PEIPING UNION MEDICAL COLLEGE HOSPITAL

Transcription

1 PEIPING UNION MEDICAL COLLEGE HOSPITAL TWENTY-SEVENTH ANNUAL REPORT OF THE SUPERINTENDENT JULY, 9 - JUNE, 9 PEIPING, CHINA

2

3 TWENTY-SEVENTH ANNUAL REPORT, 9- CONTENTS PAGE BOARD OF TRUSTEES AND OFFICERS... HOSPITAL STAFF HOSPITAL ADMINISTRATIVE COMMITTEES REPORTS: HOSPITAL SUPERINTENDENT MEDICAL SERVICES SURGICAL SERVICES OBSTETRIC AND GYNECOLOGICAL SERVICES... 7 OPHTHALMOLOGICAL SERVICE RADIOLOGICAL SERViCES PATHOLOGJCAL SI::RVICES BACTERIOI.OGICAL AND btmunological SERVICES DiETARY SERVICE... ~... NURSING SERVICE HOSPITAL SOCIAL SER\'ICE GENERAL INFORMATION: RATES Al\D REGULATIOKS TABLES I. II. III. IV. v. VI. VII. VIII. IX. X. XI. ADMISSIONS AND DISCHARGES..... DAYS OF TREATMENT AND AVERAGE HOSPITAL DAyS.... CLASSIFICATION OF TREATMENT DAyS.... DISCHARGES BY SERVICES DEATHS AND DEATHS PER DISCHARGES... ~.... POSTMORTEM EXAMINATIONS.... EMERGENCY CASES PUBLIC OUTPATIENT SERVICE ViSiTS..... PRIVATE CONSULTATION SERVYCE VISITS.... COLLEGE HEALTH SERVICE VISITS.... PHYSIOTHERAPY VISITS.... CI.ASSIFICATJON OF DISEASES CLASSIFICATION OF OPERATIONS M<:MBERS OF THE RESIDENT HOlTSE STAFF FROM

4 A cmplete bibligraphy f publicatins frm the labratries and.clinics f the Peiping Unin Medical Cllege is published separately and will be sent by the Librarian n request. The Annual Annuncement f the Medical Cllege may be secured UpOIl applicatin t the Registrar.

5 BOARD OF TRUSTEES OFFICERS Chairman Y T. TSUR f/iee- Chairman SOHTSU G. KING Secretary MARY E.FERGUSON TreaJw'er V. F. BRADFIELD A.IJiJlanl Treasurers G. G. WILSON S. A. FRYER Cntrller TREVOR BOWEN EXECUTIVE COMMITTEE Y T. TSUR, Chairman ROGER S. GREENE CHARLES R. BENNEIT Hu SHIH SOHTSU G. KING MEMBERS T Sr,.~e untillhe AntlUai Mee/ing f 97 HENRY S. HOUGHTON SOHTSU G. KING WONG WEN-HAO V. K. TING Y T. TSUR Hu SHIH T Serve ulltil the Antmal M utin f 9 J. HENG LlU LIN HSJN-KWEI SAO-KE ALFRED SZE E. C. LOBENSl'JNE PO-Ll)lG CHANG ROGER S. GREENE T Ser')e Itntil the Allnual Meeting f 9 F. H. HAWKINS CHARLES R. BENNETT J. HENG LlU, Directr f the Peiping Unin Medical Cllege* ROGER S. GREENE, Yice-Directr lulu, 9. leave abltncc

6 PETPING UNION MEDICAL COLLEGE HOSPITAL M.D., SIH-TZE WANG, SlIperintendent MILDRED F. W ALICER, Assistant t tke Superintendent HOSPITAL STAFF July, 9 - June, 9 DEPARTMENT OF MEDICINE FRANCIS R. DIEUAIDE, A.B., M.D., Prfessr f Medicine and Head f the Departmmt CHESTER NORTH FRAZIER, B. S., M.D., Prfessr f Derma/%gJ' arid &.;'Pki/lgy ROBERT ROGER HANNON, PH.C., B.S., MD., Assciate Prfessr f Medicine RICHARD HO-P'ING SIA, B.S., M.D., Assciate Prfessr f Medicille ARTHUR P. BLACK, A.B., M.D., Assciall Prfessr f Pediatrics CLAUDE E. FORKNER, A. M., M. D., AJJciate Prfessr f Medicine RICHARD SHERMAN LYMAN, A.B., M.D., Assciate PrtJftssflr f Neurlgy and Ps.yrkiatr., CHUNG-UN LEE, M.B., CH.B., D.T.M. AND H.,.Assislant Prfesstlr if Medicine GILES A.M. HALL, B.S., M.D.,.Assistant Prftssr if Medicine and Ctlllege Physician HSIAO-CH'IE!\ CHANG, M.D., Assistant Prfessr if Medicine SHIH-HAO LIU, M.D., AJJistant Prfissr f Medicine ARTHUR MARLOW, A.B., M.D., Assistant Prfissr f Medicine a lid Assciate Cllege Physician YU-LIN \\'EI, M.D., Assdate in Neurlgy and Psychiatry CHEN"-LANG TUNG, A. B., M.D., Assciate in Medicine -T Octber 9J

7 HOSPITAL STAFF 7 DEPARTMENT OF MEDICINE (cntinued) JUI-WU Mu, M.D., Anaate in Dermatlgy and Syphillgy FU-T'ANG CHU, M.D., AJJciate in P~diatric.J ANN G. KUTrNER, S.8., PH.D., M.D., AJJciate in Medicine CH'UAN-ICUEI Hu, M.D., Assciate ill Dermatlgy and Syphillgy YU-LIN CH'ENG, M.D., Assciate in Neurlgy and Psychiatry CH'AO-JEN Wu, M.D., Assciate in Medicine TA-T'UNG WANG, M.D., Assciate in Medicine and Surgery TSO-LJANG CH'IN, M.D., Auistant in Dermatlgy and 8.,phillgy HUEI-LAN CHUNG, M. D., Assistant in Medicine KUO-CHENG WANG, M.D., Assistant i,j Medicine (Cl/ege Health SeMJiu) SHU-HSIEN WANG, M. D.,.Auistant in Medicine HSIEN-I CHU, M.D., Assistant in Medicine SHIH-FAN CHUNG, M.D., Assistant in Pediatrics CHARLES WAN-NEN BIEN, M.D., Assistanl in Medicine and Resident Physician WEN-LIEN HSIEH, B.A., M.D., Assistant in Medicine CH'UAN FAN, M.D., A.IJiJlanl in Pedialrics On leave 9- "'Aui&tllnt Resident Pbyalciln frm ]uly t December n. 9

8 8 PEIPING UNION MEDICAL COLLEGE HOSPITAL DEPARTMENT OF MEDICINE (cncluded) CHIA-HSIANG WANG, M.D., AuiJtant in Neur%g)' and Psychiatry BENJAMIN H. Y. T'ANG, M.D., AuiJtant ill Medicine SAMUEL H. P'ANG, B.A., MD., AJ,si.rtant in Medicine (Cl/ert Healtk Ser vice) KUO-CHEN CH 'EN, M. D., First AJJistant Residml Physician SHOU-K'AI CHOU, M.D., AssiJtant Rendmt Physician YING-K'UEI Hsu, M. D., AsshUlIIt Resident Pkpician (Neur%gv.md P.rychiatr)') CHEN-HSIANG HUANG, M.D., Assistant Resident Phpician HAH-LIONG LEE,. M.D., Assislallt Residmt Physician HUNG-CHIUNG LI, M.D., AJJistant Residnzt PhyJician (DermllJ%K.J' an. S)phi/%gJ') KEH-HUNG LI, M.D., Assistant Residml Physicia. CHIA-TUNG TENG, M.D., Assi.rtant Resident Physician TS'UN T'UNG, M.D., Assistant Residml Ph)'sicia" CHI-WU \-VANG, M.D., Aui.rlant ResidmJ Ph)'Jician JUI-P'ING Wu, M. D., Auistanl ReJident Physician (Pdiatrics) HUAN-WEN Yu, M.D., A.uiJ/ant Rtsidmt Phpician -seplemocf I, 9. t JUlIe 8, IlllS

9 HOSPITAL STAFF 9 DEPARTMENT OF SURGERY HAROLD H. LOUCKS, A.B., M.D., f'rftjjr f Surgery and flead f the Department GEORGE Y. CHAR, B. S., M.D., PrfeJJr f Urlgy CHESTER MONTAGUE VAN ALLEN, A.B., M.D., Pr~feJs(Jr f Surgery t March 7, 9 J. BUA Lw, M.D., Pr.ftssr f Ollar.lglgy LEO J. \hltner, B.S., M.D.,'" AJJciate P"fessr f Orthpedic SItt"Ket"J' JOHN W. SPIES, M.A., M.D., Assciate PrflJJr f!l Stlfger-.J t April, 9 SUNG-T'AO KWAN, B. S., M. D., AJJistant PrjeHr j'sur-gefj' MORTON D WILLCUTrs, M.D., LT. CO~DR. (M.e.), U.S. N. Hnrary' Ltdttrer ;n Surger)' CHI-MAO MENG, M.D., Auislant Pr~lessr f Orthpedic Surgery Tze KING, M.D., Assciate ill O/lal}'fl/[lg.v YUNG-HAO TING, M.D., Assciate ;' OtlaryfIJ[lKJ' JOHN JACOB \VOLFE, L. D.S., R.C.S., (ENG,) D.D.S., M.D., Assciate in Dental Sm:ll:)' t April, 9 TA-T'UNG \VA~G, M.D., Assciate in Surgery TA-CHUN YANG, M.D., Assistant in CI;'litlll Surgery FU-EN WAN, M.D., ASJiJtant ill Clinical Surgery HSI-EN SHIH, M.D., Assistant in Sur,!:!I:}' On leave t December 9 * On leave )-H

10 PEIPING UNION MEDICAL COLLEGE HOSPITAL HSIEN-LIN CHANG, M.D., AssiItant in Surgery DEPARTMENT OF SURGERY r,.nfiuded) CH~G-P'O YANG, M.D., Assistant in Surgery and Resident Surgen ALEXANDER F. BARANOFF, D.D.S., Assistant in Dental Surgery YIN-CHONG HSI, D.D.S., AssistanJ in Denial Surgery HYEN-TAlIC Kuru, M.D., AssiJtant in Surgery CH'ING-SUNG CHANG, M. D., Assutant in Otlarynglgy CHI-CHENG CHANG, M. D., First Assistant Ruident Sltrgen YI-CH ENG CHAO, M.D., Assistant Resident Surgen HAl-SHAN FAN, MD., AJS;Jtant Resident Surg,n JIH-HSIN FAN, M.D., AJSistat Residmt Surgen HSIEN-CHIH FANG, M. D., Auistant Ruidml Surgen CHI HO Hsu, M. D., Assutant Resident Surgen HSING-AN Hsu, M.D., Assistant Resident Surgen YIN-HSIANG Hsu, M.D., Assistant Resident Surgen CHIA-SSU HUANG, M.D., Assistant Rsidlnt Surgen HUNG-JU LI, M.D.,.Assistant Ruidlt Surgen

11 HOSPITAL STAFF DEPAR rm ENT OF OBSTETRICS AND GYNECOLOGY J. PRESTON MAXWELL, M.D., B.S., (LOND.), L.R.C.P., F.R.C.S., (ENG.), F C.O.G., Prfess,. f Obstetrics and Gynulgy and Head f the Department NICHOLSON]. EASTMAN, A.B., M.D., Prfess,. f Obstet,.ics and Gyneclgy and Acting Head f the Department JOHN I.ELAND MCKELVEY, B.A., M.B., Assciate Prfeur f Obstetrics and Gyneclgy MARION YANG, M.D., Hnrary Lectu,.er in H."giene and Public Health, and i" Ohstetrics and Gyneclgy KHA-T'J LIM, M.D., Assciate in Obstetrics and Gynerlgy SUNG LIN, M.D., Assistant in OhJtetf'ics and Gyneclgy alld ResidenJ OhJtetriciaTI and GyneclQgist SHU-LIEN CHAO, M.D., ASJislant Resident Ohstetrician alld Gyneclgist YU-HO CH'ENG, M. D., Assistanl Residmt Ohstetrician and G.vnec%gist YING-K'UEI K', M.D., Assistant Reside"t Obstetrician and GJI,uclgist SHU-CHEN WEI, M.D., AssistanJ Resident Ohstetrician alld Gyneclgist DEPARTMENT OF OPHTHALMOLOGY PETER C. KRONFELD, M.D., Prfessr f Ophthalmlgy and Head f the Department HUA-TEH PI, M.D., Allistant Prfessr j Clinical Ophthalmlgy PETER S. SOUDAKOFF, B. PH., M. D., Auciate in Ophthalmlgy SHIH-PU CHANG, M.D., Auciate in Ophthalmlgy HUI-HSI FENC, M.D.,.AlliJtant in OpIJlha/!JI%gy On leave t February 9.

