New York (State). Board of Charities.

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do with the limited appropriations under its control. Its man-
agers are not responsible for the empty new power-house, the
unused new laundry, nor for the lack of sufficient dormitories to
shelter the orphan destitute Indian children who have asked in
vain for admission to the school and its training.

The State Board of Charities is not responsible for the delay
or neglect as it has earnestly and repeatedly recommended the
completion and equipment of all the buildings necessary to meet
the needs of the institution. The responsibility for the present



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340 Annual Report op Ti£fi State T^oard op Charities.

condition must lie with those who control appropriations, and it
is hoped that the Legislature of 1905 will make ample provision
to complete the school.

The Thomas Indian School has a present capacity for 160
children, but one of its dormitories for boys is a frame building
which menaces the safety of the new brick structures. It is old,
unsanitary, and out of place where it stande. If removed to
another location, it may be repaired and put to some use but
should not be longer used as a dormitory.

Statistics.

The cost of maintenance was f26,436.48. The average attend-
ance for the fiscal year was 155, and the average per capita cost,
including the value of home products, f 196.56.

For the next fiscal year the appropriation for maintenance is
f27,000. For various equipments and necessary work in their
installation, fl6,100 was appropriated, and f5,112.21 formerly
appropriated, but lapsed owing to delays, was made again avail-
able for special purposes.

Needs.

(1) One more dormitory for boys.

(2) The rearrangement and completion of the heating system,
the electric wiring, pipe covering, and similar work made neces-
sary by the growth of the asylum. The Legislature of 1903 appro-
priated f 5,300 for this work, but all bids received were in excess of
f6,000.

(3) A second boiler of 150 H. P. capacity. The removal of an
old 80 H. P. boiler to the new power-house will not give a sufficient
equipment, and will only postpone the installation of the larger
boiler, and add to the ultimate cost.

(4) Sufficient laundry machinery.

(5) The enlargement of the school houses.

Respectfully submitted,

WM. H. GRATWICK,

AUGUSTUS FLOYD,

Committee.
October 18, 1904.



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REPORT



OF THB



Committee on the New York State Hospital for the Care
of Crippled and Deformed Children



341



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REPORT.

To, the State Board of Charities:

Your committee on the New York State Hospital for the Care
of Crippled and Deformed Children reports as follows:

Little change has taken place in this institution during the
past year. Its capacity has not been increased since the institu-
tion was opened. At the beginning of the fiscal year it had under
its care twenty-flve patients, and at the close the same number,
although not all the same pritients weix> undergoing treatment.
At one time an additional child was taken in, but to make room
for him involved an uncomfortable crowding of all the others,
and the normal capacity has not been exceeded since the dis-
charge of a child reduced the number again to twenty-flve.

This hospital is intended for the temporary care of curable
cases only. It has not the "conveniences, nor is it arranged for
custodial purposes. The children received are carefully selected,
with curative treatment in view, and as a consequence in all
cases the sojourn in the institution has resulted in benefit.

Cost.

The per capita cost of maintenance was |8.6^ per week, an
increase of 26 cents over the fiscal year preceding. Were the
full expenses for all purposes included, the cost would be a little
higher. Many things were donated, and the salary of the teacher
was paid by a friend of the institution, and therefore the weekly
per capita cost only represents the amount paid from the n.ain-
tenance appropriation. Considering the special work being done,
and the small number of patients in the hospital, it is expected
that the per capita cost will be higher than in most of tlie other
State institutions.

Classification.

Fifty-two patients altogether were under treatment during the
year. Their diseases or deformities are classified as follows :

Hip-joint disease 20

Pott's disease of the spine (humpback) 8



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344 Annual Bbport of thb

Knee-joint disease (white swelling) 5

Knock knee ,, 2

Olub foot 3

Deformities of infantile paralysis 7

Lateral curvature of the spine 1

Rachitic curvature of the spine 1

Congenital dislocation of the hip 4

Torticollis (wry neck) 1

Total 52



Of the fifty-two children under treatment, thirty-three were
sufferers from tuberculous disease of the joints. Of the twenty-
seven patients discharged after treatment, over fifty per cent
were discharged as cured, and the others as gi*eatly improved.
During the year eighteen surgical operations were performed
upon nine of the patients. Some of the patients discharged as
cured were in the hospital for a short time only; other patients
have been in the hospital since its establishment, but the average
time of treatment of the twenty-seven discharged was over fif-
teen months. This shows that a prolonged residence in the
hospital is necessary to the best results.

