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from the kitchen, through the grounds, to the different wards. No means exist for properly heating, lighting, or ventilating the wards. In case of fire the buildings could not resist rapid destruction, and in any emergency it would be impossible to remove all the sick and helpless from the wards before the flames devoured the buildings and inmates."

These illustrations and citations are given with the hope that they may convey some conception of the menacing conditions which confront so worthy a charity. It is proper in this connection to state that some of these buildings are more than 25 years old, and the expenditures made necessary for constant repairs and renovations in an effort to maintain them in a propor condition for hospital work would build at least one modern building of two wards.

From a hospital point of view the out-patient department should be adequately equipped for the treatment of medical and surgical diseases, diseases of the eye, ear, nose, and throat, and diseases of women, in order to give the proper care to all suffering and needy poor who apply. Area ways could be excavated around the basement and four rooms could then be properly constructed in addition to the one room which is in use at present. This would materially facilitate the reception and prompt care of the many dispensary cases. It would, further, give better opportunity for observation of all cases and assist in better classification. Under these circumstances the out-patient department would receive proper treatment under the most favorable conditions, thus preventing their subjection to the depressing effect of witnessing the treatment of those in pain and suffering.

PATHOLOGICAL ROOM.

Bacteriology and pathology play a necessary and important role in successful diagnosis and treatment of diseases. These new methods of scientific investigation, so widely introduced throughout all well-regulated bospitals in the world, have fully demonstrated their usefulness, and this hospital should be abreast with others in furnishing every modern facility for doing such work. There is an urgent need for a pathological laboratory, which should be considered as essential to hospital results as an operating room.

In my last report extended reference was made to the inconvenience incident to the dual management of this hospital, and it was recommended that the honorable Secretary of the Interior request Congress to place the hospital management and finances under the absolute control of the Department of the Interior. Reference was also made to the unhealthy condition of the Government reservation opposite the hospital grounds, with suggestions as to how it might be improved and made a healthful and beautiful park. The necessity of establishing a ward for and authorizing the admission of pay patients was also urged. I desire to reiterate all the former report said on these subjects and renew the recommendations with regard to each.

INTERNES AND NURSES.

While the charity service of this hospital is always its primary object, the possibilities and progress of modern medicine and surgery have brought it into other relations with the public. For this reason it is a cause of profound gratitude that this institution is enabled, while administering to the sick and alleviating suffering, also to exert lasting influence through its interne system and nurse-training school for the

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accomplishment by any other such institution known in this country, Whatever changes time and the wisdom of the legislative branch of our Government may make in the charities of the District of Columbia, there can be no difference of opinion among those citizens most interested in the general welfare of the negro race as to the utility and propriety of continuing Freedmen's Hospital separate and distinct from and indepeudent of any large and general scheme which might be proposed as a substitute for the lesser plants now in operation. Whatever might be said in favor of the unification of all the charities in the District under one head—and there is much to be said in its favor—it is still clear to all observant men that the 90,000 colored residents of Washington and the ambitious negro youth of the country would not receive the same amount of help and encouragement from one general hospital that is now afforded by this plant.

It is to be hoped that Congress can be induced to view this matter in the light of the superior benefits which accrue therefrom to so large a number of an oppressed race; that it will consider how many trained doctors and nurses are scattered all through the United States, - blessing the communities in which they reside, as a result of the experience gained in this hospital, and which experience would have been inaccessible to the great majority of them had not the doors of Freedmen's Hospital been open to them, and that it will soon add to the permanence and growing usefulness of this unique institution by the erection of such modern buildings as will stand for an enduring monument of the National Government's friendly attitude toward a loyal, though unfortunate, class of citizens.

I herewith append the tabulated statistics of the hospital for the year ending June 30, 1899. Respectfully submitted.

A. M. CURTIS,

Surgeon in Chief. Hon. ETHAN A. HITCHCOCK,

Secretary of the Interior.

