PEKING UNION MEDICAL COLLEGE HOSPITAL

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1 PEKING UNION MEDICAL COLLEGE HOSPITAL NINETEENTH ANNUAL REPORT OF THE MEDICAL SUPERINTENDENT JUNE 30, 1927 P.U.M.C. PRESS Peking, China

2 127887

3 NINETEENTH ANNUAL REPORT CONTENTS PAGE BOARD OF TRUSTEES AND OFFICERS HOSPITAL STAFF HOSPITAL ADMINISTRATIVE COMMITrEES CHINESE ADVISORY COMMITTEE. PuBLICATIONS BY MEMBERS OF THE HOSPITAL STAFF REPORT OF THE MEDICAL SUPERINTENDENT REPORT OF THE DEPARTMENT OF MEDICINE REPORT OF THE DEPARTMENT OF NEUROLOGY REPORT OF THE DEPARTMENT OF SURGERY REPORT OF THE DEPARTMENT OF OBSTETRICS AND GYNECOLOGY REPORT OF THE DEPARTMENT OF OPHTHALMOLOGY REPORT OF THE DEPARTMENT OF OTOLARYNGOLOGY REPORT OF THE DEPARTMENT OF ROENTGENOLOGY REPORT OF THE DEPARTMENT OF PATHOLOGY REPORT OF THE NURSING SERVICE REPORT OF THE DIETARY SERVICE REPORT OF MEDICAL SOCIAL SERVICE GENERAL INFORMATION CONCERNING RATES AND REGULATIONS COMPLETE LIST OF MEMBERS OF THE RESIDENT HOUSE STAFJ' 3 i i2 is SO ISS TABLES CLASSIFICATION OF DISEASES CLASSIFICATION OF OPERATIONS 8S U7

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5 NINETEENTH ANNUAL REPORT 3 BOARD OF TRUSTEES OFFICERS Chairman SAO-KE ALFRED SZE rice-chairman F. H. HAWKINS Secretary MARGERY K. EGGLESTON Executive Cmmittee GEORGE E. VINCENT, C.lzairman RICHARD M. PEARCE SIMON FLEXNER ARTHUR J. BROWN FRANK MASON NORTH MEMBERS T SeMle until the Annual Meeting f 1930 SIMON FLEXNER JAMES L. BARTON JOHN D. ROCKEFELLER, JR. SAO-KE ALFRED SZE H. H. WEIR T SeMJe until the Annual Meeting f 1929 ARTHUR J. BROWN THOMAS COCHRANE GEORGE E. VINCENT T SeMle until the Annual Meeting f 1928 F. H. HAWKINS PAUL MONROE FRANK MASON NORTH WILLIAM H. WELCH HENRY S. HOUGHTON JAMES S. HOGG Directr f the Peking Unin Medical Cllege Cmptrller j the Peking Unin Medical Cllege

6 PEKING UNION MEDICAL COLLEGE HOSPITAL J. HENG LIU, M.D. SIH-TZE WANG, M.D. *KAI-CHlANG Hsu, M. D. HMABLE E. TOM, R.N. SARA ELIZABETH GRDON, A. B.... OSWALD H. ROBERTSON, S.M., M.D. FIlANClS R. DIEUAIDE, A.B., M. D. **CHARLES W. YOUNG, S.B., M.D. HENRY E. MELENEY, A.B., M.D. "CHESTER NORTH FIlAZIER, S.B., M.D. HARTHER L. KElM, S.M., M.D. CLARENCE A. MILLS, PH.D., M.D. JOHN H. KORNs, A.M., M.D. OTTO WILLNER., M.D. **H. JOCELYN SMYLY, M.A.;M.D., CH.B., L.M., F.R.C.S. (IRE LAND) thhtjohn WILKES HAMMOND, A.B., M.D. HOSPITAL STAFF Ju/;,I, June 30, 1927 ADMINISTRATION DEPARTMENT OF MEDICINE Medical Superintendent Assistant Medical Superintendent Assistant t the Medical Superintendent Admitting Officer (On furlugh t January 1, 1927) Acting Admitting Officer Prfessr f Medicine and Head f the Department (Resigned September 30, 1926) Prfessr f Medicine and Acting Head f the Department Assciate Prfessr f Medicine (On furlugh frm January 10, 1926 t N "Uember 30, 1926) Assciate Prfessr f Medicine Assciate Prfessr f Dermatlgy and Syphillgy (On furlugh frm July 17, 1926 t September 29, 1927) Assciate Prfessr f Dermatlgy and Syphillgy Assciate Prfessr f Medicine Assistant Prfessr f Medicine Assistant Prfessr f Medicine and Cllege Physician Assciate in Medicine (On furlugh t February 1, 1927) Assciate in Pediatrics (Resigned July 21, 1926) *Appintcd January HOn furlukh ***ResilrDed

7 NINETEENTH ANNUAL REPORT 5 RICHARD HO-P'ING SIA, S.B., M.D. RVTH ALLINE GUY, A.B., M.D. ERNf:ST SHEN-CHIH Ts, M.D. SHU-TAl T. W, M.D. "SHEO-NAN CHEER, A.B., M.D. DEPARTMENT OF MEDICINE (Cncluded) ARTHEMY A. HORVATH, VET. SCI. M., ApPL. CHEM. B. FOONG-KONG CHEN, M.A.,M.B., CH.B. CHUNG-UN LEE, M.B., CH.B., D.T.M. AND H. TSUN-CHI SHEN, M.D. PAO-YUNG LIU, M.D. CHI-CH'ENG LIU, M.D. SCHMORL M. LING, M.D. KANG-LIANG Hsu, M.D. GEORGE Y. C. Lu, M.D. HSIUNG-WU KWEI, M.D. ****GILES A. M. HALL, M.B. KUANG-HSUN Ll, M. D. SHIH-HAO LIU, M. D. JUl-WU Mu, M. D. CHEN-LANG TUNG, A.B., M.D. KATHERINE T. CHEN, M.D. K'uEl CHIA, M.D. AU,BELLA S. GAULT, M.D. eh'i-liang Hsu, M.D. DANIEL G. LAI, M.D. CHI-SHIH YANG, M. D. HUI-CHING YEN, M.D. JAMES L. ALLOWAY, M.D. HOn furlurh *""Prmtcd t Instructr n January Assciate in Medicine Assciate in Medicine Assciate in Pediatrics Assciate in Medicine Assciate in Medicine (Onfurluglt t Fehruary, 1928) Assciate in Chemistry in the Department f Medicine Assciate in Dermatlgy and Syphillgy Assciate in Medicine Instructr in Medicine Assistant in Medicine (Kala-Azar). Part-time Assistant in Medicine Assistant in Medicine Assistant in Pediatrics Assistant in Medicine Assistant in Medicine, Cllege Health Service. Assistant in Dermatlgy and Syphillgy. Assistant in Medicine Assistant in Medicine and Resident Assistant in Dermatlgy and Syphillgy Assistant in Medicine, Cllege Health Service Assistant Resident Assistant Resident Assistant Resident (Until September 15,1926) Assistant Resident (Resigned December 31, 1926) Assistant Resident (Until Octber 15, 1926) Assistant Resident _. Assistant Resident Assistant Resident (Frm Octber 15, 1926)

8 6 PEKING UNION MEDICAL COLLEGE HOSPITAL DEPARTMENT OF NEUROLOGY ANDREW H. WOODS, A.B., M.D. ERNST DE VRIES, M.D. ***MON-FAH CHUNG, M.D. YUNG-KANG WANG, M.D. YU-LIN WEI, M. D. Prfessr f Neurlgy and Head f the Department Assciate in Neurlgy Assistant in Neurlgy ( Resigned September 30, 1926) Assistant in Neurlgy Assistant in Neurlgy and Assistant Resident ADRIAN S. TAYLOR, M.D., F.A.C.S. GEORGE W. VAN GORDER, A.B., M.D. **BERT G. ANDERSON, D.D.S. *GEORGE Y. CHAR, S.B., M.D. HOUGHTON HOLLIDAY, A.B., D.D.S **ZUNG-DAU ZAU, M.D. HAROLD H. LUCKS, A. B., M.D. TA-CHUN YANG, M.D. SUNG-TAO KWAN, M.D. CHI-MAO M ENG, M. D. JAMES K. SHEN, M.D. WENDELL J. STAINSBY, M.D. ROBERT CORMACK, M.D. PING-CH'I TUNG, M. D. ANDREW H. K. WANG, M.D. DEPARTMENT OF SURGERY Prfessr f Surgery and Head f the Department Assciate Prfessr f Surgery Assistant Prfessr f Oral Surgery ~(Onfurlugh t September, 1927) Assciate in Surgery (Appinted Clinical A.uaate in Surgery May 1, 1927) Assciate in Oral Surgery Assciate in Surgery (On furlugh t September, 1927) Assciate in Surgery Assistant in Surgery Assistant in Surgery and Resident Assistant Resident Assistant Resident Assistant Resident Assistant Resident (Frm September 1, 1926) Assistant Resident Assistant Resident (Until Augun 31, 1926) DEPARTMENT OF OBSTETRICS AND GYNECOLOGY J. PRESTON MAXWELL, M.D., B.S., (LOND.), L.R.C.P., F.R.C.S. (ENG.) *Appinted Clinical ASlOCia!c in Sur2"cry May **On furjn~b Re.ifTlcd. Prfessr f Obstetrics and Gyneclgy and Head f the Department

9 NINETEENTH ANNUAL REPORT 1 DEPARTMENT OF OBSTETRICS AND GYNECOLOGY (Cncluded) NICHOLSON J. EASTMAN, A.B., M.D. PAUL E. LOUDENSLAGER, A.B., M.D. SUCHEN WANG, M. D. SHIH-WEI LI, M.D. HSUEH-HUI SHIH, M.D. Assciate in Obstetrics and Gyneclgy Instructr in Obstetrics and Gyneclgy Assistant in Obstetrics and Gyneclgy and Resident Assistant Resident Assistant Resident DEPARTMENT OF OPHTHALMOLOGY HARVEY J. HOWARD, A.M., M.D., OPH.D., F.A.C.S. ***TSING-MEU LI, M.D. HUA-TEH PI, M.D. WEN-PING LING, M.D. TAN-PIEW LEE, A.B., M.D. PETER S. SOUDAKOFF, B. PH., M.D. PAO-PING LIANG, M.D. RICHARD Y Y. CHIANG, M.D. CHIH-HUAN LING, M.D. Prfessr f Ophthalmlgy and Head f the Department Assciate Prfessr f Ophthalmlgy ( Resigned M'V', 1927) Assistant in Ophthalmlgy Assistant in Ophthalmlgy Assistant in Ophthalmlgy Assistant in Ophthalmlgy Assistant in Ophthalmlgy Assistant Resident Assistant Resident DEPARTMENT OF OTOLARYNGOLOGY A. M. DUNLAP, A.B., M.D. JUI-HUA LlU, M.D. SHIH-EN KA, M.D. TZE KING, M.D. YUNG-HAO TING, M.D. MAO-LIEN Hu, M.D. SHIH-PIN TSEN, M.D. SHIH-HSI LIN, M. D Prfessr f Otlarynglgy and Head f the Department Assciate in Otlarynglgy AssiStant in Otlarynglgy Assistant in Otlarynglgy Assistant in Otlarynglgy ASs1stant in Otlarynglgy and Assistant Resident Assistant Resident (Until September 30, 1926) Assistant Resident (Frm Octber 1, 1926) DEPARTMENT OF ROENTGENOLOGY PAUL C. HODGES, PH. D., M.D. CHIH-KUANG HSIEH, M.S., M.D. *** ReeiVled Assciate Prfessr f Rentgenlgy and Head f the Department Assistant in Rentgenlgy

10 8 PEKING UNION MEDICAL COLLEGE HOSPITAL DEPARTMENT OF ROENTGENOLOGY (Cncluded)' tth-shan WANG, S. B. LULA A. SWEET, R. N. CHING Wu, M.D. Assistant in Rentgenlgy Labratry Assi$mt, Department f Rentgenlgy A ssistant Resident DEPARTMENT OF PATHOLOGY CARL TENBROECK, A.B., M.D. ERNEST CARROLL FAUST, PH.D. JAMES R. CASH, A.M., M.D. HCHONG-EANG LIM, M.B., S.B., DR. P.H., D.T.M. CHEN-HSIANG Hu, M.D. JOHN F. KESSEL, PH.D. HANS SMETANA, M.D. DOROTHY HUlE, A.M. HYu, M.D. CHEN-PIEN LI, M.D. KE-FANG YAO, M.D. YIN-TANG Hsu, M.D. SWEE-NGOR LIM HOSMER F. JOHNSON, M.D. DAVID H. KIANG, M.D. K. B. LIU, M.D. SAMUEL H. ZIA, M.D. Prfessr f Bacterilgy and Acting Head f the Department A ssciate Prfessr f Parasitlgy Assciate Prfessr f Pathlgy Assciate in Bacterilgy (On furlugh t Odber, 1927) Assciate in Pathlgy Assciate in Parasitlgy Assciate in Pathlgy Assistant in Bacterilgy Assistant in Bacterilgy Assistant in Bacterilgy Assistant in Parasitlgy Assistant in Pathlgy Senir Technician in Pathlgy Assistant Resident (Until Nvember 30, 1926) Assistant Resident Assistant Resident Assistant Resident DAVID L. EDSALL, A. B., M.D., D.Sc. Visiting Prfessr f Medicine CHARLES M. OMAN, M.D., COM MANDER U.S.N. ULYS ROBERT WEBB, M. D., U.S.N. Hnrary Lecturer in Surgery (until December 31, 1926) HQnrary Lecturer in Surgery (frm January 1, 1927) *In cbar 'c f the Phtfraphic Bureau **On furlu 'h

