will accommodate about twenty-eight patients, while in cases of extreme necessity
room can be found for more. The tuberculosis pavilion will simply be shifted in
position, and will still remain available for its present purposes.
Census.
The total number of days' treatment given in Bellevue Hospital has been 316,734,
as compared with 311,711 in 1904, and the average daily census 86S, as compared with
851. The record of 1,000 patients cared for in the hospital at one time, in 1904, was
exceeded when, during 1905, the census reached 1,077, the highest it has ever been
in the history of the institution. The total number treated during the year was 28,546,
against 29,741 in 1904.
There were 81,005 visits made to the out-patient department by 31,547 patients, as
compared with 67,777 visits by 21,069 patients in 1904.
Increased Facilities.
The Ducker portable buildings, authorized at the end of 1904, in anticipation of
greatly increased need of hospital accommodations by reason of the severe winter,
were opened, two of them in February, the other two in March. Delay on the part
of the prison authorities in supplying beds and blankets was responsible for such
slight delay as occurred here. Relief was immediately felt as a result of opening
these buildings, and this has been particularly noticeable in the increased facility
enjoyed for retaining patients really too ill for transfer, but who, under the old sys-
tem, had to be removed in order to make room for those still more acute cases that
could not be refused admission. The assignment of one of these buildings to the pur-
poses of a tuberculosis ward has done much to relieve the strain arising from lack of
sufficient room for these cases, which has been a cause of complaint in the past.
Many advanced cases of consumption come to Bellevue straight from the street in a
condition too precarious to admit of immediate transfer to the Metropolitan Hospital
on Blackwell's Island. These cases must frequently be cared for in the general wards
of the hospital, where they are sometimes a menace to the health of other patients
being cared for there. This new ward, capable of thorough ventilation and e.tposed
to the fresh air and sunshine, is an excellent place for these patients, besides making
it easier to enforce the rule against admitting them to the general wards of the hos-
pital.
24
Annex to Nurses' Home.
To accommodate the additional nurses, whose servicer were made necessary by
the opening of the temporary pavilions, premises were leased at No. 212 East Twenty-
sixth street, the lease dating from August i. A special appropriation of $20,000 in rev-
enue bonds was granted the Board for this purpose. Plans and specifications for the
necessary alteration of these premises were approved by the Finance Department, and
bids for these alterations were opened on September 14. The building, when prop-
erly arranged, will accommodate twenty additional women nurses, whose services
are urgently required in the hospital.
New Nurses' Home.
Land for the erection of a new home and training school for women nurses has
been purchased by the City, upon recommendation of the Board of Trustees, on the
south side of Twenty-sixth street, immediately adjoining the site of the present Train-
ing School building. This purchase .was made in the latter part of December fpr the
sum of $244,000, and later the Board of Aldermen approved the appropriation of $10,000
for architects' fees in the preparation of plans for the new building. It is proposed
to use the building to train nurses for Bellevue and to supply pupil nurses to the De-
partment of Health, which at present employs graduate nurses at salaries of $40 per
month. It is expected that this will soon save the City from $30,000 to $40,000 per
year, an amount which would more than meet the interest on the money necessary to
purchase the site and erect the building. It is further proposed to place the school
under the joint control of the Board of Trustees, and of a Board of Managers to be
composed of ladies appointed by the Mayor from nominations made by the present
Board of Managers, and as representatives of the City, the Comptroller, the President
of the Board of Health, and the President of the Board of Trustees of Bellevue and
Allied Hospitals.
Protection from Fire.
