PEIPING UNION MEDICAL COLLEGE HOSPITAL

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PEIPING UNION MEDICAL COLLEGE HOSPITAL Frmerly The Peking Unin Medical Cllege Hspital TWENTY-FOURTH ANNUAL REPORT OF THE SU PERINTENDENT JUNE 0, 9 P. U. M. C. PRESS Peiping, China

A cmplete bibli.'raphy 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 upn applicatin t the Re'istrar.

Twenty-fuirth Annual Reprt 'CONTENTS PAGE BOARD OF TRUSTEES AND OFFICERS... HOSPITAL STAFF., HOSPITAL ADMINISTRATIVE COMMITTEES GENERAL INFORMATION CONCERNING RATES AND REGULATIONS S 7 REPORTS THE HOSPITAL SUPERINTENDENT THE MEDICAL SERVICES THE SURGICAL SERVICES THE OBSTETRIC AND GYNECOLOGICAL SERVICE THE OPHTHALMOLOGIcAL SERVICE THE RADIOLOGICAL SERVICE THE PATHOLOGICAL SERVICE THE BACTERIOLOGICAL AND IMMUNOLOGICAL SERVICE THE NURSING SERVICE THE DIETARY SERVICE THE HOSPITAL SOCIAL SERVICE 7 S 8 TABLES CLAssiFICATION OF DISEASES CLAS~IFICATION OF OPERATIONS MEMBERS OF THE RESIDENT HOUSE STAFF, 9-79 9

Twenty-furth Annual Reprt BOARD OF TRUSTEES OFFICERS Chairman Y. T. TSUR Vice-Chairman SOHTSU G. KING Secretary MARGERY K. EGGLESTON AuiJtant SecretarieJ MAR Y E. FERGUSON ELEANOR N. SHENEHON EXECUTIVE COMMITTEE Y. T. TSUR, Chairman ROGER S. GREENE Hu SHIH SOHTSU G. KING WEN-HAO WONG MEMBERS T Serrue until the Annual Meeting f 9 SOHTSU G. KING Y. T. TSUR 'VEN-HAO WONG W. 'V YEN T Ser'Ve until the Annual Meeting j 9 J. HENG LIU E. C. LOBENSTINE SAO-KE ALFRED SZE CHAO-CHU \Vu Hu SHIH T Ser'Ve until the Annual Meeting f 9 C. R. BENNETT PO-LING CHANG ROGER S. GREENE G. E. HUBBARD J. HENG LIU, Directr f the PeipilJg U'lin Medical Cllege* ROGER S. GREENE, Fiu-Directr VERGIL F. BRADFIELD, Cmptrller FLOYD P. HARNED, Ass;Jtant Cmptrller On leue f absence

feiping Unin Medical Cllege Hspital J. HENG LIU, B.S., M.D. Superintendent HOSPITAL STAFF July, 9 - June 0, 9 SIH-TZE WANG, M.D. ilssistant Superimendent and ilding Superintendent I-CHI FANG, M.D. ilssistant Supuintendent K'AI-CHIANG Hsu, M.D. ilssistant t the Superillterldent DEPARTMENT OF MEDICINE FRANCIS R. DIEUAIDE, A.B., M.D. Prfessr f Medicine and Head f the Department HAROLD L. AMOSS, M.D. Yi.Iiting Prftssr f Medicine, Odher, 9 t JatlZlary, 9 CHESTER NORTH FRAZIER, B.S., M.D.* Prfessr f Dermatlgy and Syphillgy ERNST DEVRIES, M.D. ssciate Prfessr f Neurlgy JOHN FORBES McINTOSH, A.B., M.D., C.M. AJSciate Prfessr f Medicine ROBERT ROGER HANNON, Ph. C., B.S., M.D. ilssciate Prfessr f Medicine RICHARD HO-P'JNG SIA, B.S., M.D. ilssciate Prfessr f Medicine ARTHUR P. BLACK, A.B., M.D. ilssciate Prfessr f Pediatrics ERNEST SHEN-CHIH Ts, M.D. ** ilssistant Prfessr f Pediatrics SHEa-NAN CHEER, A.B., M.D. ilssistant Prftssr f Medicine CHUNG-UN LEE, M.B., CH.B., D.T.M. AND H. ilssistant PrfiJJr f Medicine 00 leave f absence 9-.. Re.irncd September 0. 9

Twenty-furth Annual Reprt 7 DEPARTMENT OF MEDICINE (cntinu~d) GILES A. M. HALL, B.S., M.D. Auiltant Prfusr j Medicine and Cllege Physician HSIAO-CH'IEN CHANG, M. D. Auciate in Medicine YU-LIN WEI, M.D. Auciate in Neurlgy and P.rychiatry SHIH-HAO LIU, M. D. Auciate in Medicine CHEN-LANG TUNG, A.B., M.D. Auciate in Medicine JUI-WU Mu, M. D. Auciate in Dermatlgy and Syphillgy SAMUEL H. ZIA, M.D. Auciate in Medicin~ SARAH DEITRICK, A. B., M.D. Auciate in PediatriC! CH'UAN-KUEI Hu, M.D. Auistant in Dermatlgy and Syphillgy FU-T'ANG CHU, M.D.* AuiJtant in Pediatrics YU-LIN eh'eng, M.D.* Alsistant in Neurlgy CHAO-JEN Wu, M.D. Alsistant in Medicine and Resident TA-T'UNG WANG, M.D. Auistatlt in Medicine TIEN-CHUEH LI, M.D. Auiltant in Medicine (Clltge Health Service) TSUNG-TSONG NYI, B.A., M.D. Auistant in Pediatric I TSO-LIANG CH'IN, M.D. Assistant i,l Dermatlg) a'id s"phillgy and Allistant Resident HUEI-LAN CHUNG, M.D. Assiltant in Medicine and Firlt Auistant Relident KUO-CHENG WANG, M.D. Alsillant in Medicine (Cllege Health SCMJict) ---- On leave 90-

8 Peiping Unin Medical Cllege Hspital SHU-HSIEN WANG, M.D. Assistant in Medicine CHARLES W- BIEN, M.D. Allistant Rllidmt MAO-LIN CHANG, M.D. Allistant Residmt HSIEN-I CHU, M.D. Allistant Rllidllt DEPARTMENT OF MEDICINE (cdncluded) SHIH-FAN CHUNG, M.D. A..listanl Rl.Iidllt (Pediatrics) LIANG-CHUNG CHA, M.D. A..listant ReJidllt CHAO-LIN CHENG, M.D. A..listant ReJident TSU-YUAN CH'lU, M.D. AuiJtant ReJidllt CH"UAN FAN, M.D. ASJistant ReIidllt (PediatricJ) CHU LI, M.D. Allistant Rl.Iident CHIA-HSIANG V\T ANG, M. D. Allistant Residllt (N eurdlgy) DEPARTMENT OF SURGERY HAROLD H. LOUCKS, A.B., M.D. PrftIJOr f Surgery and Head f the Departmllt GEORGE Y. CHAR, B.S., M.D.* PrftJJr f Urlgy CHESTER MONTAGUE VAN ALLEN, A.B., M.D. PrftJlr f Surgery J. HUA LIU, M.D. PrfeJJr f Otlarynglgy GEORGE MONTELIUS, A.M., D. D.S. Alldate PrfesIr f Dmtal Surgery 0 leave frm December. 9.

Twenty-furth Annual Reprt 9 DEPARTMENT OF SURGERY (cntinud) LEO J. MILTNER, B.S., M.D. Auistant Prftur f Orthpedic Surgery SUNG-T'AO KWAN, B.S., M.D. Auistant Prfeur f Surgery JOHN W. SPIES, M.A., M.D. Assistant Prfessr f Surgery ROBERT G. HEINER, M.D., CAPT. MEDICAL CORPS, U.S.N. Hnrary Lecturer in Surgery TZE KiNG, M.D. Auciate in Ot/afJ'ng%gy YUNG-HAO TING, M.D. Auciate in Otlarynglgy MAO-LIEN Hu, M.D.* Assciate in Otlarynglgy PING-CH'I TUNG, M. D. Assciate in Surgery TA-CHUN YANG, M.D. Assistant in Clinical Surgery FU-EN WAN, M.D. Assistant in Surgery HENG-I CHEN, M.D. Auistant in Surgery and &sident HUA CHtEN, D.D.S. Auistant in Dental Surgery HSI-EN SHIH, M.D. Assistanl in Surgery and First Assistant Resident LI-KENG WANG, M.D. Assistant in Surgery and ilssistanl Resident HSIEN-LIN CHANG, M.D. Auistant in Surglty and Assistant Resident CHI-CHENG CHANG, M.D. Auistant &sident HYEN-TAIK KIMM, M.D. Assistant Residenl "On leave 9J-l

0 Peiping Unin Medical Cllege Hspital DEPARTMENT OF SURGERY (cncluded) HUNG-TIEN Lu, M.D. Assistant Resident t Sept. 0, 9 CHING-PO YANG, M.D. Assistant Resident HUANG Yu, M.D. Assistant Resident (Otlarynglgy) DEPARTMENT OF OBSTETRICS AND GYNECOLOGY J. PRESTON MAXWELL, M.D., B.S., L.R.C.P., (LOND.), F.R.C.S. (ENG)., F.C.O.G. Prfessr f Obstetrics and Gyneclgy alld Head f the Department AMs WONG, M.D. Assistant Prfessr f Obstetrics and Gyneclgy SHIH-WEI LEE, M. D. Assciate in Obstetric.r and Gyneclgy MARION YANG, M.D. Hnrary udurer in Hygiene and Puhlic Health and in Obstetrics alld Gyneclgy KHA-T'I LIM, M. D. Assistant in Obstetrics and Gyneclgy and Resident PING-MUI CHUNG, M. D. Assistant in Obstetric.r and Gyneclgy and First Assistant Resident THELMA K.P. TSANG, M.D. Assistant Resident CHANG-KEN CHI, M.D. Assistant &sident frm Octber, 9 ANNA CHOW, M.D. Assistant Resident CHING-K 'UEI LIN, M. D. Assistant Resident YAO-KWEN LIU, M.D. Assistant &sidentfrm September, 9 DEPARTMENT OF OPHTHALMOLOGY ARNOLD PILLAT, M.D. Pr/llsr f OphthalmlgJ' and Hlad f the Department

Twenty-furth Annual Reprt DEPARTMENT OF OPHTHALMOLOGY (cncluded) HUA-TEH PI, M.D. AJJciate in Ophthalmlgy ISAJOHN, M.D. Auciate in Ophthalmlgy WEN-PING LING, M.D. Auciate in Ophthalmlgy PETER S. SOUDAKOFF, B. PH., M.D. Assistant in Clinical Ophthalmlgy SHIH-PU CHANG, M.D. Assistant in Clinical Ophthalmlgy SING-MEl KIANG, M. D. Assistant in Ophthalmlgy and Assistant Resident TSO-HSIN P' AN, M. D. Assistant Resident WEI-TU P'AN, M.D. Assistant Resident DEPARTMENT OF RADIOLOGY CHIH-KUANG HSIEH, M.S., M.D. Assistant Prtifessr f Rentgenlgy ad Acting Head f the Departmmt MARVIN M.D. WILLIAMS, B.S., Ph.D. PhysiciJt CHING Wu, M.D. * AssiJtant in Rentgenlgy HO-SHAN WANG, B.S. Auistant in Rentgenlgy and SupeMJiJr j the PllOtgraphic Bureau YEN-CHEN SOO, M.D. Assistant in Rmtgenlgy TU-SHAN JUNG, M.D. AuiJtant in Rentgenlgy and Auistanl Resident CHU-PING CHANG, M.D. Assistant Resident HSI-HSU HSIEH, M.D. Assistant Resident frm April, 9 On leave 9-

Beipine: Unin Medical Clee:e Hspital DEPARTMENT OF PATHOLOGY REINHARD J. C. HOEPPLI, M.D., D.Se. Prfiur f Parasitlgy and Ading Head f the Department f Pathlgy CHENG-HSIANG Hu, M. D. Assistant Pr/eur j Pathlgy OO-KEK KHAW, M.B., Ch.B., D.P.H., D.T.M. Assistant Prfissr f Parasitlgy HSI-JUNG K'ANG, M.D.* Assistam in Pathlgy SHIH-KUANG NGAI, M.D. Assistant in Pathlgy LAN-CHOU FENG, M. B. Assistant in Parasitlgy KUANG-YU CH'IN, M. D. Auistant in PathlgJ' HSI-CHIEH LI, M.S. Auistant in Paras;tlg)' P' El-LlN LI, M. B. Assistant in Pathlgy DEPARTMENT OF BACTERIOLOGY AND IMMUNOLOGY CHONG-EANG LIM, M.B., B.S., DR. P.H., D.T.M. Prfus"'r j Baderilgy and Head f the Department TIMOTHY J. KUROTCHKIN, M.D. Assistant Prjessr j Baderilgy and Immunlgy DOROTHY HUIE WONG, A. M. Assciate in Baderilg y CHEN-PI EN LI, M. D. Assciate in Baderilg y WEN-KWEl CH'EN, M.D. Assistant in Bacterilgy HSING-MEI CH'EN, B.S. AJlistan! in Baderi,/g, On leave 9 )

