January 9, 1923: Diagnosis is changed to tuberculosis, chronic, pulmonary. Origin duty, not misconduct. Physical and laboratory signs as above. Another specimen of sputum positive for tubercle bacilli. To bed, treatment.

January 9, 1923: Report of board of medical survey states: "Diagnosis tuberculosis, chronic, pulmonary." Origin duty. Facts are as follows: Admitted January 8, 1923, with history of loss of weight and strength. Cough, with blood at times. Physical examination shows heart negative; chest, impairment of resonance both upper lobes with slightly increased tactile fremitus. A few persistent fine râles left apex. X ray shows mottling both upper lobes and infiltration, with much thickening peribronchial lymph glands. Sputum examination positive for tuberculosis on two occasions.

Present condition, unfit for duty.

Probable future duration, indefinite.

Recommendation: That he be transferred to the United States Naval Hospital, Mare Island, Calif., for further treatment and disposition.

January 16, 1923, transferred, via U. S. A. T. Thomas, to United States Naval Hospital, Mare Island, Calif. February 17, 1923, readmitted with tuberculosis, chronic, pulmonary. Origin duty, not misconduct. Readmitted from Canacao

via Army transport. Condition while on transport very good. History as stated above. At present feels much improved, very little cough, and scanty expectoration. Some "soreness" in left chest and shoulder.

Heart
Left

Examination: Weight, 155 pounds. General appearance very good. negative. Blood pressure 106/78. Right lung rough breath sounds apex. lung, increased vocal fremitus, more marked posteriorly, upper lobe. Roughened breathing with few râles left upper lobe. Impaired resonance on percussion. Urine negative. Sputum negative for TB.

February 19, 1923: X ray of chest; chest symmetrical. Heart enlarged. Many calcified nodes in both hilus regions. Diminished expansion right apex. Left upper lobe from apex to lower border of fifth rib is consolidated, shows many areas of calcification and fibroid changes. These conditions are the result of a chronic pulmonary tuberculosis.

March 10, 1923: Feels better. Taking daily exercise. Sputum continues negative. Tonic.

March 16, 1923: Continues to feel well, except for an occasional pain in left lower axilla.

March 22, 1923: Not feeling so well last two days. X ray shows an obliteration of the left costo-phrenic angle. Marked angulation of left border of the heart shadow. Irregularity of left diaphragm with thickened pleura between chest wall and left diaphragm. Suggestion of small accumulation of fluid in this sulcus. Diminished breath sounds and dullness left lower chest.

April 1, 1923: Feels better generally. Sputum negative. Examination of left chest shows absence of breath sounds left lower lobe, no vocal fremitus and flatness on percussion to sixth rib. Fluid increasing.

April 6, 1923: Fluoroscopic examination shows large collection of fluid in left chest. Level not established due to poor static.

April 9, 1923: Left chest aspirated in seventh interspace axillary line "dry top.' Aspirated in eighth interspace posterior to axillary line and 1,300 c. c. of clear straw-color fluid withdrawn. No complaint except slight soreness at

site of puncture.

April 16, 1923, laboratory report of aspirated fluid: Direct smear of fluid shows gram-negative micrococci. No acid-fast bacilli found. Guinea pig inoculated with 2 c. c. of fluid April 9, 1923. Died, April 13, 1923. Autopsy showed pneumonia, pleurisy, effusion left chest, acute nephritis. Pleural exudate negative for acid fast or other organisms on direct smear. Cultures show gram positive and gram negative cocci. Guinea-pig negative for tubercular pathology. Patient feels much better, but examination still shows physical signs of some fluid in left lower chest. Tonic treatment. Continues to run afternoon temperature of 99. April 26, 1923: Right tonsillectomy under local anesthesia. History of double tonsillectomy about two years. Large part of right tonsil was left and removed to-day. Has been running slight evening temperature daily.

May 3, 1923: Tonsillectomy wound healing, but patient is not feeling so well as before operation. Temperature, 101; some pain in left chest and physical signs of reaccumulation of fluid.

May 7, 1923, fluoroscopic examination: Fluid in left pleural cavity. Right apex lights up fairly well; left apex gray. Right diaphragm freely movable, left diaphragm is obliterated. Plate, left apex gray; right fairly clear. Right

Chest

hilus shows areas of calcification. Peribronchial thickening of right lung extending well out to periphery and right top. Dense shadow in left chest. aspirated in eighth interspace posteriorly, 1,200 c. c. clear straw-color fluid removed. Smear negative for organisms and no pus cells.

