the part of our Nurses.
42
Improvements.
Both wards have been painted during the year, and an additional number of wire
screens have been removed wherever deemed compatible with safety in order to render
the place more homelike. Music boxes have been purchased which contribute greatly
to the pleasure of the patients. Games, books and periodicals have been provided
through the kindness and generosity of friends interested in the institution.
Patients Transferred from the Workhouse.
I think that attention should be called here to the patients transferred from the
workhouse to the psychopathic wards for examination in regard to their mental condi-
tion. Many of these unfortunates are not brought here until the expiration of their
term of imprisonment, especially when they are quiet and tractable, and their symptoms
are mild and such as not to attract attention. While it is true that some of these become
alienated as a result of their confinement, many were undoubtedly ihsane when they
were sent there for the commission of offenses for which they were not responsible.
This unfortunate condition should be corrected by the authorities through proper and
timely examination of the inmates, as prolonged confinement may work lasting and
irreparable harm to their menial condition.
Senile Cases.
The fate of those suffering from so-called senility, senile dementia, or dotage, is
more pitiable than that of those just mentioned. The City Home for the Aged and
Infirm on Blackwell's Island is crowded with these unfortunate old men and women.
As the insanity law provides that no dotards shall be admitted to the State hos-
pitals, and as the gradation from dotage to senile insanity is indefinite and subject to
individual interpretation, these patients are frequently rejected by the State hospitals
and there being no other place for them, they are cared for in the almshouses.
While this is not a proper place to enter mto any discussion as to the technical
distinction between senility and senile insanity, the fact remains that if these patients
are not proper cases for admission to the State hospitals, they certainly are not cases
to be kept in almshouses.
It is indeed distressing to tliink that those old persons who should receive the
tenderest care and attention in their old age when their mental faculties decline through
natural decay, and perhaps from no fault of their own, are denied admission to State
hospitals, while others becoming insane through intemperance and other indiscretions,
enjoy the benefit of the excellent care of these institutions.
The care of this class of patients, as is well known, is more trying and difficult
than that of those suffering from many of the more acute forms of psychoses, and
requires most skillful and gentle handling. We receive constant complaints from the
authorities of the City Home for the Aged and Infirm, who justly contend that they are
43
unable to care properly for thc-se patients and that the other inmates, who on account
of some physical disability have become dependent upon the City's charity, are con-
stantly annoyed by these insane patients.
We are, however, helpless in the matter, and fervently hope that some provision
will be made to remedy this unfortunate condition ; either a building properly equipped
and supplied with sufficient Nurses should be provided by the City to care for these
senile insane patients, or arrangements made whereby they may be received and cared
for in State institutions.
I cannot conclude this brief report without thanking my colleagues for their con-
scientious efforts and faithful work; the General Medical Superintendent for his
ready co-operation and support and your Honorable Board for its constant expression
of sympathy and encouragement in our work.
Respectfully submitted,
(Signed) M. S. GREGORY, Resident Alienist.
44
REPORT OF DIRECTOR OE LABORATORIES.
To the Board of Trustees, Belleviie and Allied Hospitals :
Sir ā I have the honor to submit the annual report for the Pathological Depart-
ment for the year 1905-1906. The laboratory was informally opened December 13,
1904.
The staff consists of the Director and two Pathologists, Dr. Alwin M. Pappen-
heimer, appointed March I, 1905, and Dr. Thomas Flournoy, appointed April i, 1905;
a Stenographer, appointed November i, 1904, and a Laboratory Helper.
In order to examine and report upon the large amount of material received by the
laboratory, recourse has been had to the appointment from time to time, of voluntary
assistants. These assistants have been called upon to help the staff in the prepara-
tion and examination of the specimens. This privilege and opportunity was offered
to the internes having the January appointments in the four medical and surgical di-
visions of the hospital, for the six months (July, 1905, to January, 1906), preceding
their appointment to the staff. It is a matter of regret that only one interne has
availed himself of this opportunit}'. In consequence of this, several of the internes,
on leaving the hospital, were appointed as voluntary assistants for variable periods
of time. Through the courtesy of your honorable Board, these men have been granted
permission to take luncheon in the staff dining-room.
Previous to and for some time after the appointments of the Pathologists (nine
months), the services of a paid physician were employed to prepare specimens for
examination.
Bellcvue Hospital, unlike the larger and well-organized private hospitals of the
city, has no system of pathological internes. After conferring with the Executive
Committee of the Medical Board, it was deemed unwise, for various reasons, and,
indeed, impossible, on account of the lack of accommodations in the hospital, to inau-
gurate such a system. It is, however, urgently recommended that in the new hos-
pital a system of pathological interneship be established.