Twenty-furth Annual Reprt INTERNES Service BeEan In Medicine Service Ended July, 9 HSI-LI CHEN June 0, 9 July, 9 CHAO-CHU CHIANG June 0, 9 July, 9 MAO-KEN CHU June 0, 9 July, 9, HUI-HSI FENG June 0, 9 July, 9 PI-HUI H June 0, 9 July, 9 WEN-LIEN HSIEH June 0, 9 July, 9 SHIH-HSUN Hsu June 0, 9 July, 9 HUAI-HSIN HUANG June 0, 9 July, 9 FEI-CH'ING LIN June 0, 9 July, 9 SUNG LIN June 0, 9 July, 9 TSUNG-HSIEN Lu June 0, 9 July, 9 TSU-FEI Su June 0, 9 July, 9 JUN-TEH TANG June 0, 9 July, 9 P'EI-WO WANG June 0, 9 July, 9 CHING-CH'ING YEN June 0, 9 July, 9 CH'UN-HUI YEN June 0, 9 In SurEery July, 9 CH'ING-SUNG CHANG June 0, 9 July, 9 HSI-HSU HSIEH March 0, 9 July, 9 CHIEN-LIANG Hsu June 0, ]9 July, 9 FU-T'ING KE June 0, 9 January, 9 HSING-KUO WANG July, 9 M lng-shih YANG June 0, 9 July, 9 YIN-KUANG YUAN June 0, 9 In Obstetrics and GyneclfJ' Sept., 9 SU-HSIEN Lu June 0, 9 July, 9 Y AO-KWEN LIU Aug. ; 9

I?eipine: Unin Medical Cllege Hspital NURSING SERVICE As f June 0, 9 GERTRUDE E. HODGMAN, R.N., M.A., Dean f the Schl J NurJing and Superintendent f NurseJ FAYE WHITESIDE, R. N... AJJciate Supe";ntendent f NurJeJ ETHEL E. ROBINSON, R. N... AJJiJtant Superintendent f NurJeJ ELIZABETH HIRST, R. N... AJJis/ant Superintendent f NurJu RUTH I. ELLIS, R.N... Super<visr f Surgicallrards CLARA A. HOLES, R. N....... Night Super<visr RUTH H. KUNKEL, B.S., R.N... Super<viJr f Islatin Unit GLYDE M. LEACH, R.N... Super<visr f General Operating Rm MILDRED MCCORMICK, R.N... Super<visr f Islatin Unit MARY B. MOYLAN, R.N... Super<visr f Pediatric Ward MARY A. RITCHIE, B.S., R.N... Super<visr f Medical Wards KATHERINE L. STILES, R. N... Super<viJr f Ohstetrical and Gyneclg. ical Wards MARGARET R. WYNE, B.S., R.N... SuperviJr f Puh/ic Outpatient Service WEN-PING CHU-KE, N.A.C... Auistant Night Supervisr KHENG-ENG Yu, N. A. C....Assistant Night Super<visr DORIS BEAUMONT, R.N... Head Nurse, Ohstetrical Ward FRANCES V. FISHER, B.S., R.N... Head Nurse, Private Ward CHUNG HUANG, N.A.C... Head Nlrse, Men's Surgical Ward HSIN-KUO JEN, N.A. C... Head Nurse, Men"s Mixed Ward HELEN L. JOHNSON, R.N... Head Nurse, Childrm's Ward YU-HUA KA, N.A.C... Head Nurse, Men's Surgical Ward jung-hsun Ku, N.A. C... Head Nurse, Operating Rm WEI-KANG LI, N.A.C... Head Nurse, AdmiJJin Ward YU-LIN L, N.A.C... Head NurSl, Surgical Supply Rm ZUNG-YUN LUNG, N.A.C... Head Nurse, Islatin Unit ESTHER NEAL, R. N... Head NurJe, HTmen'J Mixed Ward ZENAIDA POLANSKA, R.N... Head Nurse, Men'J Medical Ward KUEI-YING SHAO, N.A.C... Health Nurse, NurJu" Drmitry LIEN-YING SHAO, N.A.C... Head Nurse, Men's Semi-private Want CHIN-CH'ENG SUN, N.A.C... Head NurJe, Puh/ic Otttpatient Service YUAN-JU TSING, R.N... Head Nllrse, Wmen's Semi-private Ward E-TSUNG WAUNG, N.A.C... Head Nurse, Metablism Ward Lucy B. YOUNG, S. R.N... Head Nurse, G..vnet'lgical Ward

Twenty-furth Annual Reprt DIETARY DIVISION KWE-PAU HUANG, PH.B...... Dietitian ANNA W. LEE, B.S... Auistant Dietitian SU-CH'IN LIAO, B. S... Secnd Auistant Dietitian DOROTHY WEN... Auistant Dietitianfrm June, 9 PHARMACY JOHN CAMERON, F.C.S., PH. C., M.P. S. (LOND.)... Super<visr j the Pharmacy MOODY MENG, PH.C., M.P.S... Assistant Pharmacist t January, 9 ARTHUR TYE... Auistant Pharmacist frm April, 9 W AN-HENG Tu... Secnd Auistant Pharmacist HOSPITAL SOCIAL SERVICE IDA PRUITT, B. A., B. S... Chief j Hspital Scial Ser<vice LI-CH'IU CHOU, B.A., M. S... Sllper'Visr f Case Wrk JULIA LIN... Super<visr f Case If'rk LING TAO, B.A., M.A... Super'Visr j'cau Wrk JU-CHI Yu, B.A... Super<visr j Case Wrk CHUNG-TANG CHANG, B.A... Case Wrker CHIH-KUNG CHANG... Case Wrker HSUAN-TZU CHU, B.A... Case l{frker CHEN-CH'IU HUANG, B.A... Case Wrker SIU-MEI KAO, B.A... Case If'rker CHUN-CHE KAO, B.A... Case Wrker SHAN-CHEN LI, B.A.... Case Wrker LIEN-CHEN LING, B.A... Case Wrker LIANG-CHAO LIU, B. A., M. A... Case Wrker TUAN PAl, B.A... Case Wrker MIRIAM NIEH... Case Wrker SSU-MING SUNG, B. A....... Case If/rker TZE-MING WANG... Case If/rker TZE-AI Y AO, B. A.......... Case Wrker ~ OTHER OFFICERS MABEL E. TOM"''''..... SHAO-LIEN LI..... JEN-HO LIANG.... TSUNG-WU Yu.... HELEN M. HOLLAND, R.N. *.... STEPHEN WANG, B.A.... EDITH C. HUANG, PED.B., PH.B., R.N. TIRZAH E. BULLINGTON.... ANNA LOH, R.N..... ALEXANDER BARANOFF, O.S..... HUNG-CHUN CHANG.... FENG-CHUN CHANG..... ",:n leave t Nvember JO, 9 On leave f abseuce Admitting Officer t January, 9 Admittitlg Officer frm August, 9 Auistaflt Admitting Officer frm August, 9 Auistant Admitting Officer frm August, 9 Anesthetist Cmtdian f Recrds Matrn Occupatinal-therapistfrm May,9 Physitherapist Oral H.J'gienist, Department j Surgery Oral Hygienist, Department j Surgery Oral HJ'gienist, Department f Surgery

Peiping Unin Medical Cllege Hspital HOSPITAL ADMINISTRATIVE COMMITTEES COMMITTEE ON THE HOSPITAL F. R. DIEUAIDE, Chairman I-CHI FANG JOHN B. GRANT J. HENG LIU* HAROLD H. LOUCKS J. PRESTON MAXWELL SIH-TZE WANG CLINICAL RECORDS COMMITTEE C. U. LEE, Chairman S. T. KWAN STEPHEN WANG AMOS WONG. C. YUAN COMMITTEE ON THE PUBLIC OUTPATIENT SERVICE RICHARD H. P. SIA, Chairman I. C. FANG K' AI-CHIANG Hsu V\r P. LING P. C. TUNG AMOS'VONG MARGARET WYNE On leave f absence

Twenty-furth Annual Reprt 7 REPORT OF THE SUPERINTENDENT OF THE HOSPITAL MR. ROGER S. GREENE, Acting Directr f th~ Peiping Unin Medical Cl/tge Sir: I have the hnr t present the Twenty-furth Annual Reprt f the Peiping Unin Medical Cllege Hspital fr the year ending June 0, 9. The year 9- brught n changes in the administrative persnnel f the hspital. Dr. Sih-tze Wang has cntinued in the pst f Acting Superintendent during the extended absence f Dr. J. Hene: Liu. Dr. I-chi Fang, wh jined the hspital staff at the beginning f the year, has been f great assistance in the administratin f the Public Outpatient Service and f the admitting ffice. Dr. K. C. Hsu has served as admitting physician in the utpatient department. Twenty-fur hur service has been established in the admitting ffice with an fficer in charge at all times. This has eliminated many f the difficulties cnnected with the admissin and discharge f patients. Flds which swept the Yangtze valley in the summer f 9 brught an appeal t the institutin fr assistance in the medical relief prgram f the Natinal Fld Relief Cmmissin. Dr. I. C. Fang supervised the wrk f a Peiping Unin Medical Cllege unit cmpsed f members f the visiting staff, huse staff, nursing service, and students, which left in Octber, 9, assigned t the Wuchang area. In Nvember he was relieved by Dr. S. T. Wang wh clsed the wrk f the unit n January 0, 9. At ne time frty-ne members f the Cllege were at wrk in W uchang. Fr the first time the cmplete bed capacity f the hspital has been in peratin during an entire year, except fr the perids when wards have been clsed because f quarantine r fr huse-cleaning. The ttal f beds has been distributed amng the varius services as indicated:

8 Peiping pnin Medical Cllege Hspital MEDICINE General... Dermatlgy.......... Islatin Pavilin... Neurlgy... 9 Pediatrics... 0 0 SURGERY General... Genit-urinary......... 9 Orthpedics... - Otlarynglgy... 89 OBSTETRICS AND GY NECOLOGY Gyneclgy............ Obstetrics............. 0 Bassinets.......... 70 OPHTHALMOLOGY 9 UNASSIGNED Emergency ward... Private and semi-private wards... Children"s ward... 8 The year has brught increased demands upn the facilities f the hspital and staff frm bth inpatients and utpatients, as may be bserved frm the cmparative tahles f statistics which fllw. ADMISSIONS AND DISCHARGES Ju~v, 9 - J~ne 0, -9 CLASSIFICATION OF p,atients CHINESE FOREIGN Ttal Male Female Male Female! 9- Ttal Ttal 90-99-0 Patients remaining July, 9... 9 S 9 Patients admitted during the year...,77,080 9 0, Ttal Dumber, treated...,809,9. 9,8 Patients discharged during the year...,90,0 0, Patients remaining June 0. 9... 9 87 9,89,99,07,0,8,99

Twenty-furth Annual Reprt 9 DISCHARGES BY DEPARTMENTS (including transfers)* July, 9 - June 0, 9 SERVICE Chinese Freign Ttal Ttal Ttal General Dermatlgy Islatin Neurlgy Pediatrics 70 8 9 90 7 7 8 8 8,9 0 78,0 09 7 9,7 *** 7 General 0 7 900 8 87 Genit-urinary 7 8 8 Orthpedics 08 7 7 0 9 Otlarynglgy 7 0 0 I Ttal,7 77 ~I~,7,9 ~ g Gyneclgy I I 09 \ i:...: Obstetrics I &7 7 9 ~ Babies brn 0 0**) 0**.. 8 ~ ~ I Ttal ~I~ ---;-~~;;:t~:;;-i~ OPHTHALMOLOGyl 7 9\ I I 87 TOTAL, 88, i~~,00 I 77,79,7,79 *There were transfers frm ne service t anther during the year. **Including 0 children admitted with mthers; 7 children were thus admitted in 90-. Beginning July, 9, these children will be admitted n the Pediatric Service and s classified. *Patients f this service credited t General Medicine.

