REPORT OF THE SURGEON-GENERAL. WAR DEPARTMENT, SURGEON-GENERAL'S OFFICE, Washington, D. C., September 9, 1896. SIR: I have the honor to submit the following report of my administration of the duties of this office during the past year. Besides the health of the troops and the sanitary condition of the various military posts, this report relates to certain duties imposed upon the SurgeonGeneral of the Army by the Revised Statutes of the United States and by acts of Congress making appropriations to be disbursed under his direction. Among the expenditures authorized by Congress for the year ended June 30, 1896, were those for artificial limbs and their commutation, for appliances for disabled soldiers, for trusses, for the support and treatment of destitute patients in the city of Washington, D. C., for the Army and Navy General Hospital, Hot Springs, Ark., for the Army Medical Museum and the library of the Surgeon-General's Office, for the construction and repair of hospitals, and for medical and hospital supplies for the use of the Army. ARTIFICIAL LIMBS AND THEIR COMMUTATION. Every officer or enlisted or hired man who has lost a limb or the use of a limb by injury or disease in the line of duty in the military or naval service of the United States is entitled to receive once every three years an artificial limb or apparatus or commutation therefor. A pensioner whose claim has been allowed is entitled to benefit only from the date on which his application was filed in this office; in other words, arrears of commutation dating back to the time of the injury, the onset of the disease, or the date on which pension was granted, are not allowed. When a limb in kind is authorized to be furnished, the beneficiary is entitled to transportation to and from the selected place of manufacture to have the limb fitted. The commutation value of an artificial leg is $75, but transportation is not commuted. Commutation in all other cases, as in disability without amputation of the leg or in amputation or disability of the arm or foot, amounts to $50 in each instance. The laws relating to artificial limbs are the Revised Statutes, sections 4787 to 4791, and the acts approved August 15, 1876, March 3, 1891, and March 2, 1895. During the fiscal year ended June 30, 1896, 21 artificial legs were furnished under the above laws, and commutation was paid in 101 cases of amputated leg, in 69 of amputated arm, and 13 of amputated foot. Commutation was paid also in 2,402 cases in which the use of a limb was lost. The money expended amounted to $135,518.16, of which $127,547.46 was from the appropriation for the year ended June 30, 1896, $7,610.74 from that of the previous year, $392.96 from the appropriation for 1894, and $30 from that of 1893, as follows: It is believed that the appropriation of $575,000 for the year ending June 30, 1897, will suffice to cover the benefits accruing to the pensioners during the current year. The amount required for the year ending June 30, 1898, will be about $183,000. This estimate is based on the fact that of the appropriation of $194,000 for the fiscal year 1895 $184,192.55 was disbursed during that year and $7,610.74 during the year 1896, making a total of $191,803.29 disbursed from the appropriation. As these benefits recur every three years, an appropriation will be required for the year ending June 30, 1898, approximating in amount the sum expended from the appropriation for the year ended June 30, 1895. The actual amount that will be required will depend on the number of those paid in 1895 who are found to have survived the interval of three years. As well as can be learned from the statistics the death rate is about 1.6 per cent annually, or 4.8 per cent for the three years. The estimate for the fiscal year would, therefore, be the amount paid in 1895 lessened by 4.8 per cent, or $183,000. APPLIANCES. The number of appliances issued to disabled soldiers during the year was 162, for which was disbursed the sum of $1,192.15 from the appropriation approved March 2, 1895, with $53.07 from that approved August 18, 1894, a total of $1,245.22. TRUSSES. There was expended in furnishing and fitting trusses to disabled soldiers under sections 1176-78, Revised Statutes of the United States, and the act of March 3, 1879, the sum of $7,699.70. The number of trusses issued and fitted during the year was 1,106. PROVIDENCE HOSPITAL. The act of Congress approved March 2, 1895, appropriated $19,000 for the support and medical treatment of destitute patients in the city of Washington, D. C., under a contract to be made with the Providence Hospital by the Surgeon-General of the Army. The amount of relief afforded under this appropriation was as follows: Patients in hospital July 1, 1895.. Total number treated...... Average number admitted, per month.. Average number of days treatment per patient.. Shortest term of treatment (days). Number of patients in hospital during the whole year.. ARMY AND NAVY GENERAL HOSPITAL. 114 1,206 1, 320 110 105 41, 872 32 114 366 1 19 The capacity of this hospital is 15 beds for officers and 64 for enlisted men. One room in the officers' division has been fitted up as a surgical operating room. Nine officers remained under treatment at the close of the year 1894, 16 were admitted during 1895, 22 were returned to duty or to their former status of sick leave, and 3 remained under treatment December 31, 1895. The 22 officers, who recovered sufficiently to resume their duties or return to their homes, were under treatment an average of fifty-eight days, ranging from eight to one hundred and fifty days. The register does not show the exact condition of these officers on leaving the hospital, as many of them resumed sick leave and only reported for duty when this leave had expired. The largest number of officers under treatment at any one time was 10, the smallest, 1. In the soldiers' division 12 men remained under treatment December 31, 1894, 70 men regularly transferred for treatment and 3 on furlough were admitted, making a total of 85 treated during the calendar year 1895. Of these cases 50 were returned to duty, 15 were discharged for disability, 3 resumed their status on furlough, and 17 remained under treatment at the close of the year. Inquiries made in regard to the 50 men returned to duty six months after they were sent from the hospital showed that 36 were doing duty with their commands or were well at the time they had been discharged for expiration of term of service, 8 had been discharged for disability on account of relapses, and 2 for venereal disease contracted subsequent to their return to duty; 3 were undergoing treatment on account of relapse, and 2 had deserted. Of the 68 completed cases 43 were cases of rheumatism, and of these cases 36 were returned to duty after an average treatment of eightyfive days and 7 were discharged for disability after an average treatment of ninety-five and six-tenths days. The special advantages afforded by the Government in this general hospital in the treatment of the diseases mentioned in Circular No. 16, A. G. O., December 8, 1892, do not seem to be appreciated properly by medical officers of the Army. It is equipped with all the latest and best appliances for the treatment of patients by hydrotherapy, electricity, massage and the Swedish movements. No sanitarium or private establishment at Hot Springs offers any such advantages. It is believed that if cases suitable for treatment at the Springs were sent earlier in the progress of the disease many serious complications might be prevented and a larger percentage of recoveries be effected. The balance, $41.95, on hand July 1, 1895, of the appropriation made by the act approved August 11, 1892, for the improvement and maintenance of the grounds of this hospital was disbursed during the past year. ARMY MEDICAL MUSEUM. The disbursements on behalf of the Museum have been as follows: The total number of specimens in the Army Medical Museum at the end of the fiscal year, June 30, 1896, was 33,746, of which 890 were received during the year. The following statement shows, in detail, the additions and changes in the different sections: |