LEAVES OF ABSENCE-ACTING ASSISTANT SURGEONS. TREASURY DEPARTMENT, OFFICE OF THE SUPERVISING SURGEON-GENERAL M. H. S., Washington, D. C., July 12, 1897. To Acting Assistant Surgeons, United States Marine-Hospital Service: Your attention is called to paragraphs 36-40, Revised Regulations, MarineHospital Service, 1889, relative to leaves of absence. It becomes necessary to call the attention of acting assistant surgeons to these requirements concerning leaves of absence, in consequence of occasional violations of the same. Officers of this grade are required to strictly observe all the rules governing leaves, and requests for same, and notification of changes in their post-office addresses during such absence. No absence from posts of duty is permissible without authority, and if a necessity for sudden departure arises the telegraph may be used, at your expense, to request authority for such absence. Information must also be given relative to names of substitutes who are to act during such authorized leave. You are directed to acknowledge receipt of these instructions. Respectfully, yours, WALTER WYMAN, Supervising Surgeon-General M. H. S. REVISED REGULATIONS, COMMISSIONED OFFICERS, AND HOSPITAL STEWARDS. TREASURY DEPARTMENT, OFFICE OF THE SUPERVISING SURGEON-GENERAL M. H. S., Washington, D. C., December 10, 1897. Medical Officers and Hospital Stewards of the United States Marine-Hospital Service: The following paragraphs of the Revised Regulations, approved November 29, and effective December 1, 1897, are published for your information: 59. Hospital stewards shall be divided into two grades, senior and junior, and original appointments shall be to the grade of junior hospital steward. 60. Promotions, according to seniority or merit, will be made after three years' service from the junior to the senior grade, after due examination on subjects connected with their official duties. * * * 70. The compensation of commissioned officers, when not provided for by statute, shall be fixed at a uniform annual rate for each rank as follows, viz: Surgeons shall receive $2,500 per annum, passed assistant surgeons shall receive $2,000 per annum, and assistant surgeons shall receive $1,600 per annum; and after five years' service an additional compensation of 10 per cent on the annual salary for each five years' service shall be allowed commissioned officers above the rank of assistant surgeon, but the maximum rate shall in no case exceed 40 per cent. Said officers placed on "waiting orders" for a period longer than two months shall receive 75 per cent of the pay of their respective ranks while so placed. 73. The compensation of hospital stewards shall be at the following annual rates, viz: Senior hospital stewards shall receive $720 per annum; junior hospital stewards shall receive $600 per annum. At the expiration of five years' service they shall receive $792 per annum, and at the expiration of ten years' service they shall receive $864 per annum. WALTER WYMAN, Supervising Surgeon-General M. H. S. EMPLOYMENT OF ATTENDANTS IN ACCORDANCE WITH CIVIL-SERVICE RULES. TREASURY DEPARTMENT, OFFICE OF THE SUPERVISING SURGEON-GENERAL M. H. S., Medical Officers and others concerned: Referring to the accompanying letter from the Civil Service Commission, your attention is especially directed to that portion of the commission's letter of September 10, 1897, relative to attendants employed after May 6, 1896, the date of the Executive order placing hospital attendants in the classified civil service. In that letter it was explained that persons temporarily appointed to the position of hospital attendant are entitled to file their papers and compete with others; that it is desirable that they should do so; that if they are the best fitted of those who compete, the system of rating must necessarily show them to be so, and then they can be selected for permanent appointment. In order that the temporary appointments of hospital attendants employed at your station may be made permanent, I return such applications as have been submitted from persons desiring such appointment, and you are therefore directed to rate them in the manner prescribed by the letter of instructions from the Civil Service Commission, and if found eligible to request that their appointments be made permanent. Respectfully, yours, WALTER WYMAN, Supervising Surgeon-General, M. H. S. CONCERNING UNIFORMS. TREASURY DEPARTMENT, OFFICE OF THE SUPERVISING SURGEON-GENERAL M. H. S., Washington, D. C., April 6, 1898. Medical Officers and Hospital Stewards, United States Marine-Hospital Service: "8. Full-dress uniform for officers.-The full-dress uniform for officers shall be worn at all general inspections made by the Surgeon-General or other inspectors at stations of the first class, at the transfer of hospital and quarantine stations, and on all occasions of special ceremony." To paragraph 10 add: "and by officers when reporting for duty at stations of the first class." Paragraph 15 changed so as to read: ‘15. Fatigue uniform for officers shall be worn by all officers while on ordinary duty at hospitals, and on ordinary quarantine duty, and when inspecting unserviceable property, and at informal inspections by the Surgeon-General, and at the office where out-patients are treated." To paragraph 19 add: "Shoes of white material may be worn with this uniform." Wherever the words "stewards of the first class" occur in the Uniform Regulations, they shall be taken as applying to senior stewards; and wherever the words "stewards of the second class" occur they shall be taken as applying to junior stewards; and all uniform regulations for stewards of the third class are hereby revoked. WALTER WYMAN, Supervising Surgeon-General M. H. S. INQUIRY CONCERNING EXPERIENCE WITH SMALLPOX. [Addressed to each commissioned medical officer.] TREASURY DEPARTMENT, OFFICE OF THE Supervising Surgeon-GENERAL M. H. S., Washington, D. C., April 27, 1898. SIR: You are directed to inform the Bureau whether you have had practical experience in the diagnosis and treatment of smallpox, and whether this experience is of such character as to give you confidence in case your services were demanded as expert. Respectfully yours, WALTER WYMAN, Supervising Surgeon-General M. H. S. ACCOMMODATIONS FOR OFFICERS REVENUE-CUTTER SERVICE. TREASURY DEPARTMENT, OFFICE OF THE SUPERVISING SURGEON-GENERAL M. H. S., Washington