Board of Charities account from July 1, 1905, to June 30, 1911.

Statement of the appropriation for salaries required by the sundry civil act approved June 25, 1909 (35 Stats., 992).

An institution of the magnitude of this can not be satisfactorily managed unless properly manned and equipped; nor is it in the interest of efficiency and economy to provide low-grade workmen. Your attention is therefore especially invited to the following needs, and it is urged that such steps as are necessary be taken to secure favorable congressional action therewith.

First is the need of a small building devoted exclusively to the pathological work of the hosnital. This can be provided at a cost of $25,000.

The rapid growth of this institution renders the services of the following additional employees imperative:

If some arrangement can be had whereby employees of the department can be detailed to the hospital, estimates for the engineer and firemen may be eliminated.

An electric ambulance, at a cost of $3,500, to replace the one drawn by horse, should be provided. One of this kind would give greater satisfaction and could be maintained and operated as economically as the present one.

The installation of an ice plant is urged, and $4,000 would cover this need. It is estimated that such a plant would pay for itself in three years.

An ash conveyer is needed to complete the remodeling of the central heating plant. The appropriation of last year for this purpose was not sufficient, and therefore $3,000 is asked.

My recommendation of last year as regards a fence, inclosing the hospital grounds, is renewed. Not only should the grounds be inclosed, but beautified as well, and in such a manner as to adorn the "city beautiful."

There is a growing demand for some provision for pay patients, and my recommendation of last year, touching this matter, is hereby renewed. The Board of Charities of the District of Columbia in discussing this matter in their report of 1910 used the following language, which explains the situation fully:

The Secretary of the Interior, under whose jurisdiction Freedmen's Hospital is conducted, recommends that the hospital be authorized to admit pay patients, and in this recommendation the board concurs. The interest of the board of charities in the matter arises from the fact that this board has a contract with the hospital under which indigent patients are admitted for treatment at the cost of the District of Columbia. Frequently colored persons who are not indigent apply to the board for admission to Freedmen's Hospital. They state that they desire treatment at that particular hospital, that they desire to be cared for by colored physicians and colored nurses, and that no other institution in the city provides such opportunity. Of course this board must deny such applications, because we are authorized to provide for indigent persons only. At the same time we recognize some force in the plea of these colored persons for treatment by nurses and doctors of their own race, for which treatment they are willing to pay. As there is no other hospital in the District of Columbia administered by colored physicians and nurses, it appears to the board that it would be proper for Freedmen's Hospital to admit pay patients. It is customary for public hospitals to admit some private pay patients.

As stated in my report of last year, a new wing to the hospital is the only means by which this class of patients can be satisfactorily cared for, and it will require an appropriation of $60,000 to cover the cost of construction.

TRAINING SCHOOL FOR NURSES.

The school of nursing has completed its seventeenth year of work and is represented by 217 graduates. These women are engaged successfully in private nursing, and not a few are engaged in institutional work in various parts of the country.

The graduating exercises were held in the Andrew Rankin Memorial Chapel May 19, 1911, at which time 13 nurses received their diplomas. It is gratifying to state that the health of the nurses, notwithstanding their crowded quarters, has been generally good, thus permitting the usual routine of classes, lectures, and hospital work to be pursued without interruption.

The course of lectures was delivered by the following staff:

Anatomy-Six lectures, one hour each.
Physiology-Eight lectures, one hour each.
Hygiene-Four lectures, one hour each.
Bandaging-Two lectures, one hour each.

Practical and theoretical nursing-One lecture a week, one hour each, from October 1 to May 1.

SECOND YEAR.

Materia medica-Six lectures, one hour each.

Bacteriology and urinalysis-Five lectures, one hour each.

Medical nursing, including the acute infectious diseases-Five lectures, one hour each.

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Surgical nursing, including anæsthetics-Eight lectures, one hour each.
Dietetics-Ten lectures, one hour each.

Practical and theoretical nursing-One lecture a week, one hour each, from October 1 to May 1.

THIRD YEAR.

Obstetrics-Six lectures, one hour each.

Children's diseases, including the feeding of infants-Four lectures, one hour each. Diseases of the eye-Three lectures, one hour each.

Diseases of the ear, nose, and throat-Four lectures, one hour each.

Gynecology-Six lectures, one hour each.

Nervous diseases-Four lectures, one hour each.

Practical and theoretical nursing-One lecture a week, one hour each, from October 1 to May 1.

First-year practical demonstrations.

[Each lesson one and one-half hours long.]
OCTOBER.

First lesson-Bed making; management of helpless patients-moving, changing giving baths. Second lesson-Note taking; pulse, temperature, respiration, mental condition. Third lesson-The temperature; the thermometer, its use and care; excretions; eruptions.

Fourth lesson-Pulse; quality, rhythm, number, etc.; hypodermic syringe, its care and use.

NOVEMBER.

Fifth lesson-Fomentations; poultices; sand bags; ice cap, its care; ice coil. Sixth lesson-The hot-water bag or bottle, use and abuse; care of instruments, sterilizing, etc.; care of rubber gloves, methods of sterilizing.

Seventh lesson-Administering of enemata, douches, cantharides, etc.; Murphy

infusion.

Eighth lesson-Counter irritations, mustard, cantharides, etc.; physiological action; dry cupping.

Ninth lesson-Hypodermoclysis; intra-venous or infusion; preparation of solution; patient, instruments.

DECEMBER.

Tenth lesson-Positions: Dorsal, Sims, Trendelenberg, Fowler's, knee and chest; lithotomy.

Eleventh lesson-Prevention and treatment of bed sores.
Twelfth lesson-Weights and measures, solutions.

Thirteenth lesson-Disinfection of clothing, excreta, sputum, etc.

JANUARY.

Fourteenth lesson-Bandaging, making and use; material, Esmark.

Fifteenth lesson-Care of patient before, during, and after anathesia.

Sixteenth lesson-Care of patient before, during, and after operation, and preparation of patient for operation.

Seventeenth lesson-Preparation of room for operation, sterilization, etc.

FEBRUARY.

Eighteenth lesson-Urine analysis, specific gravity, quantity reaction, Fehling's and Heller's tests.

Nineteenth lesson-Contagious-disease nursing, care of convalescents, feeding in particular.

Twentieth lesson-Infant feeding, sterilization, pasteurizing, child's first bath, care of eyes, buttocks, etc. Twenty-first lesson-Administration of drugs, use and effect.

MARCH.

Twenty-second lesson-Care of the dead.

Twenty-third lesson-Fumigation.