Special Reports of the New York and Kings County Asylums. government, and shall have the power to call upon the officers of these institutions to take part in the giving of instruction therein. 7. He shall make to the board such recommendations and plans as may conduce in his judgment to the more extended employment of the insane in such useful occupations as may be of benefit to themselves and the department. 8. Transfers of patients from any one to another of the institutions named, and the return of patients from the several branches to the main asylums, or from the latter to the Reception Pavilion, shall be made only with his knowledge and approval. KINGS COUNTY LUNATIC ASYLUM. The general superintendent shall be the chief executive officer of the asylums. He shall be regarded as the head of the establishment, and shall be the medium of communication between the asylums and the Board of Commissioners of Charities and Corrections. He shall have the general supervision of the buildings and grounds, together with their furniture, fixtures and stock, and the direction and control of all persons therein, with power to assign them their respective duties; also to appoint such and so many assistant physicians, attendants and other employés as he may think proper and necessary for the economical and efficient administration of the affairs of the asylums, and to prescribe their several duties and places, and to fix, with the approval of the Board of Commissioners of Charities and Corrections, their compensation, and to discharge any of them at his sole discretion. 16. What proportion of the time of the medical superintendents is actually devoted to the medical care of the patients, and how much of their time, approximately, is given up to official matters not strictly medical in character? NEW YORK CITY ASYLUMS. WARD'S ISLAND. Female Department. About nine hours a day are devoted by me to the institution, of which three or four hours are devoted to official matters not strictly medical in character. (Dr. Dent.) Special Reports of the New York and Kings County Asylums. Male Department. About one-half of my time, on the average, is given up to official matters not strictly medical in character, and one-half to matters connected with the medical care of the patients. (Dr. Macy.) HART'S ISLAND. Fifty per cent. to the medical care and 50 per cent. to official matters. (Dr. Smith.) CENTRAL ISLIP. An average of from two to three hours daily is actually devoted to medical care of the patients by the physician in charge, and the balance of the time, approximately, six or seven hours, is given up to official matters not strictly medical in character. (Dr. Evarts.) KINGS COUNTY ASYLUMS. About one-half to each, approximately. 17. In your judgment, would it be feasible or desirable to separate the strictly medical work from the business management of the asylums; and what, if any, would be the objections to such an arrangement? NEW YORK CITY ASYLUMS. No. Every detail of the business management has a bearing upon the medical work, and upon the treatment of the patients, and the head of the institution should control both, though he should also have competent and adequate assistance in both. KINGS COUNTY LUNATIC ASYLUMS. It would not be desirable. Experience in various institutions has shown that such an arrangement always brings about a confliction of authority between the medical officers and the business manager, detrimental to the institution and to the welfare of the patients. 18. How many of the medical officers of the asylums are college graduates? Special Reports of the New York and Kings County Asylums. NEW YORK CITY ASYLUMS. All are graduates of medical colleges and six hold other college degrees in addition. Four. KINGS COUNTY LUNATIC ASYLUMS. 19. What proportion of the medical officers of the asylums has had previous experience in a general hospital? NEW YORK CITY ASYLUMS. Twenty-three. KING'S COUNTY LUNATIC ASYLUMS. Seventy per cent. 20. Do the junior medical officers receive special instruction in mental medicine, mental pathology, neuro-anatomy, and in the use of instruments of precision, especially as regards the use of the microscope, ophthalmoscope, etc., and if so, by whom, and to what extent? NEW YORK CITY ASYLUMS. They receive special instructions from the senior medical officers, and many of them attend special classes in the various colleges and hospitals of the city. No. KINGS COUNTY LUNATIC ASYLUMS. 