Compliments of 
DR. SAMUEL C. BUSEY, 
1525 I Street, N. W., Washington, D. C. 
THE TRUTH ADMITTED. 
T ZHZ ZE 
Columbia Hospital 
FOR WOMEN 
AND 
L LTIJST G-I JST ASYLUM. 
BY A CITIZEN OF WASHINGTON, D. C. 
FROM JANUARY NO. RICHMOND AND LOUISVILLE MEDICAL JOURNAL. 
LOUISVILLE, KY.: 
RICHMOND AND LOUISVILLE MEDICAL JOURNAL BOOK AND JOB STEAM PRINT 
104 Green Street, 2d door west of Post-office. 
2 878. COLUMBIA HOSPITAL FOR WOMEN. 
The management of this institution has at last given to the 
public an "Annual Report." It purports to be "for the fiscal 
year ending June 30, 1877," and bears the imprint of the Gov- 
ernment Printing Office, thus sustaining the allegation hereto- 
fore made, that in addition to the other expenditures, the Gov- 
ernment pays the cost of its paper and printing. 
The document opens with the "annual report" of the " Sur- 
geon in charge," dated October 15th, eighteen days after the 
annual meeting in September, 1877. Next comes the report of 
the Treasurer, "for the fiscal year ending June 30, 1877," of 
which more hereafter. Then follows the following remarkable 
"open letter " to Congress : 
Washington, D. C., December 1, 1877. 
Anonymous accusations of mismanagement on the part of 
the Board of Directors of the Columbia Hospital for Women 
and Lying-in Asylum having appeared in a letter from Wash- 
ington to a Western medical journal of established reputation, 
which was republished in some of the papers of this city, it has 
been thought best, in the interest of the government under 
which this institution was established and has grown into its 
present great usefulness, as well as in the cause of humanity, to 
lay before Congress the following transcripts of records of in- 
spection of the hospital from January, 1876, to January, 1877, 
by the then Advisory and Consulting Board of Physicians and 
Surgeons, consisting of Doctors Johnson Eliot, Flodoardo How- 
ard, A. Y. P. Garnett, S. C. Busey, J. Ford Thompson, 
W. B. Drinkard, S. A. H. McKim, C. H. A. Kleinschmidt, as 
well as of their successors, Drs. J. 0. Stanton, J. A. Ritchie, 
Z. T. Sowers, R. W. Reyburn, N. S. Lincoln, L. Mackall Jr., 
J. T. Young, and H. C. Yarrow, from February, 1877, (when 
they entered upon duty) to November 28, 1877. 
"A complete refutation of the charge of extravagant and 
injudicious expenditure, included in the above-mentioned attack, 4 
COLUMBIA HOSPITAL. 
will be found in the annual report of the Treasurer of the Board 
to the Hon. Secretary of the Interior, appended to his report 
to the President. J. K. Barnes, M. D.; 
Chas. H. Cragin, M. D., Secretary.; 
John T. Mitchell, Treasurer.; 
Committee on Expenditures." 
Following this are eighteen pages of the transcripts from the 
records referred to. It would seem from this letter that the 
Board of Directors (General 0. E. Babcock, President,) through 
this committee (of which by the way, the Treasurer is alleged 
to be the only salaried member,) assumes all responsibility for 
the " extravagant and injudicious expenditure," and seeks vin- 
dication from any charge of improper and lavish disbursement 
of government funds donated for the maintenance of indigent 
sick women, by reference to the Treasurer's report and "the 
inspection records of the advisory and consulting physicians 
and surgeons." 