12 PEIPING UNION MEDICAL COLLEGE HOSPITAL DEPARTMENT OF OPHTHALMOLOGY (cncluded) CHING-K~UEI LIN', M.D., u;stallt in Ophthalmlgy TSUNG-HSIEN Lu, M.D., Auistallt in Ophthalmlgy WEN-YUlN CH'EN, MD., Auistallt Residenl Ophthalmlgist HSU-CHE CH'I, M.D.,'" Assis/auf Resident Ophthalmlgist CH'ENG-FANG CH 'u, M.D., Auistant Resident Ophthalmlgist CH'ANG-SUNG FAN, l\j.d., Assistant ReJident Ophthalmlgisl DEPARTMENT OF RADIOLOGY CHIH-KUANG HSIEH, M,S., M.D., Auaate Prfessr j ROelilgelllf)' atjd Hfad qllhe Department MARVIN M.D. Wn.LAMS, B.S., Ph.D., PhJ'siasl CHING Wu, M.S., M.D., Assistant Prfessr f Rentgenlgy TU-SHAN JUNG, M.D.,... Assciate in Rentgenlgy HO-SHAN WANG, B. S., *** Auislant in Rentgenlg)' and SltjJltvisr f Ihl J-hfcgrapllic };M~au ehu-ping CHANG, B.S., M.D., ilssistat ill RlntgenlgJ and ilssisfat.t Ruidellt Rlldit"gisl CHIEN-LIANG Hsu, M.D., ilssislalll Resident Radilgist SHAO-HSUN WANG, M.D., Assillant Reside,,/ Radilgi!t Nrember.9. c June JO. 9 "On leave t December 9) "'Ou leave fa Nvember 9J

13 HOSPITAL STAFF DEPARTMENT OF PATHOLOGY REINHARD J. C. HOEPPLI, M.D., D.Sc. f * Prfessr f Parasitlgy and Ading Head f the Department f Pathlgy CHENG-HSIANG Hu, M.D., Assciate Prfissr f Pathlgy and Acting Head j the Department 9- OO-KEK KHAW, M.B., Ch.n., D.p.n., D.T.M., AssiJtant Prfiur j ParaJitlgy and Ading Head f the DiviJin 9- HSI-]UNG K'ANG, M.D., Audate in Pathlgy LAN-CHOU FENG, M.D., D. T. M. AND H., Assciate in ParaJitlgy KUANG-YU CHwIN, M.D., Assistant in Pathlgy HSI-FAN Hsu, B.S., Assistant in Parasitlgy VI-TUH LIEU, B.S., M.D., Assislnt in Pathlgy SHIH-DOH Wu, M.D., AJsistant in Pathlgy DEPARTMENT OF BACTERIOLOGY AND IMMUNOLOGY CHONG-EANG LIM, M.B., B.S., D.P.H., D.T.M., Prfissr f Bacterilgy and H,ad f the Depar/~nt TIMOTHY J. KUROTCHKIN, M.D., Auistant Prfessr f Bacterilgy and Immunlgy SAMUEL H. ZIA, M.D., Auaate in Baderilgy FEI-CH'lNG LIN, B.S., M.D., Assistant in Bacterilgy CH'UN-HUI YEN, B.S., M.D., Assistant in Badlri%gy leave 9J n

14 PEIPING UNION MEDICAL COLLEGE HOSPITAL INTERNES IN MEDICINE Service Bega" July I, 9 August, 9- August, 9- July, 9 August, 9 July, 9 July, 9 September, 9 Jul)', 9 July, 9 July, 9 July, 9 July, 9 July, 9- KUANG-PI CHANG YIN-HO CHEN ING-JANG ehu SHIH-YING KANG CHIEN-WEI LANG CHIA-CHI MA \VAN-SEN MA CHING-HSIEN MI CHI-CHEN Su CHIEH SUNG SUNG-NIEN TSAO SHfH-CHUN V\r ANG KUNG-LIANG W'u K YUEH-TSUNG YANG Service E"d,d Jlme, 9 June, I9S June, 9 June, 9 June, 9 June, 9~ June, 9 June, 9 June, 9 June, 9 June, 9 June, 9 June, 9 IN SURGERY July, 9 July, 9- August, 9- July, 9 July I, 9- July I, 9H July J t 9- July J, 9 JlIly, 9 CHING-WO Au YOUNG TSUNG-SHUN CHEN YIEN CHU HESTER HAYNE TIEN-YI Hsu }EN-JUO HUANG PAUL KWAN Y ONG-KYUM LEE YING-KAI Wu -June, 9 February, 9 June, 9 June, 9S May, 9 JUlie, 9 June, 9 May H, 9 June, 9 IN OBsTE frics AND GYNECOLOGY July, 9 July, 9 July, 9 CHIN-HUA CHIANG HAZEL LIN CHUNG-TEH MA June, 9 June SO, 9 June, 9

15 -HOSPITAL STAFF NURSING SERVICE As Df June, 9 GERTRUDE E. HODGMAN, R.N., M.A., Dean f the Schl f Nursing and Superintendent f Nurses FAYE WHITESIDE, R.N.,PH.B., AJJciate SuperintmdentfNurses ETHEL E. ROBINSON, R.N.,... AJJistant SuperinteJdent f Nurses ELIZABETH HIRST, R. N.,... Assistant SuperintmdetJt f Nurses MARGARET R. WYNE, B. S., R. N.,... Assistant Superilltendent f Nurses in charge f P"hlic Outpatient Service LILA M. DALRYMPLE, R. N., Night Supervisr GLYDE M. LEACH, R.N.,... Supervisr f General Operating Rm RUTH H. KUNKEL, B. S., R.N.,. Supervisr f Islatin Pa'Vilin YI HSUEH, N.A.C.,*... Supervisr f Medical Wards BELLE M. WAGNER, R. N., Super'Visr f Obstetrical and G)'IleclgicaJ Wards CORNELIA TENNENT, B. A., R. N.,.. Supervisr f Pediatric Ward RUTH M. LAST, R.N., B.A.,... Supervisr f p,.i'vate Patients' Pa'Vilin DOROTHY D. HULI., B.S.,R.N.,..... Supe,"Visr fsu,gical Wards DORIS BEAUMONT, R. N.,... AJJistant Superrvisr f Ohstetrical and Gyneclgical Wards YUN-HUA SIA, B.S., N.A.C.,... AJJistant Supervisr, Pllhlic Outpatient Service YUN-CHU SHEH, B.S., N.A. C.,... Assistant Sllpervisr, Obs/cit'ical and Gyneclgical Clinic AI-CHING PAO, N. A. C., Assistant Supervisr, Pediatric C lini, KUEI-YING SHAO, N.A.C.,... Night Assistant WEI-KANG LI, N.A. C.,... Head Ntlrse, Admissin War. ]UNG-HSUN Ku, N. A. C. J"... Head Nurse, GmeralOprrating Rm THELMA M. HENSLEY, R.N.,... Head Nurse, GJ"leclgical Ward LIEN-YING SHAO, N.A.C.,... Head Nurst, Islatin Irardfr Adults SU-YUN WANG, N.A.C.,... Head Nllrse, lslatitj "~ardfr Children YUEH-CHIN LIAO, N. A.C.,... Head Nurle, Me.lical Wardfr Men N.A.C. dente. reriltratin with the Nul'ICI' A.lOdatin f China

16 PEIPING UNION MEDICAL COLLEGE HOSPITAL NURS[NG SERVICE (cncluded) AI f June, 9 CH'l eh'en, N.A.C.,... Head Nurse, Metahlism Ward HSING-KUO JEN, N.A.C.,... Head Nurst, Mixed li'ardfr Men YU-JUNGHsu, N.A.C.,... Head Nu,.st, Mixed li'ardfr Wmen CHAO-AI CHIANG, B.S., N.A.C.,. Head Nurst, Ohstetricalll'af'd PAO-TlSUNG, N.A.C.,... Head Nurse, Pediatric Clinic LOR-LH WANG, N.A.C.,... Head Nurse, Pediatric Ward PEARL B. NICHOLLS, R. N.,... Head Nurst, Private Patients' Ward CHEN-TUNG HUANG, N.A.C.,... Head Nurse, Puhlic Outpatient Strvvict YUAN-JU TSING, R. N.,... Head Nurse, Semi-private Patients" Ward Yu LIN L, N.A.C.,... Head Nurse, Surgical Supply Rm YU-HUA KAO, N.A.C.,... Head Nurse, Surgical Ward fr Men YU-HSIANG CHANG, N. A.C.,... Acting Helld Nursr, Surgical Ward fr }VIen CHUNG HUANG, N.A.C,... Head Nurse, Surgical Ward fr Men FU-CHING Yu, N.A.C.,... Head Nurse, Tumr Cli,lic LIANG-CHIUNG CHEN, B.A., N.A.C.,... Acting Health Nurse, Nurses" Drmitries DIETARY SERVICE ESTELLE NEBIIT, B.S.,... Chief Dietitian HELEN BURKE'IT, B.S.,... Assistant Dietitian EMILY CUItRAN, B. S., M. A., Auistallt Dietitian t Decemher, 9 WEN-YUAN I<'ANG, B. S.,... Ilssistant Dietitian frm Ilugust, 9 GENEVIEVE GORMICAN, B.S.,... Assistant Dietitialil August, 9 MARJORIE WONG, B. S.,... Assistant Dietitian H-HSUAN Yu, B.S.,... Ilssistant Dietitianfrm Fehruary,9 PHARMACY JOHN CAMERON, F.eS. PH.C.,M.P.S (LOllD.)... Supervisr fthl Pharmacy ARTHUR TYE., PH. C., M. P.S.A.,... Assistant Pharlnadst WAN HENG Tu,... Secnd As.sistant Pharmacist duq at Peipillf P.yebpathic: HOIPhal.inee February 9

17 HOSPITAL STAFF 7 HOSPITAL SOCIAL SERVICE IDA PRUITT, B.A., B.S.,... ChiiffHspital Scial Se,-vice JU-CHI Yu, B.A., AuistaJt KATHARINE R. LYMAN, B. A.,... Superq;isr (Yluntary) ANNETTE COHEN RABINOWITZ, B.A., M. A., SuperttJiJr LI-CH'IUCHOU, B.A., M.S.,... SlIperq;isr f Case Wrk SSU-MING SUNG, B.A.,... SuperttJisr f Case Wrk CHUNG-TANG CHANG, B.A., Case Wrker HSI-FAN CHAO, A.B., A. M.,... Case W;ker frm Septemher,9 WEI-KUN CHEN, B.A., M.A.,... Case Wrker CHIH-TING CHI, B.A., M.A.,... Case Wrker jrm September', 9 HSUAN-TSI ehu, B.A., Case Wrkerluly I-December 9, 9 LANG-KUANG Hsu, B. A.,... Case Wrker YU-AI J AO, B. A., Case Wrker KUAN LI, B.A.,... CaSl! Wrker SHAN-CHEN LI, B.A.,... Case Wrker PHEBE LIANG, B A., M. A.,... Case Wrker LORNA LIANG-CHAO LIU, B.A., M.A.,.. Clise Wrker CHIEN-TSENG MAl, B.A., M.A.,... Case Wrker frm February, 9 TUAN PAl, B. A.,... Case Wrker KUEI-LUAN TIEN, B.A.,... Cau /Prker TSUliG TING, B. A., Case Wrker CHEN Wu, B.A.,... Case Wrker frm lanuary, 9 OTHER OFFICERS JOHN.. PENNE... Admit/iug Officer, Priq;ate Patients JEN-HO LIANG, B.A.,... Admitting Officer, Wat d Patients LUN LIU... Admitting Officer, Ward PatimtJ TSUNG WU Yu, H. A.,... Admittillg Officer. lyllrd PatierrtJ LING TAO, B.A., M.A.,... O.P.D. Admitting Officerluly I-Dec. HSUAN-TSJ ehu, B.A.,... O. P.D. Admitting Officer frm Dec. HOI-CHEN SHE, B. A.,... O. P. D. Admillin.f Officer CHANG CHUNG-VING LI.... O. P. D. Cntact Desk HELEN M. HOLl.AND, R. N.,... Anesthetist STEPHEN WANG, B. A.,... ClIstdian f Recrds EDITHC. HUANG, PED. B., Ph. B., R.N., Matrll TIRZAH E. BUI.LNGTON Occupatinal Ther'pist MARY L. McMILLAN.... Ph)'sitherapist in Charge ANNA LOH, R.N., **... Physitherapist HUNG-CHUN CHANG Oral H)'gienist, Depa,.Immt f Surgery *On leave frm January. 9 On leave frm December. 9

18 8 PEIPING UNION MEDICAL COLLEGE HOSPITAL HOSPITAL ADMINISTRATIVE COMMITTEES COMMITTEE ON THE HOSPITAL FRANCIS R. DIEUAIDE, Chairman JOHN B. GRANT GERTRUDE E. HODGMAN PETER C. KltONFELD HAROLD H. LOUCKS J. PRESTON MAXWELL SIH-TZE WANG, Secretary CLINlCAL RECORDS COMMITTEE C. U. LEE, Chairman C. H. Hu S. T. KWAN S. P. CHANO KHA-T'J LIM I. C. YUAN STEPHEN WANG, Secretary COMMITTEE ON THE PUBLIC OUTPATIENT SERVICE MILDRED F. WALKER, Chairman R. H. P. SIA KHA-T-I LIM C. M. MENO H. T PI JU-CHI Yu MARGARET WVNE, Secretary

19 REPORT OF THE SUPERINTENDENT 9 OF THE HOSPITAL THE ADMINISTRATIVE COMMITTEE, Sirs: Peiping Unin M ediel CileZf I have the bnur t present the Twenty-seventh Annual Reprt f the Peiping Unin Medical Cllege Hspital. On July, 9, Dr. Sih-tze Wan~ became Superintendent f the Hspital. Miss Mildred F - Walker, assistant t the superintendent, cntinued in chart!e f the administratin f the pubhc utpatient services and admitting ffices. Certain imprvements have been effected thrugh the realltment f space. The separatin f the admitting ffices fr private and public ward patients has been mre satisfactry and mre cnvenient t patients and staff. The mving f the Emplyees' Clinic t H basement has prvided an extra ffice needed by Scial Service. With the additinal space made available, the recrd rm has been able t assllme respnsibility fr the central filing f recrds f all hspital and utpatients. This has enabled greater accuracy and efficiency in the recrding f diagnses, and the cmpiling f all statistics. Hwever, the fast increasing number f clinical recrds, and the grwing interest in the study f recrds n the part f staff members, makes it imperative that an extensin f the recrd rm be given early cnsideratin. Such prvisin must be cntiguus t the present quarters since rms assigned fr reading and cnferences are t remte t relieve the vercrwding in the present reading and staff wrk rms. The installatin f a flurscpe in the Public Outpatient Service is expected t expedite examinatins in the Pneumthrax and Surgical Clinics, and t relieve cngestin in the Radilgy Service. Additinal necessary imprvements, hwever, still cnfrnt us. Changes in the laundry must be made t bring abut mre healthful

