Port Tampa, Fla.-The medical attendance to be furnished by an acting assistant surgeon. Port Townsend, Wash.-Hospital patients to be cared for in the United States Marine Hospital; George E. Starrett to provide for the burial of deceased patients, at $16 each. Providence, R. I.-The Rhode Island Hospital to furnish quarters, subsistence, nursing, medical attendance, and medicines, at $1 per day, and to provide for the burial of deceased patients, at $12 each. Patients requiring long-continued hospital treatment will be furnished transportation to the United States Marine Hospital at Chelsea (port of Boston). Richmond, Va.-The medical attendance to be furnished by an acting assistant surgeon; out-patients to be treated at the Marine Hospital office, custom-house building; "Retreat for the Sick" Hospital to furnish quarters, subsistence, nursing, and medicines, at $1 per day. Rockland, Me.—The medical attendance to be furnished by an acting assistant surgeon. Hospital care and treatment will be furnished only to patients who are unable to bear transportation to the United States Marine Hospital at Portland, Me. Rome, Ga.-The medical attendance to be furnished by an acting assistant surgeon; the Martha Battey Hospital to furnish quarters, subsistence, and nursing, at $1 per day. Saginaw, Mich.-The medical attendance to be furnished by an acting assistant surgeon; St. Mary's Hospital to furnish quarters, subsistence, nursing, and medicines, at 64 cents per day. Patients requiring long-continued hospital treatment to be furnished transportation to the United States Marine Hospital at Detroit, Mich. St. Louis, Mo.-Hospital patients to be cared for in the United States Marine Hospital; John Hahn to provide for the burial of deceased patients, at $12.50 each. St. Paul, Minn.--The medical attendance to be furnished by an acting assistant surgeon; St. Joseph's Hospital to furnish quarters, subsistence, nursing, and medicines, at $1 per day; and to provide for the burial of deceased patients, at $8 each. San Diego, Cal.-The medical attendance to be furnished by a medical officer of the Marine-Hospital Service; St. Joseph's Hospital to furnish quarters, subsistence, nursing, and ambulance service, at 69 cents per day, and to provide for the burial of deceased patients, at $11 each. The Union Hospital to care for contagious cases, at the rate of $2 per day. Sandusky, Ohio.-The medical attendance to be furnished by an acting assistant surgeon; the Good Samaritan Hospital to furnish quarters, subsistence, and nursing, at $1 per day. San Francisco, Cal.-Hospital patients to be cared for in the United States Marine Hospital; out-patients to be treated at the Marine Hospital Office, rooms 1 to 3, Appraiser's building; burial of deceased patients at the hospital cemetery; burial of foreign seamen, at $10 each. San Pedro, Cal.-Randolph W. Hill, M. D., to furnish quarters, subsistence, nurs ing, medical attendance, and medicines, at 90 cents per day; contagious diseases, at $1.50 per day; and to provide for the burial of deceased patients, at $7 each. Sault Ste. Marie, Mich.-The medical attendance to be furnished by an acting assistant surgeon; Annie McNeeley to furnish quarters, subsistence, and nursing. at 75 cents per day; J. Vanderhook to provide for the burial of deceased patients, at $15 each. Savannah, Ga.—The medical attendance to be furnished by a medical officer of the Marine-Hospital Service; St. Joseph's Infirmary to furnish quarters, subsistence, nursing, and medicines, at $1 per day; Joseph Goette to provide for the burial of patients, at $7 each. Seattle, Wash.-The medical attendance to be furnished by an acting assistant surgeon; Providence Hospital to furnish quarters, subsistence, nursing, and medicines, at 60 cents per day; Bonney & Stewart to provide for the burial of deceased patients, at $8 each. Shreveport, La.-The medical attendance to be furnished by an acting assistant surgeon; out-patients to be treated at the Marine Hospital Office; Shreveport Charity Hospital to furnish quarters, subsistence, nursing, and medicines, at $1 per day; L. M. Melton to provide for the burial of deceased patients, at $16.50 each. Solomons, Md.-The medical attendance to be furnished by an acting assistant surgeon; W. H. Files to furnish subsistence, nursing, fuel, and lights, at $1 per day; T. M. White to provide for the burial of deceased patients, at $7.50 each. Patients requiring long-continued hospital treatment to be furnished transportation to the United States Marine Hospital, at Baltimore, Md. Superior, Wis.-The medical attendance to be furnished by an acting assistant surgeon; St. Mary's Hospital to furnish quarters, subsistence, nursing, and medicines, at 90 cents per day. Tacoma, Wash.