0 Peipinl! Unin Medical Cllel!e Hspital YEAR ENDING June 0, 9 June 0, 9 June 0, 90 DAYS OF TREATMENT Cmparative Study, 90 t 9 Ttal Pay Free* PRIVATE PATIENTS Public Private I prefer-i S~mi- / Ttal Wards red** private 99,88,88,00,9,88,0,998,9 /8,7/,87,87/,9, 9,97\,987,9 8,8,977,8,8 ], 7,90,97, DAYS OF TREATMENT AND AVERAGE HOSPITAL DAYS BY SERVICES July, 9 - June 0, 9 SERVICE Days f Treatment Average Hspital Days 9- Average Hspital Days 90- General,9 Dermatlgy,77 MEDICINE Islatin,9 Neurlgy,8 9 Pediatrics,8 8 Ttal 8,7 0 9 8 7 9 SURGERY General 7, Genit-urinary,8 Orthpedics 9,70 Otlarynglgy, 9 Ttal,8 0 9 0 9 0 OBSTETRICS & Gyneclgy,8 Obstetrics,80 GYNECOLOGY Babies brn,70 Ttal 7;0 OPHTHALMOLOGY 7,0 0 TOTAL 99,88 8 7 *Of staff members nly' thse wh receive maintenance in the hspital, r emplyees wh earn less than $0 per mnth are admitted as free patients. Staff members wh receive free treatment in the private and semi-private wards are included in the figures fr free patients. ** All preferred rates, except fr staff members, were discntinued frm January, 9, and patients previusly cunted in this grup were thereafter included under "private" r "semi-private"

Twenty-furth Annual Reprt There was an increase f, days f treatment,. per cent mre than in the year befre. The average number f beds in cmmissin was and the average ccupancy 7, as againt 8 with an averal!e f 8 ccupied each day during the previus year. There were thus 9 mre beds in cmmissin thrughut the year, while the increase in the average number ccupied was. On an average, eighty-fur per cent f the bed capacity was in use, the same percentage as shwn fr the year 90-. The number f deaths ccurring in the hspital and the number f autpsies perfrmed are shwn in the fllwing table: Deaths...... Pst-mrtem Examinatins... 89 Percentage f Autpsies... % 9-90- 99-0 70 78 9% DEATHS AND MORTALITY RATES July, 9 - June 0, 9 I I 9 7 % Patients Hspital I Mrtalityl Mrtality SERVICE Dis- I Rate I Rate charged Deaths I 9-90- General,088 8 7.8 7.8 Dermatlgy 9 - -.9 Islatin 9 7.90. MEDICINE Neurlgy 8.8.7 Pediatrics 98 7.8 0.7 SURGERY Ttal,89 98 0. 0.0 I.8 I. General 87 8 Genit-urinary 7 8.8. Orthpedics 0 7.9.87 Otlarynglgy 98.0 I I. OBSTETRICS & Gyneclgy 0.9. Obstetrics 7..8 GYNECOLOGY Babies brn 9 S 9.09.7 Ttal, 8.97.78 OPHTHALMOLOGY I 0 I I. I.8 TOTAL I, I I.7 I.

Peiping Unin Medical Cllege Hspital The effective handling f emergency cases, and the admissin f patients t the public wards, has becme very difficult wing' t the limited space and cnsequent cng'estin in K-basement, which serves as the admitting ward. Of eleven beds n this flr, nine beds are assigned t varius services fr their regular patients and nly tw fr emergencies. It is highly desirable that rdinary patients be remved frm this ward in rder t devte the space entirely t the care f emergency cases and t the admissin and discharge f patients. PUBLIC OUTPATIENT SERVICE The cntinued grwth in the number f patients visiting the utpatient clinics has taxed the staff and the space available fr this service t a pint beynd which it will hardly be pssible t maintain a high standard. The new bstetrical and gyneclgical clinic nw under cnstructin will prvide imprved facilities fr care f patients and teaching f students in thse services. Even with this additin, further expansin is impssible in the present buildings, and the number f patients seen daily must be limited in the near future. The present bstetrical and gyneclgical clinic will be used fr administrative ffices f the utpatient service. This will help t relieve the present ver-crwding in the lbby where patients are registered. Several new clinics have been started during the year. It is hped that the Well Bahy Clinic established by the Pediatric Service will develp int an rganized child health clinic. A Birth Cntrl Clinic has been held fr patients referred frm the Obstetrical and Gyneclgical Clinics whse full scial histry has been btained by a scial wrker. A Gastr-intestinal Clinic was established fr treatment f patients suffering frm chrnic gastr-intestinal disturbances. T c-rdinate the study f patients suffering frm neplasms wh have heretfre been seen in the clinics f the varills services, a Tumr Clinic fr utpatients has been rganized t which patients are referred after being Seen in ther clinics. There has been an increase f,08 visits ver the number fr the previus year and f 8, 7 ver 99-0. The fllwing tables give an analysis f this increase:

Twenty-furth Annual Reprt PUBLIC OUTPATIENT SERVICE Visits by Services July, 9 - June 0, 9 Re er- Ttal Referred Ttal Ttal SERVICE New Old red Patients ~~e Visits Visits ----------- I I D'-a~y 9-9 - MEDICINE General..... Dermatlgy..... Heart..... Neurlgy.... Pediatrics..... Syphilis.... Tuberculsis...., 0,,8& 7,9 0 7,79,7,097,7 90,780 7 7, 7,7,09 87,8 0,98 889,79 8,9 7,7,,09,8 7 8,0 8,0,80 7, 0,989 7,00, 0,8 7,8 8,,80 ---------------------- Ttal 9-9... 0,9,79,90 7,088,7 8,0 Ttal 90-9... 8,87,78, 8,,8 0, ----------------.,.--------------- SURGERY General... Genit-urinary... Dental Surgery... Orthpedics... Otlarynglgy...,7;8,07,8 90,9 7,8,77,77 7,9 8,8 8 8 79,998,97,00 8,7,,78 7 08,78,7,8,77 9,9.889, 9,,99 8,7,89 Ttal 9-9... 0, Ttal 90-9... 8,7 OBSTETRICS & GYNECOLOGY ------ ------------------ 8,,7 7,97, 7,9 9,,8 9,7,89,8 ------j-----i--------- Antenatal... 88,,7,0 Gyneclgy...,007,8 8,7 9,79,7 --------------'---------- Ttal 9-9...,7,09 8 7,9 0 7,99 Ttal 90-9...,000,80,80 --,80 -------------------- OPHTHAL- MOLOGY General...,099, 9 8,78,78 9,9 8,89 Trachma... 7,7 7,7 7,7,- ----------------------- Ttal 9-9...,099,890 9,9,78 7, Ttal 90-9.....,9 7, 79 0,77,77,8 ========== ==--=-- ========== ---- TOTAL 9-..., 9,79 7,8,88* 7,99 9,80 TOTAL 90-... 0,80 98,989,9-,78* 8,7, TOTAL 99-0...,8 0,07,89,07* 7,7 *These figures include emergency cases seen in the emergency ward during clinic hurs.

Peipillg Unin Medical Cllege Hspital PERCENTAGE OF ATTENDANCE IN THE PUBLIC OUTPATIENT CLINICS SERVICE 9- I 90-99-0 ------------ Medicine.0% 0.% 9.9% Surgery ~~ 7.% 7.9% Obstetrics and Gyneclgy.0% --I--.%.7% Ophthalmlgy 7.'~..% 7.%,98 visits were free (.9 per cent f the ttal);,7 f these were made by new patients and 8,8 visits by ld patients. While the number is cnsiderably larger than that fr the year befre (,9 free visits), the percentage f free cases is very nearly the same. There has been a marked increase in the number f emergency cases cming t the hspital as may be seen frm the fllwing table: EMERGENCY CASES July, 9 - June 0, 9 SERVICE Medical,0 Surgical 8 Obstetric and Gyneclgical 0 Ophthal mlgical 9 TOTAL,0 Cases admitted t the hspital 7 Cases nt admitted t the hspital,08 TOTAL 9-,0 TOTAL 90-.8 TOTAL 99-0.8 TUM OR CLINIC The installatin f the radium emanatin plant was fllwed in February, 9, by the rganiz.atin f a Tumr Clinic t undertake the study f cancer and the treatment f patients with deep x-ray and radium. The plan f the clinic is similar t that utlined by the

Twenty-furth Annual Reprt American Cllege f Surgens fr use in general hspitals. The varius clinical services interested wrk in cnjunctin with a pathlgist, a rentgenlgist, and a physicist. Representatives f the varius services are appinted t the Tumr Clinic t be respnsible fr the treatment f patients frm their respective services. An extract is given frm the reprt f Dr. Jhn W Spies, wh has been acting chairman f the Tumr Clinic in the absence f Dr. Chester N. Frazier; 'The clinic has been held n Tuesday afternns. As regards new patients, diagnsis is made and treatment advised. With ld patients, the results f treatment are evaluated, and the needs f the patient in the light f past events and present cnditins are cnsidered. Patients are first seen by the special divisins r departments and subsequently referred vluntarily t the Tumr Clinic either befre r after a cmplete examinatin has been made and rdinarily befre treatment has been instituted. It has been pssible thrugh the clse cperatin f the pathlgist t btain frzen sectin diagnses n suitable cases, thus allwing a speedier and mre satisfactry dispsitin f the patient. The Hspital Scial Service has kept a careful fllw-up f cases, and this is ne f the mst gratifying parts f the wrk t date. 'The patients with tumrs in the wards f the hspital are fllwed by members f the Tumr Clinic, and it is intended that frmal ward runds will be made nce a week in rder t evaluate the cnditin f each patient at that time. 'It is hped that varius research prblems related t tumrs, bth clinical and experimental, will be studied in the departments cncerned. A re-classificatin f tumrs seen in the past will be made frm a re-study f the clinical and pathlgical data, and statistics will be cmpiled as a basis f cmparisn with thse secured frm present and future cases in the Tumr Clinic. An attempt will be made t survey a small district r village as t the ccurrence f tumrs within the general ppulatin in cperatin with the Department f Hygiene and Public Health.'

Peiping Unin Medical Cllege Hspital PHARMACY After a year's leave abrad, Mr. Jhn Camern returned in August, 9, t resume supervisin f the pharmacy. Mr. Mdy Meng left t take a pst at the Central Hspital, Nanking, and Mr. Arthur Tye jined the staff as Assistant Pharmacist in April, 9. A ttal f 9, prescriptins were dispensed during the year; f these,7 were t inpatients, 0,87 t utpatients, and,00 repeat prescriptins:, prescriptins were issued free. PHYSIOTHERAPY SERVICE The grwing interest in physitherapy has resulted in the referring f mre patients frm the varius services fr treatment, as may be seen frm the fllwing tables: PHYSIOTHERA PY VISITS July, 9 - June 0, 9 SERVICE Visits "". pri"" Prin~ I...,~ P,bli, TOTAL and In- Out- Ward Out- ------ Students patient. patient. Patients patients ~- I ;~~ MEDICINE General Dermatlgy Neurlgy Pediatrics SURGERY General Orthpedics Otlarynglgy OBSTETRICS & GYNECOLOGY OPHTHAL- MOLOGY TOTAL First 0 7 9 0 99 7 Return 7 7 9,07,908 ---------- First Return First 7 ---:j 0 8 --8- Return 9 9,0-,079 Fi;:;t 9 Return 9 8 7 -------- First - 99 8 Return ~ S_ 9 79,,9 First 7 8 0 8 Return 870 H 8,7,9,0-,9 ~ Return 7 0 8-08 Fi;;t --f-- ------ First 8 0 Return -0 0 9 -------- -- First 8 S Return 9 7 77 7, 87 877,,0.0. ]

Twenty-furth Annual Reprt 7 PHYSIOTHERAPY TREATMENTS July, 9 - June 0, 9 Baking...,0 Massage...,0 Infra-red Ray.... 98 Ultra Vilet Ray...,80 Exercises...,09 Electric Cabinet... 7 Electric Treatment...... Diathermy...... 0 High Frequency... 7 Hydr-therapy...... Miscellaneus... Ttal 9, PRIVATE CONSULTATION SERVICE The wrk f the Private Patients' Office has increased steadily. There were, mre calls fr the year 9- than fr 90-, and,88 mre than fr 99-0. This service is cvered by physicians assigned frm the varius departments and is served by the secretarial staff f the Cllege Health Service. The calls attended by each service are shwn in the table n page 8.