20 PEIPING UNION MEDICAL COLLEGE HOSPITAL wrking cnditins. Equipment and wrkers are crwded int space entirely inadequate. It is hped that anther flr ~f M-building nw being used fr an emplyees' drmitry can be released t the laundry, by prviding ther quarters fr persns required t live near the premises. \Vith an increase in the number f wmen huse staff members, there is nt sufficient drmitry accmmdatin in the hspital. They have been required t live in the San Tia Hutung residence which, thugh nt t distant, is incnvenient fr individuals n call at night. The rms n the secnd flr f F-building, ccupied hy sme f the wmen huse fficers, are t near patients n the ward, and much t small t be desirable fr living quarters. A suitable drmitry fr wmen n the huse staff is urgently needed, with prvisin fr pleasant and well ventilated dining rms fr the entire huse staff. The cmpulsry clsing f the pediatric ward fr 8 days due t quarantine has prevented many sick children frm being treated. T allw fr the admissin f patients at all times and make pssible the se~regatin f children n islatin, a larger pediatric ward must be cnsidered in any future planning fr the hspital. Due t the clsing f the childrens' ward fr perids f quarantine and the clsing f three wards fr huse cleaning during the summer mnths, the daily averag-e f beds available fr ccupancy was 9. The daily average number f patients treated in the hspital was 8. The ttal hspital treatment days (Table: II) cmpared with the ttal f bed days available shws an ccupancy f 87. per cent, in cmparisn with 8. per cent the precedi~e year. The capacity f beds has remained the same as last year with distributin amn the services as fllws:

21 REPORT OF THE HOSPITAL SUPERINTENDENT DISTRIBUTION OF BEDS MEDICINE General... Dermatlgy... Islatin Pavilin... Neurlgy... Pediatrics Beds... Bassinets... SURGERY General Orthpedics Otlarynglgy t Tumr Urlgy... 8_ OBSTETRICS AND GYNECOLOGY Gyneclgy Obstetrics... Bassinets... OPHTHALMOLOGY S UNASSIGNED Emergency \vard... Private and semi-private wards Children's ward _--- Ttal PUBLIC OUTPATIENT SERVICE The number f new patients making applicatin fr admissin each day has ranged frm in the fall t during the spring mnths. This is a ]ar~er number than can be given adequate care in the clinics, and invlves limitatin and selectin f thse mst needing the attentin that the hspital can ffer. T give better service t persns presenting themselves fr medical care and meet their individual needs mre satisfactrily, changes have been made in the administrative prcedures f the utpatient service.

22 PEIPING UNION MEDICAL COLLEGE HOSPITAL Trained scial wrkers have been appinted as admitting fficers t interview each applicant, determine the ecnmic elegibility f each, and decide the clinic assignment. This has helped t divert t the Private Patient Service and private physicians thse able t pay, and has made it pssible t admit patients accrding t the urgency f their need fr medical care. The assistance and supervisin given by assistant residents f sme services, laned fr shrt perids, has enabled the admitting fficers t acquire experience in differentiating the medical needs f patients.. Patients unable t be accepted n the day f applicatin have been referred t a central desk fr making future appintments. On the whle the methd f admissin has been effectual, thugh the service t patients and clinics wuld be imprved by the assignment f a physician, t either the admitting r emere-ency service, t whm bscure and urgent cases culd be referred. T gain the lyal friendliness f patients satisfied with the care they have received in the utpatient sel'vice, e-reater cnsideratin must be given t means f fferine- mre individual attentin, and saving patients time and incnvenience. Appintment systems adpted t the situatins in the Pt:diatric, Syphilis, and Surgical Clinics have prved their advantal:e t patient and clinic, and have spared patients the crwding and Jn~ waiting tbat ccurs in the lbbies befre registratin hurs. Mre effrt has been made t secure payment fr special services, such as x-rays and treatments, frm patients able t pay, but greater leniency has been shwn t thse unable t affrd the established rates. Patients claiming inabiljty t meet the regular charges have been referred t the admitting fficers fr cnsideratin, the determinatin f rate, r the granting f free treatment. Clinic clerks have been relieved f all statistical wrk t give mre assistance t patients, nurses and physicians. This has placed the cmpiling f statistics fr utpatients under the clinical recrd rm. With the expert assistance f Dr.. C. Yuan a central statistical system has been devised. Recrding is dne by means f a cde which nw prvides infrmatin cmparable t ther hspitals, makes pssible any studies based n gegraphical data, and may be extended t include diaensric data fr further studies that may be desired.

23 REPORT OF THE HOSPITAL SUPERINTENDENT PRIVATE CONSULTATION SERVICE The Private Cnsultatin Service has been maintained by physicians frm the varius departments. A separate ffice fr receiving private patients has been prvided since the beginning f the year. T imprve the service a special admitting fficer with clerical staff has been assigned t this ffice t arrange appintments with physicians, and care fr admissins t the private wards. The statistics set frth in Table IX indicate the vlume f wrk perfrmed by the varius services fr private patients. COLLEGE HEALTH SERVICE Effrts have been made t imprve the health servi.ce fr members f the staff, the nurses and the students by the institutin f an appintment system. Medical cnsultatins and thse in the varius clinics have been arranged befrehand as far as pssible. Histries have been made immediately available at the time f the appintment, s preventing much delay and irritatin n the part f bth patiellt and physician. The Cllege Health Service suite f rms has been remdelled in such a way as t prvide an extra examining rm, better waiting rm facilities, and mre suitable accmmd<ltin fr the secretarial staff. The rearrangement was well planned and has prved itself well wrth the undertakinr. As heretfre, a health service fr the care f staff members wh spend their hlidays at Peitaih was arranged fr the mnths f July and August. Adequate medical and surgical supplies were sent frm the hspital under the care f physicians detailed t administer this service. The Emplyees' Clinic has been remved t mre suitable accmmdatins in the basement. Dr. S. H. P' ang has cntiuued t administer this service and is well served by nursine, scial service and secretarial staff. Statistics fr all services furnished are listed in Table X.

24 PEIPING UNION MEDICAL COLLEGE HOSPITAL PHARMACY Mr. Jhn Camern, supervisr f the pharmacy, went n furlugh in May, leavine- Mr. Arthur Tye, the assistant pharm~ci&t, in charge. The ttal number f prescriptins issued has cntinued t increase, althugh mre careful investigatin f patients' financial situatin has lessened the number f free prescriptins. While the number f hspital treatment days has been larger. mre care in the use f drugs has resulted in a per cent reductin in the issues t the wards. Year Prescri ptins Dispensed Free Prescriptins 9-7,7,9 9-7,, 9-7,889, PHYSIOTHERAPY The statistics fr this year shw an appreciable increase in the number f patients wh have received treatment in this service (Table XII), als in the variety f treatments given, as may be seen frm the accmpanying Jist. It has been gratifyin" that patients have been referred fr physitherapy frm every service in the hspital. Durine' the year there have been sme changes amng- staff members. Mr. T M. Chang has served as supervisr. Miss Mar'aret Pa has filled a vacancy caused by the resirnatin f Miss Anna B. Lh. A student physitherapist has been added frm the nursin~ service. Sme experiments were carried n under the directin f the Departments f Surgery and Bacterilgy t test the effect f ultravilet rays n cutaneus rganisms. Sme experiments als were made under the directin f the Neurpsycliiatric Service in the physilgy labratry with direct. alternatine-, and hie-h frequency currents, testine- the varius reactins upn the bld pressure and temperature.

25 REPORT OF THE HOSPITAL SUPERINTENDENT A new water cled ultra-vilet lamp and an ultra shrt-wave diathermy machine have been added t the equipment. These mdern machines ffer a new field fr bth clinical and labratry experiments. They are available t the prfessinal staff f the varius services whse cperatin and interest in the past year has been f valuable help t this service. Type f Treatment Massage Muscle Training Exercise Diathermy Aut-cndensatin Vacuum-Electrdes Infra-red Ray Electric Baking Ht Packs Helitherapy Ultra Vilet Ray Faracid Current Galvanic Current Sinusidal Current Electric Cabinet Bath Hydr-therapy TREATMENTS N. f Treatments 8, 9,,8 9...,8,97 9,7, Ttal.... 9,98 OCCUPATIONAL THERAPY The wrk in ccupatinal therapy has cntinued under the directin f Miss Tirzah Bullingtn. Mrs. H. T' Kimm was appinted assistant ccupatinal therapist and had chaqre f the wrk with bed patients. Miss Chen Shan-tze was appinted full time wrker, and had charlre f the wrk at the Psychpathic Hspital. Three hundred ninety-five patients were given ccupatinal therapy, eighty-fur f whm were utpatients. Abut sixteen patients n the wards and fifteen utpatients were under supervisin each day during the past year. Therapy fr these patients cnsisted f raffia weaving, knitting, belt makilll:', crcheting, arlve making, kntting, blanket binding, dll making, tapestry and basket weavinar.

26 PEIPING UNION MEDICAL COLLEGE HOSPITAL MATRON'S SERVICE With the increase in the number f hspital beds frm t since the pening f the.hspital in 9, increasing demands have been made upn the laundry and sewing rms. An idea f the services rendered by the divisins under the supervisin f the hspital matrn, Mrs. Edith Huane-, may be secured frm the fllwin~ cmparative fi~ures. Laundry. There were,,7 pieces laundered durin~ the year 9-, cmpared with,9,8 pieces during the year 9-, and,,9 pieces in 9-; an average f apprximately,. pieces per wrking day fr 9-, and,,8. pieces per day fr 9-. There has been an increase f abut, pieces per day in the past five years. On peak days as many as, pieces were laundered, whereas the laundry is equipped t handle a capacity f, pieces a day. With n increase in space r laundry equipment since the erectin f the buildings, it is evident that the present laundry facilities are ver-taxed, and imprvements mentined previusly in this reprt are imperative. &winz RIJm. New articles made in the sewing rm fr the year 9- numbered,9 pieces cmpared with, pieces in 9-, r an increase f 9,98 pieces during 9-. The weekly mending fr the year 9- amunted t, pieces fr the entire hspital, cmpared with 9, pieces during 9-. Detailed infrmatin f the ther services rendered bv the hspital, with cmparative figures f previus yearl, is furnished in the statistical tables and in the reprts frm the heads f the varius services that fllw. Acknwledgment is made and gratitude expressed t all members f the hspital staff fr the assistance they have given ( the administratin and fr the cperative spirit shwn. SIH-TZE WANG HfJSpital Superintendent

27 STATISTICS 7 TABLE I. ADMISSIONS AN D DISCHARGES CLASSIFICATION OF PATIENTS I Chinese Freign Ttal Ttal Ttal Male \-;:: Male I Female 9H- 9-9-] Patients remaining July, / 9 Patients admitted during the year...,97,yi7 7,9*,,7 Ttal number treated....,7,79 79,,9,98 Patients discharged during the year...,9-,98 7,9,98,9 Patients remaining June, I 9 TABLE II. DAYS OF TREATMENT AND AVERAGE HOSPITAL DAYS BY SERVICES** Days f Days f Average Average SERVICE Treatment Treatment Hspital Days Hspital Day 9-9-H 9-9- TOTAL,9,7 7 7 MEDICINE General,,8 9 Dermatlgy,88,7-9 7 Islatin,,7 J9 Neurlgy,On,98 Pediatrics, 7,8 7 7 Ttal 8,8, SURGERY General, 9,7 Orthpedics 8,7 8, 7 Otlarynglgy,,8 7 7 Tumr,778 * -... Urlgy,87,89 7 Ttal 7,, 9 8 OBS. & GYN. Gyneclgy,, Obstetrics 9,9 8, Babies Brn,9,8 9 9 Ttal,78,79 OPHTHALMOLOGY,7,98 - The ttal number f patientl admitted Inc:lude. 79 babies brn in the hspital. an increase f babie. ver the previu. year. Ba.ed n dllcharrel b,. lerric:ct whic:h include a ttal f 7 inter-service transfers. Credited t General Surrery.