At the present time the Department is without its own Morgue helper. The
laboratory has been without sufficient help, and in order to assist the single Labora-
tory Helper, the Director has been forced to employ the services of a discharged pa-
tient, who is given his board and lodging in the hospital. Owing to the lack of help,
the staff has been forced to perform routine manual work, which could be more ad-
vantageously performed by a trained laboratory assistant. It is urgently recom-
mended that a Laboratory Assistant be appointed from the Civil Service list.
Summary of the Work Done from December 13, 1904, to December 31, 1905.
45
The Department has examined and reported upon during this period 1,087 speci-
mens sent to the laboratory by the visiting staff of the Bellevue and Allied Hospitals.
The specimens as received, are entered into the specimen accession book and a record
of them is kept. The report of these specimens is filed in the clinical histories, and
a system of cataloguing the records in the laboratory has been established.
Five hundred and ninety-eight necropsies have been performed by the Department.
The cases are entered in the necropsy accession book, and the necropsy records are
typewritten and sent to the record room, to be filed with the clinical histories of the
patients. A copy of the record is filed in the laboratory, and a 'system of card indexes
is kept of the main lesions, with cross-indexes of the various complications.
The tables which follow are a summary of the specimens received from the Belle-
vue and Allied Hospitals, and of the necropsies which have been performed at Belle-
vue Hospital.
Financial Report.
A statement of the cost of the alteration of the two rooms situated above the car-
penter shop into a laboratory, and the installation of the electric light wiring, plumbing,
gasfitting fixtures and carpenter work, may be found in the report of the Pathological
Department to your Honored Board for the year 1904.
Instruments $247 76 $251 03 $498 79
Apparatus, including microscopes, etc 963 42 840 72 1,804 14
Material, including sundry chemicals and other goods 2 25 145 03 147 28
Bottles, jars, measures, etc 554 21 .... 554 21
Animals 93 65 93 65
Food for animals .... 1 8 60 1 8 60
Furniture 16 00 198 32 214 32
Books .... 96 49 96 49
Sundries 20568 13203 337 71
Value of supplies from Bellevue Hospital store .... 54 02 54 02
Value of si/pplies from drug store 66 23 647 39 713 62
$2,055 55 $2,477 28 $4,532 83
46
The following is a list of the expenses, month per month, for the supplies (alcohol,
chloroform, ether, cover-glasses and slips, xylol, aniline oil, various chemicals and
instruments) obtained from the General Drug Department, 1905:
January $41 63
February 15 62
March
52
April ,6 29
May 27 33
June 132 25
July 22 OS
August 56 71
September '. 52 64
October 91 09
November 7 39
December 131 91
Total $647 39
Publications of the Pathological Department.
The following papers have been published during the course of the year or are
still in the press:
1. "A Study of Pncumococci and Allied Organisms in Human Mouths and Lungs
After Death," by Charles Norris and Alwin M. Pappenheimer,* Journal of Experimental
Medicine, Vol. 7, No. 5, August 25, igos.f This work was commenced by Dr. Pappen-
heimer two months before his appointment as Pathologist.
2. "A Case of Spirochetal Infection in Man," October meeting of the New York
Pathological Society, 1905.
3. "A Preliminary Communication upon the Spirochetal Infection of White Rats.
Observations upon the Multiplication of the Spirochete in Fluid Medium," December
meeting of the New York Pathological Society, 1905.
4. "A Study of a Spirochete Obtained from a Case of Relapsing Fever in Man,
with Notes on Morphology, Animal Reactions and Attempts at Cultivation," by Charles
Norris, Alwin M. Pappenheimer and Thomas Flournoy, to appear in the May number of
the Journal of Infectious Diseases, 1906.
The report of the investigation upon the epidemic of cerebro-spinal meningitis
occurring in Bellevue Hospital is unfortunately not ready for publication, but it is in
preparation for publication for- the Medical and Surgical Report of Bellevue and
Allied Hospitals for 1905.
*Aided by a grant from the Commission for the investigation of acute respiratory
diseases of the Department of Health, New York City.
fThe value of this investigation was considerably decreased by the impossibility
of publishing the tables, which gave a summary of the pathological lesions of the case;
reported on.
47
A number of rare and important cases, with the necropsy findings, are ready for
publication or in process of preparation for the Medical and Surgical reports. A num-
ber of these cases have been reported upon in the various society meetings during the
current year by the Director and his assistants.
