COLUMBIA LIBRARIES OFFSITE HEALTH SCIENCES STANDARD HX64073378 RA407 H67 The statistical expe RECAP £.:..-> Columbia Sintoetsitp mtijeCttpiOrtiigork COLLEGE OF PHYSICIANS AND SURGEONS LIBRARY Digitized by the Internet Archive in 201jO with funding from Open Knowledge Commons http://www.archive.org/details/statisticalexperOOhoff THE JOHNS HOPKINS HOSPITAL REPORTS MONOGRAPHS. NEW SERIES No. IV THE STATISTICAL EXPERIENCE DATA OF THE JOHNS HOPKINS HOSPITAL BALTIMORE, MD., 1892-1911 bV FREDERICK L. HOFFMAN, LL.D., F.S.S. Statistician, The Prudential Insurance Company of America BALTIMORE THE JOHNS HOPKINS PRESS 1913 [Copyright, 1913, by The Johns Hopkins Press.] To Sir William Osier in Appreciation of His Friendship and Strong Faith in the Practical Value of the Statistical Method in Medicine \H1 CONTENTS. PAGE Introduction 1 Importance of Hospital Statistics 1 Extent of Hospital Accommodation 2 Practical Utility of Hospital Statistics 2 Need of Uniformity 4 Elements of Hospital Statistics 4 General Morbidity by Race and Sex 5 Plan and Scope of Nosography ? 5 Bellevue Classification of Diseases 6 The Problem of Morbidity 6 The Registration of Diseases 7 Notification of Infectious Diseases 8 Advantages of Publication of Hospital Experience 9 Analysis of Baltimore Population and Mortality Data 9 Admission of Non-Residents 10 Statistical Treatment of The Johns Hopkins Hospital Data 11 Limitations of Statistical Analysis 12 Historical Review 12 Comparative Admission Rates by Race and Sex 12 Comparative Admission Rates by Method of Treatment 13 Admission Rates of Male Patients by Causes 14 Admission Rates of Female Patients by Causes 15 Comparative Admission Rates by Race, Sex and Cause 16 Relative Admission Rates of White Female Patients 17 Relative Admission Rates of Colored Female Patients 19 Statistical Basis of Hospital Efficiency 21 Comparative Mortality Rate, 1902-1911 21 Comparative Mortality Rate by Race and Sex 22 Variations in Methods of Statistical Treatment of Hospital Data 23 Variations in Death Rate According to Class of Patients Treated 23 Comparative Mortality Rates of White Patients by Sex 23 Variations in Mortality Rates according to Race and Sex 23 Comparative Mortality Rates of Colored Patients by Sex 24 Mortality Rate by Divisional Periods of Life 24 Comparative Mortality by Age, Race and Sex 25 Percentage Distribution of Causes of Admission, White Patients 26 Percentage Distribution of Causes of Admission, Colored Patients 27 Summary Comparison of Admissions by Race and Sex 28 Mortality Rate by Groups of Causes and Selected Diseases, White Patients 29 ii Contents. PAGE Table of Admissions and Mortality by Selected Causes, White Males 30 Table of Admissions and Mortality by Selected Causes, White Females. . 30 Table of Admissions and Mortality by Selected Causes, Colored Patients. 31 Observations on Possible Errors in Disease Classification 33 Comparative Mortality in Medical and Surgical Cases 33 Comparative Mortality, Medical and Surgical, in Appendicitis 33 Comparative Mortality, Medical and Surgical, in Tumors 35 Special Statistics of Admission and Mortality, Malignant Tumors 36 Comparative Mortality in Medical and Surgical Cases of Injuries 37 Comparative Mortality in Colored Medical and Surgical Cases 37 Mortality Rate in Gynecological and Obstetrical Cases 37 Some Anomalies in Hospital Experience 38 Some Dispensary Statistics 39 X-Ray Department Statistics 39 Financial Statistics 39 Average Number of Days of Treatment 40 Conclusions 40 Bibliography 42 Statistical Appendix 47 FACING CHARTS. page I. Hospital Admission Rates by Race and Sex 12 II. Morbidity from Six Principal Causes 26 III. Fatality Rates by Conditions on Admission 23 IV. Fatality Rates by Principal Causes on Admission 30 THE STATISTICAL EXPERIENCE DATA OF THE JOHNS HOPKINS HOSPITAL, BALTIMORE, MD., 1892-1911. By FREDERICK L. HOFFMAN, LL. D., Statistician, The Prudential Insurance Company of America. Introduction. — In few departments of statistical research is there more urgent need of improvement and reform than in the vast and almost unexplored domain of hospital experience. For reasons which cannot be discussed on this occasion, the statistical data of American hospitals have been a subject of almost universal indifference and, with few exceptions, the published data are of small, if any, practical utility. According to a table published in the Journal of the Ameri- can Medical Association of Nov. 9, 1912, there were in 1911, 4,292 hospitals and sanatoria in the United States, with a bed accommoda- tion of 2G0,643. In the census report for 1904, only 822 hospitals were enumerated, but the wide disparity in numbers is probably the result of differences in classification, since, evidently, the term " hospi- tal " is one which does not admit of precise definition. It is of inter- est, however, to note that the number of patients in the hospitals re- ferred to on Jan. 1, 1904, was 71,427 and that the number of patients admitted during the year was 1,064,512, leaving the number remain- ing on Dec. 31, 1904, as 71,530.* Importance of Hospital Statistics. — The census report contains no information of a medical character and no distinction is made as re- gards the class of patients admitted, or the method of treatment and * According to- an editorial in " The Modern Hospital," Sept., 1913, " There are in the United States 6,665 institutions of record for the care of the sick, with a total capacity of more than 600,000 beds. By a modest estimate, these huge figures represent a money investment in land, buildings, and equipment of not less than $1,500,000,000, and an annual outlay for maintenance approaching $250,000,000. " On the human side, there are more than 100,000 trustees of hospitals, and more than 65,000 physicians on hospital medical staffs. About 10,000,000 men and women contribute annually to hospital funds, and approximately 9,000,000 men, women, and children are patients in the hospitals in the course of each year." 2 Frederick L. Hoffman. results. It would, however, seem to require no argument to sustain the conclusion that accurate and trustworthy information concerning so important a subject as institutional treatment for disease or injury should be available in a concise and practically useful form. As a matter of fact, that is not the case for any state, or even city, of the United States at the present time, and, with few exceptions, the hospital returns, as published, are therefore of very limited practical value. At the same time, it may be said that the necessary scientific classification, tabulation and periodical publication of hospital statis- tics is neither a very difficult nor an expensive task, provided the work is done with the degree of medical and statistical skill essential to an investigation of this kind. Extent of Hospital Accommodation. — It has properly been pointed out by M. E. McCalmont, E. N\, in a suggestion for a 'Bureau of Hospital Information, that there are few commercial enterprises with such an enormous investment of capital as hospitals and allied insti- tutions in the United States. According to this writer, in an article in the Dietetic and Hygienic Gazette, the estimated investment repre- sents $537,000,000, and an annual expenditure of $107,000,000 for maintenance, enlargement and improvements. As a step towards in- creased efficiency and the protection of the public health, a resolution was adopted by the American Hospital Association, at its thirteenth convention, favoring a bill to be enacted by Congress, providing for the establishment of a Division in the United States Public Health Service, with power to collect and receive, and to classify and main- tain, in such manner as may be made accessible, all important infor- mation relating to hospitals throughout the United States, but with- out specific reference to the urgent need of a qualified statistical analysis of the medical and surgical experience data, which may safely be asserted to be of vastly more public importance than the facts of financial administration. Recalling, in this connection, an address on " The Relation of the Hospital to Medical Education and Research," by Dr. Wm. H. Welch, and published in the Journal of the American Medical Association, under date of Aug. 17, 1907, it may be pointed out that the truly enormous experience of American hospitals has not been made use of to anything like the possible and desirable extent that the public importance of the data demand. Practical Utility of Hospital Statistics. — The subject of hospital statistics and their practical utility has been before the public for Statistical Experience Data. 3 many years. Certainly as early as 1852, an important discussion was published on the Vital Statistics of the Eoyal Free Hospital, in a contribution to the London Journal of Medicine. In 1861 Dr. John Charles Steele, Superintendent of Guy's Hospital, London, read an admirable paper on " The Numerical Analysis of the Patients Treated in the Hospital for the Last Seven Years, 1854-1860," before the Eoyal Statistical Society, including a discussion of the essential facts concerning 32,813 patients, of whom 2,978, or 9.1 per cent, had died. The tabular analysis makes the proper and absolutely essential dis- tinction of medical and surgical cases, with a due consideration of the elements of age and sex, the classes of diseases treated, and the results. According to this analysis, the fatality rate during the years 1854- 1860 was 14 per cent for medical cases, against only 5.6 per cent for surgical cases; but a further inquiry disclosed the fact that in medical cases the fatality rate had been 15.8 per cent for males against 11.8 per cent for females, while in surgical cases the mortality rate had been 6 per cent for male patients and 4.2 per cent for female patients. The analysis, therefore, even at this early priod, conclusively estab- lished the fallacy inherent in nearly all modern hospital statistics, of combining the sexes in the published returns, and quite frequently, also, the medical and surgical cases. In brief, the whole problem of hospital statistics was precisely presented in Guy's Hospital experience, 1851-1860, according to which the average fatility rate for all patients, whether medical or surgical, had been 9.1 per cent. The fatality rate had been as high as 15.8 per cent for male medical cases and as low as 4.2 per cent for female surgical cases. Since these differences are disclosed by every qualified analysis of hospital experience, it is obvious that all hospital statistics which combine male and female patients, or medical and surgical cases, are more or less seriously mis- leading. It requires to be pointed out also that the disparity in the fatality rate becomes much more pronounced when the various diseases or surgical operations are separately considered, with a due regard to the sex, age, race, etc., of the several classes' of patients. At the present time, with the notable exception of The Johns Hopkins Hospi- tal, there are very few, if any, hospitals in the United States for which the required information is available, to show precisely the results of hospital treatment, and even for The Johns Hopkins Hospital the in- formation is not available in the published reports as regards the ages of patients, with reference to sex, color, diseases on admission, etc. 4 Frederick L. Hoffman. Need of Uniformity. — The paper by Dr. Steele was probably sug- gested by Florence Nightingale in a proposal made to the Fourth International Statistical Congress, held in London in 1860. The proposal, which was accepted by the Congress, included in a precise form a plan for uniform hospital statistics, amplified by a nomencla- ture of diseases, prepared by Dr. Farr. The following extract from the discussion upon the plan is of historical, as well as practical, interest : In the proposition made for a uniform scheme of hospital statistics by- Miss Nightingale, that lady points out the defective state in which the general condition of hospital statistics is at the present time, the absence of any common nomenclature or classification of disease, the want of uniformity in the manner of tabulating facts, and, as a consequence, the comparative inutility of the vast mass of facts which have been accumulating in the hospital books of every country where such establishments exist. To remedy this defect in the future, she proposes the adoption in all hospital records of the nomenclature of diseases agreed to at preceding meetings of the International Statistical Congress; and as a nomenclature without some classification would involve the use of tables of unmanageable dimen- sions, she proposes that the classification which is now familiarly known in this country through the Registrar-General's Reports, and which has also been adopted in America, should be used in hospitals for practical purposes — an arrangement by which the dimensions of the forms she recommends have been reduced one-half. These forms, before being printed for use, were tried in several large hospitals; and a number of interesting results, obtained by them in connection with the comparative frequency and mor- tality of diseases at different ages and in different sexes, are given by Miss Nightingale. Several improvements also suggested themselves in the course of this experience, the results of which were embodied in those tables, which were laid before the Section, and have been adopted by it. Elements of Hospital Statistics.— On April 16, 1867, Dr. Wm. A. Guy read a paper before the Eoyal Statistical Society on " The Mor- tality of London Hospitals," which remains to this day the classical illustration of statistical analysis of hospital experience data, with a due regard to all the essential factors more or less determining the rate of recovery and mortality in hospital experience throughout the world. The facts discussed by Dr. Guy were for the thirteen principal hospitals of the metropolis and for the period 1861-1865. The fatality rate for the combined experience was 9.7 per cent, but for medical cases the rate was 14.5 per cent and for surgical cases 6.5 per cent. The fatality rate was highest for male medical cases, or 17.4 per cent, and lowest for female surgical cases, or 6.1 per cent. Considering only Statistical Experience Data. 5 patients in " special wards," representing probably what are now known as " private patients," the fatality rate among this class was only 1.5 per cent. The analysis included also a study of the mean length of stay, or duration of institutional treatment, which was found to be twenty- eight days for medical cases, thirty-two days for surgical cases, and thirty days for all cases. A full discussion of this admirable paper is out of the question on this occasion, but it has seemed to me a fitting introduction to the present-day problem in the United States, of how the status of hospital statistics may be materially improved by an intelligent consideration of the essential facts which require to be taken into account. General Morbidity by Race and Sex. — In American morbidity expe- rience data, the elements of race and nativity require to be taken into account, in addition to the factors of sex, age, condition on admission, and mode of treatment. Particularly is this true for all our southern cities, where the negro population may be anywhere from one-tenth to two-thirds of the total population. For northern cities the race factor is frequently of less importance than the nativity of the patients, and in such cases at least a broad division should be made between the native and the foreign-born, with a possible subdivision for the leading nativities, typical of the community. It is most fortunate that in the published statistics of The Johns Hopkins Hos- pital the division by race has been maintained throughout, for with- out this distinction the statistical results would be of small value. Plan and Scope of NosograpJiy. — Aside from the required classifi- cation according to sex, age, race, and condition on admission, and whether medical or surgical, the proper nomenclature of diseases on admission is of considerable practical importance. Numerous attempts have been made for many years to provide a thoroughly satisfactory nomenclature of diseases, but none of the plans or systems of modern nosology can be considered entirely successful. The terminology, itself, is rather confusing, for while the term " nosography " stands for " a descriptive treatise on the character and nature of diseases," the term " nosology " stands for " the scientific classification of diseases," which, apparently, is the equivalent of " nosonomy," which, according to Gould, means " the nomenclature of diseases." " Nosonomy " also means " the study or science of the laws of disease," whereas " nosotaxy " is another term, according to Gould, for " the classifica- tion of diseases." The term " nosology " was adopted in the treatise 6 Frederick L. Hoffman. by William Cullen, published in Philadelphia in 1816,* and, being derived from the early Latin, this term would seem to be best descrip- tive of the systematic arrangement of diseases into classes, orders, genera and species, amplified by accurate definitions and required explanations. Bellevue Classification of Diseases. — It would carry me too far to discuss in detail the problem of disease nomenclature and classifica- tion. The classical discourse on the subject is an address by Dr. John W. S. Gouley, delivered before the New York State Medical Associa- tion on Sept. 28, 1887. Dr. Gouley favored the anatomical basis for a scientific classification of diseases. He defined the scope of nosography as including, first, the description; second, the definition; third, the nomenclature; and fourth, the classification, of diseases. To the nomenclature of diseases he gives the term " nosonomy," and to the classification of diseases the term "nosotaxy." It would be of value to have these terms better defined than is at present the case. As regards nomenclature and classification, I have accepted the Bellevue Hospital method, published in 1903, as most likely to be in conformity with present-day medical and surgical opinion. The classi- fication can also be coordinated with the international classification of causes of death, as adopted by the census office, and by practically all boards of health throughout the country 7 . Since this nomenclature and classification are in permanent use by one of the largest hospitals in the country,! it would seem best that other hospitals should conform, as near as practicable, to the Bellevue classification, so as to make the returns for the different institutions comparable. In any event, the Bellevue classification is a material improvement over the classifica- tion used in The Johns Hopkins Hospital statistics, and important technical difficulties in statistical treatment will be successfully over- come by its complete adoption by the hospitals of the United States and Canada. The Problem of Morbidity. — The problem of general morbidity (as differentiated from institutional morbidity), considered from a medi- cal as well as from an economic point of view, presents more serious scientific difficulties than the problem of mortality. The term " sick- ness " seems to defy precise definition, but what is called sickness * An earlier copy of this work was published in Philadelphia in 1793. t The classification has since been adopted by many others. Statistical Experience Data. 7 occurs more or less throughout life and the ultimate cause of death may not have a definite relation to any of the various illnesses that have preceded it. In a general way, it may be said that the rate of sickness increases with age in adult life, and while there is about one week's sickness per annum at ages 20 to 25, there is about four weeks' sickness a year at ages 55 to 59. The term " sickness," as here used, includes accidents. According to German experience, the proportion of cases of sickness among wage-earners is about 37.3 per cent per annum, and the average number of days of sickness is 20.1 per case.* Considered from this point of view, sickness is evidently an economic problem of great practical importance, and a reduction in the rate of sickness is at least of equal significance to a reduction in the death rate. It has been estimated that to every death there is about two years' sickness, but this is partly conjectural. There are no facts which warrant a precise conclusion as to what the average amount of sickness in the United States is at the present time, nor as to the distribution of morbidity by principal causes, such as is partly disclosed by an analysis of hospital experience.f The Registration of Diseases. — The first effort to bring about the registration of diseases appears to have occurred in 1855, when, at a meeting of the American Medical Association, held in Phila- delphia, Dr. J. G-. Orton, of Binghamton, 1ST. Y., introduced a reso- lution providing that " It shall be the duty of each member of this Society to keep a faithful record of the diseases which may fall under his observation during each month, according to the classification adopted by this Convention, in May, 1847, stating the age and sex, occupation and nativity of the patient, the average duration of the disease, and, finally, recovery or death, and to report the same, in writing, to the Secretary, on or before the first day of February of each year, who shall transmit a digest thereof to the State Medical Society and, also, to the appropriate committee appointed by the American Medical Association for its reception." The subject again came up for discussion as the result of an ad- dress before the American Medical Association, by Prof. A. B. Palmer, * See article on " The German System of Compulsory Sickness Insur- ance," The Spectator, New York, Nov. 21, 1912. f " Memorial to the President of the United States on the Appointment of a National Commission to Study the Subject of Occupational Diseases," published by The American Association for Labor Legislation, Jan., 1911. 8 Frederick L. Hoffman. of Michigan University, at a meeting held in Detroit, in 1856. In 1858, Dr. Thomas E. Brinsmade, of Troy, submitted an elaborate re- port on his own experience, 1837-1857, inclusive, exhibiting in detail the causes, and the mortality from the several causes, classified accord- ing to accepted standards, with fatality rates worked out for each group of diseases and amplified by returns in detail by ages, months, etc. The discussion reveals many interesting facts, and, if continued to the present time, would disclose with accuracy the profound changes which have taken place in the morbidity and mortality of the city of Troy during the long intervening period. The total number of cases of sickness reported by the doctor during the period 1837-1847 was 8,195, the number of deaths was 344, and the resulting fatality rate was 4.2 per cent. In 1859, Dr. William C. Rogers, of Green Island, Albany Co., N. Y., contributed an interesting address on the registration of diseases to the transactions of the New York State Medical Society, which included a brief review of previous efforts in this direction in England, with references to remarks on the subject in the British Med- ical Almanac for 1837 and the British and Foreign Medical and Chirur- gical Beview for the same year. A suggestive fact brought out by these extracts is the recognition of the value of hospital returns, properly classified, it being stated in part that " It is clear that the time is arriving when the medical officers of hospitals will find their best interests in rendering the facts which occur in these institutions as extensively useful as possible to the profession. System will enable them to offer these facts in the best form at the least trouble." (British and Foreign Medical and Chirurgical Review, 1837, p. 265.) Notification of Infectious Diseases. — In 1876, Dr. F. W. Draper contributed an important paper on the registration of prevalent dis- eases, published in the annual report of the Massachusetts State Board of Health. Practically coincident with Dr. Draper's appeal, a more successful effort was made in the state of Michigan for the registration of infectious and other diseases, morbidity statistics having been col- lected by Michigan since that date. Of course, the registration of prevalent infectious diseases is but a first step toward the required universal notification of all important diseases, which it would seem can only be brought about by the cooperation of medical practitioners on the basis of the method suggested as early as 1855 by Dr. Orton, of Bin^hamton, New York. Statistical Experience Data. 9 Advantages of Publication of Hospital Experience. — Although the registration of deaths in the United States is now inclusive of about 63% of the total population, the registration of infectious diseases is still in a rather backward state. Until notification and registration become more general and comprehensive, the chief reliance for a study of American morbidity must be the statistics of institutions and of life and health insurance companies. The study of the subject would be immensely facilitated by the publication of hospital experience data on a uniform basis, with a due regard to the elements of the problem, as previously discussed. The present waste of these disease records is lamentable from every point of view, and the time may come when the collective experience of practising physicians will be required to establish the true incidence of sickness as it prevails throughout the country and as it is conditioned by local circumstances. But a con- solidated report of hospital experience, for even a single city such as Baltimore, would be a genuine contribution to medical knowledge. If it is argued that such an effort would involve a considerable expendi- ture, it may be said that, in all probability, the cost would not be such a serious matter as is generally assumed, and that, in any event, hospital efficiency would be greatly increased and public apprecia- tion of hospital treatment would be materially enhanced by a precise and conclusive statement of facts which are at present unobtainable. Analysis of Population and Mortality Data. — In connection with a study of hospital experience data, it is necessary to take into account the factors of population, which vary sufficiently, in American cities, to affect the local hospital results. Having reference to the city of Baltimore, it appears that, according to the census of 1910, the total population of the city was returned as 558,485, of which 41.0 per cent were white males, 43.8 per cent white females, 7.0 per cent colored males and 8.2 per cent colored females. It is hardly necessary to point out that this population distribution of Baltimore is in marked contrast to the distribution of the population of a city like New York or Boston, where the proportion of negroes is materially less. The same conclusion holds true as regards the local death rate, and it may be stated in this connection that for the decade ending with 1911 the mortality of the white population of Baltimore was 17.8 per 1000, while for the colored population the death rate was 31.8, or 14.0 per 1000 in excess. The comparative death rates for tuberculosis were 17.0 per 10,000 for the white population, against 10 Frederick L. Hoffman. 51.8 for the colored; for typhoid fever the death rate was 3.2 for the white population, against 4.3 for the colored ; for cancer the death rate was 8.3 for the white population, against 6.5 for the colored; and for pneumonia the death rate was 14.9 for the white population, against 43.5 for the colored. These comparative rates indicate the material differences in the mortality of the white and colored population of Baltimore, and emphasize the necessity of differen- tiating, in hospital statistics, at least the factor of race and possi- bly the factor of nativity. The mortality rate, however, varies also according to sex; and this factor, perhaps more than any other, re- quires to be taken into account in hospital statistics, but, unfortu- natety, it is also one of the most neglected. According to the official statistics of Baltimore, the death rate from tuberculosis was 20.2 per 10,000 for the white male population, against 14.0 for white females; and 60.2 per 10,000 for the colored male population, against 44.6 for colored females. As regards cancer, the respective death rates were 6.4 per 10,000 for white males, against 10.1 for white females; and 3.7 per 10,000 for colored males, against 8.9 for colored females. Admission of Non-Residents. — The experience of every hospital is more or less modified by the admission of non-resident patients. The statistics of The Johns Hopkins Hospital do not separate the resident from the non-resident patients, nor would this seem absolutely neces- sary for the general purposes of hospital reports. In an effort, however, to ascertain the relative admission rate, the results are likely to be materially impaired by the admission of non-residents, who, of course, cannot be accurately correlated to the local population. There are also no data on the subject of hospital admissions by local residence, but, in the official returns, the deaths in Baltimore institutions are classified according to residents and non-residents, and the following state- ment is of considerable value. It appears that during the decade ending with 1910 the institutional mortality of Baltimore was 16.7 per 10,000 for the resident white population and 32.6 for the resident colored. The proportion of deaths of non-residents was 7.0 per 10,000 for the white population and 8.3 for the colored. The institu- tional mortality of patients who were residents of the city of Balti- more was, therefore, almost exactly twice as high for the colored as for the whites. Of the total institutional mortality of the whites 70.5 per cent were residents of Baltimore, and of the colored, 79.7 per cent. Since non-resident patients usually represent the more Statistical Experience Data. 11 serious cases, which are likely to be reflected in the hospital mortality, it is obvious that the proportion of non-resident patients should be stated in the general hospital returns, so that clue allowance may be made for this fact in the subsequent interpretation of the data.* Statistical Treatment of The Johns Hopkins Hospital Data. — As has been pointed out in the introductory discussion, the statistical treat- ment of hospital data is more difficult than is generally assumed, and particularly is this the case when the returns for single years are com- bined into a period of years. Xaturally, at the beginning of each new year there are a number of patients carried forward from the previous year. This remnant, together with the number admitted during the current year, constitutes the " total number treated." In the case of a single year that would properly constitute the statistical basis for the calculation of recovery or mortality rates. When, however, these returns are combined, it is obvious that there would be duplications, in that the number remaining at the beginning of the year would be counted over and over again. Therefore, in calculating the admis- sion and mortality rates for the decade, and with special reference to particular diseases or surgical operations, the proper statistical basis would appear to be the "number admitted" during each year, plus the number of patients remaining on hand at the beginning of the first year of the decade. This explanation seems necessary, since otherwise certain unavoidable differences in mortality rates may appear to be clerical errors or fallacies of statistical treatment. If the number remaining at the beginning of each year were excluded from the calculation of the rates for single years, and if such rates were calculated only from the number admitted during the year, it is self-evident that the rates would be too high. In any event, however, regardless of the methods adopted, the differences in the aggregate rates are not as a rule of material importance. * The details of the Baltimore hospital mortality rate, as derived from official returns, are as follows: Deaths in Hospitals by Residence, Baltimore, Md., 1901-1910. Aggregate Number of rjer H?000of Population. deaths. ^SK Resident whites 4,535,105 7,565 16.7 Non-resident whites 3,161 7.0 Resident colored 826,851 2,691 32.6 Non-resident colored 686 8.3 12 Frederick L. Hoffman. Limitations of Statistical Analysis. — The present general discussion of The Johns Hopkins Hospital data is limited to the 20-year period ending with January 31, 1912. Throughout, the distinction of race and sex is maintained in the returns, but the medical and surgical data in detail are considered only for the last decade, as a whole, since a treat- ment by single years would have unduly enlarged the present discussion, while probably adding little of material value to the results. The total number of male patients treated during the 20-year period was 41,026, and the total number of female patients was 41,399. In the first decade the males outnumbered the females, whereas in the last decade there was a slight excess of women patients. The number of male patients during the last decade exceeded by 25.3 per cent the number treated during the previous decade, whereas the num- ber of female patients during the last decade increased by 39.8 per cent over the number of patients treated during the previous ten years. The tendency has, therefore, been towards a larger increase in the number and proportion of female patients during more recent years of hospital experience. The information in detail by single years is given in Table 1 of the Statistical Appendix. Historical Review. — For a full understanding of the returns by single years, a brief historical account of the hospital during the last two decades would have been of value. It would carry me, however, entirely too far to enlarge upon this discussion at the present time. I have carefully read all of the reports, and, as a general conclusion, it may be stated that the financial difficulties through which the hospital has passed at different times are naturally reflected in the hospital accommodation and the number of patients treated. Comparative Admission Bates by Race and Sex. — The average admission rate to The Johns Hopkins Hospital during the decade ending with 1911 was 81.8 per 10,000 of population of the city of Baltimore, carefully estimated on the revised results of the census, and for intercensal years.