the Navy, at the rate of twenty cents per month, and "stopped rations," charged at the rate of thirty cents per diem for every officer and man subsisted at the expense of the hospital department. On a basis of 8,500 men and about 1,500 officers, representing the legal strength of the Navy, or 10,000 persons in all, the former would yield $24,000 per annum, and the latter, taking an average of the last five years, may be counted on to yield an amount not exceeding $15,000, making the round sum of about $39,000. These sums are transferred by the Treasury Department to the credit of the naval hospital fund, not at regular aud stated intervals, but from time to time, and in larger or smaller amounts. as balances are found to be due on the settlement of paymasters' accounts. The status of the fund is therefore a very precarious one, and may fluctuate at any given period between moderate ease and complete exhaustion. Of late years, however, as a general rule, the credits have been on the smallest possible scale, and it is now well understood at the Treasury that no back or reserved credits, of any considerable amount for former years, remain to be made to it. During the last twelve months the transfers from all sources have not exceeded $112,470.70, but no transfer, except of the most trifling character, is possible in the coming year. The only other possible source of increase to the fund is from the operation of a provision in the act establishing navy hospitals, approved February 26, 1811, the second section of which directs "that all fines imposed on navy officers, seamen, and marines, shall be paid to the commissioners of navy hospitals." On careful inquiry, I cannot learn that any such disposition has ever been made of these moneys. Without doubt by far the largest portion is irrecoverably lost; but, with the hope of reclaiming even a small portion, I have caused the subject to be brought to the notice of the proper officers of the Treasury, who are now engaged in its investigation. With the most favorable results, so little can be expected from this source, that it may be practically disregarded. The support of naval hospitals thus depends, and for the future must continue to depend, on the income accruing within the year to the navalhospital fund from hospital money and stopped rations of the sick; and hereafter the aggregate of these will not be swollen by transfers made on account of preceding years. Its precise amount therefore is nothing more than the solution of a problem whose factors are all known. Now, the annual cost of maintaining the hospital department, as far as the same is chargeable to this fund, has for several years past averaged about $130,000. Notwithstanding the exercise of the most rigid economy during the last year, the expenses have fallen but little below this sum, and a less amount cannot well be depended on as sufficient for the future. It is true the outbreak of yellow fever at the navy-yard, Pensacola, entailed unusual burdens on the finances of the Bureau, and has swollen the aggregate of expenditures beyond anticipated limits. Yet such emergencies are liable to arise at any time, and when they occur must be provided for, be the cost what it may. In consequence of the death from yellow fever of the two medical officers attached to the yard, and prior to the arrival of those ordered in their places, it became necessary to employ private physicians as well as additional nurses, and hence the cominandant of the yard, (himself soon to fall a victim to the disease,) in the exercise of a wise discretion, summoned the most eminent professional talent to his assistance. The expenses of every kind, thus incurred, will amount to nearly $10,000; and yet, small as the sum is, the meager resources of the Bureau are embarrassed in its endeavors to meet it. I mention this significant fact principally to show how closely ordinary expenses must keep pace with our ordinary income. In view of the foregoing statement of facts, and of the importance of maintaining the medical department on a proper footing, I respectfully urge upon you the necessity which exists of applying to Congress for a special appropriation to the naval-hospital fund. To make good deficiencies and carry on with efficiency the hospitalservice for the remainder of the present fiscal year, $50,000 will be required, and for the fiscal year ending June 30, 1876, $100,000. NAVAL HOSPITALS. During the twelve months now closing, nothing further has been attempted than to keep these establishments as nearly as possible in the condition they were in at the last report. In spite of every effort, their deterioration is rapidly increasing, and they are now in need of repairs largely beyond our means to effect. The buildings within and without require painting and general renovation, while the grounds and cemeteries attached to them present a most neglected appearance. The sum of $25,000, asked for in the estimates of the Bureau, is barely sufficient to preserve the former from decay; and this done, but little remains for the necessary care and improvement of the surroundings. For years past this amount was regularly appropriated for "repairs and improvements," but at the last session, from motives of economy, it was cut down to $5,000; a sum so entirely inadequate that it merely serves to execute the most indispensable repairs to buildings, without leaving a dollar to spare for other purposes. This will be obvious from the consideration that seven spacious hospitals, and two smaller ones, with a large building used for a laboratory, in addition to grounds, cemeteries, &c., have to be kept in good order out of an amount no greater than that appropriated for the purchase of bunting for the Navy. Suitable accommodations for the sick are imperatively needed at the Pensacola station. The present wooden building standing in the center of the navy-yard, besides being ill adapted to hospital purposes, is a source of infection to the houses around, and its destruction as soon as the approach of cold weather permits cannot be avoided, although not the slightest provision for the care of the sick will then remain. While I am clearly of the opinion that a permanent and substantial structure should be erected in its stead, and that in the end it would be the most economical, I refrain from urging it on account of the heavy outlay required, the valuable time consumed in its erection, and the necessity which presses upon us of preparing hospital accommodation as speedily as possible after the removal of the present building. I therefore recommend that a hospital more or less temporary in character be constructed