There is urgent need of some uniform but elastic system which will bring into
closer touch the work of the visiting staff to the Pathological Department. In order
to make the reports of cases of the greatest possible value, an intimate co-operation
between the clinician and the pathologist is essential. Unfortunately, in certain instances,
such co-operation on the part of the visiting staff has not been forthcoming, and, in
consequence, a considerable delay has been experienced by the Pathological Depart-
ment in its preparation of various valuable cases for publication in the Medical and
Surgical reports.
Scope of the Work and Aims of the Laboratory.
During the past year considerable time has been devoted to the preparation of plans
for the Pathological Building of the new Bellevue Hospital. In this work Professor
T. Mitchell Prudden has given the Director the benefit of his invaluable counsel and
aid. The plans are now satisfactory.
Although it has not yet been possible in the present laboratory, owing to lack of
desk room and suitable accommodations, to supervise the ordinary routine clinical
examinations, it is our purpose to supervise the house staff or the pathological internes
or externes that may be appointed in this work. The laboratory of the hospital will
then be, so to speak, the central clearing house for all the hospital routine work. The
value of the clinical reports will thus be greatly enhanced, and uniformity and precision
will thereby be secured. It has been our constant aim to bring the laboratory and the
house staff into closer and more intimate relationships, in order to increase the value of
the hospital reports.
Up to the present time the Director has been unable to personally supervise and
attend to the laboratory w^ork of the Fordham, Harlem and Gouverneur Hospitals,
on account of the distance of each of these hospitals from the central laboratory. The
plans for the laboratories of each of these hospitals have been supervised by the Direc-
tor. No pathologist is in attendance at the Fordham or Gouverneur Hospitals. All
specimens that have been received from these hospitals have been examined and
the reports mailed to them. At the Harlem Hospital the clinical and microscopical ex-
ammations and the necropsies are made by Dr. Rogers and his assistants.
The field offered for research work in pathological chemistry and pathological
anatomy in the hospital laboratory is a promising and attractive one. It has been our
endeavor to offer the opportunity for work in these lines to young men having the
leisure to pursue this line of investigation. At the present time the staff of the labora-
tory, on account of the large- amount of hospital routine work involved in making
the examinations of the specimens and of the necropsies, and in the recording of the
48
same, has found little time to devote to tliis important work. To facilitate this line of
investigation the establishment of a good working library in the laboratory is a vital
need. A small private library has been established, which, however, cannot be in-
creased owing to lack of shelf room in the laboratory.
The care of the dead of Bellevuc Hospital is ni the hands of the Department of
Public Charities. The public morgue is used by three departments: The Department
of Public Charities, which controls the Morgue; the Coroner's Department, and the
Department of Bellevue and Allied Hospitals. The Coroner's Department has com-
plete control of the following class of hospital cases :
All the accident cases and those cases dying under suspicious circumstances. It
has been the custom heretofore to refer to the Coroner's Department all the cases
dying within twenty-four hours of admission to the hospital. Many such cases occur,
the greater number of which the Department has no cognizance of, and, in conse-
quence, the records of the hospital suffer a great and unnecessary loss. It is therefore
urgently recommended that the arbitrary hospital rule of referring the cases which
die within twenty-four hours of admission, to the Coroner, be revoked.
The official ruling of the Department of Health precisely designates those cases
which are under the jurisdiction of the Coroner's office. Unless there -are suspicious
circumstances attending the death of the patient the examination of such cases dying
within twenty-four hours of admission iloes not fall within the province of the
Coroner's Department.
The Department is practically dependent upon the Morgue Keeper, who is an
employee of the Department of Public Charities, for permission to perform necropsies
upon persons dying in the hospital who are not claimed within forty-eight hours af^er
death. A large amount of material which would be of extreme value to the Depart-
ment is lost under this management.
The delay which is frequf-ntlv experienced in obtaining permission to perform
necropsies on the unclaimed dead impairs the value of a large number of investigations.
The arbitrary ruling which forces us to wait at least two days ā Sundays and holidays
not being counted as days ā should be revoked, since the rule was made when the death
notices were sent by mail, and not by telegram, as they now are. For these reasons
it is earnestly recommended that the Department of Bellevue and Allied Hospitals,
should, when housed in its new quarters, control the management of the Morgue,
and have the care of its dead under its own supervision. The plans have in view
the care of the dead of the Bellevue and Allied Hospitals, and likewise all of the
Coroner's cases and those of the Department of Public Charities.
Yours respectfully,
CHARLES NORRIS,
Director of Laboratories of Bellevue and Allied Hospitals.
49
REPORT OF SUPERINTENDENT. TRAINING SCHOOLS FOR NURSES.