It is not surprising that a treasurer-a member of the com- 
mittee having "supervision and control of all expenditures," 
whose interest is measured either by commissions paid out of a 
fund derived from charges made against a class of patients 
illegally admitted to the hospital, or by a fixed salary appro- 
priated from the funds donated by Congress, and who keeps 
from his fellow-directors, from Congress, and from the public, 
all details of his disbursements-should tender as proof of 
economical financial management the weekly inspection records 
of a board of advisory and consulting physicians and surgeons,* 
whose connection with the finances of the institution will be 
discovered in the weekly records that the building was clean 
and the patients well attended. It is, however, extraordinary 
that two medical gentlemen, one of whom enjoys the honorable 
distinction of "General," should acquiesce in such a method of 
* One-fourth of whom were on duty for three months in each year, and 
were required " during their term of service " to inspect " the institution in 
company with the Surgeon in-Chief or Resident Physician (Section 3, Chapter 
IX of By-Laws) once during each week, and on each visit" to report "in 
writing, in a book kept for that purpose, the condition of the patients and 
building." COLUMBIA HOSPITAL. 
5 
defence against alleged "anonymous accusations of mismanage- 
ment." One can only account for this approval of the "Gene- 
ral" upon the theory that from long experience and continued 
success in getting from them what he wants, he has reached a 
very low estimate of the average congressman's capacity, and 
that a "sop to cerberus" in this instance will quiet his inquisi- 
tiveness. Or perhaps he has been taking lessons from the past 
experience of that other "General," who is likewise "Presi- 
dent," and is chary of putting on paper matters that have a 
crooked look until their innocent purity is shown by plausible 
explanations from disinterested but lucky friends. Whatever 
motive may have inspired the course of these gentlemen, the 
late Advisory and Consulting Board can not complain, since the 
small service they were permitted to render the hospital comes 
now to the fore as the principal defence of its Board of Direct- 
ors in their hour of peril. 
If this " Committee on Expenditures " feels impelled by a 
sense of personal regard and commiseration for any individual 
member to vindicate the aggregate honor of the committee, by 
entrenching themselves behind ramparts constructed of weekly 
records of the sanitary condition of the building and clinical 
condition of patients, surely the late advisory and consulting 
physicians and surgeons should not be aggrieved, but should 
commiserate the condition of men who, in their extremity, are 
appealing for help to a body of men who in their letter of resig- 
nation declared that they severed their connection with the 
institution on issues which affected the standing of the hospital, 
and reserved to themselves " the right to strive for the attain- 
ment " of measures of reform " either with the public, for 
whose benefit the institution was created, the medical profession, 
with which it should be identified," or Congress, the almoner to 
whose munificence it owes its existence; or, if said committee, 
animated by a more selfish, though less honorable motive, seeks 
to discredit the standing of the members of the late Board of 
Advisory and Consulting Physicians and Surgeons (to one of 
whom it rightfully ascribes the authorship of the communica- 
tion referred to) by publishing their names in connection with 
an institution which needs defence from " anonymous accusa- 6 
COLUMBIA HOSPITAL. 
tions of mismanagement," surely the Board can avail itself of 
the rejoinder, that during its term of service the hospital, in its 
sanitary condition and medical management, was in the main a 
creditable institution. It was the refusal of the Board of Direc- 
tors to accept the Advisory Board's recommendations fora more 
economical management of the institution (which they were 
bound to make by the terms of the by-laws under which they 
acted), which led to their resignation. The late Board of Ad- 
visory and Consulting Physicians and Surgeons accepts the pub- 
lication of the records of weekly inspection as the evidence of 
having fully, impartially and fearlessly discharged its duty. 
How unacceptable to the ring-management these recommenda- 
tions in the interest of economy and reform were, may be in- 
ferred from the fact that not only did the Directors fail to approve 
them, but they hastened to prevent any future attempt in the 
same direction by repealing the by-law under which they were 
made. 
In this attempt to utilize honest effort in support of audacious 
wrong, why withhold from the public the annual report of the 
advisory and consulting physicians and surgeons submitted at 
the annual meeting of the Directors in September, 1876, which 
proved so offensive to the controlling ring because of the recom- 
mendations in the interest of economy and efficiency? Can it 
be that these gentlemen have forgotten these suggestions, or are 
the recommendations no more acceptable now than when they 
were made? 