A communication having been received early in August by the Board of Trus-
tees from the City Visiting Committee of the State Charities Aid Association, em-
bodying a criticism by a former Chief of the Fire Department, Mr. Hugh Bonner, of
the facilities at Bellevue for an adequate protection of the inmates from fire, the
Board referred the matter to the Superintendent for a rigid investigation and the
immediate rectification of any defects susceptible of a summary improvement. For
his assistance in the conduct of this investigation the Superintendent called in the
services of the City Fire Department, whose expert went over the ground covered by
the Bonner report point by point, with the result of sustaining many of the criticisms
made therein, while some of the improvements recommended were adjudged unnec-
essary. The Board of Trustees, while reluctant to lay out a large sum of money upon
buildings soon to be torn down and replaced, were yet more unwilling to jeopardize
25
the lives of helpless patients by leaving untried any measures that might contribute
toward their security during the few years remaining in which portions of the old
building must continue to be occupied, and they accordingly requested the Board of
Estimate and Apportionment to set aside suflficient funds for a thorough compliance
with the recommendations of the report. According to the estimate made by the
Supervising Engineer of this Department the sum required was $34,335, but this was
reduced by the investigation of the Engineer of the Finance Department to whom the
matter had been referred to $21,000, which sum was appropriated by the City, and is
being expended for the purposes for which it was intended.
The Medical Service.
One of the new pavilions was set apart for meningitis cases, with the result that
a better percentage of recoveries was made under the special treatment accorded
there. The larger supply of fresh air and sunlight seemed influential in contributing
to this result.
A Committee of the Medical Board, especially appointe'd, presented to the Trus-
tees a valuable report upon hospital dietetics, which will be of service in arranging
future dietary schedules.
The Board of Trustees has approved of a new rule suggested by the Medical
Board to the efifect that patients suffering from poison or from coma, providing that
they are not under arrest, shall be treated in the general wards instead of being
assigned to the alcoholic wards, as has been the custom in the past.
Another rule, admitting to the gynaecological service post-partum patients,
referred from Emergency Hospital, has also been approved.
A recommendation that the medical teaching of graduate and undergraduate
students be extended to the Out-Patient Department has likewise met with the ap-
proval of the Board of Trustees, and this is being carried out with successful results.
With the co-operation of the Medical Board the rules relating to the use of med-
ical supplies of all kinds (from the gauze and muslin used in bandaging to the alcohol
and other spirits, as well as to the surgeons' instruments) have been amended, with
the result of obtaining a very much greater degree of economy in the use of these
supplies. The saving effected has been estimated to be as much as $525 in one month.
Besides supplying shoes and heavy overcoats to the patients in the tuberculosis
tents, the Board decided this winter to supply warm underclothing as well. The number
of patients in this tent is few, its position is exposed, and the inmates were found,
almost invariably, to be improperly clothed.
Medical Appointments.
A new rule adopted by the Board of Trustees restricts the terms of all future
medical appointments, including those of visiting physicians and surgeons on the
Medical Board, to one year, while all such appointees will be notified that they are
26
expected to visit daily during their term of service the institution to which they have
been appointed, unless prevented by illness or absence from the city.
A proposition having been made to appoint consulting eye, ear, throat and skin
specialists to Bellevue Hospital, the matter was referred to the Medical Board for its
opinion upon the need for such specialists, and its report being unfavorable, the plan
Vi'as abandoned until such time as a need shall exist.
The following medical appointments have been made and the following resigna-
tions accepted by the Trustees for Bellevue Hospital during the year :
On December 15 Dr. William F. Fluhrer resigned from the position of Attending
Surgeon to the Fourth Division. The Trustees, at their meeting of December 20,
accepted his resignation with regret, and expressed to him their great appreciation
of his long and valuable services. At the same meeting he was appointed Consulting
Surgeon to Bellevue Hospital.
Dr. Claude A. Frink was appointed Physician to Out-Patients on the First Di-
vision on January 12.
Dr. John M. Spctnagle, Genito-Urinary Surgeon to Out-Patients on the First
Division, resigned on April 5.
Dr. A. Richard Stern, Assistant Physician to Out-Patients on the First Division
in the Children's Department, resigned on March i.
Dr. Walter L. Niles and Dr. C. Clarence Sichel, Assistant Physician to Out-
Patients, resigned on June 20.
Dr. Herman F. Nordeman was appointed Genilo-Urinary Surgeon and Dr.
Gerald A. Garrigan Assistant Surgeon to Out-Patients on the Fourth Division on
June 20.
Dr. E. W. Danner was appointed Assistant Genito-Urinary Surgeon to Out-
Patients on the Fourth Division on July 5.