To the Board of Trustees, Bellevue and Allied Hospitals :
Gentlemen ā I have the honor to submit to you the following report for the year
1905 of the two Training Schools for Nurses attached to Bellevue Hospital, together
with lists of managers and officers connected with each :
Bellevue Training School for Women Nurses.
(Incorporated 1874.)
Officers.
Honorary President ā Mrs. William Preston Griffin, No. 208 East Fifteenth street.
President ā Mrs. William Church Osborn, No. 40 East Thirty-sixth street.
Vice-President ā Mrs. Robert Huntington, No. 95a Lexington avenue.
Secretary ā Miss Harriette Rogers, No. 56 East Seventy-eighth street.
Treasurer ā Mr. James Stillman, the Second National Bank.
Assistant Treasurer ā Mrs. Elliot Benedict, No. 51 East Seventy-eighth street.
Managers.
Mrs. James H. Benedict, No. 14 East Seventieth street.
Mrs. Whitelaw Reid, No. 451 Madison avenue.
Mrs. J. M. Goetchius, No. 52 West Fifty-eighth street.
Mrs. Francis M. Scott, No. 42 Park avenue.
Mrs. Moses Hopkins, No. i East Fifty-sixth street.
Mrs. Robert Temple Emmet, No. 43 East Twenty-seventh street.
Miss Fellowes, No. 50 West Eleventh street.
Miss Isclin, No. 23 Madison avenue.
Miss Alice Pine, No. 45 Fifth avenue.
Mrs. J. W. Brannan, No. 11 West Twelfth street.
Mrs. William B. Rice, No. 17 West Sixteenth street.
Miss Anna Lusk, No. 47 East Thirty-fourth street.
Miss Ruth Morgan, No. 26 Washington square.
Mrs. John L. Wilkie, No. 152 West Twelfth street.
Miss Dehon, No. 310 Fifth avenue.
Miss Louisa Kane, No. 23 West Forty-seventh street.
Mrs. George B. McClellan, No. 10 Washington square. j
so
Officers of Training Schools.
Superintendent ā Miss Jane A. Delano.
First Assistant Superintendents ā Miss Carrie J. Brink, Lucy A. Bannister. M. D.
Second Assistant Superintendents ā Miss Anna W. Kerr, Mr. Arthur W. Little.
Instructor of Probationers ā Miss Julia Gerrity.
Night Supervising Nurses ā Miss Harriet Van Sickle, Mr. Seymour Peters.
Head Nurse, Maternity Wards ā Miss Carrie Ennis.
Head Nurse, Operating Clinic ā Miss Margaret Leary.
Registry Clerk and Stenographer ā Miss Elizabeth S. Mead.
Matron of Nurses' Home ā Mrs. Margaret Faulkner.
Lecturers ā Dr. Robert J. Carlisle, Dr. George D. Hamlen, Dr. William C. Lusk,
Dr. George Blakeslee.
Committee on Examination of Nurses ā Dr. Edward G. Janeway, Dr. W. Gill
Wylie, Dr. F. S. Dennis.
The Home Physician ā Dr. Robert J. Carlisle, No. 44 West Forty-eighth street.
The school maintains :
A home for Pupil Nurses while in training, a registry for Graduate Nurses and
the Edith Summer Home, at Belle Island, Conn., open during the summer months as a
vacation home for Nurses.
Office and Training School, No. 426 East Twenty-sixth street.
Since the establishment of the school 745 women have graduated as Nurses.
The following is a summarized statement concerning the graduates :
In private nursing 338
Married 127
Institution work 83
At home 78
Died 63
Unknown 25
Practicing medicine 14
District work 17
Total 745
The present census of the school is :
Superintendent I
Assistant Superintendents 2
Instructor of Probationers I
Night Superintendent i
Clinic Nurses 2
Dispensary Nurse I
Supervising Nurse, Emergency Hospital I
51
Supervising Nurse, Female Psychopathic Ward I
Supervising Nurse, Female Alcoholic Ward i
Pupil Head Nurses l6
Senior Nurses 35
Junior Nurses 37
Probationers 8
Graduating Class, 1905.
Bishop, Miss Mabel T.
Brundage, Mrs. Sophia.
Bulow, Miss Frances J.
Butler, Miss Helen
Clapp, Miss Sadie.
Clark, Miss Ada F.
Daggett, Miss Georgia A.
Doherty, Miss Mary A.
Duff, Miss Jessie.
Dunworth, Miss Anna G.
Gallivan, Miss Maude.
Gottron, Miss Bertha.
Grailes, Miss Mayme.
Hangartner, Miss Lizzie.
Hook, Miss Minnie.
Houston, Miss Eva.
