SECOND ANNUAL REPORT OF THE MIDWIFERY DISPENSARY, 314 BROOME STREET, NEW YORK CITY. MEDICAL BOARD. Consulting Physicians. EDWARD W. LAMBERT, M.D., Pres. THOMAS M. MARKOE, M.D. SECOND ANNUAL REPORT OF THE MIDWIFERY DISPENSARY. The Midwifery Dispensary has completed its second year, and presents to the medical public in this report the results of the twelve months ending December 31st, 1891. The Dispensary occupied on the 18th of January, 1890, a single apartment in a Broome-Street tenement, and accommodated a resident physician and three students. It was not associated with any medical school, and was dependent for its income upon the generous gifts of its friends. It had no patients, and there had been no demand on the part of the medical student for such an opportunity as it was proposed to offer him. At the present time nearly the whole of a five-story tenement has been absorbed for the uses of the Dispensary, and its medical staff has increased until now it consists of a resident physician, three assistants, and twenty students, together with two trained nurses. The number of patients has increased to an average of five per day, and the applications of students are so numerous that there is often no vacancy for several weeks in succession. The Midwifery Dispensary still stands unallied to any other educational institution, and will continue to do so. In fact, it must adhere to this policy, for no one school or college could supply the number of students necessary to accomplish its work. Two of the largest medical schools in this city, however, have recognized the value of a practical course in obstetrics, and refer all their students to this institution for the two weeks' course. The financial outlook of this enterprise has also assumed a very different aspect from that of the young and immature scheme which was struggling for public recognition two years ago. The number of women treated by the Dispensary has increased from 199 during the year 1890 to 955 during the year 1891. These figures speak for themselves, and demon strate that the care and attention to detail expended upon the first patients of the Dispensary have borne good fruit. It is also evident that practitioners and students of medicine realize the advantages of the practical and thorough course in midwifery here offered. In 1890, 62 students were instructed at the Dispensary, and in 1891 this total has increased to 243. It is thus evident that the work of this institution has quadrupled during the past twelve months. The running expenses for 1891 were $6,136.20, against $1,481.07 for 1890; but the cost per patient for 1891 was only $6.42, as against $7.48 for 1890. The cost per capita will, undoubtedly, be still further reduced when the system becomes more fully developed. During the past year the permanent equipment has been expanded to the extent of $1,024.30. The increase in work has naturally demanded enlargement of the resident staff, and two additional salaried assistants to the resident physician have been appointed. Two trained nurses have also been secured, who prepare the obstetric dressings, and have the care of the labor and post-partum bags and instruments; they also accompany the attending physician to all major operations to act as trained assistants. A member A very serious defect in the former method of instruction by the Dispensary was the necessity of making all antepartum examinations at the house of the patient. During the past year a room has been fitted up in the Dispensary for the purpose of examining pregnant women. of the resident staff always conducts the examination in the presence of a nurse, instructing the student in the signs of pregnancy and the methods of mensuration. By this means also the statistics of the ante-partum condition are rendered accurate and reliable. No report from the Pathologist is published this year, because of the great difficulty in obtaining permission to perform autopsies. The report of the Embryologist is this year only an enumeration of the specimens collected. Details of work in this branch must be postponed until a later report. The position of the Orthopedic Surgeon was not created until the latter part of this year (1891). The report on this subject is limited to a single case. In the near future an amalgamation will be affected with the Society of the Lying-in Hospital of the City of New York. The attention of the medical profession is therefore called to the fact that all further reports of the work begun under the name of the Midwifery Dispensary will appear as reports of the above Society. The Society of the Lying-in Hospital of the City of New York, was incorporated under an Act of the Legislature of New York, March 1st, 1799. Subscriptions were asked for and received from many people in the City of New York, among others William Bayard, Herman Leroy, Isaac Gouverneur, Gulian Verplank, Alexander Hamilton, Peter Goelet, Stephen Tillinghast, David Clarkson, Nathaniel Pendleton, Henry Rutgers, Brockholst Livingston, Alexander Hosack, Frederick De Peyster, De Witt Clinton, Richard Riker, Nicholas Fish, Robert Benson, William Renwick, Daniel Phoenix, Leonard Bleecker and Thomas L. Ogden, and many other well-known New Yorkers of that day. The Society entered into an agreement in 1801 with the New York Hospital, by which a lying-in ward was established and opened for the reception of patients in the latter hospital. This continued in operation for twenty-six years, but inconveniences having arisen, it was finally determined to close the ward, which was done in June, 1827. Various plans were suggested, from time to time, respecting the carrying on of the work of the hospital, the plan ultimately decided upon being the aiding of females requiring assistance during confinement at their own homes. This method has been found very successful in affording relief to the persons requiring such care, and has been continued by the Society for over thirty years. The Society has a fund invested, the income derived from which is sufficient to carry on this work in a manner similar to that which has been done at the Midwifery Dispensary. The mode of aiding women in confinement adopted by both these charities is virtually the same, and a merger of the two charities into one, it has been thought, would be the best mode of carrying on the work in the future, and as the Lying in Hospital is one of the oldest charitable institutions in the State, it has been thought best that the work should |