46

REPORT ON THE CALCUTTA MEDICAL INSTITUTIONS.

      minute inspection from day to day that progress towards recovery or otherwise can be ascer-
tained with certainty. It is the absence of this means of diagnosis and prognosis which
constitutes the greatest objection to the water-closet system for hospitals in tropical climates.
This observation is specially applicable to the earlier stages of dysenteric disease, when, by
the operation of the water-closet plan of getting rid of the night-soil, the products of morbid
action might, and frequently would, be entirely cast away and lost sight of, at a period,
too, when the most accurate examination of the dejecta is all-important from a diagnostic
and prognostic point of view.

Water-supply

      I am looking forward to the introduction of the new water-supply from the municipal
water-works at an early date. It was understood, when the filtered water was first proposed
for the use of the city, that the extension of the water system of the town was to comprise
an adequate allowance to the sick treated in the General Hospital. Unfortunately,
however, just when the government of Sir George Campbell was on the eve of entertaining
my proposal to this effect, the corporation discovered that there was an insufficient supply for
the wants of the city. But as the Chandpal scheme, which is to provide for the watering
of the streets and to liberate a proportionate quantity to be sold at a large profit to the public
institutions in the suburbs, is now nearly completed, I hope no time will be lost in making
the necessary arrangements for, the extension of the municipal water to the hospital.

Presidency jail
garden.

      The Presidency jail garden has been generally kept so clean that little nuisance has
resulted; but I have sometimes noticed a very disagreeable smell from the garden, proceed-
ing not so much from unutilized and undeodorized or undisinfected night-soil manure, as from
cabbage leaves and other vegetable products in a state of decay and decomposition. I think
with careful supervision this nuisance might be altogether prevented. I have mentioned the
subject to Dr. Mackenzie, the superintendent of the jail, and I have no doubt but that
he will do his utmost to remove this source of impurity and ill-health.

      MEDICAL SUBORDINATES' QUARTERS.

Medical subbordinates'
quarters.

Whenever smells proceed from the jail garden, they are more immediately felt by the
subordinates of the hospital, whose quarters are in the immediate neighbourhood; but there
is a standing insanitary arrangement of even greater gravity in the open drain running
to the north of the buildings in which the medical subordinates dwell. I think if this were
converted into a pipe drain, with properly trapped sinks, and connected with the adjacent
sewer, the measure would materially conduce to the salubrity of the quarters in question.

      My predecessor, Dr. Brougham, entertained the opinion, in which I fully concur, that much
of the great unhealthiness among the inmates of these quarters was attributable to the open drain.

OUT-DOOR RELIEF.

Out-door relief

      I have endeavoured to work the out-patient department since the augmentation of the
subordinate and menial establishment was sanctioned in Bengal Government letter No. 1344
dated 4th April 1873; but either an additional assistant apothecary is needed to enable me
to open out the department successfully, or the appointment of my assistant, as contem-
plated in G. G. 0. No. 901 of 1866 and No. 371 of 1867.

LIBRARY.

Library.

      The library is under the direct supervision of the first resident surgeon, Dr. Palmer,
who is aided, as regards the mechanical work, such as the distribution of books, newspapers,
and periodicals, and the re-collection and immediate care of the same, by Mr. J. Smith,
the ward-master, attached to his ward. Formerly the assistant writer helped in this work;
but owing to the great increase of work in the office since the whole of the details of the
provisioning, clothing, bedding of the sick, and the preparation and rendering of accounts
devolved upon the surgeon superintendent, I took the opportunity of the sanction of an
additional ward-master being obtained, of arranging, on his appointment, that he should
relieve the assistant writer of his duties connected with the library, thus setting him free to
be employed exclusively in carrying on the heavy office work of this institution.

      The library has now been removed from its old habitation on the landing of the central
building to a well lighted and airy room on the ground floor of the same. Most of the
volumes that require rebinding have been rebound, and the whole have been arranged,
classified, catalogued, and placed in substantial cases with glass doors. A large table,
on which recent periodicals and newspapers are placed, as also forms and chairs on which,
these convalescents who are able and willing can sit and read the current literature of
the day, have been provided.

      Patients are encouraged to visit the library as much as practicable. The effect is
beneficial, and relieves them for a certain time from the monotony of the wards.

      I feel greatly indebted to Dr. Palmer for the improvement of the library, and for the
additional facilities now afforded to the sick for obtaining access to its treasures.

      I am glad to record the fact that His Honor the Lieutenant-Governor has been pleased,
with the concurrence of the Government of India, to sanction the continuance of the practice of
buying cheap second-hand books from the various reading clubs in Calcutta as opportunity offers.