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REPORT

OF THE

FREEDMEN'S HOSPITAL.

FREEDMEN'S HOSPITAL,

Washington, D. C., August 23, 1888.

SIR: I respectfully submit the annual report of this hospital for the fiscal year ending June 30, 1888.

During the year there were admitted and treated in the hospital 2,254 patients, and 3,841 in the dispensary attached.

The surgical operations numbered 164. As the success attending these operations has been all that could be desired, I will mention the principal ones: Amputation of thigh, 2; amputation of leg, 2; amputation of fingers, 5; amputation of arm, 2; excision of neuroma, 1; of cancer of breast, 2; of fatty tumors, 5; paracentesis abdominis, 5; phimosis, 10; stricture of urethra, 4; hydrocele, 5; fistula in ano, 3; pterygium, 1; abscesses, 50; reduction of dislocation of hip, 2; of dislocation of elbow, 1; of dislocation of wrist, 1; of other dislocations, 4; setting of fracture of nasal bones, 2; of fracture of inferior maxillary, 1; of humerus, 9; of compound comminuted fracture of ulna, 1; of fracture of radius and ulna, 7; of phalanges, 2; of femur, 4; of comminuted fracture of femur, 2; of fracture of tibia and fibula, 3; of compound fracture of tibia and fibula, 2; of fracture of fibula, 1; of rib, 6; gunshot wounds, 19. The accompanying tables contain a clear statement of all that has been done during the year. Tables marked A and B show the causes of death and the number of deaths in ten days after admission. The table marked C contains a full list of the injuries, surgical cases, and diseases. The table marked D shows the occupations of the patients. The table marked E shows their nativity. The table marked F shows the monthly admissions, and that marked G shows the number admitted each year for the past fourteen years. The table marked H shows the number admitted, born, discharged, and died, and the number remaining June 30, 1888.

About 180 ex-soldiers have been admitted and treated. These persons come from all parts of the country to look after claims; many become sick, and, upon the recommendation of the Commissioner of Pensions, are admitted to the hospital. A large percentage of the admissions is upon the recommendation of the police. From this source 753 were admitted. Many apply directly to the hospital for admission; others are recommended by the physicians of the city, by the associ ated charities, and other charitable enterprises. All cases, however, are inspected by the physicians of the hospital, and, if worthy and proper, are admitted.

During the year, upon the recommendation of the board of managers of the National Soldiers' Homes, 28 ex-soldiers, who were delayed in the city a few days waiting transportation, were received. For these cases a small compensation is paid by the board, sufficient to meet the cost of keeping them. The amount for last year was $55.60. Of this $21.60 has been paid and the balance will be paid, as usual, December 31.

The mortality will show a small increase in the number of deaths. In explanation, I call attention to the table marked B, which shows the number of deaths occurring within ten days after admission. As will be seen, over one-third of all the deaths occurred within this time, some dying within a few moments after admission. It seems as if many are sent to the hospital for the Government to bury. Some lives undoubtedly could have been saved if the patients had had timely medical treatment, with good nursing, proper diet, and proper hygienic surroundings. As usual, consumption causes a larger number of deaths than any other disease. From this cause alone there were 71 deaths. I am not surprised at this. It seems that these unfortunate people invite this disease. My experience is that they are not more susceptible to it than others, but from the want of information and training they violate all rules governing health. Their houses are poorly constructed, badly located, in alleys and by sewers. They sleep too many in a room, without ventilation, are covered by dirty bed-clothing-a fruitful nest for all poisonous germs. Their food is of the poorest, their clothing generally scanty and not suitable for the weather. There is a general disregard of all sanitary laws, such as bathing and taking proper rest. Many are the victims of hereditary taints which almost invariably produce lung diseases. To illustrate, the table marked C will show that one-tenth of the patients admitted during the year were admitted for venereal diseases.

In this connection I will call attention to the importance of the passage of a law forbidding the construction of tenement houses in alleys. The health of the city would be improved, and the morals and health of the majority of those who fill our hospitals and asylums would be largely benefited by preventing congregation.