11 NINETEENTH ANNUAL REPORT 9 Ser<uice Begun INTERNES Servia Ended July 1, 1926 JAMES L. ALLOWAY Octber 31, 1927 July 21, 1926 BENJAMIN C.M. BAU May 29, 1927 September 1, 1926 CHANG HSI-CHUN June 10, 1927 July 1, 1926 *CH~EN HENG-I July 31, 1926 July 1, 1926 CH'EN SHUN-MING June 30, 1927 July 1, 1926 CHU FU-T'ANG June 30, 1927 August 1, 1926 Du SWUN-LEH June 30, 1927 July 1, 1926 FANG I-CHI June 30, 1927 August 1, 1926 F RNANDO FELlNO June 20, 1927 August 1, 1926 MARIAN P FIROR June 24, 1921 July 21, 1926 LEDA R. Fx June 30, 1927 September 1, 1926 YOUNG D. HAHN June 30, 1927 July 1, 1926 HSUEH PEl-CHI June 30, 1927 September 1, 1926 Hu CH'UAN-lC'UEl June 30, 1927 July 1, ]926 *K' ANG HSl-JUNG August 31, 1926 August 1, 1926 GORDON B. LEITCH June 17, 1927 August 1, 1926 CLARENCE MAGUIRE June 17, 1927 July 1, 1926 NI YIN-YUAN June 30, 1927 July 1, 1926 SHEN CHI-YlNG June 30, 1921 July 1, 1926 SHIH CHINC.-1EN March 8, 1927 July 1, 1926 *T' ANG HAN-CHIH August 31, 1926 July 1, 1926 YAl TlLAKA June 20, 1927 July 1, 1926 WAN FU-EN June 30, 1927 July 1, 1926 YUAN I-CHIN June 30, 1927 *Spl!clal internet

12 10 PEKING UNION MEDICAL COLLEGE HOSPITAL NURSIN G SERVICE (As f June 30, 1927) RUTH InGRAM, A.M., R.N. Superintendent f Nurses MARY S. PuRCELL, R.N. First Assistant Superintendent f Nurses ETHEL E. ROBINSON, R. N. Secnd Assistant Superintendent f Nurses ELVIRA FILANDINO, R.N. Night Supervisr ARMEDA COLVER, R.N. Head Nurse, Surgical Supply Rm WINIFRED V GODARD, R. N. Head Nurse, Operating Rm GLA~YS LEMON HOLLAND, R.N. Head Nurse, Obstetrical Ward JEN HSING-KUO Head Nurse, Men's Mixed Ward MARJORIE JOSSELYN, R.N. Head Nurse, Admissin Ward KA U-HWA Head Nurse, Men's Surgical Ward HELEN F. LATIMER, R.N. Head Nurse, Men's Medical Ward EVELYN LIN, N.A. C. Head Nurse, Wmen's Mixed Ward EDITH RINELL, R. N. Head Nurse, Children's Ward MARY B. SCOTT, R.N. Head Nurse, Private Ward ADELAIDE L. TUTTLE, A.B., R.N. Head Nurse, Outpatient Department ELSIE WAUNG, N.A.C. Head Nurse, Metablism Ward MARY YANG _ Acting Head Nurse, Islatin Ward KATHLEEN U, N.A.C. Head Nurse, Semi-private Ward Ku ]UNG-HSUN. Assistant t Head Nurse in Operating Rm La U-LIN Assistant t Head Nurse in Surgical Supply Rm FRANCES CH'AO, N.A.C. ADA CHEO, N.A. C. ESTHER E. KREPS, R. N. HAZEL LIU, N.A.C. STAFF NURSES Freign-trained r P. U. M. C. Graduates SVEA LINDBERG, N.A. C. VERA NIEH, N.A.C. KATHRYN D. Rss, R.N. RAVENA TIEN, N.A.C. Graduate Wmen CHANG CHIEN-CHING CHANG CHUN-YEN CHANG MEI-YU CHANG U-CHIEH CHANG YUAN-MING CHAO EN-MI:>lG LIANG HSIU-YUN LIN PAl-CHING LIU CHOU HUEI-FANG LIU YUEH-PU LOH YUEH-YIN LONG ZUNG-YUIN

13 NINETEENTH ANNUAL REPORT 11 STAFF NURSES (Cncluded) Graduate Wmen (Cncluded) CHAO KWEI-YUNG CHEN AI-CHIH CHEN HSIU-YUN CHEN YU-CHEN CHEN YU-HUA CHEN YUNG-AN CHENG Al-M I CHENG HSIAO-PO CH'l PAO-SHAN CHIN KUEI-YU CHING KENG CHING KUEI-TING CHING WEN-SHENG CHU PAO-CHU H FU-TEH H TING-HUA HSIAO LIEN-CHU Hsu SU-CHING Hsu WEN-TIEN HUANG CHIEN-YING HUANG TUAN-CHEN LI CHEN-YU LI CHING-HSING LI CHING-YI LI PU-CHIEH PAl P HSIU-CHEN PI CHUN-TE SHAO CHEN-TE SHAO LIEN-YING SHEN T AN-HUA SHENG YU-CHEN SHIH JUI-CHEN SONG MEl-YUAN SUN HSIU-TEH TIEN YU-HUA TING KWEI-CHEN TSUI HsIU-JUI TUNG YU-HSIU TUNG YU-JUNG WANG HAl-LAN WANG HSIANG-SHAN WANG jun-lan WANG PEl-LIEN WANG SU-YUN WOO CHING YANG LAN-CHING YANG MEI-FU YANG YUNG-CHIO Yu I-sHO Yu MI-YUN Graduate Men CHANG CHING-HSIN CHANG HSIEN CHANG PO-AN CHANG SHANG-KE CHAO CHIAO CHI CHENG-CHUN CHOU I-HO CHU CHI-YUNG ehu PAO-TSAI FANG HOU-DJI Hu YU-SAN HUANG CHEN-TUNG HUANG CHUNG LI ju-chieh LI WEI-KANG MA HSI-HOU PAl TEH-YI PAl T SUN CHIN-CH'ENG SUN YEN-CHUNG T' ANG CHUN-LlANG WANG CHAO-YUNG \ ANG KE-Mll\G WANG TEH-PU WANG TSAO-HSIN Wu YAH-PO YIH CHEN-MEl

14 12 PEKING UNION.MEDICAL eollege HOSPITAL DIETARY ADMINISTRATION KWE-PAU HUANG, PH.B. ALBERTA SHAFER, RS. LOUISE KWONG Dietitian Assistant Dietitian Assistant t the Dietitian PHARMACY JOHN CAMERON, F.C.S.,.PH.C., M.P.S. (LOND.) MOODY MENG, PH. C., MIP;S. Supervisr f the Pharmacy Assistant Pharmacist MEDICAL SOCIAL SERVICE.IDA PRUITT, A.B., S.B. ISABEL INGRAM, A.B. KE-CHUN CH'EN, M.A., M.S. Medical Scial Service Wrker Assistant Medical Scial Service,"rrker (&signed February 26, 1927) Assi!>'taDt Medical Scial Service Wrker 'OTHER OFFICERS *ithelen M. HOLLAND, R.N. EDITH C. HUANG, PED.B., PH.B., R.N. ANNA LOH, R.N. ALEXANDER BARANOFF, O.S. STEPHEN WANG, A.B. I. S. CHANG A. N. STERNBERG SARA ELIZABETH GORDON, A.B. Anesthetist Matrn Physitherapist Oral Hygienist, Department f Surgery Custdian f Recrds Secretary t the Superintendent f Nurses Secretary, Student and Staff Health and Private Cnsultatin 'Service Secretary t the Medical Superintendent itretumcd frm fur)u~h March thtretumcd frm furlufh December

15 NINETEENTH AN NUAL REPORT HOSPITAL ADMINISTRATIVE COMMITTEES COMMITTEE ON THE HOSPITAL ]. RENG LIU, Chairman F. R. DIEUAIDE J. P. MAXWELL A. S. TAYLOR CLINICAL RECORDS COMMITTEE ]. H. KORNS, Chairman T M. LI G. W VAN GORDER COM MITTEE ON THE OUTPATlENT DEPARTMENT S. T WANG, Chairman RICHARD H. P. SIA GEORGE Y CHAR R. T. PI

16 14 PEKING UNION MEDICAL COLLEGE HOSPITAL CHINESE ADVISORY COMMITTEE OFFICERS Chairman Minister t Germany (1908); Gvernr f Shantung ( ); Minister f Freign Affairs (1913); Acting Premier (1914); President f the Bard f Audit (1915); Minister f Finance'(1916); Cmptrller-General f the Revenue Cuncil ( ); Premier ( ); appinted Ambassadr t Russia (1925). CHOU YI-CH'UN (Y T TsuR) A.B., A.M., Lrrr.D., &cretary Graduate f Saint Jhn's University, Shanghai (1903); and f Yale University, (1909); graduate student at the University f Wiscnsin (1910); President f Tsing Hua Cllege ( ); Secretary f the President's Office ( ); Chief Secretary f the C~missin fr the Readjustment f Finance (1923- ). CHANG PO-LING, LITT. D. MEMBERS Graduate f the Tientsin Naval Academy; graduate student at Clumbia University; President f Nankai Cllege. *CHIH CH'} Manchu nbleman; Junir Secretary f the Bard f Public Wrks, Ching Dynasty; an exile fr cnnectin with the Refrm Mvement (1898); Editr f Nanfan Pa and Managing Directr f Hu Pa, Shanghai; Tartar-General f the Blue Bannermen Crps (1913); in charge f relief wrk fr destitute Manchus. CH'UAN SHAO-CH'ING, M.D. Graduate f Peiyang Medical Schl; graduate student f the Jhns Hpkins University and f Harvard University; Medical fficer f a diplmatic missin t Tibet (1911); Advisr t the Ministry f War ( ); President f the Army Medical Cllege ( ); Vice-Minister f Educatin (1922); Directr f the Department f Public Health, Tsingta (1924- ). *Deceased. June 1927.

17 NINETEENTH ANNUAL REPORT 1'5 FAN YUAN-LIEN Graduate f the 'Shi-wu schl f Hunan; gradjate f the Higher Nrmal Cllege, Tky, Japan; Vice-Minister and Minister f Educatin (1912); Minister f Educatin (1916); studying educatinal cnditins in America and Eurpe ( ); President f the Natinal Nrmal University, Peking, ( ); Directr f the China Fundatin fr the Prmtin f Educatin and Culture (1925- ). HSIUNG HSI-LING Hanlin Schlar; fr sme time a student in Japan; travelled in Eurpe and America studying cnstitutinal gvernment and public finance (1905); Industrial Cmmissiner, Kiangsu and F engtien (1906); Cmmissiner f Freign Affairs, Hupeh (1910); Superintendent f Finance and Salt Cmmissiner, Manchuria ( 1910) ; Minister f Finance (1912); Prime Minister (1913); Directer-General f Mines (1914); President f the Administrative Curt (1914); Directr-General f the Chihli River Cnservancy Cmmissin () 924- ); actively interested in numerus educatinal and philanthrpic institutins. Ts' AI T'ING-KAN Member f the pineer student grup taken t America in 1873 by Dr. Yung Wing; a member f the naval service since his return t China in 1881; Senir Staff Member f the Navy (1912); Vice Admiral (1912); Chief Auditr f the Salt Administratin (1913); Assistant Directr-General f the Revenue Cuncil ( ) ; Directr-General f the Revenue Cuncil (1924- ); Assistant Grand Master f Ceremnies t the president (1914- ). WANG CHING-CH'U!\, Ph B. in C.E., M.A., and Ph. D. Student f Peking University, graduate f Yale University and pstgraduate student f the University f Illinis. Directr f Peking Mukden and Peking-Hankw Railways ( ); Technical Delegate f the Chinese Gvernment at the Paris Peace Cnference (1919); Directr-General, Chinese Gvernment Railways; Directr General, Chinese Eastern Railway.

18 16 PEKING UNION MEDICAL COLLEGE HOSPITAL YEN HUI-CH'ING CW- W YEN). A. B., LL. D. Graduate f the University f Virginia (1899) ; Prfessr f Lgic and Mathematics at St. Jhn's University; Editr f Nangfang Pa; Editr-in-Chief f the Chinese Editin f Webster's Dictinary; Hanlin Schlar; First Secretary at the Chinese Legatin, Washingtn; Minister t G~rmany and Denmark ( Y20); MiniSter f Freign Affairs (1920); Acting Premier (1921); Premier (1922); Minister f Agriculture and Cmmerce (1924); Chairman f the Cmmissin fr the Readjustment f Finance (1924- ); Delegate t the Chinese Custms Tariff Cnference (1925- )

19 NINETEENTH ANNUAL REPORT 17 PUBLICATIONS BY MEMBERS OF THE HOSPITAL STAFF* July 1, June 30, 1927 Jhannes H. Bauer, T'ang Fei-fang, Yii H, and Carl TenBreck (J. Bauer, F- T'ang, H. Yii, and C. TenBreck) The serlgical types f tetanus bacilli fund in China. (Abstract) Transactins Sixth CngreJs Far Eastern ASJdatin Trpical Medicine, Septemher, Jhn Camern Sme bservatins n pharmacy in Great Britain_ Pharmaceutical Jurnal (Lndn), JJ.ugust, 1926_ The danger f purchasing anywhere. China Medical Jurnal, Decemher, Pharmacy in China in 1927_ JJ.meriCaTl Druggist, March, A pharmaceutical aspect f China in JJ.merican Jurnal f Pharmacy, March, Adulteratins. China Medical Jurnal, April, Pharmaceutical sterilizatin. China Medical Jurnal, April, A few practical suggestins fr hspital pharmacies in China. China Medical Jurnal, MI.{Y and June James R. Cash (J. R. Cash) Vital staining characteristics f the epitheliid cells in experimental tuberculsis. Prceedings Sciety fr Experimental 13ilgy and Medicine, Decemher, 1926_ Cheer She-nan and Gerge Y C. Liu (S_ N_ Cheer and Y. T L) Bld transfusin as ne f the therapeutic measures in general practice. Natinal Medical Jurnal f China, April, *In rder t amid any ambil!"uity. the name f authr is lrh'en in parentheses after the name mre cmmnly used.

