PEIPING UNION MEDICAL COLLEGE HOSPITAL

PEIPING UNION MEDICAL COLLEGE HOSPITAL Frmerly The Peking Unin Medical Cllege Hspital TWENTY-SECOND ANNUAL REPORT OF THE SUPERINTENDENT JUNE, 19 P. U. M. C. PRESS Pciping, China

Twenty-secnd Annual Reprt CONTENTS PAGE BOARD OF TRUSTEES AND OFFICER'S HOSPITAL STAFF '" HOSPITAL ADMINISTRATIVE COMMITTEES REPORT OF THE HOSPITAL SUPERINTENDENT REPORT OF THE DEPARTMENT OF MEDICINE REPORT OF THE DEPARTMENT OF SURGERY REPORT OF THE DEPARTMENT OF OBSTETRICS AND GYNECOLOGY REPORT OF THE DEPARTMENT OF OPHTHALMOLOGY REPORT OF THE DEPARTMENT OF OTOLARYNGOLOGY REPORT OF THE DEPARTMENT OF ROENTGENOLOGY REPORT OF THE DEPARTMENT OF PATHOLOGY REPORT OF THE NURSING SERVICE REPORT OF THE DIETARY SERVICE REPORT OF MEDICAL SOCIAL SERVICE GENERAL INFORMATION CONCERNING RATES AND REGULATIONS COMPLETE LIST OF MEMBERS OF THE RESIDENT HOUSE STAFF 5 6 16 17 1 5 9 5 7 9 58 61 6 69 15 TABLES CLASSIFICATION OF DISEASES CLASSIFICATION OF OPERATIONS 77 17

Peiping Unin Medical Clle.re Hspital A cmplete bibli\rraphy 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.

Twenty-secnd Annual Reprt 5 BOARD OF TRUSTEES OFFICERS Ckairman Y. T. TSUR Pice Ckairman PO-LING CHANG Secretary MARGERY K. EGGLESTON Ilssistant SecretarieJ MARY E. FERGUSON ELEANOR N. SHENEHON EXECUTIVE COMMITTEE Y. T. TSUR, Ckairman PO-LING CHANG ROGER S. GREENE SOHTSU G. KING WEN-HAO WONG MEMBERS T SeMJe until tke Ilnnual Meeting f 19 C. R. BENNETT PO-LING CHANG T Serve until tke Ilnnual Meeting f 191 ROGER S. GREENE G. E. HUBBARD Y. T. TSUR F. H. HAWKINS* SOHTSU G. KING*it T Serve until tke Ilnnual Meeting f 19 PAUL MONROE* WEN-HAO WONG W. W. YEN" J. HENG LIU E. C. LOBENSTINE SAO-KE ALFRED SZE CHAO-CHU Wu SHIH Hu J. HENG LIU, Directr ftke Peiping UfJin Medical Cllege*** ROGER S. GREENE, Pice-Directr VERGIL F. BRADFIELD, Cmptrller *T February 8. 19 **Frm February 8, 19 ***On leave f absence

6 Peiping Unin Medical Cllel!e Hspital J. HENG LIU, M.D.,* Superintendent HOSPITAL STAFF July 1, 199 - June, 19 A. M. DUNLAP, A.B., M.D., Acting Superintendent t December, 199 SIH-TZE WANG, M.D.," Assistant Superintendent and Acting Superintendentfrm December, 199 K' AI-CHIANG Hsu, M. D., Assistant t the Superi11tendent MABEL E. TOM, R. N., Admitting Officer DEPARTMENT OF MEDICINE FRANCIS R. DIEUAIDE, A.B., M. D., Prfessr f Medicine and Head f the Department CHESTER NORTH FRAZIER, B.S., M.D., Assciate Prfessr f DermatfJlgy and Syphillgy ERNST DEVRIES, M.D.,*** Assciate Prfessr f Neurlgy HOBART A. REIMANN, M. D., **** Assciate Prfessr f Medicine JOHN FORBES McINTOSH, A.B., M.D., C.M., ASJciate Prftssr f Medicine ALEXANDER ASHLEY WEECH, A.B., M.D., Assciate Prfessr f Pediatrics CHESTER S. KEEFER, A.B., M.D., Assciate Prfessr f Medicine OTTO WILLNER, M.D.,"* Assistant Prfessr f Medicine RICHARD HO-P'ING SIA, B.S., M.D.,*** Assciate in Medicine.On leave **On leave t December. 199 On leave 199- ****On leave frm Octber 1. 199

Twenty-secnd Annual Reprt 7 DEPARTMENT OF MEDICINE (cntinued) ERNEST SHEN-CHIH Ts, M.D., Assciate in Pediatrics SHU-TAl T. W, M.D., Assciate in Medicine SHEO-NAN CHEER, A.B., M.D., Assciate in Medicine FOONG-KONG CHEN, M.A., M.B., CH.B. t Assciate in Dermatlgy and Syphillgy CHUNG-UN LEE, M.B., CH.B., D.T.M. AND H., Assciate in Medicine GILES A. M. HALL, M.B., B.S., Assciate in Medicine and Cllege Physician GEORG SCHALTENBRAND, M.D., Allciate in Neu,.lgy HSIAO-CH'IEN CHANG, M.D., Assciate in Medicine SCHMORL M. LING, M.D., D. Sc., Assciate in Medicine GEORGE Y. C. Lu, M.D.,** Assistant in Clinical Medicine YU-LIN WEI, M.D., Assistant in Neurlgy KANG-LIANG Hsu, M.D., Allistant in Pediatrics SHIH-HAO LIU, M.D.,* Assistant in Medicine JUI-WU Mu, M.D.,*** Allistant in Dermatlgy and Syphillgy CHEN-LANG TUNG, A.B., M.D., Allistant in Medicine, Cllege Health Ser<tJice K'UEI CHIA, M.D., Assistant in Medicine, Cllege Health Service CHI-SHIH YANG, M.D., Assistant in Medicine and Resident *On leave 199- **T September 1. 199 ***On leave frm January 19

8 Peipinlr Unin Medical Cllege Hspital DEPARTMENT OF MEDICINE (cncluded) SAMUEL H. ZIA, M.D., Auistant in Medicine and First Auistant Resident Fu-T'ANG CHU, M.D., Auistant in Pediatrics frm March 19 CH'UAN-K'UEI Hu, M.D.,.Jhristant and Assistant Resident (Dermatlgy and Syphillgy) SARAH DEITRICK, A.B., M.D., Auistant in Pediatrics THEODOR.E C. GREENE, A.B., M.D., Auistant in Clinical Neurlgy K'E-KANG HUANG, M.D., Auislant Re.Jident CHAO-JEN Wu, M.D., Auistant Resident YU-LIN CH'ENG, M.D., Auistant Resident (Neurlgy) HSIEN-LIN CHANG, M. D., Auistant Resident JUNG-PIN CHENG, M.D., Auistant Resident (Pediatrics) HUEI-LAN CHUNG, M.D., Assistant Resident KUO-CHENG WANG, M.D., Assistant Re.Jident DEPARTMENT OF SURGERY MAX M. ZlNNlNGER, A.B., M.D., Prfeur j Surgery and Head j the Dljartment HAROLD H. LOUCKS, A.B., M.D., Assciate Prfeur f Surgery GEORGE Y. CHAR, B.S., M.D., Assistant Prfeur j Clinical Surgery t April 19; Prfessr f Urlgy frm April 19 ZUNG-DAU ZAU, M.D.,* Assciate in Surgery *Rcsiilled - September ). 199

Twenty-secnd Annual Reprt 9 DEPARTMENT OF SURGERY (cncluded) JOSEPH ALBERT BIELLO, M.D., U.S.N., Hnrary Ledurer in Surgery LEE-CHUNG CHU, M.D., instrudr in Surgery TA-CHUN YANG, M.D., Auistant in Clinical Surgery SUNG-T'AO KWAN, M.D.,* Auutant in Surgery PING-CH'I TUNG, M.D., Assistant in Surgery and Resident FU-EN WAN, M.D., Assistant in Surgery and First Assistant Resident SHUN-MING CHEN, M.D., Auistant in Surgery and Assistant Resident T'UNG-HO CHANG, M.D., Assistant Resident HENG-I CHEN, M:D., Auistant Resident TEH CHEN, M.D., Assistant Resident TA-T'UNG WANG, M.D., Assistant Resident CHAO-HUEI CHANG, M.D., Assistant Resident t May 11, 19 PEH-LING CHOW, M.D., ASJistant Residentfrm Septemb,r, 199 lui-lin LEE, M.D., Assistant Resident frm December 1, 199 HSI-EN SHIH, M.D., Assistant Resident LI-KENG WANG, M.D., Assistant Resident JOSEPH Yu, M.D., Assistant Resident *n leave 199-JO

1 Peipin~ Unin Medical Cllege Hspital DEPARTMENT OF OBSTETRICS AND GYNECOLOGY J. PRESTON MAXWELL, M.D., B.S. L.R.C.P., (LOND.), F.R.C.S. (ENG.),* Prfusr f Obstetrics and Gyneclgy and Head f the Department GORDON KING, L.R.C.P.;F.R.C.S. (ENG.),.Assciate in Obstetrics and Gyneclgy and.acting Head j the Department AMOS WONG, M.D.,.Assistant in Obstetrics and Gyneclgy SHIH-WEI LEE, M.D.,.Assistant in Obstetrics and Gyneclgy MARION YANG, M.D., Instructr in Hygiene and Public Health and Yluntary.Assistant in Obstetrics and Gyneclgy LIEH-CHUNG Wu, M.D.,.Auistant in Obstetrics and Gyneclgy and Resident KH' A-T'I LIM, M.D.,.Auistant Resident PING-MUI CHUNG, M.D.,.Auistant Resident PAO-CHEN HUANG, M.D.,.Auistant Resident WEN-E LI, M.D., Assistant Resident DEPARTMENT OF OPHTHALMOLOGY ARNOLD PILLAT, M.D.,.Auciate Prfeur f Ophthalmlgy and Head f the Department t February 19 LUDWIG SALLMANN, M.D., Auciate Prftur f Ophthalmlgy and.acting Head f the Department frm February 19 HUA-TEH PI, M.D., Assciate in Ophthalmlgy ISA JOHN, M.D.,**.Assciate in Ophthalmlgy WE~-PING LING, M.D., Instructr in Ophthalmlgy *On leave 199- **Frm Nvember 199

Twenty-secnd Annual Reprt 11 DEPARTMENT OF OPHTHALMOLOGY (cncluded) PETER S. SOUDAKOFF,.B. PH., M.D.,.Auistant in Clinical Ophthalmlgy SHIH-PU CHANG, M.D., Assistant in Clinical Ophthalmlgy SING-MEl KIANG, M.D.,.Assistant Resident TIN-KWAN LAM, M.D., Assistant Resident TZE-KUANG T'ANG, M.D., Jissistant Residmt DEPARTMENT OF OTOLARYNGOLOGY A. M. DUNLAP, A.B., M.D., Prjeur f Otlarynglgy and Head f the Department ]UI-HUA Lru, M.D.,* Auistant Prfessr f Otlarynglgy SHIH-EN KA, M.D., Assistant in Clinical Otlarynglgy TZE KING, M. D., Assistant in Otlarynglgy YUNG-HAO TING, M.D., Assistant in Otlarynglgy MAO-LIEN Hu, M.D.,.Assistant in Otlarynglgy HSIEN-GIEH KUNG, M.D.,.Assistant Resident len-f'ong M, M.D., Assistant Resident DEPARTMENT OF ROENTGENOLOGY CHESTER N. FRAZIER, B. S., M. D., Assciate Prftur f Dermatlg" and Syphillgy and Ad'lJiser t the Department j Rentgenlgy CHIH-KUANG HSIEH, M.S., M.,D., Instrudr in Rentgenlgy and in charge f the Hspital X-ray SeMlice *On leave frm April 19~O