May 14, 1923: Running lower temperatures since aspirated.

May 17, 1923: Report of board of medical survey states, “Diagnosis, tuberculosis, chronic pulmonary." Origin duty. Facts are as follows: As stated previously. Sputum has been negative since arrival in this hospital. X ray confirms diagnosis of tuberculosis, both apices involved. It is believed that the high dry climate of Denver, Colo., would be beneficial to him.

Present condition: Unfit for duty.

Probable future duration: Indefinite.

Recommendation: That he be transferred to the Fitzsimons General Hospital, Denver, Colo.

May 30, 1923: Running normal temperature and feels somewhat improved. Specimen of tonsil negative for tuberculosis.

June 10, 1923: General condition good, feels comfortable except at times has slight pain below right scapula and below and external to left nipple.

June 14, 1923: Transferred, in accordance with approved recommendation of board of medical survey to Fitzsimons General Hospital, Denver, Colo. June

17, 1923, readmitted with tuberculosis, chronic, pulmonary. Origin in line of duty. Patient ambulant. T. P. R. normal. Color and appearance.

June 19, 1923, X-ray report: Pleural thickening over the left lung marked at the base obliterating the costophrenic angle and diaphragm outline. There is a poorly defined mottling and infiltration through the left lung, most marked in the upper lobe. In the right lung there is less amount of pleural thickening than in the left. There is a moderate amount of fairly well defined peribronchial infiltration and mottling through the right lung, the markings extending fairly well out to the periphery and up into the apex. Some fibrosis.

July 19, 1923: Condition fairly good. Has gained 2 pounds. No cough or sputum. Has occasional dull pain in right axilla. There seems to be some improvement in the pleurisy, left.

Naval Retiring Board, Fitzsimons General Hospital: August 8, 1923, the board, having deliberated on the evidence before it, decided that Ensign George Dewey Hilding, United States Navy, is incapacitated for service by reason of chronic pulmonary tuberculosis, that his incapacity is permanent and was incurred in the line of duty as the result of an incident of the service.

Department of the Navy: August 25, 1923, it is recommended that the findings of the Naval Retiring Board be approved.

The White House: September 5, 1923, the proceedings and findings of the Naval Retiring Board in this case are approved, and Ensign George D. Hilding, United States Navy, will be retired from active service and placed on the retired list, in conformity with the provisions of section 1453 of the Revised Statutes. Fitzsimons General Hospital, Denver, Colo.: August 19, 1923, improving. No cough or sputum. Walks to mess hall; no fatigue.

September 5, 1923: Placed on the retired list of the Navy. To be retained in hospital as supernumerary.

The following letters were submitted to the committee by the Hon. Carl E. Mapes, as evidence in the case:

Hon. CARL E. MAPES, M. C.,

FITZSIMONS GENERAL HOSPITAL,

House of Representatives, Washington, D. C.

Denver, Colo., June 4, 1929.

MY DEAR MR. MAPES: My brother Vic has forwarded to me your recent letter and inclosures. Needless to say I am very pleased at the encouraging news contained therein.

The Navy Department's letter to you, May 9, 1929, quotes Navy courts and boards as follows:

"When any officer on the active list becomes physically incapacitated to perform the duties of his office, and the probable future duration of such incapacity is permanent or indefinite, he will immediately be ordered before a retiring board, and, pending final action upon the question of his retirement, will not be examined for promotion. The foregoing shall not apply to the case of an officer whose physical incapacity develops after he has become due for promotion, and

who hay, under such circumstances, be examined physically by a board of medical examiners before being ordered before a retiring board."

By a custom of the Navy Department which was, and still is, in usage, I should have been given a year hospitalization at Fitzsimons before going before the retiring board. This statement is substantiated in the letter of Lieut. Commander M. H. Ames, a copy of which is attached hereto.

Had I been given the customary year of hospitalization at Fitzsimons, I would have made my number for promotion before appearing before the retiring board and would have been entitled to retirement, in the rank to which my seniority would have entitled me to be promoted, in accordance with the following provision of the United States statutes:

United States Code, title 34, Navy, section 390:

"Retired rank of officer failing in physical examination: Hereafter, if any officer of the United States Navy, below the rank of lieutenant commander, shall fail in his physical examination for promotion and be found incapacitated for service by reason of physical disability contracted in the line of duty, he shall be retired with the rank to which his seniority entitles him to be promoted." The case of Lieut. (Junior Grade) Archie Freels, United States Navy, retired, will serve as an example of a case of this kind.