20 11 PEKING UNION MEDICAL COLLEGE HOSPITAL Chen Fng-kng (Fng K. Chen) The diagnsis f early syphilis. China Medical Jurnal, January, W W Crt, Jhn B. Grant, Nrman R. Stll, and ther cllabratrs. (W W. CORT, J. B. GRANT, N. R. STOLL, ETC.) Researches n hkwrm in China. (Mngraph) American Jurnal f Hygiene, Mngraph Series, Odber, CHUNG MON-FAH A study f thirty-fur cases f rapidly develping paraplegia. Archives Dermatlgy and Syphillgy, August, Thrmbsis f the spinal vessels in sudden syphilitic paraplegia. Archives Neurlgy and Psychiatry, Decemher, ( A different presentatin f the ahve) ERNEST DEVRIES Friihembrynale Ursache vn Missbildungen des Nervensysterns. Schweizer Archi'Ves fur Neurlgie und Psychiatric, Nervus cmplicatins in pernicius malaria. China Medical Jurnal, June, FRANCIS R. DIEUAIDE The bichemical trend in medicine. China Medical Jurnal, July, ALBERT M. DUNLAP CA. M. DUNLAP) Clinical bservatins regarding pst-perative treatment f streptcccus hemlyticus. China Medical Jurnal, Fehruary, Clinical experience in using the transilluminatr in the Peking Unin Medical Cllege. China Medical Jurnal, May, NICHOLSON J. EASTMAN The bld sedimentatin test in the puerperium. China Medical Jurnal, June, 1927.

21 NINETEENTH ANNUAL REPORT 19 Ernest Carrll Faust The epidemilgy f Clnrchis infectin in China. Tra,uactins Far Eastern Assciatin Trpical Medicine, September, Parasitic infectins and human disease in China. Archi'VeJ Pathlgy, Augwt, An inquiry int the prevalence f malaria in China. China Medical Jurnal, Octber, Fresh-water fish as a surce f hujlan parasitic infectin. China Jurnal, January, Thelazia infectin f man and mammals in China. Tran.IactinJ Ryal Sciety Trpical Medicine and Hygiene, January, 1927 Ernest Carrll Faust and Khaw O-keh, assisted by Ya Ke-fang and Cha Yung-en (Ernest Carrll Faust, O. K. Khaw, K. F. Ya, Y E. Cha) Studies n Clnrchis sinensis (Cbbld). (Mngraph) American Jurnal Hygiene, Mngraph Series, N.8, March, 1927 Ernest Carrll Faust and Masa Nishigri Life cycle f the tw new species f HeterphJ,idae, parasitic in mammals and birds. Jurnal Parasitlgy, December, Ernest Carrll Faust and Ya Ke-fang (Ernest Carrll Faust and K. F Ya) Specific therapeusis in Clnrchis infectins. Archirves Schiffs und Trpm-kvgiene, September, Chester N. Frazier Purpuric vesiculbullus dermatitis. Jurnal American Medical ASJciatin, February', 1927, Arthur T Hertig and Marshall Hertig A technique fr the artificial feeding f sandflies (Phlebtmus) and msquites. Science, April, 1927.

22 20 PEKING UNION MEDICAL COLLEGE HOSPITAL Arthemy A. Hrvath CA. A. Hrvath) A new methd fr the determinatin f fat in sybean milk. China Medical Jurnal, July, 1926 Ammnia and bld sug-ar. Jurnal Bilgical ChemiJtry, Octber, 1926 Prductin f hyperglycemic!- in rabbits by subcutaneus injectin f mag-nesium salts. Prceedings Sciety fr Experimental Bilgy and Medicine, December, 1926 The effect f turnip-juice n avian plyneuritis. The Japan Medical Wrld, March 15, The effect f turnips and turnip juice n the bld sug-ar, phsphrus and chlesterl f rabbits. American Jurnal Physilg:)',!une, The presence and rle f the CN and DCN grups in the rganism. Beridrte uber die Wi.s.ren. Bilgie, June 29, Arthemy A. Hrvath and Chang Hsia-ch'ien CA. A. Hrvath and H. C. Chang-) The effect f sybean feeding n the bld lipase f rabbits. Transactins Si~th Cngress Far Eastern AJJciatin Trpical Medicine, September, American Jurnal Phpilgy, September, Arthemy A. Hrvath and Liu Shih-ha (A. A. Hrvath and Liu Shih-ha) Effect f sy sauce n bld sug-ar and phsphrus. The Japan Medical Wrld, April 15, HARVEY ]. HOWARD Sme imprtant but inexpensive eye apparatus fr the general practitin er. China Medical Jurnal, July, Electrlysis f wild eyelashes. China Medical Jurnal, April, Nn-specific prtein therapy in eye inbammatins with special reference t the use f typhid vaccine. China Medical Jurnal, May, 1927.

23 NINETEENTH AN NUAL REPORT 21 Harvey J. Hward and Lee Tan-piew (H. J. Hward and T P. Lee) The effect f instillatins f ephedrine slutin upn the eye. Prceedings Sciety fr Experimental Bilgy and Medicine, April, Harvey J. Hward and C. A. Mills (H. J. Hward and C. A. Mills) Bld changes fllwing injectins f typhid-paratyphid vaccme. (Preliminary reprt) Prceedings Sciety jr Experimental Bilgy and Medicine, April, Hu Chen-hsiang and James R. Cash (C. H. Hu and J. R. Cash) Cnsideratins upn the relatinship f the reticul-endthelial system t kala-azar. Prceeding! Sciety jr Experimental Bilgy and Medicine, March, RUTH INGRAM Schl f Nursing f the Peking Unin Medical Clle~e. Internatinal Nursing Quarlerfy, April, JOHN F. KESSEL The dmestic pig as a prbable reservir hst f the dysentery ameba f men. (Abstract) Transactins Sixth CngreSJ Far Eastern ASJciatin Trpical Medicinl, September, Trichmniasis in kittens. Prceedings Sciety fr Experimental Bilgy and Medicine, December, KHAW O-KEH (0. K. KHAw) Studies n the egg-miracidium stage f the life-histry f Clnrchis sinensis (Cbbld). Transactins Sixth Cngreu Far Eastern Auciatin Trpical Medicine, Septemher, JOHN H. KORNS Case data regarding serfibrinus pleurisy f tuberculus r bscure rigin. China Medical Jurnal, September, 1926.

24 22 PEKING UNION MEDICAL COLLEGE HOSPITAL JOHN H. KORNS AND GEORGE Y C. Lu (JOHN H. KORNS AND Y C. Lu) The use f the hamster in tht- diagnsis f certain frms f tuberculsis. China- Medical Jurnal, March, Susceptibility f the hamster t tuberculus infectin. Prceeding.r Sciety fr Experimental Bilgy ana Medicine, June, HENRY W. KUMM The treatment f fungus cerebri by skin graft, with reprt f a case. China Medical Jurnal, Nvember, LEE CHUNG-UN (C. u. LEE) Filiariasis investigatins in the Prvince f Kiangsu, China. Tran.racUnJ Ryal Sciety Trpical Medicine and Hygiene, Nvember 25, LEE T A N-PIEW (T. P. LEE) A simple apparatus fr determining the near pint f accmdatin and the astigmatic axis. Archive.! Ophthalmlgy, July, LI TSING-MEU (T M. LI) The early diagnsis f trachma. China Medical Jurnal, Nvemher, LIM CHONG-EANG (C. E. LIM) The effect f age and temperature n the antigenic prperties f diphtheria txin antitxin mixture. (Abstract) Tran.radin.r Sixth Cngress Far Eastern A.r.rciatin Trpical Medicine, September, Islatin f M. melitensis frm patients in China. (Abstract) Ibid. Chinese maritime quarantine (Abstract) Ibid. LIM CHONG-EANG AND YAO KE-FANG (C. E. LIM AND KEFANG YAO). A simple and rapid methd f bld matching fr the selectin f a suitable dnr. China Medical Jurnal, June, 1927.

25 NINETEENTH ANNUAL REPORT 23 'ROBERT K. S. LIM, PAUL C. HODGES, Lu CHIH-TEH, AND RUSSELL G. BIRRELL (R.K.S. LIM, P.C. HODGES, C.T L, AND R. G. BIRRELL) The influence f cnstipatin and exercise n the basal r interdigestive secretin f the stmach. (Abstract) Transactins Sixth Cngress Far Eastern ASJciatin Trpical Medicine, Sepemher, SVEA A. LINDBERG The use f tissue fibringen in the treatment f hemrrhage. Quarterly Jurnal f Chinese Nurses, Junl, SCHMORL M. LING The determinatin f prtein in spinal fluid, with a nte n the increase in prtein in the spinal fluid in typhus fever. Jurnal Bilgical Chemistry. August, Is uricase present in sy beans? Prceedings Scietyfr Experimental Bilgy and Medicine, April, LING WEN-PING (W P. LING) Spntaneus healing f syphilma f the ciliary bdy. China Medical Jurnal, April, LIU SHIH-HAD The parathyrid hrmne - a review f recent literature. Natinal Medical Jurnal f China, Octher, The partitin f serum calcium int diffusible and nn-diffusible prtins. (Preliminary reprt) Prceedings Sciety fr Experimental Bilgy and Medicine, June, LIU SHIH-HAD AND ARABELLA S. GAULT (LIU SHIH-HAD AND A. S. GAULT) Acute mercuric chlride pisning, with reprt f a ~ase. Natinal Medical Jurnal f China, August, LIU SHIH-HAD AND C. A. MILLS The effect f insulin n bld chlesterl, fat and sugar in nephrsis. Prceedings Sciety fr Experimental Bilgy and Medicine, December, 1926.

26 24 PEKING UNION MEDICAL COLLEGE HOSPITAL ].PRESTON MAXWELL On cntraceptin. China Medical Jurnal, Octher, The maternity prblem f China. China Medical Jurnal, March, Puericulture. (Chinese text) I H.sueh Chu K'an, May, Diseases f the newbrn. Quarterly Jurnal f Chine.se Nurses, June, J. PRESTON MAXWELL AND LEE M. MILES (J. P. MAXWELL AND L. M. MILES) Ostemalacia in China. Tran.sactins Sixth Cngre.f.f Far Eastern Assciatin Trpical Medicine, Septemher, HENRY E. MELENEY China-s past and present pprtunities in trpical medicine. China Medical Jurnal, Decemher,1926. The types f breeding place used by Anpheles hyrcanus In Nrth and Central China. China Medical Jurnal, April, HENRY E. MELENEY, LEE CHUNG-UN AND CHANG HSIEN-UN. (HENRY E. MELENEY, C.U. LEE, AND H. L. CHANG) A preliminary survey f the anpheline msquites f the Peking area. China Medical Jurnal, June, LEE M. MILES Endmetrima invlving the rectum. China Medical Jurnal, April, (Abstract) C. A. MILLS -The perid f inductin In bld cltting. (Preliminary reprt) Prceedings Sciety fr Experimental Bilgy and Medicine, March, 1927.

27 NINETEENTH ANNUAL REPORT 2S c. A. MII.LS (Cncluded) The "perid f inductin" in bld cltting r the sequence f events -preceding fibrin frmatin. Chinese Jurnal Physilgy, April, The rle f the platelets in bld cltting. (Preliminary repn) Prceedings Sciety fr Experimental Bilgy and Medicine, April, ERNST G. NAUCK (E. G. NAUCK) Uber Befunde im Blut Splenektmierter Nager. Archiv fur Schiff's und Trpenhygiene, July, HEINRICH NECHELES, JEANNETTE H. Y LING, AND FELINO FER NANDO (H. Necheles. J. Ling and F. Fernand) Studies n autdigestin. I. The fate f rgans implanted int the dudenum. American Jurnal j Physilgy, December 1, HEINRICH NECHELES AND FELINO FERNANDO (H. NECHELES AND F FERNANDO) Studies n aut-digestin. II. The rle f trypsin and antitrypsin. American Jurnal f Physilgy, December 1, OSWALD H. ROBERTSON AND RICHARD H. P. SIA (0. H. R. BERTSON AND RICHARD H. P SIA) The mechanism f natural immunity t pneumcccus infectin in mammals. (Abstract) TransactinJ Sixth Cngress Far EaJtern Auciatin Trpical Medicine, September, JAMES K. SHEN Tea in the treatment f burns. China Medical Jurnal, February, RICHARD H. P. SIA The presence f type-specific pneumccc-psnins in the sera f animals naturally resistant t pneumcccus infectin. (Preliminary reprt). Prceedings Sciety fr Experimmtal Bilgy and Medicine, April, 1927.

28 26 PEKING UNION MEDICAL COLLE(3E HOSPITAL HANS SMETANA (H. SMETANA) The relatin f the reticul-endthelial system t the frmatin f amylid. Prceedings Sciety fr Experimental Bilgy and Medicine, December, Jurnal Experimental Medicine. April, The bld f animals in hematprphyrin shck. Prceedings Sciety fr Experimental Bilgy and Medicine, June, H. JOCELYN SMYLY Bacillary dysentery. A chapter in the bk "A Textbk Dj Medicine by American Authrs", edited by Dr. Russell L. Cecil, published by Saunders, 'RUTH M. SVENSSON Ntes n differences in activity and resistance between the larvae f Ancylstma dudenale and Necatr americanus. Jurnal ParasitlDgy, March, RUTH M. SVENSSON AND JOHN F. KESSEL (RUTH M. SVENSSON AND J. F. KESSEL) Mrphlgical differences between Necatr and Ancylstma larvae. Jurnal Parasitlgy, December, CARL TENBROECK AND JOHANNES H. BAUER (CARL TENBROECK AND JOHANNES BAUER) The relatin f serlgical types t immunity against tetanus bacilli. (Abstract) Transadins Sixth CngreJJ Far Eastern Assciatin TrfJpica/ Medicine, September, JOSEPH TOMCSIK On carbhydrate-like specific substance in the cln aergenes grup. Prceedings Sciety fr Experimental Bilgy and Medicine, Junl, Anaphylactic shck prduced by a sluble specific substance largely carbhydrate in nature. Ibid.