1 Peipin' Unin Medical Cllege Hspital DEPARTMENT OF ROENTGENOLOGY (cncluded) HO-SHAN WANG, B.S., Allistant in Rentge.nlgy and in charge f the Phtgraphic Bureau CHING Wu, M.D., Allistant in Rentgenlgy TU-SHAN JUNG, M.D., Allistant Resident YEN-CHEN S, M.D., Assistant Resident DEPARTMENT OF PATHOLOGY JAMES R. CASH, A.M., M.D., Prfissr f Pathlgy and Head f the Department REINHARD J. C. HOEPPLI, M.D., PH.D., PrfeJsr f Parasitlgy CHONG-EANG LIM, M.B., B.S., D. P.H., D.T.M., Assistant Prfillr f Bacterilgy CHENG-HSIANG Hu, M.D.,* Assciate in Pathlgy CLARENCE ZENT GARBER, A.B., M.D., Assciate in Pathlgy OO-KEK KHAW, M.B., CH.B., D.P.H., D.T.M., Assciate in Parasitlgy TIMOTHY J. KUROTCHKlN, M.D., Assciate in Bacterilgy DOROTHY HUIE WONG, A.M.,** Assistant in Bacterilgy CHEN-PIEN LI, M.D.,* Assistant in Bacterilgy HSI-JUNG K'ANG, M.D., Assistant in Pathlgy YIN-T'ANG Hsu, M.D., Assistant in Pathlgy SHIH-KUANG NGAI, M.D., Assistant in Pathlgy *On leave 199- **On leave 1 Nvember 199

Twenty-secnd Annual Reprt 1 DEPARTMENT OF PATHOLOGY (cncluded) SHIH-EN PAl, M.D., AJJistant in Bacterilgy WEN-ICUEI CHEN, M.D., As.sislant Resident T'AO LI, M.D., Assistant Resident L-sHAN WANG,!VI. D., Assistant Resident INTERNES &rvice been July 1, 199 July 1, 199 July 1, 199 July 1, 199 September 1, 199 July 1, 199 July 1, 199 July 1, 199 July 1, 199 July 1, 199 July 1, 199 July 1, 199 July 1, 199 MAO-LIN CHANG LOUIS W. S. CHANG MEl-CHEN CHEN CH'IEN-SHIH CHENG CHEN-YUAN CH'I KUANG-YU CH'IN HSIEN-I CHU SHIH-FAN CHUNG HSIU-CH'UN LI P'EI-KUANG LI TSO-HSIN P' AN W AN-NIEN PIEN SHU-HSIEN WANG Service ended June, 19 June, 19 June, 19 June, 19 June, 19 June, 19 June, 19 June, 19 June, 19 June, 19 June, 19 June, 19 June, 19

1 Peipin~ Unin Medical Clle~e Hspital NURSING SERVICE As f June, 19 ERMA B. TAYLOR, B.S., R.N.,... Ading Dean f the Schl f Nursing and Acting Superintendent f Nursu ETHEL E. ROBINSON, R. N.,... First Assistant Superintendent f.nurses ELIZABETH HIRST, R.N.,... Secnd Assistant Superintendent f Nurses DING-YlNG CHIU, R.N.,... Acting Night Supervisr MARGARET M. GOREy...... Supervisr f Pediatric JY ard LOUISE TtrITLE HSiEH... Supervisr f General Operating Rm and Outpatient Department RUTH H. KUNKEL, R.N.,... Supervisr f Nursing MARY F. LOUCKS, R.N.,... Supervisr f Private and Semi-private Wards CORINNE G. LURTON, R.N.,... Supervisr f Surgical Wards MILDRED MCCORMICK, R.N.,... Supervisr f Islatin Unit LOUISE MULLER, M.A., R.N.,... Supervisr f Medical Wards MAIlGARET R. WYNE, B.S., R.N.,*... Supervisr f Nursing CHIA-IH CHEO, N.A.C.,... Head Nurse, Wmen's Mixed Ward YI HSUEH, N.A.C.,....Acting Head Nurse, Men's Medical Ward YU-HUA!CA, N.A.C.,... Head Nurse, Men's Surgical Ward JUNG-HSUN Ku, N.A.C.,... Head Nurse, Operating Rm LILLIAN M. LEONG, R.N.,... Head Nurse, Islatin Unit WEI-KANG LI, N.A.C.,... Head Nurse, Admissin Irard HSIAO-TSENG LIU, N.A.C.,... Head Nurse, Men's Surgical Ward YU-LIN L, N.A.C.,... Head Nurse, Surgical Supply Rm ZUNG-YUNG LUNG, N.A.C.,... Head Nurse, Islatin Unit AI-CHING PAO, N.A.C.,... Acting Head Nurse, Children's Ward LAVINIA K. RAYNER, S.R.N.,... Head Nurse, Semi-private Irard HSING-KUO REN, N.A.C.,... Head Nurse, Men's Mixed Ward LIEN-YING SHAO, N.A.C.,... Head Nurse, Private Ward CHIN-CHENG SUN, N.A.C.,... Acting Head Nurse, Outpatient Department TSAI-LEE TIEN, N.A.C.,... Head Nurse, Obstetrical irai'd YUAN-JU TsING... Head Nurse, Private Ward E-TSENG WAUNG, N.A.C.,... Head Nurse, Metablism Ward KHENG-ENG Yu, N.A. C., *... Head Nurse *On leave f absence

Twenty-secnd Annual Reprt 15 DIETARY DIVISION KWE-PAU HUANG, PH.B.,... Dietitian ANNA W. LEE, B.S.,... Assistant Dietitian PHARMACY JOHN CAMERON, F.C.S., PH.C., M.P.S. (LOND.),... SupeMJisr ftl18 Pharma~ MOODY MENG, PH.C., M.P.S.,*... Assistant Pharmacist MEDICAL SOCIAL SERVICE IDA PRUITT, A.B., B.S.,... Medical Scial SeMJice Wrker LI-CH'IU CHOU, A.B., M.S.,... Assistant Medical Scial Service Wrker GRACE CHU, A.B.,... Assistant Medical Scial SeMJice Wrker JULIA LING... A.s.sistant Medical Scial Serevice Wrker LING TAO, A.B., M.A.,... A.s.sistant Medical Scial Serevice Wrker JU-CHI Yu, A.B.,**... Assistant Medical Scial Serevice Wrklr ZANG-PUNG ZIEN, A.B.,...... Assistant Medical Scial Serevice Wrker GEORGE Y. Tsu, B.A., B. D.,... Case Wrker in Medical Scial Serevice SIU-MEI KA, B.A.,... Case Wrker in Medical Scial Serevice EN-FU LEE, B.A.,... Case Wrker in Medical Scial Service LIEN-CHEN LING, B.A.,... Case Wrker in Medical Scial Sercvice TUAN PAl, B.A.,... Case Wrker in Medical Scial Ser'Vice SSU-MING SUNG, B.A.,... Case Wrker in Medical Scial Serevice TZE-MING.WANG... Case Wrker in Medical Scial Sercvice OTHER OFFICERS HELEN M. HOLLAND, R.N.,... Anesthetist EDITH C. HUANG, PED.B., PH.B., R.N., Matrn ANNA LOH STUBO, R. N.,...... Physitherapist ALEXANDER BARANOFF, O. S.,... Oral Hygienist, Department f Surgery HUNG-CHUN CHANG... Oral Hygienist, Department f Surgery, Frm Nevember 199 C. K. KOH......... Oral Hygienist, Department f Surgery, Frm February t June 19 STEPHEN WANG, A.B.,... Custdian f Recrds *Ou leave t May 19 **On leave frm March 19

16 Peiping Unin Medical Cllege Hspital HOSPITAL ADMINISTRATIVE COMMITTEES COMMITTEE ON THE HOSPITAL AND ADVISORY COMMITTEE TO THE SCHOOL OF NURSING J. HENG LIU, Hspital Superintendent* A. M. DUNLAP, Chairman t December, 199** F. R. DIEUAIDE, Chairman frm January 19 GORDON KING M. M. ZINNINGER SIH-TZE W ANG*** CLINICAL RECORDS COMMITTEE SHEO-NAN CHEER, Chairman C. N. FRAZIER SIH-TZE WANG STEPHEN WANG AMOS WONG COMMITTEE ON THE OUTPATIENT DEPARTMENT SIH-TZE WANG, Chairman LOUISE TUTTLE HSIEH KAI-CHIANG Hsu J. HUA LIU H. H. LOUCKS *On leave f absence **Actine- Superintendent t December, 199 ***Actine- Superintendent frm December. 199

Twenty-secnd Annual Reprt 17 ROGER S. GREENE, Sir: REPORT OF THE -SUPERINTENDENT OF THE HOSPITAL A ctine Directr f the PeipinE Unin Medical Cl/eEe I present herewith the Twenty-secnd Annual Reprt f the Peiping Unin Medical Cllege Hspital fr the year ending June, 19. An extended leave f absence was granted Dr. J. Heng Liu, Superintendent f the Hspital, inasmuch as he had been appinted Minister f Health in the Natinal Gvernment in Nanking. On return frm a leave f absence abrad, in December 199, Dr. Sih-tze Wang, the Assistant Superintendent f the Hspital, became Acting Superintendent, relieving Dr. A. M. Dunlap wh had carried the wrk in the absence f the Superintendent. Dr. Kai-chiang H su has cntinued in the capacity f Assistant t the Hspital Superintendent, and has given particular attentin t the Outpatient Department and matters pertaining t the securing f autpsies. In all respects last year may be cnsidered nrmal. The statistics fr the past tw years wuld indicate what services the hspital might regularly be expected t render with its present space fr utpatient clinics, number f hspital beds and equipment. As n military disturbances ccurred anywhere near Peiping very few sldiers came t the utpatient clinics r were admitted t the hspital, which wuld accunt fr the slight de.crease as cmpared with figures fr 198-9. Inability t secure sufficient nurses has limited the number f patients cared fr in the new Islatin Pavilin and necessitated the clsing f ne f the semi-private wards at different 'times during the year. An effrt is being made t btain nurses s that the entire hspital can perate at full capactiy fr the ensuing year. A great need is still felt fr the pening f a gyneclgical ward which has been delayed because f the shrtage f nurses. The pening f the Islatin Pavilin in December 199, has increased the number f beds in the entire hspital by 5. The ttal f 11 beds has been distributed amng the varius services as fllws:

