Annual report of the Supervising Surgeon-General of the Marine Hospital Service of the United States (Volume v.8) online

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OPERATIONS



OF



THE UNITED STATES MARINE-HOSPITAL SERVICE:

1881.



CONTENTS



Page.

official Report to tiik Secretary 9_28

Relief furnished 9

Physical Examinations made 9

Receipts and Expenditures 9

Medical Corps — Appointments, Promotions, Casualties 10

Collection of Hospital-Dues 10

Fraudulent Admissions to Hospital 11

Hospital Buildings — Chelsea, Chicago, Detroit, Key West, Louisville,
Mobile, Portland, Pittsburgh, San Francisco, Saint Louis, Wilmington . 11-14

Legislation needed 14

Physical Examination of Seamen 15-19

Donations and Investments 19

Purveying Division 20

Arrangements for the Year, by Ports 20-28

8 1 \ risTics :

Financial and Economic Statistics 31

Exhibit of Operations, by Ports 32-35

Medical and Surgical Statistics 39-90

Reports of Fatal Cases, with Autopsies 95-173

Appendixes:

Memorandum relating to proposed Snug-Harbor Bill 181-185

aitary K< port —Portland Hospital 189

Sanitary Report — Mobile Hospital 193

I v<- ] 11 uts on Beri-beri -jo:i



TRBABUKT DEPARTMENT,

Document No. 175.
Marine-Hospital S



REPORT



Sir : I have the honor to submit the following report of the opera-
tions of this Service for the fiscal year ended June 30, 1881 :

RELIEF FURNISHED.

During - the year, 32,613 patients received relief from this Service, of
whom 12,449 were treated in the hospitals and 20,164 at the different
dispensaries; 309,596 days' relief in hospital were furnished; 194 trusses,
17 elastic stockings, 11 knee-caps, 7 pairs crutches, and other appliances,
have been issued to outgoing' patients. Transportation to their homes
has been furnished to 17 incurable patients.

The number of seamen treated shows an increase of 7,753 over last
year.

In addition to the relief furnished, as shown above, 44 officers, cadets,
and applicants for appointment as cadets, and 305 seamen in the Rev-
enue-Marine Service have been examined, 4,384 pilots have been ex-
amined for color-blindness, and 57 seamen for light-house and merchant
service.

HAND-BOOK FOR SHIP'S MEDICINE-CHESTS.

In further carrying out the intentions of Congress in establishing the
Service, aii attempt has been made, in providing a hand-book for the
medicine-chest, to furnish a guide in aid of masters and officers of ves-
sels when far at sea, beyond the reach of skilled assistance. Section
4560 of the Revised Statutes compels the carrying of a medicine-chest,
but no specifications were given as to what the contents of the chest
Should he, and, as a consequence, there are scarcely any two chests
alike, or even provided with proper medicines. In this book lists are
given of what the chests should contain, with plain directions for their
use. it will be issued to all vessels now required by law to keep a

medicine-chest.

RECEIPTS AM) EXPENDITURES.

The receipts from all sources were 1386,059.81, and the net expendi-
tures 1400,404.46. It is believed that the receipts will he largely in

ed during the present fiscal year, as a result of the special inves-
tigations now iii progress.



10 MARINE-HOSPITAL SERVICE.

Notwithstanding the great increase in the number of patients, the
expenditures are not greater than last year, and the per capita cost has
been still further reduced from $16.18, as reported in the last report,
to $12.27. This is due principally to the large increase in the number
of out-patients.

MEDICAL, CORPS.

Appointments.

Two examining-boards have been convened during the year.

There were thirty applications for appointment; eighteen candidates
appeared for examination; two passed, and were appointed assistant
surgeons, taking rank in the order of merit. Two candidates, having
passed the examination just previous to the present fiscal year, were
appointed assistant surgeons. There are now four vacancies.

Promotions.

One passed assistant surgeon was promoted to be a surgeon, to fill
a vacancy, and three assistant surgeons were promoted to be passed
assistant surgeons, having served the three years required by the Regu-
lations and passed a satisfactory professional examination.

Casualties.

Since the last report, one surgeon and one passed assistant surgeon
have resigned, one assistant surgeon was dismissed after a hearing be-
fore a board of inquiry, and one assistant surgeon (W. C. W. Glazier)
died of yellow fever at the Marine Hospital, Key West, Fla.

