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Foreword

The annual report of the Surgeon-in-Chief is of great interest to me because it shows that for the third consecutive year of its operation the Foundation has shown a steady growth.

It is constantly serving an ever increasing number of handicapped people who are apparently improving in health. Furthermore, the fact that many former patients return from time to time for treatment would seem to indicate that they have obtained definite benefit from Warm Springs.

Many of the friends of the Georgia Warm Springs Foundation have not yet had the opportunity to inspect our plant and to observe our method of treatment at first hand. Our Trustees felt that these people would like to read Dr. Hubbard's report because it is a concise statement of our progress during 1929.

We have therefore prepared it for distribution together with photographs of the staff.

Faithfully yours,
Franklin D. Roosevelt
For the Trustees

Honorable FRANKLIN D. ROOSEVELT, President,
Georgia Warm Springs Foundation, Inc.
Executive Mansion, Albany, N. Y.

My Dear Mr. Roosevelt:

I beg to submit the following report of the Medical Department for the year ending December 31, 1929:

Patients

The close of 1929 marks the completion of the second full year of operation of the Georgia Warm Springs Foundation for the after treatment of patients who have had poliomyelitis and other diseases of a similar type. It is gratifying to note that there has been a steady increase in the number of patients who have been coming to us for treatment.

In the nine months of operation in 1927 there were 106 patients; in 1928, 151; and in 1929, 215.

On January 1, 1929, there were 31 patients at the Foundation, all of whom had come in 1928 and remained over Christmas and the New Year. In 1928 there were 14.

The new arrivals by months were as follows:

Arrivals

Departures

Thirty patients arrived twice during the year and either departed twice or remained January 1st, 1930.

The length of stay for patients who came for treatment varied from less than one week to 52 weeks, the former a patient coming just at the close of the year.

The total weeks treatment was 3520 or an average of 17 weeks per patient.

There were 178 cases of poliomyelitis and 37 cases not poliomyelitis. The males numbered 108 and the females 107. Of the 1 78 poliomyelitis cases 86 were males and 92 females; thus for the third time demonstrating that polio is almost equally divided between the sexes.

Of the 215 patients 137 came for the first time in 1929. 59 had been at Warm Springs in 1928 and 1929, 15 in 1927, 1928 and 1929, and 4 in 1926, 1927, 1928 and 1929.

The fact that 78 of the patients, or a little over 36%, were here for treatment during one or more previous years is very interesting, for it does not seem probable that so many would come such a long distance as most of them do, and at considerable expense, unless they or their parents believed that they were deriving more benefit from this treatment than from any other method.

The age groups are as follows: --

A study of this table shows that 100 of the patients or nearly 50% were between the ages of 15 and 30, and 163 or 75 % were over 15 years of age. The majority of those over 30 years of age were in the non-polio group. Very little provision has been made in this country or any other for the after care and treatment of the adolescent and adult paralytics as practically all of the institutions take only children.

The adult case presents the most difficult problem in home care, so that I feel we are doing a real service in providing adequate care and treatment for these patients.

The classification according to the parts affected on admission is as follows -- polio cases only: --

This table shows that the majority of the polio cases were of the severe type involving a large number of muscles.

The date of onset of the attack of poliomyelitis varied from less than one year to over 40 years.

Number of years since attack and previous to admission in 1929: --

Eleven patients, or a little over 6%, came within less than a year after their attack, sixty-four, or 36%, within two years and 105, or 60%, within 5 years.

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The patients came from thirty of the forty-eight states, the District of Columbia and Canada.

New York as in past years, leads the list by states with 63 patients, followed by Illinois with 16, New Jersey, 15, Massachusetts, 13, Pennsylvania, 11, and the others with smaller numbers.

The general health of the patients while at Warm Springs has been excellent with no outbreaks since the influenza epidemic in January.

Since July first a compulsory physical examination of all new patients by Dr. Johnson has been required before they are allowed to go into the pool or take treatment, and this has proven to be very satisfactory.

The Staff

On January first the Staff comprised the Surgeon-in-Chief, the Director of Physiotherapy and eight physiotherapists. The rapid increase in the number of patients in January, and the prospect of a still further increase during the winter and spring, together with the resignation of one to return to school in February, made it necessary to secure three new physios in January and February, and another in June to take the place of one more resignation.

In the fall, one of our staff announced that she expected to return to school February first, in order to complete her course and secure her degree.

We were able to secure the return of the one who left in February, and who was very efficient.

At the close of the year there were twelve physiotherapists, one of whom is employed as a teacher of swimming and a substitute exerciser when any of the others are unable to go in the pool.

On December first. Dr. Frank Brostrom, who has had extensive institutional experience, and was for two years at the Children's Hospital, Boston, was appointed Assistant Surgeon, Dr. Brostrom brings to the work of the Foundation youth, splendid technical experience, a pleasing personality, and enthusiasm, which I am confident will make him a very valuable addition of the staff.

Dr. J. A. Johnson of Manchester, the attending physician, has held clinics three times a week for examination and treatment of patients, and has rendered a very valuable service in preserving and restoring the health of both patients and staff.

The long illness of Miss Mahony during the winter and spring, necessitated a leave of absence and required our securing the services of a trained nurse. Miss Cora Binford has filled this place most acceptably, and her technical efficiency, untiring zeal, and personal interest in every patient and employee have made her beloved by everybody, and a most valuable addition to the staff.