18 Peipine- Unin Medical Cllee-e Hspital Medicine 91 Islatin Pavilin 5 Surgery 69 Obstetrics and Gyneclgy -cribs Ophthalmlgy 17 Otlarynglgy 11 Nn-classified Private and Semi-private 5 Emergency ward Pediatrics ward 1 Deaths in the hspital during the past year numbered 19. The mrtality rate f 6.1 is nly slightly less than that fr 198-9, which seems due t the fact that many patients- cme t the hspital in a very critical cnditin. The number f emergency cases shws a slight decrease, 158 having been admitted as cmpared with 161 fr the preceding year. A greater number f autpsies was secured, due in large t the interest fstered by Dr. Dunlap while he was in the Superintendent's ffice, the increased interest and effrt n the part f the huse staff in securing permissin fr autpsies, and the c-peratin f the Peiping Department f Public Health. Pst-mrtem examinatins were made in 171 cases, an increase f 75 ver the previus year. The statistical tables which fllw summarize the service which the hspital has rendered during the past tw years. CLASSIFICATION OF PATIENTS ADMISSIONS AND DISCHARGES July 1, 199 - June, 19 CHINESE FOREIGN Ttal Ttal ------ Male I Female M ale I Female 199-198-9 Patients remaining June, 199... 1Z 1 1 11 188 Patients admitted during the year... 55 195 1161 56 99 571 1978 19 66 S 559 Ttal number treated.., 1 667 1 Patients discharged during the year... 55 19 18 S6 +991 58 Patients remaining June, 19... 117 76 9 1 1 11 61 1,

Twenty-secnd Annual Reprt 19 DISCHARGES BY DEPARTMENTS (including transfers) July 1, 199 - June, 19 SERVICE Chinese Freign I Ttal Male I Female Male I Female \199- Ttal 198-9 General 86 5 1 81 lobi 175 Dermatlgy 1 6 5 1 Neurlgy 81 8 1 1 155 111 198 1 Pediatrics 19 117 5 7 96 I Ttal -~ ~I-;;; ~r-~;;i--rn; 1 Geetal 5661 191 +.1 661 B671 91 Genit-Urinary 1 171 71 71 SI 161 17 Orthpedics 18 SO 9 8 Ttal 1- B761-~I--s-'I--71~i~ 1 Gyneclgy I 1 5 1 8 1 ::::~c. I.91 :::1 1 :: ::: ::: Ttal 1--;;1~1--1-1~ 17+ 1169 OPHTHALMOLOGY 1 171 61 1 1 B71 98 OTOLARYNGOLOGyl 81 191 91 61 1 I 7161 19861 1961 JR'I I TOTAL 7 1 511 1 5191 5 1 The ttal number f 99 patients admitted was 79 less than during the year 198-9. Of the ttal 5 were Chinese and 5 frei~n patients.

...... 1, Peiping- Unin Medical Clleg-e Hspital YEAR ENDING June, 19 DAYS OF TREATMENT Cmparative Study, 198 t 19 Privat~ Patients Semi- Ward Ttal Private i Private Private Patients Patients Preferred 1 1,81 1 1,51 I 7, 91 1 Pay 7, 611 8,8151 6, 9711 Free 7,8 June,.1991, 5 1 1,5661 8,61 71, 8711 8,5891 9,781,851 Jun., 1981 1, 5 1,611 5, 181 --- 1 I *Ward I Patient. 69,96 5,7 5,6 A revisin f the schedule f charg-es increased the hspital incme t a sman extent but has als meant that a larg-er number f patients have been g-iven free treatment. OUTPATIENT DEPARTMENT Dr. Kai-chiang- Hsu, Assistant t the Hspital Superintendent, has g-iven his time t the administratin f the Outpatient Department. New quarters fr the utpatient clinics f dermatlgy, pediatrics, phthalmlg-y, tlarynglgy, and surgery, were pened in September 199. Even with this increased amunt f space the clinics served as many patients as culd be handled satisfactrily with the present staff and equipment. The fllwing table f statistics shws a slight decrease in the number f patients and visits which may be accunted fr by the smaller number f sldiers wh have cme t the hspital fr treatment. The services have emphasized the return f ld cases fr treatment. Since the clinics have been taxed t their limit much f the year, there has been a cnsequent decrease in the number f new patients which was abut less than fr the previus year. It is felt that the varius clinics have perated t capacity and that there will be little chanl!e frm nw n. Ttal visits... t 7 Ttal free visits... 1,717 Percentage f free cases... 1.98% *It shuld be nted that frmerly all free cases, such as members f the resident and nursing staff f the hspital, were included under the figures fr ward patients. Since these figures were misleading the frm has been changed and the number f ward patients and free patients is shwn separately. Of staff members nly thse wh receive maintenance in the hspital, r emplyees wh earn less than $5 per mnth are admitted as free patients. Staff members wh receive free treatment in the Private and Semi-private wards are als included in the figures fr free patients.

Twenty-secnd Annual Reprt 1 OUTPATIENT DEPARTMENT Fisits hy Services July 1, 199 - Jum, 19 MEDICINE SERVICE New Old Re- Ttal Referred Ttal n ferred Patients ame day Visits ----------------- General...,9 7,5 1,191 1,67 8 1,9 Dermatlgy...,,11 557 7, 75 7,75 Heart... --- 671 51 7 1 7 Neurlgy... 565, III 16,89 18 5,57 Pediatrics... 1,95,89 --- 5, --- 5, Syphilis... 89 5,9 511 6,5 9 6,59 Tuberculsis... 7 ~86 51 ~ 7 ~11 --- -- --- Ttal Medicine. 199-19... 9,8 7,69,99,1 1,95 1,518 Ttal Medicine. 198-199... 1,565 1,5 1,815 1,,18 --- SURGERY General....,619,95 11 5,5 1,1 6,55 Genit-urinary 95 7,556 9 8,6 65 9,7 Orthpedics... 85 7,1 66 8, 57 8,59 Oral Surgery... 9 _1_,856 89 _]_,5 6,58 --- Ttal SUflrery. 199-19... 7,98 6,89 858 5,995,81 57,8 Ttal Sur"cry. 198-199... ~ 6,!! 5,99,95 58,89 -- OBSTETRICS AND GYNECOLOGY Antenatal... 55 77 1,5 1,5 Gyneclgical... 877 ~ ~ ~1 Ttal Obstetrics and GynecliY. 199-19... Ttal Obstetrics and Gyncc)iY. --- -- --- 1,1 5,19 6,6 6,6 96 ~98 ~ ~O 198-199... --- --- --- OPHTHALMOLOGY General...,951 1,59 7 17,76 1,86 18,66 Trachma... ~178 --I~ ~ Ttal Ophthaimi"Y 199-19,951 19,77 7,5 1,86,8 Ttal Opbthalml"Y 198-199,,1 ---,6 1,11.857 OTOLARYNGOLOGY Ttal Otlaryn"l"Y 199-19, 6,57 65 9,9 1,57 1,756 1,79 ~]89 Ttal Otlarynri"Y 198-199,77 ~ --- ~ GRAND TOTAL. 199-19...,851 16,67 5,189 1,17 7,176 11,8 GRAND TOTAL. 198-199... 5,8 18,67 1,7 7,761 11,968

Peiping Unin Medical Clleee Hspital PERCENTAGE OF ATTENDANCE IN OUTPATIENT DEPARTMENT CLINICS SERVICE' 197-8 I 198-9 199- Medicine ----W-:S% ~1% -z9.9% Surgery.% ~O% ~O% -------- Obstet~ics and Gyneclgy.8%.%.7% Ophthalmlgy 18.% --v. 6 % 17.5% --6-.9% ---- Otlarynglgy 5.9,.,; 6.9% PHARMACY The number f prescriptins dispensed during the year has been apprximately the same as in 198-9. The new extensin f the pharmacy was pened in May 19, and has relieved the cngestin in the dispensing rms. All ward supplies are carried in stck in the new rm ("F"-11) where the ward baskets with the empty bttles, jars, etc. are brught every mrning fr refilling. Tablets are nw made and stred in the new tablet rm in "F" basement. The tablet-making rm had previusly been lcated in the industrial area f the cllege but in becmin~ a part f the pharmacy prper has prved a great cnvenience. Early in June 19, a new narctic and ampule rm was pened in "F" basement. This is used fr filling, sealing, and labeling all ampules as well as string the empty and sealed stcks. The entire stck f narctics is als cared fr in indexed cupbards in this rm. There has been n change f persnnel in the pharmacy. Mr. Mdy Meng returned in April 19, frm Nanking where he had been wrking fr mre than a year with the Ministry f Health n a new Chinese Pharmacpeia which will prbably be published in the fall f 19. A number f graduate students have been given special wrk m the divisin during the year in accrdance with the usual practice f receiving a limited number f persns frm ther hspitals fr further trainin~.

Twenty-secnd Annual Reprt RADIUM The statistics fr the past few years indicate a yearly increase in the number f radium treatments given thugh the present supply f radium is nt sufficient t care adequately fr the number f patients requiring attentin. The radium has frequently been requisitined three and fur weeks in advance which has ften made it impssible t furnish treatment where it was immediately needed. It is hped that the present quantity may be increased during the cming year. The fllwing table gives the number f inpatients and utpatients f the varius services wh have received- radium treatment. SERVICE Number f Patients Number f Treatments 199-] 198-9 Medicine 5 7 8 Dermatlgy 9 6 16 Surgery 8 5 Gyneclgy 5 57 6 g g I Ophthalmlgy 8 Otlarynglgy 9 1 "--- 7 Ttal 15 181 166 PHYSIOTHERAPY Mrs. Anna Lh Stub has cntinued in charge f physitherapy, while Dr. C. N. Frazier has acted as adviser t the divisin. wman nurse and tw male nurses have assisted in the Iriving f treatments. A new rm adjining the physitherapy suite has been equipped fr lamp treatments which has very much increased the efficiency f the divisin. Thugh there has been a decrease in the number f sme treatments, crrespnding t the decrease f patients, it is interesting t nte the increasing number f rthpedic patients wh have been served. The fllwing table indicates the number f patients wh have been referred frm the varius services. A

STATISTICS FOR DIVISION OF PHYSIOTHERAPY July 1, 199 - June, 19 ~--------------------------------------------~------------.---~------------------------~--~ = = Students Private Private Ward Out- TOTAL TOTAL.~.~ and Sta~ Inpatients I_O_u_t_p_ts_,_ Patients Patients 1':"19. 9---:1 1 F::!,n ~ ~ DEPT, SERVICES VISITS 1 'II~Ci 1 'u-=-~ '-.. ~ 1,.. -~ ~ 1 H ~ 1 ~ g 1 ~ '.. &. C.) &. u &. C.) &. u &. C.) Chinese ~ ~ Freirn Chinese U U 'j;! j 'S j 'S j ~ and 198-9 -5-5 1 I-----------------~------ ~---~-~--~-~--~----~--~--~--,--~--~--~--~---~------I ~,= Fint 5 18 8.. J" 1 8 6 19.. S9 8.,Q = ~ General >. U.... Z t- -+"'"R~e::.::tu::..:m.:.:... +_-~ _--l:9.!.7+_~1~19_--.:: '-",+_--1l!t.. 9 19 1 1 188.~ _~ ~'~ g First - --.-.-.. :---1-- 1 ~ ~ ~ DermatlfY*.. til A Retur +-.!L _ 8 16 g ~ ~ First -+---+----5 +---"+--1+---1--1-7 1 6f.---'is -~. >- C ~ ~~fy AU t- +- rr~et~uc!!m!... I----+ -~77_..-!661-.!!.9~--'1~7+.. 5!9 m_. 17 15 76) 98 1.91;l., Ei G~~ Firat ).. 9 5 1 ' -- -'6 ---s 1i t- ---+~R:::et.::.!ur~n'--, I_-=17_---!:::5+_-~I+_-'=--'_-~:.=.+_~17~. ~_:_-~~-. 5 '-~ S 99] 'a First 1 18 1 1 6 1 8 119-18 159 --- lri-- -1 I:: >. Orthpedic. I -t :a t- ~ t "R:..:;et:.::u~m,'--_;---=~1+_-=6""7'_+_.-_t--;= t_~1l::..:9,+--=~_t ---'8,-+-_1.~1! 1~~ 1~9?9...!!..6 ~.!!!! ~!~L~... OBSTETRICS AND Firat 1 1 1 7 1 17 8 u 'Cij' ; e GYNECOL;::..:O,-G~Y~_+...:R~e:!.!tu::.:.r::..n_-+_..._...!1.!.1J,_---,9_-.!.7+-~1~-~,!!7 1 S 75 19 ~6 ~ ~ OPGHyTHALMOLO- First f '7 B ~ R~um t---~----t-=~--t---t--- ---t----t-------r-- -"--t--~.. ~. OTOLARYNGOLO- FirHt 11.. ~ ~ GY Return.. -... 7 -+-- --1 e-,.g First 1 16 167 ULTRA VIOLET >.... Return 1 1..-1 _~h~q.b., pl 11 ~!~_~.8.16 '8 ~ t---=t..::o"t:..:.:a:.::l'-- -f-...;;i~.,;;;;~7'_+_-6:;.:~9+-...;::.:.1=_t_...:c;...;;oc+_--=:.::=-.f--,..:95 69 USJ 11.57 99 7.~~ B.78 * A ~ TOTAL 1~ 95 199 B 5Z9 165 171 W-;- ~~S 7- -5~7- -- 9 8.11 9. 9.) '.~ W... ~