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practical cultivation of useful and scientific men and women. Since the internes have been exempted from the classified service the method of selection is from those doctors who make application and are graduates from a regular school of medicine. Four are appointed, who have passed a satisfactory examination given by the hospital authorities and whose record has been satisfactory during their college course, and also who appear best fitted for practical work. The internes and externes chosen for the coming year represent the following.medical schools, viz: Long Island Medical College, New York; Leonard Medical College, Raleigh, N. C.; Rush Medical College, Chicago, Ill.; Meharry Medical College, Nashville, Tenn., and Howard University Medical College, Washington, D. C. The appointment of two externes in addition to the four internes has been conducive to a higher order of service. This has been attested in the out-patient department, where during the clinic hours these externes are utilized as dispensary clerks, thus relieving the visiting physician of much extraneous work necessary in the treatment and classification of the cases. They have also proven valuable adjuncts to the internes as assistants in the general ward work of the hospital.

The work of the training school for nurses is steadily gaining recog. nition, as evidenced by the large number of graduates who are constantly employed in private nursing, which clearly demonstrates the value of such training as a practical working basis for young colored women. New fields are also opening, so that the graduates from the school are filling positions as superintendents of nurses to the number of eight in various hospitals recently established in different parts of the country. The annual number of applicants for admission to the training school is constantly increasing, thus permitting a more careful selection of higher-grade applicants. Many of the nurses are graduates of normal schools and seminaries, holding teachers' certificates. Such women elevate the standard of the training school, for obvious reasons, and notably increase the good care and nursing received by the inmates of the hospital, which is the primary object of the training school in connection with hospital nursing.

THE BOARD OF VISITORS.

It is an extreme pleasure that the opportunity is offered to express my warm appreciation of the admirable services rendered by the board of visitors. It is to their untiring efforts and activity in connection with every department of the hospital equipment, as also to their vigilance and complete confidence in its usefulness, that the present etticiency and success of the institution are so largely due. Their personal interest in its welfare has made it possible for me to put into execution the many reforms deemed best for the good of the hospital. It is to be hoped that the progress which has received such impetus from them will continue until Freedmen's Hospital, beneath whose charitable roof so much is being done to alleviate the sufferings of humanity and through whose doors the worthy poor always find a wel. come, shall stand in the very highest rank, presenting an architecture with all the facilities which modern science offers.

In the founding and maintenance of Freedmen's Hospital the Gov. ernment manifests its practical sympathy for the most unfortunate and helpless members of a much-persecuted race, and at the same time encourages the development of negro genius in the broad field of medical investigation and practice in a way that is impossible of

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accomplishment by any other such institution known in this country. Whatever changes time and the wisdom of the legislative branch of our Government may make in the charities of the District of Columbia, there can be no difference of opinion among those citizens most interested in the general welfare of the negro race as to the utility and propriety of continuing Freedmen's Hospital separate and distinct from and independent of any large and general scheme which might be proposed as a substitute for the lesser plants now in operation. Whatever might be said in favor of the unification of all the charities in the District under one head-and there is much to be said in its favor—it is still clear to all observant men that the 90,000 colored residents of Washington and the ambitious negro youth of the country would not receive the same amount of help and encouragement from one general hospital that is now afforded by this plant.

It is to be hoped that Congress can be induced to view this matter in the light of the superior benefits which accrue therefrom to so large a number of an oppressed race; that it will consider how many trained doctors and nurses are scattered all through the United States, blessing the communities in which they reside, as a result of the experience gained in this hospital, and which experience would have been inaccessible to the great majority of them had not the doors of Freedmen's Hospital been open to them, and that it will soon add to the permanence and growing usefulness of this unique institution by the erection of such modern buildings as will stand for an enduring monument of the National Government's friendly attitude toward a loyal, though unfortunate, class of citizens.

I herewith append the tabulated statistics of the hospital for the year ending June 30, 1899. Respectfully submitted.

A. M. CURTIS,

Surgeon in Chief. Hon. ETHAN A. HITCHCOCK,

Secretary of the Interior.

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