29 NINETEENTH ANNUAL REPORT 21 JOSEPH TOMCSIK. (Cncluded) The ptimal prprtins f hapten and immunserum in the precipitatin and cmplement fixatin reactins. Ibid. ERNEST Ts The nutritive value f the mung bean, PhaseD/us Aureus Rxburglz. Prceedings Sciety fr Experimental Bilgy and Medicine, December, Chin~se ldurnal f Physilgy, January, The effects f synthetic diets n fertility and lactatin. Prceedings Sciety fr Experimental Bilgy and Medicine, Marcil, TUNG PING-CH'I (P. C. TUNG) Fistul-in-an; a study f 150 cases. China Medical Jurnal, June, AMOS WONG Melan-sarcma f the gums. China Medical ldunzal, Nvember, ANDREW H. WOODS The incidence f nervus diseases in China. China Medical Jurnal, Nvember, Fur cases f pliencephalitis with apparent cnta2'in. China Medical Jurnal, February, Wu HSIEN AND SCHMORL M. LING Clrimetric determinatin f prteins in plasma, cerbrspinal fluid and urine. Chinese Jurnal f Physilgy, April, Wu HSIEN, CARL TENBROECK., AND LI CHEN-PIEN CWu HSIEN, CARL TENBROECK., AND LI CHIEN-PIEN) Antigenic character f denatured egg albumin. Prceedings Sciety fr Experimental Bilgy and Medicine, March, CHARLES W YOUNG AND MARSHALL HERTIG Kala-azar transmissin experiments with Chinese sandflies (Phlebtmus). (Preliminary reprt) Prceedings Sciety fr ExperilllmJal Bilgy and Medicine, June, 1927.

30 28 PEKING UNION MEDICAL COLLEGE HOSPITAL REPORT, OF THE MEDICAL SUPERINTENDENT DR. H. S. HOUGHTON, Sir: Directr f ~he Peking Unin Medical Cllege I present herewith the Nineteenth Annual Reprt f the Peking Unin Medical Cllege Hspital fr the year ending June 30, The fllwing statistical tables give a cmparisn f the extent and character f this year's hspital service with that f the previus year. ADMISSIONS AND DISCHARGES (July 1, June 30, 1927) CLASSIFICATION OF 'PATIENTS Chinese Freign Ttal Ttal Male I Female Male I Female Patients remaining June 30, P dtients admitted during the year ,146 1, ,063 3,814 Ttal number treated. 2,238 1, ,217 3,970 Patients discharged during the year... 2,145 1, ",056 3,816 Patients remaining June 30,

31 NINETEENTH ANNUAL REPORT 29 ADMISSIONS TO DEPARTMENTS (including transfers) (July 1, June 30, 1927) Chinese Freign Ttal Ttal DEPARTMENTS Male I Female Male I Female Medicine Neurlgy ,385 Surgery ,099 1,051 Gyneclgy Obstetrics Babies Ophthalmlgy I ISS Otlarynglgy : TOTAL,.. I , In view f the fact that all the statistics in these reprts are based n discharges and nt n admissins, the fllwing table is appended. In future years the "Table f Admissins" will be mitted.

32 30 PEKING UNION MEDICAL COLLEGE HOSPITAL SERVICE DISCHARGES BY DEPARTMENTS (including transfers) ( July 1, June 30, 1927) Chinese Freign Ttal Male I Female Male I Female Medical , Neurlgy Surgical ,098 Obstetrics Babies Brn Gyneclgy OPhtlWm!gy Otlarynglgy TOTAL... I 2, , ,2821 I Ttal I 1, ,05B ,016 Of the 4,063 patients admitted during the year, 3,385 were Chinese and 678 were freign. DAYS OF TREATMENT (Cmpamtive Study, 1925 t 1927) Private Patients Secnd Walll Patients YEAR ENDING Class Ttal. I Private Pnvate PId. Patients Pay I Free June 30, ,012 1,696 7,461 34, ,210 68,560 June 30, ,476 1,359 7,790 35,390 20,559 67,574 June 30, ,004 1,265 7,065 35,037 19,186 64,557

33 NINETEENTH ANNUAL REPORT 31 It will be seen frm the abve tables that, inclusive f transfers, 4,282 ward patients were treated and disch.arged during the year, and were in the Hspital fr a ttal f 68,560 days. The average duratin f stay f patients was 16 days. Thus the number f patients treated and the number f hspital days were greater than has been the case in previus years. On the ther hand, the number f private and semi-private patients treated has been smaller this year. This was t be expected, hwever, since the facilities fr travelling cntinue t be pr and many peple, bth Chinese and freign, have left Peking n accunt f the disturbed cnditins in China. In s far as the Hspital is cnsidered in the light f its primary purpse as a teaching institutin, the year has been mre successful than any pervius ne. There was n fighting in the vicinity, and while wund ed sldiers came t us f ~eir wn accrd fr treatment, their number was nt sufficient t interfere with the rutine wrk f the Hspital. The children's ward was in quarantine during the year fr 110 days. Sme f the factrs which cntributed tward making this excessive ttal will be eliminated when the new islatin ward is in peratin. The number f deaths in the Hspital was 224, which gives a mrtality rate f 5.5 as cmpared with 6.9 per cent fr last year. 114 autpsies were perfrmed, which shw an increase frm 28 per cent t 38 per cent. OUTPATIENT DEPARTMENT The Assistant Medical Superintendent has cntinued t act as Head f the Department. During the year 19,285 patients attended the clinics fr a ttal f 108,565 visits, which is an increase ver last year. With the exceptin f the medical and tlarynglgical clinics, there were mre patients treated by all services than ever befre. The fllwing table gives statistics in detail.

34 32 PEKING UNION MEDICAL COLLEGE HOSPITAL OUTPATIENT DEPARTMENT VISITS BY SERVICES (July 1, June 30, 1927) SERVICE I New I Old INeWandOJd MEDICINE General 4,105 6,660 10,765 Dermatlgy 2,029 3,705 5,734 Syphilis 157 5,063 5,220 Tuberculsis --- 2,148 2,148 Heart Pediatrics.. 1,126 1,919 2,045 Ttal Medicine. July June ,417 19,761 27,178 Ttal Medicine. July June ,876 22,574 30,450 NEUROLOGY Ttal NeurIln'. July June ,137 3,568 Ttal Neuriln'. July June ,769 I 3,179 SURGERY - General 4,802 32,051 36,853 Genit-Urinary 830 5,415 6,245 Oral Surgery 700 1,41'0 2,110 Orthpedics Ttal Sur2'ery. July June ,312 39,317 45,649 Ttal Surrery. July June ,059 33,737 39,832 Obstetrics and Gyneclgy Antenatal Gyneclglcal 498 2,196 2,694 Ttal Obstetrics and Gynecl2'Y. July June Ttal Obstetrics and Gyneclln'. july 1. 19Z5 - June ~6... ~ 690 2,603 3, ,341 2,967 OPHTHALMOI~OGY General 2,702 11,496 14,198 Tracma. - 7,279 7,~ TtalOphthalmlln'. July June ,702 18,775 21,477 Ttll Ophthalmlln'. July JundO ,395 16,555 18,950 OTOLARYNGOLOGY Ttal Otlaryn2'Iln'. july June ,713 5,681 7,400 Ttal Otlarynflln'. july June ,595 6,174 7,769 GRAND TOTAL july June ,285 89, ,565 GRAND TOTAL July June ,997 84, ,141

35 NINETEENTH ANNUAL REPORT 11 PERCENTAGE O'F ATTENDANCE IN OUTPATIENT CLINICS SERVICE Medicine 30 % 29.6% Neurlgy 2.6% 3 % Surgery 39 % 38.6% Obstetrics and Gyneclgy 2.7% 2.9% Ophthalmlgy 18.8% 18.4% Otlarynglgy 6.9% 7.5% % 3.3% 42 % 3 % 19.7% 6.8% PHARMACY Mr. Jhn A. Camern returned frm furlugh early in the year and resumed his wrk as Supervisr. The Pharmacy has carried a larger vlume f wrk during than in any previus year. Prescriptins The ttal number f rders n the Pharmacy frm the Outpatient Department was 36,250, an increase f 4,399 ver last year's figure. As 75 percent f these rders called fr mre than ne prescriptin, a ttal f 70,000 items was dispensed by this department during the year. Prescriptins filled fr inpatients and staff members, including repeats, amunted t a ttal f 21,300. The ttal number f preparatins supplied by the Pharmacy n prescriptin during the year was 91,300, which means an average f ver 300 per wrking day. Analyses During the year 250 samples f drugs and chemicals were analyzed. Many f these samples were submitted t us by ther hspitals in China. Pennnel Six f ur graduate students were appinted pharmacists r assistant pharmacists in ther hspitals.

36 34 PEKING UNION MEDICAL COLLEGE HOSPITAL RADIUM Dr. F- K. Chen has acted as custdian f the radium during the absence f Dr. Frazier n furlugh. Fllwing is a summary by departments f inpatients and utpatients treated during the year, tgether with the number f treatments given: SERVICE Number f Patients Number f Treatments Dermatlgy Surgery Gyneclgy Ophthalmlgy Otlarynglgy Ttal, Ttal, I 116 An accident ccurred t the radium in February, 1927, which made it necessary t send the stck t the United States fr restandardizatin and the cntainers fr repair. COLLEGE HEALTH AND PRIVATE CONSULTATION SERVICE The Cllege Health Service was rerganised and made an independent department in July, The supervisin f this Service was put under a special cmmittee, cnsisting f the fllwing Cllege fficials: The Head f the Department f Hygiene, Chairman The Head f the Department f Medicine. The Cllege Physician The Medical Superintendent.

37 NINETEENTH ANNUAL REPORT JS The duties f the Service were undertaken by Dr. Willner, the Cllege Physician, assisted by Drs. H. W Kuei, and c. L. Tung. The wrk in this department cnsists f three distinct parts: 1. Rutine examinatins, and preventive and curative treatment f staff and students. 2. a. Rutine examinatins, and preventive and curative treatment f emplyees and their families. b. Hme calls by public health nurse fr nursing and instructin f emplyees and their families. c. Survey f hme cnditins. 3. Prfessinal care f private patients in the Cnsultatin Office. The Cllege Physician als gives prfessinal attentin t the medical patients n the private wards. Private cases ther than medical are attended by specially appinted members f the departments. Because f the disturbed state f the cuntry and the incnvenience f travel the Cnsultatin Service has nt in increased in the usual way, as there have f necessity been fewer private patients frm places ther than Peking. The service invlved in the rutine health care f the staff has, hwever, shwn a satisfactry develpment. COLLEGE HEALTH AND PRIVATE CONSUL TATIONS (JuIJ' 1, June 30, 1927) I Student, and Staff Private Patients 1 F_ I Chl_ I SERVICE FreiiII Chinese TOTAL Office 1 Hme I Office j Hme Office! Hme I Office I Hme I I I 1 Medicine \ , j / 994 4,301 3, 1 1 Neurlgy ::1 1 1 Surgery ,417 1,987 I Obstetrics and Gyneclgy S ,199 Ophthalmlgy ' i 1,564 1,428 Otlarynglgy ~ / 1,056 1,244 I Ttal, , i3, , : , 1131 Ttal, , ,3, ,940 79/1; ,297 I I

38 ~ Il.. en ~...c: s:: ~u ~~..c: t CIS ==..c: c:.. 4"'cf'...~<~ ~CIlM f ~-" :g c < s:: eli 0 ~.2 ~ '"' ",~~ -.0" ~ ~,::r;::: N ~...,... '"... CIl C U ~ ~ J e ::s c:: u -S ~ Il..... ']... "'t:i <u bll.. Q CJ ~.gc::- CIS SERVICE STATISTICS FOR DIVISION OF PHYSIOTHERAPY VISITS (July 1, 19~6 - June 30, 1927) Students I Private Private Ward Outpatient and Staff Inpatients Outpatients Patients TOTAL Department I I Freirn and i I ] I i I.~ I j i I j.~ I j I f I j I ChillClC ~ ~ ~ ~ 0 ~ 0 ~ 0 ~ ~ 11~ ~ S3~ I 666 Firat Viaits Medicine 5 I 1Z I J Return Visit....l ~.Q ~, "'t:i !L -!Z.. 2!l !!.. First Visits < :z:... g:; e ~ DermatlfY CJ ~ 't: ~ Return Visits I I I 1 S (;j ~ ~ E b ~ FirHt Visits Z Z~ V --2-2S S-) ::: J... - Neurley ~ ~ ~ ~ :: < ~ ~ ~C1tum Visits ~ ~ _9_ -.!!.. -.!.±. 7_ ~ 5 ~ -±L ~ z ~ &.. ~,S,~ bii Firat Visits S S9 ZS 1 8S H I BIB :I... - >. ('\I c:: Surfery ~ en ~ ~"'t:i 0.';:-' Return VJ.!I~ ~ ~ ~ -E.. -.!L.-E- 5 -.!!L ~ -.Z!L 2!l Z "',... & 5... g First Visits B ::> ;... ::s... 0 = Orthpedics " e... en 4J t ~ Re_~Yl~ ~ -±±... -±L --R ~ _5 1.2!L !1!..hli Z!::..c: ~..r:::t:..0 4J b. d First Visitl 1 1 I JI1 (J... e 0 atdrlc8 an ~ < ~ E..a a ~ GyneclfY R_eturn Vis~ --I.-!LI-1!.I----l-!!.. _S_1 6Z ~ en ~ < a.- First Visits 1 2, \0 t"'i Ophthal--'---- ~ ~~ ~.~ ~~U~.'~Y4V5T I~Y~_I 1_71-E-1_1_1_1_21_1_1_71 14 ~ ~ ~ i TOTAL , 2SJ US