Twenty-secnd Annual Reprt 5 COLLEGE HEALTH SERVICE The Cllege Health Service cntinues t functin under the supervisin f a special cmmittee, with its prfessinal activities under the directin f the Department f Medicine. The services f ther departments are utilized as necessary in individual cases. Dr. Mcintsh acted as Cllege Physician until the return f Dr. Hall in September 199. Dr. Tung Ch' en-lang has been respnsible fr physical examinatins and cnsultatins n all emplyees and their immediate families, while Dr. Chia K' uei has been respnsible fr similar service t the staff, students, and nurses. The cnsultatins shwn in the accmpanying statistics include rutine physical examinatins t the number f 1,79, fr emplyees, prspective emplyees, students, staff and nurses. The recrds shw that the Cllege Health Service staff has carried ut,5 prtective inculatins, vaccinatins, Dick and Schick tests. A nurse frm the staff f the Public Health Statin has made frequent hme visits fr purpses f investigatin, advice and treatment in the case f sickness in the hmes f emplyees. PRIVATE PATIENT SERVICE Cnsultatins in the case f private patients are arranged by the same secretarial staff that serves the Cllege Health Service. They are carried ut by designated members f the varius Hspital services at specified times, by appintment nly. The table f statistics accmpanying this reprt shws the numbers f patients cared fr by the varius services.

COLLEGE HEALTH SERVICE AND PRIVATE PATIENTS July 1, 199 - June, 19 EMPLOYEES STAFF & STUDENTS PRIVATE PATIENTS AND FAMILY Ttal Ttal Cllege I -------- Office I Hm. Health Office Office I I Hme I Private Hm. ---- Patients Chinesc I Frcill"n Chlnesc I Service Frcip Chincsc I Freip Chin esc I Frcip I DEPT. OF MEDICINE General Medicine 1,871 11 117 99,59 19 5,99 55-6 7 H 995 Pediatrics 1 16 8 7 568 58 8 17 9 6 Derm. and Syph. 177 8...... 511... 696 115 15 1... 1 Neurlgy 8... '" 6... 16 7 1 76 --------------------------- DEPT. OF SURGERY General Surgery 7 7..., 1,6-... 1,765 76 158 8 Orthpedics 5 6...... 16... 6 5 6-... 89 Urlgy 1...... 71.., 1 76 11... 1 9 Oral Surgery 9 5...... 56... 1, 71 5...... 16 ---------------- ------------ DEPl'. OF OBS. & GYN. Obstetrics 66 9...... 57 1 1 I 159 11 1-1 Gyneclgy 1 -... 68.., U5 158 18 9... 8S 1- ---- --- ---- DEPT. OF OTOLARYN- GOLOGY 556 98 5 1 1... 89 ~I~.. ~I 68-1- ------ ---- DEPT. OF OPHTHAL- MOLOGY 1,618 981... 1,71... 1,17 1 59... 8 5 TOTAL 5,717 ~I~ 195,691--- - 7,185 1,871,59 ~I~.,6S1

Twenty-secnd Annual Reprt 7 Reprts f the varius services are appended. The helpful c-peratin f the heads f the departments and divisins, and f all members f the staff has been appreciated and IS gratefully acknwledged. Respectfully submitted SIH-TZE WANG, A ctinz Superintmdmt

REPORTS OF DEPARTMENTS

Twenty-secnd Annual Reprt 1 REPORT OF THE DEPARTMENT OF MEDICINE INPATIENT SERVICES The Department f Medicine cnducts fur services, General Medicine (51 beds), Pediatrics (16 beds), Dermatlgy and Syphilis (5 beds), and Neurlgy and Psychiatry (9 beds). In additin the Islatin Pavilin (5 beds) and the Metablic Ward (1 beds) are shared by the General Medical and Pediatric services, and the beds f the Private Patient Pavilin are shared by all the services. The numbers f patients cared fr are shwn in the table f discharges in the Reprt f the Superintendent f the Hspital. There was a slilrht decrease during the year 199-. The mst imprtant event f the year was the peninll' f the Islatin Pavilin in December 199. This was frmally marked by a receptin attended by representatives f the Municipal Gvernment, the freign legatins, ther medical institutins, and physicians in practice in the city. During abut six mnths' peratin f the first flr (1 beds) 19 patients were cared fr. Many cases f severe diphtheria and scarlet fever were included. The Pavilin fills a f!reat need bth frm the pint f view f carinf! fr these patients wh cannt be admitted t the general wards and frm that f prviding prper training and experience fr staff physicians and nurses. It is earnestly hped that the whle buildinf! may be perated next year. A satisfactry islatin cde was wrked ut with the aid f the Nursinf! Supervisr, Miss McCrmick. The building was fund t be hif!hly satisfactry. The staff in char!!"e under Dctrs Weech and Ts and Miss McCrmick are t be cngratulated n the manner in which the new service was perated durin!!" its initial perid. The metablic ward was again perated after a year's lapse. Special studies were cnducted by Dctrs Keefer, Weech and Ts. Miss Elsie Waunf!, after her return frm a year's study f dietetics abrad, served mst satisfactrily as Head Nurse.

Peipine- Unin Medical Cllege Hspital The department is still withut prper prvisin fr psychiatric patients, a need emphasized by the ccurrence f several difficult cases durinlr the year.. In this cnnectin the wrk f Dr. Schaltenbrand and ther members f the Neurlgical and Psychiatric Service in studying and aiding in the care f patients in the Municipal Asylum shuld be mentined. An imprtant cnnectin with the city authrities was made and fr the first time systematic attentin was given t this vital field f medicine. Fr serius ecnmic and prfessinal reasns great need is felt f prper and inexpensive means f caring fr chrnically ill patients with tuberculsis and heart disease. OUTPATIENT CLINICS Outpatient clinics are maintained in each f the fields represented by inpatient services, with a few subdivisins. The numbers f visits are shwn in the table in the Reprt f the Hspital Superintendent. T these must be added the prfessinal wrk f the Cllege Health Service and the Private Patient Cnsultatins cnducted by members f the department. The ttal number f visits (5,55) is very slightly less than the ttal fr the previus year. This represents a large vlume f wrk and is a cnsiderable prprtin f all the wrk which it is pssible fr the staff t carry n. N either the staff nr the quarters available will permit any cnsiderable increase. During the year the Dermatlgical and Syphilis Clinics and the Pediatric Clinic ccupied their new rms in the first flr f "" building and the Neurlgical Clinic was prvided fr by assigning it t the Pediatric Clinic, each clinic using the space half a day. LABORATORIES The Rutine Chemical Labratry was mved frm the Pathlgy Building t quarters within the department n the secnd flr f "J" building. The table shws the examinatins made in the varius clinical labratries cnducted by this department. There was an mcrease wing chiefly t the increased number f patients studied.

Twenty-secnd Annual Reprt CLINICAL LABORATORIES July 1, 199 - June, 19 LABORATORY EXAMINATION Ttal Ttal I Number 199-198-9 Chemical (quantitative) Amnitic fluid Ascitic fluid Bladder stne Bld 899 I eyn cntent Milk 17 Pleural fluid 8 I Spinal fluid 5 Stl Urine 68 5,15,979 Dermatlgical ---------- AcaruJ Jcabiei 6 Darkfield (spirchetes) 75 Mlds 55 96 1,5 ------ Metablic Basal metablic rate + 18 I Physilgical Electrcardigrams 1li8'--- --- Tuberculsis Heart sunds 119 17 1,5 ------ Guinea pig inculatins 1 Hamster inculatins 8 Pathlgical fluids Skin 8 Sputum Stl 8 Urine 6 89 17 --------- Ttals 7,755 6,69 The Dermatlgical Labratry has given the fllwing special treatments: quartz lamp 9, radium 6, superficial x-ray 19, electrlysis 8, carbn dixide snw 1. The Neurlgical Labratry has studied macrscpically and micrscpically 115 brains in c-peratin with the Department f Pathlgy.

Peipinlr Unin Medical Cllelre Hspital PERSONNEL Durinlr Dr. devries' absence n leave Dr. Gerg Schaltenbrand acted as Chief f the N eurllrical Service in a mst satisfactry manner. The department lst the valued services f Dr. H. A. Reimann wh was cmpelled t return t the United States in Octber 199. FRANCIS R. DIEUAIDE Prfessr f Medicine and Head f the Department

Twenty-secnd Annual Reprt 5 REPORT OF THE DEPARTMENT OF SURGERY WARD SERVICE The wrk with patients in the surgical wards cntinued alng nrmal lines. Due t the absence f military peratins in r near Peiping, it was pssible fr mre patients t cme frm a distance than in the preceding years; there were fewer war wunds t treat, and a prprtinate increase in interesting cases suitable fr teaching purpses. The need fr ward beds cntinues, and it is believed that additinal beds shuld be made available fr the department, nt s much because f the need f patients fr surgical care, as t enable mre practical training t be given the resident huse staff. In this cnnectin it may be pertinent t pint ut that the additinal beds made available t the hspital during the past year have nly affected the Department f Surgery by prprtinately diminishing its rati in relatin t the hspital as a whle. The number f inpatients shwed a slight increase ver last year. The number f peratins, while greater than fr 197-8, shwed a 1 per cent decrease frm 198-9. This was due chiefly t the reductin in the number f cases f infected war wunds requiring multiple incisin and drainage peratins. There was an increase in the number f cases perated upn under lcal anaesthesia, particularly spinal anaesthesia. The majrity f all peratins were carried ut by the members f the resident huse staff. OUTPATIENT CLINICS The number f patients seen in the Outpatient Department increased smewhat ver the preceding year. The new quarters fr the wmen's clinic made available by the pening f "" building allwed the wrk t be carried ut mre cm frtably and easily. Enlargement f the O.P.D. perating rm has been a great cnvenience and facilitated the wrk f instructing the students in the technique f minr surgical peratins. PHYSICAL EQUIPMENT During the curse f the year, the department mved int its new ffices and labratries n the secnd flr f "" building.