28 YEAR ENDING TABLE III. CLASSIFICATION OF PAY AND FREE TREATMENT DAYS PUBLIC WARDS Pay I Free Out,lde PII'I Outllde I Emplyee. a. Emplyees Patient. Ttal SEMI-PRIVATE WARDS PRIVATE WARDS.. _- --, Pay IAllwancel Free Pay IAllwancel Free Ttal OUliide I Pennnel utll;l~ I Perlnnel Patient. Pts. :-~~; : :~~~~ :_.~~_~~: June, 9 8,,7*,7 8, 9,,9** ~ Per cent Per cent z f Ttal ~ =:======:==-.::.:-:::::::-.-:-.:_=---:::::I=====:=t:=======l=== == :-= : :--:~~~-:=F==::=-=-=I=====t==---==It===ff:::=== t:!j t=' June, 9 7,87."''''-, 8, 9,OH 7,9,7 7,,7"'" ~ (") Per cent Per c~nt f Ttal * ::.-:- -- _.. ~-=----==t:======::f::---.=' I~I '---+._._-- r===-.::::.::-~ =-'-::f====i======l~=====t:====#====t~====i June, 9 8,,88 98,9 Grand Ttal f t Previus,t January, 9, babies brn in the hspital were classified as free patients n the public wards irrespective f the ::c ward service t which the mther was admitted. Since January, 9, newbrn babies have been classified in accrdance with the en "tj status f the mther, i.e., in case f a mther admitted t the semi.private ward the newbrn baby has been included in the treat- ~ ment days fr that ward. > t"" *This fi~re include..7 treatment day' fr aulnfantt brn in the hspital between July. and Dec:ernber, 9J. nthis includes a ttal f.9lreatment day' fr anlnfantt brn durinr tbe entire year 9J-H. ""'Includes.8 treatment days fr all infants brn In lhe hspital durinr the year 9B-H.." ll - ~ Z Q ~ n ~ ~ t'! Q t:!j

29 STATISTICS 9 TABLE IV. DISCHARGES BY SERVICES (including 7 transfers) July, 9 - June, 9 SERVICE MEDICfNE General Dematlgy Islatin Neurlgy Pediatrics Ttal CHINESE Male I Female FOREIGN Ttal Ttal Ttal 9- J ,ll,n,, 7 J I I I, ~~~IIII,9 ~._, ~ I I ' SURGERY I I General 88 I I H II Orthpedics I H Otlarynglgy S S Tumr Urlgy Ttal OBS. & GYN. Gyneclgy Obstetrics Babies Brn,7S 9,98,98, -= =-I-:--=- 9, II 9 I 77 8J 97 ~ l_s_~ ~,-;::-;:-::-:=:":,T:_7""ta7""I I i_'_7, I I,8,978, OPHTHAL ==M=O=L=;O=G=Y==I:==7= I 78 TOTAL,,8 I 8 99,, I,7 IIICr-edited t General Surgery.

30 PEIPING UNION MEDICAL COLLEGE HOSPITAL TABLE V. SERVICE DEATHS AND DEATHS PER DISCHARGES lui)', 9 - lulu, 9 I Deaths Per I 9+- I 9- Deaths Per Discharges Deaths Discharges Discharges TOTAL HOSPITAL,9* MEDICINE General, Dermatlgy 9.98 Islatin Neurlgy Pediatrics Hl..77 Ttal,9.7.9 SURGERY General 9 8.S.79 Orthpedics Otlarynglgy 8.9. ] Tumr 7. ** Urlgy 7.. Ttal, OBS. & GYN. Gyneclgy I Obstetrics 9 '.. Babies Brn ]. 'J.88 Ttal, I OPHTHALMOLOGY I I TABLE VI. DEATHS AND POSTMORTEM EXAMINATIONS I 9-9-/9- ldeatbs - mre than hrs. after admissin within hrs. after admissin 9 8 still births 87 Pstmrtem examinatins 9 Percentage f autpsies. -Nt incladldi' ctal f m intel'lerrlce cranller. ('mered In the fiprn f the variul.erv/cci. "Credited CO Cenera) Sur.c".. I

31 SERVICE MEDICINE General Dermatlg-y Islatin Neurlgy Pediatrics Ttal SURGERY General Orthpedics Otlarynglgy Tumr Urlgy Ttal STATISTICS TABLE VII. EMERGENCY CASES July, 9 - June, 9 Male Female Ttal Dispsitin New I Old New I Old Patients Hme I Admitted , 8 88 I '- i 7! ' I ': : ~ : '~I : : II l 8 II 7 I ~ 97 8' ----;;;-I-~;;;-r~;; I-O-B-~-. b-~-te-:-j-~-n == --;;;- ---;;- Gyneclgy 7 T ta 9 OPHTHALMOLOGY 9 G_R_A_N D_T_O_T_A_L_I_9_S_ ~ -;;;;- -.;;;-l7 TOTAL TOTAL 9- Pay Cases Partial Pay Cases Free Cases

32 PEIPING UNION MEDICAL COLLEGE HOSPITAL TABLE VIII. PUBLIC OUTPATIENT VISITS SERVICE >' OUTPATIENTS OLD OUTPATIENTS NEW Clinic New Cliuic Old I ~IFcmale Male I Female I Male I Female MEDICINE General,9,8, 77,, Dermatlgy, ,9 7 Gastr.intestinal Heart 98 9 Neurlgy 8 9 9, 77 Pediatrics, ,8,9 Syphilis 7 7,7Q, Tuberculsis, Ttal,7,7,8, 7,9, SURGERY General, 7, 97,,8 Orthpedics ,9,879 Oral 77-,8, Otlarynglgy,7, 8,7,S8 TUlDr 8 9,7,88 Urlgy,97 ~~II' Ttal 8,78,7,9,79,7, OBS. & GYN. Obstetrics - 8, Gyneclgy, - 9 7, Ttal -,98-9 9, Ttal,7 77, 8 GRAND TOTAL 7,,87,8l,8 9,99,7 TREATMENTS January June, 9 Physitherapy X-ray Therapy TOTAL OUTPATIENT VISITS Pay Visits Free Visits Percentage f Free Visits A verage Visits per Clinic Day,, ==-:==,: CLINIC VISITS 9-,,,,,7,,,, 7,,,,,, 8,,8,,7 9,7,9,7 77,7 OPHTHAL- MOLOGY I C7eueral,7 77 8,;,8 Trachma.,87 H,llS~,-,P 8, S,, CLINIC VISITS 9-,,8,,87,7 9,7,9,8,,,7.7, 8,87, 9,,8 l,88,9 8,9,,8 8,87,8 8,9.7 S9. "Prir t January I, 9, utpatient vi.ltt fr pbnllbc'llpy and x ray tberapy were UalC'd ttnder the.('... ic~ frm wbic:b tbe padent was referred. Since January firl!.acb.,i.ib bave been entered. "TrQtmen"" and d lit apper in tbe S,ares f.,i.it. CO the clinics.

33 TABLE IX. PRIVATE PATIENT CONSULTATION SERVICE VIsits hy Services July, 9 - June, 9 SERVICE MEDICINE General Pediatrics Dermatlgy and Syphillgy Neurlgy SURGERY General Orthpedics Oral Surgery Otlarynglgy Tumr Urlgy OBS. & GYN. Obstetrics Gyneclgy OPHTHALMOLOGY. TOTAL 9- TOT AL 9- OFFICE CALLS HOME CALLS TOTAL Chinese Freign Chinese Freign New Old New Old New Old New Old NEW OLD Z / l-~~ _ ' f i f f w

34 PEIPING UNION- MEDICAL COLLEGE HOSPITAL TABLE X. COLLEGE HEALTH SERVICE VIsits by Services July, 9 - June, 9 STAFF &. STUDENTS EMPLOYEES lit FAMILIES SERVICE Office Hme Office Hme MEDICINE -- *P I *C *C!tp I *C C Gener.J Dermatlgy 8& 98 Syphillgy Neurlgy Pediatrics ~URGERY I General 78 Orthpedics Oral Surgery Otlarynglgy.. 8, Tumr 7 Urlgy OBS. & GYN. Obstetrics I 97 7 Gyneclgy OPHTHAL- MOLOGY Trachma rrotal 9+- H 79 TOT AL 9-9* 7* 7S 9.p - Prphylaxis C - Cn.ultatin.* Visits t the Trachma Clinic are nt included in these figures. I "" TOTAL VISITS 9-9ft , S ,7 TOTAL VISITS S «78 ---,

35 STATISTICS TABLE xr. PHYSIOTHERAPY VISITS Staff SERVICE ViSITS and Student. Inpatients I Outpatients Private Ward Private Public TOTAL MEDICINE General Dermatlgy & Syphillgy Fint 7 Return TOTAL Firlt I Return Neurlgy Pediatrics Tuberculsis SURGERY General Oral Fint -U-;- 8 ~I Retarn 8 78 Firat Return I Fint Retarn Fint ~ ~~ ~~8 Firat Return I Orthpedics Otlarynglgy Tumr Fint -U ~ 7 97 ~I 8 Retarn ;- -;: Return Firlt 8 8 Return 8 7 n - 8 -;: Urlgy 9 Return ~ OBS. &GYN. Obstetrics Gyneclgy Fint Return -;: Return '--- OPHTHAL-Flnt MOLOGY Return 7 -=========== TOTAL

36 PEIPING UNION MEDICAL COLI.EGE HOSPITAL REPORT OF THE MEDICAL SERVICES INPATIENT SERVICES There was n chan~e in the rganizatin f the medical services r in the arrangement f the wards during the year 9-. The tables in the reprt f the Superintendent f the Hspital shw a siirht increase in the ttal number f inpatients. A decrease in the average number f days in hspital frm 9 in 9- t 7 is the principal surce f the laqrer number f patients. The average bed ccupancy was essentially unchanged. Every effrt is made t utilize all available beds. In the Islatin Pavilin it is impssible t maintain a very high average bed ccupancy, win! t great seasnal variatin in the incidence f cntagius diseases. At times the patients needing care in this building cannt all be received. Yet, when the need fr strict islatin is lighter, it is entirely unsuitable t place ther patients in these wards. This service cared fr the larest number f patients in its histry ( J. The Private Patient Service was especially busy during the year. It is increasingly apparent that flreat need exists fr mre extensive prvisin fr the hspitalizatin f sick children. These future citizens ften suffer frm diseases which bth demand and respnd t mdern treatment. Their cart' is at nce a humane undertaking, a scial insurance, and an educatinal prcedure. The diagnsis list disclses a further increase in the number f patients with kala-azar (79 against ill 9- and in 9-). Taking int cnsideratin ther experience, ne must cnclude that this disease is spreadinfl abut Peiping as elsewhere in China. A larger number f patients with malaria was als seen (9, including f quartan type and 9 sub-tertian; in 9- nly 9 benign tertian). Cmpared with bacillary dysentery ( entries), amebic dysentery (7 entries) is uncmmn in Peiping-. There were 8 diagnses f amebic liver abscess. A large number f cases f diphtheria (89) and scarlet fever () were received; the mrtality in these cases, many f which have ate hspitalizatin and are in desperate cnditin n arrival, is high (7 and deaths respectively). Rheumatic fever with entries cntinues t he seen mre frequently than years befre 9.

37 OUTPATIENT CLINICS REPORT OF THE MEDICAL SERVICES 7 As has been previllsly pinted ut, mst f the utpatient clinics have reached the maximum attendance permitted by the space and staff at hand. Nevertheless, the visits t the clinics fr pediatrics,. syphilis, and tuberculsis increased significantly. The Gastr-intestinal Clinic carried ut 8 sigmidscpic examinatins. The Tuberculsis Clinic gave artificial pneumthrax,7 times. It is hped that a cmplete appintment system may be installed, which shuld bth facilitate the wrk f the clinics and give better service t the patients. At the request f the Department f Public Health the Divisin f Dermatlgy and Syphillgy established a clinic fr the treatment and cntrl f syphilis in the First Health Statin f the Peiping Municipality. Fr the present admissin t t~e clillic is limited t pregnant wmen and!lew-brn infants. As a part f a prgram fr the preventin f natal syphilis, the clinic is als undertaking an investigatin f all members f the families f patients. The equipment f the clinic and the methds f treatment have been designed simply and ecnmically in such a way as t facilitate develpment f similar prjects elsewhere. The clinic shuld prvide in the future a valuable surce f infrmatin n the prevalence and transmissin f syphilis in the ppulatin, and n the effects f the diseases n infant mrtality. It shuld als furnish a gd demnstratin f the efficacy f antenatal treatment. LABORATORIES The examinatins made in the special labratries are shwn in the annexed table. Ordinary clinical examinatins, chiefly qualitative, carried ut by the resident staff and thsct fr utpatients are nt included. In additill the Neurlgical Service in cperatin with the Pathlgical Service studied 9 brains in cnnectin with pstmrtem examinatins ( in 9-). The Dermatlgical Service gave the fllwing special treatments: quartz lamp, radium 8, superficial x-ray 99, electrlysis, and carbn dixide snw.