There are a number of cases on record, and I have personal knowledge of several, where an officer has made his number and been ordered up for promotion while at Fitzsimons awaiting retirement, and has consequently been retired in the grade to which his seniority entitled him. These cases must be on record in the Navy Department.

The letter from the Navy Department to you also states:

"The present policy of the department in these cases, as now provided in paragraph 2122 of the Manual for the Medical Department, is to the effect that they will be retained under treatment (at Fitzsimons) for not longer than six months, at the end of which time a medical survey shall be held.' This with a view of their retirement. In the case of officers whose transfer to Fitzsimons General Hospital is not contemplated they should be surveyed with recommendation that they appear before a retiring board."

The copies of my orders which I sent you will show that I was surveyed at Mare Island and ordered to Fitzsimons for treatment, but that almost immediately upon arrival at Fitzsimons I was ordered to appear before a retiring board. That was not in accordance with the policy stated above.

There are several naval officers under treatment at Fitzsimons now who have been here, on active duty, more than a year, awaiting retirement.

I attach hereto for your convenience a copy of the letter which Lieut. Commander M. H. Ames, retired, wrote to you. Lieutenant Commander Ames is, and has been since before I was retired, the president of the Navy retiring board here.

I hope that Lieutenant Commander Ames's letter and what I have said in this letter will further assist you in presenting the case to the committee.

Faithfully,

GEORGE DEWEY HILDING.

MAY 31, 1929.

Hon. CARL E. MAPES,

House of Representatives, Washington, D. C.

SIR: George D. Hilding, ensign, United States Navy, retired, has brought to my attention the hoped-for correction of the situation consequent to his rather precipitate retirement.

At the time, I was the naval medical officer, on duty at the Fitzsimons General Hospital, and was president of Ensign Hilding's retiring board. For four years I had been on duty at the naval hospital, Fort Lyon, Colo., and on the transfer of that hospital to the Veterans' Bureau I was sent to Fitzsimons Hospital in charge of the naval unit, and at the time of Ensign Hilding's retirement I had had six consecutive years' duty with the tuberculous patients of the Navy. In those years there was no change in the custom of giving an officer at least a year of hospitalization before recommending that he appear before a retiring board, unless this action was at the officer's own request.

Ensign Hilding was not recommended for retirement by a board of medical survey, but the board's recommendation for transfer to the Fitzsimons General Hospital for treatment was changed by the Bureau of Medicine and Surgery to the recommendation that he appear before a naval retiring board. By this action the Bureau of Medicine and Surgery unwittingly worked a hardship on Ensign

Hilding by depriving him of a year's hospitalization which all other officers had received.

As president of his retiring board, I assumed that Ensign Hilding was appearing at his own request and had he brought my attention to the circumstances, I should have delayed action in his case until he had enjoyed the benefits of the customary year in hospital.

Though there is no question of injustice or partiality in this case, Ensign Hilding did not enjoy the period of hospitalization which it was the custom to give officers on the active list of the Navy. I might add, by way of explanation, that the custom of a year's hospitalization was for the purpose of rehabilitating the patient so that he might, on retirement, be capable of following a gainful occupation.

Respectfully,

M. H. AMES, Lieutenant Commander, Medical Corps, United States Navy, retired.

DENVER, COLO., January 20, 1930.

MY DEAR MR. MAPES: I have your letter of the 14th instant and have studied the inclosed report of the Navy Department carefully. After going over my file again I do not believe there are any new points that I could suggest which have not already been touched on, but it may be of some assistance to you if I review the whole matter.

In the department's report, the fourth paragraph, first line, states as follows: "Had Mr. Hilding been continued on the active list until June 3, 1924, and subsequently been retired he would have been entitled under the general law to the rank of lieutenant (junior grade) on the retired list." That of course has been my contention and since the department so states I presume that the committee will accept that point. However, my argument on that point will be found in my letter of June 4, 1929.

With the above fact established it would seem that the only other point upon which the committee should need to be satisfied is that I was entitled to be and should have been retained on the active list until some date later than June 3, 1924.

Now, the department's report also states: “Furthermore, this retirement was not effective until eight months after the first appearance of the disease, which gave ample opportunity for curative treatment and for determination of its permanent character."