* In proportion to the white male popula- tion, the admission rate was 79.9 and to the white female population, 70.4. In proportion to the colored male population, the admission rate was 99.9, and to the colored female population, 135.4. How far * Upon the basis of such information as I have been able to secure, the total number of patients treated in the large hospitals of Baltimore during 1911 was about 20,000, which would be equivalent to an institutional ad- mission rate (exclusive of dispensary cases) of 355 per 10,000 of population. Morbidity Experience 01 Baltimore, f Hospital Admission I Admissions per tO Mates 5S.0 44.9 Wl Mates SZ8 47.t Medicat Cases Surgicat Cases Gynecotogieat Cases Obstetric&t Cases Medicat Cases Snrg/cat Cases Gt/necofogicat Cases Otfstetricai Cases tVtrite Patients Mates 799 Femates 70.4 Co/ored Patients Mates 99.9 remotes t35.4 Col White at Johns Hopkins Hospital . 1902 — 1911 teg bti Race and Sex > Population fem&/es /6.6 wm 2/.s I 22.4 $2.9 38.2 Colored Statistical Experience Data. 13 these admissions are affected by other hospitals in Baltimore cannot be stated, since the information is not available as regards the total number of white and colored patients according to sex.- It is evident, however, that in The Johns Hopkins Hospital there is a tendency to admit colored females in larger proportion than either colored males or white males or females, for it is shown that the admission rate for this group of patients was nearly twice the rate for white women. The facts in detail are given in the table below : Comparative Admission Rates, Population.* White males 2,218,165 White females 2,365,045 Colored males 376,568 Colored females 451,700 1902-1911. .dmissions. Rate per 10,000 of population. 17,730 79.9 16,657 70.4 3,762 99.9 6,114 135.4 5,411,478 44.263 81.8 * For the ten years ending with 1911. Comparative Admission Rates by Method of Treatment. — Differ- entiating the admission rates according to the four classes of cases admitted — that is, for males, whether medical or surgical, and for females, whether medical, surgical, obstetrical or gynecological — the following comparison is of considerable interest: The admission rate for white medical cases was 35.0 per 10,000 for males, but only 16.6 for females. The admission rate for white surgical cases was 44.9 for males, but only 16.2 for females. But, in addition, there was a white female admission rate of 27.2 for gynecological cases and of 10.5 for obstetrical cases. Combining medical, surgical, and other admissions, it appears that the total admission rate was 79.9 per 10,000 for white males, against 70.4 for white females. Among the colored patients the admission rate for medical cases was 52.8 per 10,000 for males, against 21.8 for females. The admis- sion rate for surgical cases was 47.1 for males, against 22.4 for females. In addition thereto, the admission rate for gynecological cases was 52.9, and for obstetrical cases 38.2. Combining the admis- sions for medical, surgical, and other causes, the total admission rate was 99.9 per 10,000 for colored males, against 135.4 for colored females. 14 Frederick L. Hoffman. Combining the sexes, the total admission rate was 75 per 10,000 for the white population, against 119 for the colored. The facts in detail are given in the table below : Admissions to The Johns Hopkins Hospital, 1902-1911. White. Colored. Females. Males. Females. Class of eases. Admis- sions. Medical 7,770 Surgical 9,960 Gynecological Obstetrical Rate per 10,000. 35.0 44.9 Admis- sions. 3,925 3,821 6,426 2,485 Rate per 10,000. 16.6 16.2 27.2 10.5 Admis- sions. 1,988 1,774 Rate per 10,000. 52.8 47.1 Admis- sions. 986 1,013 2,388 1,727 Rate per 10,001. 21.8 22.4 52.9 38.2 Total 17,730 79.9 16,657 *70.4 3,762 99.9 6,114 *135.4 Admission Rates of Male Patients by Causes. — For the purpose of emphasizing more precisely the observed differences in the admission rates of white and colored patients, with distinction of sex, the fol- lowing facts are presented, with the required brevity. Considering first the male patients, it appears that for infectious diseases the white admission rate was 12.8 per 10,000, against a colored rate of 26.5. For digestive diseases, the white admission rate was 11.5, against a colored rate of 10.3. For diseases of the nervous system, the white rate was 6.8 per 10,000, against a colored rate of 3.0. For tumors, the white rate was 6.7 per 10,000, against a colored rate of 4.5. For injuries, the white rate was 6.5, against a colored rate of 8.3. For diseases of the circulatory system, the white rate was 5.3, against a colored rate of 15.4. For diseases of the reproductive organs, the white rate was 5.0, against a colored rate of 2.2. For all other causes, the white rate was 25.3 per 10,000, against a colored rate of 29.7. The most important differences in the male admission rates are found in the excess of admissions of colored males on account of infectious * Throughout the aggregate rates are the result of original calculations by division and do not represent the addition of the individual rates. In the present case the correct aggregate rates to the second decimal are 70.4 for white females and 135.4 for colored females, whereas the rates by simple addition would be 70.5 and 135.3, respectively. Statistical Experience Data. 15 diseases, injuries and circulatory diseases. An excess in the admis- sion rate of white male patients over the colored is observed in the case of diseases of the digestive system, nervous system, tumors, and diseases of the reproductive organs. In the case of certain special, or particular, diseases the following differences are suggestive : For appendicitis, the white male admission rate was 3.8, against 2.3 for the colored. For syphilis, the white rate was 1.2, against 2.7 for the colored. For tuberculosis of the lungs, the white rate was 1.1, against 2.6 for the colored. For other forms of tuberculosis, the white rate was "2.3, against 9.0 for the colored. For typhoid fever, the white rate was 3.1, against a colored rate of 6.1. For lung diseases, the white rate was 1.5, against a colored rate of 7.3. For kidney diseases, the white rate was 2.6, against a colored rate of 3.0. With the exception, therefore, of appendicitis, the admission rate for all of the special, or particular, diseases, separately considered, was excess- ive for colored males, and particularly so in the case of other forms of tuberculosis, typhoid fever and non-tubercular diseases of the lungs.* Admission Bates of Female Patients by Causes. — For female patients, the differences in the admission rates were as follows : For infectious diseases, the white female admission rate was 5.3 per 10,000 of female population, against 13.2 for the colored. For digestive diseases, the white female admission rate was 7.2, against a colored rate of 9.8. For diseases of the nervous system, the white female admission rate was 5.1, against a colored rate of 2.1. For tumors, including cancers of all forms, the white female admission rate was 7.3, against a colored rate of 16.6. For injuries, the white rate was 1.5, against a colored rate of 2.1. For diseases of the circu- latory system, the white rate was 1.3, against a colored rate of 3.7. For diseases of the reproductive organs, the white rate was 14.7, against a colored rate of 28.4. For obstetrical cases, thewhite rate was 12.6, * The practice of the hospital with reference to the admission of tuber- culosis patients is explained in the following official statement: " We have no definite rule about the admission of tuberculosis patients. We do not generally admit open tuberculosis cases into our public wards, but have been obliged, from time to time, to receive such cases when there has been some complication which necessitated either active medical or surgical treatment. It is fair to state that the ordinary consumptive, to use common language, is not admitted at all to the hospital." 16 Frederick- L. Hoffman. against a colored rate of 41.4. For all other causes, the white rate was 15.4, against a colored rate of 17.8. With the exception, therefore, of diseases of the nervous system, the rates were in excess throughout for female colored patients, but particularly so in the case of infectious diseases, tumors, diseases of the reproductive organs and obstetrical cases. Considering some of the diseases in detail, the following facts are of interest: For appendicitis, the white female admission rate was 2.9 against a colored rate of 2.1. For syphilis, the white rate was 0.3, against a colored rate of 1.5. For tuberculosis of the lungs, the white rate was 0.7 and the colored rate 1.7. For other forms of tuberculosis, the white rate was 1.5 and the colored rate 4.6. For typhoid fever, the white rate was 1.3 and the colored rate was 2.9. For lung diseases, the white rate was 0.4 and the colored rate 1.7. For kidney diseases, the white rate was 2.2 and the colored rate 1.9. With the exception, therefore, of appendicitis and kidney diseases, the admission rates were in excess for colored female patients, but particularly so in the case of syphilis, non-pulmonary tuberculosis, t3 7 phoid fever, and dis- eases of the lungs. Comparative Admission Rates by Race, Sex and Cause. — For the purpose of convenient comparison, the facts are summarized in the following two tables : Comparative Admission Rates (per 10,000 Population), White and Colored. Males. Causes. White. Infectious diseases 12.8 Digestive diseases 11.5 Nervous diseases 6.8 Tumors 6.7 Injuries 6.5 Circulatory system 5.3 Reproductive organs 5.0 Obstetrical cases All others 25.3 Total 79.9 99.9+ 70.4 135.4 + 1 females. Colored. White. Colored. 26.5 + 5.3 13.2+ 10.3— 7.2 9.8+ 3.0— 5.1 2.1— 4.5— 7.3 16.6+ 8.3+ 1.5 2.4+ 15.4+ 1.3 3.7+ 2.2— 14.7 28.4+ 12.6 41.4+ 29.7+ 15.4 17.8+ Statistical Experience Data. 17 Comparative Admission Rates (pee 10,000 Population), Special Causes, White and Colored.* Males. Females. , K -i / * « Special causes. White. Colored. White. Colored. Appendicitis 3.8 2.3 — 2.9 2.1 Syphilis 1.2 2.7+ 0.3 1.5+ Tuberculosis of lungs 1.4 2.6+ 0.7 1.7+ Other tuberculosis 2.3 9.0+ 1.5 4.6+ Typhoid fever 3.1 6.1+ 1.3 2.9+ Lung diseases 1.5 7.3+ 0.4 1.7+ Kidney diseases 2.6 3.0+ 2.2 1.9— Relative Admission Bates of White Female Patients. — Important variations in the admission rates are disclosed by an analysis of the separate causes, with the required distinction of sex and race. Since the facts are not available by divisional periods of life, a complete analysis is out of the question. The total admission rate for white males was 79.9 per 10,000 of population, while for white females the rate was 70.4. The admission rate for females was, therefore, 88 per cent of the male rate. Considering the group of infectious diseases, the admission rate was 12.8 for males, against only 5.3 for females. The female admission rate was, therefore, only 41 per cent of the male rate. For diseases of the digestive system, the male admission rate was 11.5, against a female admission rate of 7.2. The female admission rate was, therefore, 63 per cent of the male rate. For diseases of the nervous system, the male admission rate was 6.8 per 10,000, against a female admission rate of 5.1. The female admission rate was, therefore, 75 per cent of the male rate. For tumors, including under this term all tumors and cancers, whether benign or malignant, the admission rate for males was 6.7 per 10,000, against an admission rate of 7.3 for females. The female admission rate was, therefore, 109 per cent of the male rate. For injuries, the male admission rate was 6.5 per 10,000, against a female admission rate of only 1.5. The female admission rate was, therefore, only 23 per cent of the male rate. For diseases of the circulatory system, the male admission rate was 5.3 per 10,000, against a female admission rate of only 1.3. The female admission rate was, therefore, only 25 per cent of the male rate. * The plus and minus signs indicate the excess or deficiency, respectively, in the colored as compared with the white rates. 18 Frederick L. Hoffman. For diseases of the reproductive organs, the male admission rate was 5.0 per 10,000, against a female admission rate of 14.7. The female admission rate was, therefore, nearly three times the male rate. For obstetrical cases, the admission rate was 12.6 per 10,000 of female population. For all other causes and conditions, the male admission rate was 25.3 per 10,000, against a female admission rate of 15.4. The female admission rate for the group of all other causes, not conveniently admitting of a more extended discussion, was 61 per cent of the male rate. Considering a few of the principal diseases in detail, the following are of special interest and importance : For appendicitis, the male admission rate was 3.8 per 10,000, against a female admission rate of 2.9. The female admission rate for this disease was, therefore, 76 per cent of the male rate. For syphilis, the male admission rate was 1.2 per 10,000, against a female admission rate of only 0.3. The female admission rate for this disease was, therefore, only 25 per cent of the male rate. For tuberculosis of the lungs, the male admission rate was 1.4 per 10,000, against a female admission rate of only 0.7. The female admis- sion rate for this disease was, therefore, 50 per cent of the male rate. For other tubercular diseases, the male admission rate was 2.3 per 10,000, against a female admission rate of 1.5. The female admission rate for this group of diseases was, therefore, 65 per cent of the male rate. For typhoid fever, the male admission rate was 3.1 per 10,000, against a female admission rate of 1.3. The female admission rate was, therefore, 42 per cent of the male rate. For non-tubercular lung diseases, the male admission rate was 1.5 per 10,000, against a female admission rate of only 0.4. The female admission rate was, therefore, only 27 per cent of the male rate. For kidney diseases, the male admission rate was 2.6 per 10,000, against a female admission rate of 2.2. The female admission rate was, therefore, only 85 per cent of the male rate. According to this analysis, the relative admission rates were lower for females than for males for all specified diseases, with the exception of tumors and diseases of the reproductive organs. The most important variations are met with in the case of injuries, diseases of the cir- Statistical Experience Data. 19 culatory system, syphilis and non-tubercular lung diseases. How far these differences are the result of selection, or custom and local usage, can, of course, not be stated. In other words, the results are probably not entirely conclusive as regards the true relative incidence of particu- lar diseases among the two sexes, since for local, or hospital, reasons preference may be given to one sex or the other, in the admission for particular diseases, or causes, as the case may be. Relative Admission Rates of Colored Female Patients. — The total admission rate for colored males was 99.9 per 10,000 of population, while for colored females the rate was 135.4. The admission rate for females was, therefore, 136 per cent of the male rate. (This is in contrast to a white female admission rate of only 88 per cent of the white male rate.) Considering the group of infectious diseases, the admission rate was 26.5 for males, against 13.2 for females. The female admission rate was, therefore, 50 per cent of the male rate. For diseases of the digestive system, the male admission rate was 10.3 against a female admission rate of 9.8. The female admission rate was, therefore, 95 per cent of the male rate. For diseases of the nervous system, the male admission rate was 3.0 per 10,000, against a female admission rate of 2.1. The female admission rate was, therefore, 70 per cent of the male rate. For tumors, including under this term all neoplasms, whether benign or malignant, the admission rate for males was 4.5 per 10,000, against an admission rate of 16.6 for females. The female admission rate was, therefore, 369 per cent of the male rate. (This is in curious contrast to the relative white female admission rate for tumors of only 109 per cent.) For injuries, the male admission rate was 8.3 per 10,000, against a female admission rate of only 2.4. The female admission rate was, therefore, only 29 per cent of the male rate. For diseases of the circulatory system, the male admission rate was 15.4 per 10,000, against a female admission rate of only 3.7. The female admission rate was, therefore, only 24 per cent of the male rate. For diseases of the reproductive organs, the male admission rate was 2.2 per 10,000, against a female admission rate of 28.4. The female admission rate was, therefore, 1291 per cent or nearly thirteen times the male rate. (This, also, is in curious contrast to the relative 20 Frederick L. Hoffman. white female admission rate for diseases of the reproductive organs of 294 per cent.) For obstetrical cases, the admission rate was 41.4 per 10,000 of female population. Considering a few of the principal diseases in detail, the following are of special interest and importance : For appendicitis, the male admission rate was 2.3 per 10,000, against a female admission rate of 2.1. The female admission rate for this disease was, therefore, 91 per cent of the male rate. For syphilis, the male admission rate was 2.7 per 10,000, against a female admission rate of 1.5. The female admission rate for this disease was, therefore, 56 per cent of the male rate. (In contrast, the relative white female rate for this disease was only 25 per cent.) For tuberculosis of the lungs, the male admission rate was 2.6 per 10,000, against a female admission rate of 1.7. The female admission rate for this disease was, therefore, 65 per cent of the male rate. For other tubercular diseases, the male admission rate was 9.0 per 10,000, against a female admission rate of 4.6. The female admis- sion rate for this group of diseases was, therefore, 51 per cent of the male rate. For typhoid fever, the male admission rate was 6.1 per 10,000, against a female admission rate of 2.9. The female admission rate was, therefore, 48 per cent of the male rate. For non-tubercular lung diseases, the male admission rate was 7.3 per 10,000, against a female admission rate of 1.7. The female admis- sion rate was, therefore, only 23 per cent of the male rate. For kidney diseases, the male admission rate was 3.0 per 10,000, against a female admission rate of 1.9. The female admission rate was, therefore, 63 per cent of the male rate. The conslusions, as regards the ses differences in the admission rates for the colored population, are practically the same as for the whites. The most suggestive difference is found in the enormous disproportion of admissions of colored females for diseases of the reproductive organs, equivalent to 1291 per cent of the male admis- sion rate. A very substantial difference also exists in the admission rates for tumors, which, in the case of colored females, show an admission rate of 369 per cent of the colored male admission rate. As in the case of white admissions, the lowest relative rates for women are met with in the case of injuries and diseases of the circulatory system, and also in the case of non-tubercular diseases of the lungs. Statistical Experience Data. 21 How far these differences are the result of selection, etc., cannot be stated. Statistical Basis of Hospital Efficiency.— Qualified opinion differs as regards the most conclusive test of hospital efficiency. Perhaps no single test meets all modern requirements, but it has seemed best to limit the present considerations to the death rate. In view of the fact that in The Johns Hopkins Hospital statistics the number of patients " recovered and improved " is combined, it is evident that for medical purposes no precise conclusions can be based upon this term. The term " unimproved " is also subject to a certain degree of indefiniteness, but the number of such cases is relatively small, so that the resulting percentages would not be of much practical value. The number " not treated " is an additional indefinite element which, it svould seem, should be reduced to the lowest possible minimum. This group probably represents patients admitted, but subsequently found unsuitable for hospital treatment, or not in need thereof. The num- ber " transferred " is also relatively small, and since the reasons for transfers are not given, the group cannot be dealt with to practical advantage. The deaths, however, are a precisely defined and self- limited group, which, while comparatively small, yet represents, from the medical and hospital points of view, the most important test of institutional efficiency. In what follows, therefore, the discussion is practically limited to the mortality percentage, by groups of diseases and single causes, the percentage, unless otherwise stated, being based upon the total number admitted during the decade ending with 1911 and the total number of deaths during the same period.* The only exceptions to this rule are the first 23 tables, in which the rates are calculated upon the number treated, for reasons explained in the in- troduction. By limiting the discussion of the mortality by groups of diseases and single causes to a ten-year period, a much larger and more trustworthy basis of facts is secured, so that accidental fluctua- tions in the results are, as far as practicable, eliminated. Comparative Mortality Rate, 1902-1911. — The aggregate experience of The Johns Hopkins Hospital during the decade ending with Jan. 31, 1912, includes 22,819 male and 24,138 female patients. The average mortality rate, as determined on the basis of the total number of patients "treated," was 7.6 per cent for males and 4.1 per cent for females. During the preceding decade the male mortality rate was * See page 11 for full explanation. 22 Frederick L. Hoffman. 7.8 per cent and the female rate 5.1 per cent. The range in the male mortality rate has been from a maximum of 8.9 per cent during 1901- 1902 to a minimum of 6.1 per cent during 1910. The maximum mortality rate for female patients occurred in 1892, when it was. 6.0 per cent, and the minimum rate occurred in 1908, when it was only 2.9 per cent. Comparative Mortality Bate by Race and Sex. — Throughout the entire experience, the mortality rate of colored patients has been higher, and for both sexes, than the corresponding death rate of white patients. During the last decade, it appears that the white male death rate was 6.6 per cent, while for the colored patients it was 12.6 per cent; for white female patients the death rate was 3.6 per cent, against 5.3 per cent for colored female patients. The max- imum colored mortality rate for males occurred in 1901, when it reached 14.4 per cent; the minimum rate occurred in 1910, when it was 9.1 per cent. The lowest rate for colored male patients, how- ever, was still considerably in excess of the maximum mortality rate for white male patients. The maximum death rate for colored females occurred in 1892, when it reached 14.3 per cent, and the minimum rate occurred in 1908, when it was 3.8 per cent. The differences in the mortality rates of white and colored males are, therefore, much more pronounced than in the case of white and colored females, but practically throughout, the female death rates for colored patients have been considerably in excess of the corresponding rates for white female patients. A general summary of the facts is given in the table below, for the ten years ending with 1911 : Comparative Death Rates, White and Colored, The Johns Hopkins Hospital, 1902-1911. Total Total Patients. number number treated. of deaths. percentage. Mortality White patients: Males 18,792 1,235 6.6 Females 17,675 637 3.6 Total whites 36,467 1,872 5.1 Colored patients: Males 4,027 509 12.6 Females 6,463 342 5.3 Total colored 10,490 851 8.1 Total, white and colored. 46.957 2,723 5.8 Morbidity Experience 01 Baltimore, f Fata I i til Rates bi| C< Deaths per tOO Patient*. Mecficat Cases Surgicat Cases Gyneco/og/'cat Cases Obsfe/r/'eat Cases Medtcat Cases Surg/cat Cases Ggneco/ogicaf Cases Obstetrical Cases Mates 8.0 6./ W Mates t?.2 9.4 Col White an IVtf/te Patients Mates 2 Femates 3 Cotorect Patients Mates t3 Femates 5. Johns Hopkins Hospital 1. 1902 — 1911 dition on Admission Tdmifted of Eacft C/ass * ^ fe/n&fes 5.7 ed Fem&/es /6.8 7.6 2.9 1.6 Colored Statistical Experience Data. 23 Variations in Methods of Statistical Treatment of Hospital Data. — The foregoing mortality rates, however, require to be considered with caution, since they differ slightly from the rates subsequently to be given on the basis of the patients " admitted." For reasons previously explained, this difference cannot be eliminated from the present dis- cussion, in which the returns for a series of years have been combined into a group. Since the number admitted is always less than the number treated, which includes the number remaining from the previous year, the rates based on the number " admitted " are, there- fore, slightly higher throughout than the rates based on the number " treated." Variations in Death Rate According to Class of Patients Treated. — The death rate has varied considerably, according to the class of patients treated, whether medical, surgical, gynecological or obstetrical. In the experience of The Johns Hopkins Hospital the death rate was highest during the decade under review among colored male medical cases, or 16.2 per cent, and lowest for colored obstetrical cases, or only 1.5 per cent. Comparative Mortality Rates of White Patients by Sex. — The com- parative mortality rates of white patients are given in tabular form below : Comparative Mortality Rates,* White Pattexts, 1902-1911. Hales. . Females. Class of cases.' Treated. *™{« of Percent- ' treated. dumber/* *«£*-' Medical 8,213 624 7.6 4,186 223 5.3 Surgical 10,579 611 5.8 4,054 223 5.5 Gynecological .. 6,803 141 2.1 Obstetrical . . 2,632 50 1.9 Total 18,792 1,235 6.6 17,675 637 3.6 * On the basis of the number of patients treated. The diagram opposite exhibits the fatality rates on the basis of the number admitted. Variations in Mortality Rates According to Race and Sex. — This comparison conclusively proves the importance of differentiating in hospital statistics the mortality rates of the different classes of patients. It may, therefore, be laid down as an axiom that the general hospital death rate is misleading unless corrected for sex and race and the kind of treatment — that is, medical, surgical, etc. 24 Frederick L. Hoffman. Comparative Mortality Bates of Colored Patients by Sex. — For colored patients the facts in detail are given in tabular form below : Comparative Mortality Rates,* Colored Patients, 1902-1911. Males. Females. r * , t ' ■ 1 „, . „ . , Number of Percent- T „ ..,, Number of Percent- Class of cases. Treated. deaths. age. Treated. dea ths. age. Medical 2,109 342 16.2 1,046 166 15.9 Surgical 1,918 167 8.7 1,073 79 7.4 Gynecological . . 2,504 69 2.8 Obstetrical .. 1,840 28 1.5 Total 4,027 509 12.6 6,463 342 5.3 * On the basis of the number of patients treated. According to this table, the death rate of colored male medical cases was 16.2 per cent, against 8.7 per cent for surgical cases. For females, the respective percentages were 15.9 and 7.4. For colored gynecological cases, the death rate was 2.8, and for obstetrical cases, 1.5 per cent. Mortality Rate by Divisional Periods of Life* — On account of the required brevity, the fluctuations in the medical and surgical, as well as the gynecological and obstetrical, death rates, by single years, can- not be discussed. All the facts are given in full in Tables 2-12 of the Statistical Appendix, for the white patients, and Tables 13-23 for the colored. The same conclusion also applies to the consideration of the mortality by divisional periods of life, which, however, cannot be extended to causes of admission, since these facts are only given for all patients, considered as a group. Comparative Mortality by Age, Race and Sex. — The facts, in some detail, are given in the table below, but the data in full are given in the Statistical Appendix in Tables 6-12 for the white patients, and in Tables 17-23 for the colored patients. * The table below emphasizes the importance of giving the hospital admis- sions by causes with the distinction of age and sex. In the case of many diseases the fatality rate varies considerably according to age and this is particularly true, of course, for the acute infectious diseases of infancy and childhood. That these differences are considerable and important is Statistical Experience Data. 25 Comparative Mortality * by Age. White. Colored. * . *■ Ages. Males. Females. Males. Females. Under 15 8.9 9.3 11.0 11.6 15-24 3.5 2.0 10.3 2.4 25-34 4.0 2.1 11.8 3.8 35-44 6.4 3.6 13.7 8.7 45-54 8.0 5.5 16.5 13.5 55-64 9.3 7.3 14.7 14.4 65 and over 11.0 8.4 16.5 23.3 * Rates calculated on the number of patients treated. It is shown by the above summary table that the mortality rate was relatively high at ages under 15, or, respectively, 8.9. per cent for white male patients, and 9.3 per cent for white female patients, and 11.0 per cent and 11.6 per cent, respectively, for colored males and females. The mortality rate decreased during the next decade of life, increas- ing subsequently from decade to decade, and reaching a maximum for both races at ages 65 and over. The range in the mortality rates, how- ever, was much less for colored males, and throughout life the death rates for the colored were considerably in excess of the corresponding death rates for the white patients. clear from the following statistics compiled from the Reports of the Met- ropolitan Asylums Board, London, Bng. Comparative Mortality from Specified Acute Infectious Diseases, by Sex and Age, Metropolitan Asylums Board, London, Eng., 1910-1911. Diphtheria. Scarlet Fever. Measles. Whooping Cough. Ages. 1,362 297 31 Males. Under 5 1,854 214 11.5 2,727 139 5.1 5-9 1,502 92 6.1 3,491 49 1.4 10-19 571 12 2.1 1,649 17 1.0 20-over 167 3 1.8 417 5 1.2 All Ages ... 4,094 321 7.8 Females. Under 5 1,792 228 12.7 2,718 102 3.8 1,335 5-9 1,775 135 7.6 4,050 46 1.1 363 10-19 . 704 19 2.7 1,905 16 0.8 31 20-over 303 6 2.0 643 6 0.9 14 239 17.5 2.7 3.2 543 69 56 1 1 .. 