38 8 PEIPING UNION MEDICAL COLLEGE HOSPITAL PERSONNEL In March, 9, tw members frm the Medical Service f the hspital were sent t Changsha, Hunan, t render help during the meningitis epidemic. Frm January], until the end f May, Dr. G. Canby Rbinsn, until recently Dean and Prfessr f Medicine at the Crne]] University Medical Clle~e, New Yrk, was with the department as Visiting Prfessr f Medicine. Dr. Rbinsn's visit was a surce f inspiratin and help t all the staff and will lng be remembered. In the spring he rave a mst inreresting.series f lectures n the Histry f Medicine. Frm January, until the end f the year, Dr. Dieuaide was absent abrad n leave. Dr. Frazier acted as head f the department. During the year Dr. Hannn left the department after fur years f valuable service, especially in the field f metablic disease, in which he has had Jng and wide experience. Dr. H. L. Chung was absent n leave during the secnd half year. Drs. Hall, C. K. HUt and C. J. W u returned frm leave. Dr. C. W Bien succeeded Dr. H. I. Chu as resident physician. C. N. FRAZIER Prfessr f Dermatlgy and Syphillgy and ActinE Head f the D~partment

39 ,, CLINICAL LABORATORIES OF THE 9 DEPARTMENT OF MEDICINE July, 9 - June, 9 SPECIMEN AND Number Ttal Ttal LABORATORY DETERMINATION f----i Cardiac Electrcardigrams 877 Heart sund and pulse recrd ] 89 9~ Chemical (quantitative) I_ Bld Bilimbin Calcium Carbn dixide cmbining I 89 pwer Chlrides Chlesterl 7 Creatinine 8 Fat, ttal Nitrgen, Amin acid Nitrgen, Nn-prtein,9 Nitrgen, Urea (including 7 97 fr urea clear-! ance test) : Phsphrus, Inrganic I 7 Phsphrus, Lipid I Plasma prteins Ttal prteins I 8 Alhumin I, I Euglbulin ',_ 7 Fibringen Glbulin! I Sugar,9 i \- Uric acid!~,,,9_ Cerehr-spinaljluid I! Calcium i Carhn dixide cmbining: pwer Chlrides N n -prtein nitrgen i _._Jl:~~i~~~t:~~_~.. _. I I : I _.._I--~!~ Pleural and ascitic fluids! j Chlesterl'! ] I Nn-prtein nitrgen Prteins, ttal I Albumin I l_:.~.----l-- G_l_b_l_ll_in -I Urine Bence-Jnes prtein Chlrides Creatine (as creatinine) i

40 PEIPING UNION MEDICAL COLLEGE HOSPITAL LABORATORY CLINICAL LABORATORIES (cncluded) SPECIMEN AND Number Ttal Ttal DETERMINATION Creatinine Nitrgen, ttal, urea (including 99 " 97 fr urea clearance test) Renal fildctin te-st (P.S.P.) S Urea clearance te~t 97 Uric acid Sug-ar, quantitative MisceJlalJeus bdy fluids Chlesterl Chlrides Fat Lactse N n-prtein nitrgen PrteiJls, ttal Albumin I Glbulin I 8 Dermatlgical Animal inculatins Culture {mlds} Darldield exam. (T,-epne- 9 7Ja pallidum) Hair, epidermis (mlds) H Skin ( AcarttJ.rcahiei) 78 Smear (ac id-fast bacilli) 9 89,79 I --- Metablic Basal Metablic rate Parasitic Diseases Bld (malaria) Uld (mierfilaria) 7 Bld (spirchetes) Spleen, liver smears (lcala- 7 azar) Stls (va, parasites) Pus (prt zua) Tuberculsis Pus Sputum,8 Stl 9 Urine 8 Miscellaneus 7,, TOTAL EXAMINATIONS,,9

41 REPORT OF THE SURGICAL SERVICES INPATIENT SERVICES The wrk f the inpatient services prceeded alng usual lines. The wards were filled cnstantly t capacity, a bed ccupancy f 98. per cent being maintained fr the year as a whle. This figure was attained largely because certain changes in ward assignments f the varius hspital services (carried ut at the clse f the preceding year) made it pssible t assemble in wards G-l and G- all the beds fr adult male patients cntrlled by the department, thus allwing much mre efficient management and utilizatin f available space. The disprprtin between the attendance at the utpatient clinics and the facilities fr hspital care remains such that a waiting list f patients desiring admissin is maintained at all times and there is little seasnal variatin in the wrk f the wards. The number f admissins remained practically unchanged, an increase ill the number f hspital days being explained by the fact that the average residellce \vas increased by ne day (see Tables I and II, page 7). The general mrtality fr the surgical services was.98 per cent (page ) and the perative mrtality was. per cent. These are nt unsatisfactry figures when ne cnsiders the serius nature f many f the cases which,,'ere accepted fr treatment. Careful examinatin f the classified list f diseases and peratins (pages 8 t ) will emphasize this fact. The number f peratins perfrmed in the general perating rm increased slightly. The accmpanying table shws the types f anesthesia emplyed as well as the increasing trend twards lcal and reginal anesthesia during the past ten years. OUTPATIENT SERVICES Due t a cnsistent effrt t limit the attelldance at certain clinics the ttal number f utpatient visits failed t shw an increase fr the first time in ten years. The ttal number f visits (87,), hwever, remains high. W hen visits by private patients (,8), staff and emplyees (,8) and emergency visits (87) are added, the ttal figure reaches 9,98. The number f perative prcedures carried ut in the utpatient clinics was,, an increase f apprximately per cent.

42 PEIPING UNION MEDICAL COLLEGE HOSPITAL The usual clinics were maintained thrughut the year (page ), and special clinics fr plaster wrk, urlgic diagnsis, and the treatment f tuberculus glands, hemrrhids, varicse veins and chrnic leg ulcers, were cntinued. Tables f special prcedures carried ut in the Urlgy Clinic, the Dental Clinic and the Plaster Clinic are appended, as well as a list f the apparatus manufactured in the rthpedic shp. Emphasis again shuld be given t the need f the Dental Clinic fr new quarters in which bth public and private patients can be handled and in which prper labratry facilities can be prvided. Such a change wuld nt nly centralize the wrk f the divisin and allw private dental patients t wait in sme place ther than the crridr f the perating rm flr, but als wuld make available space much needed by ther public utpatient clinics. PERSONNEL Dr. P. C. Tung resigned frm the department at the beeinning f the year in rder t accept appintment as assistant prfessr f surgery at the Natinal Medical Cllege in Shanghai. Dr. M. L. Hu similarly departed t take charge f the Department f Otlarynglgy at the Central Hspital, Nanking Dr. L. J. Miltner returned frm furlugh in early December and Dr. H. E. Shih cntinued n study leave abrad. The services f Drs. C. M. Van Allen, J. W Spies and J. J. Wlfe were terminated by the cllege in the early spring. Dr. T C. Yane resiened his psitin as clinical assistant in March t jin the staff f the Army Medical Cllege at Nanking. Dr C. S. Chang was appinted assistant in tlarynelgy and Dr. H. L. Chang assistant in surgery at the beginning f the year. Dr. C. P Yang assumed the pst f resident surgen. Lt. Cmmander Mrtn D. Willcuus (Medical Crpl, U.S.N.) returned t the United States in April after the cmpletin f his tur f duty in China, and Capt. Gerge W Shepard, wh replaced him as senir medical fficer at the American Legatin Guard, was appinted hnrary lecturer in surgery. H. H. LOUCKS Prfissr f Surgery and Head f the D~partment

43 REPORT OF THE SURGICAL SERVICES TYPE OF ANESTHESIA ANESTHESIA N umber per year Percentage JO GENERAL Ether (inhalatin) Chlrfrm Divinyl ether G<iS and xygen plus ether ] 9 9 TOTAL, INHALATION Clnic ether 9 8 plus in halatin 7 7 Avertin pills ether, G &, r lcal i. 7.. _--- TOTAL, COLONIC ~ ~ ~ I~I~. Sdium Amy tal plus ether, G &, r lcal Evipan plus ether r lcal ~I ~ l TOTAL, INTRAVENOUS I=L=O=C=A=L=&=R=E=G=I=O=N=A=L===I== TOTAL, GENERAL 77 i7 8.j..7. Sacral plus ether r G & I 7 T_O_T_A_L_,_S_A_CR_A_L I ~ ~ _.ll~.. Brachical 7 7 plus ether, G & r lcal TOTAL, BRACHIAL Spinal plus ether. G & r lcal TOTAL, SPINAL Lcal infiltratin r blck plus ether r G & TOTAL, INPILTRATION OR SLOC" 9 9 't TOTAL, LOCAL AND REGIONAL ==========..:= GRAND TOTAL

44 - PEIPING UNION MEDICAL COLLEGE HOSPITAL SPECIAL PROCEDURES CARRIED OUT IN THE UROLOGY CLINIC Cystscpy including cases with catheterizatin f ureters Cystscpy and retrgrade urgraphy Cystscpy and ureteral dilatatin and pelvic lavage Cystscpy and lithlapaxy Cystscpy antf insertin f radn Cystscpy and bipsy..._... Cystscpy and external met hrtmy Endscpy (diagnstic and treatment) Intravenus urgraphy Cystgraphy Dilatatin f bladder Bla(lder pressure determinatin Catheterizatin _ Circumcisin Sunding Fulguratin... _..._... _ Incisin and drainage..... _ Drsal slit... _ Pv eattlny Excisin (papillma, gland, etc.) Orchipe~y Vasectmy _.... Ligatin f bjeedef f penis SPECIAL PROCEDURES CARRIED OUT IN THE DENTAL CLINIC Gingivitis and stmatitis treatment.. "..... Pyrrhea alvelaris treatmen t Oral prphylactic treatment Dressing Exdntia and surgical remval f teeth..... Incisin and rainage f abscess..... Cystectmy.... Gingivectmy and flap peratins fr paradental disease..... Sequestrectmy Alvelectmy..... Apicectmy.... Rt canal treatment M jcellaneu Inpatients 8 9 Private Patimu Public Ttal..t Staff Outpatients IS S

45 REPORT OF THE SURGICAL SERVICES ORTHOPEDIC SHOP ARTIFICIAL LIMBS: 9- Artificial leg Artificial arm... ~... Artificial ft....:... Plaster py In BRACES AND SPLINTS: Back brace... Lng leg brace... Shrt leg brace... Special leg brace Knee cage splint.... Cck-up splint... 'Valldng caliper splint... Platfrm splint... Turnbuckle brace..... Ft brace... Finger and wrist splint _. Jnes splint.... Sacriliac belt... Special neck brace... Leather cllar... Leather anklets... l russ... Tractin appliance... REPAIR OF APPLIANCES SHOE-WORK: Shes.... Alteratin f shes..... Wden mdel fr she ~.... Metatarsal bar.... Wden sle.... Rubber pad..... Crk insle Leather insle..... Duramilluln insle.... Cellulid insle SURGICAl. INSTRUMENTS

46 PEIPING UNION MEDICAL COLLEGE HOSPITAL PLASTER CUNIC M ISCEI.LANEOUS Crutches.... Plaster cast ~.... Sacrlumbar pad.... Bradfrd frame.... Irn bars fr tractin..... Canvas hammck.... Accessries t plaster jacket..... Special leather wrk.... CASTS: Special plaster cllar..... Plaster bt.... Plaster mdel f extremities fr prstheses.... Figure-f-eight cast fr shulder.... Lng arm cast Shrt arn) cast Lng leg cast..... Shrt leg cast..... Bilateral leg cast.... Plaster knee cage..... JACKETS: SPICA: Plaster jacket Plaster bed..... Plaster bdy shell..... Plaster bdy head tractin.... Shulder spica..... Hip spica Lng leg spica.... Duble hip spica..... Spille spica.... SPLINTS: Arm splint.... Cck-up splint.... Lng leg splint Knee splint..... MODEL FOR BRACE REPAIR OF CASTS J 8 9 S H S S -+

47 REPORT OF THE OBSTETRICAL AND 7 GYNECOLOGICAL SERVICES CLINICAL WORK This has steadily grwn till we are cnfrnted with a difficult situatin. The number f emergency bstetrical cases sent in frm the utside has gready increased, s that the pprtunities f teaching n cases f difficult labur are nw as great as we culd wish, and the difficulty is t find beds with which t satisfy the demand. Our wrk n cancer f the uterus has als inc reased s greatly that we have always a lng waiting list. Dr. McKelvey has taken special charge f this wrk, and with ur Neplastic Clinic, and the facilities fr using radium and deep x-ray thenlpy, the prvisin fr this class f case in the hspital is very efficient. The Department f Radilgy has given us mst efficient help. Anther matter which will need special attentin during the cming year is the rapid grwth f ur utpatient service. Plans are n ft fr a mre adequate handling f these patients, and fr the further develpment f the special clinics n sterility and birth cntrl. It is urgent that mre prvisin be made fr fllwing up the numbers f patiellts wh pass thrugh ur hands. The number f deliveries ccurring ill the hspital this year was 78, (9-, 8.); the number f children brn was 79 including cases f twins ( f the twins were brn befre admissin). In additin 9 wmell were delivered in their hmes, (9-, 8). The ttal number f deliveries cnducted by the department was, (9-, 89). Frty Lipidl tests fr patency f the tubes were carried ut by the department during the year, and 7 Zndek-Aschheim tests fr the presence r absence f pregnancy. STATISTICS During the curse f the year Dr. K. T Lim, assisted by Dr. Eastman and Dr.. C. Yuan, has wrked ut a cde fr putting ur bstetrical data n punch cards fr statistical analysis. She has already carded ver a thusand f ur recrds, and it is expected that this system will prve f inestimable value in the study f many clinical prblems.

48 8 PEIPING UNION MEDICAL COLLEGE HOSPITAL Drs. Eastman and McKelvey have als spent sme time n the tabulating f ur cases f cancer f the cervix and this has revealed a failure in ur fllw-up system which it is planned t try t remedy in the cming year. LECTURES AND TEACHING Dr. Maxwell paid his annual VISit t Cheel University and dejivered a curse f lectures there during April, 9. Dr. K. T Lim delivered a curse f lectures in Chinese at the First Natinal Maternity Schl. Advanced lectures have been delivered every Saturday mrning fr the third and furth year students, and fr any visitrs, dctrs and nurses wh might like t attend. They have been given by the senir staff and have been well attended. Undergraduate teaching has gne n as usual during the year, the usual curse in bstetrics being given by Dr. Eastman and that in gyneclgy by Dr. McKelvey. Dr. McKelvey has als given special instructin in bstetric and gyneclgical pathlgy, and the arrangements fr teaching at the bedside have been further develped. The usual class fr nursing students was held during the first trimester by Dr. K. T Lim. It fllwed the same lines as thse f preceding years. POSTGRADUATE "'ORK. The pstgraduate curse was nt held last year, but in its stead a special class, cnsisting f six Chinese dctrs sent in by the Ministry f Health fr special wrk in bstetrics, public health and pediatrics, met durin" Octber, Nvember and December. Dr. Eastman cnducted the teaching in bstetrics fr the class, which made gd prgress. Midwives frm the First Natinal Maternity Schl were given the pprtunity f bserving the wrk f the department, attending fr furteen days at a time. One r tw special students jined the department fr limited perids fr revisin and imprvement f their wrk. One f these was the first (lraduate f the ld Unin lvledical Cllege, Peking.