39 NINETEENTH ANNUAL REPORT 31 PERSONNEL We nte with regret the resilrnatin at the end f the year f the fllwing Heads f Departments: Dr. A. S. Taylr - Surgery Dr. Harvey J. Hward - Ophthalmlgy Dr. Carl TenBreck - Pathlgy The service which these men have rendered t the institutin in the rganizatin and cnduct f their departments cannt be verestimated. As a grup f teachers in their respective fields they have been invaluable, and their departure will be keenly felt. Mrs. Kwe-pau Huang, the Dietitian, has als resi ned. The Hspital wes a great deal t Mrs. Huang fr her painstaking effrts in the rerganizatin and imprvement f the dietary service: Dr. K'ai-chiang Hsu was appinted Assistant t the Medical Superintendent n 1 January He resides in the Hspital. Miss Mabel E. Tm returned frm furlugh and resumed her wrk as Admitting Officer n 27 December Miss Sara Elizabeth Grdn, Acting Admitting Officer last year, became Secretary t the Medical Superintendent n 27 December Miss Mary A. Swisher f the Jhns Hpkins Hspital terminated her temprary appintment as Anesthetist in September Miss Helen M. Hlland, the Anesthetist, returned frm furlugh n 7 December DETAILED REPORTS The departmental reprts which fllw give a general idea f what the varius departments have accmplished during anther difficult year. Thanks are due t all the staff members fr the assistance they have given the administratin. Respectfully submitted, J. HENG LJU Medicl Superintendent

40 38 PEKING UNION MEDICAL COLLEGE HOSPITAL REPORT OF THE DEPARTMENT OF MEDICINE DR. J. HENG LIU Sir: M~dica' Superintmdmt f the P~Aing Unin Medical Cllegt Hspital The rganizatin f the Medical Service f the Hspital is set frth in the Manual f the Department f Medicine, a secnd editin f which was prepared by Dr. Cheer and issued during the past year. The Manual is a bk f 150 dd pages, and cntains in additin t the abve infrmatin, directins fr the perfrmance f the varius diagnstic and therapeutic prcedures, and is f great service t the junir members f the staff. During the year the Medical Service has participated in extensive revisins f the Frmulary, f the diet list, and f the regulatins in regard t cmmunicable diseases. The last named have been greatly simplified. There have been n imprtant changes in the ward service. Especial attentin has been given t the training f the huse staff and an effrt made t cunteract the all-t-prevalent tendency t regard a patient's cnditin as the sum f the varius labratry repns. The visiting physicians have clsely fllwed the wrk f the junir men and f the clinical clerks. It is hped that assistant residents will remain lnger in residence, since it is during this perid that clinical ability receives its greatest develpment. Each man will als be given an pprtunity t take part in the wrk f' ne f the clinical labratries. During the fllwing year the huse fficers will serve thrughut the year n the medical services, and it is expected that this will bring a real imprvement in the care f patients. The metablism unit in 1-3 has given excellent service and the need fr its extensin, at least during the greater part f the year, is still felt. There has als been a need fr mre beds fr wmen patients. On several ccasins the lack f prper facilities fr the care f patients with cntagius diseases has been felt. The prjected building fr this purpse will make pssible better prtectin f the children's ward frm quarantine and the prper training f junir members f the staff and nurses. The care f patients with tuberculsis is a prblem t meet which there is n prvisin. It is expensive and hampers

41 NINETEENTH ANNUAL REPORT 39 the service t have patients with such chrnic cnditins remain lng in the wards. The Cnvalescent Hstel is f cnsiderable help in this directin in cnnectin with ther diseases. Weeldy staff runds in cnjunctin with the Department f Neurlgy have been cntinued. A bi-weekly jurnal club and a weekly x-ray cnference were started. These general activities, tgether with the clinical pathlgical cnferences, are well attended and are f the greatest imprtance in the clinical training f the yunfler men. CLINICS l'he utpatient clinics have cntinued withut significant changes. The gastr-intestinal clinic was starte-d again by Dr. Smyly, wh als undertk a sigmidscpic service which is imprtant in the care f patients with dysentery, and tk ver the kala-azar clinic. Dr. K. H. Li cnducted the cardiac clinic. It is hped that in the future greater cntinuity f service thrughut the year may be maintained by visiting physicians s that patients may be cntinuusly under the care f the same physicians. In many ways the medical utpatient clinics have participated in administrative imprvementi in cnnectin with the admissin and ruting f patients. In particular, the staff has been furnished with a simplified Frmulary, and by c-peratin with the Pharmacy there has been a great reductin in the time taken in filling prescriptins. The pediatric utpatient clinic has been placed in charge f Dr. Ts wh has made several imprvements in the service. It is hped that this clinic will grw a great deal in the future. LABORATORIES The wrk f the clinical labratry is nw upn a smewhat different basis. Ordinary qualitative examinatins are dne in the ward labratries. Dr. Meleney supervises a service which has the fll~wing functins: prviding supplies and supervisin fr the ward labratries; examining rutine specimens frm the utpatient clinics and private patient clinics, and ccasinally special specimens frm the wards; training student technicians. The wrk dne in the central labratry is nw s small a part f the ttal that n figures are given in ~e

42 40 PEKING UNION MEDICAL COLLEGE HOSPITAL annexed table, since statistics cannt be gathered fr the ward labratries and wuld nt, in any case, be f interest. The rutine wrk f the ther clinical labratries f the Department is analysed in the appended table, namely, the quantitative chemical analyses, basal metablism determinatins, electrcardigrams, and examinatins fr spirchaetes and tubercle bacilli. In the dermatlgical labratry, 485 quartz lamp treatments, 137 superficial x-ray treatments, and 11 electrlysis treatments have been given. Late in the year a quartz lamp was added t the equipment which will. be used chiefly in the treatment f children by the Medical and Surgical Services. CLINICAL LABORATORIES (July 1, June 30, 1927) LABORATORY Chemical (quantitative) Dermatlgical Metablic Physilgical Tuberculsis EXAMINATION Bld Gastric fluid Peritneal fluid Pleural fluid Spinal fluid Stl Urine Dark-field Mlds Basal metablic rate Electrcardigrams Hamster inculatins Pathlgical fluids Sputum Stls Number Ttal --- 4,897 7 S9 S9 12~ 7 2,642 7, S TOTAL ,847

43 NINETEENTH ANNUAL REPORT 41 PERSONNEL The imprtant changes in persnnel have been as fllws. Frm September t the end f December, Dr. David L. Edsall, Dean f Harvard Medical Schl, served as Visiting Prfessr, and thrughut the year Dr. H. L. Keirn f the University f Michigan was n the staff as Assciate Prfessr f Dermatlgy and Syphillgy. The Department has received great stimulus frm these tw visiting members f the staff, and Dr. Edsall's help in reviewing the wrk f the Medical Service and his encuragement cannt be verestimated. Dr. C. A. Mills, f Cincinnati, assumed charge f the wrk in clinical chemistry and metablism as Assciate Prfessr. Dr. Smyly returned frm furlugh. Dr. Hammnd, wh was n furlugh, resigned. Drs. Frazier and Cheer went n furlugh, and Dr. Hrvath resigned. Dr. Liu Shih-ha was appinted Medical Resident. An additinal part-time physician, Dr. C. H. Chi, was appinted fr wrk in the utpatient clinic, especially in tuberculsis. May I express my appreciatin f the c-peratin I have met n all hands in cnducting the Medical Service during the past year? Respectfully submitted, FRANCIS R. DIEUAIDE Prjissr and A ctine Head f the Department

44 42 PEKING UNION MEDICAL COLLEGE HOSPITAL REPORT OF THE DEPARTMENT OF NEUROLOGY DR. J. HENG LIU Sir: Medical Superintendent f tit, Pdinr Unin Medical ClltLe Hspital Allw me t submit the fllwing reprt f the wrk f the Department f Neurlgy in the Hspital frm July 1, 1926 t June 30, NUMBER AND CLASSIFICATION OF PATIENTS The neurlgical patients f the Hspital arise frm the fllwing surces: (1) Outpatients Ttal number f individuals in 12 mnths 891- Ttal number f visits in 12 mnths 1,926 This service was carried n thrughut the year in the temprary cubicles n the secnd flr f K-building. 1 he patients as a rule are first seen by ther departments, and after varying perids are _referred t the neurlgists. This indirectness is due t the difficulty in crrectly classifying patients as neurlgical, since as they enter the Outpatient Department they have t be rapidly assig~ed t the varius services. (2) Public ward patients Ttal number f individuals Ttal number f days in ward beds Average stay f each patient 132 2, days Only five ward-beds are assigned by the Hspital fr male neurlgical patients, and tw fr female patients. N psychtic patients are intenrinal1y admitted t the wards. Psychneurtic patients are better cared fr in specially rganized wards; but since such wards are nt available, we frequently have been able t imprve the cnditins f these patients in the general wards. Our experience leads us t believe that a cnsiderable prprtin f the suffering and the ecnmic disability f Chinese patients is due

45 NINETEENTH ANNUAL REPORT 43 t faulty emtinal adjustment t their circumstances. Owing t certain peculiar cnditins under which Eurpeans and Americans live and wrk in China, the incidence f psychneurses in them is relatively high. (3) Cnsultatins n patients in ther departments. 416 (4) Private patients, ffice cnsultatins 106 Of the 946 diseases f the nervus rgans diagnsed, paralytic dementia cnstituted three quarters f ne per cent; meningitis (nnsyphilitic), ne per cent; myelitis (nn-syphilitic), ne and ne-half per cent; neuralgia, ne and ne-half per cent; tuberculsis, ne and ne-half per cent; tabes, tw and ne-half per cent; beriberi, fur per cent; epilepsy, five and ne-half per cent; vascular disease, seven and ne-half per cent; traumatic cases, seven and ne-half per cent; neuritis, nine and ne-half per cent; syphilis, seventeen per cent; psychneurses and neurasthenia cnstituted twenty-ne per cent f all diagnses. TEACHING The supply f clinical cases has been sufficient fr the bedside teaching f the medical students. The anatmicaj, physilgical, and pathlgical facts and principles exemplified by the syphilitic, encephalitic, and traumatic cases alne have been many and imprtant, and indicate that clinical neurlgy can be adequately learned by the medical students f China thrugh the study f actual cases. A curse f lectures and demnstratins was given by Dr. Wds and Dr. devries t the pupil nurses. Tw lectures were given by Dr. Wds t the Department f Ecnmics and Scilgy f Yenching University. NEUROPATHOLOGICAL LABORATORY Dr. de Vries has supervised the labratry wrk f the Department, and has studied and made reprts upn all f the brains, spinal crds, and ther nervus tissues remved in autpsies by the Department f Pathlgy and in the varius perating rms. Number f autpsies studied and reprted Additins t Neurpathlgical Museum

46 H PEKING UNION MEDICAL COLLEGE HOSPITAL PERSONNEL Dr. Ernst de Vries has been in direct charge f the public ward patients thrughut the year. Dr. Mn-fah Chung was Assistant in the wards and chief f the Outpatient service until Octber, at which time he returned t Hnlulu t enter private practice. He was succeeded by Dr. Vii-lin Wei, Assistant and Assistant Resident. Dr. Yung-kuang Wang entered the Neurlgical Department in Nvember as Assistant, and cntinued in the service until June 30, The clinical wrk f the Department has been furthered by the additin f ne interne fr each mnth, assigned t Neurlgy as part f the rtating interne system f the Department f Medicine. Miss Lucy Fairchild, head technician in the.neurpathlgical labratry, was frced t resign in December, and later t return t America because f ill-health. The Department suffered thus a serius lss in its immediate wrk, and a yet farther-reaching lss in that pupil technicians, wh were t have been trained by her, culd nt be prepared fr the future wrk f the labratry. Respectfully submitted, ANDREW H. WOODS Prfissr and Head f the Department

47 NINETEENTH ANNUAL REPORT REPORT OF THE DEPARTMENT OF SURGERY DR. J. HENG LIU, Sir: Medical Superintendent f the Peking Unin Medical Cllegl Hspital Since Peking and its envirns during the past year have been relatively free frm civil war, the Department f Surgery has nt been verburdened with military surgery, althugh we have had ccasinal gunsht wund cases. The develpment f the clinical material has, therefre, been alng nrmal lines, and there has been steady grwth in bth private and public cases. The statistical tables give the details f diagnses and peratins, an analysis f which brings_ ut sme items f especial interest. Our abdminal wrk, fr example, has increased markedly, gastric peratins 80 per cent, appendectmies and hernias 30 per cent. Transfusins have been resrted t mre freely, 88 being dne during the year. This has, n dubt, reduced the mrtality amng ur cases, and shrtened cnvalescence. Skin grafting has als been dne with greater frequency, thus lwering the number f hspital days per patient, and liberating much needed beds. Since we began t treat the majrity f utpatients by injectin, there has been a sharp fall in the number f hemrrhidectmies dne in the perating rm, and beds have been freed fr mre acute cases. The immediate results f ur year's wrk are nt available nw in statistical frm. It is planned t hld mnthly staff cnferences during the cming year, when a "medical audit" can be carried ut, and errrs in diagnses and results checked up prmptly. Sixty-fur deaths ccurred during the year, f which cases seven had nt been perated upn. As there were 1,193 peratins dne, this gives us an perative mrtality f abut 5.4 per cent. A review f the causes f death shws that 10 per cent were ascribed t pstperative pulmnary cmplicatins,s per cent t suppurative pleurisy,

48 46 PEKING UNION MEDICAL COLLEGE HOSPITAL and 12 per cent t acute diffuse peritnitis. The ten deaths which resulted frm cellulitis, carbuncles, and similar cnditins make bvius the fact that we shuld strive tward a better understanding and treatment f these severe infectins. It is nly by facing these failures squarely that we can hpe fr imprvement in ur resu1ts. The unimprved cases als will be clsely studied. Autpsies were dne n 50 per cent f the surgical deaths. effrt is being made t increase this percentage. An TEACHING General instructin has been carried ut accrding t schedule. The class wrk has, n the whle, been quite satisfactry. A change has been made, effective the first f July, whereby there will be n internes n the Surgical Service. The resident staff is t cnsist f ten assistant residents and furth year clinical clerks under a Resident in Surgery. GRADUATE COURSE There was n regular graduate curse given fr dctrs during the year, althugh the Department welcmed a number f physicians as visitrs. It is planned fr the cming year t admit graduates as assistant residents fr a term f three mnths, it being felt that mre satisfactry I instructin can be given in this way. One f the ten assistant residencies has been held pen fr this purpse, and there are already sufficient applicatins t keep this pst filled thrughut the year. RESEARCH Several members f the Department carried n research wrk during the past year, Dr. Kwan and Dr. Tung n surgery f the thrax and esphagus, and Dr. Shen n tea in the treatment f burns and the technique f silk sterilizatin. Further wrk in perfecting methds f aseptic intestinal anastmses has als been carried n. This investigatin was begun by Dr. Jerme Webster.

