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calomel pills cut off. We had plenty of calomel in powder on hand.
May 1, you will find two two-ounce rectal syringes, and June 1, one ounce yellow oxide of mercury missing. These are clerical errors. I had no reason for not supplying them, and you will find them on the following requisitions,
July 1 I cut off two-gallon stone jars with faucets. These were to be set in the wards for ice water, and I did not approve of them. August 15 was, I presume, the date when Mr. McCaffrey looked over my shoulder and saw me scratch, scratch, scratch drugs that were to prolong or save life. Let us look it over and see what drugs there were. We first come to one large wooden spoon. I told the doctor to make a requisition on the store. Fifty vaccine points cut to ten, in view of the fact that we did not use them very often, and they are better fresh. One pound pumice stone (one of the expensive drugs) cut, and the doctor was told to get them to give it to him on the “ Bradlee” wliere they buy it by the barrel. One-half dozen Royal P syringes
We hall other's on hand. Clock for female ward cut. You will find it ordered on the previous requisition. One dozen eyeshades cut, for the same reason as before. And finally, three ounces of sulphoval cut off, because, in my judgment, it was not needed.
September 1 I cut off one pound Navoring extract Cayenne which we use for making tincture capsicum, because I think it is hetter made from cayenue pepper; and eight ounces liquid Dovers powders. We had it in pill form, and I did not think both necessary.
November 15 I cut off tiro ounces sulphonal, because we had nearly that amount on hand; you will see it was ordered November 1, a vaccine comb, - I would not have one used on the island; they are unsafe and unnecessary; and one Allise therinhaler, · Dr. Putnam said in his testimony he did not consider one necessary, and neither do I, but I ordered one later to please Dr. Parker.
December 15 you will see that I cut off five pounds subuitrate of bismuth; that was because we had enough of it on hand, and one thousand and quarter grams sulphate of morphine tablets. We had enough sulphate of morphine.
Now, in all this time you will find that I have cut off, really, but one single drug; that was sulphonal, on August 15. If you can find any doctor of standing in the profession who will come in bere and say that the action of this drug is not well understood, and that it was necessary to experiment with it, I will cheerfully admit I made a mistake. I never deprived the physicians of any drugs or necess:ry instruments.
Another count in the indictment: “ For paupers : poor medicines, cheap medicines, were good enough." in the Visitors' report: - the use of the more expensive drugs has been, if not absolutely forbidden), at least discouraged. I think I can show you how dangeronis it is to take the simple word of any man, especially if you are not sure of his disinterestedness, when you can secure written
proof. The only drugs that were ever under discussion among us were the relative merits of aristol and iocoform, phenacetine and antikamnia, sulplional and bromide and chloral. I think this was testified to by witnesses on the other side.
Aristol costs twenty-eight dollars and eighty cepts, and iodoform four dollars and twenty-tive cents per pound; the action of each is practically the same, and well understvod. The former is odorless, the latter has a somewhat disagreeable odor. You will see by the requisitions that I ordered. aristol every time it was asked for; they may say, Yes, but it wasui't asked for as often as they wanted it. You will hardly believe that when you find it ordered
seven out of eighteen requisitions, those of March 31, May 1, June 15, August 1, September 15, October 13, and November 15. lodoform is on but three.
As to phenacetine and avtilampia, I perfer the latter, but you will find that I never cut off the former, that I sent for it every time, and as to their c'ost both come the same, sisteen dollars per pound, so I could not very well have advocated the cheaper drug. You will find phenacetine ordered on seven requisitions out of the eighteen, those of March 31, May 1, June 1, July 15, August 15, September 15, and October 15. Sulpbonal is a drug the use of which is limited, and its action well understood and too expensive to be needlessly experimented with. It is the only drug the general use of wbich I have discouraged, and I have done so not especially bec:use it is costly, but because we have no real need of it, excepting in rare cases, and there are other drugs which will take its place.
To show that I do not discourage the use of expensive drugs when they are the best known for the purpose, look at our purchases of hydrochlorate of cocaine every time it is called for. The physicians have never complained of its being denied, and yet it costs $102.40 per pound. Acetanilid has been spoken of as a cheap drug in place of phenacetine as though I advocated it. I never did, for I don't believe in it, thoughi from the way be ordered it, it seemed to be in favor with Dr. Parker.