49 REPORT OF THE OBSTETRICAL SERVICES 9 VISITING POSTGRADUATE STUDENTS Dr. J. P. Maxwell, n his way back frm furlugh, paid special visits t Bangkk, Hngkng, Cantn, Shanghai and Nanking t enquire int the wrk which was being accmplished by past members f the staff and by pstgraduate students. The results f the teaching ~iven seem t be very satisfactry, and these men and wmen are giving a real cntributin t the prblem f prviding medical aid t their wn peple. EXTRA MURAL OBSTETRICAL WORK The members f ur huse staff have carried n extra mural bstetrical wrk durin~ the year in the Public Health Area. There has been little change in the arrangements, but it is becming increasingly clear that, with the grwth f cnfidence in ur maternity wrk, plans will have t be frmulated fr the restrictin r rearrangement f this wrk. WOO PRIZE This prize, pen annually fr competitin,,"as awarded t Dr. S. C. Wei fr an essay n Tht Inductin if Labur by Bugies. RESEARCH WORK Dr. Maxwell was able t present the results f his research wrk n stemalacia and fetal rickets befre the Ryal Sciety f Medicine in Lndn, and by means f lectures in Winnipeg, Trnt, Mntreal, l\anchester. Birmingham, Cambridge and Belfast. Further wrk is nw being carried ut n the same subject. Dr. Eastman has been cntinuing his wrk n fetal physilgy particularly in relatin t the causatin f icterus nenatrum. Dr. McKelvey has taken charge f the bstetric and gyneclgical pathlgy, wrking in clse cnnectin with Dr. C. H. Hu wh has very kindly made arrangements fr him t carry ut this in the Department f Pathlgy. He has been specially wrking n the disrders f menstruatin and the effects f radiatin n cancer f the cervix.

50 PEIPING UNION MEDICAL COLLEGE HOSPITAL Dr. K. T the vagina. Lim has made a special study f the yeasts fund in Dr. P. W Wang has been making a special study f sterility as it affects ur Chinese patients. PERSONNEL The staff has been strengthened during the past year by the appintment f Dr. Jhn L. McKelvey t an assciate prfessrship in the department. Dr. N. J. Eastman accepted the pst f Prfessr f Obstetrics in the Jhns Hpkins University and Obstetrician-in-Chief t the Jhns Hpkins Hspital and left us at the clse f the year. Dr. J P Maxwell was n furlugh during the first eight mnths f the year, but returned t duty in May. J. PRESTON MAXWELL Prfissr f Obstetrics and GyneclEl' and Head f the Dep rtmmt

51 CLINICAL WORK REPORT OF THE OPHTHALMOLOGICAL SERVICE The figures included in Tables VIII, X and XI, indicate the attendance in the clinics f the Eye Service during the year 9-~. The number f new patients seen in the utpatient clinics the past year was,77 cmpared with,8 the year befre. The number f hspital patients cared fr and days f treatment rendered are shwn in Tahles I I I and IV The Eye Service was called in cnsultatin 89 timt's. The service perfrmed 8 majr peratins ( the previus year) and minr peratins ( the year befre). TEACHING Durin~ the year under review Dr. Krnfeld twice gave lectures n the Intrductin t Oplztlzalml y, during the first trimester t the furth year students, and during the third trimester- t the third year students. The practical part f the furth year undergraduate instructin was carried ut by Dr. H. T Pi. Dr. S. P. Chang taught Methds f Examinatin in Ophthalmlgy t the secnd year medical students during the third trimester and cnducted the phthalmlgical curse fr the nurses. The special pstgraduate curse in phthalmle,-y, which was mitted last year, was held frm March t April, 9. The curse, using English as the medium f instructin. was g-iven by the senir staff t a class f eleven physicians cming frm different parts f the cuntry. This time the Anatmy and Radilgy Departments, as well as the Dermatlgical and Neurlgical Services participated in the teaching, with Drs. PH. Stevensn, T. S. Jung, C. N. Frazier and R. S. Lyman respectively presenting their specialties. The Department f Ophthalmlgy wishes t recrd here its thankful acknwledgment f the splendid cperatin accrded by the several participating services. During the year graduate students were trained in phthalmlgy, amng whm received financial aid frm the cllege. Tw physicians attended the clinics as bsen'ers.

52 PEIPING ONION MEDICAL COLLEGE HOSPITAL PERSONNEL On July, 9., Dr. H. T. Pi entered upn his new appintment as clinical assistant prfessr n a half-time basis. He was given permissin t use the facilities f the hspital and the eye clinic fr his private patients. Dr C. S. Fan, assistant resident phthalml~ist since July, 9, became ill in December 9, and had t be relieved. Dr. H. C. Ch' i was appiuted assistant resident fr the perid f Dr. Fan's absence. PUBLICA TIONS In the September 9, issue f the Chinese Medical Jurnal, knwn as the Special Eye Number, mst f the year's papers frm all the members f the department were published. Several ther papers by members f the department appeared elsewhere. PETER C. KRONFELD Prfissr f Ophtha/mlEY and Htad f tht Dtj>artmmt

53 REPORT OF THE RADIOLOGICAL SERVICES The department experienced the same difficulties this year as thse mentined in the reprt f the previus year, as there has been n substantial changes in the staff r physical equipment. The prpsal t install a flurscpe in the utpatient service fr the use f the Pneumthrax Clinic was carried ut tward the end f the year. ROENTGEN DIAGNOSTIC SERVICE The fllwing tables shw the number f patients and examinatins during the year. There is an insienificant decrease in the number f patients, hut the number f examinatins is slightly higher than that f the prect"ding year. Year Inpatients PATIENTS FXAMINED Staff and Private Public Students Outpatients Outpatients I I I Ttal 9-, 977, I,78,7 I 9- I, ,, i, ,99,8 I I CLASSIFICATION OF X-RAY EXAMINATIONS --I 9- I Chest, (lung, heart, pneumthrax, etc.), 7,8 7,77 Bne and jint,89, Skull (mastid, sinus, ventricles, etc.) 8 8 Gastr-intestinal tract 7 8 Urinary tract I I ~- Female reprductive system i 7 Teeth I Ttal I,88 I, I R:NTGEN THERAPEUTIC SERVICE In spite f the limitatin in the capacity f the service, as stated in the- reprt f the previus year, there was a further increase by 77 patients (7. per cent) treated with x-rays during the year as cmpared with the statistics f the previus year ( against 7). There was cnsiderable hardship fr the service t meet this demand. The Tumr Service f the Department f Surgery cntributed a large share in the

54 PEIPING UNION MEDICAL COLLEGE HOSPITAL increase, but a greater number came frm the Gynecl'ical Service which, under the present plan, referred mst f the cases f cervical carcinma fr an intensive curse f x-radiatin immediately befre and sme weeks after the lcal applicatin f radium r radn. S far the immediate results f this plan f treatment seem t have justified the effrt. Service Gyneclgy Tumr Orthpedics Otlarynglgy General Surgery Urlgy General Medicine Neurlgy Pediatrics Islatin Dermatlgy Ttal DEEP ROENTGEN THERAPY July, 9 - Junt, 9 I I Number f Patients I Number f Treatments 8 8 S SUPERFICIAL ROENTGEN THERAPY I Number f Prts 88 I - 8 I I 97 Gyneclgy Tumr Dermatlgy 8 9 General Surgery 8 79 Tuberculsis Urlgy 7 Otlarynglgy Ophthalmlgy Islatin 7 General Medicine 8 Radilgy Experimental 9 Orthpedics 8 9 Pediatrics Ttal S HI 9-9 Ttal fr Deep and Superficial Therapy, *The actual number f patients treated was, as 7 patients received bth deep and superficial therapy r were referred by different services.

55 REPORT OF THE RADIOLOGICAL SERVICES THE USE OF RA DrUM AND RADON Medicine Surrery Gyneclf}' O!~~~~!:~- Ttal Radium Cases Tube8 and Treatments 7 Plaque Mr. Hn }~ Ii Jn Casea! Radium Tray Treatments Mi. Hrs. Radium Cases :.7 Needles Treatments!I -=====I=M=r=.=H=rI='====:I===O=.97 O~! - ---i~====== Ca.es 9 I 7 RADIUM Treatments n 9 :: TOTALS ~~: :::~ Available. 7! SO. 7.~9 _9.79 II ~!:~~~ =========::::::::::=====-=== ===':":='::"- Casea Radn Tubes Treatments Radn Tray 7 IrJ Mc. Hrs I.8% C-a-,-e-s I ----,l! H Treatments 7 I' 8 Me. Hrs ,. Radn Cases I Needles Treatment. i!_m_c_._h_fs_. _ S Radn Gld Seeds Cases Treatments Me. Hre. N. f Seeds Radn Lead Mc. Hrs. Seeds N. f Seeds 8 i; 8 97 II : I'.H _ z.;;-\iji.8 8 II 8 ===----- Cuel --9--r ' RADON Treatment TOTALS Me. Hri I.8.98 Me. "n. A \'8iable. I====I======-=====:i.. New Cases 98 : RADIUM AND Ttal Cac: 7 RADON Treatment, TOTALS Mr. and Me. Hn jill Mr. and Me. Hrs. Available i.. ========I:c=as=e=s======I====,=, - ItS - los IU8 Treatments 8 i 9 TOTALS MI!". and Mc. Hn :,.7.9 9H- M~v:~~~c. Hra. il.7. =====II:N==. =A=u=s=e=ed='===:I===O= ~S8 _ 99 9 /. Cates , 8 Treatments 9 8 I' TOTALS l\'i!". and Mc. Hra _8 7...,. Mr. and Mc. Hrs. 9- Available _.. N. Au Seed

56 PEIPING UNION MEDICAL COLLEGE HOSPITAL RADIUM AND RADON SERVICE The radium which was sent t America in 9 fr redistributin int smaller applicatrs was returned in the fall f 9. There were, milligram hurs f radium available fr use durin~ the year. The ttal use f radium fr therapy and experimental wrk was abut per cent f that available (as against abut 7.S per cent fr 9-), being almst duble that f the previus year. Fr therapy alne the increase was per cent. The radn plant has functined satisfactrily thrughut the year with but ne minr accident. The plant was perated a ttal f times. The average per cent f the theretical yied was 87. (abut per cent higher than fr the previus year). The daily average f radn available fr use was millicuries. There was available fr use during the year,, millicurie hurs f radn. The ttal use f radn fr the year was per cent less than fr the previus year and was 9 per cent f that available. The amunt used fr treatment f patients was per cent f that available and was per cent less than the amunt used during the previus year. The cmbined use f radium and radn fr the year was per cent f the available amunt and was per cent less than the previus year. The number f cases treated with radium r radn r with bth decreased frm 8 fr the previus year t. A summary f the use f radium and radn in different applicatrs by the varius services is presented in the preceding table. PERSONNEL Dr. c. W u entered private practice in Peiping and became a part time member f the department in February 9. Dr. T S. lung and Mr. H. S. Wane returned frm abrad in Nvember. C. K. HSIEH A!Sciate Prfissr f Rmtzmlzy and Head f the Department

57 REPORT OF THE PATHOLOGICAL SERVICES 7 DIVISION OF PARASITOLOGY The fllwing tabes summarize the wrk perfrmed by the Parasitlgical Diagnstic Labratry fr the hspital: INCIDENCE OF INTESTINAL PROTOZOA AND OF HELMINTH INFECTIONS July, 9 - June C!, 9 Ttal cases examined,7 Ttal examinatins made,7 Number Psitive Cases Per cent Psitive Cases PROTOZOA Entameba histlytica 9. Entameba cli 87.- Endlimax nalla 9. Idameba buetschlii. Giardia lamblia 98. Trichmnas hminis.77 Chilmastix mesnili. HELMINTHS Ascaris lumbricides Ancylstma r Necatr U7.79 Trichcephalus trichiurus.& Enterbius vermicularis.9 Clnrchis sinensis 8.7 Schistsma japnicum I I. Fascilpsis buski.7 Dicrcelium dendriticum I.- Philphthalmus species *. Trichstrngylus rientalis I. Taenia spp. (intestinal). Hymenlepis nan a I. Echincccus cysts. Accidental. Ova temprcuily present. N wrms fund.

58 S8 PEIPING UNION MEDICAL COLLEGE HOSPITAL EXAMINATIONS OF BLOOD July, 9 - June, 9 Number f persns examined Number f examinatins made 7 S9 /Number Psitive Cases Per cent Psitive Cases Plasmdium vivax Plasmdium malariae Plasmdium falciparum Spirchaeta recurrentis EXAMINATIONS FOR LEISHMAN-DNOVAN BODIES Number f persns examined N umder f psitive cases July, 9 - June, 9 Ttal Number Examinatins Number Psitive Examinatins 9 Per cent Psitive Examinatins Culture f splenic pulp* Smear f splenic pulp 98 Culture f liver material Smear f liver material Culture f bld Culture f bne marrw Smear f ear swab Culture f swab frm abscess f Lymphgranulma inguinale Cultures were made nly in cases f extreme dubt.,.8,.

59 REPORT OF THE PATHOLOGICAL SERVICES 9 DIVISION OF PATHOLOGY AUTOPSIES ON INPATIENTS AND OUTPATIENTS July, 9 - June, 9 I Deaths SERVICE ~ c u b. Iii c 'ij ' :.c... f-. u ~ INPATIENTS: Medicine los Islatin 7 7 Neurlgy 8 9 Pediatrics 9 9 Obs. & GyP. t Adults I Infants 9 9 Surgery 7 7 I ~ Urlgy Orthpedics Otlarynglgy --- ~ ~~~-~~ OUTPATIENTS: Medicine Islatin Neurlgy Pediatrics Surgery ~I Autpsies :! c u bt Cii c 'ij - E-c :.c... u ~ 8 9 I I I , I Percentage ~ bi!.= -E >..J ~ <;j ' r Ttal * 9, HOSPITAL CASES: Inpatients Outpatients Nn-registered fetus Outside cases (chiefly infants) 9 Ttal The number f autpsies shws a slight increase ver that f the previus year. It is t be nted that f the autpsies perfrmed, abut 7 cases, r 8 per cent, were frm the Obstetric and Pediatric Services f the hspital and frm utside hspitals. *Ipcluding bdies upn which permissin fr autpsy bas nt yet been btained.

