55
PRESIDENCY GENERAL HOSPITAL.
During my connection with the hospital I have been much struck with the kind
manner in which wounds heal both after accident and operation, and also at the singular
freedom we have enjoyed from hospitalism, pyæmia, osteomyelitis, tetanus, &c., which
immunity may be attributed to the airy and well ventilated condition of my wards, in which
most of the operations have been treated. The general or comparative healthiness of the
hospital, though by no means a good one according to modern views, may perhaps he
admitted as an additional plea in justification of my reiterating the proposal for the institution
of a few beds for the treatment of native surgical cases.
Midwifery.—During the past year there have been fifteen deliveries, all of which have
been successful, including the one remaining over at the end of the year. Like surgical
diseases, parturition is a condition which forms a good test of the general healthiness of a
hospital. We have not had a single instance of septic disease complicating the parturient
state, and this, too, notwithstanding the fact that in most of the deliveries the women have
been anæmic and below par. In one case the woman had the most profuse flooding I ever
witnessed consistent with ultimate recovery. She remained a long time in a blanched condi-
tion with tendency to fainting, and frequent recurrence of distressing palpitation, and had to
be kept upwards of a couple of months in the recumbent position with her head lower than
her trunk. She is now in robust health.
Absence of hospi-
talism.
Dieting.—A very large proportion of our patients, especially of those drawn from the
mercantile marine, are, when admitted, tainted with scurvy, or at least a scorbutic condition
of the blood, as indicated by a sponginess, recession, and bleeding of the gums. I confess I
was not sufficiently alive to this state of things in two operations I performed for the radical
cure of inguinal hernia, both of which failed, although they seemed to be cases affording
full promise of success. The cause of failure was a scorbutic state of the blood with spongy
and bleeding gums. This was corrected. A second operation in each case subsequently
proved quite successful.
The dieting of the sick is now conducted by the Surgeon of the hospital under the
Deputy Inspector-General and the Inspector-General of Hospitals. All articles of diet are
regularly supplied by contract, and the contracts are so framed as to give the Surgeon suffi-
cient power to enforce the supply of good, wholesome, and nutritious food, with a minimum
of trouble. The Surgeon of the hospital is now vested with power under this system to feed
the sick much better than they ever could have been fed under the old arrangements, and I
cannot help thinking that this improved state of things must have had something to say to the
reduction of mortality.
Next to the provision of good food for the sick comes cooking. This has received
unremitting attention. Considerable improvement has followed the introduction of the new
cooking apparatus ; but until we are provided with large covered trays for the transport
of the food from the kitchen to the patients before it grows cold, there will still be room
for complaint and dissatisfaction. When the contracts for 1872-73 are completed I purpose
rectifying this defect. The patients have very seldom complained of the quality of the
food ; but they have repeatedly reported that it has been served up to them cold. Every
available device has been adopted to mitigate this just cause of complaint, but it will be
impossible to remove it entirely until large trays are provided, on which the diets can be
transported in large numbers from the cook-room to the wards without any avoidable delay.
The use of appropriate therapeutical means is an important aid to the cure of disease : these
are powerless unless good nourishing food be also allowed, and this to be advantageous to
the highest degree attainable, must not only be well cooked but served up to the sick, warm
and in the most attractive and palatable form practicable.
Sanitary .—One of the principal improvements under this heading has been the change
in the destination of the night-soil and urine. Prior to the transfer of the hospital from
the military to the civil department, the filth was daily carted away by the Garrison
Dieting.
System of supply.
Cooking.
Improvement sug-
gested.
Sanitation.
Disposal of exereta.