the equipment in the rooms now used as music rooms to special rooms in the addition, that will provide two more classrooms. We plan to take the art-room equipment and put it in the regular art rooms in the addition, which will provide two additional classrooms in the building. We also plan to move the print shop from the present building, and put it in the addition.

I think that the net increase in the number of classrooms will be about 9 or 10, and that will provide additional capacity of about 350; but we also get additional capacity from the art rooms, the music rooms, the three new shops, and the home-economics laboratories in the addition.

The Browne was built in 1932, was it not, Dr. Wilkinson?

Dr. WILKINSON. Yes.

Mr. HEINMILLER. The music, art, and shop classes were put in regular classrooms which is not the practice any more in any of our junior high schools.

Dr. WILKINSON. Yes; and a further point ought to be in Mr. Heinmiller's testimony, which is that there is only one gymnasium there now, whereas there are over 1,000 pupils there, and a junior high school always rates two gymnasiums.

Mr. BATES. You do plan to have gymnasiums in those two buildings?

Dr. WILKINSON. That is true, sir.

Mr. BATES. How are the white schools equipped with gymnasiums? Dr. CORNING. All of them have two gymnasiums except one white junior high school which has only one, the Eliot School. I think all of the other junior high schools have two.

LIBRARIES

Mr. BATES. Are there any library arrangements in this building? Dr. WILKINSON. There will be a new library in this junior high school.

Mr. HEINMILLER. The other thing about this, Mr. Bates, is this, once Browne is completed with this addition, the facilities in it will be comparable to the Miller and the Sousa Junior High Schools, both of which were recently constructed. It will not have any facilities in excess of what those schools have with the possible exception of this home-economics suite I referred to, because with a junior high school as large as Browne, which will have an enrollment of about 1,600 or 1,700 when the addition is completed, it will require one foods laboratory and two home-making laboratories to take care of that large enrollment.

Mr. BATES. Did you ask for this in the regular budget?

Mr. HEINMILLER. We submitted it to the Commissioners with the 1951 estimates and since it was a very urgent request, we agreed to take it out of the regular budget with the understanding that it would go into a supplemental bill. We thought at that time that the hearings on 1950 supplemental requests would be earlier than they turned out to be. I am not sure, but if my memory serves me correctly, I think we made reference to the emergency situation at Browne in our testimony before the Senate subcommittee, and I think there was some reference to it during the House budget hearings, was there not, Mr. Wilding?

Mr. WILDING. Yes; very definitely there was reference to it.

Mr. HEINMILLER. I think that there was reference to it in both hearings, but we expected that we would have the hearing on this request around March.

Mr. BATES. You do not think this could be put off until 1952?
Mr. HEINMILLER. No; it would be a tragedy to do so.

Dr. CORNING. We would have trouble on our hands immediately. It is because of the high priority in which we hold this project that we are before you today.

Mr. BATES. Nobody wants to see the youth of the country taken care of any more than I do; I am just trying to do it within the means of the District.

Dr. CORNING. I understand that, sir.

Thank you very much for the courteous hearing you have given us.

HEALTH DEPARTMENT

CAPITAL OUTLAY, GALLINGER MUNICIPAL HOSPITAL

WITNESSES

DR. DANIEL L. SECKINGER, HEALTH OFFICER, DISTRICT OF COLUMBIA.

DR. DAVID LEIBOVICI, SUPERINTENDENT, UPSHUR STREET HOSPITAL

PAUL KEEN, ASSISTANT SUPERINTENDENT, GALLINGER HOSPITAL

REHABILITATION OF UPSHUR STREET HOSPITAL

Mr. BATES. Doctor, you may proceed in your own way, sir. Dr. SECKINGER. Mr. Chairman, the request that we wish to present this afternoon is for taking care of needed repairs at our Upshur Street Hospital, the Tuberculosis Hospital for Convalescents of the District of Columbia, in the amount of $68,500.

We have occupied these premises for a number of years for the care of convalescent patients, but no structural repairs of any considerable consequence have been made during this interim.

NEED FOR REPLACEMENT OF BOILERS

We have reached the point where Mr. Archie Hutson, the Director of Construction, tells us that something must be done with the boilers at that institution, or sooner or later we will get ourselves into serious difficulty.