60 PEIPING UNION MEDICAL 'COLLEGE HOSPITAL Our series f autpsies includes the fllwing cases f special interest: tuberculsis cases, bacillary dysentery cases, fetal rickets cases, subtertian malaria case, ascaris in liver causin~ fatal hemrrhage case, amytnia cngenitall case, syphilitic aneurysm f splenic artery with rupture case, myxma f heart bstructine the mitral rifice case, ndular cirrhsis f liver cases, beriberi case, reticular cell tumr f liver case, retrperitneal multilcular cyst in a male child case. The fllwing table shws the number f autpsies perfrmed n bth inpatient and utpatient cases during the past ten years. Year I Deaths I Autpsies I Percentage Chinese I Freirn I Ttal I Chinese I Freirn I Ttal I ChineJC I Frei~n I I.8 /.9 Ttal 9! I 9 i 7 / 8. I 78.7 I I I I I , 9 7, , I I I 9-8 I I. 9 I I 9 I! j \l I I i I. SURGICAL PATHOLOGY 'l'he ttal number f surgical specimens received during this year was,8, r 78 mre than the previus,year. This increase was cntributed t hy the Departments f Surgery and Ohstetrics and Gyneclgy.

61 REPORT OF THE PATHOLOGICAL SERVICES SURGICAL SPECIMENS RECEIVED DURING 9- Medicine 9 Dermatlgy Neurlgy Surgery,877 Dentistry 78 Otlarynglgy Obstetrics and Gyneclgy,779 Outside 88 Ttal,8 The fllwing table shws the number f specimens received during the past years: ~ Medicine ~ 9 9 Dermatlgy 7! 8 Neurlgy I \ Surgery ,,,87~ Dentistry 78 Otlary nglgy Obs. & Gyn S , 9,77,779 Outside TOTAL, , +,998, +,+,+.8 PERSONNEL Dr. R. J. C. Heppli was away in Eurpe n furlugh during which time Dr. C. H. Hu served as Acting Head f the Department. Dr. L. C. Feng returned frm his furlugh in September t the Divisin f Parasitlgy. Drs. V - T Lieu and S. T W u jined the staff in the Divisin f Pathlgy. R. T C. HOEPPLI Prfessr Df ParasitlLJ and.jctile Head f the DtjJartment

62 PEIPING UNION MEDICAL COLLEGE HOSPITAL REPORT OF THE BACTERIOLOGICAL AND IMMUNOLOGICAL SERVICES In the year 9-9 the activity f this labratry has been cnfined t the same type f wrk as in previus years. As shwn in the accmpanying tables sme decrease in the numberf specimens examined in the Bacterilgical Labratry ccurred. It is t be pinted ut that with better cperatin with members f the huse staff the number f psitive stl cultures f acute dysentery has been abut 7 per cent. We cntinued t islate B. suipestifir frm bld and ther specimens f mre than patients in the current year, and recrded an additinal case f undulant fever fr which vaccine and immune serum have been prepared in this labratry in al attempt t give hejp t the clinical staff. As befre, effrts at imprving and simplifying labratry technique have been made, and sme new but standardized technical prcedures have been elabrated. Mst f these are included in the revised and enlarged editin f the Bacterilgical Manual which appeared in May 9. The rapid slide typing f pneumcccus and rapid swab culture fr B. diphtheriae have been tried. A preliminary tt"st cmparintr l!uinea pigs and hamsters as test animals fr virulence f B. diphtheriae has been cmpleted. and \ve were able t shw that the latter is just as satisfactry fr this purpse as the frmer. In ding stl cultures, we have used in the latter part f the year, instead f the usual Durham sugar fermentatin tubes, a mdified Russell's medium, which has affected a savine- f at least ne half f the labr bth in the preparatin f media and in carryin" ut the test. Sme members f the huse staff n the l\tledical Service have spent frm ne t three mnths in this labratry t take care f the specimens s~nt in utside f the regujar ffice hurs. \Vhile sen-jng in this capacity sme f them made clinical r labratry studies. Bth Dr. Lee's case reprt Enteritis injectin f Liver Abscess and Dr. Yu-s study n /7anatin in Streptcccus Fibrinlysin have been published during the year. Dr. TunR' has made an interesting study the effect f phtdynan:tic actin f methylene blue n bacteria. One f the fifth year students f the Natinal Medical Clleee in Shanghai, cmpleted her graduatin thesi& n

63 REPORT OF THE BACTERIOLOGICAL SERVICES BACTERIOLOGICAL LABO RA TOR Y SPECIMEN 9-H 9 Bile... Bld - agglutinatin... culture... Bdy Fluids - ascitic... S, 98,,9 8 pericardial... 9 pleural... spinal... 9 Milk Sputum Stl...;...,,8 Swab ear eye... - nse..., 9 pus...,7,8 thrat , I,77 Tissue..._... 8 Urine... Water TOTAL SPECIMENS AND TESTS,79 SEROLOGICAL LABORATORY SPECIMEN I 9-9 I 9-9. I, Specimens Tests Specimens Tests Bld (Cmpatability test), 89 Gruping..., I,77 Matching... 9,7,7,9, I,7 BI:~! S~P.hili~C.:~.t)... Klin,,8 Wassermann... i,7,9 Spinal Fluid... 8 Cllidal gld test Gum mastic test... 7 Rss Jnes test... Wassermann Other bdy fluid... I TOTAL I, I 7, I 9,9 I,

64 PEIPING UNION MEDICAL COLLEGE HOSPITAL Abrtus.ALLlutininr ill Bld SmpllS which was cnsidered t be the best amng thse presented by members f her class. Seven dctrs spent frm ne mnth t a year in this labratry as graduate students, and tw technicians spent frm six mnths t a year as special students. One technician partially trained has been recmmended t the Hspital fr Treatment f Narctic Addicts. We are cntinuing t g-ive him additinal training after his fficial cnnectin with th is institutin has been severed. Fr thse wh culd stay fr nly ne r tw mnths, a new plan f rganized labratry exercises was given. It was fund t be f mre value t these students than t let them be bservers in the rutine labratry withut systematic insrructin. In the Serlgical Labratry sme increase in the number f specimens and tests has been recrded. As in previus years we cntinued t emply fr the diagnsis f syphilis, three different serlgical tests. An imprved antigen fr cmplement fixatin test in cases f gncccus infectin has been devised in this labratry and ext~nsively tried with gratifying results. An attempt has been made with encuragiljg' result t use the Kline test fr the diagnsis f neur-syphilis. 'rhrughut the year we cntinued t supply Kline and Kahil antigens t ther hspitals. PERSONl'EL Dr. C. E. Lim left n a shrt furlugh t Eurpe and America. Dr. Samuel Zia re-turned t this labratry frm abrad. Dr. R. Lvff has been appinted labratry assistant fr a perid f six mnths. T J. KUROTCHKIN.AsJistant Prfessr f BOlan%n ana Acting Head ft"e Departmmt

65 REPORT OF THE DIETARY SERVICE The fllwing" meals were served t patients, staff plyees during the past year: CHINESE MEALS FOREIGN Public Ward Patients,,9 Private & Semi-private Patients,7,8 9,9 Staff and Emplyees 99,8,99 Ttal,79 88, 9,9 and em- MEALS 9-,77,77 NUMBER OF MEALS SERVED DURING 9- First Class Chinese First Class Freign Secnd Class Chinese Secnd Class l'reign Third Class Staff Nurses Dressers Emplyees,,,8 7,,OH 8,9,77 8,9,78 Ttal 9,9 The average number f meals served per day was f which the average number t patients \\'as 9. Installatin f sme new fd service equipment and clse supervisin f fd planning", preparatin and service has resulted In imprvement f the quality f fd withut increase in fd cst. STUDENTS Miss Fang Wen-yuan and Miss Wang Wan-ming, graduates f the Hme Ecnmics curse at Yenchini U niversit}" cmpleted in August a six mnths traininl!' curse in Hspital Dietetics and Nutritin. Miss Fang immediately became a member f the staff and Miss Wang is teaching ill Cantn. Miss Yii Hsi-hsuan, als a graduate in Hme Ecnmics frm Yenchin" University, was an appintee fr the same curse beginning in September and n cmpletin f the curse in January was immediately appinted t the staff. Miss Hsieh Wen-mei and!vliss Chan" Hsiu-chen, graduates f the Schl f Nursing, Peiping- Unin Medical Cllege, entered as student dietitians in February and will cmplet~ the curse in AUuSt.

66 PEIPING UNION MEDICAL COLLEGE HOSPITAL An intensive curse in dietetics incjudinlr six lectures and demnstratins, was given t furth year students in the Medical Schl. The fllwing curses were given in the Schl f Nursinlr by the dietary staff:. Dietetics, Nrmal Nutritin and Diet in Disease fr first year student nurses. The curse included thirty hurs f lectures, sixty hurs f labratry practice and three weeks practical experience in the Dietary Service. The time fr practical experiellce was extended frm tw weeks t three weeks.. Hme Ecnmics in public Health fr first year nurses cnsisted f lectures.. Dietetics and N utritill fr pstgraduate nurses cnsisted f thirty hurs f lectures and twenty hurs f labratry practice. Each student spent sme time in the kitchens fr practical experience, the time varying frm tw t five weeks.. Dietetics and Nutritin fr students in Public Health Nursing. The curse included thirty hurs f lectures and twenty hurs f labratry practice. PERSONNEL Miss Genevieve Grmicall cmpleted tw years service as assistant dietitian and departed fr America in September. She was succeeded by Miss Helen Burkett, f Mntifire Hspital, New Yrk City, and Clumbia University. M iss Sphie Chen resigned in August t take a psitin with the Peiping City Health Department. This vacancy was filled by the appintment f Miss Fang Wen-yuan. Mrs. Emily Curran Liang resigned in December and was succeeded by l\iss Yii Hsi-hsuan. EsTELLE NESBITT Chiif Dietitian

67 REPORT OF THE NURSING SERVICE 7 GENERAL NURSING STAFF The increase in the vlume f wrk, that is days f patient-care in the hspital and visits t the Public Outpatient Service, during the past tw years, has put a cnsiderable strain n the Nursing Service. Further increase must be met with an increase in staff if the quality f the service rendered is t be maintained. In spite f effrts t reduce the turnver f staff, eighty-ne nurses ut f an average f staff psitins filled, r almst frty per cent, exclusive f head nurses and supervisrs, left the service. Of these, seventy-six were wmen and five were men. Seventeen f these had been in the service less than ne year. The reasns given fr leaving were as fllws: Fr ther psitins... T return hme... Health S ( f r pregnancy) Special Study fr Public Health t the Midwifery Schl t Yenching University t Physitherapy t study in the United States Did nt return frm vacatin Rejected n health examinatin Jined Private Duty Nurses' Registry Married... Wrk unsatisfactry T fill these resignatins and, in additin, t replace six staff nurses wh were prmted (tw t head nurses, ne t acting head nurse, ne t substitute head nurse, and tw t night assistants), eighty-seven new nurses Were emplyed. At the present time we have n ur staff Chinese graduate nurses frm fifty different N.A.C. registered schls in China and three American schls, eight frm the riginal Unin tvjedical Cllege Schl and twellty frm the Peiping Unin l\edical Cllege Schl.

68 8 PEIPING UNION MEDICAL COLLEGE HOSPITAL STUDENTS An average f frm fifty t sixty students (Peiping Unin Medical Cllege undergraduates, affiliating students frm ther schls, and graduate nurses in varius types f curses) have been receiving experience in the hspital and Public Outpatient Sen ice thrughut the year. While these students, in a very real sense, are nt depended upn t prvide the essentia nursing services f the hspital, they d act as a reserve fr vacatin and sickness perids, fr which n ther prvisin is made. Fr each f the staff f nurses fur weeks f vacatin must be prvided. Ninety-three f these can be arranged by the summer dsing f three wards, but the remaining wuld be a serius impairment t the required staffing if it were nt fr the adjustments made pssible by the student grups. SPECIAL DUTY Several rather imprtant develpments have ccurred in cnnectin with the private duty nurses emplyed in the hspital. Frm March, 9, an ei~ht-hur schedule was adpted as an experiment fr six mnths. The shifts are frm 7 A.M. t P.M., P.M. t P.M., and P.M. t 7 A. M. The fees paid t the nurses have remained as befre, at five dlars, but patients have nt been charged fr nurses' meals, which frmerly amunted t ne dllar a day per nurse. The ttal charge t the patient fr -hur service nw amunts t S. per day, whereas frmerly it was $.. Hwever, a patient may emply nly tw nurses ver a perid f sixteen hurs, thereby reducini his csts t $., in many instances withut any incnvenience t himsejf, and withut taxing the flr service unduly. Als, a new rule was put int effect that all private duty nurses emplyed in this hspital must underg physical examinatins by the Cllege Health Service accrding t the rutine f all nurseemplyees. These nurses paid a fee f tell dllars fr the initia I examinatin cvering chest x-ray. One nurse was fund t have active tuberculsis, but the remainder f the fifty nurses nw emplyed n the registry passed the examinatin succe'.!sfully. This seemed