49 NINETEENTH ANNUAL REPORT 47 GENITO-URINRAY DIVISION Since last September female urlgical cases frmerly treated in the Department f Obstetrics and Gyneclgy have been taken ver int this divisin. The imprtance f this service is being mre and mre realized, and many patients have been!eferred frm ut f twn. Althugh there has been a cntinuus grwth, we are lking frward t rendering a larger service in the future. DIVISION OF ORTHOPEDIC SURGERY The wrk f the Divisin f Orthpedic Surgery during the past year has nt been unusual in any way. The absence f lcal military strife resulted in a great decrease in the number f cases f fresh gunsht wunds admitted t the Hspital, and has permitted the rthpedic clinic t return t a status mre nearly nrmal. A great prprtin f the cases in this Divisin cntinues t be thse f jint tuberculsis, and chiefly f the chrnic neglected type. Ostemyelitis als is very frequently seen, as are ld dislcatins and malunin f fractures. The gradual increase in the number f cases f infantile paralysis cming t us thrughut the year has been interesting t bserve. A distinct change was made in the teaching f Orthpedic Surgery this year. Heretfre a series f lectures was given, and the lecture subjects illustrated either by lantern slides r demnstrative cases. This year it was thught wise t emply the methd f case teaching alne, in the frm f a clinic, using patients whenever pssible as the subject fr discussin and as demnstratins fr teaching. The third and furth year classes attended these clinics n alternate Tuesdays thrughut the year. The result f the methd this year was that, because f lack f varied illustrative cases, a less cmprehensive knwledge f rthpedic cnditins in general was btained by the students. Hwever, thse subjects which were discussed will prbably make a deeper impressin upn the student mind.

50 48 PEKING UNION MEDICAL COLLEGE HOSPITAL A list f sme f the wrk dne in the Orthpedic Outpatient Plaster Rm and in the Orthpedic Shp is appended. Plaster Spica (hip) Plaster Spica (shulder) Leg Cast Ann Cast , 37 Plaster Pyln Plaster Mlds Bdy Casts Psterir Shells ,.,...,.., Artificial Legs Ft Plates Drp Ft Apparatus... 4 Walking Caliper Splints... 3 Sacr-Iliac Belts Metatarsal Pads The abve des nt include the making f splints nr the repair wrk dne. DIVISION OF ORAL SURGERY The Divisin f Oral Surgery has assisted in cnsultatins with ther departments f the Hspital in a larger measure than heretfre. A series f demnstratins in muth hygiene was given t the nursing students fr the first time this year, and the Divisin has cared fr a steadily increasing clientele. The statistical reprt f clinical activities appear belw: CLASSIFICATION OF VISITS PRIVATE CLINIC Cnsultatin and Examinatin GENERAL CLINIC Inpatients I Outpatients Patients I Ttal 6~_1~~. X-ray Exdntia ,072 Operatins n alvelar prcess "f- lo 6 20 Pst-perative treatment I I Treatment fr gingivitis and pyrrhea GRAND TOTAL... 4,476

51 NINETEENTH ANNUAL REPORT +9 PERSONNEL At the clse f the year the Head f the Department, Dr. A. S. Taylr, resigned, and returned t America t enter private practice. It is unnecessary t say that this entails a tremendus lss t the Depanment. Dr. J. R. B. Branch, frmerly Prfessr f Surgery and Gyneclgy in the Hunan-Yale Cllege,f Medicine, has been appinted t fill his place during the cming year. Dr. Z. D. Zau, Assciate in Surgery, and Dr. B. G. Andersn, Head f the Dental Divisin, have been absent n furlugh. Dr. Hughtn Hlliday, wh carried n during Dr. Andersn's absence in America, resigned in June, and Mr. Baranff was placed in charge f the Divisin. Dr. T C. Yang, Assistant in Surgery, returned frm graduate study in America. Althugh Dr. Char has resigned t take charge f the Central Hspital, we are fnunate in being able t retain his services n a pan-time basis during the cming year. Dr. Oman, Hnrary Lecturer, has left Peking and Dr. Webb has taken his place. Dr. Lucks left n furlugh in June. Dr. S. T Kwan, wh cmpletes his secnd year f residency the first f July, has been appinted ~ssistant in Surgery. Respectfully submitted, J. R. B. BRANCH A ssaate Prftss,r and A ctine Head f tlzt Department

52 SO PEKING UNION MEDICAL COLLEGE HOSPITAL REPORT OF THE DEPARTMENT OF OBSTETRICS AND GYNECOLOGY DR. J. HENG LIU, Sir: Medical Superintendent f the PeRing Unin Medical C(Jllege Hspital CLINICS Our clinics have steadily grwn. The number f patients attending the antenatal clinics, and f patients admitted t the maternity ward have increased in spite f the disturbed plitical cnditin. There has been increased c-peratin between the Public Health Demnstratin Statin and urselves, t the mutual benefit f bth services. There have been fewer deliveries utside the Hspit~l than during last year. This is partly due t the fact that mre patients t whm we were called have been persuaded t becme inpatients, and have been brught in by ambulance, and partly t there having been n attempt t develp this branch f the wrk. It is hped, hwever, that mre may be dne in this respect during the year that is cming. Fllw-up wrk has been steadily develped, and every bstetrical and gyneclgical case is apprached at the end f ne mnth, six mnths, and a year, and invited, besides answering the frmal questins, t cme and see us free f charge. Changes in the curriculum and the abandnment f the rtating service fr internes have made alteratins in the methds f wrk imperative, s that it is a little difficult t cmpare with the previus year, but the wrk has shwn steady grwth. TEACHING The usual undergraduate classes have been held, and Instructin n cases f labr is nw undertaken in a much mre systematic fashin, the students having t present t the Prfessr

53 NINETEENTH ANNUAL REPORT 51 within twenty-fur hurs a cmplete reprt f each case attended. These reprts are criticized at the regular Saturday clinic. The cmmencement f maternity training in its practical sense has nw been placed in the' third trimester f the third year, and during the clerkships f the furth year each student will, in additin t his statutry cases, deliver, under supervisin, sme f the patients. Classes have been held in bth bstetrics and gyneclgy fr the student nurses f the third year. The intensive graduate curse was held as usual in the mnth f September, and was well attended in spite f the difficulties f travel. The plans fr giving an advanced curse f maternity training t a picked grup f graduate nurses prved t be impssible wing t lack f applicatins, and fr ther causes. It seems likely that this scheme will be abandned, but it is pssible that we may be able t c-perate with the Public Health Demnstratin Statin in a new plan which is nw under cnsideratin. RESEARCH All the members f the visiting staff have been engaged n research prblems. The Prfessr has cntinued his studies n stemalacia, and n the ld bstetrical and gyneclgical wrks in China. Papers n the latter subject are nw in the press. He has als been engaged n the translatin int Chinese f a vlume f clinical lectures n bstetrics and gyneclgy. Dr. Eastman has cntinued his studies n the bld sedimentatin test in the puerperium, and h as als taken up ther prblems, especially thse bearing relatin t pregnancy txaemia. Dr. Marin Yang is still cllecting statistics f the incidence f menstruatin and the menpause amng the Chinese. Dr. s. W Lee has written a small mngraph in Chinese n the expectant mther and antenatal care, which will be published shrtly.

54 S2 PEKING UNION MEDICAL COLLEGE HOSPITAL ARTHUR W WOO PRIZE IN GYNECOLOGY This prize was awarded t Mr. Ch'en Shun-mine; fr an essay n "Ectpic Gestatin" FEMALE UROLOGY The care f female patients suffering frm urlgical cmplaints has been handed ver t that sectin f the Department f Surgery cncerned with urlgy, as it was felt that it wuld be be.tter that this wrk fr bth male and female patients shuld be cncentrated. STATISTICS During the year there were cnfined n the maternity ward 290 wmen wh were delivered f 292 children Cf this number 48 patients were freign); in additin 8 patients were delivered in their wn hmes. Caesarean Sectin Inductin f Labr Frceps Cranitmy Versin. Repair f perineum. Episitmy Ttal OBSTETRICAL OPERATIONS Si GYNECOLOGICAL OPERATIONS In the Operating Rm 176 In the Outpatient Department Rubin's test., SO (Detailed statistics will be fund n pages 151 and 152.) RADIUM As during previus years, cbnsiderable use has been made f radium, and the fllwing cnditins were under treatment:- Carcinma f cervix (inperable) 33 Chrl-epithelima 1 Carcinma -4 Menrrhagia, 1 Metrrrhagia (nt cancer) 1 Sterilizatin Fibrmyma f uterus Sarcma f vary Carcinma f vulva

55 NINETEENTH ANNUAL REPORT SJ PERSONNEL During the past year the persnnel f the Department f Obstetrics and Gyneclgy cnsisted f Dr. J. Prestn Maxwell, Prfessr and Head f the Department; Dr. Nichlsn J. Eastman. Assciate; Dr. Paul E. Ludenslager, Instructr; Dr. Suchen Wang, Resident and Assistant; Drs. S. W Lee and H. H. Shih, Assistant Residents. Efficient help has als been rendered us by Dr. Marin Yang f-the Public Health Demnstratin Statin, and Dr. David Hudsn f the Methdist Men's Hspital, wh have taken charge f the Outpatient Department n fixed days, and by ur vluntary assistants, Dr. Vedernikff f Mscw, Dr. Chan f Cantn, Dr. Liljestrand and Dr. Gladys Cunningham f Szechuen. Respectfully submitted, J. PRESTON MAXWELL Prfessr and Head f the Department.

56 54 PEKING UNION MEDICAL COLLEGE HOSPITAL DR. J. HENG LIU Sir: REPORT OF THE DEPARTMENT OF OPHTHALMOLOGY Medical Superintendent f tlu PekinE Unin Medical Cl/eEe Hspital There has been a gratifying increase in the number f visits t the utpatient clinic f the Department f Ophthalmlgy, but, in rder t prvide sufficient material fr all the teaching that the Department is called upn t d, the clinic shuld be mre than twice as large as it is at present. When the new utpatient building is ready, there shuld be adequate facilities fr handling a much larger clinic. The number f inpatients remains abut the same frm year t year. N increase is pssible because f the limited number f beds. We have had several plasmma cases under ur charge, mst f which respnded well t radium applicatins. We cntinue t have a prprtinably large number f glaucma and a small number f cataract cases. Frm several years' experience we are led t believe that cataract is less cmmn in Nrth China than in any ther part f Asia, r in Eurpe and America, while glaucma is mre cmmn than m these ther cuntries. TEACHING In additin t the undergraduate curse, the usual intensive curse f ne mnth's duratin fr graduate students was given by Dr. Pi and the ther assistants. The curse was given, as last year, in the Chinese language. The enrllment f graduate students fr the entire year was 21, including 10 wh attended the special curse. RESEARCH Dr. Ling has taken ver frm Dr. Li the respnsibility fr the pathlgical wrk and investigatins in that field. Dr. Pi has carried n mst f the bacterilgical investigatins. Special investigatins

57 NINETEENTH ANNUAL REPORT S5 were carried n by varius members f the staff in the subjects f trachma, the use and reactins f typhid vaccine, the actin f ephedrine slutins, and n the experimental prductin f tuberculsis in the eyes f rabbits. PFRSONNEL Three members f the staff. terminated their services with the institutin at the end f the year. Dr. T M. Li left early in May t enter private practice in Shanghai, and t becme Visiting Prfessr in Ophthalmlgy at St. Jhn's Medical Schl, Shanghai, fr a perid f at least ne year. Dr. P. P Liang plans t spend the year ding labratry wrk in the Department f Medicine, and then jin t his brther in private practice in Tientsin. The Head f the Department left in June t return permanently t the United States. Dr. C. H. Chu, wh was frmerly ne f ur graduate students, and :wh was fr several years in charge. f the eye wrk at Hunan-Yale Medical Schl, is jining the staff n July 1, This leaves tw vacancies n the staff, which shuld be filled as sn as prperly trained men are available. Respectfully submitted, HARVEY J. HOWARD Prfissr and Head f tht Department

