11

CALCUTTA MEDICAL INSTITUTIONS.

and practice of the Medical Department; but the Deputy Inspector-General was cautioned
to exercise the function of supervision and control inherent in his office "with a proper con-
sideration for the position of the eminent medical officers who are entrusted with the charge
of the various wards of the hospital." I am glad to be able to report now that the
relations which have existed between the officers of the hospital and the administra-
tive officer at the Presidency have been of the most pleasant kind, and that the arrange-
ment re-established in February has been characterized by harmony and co-operation.

      14. An incident occurred in January which rendered it evident that the preparation
of a code of rules for the guidance of the subordinates doing duty in the wards of the
hospital was desirable. The medical officers were accordingly requested to draw up a set
of instructions indicating precisely the duties of House Surgeons and Sub-Assistant Surgeons
ordinarily and in cases of emergency, and suspend them in the wards and waiting rooms.
These instructions have been satisfactorily complied with.

Rules for the con-
duct of subordi-
nates.

  1. Discharged cured.
  2. Ditto relieved.
  3. Ditto otherwise.
(The precise mode or cause
of discharge to be indi-
cated by foot-note.)
  4. Died.

    15. The revision of the forms of returns was also discussed. It was considered desirable
to show the issue of cases treated more precisely, and more particularly to distinguish cases
"cured," from those "relieved," and to state more accurately the
causes of removal of persons leaving the hospital or removed from
it before either cure or relief had been obtained. The results of
cases will accordingly be shown in future as on the margin. The
change could not be effected this year, because the registers had not been kept up according
to the form in question.

Amendment of
forms.

       16. The appointment of a Resident Physician, which was finally sanctioned in October
1871, will undoubtedly add most materially to the efficiency of the hospital staff, and
Assistant Surgeon McConnell, M.D., who was appointed on the 15th of December to the
conjoined duties of Resident Physician and Professor of Pathology, gives every promise of
filling these important posts with credit to himself and benefit to the institution.

A Resident Phy-
sician appointed.

       17. Dr. Chevers mentions in his report that more liberal and elastic rates of dieting
came into operation on the 1st of April 1871. The circumstances under which this change
came about are as follows:—In March 1867 the Medical College Hospital had fallen into
debt to the amount of Rs. 4,231-1-7¼ on account of diet, and the contractors took legal
proceedings against the Principal for the amount. The practice had been to allow the
institution a fixed grant, irrespective of actual expenditure, on this account. Any saving
effected was placed to the credit of the institution, and any excess of expenditure over the
grant became a personal debit against the officers of the hospital. On the recommendation
of the Government of Bengal the debt above specified was liquidated out of the budget
grant of the year, and a capitation allowance of four annas a day for Native, and eight annas
ten pie for European patients fixed. This allowance was to include wines and extras,
and to be payable within the limit of the grant on the audit of the Examiner of Medical
Accounts. Under these rules it was found that while a saving was effected in European diets,
the expenditure on Native diets exceeded the allowance. The matter was adjusted by crediting
to the head of Native diets the saving on European diets, and the grant on the whole was
thus found to be adequate. In his report for the year 1869 the Principal urged the expe-
diency of increasing the allowance for Native diets. This proposal was warmly supported by
the Deputy Inspector-General of Hospitals, and in transmitting the report to Government,
my predecessor, Dr. Murray, suggested the appointment of a committee to take the whole
question of dieting into careful consideration. A committee was accordingly convened,
(Bengal Government letter No. 3717, dated the 8th November 1870,) consisting of
Mr. Saunders as president, and Drs. Chevers and Payne as members, for this purpose. The
Committee found that the cause of the insufficiency of the allowance for Native diets was
the necessity of largely prescribing stimulants and extras for the very debilitated patients
of this class admitted into the hospital in such numbers. They found, moreover, that, though

Dieting—increase
of allowance.