Police Matrons in Wards.
The assignment of two police matrons to duty in the prison ward for women in
place of the policemen who have hitherto been stationed there was brought about
early in May. The Trustees have long advocated this arrangement, which is certain
to produce an improvement in the management of these wards, while it liberates
for service elsewhere in the hospital grounds the three patrolmen hitherto doing duty
there.
Status of Hospital Records.
The legal status of the contents of the record room has long been a subject of
dispute, which has now been settled by an opinion from the Corporation Counsel,
given in response to the Trustees' request. In this opinion the Corporation Counsel
practically upholds the doctrine of the sanctity of the relation existing between a
physician and his patient, and justifies the action of the Trustees in refusing to allow
27
reporters of newspapers access to those records, while holding them open to in-
spection by the courts in proper cases.
Reception Office Reform.
While a considerable improvement in the management of the reception ofifice has
been effected, it is felt by the Trustees that this ofifice, in one respect the most im-
portant in the hospital, since it is here that patients receive their first impressions,
will not be managed as it should be until money is available to pay for the services
of a first-clasa man to be in charge, as well as those of a trained nurse (woman),
and to pay salaries that will attract a better class of young men to act as stretcher
carriers. The presence of paid examining physicians, to be in charge of the work
of admitting patients (if it shall prove possible to obtain these physicians at the
salaries allowed), will also contribute powerfully to an improvement in the conduct
of the office.
Psychopathic Wards.
A communication requesting information concerning the probable saving of
expense to the psychopathic wards by the establishment of a psychopathic hospital
in the City was received by the Board at its meeting of June 5, and reply was made
that provided the new institution is established according to the plans outlined by
the managers, and provided that necessary changes are effected in the Lunacy Law,
a large reduction of expense to the present wards may be confidently anticipated.
The Board of Trustees further expressed its opinion that such an institution is needed
for the care of the City's insane.
In accordance with Dr. Gregory's recommendation a music box has been pur-
chased for the men's ward, that in the ward for women having produced an excel-
lent effect upon the inmates there.
The change of title of Resident Physician and Assistant Resident Physician in the
Psychopathic Wards to Resident Alienist and Assistant Resident Alienist has been
approved by the Board of Estimate and Apportionment, the Board of Aldermen and
the Municipal Civil Service Commission, the salaries of the positions being fixed at
$3,500 and $1,500 respectively. From eligible lists established by the Municipal Civil
Service Commission under the new title of Alienist the following appointments have
been made:
Dr. Michael J. Thornton, of the Manhattan State Hospital at Central Islip, was
appointed First Assistant Resident Alienist on February 15, and Dr. Paul Waterman,
a graduate of the Bellevue house staff, was appointed Second Assistant Resident
Alienist on Siptember 15.
A full statement of the work of these wards is given in the Resident Alienist's
report.
28
Miscellaneous.
The work of filling in the extension within the new bulkhead has been completed,
and it has been necessary to build a fence along the south side of Twenty-eighth
street to protect the new ground.
The erection of the Ducker buildings deprived the doctors of their tennis court.
As it is quite essential that these hard-worked young men should have some means
of recreation at hand, a new site for the court was found just behind the psychopathic
wards, and it was in use so long as the weather permitted.
Improvements, Alterations and Repairs.
Among the many important improvements and alterations that have been made
or projected during the past year may be mentioned the following:
A New Dormitory — The old boiler room under the pathological laboratory has
been cleaned out and converted into a dormitory for men employees. To render it
entirely available it was necessary to put in a new flooring and a metal ceiling, and
to install a bathroom and toilet, all of which was done at an expense of about $600.
More Office Room — More oflFice room for the General Medical Superintendent and
the Secretary to the President and more space for supplies have long been desiderata
at Bellevue, the room occupied as his office by the Superintendent having to serve as
well for the Secretary to the President and for two stenographers, all of whom
were constantly interrupted in their work by the ringing of telephones, the intrusion
of visitors, etc., etc. To relieve this congestion it has been found necessary to take
for hospital purposes the room occupied by the Protestant Chaplain, and in order
that his work may not suffer it has been arranged to erect a partition at the end
of the library, thus creating an apartment for his use. This change permits of the
use of the Chaplain's room as a place for the storage of supplies, while the room
formerly occupied for this purpose has been arranged as an office for the Secretary
to the President.