A New Hospital.

The necessity for a larger building has been set forth hereto-
fore, and your committee believes that without enlargement it
will be impossible for the hospital to do the work contemplated
by its establishment. The selection of a location was committed
to a special commission in 1903, and, after the examination of
a number of proposed locations, one in the neighborhood of
Haverstraw has been chosen. This place has ample ground for
all necessary new buildings, and is convenient to the city. Prob-
ably before another year has passed, the hospital will have been
moved to this place, and the sooner the removal is accomplished,
the better. The present building is in no way suitable for hospi-
tal uses, and is now in such state as to require the expenditure
of considerable money to put it in good condition, but every dollar
available for the hospital should be expended where it will have



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State Board of Charitibs. 345

permanent value. For this reason your conmiittee urges the
removal of the Hospital for the Care of Crippled and Deformed
Children to the new site at the earliest possible date.
Respectfully submitted,

ANNIE G. DE PEYSTER,
STEPHEN SMITH, M. D.,
AUGUSTUS FLOYD,

Committee,
October 12, 1904.



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FOURTH AlINUAL REPORT



OF THB



New York State Hospital for the Care of Crippled and
Deformed Children, to the State Board of Charities



347



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LOCATION OP THE HOSPITAL.



The hospital building is located at Tarrytown, N. Y., about
one mile south of New York Central and Hudson River Railroad
station, at Paulding avenue, on the banks of the Hudson river.

New York, November 14, 1904.
Hon. Enoch Vine Stoddard, M. D. :

M3' Dear Sir. — With this I beg to transmit to you the report of
the surgeon-in-chief of the New York State Hospital for the Care
of Crippled and Deformed Children for the year ending September
30, 1904.

This report, I would add, has been submitted to the Board of
Managers and approved and adopted by them.

Very faithfully yours,

HENRY C. POTTER,

President.



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BOARD OF MANAGERS.
Appointed by the Governor of the State.



THE RT. REV. HENRY C. POTTER, D. D.

J. HAMPDEN ROBB.

J. ADRIANCE BUSH.

GEORGE BLAGDEN, Jr.

NEWTON M. SHAFFER, M. D.



OfiBcers of the Board.



President.
THE RT. REV. HENRY C. POTTER, D. D.

Secretary and Treasurer.
GEORGE BLAGDEN, Jr.

CUAIRMAN OF THE EXECUTIVE COMMITl'EK.

NEWTON M. SHAFFER, M. D.



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MEDICAL STAFF.



Consulting Physicians and Surgeons.

Of the College of Physicians and Surgeons^ Ntw York City.

ROBERT F. WP]IR, M. D.
FRANCIS DELAFIELD, M. D.

Of the Cornell University Medical College^ New York City,

LEWIS A. STIMSON, M. D.
W. OILMAN THOMPSON, M. D.

Of the University-Bellemie Medical College, New York City,

JOSEPH D. BYRANT, M. D.
A. ALEXANDER SMITH, M. D.

Of the Albany Medical College,

A. VANDERVEER, M. I).
SAMUEL B. WARD, M. D.

Of the Buffalo Medical College, Buffalo, N. Y,

ROSWELL PARK, M. D.
CHARLES G. STOCKTON, M. D.

Of the Lo7ig Island Medical College, Brooklyn, N. Y,

JOHN 1). RUSHMORE, M. D.
JOHN A. McCORKLE, M. D.

Of tJve Syracuse University, Syracuse, N, Y,

JOHN A. VAN DUYN, M. D.

HENRY L. ELSNER, M. D.

REGINALD H. SAYRE, M. D., of New York City.

L. A. WEIGEL, M. D., of Rochester, N. Y.

RICHARD B. COIITANT, M. D., of Tarrjtown, N. Y.

HENRY A. GATES, M. D., of Delhi, N. Y.

GRANT C. MEDILL, M. I)., of Ogdensburg, N. Y.

FRANK W. SEARS, M. D., of Binghamton, N. Y.



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Attending Medical Staff.



Hurgeon-inChicf NEWTON M. SHAFFER, M. D.

First Assistant Surgeon P. HENRY FITZHUGH, M. D.