during the winter, on or close to the site of the old hospital, near the Barrancas, which has the reputation of being a healthy situation, is easy of access, and is incapable of diffusing infection through the navy-yard or the adjacent towns. The cost of such a building will be about $30,000, for which an appropriation will be required. I beg to renew the recommendation made in the last annual report, that an appropriation of $50,800 be asked of Congress, for the construction of surgeon's quarters, drains, roads, water pipes, &c., at the naval hospital, Mare Island, Cal. As these improvements have long been needed and would greatly conduce to the efficiency of the estab lishment, the propriety of soon commencing them is commended to your favorable consideration. The want of libraries for the use of the sick at our naval hospitals is greatly to be regretted, but owing to insufficiency of means could never be obviated save in the most imperfect manner. Some of the hospitals are entirely without these indispensable comforts for the sick, and those best off in this respect possess but a handful of half-worn books, for which they have been indebted to private liberality and occasional charity. Surely a state of things like this reflects no credit on the Navy, and should not be allowed to continue a moment longer than is absolutely necessary. A special appropriation in this case is not contemplated; but should an increase of the hospital fund be allowed, it is my intention, with your approbation, to apply as much of it as can be. spared from more pressing wants to this much-needed and humane object. YELLOW-FEVER EPIDEMIC AT PENSACOLA, FLA. During the recent prevalence of yellow fever at the Pensacola navyyard, two medical officers, I regret to say, fell victims to its ravages, viz, Surgeon John B. Ackley and Acting Passed Assistant Surgeon George B. Todd, while a third medical officer, subsequently ordered there, experienced soon after his arrival an attack of the disease. Doctors Ackley and Todd were officers of high professional attainments and general intelligence. They fell in the heroic discharge of duty, leaving behind them an example that sheds luster on the branch of the service to which they belonged. SURGEONS' NECESSARIES AND APPLIANCES. By the naval appropriation bill for 1874-75, the amount allotted for "surgeons' necessaries and appliances" was reduced from $40,000 to $30,000. As the latter sum is found to be entirely inadequate for the medical and surgical wants of the Navy, in the estimates for the next fiscal year I have recommended that the appropriation be restored to the first-named amount, which, for many years, was the regular appropriation, and had never been found more than sufficient for the purpose. The irregularly-recurring demands of the service compel the labora tory to keep on hand a considerable stock of medicines and instruments for any emergency that may arise, and for this reason the appropriation for one year has to be partially expended in laying up a stock of articles for issue in the next. In consequence of the large number of vessels fitted out during the Spanish excitement last autumn, an unexpected burthen of $20,000 devolved upon the Bureau, no portion of which has since been refunded, as was done by special act in the case of other bureaus similarly circumstanced. Owing to this cause the present fiscal year found the Bureau with its supplies materially diminished, and withont the means of replenishing them. Under these circumstances it considers its request, for the restoration of the appropriation to its original amount of $40,000, nothing more than reasonable. NAVAL MEDICAL SCHOOL. I again respectfully solicit your favorable consideration of the project of providing higher medical instructions for assistant surgeons. As my views on the subject were expressed at considerable length in the last annual report of the Bureau, it is not deemed necessary to repeat them here. I will only add that, on mature reflection, I am more than ever convinced of the great need of something in the nature of an organized system, by which practical instruction, not otherwise within their reach, except at great personal expense, may be secured for this class of young officers. The object now proposed is not to establish an academy analogous to that at Annapolis for the education of midshipmen and engineers, but to provide at some central point, on a moderate scale, the requisite facilities for completing the professional training of assistants in such branches as practical anatomy and surgery, the use of the microscope, &c., and the performance of chemical operations as far as applicable to medicine. Most of the young medical men who come before our naval board for examination possess the merest theoretical knowledge on these branches, a practical acquaintance with which is universally recognized as of the greatest value to the physician. A comparatively small sum would purchase all the microscopes, surgical instruments, chemical apparatus, anatomical material, books, &c., necessary for the use of the school. As the instruction is designed to be given by medical officers already in the Navy, and as far as practicable by those discharging other duties, there would be no additional expense on this score. BUREAU PUBLICATIONS. An intelligent and experienced medical officer of the Navy, for the last two years, in the intervals of other duties, and with but little extraneous assistance, has been sedulously employed under the supervision of the Bureau in the examination of hundreds of medical journals from hospitals and ships, with a view to the collection of the numerous cases of surgical injuries they were known to contain. A most extensive body of facts, replete with scientific value and of the greatest interest to the profession, is the result of this investigation. I am gratified to announce that the work of arranging and classifying these cases has been prosecuted with so much diligence that a volume of cousiderable size is now in manuscript, and will be ready for the hands of the printer early in the coming year. Thus far the enterprise has been carried on without other aid than that afforded by our own resources, but unless pecuniary assistance is obtained to defray the cost of publication, this valuable record of naval medical experience cannot be given to the world. To publish it in a durable form $30,000 will be required, and I respectfully ask that Congress be appealed to for the necessary appropriation. Very respectfully, your obedient servant, Hon. GEORGE M. ROBESON, J. BEALE, Surgeon General United States Navy. Secretary of the Navy. |