Mr. KEEN. Before the next heating season.

Dr. SECKINGER. Yes; it should be done before the next heating season, because he cannot guarantee that they will be of service that long. While he says that he does not know of anything that is dangerous in connection with the operation of these boilers, he cannot insure their safety. They are right under the wards, with the second and third floors above them, so I am concerned for their structural safety.

PURPOSE OF HOSPITAL

Mr. BATES. What is the purpose of this hospital?

Dr. SECKINGER. This hospital is for the purpose of taking care of tuberculosis patients from both Gallinger and Glenn Dale that have recuperated to such an extent that they may be ambulant, to a certain extent, where, otherwise, at Glenn Dale and Gallinger they would be mixed up with the regular run of bed patients.

Administratively, it is a good thing to separate the people who are critically ill from those who are up and around, and so, as soon as we can get them from either Gallinger or Glenn Dale when they have recuperated to the extent that they can be considered as convalescent, we do so.

Mr. BATES. You do not have any arrangement at Gallinger or Glenn Dale, where you could do this work?

Dr. SECKINGER. No, sir; we do not.

Mr. BATES. You do not?

Dr. SECKINGER. No. This, at Upshur, is an excellent arrangement because it brings convalescent patients together and it greatly aids getting them back into reemployment.

NUMBER OF PATIENTS

Mr. BATES. How many patients do you have out there?

Dr. SECKINGER. Dr. Leibovici.

Dr. LEIBOVICI. We have 125 beds, and we had 82 patients as of this morning.

Mr. BATES. How many doctors do you have?

Dr. LEIBOVICI. Just one.

Mr. BATES. How many nurses do you have?
Dr. LEIBOVICI. We have six nurses.

Dr. SECKINGER. Now, Dr. Leibovici has given a great deal of time and thought to the care of convalescents. He has a very interesting story to tell in connection with them. We know that if we discharge patients from tuberculosis hospitals without this process of curing and hardening to go back into normal every-day life that about 42 percent of them will come down with infections later on; in other words, that they have a recrudescence of their infection, whereas after Dr. Leibovici is through with them, I believe you have only about 25 percent? Dr. LEIBOVICI. Twenty-three to twenty-five percent counting everything.

Dr. SECKINGER. I would like, if you will permit it, Mr. Chairman, to ask Dr. Leibovici to just tell you what he does with them. Mr. BATES. Yes.

Dr. LEIBOVICI. The Upshur Street Hospital is chiefly a rehabilitation center where patients from Glenn Dale and Gallinger, after their disease is quiescent and they are no longer bed patients, but still in hospitals, are transferred to this hospital, where a program of graduated exercises .under close supervision is started for the purpose of seeing how much exercise they can tolerate and for the purpose of building up their tolerance for work. At the same time, besides giving them exercise, plans are made for their future life in the community, vocational training, or help in part-time employment or social welfare service is given, and the strictly medical care is continued in the same way that it had been started at Glenn Dale or Gallinger.

Studies made several years ago, and even more recent studies, show that with tuberculosis it is not enough to treat the patient for tuberculosis. The patients have a tendency to relapse, and we must consolidate treatment by making as certain as we can that there will not be a relapse. Studies made in big cities like Philadelphia and New York show that between 40 and 50 percent of the patients discharged from the hospitals, and these are medical discharges, not against advice, that between 40 and 50 percent of the patients, depending on the nature of the study, relapse within 2 years and are back again for further treatment.

I feel in such cases that the treatment was not as complete as it could have been, and, certainly, it becomes financially expensive.

In the Upshur Street Hospital in connection with the program of rehabilitation, hardening, training and assistance, follow-up studies have been continued ever since 1945 and today we find that of the patients discharged medically from the Upshur Street Hospital, the total deaths and relapses at a maximum figure is 25 percent, roughly, or, to put it another way, it means that 75 percent of the patients discharged are alive, well, and productively working, and that the patients who are spared a recurrence of the disease and the necessity for much longer hospitalization do much better that way.

DISCUSSION OF CONTINUANCE OF HOSPITAL IN OPERATION

Mr. FOWLER. The site is the site of the old tuberculosis hospital. In 1942 it was renovated and opened for these convalescent tuberculosis patients and undoubtedly has rendered a very good service.

