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The following table covers expenditures by the Bureau of Mines to June 30, 1935, from allotments from National Industrial Recovery and Public Works appropriations:

[graphic][table]

ST. ELIZABETHS HOSPITAL

(william A. White, M. D., Superintendent)
MOVEMENT OF POPULATION

On June 30, 1935, 5,315 patients remained in the hospital as compared with 5,191 on June 30, 1934, an increase of 124.

The total number of patients under treatment during the year was 6,015, as compared with 5,875 for the preceding year, an increase of 140.

The total number of admissions during the year was 824, as compared with 894 the preceding year, a decrease of 70.

The total number of discharges for the year was 396, as compared with 426 for the preceding year, a decrease of 30.

The total number of deaths for the year was 304, as compared with 258 for the preceding year, an increase of 46, or about 18 percent.

The total number of discharges and deaths, combined, was 700, compared with 684 for the preceding year, an increase of 16, or about 2y2 percent.

There were 64 burials in the hospital cemetery, as compared with 57 the preceding year, an increase of 7. With the cooperation of the War Department the bodies of 36 service men, honorably discharged, were buried in the Arlington National Cemetery, several as "indigent" who had no estate whatever. The other 268 bodies were buried by private undertakers, in cemeteries in Washington and elsewhere throughout the United States, one having been shipped to England.

The daily average patient population was 5,266.5, as compared with 5,049 the preceding year, an increase of 217.5.

Movement of patient population, fiscal year 1935

[table]

Farm and Garden.—The past fiscal year has not been marked by any serious disturbing factors, neither have any unusual successes been attained. Some improvements have been made that are not apparent on the surface, the chief item being the maintenance of general production in spite of reductions in both land and labor. As previously reported, this has been done at some sacrifice to general appearance of the farm and premises.

The amount of land available for production is gradually decreasing. No additional land has been purchased for farming purposes since 1891, when the hospital had about 1,200 patients, while it now has 5,300 patients. To house the increased number of patients required more beds and more buildings. Each building reduced the land available for farming. Each building required other utilities— lawns, walks, water, steam pipes, electric lights, etc. All of this reduced the land that could be cultivated for farm and gardening. The time has been reached when something should be done. When St. Elizabeths Hospital was first established it was located some distance away from the center of the city of Washington. The growth of the city has encompassed the hospital. The city that now surrounds the main portion of the institution, and what was formerly rural district is part of the city itself. The cow barns and piggery are located adjacent to Nichols Avenue and close to several of the buildings housing patients. Provision should be made for the purchase of land some distance away from the main portion of the hospital to locate the farm activities. This should include not only land for raising forage, fruits, and vegetables, but also to establish the dairy, piggery, and poultry plant. If about 5,000 acres of land could be purchased, the various items named could be located on the new farm and building erected, providing quarters for about 240 patients, whose services could be used helping to do the work on the farm and we believe such work would be of therapeutic value to the patients.

Diet.—The hospital continues the study of the diet. Not only are efforts being made to serve a greater variety of food to the patients and a larger variety of greens, but even greater efforts are being made to see that the food is being served in a more appetizing manner.

The manner of feeding through cafeteria has been extended. A cafeteria has been opened for the West Lodge dining room, which furnishes food not only for the patients in the West Lodge building but many from the Garfield, Dawes, and Ash wards. Four hundred and sixty patients are served in this cafeteria.

The dining room adjacent to the Detached Building has been equipped for cafeteria feeding, and 596 patients are served in this dining room.

The dining room attached to the S. P. B. group has been equipped for cafeteria service, and 530 patients are served in this dining

room.

More than 2,600 patients are now fed by the direct cafeteria system, and 1,000 additional by a modified form of cafeteria system which will best suit the needs of the various patients. That means that about 3,500 out of 5,300 patients at the hospital are fed by the cafeteria system, which permits them to participate in the choosing of the food that they are to eat. The hospital method of furnishing food by cafeteria style is to give the patients an election. The result of this change seems to be appreciated by the patients, who have not hesitated to express their approval of the improvement in the manner in which the food is served.

The cafeteria set aside for employees has been reconditioned, new toilet and locker rooms being provided.

Two classes in dietetics have been taught this year by one of the dietitians. Each class had 13 student nurses. The class consisted of 15 hours of lectures and 30 hours of laboratory work.

Two classes in diet and disease have also been taught by one of the dietitians. There were 15 students in one class and 10 students in the other, these classes consisting each of 15 hours of lecture.

Ice cream and pasteurizing plant.—A total of 263,975 gallons of milk, or a daily average of 723 gallons, were clarified and pasteurized at 148° F., held for 30 minutes, cooled as rapidly as possible to 46° F., and then bottled and canned. The bottles and cans had been thoroughly washed, steamed, and inspected before being used.

About 25 gallons of buttermilk were made daily and bottled and canned.

In the ice-cream department a total of 21,667 gallons of ice cream, or a daily average of 59 gallons, was made.

Bakery.—The output of bread during the year was 850,000 loaves, with 3,275,000 rolls and 90,000 pounds of pastry. During the year a change was made in the ingredients used in the dough by adding powdered milk and malt sirup which, it is believed, has made a great improvement in the output of the bakery.

Laundry.—The work of the laundry continues to increase. The number of pieces laundered during the past year was 11,293,923, about 550,000 increase over the previous year. There has been no increase among the paid employees, notwithstanding the additional number of pieces laundered.

A new disinfector has been installed, and a larger air compressor is at present being installed.

During the month of April more than 1,000,000 pieces were washed and laundered. We have practically reached the limit of the capac

Farm and Garden.—The past fiscal year has not been marked by any serious disturbing factors, neither have any unusual successes been attained. Some improvements have been made that are not apparent on the surface, the chief item being the maintenance of general production in spite of reductions in both land and labor. As previously reported, this has been done at some sacrifice to general appearance of the farm and premises.

The amount of land available for production is gradually decreasing. No additional land has been purchased for farming purposes since 1891, when the hospital had about 1,200 patients, while it now has 5,300 patients. To house the increased number of patients required more beds and more buildings. Each building reduced the land available for farming. Each building required other utilities— lawns, walks, water, steam pipes, electric lights, etc. All of this reduced the land that could be cultivated for farm and gardening. The time has been reached when something should be done. When St. Elizabeths Hospital was first established it was located some distance away from the center of the city of Washington. The growth of the city has encompassed the hospital. The city that now surrounds the main portion of the institution, and what was formerly rural district is part of the city itself. The cow barns and piggery are located adjacent to Nichols Avenue and close to several of the buildings housing patients. Provision should be made for the purchase of land some distance away from the main portion of the hospital to locate the farm activities. This should include not only land for raising forage, fruits, and vegetables, but also to establish the dairy, piggery, and poultry plant. If about 5,000 acres of land could be purchased, the various items named could be located on the new farm and building erected, providing quarters for about 240 patients, whose services could be used helping to do the work on the farm and we believe such work would be of therapeutic value to the patients.

Diet.—The hospital continues the study of the diet. Not only are efforts being made to serve a greater variety of food to the patients and a larger variety of greens, but even greater efforts are being made to see that the food is being served in a more appetizing manner.

The manner of feeding through cafeteria has been extended. A cafeteria has been opened for the West Lodge dining room, which furnishes food not only for the patients in the West Lodge building but many from the Garfield, Dawes, and Ash wards. Four hundred and sixty patients are served in this cafeteria.

The dining room adjacent to the Detached Building has been equipped for cafeteria feeding, and 596 patients are served in this dining room.

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