58 S6 PEKING UNION MEDICAL COLLEGE HOSPITAL DR. J. HE~G LIU Sir: REPORT OF THE DEPARTMENT OF OTOLARYNGOLOGY Medical Superintendent f the Pelcing Hspital Unin Medical Cllegt The wrk f the utpatient clinic has been divided amng the staff, and has increased; a study f the statistics will ~hw a larger vlume f wrk dne this year than in any previus year. Dr. King has cntinued with the Methdist Hspital Clinic three times a week. Frm time t time he has brught int the Peking Unin Medical Cllege Hspital difficult cases which he has encuntered in this clinic. On several ccasins members f the staff have c-perated with the physician in the Health Center in the examinatin f schl children. As a result f these examinatins sme patients have been admitted t the clinic fr further treatment, and t the Hspital fr tnsil and adenid peratins. PRIVATE CONSULTATION AND REFER SERVICE The private clinic, especially fr freigners, has been cnsiderably reduced this year wing t the cntinued difficulties f transprtatin and the plitical unrest thrughut Nrth China which has prevented many patients cming frm any distance fr treatment. On the ther hand, as was the case last year, many Chinese in Peking have availed themselves f this service. SURGERY The perative wrk f this service has been apprximately that f last year. The increase in precipitatin in this lcality, principally in the frm f the winter's snw, has apparently reduced the amunt f upper respiratry infectins which, in frmer years, led t a great

59 NINETEENTH ANNUAL REPORT 51 deal f ear truble cmplicated by mastid diseases. Furthermre, the prevailing rganisms f the ear infectins during the winter have nt been f a virulent type. Mst titis medias have terminated satisfactrily fllwing incisin f the ear drum. Cnsequently there have been fewer cases f mastiditis amng bth freigners and Chinese, althugh there has been a slight increase in the number f tnsillectmies and nasal peratins. WEEKLY STAFF CONFERENCES On Friday evenings frm eight t ten, the staff has met in cnference t review thse cases f the week which caused special cncern. Recent articles f interest in the current medical literature have als been reviewed. PERSONNEL The wrk f the Department has been almst cmpletely under the supervisin f Dr. Jui-hua Liu, due t the fact that, during the past year, the Head f the Department has been largely ccupied with administrative duties. The yunger members f the staff have assumed their share f respnsibility and, n the whle, wrk has been carried n satisfactrily. Dr. Ka returned frm America in the latter part f the summer, and brught with him a number f anatmical preparatins which have been f assistance in the teachin2" f students and ~raduates. Respectfully submitted, A. M. DUNLAP Prfessr and Head f tlte Department

60 58 PEKING UNION MEDICAL COLLEGE HOSPITAL DR. J. HENG Llu Sir: REPORT OF THE DEPARTMENT OF ROENTGENOLOGY Medicl Superintentimt f the Peking Unin Medical Clkge Hspital The fllwing table shws the cmparative number f cases examined by the Department f Rentgenlgy during the past fur years. The ttal fr this year is 3,452 cases, including 211 gastrintestinal cases, 56 genit-urinary cases, and 2 cases f superficial therapy. The ttal shws a smail increase ver previus years. Private Outpatients Out- Ttal Ttal Grand Patient YEARS In-Patients Student I ri I Misand Staff P vate sinarice Depanmellt Chinese Freip Tw 1_1_9_2_3_-1_9_24_1 1-",_29_7 1 14_7_ ~ ~ 1,149 2,296' 501 2, _2_4_-1_9_2_5_t l.-:;,_4_70 i 99_ ~ ~ 1,129 2,411 ~ 2, _2_S_-1_9_2_6_1 l-",~8_00 ~ ~ ~ 1,283 2,9331~ 3, , ,114 2,850 I 602 3,452 ROENTGEN THERAPY During the year, X-ray treatment f skin diseases has been carried n entirely by the Divisin f Dermatlgy f the Department f Medicine. Superficial therapy f cnditins ther than skin diseases is nw pssible since the machine frmerly used fr this treatment is again installed, having been dismantled until recently wing t lack f space. Facilities fr deep therapy will nt be prvided until the new building is cmpleted. RESEARCH Althugh there has been n investigatin f the type which wuld lead t publicatin, we have carried ut a revisin f the fllw-up system, a cmplete re-rganizatin f the methd f examinatin f gastr-intestinal cases, and further imprvement has been

61 NINETEENTH ANNUAL REPORT S9 made in the system f indexin2' X-ray reprts. A new lantern slide system, cnsisting f slides f instructive cases, brief data n each, and crss indices, has been started. This cllectin will prvide material fr teaching clinical rentgenlgy by members f the Department and ther clinical departments as wel1. Dr. Hdges and Mr. Wang installed cmplete mdern X-ray apparatus at the Hung Jen Hspital at Chingkian2'. The X-ray equipments f the Methdist Hspital, f the German Hspital, and f the Central Hspital, all f Peking, have been remdeled and brught up t date. An il-immersed flurscpic unit has been desj2'ned and installed in the Department f Physilgy. TEACHING The undergraduate curse was given t the first year dass during the first tw weeks f the first trimester. The fifth graduate curse tk place frm April 4 t May 6. Because f unsettled cnditins in China nly six students enrlled, but in spite f the small attendance, teaching was carried n with a full schedule. The prgram f the curse cnsisted f three weeks f technical wrk and tw weeks f clinical rentgenlgy. A jint cnference f the Departments f Medicine and Rentgenlgy tk place nce a week during the year. It was well. attended and prved mutually beneficial. PERSONNEL Dr. Ching Wu, Vluntary Assistant in the Department frm 1925 t 1926, became Assistant Resident n July 1, Dr. Lawrence M. Knx, Assistant Resident during , remained t the end f September t help in the teaching f the undergraduate curse. Dr. C. K. Hsieh returned t the Department in September as Assistant. He had been absent frm Peking fr a year, wrkin2' in Dr. Hickey's X-ray Clinic at the University f Michiean.

62 60 PEKING UNION MEDICAL COLLEGE HOSPITAL Dr. C. H. Teng, a China Medical Bard Fellw, has served in the Department as Vluntary Assistant since Nvember. Fr the cming year he is t be in charge f the Department f Rentgenlgy at the Central Hspital, and als is t act as Surgen in; the Red Crss Hspital. Dr. Take Inuye f St. Luke's Internatinal Hspital, Tky, came in February t the Department as a Vluntary Assistant n a Rckefeller Fundatin Fellwship in Rentltenlgy. He tk the graduate curse in April and May. After havinlt spent three mnths here, he returned t Japan, where he is t be in charge f the Department f Rentgenlgy at St. Luke's Internatinal Hspital. Dr. H. Dabney Kerr jined the Department in June, 1927, as Instructr. Dr. Paul C. Hdges, Head f the Department, left early in June n leave f absence. Fr the next year he will be Assciate Prfessr f Rentgenlgy in the Department f Medicine at the University f Chicag, and will take up the rganizatin f that department in the University Hspital. Durinlt his absence, Dr. Chester N. Frazier will act as Advisr t the Department, and Dr. C. K. Hsieh will be in charge f clinical rentgenlgy. Respectfully submitted, C. K. HSIEH In Charge f Clinical Rentgenlgy

63 NINETEENTH ANNUAL REPORT 61 REPORT OF THE DEPARTMENT OF PATHOLOGY DR. J. HENG LIU Sir: Medical Superintendent f tlte Peking Unin Medical Cl/egt Hspital During the past year there has been n essential chang-e in the relatinship between the Department f Pathlgy and the wrk f the Hspital. DIVISION OF PATHOLOGY It has been particularly gratifying t nte the steadily increasing interest f members f the clinical staff in autpsies. Due t the effrts f a number f these men and the cntinued able assistance f the Hspital administratin it has been pssible fr us t perfrm pst-mrtem examinatins upn the fllwing cases: Hspital cases Outpatients. Infants frm the Department f Obstetrics Cases frm ther hspitals in Peking Ttal AUTOPSIES ON INPATIENTS (July 1, June 30, 1927) SERVICE DEATHS AUTOPSIES PERCENTAGE Chinese I Freian I Ttal Chines: I Freian I Ttal Chinese I Freilrll I Ttal Medicine 134 B S SO NeurlEY Surrery Obstetrics and Gynccln OphthalmlEY 1 1 I Otlaryn201fY TOTAL TOTAL TOTAL S

64 62 PEKING UNION MEDICAL -COLLEGE HOSPITAL Thugh the ttal number f autpsies perfrmed this year is appreciably g-reater than the number dne during any preceding year, it is very discuraeing- t nte that n significant gain in the percentage f autpsies perfrmed upn hspital patients has been made within the last tw years. There is n reasn t think that ur present system f btaining permissin fr autpsies will ever enable us t secure sufficient pathlgical material t meet the demands f a teaching hspital. In view f the pressing needs f ur institutin we strngly reiterate ur recmmendatin that permissin fr. autpsy be required f all third class patients upn entry t the Hspital. In this cnnectin we shuld like t pint ut that t a limited extent die tuberculsis clinic has pursued this plicy with great success fr the past tw years. The ttal number f surgical pathlgical specimens has shwn a slight decrease fr the past year. This service, hwever, has been a very active ne and the material excellent. We shuld like t express Qur appreciatin t the varius clinical departments fr their interest in this wrk and fr the helpful c-peratin they have given us. SPECIMENS REFERRED FOR EXAMINATION M~~ S Dermatlgy 7S Surgery 627 Obstetrics and Gyneclgy 479 Otlarynglgy 225 Outside Hspitals. 258 Ttal 1,669 DIVISION OF BACTERIOLOGY Under the supervisin f the Divisin f Bacterilgy the fllwing examinatins and tests have been perfrmed fr the hspital in the clinical labratry f bacterilgy and serlgy: Bacterilgical Examinatins Wassermann Tests Kahn Tests. Tests ther than Wassermann and Kahn Bld Gruping 7,222 7,307 6, Ttal 22,372

65 NINETEENTH ANNUAL REPORT 63 This ends the secnd year in which this wrk has been executed by the Divisin f Bacterilgy, and, frm the standpint f hspital efficiency, the arrangement has appeared t be highly satisfactry. We have n desire t effect any radical changes in the present system, but shuld like t call attentin t the fact that many f the yunger members f the clinical staff are missing an essential part f their training by having all f this wrk dne fr them. We therefre suggest that the varius departments ur2'e their men t becme familiar with the practical applicatin f these prcedures under the supervisin f the present staff in the clinical labratry f bacterilgy and serlgy. We will gladly give them every facility t accmplish this task rapidly, and, in selected cases, affrd means fr wrk n special prblems. Six technicians have been trained fr ther departments f the Hspital and ther institutins. DIVISION OF PARASITOLOGY During the past year 11,068 rutine stl-examinatins have been made frm 2,960 patients. In additin, 206 bld-films have been examined fr malaria and spirchaetal infectins. Curses have been given in parasitlgical diagnsis t members f the Hspital staff, and eight eraduate students frm ther institutins have pursued mre extensive studies in parasitlgy. Tw technicians have been trained fr ther hspitals. CHANGES IN PERSONNEL In respnse t a call frm the Rckefeller Institute in Princetn, N. J., Dr. Carl TenBreck recently tendered his resignatin as Prfessr f Bacterilgy and Acting Head f the Department. Dr. TenBreck's presence in the Department, as well as his energetic effrts t increase the efficiency f ur entire institutin and t braden its sphere f influence, will be greatly missed. Each member f the Department feels a persnal lss at his departure. The appintments f Dt. Hans Smetana f the Divisin f f Pathlgy, and Dr. J. F. Kessel f the Divisin f Parasitlgy expired at the end f this year. Respectfully submitted, JAMES R. CASH Prfissr f Pathlgy and Acting Head f tlu Deprtmmt

66 64 PEKING UNION MEDICAL COLLEGE HOSPITAL DR.. J. HENG LIU Sir: REPORT OF THE NURSING SERVICE MEdical Supmntmdmt f tile Pdinz Unin Medical Cl/eze Hspital The wrk f the Nursing Service has been carried n withut serius interruptin thrughut the year. We have received mre applicatins frm bth men and wmen nurses than we had vacancies t fill. Fr the first time in the histry f the Servic~ we have been able t make sme chice in ur selectin f Chinese graduate nurses with cnsequent imprvement f the entire service. This is largely due t the fact that many hspitals thrughut the cuntry are clsed n accunt f the present plitical disturbances,. and a large number f Chinese graduate nurses have been thrwn ut f wrle. year. The fllwing statistics shw the changes in staff during the Ttal number f nurses n staff. 73 I Chinese I Chinese I Freign wmen men wmen I New appintments Re-appintments S Appintments cmpleted Left befre cmpletin f appintment Discharges Transfer t ther services Leave f ab'.ne

67 NINETEENTH ANNUAL REPORT 65 The private duty field is very ppular, and thirty Chinese graduates and three freigners are nw n ur register. The fllwinf table shws the number f days f special nursine dne in the Hspita) since 1923: I I I Freign graduates l 330 days 3741 day, day, 1 H+1 day' Chinese graduates 1 1,052 days 1,528 days 12,596 days 11,876 days Ttal 1 1,382 days 11,9021 day, 12,8931 day, 12,2201 days TEACHING Mr. Leslie R. Severinghaus has carefully wrked ut a set f English lessns based upn the vcabulary which the nurses need n the wards f the Hspital. We plan t have every nurse cminf n ur staff cmplete this curse f lessns. If the nurse has cnsiderable knwledge f English, he r she may cmplete the curse in ne semester; if English is limited, it will require tw semesters r even lnger. Miss Ida M. Dwns cnducted a very interesting class in Histry f Nursing fr the graduates whse English is mst advanced. Twice during the year Miss Hilda Wang gave a 50-hur curse in Nursing prcedure t all new appintees t the staff. This wrk is given in Chinese. Because we have had an unusual number f new nurses during the year, an extra burden f supervisin has been laid upn the practical nursing instructrs as we} as the head nurses. In February, 1927, tw nurses enrlled fr a graduate curse in Surgical Nursing, but ne was called back t his hspital befre the cmpletin f his curse.