12.7 1.8 8,284 210 2.5 1,698 248 14.6 600 70 11.7 217 11 16.3 3.0 579 67 2 71 4 12.3 6.0 All Ages 4,574 388 8.5 9,316 170 1.8 1,743 228 13.1 648 75 11.6 26 Frederick L. Hoffman. I am not aware of any corresponding information for other public or private hospitals of the United States, although as here shown the age factor is of considerable importance in determining the general death rate. Obviously, a hospital admitting a disproportionately large number of patients at ages 15-34, when the death rate is relatively low, must have a more favorable general death rate, without necessarily any reference to the true results of institutional treatment, than a hos- pital admitting an unduly large proportion of patients at ages under 15 or over 35, when the specific death rates, by divisional periods of life, are above the average for all ages. Percentage Distribution of Causes of Admission, White Patients. — In the concluding discussion of the mortality, by groups of diseases, or special causes, the mortality percentage is always determined on the basis of the number of " admissions." Before considering; the mortality rate by diseases in detail, however, it will serve a useful pur- pose to point out briefly the percentage distribution of principal causes of hospital admission , with a due regard to sex and race. Among white male patients, 16.0 per cent of the morbidity was due to infectious diseases, 14.4 per cent to diseases of the digestive system, and 8.6 per cent to diseases of the nervous system. These three groups of causes, therefore, accounted for 39.0 per cent of the morbidity from all causes. The ten specified causes given in the following table accounted for 83.1 per cent of the morbidity from all causes. Among the white female patients the principal cause of morbidity was diseases of the repro- ductive organs, or 20.8 per cent of the morbidity from all causes. The next most important group of disorders was obstetrical conditions, or 17.8 per cent, followed by cancers and tumors, with 10.4 per cent. These three groups of disorders, therefore, accounted for 49.0 per cent of the morbidity from all causes. The ten specified groups of causes, according to the table below, accounted for 84.8 per cent of the morbidity from all causes. Among other interesting facts, it is shown, by this comparison, that diseases of the reproductive functions * are of predominating importance among women, whereas, among white male patients, injuries are of the fifth order of importance, accounting for 8.1 per cent of the morbidity f from all causes, against 2.1 per cent for female patients. Another significant feature of the morbidity of * In hospital experience. f The term morbidity is here used in a general sense and includes injuries as well as diseases and non-pathalogical reasons for admission. Morbidity Experience o Baltimore, Morbidifij from ondrf/o/?s 0/ooct -rOHI^HHJMB Lung /d. 6 HH^HH Luny ^HHHB f/zdocanf/i/n?, Vd/ves 16. J ■■■■■■ Bndocard/um. Va/ves JBiBHm Bra//?. dp//?a/6ord /j.o^KKKKM Bra//?. Spins/ Cord /?. o ■Baaam /njur/es //. 7 ■■■■■ L/ver . : ;jHHH 7umord. Ma/ignanf /o. 7 ■■■■ 7uff?or<5,ffy//(j/?ant ,/ : /HIMRn Meercu/oj/ereii/om. Otter ,-.'!Hni 7umor<5. Ben/g/? s.sWtk 7u/?ercu/os/a, Lungs zzVM Ga// B/ddder. Di/efe zsWM 7yp/?o/d Fever tsWKKM Jveraoe.M Causes 3.8TH J/veraye, MGsuses zohzd Bo/?e& 3.6WM Proj/d/e O/dnd s.ewtk 7fiyro/d G/e/eura 4.7WM OMetr/ca/ 2.0W Ure/Ars 4.0WM *tfppe/?d/x /.iM J/ppend/x &m Vap//?a //■ cS/omacfi 3.0M B/adder /./■ Bronc///. Trachea &m rf/hd &?m <£ypftr///&, Benign ..■Di id £?■■■ Jfverjge, MGszm ^£=3 e/o/nfe ^■B 73mo/&. Benign ^■1 fiectum, JFnusS J^BI VdfflPd /?.?■§ ffern/j /»■ Ovjr/&j, 7ui>eef /£■ OAsfefrfcs/ /£■ Statistical Experience Data. 31 been tabulated with reference to diseases represented by more than 250 admissions : Admissions and Mortality by Selected Causes, 1902-1911. white females. _ . , , Number of Number of p„-„„„(.„ . Selected causes. admissions. deaths. Percentage. Appendicitis 678 8 1.2 Gall bladder and duct 311 15 4.8 Thyroid gland 368 11 3.0 Tuberculosis (non- pulmonary) 353 29 8.2 Typhoid fever 307 18 5.9 Diseases of the joints 265 2 0.8 Diseases of the mind 274 1 0.4 Functional nervous diseases . . 913 3 0.3 Functional diseases of repro- ductive organs 624 1 0.2 Ligaments, tubes, ovaries. .. . 1,256 27 2.1 Uterus 856 4 0.5 Vagina 611 7 1.1 Benign tumors 750 39 5.2 Malignant tumors 981 105 10.7 Diseases of the kidneys 521 40 7.7 Obstetrical conditions 2,973 59 2.0 Injuries 350 41 11.7 Note. — This table includes all causes represented by more than 250 admissions. Table of Admissions and Mortality by Selected Causes, Colored Patients. — The morbidity distribution for colored patients is somewhat less varied than for the whites, but the mortality differences for the two sexes are equally pronounced. For diseases of the circulatory system the mortality was 19.1 per cent for colored males, against 21.8 per cent for colored females. For diseases of the digestive system the respective death rates were 8.0 per cent for males and 9.3 per cent for females. For infectious diseases the mortality percentages were 14.4 for males and 10.2 for females. For diseases of the nervous system the male mortality percentage was 18.7 and the female 29.8. Considering diseases of the brain and spinal cord separately, the mortality rate for males was 33.3 per cent, against 55.8 per cent for females. For diseases of the reproductive organs the mortality was 14.8 per cent for males, against only 1.3 per cent for females. For diseases of the respiratory system the death rate for males was o^ Frederick L. Hoffman. 17.9 per cent, against 21.2 per cent for females. For tumors, both benign and malignant, the mortality percentage was 20.0 for males, against 6.0 for females. Considering benign tumors separately, the mortality rates were 5.9 per cent for males, against 4.0 per cent for females. For malignant tumors the death rate was 26.1 per cent for males, against 11.3 per cent for females. For diseases of the urinary organs the mortality was 17.5 per cent for males, against 13.6 per cent for females. For obstetrical conditions the colored female mortality rate was 1.6 per cent. For injuries the male mortality rate was 4.5 per cent and the female rate 14.0 per cent. The following table will show in some detail, for colored males, the principal causes of admission, represented by more than 200 admissions : Admissions and Mortality by Selected Causes, 1902-1911. colored males. •„ , , , Number of Number of D .„ +„„.„ Selected causes. admissions. deaths. Percentage. Arteries, veins 316 60 19.0 Endocardium 214 44 20.6 Tuberculosis (non- pulmonary) 340 56 16.5 Typhoid fever 231 29 12.6 Diseases of the lungs 274 61 22.3 Injuries 312 14 4.5 Note. — This table includes all causes represented by more than 200 admissions. The table which follows gives the same information for colored females, but only for causes represented by more than 100 admissions : Admissions and Mortality by Selected Causes, 1902-1911. colored females. Selected causes. ^ons. ^TatrT* Percentage. Rectum and anus 124 4 3.2 Tuberculosis (non- pulmonary) 209 22 10.5 Typhoid fever 129 12 9.3 Ovaries, tubes 953 15 1.6 Uterus 123 Benign tumors 545 22 4.0 Malignant tumors 203 23 11.3 Obstetrical 1,868 30 1.6 Injuries 107 15 14.0 Note. — This table includes all causes represented by more than 100 admissions. Statistical Experience Data. 33 Observations on Possible Errors in Disease Classification. — On. account of the required brevity, a discussion in detail of the mortality percentages for medical, surgical, gynecological and obstetrical cases has to be omitted. All the facts are given in full in Tables 42, 43, 44 and 50, 51 and 52 of the Statistical Appendix. The diseases in these tables have been arranged alphabetically, as given in the annual reports of The Johns Hopkins Hospital. For some purposes, however, the summary tables will be more useful than the others. Since the precise meaning of medical and surgical cases cannot always be given, it is obvious that for certain purposes these cases require to be combined, and the same holds true of gynecological cases, also. In the alphabeti- cal arrangement of the causes of admission, I have combined many equivalent terms which were separately given in the orginal reports, such for illustration as whooping cough and pertussis, etc. Such needless and confusing repetitions are entirely avoided by the use of the Bellevue classification. Comparative Mortality in Medical and Surgical Cases. — The com- parative mortality rate in medical and surgical cases, due to the same disease, is, of course, a matter of special interest from a medical and surgical point of view. For the present purpose the comparison is necessarily limited to a few typical illustrations, and, unless other- wise stated, the observations have reference to white patients only. In typhoid fever the mortality rate in white male medical cases was 4.4 per cent, against 59.0 per cent for surgical cases. For white females the percentage was 4.8 for medical cases, against 36.4 for surgical cases, but it should be understood that the actual number of surgical typhoid fever cases was relatively small. Comparative Mortality, Medical and Surgical, in Appendicitis.- — In appendicitis the mortality rate in medical cases was 2.3 per cent for white males, against a surgical mortality rate of 3.5 per cent. For white females the mortality rate was nil in medical cases and only 1.5 per cent in surgical cases. On account of the medical and surgical significance of this disease, I give the facts for both the white and the colored patients in tabular form, as follows : 34 Frederick L. Hoffman. Mortality Rate in Appendicitis, The Johns Hopkins Hospital, 1902-1911. white patients. Males. Females. m ,„„„, Number of Number of p „ r „ u „ taa .„ Number of Number of pt Class of cases. admissions . deaths . Percentage. adlrissions . de aths. Percentage Medical 44 1 2.3 42 Surgical 796 28 3.5 410 6 1.5 Gynecological .. .. 226 2 0.9 Total 840 29 3.5 678 8 1.2 COLORED PATIENTS. Medical 5 1 20.0 5 Surgical 80 9 11.3 50 7 14.0 Gynecological . . . . 40 3 7.5 Total 85 10 11.8 95 10 10.5 This table, in addition to the medical and surgical cases, gives also, for both white and colored women, the gynecological cases compli- cated by appendicitis. The relatively high mortality rates for the colored are of special significance. For diseases of the stomach the mortality rate in white male medical cases was 0.6 per cent, against 11.8 per cent in surgical cases. For white females the respective mortality rate was nil for medical cases and 21.1 per cent for surgical cases. For syphilis the mortality rate was 2.0 per cent in white male medical cases, against 2.9 per cent in surgical cases. For tuberculosis of other forms (excluding tuberculosis of the lungs, tuberculosis of the meninges, and miliary tuberculosis), the mortality rate of white males was 17.9 per cent for medical cases, and 2.5 per cent for surgical cases. The corresponding mortality rates for white females were 17.4 per cent for medical cases, 2.1 per cent for surgical cases, and 5.9 per cent for gynecological cases. For diseases of the brain and spinal cord the mortality rates were 13 per cent for white male medical cases and 23.7 per cent for surgi- cal cases. The corresponding mortality rates for white females were 12.7 per cent for medical cases and 14.5 per cent for surgical cases. For diseases of the reproductive organs the mortality rates fox white males were 4.2 per cent for medical cases and 4.1 per cent for surgical cases. The corresponding mortality rates for white females Statistical Experience Data. 35 were nil for medical cases, 1.8 per cent for surgical cases, and 1.1 per cent for gynecological cases. For diseases of the respiratory system the mortality rates for white males were 11.7 per cent for medical cases and 7.1 per cent for surgical cases. The corresponding rates for white females were 10.4 per cent for medical cases, 2.9 per cent for surgical cases, and nil for obstetrical cases. Comparative Mortality, Medical and Surgical, in Tumors. — For tumors the facts are of such exceptional interest that the information is given in tabular form below, according to sex and race, with distinc- tion of benign and malignant tumors, subsequently to be discussed in more detail: Mortality Rate in Tumors, The Johns Hopkins Hospital, 1902-1911. benign tumors, white patients. Males. Females. ™„„„ .„„,„„ Number of Number of n„..^„_, Number of Number of „ Class of cases. admissions . deaths . Percentage. admissionS- deaths percentage. Medical 65 5 7.7 44 5 11.4 Surgical 372 41 11.0 218 19 8.7 Gynecological . . . . 488 15 3.1 Total 437 46 10.5 750 39 5.2 MALIGNANT TUMORS, WHITE PATIENTS. Medical 256 38 14.8 93 14 15.1 Surgical 803 121 15.1 485 46 9.5 Gynecological . . . . 403 45 11.2 Total 1059 159 15.0 981 105 10.7 BENIGN TUMORS, COLORED PATIENTS. Medical 11 1 9.1 16 2 12.5 Surgical 40 2 5.0 47 1 2.1 Gynecological .. .. 482 19 3.9 Total 51 3 5.9 545 22 4.0 MALIGNANT TUMORS, COLORED PATIENTS. Medical 37 8 21.6 13 3 23.1 Surgical 82 23 28.0 88 8 9.1 Gynecological • • • ■ 102 12 11.8 Total 119 31 26.1 203 23 11.3 36 Frederick Li Hoffman. These tables are self-explanatory and require no extended discus- sion. The results are rather conflicting and not entirely conclusive. For illustration, the mortality rate in benign tumors was 7.7 per cent for white medical cases, against 11.0 per cent for surgical cases: but for white females the mortality rate for medical cases was 11.1 per cent, against 8.7 per cent for surgical cases and 3.1 per cent for gynecological cases. For malignant tumors the mortality rate for white male medical cases was 11.8 per cent, against 15.1 per cent for surgical cases; but the corresponding rates for white females. were 15.1 per cent for medical cases, 9.5 per cent for surgical cases, and 11.2 per cent for gynecological cases. Some interesting con- trasts are presented in the white and colored mortality rates, but these cannot be discussed here in detail. Xor is it possible, on account of the required brevity, to enlarge upon the mortality rate in the dif- ferent forms of cancer, which, however, are given in full detail in the alphabetical tables of the Statistical Appendix (Tables 12-11 and 50-52). Special Statistics of Admission and Mortality. Malignant Tumors. — - To facilitate the study of the statistics of malignant tumors, I have abstracted the same from the annual reports, separately, by single years. The facts are given in detail in Tables 51-57 of the Statisti- cal Appendix, together with the admission rates per 10,000 of popu- lation, and the mortality rates according to color and sex. Having reference only to the death rate, it is shown that for all cases of malig- nant tumors combined, the rate has remained practically the same for white patients, but for colored patients the rate has increased for males, but decreased considerably for females. The admission rates for malignant tumors have increased for white male patients from 1.1 to 1.8 per 10,000 of population, comparing the last ten years with the previous decade, but the admission rates decreased for white female patients from 5.8 to 1.2. For colored male patients the admission rates have increased from 2.3, during the first decade, to 3.2 during the last, but for colored females the admission rates increased only from 1.1 to 1.5. As shown in the preceding table, the number of admissions of female colored patients for benign tumors has largely exceeded the admis- sions for malignant tumors, or, to be precise, the former numbered 545 during the last decade, against 203 for the latter. In contrast, the number of white females admitted for malignant tumors consider- ably exceeded the number of patients admitted for benign tumors. Statistical Experience Data. 37 or, to be precise, the former numbered 981, against 750 for the latter. In the case of both white and colored males the number of admissions for malignant tumors far exceeded the number of admissions for benign tumors, but at present no explanation can be given for these rather curious, though interesting, differences in the tumor admission rates, according to color and sex. Comparative Mortality in Medical and Surgical Cases of Injuries. The discussion of the comparative mortality of medical and surgi- cal cases must here be concluded by a brief reference to injuries. For white males the mortality rate in injury cases was 5.3 per cent for medical cases, against 5.6 per cent for surgical cases. The corre- sponding mortality rate for females was nil for medical cases, but 12 per cent for surgical cases. Comparative Mortality in Colored Medical and Surgical Cases. — It would not seem necessary to discuss in similar detail the compara- tive mortality of colored medical and surgical cases, except as has been done in the tabular presentation of the experience data for appendicitis and tumors. As has been pointed out, the terms medical and surgical are not precisely defined, and it is quite possible that serious medical cases have been reported as surgical, merely because of some simple, but necessary, surgical operation. It would be a most useful contribution to medical knowledge if a better definition of these terms were adopted, if only as an aid to a more satisfactory statistical classification. Mortality Bate in Gynecological and Oostetrical Cases. — To a cer- tain extent, the same conclusion applies to gynecological cases, which, as shown by the tables, include a large variety of diseases and com- plications, not necessarily peculiar to the sex. For obstetrical cases, however, I have prepared two special tables, showing details of special interest and importance. The tables are self-explanatory and require no extended discussion. For white patients the mortality rate in cases of operative labor was 4.5 per cent, while for colored patients the rate was 6.9 per cent. For spontaneous and premature labor the mortality rate was 1.8 per cent for white patients, against 2.7 per cent for colored. In further contrast, however, in cases admitted in a post-partum condition, the death rate was 16.7 per cent for white patients, against 28.6 per cent for the colored. Because of the peculiar fact, for which I am not prepared to offer an explanation, that the class of patients admitted varied considerably for the two races, the 38 Frederick L. Hoffman. death rate for all cases is higher for white obstetrical cases (1.9 per cent) than for the colored (1.5 per cent). This difference provides an excellent illustration of statistical fallacies, when conclusions are arrived at upon the basis of mere numbers, without reference to the constituent units, which should always be taken into account and subjected to critical analysis. If the number of white obstetrical cases admitted had been distributed according to the condition on admission, in the same manner as the colored, the corrected white death rate would have been 1.4 per cent, instead of 1.9 per cent, as actually shown, according to the tables. If the colored admissions had been distributed in the same manner as the white patients, the corrected colored death rate would have been 2.0 per cent, instead of 1.5 per cent, as shown, according to the tables. In part, this curious result is due to the fact that the proportion of cases of operative labor was 15.4 per cent of the total for white patients, against 12.1 per cent for the colored. Since the death rate in this group is con- siderably above the average, the rate for all cases is materially increased by this larger proportion. The same is true of cases of abortion, which, for white patients, formed 10.8 per cent of the total, against only 6.2 per cent for the colored. The death rate in this group was 4.7 per cent for the white patients, against only 1.1 per cent for the colored. The tables are an interesting contribution to obstetrical knowledge and are deserving of careful study, with the suggestion of a more extended inquiry into the mortality in preg- nancy according to race. Some Anomalies in Hospital Experience. — There are many other in- teresting anomalies in the actual and relative admissions for specified causes, according to sex and race, but since all of the facts are given in detail in the alphabetical tables, they need only be very briefly referred to. Perhaps the most interesting disclosure of the analysis is the much higher proportion of male admissions for pernicious anaemia, amoebic dysentery, catarrhal jaundice, malarial fever, and other diseases probably of tropical or subtropical origin. These admissions are of more than local significance, since it is practically certain that many Americans returning from the Panama Canal Zone, Porto Eico, Cuba, etc., are materially impaired in health on account of tropical residence. Another suggestive contrast in the number of admissions is found in exophthalmic goiter, although it is well known that this affliction is more common among women Statistical Experience Data. 39 than men.* Finally, attention may be drawn to the fact that there were 37 admissions on account of lead-poisoning for white males, against only one such admission for white females. A further analysis by occupations could possibly be made, which would add to our in- formation regarding the occurrence of industrial lead-poisoning in different sections of the country. Dispensary Statistics. — The statistics of institutional morbidity, as thus far discussed, are more or less impaired in value by the fact that they do not include the entire hospital admissions of the city of Baltimore, and furthermore by the omission of dispensary cases, which, no doubt, include many patients more or less suitable for ward treatment. It has not been feasible to give extended con- sideration to the dispensary statistics, partly because the informa- tion is not given by race, which, as pointed out in the earlier dis- cussion, is absolutely essential for a full understanding of the relative importance of particular facts. It has seemed, however, ad- visable to bring the available statistics together in a form convenient for future reference, and, accordingly, the facts are presented in Tables 62-70 of the Appendix. The tables differentiate the patients treated in the fourteen departments, excluding the statistics of the Eoentgen-ray treatment, radiographs, and fluoroscopic examinations, which are given in detail in Table 71. It need only to be stated that the number of dispensary cases increased from 592,458, during the decade ending with 1901, to 720,674, during the decade ending with 1911, to emphasize the practical importance of a complete analysis of hospital statistics of this kind. X-Ray Department Statistics. — With reference to the statistics of the X-Ray Department, it may be stated that during the period 1903- 1911, 476 cases were treated, including 7,282 treatments, and 15,026 radiographs were made and 995 fluoroscopic examinations. Financial Statistics. — It has also not been feasible to present an analysis of the financial statistics of The Johns Hopkins Hospital, which have only been given in detail in the report for 1912, but in an admirable manner, with the comparative data for the four previous years. These tables are self-explanatory and emphasize some of the more important facts of hospital experience from a financial point of view, it being shown, among other facts, that the average gross cost * The admission rate for white males being 0.3 per 10,000 of population as against 0.1 for colored males; and for white females 1.0 against 0.2 for the colored. 40 Frederick L. Hoffman. per patient per day increased from $2.88 in 1907 to $3.61 in 1911, and the net cost increased from $1.26 in 1907 to $1.69 in 1911. An excellent table contained in the 1912 report gives the expenses of the hospital, in detail, for all of the important items, and also for the five-year period 1907-1911. In course of time this information must become exceedingly valuable to the student of hospital economics, efficiency and methods of treatment, related to cost.* Average Number of Days of Treatment. — For the purpose of pre- senting in a convenient form the aggregate experience of The Johns Hopkins Hospital during the last twenty years, with reference to patients treated and the number of days of treatment, as well as the average for each } r ear, I have abstracted the required information from the several annual reports, and the same are given in detail in Table 61 of the Statistical Appendix. According to this table, the average number of days of treatment decreased from 24.2 during the first decade to 22.1 during the last. The highest average occurred in 1892, or 27.4 days, and the lowest in 1911, or 19.3 days. Unfor- tunately, the number of days of treatment is not given by particular causes, which for medical, as well as for economic, purposes would be quite useful. It is well known, of course, that the average dura- tion of sickness varies with the different causes of sickness, but con- cerning the exact duration there is as yet, at least for the United States, very little trustworthy information. To provide the data for an estimate as regards the economic cost of sickness, it is necessary that the duration of sickness, whether institutional or otherwise, as well as the approximate cost thereof, should be known. Given the average duration and the average cost per patient per day, it is feasi- ble to calculate the economic cost of sickness due to particular causes with approximate accuracy, which is about all that is required to be shown. Conclusions. — In concluding this analysis of The Johns Hopkins Hospital experience, I desire to express my profound appreciation of the person, unknown to me, who, with remarkable foresight, estab- lished the existing statistical basis for an intelligent presentation of the facts. I am not aware of any other hospital in the United States for which the required information is presented in an equally admi- rable manner, and out of the experience of which so much useful in- formation can be drawn, not only for the benefit of the student of * See table 72 of the Statistical Appendix. Statistical Experience Data. 41 medicine and surgery, but also for students of economics and insur- ance. If the analysis, as here presented, facilitates the scientific study of medicine in its larger aspects as a community problem, I shall feel amply repaid for the labor necessary to present the facts in a more convenient form than in the annual reports, which must necessarily be accessible only to the few. Much, however, is gained by a consoli- dation of the facts for a period of sufficient length, and I feel that the combined data for the last decade meet all reasonable statistical, as well as medical, requirements. By presenting the experience of a large hospital, typical of modern methods of medical and surgical treat- ment, in a convenient form, a basis has been provided for a begin- ning, at least, in modern uniform hospital statistics, which are abso- lutely necessary as an aid towards the study of medical problems in their relation to broad questions of public policy. It is also to be hoped that as the result of this investigation The Johns Hopkins Hospital may be induced to adopt the Bellevue Hospital classification, as prac- tically the most suitable for medical and other purposes. In return, the hope may be indulged that Bellevue Hospital, and other great hospitals throughout the country as well, may be induced to adopt, in their reports, the method of statistical presentation which has been suc- cessfully carried forward from year to year by The Johns Hopkins Hospital from its beginning, and which, if adopted by other insti- tutions, would bring order out of chaos and make the enormous amount of hospital experience really useful to the student of medi- cine, as well as of many other branches of learning, vitally interested in the facts which have a much broader social and economic signifi- cance than is usually assumed to be the case. 42 Frederick L. Hoffman. List of Eeferences to Address on the Statistical Experience Data of The Johns Hopkins Hospital, 1892-1911. The Eelation of the Hospital to Medical Education and Eesearch, by William H. Welch, M. D., Journal of the American Medical Association, August 17, 1907. Comparative Study of the Eoutine Treatment of Certain Diseases in Four of the Large New York Hospitals, by Henry P. Loomis, M. D., New York Medical Eecord, January 10, 1903. A Bureau of Hospital Information, by M. E. McCalmont, The Dietetic & Hygienic Gazette. Symposium on Hospital Statistics, etc., Journal of the American Medical Association, November, 1912. Eeport on Death Certification, ordered to be printed by the House of Commons, August 15 and September 1, 1893, London, 1893. A Plea for a More Liberal Nomenclature of the Naval Medical Service, Navy Medical Bulletin, January, 1912. Nomenclature of Diseases Prepared for the Use of the Medical Offi- cers of the United States Medical Hospital Service, Washington, 1874. International Classification of Causes of Sickness and Death, pub- lished by the Division of Vital Statistics, Bureau of the Census, Washington, 1910. Annual Eeports of The Johns Hopkins Hospital, 1892-1911. Tenth Annual Eeport Bellevue and Allied Hospitals, State of New York, 1912. Discussion on Nosography, Transactions New York State Medical Association, 1888. Practical Conditions Concerning the Human Nosography, by J. W. S. Gouley, Transactions of the International Medical Congress, Washington, 1887. Address on Human Nosography, by J. W. S. Gouley, M. D., New York State Medical Association, 1887. * The list of references includes quite a number of works not referred to in the text but made use of in the preparation of the paper, with particular reference to the importance of disease registration and the practical utility of institutional and other morbidity records as an aid towards the more suc- cessful solution of pressing problems of labor, social service, medicine, public health and insurance. Statistical Experience Data. 43 Nomenclature for the Different Classes of Infectious Diseases, by W. H. Thomson, Transactions New York Academy of Medicine, 1894. Statistics of Health, by T. E. Edmonds, Report of the Proceedings of the Fourth Session of the International Statistical Congress, London, 1861. Eeport on Nomenclature of Diseases, by Dr. Francis G. Smith, New York Medical Record, 1872. The Budapest System of Death Classification, by Frederick L. Hoff- man, American Journal of Public Hygiene, February, 1910. Eeport of Committee on Classification of Diseases and Causes of Death, Proceedings American Association of Medical Examiners, June, 1909. Eeport of Committee on Scientific Nomenclature, ^sew York Medical Eecord, June 12, 1909. Unsatisfactory Eeturns of Causes of Death, Monthly Bulletin of the State Board of Health of Michigan, December, 1908. A Simple, Efficient, and Elastic System for Indexing Case Histories and Filing Current Literature and References, New York Medi- cal Record, November 2, 1912. Report of the Committee on Clinical Nomenclature, Vincent Y. Bowditch, Chairman (n. d.). The Nomenclature and Classification of Diseases, by Surgeon-Gen- eral George M. Sternberg, U. S. Army, March, 1895. The Nomenclature of Diseases, Journal American Medical Associa- tion, August 8, 1896. Report on the Registration of Prevalent Diseases, by T. W. Draper, M.D., Boston, 1876. Systematic Study of the Causes of Sickness and Death, by H. B. Baker, M. D., Lansing, Mich., 1881. Digest of the Laws and Regulations of the Various States Relating to the Reporting of Causes of Sickness, by John W. Trask, Government Printing Office, Washington, 1911. Some of the Defects in the Present System of Registration of Deaths in England and Wales, by Arthur Ransome, Manchester, England, 1867. Inquest Under National Authority, Senate Report, No. 517 Fiftieth Congress, First Session, March 12, 1888. 