6 Peiping Unin Medical Cllege Hspital DIVISION OF ORTHOPEDICS The wrk f the Divisin f Orthpedics was directed thrughut the year by Dr. Lee-chung Chu. Here, t, the type f wrk fllwed much mre nrmal lines than fr sme years past. A glance at the classificatin f peratins will cnfirm the fact. A statistical reprt f the wrk dne in the rthpedic shp and plaster rm fllws. ORTHOPEDIC SHOP Frames and accessries fr plaster pylns... Artificial arms... Artificial legs......... 1 Wden screw muth gags... Thmas cllars...... Metal cck-up splints...'... Wden triangular axillary splints... 5 Back braces..._... 8 Back brace with head supprt... 1 Sacr-iliac belts...... Walking caliper splints... Duble leg braces with pelvic supprt... 1 Cnvalescent hip brace... 1 Irn knee cage... 1 Elastic knee cap... 1 Lw leg braces... Ft braces... Ft drp splint... 1 Ft plates... 6 Felt arch supprts and metatarsal pads... Cm pads... Alteratin f shes... 6 Wden sles... 7 Repair wrk... 5 PLASTER ROOM Plaster jackets including head... 5 Plaster jacket up t the head... 1 Plaster bdy jackets... 5 Plaster jackets including thigh... 11 Plaster shulder spicas... 6 Lng arm casts............... 5 Plaster shells... 8 Single lng hip spicas... 6 Single shrt hip spicas...... 1 Duble shrt hip spicas... Lng leg casts... lis Psterir plaster leg shell... 1 Plaster pylns...... Plaster knee cage... 1 Plaster bts... 8 Repair wrk fr plaster casts...

TV:enty-secnd Annual Reprt 7 DIVISION OF UROLOGY The last mnths f the year 199-, saw the return f Dr. G. Y. Char, as Prfessr f Urlgy and full time Head f the Divisin. He has been busy rerganizing this wrk, which already has shwn a gratifying increase in the number and type f cases presenting themselves fr treatment. Additinal equipment fr treating this greater number f patients has been planned. DIVISION OF ORAL SURGERY Fllwing the resignatin f Dr. B. G. Andersn in July 19, Dr. Crnelius H. Mack, U. S. N., was appinted temprary Head f the Divisin frm July 1, 19 t Nvember, 19, until the new Head, Dr. G. A. Mntelius, culd reach Peiping. Since the latter's arrival there has been a rerganizatin f wrk which allws fr bth mrning and afternn hurs in the utpatient clinic. The year's reprt f the clinical activities f the divisin fllws. Private Patients Out Ttal Ttal Inpatients and Staff Members patients 199 198 9 ------ Examinatin and Cn8ultatin... 758 158 86 1968 X ray...--... 18 7 199 599 66 FiIlilr. Temprary... 6 Pulp Treatment '... 6 1 Sedative Treatment... 6 1 15 Rt Canal Treatment........."..... 5 5 Remval f the Dead Bne f Alvelar Prcess... Remval f Epulis... Alvectmy... Remval f Dental Cysts... Sequestrectmy... Resectin f Rt... 1 1 Ginlrivitis Treatment... 17 899 1111 16 Pyrrbea Treatment... 1 8 119 7 Prphylactic Treatment... 8 8 195 559 SSO Pst-perative Treatment... 9 15 9 756 S71 Exdntia ( per cent Nvcain)... 6 18 59 7 69; Exdntia (Elhyl Chlride)... 1 9 11 1 1 Exdntia (Gae ci OXYlren)... 7 8 Exdntia (Withut Anesthetic)... 7 9 18 6 Pyrrhea Treatment fr Kala Aur Cases... Pyrrhea Treatment fr Vincent Infectin Cases 9 11 Curettement f Anterir Alvelar Prcess... 1 1 Crrect Treatment f Fracture f Mandible... Prphylactic Treatment fr Typhid Fever Caees 59 Ope rati s n Alvelar Prcess... ---- 1 TOTAL 78 186 111 6681 67

8 Peiping Unin Medical Cllege 'Hspital PERSONNEL The department, was smewhat handicapped by the small number f men n the visiting staff, which during mst f the year cnsisted f nly fur members, ne f whm was n part time. Dr. Z. D. Zau resigned in April 19, t accept a psitin in the Central Hspital, Nanking. Dr. G. Y Char, wh was Assistant Prfessr f Clinical Surgery, accepted appintment as Prfessr f Urlgy, and is again with the institutin n a full-time basis. He tk up active duty April!, 19. Dr. G. A. Mntelius arrived in Peiping during January 19, t assume charge f the Divisin f Oral Surgery. Dr. Jseph BieIl, Captain U.S.N., f the American Legatin, was f great assistance t the department by helping in the wrk in the utpatient department and aiding in the teaching. M. M. ZINNINGER Prfessr f Surgtry and Head f the Department

Twenty-secnd Annual Reprt 9 REPORT OF THE DEPARTMENT OF OBSTETRICS AND GYNECOLOGY WARD SERVICE The mst utstanding feature f the year's wrk has been the marked increase in the number f bstetrical cases admitted t the hspital. The ttal number f deliveries fr the year is 86, which exceeds by ver per cent the previus recrd f the year 198-9. As may be imagined the accmmdatin f the bstetrical ward and the resurces f the staff have at times been taxed t the utmst in dealing with this great influx f new patients, and the extra accmdatin t be prvided during the cming year by the pening f K- will be nthing shrt f a necessity. The gyneclgical beds have been kept filled by a steady stream f patients, and a large variety f interesting cases has been treated during the curse f the year. There has been an increasing tendency thrughut the year twards the use f sacral anaesthesia fr vaginal peratins and spinal anaesthesia fr cases f abdminal sectin, with very satisfactry results. Radium treatment has again ccupied a prminent psitin in the wrk f the department, and has been administered t 6 cases. There is usually a lng waiting list f patients fr whm this treatment has been recmmended. OUTPATIENT CLINICS Attendances in the Outpatient Department have been mre than maintained, and shw a substantial increase ver the previus year. The time has been reached when the limits f space wuld seem t render further expansin impssible, unless extra accmmdatin be prvided, as thrughut the week there is hardly an hur during the wrking part f each day when the examining rms are nt crwded with patients. During the year the fllwing numbers f special investigatins, labratry examinatins and treatments have been carried ut in the Outpatient Clinic:- Rubin's Tests...... 78 Hystersalpinggrams............ 7 ~::;~~x~:h~!~f ~~.::::::::::::::::::::::::::::::::::::::::::::::::: ~~~ Urine examinatins... 18 Treatments... 8

Peiping Unin Medical Cllege Hspital TEACHING A great deal f excellent material has been available in the wards fr teaching purps~s, and full use has been made f this during the special ward runds and perative clinics fr the third and furth year classes. In additin the usual instructin n labur, cases in the delivery rm has been given. The custmary curses f lectures and ward demnstratins were given t the nurses f the third year class during the first and secnd trimesters. The usual Intensive Curse fr Pst-graduates was held during August and September 199, and was attended by nine members. Fur ther members wh had enrlled were prevented at the last mment frm attending wing t unsettled travelling cnditins. Three special pst-graduate students have attended the practice f the department fr varying perids thrughut the year. During the year Dr. Shih-wei Lee, at the request f Dr. Marin Yang, has given a special curse f lectures in Chinese t the students f the First Natinal Midwifery Schl n the subject f Abnrmal Pregnancy. RESEARCH WORK During his absence n furlugh the Prfessr and Head f the Department has cntinued his researches int the subject f Ostemalacia, and has published a further valuable cntributin t the existing knwledge n this disease. He has als made a mst interesting additin t the literature n Fetal Rickets, based upn children whse mthers were the subject f stemalacia. Dr. Grdn King has cntinued his wrk n pregnancy txaemia and has made a special investigatin f the cmparative value f spinal anaesthesia in bstetric and gyneclgical surgery. He cntributed a paper n this latter subject t the biennial meeting f the Natinal Medical Assciatin in Shanghai, and has als published papers during the year n Tetany cmplicating Pregnancy Txaemia, and Carcinma f the Cervix cmplicating Parturitin.

Twenty-secnd Annual Reprt 1 Dr. Ams Wng has cmmenced an investigatin int the nature and causes f dysentery cmplicating the puerperium. He has cntinued his wrk n hyster-salpinggraphy and has cntributed papers t the literature n Bacillus Welchii Infectin during Labur, and Sacral Anaesthesia in Gyneclgy. Dr. Shih-wei Lee has cmpleted a valuable statistical study, based n ver cases, which will d a great deal t standardize knwledge as t the maternal pelvic measurements amng Chinese, and the average weights and measurements f the Chinese newbrn. He represented the department at the Natinal Medical Cnference at Shanghai and presented papers n behalf f himself and the ther members f the department. He has als translated fur f Prfessr Maxwell's papers int Chinese and has published a new editin in Chinese f Advice t the Expectant Mther. Dr. Lieh-chung Wu made a study f separatin f the symphysis pubis during labur and has cmpleted a paper n the subject. PERSONNEL Prfessr Maxwell has been absent n furlugh thrughut the year, and the visiting staff has cnsisted f Dr. Grdn King, wh has served as Acting Head f the Department, Dr. Ams I. H. Wng and Dr. Shih-wei Lee. Dr. Lieh-chung W u has been acting as resident and assistant, but has been cnsiderably handicapped by ill health during the latter part f the year. During his absence n sick leave his place was taken by Dr. Kh'a-ti Lim, senir assistant resident. Dr. Marin Yang, Directr f the Natinal Midwifery Sch], has cntinued t serve in the capacity f Vluntary Assistant t the Department and has given valuable help in the utpatient service. During the curse f the year there has been a cnsiderable amunt f c-peratin between the Department f Obstetrics and Gyneclgy and the First Natinal Midwifery Schl. GORDON KING, F.R.C.S. A ssciatl in Obstetrics f Gynec%EY and Acting Head f the Department

Peipin~ Unin Medical Clle~e Hspital REPORT OF THE DEPARTMENT OF OPHTHALMOLOGY WARD SERVICE The admissin f inpatients fr the year 199-, shws nly a marginal difference f a decrease f 8 cases in cmparisn with that f the previus year. It may be stated that mre than 6 inpatients under the care f the ther services have been referred t the eye service fr cnsultatin and examinatin. During the year under review, 58 majr peratins have been perfrmed by the Acting Head and the ther members f the staff in the general peratin' rm and 17 minr peratins in the utpatient eye clinic. OUTPATIENT CLINICS The statistical figure f new patients admitted t the clinics shws a slight decrease in cmparisn with that f the previus year. This difference may be explained by the fact that the increase by ne-third in the admissin f new cases ccurring last year ver that f the year befre last, was because f the admittance t the clinic f an unusually laree number f sldiers. Mst f the new cases were seen and diagnsed by the Acting Head after they had been seen by the ther members f the staff. The ld cases have been under the alternate care f Dr. Jhn and Dr. Ling~ The statistical figure f the trachma clinic registers an increase f nearly ne-third ver that f the previus year. This steady increase year after year is due mst prbably t the spirit f realizatin by the cmmunity f the danger and menace f this dread disease, particularly the students wh have been subject t underging entrance physical examinatins, due t a ruiin~ adpted by mst f the schls in Peiping.. The private patients' clinic attendance shws an mcrease f a little ver ne-third ver that f the previus year.