Two years ago I felt constrained to call attention to the increase of patients in the maternity ward. The increase in numbers continues out of all proportion to the increase of population. With few exceptions, the children thus born are illegitimate. I can not offer any explanation of this increase other than that the hospital has grown to be looked upon with increased favor by the poor and sick, and is sought as a safe refuge during illness. My observation leads me to believe that the morals of the people are better. The class I have to contend with are poor and ignorant, and in the main orphans, who have had no home instruction or protection, and, consequently, are easily victimized. As a rule these unfortunate women can give but little account of the fathers of their children, who, for the want of law, fail to contribute anything towards the support of their offspring. To the credit of this class, I desire to state that most of them take care of and support their children, and make great personal sacrifice to do so.

We have cared for and treated 85 cases of alcoholism, including delirium tremens. These patients, with few exceptions, are a worthless class, without self respect or a desire to reform. I do not, after years of experience, believe in an inebriate asylum for them. They should be looked upon as vagrants, and their inebriety should be considered a misdemeanor and punished accordingly. In cases of long standing, where the habit of drinking is a confirmed one, and organic changes have taken place, causing dementia, the insane asylum is the place.

During the year there has been an increase of 60 per cent. in typhoid fever cases over the year 1886-'87.

The past year has been a busy one. The surgeons and attendants have had their time fully occupied. The hospital has a capacity of 300 beds. It is the largest in the district. While its name is of historical value, it does not indicate its true character. It is decidedly catholic, and admits all classes needing medical and surgical care and treatment. The buildings and wards are plain but healthy and comfortable, and are always kept in as sanitary à condition as possible. The food supplied to the hospital is of the best, and is purchased by contract. The diet is one of the most difficult things to regulate. Few patients have a realizing sense as to what they should eat. The majority desire and demand that which would tax the digestive organs of the healthiest of men. The daily cost of running the institution is 55 cents per capita. This includes every expense, and is 100 per cent. less than it costs any similar institution in the District. There are some improvements I would like to make, but I am deterred from asking appropriations for the same because the Government does not own the buildings and grounds, which it should do, and I would suggest that they be purchased.

I have always made it a rule to exact from convalescent patients and from women waiting to be confined some light duty. The men work in the flower beds and the women do some sewing. The following articles have been made by them: Bedsacks, 20; pillow-cases, 201; sheets, 284; towels, 46; shirts, 288; drawers, 182; chemises, 47; dresses, 80; aprons, 123; handkerchiefs, 19; skirts, 37; caps, 6; trousers, 1; nightgowns, 41; curtains, 12.

The religious services, as usual, have been conducted by two theological students from Howard University. They visit the wards and write letters for the patients. For their services they receive their board. Valuable services have been rendered by Rev. Fathers Richard Burke and George Glaab, and Rev. Edward Marshall Mott, who have been constant visitors to the sick and wounded. Mrs. Ada E. Spurgeon continues her charitable work among the sick, bringing them reading matter and securing burial for some who would otherwise have been sent to the potter's field. Mrs. Spurgeon has also been instru mental in securing homes for some of the babies, whose mothers have died or were too poor to provide for them.

Very respectfully,

Hon. Wм. F. VILAS,

CHAS. B. PURVIS, M. D.,
Surgeon in Chief.

Secretary of the Interior, Washington.

INT 88-VOL III-39

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TABLE B.-Number of deaths occurring within ten days after admission, and the time each

case was in the hospital prior to death.

1 died in 12 minutes after admission.

1 died in 30 minutes after admission.

2 died in 1 hour after admission.

2 died in 2 hours after admission.

4 died in 3 hours after admission.

2 died in 5 hours after admission. 1 died in 8 hours after admission. 2 died in 12 hours after admission. 1 died in 14 hours after admission. 4 died in 18 hours after admission. 5 died in 20 hours after admission.

3 died in 24 hours after admission. 7 died in 14 days after admission. 1 died in 2 days after admission. 8 died in 3 days after admission. 4 died in 4 days after admission. 7 died in 5 days after admission. 9 died in 6 days after admission. 10 died in 7 days after admission. 6 died in 8 days after admission. 3 died in 9 days after admission. 6 died in 10 days after admission.

Total 89-over one-third of all the deaths occurring during the year.

TABLE C.-The diseases and conditions for which patients were admitted to hospital and treated in dispensary.

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