22      REPORT ON THE

of food as there is in having it properly cooked and served in a palatable form to the sick.
Even under the strictest system of scrutiny and check it often happens that miscarriage
and mistakes occur when least expected. An attempt has been made to improve matters by
concentrating the responsibility and appointing a head cook on a higher salary than was
formerly given. The system is not at present working smoothly, and there remains much to
be done towards the improvement of this important branch.

The connection of
the drains with the
municipal sewers.

Condition of the
hospital road and,
grounds.

Erection of the
railing round the
hospital grounds.

      20. Regarding the connecting of the hospital bath-rooms, &c., with the municipal
drains, Dr. Elliot reports as follows:—"The drains and pipes in connection with the various
latrines, lavatories, and bath-rooms, which have been recently connected with the municipal
system of drainage, appear to be patent, and are working favourably. There have been no
complaints regarding defects in the arrangements which have been entered into for this
purpose throughout the various buildings." A considerable amount of attention has, it is
said, been bestowed on improving the roads and laying out the hospital grounds under the
kind superintendence of Dr. King, Superintendent of Botanical Gardens; but there were no
funds available from which to meet the pay of the establishment that it would be necessary
to keep up for this purpose. However, such assistance as could be rendered by the coolies
attached to the hospital was afforded from time to time, and the Superintendent states that
the general appearance of the grounds has been greatly improved. The appearance of the
hospital has been vastly improved by the erection of a handsome iron railing (on a three-
feet brick wall) and with suitable entrance gateways to the various buildings. This work
has been completed, and must contribute in no small degree to the healthiness of the institu-
tion, and to the recovery of the patients in it, since, by the removal of the "unsightly and
jail-like wall" which formerly existed, and the substitution of iron railings for it, the free
circulation of air through the hospital compound has been secured—a measure which cannot
be too highly estimated as a sanitary improvement.

Quarters of
medical
subordinates.

      21. Attention has been again drawn to the insanitary condition of the quarters occu-
pied by the medical subordinates. These are stated to be damp, defective in ventilation,
unfit for habitation, and their removal, Dr. Elliot says, "would prove conducive to health, by
the admission of air to the occupants of the eastern building."

Library.

      22. It is stated that the sum allowed by Government for the purchase of books and
keeping them in good order has enabled the Superintendent to add to the number of books
in the library. Small contributions of books and periodicals have been received from private
sources, and have been duly appreciated by those patients who were able to make use of
them. Dr. Elliot considers that "credit is due to ward-master Smith for the manner in which
he manages this department." The reading-room for the use of the subordinate medical
staff was furnished with the leadign medical periodicals of the day.

Nursing.

      23. Two ladies, Miss Huband and Miss Best, have been connected with the nursing
department—the former as lady superintendent, the latter as her assistant in special charge of
the 1st Resident Surgeon's ward. A third lady, Miss Farrell, arrived on the 3rd December
last, and has taken charge of the nurses in the 2nd Resident Surgeon's ward. "All of
them (Dr. Elliot reports) are thoroughly devoted to their work, and under their unremitting
care, watchfulness, and tact, the nursing arrangements have undergone very great improve-
ment indeed. To Miss Best's unwearied efforts in the cholera ward especially, and to
good nursery, I attribute mainly the recovery of so many of those who were admitted
labouring under that disease."

Medical
establishment.

      24. Dr. Elliot records his sense of the cordial co-operation and ready assistance which
he invariably received, in all matters connected with the hospital, from Drs. Raye and
Mackenzie, in very flattering terms. He also records his appreciation of the services rendered
by Assistant Apothecaries Fleming and Toomey, and also by Mr. Clements, passed Hospital
Apprentice.

Clothing.

      25. Under this heading Dr. Elliot reports as follows:—"The clothing department was
found to be in a most unsatisfactory state, which rendered an investigation into the whole
matter necessary. The matter has been thoroughly gone into, and has since received special
attention. I am glad to say that this branch is now working satisfactorily on a different
system."

Remark of the
Deputy Surgeon-
General.

      26. The Deputy Surgeon-General of the Presidency Circle, when forwarding the report
of this hospital, submitted with his memorandum No. 31E., of the 14th February 1877,
makes the following remarks:—"The institution has fully maintained its former usefulness—
the daily average number of in-patients being higher than in any other year, except one of the
past ten, and the number of out-door patients has nearly doubled that of the previous year.
The hospital has been frequently visited by the undersigned during the year, and he has on
all occasions found the wards and every part of the premises very clean and in good order,
and the patients comfortable and well cared for. The addition now being made to the front
of the west building, in the shape of an operating-room to the surgical ward and a lying-in
room to the women's and children's wards, will no doubt be of very great advantage. The
most necessary further improvement is the erection of fresh quarters for the hospital subor-
dinates on some other site, the present quarters being very old and ill-suited for the purpose
they serve."