COLLECTION OF HOSPITAL-DUES.

The action of the Department, in determining the impossibility of
carrying out the schedule plan for the collection of hospital-dues, has
met with the general approval of those concerned. In almost all coun-
tries hospital-dues of some sort are collected. In many foreign ports
an assessment, according to the registered tonnage of the vessel, is
levied on all shipping as hospital-money, but in this country the tax-
ation being paid by the beneficiaries of the Service, its equitable nature
is apparent, and as payment is made for the time of actual employment,
there is no hardship from its collection. Notwithstanding this fact, it
has been brought to the attention of this office that the owners and
masters of many vessels were in the habit of defrauding the Service
out of considerable amounts. This was done by neglect to furnish the
names of all the members of the crew to the customs officers. In one



MARINE-HOSPITAL SERVICE. 11

instance, while the owners properly accounted for the crew, the " broker,
who was intrusted with the settlement of the account at the custom-
house, retained more than one-half the money.

A cursory examination having shown the necessity of a thorough
investigation into these frauds, a special inspector of customs was, upon
the request of this office, assigned to that duty by the Supervising-
Special Agent of the Treasury. The investigation is still in progress
with satisfactory results, several thousand dollars having been collected
that would otherwise have been lost to the fund. The imperative
necessity for the permanent employment of an officer for the regular
inspection of seamen's time-books, and examination of returns of hos-
pital-dues, made to customs officers, has become apparent. Indeed,
frauds can be prevented in no other way so surely and certainly. It is,
therefore, recommended that the attention of Congress be invited to
this point.

FRAUDULENT ADMISSIONS TO HOSPITAL.

The furnishing of hospital or dispensary relief to persons not sailors
occasionally happens, notwithstanding the great care exercised by the
medical officers at the several stations to exclude those not entitled to
the benefits of the Service. The only statute under which such persons
are punished is the general one providing a penalty for frauds against
the Government. (Sec. 5438.) Two convictions have been made, and
other cases are pending. In both these instances the discharge papers
of a sailor had been purchased. As in all cases where the medical
officer is in doubt as to whether or not the applicant is a seaman,
he is instructed, in the interest of humanity, to admit such applicant,
it is only reasonable that a severe penalty should be enforced against
persons taking advantage of this necessary regulation. It is further
suggested that fines collected as penalties from convictions of those
defrauding this Service be covered into the marine-hospital fund, as is
now done with the proceeds of fines collected under the provisions of
section 2 of the act of March 3, 1875.

HOSPITAL BUILDINGS.

Tin- ordinary repairs to the hospital buildings and grounds have been
made ;^ usual under the direction of the Supervising Architect of the
Treasury Department, and under the immediate supervision of (lie

superintendents of construction acting under his direct ion. The 63

traordinary repairs estimated fur, as necessary Last year, were no!
appropriated for by Congress. The committee by whom (lie subject



12 MARINE-HOSPITAL SERVICE.

was considered arrived at the conclusion that the unexpended balance
having been acquired by reason of the sale of hospital buildings, its
expenditure for repairing those retained by the Government was a
legitimate one, and that it could properly be done before asking Con-
gress for additional appropriations for this purpose. With this view,
plans and specifications have been prepared for repairing each of the
hospitals enumerated in the last report, and the work will be entered
upon during the coming summer.

A summary of the work clone at the several hospitals is as follows:

Hospital at Chelsea.

A few minor repairs have been made on this building during the past
year, involving an expenditure of $44. The estimate for extraordinary
repairs given in the report of last year as necessary, will be commenced
during the current fiscal year. According to the report of the surgeon-
in-charge, the engineer of this hospital died, as a consequence of the
leaking and defective drain under the hospital. "The sewer was origi-
nally of brick, cemented on the inside. It was laid in 1858, and has
been in constant use. A new one is now being constructed.

Hospital at Chicago.