Why suppress all the acts and suggestions of that Board 
looking to increased efficiency in the medical management of 
the institution and suggesting methods of economy and reform, 
and give to the public the weekly records of inspection, which 
only exhibit its careful and judicious supervision of the hygienic 
condition of the building and medical care of the sick ? Is the 
hope entertained that the honor reflected upon their administra- 
tion by the prudent superintendence of the matters committed 
to the inspection of the advisory and consulting physicians and 
surgeons would bridge them over the chasm, obliterate their 
mistakes and wrong-doing, and restore them to the confidence 
of the community, or was it to hold them up as exemplars to COLUMBIA HOSPITAL. 
7 
those who came quickly to the places of honor vacated by their 
predecessors on issues affecting the standing of the hospital ? 
One would imagine that these anxious guardians of the institu- 
tion's future fear the effect of these documents upon the munifi- 
cence of Congress, and hope by putting forth only part of the 
record to stifle inquiry and preserve their control. 
Space is too limited to republish these records of inspection, 
which covered a period of nearly two years, but in the interest 
of impartial justice, and as proof that the successors have 
disregarded the lessons of prudence bequeathed by their exem- 
plars, the following inspection record of May 1, 1877, may be 
introduced: 
"May 1, 1877.-We met, at the request of the Surgeon-in- 
Chief, to assist in the removal of a supposed ovarian tumor 
which had been decided at previous consultations to be a fit sub- 
ject for ovariotomy. The patient, H. J., had been tapped three 
times, and the fluid examined microscopically on each occasion; 
by Dr. Shaeffer twice, and once at the Army Medical Museum, 
and pronounced ovarian without doubt. The operation was 
performed by the Surgeon-in-Chief, in the presence of the Ad- 
visory Board and Drs. Reyburn, Young, Ashford, J. H. Thomp- 
son, Jr., and the Resident Physician. An incision three inches 
in length, commencing an inch below the umbilicus and extend- 
ing downwards, was made; the vessels were carefully tied in 
the abdominal parietes until the peritoneum was reached. The 
peritoneal cavity was found to contain several pints of serous 
fluid, and the ovaries found to be a mass of colloid growths. 
The operation was then discontinued and the opening closed. 
" J. 0. Stanton, M. D.; 
" Z. T. Sowers, M. D." 
How dare you, gentlemen of the succeeding advisory and con- 
sulting board of physicians and surgeons, arraign the Army Medi- 
cal Museum on the charge of mistaken diagnosis, and thus attempt 
to shirk the responsibility of slitting open an indigent woman's 
abdomen in search of something you knew not of, and having 
found it, "discontinued" the lesson of instruction, and then, 
wiser by at least one jot or tittle, "closed" the wound. The 8 
COLUMBIA HOSPITAL. 
records of your predecessors exhibit no such mistake. This is 
one of the items " in the cause of humanity " to which Sur- 
geon-General Barnes invites the attention of Congress, and 
cites, with commendable exultation, as an illustration of the 
" present great usefulness " of this hospital, of the management 
of which he and another " general " are the most conspicuous 
members. 
" But," says the committee, " a complete refutation of the 
charge of extravagant and injudicious expenditure included in 
the above-mentioned attack will be found in the annual report 
of the Treasurer," to which the attention of the reader is now 
invited. 
On page 6 of the report the Treasurer says : " On the 1st of 
July, 1876, there was placed to the credit of the Columbia 
Hospital for Women and Lying-in Asylum in the United States 
Treasury the unexpended balance from the preceding year, 
$2,898.15, with the appropriation of $16,000 for the ensuing 
fiscal year." * * ****** 
" The accompanying schedule, accurately compiled from the 
inventory furnished the Treasury Department, fully and, I trust, 
satisfactorily explains how this sum of money-$18,898.15- 
has been expended." 