44 Frederick L. Hoffman. A Eeport on a Uniform System of Eegistration of Causes of Death Throughout the United States, by Charles P. Eussell, M. D., New York. New Tables issued by the Local Government Board and Schedule of Causes of Death, London, 1901. Eeport on Uniform System of Births and Deaths Eegistrations, House of Eepresentatives, Fifty-seventh Congress, First Session, Eeport No. 1932, May 7, 1902. Eelation of Physicians to Mortality Statistics, U". S. Census Office, Washington, 1903. Manual of the International List of Causes of Death, Government Printing Office, Washington, D. C, 1911. Eeprint 1913. Defects in Eegistration, by F. D. Beagle, New York State Depart- ment of Health, Albany, 1908. Eeport on Diseases in the Philadelphia Dispensary, The Philadelphia Medical Museum, Yol. I, Philadelphia, 1805. Observations on the Statistics of Sickness, Insurance Monitor, New York, 1884. A Study of Diseases, by Dr. E. S. Keelor, Proceedings National Asso- ciation of Accident Underwriters, July 8, 1903. Sickness Experience in Friendly Societies, British Medical Journal, August 13, 1910. Statistics of Puerperal Fever and Allied Infectious Diseases, by George Geddes, Bristol, 1912. Annual Eeports of the Metropolitan Asylum Board, London. The Hospital and the Community, Journal American Medical Asso- ciation. June 13, 1908. Essay and Paper on Some Fallacies of Statistics, by Henry W. Eum- sey, M. D., London, 1875. Manual on the International List of Causes of Death for Official Use, London, 1912. The Nomenclature of Diseases drawn up by a Joint Committee ap- pointed by the Eoyal College of Physicians of London, 3d edition, London, 1896; 4th edition, London, 1906. The Bellevue Hospital Nomenclature of Diseases and Conditions, with Eules for the Eecording and Filing of Eeturns, New York, 1911. Nomenclature of Diseases and Injuries, adopted by the Medical De- partment of the L T . S. Navy, Government Printing Office, Wash- ington, 1912. Statistical Experience Data. 45 Wasted Records of Disease, by Charles E. Paget, published by Edward Arnold, London, 1897. Statistics of Benevolent Institutions of the United States, The Survey, New York, February 15, 1913. Special Eeport on Benevolent Institutions, by John Koren, Expert Special Agent, Bureau of the Census, Washington, 1905. Proposals for an Uniform Plan of Hospital Statistics, Proceedings of the Fourth Session of the International Statistical Congress, held in London, July, 1860. Pub. London, 1861. The Registration of Diseases, by William C. Rogers, M. D., Transac- tions of the Medical Society of the State of New York, Albany, 1859. Statistics of Sickness Derived from Medical Experience, by Thomas C. Brumsmade, M. D., Transactions of the Medical Society of the State of New York, Albany, 1858. Statistical Nosology, Transactions of the Medical Society of the State of New York, Albany, 1858. Numerical Analysis of Patients Treated in Guy's Hospital, 1854-61, Journal of the Royal Statistical Society, Vol. XXIV, 1861. Report on the Mortality of London Hospitals, Journal of the Royal Statistical Society, Vol. XXX, London, 1867. The Importance of Collecting Hospital Records, by Robert D. Cough- lin, New York Medical Record, A T ol. IX, 1911. The Mortality of Hospitals, General and Special, in the United Kingdom in Past and Present, Journal of the Royal Statistical Society, Vol. XL, London, 1877. Report on the Hospitals of the United Kingdom, John S. Bristowe, M. D., and Timothy Holmes, Privy Council, Medical Report, Lon- don, 1863. Sickness Statistics, by H. B. Baker, Lansing, Mich., 1892. A National System of Notification and Registration of Sickness, by Arthur Newsholme, M. D., Jour. Royal Stat. Soc, March, 1896, Vol. LIX. Sickness Statistics Report of the Committee on Vital Statistics of the National Conference of State Boards of Health, by Henry B. Baker, M. D., Lansing, Mich., 1892. The Defects of Medical Terminology, British Medical Journal, September 21, 1912. Air, Food and Exercise, by Rabaglati, New York, 1904. (Includes important discussion of terms, definitions, etc.) 4 46 Frederick L. Hoffman. Diseases of the House Officers in Hospitals, Journal American Medi- cal Association, December 19, 1903. Nosology of Diseases Arranged in their Classes, etc., by W. Cullen, London, 1808. A Synopsis of Nosology, by W. Cullen, translated by Henry Wilkes, Philadelphia, 1793. Dictionary of Medicine, by Gould and Pyle, Philadelphia, 1907. Hospital Morbidity Statistics, by C. F. Bolduan, New York Medical Journal, March 29, 1913. Morbidity and Morphology, by E. B. Bean, Johns Hopkins Hospital Bulletin, December, 1912. The Surgical Peculiarities of the American Negro, by E. Matas, Trans- actions of the American Surgical x\ssociation, -1896. Medical and Surgical History of the War of the Bebellion, by Surgeon- General J. K. Barnes, Washington, 1870. Medical and Anthropological Statistics of the Provost-Marshal-Gen- eral's Bureau of the War of the Bebellion, Washington, 1875. Eelation of Morbidity Eeports to Public Health Administration, by J. W. Trask, M. D., American Journal of Public Health, Vol. Ill, No. 5, May, 1913. Morbidity Eeports, Their Purpose and Present Status, by John W. Trask, M. D., Journal of the American Medical Association, Sep- tember 20, 1913. Eeport of the Special Committee on Morbidity and Mortality Statistics in the United Kingdom, Journal of the Eoyal Statistical Society, July, 1913. The Promotion of Uniformity in the Eegistration of Diseases in Hos- pitals, E. F. Tobin, Medical Press and Circular, Vol. LXXV, 1908. Benevolent Hospitals in Metropolitan Boston; William H. Mahoney, Quar. Pubs. American Statistical Association, June, 1913. Age Incidence, Sox, and Comparative Frequency in Disease, James G. Andrew, Glasgow, 1909. Eeport of the Local Government Board on Statistics of the Incidence of Notifiable Infectious Diseases in Each Sanitary District in England and Wales. London, 1913. Statistical Experience Data. 47 Statistical Appendix to Address on the Statistical Experience Data of The Johns Hopkins Hospital, 1892-1911. TABLES. 1. Summary table of patients treated, with recovery and mortality data, 1892-1911. Section A. 2. Summary table for white patients, 1892-1911. 3. White medical cases, 1892-1911. 4. White surgical cases, 1892-1911. 5. White gynecological and obstetrical cases, 1892-1911. 6. White patients treated, and mortality, ages under 15. 7. do. 15-24. 8. do. 25-34. 9. do. 35-44. 10. do. 45-54. 11. do. 55-64. 12. do. 65 and over. Section B. 13. Summary table for colored patients, 1892-1911. 14. Colored medical cases, 1892-1911. 15. Colored surgical cases, 1892-1911. 16. Colored gyncological and obstetrical cases, 1892-1911. 17. Colored patients treated, and mortality, ages under 15. 18. do. 15-24. 19. do. 25-34. 20. do. 35-44. 21. do. 45-54. 22. do. 55-64. 23. do. 65 and over. Section C. • 24. Admission rates, white patients, by causes and conditions, 1902-1911. 25. Admission rates, colored patients, by causes and conditions. 26. Comparative admission rates, by causes — white medical. 27. do. white surgical. 27A. do. gynecological and obstetrical. 28. do. colored medical. 29. do. colored surgical. 29A. do. colored gynecological and ob- stetrical. 48 Frederick L. Hoffman. Section D. 30. Percentage distribution of admissions, by causes — white, 1902-1911. 31. do. white medical. 32. do. white surgical. 33. do. white gynecological and obstetrical. 34. Percentage distribution of admissions, by causes — colored. 35. • * do. colored medical. 36. do. colored surgical. 37. do. colored gynecological and obstetrical. Section E. 38. Summary of admissions and mortality, by causes — white, 1902-1911. 39. do. white medical. 40. do. white surgical. 41. do. white gynecological. 42. Admissions and mortality, alphabetically arranged — white medical. 43. do. white surgical. 44. do. white gynecolog- ical. 45. Summary of white obstetrical cases, 1904-1911. Section F. 46. Summary of admissions and mortality, by causes — colored, 1902-1911. 47. do. colored medical. 48. do. colored surgical. 49. do. colored gynecologi- cal. 50. Admissions and mortality, alphabetically arranged — colored medical. 51. do. colored surgical. 52. do. colored gynecologi- cal. 53. Summary of colored obstetrical cases, 1904-1911. Section G. 54. Supplementary table on malignant tumors, admission rate — white. 55. do. colored. 56. Supplementary table on malignant tumors, mortality rate — white. 57. do. colored. 58. Baltimore population statistics, by sex and race, 1892-1911. Statistical Experience Data. 49 Section G. — Continued. 59. Baltimore mortality statistics, by sex and race, 1902-1911. 60. Baltimore mortality from tuberculosis and other causes, 1907-1911. 61. The Johns Hopkins Hospital statistics of days' treatment, 1892-1911. 62. Dispensary statistics — Medical and surgical departments, 1892-1911. 63. 64. 65. 66. 67. 68. 69. 70. do. do. do. do. do. do. do. do. Gynecological and obstetrical departments. Children's and orthopedic departments. Dermatological and department of venereal dis- eases. Ophthalmological and otological departments. Genito-urinary and laryngological departments. Neurological and hospital cases. Phipps Dispensary — total treated. Summary for last 20 years. 71. Statistics of X-ray department. 72. Financial statistics, 1889-1911. MORTALITY AND MORBIDITY STATISTICS OF THE JOHNS HOPKINS HOSPITAL, 1892-1911. Table 1. Summaby of White and Colored Patients. Males. Females Year. Treated. Im- proved. Per cent. Died. Per cent. Treated. Im- proved. Per cent. Died. i Per cent- 1892 .. . 1155 813 70.4 94 8.1 1098 773 70.4 66 6.0 1893 .. . 1360 974 71.6 107 7.9 1262 843 66.8. 59 4.7 1894 . . . 1528 1064 69.6 133 8.7 1490 1022 68.6 64 4.3 1895 . . . 1821 1331 73.1 143 7.9 1565 1087 69.5 93 5.9 1896 . . . 1864 1331 71.4 128 6.9 1738 1206 69.4 87 5.0 1897 . . . 1818 1308 71.9 132 7.3 1815 1313 72.3 85 4.7 1898 . . . 1930 1475 76.4 137 7.1 1885 1405 74.5 102 5.4 1899 .. . 2099 1546 73.7 160 7.6 1975 1456 73.7 94 4.8- 1900 . . . 2396 1733 72.3 179 7.5 2306 1641 71.2 129 5.6 1901 . . . 2236 1603 71.7 199 8.9 2127 1584 74.5 96 4.5 1902 . . . 2028 1439 71.0 181 8.9 2136 1553 72.7 123 5.8 1903 . . . 2076 1528 73.6 168 8.1 2090 1536 73.5 94 4.5 1904 . . . 2296 1659 72.3 177 7.7 2235 1668 74.6 103 4.6 1905 . . . 2041 1482 72.6 153 7.5 2183 1668 76.4 90 4.1 1906 . . 2154 1492 69.3 178 8.3 2396 1829 76.3 85 3.5 1907 . . . 2268 1581 69.7 176 7.8 2591 1962 75.7 95 3.7 1908 . . . 2313 1591 68.8 187 8.1 2599 2016 77.6 76 2.9 1909 . . . 2524 1757 69.6 175 6.9 2561 1970 76.9 111 4.3 1910 . . . 2595 1840 70.9 159 6.1 2672 2025 75.8 99 3.7 1911 . . . 2524 1725 68.3 190 7.5 2675 2033 76.0 103 3.9 1892-01 . 18207 13178 72.4 1412 7.8 17261 12330 71.4 875 5.1 1902-11 . 22819 16094 70.5 1744 7.6 24138 18260 75.6 979 4.1 50 Frederick L. Hoffman. SEC. A. WHITE PATIENTS, SEX AND AGE, 1892-1911. Table 2. Summary of "White Patients. Males. A Females. A Year. r Treated. Im- proved. Per cent. Died. Per cent. Treated. Im- proved. Per cent. Died- Per cent. 1892 . . . . 1006 723 71.9 73 7.3 958 690 72.0 46 4.8 1893 . . . . 1185 852 71.9 83 7.0 1111 734 66.1 48 4.3 1894 ... . 1335 937 70.2 107 8.0 1289 902 70.0 44 3.4 1895 . . . . 1553 1169 75.3 106 6.8 1341 943 70.3 66 4.9 1896 . . . . 1578 1139 72.2 100 6.3 1452 1025 70.6 68 4.7 1897 . . . . 1515 1100 72.6 90 5.9 1515 1113 73.5 61 4.0 1898 ... . 1566 1226 78.3 93 5.9 1491 1119 75.1 63 4.2 1899 . . . . 1703 1260 74.0 115 6.8 1570 1159 73.8 59 3.8 1900 . . . . 1923 1406 73.1 124 6.4 1796 1278 71.2 89 5.0 1901 . . . . 1804 1300 72.1 137 7.6 1616 1212 75.0 58 3.6 1902 . . . . 1653 1177 71.2 128 7.7 1633 1181 72.3 85 5.2 1903 . . . . 1701 1256 73.8 123 7.2 1567 1141 72.8 60 3.8 1904 . . . . 1857 1357 73.1 118 6.4 1625 1201 73.9 65 4.0 1905 . . . . 1645 1209 73.5 97 5.9 1590 1204 75.7 63 4.0 1906 . . . . 1741 1197 68.7 128 7.4 1714 1293 75.4 50 2.9 1907 . . . . 1887 1314 69.6 128 6.8 1892 1424 75.3 60 3.2 1908 . . . . 1919 1338 69.7 130 6.8 1921 1472 76.6 50 2.6 1909 . . . . 2101 1443 68.7 127 6.0 1868 1431 76.6 76 4.1 1910 ... . 2144 1518 70.8 118 5.5 1959 1440 73.5 68 3.5 1911 ... . 2144 1473 68.7 138 6.4 1906 1428 74.9 60 3.1 1892-01. . 15168 11112 73.3 1028 6.8 14139 10175 72.0 602 4.3 1902-11. . 18792 13282 70.7 1235 6.6 17675 13215 74.8 637 3.6 Table 3. White Medical Cases. Males. Females. A Year. Treated. Im- proved. Per cent. Died. Per cent. Treated. Im- proved. Per cent. Died. Per cent. 1892 . .. 546 374 68.5 53 9.7 226 154 68.1 18 8.0 1893 . . . 648 435 67.1 53 8.2 272 175 64.3 19 7.0 1894 . . . 636 431 67.8 73 11.5 292 199 68.2 18 6.2 1895 . . . 700 522 74.6 56 8.0 285 178 62.5 32 11.2 1896 . . . 777 552 71.0 70 9.0 328 214 65.2 23 7.0 1897 . . . 726 507 69.8 50 6.9 334 227 68.0 29 8.7 1898 . . . 733 569 77.6 48 6.5 312 222 71.2 21 6.7 1899 . . . 777 548 70.5 70 9.0 357 244 68.3 17 4.8 1900 . . . 890 617 69.3 75 8.4 447 298 66.7 38 8.5 1901 . . . 866 589 68.0 80 9.2 356 252 70.8 21 5.9 1902 . . . 737 522 70.8 61 8.3 339 218 64.3 33 9.7 1903 . . . 789 554 70.2 68 8.6 374 270 72.2 20 5.3 1904 . . . 790 544 68.9 64 8.1 347 240 69.2 26 7.5 1905 ... 726 490 67.5 51 7.0 326 209 64.1 23 7.1 1906 . . . 771 481 62.4 67 8.7 420 279 66.4 18 4.3 1907 . . . 843 507 60.1 77 9.1 426 266 64.8 17 4.0 1908 . . . 832 539 64.8 62 7.5 453 294 64.9 18 4.0 1909 . . . 874 528 60.4 70 8.0 477 281 58.9 27 5.7 1910 . . . 914 583 63.8 49 5.4 530 320 60.4 24 4.5 1911 . . . 937 588 62.8 55 5.9 494 303 61.3 17 3.4 1892-01. . 7299 5144 70.5 628 8.6 3209 2163 67.4 236 7.4 1902-11. . 8213 5336 65.0 624 7.6 4186 2680 64.0 223 5.3 Statistical Experience Data. 51 Table 4. White Surgical Cases. M ales. Females. Treated. Im- proved. Per cent. Died. Per cent. Treated. Im- proved. Per cent. Died. Per cent. 460 349 75.9 20 4.3 156 114 73.1 7 4.5 537 417 77.7 30 5.6 203 145 71.4 10 4.9 699 506 72.4 34 4.9 287 196 68.3 12 4.2 853 647 75.8 50 5.9 308 238 77.3 8 2.6 801 587 73.3 30 3.7 313 235 75.1 17 5.4 789 593 75.2 40 5.1 297 222 74.7 18 6.1 833 657 78.9 45 5.4 302 231 76.5 15 5.0 926 712 76.9 45 4.9 306 224 73.2 16 5.2 . . 1033 789 76.4 49 4.7 359 243 67.7 24 6.7 938 711 75.8 57 6.1 349 259 74.2 19 5.4 916 655 71.5 67 7.3 345 246 71.3 16 4.6 912 702 77.0 55 6.0 363 252 69.4 16 4.4 . . 1067 813 76.2 54 5.1 398 294 73.9 25 6.3 919 719 78.2 46 5.0 355 271 76.3 20 5.6 970 716 73.8 61 6.3 375 284 75.7 18 4.8 . . 1044 807 77.3 51 4.9 434 321 74.0 29 6.7 . . 1087 799 73.5 68 6.3 423 308 72.8 19 4.5 . . 1227 915 74.6 57 4.6 429 313 73.0 33 7.7 . . 1230 935 76.0 69 5.6 461 318 69.0 26 5.6 . . 1207 885 73.3 83 6.9 471 335 71.1 21 4.5 . . 7869 5968 75.8 400 5.1 2880 2107 73.2 146 5.1 . . 10579 7946 75.1 611 5.8 4054 2942 72.6 223 5.5 Table 5. White Gynecological and Obstetrical Cases. Gynecological cases. Obstetrical cases , * , , » Treated Im " Per Died Per Trpiterl Im " Per ireatect. provfed- cent- Oied. cent _ lreated. proved _ cent _ 576 422 73.3 21 3.6 636 414 65.1 19 3.0 710 507 71.4 14 2.0 748 527 70.5 26 3.5 801 572 71.4 28 3.5 10 4 40.0 785 585 74.5 13 1.7 99 79 79.8 731 542 74.1 26 3.6 146 124 84.9 771 583 75.6 23 3.0 136 108 79.4 815 605 74.2 24 2.9 175 132 75.4 775 597 77.0 17 2.2 136 104 76.5 747 555 74.3 29 3.9 202 162 80.2 674 491 72.8 22 3.3 156 128 82.1 665 481 72.3 12 1.8 215 186 86.5 662 509 76.9 12 1.8 247 215 87.0 673 523 77.7 11 1.6 246 207 84.1 755 585 77.5 11 1.5 277 252 91.0 719 586 81.5 9 1.3 326 284 87.1 642 545 84.9 8 1.2 320 292 91.3 671 536 79.9 13 1.9 297 266 89.6 595 489 82.2 14 2.4 346 301 87.0 7348 5354 72.9 211 2.9 702 551 78.5 6803 5300 77.9 141 2.1 2632 2293 87.1 Di Per cent 1 1.0 1 0.7 3 2.2 3 1.7 1 0.7 7 3.5 2 1.3 2 0.9 8 3.2 3 1.2 3 1.1 4 1.2 8 2.5 5 1.7 8 2.3 9 1.3 50 1.9 52 Frederi ck L. Ho ffman. Table 6. White Patients, Ages Under 15. Males. Females. Year. Treated. Died. Per cent. Treated. Died. Per cent. 1892 . . 106 4 3.8 52 2 3.8 1893 . . 105 4 3.8 70 5 7.1 1894 . . 137 6 4.4 112 5 4.5 1895 . . 199 6 3.0 120 9 7.5 1896 .. 222 6 2.7 174 7 4.0 1897 . . 203 11 5.4 165. 6 3.6 1898 . . 204 7 3.4 184 8 4.3 1899 . . 159 8 5.0 90 5 5.6 1900 . . 223 11 4.9 130 9 6.9 1901 . . 170 9 5.3 109 7 6.4 1902 .... . . 179 20 11.1 95 9 9.5 1903 .... . . 206 17 8.3 116 5 4.3 1904 . . 193 15 7.8 106 12 11.3 1905 .. 159 9 5.7 111 14 12.6 1906 .... . . 172 16 9.3 131 6 4.6 1907 . . 234 27 1-1.5 128 14 10.9 1908 . . 260 24 9.2 129 12 9.3 1909 . . 263 22 8.4 137 22 16.1 1910 . . 228 18 7.9 153 12 7.8 1911 .. 261 22 8.4 146 11 7.5 1892-01.. . . 1728 72 4.2 1206 63 5.2 1902-11.. . . 2155 190 8.9 1252 117 9.3 Table 7. White Patients, Ages 15-24. Males. Females. Year. Treated. Died. Per cent. Treated. Died. Per cent. 1892 . . 231 14 6.1 209 7 3.3 1893 . . 245 8 3.3 272 10 3.7 1894 . . 308 8 2.6 314 7 2.2 1895 8 2.2 330 13 3.9 1896 . . 364 12 3.3 353 16 4.5 1897 . . 357 22 6.2 377 19 5.0 1898 .... .. 363 28 7.7 404 16 4.0 1899 . . 308 13 4.2 345 6 1.7 1900 . . 314 18 5.7 418 13 3.1 1901 . . 349 12 3.4 348 7 2.0 1902 . . 313 13 4.2 354 19 5.4 1903 . . 332 11 3.3 354 9 2.5 1904 . . 369 11 3.0 406 8 2.0 1905 . . 299 6 2.0 418 6 1.4 1906 . . 356 14 3.9 549 8 1.5 1907 . . 416 12 2.9 550 10 1.8 1908 . . 374 16 4.3 599 6 1.0 1909 . . 409 14 3.4 533 10 1.9 1910 . . 398 12 3.0 558 13 2.3 1911 . . 425 19 4.5 567 8 1.4 1892-01.. . . 3202 143 4.5 3370 114 3.4 1902-11.. . . 3691 128 3.5 4888 97 2.0 Statistical Experience Data. 53 Table 8. White Patients, Ages 25-34. Males. Year. Treated. Died. Per cent. Treated. Died. Per cent. 1892 196 19 9.7 293 9 3.1 1893 270 14 5.2 360 2 0.6 1894 324 11 3.4 359 4 1.1 1895 405 12 3.0 370 6 1.6 1896 401 15 3.7 383 12 3.1 1897 398 35 8.8 435 25 5.7 1898 415 42 10.1 400 31 7.8 1899 367 22 6.0 463 16 3.5 1900 451 25 5.5 549 12 2.2 1901 408 21 5.1 476 4 0.8 1902 352 11 3.1 508 14 2.8 1903 360 17 4.7 466 13 2.8 1904 409 20 4.9 466 8 1.7 1905 357 12 3.4 473 10 2.1 1906 363 17 4.7 450 9 2.0 1907 383 22 5.7 552 8 1.4 1908 359 21 5.8 523 13 2.5 1909 408 21 5.1 554 7 1.3 1910 393 14 3.6 518 8 1.5 1911 417 19 4.6 549 17 3.1 1892-01 3635 216 5.9 4088 121 3.0 1902-11.... 3801 174 4.6 5059 107 2.1 Table 9. White Patients, Ages 35-44. Males. Females. Year. Treated. Died. Per cent. Treated. 1892 168 13 7.7 195 14 7.2 1893 223 21 9.4 193 9 4.7 1894 176 28 15.9 175 12 6.9 1895 201 33 16.4 185 15 8.1 1896 200 25 12.5 181 9 4.9 1897 212 12 5.7 196 5 2.6 1898 228 9 3.9 199 3 1.5 1899 338 25 7.4 343 12 3.5 1900 379 32 8.4 336 19 5.7 1901 347 26 7.5 359 16 4.5 1902 284 23 8.1 378 19 5.0 1903 291 27 9.3 339 15 4.4 1904 305 19 6.2 337 7 2.1 1905 284 15 5.3 322 13 4.0 1906 336 22 6.5 333 12 3.6 1907 313 20 6.4 356 13 3.7 1908 310 21 6.8 368 8 2.2 1909 355 15 4.2 329 16 4.9 1910 384 21 5.5 361 11 3.0 1911 342 21 6.1 359 12 3.3 1892-01 2472 224 9.1 2362 114 4.8 1902-11 3204 204 6.4 3482 126 3.6 54 Frederick L. Hoffman. Table 10. White Patients, Ages 45-54. Males. Females. Year. Treated. Died. Per cent. Treated. Died. Per cent. 1892 . . 152 7 4.6 118 11 9.3 1893 . . 181 25 13.8 128 16 12.5 1894 . . 210 21 10.0 152 7 4.6 1895 . . 207 15 7.2 145 13 9.0 1896 . . 199 18 9.0 155 15 9.7 1897 . . 178 4 2.2 161 1898 . . 164 5 3.0 153 3 2.6 1899 . . 232 21 9.1 190 12 6.3 1900 . . 274 22 8.0 204 17 8.3 1901 . . 258 29 11.2 167 11 6.6 1902 . . 249 23 9.2 167 14 8.4 1903 . . 229 15 6.6 168 9 5.4 1904 . . 273 27 9.9 168 13 7.7 1905 . . 242 22 9.1 146 8 5.5 1906 . . 224 24 10.7 165 9 5.5 1907 . . 247 23 9.3 196 9 4.6 1908 . . 272 14 5.1 197 8 4.1 1909 . . 321 28 8.7 181 13 7.2 1910 . . 292 15 5.1 236 14 5.9 1911 . . 291 20 6.9 186 3 1.6 1892-01.. . . 2055 167 8.1 1573 105 6.7 1902-11.. . . 2640 211 8.0 1810 100 5.5 Table 11. White Patients, Ages 55-64. Males. Females. Year. Treated. Died. Per cent. Treated. Died. Per cent. 1892 . . 100 7 - 7.0 70 2 2.9 1893 . . 117 4 3.4 71 4 5.6 1894 . . 126 17 13.5 142 6 4.2 1895 . . 126 20 15.9 154 4 2.6 1896 . . 135 18 13.3 158 6 3.8 1897 . . 123 5 4.1 136 5 3.7 1898 . . 129 1 0.8 118 1 0.8 1899 .... . . 185 14 7.6 103 5 4.9 1900 . . 174 10 5.7 121 15 12.4 1901 . . 180 25 13.9 114 10 8.8 1902 . . 180 22 12.2 99 10 10.1 1903 . . 176 18 10.2 92 8 8.7 1904 . . 160 12 7.5 103 10 9.7 1905 . . 190 19 10.0 86 9 10.5 1906 .... . . 173 19 11.0 59 3 5.1 1907 . . 194 18 9.3 86 4 4.7 1908 . . 205 20 9.8 75 3 4.0 1909 .... . . 215 13 6.0 93 2 2.2 1910 .. 261 25 9.6 108 8 7.4 1911 . . 242 19 7.9 75 7 9.3 1892-01.. . . 1395 121 8.7 1187 58 4.9 1902-11.. . . 1996 185 9.3 876 64 7.3 Statistical Experience Data. 55 Table 12. White Patients, Ages 65 and OVEE. Males. Females. Year. Treated. Died. Per cent . Treated. Died. Per cent. 1892 ... 53 9 17.0 21 1 4.8 1893 . . . 44 7 15.9 17 2 11.8 1894 . . . 54 16 29.6 35 3 8.6 1895 . . . 52 12 23.1 37 6 16.2 1896 . . . 57 6 10.5 48 3 6.3 1897 . . . 44 1 2.3 45 1 2.2 1898 . . . 63 1 1.6 33 1 3.0 1899 . . . .. 114 12 10.5 36 3 8.3 1900 . . . .. 108 6 5.6 38 4 10.5 1901 . . . 92 15 16.3 43 3 7.0 1902 . . . 96 16 16.7 32 1903 . . . .. 107 18 16.8 32 1 3.1 1904 ... .. 148 14 9.5 39 7 17.9 1905 . . . .. 114 14 12.3 34 O 8.8 1906 . . . .. 117 16 13.7 27 3 11.1 1907 ... .. 100 6 6.0 24 2 8.3 1908 . . . .. 139 14 10.0 30 1909 . . . .. 130 14 10.8 41 6 14.6 1910 . . . .. 188 13 6.9 25 2 8.0 1911 . . . . . . 166 18 10.8 24 2 8.3 1892-01. . .. 681 85 12.5 353 27 7.6 1902-11. . . . 1305 143 11.0 308 26 8.4 SEC. B. COLORED PATIENTS, SEX AND AGE, 1892-1911. Table 13. Summary of Colored Patients. Males. Females. Year. Treated. Im- proved Per cent. Died. Per cent. Treated. Im- proved. Per cent. Died. Per' cent. 1892 .... 149 90 60.4 21 14.1 140 83 59.3 20 14.3 1893 175 122 69.7 24 13.7 151 109 72.2 11 7.3 1894 193 127 65.8 26 13.5 201 120 59.7 20 10.0 1895 268 162 60.4 37 13.8 224 144 64.3 27 12.1 1896 . . . 286 192 67.1 28 9.8 286 181 63.3 19 6.6 1897 .... 303 208 68.6 42 13.9 300 200 66.7 24 8.0 1898 . . . 364 249 68.4 44 12.1 394 286 72.6 39 9.9 1899 . . . 396 286 72.2 45 11.4 405 297 73.3 35 8.6 1900 ... 473 327 69.1 55 11.6 510 363 71.2 40 7.8 1901 . . . 432 303 70.1 62 14.4 511 372 72.8 38 7.4 1902 ... 375 262 69.9 53 14.1 503 372 74.0 38 7.6 1903 . . . 375 272 72.5 45 12.0 523 395 75.5 34 6.5 1904 . . . 439 302 68.8 59 13.4 610 467 76.6 38 6.2 1905 . . . 396 273 68.9 56 14.1 593 464 78.2 27 4.6 1906 . . . 413 295 71.4 50 12.1 682 536 78.6 35 5.1 1907 . . . 381 267 70.1 48 12.6 699 538 77.0 35 5.0 1908 . . . 394 253 64.2 57 14.5 678 544 80.2 26 3.8 1909 . . . 423 314 74.2 48 11.3 693 539 77.8 35 5.1 1910 ... 451 322 71.4 41 9.1 713 585 82.0 31 4.3 1911 ... 380 252 66.3 52 13.7 769 605 78.7 43 5.6 1892-01. . 3039 2066 68.0 384 12.6 3122 2155 69.0 273 8.7 1902-11. . 4027 2812 69.8 509 12.6 6463 5045 78.1 342 5.3 56 Frederick L. Hoffman. Table 14. Colored Medical Cases. Males. Females Year. Treated. Im- proved Per. cent. Died Per cent. Treated. Im- proved. Per cent. Died. Per cent. 1892 ... 84 45 53.6 17 20.2 39 18 46.2 10 25.6 1893 ... 98 64 65.3 17 17.3 35 21 60.0 9 25.7 1894 . . . 106 70 66.0 20 18.9 50 25 50.0 9 18.0 1895 ... 128 71 55.5 33 25.8 62 35 56.5 13 21.0 1896 . . . 163 103 63.2 24 14.7 80 43 53.8 13 16.3 1897 ... 164 101 61.6 33 20.1 66 37 56.1 13 19.7 1898 ... 198 129 65.2 34 17.2 96 62 64.6 21 21.9 1899 . . . 211 146 69.2 34 16.1 92 62 67.4 20 21.7 1900 . . . 263 168 63.9 41 15.6 124 68 54.8 26 21.0 1901 ... 263 182 69.2 42 16.0 113 71 62.8 18 15.9 1902 ... 209 148 70.8 35 16.7 115 73 63.5 23 20.0 1903 ... 221 160 72.4 32 14.5 91 65 71.4 15 16.5 1904 ... 231 149 64.5 44 19.0 94 54 57.4 19 20.2 1905 . . . 194 120 61.9 35 18.0 94 60 63.8 12 12.8 1906 ... 214 139 65.0 31 14.5 107 68 63.6 12 11.2 1907 ... 193 119 61.7 35 18.1 103 55 53.4 21 20.4 1908 . . . 207 121 58.5 41 19.8 111 69 62.2 14 12.6 1909 ... 219 149 G8.0 31 14.2 119 71 59.7 19 16.0 1910 ... 231 159 68.8 27 11.7 102 70 68.6 12 11.8 1911 ... 190 123 64.7 31 16.3 110 65 59.1 19 17.3 1892-01. . 1678 1079 64.3 295 17.6 757 442 58.3 152 20.1 1902-11. . 2109 1387 65.8 342 16.2 1046 650 62.1 166 15.9 Table 15. Colored Surgical Cases. Males. Females Year. Treated. Im- proved Per cent. Died. Per cent. Treated. Im- proved Per cent. Died. Per cent. 1892 ... 65 45 69.2 4 6.2 24 16 66.7 5 20.S 1893 . . . 77 58 75.3 7 9.1 33 28 84.8 1 3.0 1894 ... 87 57 65.5 6 6.9 54 28 51.9 4 7.4 1895 . . . 140 91 65.0 4 2.9 52 37 71.2 2 3.8 1896 ... 123 89 72.4 4 3.3 62 37 59.7 4 6.5 1897 ... 139 107 77.0 9 6.5 53 38 71.7 3 5.7 1898 . . . 166 120 72.3 10 6.0 75 57 76.0 7 9.3 1899 . . . 185 140 75.7 11 5.9 65 41 63.1 8 12.3 1900 . . . 210 159 75.7 14 6.7 95 65 68.4 4 4.2 1901 . . . 169 121 71.6 20 11.8 83 62 74.6 8 9.6 1902 . . . 166 114 68.7 18 10.8 59 42 71.2 4 6.8 1903 . . . 154 112 72.7 13 8.4 81 59 ' 72.8 7 8.6 1904 . . . 208 153 73.6 15 7.2 112 81 72.3 10 8.9 1905 ... 202 153 75.7 21 10.4 95 73 76.8 5 5.3 1906 . . . 199 156 78.4 19 9.5 117 88 75.2 13 11.1 1907 ... 188 148 78.7 13 6.9 116 88 75.9 7 6.0 1908 . . . 187 132 70.6 16 8.6 120 91 75.8 5 4.2 1909 . . . 204 165 80.9 17 8.3 95 65 68.4 6 6.3 1910 . .. 220 163 74.1 14 6.4 119 87 73.1 11 9.2 1911 . .. 190 129 67.9 21 11.1 159 122 76.7 11 6.9 1892-01. . 1361 987 72.5 89 6.5 596 409 68.6 46 7.7 1902-11. . 1918 1425 74.3 167 8.7 1073 796 74.2 79 7.4 Statistical Experience Data. 57 Table 16. Colored Gynecological and Obstetrical Cases. Gynecolc gical case Obstetrical ease Year. Treated Im- Per Died. Pe r r Treated. Im- Per Died. Per proved cent. cent. proved. cent. cent. 1892 ... 77 49 63.6 5 6.5 1893 . . . 83 60 72.3 1 1.2 1894 . . . 97 67 69.1 7 7.2 1895 . . . 110 72 65.5 12 10.9 1896 . . . 128 90 70.3 2 1.6 16 11 68.8 1897 . . . 130 81 62.3 8 6.2 51 44 86.3 1898 . . . 145 101 69.7 9 6.2 78 66 84.6 2 2.6 1899 . . . 155 114 73.5 7 4.5 93 80 86.0 1900 . . . 176 134 76.1 7 4.0 115 96 83.5 3 2.6 1901 . . . 163 118 72.4 8 4.9 152 121 79.6 4 2.6 1902 . . . 171 123 71.9 7 4.1 158 134 84.8 4 2.5 1903 . . . 187 131 70.1 10 5.3 164 140 85.4 2 1.2 1904 . . . 210 160 76.2 5 2.4 194 172 88.7 4 2.1 1905 . . . 211 162 76.8 7 3.3 193 169 87.6 q 1.6 1906 . . . 274 223 81.4 5 1.8 184 157 85.3 5 2.7 1907 . . . 292 229 78.4 5 1.7 188 166 88.3 2 1.1 1908 ... 263 217 82.5 5 1.9 184 167 90.8 2 1.1 1909 293 241 82.3 6 2.0 186 162 87.1 . 4 2.2 1910 .... 308 260 84.4 8 2.6 184 168 91.3 1911 295 244 82.7 11 3.7 205 174 84.9 2 1.0 1892-01.. 1264 886 70.1 66 5.2 505 418 82.8 9 1.8 1902-11. . 2504 1990 79.5 69 2.8 1840 1609 87.4 28 1.5 Table 17. Colored Patiexts Ages Under 1 5. "ear. Males. Females. "5 Treated. Died. Per cent. Treated. Died. Per cent. 1892 16 1 6.3 8 1 12.5 1893 14 6 1 16.7 1894 20 1 5.6 20 2 10.0 1895 36 4 11.1 24 2 8.3 1896 39 2 5.1 47 4 8.5 1897 33 6 18.2 39 6 15.4 1898 34 5 14.7 47 6 12.8 1899 57 4 7.0 27 2 7.4 1900 50 6 12.0 43 O O 7.0 1901 36 6 16.7 50 6 12.0 1902 30 1 3.3 49 5 10.2 1903 40 6 15.0 47 6 12.8 1904 42 1 2.4 53 11 20.8 1905 52 6 11.5 48 8 16.7 1906 48 7 14.6 53 6 11.3 1907 51 6 11.8 68 1 1.5 1908 63 10 15.9 59 6 10.2 1909 46 6 13.0 63 8 12.7 1910 68 5 7.4 58 7 12.1 1911 53 6 11.3 95 11 11.6 1892- 01 335 35 10.4 311 33 10.6 1902- 11 493 54 11.0 593 69 11.6 58 Frederick- L. Hoffman. Table 18. Colored Patients, Ages 15-24. Males. Females. Year. Treated. Died. Per cent. Treated. Died. Per cent. 1892 45 6 13.3 48 7 14.6 1893 31 4 12.9 46 2 4.3 1894 29 5 17.2 37 3 8.1 1S95 50 10 20.0 39 6 15.4 1896 55 4 7.3 55 6 10.9 1897 75 12 16.0 72 8 11.1 1898 96 13 13.5 97 12 12.4 1899 . 131 9 6.9 174 8 4.6 1900 . 136 9 6.6 197 7 3.6 1901 86 9 10.5 203 4 2.0 1902 98 8 8.2 215 7 3.3 1903 98 13 13.3 229 5 2.2 1904 , . 115 12 10.4 284 7 2.5 1905 84 9 10.7 290 5 1.7 1906 , . 113 12 10.6 324 7 2.2 1907 . . 103 12 11.7 317 10 3.2 1908 91 11 12.1 323 7 2.2 1909 . . Ill 13 11.7 299 8 2.7 1910 . . 116 8 6.9 319 4 1.3 1911 74 5 6.8 353 11 3.1 1892-01.. . . 734 81 11.0 968 63 6.5 1902-11.. . . 1003 103 10.3 2953 71 2.4 Table 19. Colored Patients, Ages 25-34. Males. Females. Year. Treated. Died. Per cent. Treated. Died. Per cent. 1892 44 6 13.6 32 1 3.1 1893 46 3 6.5 51 3 5.9 1894 47 3 6.4 49 4 8.2 1895 62 9 14.5 58 7 12.1 1896 63 5 7.9 59 6 10.2 1897 73 12 16.4 62 4 6.5 1898 89 13 14.6 106 12 11.3 1899 90 4 4.4 77 5 6.5 1900 . 102 10 9.8 119 8 6.7 1901 . 102 10 9.8 128 10 7.8 1902 86 8 9.3 134 10 7.5 1903 79 10 12.7 137 5 3.6 1904 90 10 11.1 155 4 2.6 1905 94 14 14.9 138 3 2.2 1906 94 10 10.6 172 9 5.2 1907 84 10 11.9 167 7 4.2 1908 84 10 11.9 155 3 1.9 1909 87 7 8.0 196 7 3.6 1910 81 9 11.1 192 9 4.7 1911 80 13 16.3 183 5 2.7 1892-01.. . . 718 75 10.4 741 60 8.1 1902-11.. . . 859 101 11.8 1629 62 3.8 Statistical Experience Data. 59 Table 20. Colored Patients, Ages 35-44. Males. Females. Year. Treated. Died. Per cent. Treated. Died. Per cent. 1892 23 3 13.0 24 6 25.0 1893 32 4 12.5 27 3 11.1 1894 37 9 24.3 37 6 16.2 1895 45 10 22.2 40 9 22.5 1896 49 7 14.3 49 2 4.1 1897 51 8 15.7 55 2 3.6 1898 59 5 8.5 62 4 6.5 1899 62 5 8.1 46 6 13.0 1900 87 13 14.9 83 3 3.6 1901 89 15 16.9 83 10 12.0 1902 66 8 12.1 65 7 10.8 1903 65 6 9.2 64 7 10.9 1904 76 13 17.1 71 10 14.1 1905 65 13 20.0 75 5 6.7 1906 78 11 14.1 83 7 8.4 1907 70 10 14.3 81 8 9.9 1908 50 7 14.0 87 6 6.9 1909 80 9 11.3 87 5 5.7 1910....... 90 8 8.9 85 5 5.9 1911 67 12 17.9 88 8 9.1 1892-01 534 79 14.8 506 51 10.1 1902-11 707 97 13.7 786 68 8.7 Table 21. Colored Patients, Ages 45-54. Males. Females. Year. Treated. Died. Per cent. Treated. Died. Per cent. 1892 8 3 37.5 18 2 11.1 1893 20 7 35.0 11 1 9.1 1894 23 2 8.7 20 4 20.0 1895 26 2 7.7 25 3 12.0 1896 24 10 41.7 30 1 3.3 1897 32 3 9.4 32 1 3.1 1898 32 5 15.6 43 2 4.7 1899 29 11 37.9 44 4 9.1 1900 57 6 10.5 40 9 22.5 1901 60 11 18.3 32 3 9.4 1902 67 19 28.4 27 4 14.8 1903 53 6 11.3 37 9 24.3 1904 64 16 25.0 28 4 14.3 1905 51 5 9.8 29 3 10.3 1906 37 9 24.3 33 3 9.1 1907 41 7 17.1 46 7 15.2 1908 57 9 15.8 42 3 7.1 1909 50 6 12.0 33 5 15.2 1910 56 7 12.5 37 3 8.1 1911 57 4 7.0 35 6 17.1 1892-01.... 311 60 19.3 295 30 10.2 1902-11.... 533 88 16.5 347 47 13.5 80 Frederick L. Hoffman. Table 22. Colored Patients, Ages 55-64. Males. Females. Year. Treated. Died. Per cent. Treated. Died. Per cent 1892 10 1 10.0 7 o 42.9 1893 27 5 18.5 5 1 20.0 1894 31 6 19.4 30 1895 36 1 2.8 28 1896 40 30 1897 26 26 3 11.5 1898 39 1 2.6 30 2 6.7 1899 14 7 50.0 18 4 22.2 1900 25 5 20.0 21 8 38.1 1901 45 9 20.0 9 3 33.3 1902 23 7 30.4 10 Q 30.0 1903 29 4 13.8 5 1 20.0 1904 34 2 5.9 14 2 14.3 1905 33 7 21.2 8 2 25.0 1906 27 1 3.7 14 2 14.3 1907 22 1 4.5 19 2 10.5 1908 37 5 13.5 8 1 12.5 1909 33 5 15.2 14 2 14.3 1910 29 4 13.8 18 1 5.6 1911 32 8 25.0 15 2 13.3 1892-01.. . . 293 35 11.9 204 24 11.8 1902-11.. . . 299 44 14.7 125 18 14.4 Table 23. Colored Patients, Ages 65 and Over. Males. Females. Year. Treated. Died. Per cent. Treated. Died. Per cent. 1892 3 1 33.3 3 1893 5 1 20.0 5 1894 6 8 1 12.5 1895 13 1 7.7 10 1896 16 16 1897 13 1 7.7 14 1898 15 2 13.3 9 1 11.1 1899 13 5 38.5 19 6 31.6 1900 16 6 37.5 7 2 28.6 1901 14 2 14.3 6 2 33.3 1902 5 2 40.0 3 2 66.7 1903 11 4 1 25.0 1904 18 5 27.8 5 1905 17 2 11.8 5 i 20.6 1906 16 3 l 33.3 1907 10 2 20.6 1 1908 12 5 41.7 4 1909 16 2 12.5 1 1910 11 4 2 50.6 1911 17 4 23.5 ... 1892-01.. . . 114 19 16.7 97 12 12.4 1902-11. . . . 133 22 16.5 30 7 23.3 SEC. C. COMPARATIVE ADMISSION RATE, 1902-1911. Table 24. Summary of White Cases. Males. Females. i * -\ i * "> Rate per Rate per Diseases and conditions. Admitted. p^X- Admitted. ™£®^. tion. tion. Abnormities, congenital malformations 111 0.50 62 ' 0.26 Blood 185 0.83 75 0.32 Bones and cartilages 389 1.75 140 0.59 Bursa? 27 0.12 12 0.05 Circulatory system 1171 5.28 315 1.33 Digestive system 2546 11.48 1711 7.23 Ductless glands and spleen 118 0.53 394 1.67 Ear 82 0.37 56 0.24 Eyeandadnexa 182 0.82 79 0.33 Hernise 903 4.07 229 0.97 Infective diseases 2843 12.82 1262 5.34 Joints 386 1.74 265 1.12 Lymphatic system 101 0.46 43 0.18 Mind 292 1.32 274 1.16 Miscellaneous 770 3.47 834 3.53 Muscles, fasciae, tendons 102 0.46 48 0.20 Nervous system 1518 6.84 1195 5.05 Parasites 38 0.17 8 0.03 Poisonings, intoxications 137 0.62 40 0.17 Reproductive organs 1099 4.95 3472 14.68 Respiratory system 840 3.79 291 1.23 Skin, hair, nails 75 0.34 41 0.17 Tumors 1496 6.74 1731 7.32 Urinary organs 881 3.97 757 3.20 Obstetrical conditions 2973 12.57 Newborn child 2 0.01 Injuries 1436 6.47 350 1.48 Grand total 17730 79.93 16657 70.43 Table 25. Summary of Colored Cases. Males. Females. , *- -> r » , Rate per Rate per Diseases and conditions. Admitted. 10.000 Admitted. 10 -°0° popula- popula- tion, tion. Abnormities, congenital malformations 11 0.29 14 0.31 Blood 10 0.27 13 0.29 Bones and cartilages 78 2.07 40 0.89 Bursa? 3 0.08 3 0.07 Circulatory system 581 15.43 165 3.65 Digestive system 387 10.28 441 9.76 Ductless glands and spleen 3 0.08 19 0.42 Ear 11 0.29 10 0.22 Eye and adnexa 25 0.66 29 0.64 Hernia? 131 3.48 56 1.24 Infective diseases 997 26.48 598 13.24 Joints 70 1.86 61 1.35 Lymphatic system 32 0.85 30 0.66 Mind 13 0.35 11 0.24 Miscellaneous 65 1.73 186 4.12 Muscles, fasciae, tendons i 12 0.32 6 0.13 Nervous system 112 2.97 94 2.08 Parasites 7 0.19 3 0.07 Poisonings, intoxications 8 0.21 6 0.13 Reproductive organs 81 2.15 1284 28.43 Respiratory system 391 10.38 137 3.03 Skin, hair, nails 51 1.35 45 1.00 Tumors 170 4.51 748 16.56 Urinary organs 200 5.31 140 3.10 Obstetrical conditions 1868 41.35 Newborn child 1 0.03 .... Injuries 312 8.29 107 2.37 Grand total 3762 99.90 6114 135.36 5 (61) Table 26. White Medical Cases. Diseases and conditions. Admitted. Abnormities, congenital malformations 13 Blood 177 Bones and cartilages 26 Bursa? 2 Circulatory system 1044 Digestive system 760 Ductless glands and spleen 45 Ear 15 Eye and adnexa 8 Hernia? 6 Infective diseases 2035 Joints 186 Lymphatic system 23 Mind 272 Miscellaneous 406 Muscles, fascia?, tendons 26 Nervous system 1123 Parasites 7 Poisonings, intoxications 128 Reproductive organs 47 Respiratory system 657 Skin, hair, nails 32 Tumors 321 Urinary organs 392 Obstetrical conditions Newborn child Injuries 19 Grand total 7770 ales. Females. Rate per Rate per 10,000 10,000 popula- popula- tion. tion. 0.06 6 0.03 0.80 68 0.29 0.12 9 0.04 0.01 2 0.01 4.71 273 1.15 3.43 421 1.78 0.20 131 0.55 0.07 6 0.03 0.04 11 0.05 0.03 9.17 795 3.36 0.84 131 0.55 0.10 7 0.03 1.23 264 1.12 1.83 201 0.85 0.12 12 0.05 5.06 910 3.85 0.03 6 0.03 0.58 36 0.15 0.21 41 0.17 2.96 222 0.94 0.14 25 0.11 1.45 137 0.58 1.77 182 0.77 22 0.09 0.09 7 0.03 35.03 3925 16.60 Table 27. White Subgical Cases. Diseases and conditions. Admitted. Abnormities, congenital malformations 98 Blood 8 Bones and cartilages 363 Bursa? 25 Circulatory system 127 Digestive system 1786 Ductless glands and spleen 73 Ear 67 Eye and adnexa 174 Hernia? 897 Infective diseases 808 Joints 200 Lymphatic system 78 Mind 20 Miscellaneous 364 Muscles, fascia?, tendons 76 Nervous system 395 Parasites 31 Poisonings, intoxications 9 Reproductive organs 1052 Respiratory system 183 Skin, hair, nails 43 Tumors 1175 Urinary organs 489 Obstetrical conditions Newborn child 2 Injuries 1417 Grand total 9960 ales. Fema les. Rate per Rate per 10,000 popula- Admitted. 