PRIVATE CONSULTATION SERVICE OFFICE CALLS HOME CALLS TOTAL SERVICE Chinese Freign Chinese Freign I New Old New Old New Old New Old NEW OLD 9-90- MEDICINE General Dermatlgy and 08 9 9 9 7,00 88,888,9 Syphillgy 8 78 7 Neurlgy 8 8 8 7 0 9 0 0 Pediatrics 8 9 7 8 0 9 0 97 Ttal 79 7 7 9 00 0,,0,,9 SURGERY General 0 7 08 7 7 0 Genit-urinary 8 8-90 8 8 7 Dental Surgery 7 0 - - 8 Orthpedics 9 8 0-8 I Otlarynglgy 80 0 8 9 8 77 70 Ttal 87 97 9 7 8 8.8.0,8, OBSTETRICS AND GYNECOLOGY Obstetrics 8 0 0 7 7 808 77 Gyneclgy 79 0 0 - - - 7 Ttal 7 0 - - 9.79,7.0 OPHTHALMOLOGY 0 9-7 8 77 -,8,80,,tU 9 0 8 I TOTAL 9-,8,0 8,9,9 7,09 TOTAL 90-,,9 8 0,880,,99

Twenty-furth Annual Reprt 9 C0LLEGE HEALTH SERVICE The Clleee Health Service has cntinued t functin under the supervisin f a special cmmittee. Its prfessinal activities are under the directin f the Department f Medicine, assisted by ther departments in cnsultatin. Dr. Giles A. M. Hall, the Clleee Physician, has been in charee f the wrk f this service, assisted by Dr. K. C. Wane and Dr. T C. Li. Rutine physical examinatins, vaccinatins, immunity tests and refractins are included in the preventive wrk f the service and are shwn in the fllwing table under "prphylaxis" Cnsultatins and treatments, as well as repeated examinatins f individuals under bservatin are listed under "cnsultatins" SERVICE MEDICINE COLLEGE HEALTH SERVICE Fisils by Services July, 9 - June 0, 9 PRO PH YLAXIS CONSULTATION TOTAL Em- Staff and Emplyees Staff VISITS plyee8 Students & Families d Stu- Ttal Ttal and dents Office Hme Office Hme 9-90- ------ Families -I,,,8 9,, General,88,98 Derm. s.80 & Syph. 8 90 87 87 99 Neurlgy 88 Pediatrics 0 7 79 79 79 - ------------------ SURGERY General 8...,,7,7, Genit-urinary 0,00,080,080,09 Dental 9 9 78 7,0-,9 Orthpedics 78 09 09 70 Otlarynglgy 7 7 9 79,7,09 = Obstetrics 7-8 Gyneclgy 9 9 9 MOLOGY 0 98,,,09 9,,9,7 OBS. & GYN. --I~ -----: OPHTHAL- ---------= 0,9/ Ttal 9-,f,iZ,899 8,OlliIS,8 98,9 "8"," 79 9,70 Ttal 90-,0,0.7,, 90,088,80

0 Peiping Unin Medical Clleare Hspital The helpful cperatin f the members f the hspital staff has facilitated the administratin f the hspital and grateful acknwledgment is made ~f the assistance that has been given. Mre detailed infrmatin abut the wrk that has been dne will be fund in the reprts submitted herewith frm the heads f the varius departments and services f the hspital. Respectfully submitted SIH-TZE WANG, A ctint Superintendent

Twenty-furth Annual Reprt REPORT OF THE MEDICAL SERVICES INPATIENT SERVICES The wrk during the past year was nt marked by any very unusual event. Frm Octber t January It was cnsiderably interfered with by the absence f members f the staff n fld relief duty in Wuchang. There was a slight increase in the number f inpatients cared fr (0) ver thse f the previus year (90). The tw flrs f the Islatin Pavilin were bth pen fr abut six mnths f the year and patients were received as cmpared with 7 the year befre. The Pediatric Service was unable t receive as many patients as in 90- wing t repeated perids f quarantine fr cntagius disease. This service badly needs separatin int tw distinct units in rder that quarantine may nt cmpletely interrupt ur receptin f pediatric patients. The desirability f suitable sanitarium facilities is emphasized by the ccurrence in the year's diagnsis list f 9 entries fr the varius stages f pulmnary tuberculsis, as many f these cases d nt need the type f care the hspital is designed t Irive. Amn' the dialrnses f infectius disease attentin may be called t meninlr0cccus meningitis (9 entries), paratyphid A and B fever (7 and entries), typhid fever (7 entries), diphtheria (7 entries), erysipelas ( entries), bacillary dysentery (l00 entries), and amebic dysentery (nly entries). Scarlet fever with 8 entries and 9 deaths, upper respiratry infectin with 0 entries, and typhus with, are ntewrthy. Crnary cclusin and thrmbsis were entered fur times. There were 07 entries f acute and chrnic renal disease and 0 f diabetes mellitus. The number f entries under neplasms is distressingly high, as is als the number f cases f acute pisning by a wide variety f drugs. The needs f the medical ward services which have been previusly mentined are still unmet. In additin it has becme apparent that the facilities fr the receptin f emerlrency cases and f newly admitted patients are inadequate s that numerus difficulties arise which interfere with the efficiency and quality f the wrk.

Peipin~ Unin Medical Cllege Hspital OUTPATIENT CLINICS During the year the visits t clinics increased s that the ttal was cnsiderably in excess f that fr any previus year in ur histry. The grand ttal f visits t all sectins f the Medical Services was,07 (90-,,00). There can be n significant increase in this figure and sme steps have been taken t prevent further increase but ther measures will undubtedly becme necessary in the future. The wrk f the Tuberculsis Clinic was much increased, principally thrugh establishment f a special sectin fr the creatin f artificial pneumthrax, which was perfrmed times. The Clinic fr Gastr-intestinal Diseases was re-established in January under charge f Dr. H. C. Chang. There is a special sectin fr peridic treatments with enemas, particularly f ambulatry patients with chrnic dysentery. It is believed that bth these clinics fulfil imprtant functins, especially in relieving the hspital f the necessity f admittine all such patients. A special sectin f the Pediatric Clinic was initiated fr well babies. The regulatry care f well infants is nw ne f the mst imprtant duties f pediatricians and this sectin prvides fr such service and als separates well frm ill children. LABORATORIES N change in the rganizatin f labratry wrk was made during the year. The accmpanyinll table 0 page shws the examinatins made during the year. The ttal shws an increase which is at least partly justifiable. In additin, the Neurlgical Service in cperatin with the Pathlgical Service studied macrscpically 8 brains in cnqectin with pst-mrtem examinatins, including 9 specimens frm withut the hspital. The Dermatleical Service gave the fllwing special treatments: quartz lamp 87, radium, superficial x-ray 9, electrlysis, carbn dixide snw.

Twenty-furth Annual Reprt CLINICAL LABORATORIES OF THE DEPARTMENT OF MEDICINE LABORATORY Chemical July, 9 - June 0, 9 SPECIMEN ANI) Number Ttal Ttal DETERMINATION 9-9- 90- ------------- Ascitic fluid (quantitative) Bilirubin Prteins 7_ --~ I Bld Bilirubin 0 Calcium Carbn dixide capacity Carbn mnxide: Chlrided Chlesterl 9 Creatinine 9 Icterus index J Nitr!!"en. nn-prtein. Nitr!!"en. urea OXYl!"en Plasma prteins. ttal Albumin EU0bin 8 Fibrin!!"en 8 Glbulin Phsphatase Pbsphrus. inrpnic 7 Spectrscpic examinatin Su!!"ar 77 Uric acid 0 ~ _.778 Dru8 Acid radicals Hal0ens Heavy metals --- E}'e fluid Bilirubin Bld piment Fibrinl!"en ----- Milk Calcium Fat Lactse Prtein ---- Pleural fluid ---- Bilirubin Chlride Chlesterl Prtein 8, Saliva Calcium Pbsphrus ph --- Spinal fluid Calcium Chlride Glbulin L Nitre'en. nn-prtein Phsphrus Prtein. ttal 7 SUJrllr 88 7 ~ Stmach cntents Mrphine

Peipin~ Unin Medical Clleg-e Hspital CLINICAL LABORATORIES OF THE DEPARTMENT OF MEDICINE (CntinUed) July, 9 - June 0, 9 LABORATORY SPECIMEN AND Numberl Ttal I Ttal DETERMIN A TIO N 9-9- 90- Chemical Stl (quantitative) Calcium BOaps I (Cntinued) Mercury I Urine Brmine I Calcium I Chlride 7 Fat. ttal Lead Mercury Nitr&,en. urea IDS Phspbrus 8 Prteins Penlsulfnpbtbaleln Supr Urea clearance test 8 S Dermatlgical Culture <mlds) Daddield exam. (Trepnema pallidum) 9 Hair. epidermis <mlds> --- ~I thers 0 Skin ( AcaruJ Jcabiei). Metablic Basal metablic rate 9 9 I ------ Physilgical Eec:trcardi&,rams.98 Helln BOund recrds 0.08.89 ------ Tuberculsis I Guinea pi&, inculatins Hamster inculatins Pathl&,ical fiuids Pathl&,ical dlsue Sputum 0 Stls Urine 7 ~ ~ TOTAL EXAMINATIONS 9.8 un PERSONNEL During- the year Dr. Frazier was absent n leave and Dr. Luise Pearce f the Rckefeller Institute, served as Visiting- Prfessr f Syphillgy. Dr. H. L. Amss, Prfessr f Medicine at Duke University, Nrth Carlina, spent fur mnths n service as Visiting Prfessr f Medicine. The Medical Services prfitted very ~reatly by these visits. Dr. A. P. Black was appinted chief f the Pediatric Service. Drs. Y. L. Wei and C. L. Tun~ returned frm leave, and Drs. Y. L. Ch' eng and F- T Chu were granted leave. Dr. E.S. C. Ts resigned. F- R. DIEUAIDE Prfessr Dj Medicine and Head f tlte Department

Twenty-furth Annual Reprt REPORT OF THE SURGICAL SERVICES Tw develpments in the rganizatin f the Surgical Services are wrthy f mentin. By the first, the Department f Otlarynglgy was united with the Department f Surgery at the beginninlr f the year. This unin was carried ut in the belief that tlarynglgy, in cmmn with the ther surgical specialities, shuld nt ccupy an islated psitin in respect t its parent service. The amalgamatin prved a beneficial ne t bth services and made pssible a clser crrelatin f all surgical wrk. The secnd develpment cnsisted in the participatin by the varius divisins f the Surgical Service in the frmatin f a tumr clinic. Dr. J. W Spies, wh came t the department frm Yale University, acted as chairman f this grup and cntributed largely t the wrk f rganizatin and the directin f the activities f the unit. This clinic, which was rganized alng lines suggested by the Cmmittee n Malignant Diseases, American Cllege f Surgens, has made careful preparatin fr a serius study f neplastic diseases and the applicatin f raditherapeutic as well as surgical methds t their treatment. INPATIENT SERVICE The number f surgical inpatients cared fr during the year was 9, an increase f 9.0 per cent ver the previus year. The increase was due t the fact that an additinal nine beds were made available t the department. With the present alltment f ward space, it is nt prbable that this number f inpatients will be increased further. Despite a cnsistent effrt during the past year t reduce the average days f residence per patient, the figure was lwered frm. 7 t. days nly. With wrkers interested in the study f suppurative diseases f the chest, bne and jint tuberculsis, neplasms and ther chrnic cnditins, it is nt pssible t achieve the rapid turnver f inpatients that is recrded by institutins devted t the treatment f acute cnditins exclusively. The degree f utilizatin f ward beds remained, as in 90-, at 9. per cent. This als seems t be a maximum figure as lng as a rigid divisin f beds amng the varius special services is maintained. The necessity fr additinal ward space was rendered even mre urgent by the lelritimate demands f the tumr grup.

Peiping Unin Medical Cllege Hspital The yearly statistical classificatin f peratins and diseases cntains certain items f special interest. The number f intracranial peratins increased SO per cent ver that f the previus year. Six prstatectmies were perfrmed fr benign hypertrphy, a cnditin which has been suppsed t be practically nn-existent amng the Chinese. The diagnsis f chlecystitis was made frty-five ti~es, althugh nly ten patients came t peratin. Eighteen cases f c~rcinma f the esphagus were bserved during the year, f which nne were sufficiently early t make pssible an attempt at excisin f the tumr. Eleven patients were seen wh had epithelima f the penis. Peptic ulcer was diagnsed fifty-tw times and treated surgically in twenty instances. Of this number perfratin had ccured in fur instances. Gastric carcinma was diagnsed ten times. There were fifty-three peratins fr inguinal hernia; in eight instances the hernia was f the strangulated type. One hundred and thirty skin grafting peratins were perfrmed, a prcedure which is carried ut in this clinic with ever increasing frequency. The number f bld transfusins rse t ne hundred and ninety-six. One hundred and eight appendectmies were dne, with but tw deaths pstperatively. The use f Orr's technique in the treatment f stemyelitis was emplyed very frequently, and has prved a methd particularly suited t lcal needs. There was a great increase in the number f recnstructive peratins upn jints. Freign bdies were remved frm the esphagus five times and frm the air passages in nine instances. The general mrtality fr the year was.9 per cent, and the perative mrtality. per cent. As usual this mrtality was brne chiefly by the Divisin f General Surgery, t which mst f the serius emeqrency cases came. In the subdivisin f thracic surgery there were n pstperative deaths. The percentage fr the neursurgical cases was 9. per cent, a reasnable figure fr any clinic which is willing t accept fr treatment patients suffering frm the mre serius intracranial diseases. The perative mrtality fr the Divisin f Urlgy was. per cent, fr the Divisin f Orthpedics. per cent, and fr the Divisin f Otlarynglgy 0. per cent.