Assistant Surgeon HENRY SCOTT, M. I>.

Assistant Surgeon FANEUIL S. WEISSE, M. D.

Assistant Surgeon JOHN JOSEPH NUTT, M. D.



EXECUTIVE OFFICERS.
Superintendent THE SURGEON-IN-CHIEF.



Resident OfiBcers.

Resident Physician and Assistant Superintendent

LEE A. WHITNEY, M. D.

Matron MISS GERTRUDE A. HOXIE.

Stenographer MISS JESSIE WELLEB.

Trained Nurses ^"^^ MARGARET HOWELL.

MISS NELLIE H. MULCAHY.



Non-Resident.
Storekeeper GEORGE M. WHITE.



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REPORT OF THE SURGEON-IN-CHIEF AND SUPERIN-

TENDENT.*

To the Board of Managers of the New York State Hospital for
the Care of Crippled and Deformed Children:

Gentlemen. — I have the honor to submit for your consideration
a report of the work performed in your hospital for the year
ending September 30, 1904. .

On the 1st of October, 1903, all of the 25 beds in the wards of
the hospital were occupied by patients. During the year ending
September 30, 1904, 17 new patients were admitted, making a
total of 42 patients treated during the year. These patients are
classified as follows:

Hipjoint disease 16

White swelling (kneejoint disease) 3

Major deformities of infantile paralysis 5

Pott's disease of the spine (humpback) i

Congenital dislocation of the hip 5

Bowlegs 2

Clubfoot (congenital) 1

Clubfoot (acquired) due to infantile paralysis 6

Total 42



All of these deformities are, I think, suflSciently indicated by
the well-known appellation which pretty accurately describes
the condition, exeept those of that apparently increasing and
intractable condition known as infantile paralysis. An acute
affection, occurring usually in infancy, and formerly known as
" teething paralysis," its sudden onset, invading tlie motor tract
of the spinal cord, leaves behind it a more or less extensive
paralysis of the voluntary muscles from which there is likely to
be a partial recovery only. But, any muscle, or any group of
muscles, may remain permanently paralyzed, with the result that
always follows a localized loss of muscular power, viz., a con-

* Bead before a stated meeting of the Board of Managers held November
14, 1904.

23



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354 Annual Kbport of the

traction of the opposing unparalyzed group. The consecutive de-
formities are sometimes the most severe of those which occur in
what is known as orthopaedic surgery. Of the eleven cases of
infantile paralysis treated at your hospital this year, six were
afflicted with paralysis of the muscles on the anterior part of
the leg followed by a gradually increasing contraction of the
healthy muscles at tlie calf of the leg, producing an acquired
club foot. The permanent character of the paralysis makes an
actual cure impossible, especially in the late stage which presents
when the patients are brought to our notice at the hospital. By
dividing or stretching the contracted muscles the deformity is
removed. Intelligently applied apparatus retains the deformed
foot in a normal position, and prevents a recurrence of the con-
traction. The patient is thus enabled to get about with but
slight hindrance and no deformity.

The problems are simple from a surgical and mechanical stand-
point in ordinary club foot brought about in this way. When,
however, the tliigh muscles are affected or, more especially the
muscles of the spine are involved, we have a much more difficult
problem. Five of these patients had infantile paralysis produc-
ing a severe grade of contraction at the hip, at the knees, or in
the spine, with very extreme deformities. Three of these were
unable to walk or to stand alone when they entered the hospital.
The contracted muscles were divided or stretched, the deformity
removed, and apparatus applied. These patients, who would
have been condemned to a life of almost absolute inactivity, at
best being wheeled about in a chair, are now able to get about
with comparative ease and comfort.

Seventeen patients were discharged (40.47 per cent of the
number treated) during the year, leaving twenty-five in the hospi-
tal under treatment at the end of the year. Of those discharged,
four with congenital dislocation of the hip, and one with the
club foot of infantile paralysis were discharged cured. Four with
hip joint disease and three with the severe forms of infantile
paralysis were discharged as 7nnch improved. It would not be
a very great exaggeration to say that the most of these dis-
charged as " much improved " were practically " cured," the
Improvement was so marked and the benefit conferred was so
great. One with hip joint disease, and two with infantile



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State Board op Charities. 355

paralysis were discharged as improved. This means a very con-
siderable im'provement. One, with knee joint disease, and com-
mencing Potfs disease (humpback) was removed by his mother
in an unimproved condition. His knee joint trouble (white swell-
ing) was much better, and if the patient had remained, there is
no doubt tliat the ultimate benefit received w^ould have been great.
As a rule, however, it is not deemed expedient to receive patients
with multiple tuberculous joint disease, the multiple foci of dis-
ease indicating a systemic infection rather than a localized ex-
pression of the disease, and the time required to secure a good
result when the disease is not localized is so long that it seems
best, in the present great demand upon our resources, not to
encumber the wards with patients of this class.

