REPORT

OF

THE COLUMBIA HOSPITAL FOR WOMEN AND LYING

IN ASYLUM.

COLUMBIA HOSPITAL FOR WOMEN

AND LYING-IN ASYLUM, Washington, D. C., October 23, 1878. SIR: The committee appointed from the board of directors of the Columbia Hospital for Women and Lying-in Asylum beg leave to transmit the annual reports of the surgeon in charge and advisory board of physicians and surgeons, together with the synopsis of the receipts and disbursements of the treasurer, the duly-qualified vouchers for which have been presented to the Treasury Department for settlement, and approved for three quarters of the past fiscal year ending June 30, 1878. The last quarter has not yet been audited, though the vouchers therefor have been presented as approved by the hospital committee on expenditures.

The report of the matron also is transmitted, and it is hoped that these records furnish abundant evidence of the care bestowed upon the inmates of this institution, and that the property of the government invested therein is judiciously managed and protected.

It is a source of much satisfaction to the directors that the mortality of the hospital during the past year has been so small, and that the results of operations, some of which are among the most severe and dangerous in surgery, have been so unusually successful.

During the fiscal year just past, certain charges against the surgeon in charge and the management of the hospital were filed in the Interior Department, and a committee of investigation appointed. It having been decided that the committee had no power to act, the board of directors deemed it necessary for the well-being of the hospital to appoint a committee consisting of the eight eminent physicians constituting the "advisory and consulting board of physicians and surgeons" of the hos pital, with instructions and full powers to make a thorough and impar tial inquiry into the truth of the allegations set forth in the charges presented to your department, and of all others subsequently furnished. The committee appointed to make the inquiry thought proper to hold their sessions publicly, so that ample opportunity might be afforded and sufficient protection guaranteed all those preferring said charges. All evidence was taken under oath, and no testimony permitted to be given unless certified to in that manner.

The result of such full and searching investigation is embodied in a report signed by the committee unanimously, and submitted to the board

of directors at their special meeting held September 30, 1878, by the advisory and consulting board of physicians and surgeons, and which is herewith transmitted. The report was accompanied by an appendix containing a journal of the meetings of the committee and all the testimony taken under oath and reported verbatim by a stenographer, and now on file with the records of the hospital, open to inspection by all wishing to know the facts.

The report concludes in these words:

In carefully reviewing the testimony adduced, a work absolutely necessary in order to arrive at the result desired by the board of directors, the advisory board have had the conviction forced upon them that, not only are their conclusions as previously given entirely just in every particular, but that Dr. Murphy is entitled to the highest commendation for the fidelity and conscientious discharge of his duty; and further, the advisory board feel that they would have but illy performed their task should they fail to express their appreciation of the professional skill of Dr. Murphy, and their entire confidence in his ability to meet any emergency that may arise in an institution of this kind. In conclusion, the board feel themselves at liberty to state that, being more or less familiar with hospital affairs, they consider that the management of Columbia Hospital while under Dr. Murphy's charge compares favorably with that of any similar institution in the country; and they desire to express their unfeigned regret that persons should endeavor, through hearsay evidence or distorted impressions, to break down or impair, in any way, the usefulness of so noble a charity. Respectfully submitted.

CHARLES H. CRAGIN, M. D.,

Hon. SECRETARY OF THE INTERIOR DEPARTMENT.

Secretary.

To the President and Board of Directors of the Columbia Hospital for Women and Lying-in Asylum:

GENTLEMEN: In presenting to your honorable body the twelfth annual report of the Columbia Hospital for Women and the Columbia Hospital Dispensary for the fiscal year ending June 30, 1878, there is much that deserves more than a passing notice. During the past twelve months the hospital has been entirely free from any of the diseases usually occurring in lying-in asylums; no adult death being recorded in the obstetrical department of this institution for the period specified.