Huppuck, Miss Augusta M.
Johnson, Miss Agnes.
Kreutz, Miss Mary.
Lynch, Miss Monica B.
Maguire, Miss Minnie E.
O'Sullivan, Miss Mary C.
Rogers, Miss Mary E.
Ryan, Miss Florence T.
Shaw, Miss Clara E.
Stuart, Miss Mary A.
Vient, Miss Jessica V.
White, Miss Jennie E.
107
The Bellevue Training School for Men Nurses.
Established 1888, under the direction of the Board of Trustees of Bellevue and
Allied Hospitals, New York City, John W. Brannan, M. D., President.
Managers.
Dr. W. Gilman Thompson, Chairman.
Mr. Ogden Mills, Secretary.
Dr. George B. Fowler.
Dr. Joseph B. Bissell.
Dr. William K. Draper.
Hon. John G. McCullough.
Miss Jane A. Delano, Superintendent.
Mr. Arthur W. Little, First Assistant
Superintendent.
Lecturers and Examiners.
George A. Blakeslee, M. D.
Leander H. Shearer, M. D.
William C. Lusk, M. D.
Joseph McCarthy, M. D.
This school has a separate home for Nurses in training, and the alumni maintain
a registry for Graduate Nurses.
Office and home. No. 431 East Twenty-sixth street.
Since the establishment of the school 354 men have graduated as Nurses.
52
The following is a summarized statement concerning the alumni of the school:
Private nursing
In business
Practicing medicine
Deceased
In custom house
Mi:
mistry
Unknown
Institution work
Navy
Present Census.
Superintendent
Assistant Superintendent
Night Superintendent
Supervising Nurse, Male Alcoholic Ward
Supervising Nurse, Male Psychopathic Ward.
Senior Nurses
Junior Nurses
Probationers
132
72
49
23
60
354
Graduating Class, 1905.
Walter M. Delevan.
James Delaney.
John Doyle.
Joseph Collopy.
Joseph Holding.
Joseph Shamo.
Hallett Roach.
William G. Johnson.
Daniel J. Summers.
Olin H. Stuck.
James O'Connor.
Richard Connoughton.
Joseph A. Muhlbauer.
Andrew G. Opinsky.
Alexander Hibbard.
Bernard D. Wells.
Joseph Rafferty.
Frank Phillips.
Henry von Steuben.
Frank Groves.
Frank McGann.
The diet kitchen carried on by the Pupil Nurses has supplied kumyss for the
entire hospital, and has distributed to various wards about five hundred special
orders daily. Miss Rulon, a graduate of Pratt Institute, has given an excellent
course in practical dietetics and over one hundred nurses have attended. The nurses
have also had a course in physical culture, which they have greatly enjoyed. Pupil
53
nurses have been assigned to' two additional male wards, making in all a total of
five male wards now under the care of women Pupil Nurses. Graduate Nurses have
been placed in charge of the male alcoholic and prison wards, and an additional
Graduate Clinic Nurse has been secured for the amphitheatre, making it possible to
have a nurse available both day and night for emergency work.
Tubercular district visiting work for Bellevue, Harlem and Gouverneur Hospitals
was begun in the summer of 1905, and during the year about 5,000 visits were made
by our nurses to patients in their homes, and instructions given to both patients
and family in regard to preventing the spread of the disease. The school has had
forty-four calls to fill hospital positions during the year, and our graduate nurses
have been kept very busy.
Respectfully submitted,
JANE A. DELANO,
Superintendent, Training Schools.
GENERAL STATISTICS
Bellevue and Allied Hospitals
iqo5
57
TABLE No. I.ā GENERAL STATISTICS, BELLEVUE AND ALLIED HOS-
PITALS. CONSOLIDATED, 1905.
Bellevue and Allied Hospitals.
Census for 1905.
Total, Total,
Men. Women. 1905. 1904.
Remaining in hospitals January 1, 1905 683 322 i ,005 987
Admitted to medical wards during the year 15,001 8,765 23.766 25,204
Admitted to surgical wards during the year 8,452 2,622 11,074 11.226
Births 179 180 359 327
Total in hospitals during the year 24.315 11,889 36,204 37,744
Discharged and Died ā
Recovered 8,875 4,082 13067 9,418
Improved 6,792 2,611 9.403 13,036
Unimproved 913 570 1,483 1,538
'J'=d 2.326 1. 149 3,475 3,489
Total 19,016 8,412 27,428 27,481
Transferred 4,623 3,162 7,785 9,257
Remaining December 31, 1905 676 315 991 1,006
Total in hospitals during the year 24.315 11,889 36,204 37,744