10,000 popula- tion. tion. 0.44 49 0.21 0.04 3 0.01 1.64 124 0.52 0.11 10 0.04 0.57 40 0.17 8.05 866 3.66 0.33 261 1.10 0.30 50 0.21 0.78 68 0.29 4.04 127 0.54 3.64 362 1.53 0.90 132 0.56 0.35 30 0.13 0.09 10 0.04 1.64 127 0.54 0.34 36 0.15 1.78 250 1.06 0.14 2 0.01 0.04 1 4.74 110 0.47 0.83 68 0.29 0.19 13 0.05 5.30 703 2.97 2.20 34 0.14 4 0.02 0.01 6.39 341 1.44 44.90 3821 16.16 (62) Table 27A. White Gynecological and Obstetrical Cases. Gynecological cases. Obstetrical cases. Diseases and conditions. Admitted. Abnormities, congenital malformations 7 Blood 4 Bones and cartilages 7 Bursas Circulatory system 2 Digestive system 424 Ductless glands and spleen 2 Ear Eye and adnexa Hernise 102 Infective diseases 105 Joints 2 Lymphatic system 6 Mind Miscellaneous 506 Muscles, fascias, tendons Nervous system 35 Parasites Poisonings, intoxications 3 Reproductive organs 3321 Respiratory system 1 Skin, hair, nails 3 Tumors 891 Urinary organs 541 Obstetrical conditions 462 Newborn child Injuries 2 Grand total 6426 Rate per 10,000 *,,„.-++ A popula- Admitted, tion. 0.03 0.02 0.03 b'.oi 1.79 0.01 0.43 0.44 0.01 0.03 2.14 ..... 0.15 ..... b'.oi ..... 14.04 o'.oi ..... 3.77 2.29 1.95 2485 b'.oi ..... 27.17 Table 28. Colored Medical Cases. Males. Diseases and conditions. Admitted. Abnormities, congenital malformations Blood 9 Bones and cartilages 3 Bursa? 1 Circulatory system 549 Digestive system 102 Ductless glands and spleen 2 Ear 2 Eye and adnexa 3 Hernia? Infective diseases 606 Joints 25 Lymphatic system 10 Mind 12 Miscellaneous 35 Muscles, fascias, tendons 7 Nervous system 71 Parasites 3 Poisonings, intoxications 7 Reproductive organs 4 Respiratory system 368 Skin, hair, nails 3 Tumors 48 Urinary organs 115 Obstetrical conditions Newborn child 1 Injuries 2 Grand total 1988 (63) Rate per 10,000 popula- tion. 0.24 0.08 0.03 14.58 2.71 0.05 0.05 0.08 l'6.09 0.66 0.27 0.32 0.93 0.19 1.89 0.08 0.19 0.11 9.77 0.08 1.27 3.05 0.03 0.05 52.79 Rate per 10,000 popula- tion. 10.51 2485 10.51 Females. Admitted. 13 1 153 62 5 1 4 360 19 4 10 34 1 65 6 12 125 4 29 70 7 Rate per 10,000 popula- tion. 0.29 0.02 3.39 1.37 0.11 0.02 0.09 7.97 0.42 0.09 0.22 0.75 0.02 1.44 0.13 0.27 2.77 0.09 0.64 1.55 0.15 0.62 986 21.83 Table 29. Colored Surgical Cases. Males. Females. Diseases and conditions. Abnormities, congenital malformations Blood Bones and cartilages Bursas Circulatory system Digestive system Ductless glands and spleen Ear Eye and adnexa Hernias Infective diseases Joints Lymphatic system Mind Miscellaneous Muscles, fasciae, tendons Nervous system Parasites Poisonings, intoxications Reproductive organs Respiratory system Skin, hair, nails Tumors Urinary organs Obstetrical conditions Newborn child Injuries Admitted. 11 1 75 2 32 285 1 9 22 131 391 45 22 1 30 5 41 4 1 77 23 48 122 85 310 Rate per 10,000 popula- tion. Admitted. Rate per 10,0U0 popula- tion. 0.29 12 0.27 0.03 1.99 39 0.86 0.05 3 0.07 0.85 12 0.27 7.57 207 4.58 0.03 14 0.31 0.24 9 0.20 0.58 25 0.55 3.48 33 0.73 10.38 197 4.36 1.20 42 0.93 0.58 16 0.35 0.03 1 0.02 0.80 19 0.42 0.13 5 0.11 1.09 26 0.58 0.11 2 0.04 0.03 2.04 48 1.06 0.61 11 0.24 1.27 39 0.86 3.24 135 2.99 2.26 9 0.20 3 0.07 8.23 106 2.35 Grand total 1774 47.11 1013 22.43 Table 29A. Colored Gynecological and Obstetrical Cases. Gynecological cases. Obstetrical cases. Diseases and conditions. Admitted. Abnormities, congenital malformations Blood , Bones and cartilages Bursas Circulatory system Digestive system Ductless glands and spleen Ear Eye and adnexa Hernias Infective diseases Joints Lymphatic system Mind Miscellaneous Muscles, fascia?, tendons Nervous system Parasites Poisonings, intoxications Reproductive organs 1224 172 23 41 "io 133 "3 1 Respiratory system . . Skin, hair, nails Tumors Urinary organs Obstetrical conditions Newborn child Injuries 1 2 584 61 131 Grand total 23! Rate per 10,000 popula- tion. 0.04 5.81 0.51 0.91 0.22 2.94 0.07 0.02 27.10 0.02 0.04 12.93 1.35 2.90 52.87 Rate per Admitted. 10 ' 000 popula- tion. 1727 1727 38 23 38.23 (64) SEC. D. DISEASES AND CONDITIONS ON ADMISSION, 1902-1911. Table 30. Summary of "White Cases. Males. Females. f * ( f * , Diseases and conditions. Admitted. Per cent. Admitted. Per cent. Abnormities, congenital malformations 111 0.6 62 0.4 Blood 185 1.0 75 0.5 Bones and cartilages 389 2.2 140 0.8 Bursae 27 0.2 12 0.1 Circulatory system 1171 6.6 315 1.9 Digestive system 2546 14.4 1711 10.3 Ductless glands and spleen 118 0.7 394 2.4 Ear 82 0.5 56 0.3 Eye and adnexa 182 1.0 79 0.5 Herniae 903 5.1 229 1.4 Infective diseases 2843 16.0 1262 7.6 Joints 386 2.2 265 1.6 Lymphatic system 101 0.6 43 0.3 Mind 292 1.6 274 1.6 Miscellaneous 770 4.3 834 5.0 Muscles, fasciae, tendons 102 0.6 48 0.3 Nervous system 1518 8.6 1195 7.2 Parasites 38 0.2 8 Poisonings, intoxications 137 0.8 40 0.2 Reproductive organs 1099 6.2 3472 20.8 Respiratory system 840 4.7 291 1.7 Skin, hair, nails 75 0.4 41 0.2 Tumors 1496 8.4 1731 10.4 Urinary organs 881 5.0 757 4.5 Obstetrical conditions ... 2973 17.8 Newborn child 2 ... Injuries 1436 8.1 350 2.1 Grand total 17730 100.0 16657 100.0 Table 31. White Medical Cases. Males. i * \ Diseases and conditions. Admitted. Per cent. Abnormities, congenital malformations 13 0.2 Blood 177 2.3 Bones and cartilages 26 0.3 Bursae 2 .... Circulatory system 1044 13.4 Digestive system 760 9.8 Ductless glands and spleen 45 0.6 Ear 15 0.2 Eye and adnexa 8 0.1 Herniae 6 0.1 Infective diseases 2035 26.2 Joints 186 2.4 Lymphatic system 23 0.3 Mind 272 3.5 Miscellaneous 406 5.2 Muscles, fasciae, tendons 26 0.3 Nervous system 1123 14.5 Parasites 7 0.1 Poisonings, intoxications 128 1.6 Reproductive organs 47 0.6 Respiratory system 657 8.5 Skin, hair, nails 32 0.4 Tumors ., 321 4.1 Urinary organs 392 5.0 Obstetrical conditions Newborn child Injuries 19 0.2 Grand total 7770 100.0 Females. Admitted. Per cent. 6 0.2 68 1.7 9 0.2 2 0.1 273 7.0 421 10.7 131 3 3 6 0.2 11 0.3 795 20.3 131 3.3 7 0.2 264 6.7 201 5.1 12 0.3 910 23.2 6 0.2 36 0.9 41 1.0 222 5.7 25 0.6 137 3.5 182 4.6 22 0.6 7 ' 0.2 3925 100.0 (65) Table 32. White Sukgical Cases. Males. * , Diseases and conditions. Admitted. Per cent. Abnormities, congenital malformations 98 1.0 Blood 8 0.1 Bones and cartilages 363 3.6 Bursas 25 0.3 Circulatory system 127 1.3 Digestive system 1786 17.9 Ductless glands and spleen 73 0.7 Ear 67 0.7 Eye and adnexa 174 1.7 Hernia? 897 9.0 Infective diseases 808 8.1 Joints 200 2.0 Lymphatic system 78 0.8 Mind 20 0.2 Miscellaneous 364 3.7 Muscles, fasciae, tendons 76 0.8 Nervous system 395 4.0 Parasites 31 0.3 Poisonings, intoxications 9 0.1 Reproductive organs 1052 10.6 Respiratory system 183 1.8 Skin, hair, nails 43 0.4 Tumors 1175 11.8 Urinary organs 489 4.9 Obstetrical conditions Newborn child 2 .... Injuries 1417 14.2 Grand total 9960 100.0 Admitted. 49 3 124 10 40 866 261 50 68 127 362 132 30 10 127 36 250 2 1 110 68 13 703 34 4 341 Per cent. 1.3 0.1 3.2 0.3 1.0 22.7 6.8 1.3 1.8 3.3 9.5 3.5 0.8 0.3 3.3 0.9 6.5 0.1 ' 2.9 1.8 0.3 18.4 0.9 0.1 ' 8.9 3821 100.0 Table 33. White Gynecological and Obstetrical Cases. Gynecological cases. Diseases and conditions. Admitted. Abnormities, congenital malformations 7 Blood 4 Bones and cartilages 7 Bursae Circulatory system 2 Digestive system 424 Ductless glands and spleen 2 Ear Eye and adnexa Hernia? 102 Infective diseases 105 Joints 2 Lymphatic system 6 Mind Miscellaneous 506 Muscles, fasciae, tendons Nervous system ' 35 Parasites Poisonings, intoxications 3 Reproductive organs 3321 Respiratory system 1 Skin, hair, nails 3 Tumors 891 Urinary organs 541 Obstetrical conditions 462 Newborn child Injuries 2 Per cent. 0.1 0.1 0.1 6.6 1.6 1.6 "o.i ' 7.9 ' 0.5 o.i 51.7 ' 0.1 13.9 8.4 7.2 Obstetrical cases. r .A Admitted. Per cent. 2485 100.0 Grand total 6426 100.0 2485 100.0 (66) Table 34. Summary of Colored Cases. Males. Diseases and conditions. Admitted. Per cent. Abnormities, congenital malformations 11 0.3 Blood 10 0.3 Bones and cartilages 78 2.1 Bursa? 3 0.1 Circulatory system 581 15.4 Digestive system 387 10.3 Ductless glands and spleen 3 0.1 Ear 11 0.3 Eye and adnexa 25 0.7 Hernise 131 3.5 Infective diseases 997 26.5 Joints 70 1.9 Lymphatic system 32 0.9 Mind 13 0.3 Miscellaneous 65 1.7 Muscles, fascia?, tendons 12 0.3 Nervous system 112 3.0 Parasites 7 0.2 Poisonings, intoxications 8 0.2 Reproductive organs 81 2.2 Respiratory system 391 10.4 Skin, hair, nails 51 1.4 Tumors 170 4.5 Urinary organs 200 5.3 Obstetrical conditions Newborn child 1 .... Injuries 312 8.3 Grand total 3762 100.0 Table 35. Colored Medical Cases. Males. , * . Diseases and conditions. Admitted. Per cent. Abnormities, congenital malformations Blood 9 0.5 Bones and cartilages 3 0.2 Bursa? 1 0.1 Circulatory system 549 27.6 Digestive system 102 5.1 Ductless glands and spleen 2 0.1 Ear 2 0.1 Eye and adnexa 3 0.2 Hernia? Infective diseases 606 30.5 Joints 25 1.3 Lymphatic system 10 0.5 Mind 12 0.6 Miscellaneous 35 1.8 Muscles, fascia?, tendons 7 0.4 Nervous system 71 3.6 Parasites 3 0.2 Poisonings, intoxications 7 0.4 Reproductive organs 4 0.2 Respiratory system 368 18.-5 Skin, hair, nails 3 0.2 Tumors 48 2.4 Urinary organs 115 5.8 Obstetrical conditions Newborn child 1 0.1 Injuries 2 0.1 Grand total 1988 100.0 Females. Admitted. Per cent. 14 0.2 13 0.2 40 0.7 3 165 2.7 441 7.2 19 0.3 10 0.2 29 0.5 56 0.9 598 9.8 61 1.0 30 0.5 11 0.2 186 3.0 6 0.1 94 1.5 3 6 o.i 1284 21.0 137 2.2 45 0.7 748 12.2 140 2.3 1868 30.6 107 ' 1.8 6114 100.0 Females. Admitted. Per cent. 13 ' 1.3 1 0.1 153 15.5 62 6.3 5 0.5 1 0.1 4 0.4 360 36*. 5 19 1.9 4 0.4 10 1.0 34 3.4 1 0.1 65 6.6 6 ' 0.6 12 1.2 125 12.7 4 0.4 29 2.9 70 7.1 7 0.7 1 ' o.i 986 100.0 (67) Females. Table 36. Colored Surgical Cases. Males. Diseases and conditions. Admitted. Per cent. Abnormities, congenital malformations 11 0.6 Blood 1 0.1 Bones and cartilages 75 4.2 Bursas 2 0.1 Circulatory system 32 1.8 Digestive system 285 16.1 Ductless glands and spleen 1 0.1 Bar 9 0.5 Eye and adnexa 22 1.2 Heinise 131 7.4 Infective diseases 391 22.0 Joints ' 45 2.5 Lymphatic system 22 1.2 Mind 1 0.1 Miscellaneous 30 1.7 Muscles, fascias, tendons 5 0.3 Nervous system 41 2.3 Parasites 4 0.2 Poisonings, intoxications 1 0.1 Reproductive organs 77 4.3 Respiratory system 23 1.3 Skin, hair, nails 48 2.7 Tumors 122 6.9 Urinary organs 85 4.8 Obstetrical conditions Newborn child Injuries 310 17.5 Grand total 1774 100.0 Table 37. Colored Gynecological and Obstetrical Cases. Gynecological cases. Admitted. Per cent. 12 1.2 39 ' 3.8 3 0.3 12 1.2 207 20.4 14 1.4 9 0.9 25 2.5 33 » 3.3 197 19.4 42 4.1 16 1.6 1 0.1 19 1.9 5 0.5 26 2.6 2 0.2 48 ' 4.7 11 1.1 39 3.8 135 13.3 9 0.9 3 0.3 106 10.5 1013 100.0 al Cases. Obstetrical cases. » Diseases and conditions. Admitted. Abnormities, congenital malformations 2 Blood Bones and cartilages Bursas Circulatory system Digestive system 172 Ductless glands and spleen Ear Eye "and adnexa Herniae 23 Infective diseases 41 Joints Lymphatic system 10 Mind Miscellaneous 133 Muscles, fasciae, tendons Nervous system 3 Parasites 1 Poisonings, intoxications Reproductive organs 1224 Per cent. 0.1 7.2 Admitted. Per cent. Respiratory system . . Skin, hair, nails Tumors Urinary organs Obstetrical conditions Newborn child Injuries 1 2 584 61 131 1.0 1.7 0.4 5.6 0.1 51.3 ' 0.1 24.5 2.6 5.5 1727 100 Grand total 2388 100.0 1727 100.0 (68) Statistical Experience Data. 69 SEC. E. MORTALITY RATES BY CAUSES ON ADMISSION, WHITE PATIENTS, 1902-1911. Table 38. Summary of White Cases. Diseases and conditions. Abnormities, congenital malfor- mations Blood Bones and cartilages Bursa? Circulatory system Arteries and veins Endocardium and valves Myocardium Neuroses Pericardium Digestive system Appendix Intestine Liver Gall bladder and ducts Mesentery Omentum Peritoneum Lips Mouth Palate, uvula Pharynx Salivary glands Teeth, gums, alveoli Tongue Tonsils Oesophagus Pancreas Rectum and anus Stomach Ductless glands and spleen Carotid gland Parathyreoid gland Pineal gland Pituitary body Spleen Suprarenal gland Thymus gland Thyreoid gland Ear Eye and adnexa Infective diseases Dysentery Gonorrhoea Influenza Malaria Rheumatic fever Septicemia Syphilis 1\ [ales. Females Admitted. Died Per " cent. Admitted. Ill 5 4.5 62 3 4.8 185 42 22.7 75 13 17.3 389 7 1.8 140 5 3.6 27 12 1171 169 14.4 315 44 14.0 615 74 .12.0 95 7 7.4 397 71 17.9 180 29 16.1 120 16 13.3 27 6 22.2 24 2 8.3 5 15 6 40.0 8 2 25.0 2546 134 5.3 1711 58 3.4 840 29 3.5 678 8 1.2 252 28 11.1 168 17 10.1 189 29 15.3 36 5 13.9 177 15 "io 8.5 33.3 311 3 56 15 "7 4.8 30 12.5 3 16 1 6.3 3 1 13 2 15.4 4 1 8 15 3 225 4 1.8 183 2 1.1 25 3 12.0 1 14 2 14.3 4 513 4 0.8 156 230 7 3.0 99 4 4.0 118 7 5.9 394 12 3.0 15 1 6.7 19 i 5.3 1 4 16 Q "3 18.8 3.5 3 368 11 86 3.0 82 6 7.3 56 2 3.6 182 2 1.1 79 2843 172 6.0 1262 75 5.9 135 6 4.4 13 1 7.7 88 1 1.1 44 1 2.3 86 38 238 4 1.7 24 70 3 4.3 15 20 15 75.0 18 8 44.4 266 6 2.3 73 2 2.7 70 Frederick L. Hoffman. Tarle 38. Summary of White Cases — Continued. Males. Females. Diseases and conditions. Admitted. Tuberculosis, meninges 27 Tuberculosis, lungs 312 Tuberculosis, miliary 5 Tuberculosis, other forms 483 Typhoid fever 695 Other infective diseases 418 Hernias 903 Joints 386 Lymphatic system 101 Mind 292 Miscellaneous '. 770 Diabetes 128 Gout 41 Obesity 3 Rheumatism, ch. art 61 Rheumatism, n. s 11 Other miscellaneous 526 Muscles, fasciae, tendons 102 Muscles and fascia? 89 Tendons and sheaths 13 Nervous system 1518 Brain, spinal cord, meninges. . 360 Cranial and spinal nerves 143 Functional nervous disorders. 1015 Parasites 38 Poisonings and intoxications. . . . 137 Reproductive organs 1099 Functional disorders 1 Mammary gland Ligaments, ovaries, tubes Uterus Vagina Vulva Cowper's glands Penis 19 Prostate gland 767 Scrotum 8 Seminal vesicles 2 Spermatic cord 105 Testicle and epididymis 77 Tunica vaginalis 120 Respiratory system 840 Bronchi and trachea 175 Larynx and epiglottis 10 Lung 341 Nose and nasal passages 43 Accessory sinuses 13 Pleura .'. 258 Skin, hair, nails 75 Skin and hair 72 Nails 3 Tumors 1496 Benign 437 Malignant 1059 19 24 4 18 52 20 18 3 2 8 54 7 1 43 2 2 69 63 2 4 7 7 45 43 1 1 90 5 71 1 1 12 1 1 205 46 159 Per cent. 70.4 7.7 80.0 3.7 7.5 4.8 2.0 0.8 2.0 2.7 7.0 5.5 2.4 4.9 8.2 2.0 2.2 4.5 17.5 1.4 0.4 18.4 5.1 4.1 Admitted. Died. 5.6 12.5 0.8 10.7 2.9 20.8 2.3 7.7 4.7 1.3 1.4 13.7 10.5 15.0 16 154 3 334 307 223 229 265 43 274 834 69 4 11 19 7 724 •48 42 6 1195 140 142 913 8 40 3472 629 78 1256 856 611 42 291 79 6 102 12 5 87 41 37 4 1731 750 981 Per cent. 13 81.3 5.8 100.0 3.9 9 3 13 18 7 14 2 2 1 24 5 2 1 16 1 1 23 19 1 3 4 40 1 1 27 4 7 25 5.9 3.1 6.1 0.8 4.7 0.4 2.9 7.2 10.5 14.3 2.2 2.1 2.4 1.9 13.6 0.7 0.3 10.6 1.2 0.2 1.3 2.1 0.5 1.1 8.6 5.1 19 18.6 2.3 7.3 8.1 144 39 105 8.3 5.2 10.7 Statistical Experience Data. 71 Table 38. Slaimaby of White Cases — Continued. Males. Diseases and conditions. Admitted. Died Urinary organs 881 100 Bladder 104 9 Kidney 575 83 Ureter 2 Urethra 200 Obstetrical conditions Newborn child 2 .... Injuries 1436 80 Grand total 17730 1235 Per cent. 11.4 8.7 14.4 8 4.0 5.6 Females. Admitted. Died. 757 178 521 22 36 2973 '356 42 2 40 Per cent. 5.0 1.1 7.7 7.0 16657 637 Table 39. "White Medical Cases. Males. Diseases and conditions. Admitted. Abnormities, congenital malfor- mations 13 Blood 177 Bones and cartilages 26 Bursae 2 Circulatory system 1044 Arteries and veins 491 Endocardium and valves 395 Myocardium 120 Neuroses 24 Pericardium 14 Digestive system 760 Appendix 44 Intestine 129 Liver 154 Gall bladder and ducts 61 Mesentery Omentum Peritoneum 4 Lips Mouth 4 Palate, uvula Pharynx 9 Salivary glands Teeth, gums, alveoli 2 Tongue 1 Tonsils 137 CEsophagus 9 Pancreas 7 Rectum and anus 20 Stomach 179 Ductless glands and spleen 45 Carotid gland Parathyreoid gland Pineal gland Pituitary body 2 Spleen 1 Died. 157 63 71 16 2 5 31 1 6 16 Per cent. 42 23.7 15.0 12.8 18.0 13.3 8.3 35.7 4.1 2.3 4.7 10.4 1 25.0 1 11.1 3 2.2 1 0.6 2 4.4 Females. Admitted. Died. 9 2 273 54 179 27 421 42 80 24 77 100 "2 4 79 131 1 14 Per cent. 72 Frederick L. Hoffman. Table 39. White Medical Cases — Continued. Diseases and conditions. Suprarenal gland Thymus gland Thyreoid gland Ear Eye and adnexa , Infective diseases Dysentery , Gonorrhoea , Influenza Malaria Rheumatic fever Septicemia Syphilis Tuberculosis, meninges Tuberculosis, lungs Tuberculosis, miliary Tuberculosis, other forms. . . . Typhoid fever Other infective diseases Hernia? , Joints Lymphatic system Mind Miscellaneous Diabetes Gout Obesity '. Rheumatism, ch. art Rheumatism, n. s Other miscellaneous Muscles, fascia?, tendons Muscles and fascia? Tendons and sheaths Nervous system Brain, spinal cord, meninges. . Cranial and spinal nerves.... Functional nervous disorders. Parasites Poisonings and intoxications... Reproductive organs Functional disorders Mammary gland Ligaments, ovaries, tubes Uterus Vagina Vulva Cowper's glands '. Penis Prostate gland Scrotum Seminal vesicles Males. Females A.dmitte( i. Died Per cent. Admitted. Died. -> Per cent. 13 2 15.4 3 126 1 29 0.8 15 6 8 1 12.5 11 2035 110 5.4 795 49 6.2 134 5 3.7 13 1 7.7 43 18 1 5.6 85 37 235 4 1.7 24 70 3 4.3 15 13 8 61.5 10 3 30.0 198 4 2.0 49 2 4.1 20 14 70.0 13 10 76.9 300 23 7.7 148 8 5.4 4 3 75.0 2 2 100.0 39 7 17.9 23 4 17.4 656 29 4.4 292 14 4.8 238 la 4.2 151 4 2.6 6 186 2 1.1 131 23 2 8.7 7 272 8 2.9 264 1 0.4 406 29 7.1 201 15 7.5 125 6 4.8 66 5 7.6 41 1 2.4 4 2 10 60 3 5.0 19 2 10.5 8 6 1 16.7 170 19 11.2 96 7 7.3 26 1 3.8 12 1 8.3 26 1 3.8 12 1 8.3 1123 30 2.7 910 12 1.3 208 27 13.0 71 9 12.7 51 1 2.0 32 864 2 0.2 807 3 0.4 7 6 128 7 5.5 36 4 11.1 47 2 4.3 41 7 1 21 4 8 1 36 2 5.6 Statistical Experience Data. 73 Table 39. White Medical Cases — Continued. Males. Females. Diseases and conditions. Spermatic cord Testicle and epididymis... Tunica vaginalis Respiratory system Bronchi and trachea Larynx and epiglottis Lung Nose and nasal passages. . . Accessory sinuses Pleura Skin, hair, nails Skin and hair Nails Tumors Benign Malignant Urinary organs Bladder Kidney Ureter Urethra Obstetrical conditions Newborn child Injuries Grand total Admitted. Died. Per cent. Admitted. Died Per ' cent. 10 657 "77 11.7 222 23 10.4 166 4 2.4 73 4 5.5 2 4 333 69 20.7 98 19 19.4 15 1 6.7 2 141 "3 2.1 45 32 1 3.1 25 2 8.0 32 1 43 3.1 13.4 25 137 2 19 8.0 321 13.9 65 5 7.7 44 5 11.4 256 38 14.8 93 14 15.1 392 78 19.9 182 30 16.5 20 5 25.0 13 341 72 1 21.1 3.2 164 5 30 18.3 31 i 5.3 22 7 1 4.5 19 . *. 624 8.0 5925 223 5.7 Table 40. White Sukgical Cases. Diseases and conditions. Abnormities, congenital malfor mations Blood Bones and cartilages Bursa? Circulatory system , Arteries and veins Endocardium and valves Myocardium Neuroses , Pericardium , Digestive system 1786 Appendix Intestine , Liver Gall bladder and ducts Mesentery Omentum Peritoneum Lips Mouth 12 Males. Females. Admitted. Died Per " cent. Admitted. Died. Per cent. 98 5 5.1 49 2 4.1 8 3 363 7 1.9 124 5 4.0 25 10 127 12 9.4 40 1 2.5 124 11 8.9 39 1 2.6 2 "i 100.6 1 1 1786 103 5.8 866 38 4.4 796 28 3.5 410 6 1.5 123 22 17.9 61 10 16.4 35 13 37.1 9 3 00.0 116 13 "9 11.2 34.6 194 7 12 "l 6.2 26 14.3 3 74 Frederick L. Hoffman. Table 40. White Surgical Cases — Continued. Diseases and conditions. Palate, uvula Pharynx Salivary glands Teeth, gums, alveoli Tongue Tonsils CEsophagus Pancreas Rectum and anus Stomach Ductless glands and spleen Carotid gland Parathyreoid gland Pineal gland Pituitary body Spleen Suprarenal gland Thymus gland Thyreoid gland Ear Eye and adnexa Infective diseases Dysentery Gonorrhaea Influenza Malaria Rheumatic fever Septicemia Syphilis Tuberculosis, meninges Tuberculosis, lungs Tuberculosis, miliary Tuberculosis, other forms Typhoid fever Other infective diseases Herniae Joints Lymphatic system Mind Miscellaneous Diabetes Gout Obesity Rheumatism, ch. art Rheumatism, n. s Other miscellaneous Muscles, fasciae, tendons Muscles and fasciae Tendons and sheaths Nervous system Brain, spinal cord, meninges. . Cranial and spinal nerves.... Functional nervous disorders. Males. Females ^.dmitte d. Diec , Per ' cent. Admitted 1 . . . 4 1 25.0 1 1 7 13 2 . • • 88 1 1.1 82 2 2.4 16 3 18.8 1 ... 7 2 28.6 2 ... 493 4 0.8 70 51 6 11.8 19 4 21.1 73 5 6.8 261 11 4.2 13 "i 7.7 18 "i 5.6 "i "3 33.3 5.3 1 242 io 3 57 4.1 67 6 9.0 50 2 4.0 174 1 0.6 68 808 62 7.7 362 19 5.2 1 1 100.0 45 1 2.2 23 1 1 3 7 "7 100.0 6 "4 66.7 68 2 2.9 15 7 5 71.4 3 3 100.0 12 1 8.3 3 1 1 100.0 444 11 2.5 243 5 2.1 39 23 59.0 11 4 36.4 180 10 5.6 57 3 5.3 897 18 2.0 127 11 8.7 200 1 0.5 132 2 1.5 78 30 2 6.7 20 10 364 25 6.9 127 8 6.3 3 1 33.3 1 1 1 3 356 24 6.7 126 8 6.3 76 1 1.3 36 63 1 1.6 30 13 6 395 39 9.9 250 11 4.4 152 36 23.7 69 10 14.5 92 1 1.1 109 1 0.9 151 2 1.3 72 Statistical Experience Data. 75 Table 40. White Surgical Cases — Continued. Males. Diseases and conditions. Admitted. Parasites 31 Poisonings and intoxications. ... 9 Reproductive organs 1052 Functional disorders 1 Mammary gland Ligaments, ovaries, tubes Uterus Vagina Vulva Cowper's glands Penis 18 Prostate gland 731 Scrotum 8 Seminal vesicles 2 Spermatic cord 105 Testicle and epididymis 67 Tunica vaginalis 120 Respiratory system 183 Bronchi and trachea 9 Larynx and epiglottis 8 Lung 8 Nose and nasal passages 28 Accessory sinuses 13 Pleura 117 Skin, hair, nails 43 Skin and hair 40 Nails 3 Tumors 1175 Benign 372 Malignant 803 Urinary organs 489 Bladder 84 Kidney 234 Ureter 2 Urethra 169 Obstetrical conditions Newborn child 2 Injuries 1417 Grand total 9960 Died. Per cent. 7 22.6 3 4.1 41 1 1 0.8 13 7.1 1 11.1 2 25.6 162 41 121 22 4 11 7.7 7.7 13.8 11.0 15.1 4.5 4.8 4.7 4.1 79 5.6 611 6.1 Females. Admitted. Died. 2 1 110 2 77 24 3 3 5.6 ! 12.5 6 2 q 10 5 42 13 9 4 703 218 485 34 2 32 341 2 1 1 65 19 46 Per cent. 1.8 1.3 4.2 2.9 4.8 7.7 11.1 9.2 8.7 9.5 41 12.0 3821 223 5.8 Table 41. White Gynecological Cases. Diseases and conditions. Admitted. Abnormities, congenital malformations. . 7 Blood 4 Bones and cartilages 7 Bursas Circulatory system 2 Arteries and veins 2 Endocardium and valves Myocardium Neuroses Pericardium Died. Per cent. Frederick L. Hoffman. Table 41. White Gynecological Cases — Continued. Diseases and conditions. Admitted. Died. Digestive system 424 Appendix 226 Intestine 27 Liver 3 Gall bladder and ducts 40 Mesentery Omentum 2 Peritoneum 42 Lips Mouth Palate, uvula Salivary glands Teeth, gums, alveoli Tongue Tonsils 1 (Esophagus Pancreas Rectum and anus 82 Stomach 1 Ductless glands and spleen 2 Carotid gland Parathyroid gland Pineal gland Pituitary body Spleen 2 Suprarenal gland Thymus gland Thyreoid gland Ear Eye and adnexa Infective diseases 105 Dysentery Gonorrhoea 3 Influenza Malaria Rheumatic fever Septicemia 2 Syphilis 9 Tuberculosis, meninges Tuberculosis, lungs 3 Tuberculosis, miliary 1 Tuberculosis, other forms 68 Typhoid fever 4 Other infective diseases '. 15 Hernia? 102 Joints 2 Lymphatic system 6 Mind Miscellaneous 506 Diabetes 2 Gout Obesity 1 Rheumatism, ch. art Rheumatism, n. s 1 Other miscellaneous 502 12 2 3 Per cent. 2.8 0.9 11.1 5.6 11.9 6.7 50.0 33.3 100.0 5.9 2.9 0.2 0.2 Statistical Experience Data. 77 38 1.1 1 0.2 26 2.1 4 0.5 7 1.2 Table 41. White Gynecological Cases — Continued. Diseases and conditions. Admitted. Died. Per cent. Muscles, fasciae, tendons Muscles and fascia? Tendons and sheaths Nervous system 35 Brain, spinal cord, meninges Cranial and spinal nerves 1 Functional nervous disorders 34 Parasites Poisonings and intoxications 3 Reproductive organs 3321 Functional disorders 619 Mammary gland Ligaments, ovaries, tubes 1211 Uterus 849 Vagina 600 Vulva 42 Cowper's glands Penis Prostate gland Scrotum Seminal vesicles Spermatic cord Testicle and epididymis Tunica vaginalis Respiratory system 1 Bronchi and trachea Larynx and epiglottis Lung 1 Nose and nasal passages Accessory sinuses Pleura Skin, hair, nails 3 Skin and hair 3 Nails Tumors 891 Benign 488 Malignant 403 Urinary organs 541 Bladder 163 Kidney 325 Ureter 22 Urethra 31 Obstetrical conditions 462 8 1.7 Newborn child Injuries 2 60 6.7 15 3.1 45 11.2 12 2.2 2 1.2 10 3.1 Grand total 6426 141 2.2 Frederick L. Hoffman. Table 42. White Medical Cases. Males. Females. Causes. Admitted. Died. Abdominal pain 9 Abortion Abscess, alveolar 1 Abscess, breast Abscess, chest wall 1 Abscess, gluteal 1 Abscess, intra-abdominal 1 Abscess, kidney 1 Abscess, leg 1 Abscess, liver 15 Abscess, lung 4 Abscess, mastoid 1 Abscess, mediastinal 1 Abscess, multiple Abscess, pancreas Abscess, pelvic Abscess, perinephric 6 Abscess, perirectal 1 Abscess, perirenal 5 Abscess, peritoneum Abscess, peritonsillar 2 Abscess, periurethral 2 Abscess, prostatic 1 Abscess, retroperitoneal 1 Abscess, subdiaphragmatic 1 Abscess, subphrenic 1 Abscess, thigh 1 Abscess, tonsillar 2 Achlorhydria 2 Achylia gastrica 1 Acrocyanosis 8 Acromegaly 2 Acroparesthesia chronica Addison's disease 8 Adenitis 9 Adenocarcinoma, stomach 1 Adenoids 9 Adhesions 2 Adhesions, omental Adiposis dolorosa 2 Aerophagia, hysterical Albuminuria 6 Alcoholism 62 Amblyopia, tobacco 1 Amenorrhea Anacidity 6 Anaemia, aplastic 2 Anaemia, pernicious 99 23 Anaemia, secondary 6 2 Anaemia, splenic 10 1 Aneurism, abdominal 5 2 Aneurism, aortic 42 4 Aneurism, arteriovenous 2 Aneurism, cirsoid 1 Admitted. Died. 12 1 Per cent. 1 2 1 1 3 7 i 6 1 10 1 25 9 100.0 50.0 58.0 Statistical Experience Data. 79 Table 42. White Medical Cases — Continued. Males. Females. Causes. Admitted. Died. Aneurism, thoracic 45 Angina, pseudo- 2 Angiomata 1 Anorexia nervosa 4 Aphasia 1 Aphasia, motor 2 Aphonia, hysterical Appendicitis 44 Argyria 1 Arrested sexual development 1 Arteriosclerosis 363 Arthritis 12 Arthritis deformans 89 Arthritis, gonorrhceal 34 Arthritis, hypertrophic 5 Arthritis, infectious 35 Arthritis, knee 1 Arthritis, rheumatoid 1 Arthritis, villous 2 Ascites 1 Asphyxia Asthenia 1 Asthma 41 Astigmatism, myopic 1 Asynergy, cerebellar 5 Ataxia, cerebellar 1 Ataxia, Friedreich's Ataxia, locomotor 18 Atrophy, muscular 18 Bacilluria 3 Bacteriuria . 1 Banti's disease 1 Brachialgia Bronchiectasis 16 Bronchitis 79 Bubo, inguinal 4 Burns Bursitis 2 Calculus, biliary 49 Calculus, renal 23 Calculus, urethral 1 Carcinoma, bile passages 4 Carcinoma, breast 1 Carcinoma, caecum 1 Carcinoma, cervix uteri Carcinoma, colon 1 Carcinoma, face 1 Carcinoma, gall bladder Carcinoma, glands neck 1 Carcinoma, ilium Carcinoma, intestine 6 Carcinoma, kidney 2 Carcinoma, latent 1 Carcinoma, liver 12 51 Per cent, 8.9 6 14 100 12 16.7 Admitted. Died. 2 10 2 42 42 9 81 12 4 22 2 1 18 1 4 44 2 2 73 10 *6 5 2 1 Per cent. 33.3 16. 25. 6. 1. 16. 100. 66. 50. 80 Frederick L. Hoffman. Table 42. White Medical Cases — Continued. Males. Females. Causes. Admitted. Died. „„„f Admitted. Died. cent'. Admitted. Died. *» Carcinoma, lung 2 2 100.0 1 Carcinoma, oesophagus 9 3 33.3 2 1 50.0 Carcinoma, ovary 1 Carcinoma, pancreas 5 6 Carcinoma, pelvis 2 1 1 100.0 Carcinoma, prostate 11 1 9.1 Carcinoma, rectum 8 2 Carcinoma, sigmoid flexure 1 1 Carcinoma, stomach 135 18 13.3 33 4 12.1 Carcinoma, submaxillary gland.... 1 Carcinoma, thyroid gland 1 Carcinoma, tongue 1 Carcinoma, tonsil 1 Carcinoma, uterus .... 1 Carcinoma, ventriculi 12 2 16.7 6 Carcinoma, vertebra? 1 1 1 100.0 Carcinomatosis, general 1 2 Carcinosis 2 Caries, spine 1 Catarrh, nasal 1 Cellulitis 4 1 1 100.0 Cephalalgia 3 5 Chancroid 1 Chlorosis 6 Cholangitis 2 Cholecystitis 10 4 Cholera infantum 1 1 100.0 Chorea 22 1 4.5 42 1 2.4 Cirrhosis, liver 91 16 17.6 16 1 6.3 Cirrhosis, stomach 1 Coccygodynia 1 Coccyxitis 1 Colic, intestinal 1 Colic, renal 4 Colitis 14 1 7.1 22 1 4.5 Colitis, polypoid 1 Colitis, ulcerative 2 Coloptosis 1 Coma 1 1 Conjunctivitis 1 6 Constipation 14 8 Contusion 2 Convalescence 6 19 1 5.3 Convulsions, infantile 4 Coxalgia 1 Coxa valga 1 Cretinism 1 2 Crushed hand 1 Cyanosis 2 Cyst, breast 1 Cyst, cerebellum 2 2 100.0 Cyst, liver 1 [[ Cyst, ovarian 6 1 16.7 Cyst, renal , 5 1 20.6 1 Statistical Experience Data. 81 Tarle 42. White Medical Cases — Continued. Males. Females. Causes. Admitted. Died. "; Admitted. Died. eeS. Admitted. Died. ^ Cystinuria 1 Cystitis 16 5 31.3 11 Dementia 6 Dementia, alcoholic 2 Dementia paralytica 3 Dementia praecox 11 9 Dementia, senile 1 1 Dermatitis 2 1 Deviation nasal septum 1 Diabetes insipidus 3 Diabetes mellitus 122 6 4.9 66 5 7.6 Diarrhoea 38 1 2.6 13 Dilatation, aorta 7 Dilatation, colon 1 Dilatation, duodenum 1 Dilatation, stomach 9 4 Diphtheria 58 3 5.2 64 3 4.7 Diplegia 1 1 ... .... Diplegia, spastic 1 Displacement, kidney 1 Disturbance, glands of internal se- cretion 2 Drug habit 1 Dysentery 10 1 10.0 2 Dysentery, amoebic 123 4 3.3 11 1 9.1 Dysentery, chronic 1 Dysmenorrhcea 2 ... Dyspepsia 11 Dyspepsia, nervous 36 22 Dystrophy, muscular 1 Eczema 4 5 Elephantiasis 1 Emphysema 30 2 6.7 7 Empyema 29 1 3.4 8 1 12.5 Encephalitis 2 2 Encephalomalacia 1 1 100.0 Encephalo-myelitis 1 Endothelioma, lung 1 1 100.0 Enlarged liver 1 Enlarged prostate 4 Enlarged spleen 1 1 Enlarged thyroid 1 Enlarged tonsils 1 Enteritis 12 1 8.3 2 Enterocolitis 2 2 100.0 Enteroptosis 1 12 Epididymitis 6 Epilepsy 54 17 Epilepsy, Jacksonian 2 Epistaxis 3 1 33.3 Epithelioma 1 Epithelioma, oesophagus 1 1 100.0 Epithelioma, tonsil 1 1 100.0 Error of refraction 1 82 Frederick L. Hoffman. Taele 42. White Medical Cases — Continued. Males. Females. 29 Causes. Admitted. Died. Erysipelas 10 Erythema 4 Erythromelalgia 2 Ethmoiditis 1 Febricula 85 Fecal impaction Fever, continuous 43 Fever, ephemeral 1 Fever, glandular 2 Fever, malarial 235 Fever, paratyphoid 2 Fever, remittent 1 Fever, rheumatic 70 Fever, scarlet 6 Fever, typhoid 606 Fever, typhus 3 Fever, unknown cause 1 Fibroma Fibroma, ovary Fibro-sarcoma, spinal cord 1 Fistula, oesophageal 2 Foreign body in eye 1 Fracture, femur 2 Fracture, lumbar vertebra? 2 Furunculosis 1 Gangrene 1 Gangrene, toes and feet 1 Gastralgia Gastrectasis 1 Gastritis 30 Gastro-enteritis 19 Geographical tongue 1 Giant colon 1 Gigantism 1 Glaucoma Glycosuria 1 Goitre 1 Goitre, colloid 1 Goitre, exophthalmic 19 Gonorrhoea 4 Gout 41 Gumma 1 Gumma, testicle 1 Heart diseases: Adherent pericardium 1 Angina pectoris 10 Arrhythmia 2 Bradycardia 1 Congenital 4 Endocarditis 38 Hypertrophy 2 Myocarditis 98 Neurosis Pericarditis 11 21 15 Per cent. 10.0 100 10 55 Admitted. Died. 9 7 1 29 1 17 24 3 15 7 271 Per cent. 1 1 6 81 12 22 1 6 14 12. 100. 50. 27. 16. Statistical Experience Data. 83 Table 42. White Medical Cases — Continued. Males. Females. Causes. Admitted. Died. ^1 Pericarditis, tuberculous 2 1 50.0 Stokes-Adams disease 4 Tachycardia 10 1 10.0 Aortic dilatation 1 Aortic insufficiency 53 10 18.9 Aortic insufficiency and stenosis. . 1 1 100.0 Aortic and mitral insufficiency .. . 75 12 16.0 Aortic insufficiency, mitral insuffi- ciency and stenosis 18 2 11.1 Aortic, mitral, myocardial insuffi- ciency 8 Aortic, myocardial insufficiency. . 2 1 50.0 Aortic, mitral, tricuspid insuffi- ciency 1 Aortic and mitral insufficiency and stenosis 6 1 16.7 Aortic insufficiency, mitral insuffi- ciency and stonosis 12 2 16.7 Aortic insufficiency and mitral stenosis 5 1 20.0 Aortic insufficiency and stenosis, mitral insufficiency and stenosis 4 1 25.0 Aortic stenosis 1 Aortic stenosis and insufficiency. . 9 1 11.1 Aortic and mitral stenosis 1 Aortic stenosis, mitral insuffi- ciency 3 Mitral insufficiency 69 5 7.2 Mitral insufficiency and stenosis. . 54 11 20.4 Mitral and myocardial insuffi- ciency 9 Mitral, myocardial insufficiency mitral stenosis 3 Mitral stenosis 20 2 10.0 Mitral and tricuspid insufficiency and stenosis Mitral and tricuspid insufficiency Mitral stenosis and tricuspid in- sufficiency 1 Mitral and tricuspid insufficiency and stenosis Myocardial insufficiency 13 1 7.7 Myocardial insufficiency, mitral stenosis 3 Tricuspid insufficiency and sten- osis 1 Pulmonary stenosis Heat prostration 6 1 16.7 Hebephrenia 1 Hemachromatosis 8 3 37.0 Hematemesis 3 Hematoporphyrinuria Hematuria 10 Hemianopsia 1 Admitted. Died. 6 16 1 1 1 1 32 53 1 28 Per cent. 16.7 12.5 12.5 25.0 1 100.0 1 100.0 1 100.0 12.5 13.2 33.3 2 7.1 1 100.0 2 100.0 84 Frederick L. Hoffman. Tarle 42. White Medical Cases — Continued. Males. Causes. Admitted. Died. Hemichorea Hemicrania Hemiplegia 29 Hemophilia 8 Hemoptysis 3 Hemorrhage, cerebral 7 Hemorrhoids 12 Hernia 3 Hernia, inguinal 2 Hernia, strangulated 1 Herpes zoster 3 Hodgkin's disease 11 Hydrocele 1 Hydrocephalus 6 Hydrocystoma Hydronephrosis 4 Hydrosalpinx Hyperacidity 21 Hyperchlorhydria 2 Hypernephrosis Hyperthyroidism 5 Hypertrophy, liver 2 Hypertrophy, prostate 3 Hypertrophy, uterus Hypochondriasis 3 Hysteria 16 Ichthyosis hystrix Icterus Idiocy 2 Imbecility Inanition 2 Infection, hand 2 Inflammation, heels 1 Influenza 83 Injury, foot 1 Insanity, manic depressive 10 Insomnia 3 Intestinal obstruction 7 Intussusception 1 Irido-cyclitis 1 Jaundice 1 Jaundice, catarrhal 41 Jaundice, obstructive 4 Kyphosis Laryngitis 1 Laryngitis, syphilitic 1 Leptomeningitis Leucorrhcea Leukaemia 13 Leukaemia, lymphatic 7 Leukaemia, splenomyelogenous .... 13 Lipomatosis 1 Lues 22 Lues, cerebral 14 Per cent. 10 57 IS 16 33 14 Admitted. Died. 1 1 12 Per cent. 1 1 1 6 1 3 27 78 1 1 1 1 37 19 1 1 1 1 5 "i 4 1 1 7 2 4 2 4 4 100. 100. 