The ordinary repairs to the plumbing and heating apparatus have
been made during the past year, but the plumbing is dangerously de-
fective and the heating apparatus is worn out. A new dumb-waiter
has been placed in the building at a cost of $175. The general repairs
to the building, enumerated in the report of last year, and the change
in the sewerage of the hospital, remain to be completed; the estimate
for the work is $18,900, plans for which have been prepared. The
steam-boilers being worn out, require replacing. This building is
more expensive, and on account of its general plan, the annual expense
of its management is greater than any other hospital in the Service.
The plan for these repairs also includes such alterations as will render
the administration more economical. It was found that the amount of
money estimated for was insufficient to pay the expense of grading and
turfing the grounds, or to construct the bulkhead necessary to prevent
the encroachment of the lake.

Hvspital at Detroit.

The iron roof has been repaired and painted, a new flag-staff erected
in lieu of one destroyed by lightning, the kitchen floor repaired, the
ceiling and piazza repaired and painted, the plastering of the corridors



MARINE-HOSPITAL SEE VICE. 13

repaired, and the wards and ceilings of the wards painted at an expen-
diture of $800. The necessary repairs to this hospital require an ex-
penditure of $3,500.

Hospital at Key West.

Minor repairs have been made to the roof of this hospital, and cer-
tain parts of the building have been repainted at an expenditure of
$220, and a new Hag-staff erected. The $1,000 appropriated by Con-
gress for building the sea-wall or bulkhead in front of the marine-
hospital building has been expended, but there are still extensive
repairs necessary. At least $4,000 to complete the bulkhead for the
proper protection of the hospital building, and $4,000 for needed re-
pairs to the hospital building, are necessary.

Hospital at Louisville.

Minor repairs to the plumbing of the hospital have been made,
involving an expenditure of $83.65. The estimate for the necessary
repairs to this buildiug remains as heretofore, $5,787.65. The wall
around the grounds is out of repair, and needs pointing throughout.

Hospital at Mobile.

There have been no repairs to this hospital during the past year.
The estimate for necessary repairs remains as last year, $1,515. The
work has been estimated for and will be speedily completed.

Hospital at New Orleans.

The condition of the old unfinished hospital at New Orleans and the
great necessity for a hospital at that port were fully set forth in a report
transmitted to Congress by your predecessor, and the building, after
extensive advertising, was offered for sale at public auction. There
was but one bid for the property, and that so far below its real value
that the Secretary rejected the bid.

Hospital <ti Portland, Maine.

The roof of this building has been repaired at, an expense of $184.10.
Repairs to the heating apparatus and plumbing have been made.

Hospital <it Vittsbwgh.

Ah heretofore reported, $7,000 is available for the building at

Pittsburgh, and plans were prepared by the Supervising Architect, at

the request of this office, for the erection of a cottage hospital at that



14 MARINE-HOSPITAL SERVICE.

port; but it was discovered that the State of Pennsylvania had not
ceded the jurisdiction required by section 355, Kevised Statutes, and an
application was necessary to be made to the Governor for that purpose.
The State having recently ceded the jurisdiction by a special act of the
Legislature, the erection of the building will be commenced as soon as
practicable.

Hospital at San Francisco.

Minor repairs to the steam-heating pipes have been made at an ex-
penditure of $55. Authority has been given for the construction of a
fence to enclose the hospital reservation.

Hospital at St. Louis.

The water-closets of this hospital have been repaired at an expendi-
ture of $331, and minor repairs have been made involving an expendi-
ture of $150. The repairs estimated for last year are now in progress,
and will probably be completed before winter.

Hospital at Wilmington, N. C.

This building, having undergone extensive repairs, was open for the
reception of patients May 18, and the seamen of this Service who had
been treated at the hospital of the Seaman's Friend Society were trans-
ferred to the marine hospital. The building is now in excellent condi-
tion ; the fences, however, were all destroyed during the time it was
out of the possession of the Government, and require rebuilding. As
this is the general hospital for a large portion of the South Atlantic
coast, the number of patients is steadily increasing, and an additional
ward and store-room should be constructed; $5,000 are considered as
necessary for the work.

LEGISLATION NEEDED.

The recommendations heretofore made for providing hospitals at
New York, Baltimore, New Orleans, Cincinnati, Cairo, Yicksburgh,
Norfolk, Galveston, Savannah, and Port Townsend are respectfully re-
newed; and attention is once more invited to the propriety of statutory
provision for the appointment of medical officers ; compulsory physical
examination of seamen ; the establishment of a National Snug Har-
bor ; also some enactment relative to the sale of unclaimed effects of
deceased seamen; specific penalty for defrauding the Service; and
the old law providing for investing surplus funds ought certainly to be
re-enacted.