D. C., May 7, 1898. To Medical Officers and Acting Assistant Surgeons, United States Marine-Hospital Service: You are informed that the Bureau intends hereafter to provide special accommodations for sick and wounded officers of the Revenue-Cutter Service at relief stations where there is no marine hospital, and you are hereby directed, upon the application of such officers for hospital relief, to make arrangement on the best possible terms for their admission to a private room or ward in the contract or other hospital at your station, reporting your action in each case for approval, giving the rate of charge. WALTER WYMAN, Supervising Surgeon-General M. H. S. PATHOLOGICAL SPECIMENS. TREASURY DEPARTMENT, OFFICE OF THE SUPERVISING SURGEON-GENERAL M. H. S., Medical Officers in Command: Two sets of specimens should be prepared, one set to be placed in 50 per cent alcohol for two weeks and then placed over in 95 per cent alcohol for a week or ten days; the other to be placed in Muller's fluid (bichromate of potash, 1 part; sodium sulphate, 2 parts; water, 100 parts) for three days and then changed to fresh fluid and allowed to remain a week. The specimens should then be washed for several hours and then placed in 95 per cent alcohol for a week or more. The specimens are best labeled by wrapping each in paper, using a lead pencil for labeling. In preparing the specimens for the laboratory a special mailing case will be sent you. After the specimens are placed in the glass jar a quantity of absorbent cotton should be placed around the specimens sufficient to maintain them in place, after which a small quantity of 95 per cent alcohol should be poured over the cotton, just sufficient to keep them moist. A label should be affixed to the jar containing the specimens, giving the name of hospital, name of patient, permit number, and date of death. You will acknowledge receipt of this circular. WALTER WYMAN, Supervising Surgeon-General M. H. S. REPORT OF THE PURVEYING DIVISION. In the purveying division 631 requisitions for medical and other supplies to meet the needs of marine hospitals and relief stations of the Service have been filled. Eleven national quarantine stations, five detention camps, and the immigrant hospital at Ellis Island, New York Harbor (under control of the Immigration Service), have also received their supplies in whole or in part through this division. The amount of labor involved in purveying the material called for in these requisitions was as follows: Number of packages shipped.. 3,893 -pounds. 263, 194 The pharmaceutical work of this division performed by the chemist and his assistants shows a total output of 6,323,000 grams of various articles manufactured for issue, of which there were 86 different kinds. These articles are divided as follows: The following is a summary of the cost of the various supplies purchased for issue during the year: The work of this division during the past fiscal year has been carried on along the lines indicated in my previous annual report-the improvement in equipment of hospitals and supplying them with the most recent medical and surgical paraphernalia. With the exception of one hospital previously noted, all the marine hospitals have now been supplied with modern aseptic operating-room furniture. Furniture for the wards in the hospitals has also been supplied in increased quantity and improved quality, this statement referring particularly to bedsteads, bedside stands, clothing, etc., for the patients. In respect to this latter item it should be stated that a hospital suit has been adopted for the use of convalescent and other patients. The adoption of this uniform is in line with the efforts made in all hospitals to secure thorough cleanliness both of the building, its contents, and the inmates. Hitherto the patients in our marine hospitals being of the seafaring class, having only their own clothing to wear in the wards, and coming, as they do, from dirty forecastles and unclean decks, it was impossible to secure freedom from danger of infection from this source. The adoption of this hospital suit enables the medical officer in command to strip the patient upon entering the hospital, and after giving him a bath he is clothed throughout with hospital clothing, and the uniform and cleanly appearance of the patients in the wards has justified the small expenditure involved as well as added to their cleanliness and aseptic condition. The suit is made of blue flannel and made on a sailor pattern, with rolling collar, loose blouse, and trousers. The issue of microscopes and other instruments of accuracy in clinical diagnosis, hæmaglobinometers, and hæmacytometers, has been continued. The old low-power microscopes have been gradually replaced with the most modern high-power instruments, which are now required for expert histological and bacteriological work. Many of these have been issued to officers for their personal custody for the purpose of conducting special bacteriological investigations, and it has been found that this plan insures greater care of instruments as well as a personal interest in their use. Outfits for working bacteriological laboratories have also been supplied to a number of the stations to increase the facilities of the medical officers in diagnostic accuracy. These outfits consist, in addition to the microscope and blood counting instruments, of centrifuges, thermostats, sterilizing apparatus, staining agents, culture media, and necessary reagents. The development of bacteriological work in the last few years requires that this means of modern medical study should be supplied to officers of the Service in order that they may keep abreast of the times, and the work accomplished by them in the daily hospital routine has justified the issue of these articles. The use of the "X" ray apparatus having become recognized as a fairly well established aid in diagnosis, arrangements have been made for supplying the hospitals with these machines and already a number have been sent out. Contracts have been made, and during the ensuing year they will be sent to the larger stations. The funds for the support of this Service heretofore noted as being now sufficient for these expenditures, it was determined to supply the libraries of the stations with recent medical works. For several years past, owing to the limitation of the amount of funds available, but |