-The medical attendance to be furnished by an acting assistant surgeon; Fanny C. Paddock Hospital to furnish quarters, subsistence, nursing, and medicines, at 55 cents per day. Tappahannock, Va.-W. G. Jeffries, M. D., to furnish quarters, subsistence, nursing, medical attendance, and medicines at Tappahannock, Dr. W. J. Newbill at Carter's Creek, and Dr. W. S. Christian at Urbana, each at $1.50 per day. Patients requiring long-continued hospital treatment will be transferred to the United States Marine Hospital at Baltimore, Md. Toledo, Ohio.-The medical attendance to be furnished by an acting assistant surgeon; the Toledo Hospital Association to furnish quarters, subsistence, nursing, and medicines, at 80 cents per day, contagious diseases, at $2 per day, and to provide for the burial of deceased patients, at $15 each. Tuckerton, N. J.-The medical attendance to be furnished by an acting assistant surgeon. Vicksburg, Miss.-The medical attendance to be furnished by an acting assistant surgeon; the Vicksburg City Hospital to furnish quarters, subsistence, nursing, and medicines, at $1 per day; contagious diseases, at $3 per day. Vineyard Haven, Mass.-Hospital patients to be cared for in the United States Marine Hospital; M. C. Vincent to provide for the burial of deceased patients, at $17 each. Washington, D. C.-The medical attendance to be furnished by a medical officer of the Marine-Hospital Service; out-patients to be treated at the dispensary, No. 3, B street SE.; Providence Hospital to furnish quarters, subsistence, nursing, interne attendance, and medicines, at 75 cents per day. Wheeling, W. Va.-The medical attendance to be furnished by an acting assistant surgeon; the Wheeling Hospital to furnish quarters, subsistence, nursing, and medicines, at 75 cents per day. Wilmington, N. C.-Hospital patients to be cared for in the United States Marine Hospital; Walter. E. Yopp to provide for the burial of deceased patients, at $11.50 each. At the following-named ports, hospital or other relief will be furnished only under the provisions of the regulations for the Marine-Hospital Service as to third-class stations: Barnstable, Mass.; Beaufort, N. C.; Beaufort, S. C.; Belfast, Me.; Burlington, Vt.; Castine, Me.; Cedar Keys, Fla.; Chatham, Mass.; Dennis, Mass.; Eastport, Me.; Edgartown, Mass.; Hyannis, Mass.; Neport News, Va.; Perth Amboy, N. J.; Provincetown, Mass.; Sag Harbor, N. Y.; Salem, Mass.; Sitka, Alaska; Somers Point, N. J.; Waldoboro, Me.; Wilmington, Del.; Wiscasset, Me. The rate at ports not specifically provided for by this circular will, in each special case, be fixed by the Department, upon the recommendation of the proper officer, in accordance with the regulations. The rate of charge for seamen from vessels of the Navy and Coast Survey, admitted to hospital under the provisions of the regulations, and of foreign seamen admitted under the act of March 3, 1875, is hereby fixed at the uniform rate of $1 per diem. At all ports not otherwise specified the dispensary is located at the custom-house or marine hospital. INSPECTIONS OF RELIEF STATIONS OF THE SECOND CLASS. With a view to accuracy of information concerning stations of the second class, the following blank form has been provided: Instructions to medical officers of the Marine-Hospital Service detailed to make inspections of relief stations of the second class. 1. Your visit to the station should be unannounced. 2. Upon arrival at the port you will first call upon the acting assistant surgeon and arrange with him for an inspection of the hospital, which should be made as soon after arrival as practicable. 3. You will then visit the office where out relief is furnished. 4. You will then call upon the collector of customs, if that officer issues relief certificates, and examine the records of the same. 5. You will make appropriate entries to each question of this inspection blank and forward to this office upon the completion of your duty. 1. Location of building used as hospital. 2. Is it used entirely for hospital purposes; and if not, for what other purpose: used? 3. Describe general construction. is it 4. Are the marine-hospital patients treated in separate wards? (This should be insisted upon when practicable.) 5. Describe the wards occupied by marine-hospital patients. (a) Dimensions. (b) Number of beds in each ward. (c) Cubic air space allowed each patient. (d) Heating, lighting, and ventilating. 6. Hospital furniture. (a) What kind of bedsteads, and what kind of mattresses and bedding?- patients. (e) Are the beds clean and free from vermin. 7. What is the condition of wards as to general cleanliness? 8. Is the nursing sufficient, and is the nurse employed trained to the duties? 9. Is the character of the diet furnished the same or equal to that prescribed in the diet table for marine hospitals? 10. If not, what is the ordinary diet furnished? 11. Is extra diet furnished for special cases? 