On page 8 he says : "The amount of appropriation available 
for the fiscal year ending June 30, 1877, .... is $18,- 
192.44," which shows a discrepancy of $705.71 in favor of the 
sum previously stated as having been expended. 
Immediately following the above statement occurs the follow- 
ing (see page 8): 
Appropriation for the fiscal year ending June 30,1877, $18,192 44. 
Gen'l repairs, furniture, etc., per vouchers in Treas. Dep't $3,415 91 
For support and of patients 14,776 53 
18,192 44 
Thus it appears that the expenditures are made to aggregate 
the smaller amount stated as available, leaving the $705.71 
unaccounted for. The report contains but two items of ex- 
penditure, leaving unexplained the disposition of the little sum 
of $705.71. One can not help wondering how much of this 
money was spent in "general repairs," and of what kind, espe- 9 
COLUMBIA HOSPITAL. 
cially when one finds but a little further on a carefully itemized 
statement of the disposition of $8,000 appropriated for Mansard 
roof and repairs, and if they have ever been in the hospital, 
how much and what kind of furniture was purchased, and 
whether there were any more sumptuous book-cases, arm-chairs, 
moquette carpets and the like, found necessary. And then in the 
matter of "for support and of patients," one must own that a 
little more elaboration of detail would have strengthened the 
paper as a "refutation of the charge of extravagant and inju- 
dicious expenditure." For instance, items indicating how much 
it cost for salaries of attendants, for fuel and lights, for sub- 
sistence, etc. And just here, attention is invited to another 
discrepancy. The Treasurer charges himself with an unex- 
pended balance from the preceding year of $2,898.15, whereas 
in the act of Congress (July 31, 1876,19 Stat. 108,) the follow- 
ing clause is found: 
"For the support of the Columbia Hospital for Women and 
Lying-in Asylum over and above the probable amount which will 
be received from pay-patients, $16,000, in addition to $3,500, 
being the unexpended balances of former appropriations which 
is hereby made available." Here is a discrepancy of $601.85. 
Following the above statement of the expenditures, occurs the 
following remarkable disclosure: "Estimating the number of 
patients as forty-four of a daily average, their maintenance and 
support cost the United States $40.48| per diem, or ninety-two 
cents for each individual." To which is appended a foot-note in 
these words: "Forty-four includes patients and employes." 
Thus it is shown in his own language that the Treasurer, who 
has united with the other two members of the committee in 
attesting the accuracy of his accounts and his care and economy 
in the management of the finances of the institution, has fixed 
the estimated daily average of patients at forty-four, but in a 
foot-note, where it was hoped the truth would escape observa- 
tion, it is added that the " forty-four includes patients and 
employes," and continuing to evade a correct statement of the 
daily average cost of each patient, he proceeds with the words: 
"Their maintenance and support cost the United States $40.48J 
per diem, or ninety-two cents for each individual/' Observe 10 
COLUMBIA HOSPITAL. 
that the words are "costs the United States," not the institution, 
and why thus expressed? Because this daily average expend- 
iture is calculated upon the basis of a gross disbursement of 
$14,776.53 instead of $18,192.44, admitted to have been ex- 
pended, and for a daily average of patients estimated at forty- 
four, which number it is admitted includes all the employes, 
and the "pay-patients," who are charged with the cost of 
maintenance and medical care. Thus to deceive the Secretary 
of the Interior, the President, and Congress, he excludes from 
his calculation the sum of $3,415.91, which he admits was ex- 
pended in general repairs, furniture, etc.; the sum of $601.85 
difference between the unexpended balance placed to the credit 
of the institution and that named in the act of Congress; the 
sum of $705.71 not accounted for, and the sum of $1,075, 
amount received from thirty-two "pay-patients" admitted to 
the hospital during the fiscal year. To deceive the almoner of 
the institution, to foster waste, to conceal lavish and unnecessary 
expenditures, to retain control of the charity, and to escape 
investigation, the average daily cost of each patient has been 
willfully and wantonly under-estimated, both by augmenting the 
daily average number of patients by the addition of the em- 
ployes and by deducting from the gross amount of expendi- 
tures all sums not included in the item denominated " for sup- 
port and of patients." No allusion is made to the salaries paid 
to the Treasurer and Surgeon in charge, though it is admitted 
that salaries are paid to "officers" and "employes." Such are 
the exhibits of this officer, which J. K. Barnes, M. D., and 
Charles H. Cragin, M. D., Secretary, together with John T. 