In the medical and surgical division of the hospital one death is mentioned as having occurred. The patient, a young girl aged 16, was admitted for the treatment of a disease peculiar to her sex. The symptoms she presented at the time of admission were those common to her affection and the prodromal stage of typhoid fever, which latter disease subsequently developed and ended in her death. Thus, in the treatment of 294 patients (see accompanying synopsis) 97 of whom were delivered, and on 24 of whom operations more or less severe were performed, we have only to report a single death, and that, too, from a disease which, strictly speaking, ought not to be reckoned in the hospital mortality.

The number of patients admitted during the year shows an increase of 44 over that of any previous year since the establishment of the institution, and this increase is of special significance when it is remembered that no case has been retained within the hospital for which provision is not made in the charter. Appended I present a list of the operations performed during the year, included in which will be found two cases of ovariotomy. The first operation was performed by the advice of the advisory and consulting physicians and surgeons at the house of the patient, who, though an inmate of the hospital for some time prior to the operation, preferred to be at home during that trying ordeal.

The second tumor was removed within the hospital, and, though "still in house" June 30, the time which has since elapsed enables me to state that the patient is now perfectly well. The object in here referring to these cases, a full history of which is elsewhere given, is to call attention to the fact that recovery was more rapid in the case of the patient who remained within the house; thus showing that those deleterious influences which are supposed so often to manifest themselves in hospitals were either entirely absent or completely counteracted by the precautions taken.

The dispensary service has afforded much relief to that large class of indigent females who, in the majority of instances, having large families either to support or take care of, are unable to seek admission into hospitals. The number treated, 485, during the year shows an increase of 98 over that of the preceding year.

By the request and direction of your honorable body an investigation into the management of the institution while under my charge has been undertaken and completed by the board of advisory physicians and surgeons. The result of their labors is embodied in their report, which has been submitted, and is now before you. No comments of mine are necessary further than to state, that no pains were spared to make the inquiry complete and searching in every particular, and that I am indebted to the gentlemen comprising that board for the fairness, impartiality, and courtesy which characterized their proceedings.

In conclusion, I wish to express my high appreciation of the services rendered by the advisory board, during the past year, in conducting the affairs of the hospital and dispensary. Their valuable counsel, their untiring zeal, and their friendly interest have, in a great measure, conduced to the past success and present favorable condition of the hospital.

It also affords me much pleasure to state that the nurses and employés have been faithful in the discharge of their duties, and that there is every reason to hope for a continuance of the present satisfactory condition of the hospital and its inmates.

Delivered before June 30, 1877, but not discharged till after that date..
Delivered during the year

Left before delivery..

Remaining in house undelivered....

Multiparæ 44, Primiparæ 78.......

The triplets and one case of twins were premature, and died within twelve hours. Of the other two children lost, one was premature, the other died from gastro-enteric catarrh.

The following is a list of the principal operations performed during the year on patients, all of whom were suffering from some disease peculiar

Report of Columbia Hospital and Dispensary, Washington, D. C., for the year ending June 30, 1878.

To the Board of Directors of Columbia Hospital:

GENTLEMEN: In accordance with the requirements of your regulations, the advisory and consulting board beg leave to submit the following as their report for the year ending September, 1878:

The present board organized at a meeting held September 29, 1877, by electing Dr. Joshua A. Ritchie chairman; J. O. Stanton, M. D., secretary; and Louis Mackall, M. D., as the representative to your body. It was also arranged at this meeting that two members of the board should in turn be on duty as weekly attendants to the hospital, and that their time of service should continue for three months.

The service of the quarter beginning October 1 devolved upon Drs. Lincoln and Stanton; the duties of the second, upon Drs. Ritchie and Yarrow; Drs. Mackall and Sowers were in attendance during the third. During the past three months the duties have been performed by Drs. Reyburn and Young. A reference to the weekly reports will show that generally two and always one of the staff made weekly visits, and thoroughly examined into the condition of both patients and buildings. In addition to