Twenty.secnd Annual Reprt TEACHING Instructin t the third year medical undergraduates, as scheduled in the first trimester, was given by Dr. Pillat with the assistance f Dr. Pi. Instructin t the secnd year nursing undergraduates was given by Dr. Pi alne. Since the adptin f the small grup teaching system fr the cming year, a preliminary curse t the secnd year medical undergraduates was carried ut by Dr. Pi tward the end f the third trimester. The intensive pst-graduate curse in Chinese, given every ther year was cnducted by Dr. Pi and Dr. Ling n varius subjects cvering the whle field f phthalmlgy. At the invitatin f the department, Dr. Yii-Lin Wei f the Neurlgical Service als participated in this curse by delivering a series f lectures cncerning th~ neurlgical cnditins f the eye. A series f lectures n sme imprtant eye diseases was given by Dr. Pi and Dr. S. P. Chang t a class f pst-graduate students attending the Extensin Curse in Medicine given at the end f April 19. STAFF CONFERENCES AND OTHER ACTIVITIES The staff jurnal and pathlgical cnferences have been held regularly as befre. Aside frm the publicatin f a gratifying number f phthalmic articles appearing in the different jurnals in China and abrad, it is wrthy t nte that a "Special Eye Number", cmpiled and dedicated by the members f the eye staff, was published by the Natinal Medical Jurnal f China in its issue f Octber 199. The histpathlgy f the eye has been in Dr. Ling's charge under the supervisin f the Acting Head f the Department. During the entire year, 19 pathlgical specimens have been carefully studied and described. PERSONNEL Dr. A. Pill at, Acting Head f the Department, left the service in the early part f January 19, n a leave f absence fr ne year.

Peiping Unin Medical Cllege Hspital Dr. Liu Pa-hua, Assistant in Ophthalmlgy, at the urgent request f the authrities f the Natinal Medical Cllege f Peiping, was mst reluctantly spared frm the service at the end f Nvember 199, t assume the headship f the Department f Ophthalmlgy f that medical institutin. Due t the shrtage f wrking members n the eye staff, Dr. 1. Jhn f Vienna jined the staff at the end f Nvember 199. The Acting Head f the Department arrived in Peiping in the middle part f April 19, assuming his duties immediately upn arrival. Between the perid f Dr. Pillat's departure and the arrival f the new Head, Dr. Pi acted as Head f the Department. L. SALLMANN, Assciate Prfissr f Ophthalmlzy and Acting Head f the Department

Twenty-secnd Annual Reprt 5 REPORT OF THE DEPARTMENT OF OTOLARYNGOLOGY WARD SERVICE In general the activities f the Department f Otlarynglgy have been alng similar lines t thse fllwed in previus years. The pening f the Islatin Pavilin, making pssible the admissin f a larger number f infectius disease cases than in the past, hwever, has increased the vlume f wrk. In fact, there have been s many cmplicatins f the thrat r ear requiring peratins that an perating rm has been equipped in the basement f the Pavilin t care fr them. The frequent clsing f the pediatric ward n accunt f the appearance f infectius diseases amng the children, has cntinued t create a prblem fr this service. At such times, nt nly has it been difficult t treat satisfactrily ur cases f laryngeal stensis n that ward, but children needing hspital care culd nt be admitted. During the year the number f patients shws nly a slight increase in spite f the significant increase in number f mastidectmies and peratins fr sinus thrmbsis. OUTPATIENT CLINICS The clinic has been extremely active thrughut the year and especially s during the spring mnths. It was remarked that nt a few came frm great distances. Anther pleasing feature f the clinic has been the grwth f what we chse t call "The Baby Service" It is gratifying t have mthers bring their babies fr examinatin in the early stages f their diseases. TEACHING The usual instructin was given in the clinic t third year medical students; and fr the first time, the secnd year medical students were instructed in the methds f examinatin and the appearance f the nrmal nse, thrat, and ear.

6 Peipin~ Unin Medical Clle~e Hspital PERSONNEL The Head f the Department was liberated frm administrative wrk at the end f December 199, and has since devted his entire time t the affairs f the department. Dr. J. Hua Liu departed fr a year f study abrad early in April 19. Dr. Y H. Ting returned t the service in Octber 199, after his year f study in America. The remainder f the staff has nt chan~ed. A. M. DUNLAP Prftssr f Otlarynglgy and Head f the Department

Twenty-secnd Annual Reprt 7 REPORT OF THE DEPARTMENT OF ROENTGENOLOGY The wrk f the Department f Rentgenlgy has been very much facilitated by the increased space prvided in the new quarters which the department has ccupied since the early fall f 199. One rm is used entirely fr flurscpic wrk and chest x-rays, anther rm fr rdinary rutine x-rays and a third fr sterescpic wrk. In spite f better facilities, hwever, the rutine wrk f the department has nt been handled entirely withut difficulty because f a smaller staff. The ttal number f 566 cases examined during the year 199- shws a slight increase f as cmpared with 5 cases examined fr the previus year. Amng the interesting cases were tw patients f unilateral duplicatin f ureter and renal pelvis. One case f ld, perfrated dudenal ulcer with air cysts f small intestine was als seen. The fllwing table gives a cmparisn f the wrk f the last tw years: Year In- Students Private Out- Ttal Ttal Grand Outpatients Chinese Freign patients and Staff patients Ttal ------------------ 198-9,6 5 161,67,789 5 5, ----------------- 199-,7 7 1.581 5, 5,66 A ttal f 619 x-rays were taken f the 566 patients referred t the department which may be classified as fllws: Chest (lungs, heart, etc.),566 Bnes and Jints,567 Mastid and nasal sinuses Gastr-intestinal tract 17 Kidney, Ureters and Bladder 75 Pregnant Uterus and Hystersalpinggram 78 Superficial therapy 1- Ttal 6,19

8 Peipinll Unin Medical Cllee Hspital TEACHING The underllraduate curse f the first year and the weekly clinical x-ray cnferences were cnducted as in previus years. Several physicians spent perids f a few mnths in the department as special students. TECHNICAL SERVICES The x-ray wrk shp, under the supervisin f Mr. H. S. Wanll, has cntinued t serve the department and ther hspitals as well. RESEARCH The rutine clinical wrk has required practicaijy all f the time f the members f the department s there has been little pprtunity fr extensive investigatin. Dr. C. K. Hsieh has published a paper n Echincccus Invlvement f the Bnes in Radilgy and Dr. Ching Wu reprted a paper n Rentgenlgical Study f Intestinal Tuberculsis in The Natinal Medical Jurnal f China. The ther members f the department have als bel!un t study cases f appendicitis and bne abscess. C. Wu Fr C. K. HSIEH, Instructr in RentEenlgy and in charge f the Hspital X-ray &rvice

Twenty-secnd Annual Reprt 9 REPORT OF THE DEPARTMENT OF PATHOLOGY The past year has been, n the whle, quite satisfactry, and the members f the Department f Pathlgy wish t take this pprtunity t express their appreciatin f the helpful c-peratin shwn by the members f the clinical staff as well as by the administrative fficers f the hspital. DIPISION OF PATHOLOGY As the result f a marked decline in the percentage f autpsies perfrmed upn patients dying in the hspital during 198-9, a special effrt has been made during the past year t increase the number f pst-mrtem examinatins. Whereas the administrative fficers f the hspital have played their usual active rle in securing permissins fr autpsies, the heads f the varius clinical departments, as well as their junir staff members, have shwn far greater activity in this wrk than ever befre. The result f these cmbined effrts, which have been mst gratifying since first begun in July 199, are seen in the fllwing summary f deaths and autpsies frm the varius clinical departments. The beneficial effect f this added amunt f material has been very great. AUTOPSIES Hspital cases... 17 Outpatient Department cases...,... Infants frm Department f Obstetrics... Outside cases... 17 Emergency cases... Ttal... 195

5 Peiping Unin Medical Cllege Hspital SERVICE AUTOPSIES ON INPATIENTS. DEATHS AUTOPSIES PERCENTAGE CJ r:: CJ r:: I CJ....,..~ CJ OJ r:: ~ ' r:: f ' :E :E = ~ TW :E ~ ~ ~ 199-198-9 f..i f..i!-< f..i I I I I I I T.~ Medicine 116 7 1 5 7 57 1 6 8 Pediatrics 78-78 57-57 7-7 Neurlgy 8 - S - 7. 7 Surgery 57 5 6 i 7 6 Obstetrics and Gyneclgy 5 1 6 6-6 58-56 7 Otlarynglgy 1 1 1 1 5 5 Ttal fr 199-7 1-1 161 11 17 5 71 5 Ttal fr 198-9 96 18 1 8 H 96 8 7 SURGICAL SPECIMENS Medicine... 15 Dermatlgy... Neurlgy... 1 Surgery............ 696 Obstetrics and Gyneclgy... 99 Otlarynglgy... Ophthalmlgy... 97 Outside hspitals... 6 Ttal.... 1 The ttal number f surgical specimens received by the Divisin f Pathlgy fr examinatin has shwn an increase f ver that f last year. Of these additinal specimens, 57 were supplied by ur wn clinical departments and 66 sent t us by ther hspitals. Inasmuch as a great deal f material sent frm.ther institutins has prven very valuable fr the training f ur staff and students we have made n charge fr this service.

Twenty-secnd Annual Reprt S1 DIYISION OF BACTERIOLOGY Diagnstic wrk fr the hspital, cnducted in the serle-ical and bacterilgical labratries f this divisin, has cntinued t increase steadily as shwn in the tabulatin belw: Years Bactedlgical Te'U I Serlgical Tests 195-196 7,9 1,15 196-197 I 7, 15,15 I Ttal I 18,58,7 197-198 8,8 18,65 7,188 198 199 9,86 1,S 1,17 199 19 1,859,86,69 I In cnnectin with the serum diagnsis f syphilis, ur rutine practice has been t perfrm bth the cmplement fixatin and Kahn tests n each specimen submitted. In rder t have a simple test fr cntrlling the Kahn test, a cmparative study f the Meinicke reactin (M. T.R.) was perfrmed during the year. In spite f the strict search and eliminatin f syphilitics frm ur list f ver a hundred bld dnrs, ccasinally a psitive Kahn was fund just befre bld transfusin. A rutine has, therefre, been established t perfrm an emergency Kahn test and bld matching befre the dnr's bld is remved fr transfusin. In the bacterilgical labratry an increase f nearly 1, specimens ver thse f the previus year is shwn. In rder t encurage the intelligent use f the labratry, we have tabulated belw the percentage f psitive cases amne: the different kinds f specimens submitted. It may be pinted ut here that ut f,78 stl specimens nly 618 r 16.5 per cent shwed psitive cultures fr pathgenic rganisms. A cmparative study f the varius methds used has been made and the China-blue rsalic acid medium used has been demnstrated t be the mst reliable medium in ur hands. This has been verified by Dr. H. J. Smyly in a recent paper n "The Diagnsis and Treatment f Chrnic Dysentery."