Mitchell, Treasurer, allege will constitute "a complete refuta- 
tion of the charge of extravagant and injudicious expenditure." 
Such are the methods of estimating the daily average cost of 
patients maintained in a hospital established and supported by 
the government, accepted and approved by the Surgeon-General 
of the Army and the Secretary of the establishment, who, with 
the Treasurer, " have the supervision and control of all expend- 
itures." If similar methods of estimating the daily average 
cost of maintaining sick soldiers are in use in the army, it is 
quite time that the Hon. H. B. Banning (who has so gener- COLUMBIA HOSPITAL. 
11 
ously espoused the cause of a prominent purveyor for the suc- 
cession, and who predicts that before the Ides of the coming 
March shall have passed, a first-class funeral cortege will move 
with imperial pomp from the Surgeon-General's office to the 
cemetery of official and senile retirement) should undertake 
the fulfillment of his prophecy, in the interest of economy and 
reform, even though his friend, the purveyor may not find his 
way to the succession' so easy. To recur to the Treasurer's 
account, to divest it of its deceptive and evasive features, and 
giving him the benefit of his discrepancies, it may be stated 
as follows: 
Balance from preceding year $ 2,898 15 
Appropriation for year ending June 30, 1877, 16,000 00 
Amount received from pay-patients 1,075 00 
Gross receipts $19,973 15 
Deduct balance on hand, June 30,1877 1,005 71 
Amount expended $18,967 44 
To this should be added interest on the value of the property 
occupied by the hospital which the Treasurer states as follows: 
Grounds surrounding hospital$ 91,647 00 
Building and improvements 50,000 00 
Library, furniture, surgical instruments, hospital stores, etc 15,000 00 
$156,647 00 
This amount at four per cent, interest would add annually to 
the gross expenditures of the institution the sum of $6,265.88. 
The Treasurer, as has been previously stated, estimates the 
daily average of patients and employes at forty-four. To ascer- 
tain a correct daily average of patients, the number of em- 
ployes and officers, whose salaries and cost of maintenance are 
defrayed from the funds of the institution, should be deducted. 
From an official communication of the "Surgeon-in-charge," 
now before the writer, the number of employes is fixed at 
fourteen, at a total aggregate salary of $221 per month. To 
this number must be added the matron and the surgeon-in- 
charge, whose salaries (omitted from the above communication) 
and subsistence are likewise defrayed from the common funds 
of the establishment. Deducting then sixteen, the number of 
employes maintained at the cost of the United States from the 12 
COLUMBIA HOSPITAL. 
number incorrectly stated by the Treasurer (forty-four), and 
the daily average of patients for the year ending June 30,1877, 
is found to be but twenty-eight. From this number must also be 
deducted the daily average of pay-patients, for they are charged 
with the cost of maintenance, medicines, and medical and sur- 
gical attendance. The Treasurer states the amount received 
during the fiscal year from pay-patients to be $1,075, which, 
at the highest charge of ten dollars per week for each patient, 
would give two as the daily average of pay-patients during the 
fiscal year. Thus the daily average of patients maintained in 
the institution at the cost of the United States is ascertained to 
be but twenty-six. Then to recapitulate : Expenditures for year 
ending June 30, 1877, $18,898.15; daily average of patients, 
twenty-six; expenditure per diem, $51.77; average daily cost 
per patient, $1.99; average cost per annum per patient, $726.35. 