Quarters for the House Staff — At the beginning of the year it was found neces-
sary to engage a room outside of the hospital for two members of the house staff
whose quarters in the old building were disgracefully crowded. This arrangement,
however, proved exceedingly inconvenient in view of the difficulty of procuring the
services of the doctors at night, and later a change was effected by which these two
members of the house staff were assigned to the room previously occupied by the
Night Superintendent. As he used it only during the day, when he was much dis-
turbed by the noisy surroundings, the change to a room outside of the hospital was
as much to his advantage as it was to the service of the hospital.
For Quiet in the Wards — For the greater comfort of very sick patients who may
be disturbed by the noise and by persons passing through the ward cork strips have
been placed in every ward from door to door. This has effected an astonishing im-
29
provement. The Superintendent has also been authorized to experiment with a plan
of equipping the beds in a certain ward with movable rubber castors, the object
being to avoid the noise in the ward beneath from the moving of beds whenever
ward cleaning is going on.
Roofs and Leaders — Speciiications have been prepared and an advertisement au-
thorized for bids upon -the work of repairing the roofs and leaders of the main build-
ing and towers at Bellevue. This work is very necessary, and it is hoped that it can be
undertaken early in the coming year.
New Bath Tubs — It has been decided to replace the old bath tubs, which, besides
being extremely unsightly in appearance, are inconvenient and antiquated in plumbing,
with new porcelain, open plumbing tubs at a cost of $615 delivered at the hospital, the
department plumbers to put them in place.
The Kitchen Service — To facilitate the cleaning of dishes and lessen the breakage,
three dish-washing machines to cost about $300 each have been ordered. Gas stoves
have been substituted for the two-burner gas heaters previously in us in the several
diet kitchens of the hospital — an improvement which will permit of the warming of the
plates at the same time as the food itself. Racks for holding kitchen utensils and tables
for keeping the food warm in the general kitchen have also been purchased.
Miscellaneous — Among the other improvements made or authorized may be men-
tioned the repair 0/ cement flooring in the laundry and the purchase of a new extractor
and tumbler, the erection of three additional storm doors, purchase of a new ambulance,
repair of the X-ray apparatus, new lockers for dormitories, time stamps for letters, etc.
GOUVERNEUR HosPIT.-\L.
Progress upon the new wing' of Gouverneur Hospital has not been as rapid as the
Trustees could have wished, and the year closes without the use of the new portion of
the hospital, while the old portion is much cut up and disturbed by the presence of the
workmen engaged upon the necessary alterations and connections. In the early part of the
year the extreme severity of the winter accounted in great part for the delay in the work,
but the contractor cannot be held guiltless in that there have been times when the force
of laborers on hand was entirely inadequate to prosecute the work expeditiously. The
contractors have been warned that the time upon their contract has expired and that
they will be held accountable for past and any future delays. The present status of the
building is as follows :
The exterior of the new wing has been practically completed. The partitions have
been built and plastered throughout, but some patching and painting remains to be done.
Most of the work of laying the floors has been done except the varnishing of the fin-
ished floors. The plumbing, heating and ventilating, and structural work, and the in-
terior work generally are well advanced, but the progress made has been extremely slow.
The materials furnished and the work done have been unsatisfactory in many instances
30
and a great deal of this still remains to be corrected, in spite of repeated instructions
from the architect to the contractor.
The following changes in the plans have been decided upon during the year :
The alteration and completion of twelve casement windows in the old and new
wings.
The constnit:tion of a slat platform and railing for the extension roof over the
stairwell.
The construction of a scope room and the placing of a partition in the end of the
examining room on the first floor of the new wing.
The morgue building is almost finished.
Out Patient Department.