Now, according to tbe testimony of Dr. Parker given before this committee, le bas felt free since January 1 to order any drug he wanted or thought necessary, has done so, and has always got what he ordered. Please look over the requisitions and see how often he bas called for either drug under discussion. Aristol twice, February 1 and March 31 sulphonal twice, March 31 ; and June 15, and phenacetipe just once on April 14.
With these facts in mind no one could consistently claim tbat I discouraged, much less forbade, the use of expensive drugs ; and I don't believe that as honorable a man as Dr. Putnam would have allowed the statement to wbich I referred to have appeared in his report if he had known the true facts as I have stated them.
Reference has been made to the pharmacy at Tewksbury, and their pbarmacist. We bave a pharmacy, too, but no registered pharmacist; yet we have a graduate of medicine to compound the drugs, and under the laws of Massachusetts the latter is considered equal to the former. I object to shouldering the blame for putting Mr. Morphy in charge of the pharmacy, for I found him there when I went to Long Island, and he was recommended to me as well fitted for the position by Dr. Harkins; but as I considered it was for the best interest of the hospital to make a change, I did, relieving him from work there and placing the physician or interne in charge, and this was not because Mr. Morphy refused to do the work, as was stated by one witness.
The statement is made that the preparation of foorl and its serving has been such as to prove in many instances fatal to tbe invalids. That is a perfectly outrageous statement to make without any evidence to support it. I suppose counsel had in mind the case of Herrick, but if Dr. Parker testified to the truth Herrick did not die because of the piece of meat in his fauces or trachea.
As to the matter of light in the hospital, I wish to say that the hospital was opened before there had been any provision made to light it with gas, and I don't think any sensible person would say that we would have been justified in running a large electric light plant for not over half a dozen lights where their places could be, as they were, satisfactorily supplied by lamps or lanterns. There were four lamps and six lanterns in use in the hospital before we got the gas on. By the way, our lanterns, those that we use, are kerosene with a lamp burner, and not " barn lanterns." We got the gas on the hospital in Angust, and it worked as well as could be desired up to the middle of November, when it failed us. It took us some time to find out what the trouble was, but we got it going again December 12, and have not had any trouble with it since excepting on two nights, one in December, which I think was due to water in the pipes, and a niglit in January just after Mrs. Lincoln's letter on the subject appeared in the Transcript.” This time it was due to some evil-disposed individual going down in the basement between 12 and 1 at night and shutting off the supply.
As far as I am concerned, and for my own personal convenience, I should much prefer to run the electric lights throughout the institution and hospital all night, but we have tried it on several occasious, and have always had complaints from those inmates who were anywhere near the lights that they could not sleep on account of them. The first of these were in May, 1893, when we put in our new gas machine. We run the lights then one night, though Mr. McCaffrey did not seem to recollect it. I should like to say here, that the clergyman, Father McAvoy, told me that no night purse or watchman ever took a light away from him to put in a wind while he was with any sick or dying patient, nor did there ever, to my knowledge, any women lie in agony or her fatal sickness with a single lantern.
In regard to changing diets to make them plentiful, or for any other reason, prior to May 29, 1894, when I assumed active control of our patients, I never had done it but once, and that was on August 16, 1893, when it was done in a perfectly proper manner. Dr. Sullivan was a way on a vacation ; he was gone from August 6 to August 21, inclusive, and Dr. Bennett was taking his place. I made the ward visit in company with Dr. Bennett that day, and made what alterations I thought for the best. They were not made over Dr. Bennett or any one else, and were made because I thought at that time it was my duty, and I think so still. I never interfered directly in any way with diet or treatment of patients in the hospital; the only thing I ever did was, after careful study, to arivise the physician, and it was proper that I should. There never was a time that I was not about as familiar with the cases in the hospital as the attending physicians. It was always my custom to spend more or less time each day in the wards, talking to the patients, many of whom I had known in other hospitals. All of the more interesting cases I was thoroughly acquainted with and have followed up. As to the matter of consultation, I was always very much pleased to be called on, and ready to give advice to the best of my ability, nor was it ever done in a hesitating and reluctant manner.
The cut of August 16 could not have been made in the interest of economy, as far as milk was concerned, for at that time we had much more than we actually peeded.