14 50 25 Statistical Experience Data. 85 Table 42. White Medical Cases — Continued. Males. Females. Causes. Admitted. Died. Per cent Lues, congenital 1 Lues, liver 1 Lues, secondary 6 Lues, tertiary 16 Lumbago 2 Lumbar pain 1 Lupus 1 Lymphadenitis 1 Lymphomatosis Lympho-sarcoma 5 Malaise 1 Malformation, urethra 1 Malingering 1 Malnutrition 1 Mania, acute Marasmus Mastitis Mastoiditis, acute 2 Measles 9 Melancholia 9 Melena 1 Meningitis 5 Meningitis, cerebrospinal 30 Meningitis, streptococcus Merycismus 1 Microcephaly Migraine 3 Monoplegia 2 Morphinism 21 Myalgia 1 Myasthenia gravis 1 Myelitis 8 Myoma Myoma, uterus Myxcedema 2 Necrosis, rib 1 Neoplasm 2 Neoplasm, intrathoracic Neoplasm, rectum 1 Nephritis : 269 Nephritis, parenchymatous Nephroptosis 1 Neuralgia 9 Neuralgia, brachial 1 Neuralgia, supraorbital Neuralgia, trifacial Neurasthenia 693 Neuritis 12 Neuritis, alcoholic 5 Neuritis, arsenical 1 Neuritis, ascending 1 Neuritis, multiple 3 Neuritis, optic 2 Neuritis, peripheral 4 M 20 100 12 25 100 Admitted. Died. Per cent. 3 2 1 1 1 19 7 1 4 1 1 9 5 1 130 1 1 7 1 1 1 636 11 100. 14. 53. 20. 86 Frederick L. Hoffman. Table 42. White Medical Cases — Continued. Males. Females. Causes. Admitted. Neurofibromata, multiple Neurosis 36 Neurosis, traumatic 1 Neurosis, vasomotor Nevus telangiectatic 1 CEdema 2 (Edema, angioneurotic 4 (Esophageal diverticulum 1 (Esophageal obstruction 2 Ophthalmoplegia 1 Orthopnea, paroxysmal 1 Osteitis deformans 1 Osteoarthritis 11 Osteoarthropathy, hypertrophic pul- monary 1 Osteoma 1 Osteomyelitis 4 Otitis media 12 Pachymeningitis 1 Painful hip 1 Palsy 2 Pancreatitis 6 Pancreatitis, gangrenous 1 Papilloma 2 Papilloma, rectum 1 Paralysis 21 Paralysis, facial 3 Paralysis, post-diphtheritic 3 Paralysis, spastic Paramyoclonus multiplex 2 Paranoia Paraplegia 2 Paraplegia, ataxic 2 Paraplegia, hysterical Paraplegia, spastic 10 Parasites, intestinal 3 Paregoric habit Paresis 23 Paresis, general 11 Parotitis 20 Pellagra 10 Pelvic inflammatory disease Pemphigus foliaceus 3 Pemphigus vegetans Periostitis 3 Peritonitis, general 3 Pertussis 5 Pharyngitis 9 Phimosis 1 Phlebitis 7 Phlebitis, post-typhoid 1 Phlegmon, neck 1 Pleurisy 33 Pleurisy, diaphragmatic Per cent 100 100 33 Hi Admitted. Died. 2 6 Per cent. 11 50. 16. Statistical Experience Data. 87 Table 42. White Medical Cases — Continued. Males. Females. Causes. Admitted. Died. Pleurisy, fibrinous 33 Pleurisy with effusion 66 Pleurodynia 1 Pneumonia, bronchial 34 Pneumonia, influenzal 2 Pneumonia, lobar 263 Pneumonia, tuberculous Pneumothorax Poisoning, acetanilide Poisoning, arsenic Poisoning, atropine Poisoning, bichloride of mercury. Poisoning, carbolic acid Poisoning, carbon monoxide Poisoning, chloroform Poisoning, drug Poisoning, gas 3 2 1 2 1 2 6 3 1 1 5 Poisoning, lead 37 Poisoning, lye 1 Poisoning, mercurial 2 Poisoning, morphine 1 Poisoning, oil sassafras 1 Poisoning, opium 6 Poisoning, paraldehyde Poisoning, potassium cyanide 1 Poisoning, ptomaine 2 Poisoning, salicylic acid Poisoning, strychnia 1 Poisoning, vegetable 1 Poisoning, wood alcohol Poliomyelitis 6 Polyarthritis 3 Polyarthritis, gonorrhceal 5 Polyarthritis, infectious 5 Polycythemia 5 Polypi, larynx 1 Polypi, nasal 1 Polyserositis 4 Pregnancy Proctitis 3 Prolapsus, colon Prolapsus recti 2 Prostatitis 28 Pruritus Pseudo-cyesis Pseudo-tabes 2 Psoriasis 4 Psychasthenia 101 Psychoneurosis 24 Psychosis 6 Psychosis, post-typhoid 1 Purpura 3 Purpura hemorrhagica Purpura, Henoch's 4 54 Per cent. 38 33 100 20 100 16 20 2d Admitted. Died. 13 23 25.0 21 66 1 1 18 159 48 6 "i 2 3 14 Per cent. 14.c 21.1 25. 100. 100.( 100.C 33.; 100.0 Frederick L. Hoffman. Tarle 42. White Medical Cases — Continued. Males. Females. Causes. Admitted. Died. Purpura rheumatica 2 Purpura simplex 1 Pyaemia Pyelitis 7 Pyelonephritis Pyonephrosis 1 Pyorrhoea alveolaris 1 Pyuria 1 Quinsy 3 Rachitis 1 Raynaud's disease 5 Recklinghausen's disease 1 Relaxation, joint 2 Relaxed vagina Retinitis Retroflexion, uterus ." Retroversion, uterus Rheumatism 8 Rheumatism, articular 60 Rhinitis Salpingo-oophoritis Sarcoma, cerebrum 1 Sarcoma, cervical gland 1 Sarcoma, ileum 1 Sarcoma, intra-nasal 1 Sarcoma, intra-thoracic 1 Sarcoma, kidney 3 Sarcoma, liver 2 Sarcoma, lymph-glands Sarcoma, osteo- 2 Sarcoma, prostate 1 Sarcoma, retroperitoneal 5 Sarcoma, spinal cord 1 Sarcoma, sternum 1 Sarcomatosis Schonlein's disease 6 Sciatica 8 Scleroderma 2 Sclerosis 6 Sclerosis, lateral 1 Sclerosis, multiple 5 Scoliosis Scurvy 4 Senility 8 Septicemia 11 Septicemia, gonococcus Septicemia, puerperal Serum disease Singultus 1 Sinusitis 13 Smallpox 2 Spasm, intestinal 1 Splanchnoptosis Splenomegaly 9 Per cent 100 100 100 22 Admitted. Died. 4 1 2 1 6 19 1 17 1 2 3 1 10 3 1 1 9 2 1 1 i 2 i 3 Per cent. 12.5 50.0 16.7 10.5 100.0 100.0 33.3 50.0 100.0 Statistical Experience Data. 89 Table 42. White Medical Cases — Continued. Males. Causes. Admitted. Died. Spondylitis 12 Spondylitis deformans 5 Spondylitis, infectious 3 Spondylolisthesis Sprain 2 Stenosis, pyloric 10 Stenosis, rectal 1 Stomach, hour-glass 1 Stomatitis 2 Stricture, Gesophagus 4 Stricture, rectum Stricture, urethra 2 Strongyloides intestinalis 1 Subacidity Subluxation, sacro-iliac 1 Synovitis 2 Synovitis, knee 1 Syphilis 131 Syphilis, cerebral Syphilophobia 1 Syringomyelia 3 Tabes dorsalis 44 Tabo-paresis 1 Taenia saginata 1 Talipes equino-varus 1 Teleangiectasis 7 Teniasis 2 Tetanus 7 Thickened pleura 7 Thrombosis 6 Thrombosis, axillary 1 Thrombosis, cerebral 3 Thrombosis, femoral Thrombosis, iliac 1 Thrombosis, venous 1 Tinea cruris 1 Tonsillitis 129 Torticollis 6 Tremor 1 Trichinosis 2 Tuberculosis, abscess 1 Tuberculosis, arthritis 3 Tuberculosis, bone Tuberculosis, caecum Tuberculosis, clavicle Tuberculosis, general 3 Tuberculosis, genito-urinary tract.. 1 Tuberculosis, glandular 3 Tuberculosis, hip joint 1 Tuberculosis, intestines 1 Tuberculosis, larynx 3 Tuberculosis, meningeal 20 Tuberculosis, mesenteric glands. ... 1 Tuberculosis, miliary 4 Per cent 10 100 42 14 66 100 70 75 Admitted. Died. Per cent. 93 6 2 1 1 1 1 1 4 3 4 1 2 13 10 100. 100. 76. 100. 90 Frederick L. Hoffman. Tarle 42. White Medical Cases — Continued. Males. Causes. Admitted. Died. 1 1 280 20 Tuberculosis, peritoneal 5 1 Tuberculosis, peritoneal, pleural. .. . 1 1 Tuberculosis, pleural 4 Tuberculosis, pleural, pericardial, meningeal Tuberculosis, pleural and peri- toneal Tuberculosis, polyserositis Tuberculosis, pulmonary Tuberculosis, pulmonary and in- testinal Tuberculosis, pulmonary and laryn- geal Tuberculosis, pulmonary and men- ingeal Tuberculosis, renal Tuberculosis, sacro-iliac joint Tuberculosis, spine Tuberculosis, spleen Tuberculosis, spondylitis Tumor, abdominal Tumor, bladder Tumor, cauda equina 1 Tumor, cerebral 41 Tumor, colon 1 Tumor, kidney 4 Tumor, liver 3. Tumor, mediastinal 2 Tumor, pylorus 1 Tumor, retroperitoneal 1 Tumor, spinal cord 2 Tumor, testicle 2 Typhoid spine 5 Ulcer, duodenal 9 Ulcer, gastric 39 Ulcer, rectum 1 Uncinariasis 15 Uncinate gyrus attacks 1 Uraemia 2 Urethritis 25 Urticaria 3 Uveitis Vaccination 6 Vaginitis Varicella 1 Varicose veins 1 Vertigo 8 Vomiting, hysterical 1 Vomiting, pernicious Vomiting, pregnancy Wound, gunshot Zeroderma pigmentosa 1 ^Unclassified 91 21 Females. \ r Per cent. 20.0 100.0 Admitted. Died. 7.1 143 66.7 . . . 100.0 50.0 100.0 50.0 50.6 7.3 21 100.0 23.1 1 1 21 3 2 1 1 "4 2 1 1 i 1 1 1 37 Per cent. 100.0 4.9 25.( 50. 50. 100.0 16.2 * Includes cases of doubtful terminology. Statistical Experience Data. 91 Table 43. White Surgical Cases. Males. Females. Causes. Ad- mitted. Abdominal pain 17 Aberrant thyroid Abscess Abscess Abscess Abscess Abscess Abscess Abscess Abscess Abscess Abscess Abscess Abscess Abscess Abscess Abscess Abscess Abscess Abscess Abscess Abscess Abscess Abscess Abscess Abscess Abscess Abscess Abscess Abscess Abscess Abscess Abscess Abscess Abscess Abscess Abscess Abscess Abscess Abscess Abscess Abscess Abscess Abscess Abscess Abscess Abscess Abscess Abscess Abscess Abscess Abscess Abscess Abscess abdominal 11 alveolar 12 antrum of Highmore 1 arm 3 axillary 14 back breast buttocks cerebral cervical cheek chest wall elbow face foot groin iliac inguinal intermuscular . intra-abdominal intracranial . . . ischio-rectal . . . jaw leg lip 4 3 6 4 17 1 liver IS prostate psoas rectal retroperitoneal . retropharyngeal sacro-iliac Died. Per cent. 18.2 liver, amoebic 9 lumbar 4 lung 2 mastoid 5 mouth 1 neck 22 nose 1 palmar 1 pelvic perigastric 1 perineal 8 perinephritic 18 2 periprostatic 1 1 perirectal 53 perirenal 2 peritonsillar 10 periurethral 14 pharynx 1 popliteal 3 prepatellar bursa 100.0 7.1 75.0 11.1 20.0 50.0 33.3 11.8 27.7 44.4 20.0 11.1 100.0 7.1 20.0 50.0 Ad- mitted. 1 10 5 "2 1 ii 4 3 Died. 11 Per cent. 10. 25. 25. 100. 92 Frederick L. Hoffman. Table 43. White Surgical Cases — Continued. Causes - mitted. Abscess, sacrum Abscess, scalp 1 Abscess, scapula 1 Abscess, scrotum 7 Abscess, shin 1 Abscess, shoulder 1 Abscess, sinus, frontal 2 Abscess, space of Retzius 1 Abscess, spleen Abscess, stitch 1 Abscess, subphrenic 5 Abscess, temporal 2 Abscess, thigh 25 Abscess, tonsillar 1 Abscess, trachea 1 Abscesses, multiple 4 Achlorhydria 1 Acromegaly 7 Actinomycosis 7 Actinomycosis, liver Actinomycosis, ribs 1 Addison's disease 3 Adenitis, axillary 1 Adenitis, axillary, suppurative 2 Adenitis, cervical Adenitis, cervical, inflammatory Adenitis, cervical, suppurative 5 Adenitis, inguinal 5 Adenitis, inguinal, chancroidal 3 Adenitis, inguinal, suppurative 27 Adenitis, inguinal and iliac 1 Adenitis, submaxillary 1 Adeno-carcinoma 2 Adeno-carcinoma, cheek 1 Adeno-carcinoma, rectum 1 Adeno-fibroma, breast Adenoids 8 Adenoma Adenoma, thyroid 1 Adenomata, multiple 1 Adherent prepuce 1 Adhesion, peritoneal 2 Adhesions 4 Alcoholism 5 Amentia, infantile 1 Amputation, stump 10 Amputation, traumatic 7 Anaemia, pernicious 2 Anaemia, splenic 1 Aneurism 30 Aneurism, abdominal 1 Aneurism, aortic 1 Aneurism, arterio-venous 3 Aneurism, sciatic artery 1 Died. Per cent. 50.0 l'o'o'.o 14.3 33.3 28.6 10.0 Ad- mitted. 1 Died. Per cent. 11 33. 20. 16. 100.0 Statistical Experience Data. 93 Table 43. White Surgical Cases — Continued. Males. „ Ad- Causes - mitted. Aneurism, subclavian Angina 3 Angina, Ludwig's 1 Angioma 3 Angioma, abdominal 1 Angioma, cheek 1 Angioma, chest wall Angioma, eyelid Angioma, lip 4 Angioma, neck 1 Angioma, scalp 1 Angioma, thigh 1 Angiomata, multiple Angiosarcoma, rectum Ankylosis 12 Ankylosis, elbow 1 Ankylosis, hip 1 Ankylosis, jaw 3 Ankylosis, knee 2 Ankylosis, shoulder 2 Aphonia, hysterical Apoplexy, cerebral 2 Appendicitis 791 Arachnoiditis 1 Argyria 1 Arteriosclerosis 10 Arthritis 6 Arthritis deformans 16 Arthritis, elbow 3 Arthritis, foot, infectious Arthritis, hip 5 Arthritis, hip, rheumatoid 1 Arthritis, hip, villous 1 Arthritis, infectious 43 Arthritis, knee 12 Arthritis, knee, infectious 2 Arthritis, knee, suppurative 6 Arthritis, knee, traumatic 2 Arthritis, knee, villous 6 Arthritis, metacarpophalangeal ... 3 Arthritis, shoulder 1 Arthritis, sternoclavicular joint Arthritis, suppurative 1 Arthritis, tarsus 1 Arthritis, traumatic 5 Arthritis, villous 1 Arthritis, wrist Arthritis, wrist, infectious Arthropathy (Charcot) 1 Ascaris lumbricoides Ascites . 1 Asthma Athetosis, double 1 Atresia, rectum 7 Died. Per cent. 2 28 100.0 3.5 30.0 Ad- mitted. 1 "l 2 Died. Per cent. 3 1 1 3 409 50 12 3 i 1 33 94 Frederick L. Hoffman. Table 43. White Surgical Cases — Continued. Males. Females. 1 10 1 1 12 22.2 37 1 100.0 42.9 22 8 1 1 10 12.0 143 "2 Ad- Causes, mitted Died- Per cent - Atresia, small intestines, congenital 1 Atrophy, progressive muscular 1 Bacteriuria 1 Blood transfusion Bronchiectasis Bronchitis 3 Burn 54 Burn, arm 1 Burn, carbolic acid 1 Burn, face and hands 2 Burn, hand Burn, superficial 21 Bursitis 24 Bursitis, suppurative 1 Cachexia Calculus, biliary 83 Calculus, prostatic 1 Calculus, renal 43 Calculus, submaxillary 2 Calculus, ureteral 16 Calculus, urethral 9 Calculus, vesical 62 Callus, foot 1 Cancrum oris 2 Carbuncle 34 Carcinoma, abdominal wall 1 Carcinoma, antrum 3 Carcinoma, appendix 1 Carcinoma, axilla 5 Carcinoma, bile duct 2 Carcinoma, bladder 30 Carcinoma, breast 2 Carcinoma, caecum 8 Carcinoma, cervical glands 25 Carcinoma, cheek 5 Carcinoma, chest wall Carcinoma, colon 5 Carcinoma, ear 1 Carcinoma, face 11 Carcinoma, fauces 1 Carcinoma, foot 1 Carcinoma, gall bladder 3 3 Carcinoma, groin 2 Carcinoma, gums 2 1 Carcinoma, hand 1 Carcinoma, humerus Carcinoma, inferior maxilla 3 1 Carcinoma, inguinal gland 1 Carcinoma, intestines, multiple .... 9 4 Carcinoma, intra-abdominal 2 Carcinoma, jaw 3 Carcinoma, kidney 2 Carcinoma, larynx 4 1 Carcinoma, lip 23 2 11.1 3.2 50.6 50.0 33.3 50.0 12.5 32.0 60.0 ' 9.1 100.6 50.6 33.3 44.4 25.0 8.7 Ad- mitted. Died. 6 2 "4 3 1 248 10 3 1 12 2 Per cent. 22 10 59.5 45.5 6.3 14 3 100.0 5.6 33.3 25.0 50.0 Statistical Experience Data. 95 Table 43. White Surgical Cases — Continued. Males. Ad- Causes - mitted. Carcinoma, lip and penis 1 Carcinoma, liver 9 Carcinoma, maxilla 1 Carcinoma, mouth 4 Carcinoma, neck glands 21 Carcinoma, neck and pharynx 1 Carcinoma, nose 1 Carcinoma, oesophagus 19 Carcinoma, orbit 1 Carcinoma, palate 2 Carcinoma, pancreas 15 Carcinoma, parotid 2 Carcinoma, pelvic glands 2 Carcinoma, penis 15 Carcinoma, pharynx 2 Carcinoma, prostate 83 Carcinoma, pylorus 4 Carcinoma, rectum 36 Carcinoma, retroperitoneal glands. . 1 Carcinoma, sacrum 1 Carcinoma, scalp 3 Carcinoma, scrotum 1 Carcinoma, sigmoid flexure 4 Carcinoma, spine Carcinoma, stomach 69 Carcinoma, submaxillary gland 3 Carcinoma, superior maxilla 4 Carcinoma, temporal bone 1 Carcinoma, thyroid 1 Carcinoma, tongue 32 Carcinoma, tonsil 7 Carcinoma, uterus Carcinoma, ventriculi 2 Carcinoma, vertebrae 3 Carcinosis, general 4 Carcinosis, peritoneal 2 Cardiospasm Cellulitis 106 Cervical rib 1 Chancroid 4 Cholangitis Cholecystitis 29 Cholesteatoma Chondritis, typhoid 1 Cirrhosis, liver 11 Clavus, infected 1 Cleft palate 18 Club-foot 15 Coccygodynia Colic, biliary 1 Colic, lead 3 Colic, renal 12 Colitis r 6 Colitis, mucous 3 Died. Per cent. 22.2 25.6 14.3 100.6 31.6 100.0 50.0 20.0 2 10 6.7 50.0 10.8 50.0 16.7 50.0 14.5 9.4 28.6 i 25.6 ' 3 ' 2.8 3 10.3 "5 45.5 2 li'.i Ad- mitted. Died. 2 20 4 2 30 1 1 1 "l 37 1 1 47 1 Per cent. 33.3 28.6 50.0 10.0 100.0 16.7 100.0 5.4 100.0 2.1 100.0 33.3 16.7 96 Frederick L. Hoffman. Table 43. White Surgical Cases — Continued. Males. Females. Causes. Jfi^ Died. Per cent. Jg^ Died. £« Colitis, polypoid 4 1 25.0 Compression, spinal cord 1 Concussion, brain 14 1 7.1 Condylomata 2 1 Congested verumontanum 1 Constipation 6 3 Contracting, scar 1 Contracture, arm 1 Contracture, face 1 3 Contracture, hand 2 2 Contracture, plantar fascia 2 Contracture, tendons of forearm .... 1 Contractures 34 11 Contusion, abdomen 7 1 14.3 Contusion, arm 3 1 Contusion, back 4 1 Contusion, chest 1 Contusion, eye 1 Contusion, face 2 Contusion, foot 2 Contusion, head 12 Contusion, hip 2 Contusion, jaw 1 Contusion, kidney 4 Contusion, knee 2 1 Contusion, leg 7 Contusion, shoulder 3 Contusion, testicle 1 • • • Contusion, thigh 1 Contusion, toe 1 Contusion, urethra 1 Contusion, vertebra 3 Contusions 34 6 Contusions, multiple 1 • • • Cornu cutaneum 1 Coxa valga 1 Coxa vera 5 1 Curvature, spine, traumatic 1 Cyst, axilla 1 Cyst, bladder 1 Cyst, breast 1 45 Cyst, cerebellar 14 3 21.4 10 1 10.0 Cyst, chest wall 1 Cyst, dentigerous 2 Cyst, dermoid 2 3 Cyst, epididymis 2 Cyst, fibula 1 Cyst, humerus 1 1 Cyst, inferior maxilla 1 1 100.0 Cyst, kidney 1 Cyst, lip 1 Cyst, liver * 1 Cyst, mesenteric 1 Cyst, neck , 3 3 Statistical Experience Data. 97 Table 43. White Surgical Cases — Continued. Males. Causes - minted. Cyst, neurenteric 1 Cyst, ovarian Cyst, pancreas Cyst, scalp Cyst, sebaceous Cyst, thyroid 4 Cyst, thyroglossal Cyst, kidney 5 Cystitis 61 Deafness 1 Deformity, face 1 Deformity, foot 2 Deformity, hand Deformity, knee 1 Deformity, leg 1 Deformity, lip 1 Deformity, nose 8 Deformity, penis 1 Deformity, postoperative 1 Deformity, wrist 1 Delirium tremens 2 Dementia praecox 6 Dementia paralytica 1 Dementia, senile 1 Dermatitis 7 Dermatitis, blastomycetic Dermatitis, iodoform 2 Dermatitis, leg '. . . 1 Diabetes mellitus 3 Dilatation, arteries Dilatation, duodenum Dilatation, stomach Diphtheria 3 Dislocation 18 Dislocation, astragalus 1 Dislocation, clavicle 1 Dislocation, elbow 2 Dislocation, elbow, congenital 1 Dislocation, femur 1 Dislocation, femur, congenital Dislocation, hip, congenital 3 Dislocation, humerus 2 Dislocation, interior cuneiform and scaphoid 1 Dislocation, knee 1 Dislocation, metacarpal bone 1 Dislocation, navicula 1 Dislocation, os calcis 1 Dislocation, os magnum 1 Dislocation, radius 4 Dislocation, radius and ulna 1 Dislocation, semilunar cartilage ... 1 Dislocation, shoulder 9 Dislocation, ulna Died. Per cent. 100 Ad- mitted. 3 1 1 2 16 1 1 1 2 1 12 Per cent. 9S Frederick L. Hoffman. Table 43. "White Sukgical Cases — Continued. Males. Females. Ad- Causes - mitted. Dislocation, vertebral 1 Diverticulitis 1 Diverticulum, bladder 2 Diverticulum, oesophagus 1 Diverticulum, urethral 1 Divided ulnar nerve 1 Division, tendon of thumb 1 Dupuytren's contracture Dysentery, amoebic 14 Dysentery, chronic 1 Dysmenorrhea Dyspnoea 1 Dysuria 2 Ectropion 2 Eczema 3 Elephantiasis __ 3 Embolism, cerebral . . ." 1 Empyema 106 Encephalocele Encysted stitch 1 Endocarditis 1 Endothelioma 4 Endothelioma, parotid Enuresis, nocturnal 2 Enlarged aorta '. Enteroptosis 2 Epididymitis 47 Epilepsy 105 Epiphyseal separation 1 Epiphysitis 11 Epistaxis 6 Epithelioma 91 Epithelioma, abdominal wall Epithelioma, arm ■ 1 Epithelioma, axilla Epithelioma, eyelid 1 Epithelioma, face 12 Epithelioma, hand and nose 1 Epithelioma, leg 1 Epithelioma, lip 25 Epithelioma, nipple Epithelioma, nose 2 Epithelioma, palate 1 Epithelioma, penis 4 Epithelioma, scalp 1 Epithelioma, skin over chest wall. . . 1 Epithelioma, thigh 1 Epulis 2 Erysipelas 26 Ethmoiditis 5 Exophthalmos 1 Exostosis 18 Exostosis, femur 3 Exostosis, multiple 2 Died. Per cent. 1 100.0 100 21 100 50 100 7 50 25 Ad- mitted. Died. Per cent. 40 1 13 34 3 1 13 1 1 2 3 3 11 '*2 2 Statistical Experience Data. 99 Table 43. White Surgical Cases — Continued. Males. Females. Causes - mUted. Exostosis, os calcis 3 Exostosis, multiple 1 Exstrophy, bladder 1 Extravasation, urine 2 Facial tic Fatty body in knee 1 Fever, cerebro-spinal Fever, malarial 3 Fever, paratyphoid 1 Fever, scarlet 1 Fever, typhoid 24 Fever, typhoid (intestinal perfora- tion) 12 Fibro-adenoma Fibro-lipoma 5 Fibro-lipoma, groin 1 Fibroma 3 Fibroma, intracanalicular Fibroma, molluscum Fibroma, nose 1 Fibroma, palate Fibro-sarcoma, spinal cord 1 Fissure in ano 35 Fistula, abdominal 1 Fistula in ano 136 Fistula, appendical 1 Fistula, arterio-venous 1 Fistula, biliary 2 Fistula, buccal 1 Fistula, fecal 9 Fistula, gastric 1 Fistula, intestinal 1 Fistula, perineal 9 Fistula, recto-urethral 5 Fistula, recto-vesical 2 Fistula, renal 2 Fistula, suprapubic 5 Fistula, scrotal 1 Fistula, urethral 13 Fistula, urinary 1 Fistula, vesical 1 Flat-foot 21 Floating cartilage 6 Foot drop 1 Foreign body in bronchus 4 Foreign body in caecum 1 Foreign body in eye 1 Foreign body in face 1 Foreign body in foot 3 Foreign body in hand Foreign body in knee Foreign body in larynx 2 Foreign body in leg 2 Foreign body in oesophagus 5 Died. Per cent. 12 11 50.0 91.7 100.0 100.6 0.7 11.1 20.0 100.0 25.0 Ad- mitted. 2 Per cent. 12 100 50, 50. 33. 40.0 100 Frederick L. Hoffman. Table 43. White Surgical Cases — Continued. Males. Females. Causes. Ad- mitted. 1 Foreign body in os calcis Foreign body in stomach 1 Foreign body in trachea 1 Fracture, acromion 1 ankle 3 astragalus 3 clavicle 12 coccyx Colles* 13 cuboid 1 elbow 9 femur 115 femur and skull 1 fibula 14 glenoid fossa 1 hip 4 humerus 47 humerus and ulna 1 ilium 2 inferior maxilla 16 jaw 5 malleolus 1 malleolus and fibula 1 maxilla 1 metacarpus 5 metatarsus 9 nasal bone 6 olecranon 7 os calcis 11 patella 38 pelvis 7 phalanges 10 Pott's 52 radius 12 radius and ulna 45 rib 22 scapula 3 shoulder skull 103 Fracture Fracture Fracture Fracture Fracture Fracture Fracture Fracture Fracture Fracture Fracture Fracture Fracture Fracture Fracture Fracture Fracture Fracture Fracture Fracture Fracture Fracture Fracture Fracture Fracture Fracture Fracture Fracture Fracture Fracture Fracture Fracture Fracture Fracture Fracture Fracture Fracture Fracture Fracture Fracture Fracture Fracture Fracture Fracture Galactocele . . . Ganglion Gangrene Gastritis , Gastro-enteritis Gastroptosis . . spine 3 sternum 1 superior maxilla 2 thumb 2 tibia 38 tibia and fibula 100 tibia and ribs 1 ulna 7 vertebra 17 2 21 5 8 1 Died. Per cent. 18 17 oO 12. Ad- mitted. 2 2 2 5 "2 41 3 19 11 3 4 1 1 18 Died. Per cent. 12. 50. Statistical Experience Data. 101 Table 43. White Suegical Cases — Continued. Males. Females. „ Ad- Causes, mitted. Genu valgum 12 Genu varum 5 Giant colon Gigantism 1 Glioma 1 Glossitis .• • • • 1 Goitre 8 Goitre, colloid 4 Goitre, cystic Goitre, exophthalmic 39 Gonorrhoea! adenitis, inguinal 4 Gonorrheal arthritis 22 Gonorrhceal arthritis, ankle 1 Gonorrhceal arthritis, hip 1 Gonorrhceal arthritis, knee 11 Gonorrhceal arthritis, shoulder Gonorrhceal arthritis, wrist 4 Gonorrhceal ophthalmia 1 Gonorrhceal peritonitis Gonorrhceal salpingitis Gonorrhceal urethritis 1 Granuloma 3 Growth, axilla (new) 1 Gumma 11 Gumma, back Gumma, face 1 Gumma, frontal bone 2 Gumma, liver 1 Gumma, testicle 3 Gumma, toe Hallux valgus 4 Hammer-toes 3 Harelip 17 Harelip and cleft palate Headache 1 Hemangioma 2 Hematemesis 2 Hematoma 21 Hematoma, scalp 1 Hematomyelia 10 Hematoporphyrinuria Hematuria 33 Hemianopsia 1 Hemiplegia 2 Hemophilia 2 Hemopneumothorax 1 Hemorrhage 27 Hemorrhage, cerebral 2 Hemorrhage, intestinal 1 Hemorrhage, pancreatic 1 Hemorrhage, postoperative 2 Hemorrhage, subdural 1 Hemorrhoids 227 Hepatitis 1 Died. Per cent. 33 11 10 50 14 50 100 100 Ad- mitted. 1 2 1 41 19 3 156 1 14 Died. 13 2 5 2 30 1 Per cent. 100. 66. 100. 102 Frederick L. Hoffman. Table 43. White Subgical Cases — Continued. Males. Females. Causes. mitted ^ied. Per cent. Hernia, abdominal 1 Hernia cerebri 4 3 75.0 Hernia, epigastric 2 Hernia, femoral 16 Hernia, femoral, strangulated 8 4 50.0 Hernia, inguinal 648 5 0.8 Hernia, inguinal, double 28 Hernia, inguinal, left 27 Hernia, inguinal, right 80 Hernia, inguinal, strangulated 62 8 12.9 Hernia, postoperative 3 Hernia, umbilical 10 Hernia, umbilical, strangulated.... 2 50.0 Hernia, ventrical 10 Herpes 1 Hodgkin's disease 21 Horseshoe kidney 1 Hydrocele 120 1 1.7 Hydrocephalus 22 8 36.4 Hydronephrosis 5 Hydrosalpinx Hyperacidity ! 1 1 100.0 Hypernephroma 4 2 50.0 Hyperthyroidism Hypertrophied breast 4 Hypertrophied tonsils and adenoids. 1 Hypertrophy, turbinates 3 Hypertrophy 10 1 10.0 Hypopituitarism 6 Hypospadias 20 Hypothyroidism Hysteria 4 Hysterical hip 1 Hysterical spine Icterus 1 1 100.0 Idiocy 2 Imbecility Incontinence, feces 1 Incontinence, urine 7 Induration, penis 1 Infantilism 2 Infarct, septic Infection, antrum Infection, orbit Inflammation, antrum of Highmore. 1 Inflammation, intestinal 1 Inflammation, palate 1 Inflammation, ureteral orifice 1 Influenza 1 Ingrowing toe-nail 3 Injury, head 1 Insanity 1 Intestinal obstruction 40 11 27.5 Intestinal obstruction, strangulated 2 1 50.0 Ad- mitted. 21 12 35 1 3 6 3 20 6 20 io "2 10 1 1 1 2 i 3 6 13 2 3 2 1 "i 1 2 Died. 1 4 i 13 1 Per cent. 4. 16. 33. 10. 50. 10. 10 30. 100. 38, 100, Statistical Experience Data. 103 Table 43. White Sxtegicae Cases — Continued. Males. r, Ad- Intestinal obstruction, volvulus 4 Intussusception 4 Irritable sphincter 1 Jaundice, catarrhal 4 Keloid 3 Kidney, floating Kyphosis 1 Laceration 11 Laceration, hand 1 Laceration, lateral ligaments 1 Laceration, thigh 1 Lameness, intermittent 1 Laryngeal obstruction 2 Laryngitis 2 Leptomeningitis 1 Leukaemia 2 Leukaemia, spleno-myelogenous .... 1 Lipoma 12 Lipoma, abdominal wall 1 Lipoma, back Lipoma, buttocks 1 Lipoma, groin 2 Lipoma, shoulder Loose cartilage 1 Lordosis 1 Lues, cerebral 1 Lumbago 2 Lupus vulgaris Lymphangioma 5 Lymphangitis 4 Lympho-sarcoma 3 Malformation, external genitalia, congenital 1 Malformation, anus, congenital 1 Malformation, thumb 1 Mastitis Mastoiditis 23 Measles 1 Melano-sarcoma 1 Melena 1 Meningitis 18 Meningitis, cerebro-spinal 1 Meningocele 2 Meningo-encephalocele Metatarsalgia Microcephalia Migraine 3 Mitral insufficiency 1 Morphinism 3 Myasthenia gravis Myelitis 2 Myeloma Myoma, hand 1 Myoma, uterus Died. Per cent. 25 33 10 55 Ad- mitted. 17 19 Per cent. 50. 100. 104 Frederick L. Hoffman. Table 43. White Surgical Cases — Continued. Males. Females. Causes. _^?Ij mitted. Myositis 3 Myxo-fibroma 1 Myxoma Myxoma, breast Myxo-sarcoma 2 Nasal spur 1 Necrosis 2 Necrosis, inferior maxilla 2 Necrosis, jaw Necrosis, ribs 3 Necrosis, skull 2 Necrosis, superior maxilla 1 Necrosis, vertebrae 1 Neoplasm, cerebral 1 Nephritis 7 Nephrolithiasis 3 Nephroptosis 4 Neuralgia 14 Neuralgia, facial 59 Neuralgia, post-zoster 1 Neurasthenia 31 Neurasthenia, sexual 1 Neuritis 4 Neuritis, alcoholic 1 Neuritis, sciatic 1 Neuroma 3 Neuromata Neurosis 1 Neurosis, gastric 5 Neurosis, traumatic 6 Nevus, pigmented 1 Non-erupted tooth 1 Obesity 1 Obstruction, oesophageal 1 CEdema 2 CEdema, arm CEdema, cerebral 1 CEdema, foot 1 CEdema, leg Onychia Orchitis 8 Osteitis deformans 1 Osteoarthritis 11 Osteochondroma 2 Osteoma 6 Osteomyelitis 168 Osteomyelitis, astragalus 1 Osteomyelitis, femur 21 Osteomyelitis, fibula 2 Osteomyelitis, frontal bone 1 Osteomyelitis, humerus 9 Osteomyelitis, ilium 2 Osteomyelitis, inferior maxilla 2 Osteomyelitis, multiple 2 Died. Per cent. 50 Ad- mitted. 10 4 Per cent. 17 82 30 1 1 1 i l i 2 1 2 64 3 1 Statistical Experience Data. 105 Table 43. White Sukgical Cases — Continued. Males. Females. Causes. nn ^ d . Died. Percent. Osteomyelitis, os calcis Osteomyelitis, pelvis 3 Osteomyelitis, phalanges 4 Osteomyelitis, radius 2 Osteomyelitis, rib 5 Osteomyelitis, sternum 1 Osteomyelitis, tibia 19 Osteosarcoma, fibula Otitis media 14 1 7.1 Oxycephaly 1 Pachymeningitis 2 Pain in side 1 Painful back 2 Painful breast Painful heel 1 Painful leg 1 Painful micturition 1 Painful rib Painful scar 1 • ■ ■ Painful shoulder 1 Painful stitch 1 Painful wrist 1 Palsy 1 • • • Palsy, cerebral 1 Palsy, infantile cerebral 1 1 100.0 Pancreatitis 6 1 16.7 Papilloma, bladder 19 Papilloma, mouth Papilloma, peri-ureteral Papilloma, prepuce 1 Papilloma, tongue 1 Papilloma, urethral roof 1 Papilloma, vocal cords 1 Paralysis 25 1 4.0 Paralysis, arm 1 Paralysis, brachial Paralysis, circumflex nerve Paralysis, hand Paralysis, infantile 1 Paralysis, obstetrical 1 Paralysis, ulnar nerve 1 Paramyclonus multiplex Paranoia Paraphimosis 1 Paraplegia 2 Paraplegia, infantile 3 Paraplegia, spastic 1 Paratyphoid 1 Paresis 2 Parotitis Pellagra 1 Perforation, intestinal 5 2 40.0 Pericarditis 1 1 100.0 Perichondritis 1 Ad- mitted. 1 1 1 1 14 Per cent. 11 1 1 1 1 9.1 106 Frederick L. Hoffman. Table 43. White Surgical Cases — Continued. Males. Females. „ Ad- CausPS - mitted. Periostitis 11 Periostitis, femur 1 Periostitis, radius 2 Periostitis, superior maxilla 1 Periostitis, tibia 3 Periostitis, typhoid 1 Peritonitis 15 Peritonitis, traumatic Perityphlitis Pes cavus Pharyngitis 1 Phimosis 12 Phlebitis 1 Pigmented mole Pleurisy 4 Pleurisy, diaphragmatic 1 Pleurisy with effusion 3 Pneumonia 5 Pneumonia, broncho- 1 Poisoning, bichloride 1 Poisoning, cocaine Poliomyelitis 4 Polycythemia Polyp, bladder 1 Polyp, nasal 2 Polyp, rectal 4 Porencephalitis 1 Pott's disease 1 Pregnancy Proctitis 1 Prolapse, rectum 9 Prostate, enlarged 644 Prostate, hypertrophied 12 Prostatitis 68 Pruritus vulva? 1 Psychasthenia Psychoses, postoperative Ptosis, congenital 1 Purpura, Henoch's 1 Pyasmia 1 Pyelitis 22 Pyelonephrosis 2 Pylorospasm Pyonephrosis 9 Pyopneumothorax 2 Pyorrhoea 1 Pyrexia Quinsy Rachitis 1 Ranula 1 Recklinghausen's disease 1 Redundant colon. 2 Redundant prepuce 1 Relaxed joints 6 Died. Per cent. 60.0 40.0 37 2 100.0 5.7 16.7 100.0 13.6 11.1 50.0 Ad- mitted. 1 10 1 i 1 Died. Per cent. 14. LOO. Statistical Experience Data. 107 Table 43. White Surgical Cases — Continued. Causes. Ad- mitted. Relaxed vaginal outlet Resected elbow 2 Retention, urine 4 Retroposition, uterus Retroversion, uterus Rheumatism 3 Rheumatism, chronic 1 Rhinitis 1 Rib, anomaly of Rupture, biceps 1 Rupture, bladder 1 Rupture, brachial plexus 4 Rupture, capsule ankle-joints 1 Rupture, intestines 2 Rupture, kidney 2 Rupture, nerve trunks 1 Rupture, plantaris tendon 1 Rupture, sciatic nerve 1 Rupture, sphincter ani 1 Rupture, spleen, traumatic 2 Rupture, urethra 9 Rupture, vesical sphincter 1 Salpingitis Sacro-iliac disease 1 Sarcoma, alveolar 1 Sarcoma, antrum 3 Sarcoma, arm Sarcoma, axillary 1 Sarcoma, back 2 Sarcoma, breast Sarcoma, buttocks 1 Sarcoma, cervical glands 5 Sarcoma, cheek 1 Sarcoma, chest wall 3 Sarcoma, ear Sarcoma, femur 11 Sarcoma, fibula Sarcoma, finger Sarcoma, foot Sarcoma, groin Sarcoma, humerus Sarcoma, ilium Sarcoma, inferior maxilla. Sarcoma, inguinal glands. Sarcoma, intestines Sarcoma, intraperitoneal . Sarcoma, jaw Sarcoma, kidney Sarcoma, knee Sarcoma, leg Sarcoma, lip Sarcoma, mediastinal Sarcoma, melanotic Sarcoma, naso-pharynx . . . Males. Died. Per cent. 25.0 100.0 100.0 11.1 100.0 33.3 100.0 20.0 9.1 100.0 50.0 100.0 Females. Ad- mitted. 17 10 Died. Per cent. 100. 108 Frederick L. Hoffman. Table 43. White Subgical Cases — Continued. Males. Causes. sciatic nerve scrotum skin skull shoulder , stomach superior maxilla, temporal bone. . . testicle thigh thumb thyroid tibia tonsil vertebral Sarcoma, Sarcoma, Sarcoma, Sarcoma, Sarcoma, Sarcoma, Sarcoma, Sarcoma, Sarcoma, Sarcoma, Sarcoma, Sarcoma, Sarcoma, Sarcoma, Sarcoma, Sarcoma, Sarcoma, Sarcoma, Sarcoma, Sarcoma, Sarcoma, Sarcoma, Sarcoma, Sarcoma, Sarcoma, Sarcoma, Sarcomatosis Scar, breast Scar, contracted Scar, painful Schimmelbusch's disease Sciatica Sclerosis Scoliosis Senile breast Separation of epiphyses Septicaemia Sinus, abdominal Sinus of amputation stump. . . Sinus following appendectomy Sinus, arm Sinus, axillary Sinus, back Sinus, buccal Sinus, buttocks Sinus, cervical Sinus, chest Sinus, flank Sinus, foot Sinus, groin Sinus, jaw Sinus, leg Sinus, lumbar region Sinus, neck Ad- mitted. 7 5 neck orbit ovary parotid 1 pelvis 1 pharynx prostate 1 psoas muscle 1 radius retroperitoneal 14 scalp 20 6 Died. Per cent. 1 100 14 50 50 6 100 Females. Ad- mitted. Died. Per cent. 100. 100. 100. 100. 75. ■Statistical Experience Data. 109 Table 43. White Stjkgical Cases — Continued. Males. 16 100 100 Ad- Causes. mitteO. Dle(L Per cent " Sinus, perineal 3 Sinus, pilonidal 12 Sinus, shoulder 1 Sinus, supra-pubic 3 Sinus, thigh 3 Sinus, urethral 1 Sinuses, multiple 2 Sinusitis 6 Skin, grafting 2 Slough, dorsum of foot Snake bite 1 Spasm of glottis 1 Spermatocele 6 Spina bifida 1 Splenomegaly 2 Spondylitis 12 Spondylitis deformans 1 Spondylitis, post-typhoid Spondylolisthesis Sprain, ankle 4 Sprain, back 4 Sprain, knee 4 Sprain, wrist 3 Stenosis 1 Stenosis, pyloric 5 Stomach, hour-glass 2 Stomatitis 1 Strain, abdomen 1 Strain, muscular 1 Stricture, anus 1 Stricture, bile duct 1 Stricture, duodenum 1 Stricture, larynx 1 Stricture, oesophagus 9 Stricture, pylorus 10 2 Stricture, rectum 12 3 Stricture, ureter 2 Stricture, urethra 64 3 Subluxation, clavicle 1 Subluxation, joint 1 Subluxation, sacro-iliac 1 Subluxation, vertebra 1 Syndrome, polyglandular 1 Synovitis 5 Synovitis, knee 2 Syphilis 37 Syphilis, congenital Syphilis, sternum 1 Syphilitic adenitis, cervical Syphilitic arthritis, elbow 1 Syphilitic arthritis, knee 1 Syphilitic paraplegia 1 Syphilitic ulcer, arm Syphilitic ulcer, leg 4 100 Ad- mitted. Per cent. 66. 50. 110 Frederick L. Hoffman. Table 43. "White Sukgical Cases — Continued. Males. Causes. Ad- mitted. Syringomyelia 1 Tabes dorsalis 16 Talipes equino-varus 11 1 Tender cartilages Tenosynovitis 6 Tetanus 9 5 Throm bo-phlebitis 1 Thrombosis 8 2 Thrombosis, femoral vein 1 1 Thyroiditis 1 Thyroid, enlarged 1 Tinnitus aurium 2 Tonsillitis 27 Tonsils, enlarged 47 Torticollis 19 Transfusion, blood 1 Tubercle, cerebellar 3 Tuberculosis, abdominal wall 1 ankle 1 astragalus 1 bladder 6 breast cagcum cutis 3 elbow epididymis 18 Tuberculosis Tuberculosis Tuberculosis Tuberculosis Tuberculosis Tuberculosis Tuberculosis Tuberculosis Tuberculosis Tuberculosis Tuberculosis Tuberculosis Tuberculosis Tuberculosis Tuberculosis Tuberculosis Tuberculosis Tuberculosis Tuberculosis Tuberculosis Tuberculosis Tuberculosis Tuberculosis Tuberculosis Tuberculosis Tuberculosis Tuberculosis Tuberculosis Tuberculosis Tuberculosis Tuberculosis Tuberculosis Tuberculosis Tuberculosis Tuberculosis Tuberculosis foot 1 genito-urinary tract. . 3 groin 1 hand, tendon sheaths. 1 hip 8 humerus kidney 20 larynx liver miliary general. . neck os magnum pelvis prostate , pulmonary rectum ribs ribs and sternum. sacro-iliac shoulder skin sternum tarsus tendon sheaths. . . testicle tibia trochanter vas deferens Died. Per cent. 55 25 100 (Hi 25 100 Ad- mitted. 