The reports of progress and the results of the investigations car ried on by the Division of Research appear in the Public Health Reports from time to time.

Hospital and Medical Statistics.

In addition to the statistical work outlined in the preceding pages, the Public Health Service collects and compiles hospital and medical statistics relating to patients treated by the Service in its own hospitals and in outside institutions.

Until 1919 the number of patients treated by the Public Health Service was comparatively small, and the problems of hospitalization did not require an extensive system of statistical reports. However, with the passage of the Act of March 3, 1919, authorizing the Secretary of the Treasury to provide hospital and sanatorium facilities for discharged sick and disabled soldiers, sailors, and marines, Army and Navy nurses (male and female), who are patients of the Veterans' Bureau, the number of patients was greatly increased, and the problems of hospitalization raised by this very large class of beneficiaries now require for their solution the regular collection and interpretation of much statistical data.

To provide adequately for the care and treatment of all the beneficiaries1 of the Service, the United States was divided into 14 districts. In nominal charge of each district was an officer of the Public Health Service known as the district supervisor. By an order of the Secretary of the Treasury, dated April 19, 1921, the district supervisors were transferred to the Bureau of War Risk Insurance. This transfer was later confirmed by the Act of August 9, 1921, which also changed the name of the Bureau of War Risk Insurance to its present designation, Veterans' Bureau. In 1921 the Public Health Service maintained 66 hospitals 2 with a bed capacity of about 21,500, as compared with only 22 hospitals with a total bed capacity of only 1,500 in 1919.

For each patient admitted into a hospital a record card is made out giving the name, address, religion, nativity, date of birth, sex, race, marital condition, and occupation of the patient; the class

1 The facilities of the Service have been extended from time to time so as to embrace not only officers and seamen of the merchant marine (for whose benefit these facilities were originally intended), but also officers and seamen of the Coast Guard and Lighthouse Service, keepers and assistant keepers of lighthouses, seamen employed on vessels of the Mississippi River Commission and of the Engineer Corps of the Army, keepers and surfmen of the Coast Guard, employees of vessels of the Coast and Geodetic Survey, civil employees injured while in the performance of their duty, as well as the patients of the Veterans' Bureau already referred to.

By the Executive order of April 29, 1922, the control of all hospitals caring for patients of the Veterans' Bureau was transferred to that Bureau on May 1, 1922.

This new (card) system of keeping patients' records was inaugurated in 1920 for the purpose of replacing the old book register of patients which had been used in the hospitals of the Service for decades.

of beneficiaries to which he belongs, the date of his last military service, and his last rank and organization; the date and source of admission, and the authority therefor; the diagnosis, giving the diseases or conditions in order of severity and importance, and the complication, sequela, etc., with dates; how, when, and where the sickness or disability was incurred; the kind of operation, with date, and the anesthetic used; the disposition of the case, with reasons and date; the condition on disposition (for each disease) or the specific cause of death; the number of days in hospital; and other miscellaneous information. A duplicate of each record card is sent to the Statistical Section of the Division of Marine Hospitals and Relief as soon as the patient to whom it relates has been admitted and his disease or injury diagnosed, followed by the completed report card upon his discharge, transfer, death, etc.

The data on these cards are tabulated in the Statistical Section. They are being used for administrative purposes at present, and will also form the basis for future studies in hospitalization and epidemiology.

In addition to the record cards, the Public Health Service receives a Weekly Census Report from each hospital, and a Medical Officer's Monthly Report of Relief from each hospital or station, on standard forms provided by the Service. These reports are designed for current administrative purposes. The census is taken each Saturday at noon and the report is mailed on the same day. States lying west of the Mississippi River send telegraphic reports which are confirmed later. The form calls for the following information: The number of beds occupied by patients, the number of beds empty, and the number of personnel on Saturday at noon; the number of "inpatients" treated, the number admitted, and the number discharged during the week ending Saturday at noon; and the number of times. out-patient relief was furnished at the hospital and the number of physical examinations of out-patients performed at the hospital. Patients are classified as Veterans' Bureau beneficiaries and all other beneficiaries. Each of these classes is further subdivided by diseases, general, tubercular, or neuropsychiatric. The data contained in the Weekly Census Reports are tabulated and published by Wednesday of each week, and are circulated among officials of the Public Health Service, the Veterans' Bureau, and others concerned.

Monthly reports are rendered by each station on the first day of the month succeeding that covered by the report, or as soon thereafter as possible, on forms provided by the Statistical Section. The forms call for the following information: The number of patients of each class of beneficiaries remaining under treatment from the previous month, the number admitted during the month, the total number treated, the number discharged, the number died, the number

remaining under treatment at the end of the month, and the total number of days relief furnished; the number of out-patients treated during the month (old cases and new cases), the number of times relief was furnished to them, and the number of examinations made. In case a station is divided into several substations or units, the foregoing items are also shown for each substation or unit, except that in the latter case patients are considered as one group and are not shown by classes of beneficiaries. The forms also call for a classification of examinations and out-patient treatments as general, medical, and special, the latter having several subclasses. The data contained in these monthly reports are tabulated and used for administrative purposes by the office in Washington and by the officers in charge of field stations. Facts of special interest are published in the Annual Report of the Surgeon General.

UNITED STATES COAST GUARD.

The United States Coast Guard was established by the Act of January 28, 1915, through the consolidation of the Revenue-Cutter Service and the Life-Saving Service. The Coast Guard collects no statistical data except such as is incidental to its work of assisting and safeguarding navigation along the coasts and that hereinafter mentioned required by the acts of June 20, 1874, and June 18, 1878. Certain statistical statements, however, are included in the Annual Report of the Captain Commandant of the Coast Guard, relating to assistance rendered to vessels and persons in distress; to derelict operations; to wrecks, and other marine casualties.

The statements relating to assistance rendered by the Coast Guard to vessels in distress show the date of each service; the name of the cutter or station performing the service; the location of the vessel assisted; the name, description, and tonnage of the vessel; the nature of the cargo; the value of the vessel and of the cargo; the number of persons on board; the number of lives saved and of persons rescued from peril; and the number of persons succored. A brief description is also given of the disaster and the nature of the service rendered.

For derelict operations the tables show the name of the cutter éngaged in the operation; the name and description of the derelict or obstruction; the locality where found; the duration of the operations; the disposition made of the derelict or obstruction, and the value of any property recovered.

The material for the above statements is compiled from cutter and station reports forwarded to the Washington Office.

The statement of wrecks and other marine casualties occurring to American vessels whether in United States or foreign waters shows the nature of the casualty and the general locality where it occurred. It includes information as to the number of vessels involved and their total tonnage; the number of vessels totally lost and their tonnage; the total value of the vessels involved and of their cargoes; the value of vessels and of cargo lost; the number of persons on board vessels involved in marine casualties, subdivided to show number of passengers and of the crew; and the number of lives lost, subdivided to show the number of passengers and of the crew. The data for this statement are obtained from reports of casualties required of masters, agents, or owners of vessels. Such reports are made to the collector of customs of the district from which the vessel hails or within which the casualty occurred and are forwarded by the collectors to the Commandant of the Coast Guard. This information is collected and compiled in accordance with the provisions of the acts of June 20, 1874, and June 18, 1878.

OTHER BUREAUS AND SERVICES OF THE DEPARTMENT OF THE TREASURY.

The other bureaus and services of the Department of the Treasury, viz, the Bureau of the Budget, the Register of the Treasury, the Bureau of Engraving and Printing, the Supervising Architect's Office, and the General Supply Committee are not engaged in the collection and dissemination of statistical information.