68 66 PEKING UNION MEDICAL COLLEGE HOSPITAL HOUSING The drmitries have been even mre crwded than usual thrughut the year, but this cnditin will be remedied when we mve int a prtin f the new Oliver Jnes Drmitry in September. We shall then be able t vacate Ward G-III, and thus release it fr the admissin f patients. PERSONNEL We were glad t welcme Miss Mary S. Purcell, First Assistant Superintendent f Nurses, and Miss Ethel E. Rbinsn, Secnd Assistant Superintendent f Nurses, back frm furlugh during the year. Miss Faye Whiteside, Head Nurse f the Operating Rm, has resigned in rder t take a psitin in the United States. Her ging means a great lss t us. Miss Lucile G. King was transferred frm the nursing service t the faculty f the Schl f Nursing as Acting Instructr in the Thery and Practice f Nursing. All fur members f the graduating class f 1927 have jined the nursing staff. Mrs. Ding-ying Chiu has spent the year in the Cntagius Department f the Prvidence City Hspital where she is preparing herself fr wrk in ur prpsed islatin unit. The amunt f illness that has ccurred n the staff during the year has decreased. Much credit is due t the Student and Staff Health Office fr its tireless care and watchfulness ver the health f the nurses. The fllwing table shws the number f days f illness this year as cmpared with last: STAFF Wmen { ( I I i days I days - Men ~ Ttal... I 152 " 8131 days I Respectfully submitted, 96,, 735 days RUTH INGRAM Superintendent 1Jf Nurses

69 NINETEENTH ANNUAL REPORT 67 DR. J. HENG LIU Sir: REPORT OF THE DIETARY SERVICE Medical Superintendent f the Peking Unin Medical Cl/eEl Hspital The fllwing reprt f the Dietary Service is submitted. THE MAIN KITCHEN Mr. Chen cntinues as Supervisr f the Chinese service and as Buyer. During the year, the per capita cst has been kept within ur allwance and there has been an imprvement in the service. An effrt is being made in the freign kitchen t give mre respnsibility t the head ck, with the bject f reducing the number f supervisrs. THE DIET KITCHEN The wrk in the Diet Kitchen has been unusually heavy, as the fllwing table shws. SPECIAL DIETS TYPE NUMBER,---- ( ) ( ) Alkaline - 81 Anemia Baby Beriberi Diabetic Dysentery 1, Epilepsy 48 - Gastric Gut.. ]9 7 High Calric (liquid and semi-liquid) 2,575 3,307, Sft (typhid) " " (light and full) " " High Prtein 49 Lw Prtein (lw salt) Lw Prtein Lw Salt and Salt Free Jaundice - 8 Nephrsis - 37 Obesity Ostemyelitis, Schlayers' Renal Test 10 3 Sippy Tube Feeding Tuberculsis Special Diets Selected Diets Miscellaneus TOTAL 7,867 10,841 I

70 68 PEKING UNION MEDICAL COLLEGE HOSPITAL In additin t the special ~ietst 5,988 sft diets and 3,613 light diets have been prepared fr the Chinese patients. During the year there have been 3,187 infant feedings, 400 liquid diets, and 79 sprue diets. Althugh these diets are nt served entirely frm this kitchen, certain items f fd required a.re prepared under the supervisin f this Service, and them sent t the wards. PERSONNEL The persnnel f"the Dietary Service this year has been as fllws: KWE-PAU HUANG, Dietitian ALBERTA SHAFER, Assistant Dietitian LOUISE KWONG, Assistant t the Dietitian BLANCHE LI, Supervisr (until January 1, 1927) HELEN HSIEH, Supervisr CHEN SHIH-KWEl, Supervisr HUANG LI-CHEN, Assistant Supervisr (until January 1, 1927) TAO YU-YUN, Assistant Supervisr LI HSIEN-CHEN, Assistant Supervisr CHANG jen-yu, Assistant Supervisr Miss Julia Han, B.A., University f Michigan, and M.A., Clumbia, has been in the Dietary Service n a China Medical Bard Fellwship frm January 1, RespectfuUy submitted, KWE-PAU HUANG Dietitian

71 NINETEENTH ANNUAL REPORT 69 REPORT OF MEDICAL SOCIAL SERVICE DR. J. HENG LIU Sir: Medical Superintmdent f the PelinE Unin Medical Clltze Hspital When scial service was started in the Pekin2" Unin Medical Cllege Hspital in 1921 there was a questin whether such wrk culd be dne at all in China. Therefre, during the first five years attentin has been directed mainly tward case wrk and seeing if, as a therapeutic prcess, scial service is a pssibility. It has been fund that many cases can be seen t a successful cnclusin in the Hspital and back int a nrmal scial life, that recvery is greatly hastened if the patient is gt int a better scial r mental cnditin, r if a given curse f treatment is fllwed in the hme. If n medical aid is pssible, peaceful last days can be arranged fr the patient by the effrts f scial service. Althugh frmal resurces are limited in extent, the family and friends stand by the patient in a way that makes up t sme extent fr the lack f such resurces. Furthermre, persnality prblems cannt be settled by mney alne, and their slutin ften lies in the skill f the wrkers in adapting existing situatins t the needs f the patients. It had been felt that the wrk f the Medical Scial Service was t detached frm that f the Hspital as a whle. T vercme this difficulty the Head Wrker made a survey f the field while n furlugh in America. As a result f this study, a system similar t that f the Presbyterian Hspital, New Yrk, was started upn her return. Wrkers are nw assigned t special clinical services, s that every patient is knwn persnally, scial prblems are taken care f as they arise and in c-peratin with the physician in charge; the scial service ntes are entered in the individual's histry. In this way the scial wrk is inte2"rated with the ther departments s that the patient, the physician, the Hspital, and the cmmunity are all served with the least duplicatin f effrt and with the best results.

72 70 PEKING UNION MEDICAL COLLEGE HOSPITAL Tw wrkers e-ive their full time t the Surgical Service. and-the Medical Service is cvered n the men's medical ward, the wmen's mixed ward, and the children's ward. The Obstetrical Service als is cared fr. Wrk frm the ther departments still cmes in by the refer methd, and is taken care f by whmever happens t be free in the Scial Ser~ice at the time. Only a bee-inning has been made, and there are nt, as yet, sufficient wrkers. It is hped, hwever, that with the new wrkers wh.are cming in the autumn all services will be adequately taken care f. Special wrk has been dne in the tuberculsis clinic, and a half day a week has been e-iven t the Public Health Center. Much incidental fllw-up has been dne t aid in special studies, but this will be ~reatly lessened when all the services are cvered. Then the ward patients will all be knwn persnally, and nt nly wi1l less effrt be required t secure the patient's return, but a larg~r percentage f returns can be effected. The filing f the scial ntes, bth f investie-atin and f actin taken, in the unit histry is fdt t he a distinct advantage, as they are then in a frm t be used by all f the Hspital staff. The backgrund frm which a patient cmes and the settine- t which he returns are thus recrded with the histry f the illness. Addresses f friends and f members f the family are als secured t aid in keeping in tuch with the patient. TEACHING Owing t the smallness f the staff, there has nt been much teachine- dne. Lectures have been given t the students f the Yenching Scilgy Department by Miss Ch' en and Miss Pruitt, and t the public health nursing grup by Miss Pruitt and Miss Yu.

73 NINETEENTH ANNUAL REPORT 11 THE CONVALESCENT HOSTEL FOR MEN The Cnvalescent Hstel fr Men has cntinued t be an imprtant adjunct t the wrk f the Hspital. During the year hstel care was given t 247 patients fr a ttal f 3,QS7 days. These patients were referred frm the fllwing services: SERVICE Medicine Dermatlgy Neurlgy Surgery Dental Ophthalmlgy Otlaryng.lgy Number f Patients Cared fr H Ttal 247 The lne-est stay in the Hstel was five mnths and tw days, the shrtest stay ne day, and the average stay 16 days. WOMEN'S HOSTEL A rm was rented in a private hme and used t huse wmen patients and babies wh needed hstel care. 110 were cared fr in this way fr a ttal f 1,334 days. These patients were referred by the filwjn~ services: SERVICE Number f Patients Cared fr Medicine 8 Dermatlgy If Pediatrics 7 Neurlgy 1 Surgery 41 Obstetrics and Gyneclgy 18 Ophthalmlgy 21 Ttal 110 Only a very small number f hstel patients were able t pay fr their bard.

74 72 PEKING UNION MEDICAL COLLEGE HOSPITAL CARE OF TUBERCULOUS PATIENTS The tuberculsis fllw-up wrk is ne f the mst imp~rtant and, at the same time, mst difficult prblems which the Service is "Called upn t slve. It is bviusly ut f the questin t attempt t care fr all the patients wh cme t the hspital wards and the utpatient clinics suffering frm tuberculsis. The factrs which make the wrk difficult are; 1. The scarcity f places where the patients can be cared fr and t which they can be referred. (There are three fr men and ne fr wmen.) 2. Financial difficulties f patients. a. Inability t pay the fees char&red by the sanatrium. b. Inability t abandn the wrk which may mean the sle supprt f a large family. c. Inability t pay fr the prper fd advised by the Hspital. 3. The difficulty t impress upn thse suffering frm the mild r beginning frms f the disease the necessity f giving up their ccupatins and f taking prlnged treatment. Sixty-ne patients were intensively cared fr by the Service durinr the year. Of these, six have returned t part-time wrk, thirty-tw are still n the fllw-up list f the Service, seven have died f the disease, and sixteen have been lst t ur recrds. KALA-AZAR AND CARDIAC PATIENTS The fllw-up f these cases has given satisfactin t the Service as well as t the clinical staff. Of a ttal f seventeen kala-azar patients, eilrht are still being treated, fur were discharged as cured, fur were lst t ur recrds, and ne died. patients were men and fur were wmen. Thirteen f these

75 NINETEENTH ANNUAL REPORT 13 During the year sixty-six cardiac patients were cared fr. Of these twenty-ne were new patients, three Were returned t their hmes, five were transferred t anther service, nine were lst t ur recrds, seven died, tw were discharged as cured, eleven were ld patients, and eight refused t return. Of these patients twentynine were wmen and thirty-seven were men. THE CARE OF CHILDREN One f the mst dramatic and pleasant services, thugh bulking small in numbers, is the care f the illegitimate and unwanted babies wh are accepted as wards by the scial service. Befre accepting a baby as a ward, a careful investigatin is made f the family, and persns applying fr babies are als carefully investigated befre a child is given in adptin. Cntact is subsequently maintained with the adpting family t ensure prper care. During the year sixteen babies were cared fr. Seven have been placed in gd hmes, fur in ther institutins, and three have died. Tw are still beine cared fr by the Service. During the past year fur babies were brugh~ int the Hspital frm the Qutside at the request f the Divisin f Pediatrics fr special metablism study. FUNERAL ARRANGEMENTS The Medical Service has aided in, r undertaken cmplete charge f funeral arrangements fr ut-f-twn patients wh have died in the Hspital. Sme staff members have als availed themselves f the department's assistance in funeral arrangements. There were twenty-seven burials in the Cllege cemetery. These were all Chinese with the 'exceptin f ne Krean and ne Russian. PERSONNEL The past year has been ne f many changes. Miss Ingram was seriusly ill during the autumn, during which time Miss K. C. Ch' en carried n the wrk f the Service. In February Miss Pruitt returned frm her year's furlugh in America, and Miss Ingram

76 14 PEKING UNION MEDICAL COLLEGE HOSPITAL resigned, A Yenchin~ Scilgy graduate student has dne his year's field wrk in the department, supervised by Miss Ch' en and Miss Pruitt. Tw f the Yenching students expect t d their summer wrk in the department a5 student assistants. Respectfully submitted. IDA PRUITT Head WDrker

77 NINETEENTH ANNUAL REPORT 7S GENERAL INFORMATION CONCERNING RATES AND REGULATIONS* The Peking Unin Medical Cllege Hspital is designed fr the treatment f accident cases, acute and sub-acute diseases, and maternity cases. Patients suffering frm cntagius and incurably chrnic diseases, insanity, and delirium tremens will nt be admitted. Patients sufferin2 frm severe accidents r serius illnesses are admitted at any hur f the day r ni2ht. Other patients are admitted between the hurs f 9 a. m. and 5. p. m. If patients are unable t apply in persn, they shuld send sme respnsible persn with whm arrangements may be made fr their admissin. Private cases amng the freign cmmunity are seen fr cnsultatins nly at the retjuest f their wn ph:vsicians, r when definitely referred by them t the hspital. Chinese patients are seen withut references frm utside practitiners. Applicatins by Jetter fr the admissin f patients shuld be addressed t the Medical Superintendent, Peking Unin Medical Cllege Hspital, Peking. As the demand fr hspital accmmdatins is at mst times greater than the number f be,ds that are available, patients frm a distance shuld nt present themselves expecting immediate admissin unless.they have made arrangements prir t their cmm2 All patients are accepted fr treatment in the hspital with the understanding that they will, within reasn, be available fr teaching purpses. A depsit is required n admissin t cver the cst f the rm r bed fr ne week, and als t cver the charges fr special nurses fr ne week when such service is necessary. Bills will be presented weekly fr services rendered, the depsit made always being carried frward. Patients are expected t settie their accunts as sn as treatment is cmpleted. Patients with n permanent Peking address wh cme fr ffice cnsultatins are expected t pay cash at the time treatment is rendered. Patients are nt permitted t receive fd f any kind frm their friends except by special permissin f the physician r the nurse in charge. *The chare-el anven are in silver currency.

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