be specially constructed for the purpose, upon the latest and most approved plans. The erection of a small building, containing such rooms and connected with the present building, would also render convenient the construction of better bathing facilities for the colored patients of the lying-in department than now exists.

The report for 1893 shows receipts from pay patients to the amount of $5,238; the two new delivery rooms had been provided, with bathrooms, closets, hot and cold water and good facilities for heating, an improvement that placed the hospital maternity on a thoroughly good basis. The gynecological department also received a new equipment of model surgical beds. A training school for nurses had been established and the first class was graduated. The next demand was for a nurses' home; and this need was supplied during the next year by an appropriation of $10,000. Owing, however, to the depressed condition of business the pay patients receipts decreased to $3,395, while the number of free patients increased; and in 1895 the income from pay patients was further reduced to $2,089. In this connection the observations of the superintendent, Ella Underhill, in her report for 1895 are pertinent: "Careful observation," says Miss Underhill, "has shown a decided indisposition on the part of many patients to pay even a small sum weekly, although circumstances point to their ability to do so. In this way many beds are taken up by people who might pay, thereby occupying other than free beds, increasing the income of the hospital, and

THE CHILDREN'S HOSPITAL.

83 depriving the really poor people of room which would otherwise be theirs. This is an established fact, but one which it is difficult to obviate."

In the report for 1895 also is the first statement made in regard to the school of nursing, then numbering 30 nurses, 18 under instruction at the Children's Hospital and 12 at Columbia. Out of 180 applicants in 1895 but 22 were accepted. Lectures were delivered on obstetrics by Dr. A. F. A. King, on gynecology by Dr. D. S. Stone, on general survey by Dr. J. Wesley Bovée, on anatomy by Dr. J. Foster Scott, on physiology by Dr. G. N. Acker, on diseases of the eye by Dr. Swan M. Burnett, on diseases of children by Dr. S. S. Adams, on special emergencies and fevers by Dr. J. Van Rensselaer, on materia medica by Drs. Stoutenburgh and Barton. Applications for entrance came from Illinois, Texas, Canada and other distant localities, but few from the section near Washington. Nurses from Boston, Philadelphia, and Baltimore applied for entrance to the post-graduate course in obstetrics. The graduates numbered 28, two of whom gained enviable reputations in smallpox work, two others obtained responsible positions in hospitals, and the remainder were doing private duty.

II.

When, in 1869, a department of diseases of infancy and childhood was established in connection with the Columbia Hospital Dispensary, the fact that cases of disease that could not properly be treated in a dispensary were so frequent as to impel Dr. S. C. Busey, then connected with that hospital, to consider the propriety of an attempt to establish in Washington a children's hospital. In March, 1870, Dr. Busey interested Dr. F. A. Ashford in the project, and they called in Drs. William B. Drinkard and W. W. Johnson. At the suggestion of Dr. Drinkard, the board of lady managers of the Washington City Orphan Asylum were interested and a committee of that body, consisting of Mesdames S. P. Lee, J. Zeilin, William Stickney, J. C. Harkness, A. J. Brown, A. E. Perry, H. S. Reynolds, and Miss Margaret Washington, was appointed to confer with the above-named doctors. The conferences were held at the home of Mrs. A. J. Brown, and the Misses Virginia and Sally C. Miller and Miss M. L. Thompson also were present. Drs. J. C. Hall, Thomas Miller, W. P. Johnson, C. H. Liebermann, and Grafton Tyler were interested in the subject.

Dr. Busey says that "from the time when he was first advised of our object, Dr. William P. Johnson manifested the liveliest interest in its success, and exercised an active and controlling influence in perfecting the organization. There was no lack of effort on the part of any one of these five [last named] gentlemen, but Dr. Johnson's enthusiasm and earnestness assured success." The laity was represented at first by Mr. F. B. McGuire, and afterwards by Messrs. J. C. Kennedy, M. W. Galt, S. V. Niles, Joseph H. Bradley, jr., and Rev. A. N. Zevely. On

'Dr. Busey's Reminiscences, p. 118.

November 25, 1870, those interested met at the office of Dr. W. P. Johnson to form a preliminary organization, and at a public meeting held at Lincoln Hall December 9 the organization was completed by the selection of corporators and the election of a board of directors. The corporators finally adjourned after adopting the report of the committee to name trustees.

The "Children's Hospital of the District of Columbia" became incorporated on December 2, 1870, under the general incorporation law of the District; and on June 24, 1884, an amended certificate was recorded, under the provisions of section 3, of the amendatory act approved April 23, 1884, by virtue of which the hospital became incorporated for 1,000 years. The object stated was "to establish and maintain in the District of Columbia a hospital and dispensary for the gratuitous medical and surgical treatment of indigent children under the age of 12 years, without distinction of race, sex, or creed;" but it was provided that sick and disabled children, whose parents or guardians may be able and willing to defray the expense of care and treatment, in whole or in part, may be admitted to the hospital upon such terms as may be prescribed by the rules of the board of directors.

Dr. Busey relates that at his first interview with Dr. James C. Hall,1 he indicated his willingness to contribute means, but declined on account

*

*

*

*

*

*

Dr. James Crowdhill Hall was born in Alexandria, Va., in 1805. His father having died, his mother removed to Washington and married Dr. Laurie, a distinguished clergyman. Dr. Hall was graduated at Jefferson College, Canonsburg, Pa., and studied medicine with Dr. Thomas Henderson, one of the founders of the Medical Society of the District of Columbia, and a surgeon in the United States Army. He subsequently graduated in medicine from the University of Pennsylvania in 1827, and immediately entered Blockley Hospital as a resident physician, and there familiarized himself with the new methods of investigation and physical exploration then being introduced. "He was a skillful, conscientious, and benevolent physician, more willing to render service to the suffering poor than to receive remuneration; as a citizen he was always ready and willing to discharge every duty of good citizenship. He was charitable, just, and honorable. Besides numerous personal charities during his lifetime, his bequests to the Washington City Orphan Asylum and the Children's Hospital will be held through many years to come in commemoration of his benevolence." He was the family physician of every President of the United States, beginning with Jackson and ending with the death of Lincoln's son. For many years he attended the families of every justice of the Supreme Court; through many administrations the families of every member of the Cabinet; and for a long series of years every foreign legation, and every prominent Senator and Member of the House of Representatives employed his services. For twenty years after his retirement from active practice his professional advice was constantly sought by both physicians and laymen. In 1830 he was the professor of surgery in Columbian University, and was a contributor to the American Journal of the Medical Sciences in 1828. About 1850 he was tried by the Medical Association for neglecting to make charges and failure to send bills for professional services. He pleaded guilty, and promised reformation! An examination of his books disclosed the fact that his annual receipts exceeded those of any other Washington physician, all of which had been paid without the presentation of a single account. In 1880, he died at the age of 75.—Dr. Busey's Reminiscences, pp. 105, 147-152.