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THE MARINE HOSPITAL SERVICE OF THE UNITED STATES.
55 provides for the care of its sick seamen by the imposition of a tax of 40 cents per month upon every officer
inst. facial erysipelas set in, but the redness and swelling have now almost completely subsided. Of the fifty-two cases first admitted, only twenty-three Three have died, but all now remain in the infirmary. those who have been discharged have practically recovered, and their wounds are almost, if not quite, healed. Of the cases now in the infirmary, only three can be said to be in a critical condition. The first is the young man whose right arm was amputated just above the condyles of the humerus. The wound in the stump is rapidly granulating up, the temperature is normal, and the appetite is good; but the patient has been severely injured about the head, and has a large lacerated wound over the right forehead. The second case is a young women aged twenty-three, who has sustained fracture of the base of the skull. This patient was completely unconscious for two days, and had at first bleeding from the left ear. She subsequently recovered consciousness, and could answer questions, but has remained in an excitable, restless condition, and frequently wanders and complains of pain when she is touched. She had a recurrence of bleeding from the left ear, and on the 31st ult. she had spasm of the left side of the face, followed by imperfect paralysis, which has persisted. The third case is a woman, aged fifty-four, whose right clavicle was very much comminuted, and who sustained fracture of four or five of the upper ribs on the right side near the sternum. The patient, moreover, was very much bruised about the
ment
and sailor in the mercantile marine serving=afloat. This tax not only suffices to afford medical and surgical aid and hospital accommodation to the sick, but a sufficient margin is left to be expended in the building of new hospitals at various ports as they are found to be required. Under present regulations, the hospital tax is collected at the Custom House in each port, where also the sick sailors apply in the first instance for relief. A medical officer is on duty at the Custom House, whose function it is to examine the candidates for admission, decide as to their eligibility, and send them off to hospital. The report does not record either summarily or in detail the total number of medical officers on this staff, or the places at which they are stationed. The duties of the supervising surgeon(who has his head-quarters at Washington) are both numerous and important. He has been charged with the construction of a code of rules and regulations in consonance with the scope and intent of the Act; to advise the establishment of a. hospital, and the kind of building that should be erected; to collect, check, and summarise the returns and statistics sent in by his colleagues from the outports; and to direct generally the application of the Marine Hospital Fund for the relief of sick and disabled seamen. Certain revised regulations, which came into force about four years ago, define very clearly the duties of the medical as distinguished from the fiscal department, so that no clashing of officials can well occur. It is not necessary to quote many figures9 back. but we may record, as an evidence of the usefulness and There has been a marked absence of inflammatory reac- success of the present system, that during the year 1873 tion in all the cases, the compound fractures included. Many 13,529 sick and disabled seamen received medical and of the wounds healed by first intention, and in one or two surgical aid; 12,697 seamen were maintained in hospital 420,160 days, or an average of about 33 days for each cases only a fine linear scar marks the spot where the lip or hospital patient; and 832 others, who were suffering from the cheek had been cut completely through. All the cases diseases and injuries of a character not requiring treatment of compound fracture are, doing exceedingly well under in hospital, were relieved as out-patients. The average simple treatment. The case of compound comminuted daily number of patients in hospital throughout the year fracture of the ankle-joint in a man aged fifty is in a very was 1151, and the average cost of maintaining and treating each patient was a fraction over 4s. per day. The hospitalsatisfactory state, notwithstanding the occurrence of tax produced last year .B62.170, and it is believed that a secondary hsemorrhage from a wound just behind the outer large percentage of the lawful tax is still lost to the funds, ankle. The wound was closed by means of lint soaked in as masters of vessels make their returns loosely, and appear the blood from the wound, and the limb was fixed on a to have little fear of the penalties named in the law. But back splint. Up to Wednesday last the dressings had not the report is not valuable only in a statistical sense. Besides including papers on the natural history of yellow been disturbed. There is no swelling, heat, or redness fever in the United States, Dr. J. M. Toner (briefly about the foot or ankle. So free, indeed, are they from noticed in THE LANCET of theby 27th of June last), and some these that all the tendons on the front of the foot can be dis- special operations performed in the marine hospital, and tinctly seen. The temperature of the patient has not been on the general condition of the mercantile marine, by above normal. The man who suffered compound fracture of Drs. Minor, Ellmwood, Crampton, and Heber Smith, the the left radius and ulna, notwithstanding an extensive supervising surgeon has contributed a very valuable article on hospitals and hospital construction, to which numerous lacerated wound stripping offa large patch of skin from the sectional and other sketches are appended. It includes, forearm, is doing well. There has, however, been a con- among other useful matter, a detailed account of the prosiderable amount of inflammation in one case, in which a posed marine hospital at San Francisco. Much of the work described has been borrowed from the Herbert and other man aged twenty-seven received a severe lacerated wound, British hospitals, as detailed by Colonel Douglas Galton across the orbit. the into extending right temporal region in his address on Hospital Construction. The authorities, The wound suppurated, and a good deal of grass and dirt however, are all quoted, and the article, as well as the enhas come away in the discharge. The eyeball, however, isI tire report, evinces in its compilation a great deal of care and labour on the part of Dr. Woodworth, who has probably uninjured, and the wound is now closing. At the post-mortem held on the child who died last week: more than enough to do in superintending the details of a without having recovered consciousness, nothing beyond service extending (as he remarks) from the Atlantic to the Pacific, and from the Great Lakes to the Gulf. slight congestion of the pia mater was found. and our The Marine of the Board of ’
.