It has been decided by the Medical Board, with the approval of the Board of
Trustees, that on and after January I, or at such time as the new quarters shall be
ready for the installation of the out patient department, a complete stafT of physicians
and surgeons to take charge of this service shall be appointed, thus releasing from it
the members of the hospital staff, who will be sufficiently employed with the added work
of the new hospital wards. Despite the very unfortunate conditions attending any work
in the midst of the dirt and disorder of building operations, cramped quarters, etc., ex-
cellent work has been done and the clinics have increased in numbers and importance.
A communication was received early in Januarv from the Committee on Prevention
of Tuberculosis of the Charity Organization Society offering to pay $40 apiece per
month to two physicians, to be employed under Dr. Iluddleston, a member of the
Gouverneur Hospital Medical Board, in the tuberculosis clinic of the Out Patient De-
partment, this payment to be continued for an experimental period of six months.
These physicians were already attached to the staff of the Out Patient Department,
where they had been doing excellent work, but were on the point of resigning by reason
of the large demands upon their time in the service of the city, for which no compensa-
tion was made. The offer of the committee was therefore accepted by the Board of
Trustees, the new plan being regarded in the light of an experiment. Although entirely
successful, the Anti-Tuberculosis Committee were unable to continue their aid after
November l, and the payment was then discontinued, although the work goes on.
Census.
The total number of days' treatment given at Gouverneur Hospital during the year
has been 32,436, as compared with 36,451 in 1904, and the average daily census 89, as
compared with 99. On April 7, 11 and 27, 122 patients were under treatment in the
hospital, which is 20 more than the nominal capacity, and 7 more than the largest num-
ber treated at any one time in 1904. The total number cared for was 3,663, against
4,236 in 1904.
31
There were 69,676 visits made to the out patient department by 28,474 patients, as
compared with 75334 visits by 29,043 patients in 1904.
jNIedical Appointments.
The following medical appointments hftve been made and the following resigna-
tions have been accepted by the Trustees for Gouverncur Hospital during the year :
Dr. L. A. Conner and Dr. S. A. Knopf were appointed Advisers to the Tuberculosis
Clinic on May 10.
Dr. Bruno S. Horowitz was appointed Assistant Surgeon to Out Patients on
June 5. He resigned on August 18.
Dr. Harlow Brooks resigned from the position of Pathologist to Gouverneur Hos-
pital on June 5.
On December 27 the following appointments were made to the Out Patient De-
partment :
Dr. Murrhae N. Horowicz, Assistant Physician to Out Patients; Dr. B. J. Bock-
schitzky, Assistant Physician to Out Patients, Skin Department; Dr. Meyer Rabino-
witz. Gynecologist to Out Patients ; Dr. M. A. Werner and Dr. Max Feldman, Assistant
Laryngologists to Out Patients.
The following temporary appointments of Assistants were made :
Dr. R. Abrahams, skin diseases ; Dr. A. W. Taves, Dr. F. G. Goodrich and Dr.
A. C. Henderson, in general medicine.
Harlem Hospital.
The contractor in charge of the construction of the new Harlem Hospital has, like
his fellow contractor at Gouverneur, fallen behindhand in his work of completing the
interior of the building, owing to disputes with sub-contractors, etc., and it has been
necessary to notify him that he has exceeded the term of his contract and will be held
accountable to the City. Advantage, however, has been taken of the delay to effect
some minor improvements in the -original plan, the principal of which is the widening
of the balconies from 6 to 8 feet and the cutting of new openings upon them from the
wards, thus permitting the rolling of patients in their beds out upon the balconies
where they can enjoy the advantage of fresh air treatment whenever this may be pre-
scribed. The first set of bids upon these balconies was rejected to permit of this change,
and the lowest bidder in the second set, received on December i, asked to be allowed
to withdraw his bid, by reason of a mistake made by him. Time had to be taken to
investigate whether this mistake was a bona fide one, and so a regretable delay has
ensued, which will not, however, retard the building be3'ond the time it is in the hands
of the contractor. A mistake of the architects in providing an ornamental plaster
cornice for the operating room has also been remedied, hospital practice proving the