MARINE HOSPITALS AND RELIEF. RELIEF STATIONS. During the fiscal year ended June 30, 1917, the service operated 19 marine hospitals, all of which are owned by the Government, and maintained 119 other relief stations where hospital and out-patient relief was furnished patients. In addition, the service maintained a sanatorium at Fort Stanton, N. Mex., for the care and treatment of patients suffering from tuberculosis. On account of the decrease in the number of patients treated at Pittsburgh, Pa., and Wilmington, N. C., the marine hospitals at those places were closed during the year and contracts made with local hospitals for the care of service patients. RELIEF TO SEAMEN AND OTHER PATIENTS. There were 64,033 patients treated at the various marine hospitals and relief stations of the service during the year, including the patients treated at the tuberculosis sanatorium at Fort Stanton, N. Mex. This number also includes patients treated by local physicians (93 in number) who were appointed to furnish professional services during the year to members of certain coast guard stations. Of the above-mentioned number 17,991 patients were treated in hospitals a total of 500,578 days, and 46,031 patients were treated at dispensaries a total of 102,228 times. During the same period 366 foreign seamen were furnished 8,220 days' hospital treatment. In addition to the foregoing, medical officers detailed for duty on board various vessels of the Coast Guard furnished a great deal of medical relief both to beneficiaries of the service and to the natives of Alaska. PHYSICAL EXAMINATIONS. The medical officers of the service made 28,356 physical examinations of candidates for various positions during the year, as noted under the special headings given below: United States Coast Guard.-Three thousand one hundred and ninety-eight applicants were examined, of whom 1,230 were rejected. Post Office Department. Two hundred and forty-two applicants were examined, of whom 10 were rejected. Coast and Geodetic Survey.-Two hundred and thirty-five applicants were examined, of whom 17 were rejected. Lighthouse Service.-One hundred and four applicants were examined, of whom 14 were rejected. Immigration Service. One thousand seven hundred and sixty persons were examined on account of the Immigration Service, of whom 443 were rejected. Civil Service Commission.--One thousand nine hundred and fortytwo applicants were examined, of whom 212 were rejected. Panama Canal.-One applicant was examined and passed. Philippi e Islands.-Twelve applicants were examined and passed. Alaska Engineering Commission.-Six hundred and seventy applicants were examined, of whom 94 were rejected. United States Navy.-Fourteen applicants were examined and passed. United States Army.-One applicant was examined and passed. Bureau of Education.-Four applicants were examined and passed. Steamboat-Inspection Service. Five thousand nine hundred and eighty-nine applicants were examined, of whom 125 were rejected. Merchant seamen of the United States.-Eleven thousand three hundred and seventy-three American seamen were examined, of which number 1,225 were rejected. Foreign seamen.-Two thousand eight hundred and five foreign seamen were examined for service, of whom 239 were rejected. PURVEYING DEPOT. The following statistics show the transactions of the purveying depot during the fiscal year: Total weight of supplies shipped from depot (pounds). Total weight of supplies shipped direct to stations by contractors (pounds). TUBERCULOSIS SANATORIUM AT FORT STANTON, N. MEX. 185, 945 121, 297 REPORT FOR THE YEAR ENDED JUNE 30, 1917, BY F. H. M'KEON, SURGEON. General information. Number of patients present July 1, 1916_. Total number treated during the year. Number of patients discharged during the year. Total number of days' treatment furnished patients_ Number of officers and attendants.. Number of patients who left against advice_. Number of patients discharged for causes affecting discipline___. Number of patients transferred to other stations. Number of physical examinations made during the year__. Number of patients who returned at their own expense_ 197 130 327 109 43 42 218 234 187 77,272 98 35 1 3 1,273 19 9 28 Total number readmitted___ Average duration of stay of patients discharged, 1 year 9 months 3 days. Minimum stay, 3 days. Maximum stay, 9 years 11 months 26 days. Patients discharged during the year, with stage of disease and result of Eighty-one and five-tenths per cent of the cases were far advanced when received. Of the 43 who died, 17 remained over 2 years, 10 between 1 and 2 years, 7 between 6 and 12 months, 5 between 3 and 6 months, and 4 less than 3 months. One patient died