5 Peiping Unin Medical Cllege.Hspital BACTERIOLOGICAL LABORATORY, I Specimen Negative I Psitive I N. Tested I 1 Per.c~nt psitive Autgenus vaccine 6 6 1 Bld - Agglutinatin 6 8 51.8 Culture 86 67 19. Bdy fluids - Ascitic 156 15 1 1. Pericardial 1 8. Pleural 11 89.5 Spinal 5 178 76 I 9.9 Mille 8 8 1 Sputum culture 66 6 I 18 8. Stl culture,78,1 618 16.5 Swabs Ear 1 15 8 97 1 9. Eye 1 1 1 Mastid 61 1 I 16 5 7.7 Nse 5 67 168 71.5 Pus 1,56 567 979 6. Thrat 1,765 8 95 5.5 Tissue culture 1 1 7 5 Urine culture 16 169 5.7 Water 7 7.9 Miscellaneus 67 1 65.9 Ttal 1 1,857 1 6,917,9 6. SEROLOGICAL LABORATORY I Specimen 1 ~~~d 1 Negative Psitive I Per.c~nt positive 1--B-IO-O-d--g-r--t-1P-i-n-g-a-n-d-m-a-t-ch-i-n-g--i--}-, 1 1, 1 Kahn test 1,19 6,56,78 6.6 Wassermann test 1,6 6,98,78 6. Spinal fluid - Cllidal gld test 59 6 15.6 Cllidal gum mastic test I 1 1 17 9 Rss Jnes test 91 5 1. Wassermann test 86 7 116.!-------------------------------------I-------I--------I 1 Ttal 1,86 1 1,78 9,5 I 9.61 Amng the examinatins f special interest were the islatin f meningcccus frm seven cases f cerebrspinal meningitis and f chlera frm tw spradic cases. In view f the refractive character f the meninllcccus infectin t treatment with.. specific imprted

Twenty-secnd Annual Reprt S serum, cultures f the lcal strains islated were sent t the Natinal Epidemic Preventin Bureau fr use in the preparatin f its antimeningcccic serum. The diagnstic labratries, in additin t their rutine prcedures, cntinue t extend their usefulness t institutins in different parts f this cuntry thrugh the training f technicians and dctrs. During the year ten technicians and five dctrs were received fr trammg. With the develpment f public health wrk, there cntinues the demand fr trained technical wrkers. Owing t ur limited space, it is felt that the resurces f the labratry culd be utilized t greater advantage fr the training f graduates and specialists capable f taking charge f a labratry and training their wn technical help. With this end in view the training f technicians will be discntinued after this year. It is prpsed t ffer a tw year curse in labratry prcedures fr persns wh pssess a university degree t qualify fr a psitin as medical technlgist as specified in the Registry f Technicians f the American Sciety f Clinical Pathlgists. After cmpleting their training, they shuld be in a psitin t fill vacancies that ccur frm time t time in the labratries that are being established in different p'arts f the cuntry. Anther ntable change the past year is the assignment f Assistant Residents in Medicine fr duty in the diagnstic labratries fr a perid f three t six mnths. This prvides labratry experience fr clinicians and will be helpful in bringing abut clser and mre intelligent c-peratin between clinicians and labratry wrkers. Aside frm rutine bacterilgical examinatins, the divisin has als been carrying ut myclgical examinatins n all cases f suspected infectin with fungi. As the etilgy f fungus diseases in China has never been satisfactrily investigated, this wrk will be f sme value t clinicians. Attentin has been directed mainly t the study f skin and scalp infectins due t Trchphytn, Micrsprum and Achrin. The study f yeast-'ike fungi in relatin t their distributin and frequency in different diseases has been carried ut. An extensive myclgical study f cases f Hng-kng ft, an infectin f particular interest in China, has als been cmpleted and a reprt f the findings will be published separately.

5 Peiping Unin Medical Cllege Hspital It is gratifying t nte that the wrk f the divisin has been greatly facilitated by the allcatin f the entire east wing f the secnd flr f "1" building t the diagnstic wrk which has affrded cnsiderable additinal space fr the accmmdatin f students and graduates. DIVISION OF PARASITOLOGY The services rendered the hspital by the Divisin f Parasitlgy are summarized in the fllwing tables: INCIDENCE OF INTESTINAL PROTOZOA AND OF HELMINTH INFECTIONS July 1, 199 - June, 19 N. f persns examined... 9 N. f examinatins made... 11897 Intestinal Parasites PROTOZOA Endameba histlytica.... Endameba cli.... Endlimax nana.... Cuncilmania lafieuri (?)...,.... Idameba buetschlii..... Giardia lamblia.... Trichmnas hminis.... Chilmastix mesnili.... Embadmnas sinensis.... HELMINTHS Ascaris lumbricides.... Ancylstma r Necatr.... Trichcephalus trichiurus.... Enterbius vermicularis.... Clnrchis sinensis...... Schistsma japnicum.... Hymenlepis nana.... Hymenlepis diminuta.... Taenia spp. (intestinal)..... Fascilpsis buski.... Strngylides stercralis.... Dicrcelium dendriticum.... N. Psitive Cases 9 89 7 1 161 1 9 58 1 1577 199 16 19 1 1 1 Per cent Psitive Cases 5. 18. 7. S...7 1.9 1.....5... O.!9..6 (L8..6

Twenty-secnd Annual Reprt 55 PARASITOLOGICAL EXAMINATIONS OF BLOOD July 1, 199 - June, 19 N. f persns examined... 7 N. f examinatins made... 5 N. Psitive Cases Per cent Psitive Cases Plasmdium vivax 5 Plasmdium malariae 1. Plasmdium falciparum 1.8 EXAMINATIONS FOR LEISHMAN-DONOVAN BODIES July 1, 199 - June, 19 Number f persns examined... 6 IT al N f N P.. I Per cent t. ~... OSl.tlve Psitive ExammatlOns ExammatlOns, E xamma. t' Ins Culture f splenic pulp 98 8 I 8 Smear f splenic pulp 79 5 Culture f liver pulp 1 1 7 Smear f liver pulp 1 15 Culture f bld 7 1 J.7 Culture f urine I E. histlytica. PROTOZOA E. histlytica were demnstrable in the pus f a case f empyema and sixteen cases f liver abscess. Malaria. It may be a cincidence that all cases f subtertian came frm Shantung and thse f quartan frm Anhwei.

56 Peipin~ Unin Medical Clle~e Hspital Kala-azar. Thirty-ne ut f sixty-fur suspected cases were fund t be psitive, in all f which Leishman-Dnvan bdies were detected in spleen smears r cultures. N ther methd is as reliable. Befre a pure culture is declared as neg-ative, it must be incubated fr at least fur weeks. Flag-ellates have been seen in cntaminated cultures if the latter were examined early befre they were vergrwn by bacteria. On fur ccasins when liver puncture was dne, three smears were ne~ative, and ne culture psitive, thugh spleen smears and cultures were all psitive. Bld smears were examined in three cases all f which were negative. In all suspicius cases splenic puncture is recmmended. Ascaris lumbricides. HELMINTHS The yung-est case n recrd here was in an infant days ld. Clnrchis sinensis. Six cases were recrded frm Hpei. Nne f them had been suth. In ne case, that f a be~ar wh died f tetanus and gangrene f the feet, there was n va fund during life. At autpsy abut twelve wrms were recvered frm the liver. Schistsma japnicum. Of special interest w'as a case f chrnic appendicitis. The patient gave a histry f abdminal truble f three years' duratin. He was seen fur times, n the last ccasin f which appendectmy was dne. In the wall f the excised appendix, va f Schistsma japdnicum were fund, sme degenerated, thers calcified. Thugh stls were examined ten times n va were detected. There was n esinphilia. Hymenlepis diminuta. Ova were fund in a male Hunanese aged 16, wh was admitted fr tuberculsis f the lungs. There were n symptms. Fascilpsis bus /d. Ova were detected in the curse f rutine examinatins. Nne came in fr gastr-intestinal truble. Tw cases were frm Kwangtung, ne frm Hupeh and ne frm Kiangsi.

Dicrcelium dendriticum. Twenty-secnd Annual Reprt 57 In all three cases the presence f va was due t dietary cntaminatin. They disappeared n subsequent examinatins. All cases mentined in previus literature belng mst prbably t this categry. While the liver treatment fr anaemia is in vgue, physicians must check up their stl examinatins befre diagnsing a case as ne f dicrceliasis. CHANGES IN ADMINISTRATION Fllwing the unanimus apprval f the three divisins f the Department f Pathlgy and the members f the Prfessrs' Cmmittee, the Head f the Department f Pathlgy recmmended that the Divisin f Bacterilgy be created an independent department frm July 1, 19. This recmmendatin has been apprved by the Acting Directr and the Bard f Trustees. Dr. C. E. Lim has been appinted Prfessr f Bacterilgy and Acting Head f the Department. This arrangement gives every prmise f being a highly satisfactry ne and it is hped that it will be cntinued indefinitely at the end f the cming year. PERSONNEL The Divisin f Parasitlgy has been extremely frtunate In securing the services f Dr. Reinhard Heppli as Prfessr f Parasitlgy and Head f the Divisin. Dr. Hsu Ying-tang has left us t becme head f the pathlgical labratry f the new Central Hspital in Nanking, and Dr. Pai Shih-en has accepted a psitin with the public health service in Shanghai. All vacancies have been filled by prmising men and the department begins the new year with its full quta f wrkers. J. R. CASH prfessr f PathlD and Head the Department

58 Peiping Unin Medical Cllege Hspital REPORT OF THE NURSING SERVICE The nursing serv'ice has steadily carried n this year lyally and faithfully despite varius difficulties. TEACHING The English classes fr all new graduates jining ur staff were discntinued but the classes in Nursing Prcedures have been held 'Cntinuusly during the year. In additin, a pst-graduate curse f six mnths was ffered beginning March 1, 19, the first three mnths f which were devted t teach.ing and the last three mnths t bservatin and practice in the varius wards and special services, with emphasis n administratin. Nine nurses came frm seven different cities in China fr the entire curse, besides tw wh were already engaged in wrk at this hspital and wh were enabled t remain fr the first half f the curse. Mst f these special students are engaged in administrative and teaching psitins in their wn hspitals and will return fr further sevices there. This mdest curse seems t be much in demand as an pprtunity fr brader experience and preparatin fr nurses engaged in imprtant psitins in the smaller hspitals. Mst f them ~ave made the best f their pprtunities here. During the past year cnsiderable ward teaching in Chinese fr graduate nurses has been accmplished thrugh the effrts f the teaching supervisrs, the nead nurses and the members f the clinical staffs. PRIVATE DUTY NURSING The fllwing is a yearly cmparisn f the days f special nursing: I 196-7 I 197-8 I 198-9 I 199- Chinese graduates... 1 1,876 I 1,55 I,9 I 1,5 Freign graduates... 1 I I i I Ttal...\,i 1,8-,66 1,675 I I I 7 I 15 1 175

Twenty-secnd Annual Reprt S9 PERSONNEL Chanlres in staff cntinue as usual, due t expiratin f cntracts, needs f ther hspitals and the develpment f the public health field, with the cnsequently increasinlr demand fr the lrraduate nurse in China tday. The steadily increasinlr size f the hspital added t the abve factrs, means that the nursing staff has nt s far succeeded in keepinlr pace with the hspital bed capacity. Chanlres in Staff, 199-19 Chinese wmen Chinese men Freign wmen Ttal number f nurses n staff under cntract.... 8 6 1 Nurses n temprary duty r withut cntract.... 9 New appintments... 1 9 - Reappintments cmpleted.... 5 7 6 Appintments cmpleted.... 1 Left befre cmpletin f appintment.... 1 Leave f absence.... Discharges.... HEALTH Very few serius illnesses have ccurred amng the staff this year, but the minr illnesses have nt shwn much change: Wmen... 97 days sick leave Men... 189 " " " HOUSING Durinlr the past year the Oliver Jnes Drmitry fr Chinese nurses has been cmpletely pened, with cmfrtable and pleasant livinlr and receptin rms and the very pleasant inner curtyard

