List of contracts entered into for furnishing labor and materials for the fire-proof building for Pension Office from September 15, 1882, to October 27, 1884, by General M. C. Meigs, supervising engineer and architect. Materials and labor, fitting up two Materials and labor, laying floors, and Aug. 26. J. J. Desmond & Co., Wash- Laying sewer-pipe around the build. ing. Oct. 11... Pittsburgh Bridge Company, All the iron work for roofs ington, D. C. Pittsburgh, Pa. County, Maryland. Oct. 21... Frank M. Lee, Baltimore 3,000 barrels of lime $1,287 for all. For flooring, $1,779; sash and doors, At 69 cents per linear 93 cents per barrel of 300 pounds. REPORT OF THE FREEDMEN'S HOSPITAL. FREEDMEN'S HOSPITAL, Washington, D. C., September 17, 1884. SIR: I respectfully submit the annual report of this hospital for the fiscal year ending June 30, 1884. During the year there have been 1,723 patients admitted and treated; 1,021 were colored, 702 white. Of the colored, 515 were males, 506 females. Of the white, 577 were males, 125 females. The whole number admitted was 1,509. The average admissions were 125 per month. The accompanying tables will set forth the conditions and the diseases for which patients were admitted and treated. During the year there have been 176 deaths. The table marked A will show the causes of death. That some idea may be had of the condition of many of the cases when admitted, I submit the following table marked B, showing the number of deaths occurring within ten days after admission, and the time each was in the hospital prior to death. During the year there were 95 surgical operations performed. They were uniformly successful. I will mention the principal ones. Amputation of arm, 1; of thigh, 1; of leg, 1; of foot, 1; of fingers, 4; reduction of dislocation of shoulder, 2; removal of cancers, 2; removal of fatty tumors, 2; of fibrous tumors, 2; of tumor of eye, 1; of bursa, 1; of foreign body (hairpin) from uterus, 1; of necrosis of superior maxillary, 1; of malar bone, 1; fistula in ano, 8; vesico-vaginal fistula, 1; urethrotomy, 2; circumcision, 3; reduction of strangulated inguinal hernia, 3; paracentesis abdominis, 4; neuroma, 1; ectropion, 1; cataract, 2; setting of fractured forearm, 3; of humerus, 1; of clavicle, 2; of inferior maxillary, 1; of femur, 1; of leg, 1; of ribs, 3; gunshot wounds, 14. There were 77 cases of confinement. In this connection, I will mention the fact that during the past four years there have been 279 women confined in the hospital and not a death has occurred; there has not been a case of puerperal fever. I attribute this absence of puerperal complications to the strict observance of sanitary rules. The patients are kept scrupulously clean in their persons, and great attention is given to the bedding, clothing, and surroundings. The table marked C contains a full list of the injuries, surgical cases, and of the diseases. The table marked D will show the nativity of the patients. About 215 ex-sol liers have been admitted and treated. This class of cases comes from all parts of the country to look after their claims; many become sick and upon the recommendation of the Commissioner of Pensions are admitted to the hospital. The majority of the patients are admitted upon the recommendation of the chief of police. All cases, however, are inspected by the physicians of the hospital, and, if worthy and proper, are admitted. No distinction is made in favor of any class, race, or sex. Patients are admitted for treatment for every disease ex cept small-pox. During the year, upon the recommendation of the secretary to the Board of Managers of the National Soldiers' Home, 47 ex-soldiers, who were delayed in the city for a few days waiting transportation, were received. For these cases a small compensation has been paid by the Board, sufficient to meet the cost of keeping them, amounting to $98.80. During the year 74 persons were treated for conditions arising from alcoholism. For the past few years applications for admission of this class of cases have been steadily on the increase. All persons applying have not been admitted; distinction is made between those who really need medical treatment, and those who merely desire to remain until the effect of their debauchery wears off. While many of the cases have been of a serious nature, there has been only one death resulting from congestion of the brain. This case was neglected prior to admission, and he had been under the influence of liquor for four months continuously. The medical treatment of these cases has been confined to meeting the various conditions arising; sedatives have generally been used. Stimulants have been avoided, and only used when absolutely necessary. lu such cases we have yielded our prejudices to our judgments. The treatment and management of inebriates have long been subjects of discussion. As a result of my observation, I am of the opinion that inebriate asylums will not accomplish much. Wheu a person is diseased bordering upon mania a potu, he should be admited to a hospital and treated as any other patient; when the mind has become permanently diseased, the patient should be sent to an insane asylum. Other cases resulting from