Twenty-furth Annual Reprt 7 OUTPATIENT CLINICS During the past year 7,9 visits were made t the cmbined surgical clinics f the Public Outpatient Service. This cnstituted 7. per cent f all public utpatient visits and was an increase f. per cent ver the registratin f the previus year (,8). The average daily number f patients seen was 8. During the mnth f April 7.8 visits were made, a daily average f 8. This increased attendance put a tremendus burden upn the staff f the department and resulted in the frmulatin f regulatins t becme effective September, 9, limiting the registratin f utpatients fr each clinic. Already the prprtin f utpatients t inpatients has far exceeded that which allws the majrity f patients needing hspitalizatin, r thse desired fr the purpses f teaching r investigatin, t be received int the wards. The prpsed limitatin, therefre, shuld prve a salutary measure frm every pint f view While ne may survey the cntinued grwth f the utpatient clinics with a certain amunt f justifiable pride, it must be admitted that such grwth cannt be allwed t cntinue and that the present number f patients already ver-taxes the facilities and persnnel at hand. RECORD OF SURGICAL OUTPATIENT ATTENDANCE YEAR Gen. Surg. G.U. Orth. Dental I E.N.T. Ttal 9- - - - - - 7,87 9-8,998,7 0 8,09 0,9 9-,0,8 0,0 I,87 7,9 9- I 7,9,7 9 I,, 0, 9-,7,08 7,9 7,79 7,0 9-7,8,,l0 7,00,09 97-8 7,8 7,0,9,0 8,8 7,9 98-9 8, S 9,08 7,780, 9,89 8,08 99-0, 9,07 8,9,08 0,7 I 8,99 90-, 9, 8,7,99,89 9-,7,8 9,9,77,89 I,8 7,9 In additin t the attendance at the Public Outpatient Service,77 visits were made t the surgical divisins f the Cllege Health Service and,9 visits t the private surgical clinics, a e-rand ttal f 8, utpatient visits fr the year.

8 Peipine- Unin Medical Clleee Hspital Alng with the daily clinics in general surgery, rthpedics, tlarynglgy, genit-urinary and dental surgery, the biweekly plaster clinic has been cntinued, as well as the special weekly clinics fr the treatment f hemrrhids, varicse veins and ulcers f the leg. A weekly tumr clinic was added frm the middle f the year. Members f the Departments f Radilgy, Pathlgy, Obstetrics and Gyneclgy, and Ophthalmlgy participated in this wrk, as well as representatives frm the varius surgical services. All cases f neplastic grwth were referred t this grup fr diagnsis and suggestins as t therapy, and t this clinic cme fr fll,\t-up inspectin all similar cases discharged frm the hspital wards. A ttal f, peratins was perfrmed In the utpatient clinics, an increase f mre than,000 peratins beynd the ttal fr last year. A tabular reprt f the wrk f the Orthpedic Shp and Plaster Clinic is given. ORTHOPEDIC SHOP AND PLASTER CLINIC 9-90- Artificial arms... Artificial lr-gs... Artificial limbs, including thigh... 7 Artificial ft... Apparatus: Braces: Wden screw fr separatin f jaw... Leather cap appliance... 0 Steel pins, screws, etc., fr fracture appliances. 0 Fracture appliances, varius pieces f... 0 Turnbuckles and jints...,... 0 Bradfrd frames... 0 Accessries fr plaster pylns... 90 Back brace... 0 Ft braces... Shrt leg braces... t Lng leg braces... Knee cage splints... Leather anklets... 0 Prnatin splints (frearm)... Cck-up splints (wrist r fingers)... 0

Twenty-furth Annual Reprt 9 She wrk: Casts: 9-90- Glve tractin splints (fingers).... Platfrm splints (shulder)...... Turnbuckle braces (elbw)......... Turnbuckle braces (knee)... Taylr spinal braces... 8 Reinfrced crsets (metal)...... 0 0 Cervical cllars... g Cnvalescent hip braces...... Braces and apparatus fr repair...... 0 7 Banj splint...... 0 Felt insles.......... 0 Leather insles......... 0 IS Metal insles...... 7 - Metatarsal bars... 0 Other alteratins f shes......... 0 Callus and cm pads........ S Steel she frames... 0 Lng arm... 0 0 Shrt arm...... 8 0 Lng leg.... 8 Shrt leg.... 0 90 Plaster jackets including head and thrax...... 8 Plaster jackets including thrax and pelvis...... Plaster jackets including thigh... 0 Plaster bts... 80 0 Plaster mdels... 0 Spicas: Splints: Shulder....... '0 Lng hip.... + 0 Shrt hip... S Wrist cck-up (remvable)... 0 Lng leg.... + Knee... 0 8 Bivalved plaster shells...... 0 Plaster pylns...... 8 SO Repair wrk n plaster casts... 00 0 Remvable plaster cenrical cllars... 0

0 Peiping Unin Medical Cllege Hspital RELIEF EXPEDITIONS At the beginning f the year, in respnse t repeated urgent appeals frm the Natinal Gvernment, a surgical unit was dispatched t the scene f the anti-cmmunist campaign in Kiangsi. Dr. P.C. Tung again headed the unit, which in additin cnsisted f Dr. H.L. Chan~, Dr. T. H. P'an (Department f Ophthalmlgy), a furth year student and tw male nurses. They prceeded t Nanchangvia Nanking and later stpped fr a shrt perid at Anking n the way hme. Changes in the military situatin reduced the number f casualties which had been anticipated and a relatively small number f wunded were given surgical care. After an absence f six weeks, the unit returned t Peiping n August, 9. Six weeks later, when the Cllege decided t participate extensively in the wrk f fld relief, Dr. S. T Kwan was despatched with the first grup wh left fr the Wuhan area t inspect the situatin and make plans fr the prject. Accmpanying the main prtin f the unit which left tw weeks later were Dr. C. C. Chang and the furth year surgical clerks. Dr. Kwan returned n December and Dr. Chang n January 7. The students were absent frm fur t six weeks. On February 9, a surgical unit under the auspices f the P. U.M. C. Medical Crps was sent fr relief wrk in the Shanghai war area. Dr. F- E. Wan acted as surgen-in-chief. Dr. L. K. Wang als was a member f the rganizatin. The unit served fr six weeks in the Wmen' s Hspital and the Internatinal Hspital, during which time they cared fr mre than 00 wunded sldiers and perfrmed apprximately 00 peratins. They returned t Peiping n April. PERSONNEL Dr. J. W Spies arrived in Peiping early in Nvember, 9, t 0m the staff f the Cllege as Assistant Prfessr f Surgery. Dr. F. E. Wan was appinted Assistant in Orthpedics. His pst as resident surgen was filled by Dr. H.. Chen. Dr. Ch' en Hua came frm Chengtu as Assistant in Dental Sur~ery. Dr. M. L. Hu was ~ranted a fellwship fr study abrad. H. H. LOUCKS Prfessr f SUrEtry and Head if tilt Departmtnt

Twenty-furth Annual Reprt REPORT OF THE DEPARTMENT OF OBSTETRICS AND GYNECOLOGY UNDERGRADUATE WORK During the year there have been n essential changes, but the wrk f the third and furth year students has been further develped. A teaching ward rund is held by the prfessr n three mrnings in the week, and the teaching material this year has been f unusually high quality. The usefulness f the new ward has been mre than prved, and it has been pssible t give a cnsiderable amunt f teaching n puerperal sepsis. The pssibility f remving all cases f sepsis frm the clean maternity ward has resulted in a distinct diminutin in the number f mrbid cases there. Antenatal wrk has made steady headway, and when we are able t use the new suite fr the Obstetric and Gyneclgical Clinics we shall undubtedly see cnsiderable develpment in this directin. The usual class fr undergraduate nurses was given during the first trimester, and fr this year bstetrics and gyneclgy were cmbined in the ne class. A cnsiderable part f the teaching was given at the bedside. POSTGRADUATE WORK The usual pstgraduate class was held in August and September, q. Fr the first time the numbers were up t ur limit f twenty-five. The class was very diligent, the peratin list was unusually gd, and there is n dubt that they prfited by the teachin~ and clinical experience. Thanks are due t the ther departments wh cperated with us in the curse. Three fellwship students have been with us thrughut the year. Dr. Eum f Bangkk, besides fllwing the wrk f the department, has been ene-aged in special wrk n the Zndek - Aschheim test, and n the incidence f Bacillus Welchii infectin in pregnancy and parturitin. Dr. T. F. Leung and Dr. S. F. Hsu, graduates f the Hackett Medical Cllege, have als been fllwing the wrk f the department during the last year.

Peipng Unin Medical Cllege Hspital OUTPATIENT CLINICS The wrk in the Public Outpatient Service has steadily grwn and bth Dr. Maxwell and Dr. Ams Wng are fully emplyed in the Private Patient Clinics, which have smetimes been t large fr the accmmdatin at ur dispsal. But ne is very pleased t be able t add that in anther six mnths we hpe t have anew, up-tdate utpatient department which will enable us t give systematic teaching t students f the third and furth years, as well as t separate ur clinics s as t be able t treat patients mre efficiently. We have pened a birth cntrl clinic under the care f Dr. Ams Wng in which married wmen wh have had at least ne child can get advice and instructin as t the methds which are best in their cases. A careful physical examinatin is carried ut in each case, a separate relitister kept, and the clinic has already prved its usefulness. Hysursalpinggraphy has been carried n thrughut the year by Drs. Ams Wng, S. W Lee and K. T Lim, and it has been fund very helpful in cases f sterility. OUTSIDE ACTIVITIES During the year an exchange lectureship in bstetrics and gyneclgy has been inaugurated with Cheel University, Tsinan, Shantung. The prfessr visited Tsinan in April and gave fur lectures n Ostemalacia; Vitamin Deficiency in the Antenatal Perid; Chri-epithelima and Hydatidifrm Mle; and Abrtin. Reciprcally. Dr. Grdn King is t visit us at the time f the pstgraduate class and help in the teaching. Dr. S. W Lee has given several lectures in Chinese at the First Natinal Midiwifery Schl, and the members f their advanced class f pupil midwives were allwed t cme t the department fr a frtnight, fllwin' all the wrk f the service as bservers, tw members cming at a time. Dr. Kha-t'i Lim has lectured in Chinese at the First Natinal Midwifery Schl. They have sent in t us many abnrmal cases durin' the year. She als lectured in Chinese at the Child Welfare Statin f the Public Health Demnstratin Area. The prfessr,

Twenty-furth Annual Reprt with the help f Dr. Lim, delivered a curse f lectures n C 'Sex" at the Y-W.C.A. hstel in the West City, and ne lecture n the same subject was given at the Methdist Episcpal Missin Girls' Middle Schl in Peiping. Drs. Ams Wng and S. W Lee have dne sme wrk at the Metrplitan Hspital and the staff f the department have acted n several ccasins as cnsultants fr the Duw Hspital and the First Natinal Midwifery Schl. FOLLOW-UP WORK During the past few years we have sent ut printed frms t all patients, three such papers being sent t each at intervals f ne mnth, six mnths and a year. Althugh stamped envelpes fr reply have been sent, a bare fifth f the patients have taken the truble t reply and the system with the increase in pstal rates is getting mre cstly. After careful cnsideratin, we have decided n a new system in which arrangements fr a return visit will be made with the patient befre she leaves the hspital. This will cver the first pstperative r pstpartum visit, and a new card will be given her n this visit which will arrange fr the next ne if needed. A special clinic is being arranged fr these reprt cases. RESEARCH Steady wrk has been carried n by several members f the department. Prfessr Maxwell has been engaged in further wrk n stemalacia and fetal rickets. Dr. Ams Wng has been wrkin~ n a manual f Obstetric and Gyneclgical Pathlgy in Chinese; Dr. S. W- Lee has been engaged in wrk n pregnancy txaemia and a new editin f the Expectant Mther in Chinese. Cnjined wrk has been undertaken n the intestinal cmplicatins f pregnancy and labur, and the puerperium, and careful studies f a number f rare cases have been cmpleted. The February number f the Chinese Medical Jurnal cntained a number f these cases.