MARINE-HOSPITAL SERVICE. 15

PHYSICAL EXAMINATION OF SEAMEN.

Ill previous reports the regular shipment of a great number of un-
seaworthy sailors has been mentioned, so ofteu, in fact, as to almost ren-
der the subject threadbare; but while the evil exists, it is presumed that
the legal remedy is not beyond reach, or its ultimate application alto-
gether hopeless. Year by year the records of the shipment of incura-
ble syphilitics, chronic invalids, and even lunatics, accumulate ; and this
only represents the indirect damage to shipping, the actual damage
being obscured by causes apparently more immediate. When a vessel
is reported as being lost at sea, the not uncommon fact that at the onset
of the storm one-third of the crew were unfit for duty, from sickness
or old injuries, escapes notice or remark. Thousands of dollars are
properly expended, through the Life- Saving Service, in saving the
lives of persons engaged in commerce with the United States, but we
have as yet no public provision looking to the prevention of disasters
to sailing craft from weak and inefficient crews; and this notwithstand-
ing the fact that no specific appropriation is required to carry out the
necessary regulation. As stated in my last annual report, the " blood-
money" takers are really responsible for the non-acceptance of the
facilities offered by this Service for the physical examination of crews
as preliminary to shipment." There has been, however, a great awaken-
ing of public opinion in connection with this matter. The burning fact
that crews are openly sold like cattle in our great seaports has stimu-
lated renewed inquiry, and a short time since the United States district
attorney for the southern district of Xew York brought up one of the
cases for trial under the provisions of section 4G09 of the Revised
Statutes, but it was shown upon the trial that the accused had sold the
crew to a foreign vessel instead of to an American vessel, and the
judge decided in favor of the accused, on the ground that there was no
evidence that Congress intended to prohibit the traffic as far as foreign
vessels wen- concerned. The effect of this decision is to enable the
blood-money meo to control the sailor market, and if eventually pro-
hibited from plying their trade on American crews, they may still mo-
nopolize that of foreign vessels,and prevent the employment of Ameri-
can sailors on foreign crafl in our ports. It is not difficult to see that

the source of this evil lies in the advance-waives system. hYf'iise

advance wages, and there will be no incentive to deprive the sailor of
his haul earned stipend.



Shipping Commissioner ai the port of NTew Sort publishes monthly the Dumber of per-
nans shipped through hisjofflce, and each time adds, "There were no masters of outgoing vessels that
availed thernsttlves of the f;i<ilitii-s offered by the Governmeni tor the fn i laminattanol

ii <lcu ing the month."



16 MARINE-HOSPITAL SEEVICE.

Eepeated but unavailing efforts have been made for the abolition of
advance wages both by statutory enactment and by private voluntary
agreement. The ]STew York Chamber of Commerce, in 1857, took action
on this subject, and one hundred and seven firms signed an agreement
that "on and after the 1st day of July, 1857, they will not pay advance
wages to seamen. They also declare that they will add to the monthly
pay of sailors 10 per cent, to the men who return in the ships they go
out in." a This movement was unsuccessful on account of a combination
of sailor landlords and shipping agents. They would not and did not
permit the men to go to sea, although large numbers of vessels were
then in port waiting to sail. Fifty at least lay at the wharves or in the
stream in that condition, unable to leave the port for want of crews,
which could not be obtained, and so remained for from three to five
days. Only one or two of them were successful in obtaining men, and
in sailing without paying advance. 6

The following graphic description of a settlement between a sailor
and his landlord is copied from the article already quoted. No more
forcible illustration can be furnished of this side of the question:

It is not many weeks since a friend of mine in Boston had a ship going to sea at
three o'clock on a certain day. He went to his shipping-master, Mr. Miller, and
said: "Miller, my ship is going to sea at three o'clock; I want my crew on hoard at
two." "Very well, sir," Mr. Miller says; "your crew are all down at old Green's —
(I will call him Green, but his name is not Green) — a negro hoarding-house keeper;
there will be some sport down there ; suppose you go down and see how the old fellow
manages." My friend went. The shipping-master said to Green, "The crew of

the must be on board at two o'clock; will you have them there?" "Yes, sir,

sartain," and he looks over the crew. They were nearly all sitting in the room.
."Now," he says, "boys, we must settle, and you be on board the ship at two o'clock.
Gome here, Jim," says he, "we'll begin with you," and calls him into a side-room.
My friend and the shipping-master went in, too. "Now, Jim," he says, "you have
been in my house two weeks." "Two weeks! No, sir; I aint been in your house
but five days." "Jim, don't yon suppose /know? Do you forget I am in my own
house? You have been in my house two weeks." "But, Mr. Green, I say I haven't
been here but five days." "Why, don't you suppose / know ; /who buy the bread
and butter and the meat ; hadn't I ought to know better than you who have been
drunk half the time?" "Well, sir, if you say so, I suppose it must be so; but I
thought I hadn't been here but five days." "Now, then, Jim, there's the old woman's
wash-bill; that's $2.50." "Two dollars and a half! Why, Mr. Green, I had only
two pieces of clothing when I came here, and one of them the old woman said was so
old that she threw it away." "You only had tivo pieces when you came here; you
came to my house with only two pieces of clothing! You get off cheap with two
dollars and a half, cheap enough. A man like you to come to my house! Now, Jim,
don't you remember down at the door there was a white man talking to you, and yoti
wanted three dollars? There was three dollars cash." "Yes, sir, I wanted three
dollars, but I didn't get it. I asked you for it, and you didn't give it to me." "Now,
Jim, don't you suppose /know best whether you got the money or not? I gave you
the money out of my pocket — money I had earned hard, and you fooled it away.
Don't you suppose I know best? Do you suppose / would take advantage of you?
You have known me a great many years, Jim." "No, sir; I don't sivppose you
would." "J tell you, Jim, you had it, and I know best. Now, Jim, there is $12 for
board, and $2.50 for washing, that is $17.50, and there is $3 cash, making $22, Jim.
Now your advance only comes to $20. Where am I going to get the other two dol-

aEditorial in the "Sailors' Magazine," April, 1881.
6 "Sailors' Magazine," Loc. Oit.



MARINE-HOSPITAL SERVICE. 17

lars— where is that coming from?" "Mr. Green, you know when I come back, I
will come here." ••< >h. yes, Jim, you will come here becau.se I'll bring you. I have
to look out for you, or you would fall into the hands of the land-sharks, and they
would rob you of everything you have." "Well, Mr. Green, when I do come, and
when I have some money. I will pay you." "That is all very well, Jim. You will
pay me when you have some money, but the fact is you never have any. But, never
mind. Jim. yon may go, and I a'int a going to send you off destitute neither. I'll
give you something in the bottle, and some tobacco; and if you cheat me then out
of my two dollars, that is your fault." You may laugh— but Jim didn't laugh, when
for a whole month he had to work night and day, storm and sunshine, to make that
twenty dollars again, that he had been cheated out of. These are not rare or over-
drawn cases, hut such as occur daily in our seaports.

The blood-inoney practices are said to be as prevalent now as they
were prior to the enactment of the shipping-commissioners' law of 1872.
The shipping commissioners, in fact, ship only such men as appear be-
fore them for the purpose, and they are brought under the surveillance
of landlords to whom the advance wages of the sailor have been pre-
viously assigned."

Dr. Alexander Jamieson, in his report on the health of Shanghai for
the half year ended September 30, 1876, says — (Chinese Customs Med-
ical Reports:)

"It will be noticed that non-residents contribute largely to the mor-
tality of the port. Most of the fatal cases among this class pass through
the General Hospital, and the majority of these are seamen, sent from
ships in the harbor. It is nothing uncommon to find in the wards men,
fresh from European and American ports, who are yet suffering from
advanced heart disease, aortic aneurism, or chronic kidney disease, or
are in the last stage of phthisis. To take men on board ship for a long
voyage, wherein they are certain to be exposed to all the conditions
most fatal to persons in their situation, is absolutely inexcusable; but
it is not easy to say where the blame lies. Medical inspection before
shipping is clearly the only way of meeting the difficulty, and, accord-
ingly, the framers of the merchant shipping bill of 187G took the matter
in hand, hut without result. The twenty-tilth section of the bill, as it
originally stood, recited that every owner or master, signifying at a
Shipping office his intention to engage a crew, should, at the same time,
state whether he intended to have Ids men examined by a medical in-