6 Peiping Unin Medical Cllege Hspital pened fr scial life: It is the first time in several years that there have been such adequate and attractive living and scial cnditins fr ur nurses. With the pening f the new wards this year, the living accmmdatins will almst be filled. The recent clsing f Laura Spelman Hall and the pening f the Hstel in Nrth Cmpund fr sme f the freign nurses, as well as the pening f the suite fr freign nurses in Oliver Jnes Hall, means a mre hmelike develpment f living cnditins fr this grup. Sme f the male nurses are nw cmfrtably cared fr in a huse with garden n San Tia H utung, with the remainder living n the secnd flr f "F" building. ERMA B. TAYLOR Aefinr Dean f the Schl f Nursinr and AetinE Superintendent f Nurses

Twenty-secnd Annual Reprt 61 REPORT OF THE DIETARY SERVICE The average number f meals served daily in the hspital during the year 199- is shwn in the fllwing table: Chinese patients private ward 5 Chinese patients semi-private ward 6 Chinese patients public ward S7 Freign patients private ward 19 Freign patients semi-private ward 6 Staff dining rm 9 Dressers and attendants 8 Emplyees 56 Ttal 1,67 An average f 9 special diets was prepared daily in the diet kitchen. These were rdered fr patients suffering frm diabetes, nephritis, nephrsis, anemia, typhid, dysentery, gut, arthritis, beriberi, pelagra, epilepsy, and frm cardiac and gastric cnditins as well as nutritinal deficiency. In September 199, the purchase f perishable fds thrugh a buyer was discntinued. The fd is rdered directly frm fur reliable dealers apprved by the Cmptrller. When the fd arrives in the Cllege receiving rm, the quantity and quality are checked by a member frm the Purchasing Department and ne frm the Dietary Divisin. The Dietitian then checks ver the prices befre the invices are passed n fr payment which is made directly t the dealers by the cashier. This new system wrks ut remarkably well and is a great imprvement ver the ld. The new dining rm in "J" basement was pened in Nvember 199, and has ~ prved a success. The staff tea rm has becme an imprtant place. Frm fur t five 'clck each afternn it is a rendezvus fr staff members wh at ther hurs f the day may nt have pprtunities t meet. Abut sixty persns gather arund the tea tables daily. As a health measure raw lettuce was nt allwed t be served. This year thrugh the c-peratin f the Superintendent f Buildings and Grunds we have been able t grw lettuce n the premises under sanitary cnditins and prper supervisin. Its use has been apprved by the Department f Health and is a desirable additin t the regular meals.

6 Peiping Unin Medical Cllege Hspital It is gratifying t' see the grwing interest in dietetics amng hspital wrkers. We have had nurses frm hspitals in different parts f the cuntry cme fr training fr perids ranging frm ne week t six mnths. The translatin f ur Diet Lists int Chinese seems a help t hspitals all ver China. Thrugh the curtesy f Miss Camilla Mills, Head f the Hme Ecnmics Department f Yenching University, the Dietitian had an pprtunity t address the students specializing in Hme Ecnmics. One f the graduates, Miss Lia Su-chin has been accepted as student dietitian frm July 19. It is hped that we may have mre recruits frm the yung wmen f Yenching t receive training fr hspital service. A need fr mre dining rm space fr emplyees is greatly felt. As the cst f fd increases these men find it much mre ecnmical t bard in the hspital, but wing t crwded cnditins many have been refused admissin. Respectfully submitted, HUANG KWE-PAU Dietitian

Twenty-secnd Annual Reprt 6 THE REPORT OF MEDICAL SOCIAL SERVICE The year 199- has been an unusually interestine- ne. Fr the first time in the histry f the divisin there have been enugh wrkers t cver all the public wards in the main hspital, and t d much f the Outpatient Department wrk. In several f the clinics, surgical, pediatric, tuberculsis. syphilis, cardiac and rthpedic, there has been a wrker cnstantly n duty. The wrker in charge f the ward fr a particular service als has been n can fr ther clinics. Tward the end f the year it was pssible t put a wrker daily in the medical clinic. By the entire staff taking turns a wrker has been n duty each mrning and afternn in the admittineffice t discuss prblems with the families f the patients. This increased emphasis n the Outpatient Department is felt t be in the right directin, and the time is anticipated when the main energies f the divisin can be cncentrated there. It is here that the patient with his prblems cmes first, and it is t the Outpatient Department that he shuld return. Many f the mst cnstructive pieces f wrk can be dne with patients wh never need admittance t the ward and the necessity fr ward care can ften be bviated by this utpatient care. The surgi'cal fllw-up wrk has shwn very gratifying returns f patients t clinics and f lett~rs received. There have been the usual calls frm the dctrs fr the return f special patients. The medical fllw-up clinic has been small, but the returns satisfactry. The cardiac fllw-up wrk has als brug.ht satisfactry results. The regular case wrk f the divisin has been apprtined t the varius wrkers as shwn in the accmpanying table. An attempt has been made t indicate the vlume f wrk by the number f cases handled and the number f services perfrmed. This f curse can be suggestive nly, as different wrkers list services in different ways, and sme services require much mre time fr their executin than thers. Sme services that can be listed nly nce may take days t perfrm.

6 PeipinL! Unin Medical ClleL!e Hspital In additin t the regular medical scial case wrk and fllw-up there have been several pieces f special wrk. The Men's and Wmen's Hstels have been run by cmmittees f the staff. The emplyees' cmpensatin cases have taken much time. A special study f the babies given in adptin, and f the unmarried mthers has been made. These pieces f wrk have been given t thse having the smaller vlume f stated duties. The Bureau f Plitical and Scial Research has had a wrker in the divisin during the past year studying the three thusand and mre recrds f cases handled during the first five years the divisin was rganized. Because f lack f space all ward reprts cannt be included, but that f the Pediatric Service is a fair example. PERSONNEL The divisin has been very frtunate in its persnnel the past year. There have been tw wrkers, Miss Grace Chu and Miss Zang-pung Zien, frm the N ew Yrk Schl f Scial Wrk, and Miss Julia Ling and Miss Ling Ta wh have had ther training in America. One fthe staff, Miss Li-chiu Chu, received her Master's degree in Scial Wrk at Yenching University. Anther member f the staff, Miss Ju-chi Yu, is at present takinl! a year's curse in the N ew Yrk Schl f Scial Wrk. The Head f the Divisin has taught a curse in Case Wrk in y enchin~ University. M iss Chu, assistant, has taught fr tw trimesters in the Public Health Demnstratin Statin. Miss Zien, assistant, has lectured t the L!raduate nurses. Respectfully submitted, IDA PRUITT Medical &cia/ Service Wrmand Heady the Divisin

Number f Psitin f cases handled Number f Clinics and Wards Name f Wrker services Wrker With--I-~ rendered 1 ~ I----- -_----- I --------_I_=p_rblem prblem ----------1 General Medical Ward G-III Miss Julia Ling Assistant 16 66 General Medical Ward H-I and Cardiac Clinic Mr. Tuan Pai Case Wrker 167 1 General Medical Ward H-II and Fllw-up Clinic Miss En-fu Li I Case Wrker ~E~~:~~~~~:I:::n~~~i:;~SYIum I g:: f~i('i~f;:~ I ~~~~:~~rker Miss Siu-mei Ka I year Case Wrker 8 9~ 1-67 71 671 1----7----------------------------1-------------------1----------1--------1-------1--------- General Surgical Ward G-II and Clinics Mr. Ssu-ming Sung General Surgical Wards G-III and H-III and Clinics. Miss Ling Ta Orthpedic and G. U. Ward G-I and Clinics Mr. Tze-ming Wang Case Wrker Assistant Case Wrker 7 + 17 1 85 1896 1688 1 75 681 18 1 17 1 I--~------------ --------------------I--------------------I------------I--------I--------1----------,,; "' e. Obstetrical and Gyn. Wards G-III, c ~ ~ K-III and Clinics Miss Grace Chu Assistant 68 59 9 E.N.T. Service Eye Service } Ward and Clinic cases Miss Lien-chen Ling 66) Case Wrker 6)6 9)6 ) 15) 891 79)

~~VICE PEDIATRIC SERVICE - January 19 - June 19 Medical Care I E~:t I Educatin I Finance I Child Care N Service PROBLEM ~...... Desened child Half rphan 1 1 1 1 1 lllee-itimacy S 6 1 18 Lack f hme care 1 1 1 1 1 1 1 1 Nedected child Nutritin disability 1 1 1 lis Orphans 1 1 Unwanted child 6 6 8 _----------_-1-_---1-------.. -+---l--i--+----f--.+--+---l----i--+--_i--+-+_--if--+-+---i--l---+--- Abslute pverty ~~ ~~.I-F-in-a-nc-i-al-d-i-ffi-c-ul-ty----------I+-~~--S+---I--l+---I--1+_--~_-l----r--l1---+_-~---7+-_Il---1_r I---+--+--+_--~_t--_S_+_--~S lo: ~ Insufficient incme 6 5 5 1 1 1 1 6 1 " 1 Unemplyment 5 Chrnic disease 1 1 1 1 1 19 Incurabl c diseasc 1 1 Family heal_th -It + + I--+.::.1--+ + + t-- -+ +-=1+--1 -+_+ +---,~-J..::1._...:1+-_+-_...:.f Slavcry 1 1 1 1 1 5 Lack f resurce. Ie-nurancc Chincsc mcdicine 1 1 f-ifd~_ra_n_t_~pi_n_i_n_at_ed_m_e_m_b_e_r t+-_l~--+_~~-+--~ 1+---i~--+--~11_~1+---1_-t--~1. 1 1 1 8 N prblem 1 1 7 1 1 Ttal 1 16 18 1 S 8 6 1 J 11 1 7 1 15 1

GENERAL INFORMATION

Twenty-secn~d Annual Reprt 69 GENERAL INFORMATION CONCERNING RATES AND REGULATIONS The Peiping Unin Medical Cllege Hspital is designed fr the diagnsis and treatment f accident cases, acute and sub-acute diseases, maternity cases, and a limited number f patients suffering frm cntagius diseases. Patients having incurable chrnic diseases, insanity and delirium tremens will nt, as a rule, be admitted. Patients suffering frm severe accidents r serius illnesses are admitted at any hur f the day r night, ther patients are admitted between the hurs f 9 a. m. and 5 p.m. If patients are unable t apply in persn, they shuld send sme respnsible persn with whm arrangements may be made fr their admissin. Private cases amng the freign cmmunity are seen fr cnsultatin nly at the request f their wn physicians. Temprary members ~f the freign cmmunity withut persnal physicians may be seen fr cnsultatin and treatment. The hspital is unable t prvide fr the cntinued care f patients at their hmes. Applicatins by letter fr the admissin f patients shuld be addressed t the Superintendent, Peiping Unin lvledical Cllege Hspital, Peiping. As the demand fr hspital accmmdatin is at mst times greater than the number f beds available, patients frm a distance shuld nt present themselves expecting immediate admissin unless they have made arrangements prir t their arrival. All patients are accepted fr tre.atment in the hspital with the understanding that they will, within reasn, be available fr teaching purpses. It is desirable that pst-mrtem examinatins be made n all cases ending fatally in rder t make mre cmplete ur knwledge f the cause f death. Bills fr services rendered will be presented weekly, the depsit made always being carried frward. Patients are expected t settle their accunts as sn as treatment is cmpleted. Patients wh cme fr single ffice cnsultatins are expected t pay cash. Inpatients are nt permitted t receive fd f any kind frm their friends except by special permissin f the physician in charge f the case.