If to this be added a moderate rental of the premises occupied, 
or four per cent, annual interest on the Treasurer's estimated 
value of the property, the average daily cost of each patient 
would be considerably increased; but, as it stands, the daily 
cost is $1.07 in excess of the amount which the Treasurer, with 
evasive effrontery and culpable impudence, estimates at ninety- 
two cents. 
But this is not all. On page 7 there is the following state- 
ment of the amount of appropriations for support of the Colum- 
bia Hospital for Women from the beginning of the fiscal year 
July 1, 1871, to the end of the fiscal year July 30, 1877: 
Support. Property. 
Appropriation for fiscal year June 30, 1872$ 15,000 
Rent of building $ 3,000 
Purchase of surgical instruments 500 
Appropriation for fiscal year June 30, 1873 18,300 
Purchase of building and 40,000 feet of ground 25,000 
Alteration and repairs of building 7,000 
Appropriation for fiscal year ending June 30, 1874 28,500 
Appropriation for fiscal year ending June 30, 1875 24,000 
Grading ground and building walls 8,500 
Appropriation for fiscal year ending June 30,1876 24,300 
To complete purchase of grounds 25,000 
Appropriation for fiscal year ending June 30,1877 16,000 
Mansard roof to building 8,000 
126,100 77,000 
77,000 
Total amount (not including 1878) 203,100 COLUMBIA HOSPITAL. 
13 
Why are the annual appropriations for the six preceding 
years, which in the aggregate amount to $73,000, and the 
amount annually received from pay-patients, which, except for 
the years 1876 and 1877, is an unknown quantity, and the 
amounts donated by the municipal government omitted from 
this statement ? Why is the rental in 1872 carried to the 
property account ? But take the figures as they are and esti- 
mate the daily cost of the patients on the basis of a daily aver- 
age of twenty-six, which is probably in excess of any previous 
year, and the daily cost for each patient to the United States 
varies from $1.99 to $3; yet the Treasurer dares to assert that 
" the average daily number of patients and employes during 
that period is forty-four, making the entire cost $1.30 for each 
individual per diem." Will the Treasurer and his committee 
colleagues, together with "0. E. Babcock, President," seek to 
conceal these gross misstatements of facts, these evasive mis- 
representations of aggregate expenditures and average daily 
disbursements, and these manipulations of accounts in the in- 
terest of and in obedience to the behests of a controlling ring, 
under the hypocritical garb of inexperience in hospital manage- 
ment; or, in the cant phraseology of the Christian statesman, 
ascribe them to errors of judgment; or, even worse, seek to cover 
them under the inspection records of a body of innocent doctors ? 
To contrast the conduct of this institution with that of an- 
other, in the management of which there is no controlling ring, 
the following report of the Board of Hospital Administration 
of the Children's Hospital is subjoined : 
Children's Hospital, December 1, 1877. 
7b the President of the Board of Directors: 
In submitting the seventh annual report of the amount and 
character of the work accomplished by the attending physicians 
of the hospital, which are clearly set forth in the accompanying 
tabulated statements, the Board of Hospital Administration 
desires to call the attention of the members of the Board of 
Directors to the economical management of the institution. 
To definitely determine the average daily cost of maintaining 
each patient admitted to the hospital, a system of daily reports, 14 
COLUMBIA HOSPITAL. 
authenticated by the house-physician, was established and put 
in operation in February last, by which the daily admissions, 
discharges, deaths, and number remaining were recorded every 
day, from which a monthly daily average of children occupying 
beds in the hospital for the past nine months has been accu- 
rately ascertained, as follows: 
March 33.1 August 31.5 
April 34.8 September 32.9 
May 33. October 31. 
June 28.7 November 32.8 
July 27.4 
Thus it is shown that the daily average of patients under 
treatment in the hospital was 31.72, which may be assumed to be 
an approximate estimate of the daily average for the entire year. 