21. Give a list of the "instruments of precision," surgical instruments and medical appliances possessed by the asylums. Special Reports of the New York and Kings County Asylums. WARD'S ISLAND. Female Department. One ophthalmoscope, 1 sphygmograph, 1 microscope, 1 æsthesiometer, vaginal specula, 2 bivalve, Cusco's, 1 Ashton's fenestrated, 5 Ferguson's tubular, 1 Blakeley's resilient, 1 Munde's, 2 Sims', 1 trivalve, 1 set of Barnes' dilators, 2 spoon curettes, 1 dull curette, 1 whalebone and 1 silver applicator, 1 uterine probe, 2 pairs cervical scissors, 1 Sims' double depressor, 1 wire twister, 2 soft rubber returnflow catheters, 2 dozen alpha fountain syringes, 12 tupelo tents, 2 sharp curettes, 1 Thomas curette, 1 uterine sound, 4 pairs cervical hooks, 5 sponge holders, 12 Goodyear syringes, 3 Bozeman's intrauterine return-flow catheters, 1 Keyes' bladder irrigator, 1 pair short obstetrical forceps, 1 pair Lusk's axis-traction forceps, 2 Hodge's pessaries, 2 Taliaferro pessaries, 2 Taliaferro retro-displacement pessaries, 1 Kieth's compression forceps, 1 head mirror, 1 Bowman's eye speculum, 3 knives iridectomy and canalicula, 1 set of ear specula, (3) 2 Politzer ear spoons, 2 dozen glass ear syringes, 1 Politzer air bag, 1 Jarvis nasal speculum, 2 atomizers, 1 probang with silver bucket, 1 aspirator, 1 small operating case, 12 soft rubber urethral catheters, 1 pair long curved obstetrical forceps, 2 ring pessaries, 2 Emmet Smith's pessaries, 2 Hunter's bow pessaries, 1 Peaslee's needle, 1 perineum membrane forceps, 5 composite catheters male and female with porte-caustic, 3 exploring needles, 1 set of Bowman's probes, 1 bivalve ear speculum, 1 pair polypus forceps, 1 hard rubber ear syringe, 1 nasal speculum, 3 laryngoscopic mirrors, 4 tracheotomy tubes (Cohn's), 2 probangs (Bristle), 1 post-mortem case, 1 large operating case containing 1 saw, 2 amputating knives, 1 masculum forceps, 1 male and female catheter and porte-caustic, 2 pair scissors, 1 pair of bone forceps, 1 tourniquet, 1 probe-pointed bistoury, 1 tenotomy knife, 1 double tenaculum, 2 retractors, 8 suture needles, 1 artery forceps, 1 Nelaton bullet probe, 1 silver probe, 8 small and 2 large acupressure needles, 12 surgical pocket cases, 1 pair of bone forceps, 1 hernia saw, 1 Volkmann spoon, 1 grooved director, 1 Paquelin cautery, 1 Esmarch tourniquet, 2 bandage rollers, 1 stomach pump, 1 Faradic battery, 12 cells and electrodes, 1 ice helmet, 6 nasa) feeding tubes, 6 water beds, 2 dozen thermometers, 1 set tooth forceps, 10 pairs; 1 Robert's urine test apparatus, 1 Satterthwaite's rachitome, 1 hernia director, 1 Ferguson's lion-jaw forceps, Special Reports of the New York and Kings County Asylums, 1 bone chisel, 1 trochar and canula, 12 vidal serrefines, 2 Esmarch bandages, 6 pus basins, 1 Stoehrer galvanic battery, 36 cells and elec trodes; 1 stomach siphon, 12 oesophageal feeding tubes, 6 hot-water bags, 18 hypodermic syringes, 1 dozen stethoscopes, 1 set of dentist's scalers. Male Department. One autopsy case (complete), 1 brain knife, dozen objectives (} inch, inch,inch, inch, inch, 1 inch), 1 Tiemann's microtome, gross glass slides and covers and watch crystals, etc., 1 dozen stethoscopes, 1 set aural speculums, 1 dozen clinical thermometers, 1 complete stand of apparatus for volumetric analysis of urine, 1 McIntosh faradic battery, 1 case of test glasses (optical), dozen water beds, dozen rubber hot-water bags, dozen rubber ice bags, 1 cylinder of oxygen, 1 dozen Davidson syringes, 1 Alpha syringe (fountain), 13 dozen bed pan-, 1 soft rubber cup, 1 Politzer air bag, 1 dozen assorted gliss and hard rubber ear syringes, 1 Jarvis caustic applicator, dozen laryngeal mirrors, dozen eustachian catheters, 3 tongue depressors, 1 entropium forceps, 3 tracheotomy tubes, 1 set (18) tooth forceps, 1 U. S. army operating case (complete), 1 brass stomach pump, 1 section knife frame and stand, 2 microscopes, 2 pairs of scissors (microscopic use), 1 freezing microtome (carbonic oxide) and cylinder of gas, 1 pair dissecting forceps, 2 dynamometer (microscopic), 1 aesthesiometer, 1 anal speculum, 1 eye speculum, 1 urinometer, 1 dry Le Clanché galvanic battery with miliampere meter and rheostat, etc., 1 improved Dawson galvano-caustic with electrodes, 1 fracture box and set of wooden splints (assorted), 2 oxygen bags (5 gallons each), dozen air cushions, 4 dozen assorted glass syringes, 1 dozen rubber 2 ounce syringes, 1 hard rubber syringe 4 ounce, 1 dozen cupping glasses, 1 laryngeal lamp with condensor, 1 post-nasal syringe, dozen laryngeal aural and nasal probes and applicators, 1 ear snare, 1 each, nasal and throat forceps, 1 set lachrymal probes and knife, 1 tonsilitome, 1 each, nasal saw and scissors, 1 complete set steel sounds (urethral), 3 dozen soft catheters, 1 dozen English gum catheters, 1 dozen esophageal tubes and bougies, dozen bougies, A. Boule; 1 urethral dilator (graduated), 1 phimosis forceps, 5 forceps for the removal of foreign bodies from larynx, etc. (assorted); 14 pocket cases (surgical), 2 dozen skeins surgeon's silk sterilized cat-gut and aseptic braided silk, 2 trochars (canula) for paracentesis, 4 bone-cutting forceps, 2 sequestrum forceps, 8 Tait's clamp |