.
’
,
.
Department
THE MARINE HOSPITAL SERVICE OF THE UNITED STATES. OUR transatlantic
Trade,
kingdom, are now discussing the best means whereby to popularise our own merchant service, now considerably at a discount. Compulsory apprenticeship, training ships, and the abolition of advance notes are all proshipowners
posed
as
all
over
the
remedial agents.
Would it nob be worth while to
neighbours, ahead of us in many take a leaf out of the book that we have just briefly noticed, are most things, decidedly in advance of the old country inand extend systematically the useful practical work that has been done at Greenwich, for fifty years afloat and now for the care of their sick sailors. We have beforet providing ashore, by the Seamen’s Hospital Society ? If returns were us a most elaborate and exhaustive report by Dr. John M. it would be found that the United : forthcoming, Woodworth, the supervising surgeon of the Marine Hospitall spends little more than the United States for her Kingdom sick seaService of the United States -an office that was createdl although the ships of the former, compared with the
only
about three years ago.
.
The United States Govern.
.
men, latter,
are as
ten to
one.
inst. facial erysipelas set in, but the redness and swelling have now almost completely subsided. Of the fifty-two cases first admitted, only twenty-three Three have died, but all now remain in the infirmary. those who have been discharged have practically recovered, and their wounds are almost, if not quite, healed. Of the cases now in the infirmary, only three can be said to be in a critical condition. The first is the young man whose right arm was amputated just above the condyles of the humerus. The wound in the stump is rapidly granulating up, the temperature is normal, and the appetite is good; but the patient has been severely injured about the head, and has a large lacerated wound over the right forehead. The second case is a young women aged twenty-three, who has sustained fracture of the base of the skull. This patient was completely unconscious for two days, and had at first bleeding from the left ear. She subsequently recovered consciousness, and could answer questions, but has remained in an excitable, restless condition, and frequently wanders and complains of pain when she is touched. She had a recurrence of bleeding from the left ear, and on the 31st ult. she had spasm of the left side of the face, followed by imperfect paralysis, which has persisted. The third case is a woman, aged fifty-four, whose right clavicle was very much comminuted, and who sustained fracture of four or five of the upper ribs on the right side near the sternum. The patient, moreover, was very much bruised about the
ment
and sailor in the mercantile marine serving=afloat. This tax not only suffices to afford medical and surgical aid and hospital accommodation to the sick, but a sufficient margin is left to be expended in the building of new hospitals at various ports as they are found to be required. Under present regulations, the hospital tax is collected at the Custom House in each port, where also the sick sailors apply in the first instance for relief. A medical officer is on duty at the Custom House, whose function it is to examine the candidates for admission, decide as to their eligibility, and send them off to hospital. The report does not record either summarily or in detail the total number of medical officers on this staff, or the places at which they are stationed. The duties of the supervising surgeon(who has his head-quarters at Washington) are both numerous and important. He has been charged with the construction of a code of rules and regulations in consonance with the scope and intent of the Act; to advise the establishment of a. hospital, and the kind of building that should be erected; to collect, check, and summarise the returns and statistics sent in by his colleagues from the outports; and to direct generally the application of the Marine Hospital Fund for the relief of sick and disabled seamen. Certain revised regulations, which came into force about four years ago, define very clearly the duties of the medical as distinguished from the fiscal department, so that no clashing of officials can well occur. It is not necessary to quote many figures9 back. but we may record, as an evidence of the usefulness and There has been a marked absence of inflammatory reac- success of the present system, that during the year 1873 tion in all the cases, the compound fractures included. Many 13,529 sick and disabled seamen received medical and of the wounds healed by first intention, and in