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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 cottora, 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, S93 Total weight -------------------------------------------------- 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:

Elixirs --------------------------------------------------------------- 1,050,000 Fluid extracts-------------------------------------------------------- 640,000 Medicated waters----------------------------------------------------- 75,000 Liniments------------------------------------------------------------ 1.000,000 Spirits --------------------------------------------------------------- 146,000 Miscellaneous -- - - ------------------ - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - 968,000 Sirups --------------------------------------------------------------- 1,409,000 Tinctures ----------------------------------------------------------- 970,000 Medicated wines------------------------------------------------------ 65,000

The following is a summary of the cost of the various supplies purchased for issue during the year:

Medical supplies ----------------------------------------------------- $14,583.50

Hospital stores ------------------------------------------------------- 8,391.52 Hospital sundries ---------------------------------------------------- 8,972.98 Surgical instruments and appliances---------------------------------- 11, 301, 12 Bedding and clothing---------------------------------- - - - - - - - - - - - - - - 12,807.00 Medical books and journals------------------------------------------- 7, 113.31

The work of this division during the past fiscal year has been car. ried 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, haemaglobinometers, and haemacytometers, 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

few books have been furnished; but during the past year this lack has been made up by supplying some of the most recent and approved works in the various departments of medicine and surgery.

The need of adequate room for the use of this division has been mentioned in two of my previous reports, and the subject becomes of more consequence each year. With the increased number of stations, the growing demands of the Service, and the probability of the opening and maintaining of stations in outlying territory which may be acquired as a result of the war, will place upon the department the necessity of providing more space and better facilities for its operation. I respectfully refer to my previous allusions to this subject, and feel that something should be done to meet this necessity. The subject of establishing it in New York City has been considered, following the plan adopted by the Army and Navy. This would probably be the best solution of the problem.

In this connection the following letter was addressed to me by the medical officer in charge of the purveying division:

AUGUST 3, 1898. Sir: After an experience of over three years in charge of the purveying division, I have the honor to submit the following suggestions in regard to its improvement and development.

The gradual increase of the Service, both in the number of stations and the demands of them upon the Service for medical and surgical supplies and general stores, the increase consisting of an addition of six new marine hospitals within the last ten years and eleven national quarantine stations in the last fifteen years, constitutes an increase of work in the purveying division, which has now come to the practical limit of its capacity in its present quarters. From a business point of view—and this is the commercial division of the Service the removal of the purveying division and the establishment of it in New York City, the great trade and railroad center of the country, would, in my judgment, be a wise and economical change. A large part of our supplies comes from New York now, and many of them are shipped back over the same lines to stations north and west. Washington is neither an available business, railroad, nor manufacturing center, and proximity of the large and varied market in New York would result to the better interests of the Service in the purchase of equipment and supplies. A suitable building could be rented in the city of New York, selected for its availability for this division, and thus the present problem of requisite and desirable quarters for it would be solved in a very simple way.

The present condition is one of inadequate storage and manufacturing room, and the facilities for the shipping and handling of goods are very cumbersome.

In view of the forthcoming expansion of territory, and with colonial possessions in the West Indies, where in all probability a number of stations will be established in the near future, and with which New York is in direct communication by sea, there exists an additional reason for making the headquarters of the purveying division in New York. This would obviate reshipment at Southern points and add to the rapidity with which supplies can be forwarded to those stations. A large part of the work of the purveying division is performed for the quarantine service, and disinfecting material-sulphur, bichloride, etc.-can not be kept in stock in the present storage rooms, and emergency orders for these articles have to be made direct to the contractors, who, in the past and at present, are located in St. Louis, thus involving considerable delay in delivering material.

The necessity of having sufficiently large stores of hospital and other supplies on which to draw for emergency orders scarcely requires elaboration. It is the basis of successful administration of this division. With increased capacity, additional classes of hospital supplies could be stored, such as kitchen and hospital utensils and subsistence stores, which are now purchased in small quantities at each station at retail prices. This additional storage capacity would also enable the officer in charge of the purveying division to inspect goods purchased before they are sent out. In the absence of this facility goods are ordered direct from the contractors and manufacturers, and no examination of them can be made prior to issue, and neither the receiving officer nor the medical purveyor can know that the goods delivered are of the required standard. It is only by occasional information, incidentally obtained, that the quality of these goods is known. This plan of locating the supply department for the Army and Navy has been in operation for many years in New York. I believe that the same reasons which impelled those services to adopt this plan are equally applicable to this Service. The change suggested would be of reciprocal advantage to the internal economy of the headquarters of your office, in that it would add to the available office room a fine apartment on the first floor, which could be utilized as a library and board room and for such literary work as is always in progress, and which can not be satisfactorily done in the confusion of the working parts of the bureau. The change would involve no difficulties of administration, as the officer detailed as medical purveyor, in charge of the service stores at New York, would simply fill approved requisitions forwarded to him from the bureau, and in all respects be governed by the same regulations as a station of the first class. The present force in service in the purveying division would be ample for duty at the storehouse, with the probable addition of one clerk as stenographer and accountant. Respectfully, yours,

CHAs. E. BANks, Surgeon, M. H. S. SURGEoN-GENERAL MARINE-HOSPITAL SERVICE.

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