During Miss Mahony's absence we were fortunate in securing the services of Miss Alice L. Plastridge of Chicago, a physiotherapist with years of special training in polio work, and who had been to Warm Springs several times and was familiar with the methods and aims of the Foundation. She carried on the supervising work with skill, enthusiasm and vigor.

Miss Mahony returned in the fall much improved in health and has since carried on her work with all her former vigor and efficiency.

STAFF OF PHYSIOTHERAPISTS

Mary Lucille Daniels,
Halls, Tenn.

Phyllis de Brick,
Bluefield, W. Va.

S. Frances Holmes,
Valdosta, Ga.

Janice Howe,
Gadsden, Ala.

Mary Hudson,
Albany. Ga.

Helen Lauer,
Washington, D. C.

Mamoi Little,
Warm Springs. Ga.

Elizabeth Ann Lowe,
Equality, Ala.

Mrs. Martha Parker Mays,
Warm Springs, GA.

D. Louise Mims,
Thomasville, Ga.

Margaret Moore,
Algood, Tenn.

Sinclare Norton,
Rome, Ga.

Vera Rickman,
Nashville, Tenn.

Amy E. Shipley,
Cooksville, Tenn.

Mrs. Elizabeth W. Thomson,
Nashville, Tenn.

Nancy Watson,
Whitehaven. Tenn.

Ruth Womelsdorf,
Catersville, Ga.

Improvements and Additions

The two outstanding improvements and additions to the plant in 1929 were the installation of the new water system and the building of the Infirmary. The former was put in operation in July, and while the latter was not entirely completed in 1929 it will be ready for occupancy early in 1930.

The water of the spring is now pumped by means of rams into a concrete reservoir on the hill about 1 00 ft. above the Inn and distributed by gravity to the Inn and cottages. The pressure is sufficient to throw four large streams of water to the top of the Inn, thus securing better fire protection than we have ever had.

While the water of the spring is pure and is protected from surface contamination, it was deemed advisable, as additional protection, to install a chlorinating plant; so that we now have an abundant supply of pure water for domestic consumption, and the swimming and exercise pools are made more sanitary.

The Infirmary

One of the most important needs of the Foundation has been an Infirmary or isolation unit, in which patients, who have any illness, may be segregated. Whether the illness is slight, serious or contagious, it is to the advantage of both patient and colony that he be segregated so that he may receive proper medical attention. The need for such a building was emphatically felt in January, 1929, when Warm Springs experienced a slight epidemic of influenza.

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This matter was brought to the attention of the patients at a meeting around the fireplace one evening during the winter, with the result that all were greatly interested. At the time. Foundation funds were not available and the patients, with their families and friends volunteered to assume the entire financial responsibility for the new Infirmary. Subscriptions ranging from small amounts to very large sums were turned in. Mr. and Mrs. F. D. Wilson of Philadelphia were especially interested and made a very generous subscription. The Trustees have named the new infirmary "The Norman Wilson Memorial" in memory of their son.

It is a one story building of fireproof construction and southern colonial architecture, and is located at the northeastern corner of the campus. It is equipped with private rooms, public wards and offices for the medical staff. There is also an X-Ray room, a research laboratory and a plaster and brace room. As the year closes the infirmary is practically completed and will be opened early in 1930.

Patients and staff take a special pride in the new Infirmary because it has been constructed entirely by the generous interest of Warm Springs patients and their families in response to a long felt need for better health protection.

The Play House

A minor improvement, but one which has added greatly to the comfort and pleasure of the patients, is the renovation of the inside of the former dance hall, which has been christened the Play House.

A new ceiling was put in, the side walls lined and decorated, and with the new lighting system, window draperies, etc., it was made a very attractive place. Moving pictures are shown twice a week and those interested in craft work assemble there three evenings a week. The other evenings are used for general recreation.

This improvement was also made possible by a generous gift from a patient, who was here during the summer.

Because weather conditions are of great importance to people taking treatment for their health, I submit herewith a copy of my records for 1929. It indicates that climatic conditions are generally very favorable at Warm Springs..

Respectfully submitted,
LeRoy W. Hubbard
Surgeon-in-Chief

January 14, 1930.

METEROLOGICAL RECORD
1929

1929 was a year of a very unusual amount of rain, the record rain-fall at the United States Government Station in Atlanta being over 65 inches, or more than 20 inches above the normal, and exceeding all previous records.

The record for rain shows the number of days during which there was any precipitation and there were only 92 days that were cloudy all day.

TRUSTEES

Franklin D. Roosevelt, President
D. Basil O'Connor, Treasurer
Dr. Leroy W. Hubbard, Warm Springs, Ga.
George Foster Peabody, Saratoga, N. Y.
Frank C. Root, Greenwich, Conn.
Herbert N. Straus, New York City
James T. Whitehead, Detroit, Mich.
Lehighton McCarthy, Toronto, Canada

Board of Consultants

Dr. Leroy C. Abbott
St. Louis, Mo.

Dr. Fred. Warren Bailey
St. Louis, Mo.

Dr. George E. Bennett
Baltimore, Md.

Dr. Frank D. Dickson
Kansas City, Mo.

Dr. George Draper
New York City

Dr. Albert H. Freiberg
Cincinnati, Ohio

Dr. Ludvig Hektoen
Chicago, Ill.

Dr. Frederick C. Kidner
Detroit, Mich.

Dr. Arthur T. Legg
Boston, Mass.

Dr. Beveridge H. Moore
Chicago, Ill.

Dr. Frank H. Ober
Boston, Mass.

Dr. Robert B. Osgood
Boston, Mass.

Dr. John Lincoln Porter
Evanston, Ill.