habit, desire, and a general tendency to debauchery should be treated as cases of misdeineanor against the community, and punishment should be imposed not by fine, but by confinement, and the party should be compelled to work to meet the expense of his keep. In the dispensary attached 2,455 persons have been prescribed for dur ing the year. I have endeavored to restrict the treatment of these outdoor patints to those who are worthy. I find there is quite a large number of persons in the community who avail themselves of the benefits of the dispensaries of the city who are not really deserving cases. While the practice of keeping open dispensaries for out-door poor is a commendable charity, it can be overdone and lead to abuses by increasing the number of mendicants in the community. The present capacity of the hospital is 300 beds. When necessity requires it, the beds can readily be increased to 400 by utilizing the additional rooms that are in the main building. I think, however, the present number of beds is sufficient to accommodate all who are likely to need hospital care and treatment for a number of years to come. There have always been from 40 to 50 unoccupied beds to meet any emergency that might arise. During the year 16 cases of idiopathic erysipelas were admitted and treated. As the numbers were so unusually large and the cases severe ones, I deem it best to call attention to them. I desire also to call attention to the number of cases of consumption. There have been 131 cases treated. Of this number 60 died. The treatment of these cases has not been satisfactory. Very few apply for admission to the hospital until their condition has become hopeless. The majority of the cases which come are from that class which has been subjected to the worst moral and physical influences. The disease, as a rule, has advanced too far to be checked by the administration of physic. Medicines do not accomplish much; they act simply as palliatives. Mental, moral, and physical hygiene will accomplish much more. One of the chief reasons why such small success follows the treatment is the inability to have control of the cases in their incipient form; and, again, because patients will not remain under treatment after they commence to feel better. Contrary to the practice of most hospitals, I keep these patients as long as possible, and give them the advantage of treatment. The sanitary condition of the institution has been excellent. After much effort I succeeded in getting Congress to appropriate $1,500, to build four bath rooms for the female wards, which were much needed, and to repair as far as possible the porches and make them a means of fire-escape. Convalescent patients and those waiting to be confined are required, as far as possible, to perform some light service. The men assist in taking care of the grounds, and the women assist in sewing. Most of the clothing used in the hospital is made by the female patients; the mending is done by them. The following articles have been made: Pants, 2; shirts, 189; chemises, 61; skirts, 42; aprons, 134; dresses, 110; bedsacks, 27; handkerchiefs, 44; bonnets, 8; sheets, 76; drawers, 185; pillow cases, 119; curtains, 17; tray-covers, 6; pillow-ticks, 35; nightgowns, 48; towels, 60; caps, 2. Supplies for the hospital during the year were purchased under contract. This is the first time supplies have been purchased by this method, and it has proved to be a success. The articles supplied are . fully equal in quality to those heretofore received, and the price very much less. I have been able under this system to make a saving of $2,000 in subsistence alone. The Board of Visitors recently appointed by you have visited the institution. They will submit a report, the result of their observations. Religious services are held, as formerly, three times a week in the chapel. These exercises are conducted by two theological students from Howard University, who receive their board for their services. They visit the wards daily, write letters for the patients, and perform such other services as may be required of them. Ministers from the city, representing the various denominations, are permitted to visit the hospital at all hours. Medical students from the several medical colleges of the city have availed themselves of the clinical advantages offered. The opportunity to witness operations, to study diseases at the bedside, has been of special advantage to the colored medical students, who are not received cordially by kindred institutions. Quite a number of the female students from the training school for nurses have been permitted to walk the wards and gather all the practical information possible. I have encouraged this class of students in their work, and have often found their services valuable. After many months of urging I have succeeded in getting the Commissioners of the District to pave the main street leading to the hospital. All of which is respectfully submitted. Very respectfully, TABLE B.-Number of deaths occurring within ten days after admission and the time each was in the hospital prior to death. 1 died in 20 minutes after admission. 1 died in 45 minutes after admission. 1 died in 13 hours after admission. 1 1 |