Upon my arrival from the Orient at the naval hospital, Mare Island, February 17, 1923, the doctors there were unable to find any positive evidence of tuberculosis on me. I was kept there under observation and the final diagnosis was not made till late in May when I appeared before a survey board which recommended that I be sent to Fitzsimons for treatment. The survey board did not recommend immediate retirement but the survey board's recommendation was so modified by the Bureau of Medicine and Surgery as to cause the Navy Department to issue orders for me to appear before a retiring board when notified by the president of the board at Fitzsimons. Please refer to your copy of the order dated June 9, 1923, and also to Commander Ames's letter of May 31, 1929.

I shall ask Doctor Ames to comment on the curative value of the treatment prescribed while I was at Mare Island for he is familiar with the records in my case as he was the Navy medical officer on duty at Fitzsimons when I arrived there, and, as you know, was at that time the outstanding authority on tuberculosis in the Navy.

I do not believe the Navy Department intentionally discriminated against me in issuing orders for me to appear before a retiring board at the time it did, but by the action taken it unwittingly deprived me of a period of hospitalization at Fitzsimons, on the active list, which it was the practice to give tubercular patients, and also of the retired rank of a lieutenant (junior grade).

My state of mind when I arrived at Fitzsimons was this. I expected that I would be given the customary year of hospitalization there before being called before a retiring board and I hoped and expected that at the end of that time I would have regained my health and be restored to regular duty.

A young officer is not familiar with the eccentricities of retiring boards and when I received orders to appear before a retiring board when notified by the

president of the board who was the Navy medical officer in charge at Fitzsimons, I had reasons to feel that I would not be called before the board until after I had been under treatment at Fitzsimons for a year, or if called, that the board would recommend that I be continued on treatment for the customary period. Consequently I did not burden the department with any request that my orders be delayed until I had received a year of hospitalization on active duty in order that I might to some extent be rehabilitated and at the same time make my number for promotion so that if retired I would be better able to take care of myself in civilian life.

I am sure that had I known what to expect at the time and had then had the matter presented to the department before the retiring board acted, the department would have allowed me the customary year of hospitalization at Fitzsimons before retirement. And I believe its unfavorable report on this bill is due to the department's general policy to not favorably recommend private legislation rather than for any lack of merit in this case.

Commander Ames, who was the president of my retiring board, stated in his letter of May 31, 1929, that he presumed that I was appearing at my own request, and that had he known the circumstances, he would have taken the responsibility of continuing me on active duty until I had received the customary period of treatment at Fitzsimons. Had I received this consideration I would of course have made my number for promotion and been retired as a lieutenant (junior grade).

To substantiate my former statement, viz, that it was and is the policy of the department, in cases of officers being treated at Fitzsimons, to retain them on active duty status for one year before retirement, I again respectfully call your attention to the letter written to you by Commander Ames on May 31, 1929, and to the Navy Department's records of the following-named officers who were on active duty under treatment at Fitzsimons for a year or more before being retired:

Fred J. Cunningham, lieutenant, United States Navy, retired.

E. V. Carrithers, lieutenant, United States Navy, retired.

S. C. Seale, chief machinist, United States Navy, retired.

A. J. Freels, lieutenant (junior grade), United States Navy, retired.

C. E. Beatty, lieutenant (junior grade), United States Navy, retired.
V. J. Moore, lieutenant, United States Navy, retired.

J. M. Quinn, lieutenant (Marine Corps), United States Navy, retired.
J. Slattery, lieutenant (Marine Corps), United States Navy, retired.
H. P. Cook, lieutenant (junior grade), United States Navy, retired.
And many others whose names are not before me now.

In regard to the fact that I remained at Fitzsimons for several months after I was retired, this was of my own volition and on the advice of the Army doctor under whose care I was.

As to the additional cost to the Government of $375 per annum which this legislation would cause, this does not seem great when my retired pay is compared to the cost to the Veterans' Bureau of caring for men similarly disabled. Although I entered the service in June, 1917, and no doubt received the inception of tuberculosis from two severe attacks of influenza in 1918 and 1919, I am not eligible to hospitalization or other aid from the Veterans' Bureau because of my retired status.

I trust this résumé and comment will further assist you in discussing the matter before the committee. I have confidence that you will be able to convince the committee that this bill deserves their favorable consideration. Kindest regards. Faithfully,

GEORGE DEWEY HILDING.

FITZSIMONS HOSPITAL, Denver, Colo., March 1, 1929.

I entered the United States Naval Academy in June, 1917, was graduated and commissioned an ensign United States Navy, June 2, 1921.

In January, 1923, while attached to a destroyer at Cavite, P. I., I became ill and was ordered to the naval hospital at Canacao, P. I. From there I was ordered to the naval hospital at Mare Island, Calif., arriving there February 17, 1923.