12. Are the patients under treatment in hospital correctly recorded in the register, and are all present? 13. If any marine-hospital patients are not at hospital at time of examination, state why.. 14. What is the practice in regard to allowing marine-hospital patients to leave the hospital? Are they allowed to remain out over night? 15. Are the cases under treatment proper ones for hospital relief? 16. How are the medicines administered to the patients? III. OFFICE OR OUT RELIEF. 1. Is the room for the reception of marine-hospital patients suitable for the purpose? Location and distance from hospital. 2. Is it kept clean and in order? 3. Is it satisfactorily equipped for dispensary purposes? 4. Is the supply of medicines sufficient? 5. What is the condition of the public property (furniture, medicines, implements, instruments, etc.)? 6. What records are kept? 7. Are they correctly kept, and up to current work? 8. Are copies of reports kept on file? IV. GENERAL ADMINISTRATION. Give number of marine-hospital patients treated during the last fiscal year; and the number treated during the present fiscal year to date of report. Number of days relief furnished marine-hospital patients during the last fiscal year; average duration of treatment in hospital. Give the number of out-patients during the last fiscal year; and the number of out-patients during the present fiscal year to date of report. In your opinion, are marine-hospital patients sent to the hospital who might be treated at the office? Give the ratio of hospital to out-patients during the last fiscal year, and during the present fiscal year to date of report. V. REMARKS AND RECOMMENDATIONS. I certify that the foregoing is a careful and correct statement of the condition of the service at the port of - inspected by me this day of 189-. Surgeon, U. S. M. H. S. Inspector. CIRCULAR LETTERS RELATING TO ADMINISTRATIVE DETAILS. Following are circular letters addressed from time to time to medical fficers and acting assistant surgeons of the Marine-Hospital Service relative to administrative details: CIRCULAR LETter relating TO CERTIFICATES OF DISCHARGE. TREASURY DEPARTMENT, OFFICE OF SUPERVISING SURGEON-GENERAL, M. H. S., To medical officers of the Marine-Hospital Service and others concerned : The giving of a certificate of discharge to a hospital patient of the MarineHospital Service is wholly discretionary with the physician in charge. Such certifi cate, when presented at any other relief station, is not sufficient evidence of the applicant's title to marine-hospital relief, but may be considered as collateral to other satisfactory data submitted by the seaman. Respectfully, yours, WALTER WYMAN, Supervising Surgeon-General, M. H. S. CIRCULAR LETTER RELATING TO SUBSISTENCE AND LAUNDRY WORK AT QUARANTINE STATIONS. TREASURY DEPARTMENT, OFFICE OF SUPERVISING SURGEON-GENERAL, M. H. S., Washington, D. C., November 30, 1894. To medical officers and acting assistant surgeons in charge of United States quarantine stations: You are hereby informed that after this date subsistence and laundry work at public expense will not be allowed to medical officers or acting assistant surgeons in charge of national quarantine stations, except when quartered on vessels in commission. WALTER WYMAN, Supervising Surgeon-General, M. H. S. CIRCULAR LETTER RELATING TO PROMPT DISCHARGE OF PATIENTS FROM CONTRACT HOSPITALS AND TO TREATMENT OF OUT-PATIENTS. TREASURY DEPARTMENT, OFFICE OF SUPERVISING SURGEON-GENERAL, M. H. S., Washington, D. C., January 30, 1895. To medical officers, acting assistant surgeons, and others in charge of marine-hospital patients in contract hospitals: Your attention is hereby called to the necessity of discharging patients promptly upon the termination of the necessary hospital treatment. No provision has been made for mere quarters and subsistence of seamen at the expense of the marinehospital fund. Your attention is also directed to paragraph 173 of the regulations, which requires that sick and disabled seamen entitled to the benefits of the Marine-Hospital Service, whose diseases or injuries can properly be relieved without admission to hospital, should be treated as out-patients. You are requested to acknowledge the receipt of this letter. WALTER WYMAN, Supervising Surgeon-General, M. H. S. CIRCULAR LETTER CALLING FOR INFORMATION CONCERNING DUTIES OF HOSPITAL ATTENDANTS. TREASURY DEPARTMENT, OFFICE OF SUPERVISING SURGEON-GENERAL, M. H. S., Washington, D. C., February 15, 1895. Medical officer in command United States Marine-Hospital Service. SIR: You are directed to forward without delay a list of the hospital attendants employed at your station, stating the compensation and giving in detail the duties required of each attendant. Respectfully, yours, WALTER WYMAN, Supervising Surgeon-General, M. H. S. |