Peiping Unin Medical Clle~e Hspital MUSEUM The further develpment f the Obstetrical and Gyneclgical Ivluseum, the specimens in which are n lan frm the Department f Pathlgy, has gne n apace. A fair number f valuable specimens have been added during the year and special teaching n bstetric and ~yneclgical pathlgy has been given nce a week thrughut the year by Dr. Ams Wng t the third year students wh were wrking n the service, and t the fellwship students. PERSONNEL There has been n essential change in the persnnel f the Department during the past year. Dr. K. T Lim, the resident, left at the end f the year fr special study in England. J. PRESTON MAXWELL PrfiSSDr f Ohstttrics and Gyneclgy and Head f the Department

Twenty-furth Annual Reprt REPORT OF THE OPHTHALMOLOGICAL SERVICE INPATIENT SERVICE The ttal number f inpatients admitted n the Eye Service during the year under review shws a definite increase ver that f the previus year, which is against, the highest figure that has ever been recrded. This increase is due partly t the fact that the service has been alltted tw mre beds fr wmen n ward K- and als tw fr men n ward K-O. It shuld be nted that nt less than 800 cases were referred frm ther services fr eye cnsultatin and examinatin, a figure representing a definite increase f 0 cases ver that f the year befre. The increase in part is due t the special investigatin made by the head f the dt:partment fr cases f txemia in preltnancy and partly t Dr. Ling's further study n infectius diseases. During the year 9-, 0 majr and 90 minr peratins were perfrmed by the different members f the staff. In cmparisn with the figures f the previus year, they shw a definite increase, particularly fr minr peratins. This may be explained by the fact that a certain number f the peratins perfrmed in the utpatient department were nt entered heretfre in the peratin recrd but were included this past year. OUTPATIENT CLINICS The attendance f bth ld and new patients shws a definite increase ver that f the previus year. The ttal number f visits figured,9, being the largest number that the Eye Service has ever recrded. The ttal number f visits t the Trachma Clinic durine the year under review is 7,7, which shws an increase f,0 ver that f the previus year. The Private Patient Eye Clinic was attended by 8 patients, an increase f 7 ver that f the past year.

Peiping Unin Medical Clle~e Hspital TEACHING Owing t the change in the curriculum transferring instructin in phthalmlgy frm the third year t the furth, the regular curse fr undergraduates was mitted this year since the furth year class had cvered it in the third year. The nly undergraduate instructin given was the usual intrductry curse in the third trimester fr secnd year students as a part f their training physical diagnsis. The intensive pstgraduate curse given Chinese this year was cnducted by the head f the department, Drs. Pi and Ling. Dr. Wei Yu-lin f the Divisin f Neurlgy als delivered a series f lectures n neurlgical cnditins f the eye. Thrughut the whle academic year under review, a series f lectures cvering varius subjects, such as fundus diseases, refractin, examinatin methds, and histpathllit, was given t the pstgraduate students and the junir members f the staff by the head f the department, Drs. Pi, Jhn and Ling. STAFF CONFERENCES AND OTHER ACTIVITIES Staff cnferences and ther activities have fllwed practically the same prgram as the previus year. Dr. Ling has been engaged at wrk, under the supervisin f the head f the department, n histpathlgy f eye materials cllected frm the eye clinic and received frm utside institutins. It is regretted that very little prgress in the translatin f the fifteenth editin f E. Fuchs's Len njuch dtr AUEenneillunde int Chinese by Drs. Pi, Ling and Chang, has been made due t the unusually heavy pressure f wrk and research activities. It is hped, hwever, that this may be cmpleted at an early date. EYE PATHOLOGICAL LABORATORY The wrk dne in the Eye Pathlgical Labratry frm July, 9, t June 0, 9, was as fllws:,000 r s, histlgical slides were sectined and prepared frm a ttal f cases frm July, 9 t June 0, 9. Of these, specimens came frm eye surgical cases and 78 frm cases fr experiment.

Twenty-furth Annual Reprt 7 RADIUM CLINIC In the Radium Clinic f the Eye Service, bth Drs. Jhn and Sudakff were engaged in the applicatin f radium treatment every Thursday thrughut the year. A ttal f cases was treated. RESEARCH Dr. H. T Pi has been engaged in the study f inclusin bdies in trachma and in study f the prblem f iridcyclitis. Dr. W P. Ling has cntinued his fundus examinatin n infectius diseases. Dr. p, S. Sudakff has ccupied his time in the study f darkadaptatin in Vitamin A deficiency diseases. Dr. S. P. Chang has been engaged in the statistical study f the incidence f trachma and clr blindness in the students f varius ~vernmental schls in Peiping. PERSONNEL Dr. Isa Jhn, whse appintment expired n June 0, 9, left the department t return t Vienna. A. PILLAT Prfiss r f Ophtha/mlzy and Head f the Department

8 Peiping Unin Medical Cllege Hspital REPORT OF THE RADIOLOGICAL SERVICE 9-9 Since July, 9, the Department f Rentgenlgy has becme the Department f Radilgy. The scpe f the department was enlarged t include rentgenl'ic diagnsis and therapy, the custdianship f radium, the management f the radium emanatin plant and assistance t ther clinical services in the applicatin f radium and radn. During- the year, while diagnstic service and research wrk have been carried n with n imprtant chane-e, the department has been re-rganized t meet the new respnsibilities. DIAGNOSTIC SERVICE The number f cases examined fr the year is 9,, being-,00 mre than fr the previus year, as shwn by the table belw. This increase has been cntributed largely by the grwth f the pneumthrax clinic f the Medical Service. During the year,7 pneumthrax cases were examined. The department has reached practically the limit f the capacity f the present persnnel, quarters and equipment. It is hped that the changes which have been authrized, which are the additin f a flurscpic rm and the rearrangement f quarters will relieve the cngestin f the diagnstic clinic. NUMBER OF CASES EXAMINED Private Public Year patients Students Out- Out- Ttal patients patients 99-0, Z I 0,, 90-,00 9 I,9 8, 9-, 889 8,00 9, In- I Staff and I Of these 9, cases, the examinatin f 9,908 was made accrding t a general classificatin, tabulated n page 9. The figures in the table d nt represent the actual number f flurscpic r rentgengraphic examinatins; fr example, a gastr-intestinal case may be flurscped and rentgengraphed ten r mre times during

Twenty-furth Annual Reprt 9 the three r fur days f the investigatin and yet the cmplete study cnstitutes nly ne examinatin. A better idea f the vlume f the wrk f the x-ray diagnstic service may by gained frm these figures: apprximately 0,000 flurscpic examinatins and,000 rentgengrams were made during the year. CLASSIFICATION OF X-RAY EXAMINATIONS 9-90- Chest (lung, heart, pneumthrax etc.),,0 Bne and jint,907,88 Skull (mastid, nasal sinus etc.) 88 Gastr-intestinal tract I 0 7 Urinary tract S 7 Pregnancy and hystersalpinggraphy 7 88 Ttal 9,908 I 8,0 RADIOTHERAPY Preparatin f the physical plant fr the new activities in raditherapy, under the directin f Mr. M. M. Williams, was begun in Nvember, 9. The installatin f the radium emanatin plant was cmpleted in the first part f 9 and radn frm the five hundred milligrams f radium became available n April, 9. The deep x-ray equipment \vith valve rectificatin and cndensers supplying 00 peak kilvlts and 0 milliamperes was ready fr clinical applicatin at the end f June, 9. The custdianship f the Cllege's ne hundred milligrams f radium was transferred frm the Divisin f Dermatlgy t the Department f Radilgy n March, 9.. Preliminary rganizatin f a tumr clinic has been wrked ut in cnjunctin with the Departments f Surgery and Pathlgy. This new clinic is frmed by representatin frm all clinical departments and the Department f Pathlgy. The Department f Radilgy is represented by Dr. C. K. Hsieh and Mr. ' YiIliams. Reference t the wrk f this clinic is made in the Reprts f the Hspital Superintendent and the Surgical Service. It is hped that this rganizatin

0 Peiping U Ilin Medical Cllege Hspital f centralizatin f available material will facilitate mre careful study and clser fllw-up f tumr cases and will wrk tward the standardizatin f methds in applicatin f radium and radn fr future evaluatin and imprvement. The fllwing tables cver the use ()f radium by the various clinical services frm April, 9, t June 0, 9. USE OF RADIUM AND RADON BY SERVICES SERVICES Ttal Number f Number f Millil!raDl Millicurie Milli "ram ct: Patients Treatments Hurs Hurs Millicurie Hurs Dermatlgy,8 0,8 Gyneclgy 0,980,, Ophthalmlgy,9, Otlarynglgy,0,7 S,097 Surgery 8 8,87 8,98 8,80 Ttal 78 97,,08 0,8 FORMS IN WHICH RADIUM AND RADON WERE USED FORM RADIUM I RADON TOTAL Cases I I Treatment Cases I Treatment Cases Treatment ------------ ~~~um Plaque ~ I ~ ~ I ~ I ~ ~ Tubes I 8 I 79 I 9 90 Needles 0 0._G_O_I_d_S_e_ed_s_* 0 I 0 0 0 Ttal ---~--0-0 * A ttal f 9 gld seeds cntaining millicuries f radn were used. PERSONNEL Dr. C. K. Hsieh returned frm abrad n September 0, 9. Dr. Marvin M. D. Williams arrived in Peiping n Octber, 9, t take up duty as Physicist. Dr. C. Wu was granted a fellwship t study abrad and left at the end f August, 9, t spend the year with Dr. Paul C. Hdges in Chicag. C. K. HSIEH A ssistan t Prfessr f RQentgenDIEY and A ctinz l{ead f the Department

Twenty-furth Annual Reprt REPORT OF THE PATHOLOGICAL SERVICE The fllwing tables summarize the wrk perfrmed by the Parasitlgical Diagnstic Labratry fr the hspital during the year 9-. INCIDENCE OF INTESTINAL PROTOZOA AND OF HELMINTH INFECTIONS July, 9 t June 0, 9 Ttal cases examined...,9 Ttal examinatins made...,7 PROTOZOA Endameba histlytica.... Endameba cli.... Endlimax nana.... Idameba buetschlii.... Giardia lamblia..... Trichmnas hminis.... Chilmastix mesnili.... HELMINTHS Ascaris lumbricides..... Ancylstma r Necatr.... Trichcephalus trichiurus.... Enterbius vermicularis..... Clnrchis sinensis..... Schistsma japnicum..... Hymenlepis nana..... Taenia spp. (intestinal)..... Fascilpsis buski..... Trichstrngylus rientalis.... Strngylides stercralis..... Dicrcelium dendriticum.... Number Psitive Cases 0 89 7 78 9 7-8 7 9 PARASITOLOGICAL EXAMINATIONS OF BLOOD July, 9 t June 0, 9 Per cent Psitive Cases..00 8.90.90.80.0 0.90 8.0.90.00 0.0 0. 0.0 0.0 0.0 0.0 0.0 0.0 0.0 Number f persns examined... Number f examinatins made... Number, Per cent Psitive Cases Psitive Cases I Plasmdium vivax 9 0. Plasmdium falciparum. Trepnema recllrrentis 0.

Peiping Unin Medical Cllege Hspital EXAMINATIONS FOR LEISHMAN-DONOVAN BODIES July, 9 t June 0, 9 Number f persns examined... l0 Number f psitive cases... Ttal N. f N. Psitive Per cent Psitive Examinatins Examinatins Examinatins Culture f splenic pulp 8 0.7 Smear f splenic pulp 9 0.0 Culture f liver material 7.0 Smear f liver material 7.7 Culture f bld 7.0 REINHARD HOEPPLI Prfissr f parasitlgy and Hlad f the Department

Twenty-furth Annual Reprt REPORT OF THE BACTERIOLOGICAL AND IMMUNOLOGICAL SERVICE The number f specimens examined in the bacteril~ical and immunlgical labratries has increased during the last year by, fr bacterilgy and 87 fr serlgy. Of the varius diagnses made, attentin is called t 9 epidemic meningitis cases and undulant fever cases. Amng these meningitis cases, rganisms nt agglutinable by the serum prduced by the Natinal Epidemic Preventin Bureau have been islated. These cultures have been supplied t the bureau s that the types existing in China may be used in the preparatin f the serum thus increasing its value. The undulant fever cases were diagnsed bth by bld culture and agglutinatin test. This cntinued psitive diagnsis f the disease suggests that the disease may be fund t be mre prevalent in China if sufficient emphasis is placed upn it by the medical prfessin. Tw imprtant methds have been intrduced int the labratry, viz. the typhid "0" agglutinatin in the Widal test and a mdificatin f the micrscpic Kline precipitatin test fr the diagnsis f syphilis. A preliminary trial f the "0" agglutinatin has shwn that in sme cases an earlier diagnsis may be made and in ther cases a diagnsis may be made nly by its use. The Kline test, because f its inexpensiveness and simplicity is recmmended as a check test fr the Kahn test in small hspital labratries where it is nt pssible t perfrm the Wassermann reactin. In this hspital it has prved its usefulness especially in the Pediatric Service where bld, in a sufficient quantity fr the ther syphilitic reactins is difficult t cllect frm yung children, may have the Kline tests perfrmed n it since the test requires but 0.0 c.c. f whle bld.