By reference to the Treasurer's books it appears that the 
gross expenditures, as per detailed statement below, for the 
year ending November 30, 1877, amounted to $6,713. 
DISBURSEMENTS. 
Rent $1,300 00 
Maiketing and groceries 1,450 00 
Printing and advertising 185 75 
Fuel and gas 646 54 
Matron and nurses 1,542 00 
Bread and milk 796 71 
Drugs and medicines, and surgical instruments and appliances 643 08 
Furniture and repairs 54 69 
Postage and stationery 12 50 
Building fund 38 95 
Sundries, detailed in journal 42 78 
From these data it is shown that the daily average cost of 
each child occupying a bed in the hospital was 58 cents. In 
this estimate is included the entire cost of the medicines dis- 
pensed to 766 out-door patients, which, together with the item 
of $38.95 transferred to the building fund, should not be in- 
cluded in the gross expenditures for the maintenance of the 
157 children admitted to and treated in the hospital. Fully 
one-half of the amount disbursed for drugs ($643.08) was ex- 
pended in supplying medicines to the out-door sick children; 
but as it is a proper and legitimate expenditure, enabling the 
attending physicians to extend the benefits of the institution to 
a number of indigent children who could not be accommodated 
in the hospital building, and who would otherwise suffer for 
needed medical attendance and medicines, the Board of Hos- COLUMBIA HOSPITAL. 
15 
pital Administration is quite willing that it should be included 
in the estimate of the daily average cost of maintaining each 
child admitted to and treated in the hospital. 
In submitting this evidence of the economical management 
of the institution the Board of Hospital Administration can 
not refrain from commending the careful and judicious super- 
vision of the domestic and purchasing departments of the in- 
stitution, which the Board of Lady Visitors has so constantly 
and cheerfully exercised, and to whom the Board is mainly in- 
debted for the strict economy thus made manifest in the dis- 
bursement of the funds contributed to the support of the in- 
stitution. 
In this connection it is proper to state that not one dollar of 
the funds contributed by a generous public or appropriated by 
the Congress of the United States is expended in the payment 
of salaries to any member of the Board of Directors, officers or 
physicians of the institution. The matron, nurses, and domes- 
tics are the only persons connected with the institution who 
receive any compensation for their services. 
J. C. Hall, M. D., 
Chairman Board of Hospital Administration. 
F. A. Ashford, M. D., 
Samuel C. Busey, M. D., ™ .. 
W. V. Marmion, M. D., [ Attendlng Physicians. 
W. W. Johnston, M. D., 
And even now the story is untold. In the act of July 31, 
1876 (19 Stat. 108) following the paragraph previously quoted 
from the same act are these words : " For a Mansard roof for 
the buiding, $8,000." On page 9 of the Treasurer's report is 
to be found the following: 
Appropriation for Mansard roof and repairs $8,000. 
Special appropriation for Mansard roof $8,000 00 
Amount work by contract $5,950 00 
extra authorized 250 75 
Rebuilding porch and walls 292 53 
Extension, heating apparatus and gas fixtures 421 50 
Painting per contract 325 00 
extra in building 75 00 
Salary superintendent and architect 300 00 
New frames and sashes 364 00 
7,978 78 
Balance on hand 21 22 16 
COLUMBIA HOSPITAL. 
Section 3678 R. S., page 728, provides that " all sums appro- 
priated for the various branches of expenditure in the public 
service shall be applied to the objects for which they are respect- 
ively made, and for no others." 
Was not the appropriation of $8,000 for a special purpose, 
and, if so, are the items of expenditure in accordance with the 
true intent and-meaning of the law ? Is it not manifest that 
the Treasurer has interpolated the words "and repairs" to 
cover disbursements not contemplated by the law ? 
As this is a government hospital and supported chiefly from 
the public treasury, and as all citizens are therefore desirous 
that errors or abuses should be exposed and corrected, these 
facts are respectfully submitted.