Annual report of the Surgeon General of the Public Health Service of the ...

said section eleven of the act approved June nineteenth, one thousand eight hundred and eighty-six, upon vessels entered in the ports of the United States directly from the port of Copenhagen, in the Kingdom of Denmark.

Provided, That there shall be excluded from the benefits of the suspension hereby declared and proclaimed the vessels of any foreign country in whose ports the fees or dues of any kind or nature imposed on vessels of the United States, or the import or export duties on their cargoes, are in excess of the fees, dues, or duties imposed on the vessels of such country or on the cargoes of such vessels; but this proviso shall not be held to be inconsistent with the special regulation by foreign countries of duties and other charges on their own vessels, and the cargoes thereof, engaged in their coasting trade, or with the existence between such countries and other States of reciprocal stipulations founded on special conditions and equivalents, and thus not within the treatment of American vessels under the most favored nation clause in treaties between the United States and such countries.

And the suspension hereby declared and proclaimed shall continue so long as the reciprocal exemption of vessels belonging to citizens of the United States and their cargoes shall be continued in the said port of Copenhagen and no longer. In witness whereof I have hereunto set my hand and caused the seal of the United States to be affixed.

Done at the city of Washington, this 19th day of July, in the year of our Lord one thousand eight hundred and ninety-eight, and of the Independence of the United States the one hundred and twenty-third.

[SEAL.]

By the President:

WILLIAM R. DAY,

Secretary of State.

WILLIAM MCKINLEY.

MARINE HOSPITALS AND RELIEF FURNISHED.

During the fiscal year 1898 the total number of patients treated by this Service was 52,709, of which number 11,914 were treated in the hospitals of the Service and in the hospitals at contract stations, and the remainder (40,795) were treated as out-patients.

INSPECTION OF STATIONS OF THE SERVICE.

The following inspection blanks to be used in the inspection of marine-hospital stations of the first, second, third, and fourth class have been adopted, and are now in use:

REPORT OF INSPECTION OF STATIONS OF CLASS 1.

Instructions to inspector.

1. Your visit to the station should be unannounced.

2. Upon arrival at the port you will first call upon the commanding officer and arrange with him for an inspection of the hospital, which should be made as soon after arrival as practicable.

3. You will then visit the office where out-relief is furnished.

4. You will make appropriate entries to each question of this inspection blank, and forward to this office upon the completion of your duty.

WALTER WYMAN,

Supervising Surgeon-General U. S. Marine-Hospital Service.

Name of station.
When was station last inspected?

Name of inspector.

I. PERSONNEL.

Name and rank of officer in command of station.

Give number of members in family.

Date of assignment to duty.

Name and rank of assistants, with dates of assignment, including acting assistant surgeons and internes; also give number of members in each family. Number of stewards and number of members in each family.

Name, duties, and pay of each attendant.

Is there necessity for additional officers or employees? If so, give reasons.

(h) What kind of bedsteads and what kind of mattresses and bedding.

(i) Report upon condition of bedding used by the patients.

Are separate rooms or wards provided for the treatment of officers?

Give number of beds.

What is the condition of wards as to cleanliness?

Is there an operating room?

Is it properly equipped?

Is the force of nurses sufficient?

Are those so employed trained to their duties?

Does the character of the diet furnished conform to that prescribed by the regulations?

Give number of patients in hospital on date of inspection.

Are the patients under treatment in hospital correctly recorded in the register, and are all present?

If any patients are not at hospital at time of examination, state why.
What is the practice in regard to allowing patients to leave the hospital?

Are they allowed to remain out overnight?

Are the cases under treatment proper ones for hospital relief?

Are the medicines administered to patients by the nurses or left with patients for self-administration?

Give name and diagnosis of patients who have been under treatment in hospital for a period of one year or more.

State whether, after careful examination, you recommend the discharge of any of these patients.

Is the clinical record system properly kept?

What precautions are taken with tuberculous patients?

What was the average cost of a ration for the past fiscal year?

Is there a complete set of annual reports, Marine-Hospital Service, on file?

Are the records of the station properly kept, and up to current work?

Describe general construction of the outbuildings.

Is there an isolation ward?

Give number of beds.

Is there an autopsy room?

Is it properly equipped?

Describe officers' quarters and condition of furniture therein?

Describe steward's and attendants' quarters and condition of furniture therein.

How are rations supplied to the steward, and is a proper record kept of the same?

Describe hospital dining room and condition of table furniture and tableware?

State the condition of kitchen and its equipment.

State the condition of dispensary.

State the condition of laundry.

State the condition of road approaches to hospital.

State the condition of fences and grounds.

State condition of engine room.