1 11 1 2 1 26 51 10 Died. Per cent. Statistical Experience Data. Ill Table 43. White Surgical Cases — Continued. Males. Causes. Ad- mitted. , 82 Tuberculosis, vertebras Tuberculosis, vulva Tuberculosis, wrist 1 Tuberculous abscess, cervical 1 Tuberculous adenitis, axillary 5 Tuberculous adenitis, cervical 64 Tuberculous adenitis, inguinal. .... 10 Tuberculosis arthritis 76 Tuberculous arthritis, ankle 10 Tuberculous arthritis, elbow 7 Tuberculous arthritis, hip 45 Tuberculous arthritis, knee 28 Tuberculous arthritis, metacarpo- phalangeal 1 Tuberculous arthritis, sacro-iliac joints 6 Tuberculous arthritis, shoulder.... 6 Tuberculous arthritis, tarsus Tuberculous arthritis, wrist 5 Tuberculous cystitis 2 Tuberculous meningitis 4 Tuberculous peritonitis 2 Tuberculous pleurisy 1 Tuberculous sinus Tuberculous sinus, hip 1 Tuberculous tenosynovitis Tuberculous ulcer, foot 1 Tumor, abdominal 8 bladder 8 bone 1 brain 153 breast 1 buttocks epididymis 1 face 1 foot 1 humerus 1 hypophysis 17 Tumor Tumor Tumor Tumor Tumor Tumor Tumor Tumor Tumor Tumor Tumor Tumor Tumor Tumor Tumor Tumor Tumor Tumor Tumor Tumor Tumor Tumor Tumor Tumor Tumor Tumor kidney 1 mediastinal 1 neck 2 palate 1 parotid 9 pons 1 popliteal nerve 1 prostate 1 scalp sigmoid flexure 1 spinal cord 13 testicle 3 thyroid 1 tonsil 2 trachea uterus Died. Per cent. 4 4.9 35 16 22 17 100 100 Females. Ad- mitted. 41 1 6 67 3 37 3 4 31 15 Died. 1 82 2 Per cent. 4.9 100. 17 14. 20. 112 Frederick L. Hoffman. Table 43. White Surgical Cases — Continued. Males. Females. Ad- Causes - mitted. Turbinates, enlarged 2 Typhoid spine 1 Ulcer, abdominal wall 1 Ulcer, arm 1 Ulcer, back Ulcer, bladder 1 Ulcer, cheek 2 Ulcer, duodenal 9 Ulcer, face 1 Ulcer, finger 2 Ulcer, foot 6 Ulcer, gastric 14 Ulcer, hand 1 Ulcer, heel, with foot 3 Ulcer, leg 17 Ulcer, lip 1 Ulcer, mouth 1 Ulcer, nose 1 Ulcer, penis 1 Ulcer, pylorus 1 Ulcer, rectum 4 Ulcer, scar of old burn 1 Ulcer, thigh 2 Ulcer, tongue 1 Ulcer, tonsil 1 Ulcer, urethra 1 Ulcer, varicose 4 Undescended testicle 6 Uraemia 3 Ureter, double 1 Urethral defect 1 Urethritis 32 Varicocele 105 Varicose veins 60 Vera montanitis 3 Vertigo 1 Vesiculitis 1 Volvulus 10 Vomiting 1 Wart 1 Web fingers 1 Wound, abdomen 1 Wound, abdomen, gunshot Wound, abdomen, stab 1 Wound, ankle, lacerated 1 Wound, ankle, superficial 1 Wound, anus 1 Wound, arm, granulating 1 Wound, arm, incised 1 Wound, arm, infected 4 Wound, contracted 1 Wound, contused 5 Wound, eye 1 Wound, eye, gunshot 1 Died. Per cent. Ad- mitted. Per cent. 33.3 33.3 Statistical Experience Data. 113 Table 43. White Stjbgical Cases — Continued. Males. Females. Causes - mitted. Wound, face, granulating 1 Wound, face, gunshot 1 Wound, face, lacerated 1 Wound, finger, infected 1 Wound, foot, gunshot 2 Wound, foot, infected 1 Wounds, granulating 18 Wounds, gunshot 57 Wound, hand, infected 2 Wound, hand, lacerated 1 Wound, hand and arm, lacerated. . . 1 Wound, incised 20 Wounds, infected 70 Wounds, lacerated 45 Wound, leg, gunshot 1 Wound, leg, infected 3 Wound, lip, incised 1 Wound, neck, granulating 1 Wound, perineum, lacerated 1 Wound, punctured 6 Wound, scalp 10 Wound, scalp, lacerated 1 Wound, skull, gunshot 2 Wound, spine, gunshot 1 Wounds, stab 13 Wound, thigh 1 Wound, throat, incised 1 Wry neck X-ray burn *Unclassified 3 Eye and ear cases: Abscess, epidural 1 Abscess, mastoid 1 Atrophy, optic Blindness 2 Burn of eye 1 Cataract 40 Cholesteatoma Choriditis 1 Conjunctivitis 2 Contusion, eye 2 Corneal opacity 1 Cyst, eyelid Cyst, lachrymal gland 1 Dacryocystitis 1 Detachment, retina 1 Ectropion, upper lid 1 Endothelioma, lachrymal gland. . . 1 Enucleation, eye 3 Foreign body in eye 21 Glaucoma 9 Hemorrhage after tonsillotomy.. 1 Hernia, iris 2 Died. Per cent. 10 17.5 7.1 6.7 53.3 100.0 Ad- mitted. 1 6 10 1 18 Per cent . 100. 5.6 * Includes cases of doubtful terminology. 114 Frederick L. Hoffman. Table 43. White Sukgical Cases — Continued. Males. Females. Ad- Causes - mitted. Infection, orbit Inflammation, middle ear 1 Intra-ocular neoplasm 1 Irido-cyclitis 27 Irido-dialysis 1 Iritis 6 Irritation, sympathetic 1 Keratitis 6 Keratocele 2 Laceration, eye 1 Mastoiditis 6 Metal in vitreous 3 Myopia 1 Occlusion, pupil 3 Opacity, corneal 1 Ophthalmia 1 Ophthalmia, sympathetic 2 Otitis media 13 Panophthalmitis 18 Phthisis bulbi 1 Ptosis 1 Retinitis 3 Rodent ulcer, cornea 3 Rupture, anterior capsule of lens. 2 Rupture, eyeball 1 Rupture, iris 1 Sarcoma, choroid 3 Sclerosis, traumatic 1 Separation, retina 1 Staphyloma, cornea 1 Steel in vitreous 1 Stenosis, lachrymal duct Strabismus 4 Symblepharon 2 Tinnitus 1 Trachoma 2 Ulcer, cornea 1 Uveitis 2 Wound, cornea 3 Wound, eyeball 7 Unclassified eye and ear cases. ... 5 Died. Per cent. 15 Ad- D - , Per mitted. mea> cent 2 1 Table 44. White Gynecological Cases. Causes. Admitted. Died Abdominal pain 55 Abdominal trouble, obscure 1 1 Abnormal mobility of synchondrosis 1 Abortion 10 Abortion, incomplete 1 Abortion, infected 1 Abortion, threatened 10 Abortion, tubal 2 Abscess, abdominal 14 Abscess, broad ligament 3 Per cent. 100 14 Statistical Experience Data. 115 Table 44. White Gynecological Cases — Continued. Causes. Admitted. Died. Pe Abscess, ischio-rectal 5 Abscess, kidney 2 Abscess, ovarian 4 Abscess, pelvic 94 2 Abscess, perinepbritic Abscess, perirenal Abscess, periurethral Abscess, postoperative Abscess, recto-vaginal septum. Abscess, renal Abscess, suburethral Abscess, tubo-ovarian Abscess, uterus 2 1 1 1 1 3 1 20 1 Abscess, vulvo-vaginal glands 22 Abscess, uterus and vagina 1 Adenitis, inguinal 6 Adeno-myoma 3 Adeno-carcinoma, uterus 5 Adherent clitoris 2 Adhesions, intestinal 10 Adhesions, omental 2 Adhesions, pelvic 4 Adhesions, peritoneal 2 Adhesions, postoperative 56 Adiposis 1 Amenorrhcea 10 Anemia 2 Angioma . . . . , 1 Appendicitis 216 Appendix, abscess 3 Appendix, adherent 6 Arthritis deformans 2 Ascites 4 Atresia 3 Atresia, uterine canal 1 Atresia, vagina 1 Bacilluria 1 Calculus, biliary 31 Calculus, renal 21 Calculus, ureteral 5 Calculus, vesical 3 Carcinoma, bladder 6 Carcinoma, breast 2 Carcinoma, clitoris 4 Carcinoma, coecum 2 Carcinoma, colon 2 Carcinoma, Fallopian tubes 1 Carcinoma, gall bladder 1 Carcinoma, inguinal glands 1 Carcinoma, intestines 2 Carcinoma, kidney 1 Carcinoma, liver 3 Carcinoma, ovary 49 Carcinoma, pelvic glands 1 Carcinoma, pelvis 13 Carcinoma, pylorus 1 2.1 50.0 66.7 10.0 33.3 3.6 0.9 100.0 ' 6.5 4.8 13.3 33.3 18.4 100.0 116 Frederick L. Hoffman. Table 44. White Gynecological Cases — Continued. Causes. Admitted. Carcinoma, rectum 10 Carcinoma, sigmoid flexure 4 Carcinoma, small bowel 1 Carcinoma, stomach 3 Carcinoma, urethra 1 Carcinoma, uterus, body 6 Carcinoma, uterus, body and cervix 1 Carcinoma, uterus Carcinoma, uterus, Carcinoma, vagina Carcinoma, vulva Carcinosis, general Carcinosis, general with ascites Carcinosis, peritoneal Caruncle, urethral 22 Cellulitis 12 body and cervix cervix 201 fundus 31 20 3 4 1 2 Cervicitis Cholelithiasis Cholecystitis Chorio-epithelioma, uterus Cirrhosis, liver Coccygodynia Colic, intestinal Colic, renal Colitis, mucous 2 5 3 1 2 4 2 1 1 Complete tear, recto-vaginal septum 34 Condylomata 1 Condylomata, vulva 1 Congenital absence of cervix 1 Constipation 4 Contusion, coccyx 1. Cribriform hymen 1 Cyst, abdominal 1 Cyst, Bartholin's glands 5 Cyst, corpus luteum 5 Cyst, ovarian 158 Cyst, ovarian, Graafian follicle 15 Cyst, ovarian, infected 2 Cyst, ovarian, intraligamentary 4 Cyst, ovarian, parovarian 1 Cyst, parovarian 28 Cyst, perineal 1 Cyst, retroperitoneal . 1 Cyst, tubo-ovarian 1 Cyst, vaginal 1 Cystic kidney 1 Cystic ovary 1 Cystitis 132 Cystitis, ulcerative 2 Cystocele 14 Deciduoma malignum 2 Descensus uteri 14 Diabetes mellitus 2 Diastasis, rectal muscles 2 Dilated veins 1 Dislocation, ureter 1 Died. 1 1 1 1 24 Per cent. 10.0 25.0 oo.6 16.7 100.0 11.9 25.0 4.5 2.9 4.4 6.7 50.0 50.6 Statistical Experience Data. 117 Table 44. White Gynecological Cases — Continued. Causes. Admitted. Died. Per cent. Dysmenorrhea 294 Dyspareunia 2 Dysuria 1 Eczema 1 Elongated cervix 2 Emphysema 1 Endocervicitis 13 Endometritis Enlarged floating spleen , Enteroptosis Enuresis , Epilepsy Epithelioma Epithelioma, thigh , Epithelioma, vulva Erosion, cervix Eversion, rectal mucosa Examination, cystoscopic Fecal impaction Fever, typhoid Fibroid, labium maius Fibroid, uterus Fibroma, ovary Fissure in ano Fistula, abdominal and recto-vaginal. 2 1 1 4 O . . £> 1 1 1 4 1 2 5 5 1 Fistula in ano 13 1 1 2 1 6 1 1 2 2 2 .. 34 1 1 2 1 1 2 2 1 3 1 2 1 2 Fistula, biliary Fistula, fecal Fistula, urethro-vesico-vaginal Fistula, recto-cervical Fistula, recto-vaginal Fistula, recto-vesico-vaginal Fistula, uretero-abdominal Fistula, uretero-vaginal Fistula, vesico-abdominal Fistula, vesico-urethro-vaginal Fistula, vesico-vaginal Fracture, coccyx Gastroptosis Gonorrhoea Gonorrhoea! peritonitis Granuloma, urethra . Gumma, liver Hematocele Hematokolpos Hematoma Hematoma, ovary Hematoma, pelvic Hematometra Hematosalpinx Hematuria 19 Hemorrhage - 1 Hemorrhage, postoperative 1 Hemorrhage, uterine 48 Hemorrhoids 33 100 .-" 50 118 Frederick L. Hoffman. Table 44. White Gynecological Cases — Continued. Causes. Admitted. Died. Per cent. Hernia, femoral 10 Hernia, inguinal 16 Hernia, postoperative 19 3 15.8 Hernia, umbilical 21 Hernia, vaginal 1 Hernia, ventral 36 Hydatidiform mole 1 Hydro-appendix . . , 1 Hydrocele, inguinal canal 1 Hydronephrosis 14 1 7.1 Hydrosalpinx 20 Hyperemesis gravidarum 2 Hyperesthesia 1 Hyperesthesia, vagina 1 Hyperesthesia, vulva 1 Hypernephroma 2 1 50.0 Hypertrophy, cervix 62 Hypertrophy and erosion of cervix 1 Hypertrophy, labia and clitoris 1 Hypertrophy and prolapse of uterus 1 Hysteria 5 Ileus 1 Imperforate hymen 1 Incontinence, urine 10 Infantile pelvic organs 3 Infantile uterus 2 Infection, puerperal 4 1 25.0 Infection, renal, bilateral 1 Infection, Skene's glands 3 Intestinal obstruction 6 2 33.3 Intestinal perforation 1 1 100.0 Jaundice 3 Kidney atrophy 1 Kraurosis vulva? 1 Laceration, cervix 54 Leucorrhcea 34 Leukaemia, spleno-myelogenous 2 Malformation, pelvis 1 Menopause 1 Menorrhagia 45 Metrorrhagia 164 1 0.6 Morphinism 3 Movable spleen 1 Myoma, uterus 398 12 3.0 Necrosis, sacrum 1 Nephralgia 13 Nephritis 6 Nephrolithiasis 5 1 20.0 Nephroptosis 181 1 0.6 Neurasthenia 27 Neuritis 1 Osteomyelitis 1 Papilloma, bladder 5 Papilloma, ovan^ 3 Pelvic inflammatory disease 17 Statistical Experience Data. 119 Table 44. White Gynecological Cases — Continued. Causes. Perihepatitis Perimetritis 1 Periproctitis 1 Peritonitis, general 32 Peritonitis, pelvic 3 Periureteritis 1 Phlebitis 1 Polyp cervical 26 Polyp, rectal 1 Polyp, uterine 1 Polyp, vaginal 2 Polypoid endometrium 7 Pregnancy 100 Pregnancy, extra-uterine 114 Proctitis 7 Prolapse, ovary 12 Prolapse, rectum 2 Prolapse, uterus 130 Prolapse, vagina 6 Prolonged and irregular menstruation 1 Pruritus 2 Puerperal infection 6 Pyelitis 39 Pyelonephrosis 2 Pyometra 6 Pyonephrosis 13 Pyosalpinx 50 Pyuria 6 Rectocele 3 Redundant vaginal mucosa 1 Relaxed abdominal wall , 2 Relaxed anal sphincter 1 Relaxed recti muscles 2 Relaxed urethral sphincter 2 Relaxed vaginal outlet 486 Retained secundines 176 Rheumatism 1 Rupture, recto-vaginal septum 14 Salpingitis 3 Salpingo-oophoritis 788 Sarcoma, ovary 3 Sarcoma, pelvis 1 Sarcoma, rectum 2 Sarcoma, uterus 2 Scar, ulcerated 1 Septicemia 2 Septicemia, puerperal 2 Sinus, abdominal 6 Sinus, abdomino-vaginal 1 Sinus, postoperative 16 1 4 1 Admitted. Died. Per cent. 1 Sinus from silver suture . Stenosis, internal os uteri Stenosis, vaginal Sterility Stricture, rectum 12 15.6 14.3 1.0 2.6 0.8 16.7 2.6 16.7 15.4 4.0 50.0 50.0 120 Frederick L. Hoffman. Table 44. White Gynecological Cases — Continued. Causes. Admitted. Died Stricture, ureter 3 Stricture, ureteral 11 Stricture, vagina 1 Syphilis 3 Syphilis, tertiary 1 Syphilitic periproctitis 1 Tear, sphincter ani 1 Tenesmus, rectal 1 Teratoma 1 Tonsillitis 1 Trigonitis 3 Tuberculosis, appendix 2 Tuberculosis, bladder 7 Tuberculosis, cervix 1 Tuberculosis, endometrium 2 Tuberculosis, kidney 31 2 Tuberculosis, kidney and ureter 2 Tuberculosis, miliary general 1 1 Tuberculosis, pelvic general 4 1 Tuberculosis, peritoneum 6 Tuberculosis, pulmonary 3 Per cent. Tuberculosis, rectum Tuberculosis, tubes and endometrium Tuberculosis, tubes and ovaries Tuberculosis, tubes and peritoneum . Tuberculosis, ureter Tuberculous peritonitis 1 2 o 1 1 2 Tuberculous salpingitis 3 Tumor, abdominal 1 Tumor, liver 1 Tumor, ovarian 1 Tumor, pelvic 3 Ulcer, bladder 1 Ulcer, vagina 1 Ulceration, rectum and vagina, syphilitic. . . 1 Urethritis 26 Uterus, anteflexion 10 Uterus, bicornate 1 Uterus, malformation 1 Uterus, punctured 1 Uterine retroposition 476 Uterine subinvolution 5 Vaginitis 21 Varicocele 1 Visceroptosis 1 Vulvitis 1 Wart, vaginal 1 *Unclassified 320 100. 25. 0.3 Includes cases of doubtful terminology. Statistical Experience Data. 121 Table 45. Summary of White Obstetrical Cases for the Period 1904-1911. Causes. Admitted. Died. Per cent. Labor, spontaneous at term 1265 3 0.2 Labor, spontaneous, premature 57 1 1.8 Labor, operative 332 15 4.5 Abortion 234 11 4.7 Admitted post-partum 48 8 16.7 Pregnant, not delivered 190 3 1.6 Not pregnant 35 0.0 Total 2161 41 1.9 Admitted. Died. Per cent. Number. * + Number Labor, spontaneous at term 1265 58.5 3 Labor, spontaneous, premature 57 2.7 1 Labor, operative 332 15.4 15 Abortion 234 10.8 11 Admitted post-partum 48 2.2 8 Pregnant, not delivered 190 8.8 Not pregnant 35 1.6 Total 2161 100.0 41 100.0 SEC. F. MORTALITY RATE BY CAUSES ON ADMISSION, COLORED PATIENTS, 1902-1911. Table 46. Summary of Colored Cases. Diseases and conditions. Admitted. Abnormities, congenital malfor- mations 11 Blood 10 Bones and cartilages 78 Bursas 3 Circulatory system 581 Arteries and veins 316 Endocardium and valves .... 214 Myocardium 45 Neuroses Pericardium 6 Digestive system 387 Appendix 85 Intestine 43 Liver 39 Gall bladder and ducts 9 Mesentery 1 Omentum Peritoneum 22 Lips Mouth 3 1 33.3 Palate, uvula Pharynx 2 1 50.0 lies. Females. Died. Per cent. Admitted. Died. Per cent. 1 9.1 14 1 7.1 2 20.0 13 2 15.4 2 2.6 40 3 2 5.0 111 19.1 165 36 21.8 60 19.0 58 16 27.6 44 20.6 89 17 19.1 6 13.3 17 3 17.6 "i 16.7 "i 31 8.0 441 41 9.3 10 11.8 95 10 10.5 7 16.3 38 8 21.1 4 10.3 9 1 11.1 14 1 7.1 1 100.0 1 1 5 22.7 81 12 14.8 122 Frederick L. Hoffman. Table 46. Summary or Colored Cases — Continued. Males. Females. Diseases and conditions. Admitted. Salivary glands Teeth, gums Tongue Tonsils (Esophagus Pancreas Rectum and anus Stomach Ductless glands and spleen .... Carotid gland Parathyroid gland Pineal gland Pituitary body Spleen Suprarenal gland Thymus gland Thyroid gland Ear Eye and adnexa Infective diseases Dysentery Gonorrhoea Influenza Malaria Rheumatic fever Septicaemia Syphilis Tuberculosis, meninges Tuberculosis, lungs Tuberculosis, miliary Tuberculosis, other forms . . . Typhoid fever Other infective diseases .... Hernias Joints Lymphatic system Mind Miscellaneous Diabetes Gout Obesity Rheumatism, chronic artic- ular Rheumatism, n. s Other miscellaneous Muscles, fascia?, tendons Muscles and fasciae Tendons and sheaths Nervous system Brain, spinal cord, meninges. Cranial and spinal nerves . . . Functional nervous disorders Parasites Poisonings and intoxications. . . 26 5 116 23 3 2 11 25 997 10 45 12 43 29 8 101 6 99 15 319 231 79 131 70 32 13 65 7 5 1 52 12 8 4 112 63 10 39 7 Died. 1 144 1 4 10 6 30 13 37 29 14 6 1 3 2 17 2 14 21 21 Per cent. 12.5 0.9 14.4 10.0 50.0 9.9 100.0 30.3 86.7 11.6 12.6 17.7 4.6 1.4 9.4 15.4 26.2 28.6 20.0 26.9 18.7 33.3 14.3 12.5 Admitted. Died. 6 2 1 2 46 1 8 1 124 4 11 2 19 1 19 10 29 598 2 22 9 11 29 2 69 7 75 5 197 129 41 56 61 30 11 186 11 172 6 2 4 94 43 9 42 3 6 61 1 5 5 19 5 12 12 1 1 3 28 24 "i 1 1 Per cent. 50.0 2.2 12.5 ' 3.2 18.2 5.3 5.3 10.2 50.0 3.4 ' 7.2 71.4 25.3 100.0 6.1 9.3 2.4 1.8 4.9 3.2 18.2 2.3 29.8 55.8 ' 9.5 33.3 16.7 Statistical Experience Data. 123 Table 46. Summary of Colored Cases — Continued. Diseases and conditions. Reproductive organs Functional disorders Mammary gland Ligaments, ovaries, tubes. Uterus Vagina Vulva Cowper's glands Penis Prostate gland Scrotum Seminal vesicles Spermatic cord Testicle and epididymis . . Tunica vaginalis Admitted. 81 3 36 7 .' i 18 16 Respiratory system 391 Bronchi and trachea 33 Larynx and epiglottis Lung 274 Nose and nasal passages .... 2 Accessory sinuses Pleura 82 Skin, hair, nails 51 Skin and hair 51 Nails Tumors 170 Benign 51 Malignant 119 Urinary organs 200 Bladder 15 Kidney 113 1 . 71 Ureter Urethra Obstetrical conditions Newborn child Injuries 312 Grand total 3762 Died. 12 11 1 70 1 61 1 1 34 3 31 35 3 30 14 509 Per cent. 14.8 30.6 14.3 17.9 3.0 22.3 9.8 2.0 2.0 20.6 5.9 26.1 17.5 20.0 26.5 ' 2.8 4.5 13.5 Females. Admitted. 1284 99 20 953 123 73 16 137 26 78 33- 45 43 2 748 545 203 140 39 13 1868 107 6114 Died. 17 29 26 45 22 23 19 Per cent. 1.3 1.6 2.7 21.2 33.3 9.1 6.7 7.0 *6.0 4.0 11.3 13.6 18 20.5 7.7 1.6 15 14.0 342 5.6 Table 47. Colored Medical Cases. Males. Diseases and conditions. Admitted. Abnormities, congenital mal- formations Blood 9 Bones and cartilages 3 Bursa? 1 Circulatory system 549 Arteries and veins 286 Endocardium and valves.... 213 Myocardium 45 Neuroses Pericardium 5 Died. 104 53 44 6 Per cent. 22.2 18.9 18.5 20.7 13.3 20.6 Females. Admitted. Died. 13 1 153 46 17 36 16 17 3 Per cent. 15.4 23.5 34.8 19.1 17.6 124 Frederick L. Hoffman. Table 47. Colored Medical Cases — Continued Males. ] 5 14 33 3 16 16 2 Diseases and couditions. Digestive system 102 Appendix Intestine Liver Gall bladder and ducts . . . Mesentery Omentum Peritoneum Lips Mouth Palate, uvula Pharynx Salivary glands Teeth, gums Tongue Tonsils (Esophagus Pancreas Rectum and anus Stomach Ductless glands and spleen. . Carotid gland Parathyroid gland Pineal gland Pituitary body Spleen Suprarenal gland Thymus gland Thyroid gland Ear Eye and adnexa Infective diseases Dysentery Gonorrhoea Influenza Malaria Rheumatic fever Septicaemia Syphilis Tuberculosis, meninges . . Tuberculosis, lungs Tuberculosis, miliary .... Tuberculosis, other forms Admitted. Died. 6 1 1 2 3 606 9 22 12 43 29 4 70 5 95 15 50 Typhoid fever 215 Other infective diseases Hernige , Joints , Lymphatic system Mind Miscellaneous diseases Diabetes Gout Obesity 37 25 10 12 35 7 5 1 95 1 9 5 28 13 16 19 1 1 1 13 2 1 Per cent. 5.9 20.0 6.1 16.7 50.0 14.3 15.7 11.1 75.0 12.9 100.0 29.5 86.7 32.0 8.8 2.7 10.0 8.3 37.1 28.6 20.0 Admitted. 62 5 12 6 5 9 1 1 4 1 io 5 1 4 360 2 11 9 10 29 2 41 7 69 5 29 121 25 19 4 10 34 10 Died. 5 50 1 5 19 5 6 10 Per cent. 8.1 ' 8.3 16.7 11.1 10.0 14.3 13.9 50.0 3.4 7.3 71.4 27.5 100.0 20.7 8.3 11.8 20.0 Statistical Experience Data. 125 Table 47. Colored Medical Cases — Continued Males. Females. Diseases and conditions. Admitted. Died. Rheumatism, chronic' artic- ular Rheumatism, n. s Other miscellaneous 22 Muscles, fasciae, tendons 7 Muscles and fascia? 6 Tendons and sheaths 1 Nervous system 71 Brain, spinal cord, meninges. 44 Cranial and spinal nerves... 5 Functional nervous disorders 22 Parasites 3 Poisonings and intoxications. . . 7 Reproductive organs 4 Functional disorders Mammary gland Ligaments, ovaries, tubes .... Uterus Vagina Vulva Cowper's glands Penis Prostate gland Scrotum Seminal vesicles Spermatic cord Testicle and epididymis 2 Tunica vaginalis Respiratory system 368 Bronchi and trachea 33 Larynx and epiglottis Lung 273 Nose and nasal passages Accessory sinuses Pleura 62 Skin, hair, nails 3 Skin and hair 3 Nails Tumors 48 Benign 11 Malignant 37 Urinary organs 115 Bladder 1 Kidney 103 Ureter Urethra 11 Obstetrical conditions Newborn child 1 Injuries 2 Per cent. 10 45.5 15 21.1 15 34.1 66 1 60 28 28 14.3 17.9 3.0 22.0 8.1 18.8 9.1 21.6 24.3 27.2 50.0 Admitted. Died. 22 1 1 65 28 3 34 6 12 10 2 125 26 76 23 4 29 16 13 70 1 67 2 7 18 14 4 1 26 1 1 1 5 2 3 18 Per cent. 9.1 27.7 50.0 11.8 16.7 20.8 52.9 4.3 25.0 25.0 17.2 12.5 23.1 25.7 18 26.9 Grand total 1988 342 17.2 986 166 16.8 126 Frederick L. Hoffman. Table 48. Colobed Suegical Cases. Males. Diseases and conditions. Abnormities, congenital mal- formations Blood Bones and cartilages Bursse Circulatory system Arteries and veins Endocardium and valves .... Myocardium Neuroses Pericardium Digestive system Appendix Intestine Liver Gall bladder and ducts Mesentery Omentum Peritoneum Lips Mouth Palate, uvula Pharynx Salivary glands Teeth, gums Tongue Tonsils CEsophagus Pancreas Rectum and anus Stomach Ductless glands and spleen .... Carotid gland Parathyroid gland Pineal gland Pituitary body Spleen Suprarenal gland Thymus gland Thyroid gland Ear Eye and adnexa Infective diseases Dysentery Gonorrhoea Influenza Malaria Rheumatic fever Septicemia Syphilis Tuberculosis, meninges Tuberculosis, lungs Tuberculosis, miliary Admitted. Died. 11 1 1 75 2 2 39! 7 1 285 80 29 6 6 1 16 2 1 5 10 5 116 7 1 1 9' 22 391 1 23 4 31 1 4 25 9 7 2 1 100 25 4 'J Per cent. 9.1 ' 2.7 50 12 25 3 100 50 Admitted. Died. 12 39 Q 12 12 207 50 19 o 7 1 15 1 2 1 2 36 59 3 14 14 9 25 197 10 21 3 19 7 100. 12. 1. 10 Per cent. 9. 14. 21. 33. Statistical Experience Data. 127 Table 48. Coloeed Surgical Cases. — Continued. Males. Diseases and conditions. Tuberculosis, other forms . . . Typhoid fever Other infective diseases Hernias Joints Lymphatic system Mind Miscellaneous diseases Diabetes Gout Obesity Rheumatism, chronic artic- ular Rheumatism, n. s Other miscellaneous Muscles, fasciae, tendons Muscles and fasciae Tendons and sheaths Nervous system Brain, spinal cord, meninges. Cranial and spinal nerves . . . Funtional nervous disorders. Parasites Poisonings and intoxications.. Reproductive organs Functional disorders Mammary gland Ligaments, ovaries, tubes. . . . Uterus Vagina Vulva Cowper's glands Penis Prostate gland Scrotum Seminal vesicles Spermatic cord Testicle and epididymis Tunica vaginalis Respiratory system Bronchi and trachea Larynx and epiglottis Lung Nose and nasal passages Accessory sinuses Pleura Skin, hair, nails Skin and hair Nails Tumors Benign Malignant Admitted. Died. 269 16 42 131 45 22 1 30 21 10 13 6 1 2 1 Per cent. 7.8 62.5 31.0 4.6 2.2 9.1 100.0 13.3 Admitted. Died. 148 2 12 33 42 16 1 19 1 Per cent. 4.1 50.0 8.3 3.0 7.1 30 4 13.3 17 5 5 2 2 O 3 41 6 14.6 26 10 38.5 19 6 31.6 15 10 66.7 5 6 17 5 4 1 25.0 2 1 77 12 15.6 48 19 ° 6.3 .... 26 3 11.5 1 2 3 34 11 32.4 7 1 14.3 1 16 16 23 4 17.4 11 3 27.3 1 1 100.0 1 1 100.0 2 20 3 15.0 10 2 20.0 48 1 2.1 39 2 5.1 48 1 2.1 37 2 2 5.4 122 25 20.5 135 9 6.7 40 2 5.0 47 1 2.1 82 23 28.0 88 8 9.1 128 Frederick L. Hoffman. Table 48. Coloked Surgical Cases. — Continued. Males. Females. Diseases and conditions. Admitted. Died. Urinary organs 85 Bladder 14 Kidney 10 Ureter 1 Urethra 60 Obstetrical conditions Newborn child Injuries 310 Grand total 1774 13 167 Per cent. 8.2 21.4 20.0 ' 3.3 4.2 9.4 Admitted. Died. 9 4 5 Per cent. 106 1013 Table 49. Colored Gynecological Cases. 17 Diseases and conditions. Admitted. Di Abnormities, congenital malformations. ... 2 Blood Bones and cartilages Bursas Circulatory system Arteries and veins Endocardium and valves Myocardium Neuroses Pericardium Digestive system 172 Appendix 40 Intestine 7 Liver Gall bladder and ducts 2 Mesentery Omentum 1 Peritoneum 57 Lips Mouth Palate, uvula Pharynx Salivary glands Teeth, gums Tongue Tonsils (Esophagus Pancreas Rectum and anus 64 3 Stomach 1 1 Ductless glands and spleen Carotid gland Parathyroid gland Pineal gland Pituitary body Spleen Suprarenal gland Thymus gland Thyroid gland Ear 15 79 14 ed. Per cent 100 2 7.8 Statistical Experience Data. 129 Table 49. Colored Gynecological Cases — Continued. 41 Diseases and conditions. Eye and adnexa Infective diseases Dysentery , Gonorrhoea Influenza Malaria Rheumatic fever Septicaemia Syphilis , Tuberculosis, meninges , Tuberculosis, lungs , Tuberculosis, miliary , Tuberculosis, other forms Typhoid fever Other infective diseases , Hernia? Joints Lymphatic system , Mind Miscellaneous diseases 133 Diabetes Gout Obesity Rheumatism, chronic articular Rheumatism, n. s Other miscellaneous 133 Muscles, fasciae, tendons Muscles and fasciae Tendons and sheaths Nervous system 3 Brain, spinal cord, meninges Cranial and spinal nerves Functional nervous disorders 3 Parasites 1 Poisonings and intoxications Reproductive organs 1224 Functional disorders 99 Mammary gland 1 Ligaments, ovaries, tubes 917 Uterus 122 Vagina 69 Vulva 16 Cowper's glands Penis Prostate gland Scrotum Seminal vesicles Spermatic cord Testicle and epididymis Tunica vaginalis Respiratory system 1 Bronchi and trachea Larynx and epiglottis Lung 1 Nose and nasal passages Accessory sinuses Pleura Admitted. Di 14 12 ed. Per cent. 16. 100. 1. 1. 2 130 Frederick L. Hoffman. Table 49. Colored Gynecological Cases — Continued. Diseases and conditions. Admitted. Died. Per cent. Skin, hair, nails 2 Skin and hair 2 Nails Tumors 584 31 5.3 Benign 482 19 3.9 Malignant 102 12 11.8 Urinary organs 61 1 1.6 Bladder 34 Kidney 16 Ureter Urethra 11 1 9.1 Obstetrical conditions 131 2 1.5 Newborn child Injuries Grand total 2388 69 2.9 Table 50. Colored Medical Cases. Males. Ad- Causes. mitted _ Died. Abdominal pain 2 Abscess 2 Abscess, alveolar Abscess, axillary 1 Abscess, cerebral 1 Abscess, liver 4 Abscess, liver, amoebic 1 Abscess, lung Abscess, pelvic Abscess, perirectal Abscess, peritonsillar Abscess, tonsillar Addison's disease 1 Adenitis 2 Adenitis, cervical 2 Adenitis, inguinal Adenitis, suppurative 3 Alcoholism 5 Anemia ... 3 Anemia, pernicious 4 Anemia, splenic Aneurism^ abdominal 1 Aneurism, abdominal aorta 1 Aneurism, aorta 47 8 Aneurism, innominate artery 1 1 Aneurism, thoracic 28 7 Appendicitis 5 1 Arteriosclerosis 205 36 Arthritis 5 Arthritis deformans 4 Arthritis, infectious 11 Arthritis, knee 1 Arthritis, villous 1 Asthma 9 Per cent 20 25 100 17 100 25 20 17 Females. Ad- mitted. 5 37 2 7 5 1 Died. 12 Per cent. 50. 100. Statistical Experience Data. 131 Table 50. Colored Medical Cases — Continued. Males. „ Ad- Causes, mitted. Asthma, bronchial Atony, stomach 1 Atrophy, acute yellow Atrophy, progressive muscular 1 Barlow's disease Bronchiectasis 5 Bronchitis 19 Bursitis 1 Calculus, biliary 2 Calculus, renal Carcinoma, bladder 2 Carcinoma, bile ducts 1 Carcinoma, breast Carcinoma, liver 4 Carcinoma, lungs 1 Carcinoma, ovary Carcinoma, pancreas 2 Carcinoma, prostate 2 Carcinoma, rectum 1 Carcinoma, seminal vesicle 1 Carcinoma, stomach 20 Carcinoma, uterus Carcinomatosis Cellulitis 1 Chancroid 2 Chicken-pox Cholecystitis 1 Cholelithiasis Chorea 2 Chorea, Huntingdon's 1 Cirrhosis, liver 15 Colitis Colitis, ulcerative Conjunctivitis 1 Constipation 2 Convulsions Cryptorchidism 1 Cystitis Cyst, ovarian Degeneration of cord, posterior and pyramidal tracts Delirium tremens 1 Dementia 1 Dermatitis 1 Dermatitis exfoliativa 1 Dermatomyositis 1 Diabetes mellitus 7 Diarrhoea 3 Dilatation, aorta 3 Dilatation, stomach 1 Diphtheria 9 Dysentery 3 Dysentery, amoebic 5 Dysentery, catarrhal 1 Died. Per cent 20 100 50 28 11 2o Ad- mitted. 1 19 3 1 1 1 2 1 1 10 1 Died. Per cent. 100.0 100.0 33.3 50.0 100.0 100.0 100.0 20.6 loco 132 Frederick L. Hoffman. Table 50. Coloeed Medical Cases — Continued. Males. „ Ad- Causes - mitted. Dyspepsia, nervous 1 Ectopia cordis interna 1 Embolus, cerebral 1 Empyema 4 Emphysema 5 Enlarged glands 1 Enteritis 3 Enteroptosis Epididymitis 1 Epilepsy 4 Epilepsy, Jacksonian 1 Erysipelas 3 Febricula 12 Fever, continuous 6 Fever, malarial 43 Fever, paratyphoid 1 Fever, rheumatic 11 Fever, scarlet 1 Fever, typhoid 208 Fever, unknown origin Fibroma, uterus Fracture, vertebral 1 Fracture, wrist Gangrene, toes Gastralgia Gastritis 9 Gastro-enteritis 5 Glaucoma Glycosuria 1 Goitre, exophthalmic 1 Gonorrhoea 2 Gonorrhceal arthritis 20 Gout 5 Heart diseases. Aortic insufficiency 77 Aortic and cardiac insufficiency.. 1 Aortic and mitral insufficiency. . . 74 Aortic, mitral and myocardial in- sufficiency 1 Aortic and myocardial insuffi- ciency 3 Aortic and mitral insufficiency and stenosis 5 Aortic, mitral and tricuspid in- sufficiency, and mitral stenosis. . . . Aortic stenosis 2 Aortic stenosis and insufficiency. . 1 Cardiac decompensation Endocarditis 15 Mitral insufficiency 21 Mitral and myocardial insuffi- ciency 1 Mitral and myocardial insuffi- ciency and stenosis Died. Per Ad- cent, mitted. 19 9.1 1 19 11 1 20.0 24.7 10.8 33.3 20.0 73.3 4.8 Died. 12 4 10 1 14 1 116 1 2 1 1 1 2 2 3 ii 10 22 4 1 1 1 1 4 13 1 1 Per cent. 100.0 10 7.1 8.6 30.0 18.2 66.7 100.0 100.6 50.6 30.8 Statistical Experience Data. 133 Table 50. Colored Medical Cases — Continued. Males. Females. Causes. Ad- mitted. Mitral stenosis 1 Mitral stenosis and insufficiency. . 9 Mitral and tricuspid insufficiency 2 Myocardial insufficiency 6 Myocarditis 35 Pericarditis 5 Stokes-Adams syndrome 1 Hematuria 2 Hemichorea Hemiplegia 8 Hemiplegia, infantile Hemoglobinuria Hemorrhage 2 Hemorrhage, cerebral 2 ' Hepatitis Herpes zoster 1 Hodgkin's disease 2 Hyperacidity Hypernephroma Hyperthyroidism Hypertrophy, prostate 1 Hysteria 1 Imbecility 1 Impetigo Infarction, pulmonary Infection, strongyloides intestin- alis 1 Influenza 12 Insanity 1 Intestinal hemorrhage 1 Jaundice 2 Jaudice, catarrhal 12 Leukaemia 1 Leukaemia, lymphatic 1 Locomotor ataxia 2 Lues 1 Lues, cerebral 5 Lues, secondary 11 Lues, tertiary 10 Lympho-sarcoma 1 Malnutrition Mania 1 Measles 4 Mediastinitis 1 Meningitis 15 Meningitis, cerebro-spinal 6 Mikulicz's disease 1 Myalgia 2 Myelitis Myoma, uterus Myomata Myxcedema Neoplasm 1 Nephritis 100 28 22.2 50.0 17.1 20.0 100.0 100.0 50.0 100.0 50.0 20.0 60.0 50.0 17 1 1 1 1 ii 28.0 1 4 1 1 56 17.6 1 100.0 4 44.4 2 100. 1 100. 50. 17 100.0 57.1 66.7 100.0 50.0 30.4 134 Frederick L. Hoffman. Table 50. Colored Medical Cases — Continued. Males. Lauses - mitted. Neuralgia 1 Neurasthenia 10 Neuritis, optic Neuritis, peripheral 1 Neuro-flbromata Neurosis 1 Obesity 1 Osteoarthritis 1 Osteomyelitis 1 Otitis media 2 Palsy Panophthalmitis 1 Paralysis •. 1 Paralysis, bulbar Paralysis, obstetrical Paramyoclonus multiplex 1 Paraplegia, spastic 3 Parotitis 3 Pellagra 2 Pelvic disease Periostitis 1 Peritonitis 6 Peritonitis, pelvic Pertussis 2 Pharyngitis Phlebitis 2 Pleura, thickened 2 Pleurisy 1 Pleurisy, adhesive 1 Pleurisy, diaphragmatic 2 Pleurisy with effusion 42 Pleurisy, fibrinous 9 Pleurisy and peritonitis, tuber- culous 1 Pleurisy, peritonitis and pericar- ditis, tuberculous 2 Pneumonia 21 Pneumonia, broncho- 8 Pneumonia, lobar 239 Poisoning, alcoholic 1 Poisoning, carbolic acid 1 Poisoning, coal-gas 1 Poisoning, creosote Poisoning, lead 2 Poisoning, mercurial Poliomyelitis 2 Polyarthritis 2 Polyneuritis Polyserositis 4 Pott's disease 2 Pregnancy Premature birth 1 Prolapse, colon Prostatitis 1 Died. Per cent 5D 16 4 54 11 25 Ad- mitted. 13 1 1 2 1 2 9 2 4 11 5S "2 2 "l Died. Per cent. 100. 16. 1 7 16 25.0 63.6 27.6 100.0 Statistical Experience Data. 135 Table 50. Colored Medical Cases — Continued. Males. Females. Causes. Ad- mitted. Psychoneurosis 2 Purpura Pyelitis ... Pyelonephritis Pyelonephrosis Pyonephrosis Pyuria 1 Quinsy Rachitis 2 Recklinghausen's disease Relaxation, sacro-iliac 1 Rheumatism 17 Rheumatism, acute articular 1 Rupture, bladder 1 Salpingo-oophoritis Sarcomatosis 1 Sciatica 2 Separation, symphysis 1 Septicaemia 4 Septico-pyaemia Small-pox 1 Stenosis, pyloric 1 Stomatitis 2 Stricture, rectum Syphilis 42 Syphilis, cerebral 1 Syringomyelia 3 Tabes dorsalis 2 Tenosynovitis Tetany 3 Thrombosis Tonsillitis 16 Torticollis 2 Tuberculosis 1 Tuberculosis, ankle Tuberculosis, brain, intestines and liver Tuberculosis, elbow 1 Tuberculosis, Fallopian tube Tuberculosis, general 11 Tuberculosis, intestines 1 Tuberculosis, lymph glands 3 Tuberculosis, miliary 15 Tuberculosis, peritoneal 1 Tuberculosis, pleural and peritoneal 2 Tuberculosis, pulmonary 80 Tuberculosis, pulmonary and intes- tinal 1 Tuberculosis, pulmonary and laryn- geal 3 Tuberculosis, pulmonary and perit- oneal 1 Tuberculosis, serous membrane .... 1 Tuberculosis, skull Died. 25 Per cent 100 75 50 n; 81 100 86 31 100 100 Ad- mitted. 3 2 5 1 1 1 "i l 2 13 2 1 1 1 i l 32 1 1 1 2 1 1 2 1 5 1 1 62 1 1 15 Per cent. 1 100. 100. 100. 50. 100 100, 100 24, 100. 136 Frederick L. Hoffman. Table 50. Colored Medical Cases — Continued. Males. Ad- mitted. 4 1 6 2 5 3 Died. 1 Causes. Tuberculosis, spine Tuberculosis, sternum Tuberculous adenitis Tuberculous arthritis Tuberculous meningitis Tuberculous pericarditis Tuberculous peritonitis 13 Tuberculous pleurisy 1 Tuberculous pneumonia 3 Tuberculous spondylitis 1 Tumor, abdominal 2 Tumor, cerebral 5- Tumor, intra-thoracic 1 Tumor, mediastinal 1 Tumor, neck 1 Tumor, spinal cord 1 Ulcer, gastric 3 Ulcer, leg 1 Uncinariasis 2 Uremia 1 Urethritis 11 Vaginitis Vomiting Vomiting, pregnancy *Unclassified 9 8 Per cent. 25.0 16 100 33 7 66 20 88.9 Table 51. Colored Surgical Cases. Males. Causes. Abdominal pain Abscess, abdominal wall Abscess, alveolar Abscess, ankle Abscess, arm Abscess, axillary Abscess, back Abscess, breast Abscess, buttocks Abscess, cerebral Abscess, cervical Abscess, cheek Abscess, chest Abscess, face Abscess, groin Abscess, hip Abscess, intra-abdominal Abscess, intra-orbital . . . Abscess, ischio-rectal . . . Abscess, jaw Abscess, knee Abscess, leg Abscess, liver Ad- mitted. 