on the third day after arrival. Twenty-six necropsies were performed. Prognosis on arrival. Favorable for apparent cure. Favorable for arrest_. Favorable.. Favorable for prolongation of life by living under proper conditions_. Doubtful. Unfavorable. No prognosis_. Not examined Total 1 42 12 41 3 8 1 1 109 CAUSES OF DEATH. Of the 43 deaths which occurred during the year, 4 were due to massive hemorrhage, 1 to septic pneumonia, 1 to tuberculous meningitis, 1 to tuberculosis of the pons, 1 to pulmonary embolism, and fibrous pericarditis, 2 to pericarditis, 2 to tuberculous enteritis, 3 to nephritis, 1 to suicide, and 2 to insanity. It will be understood that all the special cases of death mentioned above occurred in cases which were complicated by advanced pulmonary tuberculosis. Twentyfive deaths were registered as being caused by tuberculosis of the lungs, uncomplicated. TREATMENT. Methods of treatment in vogue during the fiscal year ending June 30, 1916, have not been materially altered during the fiscal year for which this report is made. Therapeutic pneumothorax has been continued in 17 selected cases, with results that have been generally satisfactory. Continuing the policy inaugurated by Surg. F. C. Smith, only selected cases have been given this treatment, the selection being based upon the opinion of a board of medical officers. The total number of such treatments given during the year was 209, the largest number given to one patient being 17. The investigation into pyorrhea alveolaris has been discontinued, for the reason that the results obtained by treatment with emetine proved to be unsatisfactory. It is believed that this finding is in accord with the findings of physicans throughout the country who have pursued such investigations. However, an effort has been made to place every patient's mouth in such condition as would enable him to properly masticate his food, for the obvious reason that the tuberculous individual with poor teeth or insanitary dental condition must necessarily be greatly handicapped in benefiting by institutional treatment. The station dentist rendered the usual institutional relief, which included 170 extractions, 248 fillings, and 1,397 other treatments. Eye, ear, nose, and throat treatments numbered 1,974. Forty-seven surgical operations were performed. Routine sanatorium treatment consisted of rest, regulated diet, and in selected cases, exercise. Work squads, who performed special detail, performed 5,505 hours of labor, and those who took exercise in the form of walking, 578 hours. The earnings of patients privately employed amounted to $4,055.65, while patients convalescent or recovered, who were employed as attendants, received $13,031.04. The work done by the laboratory was largely routine, consisting of examinations of sputa and urine. Specimens of blood have been taken by the laboratory force from a vein in the forearm for transmission to the Hygienic Laboratory for the Wassermann test. It has been found that a small percentage of patients under treatment at Fort Stanton are positive for the Wassermann test. In selected cases, antisyphilitic treatment with neo-salvarsan, salvarsan, and succinimide of mercury has been given with gratifying results. AMUSEMENTS. The moving-picture show of the Amusement Association has been continued, performances being given twice weekly for the benefit of patients and attendants. A number of special entertainments were provided during the year. In the summer of 1916, a baseball team, consisting of nontuberculous attendants, played a number of games with neighboring teams at such times as their duties permitted. A considerable number of patients have, with the permission of this office, organized themselves into a social club, not only with the idea of providing considerable social recreation but with the further idea of building up a spirit of loyalty to the sanatorium and to the Government. This club operates a pool table and at times has given light entertainments in the way of vaudeville performances for the benefit of all patients at Fort Stanton. ECONOMIES. Forty-one and one-half gallons of liquid soap and 3,500 gallons of soft soap were made and used, waste tallow being generally used in the making. Sixty quarts of flavoring extracts for use in the bake shops and kitchen were made in the dispensary, which department also made most of the baking powder used in the station kitchens. The practice of using powder and solid extracts and drugs in stock to make up tinctures has been continued. Twenty-one pillows were remade. Seventy-one hospital pajamas, as well as 328 sheets and 526 pillowcases and 202 kitchen aprons, were made by station labor. |