Peipin~ Unin Medical C]]e~e Hspital BACTERIOLOGICAL LABORATORY Specimen Number Tested Negative.Psitive Per cent Psitive Bld - Agglutinatin 98-8.9 Culture,00 77 0.8 Bdy Fluids Ascitic 9 89 0 0.9 Pericardial 0 7 I Pleural 8 7 Spinal 8 8 7 0 Milk 9 0 9 00 Sputum 797-0 7. Stl, I,7 00. Swabs Ear 08 0 98 90.7 Eve 0. Mastid 8 I. Nse 80. Pus,9 0 909. Thrat,- 8,8 7 Tissue I 0 7.9 Urine 9 0. Water 7 I 9. Ttal,0 7,,89 0. Specimen SEROLOGICAL LABORATORY Number Tested Negative I Psitive I Per cent Psitive Bld gruping,0,0 00 matching 7 0 7-00 Kahn test 0,,77,-8.9 Wassermann reactin 0,80 7,, 9.7 Spinal fluid cllidal gld test 9. Gum mastic test 7-7 7.9 Rss Jnes test 0 S 0 Wasserman reactin 7 87 8.8 Ttal,79,00 8,79.7, Besides the dia~nstic service rendered t the hspital, the labratries have cntinued t answer calls frm ther hspitals and ther departments f the Clle~e fr examinatin f specimens and fr the supply f cultures, immune serums and antigens whenever these supplies culd nt be btained elsewhere. During the year three dctrs n fellwship have wrked in the labratries gaining a knwledge f the fundamental principles f labratry diagnsis. One labratry directr wh will be in charge

Twenty-furth Annual Reprt f the curse fr technicians in the Institute f Hspital Technlgy spent a perid f six mnths with us. Three technicians have received training here during the past year, tw thrugh the special request f prfessrs f ther departments f the hspital and ne cmpleting his curse f the year befre. These will be the last f this categry wh will be received since an adequate technician's curse is nw ffered elsewhere, in the Schl f Medicine f Cheel University at Tsinan, in the Nanking University Hspital at Nanking and in the Institute f Hspital Technlgy at Hankw. Fur dctrs and ne technician have bserved ur methds fr varius lengths f time, learning special prcedures which are needed in the varius hspitals frm which they came. Tw f the medical students have utilized their free labratry perid fr training in these labratries. The assie-nment f medical assistant residents fr duty in this labratry has cntinued t be f value t bth services. It is t be regretted, hwever, that due t the decrease and change in staff during the time f fld relief, the regular schedule f three mnths' assignments culd nt nt be carried ut s that the actual technique f all the mre useful tests was nt learned by the dctrs assigned t us. The assistant residents act as liaisn between the clinical and labratry staffs f the hspital, they are required t be present each day at the reading and signing f labratry reprts, t attend the medical and surgical weekly staff runds, and t reprt each mrning any imprtant emergency case f the previus day. They are als respnsible fr immediate attentin t all emergency calls such as the immediate inculatin n suitable media f all emergency bacterilgical specimens, the immediate perfrmance and reprt f the results f all emergency bld gruping, bld cmpatability and Kahn tests, the careful fllw-up f all pneumnia cases especially in regard t typing f culture, and any ther special cultures, such as diphtheria, that may be requested by the clinician. c. E. LIM PrfessDr f Bacterid/D and Head f the Department

Peiping Unin Medical Cllege Hspital REPORT OF THE NURSING SERVICE INPATIENT SERVICE With the exceptin f the perid when there was a general call fr nurses in the fld and famine relief areas, there has been a mre than adequate supply f nurses, bth men and wmen, available fr the increased demands f the Nursing Service f this hspital. Three units have been sent ut fr emergency wrk during the past year. Three nurses went t Nanking frm July t August, 9; ten nurses, ne supervisr, and six senir students were at Wuchang fr varying lengths f time between September, 9, and January 9, 9; and fur staff nurses and seven temprary appintees were in Shanghai frm February t April 0, 9. The salary cst f these units was carried n the nursing budget f the hspital. T meet these emergencies with a minimum increase in staff, the nurses in the hspital agreed t return t the -hur week frm Octber, 9, t January, 9. The average number f staff nurses emplyed during the past year was 9, an increase f ver the previus year. There has, hwever, been a planned increase directed largely t imprving the care f patients during the night perid, especially between the hurs f 7:00 and :00 P.M., as fllws: A 8-hur week fr night nurses in accrdance with a plan started in January, 9. This necessitated an increase in nurses n night duty by........ Increased activities in the Islatin Unit, especially in cnnectin with utpatient examinatins and treatments n the admitting flr... New utpatient clinic requirements...... One additinal nurse in each f the general wards... UK" Basement (admissin and emergency service), t prvide fr wmen patients.... Children sward... '"............... Private ward.... Ttal... 0

Twenty-furth Annual Reprt 7 Fr the cming year a few increases in staff are planned in units where such increases are needed fr imprved service. As had been hped, the shrtening f the hurs f night duty has made this wrk mre acceptable. Night-duty assignments fr staff nurses are nw fr a minimum f tw mnths, instead f ne as befre. Three regular appintments fr night duty fr ne year have been made, and there have been several requests fr extended night service. This stabilizatin f the night persnnel shuld be cnducive t a mre efficient and satisfactry service. A study f the actual hurs f nursing care n each ward f the hspital has been made by the supervisrs, i.e., the number f hurs nurses wrked in these wards, exclusive f all absences fr any cause f nurses assigned t the ward. The main cnclusins f this study are as fllws: AVERAGE HOURS OF NURSING CARE BY UNITS Private wards... units Metablism ward... units Public wards... units (medical and surgical) Children"s ward...! unit Gyneclgical and bstetrical wards... units Islatin wards... units Graduates..9.... Graduates plus Studenu (N 0 students)...9..7 This study shws a great variatin in the number f hurs f care given t patients in the different units - the islatin service requiring the largest number f hurs, and the large general surgical, medical, and mixed wards the least. Generally speaking, the service. rendered seems t have been f gd quality - nt a minimum, but, in cmparisn with demands and requirements f patients in ther parts f the wrld in similar institutins by n means a maximum. Fifty-eight nurses ( men and wmen) have left the service this year. This is a turnver f 0% amng the men, % amng the wmen, and an average turnver f %. This is a reductin by % fr the men, % fr the wmen, and % fr bth ver the previus year. NOTE:- See Reprt, June 0, 9, ntes n pp. 0-.

8 Peipinlr Unin Medical Cllelre Hspital Effrts have been made t determine the causes f resignatin frm the staff. The largest number () gave as a reasn family pressure t return hme and wuld give n mre definite explanatin. Fur gave very indefinite reasns, such as need f rest. This may have meant that marriage had been arranged by the family. Other causes fr leaving have been as fllws: Returned t psitins in wn hspitals:. Temprary appintments fr special experience..... One-year cntract cmpleted... 9 Wrk unsatisfactry... ] Health cnditins... 0 Pregnancy (a small number f married wmen are emplyed)... Tuberculsis... Hydrnephrsis.... Bund feet..... Transferred t ther departments r rganizatins... X-Ray..... Public Health... Midwifery............ Entered special nursing (greater remuneratin)...... 0 Ttal... PUBLIC OUTPATIENT SERVICE A slight beginning has been made in the plan t develp a mre cnstructive prgram f nursinlr service in the Public Outpatient Service. One f the graduates f the Schl f Nursing in 9, Miss Yun-hua Hsieh, has been assigned t the children's clinic. Fllw-up visits are being made in cnnectin with the feeding clinics inaugurated by the Divisin f Pediatrics, as well as fr the general service fr sick children, and instructin fr mthers is being put n an rganized basis. The vlume f wrk seems t warrant an additinal nurse in the Pediatric Clinic fr the cming year, and a graduate f the Schl f Nursing in 9 will be assigned t this duty. With the pening f the new building fr the gyneclgical and bstetrical clinics it is hped that similar fllw-up wrk and teaching may be inaugurated. These activities are being develped in clse cperatin with the Hspital Scial Service as well as with the medical services.

Twenty-furth Annual Reprt 9 In additin t these new activities, much effrt has been put int the imprvement f the service in all ther clinics, especially s as t make valuable teaching material available under mre satisfactry cnditins. Students are assigned t these clinics fr lnger perids f instructin than in the past. Much still remains t be dne t imprve the efficiency and quality f service rendered. SPECIAL DUTY During the past year there has been a change in the management f the special nurses' registry. The Sleeper Davis Hspital turned ver all respnsibility fr this wrk t the Peiping Branch f the Nurses' Assciatin f China,which appinted a special cmmittee, chsen frm the grup f special nurses. A new ffice has been started which at present seems t functin satisfactrily. There are twenty-tw Chinese nurses nw n the registry. The number f days f special nursing in the hspital was as fllws: Chinese graduates Days... 8 Nights..................... 99 80 Freign grdduates Days... Nights...... This is a decrease f 9 days fr Chinese nurses and f days fr freign nurses as cmpared with the year 90-9. There have been ccasinal requests frm small grups f special nurses fr an increase in the amunt f pay, but since nne f these requests had the backing f the grup as a whle, n actin has been taken. It is hped, hwever, that rather than any increase in the charges at this time, sme plan can be wrked ut fr a decrease in the hurs f service as a means f making the cnditins f private-duty nursing mre effective and satisfactry, and als t prvide mre cntinuus emplyment fr mre nurses.

0 Peiping- Unin Medical Clleg-e Hspital HEALTH The ttal days f illness during the year have been smewhat reduced in cmparisn with 90-9 as will be seen by the fllwing table: 9-90- Reductin Men 0 8 7 Wmen 09 7 Ttal 9 907 8 days Less cases f tuberculsis 7 0 7 (One nurse was n duty nly ne day.) 98 0 days This represents an average number f days f illness as fllws: Men..7. Less days f absence f ne man treated fr tuberculsis, days. 8.9. 8 Wmen 8. 9.. Less days f absence f tw nurses treated fr tuberculsis.8 7..8 Whether the effrts which have been made t reduce the sickness rate have prduced these results r whether this represents a nrmal fluctuatin, it is difficult t state. Hwever, great effrt has been made t supervise the health f the nurses, largely thrugh the emplyment f a health nurse, Miss Sha Kuei-ying, wh has been respnsible fr the reprting- and care f early illness, the fllwing-up f recmmended treatments, the cntrl f cmmunicable diseases in the residences, and general health supervisin and advice. This has relieved the administrative nursing staff f the hspital f a cnstantly distracting and time-cnsuming respnsi.bility, while, at the same time, it seems t have brught abut a better and mre cnstructive attitude twards their wn health n the part f the nurses.