2 4 4 2 2 4 Died. Per cent. 100.0 100.0 Ad- mitted. 1 6 7 12 Per cent. 66. 14. 16. 100. 100. 11.1 Females. Ad- mitted. 1 Died. Per cent. 40.0 * Includes cases of doubtful terminology. Statistical Experience Data. 137 Table 51. Colored Surgical Cases — Continued. Males. Females. Causes. Abscess Abscess Abscess Abscess Abscess Abscess Abscess Abscess Abscess Abscess Abscess Abscess Abscess Abscess Abscess Abscess Abscess Abscess Abscess Abscess Abscess Abscess Abscess Abscess Abscess Abscess Ad- mitted. 1 1 liver, amoebic lumbar mastoid neck 10 palmar 1 pelvic perineal 4 perirectal 24 peritonsillar 2 periurethral 10 popliteal 1 postauricular 1 prostate 1 psoas 2 retroperitoneal 1 retropharyngeal 2 scalp 1 scrotum 1 shoulder 1 submental 1 thigh 5 tibia 1 tongue tonsillar urachus multiple Actinomycosis Actinomycosis, jaw Adenitis, axillary, infectious .... Adenitis, axillary, suppurative . . Adenitis, cervical Adenitis, cervical, suppurative . . . Adenitis, inguinal Adenitis, inguinal, chancroidal... Adenitis, inguinal, suppurative . . Adeno-carcinoma, palate Adeno-fibroma Adenoids Adenoma Adhesions Adiposis Ainhum Alcoholism, chronic Amputation, leg, traumatic Amputation, stump Anaemia Aneurism 19 Aneurism, popliteal 1 Angio-fibroma Angioma 2 Ankylosis Ankylosis, knee 1 Aortitis 1 Apoplexy 1 Died. Per cent. 100.0 25.0 10.0 100.0 50.0 33.3 50.0 100.0 26. 1 100.0 100.0 Ad- mitted. 13 Per cent. 100. 100. 100. 138 Frederick L. Hoffman. Table 51. Colored Subgical Cases — Continued. Males. Females. n Ad- LaUbes - mitted. Appendicitis SO Arthritis deformans Arthritis, elbow 1 Arthritis, hip 1 Arthritis, infectious 8 Arthritis, knee 2 Arthritis, knee, infectious Arthritis, knee, purulent 1 Arthritis, knee, rheumatoid Arthritis, knee, suppurative 1 Arthritis, knee, traumatic 1 Arthritis, knee, villous 2 Arthritis, metatarso-phalangeal joint 2 Arthritis, villous 1 Ascites 1 Buboes Bullet in foot 1 Burns 4 Burn, superficial 16 Bursitis 2 Calculus, biliary 3 Calculus, ureteral 1 Calculus, vesical 6 Carcinoma, antrum 1 Carcinoma, back Carcinoma, bladder 2 Carcinoma, breast 1 Carcinoma, caecum 1 Carcinoma, cervical glands 2 Carcinoma, chest wall Carcinoma, gall bladder 1 Carcinoma, inguinal glands 1 Carcinoma, intestines 3 Carcinoma, liver 1 Carcinoma, lung 2 Carcinoma, maxilla 1 Carcinoma, mouth 1 Carcinoma, nasopharynx 5 Carcinoma, neck 2 Carcinoma, pancreas 1 Carcinoma, penis 6 Carcinoma, prostate 4 Carcinoma, rectum 7 Carcinoma, scalp Carcinoma, sigmoid 2 Carcinoma, stomach 13 Carcinoma, tongue 1 Carcinoma, tonsils Carcinosis Cellulitis 28 Chancroids 7 Cholecystitis 2 Cirrhosis, liver 1 Cleft palate 1 Died. 9 Per cent. 11.2 100.0 O O 9 oo.o 50.6 100.0 20.0 ibo.6 33.3 25.0 42.9 53.8 10. Ad- mitted. 50 1 2 "i "s 19 3 5 1 50.0 1 1 1 100.0 1 1 100.0 ed - cent. 7 14.0 100 50 lit; 1 100 1 100 1 11 1 100.0 Statistical Experience Data. 139 Table 51. Colored Suegical Cases — Continued. Males. Causes - mitted. Club-foot 3 Colitis 1 Concussion, brain 1 Condyloma 1 Constipation Contracture, foot, following burn. . . 1 Contracture, hand Contractures 3 Contusions 12 Contusion, abdomen 3 Contusion, back 1 Contusion, elbow 1 Contusion, flank 1 Contusion, bead 4 Contusion, hip 2 Contusion, knee 2 Contusion, shoulder Contusion, thorax 2 Contusion, general 1 Convulsion, cerebral 1 Coxa vara 3 Cyst, breast Cyst, dentigerous 1 Cyst, femur Cyst, mesenteric Cysts, neck 2 Cyst, thyroglossal duct Cyst, thyroid gland Cystitis 6 Deformity, ears 1 Deformity, face 1 Dermatitis, blastomycetic 5 Diabetes Dilatation, colon 1 Diphtheria 2 Dislocation, elbow 1 Dislocation, femur 1 Dislocation, hip : . . 6 Dislocation, humerus 1 Dislocation, semilunar cartilage. ... 1 Dislocation, shoulder 5 Dislocations 4 Dysentery, amoebic 1 Eczema Embolism, cerebral 1 Empyema 15 Encephalocystocele Endocarditis 1 Enteritis 2 Epididymitis 16 Epilepsy 6 Epiphysitis 1 Episcleritis Epistaxis 1 Per cent if; 13 Females. Ad- mitted. 10 1 ied. Per cent. 100.0 100.0 20.0 100.0 140 Frederick L. Hoffman. Table 51. Colored Surgical Cases — Continued. Males. Females. „ Ad- Causes - mitted. Epithelioma 5 Epithelioma, arm Epithelioma, lip Erysipelas Erythema Exostosis Exostosis, femur 2 Exostosis, os calcis 1 Fever, malaria Fever, typhoid 15 Fever, typhoid (intestinal perfora- tion) 1 Fibro-adenoma, breast Fibro-carcoma Fibroma, rectus muscle Fibromata, multiple 1 Fissure in ano 2 Fistula in ano 45 Fistula, fecal 1 Fistula, perineal 2 Fistula, urethral 5 Flat-foot 2 Floating cartilage in knee 1 Foreign body in brain 1 Foreign body in foot Foreign body in gastro-intestinal tract Foreign body in oesophagus Fracture, arm 1 Fracture, clavicle 1 Fracture, Colles' 3 Fracture, femur 25 Fracture, fibula 3 Fracture, frontal bone 1 Fracture, humerus 7 Fracture, jaw 1 Fracture, malleolus 2 Fracture, maxilla 1 Fracture, metacarpal bone 1 Fracture, metatarsals 1 Fracture, nose 3 Fracture, olecranon Fracture, patella 3 Fracture, pelvis 4 Fracture, phalanges 2 Fracture, Pott's 11 Fracture, radius Fracture, radius and ulna 3 Fracture, ribs 6 Fracture, scapula Fracture, skull 11 Fracture, tarsus 2 Fracture, tibia 15 Fracture, tibia and fibula 16 Per cent 60 100 25 16 Ad- mitted. 2 1 1 3 1 1 1 "l 2 Died. 14 2 1 14 2 4 1 Per cent. 100.0 50. 50. 100. Statistical Experience Data. 141 Table 51. Colored Surgical Cases — Continued. Males. Females. Per cent \d- Causes. m j tted _ Died. Fracture, toe 1 Fracture, ulna 3 Fracture, vertebra 3 3 100 Fracture, wrist 1 Frost bite 6 Gangrene 9 Gastro-enteritis 1 Genu valgum 15 Genu varum 7 Giant colon 2 Glaucoma 1 Goitre Goitre, colloid Goitre, exophthalmic 1 Gonorrhoea 1 Gonorrhceal arthritis 8 Gonorrhceal arthritis, ankle 2 Gonorrhceal arthritis, elbow 1 Gonorrhceal arthritis, knee 6 Gonorrhceal arthritis, shoulder .... 2 Gonorrhceal arthritis, wrist 1 Gonorrhceal inguinal adenitis 1 Gonorrhceal ophthalmia 1 Gonorrhceal peritonitis Gumma 3 Gumma, arm Gumma, larynx Gumma, liver 1 Gumma, nares Gumma, ribs 1 Gumma, testicle 1 Gumma, tibia 1 Hammer toe Harelip 5 Hemangioma 1 Hematoma 4 Hematomyelia 5 1 20.0 Hematuria 5 1 20.0 Hemorrhage 3 2 66 Hemorrhage, intracranial 1 Hemorrhages, postoperative 1 Hemorrhage, traumatic 1 Hemorrhoids 31 Hernia, femoral 1 Hernia, inguinal 83 Hernia, inguinal, double 3 Hernia, inguinal, left 4 Hernia, inguinal, right 11 Hernia, inguinal, strangulated .... 21 3 14 Hernia, umbilical 1 Hernia, umbilical, strangulated 1 1 100 Hernia, ventral 5 Hirschsprung's disease Hodgkin's disease 1 1 100.0 10 Ad- mitted. 1 1 17 10 2 3 3 6 5 1 Per cent. 12 2 1 1 16. 100. 100. 12. 142 Frederick L. Hoffman. Table 51. Colored Surgical Cases — Continued. Males. „ Ad- Causes - mitted. Hydrocele 16 Hydrocephalus 1 Hydronephrosis 1 Hypernephroma Hypertrophy 1 Hypospadias 1 Hysteria Infected arm 1 Infected keloid 1 Ingrowing toe-nail Intestinal obstruction 13 Intestinal obstruction, volvulus. ... 1 Insanity Jaundice 1 Keloid 8 Keloid, breast Keloid, face and scalp 1 Laceration, hand 2 Laceration, penis 1 Lacerations 4 Lipoma 2 Lipoma, back Lipoma, groin 1 Lipoma, loin Lipoma, shoulder 1 Lipoma, thigh 3 Loose cartilage in knee 1 Lues 1 Lumbago 3 Lupus vulgaris Lymphangioma 2 Mammitis Mastitis 1 Mastoiditis 5 Meningitis 2 Myelitis 1 Myoma, uteri Myositis 2 Myxoma 1 Myxoma, breast Myxoma, intracanalicular Myxo-sarcoma Necrosis, skull Necrosis, superior maxilla 1 Nephritis 3 Neuralgia Neuralgia, facial 3 Neuralgia, intercostal 1 Neurasthenia 4 Neurosis 2 Neurosis, posttraumatic 1 New growth of cervical glands 1 Obstruction, intestines 3 GEdema Died. Per cent. 100.0 100.0 38.5 100.0 100.0 Ad- mitted. 2 2 100.0 Per cent. 100.0 25.0 100.0 33.3 Statistical Experience Data. m Table 51. Colored Surgical Cases— Continued. Males. Females. Per cent. Causes. m ^ Died. Osteitis 1 Osteoarthritis 4 Osteoma 1 Osteomyelitis 24 1 4.2 Osteomyelitis, femur 1 Osteomyelitis, fibula Osteomyelitis, humerus 1 Osteomyelitis, inferior maxilla .... 2 Osteomyelitis, patella 1 Osteomyelitis, phalanx 1 Osteomyelitis, tibia Otitis media 1 Oxycephaly Painful ankle Papilloma, rectum Paralysis, facial 1 Paralysis, obstetrical Paraphimosis 1 Paraplegia, spastic 1 Pelvic inflammatory disease Pericarditis 1 Pericholecystitis 1 Periostitis 6 Periostitis, femur 1 Periostitis, tibia 1 Periostitis, traumatic 1 Peritonitis 14 4 28.6 Pleurisy 1 Pleurisy, diaphragmatic 1 Pleurisy with effusion 1 Pneumonia 1 1 100.0 Poliomyelitis 2 Poliomyelitis, anterior 1 Polyp, rectum 1 Pott's disease Pregnancy Proctitis Prolapse, rectum 8 1 12.5 Prolapse, sigmoid 2 Prostatitis 2 Prostate, enlarged 30 10 33.3 Prostate, irritable 1 Pyelitis Pyonephrosis 1 Pyopneumothorax 2 1 50.0 Pyosalpinx, double Rachitis 4 1 25.0 Ranula 1 Recklinghausen's disease Redundant prepuce 1 Relaxed joints Retention, urine 2 Retroflexion, uterus Rupture, bowel 1 1 100.0 Ad- mitted. 2 14 15 Per cent. 100. 144 Frederick L. Hoffman. Table 51. Colored Surgical Cases — Continued. Males. n Ad- Causes - mitted. Rupture, duodenum 1 Rupture, liver 1 Rupture, sphincter ani Rupture, urethra 7 Sabre-shins 1 Salpingitis Salpingo-oophoritis Sarcoma, ankle 1 Sarcoma, breast Sarcoma, cervical gland 1 Sarcoma, femur 2 Sarcoma, groin 1 Sarcoma, heel 2 Sarcoma, humerus 2 Sarcoma, ilium 1 Sarcoma, leg 1 Sarcoma, inferior maxilla 1 Sarcoma, inguinal glands 1 Sarcoma, maxilla Sarcoma, neck 1 Sarcoma, retroperitoneal 2 Sarcoma, right superior maxilla Sarcoma, skull 1 Sarcoma, superior maxilla Sarcoma, thigh Scabies Scar Scar, painful Scars, contracted 1 Scoliosis Separation, epiphysis Septicaemia 2 Shock, postoperative Sinusitis 4 Sinus, back 1 Sinus, chest 1 Sinuses, perineal 1 Sinus over trochanter 1 Solitary tubercle 1 Sprain 1 Sprain, back 1 Stomatitis 1 Stricture, oesophagus 5 Stricture, rectum 3 Stricture, urethra 34 Synovitis, knee 3 Syphilis 10 Syphilis, tertiary Syphilitic periostitis 1 Syphilitic ulcer, leg 2 Talipes equino-varus 2 Tenosynovitis 3 Tetanus 10 Thrombosis 1 Died. 1 1 Per cent. 100.0 100.0 14 50 100 50 100 100 10 100 Ad- mitted. 5 18 4 12 1 Per cent. 50. 33. 14. 50. Statistical Experience Data. 145 Table 51. Causes. Colored Surgical Cases- Males. -Continued. Females. Per cent. Thrombosis, mesenteric Tonsil, enlarged Tonsillitis Transfusion, blood, donor of Tubercle, brain Tuberculos Tuberculos Tuberculos Tuberculos Tuberculos Tuberculos Tuberculos Tuberculos Tuberculos Tuberculos Tuberculos Tuberculos Tuberculos Tuberculos Tuberculos Tuberculos Tuberculos Tuberculos Tuberculos Tuberculos Tuberculos Tuberculos Tuberculos Tuberculos Tuberculos Tuberculos Tuberculos Tuberculos Tuberculos Tuberculos Tuberculos Tuberculos arm axillary glands breast carpal bone caecum cervical glands chest wall cutis elbow foot general groin hip humerus jaw kidney os calcis pulmonary rib sacro-iliac joint sacrum salivary glands tarsus tendon sheaths testicle thigh tibia trochanter 1 skull sternum 2 vertebrse 50 wrist 1 Tuberculous abscess, back Tuberculous abscess, cervical 2 Tuberculous abscess, chest Tuberculous abscess, groin 1 Tuberculous abscess, inguinal 1 Tuberculous abscess, n. s 1 Tuberculous adenitis, axillary 2 Tuberculous adenitis, cervical 80 Tuberculous adenitis, iliac Tuberculous adenitis, inguinal .... 6 Tuberculous adenitis, mesenteric . . 3 Tuberculous adenitis, peritonitis . . 9 Tuberculous arthritis 24 Tuberculous arthritis, ankle 6 Tuberculous arthritis, elbow 8 1 Tuberculous arthritis, hip 6 Tuberculous arthritis, knee 14 1 1 100.0 100.0 14.3 33.3 50.6 14.0 55.6 12.5 ' V.i l 2 11 1 2 1 2 65 1 "i 4 15 5 2 11 2 146 Frederick L. Hoffman. Table 51. Colored Sxjbgical Cases — Continued. Males. Females. Causes. m ££ d> Died. Tuberculous arthritis, wrist 8 2 Tuberculous arthritis, sacro-iliac region • 1 ... Tuberculous arthritis, shoulder ... 1 Tuberculous cystitis 2 1 Tuberculous epididymitis 1 Tuberculous laryngitis Tuberculous peritonitis 9 5 Tumor, breast Tumor, cerebral 6 1 Tumor, fauces - 1 Tumor, inguinal region Tumor, parotid 2 Tumor, pelvic 1 Tumor, spermatic cord 1 Tumor, spinal cord ... 1 1 Ulcer, corneal 1 Ulcer, duodenum Ulcer, foot 1 Ulcer, gastric 7 Ulcer, leg 2 Ulcer, leg, varicose Ulcer, neck 1 Ulcer, penis 1 Ulcer, varicose Uraemia Urethritis 10 Varicocele 1 Varicose veins 8 Visceroptosis Volvulus, sigmoid 1 Wound, abdomen, infected Wound, abdomen, gunshot 1 Wound, buttocks, granulating 1 Wound, contused 2 Wound, face, gunshot 1 Wound, foot, infected 1 Wound, granulating 2 Wound, gunshot 21 3 Wound, incised 7 Wound, infected 9 Wound, lacerated 11 Wound, leg, gunshot • 1 Wound, punctured 3 Wound, scalp 1 Wound, shoulder, gunshot 2 Wound, stab 12 Wrist-drop 1 Eye and ear diseases Cataract 5 ... Cataract, traumatic 1 Closed pupil Conjunctivitis Ectropion ... Per cent. 25.0 50.0 55.6 16.7 100.0 14.3 Ad- mitted. 10 i 2 1 Per cent. 25.0 40.6 16.7 50.0 Statistical Experience Data. 147 Table 51. Colobed Surgical Cases — Continued. Males. Causes. ££", nutted. Foreign body in eye 1 Glaucoma 2 Glioma, retina 1 Inflamed eyeball Irido-cyclitis 2 Obstruction, lachrymal duct .... 1 Occlusion, pupil 1 Opacity, lens Ophthalmitis 1 Otitis media 1 Panophthalmitis 3 Pterygium Rupture, cornea 2 Rupture, eyeball Staphyloma, cornea 2 Unclassified Died. Per cent Females. Ad- mitted. Died. Per cent. Table 52. Colobed Gynecological Cases. Ad- Causes, mitted. Abdominal pain 12 Abortion 3 Abortion, incomplete 1 Abscess, abdominal 5 Abscess, Bartholin's gland 7 Abscess, breast 1 Abscess, broad ligament 1 Abscess, inguinal gland 1 Abscess, ischio-rectal 9 Abscess, labial 1 Abscess, ovarian 1 Abscess, pelvic 104 Abscess, perirectal 1 Abscess, tubo-ovarian 20 Abscess, vagina and uterus 1 Abscess, vulvo-vaginal gland 2 Actinomycosis 1 Adenomyoma 1 Adenitis, inguinal 9 Adeno-carcinoma 2 Adhesions, intestinal 1 Adhesions, omental 1 Adhesions, postoperative 8 Amenorrhea 9 Anemia due to menorrhagia 1 Appendicitis 40 Ascites 1 Atresia, vagina 4 Buboes 2 Calculus, biliary 2 Carcinoma, bladder 2 Carcinoma, breast 1 Died. 20.0 5.8 loo.o o.o 148 Frederick L. Hoffman. Table 52. Coloked Gynecological Cases — Continued. Ad- Causes, mitted. Carcinoma, colon 1 Carcinoma, kidney 1 Carcinoma, ovary 2 Carcinoma, pelvic 2 Carcinoma, rectum 3 Carcinoma, sigmoid flexure 2 Carcinoma, stomach 1 Carcinoma, urethral 4 Carcinoma, uterus (cervix) 68 Carcinoma, uterus (fundus) 1 Carcinoma, uterus and ovary 1 Carcinoma, vagina 1 Carcinosis 2 Carcinosis, peritoneum 1 Caruncle, urethral 7 Cellulitis 4 Cervicitis 1 Chancroid 3 Colostomy, inguinal 1 Condylomata 1 Condylomata, vulva 1 Cyst, dermoid 2 Cyst, labial 2 Cyst, ovarian 45 Cyst, ovarian adeno-cystoma 4 Cyst, ovarian dermoid 1 Cyst, ovarian, Graafian follicle 2 Cyst, tubo-ovarian 1 Cystitis 29 Cystocele 1 Dysmenorrhea 42 Dyspareunia 2 Elongated cervix Endocervicitis Endometritis Erosion, cervix Fever, typhoid Fibroma Fibroma, abdominal wall Fibroma, labium Fibroma, pelvis Fissure in ano Fistula in ano Fistula, rectal , Fistula, recto-vaginal . . . Fistula, urethral Fistula, urethral-vaginal Fistula, vesico-vaginal 10 Foreign body in bladder Foreign body in vagina Gastritis Gonorrheal peritonitis . . Hematocele, pelvic Hematuria Died. Per cent. ?,Z 11 25 16 12 20 inn Statistical Experience Data. 149 Table 52. Colored Gynecological Cases — Continued. Ad- Causes, mjtted. Hemorrhage • 1 Hemorrhage, post-partum 1 Hemorrhage, uterine 5 Hemorrhoids H Hernia, femoral 2 Hernia, inguinal 2 Hernia, inguinal, left 1 Hernia, inguinal, right 1 Hernia, postoperative 1 Hernia, umbilical 3 Hernia, ventral 13 Hydrocele 4 Hydrosalpinx 4 Hypernephroma 2 Hypertrophy, cervix 8 Hypertrophy, labium 1 Hypertrophy, labia majora 1 Hypertrophy, vaginal wall 1 Hysteria 1 Incontinence, urine 3 Infantile pelvic organs 1 Intestinal obstruction 6 Irregular menstruation 1 Laceration, cervix 3 Laceration, para-urethral 1 Leucorrhoea 6 Menopause, artificial 1 Metrorrhagia 34 Myoma, uterus 464 1 1 1 1 38 Pregnancy, extra-uterine 54 Proctitis 4 Prolapse, vagina 1 Pseudocyesis 1 Pyelitis 4 Pyonephrosis 5 Pyosalpinx 46 Relaxed sacro-iliac joint 1 Relaxed vaginal outlet 33 Retained secundines 30 Died. Per cent. 9.1 IS 50. Nephritis 1 Nephroptosis 2 Neurasthenia 2 Papillocystoma, ovary 1 Papilloma, ovary 1 Pelvic inflammatory disease 13 Perineal tear 1 Peritonitis 48 5 Peritonitis, general 3 1 Peritonitis, pelvic Peritonitis, plastic Periureteritis Pneumonia Polyp, cervical Pregnancy 50.0 100 10.4 33.3 3.7 4.3 150 Frederick L. Hoffman. Table 52. Colored Gynecological Cases — Continued. Ad- Causes, mitted. Retention, urine 1 Salpingitis 2 Salpingo-oophoritis 681 Sarcoma, canal of neck 1 Sarcoma, kidney 1 Sarcoma, ovary 1 Sarcoma, uterus 2 Septicaemia, puerperal 3 Sinus, abdominal 2 Sinus, postoperative 1 Sterility 3 Stricture, rectum : 27 Stricture, ureteral 2 Syphilis 1 Syphilitic condylomata 1 Tear, recto-vaginal septum 7 Tuberculosis, bladder 1 Tuberculosis, intestinal 2 Tuberculosis, kidney 2 Tuberculosis, pelvic organs 4 Tuberculosis, pulmonary 2 Tuberculosis, retroperitoneal 1 Tuberculosis, sacro-iliac region 1 Tuberculosis, tubes 2 Tuberculous peritonitis 7 Tuberculous pleurisy 1 Tumor, rectal 1 Ulcer, vagina 2 Ulcer, vulva 2 Urethritis 5 Urethritis and vaginitis 1 Uterus, anteflexion 2 Uterus, collapse 24 Uterus, descensus 1 Uterus, inversion 1 Uterus, retroposition 71 2 1 2 1 Uterus, subinvoluted Vaginitis Vulvitis Vulvo-vaginitis *Unclassifled Died. Per cent. 50 Includes cases of doubtful terminology. Statistical Experience Data. 151 Table 53. Summary of Colored Orstetrical Cases for the Period 1904-1911. Causes. " jjg^ Died. Percent. Labor, spontaneous, at term 957 1 0.1 Labor, spontaneous, premature 74 2 2.7 Labor, operative 173 12 6.9 Abortion 89 1 1.1 Admitted post-partum 21 6 28.6 Pregnant, not delivered 110 0.0 Not pregnant 9 0.0 Total 1433 22 1.5 Admitted. Died. Causes. C ~ ^ Num- Per ber. cent. Labor, spontaneous at term 957 66.8 Labor, spontaneous, premature ... 74 5.1 Labor, operative 173 12.1 Abortion 89 6.2 Admitted post-partum 21 1.5 Pregnant, not delivered 110 7.7 Not pregnant 9 0.6 Total 1433 100.0 22 100.0 Num- Per ber. cent. 1 4.5 2 9.1 12 54.6 1 4.5 6 27.3 0.0 0.0 SEC. G. SUPPLEMENTARY AND MISCELLANEOUS STATISTICS. Table 54. Admission Rate of White Cases of Malignant Tumors. Males Malignant tumors. 1892 58 1893 46 1894 50 1895 77 1896 99 1897 95 1898 82 1899 94 1900 95 1901 104 1902 92 1903 97 1904 117 1905 108 1906 103 1907 99 1908 U9 1909 104 1910 117 1911 103 1892-01 800 1902-11 1059 s. ten iales. Rate per 10,000 population. Malignant tumors. Rate per 10,000 population. 3.2 79 4.0 2.5 99 5.0 2.6 131 6.5 4.0 123 6.0 5.1 122 5.8 4.8 105 5.0 4.1 168 7.8 4.6 123 5.6 4.6 141 6.4 5.0 120 5.4 4.3 112 5.0 4.5 108 4.7 5.4 110 4.8 4.9 91 3.9 4.7 82 3.5 4.4 105 4.4 5.3 108 4.5 4.6 89 3.7 5.1 106 4.3 4.5 70 2.8 4.1 1211 5.8 4.8 981 4.2 152 Frederick L. Hoffman. Table 55. Admission Rate of Colored Cases of Malignant Tumoks. M Males : Females. alignant Rate per m.nnn Malignant :ate per 10.000 i - umors - population. tumors - population. 1892 3 1.0 11 2.8 1893 7 3 2.3 1.0 7 22 1.8 1894 5.4 1895 14 9 4.3 2.7 24 11 5.8 1896 2.6 1897 4 1.2 11 2.6 1898 13 3.8 17 4.0 1899 12 3.4 23 5.3 1900 7 2.0 19 4.3 1901 4 5 1.1 1.4 26 14 5.9 1902 3.2 1903 13 3.6 10 2.2 1904 8 2.2 18 4.0 1905 17 4.6 17 3.8 1906 14 5 3.7 1.3 20 29 4.4 1907 6.4 1908 20 5.2 16 3.5 1909 10 2.6 24 5.3 1910 9 2.3 24 5.3 1911 18 4.6 31 6.8 1892-01 76 119 TE Cases 2.3 171 3.2 203 of Malignant Tumors 4.1 1902-11 4.5 Table 56. Wht Males. Females. A Ad- mitted Died. Per cent. Ad- mitted. Died. Per cent. 1892 . .. 58 5 8.6 79 8 10.1 1893 . .. 46 11 23.9 99 14 14.1 1894 . .. 50 10 20.0 131 15 11.5 1895 . . . 77 15 14 19.5 14.1 123 122 14 14 11.4 1896 . .. 99 11.5 1897 ... 95 18 18.9 105 9 8.6 1898 . .. 82 10 12.2 168 20 11.9 1899 . .. 94 13 13.8 123 9 7.3 1900 . .. 95 7 7.4 141 15 10.6 1901 . .. 104 20 19.2 120 12 10.0 1902 . .. 92 18 19.6 112 21 18.8 1903 . . . 97 17 17.5 108 11 10.2 1904 . .. 117 16 13.7 110 14 12.7 1905 . .. 108 19 17.6 91 11 12.1 1906 . .. 103 14 13.6 82 7 8.5 1907 ... 99 12 12.1 105 13 12.4 1908 . .. 119 18 15.1 108 6 5.6 1909 . .. 104 8 7.7 89 5 5.6 1910 . .. 117 15 12.8 106 13 12.3 1911 . .. 103 22 21.4 70 4 5.7 1892-01 . .. 800 123 15.4 1211 130 10.7 1902-11 ...1059 159 15.0 981 105 10.7 Statistical Experience Data. 153 Table 57. Colored Cases of Malignant Tumoes. Males. Females. mitted. DiecL Per cent. J^lfr Died - Per cent - 1892 3 1 33.3 11 4 36.4 1893 7 2 28.6 7 1894 3 2 66.7 22 2 9 1 1895 14 3 21.4 24 5 20.8 1896 9 1 11.1 11 4 36.4 1897 4 11 1898 13 2 15.4 17 3 17.6 1899 12 3 25.0 23 5 217 1900 7 1 14.3 19 4 211 1901 4 2 50.0 26 5 19.2 1902 5 2 40.0 14 3 21.4 1903 13 2 15.4 10 2 20 1904 8 5 62.5 18 2 11.1 1905 17 4 23.5 17 2 118 1906 14 8 57.1 20 5 25.0 1907 5 1 20.0 29 1908 20 3 15.0 16 2 12.5 1909 10 2 20.0 24 4 16.7 1910 9 1 11.1 24 2 8 3 1911 18 3 16.7 31 1 3.2 1892-01 76 17 22.4 171 32 18 7 1902-11 119 31 26.1 203 23 11.3 Table 58. Population of Baltimore, Md., 1892-1911. White White Colored Colored males. females. males. females. 1892 183107 196448 30437 39345 1893 186187 199575 31074 39952 1894 189267 202703 31711 40559 1895 192347 205831 32348 41166 1896 195427 208959 32985 41774 1897 198507 212087 33622 42382 1898 201587 215215 34259 42990 1899 204667 218343 34896 43598 1900 208217 221482 35063 44195 1901 210309 223793 35462 44345 1902 212401 226104 35861 44495 1903 214493 228415 36260 44645 1904 216585 230726 36659 44795 1905 218677 233037 37058 44945 1906 220769 235348 37457 45095 1907 222862 237659 37856 45245 1908 224955 239971 38255 45395 1909 227048 242283 38654 45545 1910 229141 244595 39054 45695 1911 231234 246907 39454 45845 1892-01 1969622 2104436 331857 420306 1902-11 2218165 2365045 376568 451700 154 Frederick L. Hoffman. Table 59. Deaths by Sex and Color in Baltimore, Md., 1902-1911. p, ,, Rate per ueatns. 1000 popu i a tion. White males 41904 18.9 White females 39504 16.7 Total white 81408 17.8 Colored males 13352 35.3 Colored females , 13058 28.9 Total colored 26410 31.8 Table 60. Deaths in Baltimore, Md., 1907-1911. Pulmonary tuberculosis. Pneumonia. , -* 1 , c K -\ Rate per Rate per Deaths. 10,000 Deaths. 10,000 population. population. White males 2292 20.2 1807 15.9 White females 1700 14.0 1684 13.9 Total white 3992 17.0 3491 14.9 Colored males 1164 60.2 986 51.0 Colored females 1016 44.6 846 37.2 Total colored 2180 51.8 1832 43.5 Bronchitis. Tvphoid fever. , -» , , > » Rate per Rate per Deaths. 10,000 Deaths. 10,000 population. population. White males 256 2.3 443 3.9 White females 330 2.7 312 2.6 Total white 586 2.5 755 3.2 Colored males 86 4.4 102 5.3 Colored females 118 5.2 78 3.4 Total colored 204 4.8 180 4.3 Cancer. Heart disease. , ' , , > , Rate per Rate per Deaths. 10,000 Deaths. 10,000 population. population. White males 725 6.4 1561 13.8 White females 1217 10.1 1650 13.6 Total white 1942 8.3 3211 13.7 Colored males 71 3.7 600 31.0 Colored females 202 8.9 562 24.7 Total colored 273 6.5 1162 27.6 Bright's Disease. Accident. Suicide. , * , , » , r— " > Rate per Rate per Rate per Deaths. 10,000 Deaths. 10,000 Deaths. 10,000 population. population. population. Whites 3677 15.7 1987 8.5 441 1.9 Colored... ..1075 25.5 575 13.7 24 0.6 Statistical Experience Data. 155 Table 61. Patients Treated and Days of Treatment. Ti-patpH Da y s of Average num- irearea. treatment, ber of days. 1892 2253 61772 27.4 1893 2622 68044 26.0 1894 3018 76386 25.3 1895 3386 86289 25.5 1896 3602 88690 24.6 1897 3633 87993 24.2 1898 3815 92701 24.3 1899 4074 96116 23.6 1900 4702 100128 21.3 1901 4363 101763 23.3 1902 4164 103343 24.8 1903 4166 10.0879 24.2 1904 4531 109923 24.3 1905 4224 100906 23.9 1906 4550 101178 22.2 1907 4859 103778 21.4 1908 4912 102208 20.8 1909 5085 104654 20.6 1910 5267 112150 21.3 1911 5199 100165 19.3 1892-01 35468 859882 24.2 1902-11 46957 1039184 22.1 Table 62. The Dispein'sary. Medical Department. i — ~" \ Number. Per cent. 1892 11967 24.5 1893 13920 25.0 1894 14808 26.4 1895 13755 25.0 1896 16069 25.6 1897 16613 25.9 1898 15199 24.9 1899 14638 24.6 1900 15561 23.7 1901 14070 22.1 1902 14489 23.4 1903 14660 23.0 1904 14097 22.0 1905 16100 22.5 1906 12976 19.1 1907 15654 20.9 1908 15543 18.6 1909 13872 17.6 1910 15658 18.8 1911 12656 17.9 1892-01 146600 24.7 1902-11 145705 20.2 Surgical Department. Number. Per cent. 9759 20.0 9929 17.9 9905 17.6 10047 18.2 11104 17.7 11237 17.5 11550 18.9 11862 19.9 14229 21.7 13715 21.5 11450 18.5 12938 20.3 13118 20.4 14255 20.0 14255 21.0 13088 17.4 14632 17.5 14681 18.6 13580 16.3 11819 16.7 113337 19.1 133816 18.6 156 Frederick L. Hoffman. Table 63. The Dispensary. Gynecological Department. Obstetrical Department. f * ^ r -A. . Number. Per cent. Number. Per cent. 1892 3415 7.0 1893 4678 8.4 1894 3760 6.7 9 1895 4017 7.3 369 0.7 1896 4179 6.7 594 0.9 1897 3959 6.2 593 0.9 1898 3055 5.0 758 1.2 1899 3531 5.9 745 1.3 1900 3127 4.8 1124 1.7 1901 2504 3.9 1025 1.6 1902 2398 3.9 1336 2.2 1903 2626 4.1 1385 2.2 1904 2761 4.3 1420 2.2 1905 3376 4.7 1431 2.0 1906 3491 5.1 1373 2.0 1907 4047 5.4 1904 2.5 1908 4046 4.9 2061 2.5 1909 3781 4.8 2005 2.5 1910 4630 5.6 2167 2.6 1911 3981 5.6 1925 2.7 1892-01 36225 6.1 5217 0.9 1902-11 35137 4.9 17007 2.4 Table 64. The Dispensary. Children's Department. Orthopedic Department. 1892 1893 1894 1895 1896 1897 1898 1899 1900 1901 1902 1903 1904 1905 1906 1907 1908 1909 1910 1911 1892-01 26098 1902-11 32721 Number. Per cent. Number. Per cent. 2407 4.9 2440 4.4 2646 4.7 2288 4.2 2983 4.8 3041 4.7 2723 4.5 2131 3.6 2732 4.2 2707 4.3 323 0.5 2808 4.5 ] L902 3.1 2409 3.8 \ !235 3.5 2563 4.0 : 5006 4.7 2913 4.1 [ 5416 4.8 2556 3.8 I !718 4.0 3495 4.7 \ !157 2.9 3770 4.5 5 !615 3.1 3802 4.8 I !354 3.0 4763 5.7 \ !341 2.8 3642 5.2 5 ,426 3.4 26098 4.4 323 0.1 32721 4.5 21 il70 3.E Statistical Experience Data. 157 Table 65. The Dispensary. Dermatologieal Department. r — >■ , Number. Per cent. 1892 4520 9.3 1893 5352 9.6 1894 5182 9.2 1895 4765 8.6 1896 5174 8.3 1897 5229 8.1 1898 5551 9.1 1899 6117 10.3 1900 5929 9.0 1901 5641 8.9 1902 5150 8.3 1903 4439 6.9 1904 5061 7.9 1905 5086 7.1 1906 5058 7.5 1907 5226 7.0 1908 5186 6.2 1909 4695 6.0 1910 5245 6.3 1911 5035 7.1 1892-01 53460 9.0 1902-11 50181 7.0 1 From 1907 this department is indicated as Women's Venereal. Department of Venereal Diseases. 1 , * _, Number. Per cent, 794 1.2 1283 2.1 1239 2.1 1683 2.6 1473 2.3 1374 2.2 1416 2.2 933 1.5 1222 1.7 947 1.4 1312 1.7 1241 1.5 1290 1.6 1284 1.5 1119 1.6 6472 1.1 2138 1.7 Table 66. The Dispensary. Ophthalmological Department. Number. Per cent. 1892 1977 4.0 1893 2514 4.5 1894 2653 4.7 1895 2812 5.1 1896 4065 6.5 1897 4398 6.8 1898 3402 5.6 1899 2896 4.9 1900 3659 5.6 1901 3510 5.5 1902 3520 5.7 1903 3523 5.5 1904 3031 4.7 1905 3449 4.8 1906 3336 4.9 1907 3326 4.4 1908 3331 4.0 1909 3581 4.5 1910 4092 4.9 1911 3385 4.8 1892-01 31886 5.4 1902-11 34574 4.8 Otolo 1 rieal Department. Number. Per cent 772 1.6 928 1.7 951 1.7 854 1.5 1253 2.0 1298 2.0 1087 1.8 1147 1.9 1474 2.2 1339 2.1 1035 1.7 1009 1.6 1151 1.8 1131 1.6 922 1.4 1264 1.7 1496 1.8 1159 1.5 1414 1.7 1038 1.5 11103 1.9 11619 1.6 158 Frederick L. Hoffman. Table 67. The Dispensary. Genito-urinary Department. i " V Number. Per cent. 1892 3847 7.9 1893 3865 7.0 1894 4962 8.8 1895 4393 8.0 1896 4583 7.3 1897 5247 8.2 1898 6210 10.2 1899 4989 8.4 1900 5808 8.9 1901 6715 10.5 1902 6725 10.9 1903 6838 10.7 1904 7755 12.1 1905 8200 11.5 1906 9439 13.9 1907 9503 12.7 1908 9126 10.9 1909 8724 11.1 1910 8383 10.1 1911 6600 9.3 1892-01 50619 8.5 1902-11 81293 11.3 Laryr gological Department. Number. Per cent. 4122 8.4 4437 8.0 4913 8.8 4536 8.2 5068 8.1 4712 7.3 3461 5.7 3268 5.5 3821 5.8 3476 5.5 3027 4.9 3454 5.4 3080 4.8 3110 4.4 3349 4.9 3851 5.1 4499 5.4 4281 5.4 4279 5.1 3436 4.9 41814 7.1 36366 5.0 Per cent. 0.9 Table 68. The Dispensary. Neurological Admitted to Department. Hospital. , * , / *— Number. Per cent. Number. 1892 5627 11.5 420 1893 7135 12.8 376 1894 5660 10.1 730 1895 6600 12.0 661 1896 7115 11.3 531 1897 6731 10.5 421 1898 6498 10.6 255 1899 6925 11.6 18 1900 6430 9.8 1901 7171 11.3 1902 6629 10.7 1903 6907 10.8 1904 6196 9.6 1905 •. 7746 10.8 1906 6608 9.8 1907 7156 9.5 1908 7215 8.6 1909 6745 8.6 1910 7063 8.5 1911 6298 8.9 1892-01 65892 11.1 3412 1902-11 68563 9.5 0.6 Statistical Experience Data. 159 Table 69. The Dispensary Total Number treated. 1892 48833 1893 55574 1894 56179 1895 55097 1896 62718 1897 64273 1898 61032 1899 59506 1900 65577 1901 63669 1902 61843 1903 63839 1904 64172 1905 71435 1906 67861 1907 75021 1908 83567 1909 78849 1910 83347 1911 70740 1892-01 592458 1902-11 720674 Phipps' Tuberculosis Dispensary. Number. 833 3038 8806 7879 7380 36384 Per cent. 5.0 Table 70. The Dispensary. (1892-1901.) Department. Treated. Per cent. Medicine 146600 24.7 Surgery 113337 19 1 Neurology 65892 ll!l Dermatology 53 460 9 Genito-urinary 50619 8.5 Laryngology 41814 7 x Gynecology 362 25 6.1 Ophthalmology 31886 5.4 Children 26098 4^4 otology 11103 1.9 Venereal » 6472 1.1 Obstetrical '- 5217 9 Admitted to Hospital 3 3412 6 Orthopedic 4 323 o!l Tot al 592458 100.0 1 From 1897 only. 2 From 1894 only. 3 From 1892 to 1899 only. 4 From 1901 only. 160 Frederick L. Hoffman. Table 70. The Dispensary — Continued. (1902-1911.) Department. Treated. Per cent. Medicine 145705 20.2 Surgery 133816 18.6 Genito-urinary 81293 11.3 Neurology 68563 9.5 Dermatology 50181 7.0 Phipps' Tuberculosis Dispensary 5 36384 5.0 Laryngology 36366 5.0 Gynecology 35137 4.9 Ophthalmology 34574 4.8 Children 32721 4.5 Orthopedic 25170 3.5 Obstetrical 17007 2.4 Venereal ° 12138 1.7 Otology 11619 1.6 Total 720674 100.0 . s For 1906 to 1911 only. During- this period the number of treated cases in the Phipp's Tuber- culosis Dispensary was 7.9 per cent of all treated. 6 From 1907 this department is indicated as Women's Venereal. MORBIDITY AND MORTALITY STATISTICS OF THE JOHNS HOPKINS HOSPITAL, 1903-1911. Table 71. X-Ray Department. Cases treated. Treatments _ Per cent of given. increase or decrease. 1903 114 1461 1904 101 1086 —25.7 1905 65 901 —17.0 1906 56 687 —23.8 1907 63 768 +11.8 1908 44 566 —26.3 1909 33 490 —13.4 1910 N. S. 731 +49.2 1911 N. S. 592 —19.0 1903-11 476 7282 RADIOGRAPHS. Number. Per cent of increase or decrease. Ward patients. Dispen- sary patients. Ortho- pedic. Privat 1903 1599 752 408 183 256 1904 1394 —12.8 654 455 152 133 1905 905 —35.1 418 323 157 7 1906 822 — 9.2 405 289 124 4 1907 909 +10.6 471 334 100 4 1908 1064 +17.1 508 380 176 N. S. 1909 1401 +31.7 717 557 127 N. S. 1910 2484 +77.3 1354 954 176 N. S. 1911 4448 +79.1 2597 1851 N. S. N. S. 1903-11 15026 7876 5551 1195 404 Statistical Experience Data 161 Table 71 — Continued. FLUOROSCOPIC EXAMINATIONS. Number. 1903 26 1904 57 1905 162 1906 175 1907 161 1908 177 1909 69 1910 84 1911 84 1903-11 995 Per cent of increase or decrease. +119.2 +184.2 + - + 8.0 8.0 9.9 61.0 21.7 Table 72. Financial Statistics of The Johns Hopkins Hospital, 1889-1911. Year. Expenditures. Receipts. Net cost. No. of patients treated, pat' Cost per tent treated 1899* .$ 76,085.51 $ 7,532.90 $ 68,552.61 788 $96.56 1890 139,634.77 31,236.19 108,398.58 1825 76.51 1891 154,992.87 42,156.16 112,836.71 2276 68.10 1892 161,858.29 51,162.67 110,695.62 2077 77.93 1893 172,895.42 50,499.74 122,395.68 2622 65.94 1894 178,107.11 52,012.28 126,094.83 3018 59.01 1895 188,868.83 61,168.82 127,700.01 3386 55.78 1896 191,111.74 61,635.68 129,476.06 3602 53.06 1897 200,963.72 64,391.71 136,572.01 °63° 55.32 1898 198,643.78 66,530.57 132,113.21 3815 52.07 1899 214,113.63 87,756:60 126,357.03 4074 52.56 1900 228,870.18 92,913.72 135,956.46 4702 48.68 1901 229,018.42 98,065.60 130,952.82 4363 52.49 1902 245,335.31 104,627.75 140,707.56 4164 58.92 1903 249,770.77 101,511.74 148,259.03 4166 59.95 1904 269,327.25 115,242.42 154,084.83 4531 59.44 1905 273,547.21 126,702.22 146,844.99 4224 64.76 1906 271,400.52 144,359.78 127,040.74 4550 59.65 1907 299,182.64 168,653.63 130,529.01 4859 61.57 1908 318,177.84 178,764.79 139,413.05 4912 64.78 1909 338,218.09 190,232.85 147,985.24 5085 66.51 1910 358,514.81 204,838.86 153,675.95 5267 68.07 1911 361,155.54 192,355.32 168,800.22 5199 69.47 Eight and a half months. SEPARATE MONOGRAPHS REPRINTED FROM THE JOHNS HOPKINS HOSPITAL REPORTS. Studies in Dermatology. By T. C. Gilchrist, M. D., and Emmet Rixford, M. D. 164 pages and 41 plates. Price, in paper, $3.00. The Malarial Fevers of Baltimore. By W. S. Thayer, M. D., and J. Hewet- son, M. D. And A Study of some Fatal Cases of Malaria. By Lewellys F. Barker, M. B. 280 pages. Price, in paper, $2.75. The Pathology of Toxalbumin Intoxications. By Simon Flexner, M. D. 150 pages with 4 lithographs. Price, in paper, $2.00. Studies in Typhoid Fever, I, II, III. By William Osler, M. D., and others. Extracted from Vols. IV, V and VIII of the Reports. 757 pages. Price, in cloth, $5.00. Pneumothorax. A Historical, Clinical, and Experimental Study. By Charles P. Emerson, M. D. Price, in paper, $4.00. NEW SERIES. I. Free Thrombi and Ball-Thrombi in the Heart. By J. H. Hewitt, M. D. 82 pages and 20 illustrations. Price, in paper, $1.00. II. Benzol as a Leucotoxin. By Laurence Selling, M. 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