State condition of heating apparatus.

Describe water supply.

Describe drainage and condition of water-closets.

What is the method of disposal of garbage?

State whether any animals not authorized by the Department are kept on reservation.

III. STABLE AND GARDEN EQUIPMENT.

State, approximately, the age and condition of each horse, and how long in service at this station.

Give number and character of vehicles.

Do they appear properly cared for?

Are harnesses in good condition?

Are the tools and garden implements in good condition?

IV. DISCIPLINE.

Are officers supplied with uniforms in accordance with the regulations governing uniforms?

Are attendants supplied with uniforms in accordance with the regulations governing uniforms?

State omissions, if any, in each case.

Are uniforms properly worn?

Give method of granting leaves to officers and employees.

Describe facilities for managing a fire as shown by drill performed in your presence.

Describe the methods of conducting inspection and muster as performed in your presence.

V. OFFICE OR OUT-RELIEF.

Is the room for the examination of marine-hospital patients suitable for the purpose?

What is the location and distance from hospital?

Is it kept clean and in order?

Is it satisfactorily equipped for dispensary purposes?

What are the facilities for reaching the hospital?

Is the supply of medicines sufficient?

What is the condition of the public property (furniture, medicines, implements, instruments, etc.)?

What records are kept?

Are they correctly kept and up to current work?

VI. GENERAL ADMINISTRATION.

Give number of marine-hospital patients treated during the last fiscal year. Give the number treated during the present fiscal year to date of report.

Are supplies received and issued in conformity with paragraphs 140 and 141 of the Regulations?

Give average duration of treatment in hospital of patients under treatment at date of inspection.

Give the number of out-patients during the last fiscal year and the number of out-patients during the present fiscal year to date of report.

Give the ratio of hospital to out-patients during the last fiscal year and during the present fiscal year to date of report.

Give annual amount expended at station for the past three years. (See Annual Reports.)

Does the method of disposing of the effects and moneys of seamen conform to the regulations?

Does the amount of money on hand correspond with the record (Form 1950)?

Give the immediate needs of the station as stated by the commanding officer.

VII. REMARKS AND RECOMMENDATIONS.

I certify that the foregoing is a careful and correct statement of the condition of the Service at the port of inspected by me this 189-.

day of

Surgeon, U. S. M. H. S., Inspector.

REPORT OF INSPECTION OF STATIONS OF CLASS 2.

Instructions to inspector.

1. Your visit to the station should be unannounced.

2. Upon arrival at the port you will first call upon the medical officer in command and arrange with him for an inspection of the hospital, which should be made as soon after arrival as practicable.

3. You will then visit the office where out-relief is furnished.

4. You will make appropriate entries to each question of this inspection blank and forward to this office upon the completion of your duty.

WALTER WYMAN,

Supervising Surgeon-General U. S. Marine-Hospital Service.

Name of relief station.

I. PERSONNEL.

Name and rank of officer in command of station.

Date of assignment.

Name, rank, and pay of subordinates.

Dates of assignment or employment.

Name of contractor furnishing quarters, etc.

How long has contract been held by present party?

Is there competition for it annually?

What is the charge per diem?

When was the station last inspected?
Name of inspecting officer.

Are officers and employees supplied with uniforms in accordance with the regulations governing the same?

Is there necessity for additional officer or employee? If so, give reasons.

II. HOSPITAL.

Location of building used as hospital.

Is there a resident physician or graduated interne employed?

Is it used entirely for hospital purposes; and if not, for what other purpose is it used?

Describe general construction.

Are the marine-hospital patients treated in separate wards?
Describe the wards occupied by marine-hospital patients:

(a) Dimensions.

(b) Number of beds in each ward.

(d) Heating.

(e) Lighting.

(f) Ventilation.

Is there a modern operating room?

Hospital furniture:

(a) What kind of bedsteads, and what kind of mattresses and bedding?

(b) Report upon the condition of bedding used by marine-hospital patients.

What is the condition of wards as to general cleanliness?

Is the nursing sufficient, and is the nurse employed trained to the duties?

Is the character of the diet furnished the same or equal to that prescribed in the Diet Table for marine hospitals?

If not, what is the ordinary diet furnished?

Is extra diet furnished for special cases?

Are the patients under treatment in hospital correctly recorded in the register, and are all present?

If any marine-hospital patients are not at hospital at time of examination, state why.

What is the practice in regard to allowing marine-hospital patients to leave the hospital?

Are they allowed to remain out over night?

Are the cases under treatment proper ones for hospital relief?

Are the medicines administered to patients by the nurses or left with the patients for self-administration?

III. OFFICE OR OUT-RELIEF.