15

CALCUTTA MEDICAL INSTITUTIONS.

       24. The account which Dr. Ewart gives regarding the advantages gained in a certain
class of cases from the employment of Dieulafoy's pneumatic aspirator, is worthy of notice.
An instrument of this description has recently been supplied to the hospital.

Dieulafoy's pneu-
matic aspirator.

       25. It is very satisfactory to observe that when tested by surgical and puerperal cases,
this hospital is so free from those insalubrious influences commonly indicated by the term hos-
pitalism, which result from the aggregation of a certain class of cases in improperly constructed
and insufficiently ventilated buildings. The results which experience has shown to be due
to these influences, have been for many years painfully manifest in the Medical College Hospital.
Dr. Ewart employs this immunity as one argument for extending the surgical practice of
the hospital. I admit the force of the argument, and recognise the desirability of the pro-
posal; but I am opposed, both for the sake of the patients and the hospital, to locating surgical
cases in the basement rooms of the hospital. If the wards now occupied by the sick of the
regiment of British Infantry stationed in Fort William are added to the General Hospital, the
assignment of a certain number of beds to the class of persons and cases alluded to by the
Surgeon will be in every respect a good measure.

Absence of hospi-
talism.

Proposal for ex-
tending the sur-
gical practice of
the hospital.

       26. Dr. Ewart also proposes that an out-door department should be added to the
hospital. I agree that this would be a great advantage to the sick poor of southern Calcutta;
but if the present staff is employed to the full, an arrangement of this kind would necessitate
an increased staff. On this subject Dr. Ewart will be asked to submit a special report. I
would remark, however, that the Alipore, Bhowanipore, and Aratoon Apear dispensaries
already provide out-door medical and surgical relief for the sick poor of the suburbs of
Bhowanipore, Alipore, and Garden Reach.

An out-door de-
partment pro-
posed.

       27. The Surgeon's remarks on the subject of dieting are important. The dieting of the
sick is obviously the alphabet of hospital management, and too much care cannot be bestowed
upon the subject. Dr. Ewart will be asked to submit a definite proposal regarding the provi-
sion of covered trays or doolies for the purpose of serving the food warm to the patients.
The public contract system evidently works satisfactorily in this hospital.

Dieting

       28. The improvements effected in the manner of disposing of hospital sewage are in
every respect a subject of congratulation, and I hope that ere long the arrangements which
have been during the year under discussion for the purpose of introducing the pure municipal
water into the hospital, and providing for it a system of water sewerage in connection with
the general combined drainage and sewerage of the city, will be satisfactorily completed.

Conservancy.

       29. Surgeon-Major J. P. Brougham, M.D., who had held the office of Surgeon to this
hospital during the previous twelve years with much credit to himself and great benefit to the
community, retired from the service on the 31st of March, and was succeeded by Surgeon
J. Ewart, M.D., under whose able supervision the institution promises to maintain its well
earned popularity.

Changes in the
staff.

       30. The office of Second Assistant Surgeon having become vacant towards the close of
the year 1870 by the appointment of the late Assistant-Surgeon J. Fawcus to the office of
Inspector-General of Jails, it was decided to dissever the superintendence of the Alipore and
Russa jails from the Second Assistant Surgeoncy of the hospital, and constitute the former a
sole and separate charge. As the full salary which had been drawn for the combined duty
was allotted to the Alipore Jail charge, and the Government of India objected to the appoint-
ment of an additional medical officer at the Presidency, it become a question how the
hospital duties could best be provided for. It was finally resolved, after considerable discus-
sion (Bengal Government letters Nos. 1183 and 2399, dated 18th April and 31st July,) to
unite the Second Assistant Surgeoncy of the hospital with the office of Superintendent of the
Presidency Jail. Assistant Surgeon S. C. Mackenzie, M.D., has throughout the year performed
this combined duty, and nothing has occurred to show that it is not the most satisfactory.