69 REPORT OF THE NURSING SERVICE 9 a necessary precautin n the part f the hspital, because patients dubtless believe that the nurses called int this hspital fr special dury are n the hspital's recmmendatin as, t a certain extent, they are. The number f days special nursing in the hspital was as fllws: Days Nights Evenings (- P.M.) Chinese Wmen,, Chinese Men 9 8 Freign Wmen 7 TOTAL,8,79l 7 Of these days, nights, and evenings were at hspital expense fr patients n the public wards wh required cnstant attentin. HEALTH The health f nurses wrking in hspitals in all parts f the wrld has been receiving cnsiderable attentin during- the past few years. A recent article n Tuberculsis amng Nurses which appeared in the April 9, American Jurnal j llursine cites thirty studies f this subject which have been made in the United States, Germany, France, Denmark, Nrway, Canada, and New Zealand. Effrts have been made during the past five years in this hspital t study this questin f. the health f nurses and t institute measures fr the preventin f illness. The mst imprtant measures carried ut have been: First, the reductin f the hurs f the wrking week frm fifty-tw t frty-six (beginning in the spring f 9). Secnd, the emplyment f a full-time health llurse t assist the Clleg-e Health Service in its prgram (fall f 9). Third, a mre strict weeding ut f nurses abut whse health there was sme dubt n the entrance examillatins but wh llad beeu allwed t wrk n a muth-t-muth basis. Twenty-ne were drpped frm the service during 9-9; five in 9-9. Furth, increased supervisin f nursing technique in the care f patients n any type f islatin. Data which we have cllected n illness f nurses t date are difficult t cmpare wirh these published studies. In the case f infectin with tuberculsis, it has nt been cnsidered practical here t * Beginning March, 9

70 7 PEIPING UNION MEDICAL COLLEGE HOSPITAL use Mantux Test as a means f studyine- infectin. The chest x-ray taken f all new appintees gives the mst essential infrmatin fr practical purpses. The student grup is s small that a cmparisn f illness by years wuld prbably nt be very cnvincing. Hwever, the fllwing rather striking results f a cntinuus reduced amunt f sickness amni the general nursini staff wuld seem t indicate that ur effrts these past years have been alng the right lines. AVlragl Numher f D),s f fllness per Staff Nurse J 9-J 9 J9-9 Men Tuberculsis Wmen Tuberculsis.... PUBLIC OUTPATIENT SERVICE The special nursing activities in the Public Outpatient Service have cntinued as utlined in the 9-9 reprt. A graduate nurse f the Peiping Unin Medical Cllt"ge has been assiglled t the Tuberculsis Clinic thrughut the year with e-ratifying results. Miss Sia Yun-hua acted as supervisr during Miss Wyne's leave f absence, August 9, t March 9. The fllwing data indicate the types f purely nursing activities which are carried n in these clinics: Pediatric Clinic Active cases n list (as f July, 9)... 8 Hme visits Visits t receiving hme (clsed Octber 9)... J Visits t ward patients Interviews in clinic..., Health classes Attendances at health classes A nurse fr this clinic als assisted in the private patients' clinics each week. Tuhttrulsis Clinic Active cases (as f July, 9) Hme visits Ward visits

71 REPORT OF THE NURSING SERVICE 7l Obstetrical and Gyneclgical Clinics Active calles (as f July, 9) Hme visits Visits t ward patients Clinic iuterviews..., Health classes Health class attendauces Letters sent ClleEe Health Service Active cases (as f July, 9) Sanitary inspectins & Hygiene classes Hygiene class attendances HOlne visits..., Ward visits Intervie''\'s It is hped that wrk f this type may be develped in ther clinics and that a mre cmplete educatinal and preventive prgram fr at least a small unit f patients in all these clinics may be wrked ut in cnllectin with the Health Statin activities. COOPERATION WITH THE PEIPING PSYCHOPATHIC HOSPITAL The cperatin which was described in the 9-9 reprt has cntinued thrughut this year. Tw graduate-nurse students frm the H unan-yale Hspital at Changsha came fr a year's study and experience in this institutin n June, 9. Furteen secndyear students in {he Schl f Nursing were assigned fr tw weeks f bservatin and study f patients at this hspital in cnnectin with their curse in psychiatric nursing during- the spring f 9. It has nt been pssible t admit anther class f attendants, much as these are needed t replace the ld type attendants, because f the lack f satisfactry livini quarters. Additinal nursing persnnel, t be in charge day and nieht, which are much t be desired, and further develpment f the nursinl! sen'ice as a basis fr a teaching prgram, cannt be cnsidered withut sme plan fr prper living quarters cnnected with this institutin. Any further develpment f nursing wrk in this field is largely dependent upn such physical imprvements~

72 7 PEIPING UNION MEDICAL COLLEGE HOSPITAL Duriug her vacatin in May, Miss Wng Chien-chen visited the new buildings f a hs()ital fr mental patients in Shanghai and the hspital fr mental patients which is a part f the Elizabeth Blake Hspital in Schw. PERSONNEL There have been an unusually large number f changes in persnnel dunngthe year. Miss Ritchie (Mrs. Wlseth), Miss Eis- and Miss Stiles cmpleted their fur-year appintments and returned t the United States. Miss Hirst, Miss Wyne, Miss Leach and Miss Beaumnt were n leave fr seven mnths each during the year. Miss Whiteside returned in July 9, frm thirteen mnths leave. Miss Hsueh Yi wh was appinted supervisr f medical Ilursing n December, 9, was married and left Peiping n cmpletin f her appintment June, 9. Mrs. Wagner arrived n September, 9, fr the psitin f supervisr f bstetrical nursing, and Miss Last n Octber ], 9, as supervisr f the Private Patients' Pavilin. Tw freign nurses, Miss Nichlls and Miss Hensley, were appinted t psitills f head nurse. Miss Nichlls wh came frm the West China Missin in Chengtu, Szechuan, was a member f OUf staff fr seven and ne-half mnths in 98. Misses Sia Yun-hua and Sheh Yun-chu f the Public Outpatient Service left fr a year's study in the United States early in May, 9. HOUSING Due ~hiefly t the increased numbers f students, ur drmitries fr wmen were fuhy ccupied, and by June 9. it '... as necessary t allw twenty-n ine wmen staff nurses t live utside f the drmitries. All but tw men staff nurses nw live utside. While this arrangement seems satisfactry up t a certain pint, much further increase in this adjustment may prve difficult and undesirable frm many pints f view. A drmitry larg-e enu~h t huse the student grups may be the slutin t this prblem. GERTRUDE E. HODGMAN Sup(rintmdent f Nurses

73 REPORT OF THE HOSPITAL SOCIAL SERVICE 7 CASE WORK The Hspital Scial Service has had a mst interesting year. Fr the first time, it has been pssible t assign a scial wrker t every clinic. Althugh every patient culd nt be cvered; wrkers have been available t dctrs and patients, and the case wrk has been mre intensive. This has been made pssible by reducing the case lads f many wrkers and by the appintment f scial wrkers t the utpatient admitting ffice, thus placing the prblem f rating wi.th the admitting fficers and releasing the energies f the wrkers fr ther prblems. All cardiac, syphilis, and tumr patients have been cvered by the clinic wrkers, while in ther clinics patients have been referred by the physician, r themselves have sught Scial Service. Due t limited surces available, it nly has been pssible t render service t tuberculsis cases with relatively light infectin and sme financial backing. When arrangements can be made fr medical and nursing care in the hmes f patients, mre scial wrkers will be needed t assist in this wrk. The services rendered have been extremely varied. Many services have been f particular assistance t the hspital administratin, such as furnishin" infrmatin t the admitting fficers, lcating patients, securing witnesses, assisting patients in arranging fr transprtatin, cmmunicating with cperating aiencies and ften arranging fr the burial f patients wh have died in the hspital. Miscellaneus services have cnsisted f writing letters fr patients, mailing medicine, making purchases. lendine- bks, arranging recreatin and prviding meals fr utpatients. Assistance in rearrangements f budgets, clthes and lans has been given in 8 cases. Services invlving arrangements in livin" quarters, fd, finding suitable schls, pprtullities fr training, placing children in barding hmes, interpreting patients t emplyers and parents, and adjusting quarrels numbered 7. Services have als been rendered t members f patients' families in helping t meet their scial prblems r physical disabilities thrugh arrangements fr care by ther scial agencies r in ther instituti IS.

74 7 PEJPING UNION MEDICAL COLLEGE HOSI'ITAL Cperatin with Occupatinal Therapy has been given in arranging wrk and prviding recreatin fr patients as therapeutic measures. Emphasis has been placed n making such scial plans fr patients as wuld carry ut the medical plans f the physician and reestablish the patient in sciety. This has cvered interpretin~ the hspital, instructing patients in the physicians' health prgram, lcating cntacts f disease, securing apparatus and arranging fr ut-ftwn patients temprary care in the hspital's hstels r elsewhere. Fllw-up wrk in the Cardiac, Surgical, Syphilis, and Tumr Clinics has receh'ed special attentin and it is planned t extend this intensive wrk t the Obstetrical and Gyneclgical Clinics. TEACHING A surce f satisfactin h<is been the student prgram that has prvided training in scial service fr eleven students. They were given instructin by the apprentice methd, were assigned definite cases and wrked under the supervisin f a senir wrker and a supervisr. Departmental cnferences and a few lectures, were arranged incjudine- ne n Hspital Scial Service by Dr. Canby Rbinsn, and ne n Neurses by Dr. Walter B. Cannn. Miss Pruitt e-ave a series f lectures t the first year students f the Schl f Nursing in the secnd trimester, and t the case wrk students in Y enching University during the sprinl! semester. Miss J. C. Yu, Miss L. C. Chu, and Miss C. C. Ka gave a curse f twenty-tw hurs n Scilgy and Scial Wrk t the pstgraduate nurses f the Schl f Nursinf durine- the sprinf trimester. Grup cnferences were held with nurses and scial wrkers in the Pediatric and Tuberculsis Services. Lectures were given by members f the staff t utside rganizatins. Miss Pruitt e-ave an address t the Rtary Club, t the Clle~e f Chinese Studies, and t the Chinese Wmen's Red Crss Scial Wrkers.

75 REPORT OF THE HOSPITAL SOCIAL SERVICE 7 STAFF CONFERENCES While trainine- apprentices effrts have been made t imprve the quality f the wrk dne by the staff members. With this end in view each staff member has had weekly cnferences with a supervisr, and each wrker has been given a chance t review his wrk and reprt it t the whle grup. General lectures and cnferences nce r twice a week arranged fr the students were als a part f the staff training prgram. A valuable pprtunity fr additinal training was given by the P~ychpathic Hspital, where each staff member spent three weeks wrking with mental patients. EMPLOYEES SOCIAL SERVICE The case wrk fr emplyees is directed by the chief and supervisrs f this divisin. Effrts are made t keep emplyees fit and t help reduce the great turnver in the grup. Every new emplyee is investigated t ascertain that he is living in a place suitable frm the health standpint, and an endeavr is made t place him in the right kind f wrk. Chanees in type f \yrk r department are frequently effected when it is fund that the emplyee is nt happy. In the cases f disability r death, advice and assistance is given t the emplyee's family in using t gd advantage any sick benefits r insurance. Assistance in planning budgets and keeping ut f debt is als given. A small lan fund, set aside fr this purpse, is administered by the scial wrkers in charge. PHYCHIATRIC SOCIAL WORK The wrk fr mental patients in llr hspital wards in the utpatient service, and at the Peiping I\unicipal Psychpathic Hspital has been carried n under the directin f M iss Chu Li-chiu. Intensive wrk n each patient has been dne. Each new patient has been studied. Since scial treatment may be f as much imprtance t the patient's recvery as medical treatment, attempt has been made t imprve the health, stability, efficit'ncy and cmfrt f patients by bringing abut dlanes in him, his envirnment, r bth. Patients have been fllwed upn discharge, and in many cases dse supervisin has been iven.

76 7 PEIPING UNION MEDICAL COLLEGE HOSPITAL Wrkers have Iliven assistance t Dr. Lyman in special research prblems. Special tests were given t patients t determine whether the tests arc as applicable in China as in the cuntries in which they riginated. Kuchiner's Psychlgram was g-iven in abut cases. Thurstin's Persnality Schedule was used in cases f drull addicts in the Municipal Treatment Center, in mental cases, in cnnectin with applicants fr wrk, and with the neurlgical cases admitted t the hspital. A scial adequacy test was wrked ut by Mr. Sung- Ssu-ming and Mr. Pai Tuan in cperatin with Mr. Hsu En-hsi, a psychlgist in the Neurlgical Service. This was tried in measuring abut cases, and a paper n Scial Adequacy written by Mr. Sung and Mr. Pai. SPECIAL STUDIES M iss She Hui-chen and \ iss J a Yu-ai have made a special study f ver cases t cmpile a usable list f ccupatins fr persns in this cmmunity. Miss Mai Chien-tseng- studied the prblems f widws, lising the recrds f the Family Welfare Sciety t determine whether widws present a suitable prblem fr specially rganized relief. PERSONNEL The mre intensive case wrk and teaching prgram has been made pssible by the grup f supervisrs wh have been with the service fr tw years and mre; Miss Yu Ju-chi, Mrs. Annette Rabinwitz, Mr. Sung Ssu-ming and Mrs. Katharine Lyman. Miss Chu Li-chiu returned frm tw years f study in Chicag- and tk charfle f the scial wrkers at the Peiping Municipal Psychpathic Hspital. Miss Huang- Chen-chiu f the Emplyees Scial Service was married during the year and Miss l'ien Kuei-luan was prmted t take her place. Mrs. Kuan L Wen-ying, a student, was appinted t take the place~thus left vacant. Miss Ya Tze-ai, a case wrker married, and a student, Miss Han Tu, was prmted t take her place. Miss Chu Hsuan-tze was appinted t the admitting ffice, and Mr. Wu Chen, a student, was appinted t the vacancy. Miss Ja Yu-ai served n a half-time basis and Miss Mai Chieu-tsenfl was appinted