Of the twenty-five patients now in the hospital, one has con-
genital hip dislocation, eleven have hip joint disease, four have
Pott's disease, two have white swelling (knee joint disease), four
have some deformity of infantile paralysis, two have bow legs,
one has club foot, and, dividing them as to sex there are nine
girls and sixteen boys.

Five surgical operations were performed during the year upon
three patients. In each case the results of the operations were
most satisfactory.

No elaborate record has been kept of the nunnber of applicants.
The demand is as great as ever, but the fact, now apparently so
well known, that we have only twenty-five beds, with a long
waiting list, has prevented quite a number of patients, as I know
Ijersonally, from applying.

Of tlie forty-two treated during the year, fourteen came from
New York county, six from Westchester county, three from
Orange county, four from Queens county, one from Chautauqua
county, one from Monroe county, one from Suffolk county, one
from Chemung county, two from Putnam county, two from
Cayuga county, one from Greene county, one from Ontario county,
two from Rensselaer county, one from Dutchess county, one
from Erie county, and one from Fulton county. It will be seen
from this statement that twenty-eight of the forty-two treated
during the year came from counties outside of New York and
Queens. It is our desire, oft repeated, and which we again state,
so far as possible, to reach the poor of the country districts, and



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356 Annual Report op thb

especially those districts where no adequate provision exists for
the prolonged treatment of the severer forms of chronic deformity.

Appended to this report will be found tables which show in
detail, tlie number of patients received, the diseases and condi-
tions treated, the operations performed and the condition of each
patient when discharged. To these tables I call your especial
attention. They tell, better than I can in words, of the labor
performed and the results obtained.

In my last annual report I referred, incidentally, to the press-
ing need of a new and much larger hospital. The Legislature of
1903 appropriated the sum of f50,000 to secure a site and to
build and equip a new hospital. After much woi^ on the part
of the State oflScers, and your Board of Managers and after visit-
ing many proposed sites, it was finally decided to locate the new
hospital building in West Haverstraw, Rockland county- We
found at this place the three great desiderata which our future
work very imperatively demands, viz, (1) an ample supply of
water, (2) an eflScient means of sewerage at tide water, and
(3) convenient railway facilities for the transportation of build-
ing materials and supplies directly to the hospital. The fifty
acres which were bought are admirably located on a high ridge,
overlooking the Hudson river, with a railway passing on the
rear of the property, practically at the same level as the site of
the future hospital buildings. At very small expense a switch
can bfe connected with the railway, which will deliver all needed
material and supplies at th^ doors of the hospital.

Upon the site is a large building of the Colonial type, which
at present is being remodeled to meet at least part of the
increased demands upon the hospital. This building can be
made to accommodate about thirty-five patients, which will be
ten more than we are receiving at present. It can be used
temporarily until future appropriations enable us to erect a large
modern hospital, for which we now have an admirable site
When the larger hospital is erected this present house will make
an excellent administration building.

The alterations to the building are progressing rapidly and on
or before the first day of April, 1905 (when the lease on the Tarry-
town property expires), the much -needed change from our present
inadequate quarters will be made.



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State Board op Charities. 357

When it is considered that it is only a little over four years
ago (April, 1900), that the bill incorporating the hospital passed
the Legislature, and that four years will not elapse until Decem-
ber 7, 1904, since the fii'st patient was received for treatment, it
will be appreciated by all concerned that your hospital was not
only greatly needed, but that the Btate did a most wise thing in
establishing it.

In addition to the states, Minnesota and Ohio, referred to in
my last report as either having, or being about to establish, a
hospital similar to yours, the philanthropic citizens of Chicago
are taking steps to follow our example in Illinois.