one or two surgical aid; 12,697 seamen were maintained in hospital 420,160 days, or an average of about 33 days for each cases only a fine linear scar marks the spot where the lip or hospital patient; and 832 others, who were suffering from the cheek had been cut completely through. All the cases diseases and injuries of a character not requiring treatment of compound fracture are, doing exceedingly well under in hospital, were relieved as out-patients. The average simple treatment. The case of compound comminuted daily number of patients in hospital throughout the year fracture of the ankle-joint in a man aged fifty is in a very was 1151, and the average cost of maintaining and treating each patient was a fraction over 4s. per day. The hospitalsatisfactory state, notwithstanding the occurrence of tax produced last year .B62.170, and it is believed that a secondary hsemorrhage from a wound just behind the outer large percentage of the lawful tax is still lost to the funds, ankle. The wound was closed by means of lint soaked in as masters of vessels make their returns loosely, and appear the blood from the wound, and the limb was fixed on a to have little fear of the penalties named in the law. But back splint. Up to Wednesday last the dressings had not the report is not valuable only in a statistical sense. Besides including papers on the natural history of yellow been disturbed. There is no swelling, heat, or redness fever in the United States, Dr. J. M. Toner (briefly about the foot or ankle. So free, indeed, are they from noticed in THE LANCET of theby 27th of June last), and some these that all the tendons on the front of the foot can be dis- special operations performed in the marine hospital, and tinctly seen. The temperature of the patient has not been on the general condition of the mercantile marine, by above normal. The man who suffered compound fracture of Drs. Minor, Ellmwood, Crampton, and Heber Smith, the the left radius and ulna, notwithstanding an extensive supervising surgeon has contributed a very valuable article on hospitals and hospital construction, to which numerous lacerated wound stripping offa large patch of skin from the sectional and other sketches are appended. It includes, forearm, is doing well. There has, however, been a con- among other useful matter, a detailed account of the prosiderable amount of inflammation in one case, in which a posed marine hospital at San Francisco. Much of the work described has been borrowed from the Herbert and other man aged twenty-seven received a severe lacerated wound, British hospitals, as detailed by Colonel Douglas Galton across the orbit. the into extending right temporal region in his address on Hospital Construction. The authorities, The wound suppurated, and a good deal of grass and dirt however, are all quoted, and the article, as well as the enhas come away in the discharge. The eyeball, however, isI tire report, evinces in its compilation a great deal of care and labour on the part of Dr. Woodworth, who has probably uninjured, and the wound is now closing. At the post-mortem held on the child who died last week: more than enough to do in superintending the details of a without having recovered consciousness, nothing beyond service extending (as he remarks) from the Atlantic to the Pacific, and from the Great Lakes to the Gulf. slight congestion of the pia mater was found. and our The Marine of the Board of ’
.
.
’
,
.
Department
THE MARINE HOSPITAL SERVICE OF THE UNITED STATES. OUR transatlantic
Trade,
kingdom, are now discussing the best means whereby to popularise our own merchant service, now considerably at a discount. Compulsory apprenticeship, training ships, and the abolition of advance notes are all proshipowners
posed
as
all
over
the
remedial agents.
Would it nob be worth while to
neighbours, ahead of us in many take a leaf out of the book that we have just briefly noticed, are most things, decidedly in advance of the old country inand extend systematically the useful practical work that has been done at Greenwich, for fifty years afloat and now for the care of their sick sailors. We have beforet providing ashore, by the Seamen’s Hospital Society ? If returns were us a most elaborate and exhaustive report by Dr. John M. it would be found that the United : forthcoming, Woodworth, the supervising surgeon of the Marine Hospitall spends little more than the United States for her Kingdom sick seaService of the United States -an office that was createdl although the ships of the former, compared with the
only
about three years ago.
.
The United States Govern.
.
men, latter,
are as
ten to
one.