That I ever told Mrs. Evans or any one else that I had frequently, and on various occasions, cut down the diets of the hospital, I deny. I did say tbat I had cut down the diets ; that I had discharged patients; that I had a perfect right to do it; it was my duty, and I sliould do it whenever I thought best. That I was misunderstood has been proven beyond all doubt. The cuts were all made on one occasion, and then in the manner recommended by the visitors themselves.
In regard to the two cases mentioned, if Murray's boiled milk was cut off it must have been a misunderstanding, as I did not intend that it should be doue, and I never had any conversation with Dr. Dever, as has been stated. As to Thompson, be told me the day before that he could not eat liis steak, and that was the reason it was cut off.
Now, as to the burial of the dead. When I first went to Long Island it was the custom to hold the bodies a (lay or two for the friends to claim them, and if not called for to send them to Rainsford Island for burial. They were kept in the stone-shed or blacksmith shop, as it was called, on account, I suppose, of a small portable forge in one end. This seemed to me a very poor place to keep dead bodies, so I bad a mortuary built with a capacity for twelve bodies in the refrigarator, and an autopsy-room, which could also be used for viewing the remains by friends.
This moituary was intended to take the place of a tomb), where bodies could be held for several weeks; as it is no uncommon thing for friends to clain bodies that length of time after death.
We began to inter bodies on Long Island in Joe, 1893. At that time the cemetery was laid out by myself and Mr. McCaffrey one hundred feet square ; grave number one was locater in the south-east corner, and tbey all run from east to west.
The graves are numbered and a book kept giving the name of each person buried and the number of their grave. Mr. Farmer can go down to the cemetery to-morrow with his good smart boy and jacknife, and not only obliterate the nunbers on the crosses, but pull (1)
the crosses themselves, and we can still give him any body buried there without any trouble. When we first began to bury I told the deputy, Mr. McCaffrey, as I have every deputy since, that he was to have the entire charge of burying bodies, and be held responsible for it; that he was to go to the cemetery, see the bodies placed in the graves, take the numbers, come back and give them to the clerk whose duty it was to enter the facts in the burial book. As far as I understand it, we follow Mr. Farmer's system. We consider it a good one, but if any one can suggest a better we will be pleased to try it. Having provided a good system, it was, you might say, my duty to see that it was properly carried
Granted ; but you will allow that it could not be reasonably expected of me to do it when uot on the island, or while sick in hed. The former was the case when the boilies were buried about which the mistake was made in sending up town the body of a man for a woman, and also the day the man was sent up, and the latter when the bodies remained uncovered over one night. By the way, speaking of this circumstance, I tbink it was
a put up job, else wly did Coakley, who was furnishing information against us, and this fact known to the inmates, steal out of the hospital on a cold winter night and go down to the cemetery in his slippers? Wasn't it because one of the men ordered to fill the graves had told him they had not done it, knowing that the deputy could hardly find it out before morning? If Coakley was so interested in the inmates, and was making his complaints for their good alone, as bas been stated, how can you account for this fact that he did not report the circumstances to any one on the island previous to reporting it to Mr. Farmer?
To my niind the most amusing sentence in Mr. Brandeis' opening argument is this:
si When they had there deputy superintendent a man who had some notion of the purpose of a pauper institution, who recognized that the boast of the institution should not be to make a low cost per capita, but to reduce the number, and he put them at work, they fled in Hocks, fifty at a time. The labor test almost depopulated the institution.”
Mr. McCaffrey went to Long Island Feb. 27, 1893, under Mr. Galvin, and I went there March 20, 1893. Between those dates 115 men left the island, 32 (lischarged and 83 ou a pass. From March 20, 1893, to April 10, 1893, the same length of time as before, 149 men left the island, 111 discharged, and 38 on a pass. From Feb. 1 to June 1, 1893, 510 men left the island. During the same period of 1892, before Mr. McCaffrey's value was recognized, 503 men left, and in that time of 1894, when we struggled along as best we might without him, 676 left us.
I want to say that these figures are taken from the Mondays and Thursdays, when the men came out. Between those days there may be anywhere from one to half a dozen go out during the week ; but they are just about the same each year.
I do not propose to honor Mr. McCaffrey so far even in this statement as to deny any of the many wrong statements he has made where it would simply be a question of veracity but I will contrast a few of his statements with the facts as brought out here :