During the past year the eflSciency of the hospital has been
enhanced by the appointment of a resident physician, who also
serves as an assistant superintendent. The daily visits of the
attending staff, so onerous under former conditions, have been
modified in consequence. Stated visits are now made \yy the
surgeon-in-chief once or twice a week and by one of the assistants
twice a week, the surgeon-in-chief, as well as the assistants, being
in readiness to go every day if for any reason the condition of
any of the patients should require it.

There have been no serious acute illnesses among the patients
during the year. Indeed the general health of the inmates has been
excellent. This has been largely due to the carefulness and
watchfulness of the resident staff of officers, including the matron,
who has been identified with the hospital since it was first opened.
The inconveniences to which all the resident officers have been
subjected in our cramped and crowded quarters, and which have
been so cheerfully borne, speaks well for their interest in both
the patients and the hospital itself.

A number of charitable i)ersons kindly remembered the hospital
in donations of both material and money during the year. But
for some donations in money received in previous years we should
have been obliged to discontinue our school, for which the State,
as yet, has made no appropriation. And the donations of material
have added much to the comfort of those committed to your care.
Respectfully submitted,

^EAYTON M. SHAFFER, M. D.,
Surgeon-inChief and Superintendent,
New York, November 13, 1904.



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REPORT



OP THE



COMMITTEE ON SAWITORIA FOR CONSUMPTIVES

I



359



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REPORT OF THE COMMITTEE ON SANATORIA FOR

CONSUMPTIVES.
To the IStatc Board of Charities:

Your Committee on Sanatoria for Consumptives rei)orts that
the New York State Hospital for the Treatment of Incipient
Pulmonary Tuberculosis was opened July 1, 1904.

There has been unnecessary delay in the erection of the build-
ings for this hospital, and at the close of the fiscal year, after two
years have elapsed since work on them be^an, they are not yet
nearly completed. Changes in plans and lack of an appropria-
tion thought necessary for the erection of a satisfactory building,
by the Board of Managers and the State Architect, may account
for dela^'s prior to October 1, 1902, when actual building opera-
tions began under the contract, but can not ex<u8e the delay
since that time. The hospital had to be opened with its buildings
only partially completed. At the present rate of progress, more
than another year will elapse before the work will be finished.
Many defects are apparent in the construction work, and others
in the plans and equipment. For example, the general entrance
to the building and access to the administative offices, which are
located on the second floor, is through the main diuing-hail upon
the first floor, and the cold storage room is hM-ated between the
big bake-oven and the kitchen range, the heat from which will
result in keeping tlie refrigerator warm in spite of ice.

These defects will be remedied in time, but at double tlie cost
of good work and a careful plan in the beginning. They involve
a waste of public money which should have been avoided.

liecause of the adverse conditions under which the hospital
was opened, its special work has been imi)erfectly performed, and
the patients have suffered much discomfort.

This institution will, when completed, have cai)acity for 120
inmates. Since its opening, July 1, 1901, 40 patients have been
admitted, and 1 discharged, leaving a population of 30; 23 males
and IG females, October 1, 1904.

The average number of inmates for thrcHi months was 21.

The receipts were: From special appropriations, $111,540.54;



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362 Annual Report of the

from general appropriations, |9,400; from all other sonrces,
1760.68; total, $121,701.22.

The ordinary- expenditures were, |8,298.42. The extraordinary
expenditures, fill 540.54, for buildings and improvements, and
the aggregate expenditures, |119,838.06, leaving, October 1, 1904,
a cash balance of f 1,862.26.

The progress of the institution has not been as rapid as was
anticipated when the hospital was established in 1900. The con-
struction did not begin until October, 1902, and but little progress
was made before the cold weather set in, and then wortt was
suspended. Upon its resumption in the spring of 1903 it was
expected that the administration building and connected pa-
vilions would be completed bj the close of the fiscal year, Sep-
tember 30, 1903, but delays have continued, and at the time of
the presentation of this annual report to the Legislature of 1905,
the construction work begun in 1902 is not finished. A number
of alterations have been made from time to time in the original
plans. The total appopriation for the buildings and its site
($230,350) should have provided a satisfactory hospital for the
purposes intended.

The necessity for the speedy completion of the institution is
ai>parent. There are large numbers of indigent men and women
throughout the State who are eagerly awaiting the day when



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