We have often thought, however, that it is not a very good thing to have an adjunct to Gallinger Hospital so far away. The separation of facilities of that sort undoubtedly tends toward added expenses.

We did receive from Dr. Seckinger a recommendation a short time ago that was concurred in by Dr. Stebbing and I think by Dr. Finucane that this facility be closed. As to that recommendation we concurred, and forwarded it to the Commissioners.

Thereafter, I think the Health Officer withdrew that recommendation and indicated that he had changed his opinion about closing of the facility. I presume that you saw that in the paper.

Thereafter, the Commissioners went along with the Health Officer and approved this budget estimate. Just why the recommendation was changed or withdrawn I do not know.

Dr. SECKINGER. Mr. Chairman, may I comment as to that, because I think it is important.

It is not that we ever felt that the institution was not doing a splendid piece of work, but we had the problem that the budget was already going through and we were afraid we could not get the necessary corrections, as you have fortunately given us an opportunity to speak about them today.

We did have a serious matter there, and we did not want to keep the patients there under duress, where there was a structural danger. In some way the matter was not exactly explained correctly. We never have felt that we wanted to do away with the rehabilitation program. We had hoped that eventually, when Glenn Dale's building program was completed, we might absorb this facility at Glenn Dale. But as we can see it now, it would be at least five years before we can get anything done at Glenn Dale in the way of building.

Mr. Hutson estimates it will be at least that long.

Mr. FOWLER. At the time the report was written you thought that these patients could be housed at Glenn Dale, and Dr. Finucane thought it could be done, too, if we could build an apartment house for some of the doctors occupying the wards, sufficient to house this number of patients. Do you have the original report with you?

Dr. SECKINGER. I do not have that original report with me, but we had in mind, upon the recommendation of Dr. Stebbing, what would be done.

Mr. BATES. Will you file a copy of that original report?

Dr. SECKINGER. I would be glad to submit it for the record.
(The document is as follows:)

Memorandum to: Dr. D. L. Seckinger, Health Officer.
Subject: Boiler replacement, Upshur Street Hospital.

MARCH 1, 1950.

Mr. Hutson's memorandum on this subject has been studied. It raises a very serious problem, inasmuch as the expenditure recommended is a very large one, and one which has not been anticipated by the budget office. It is not included in any of our budget estimates, while several other much needed repairs which were included have been disallowed by the Commissioners. The amounts are as follows:

There is, in addition, another fairly large project which has been urged for several years, but which was not included in our 1951 estimate, namely, the replacement of worn out cooking equipment in the kitchens. An estimate furnished by the Washington Gas Light Co. in 1947, lists the cost of the equipment as $1,504.80, exclusive of labor. There are also many other smaller items of repair and upkeep, which are urgently needed, and which aggregate more than our maintenance crew can handle.

The amount of maintenance work urgently necessary at Upshur Street, and the probable cost, make it imperative that a definite decision be reached at a very early date, as to what is to be done with this property. The fact that the Commissioners disallowed all items for Upshur Street, leads me to believe that they contemplate closing of this hospital at an early date.

May I recommend that you call a conference with Dr. Finucane and me to discuss ways and means of caring for the patients at Upshur Street in the event it becomes necessary to close that institution. It is possible that many of them could be discharged, and those who still require hospitalization could be transferred to Glenn Dale, together with sufficient personnel to avoid placing an unbearable burden on that institution.

It is evident from Mr. Hutson's report that something must be done about the boilers before the next heating season, if the plant is to continue to be used. In my opinion, this is impossible, as there is nothing in the 1950 or 1951 budgets to allow for this, nor is there any indication that it would be approved as a supplemental appropriation. Even if it were, it would become available too late to accomplish the work before the next heating season. Therefore, I would suggest that we set June 30, 1950, as the closing date, and start our planning on that assumption.

PHILIP A. E. STEBBING, M. D.,
Superintendent.

MARCH 13, 1950.

Memorandum to: The Commissioners, through Commissioner Guy Mason.
Subject: Closing of Upshur Hospital.

Hereto appendaged are two memoranda, one from Mr. Archie Hutson, Director of Construction, and the other from Dr. Phillip A. E. Stebbing, Superintendent of