Twenty-furth Annual Reprt PERSONNEL There have been few changes in persnnel. Miss Ethel E. Rbinsn returned frm leave n December, 9. The supervisrship f the private pavilin was assumed by Miss Ruth H. Kunkel n the resignatin f Mrs. Mary F- Lucks. Mrs. Frances V Fisher was appinted head nurse f the private ward frm January, 9. HOUSING Early in the spring it was apparent that additinal facilities fr the husing f wmen nurses were needed t prvide fr the new class f student nurses t be admitted in July, 9. Huses Ns. and in Nrth Cmpund, ccupied by freign nurses, have been taken ver fr this purpse. The entering class will ccupy this huse. In Oliver Jnes Hall seven beds, the number f the graduating class, have been released. This will scarcely be adequate fr the necessary increases in wmen nursing persnnel fr the cming year, and allws fr n further accmmdatin fr nurses t care fr pssible additinal hspital units. With these pssibilities in mind and with the prspect f the much desired increase in the number f nursing students, it is bvius that sme prvisin must be made in the near future fr additinal drmitry facilities fr wmen. It will prbably be pssible t slve the husing situatin fr the men nurses by permitting a larger number t live utside f the hspital prperty. The majrity f the men are married and wuld prefer t live at hme which in many ways seems desirable. TEACHING The teaching activities have cntinued alng the same lines as described in the last reprt f the Nursing Service. Instructin f undergraduate student nurses has averaged thrughut the twelve mnths as fllws:

Peiping Unin Medical Cllege Hspital Schl f Nursing ( students), average... (This indudes pre-nursing students when Ginling Cllege was clsed at the beginlling f the secnd semester f the year 9-9) Affiliates frm ther bspitals ( nurses)...... S. Graduate nurses in special curses..... Institutinal nursing (8 nurses)..... Curse in dietetics ( nurses).... New nurses admitted t staff... 0 (90 nurses, each having mnths' parttime instructin and supervisin) Ttal..... 7.7 This ttal f sixty-seven students ver a perid f twelve mnths represents the teaching lad carried by the instructrs f the Schl f Nursing, sme Of whm devte all their time t the schl, while thers have part-time duties in the hspital. With the return frm study in America f Miss Sun Tuan In the spring f 9 and the expected return f Miss Tien Tsai-Iee In the cming fall, it is hped that the instructin ffered in Chinese t the affiliating and graduate students, and staff nurses can be.put n a much mre satisfactry basis than has been pssible in the past. GERTRUDE E. HODGMAN Sup~rintmdent f Nurses

Twenty-furth Annual Reprt REPORT OF THE DIETARY SERVICE There were, special diets and 8, meals served during the year by the Dietary Service. These cvered Chinese and freign diets prepared fr patients n the private and semi-private wards, Chinese diets fr public ward patients and meals fr a number f emplyees, dressers and attendants as well as meals served in the staff dining rms, necessitating the supervisin f three separate kitchens. The imprtance and need f emphasizing the educatinal side f dietetics has been keenly felt. Miss Anna Lee and Miss Su-chin Lia, assistant dietitians, have cnducted three classes in the Midwifery Schl and Health Statin. Since cnsiderable amunt f time was given t these classes, it was impssible fr the members f the staff t d mre alng educatinal lines. There is a great need fr a fd clinic where patients frm the utpatient department and the wards may receive instructin as t their nutritinal prblems. It is hped that as sn as feasible such a clinic wi]] be established and that a dietitian specially trained fr this wrk will be fund. The service f the diet kitchen has grwn s rapidly that larger space and rerganizatin wili be necessary. It seems desirable t mve the special diet kitchen t anther lcatin whereby the kitchenette and serving rm adjining the nrth dining rm will be father apart, thus imprving the ventilatin f the dining rm. The suite f rest rms in E-basement which was cmpleted in Nvember, 9, has added much t the cmfrt and cnvenience f the dietary staff. In 99 the first Yenching University graduate in hme ecnmics and nutritin came fr trainin', and was later appinted assistant dietitian. Since then s many students in the Hme Ecnmics Department have becme interested that it is hped arrangements may be made whereby they will cme t us fr the necessary interneship in dietetics befre they are recmmended fr psitins as hspital dietitians.

Peiping Unin Medical Cllege Hspital After a year's study in America, Mrs. K. P. Huang, Dietitian, resumed her duties n August 7, 9. Upn cmpletin f her appintment, she resigned n June, 9. Miss Anna Lee (Mrs. T C. Shen) als resigned as f July, 9. Miss Drthy Wen jined the service n June, 9, as Assistant Dietitian. KWE-PAU HUANG Dietitian

Twenty-furth Annual Reprt REPORT OF THE HOSPITAL SOCIAL SERVICE Thrugh the suggestin f Scial Service tw new undertakings were added t the many services perfrmed by the hspital. Patients suffering frm cnditins needing medical care r directin ver a lng perid, are kept n the wards r in the cnvalescent hstel fr mnths and ccasinally fr even a year r mre. It was felt that such patients need t be prfitably ccupied during their cnvalescence, and as a new undertaking the part-time services f an ccupatinal-therapist were secured t give instructin in hand crafts. The patients have shwn much pleasure in the particular wrk given t them, which, in sme cases, will affrd training fr a trade with which t supprt themselves after their medical treatment is cm.pleted. The secnd undertaking was started when a special wrker was set aside t serve the emplyees f the institutin. It had been felt that if sme f the sick emplyees had been apprached early enugh their illnesses, in many cases, wuld nt have develped s seriusly and the institutin wuld have been saved the expense f sanitarium care and f furnishing financial assistance t their families. Miss S. M. Ka, therefre, was definitely assigned t the task f becming acquainted with the emplyees' prblems in rder t effect preventive measures wherever pssible. The Scial Service has cntinued t cperate with sme f the utside agencies, such as the H mefinding and Family Welfare Organizatins, mst f the members f the divisin having served n the bards f bth. There has als been friendly cperatin between the Scial Service and ther divisins f the hspital. The rutine fllw-up in the surgical, syphilis and cardiac clinics was carried n as usual with gratifying returns in patients and reprts received. A part-time wrker has been assciated with the Tumr Clinic and at the request f the dctr in charge a full-time wrker will be supplied next year. Table I n page will give sme idea f the medical scial pro'blems fund amng the patients, and f the scial treatment undertaken. There were patients assisted.

TABLE I SERVICE SERVICES RENDERED FOR PATIENTS July, 9 June 0, 9 SOCIAL RENDERED r:i u U ~ ~',= I.~..c... ~ g ~ U -0 U c u...... ~,"'C g t:: t:: e u -0 > bil e ~ 0 u =' u -0 u g u >. >. -u... bil bil c....c..c "'C"'C t:: "a v ct; ~ ='... ==.::; :.0 '0 c: c: t:: cgbil c = t:: c: -0 C = cg i c: v u 0 Ul 0,9 0 u :'- a.. u Ul 0 c: =' t'!i.e: E.~ '"'...9 u >.,~ =' u e.t:i:a... 0 '::; ti e ~ a.. cg E "'C v..c 0 v... 0 bil U U a.. I:: E~ t'!i =' _ v u c: : ~. a.. a.. a.. u c: d Y b'c'" --- 0 le u ~ =' =' a.. ~~ u~.b>. "'C- c.. '';;~ U t'!i ~ 0 ~. c ~" -;!,j V U --; --t.l..c.-::: "il... < OOU"'C 'c ~ E f:'s" I::'a e-.s I ~!l 's..c gbll U u 0 til "'C Ul 'u 'u a.. c.. t.i c.. :..== u III U III ~ il ~ f-t ~ --0 c U rio u 0 u'''' ~ ~ 0... 0 ~ ~ a~... 0 "'C u u u r:i u.t:i 0 a~ U 0 0 "'C 0 0 pr::~ ci I~..c_ c..c ~..c c.. a.. < 0 pr::'"' c.. 0 ~ ~ en rj') ~ rj') -. Z ~..c Z ~ ct: f-t ':;.S bil 0 cg PROBLEM - N prblem 8 : 89 Chrnic illness 9 8'08 97 ~ Acute illness 7 9 0 Insufficient incme 9 9 9 - ~9 Stranger in twn 7 9 8 70 Ignrance 0 8,97 Unemplyment 9 7 Pressure f Beds 8 0 07,,0 Old age 8 8 Family cnflict 0 7 8 -._-- --f----r------ Dependent child 0 0 Crilpled 9 Lack f hspital infrmatin 8 8 Unmarried mther 7 8 Mental cnflict 9 - Miscellaneus 8 8 - Ttal 89 9 7 ~9 7 8 8 809 9 97 7 7 9 / 8 7 0,

Twenty-furth Annual Reprt 7 Table II n page 8 shws the wrk that was undertaken amng the emplyees by Miss S. M. Ka. A ttal f 0 cases was handled. One f her tw aims in cnnectin with this wrk will becme realized when a lunch rm fr emplyees is pened in September. Many emplyees wh live at a lng distance cme n duty befre a mrning meal and their chief meal is at nnday. Sme bring cld crn-bread frm hme which cmprises their entire lunch. Sme eat n the street near the nrth eate f the hspital in all kinds f weather with the cnsequent danger f disease frm imprperly cked and handled fd. A prper place, therefre, where wellcked fd is served at nn time is an essential factr in the preventin f ill health and disease within this grup. It is hped that as sn as a suitable huse can be fund, a hstel in the vicinity f the hspital will be prvided fr emplyees. This is necessary since a number are suffering frm pr health althugh they are nt cnsidered sick enugh t stp wrk entirely, and with a shrt rest at nn are able t cntinue. There are als amng the emplyees sme cuntry flks, rphans and single men, wh are apt t live in small inns under cnstant temptatins f varius kinds, fr whm a hstel prviding whlesme living cnditins seems necessary. STAFF ACTIVITIES The staff has met as usual twice a week t discuss the cases undertaken by th is service r t ask utside scial wrkers t lead in the discussin f varius prblems. This supplementary help and cperatin is felt t have been a substantial assistance in furthering the general efficiency f the wrk. Curses in Medical Scial Service and Case-wrk l\ethds at Yenching University were taught by Ivliss Pruitt in the autumn semester. She als lectured in the spring t the nursing students. Miss L. C. Chu gave a curse in case-wrk during the fall f 9 t the nurses f the Public Health Statin, and served n the birth cntrl cmmittee t which she gave much time. Miss Yu lectured t the Bridgman Academy and twice t the eraduating nurses f the Cllee-e. Tw Yenching University scilgy students did field wrk in the Hspital Scial Service thrugh the year and fur came fr a half year.

TABLE II ~ICE PROBLEM ~ Ttal Cases carried ver frm last year New cases TOTAL 7 0 7 8 Occllpabns: Physicians Nurses Clerks Technicians Servants C; 0 f- 0 8 7 II 7 -~-~---+--~+--~ 0 7.. -- 00 ~ ~.a' ' IrQ ~ ::: ::I g: ~ r::l. r=i' a (') S.. ;-- IrQ () ::r:: 0 {II '0 ::;" e.-

Twenty-furth Annual Reprt 9 PERSONNEL Miss C. C. Huang wh was with the Hspital Scial Service frm 98-9 returned t the staff this past year after servin" with the Y.W.C.A. in Shanghai. During the year Miss H. T Chu and Mr. c. K. Chang, tw Yenching University graduates, served n the staff. Miss J. C. Yu returned in August after fifteen mnths' leave fr study in the New Yrk Schl f Scial Wrk. Miss Lrna Liu, als frm the same schl, jined the divisin in F ebruary. Miss Tirzah Bullingtn jined the hspital staff as Occupatinal-therapist n l\t.ay fifteenth. JU-CHI Yu Fr the Chief f Scial Service

Twenty-furth Annual Reprt 7 GENERAL INFORMATION CONCERNING RATES AND REGULATIONS The Peiping Unin Medical Cllege Hspital is desig-ned fr the diag-nsis and treatment f acute and sub-acute diseases, maternity cases, accident 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. The hspital makes every effrt t be prepared t care fr all emergency cases, but the limitatin impsed by the number f beds available n the varius services renders it necessary t make arrangements in advance fr the admissin f patients nt in an urg-ent cnditin. OFFICE HOURS AND HOLIDAYS General ffice hurs are frm 9 A.M. t : 0 P.M. and P.M. t P.M. daily, except Saturdays frm 9 A.M. t : 0 P.M. There are n ffice hurs r clinics n Sundays r hlidays. The fllwing hlidays are reg-ularly bserved in the hspital: January, March, March 9, May, Octber 0, and Nvember. Due ntice is given f additinal hlidays. ADMISSION OF PATIENTS Patients are admitted t the hspital nly after examinatin and upn recmmendatin f the delegated members f the staff f the hspital. An applicatin fr admissin and treatment must be signed. If the patient is seriusly ill r an peratin is cntemplated, this applicatin must be witnessed by a respnsible relative r friend, in accrdance with the "Regulatins Gverning Hspitals Prmulgated by the Ministry f Health," Article 8. In general patients are admitted nly between the hurs f 9 A.M. and P.M., after beingseen by a physician n duty in the apprpriate Private Patient r Public Outpatient Clinic accrding t the schedules n the fllwing pag-es. EMERGENCY AND ACCIDENT CASES Patients suffering frm serius illnesses r severe accidents are admitted thrugh the Emeq~ency Service, at any hur f the day r night. If patients are t ill t cme t the hspital fr cnsultatin, arrangements may be made, as explained under' 'Emergency Service' fr a member f the staff t visit the patient and decide whether admissin t the hspital is necessary and pssible.