9
CALCUTTA MEDICAL INSTITUTIONS.
it showed very good results." The Committee proceeded to enquire how
the hospital had acquired its bad repute, and found that it was due to the
fact that the conditions known as "hospitalism" had never been absent from the
place, and, as no other cause could be found for this, it was laid upon the con
-
struction of the hospital. The construction had not been in accordance with
the latest doctrines in one respect. Its wards, or rather the lofty, spacious halls,
which the patients occupy, were built with one end, and not with the broad
-
side, to the wind. The hospital had been therefore condemned as causing the
death of many surgical patients, who were supposed to have come from the
midst of filth from inhaling miasms and stenches of every kind, to be poisoned
by the air of a palace, in which each man occupied more space than a large
family of his class would have in their close damp hut at home. It would
have been no matter for surprise if a large majority of the natives received
into the College Hospital had been unable to bear operation, but facts proved
the contrary of this. The enquiry was very minute. Operations in general,
and test cases in particular, showed that "statistics of the hospital had com
-
pared very favourably with the results of English and foreign practice;" and the
Committee, after giving exact figures, observed:—"These are surprising results
for a hospital supposed to be so deadly to its patients, and it seems to the
Committee that in the face of them, and the generally favourable results after
primary amputations, it can hardly be maintained that the hospital is unfit for
the treatment of surgical disease."
17. Still the fact remained that hospital diseases did present themselves,
and the relation between disease imported from outside and that contracted in
the wards was carefully examined. The prevalence of the former was an ascer
-
tained fact from which the best hospitals in Europe were shown to afford
no protection to patients who had lived outside in conditions calculated to pro
-
duce it. Dr. McConnell analysed 30 cases of hospitalism in the College Hospital,
and found that 14 of them had originated outside. It was observed, also, that
while the hospital itself had heen singularly free from puerperal fever, the
disease had been frequent in the town. Dr. McConnell subsequently extended
his enquiry, and showed that the above figures were below the truth. He
analysed all the post-mortem records of six years, and found that of 64 cases of
alleged hospitalism, no less than 41 had been imported, that is, the patients
had been admitted with some form of putrefactive disorganisation already
existing. With regard to the ventilation of the wards, the Committee could find
no evidence that beds placed to leeward had yielded more cases of traumatic
affection than the windward beds. There was a general impression that they
h a d d o n e s o ; b u t t h i s wa s a n a t u r a l o u t c o me o f t h e wi n d t h e o r y , a n d i t wa s
remarked that while the supposed defect had been constant, hospitalism had
varied enormously from year to year. Dr. Lawrie, who had been Resident Sur
-
geon for five years, stated his belief that in no instance had hospital disease been
communicated from one patient to another.
18. The Committee were bound to conclude that there was no case against
the hospital on the broad question of construction, but they found some impor
-
tant defects, which could be removed or corrected. The means of segregating
dangerous cases were quite insufficient. Space was inadequate to meet the
demands on t he hospi t al . The work of a l arge out -pat i ent depart ment was done
on the ground floor, and the obstetric wards were under one roof with
the rest. Recommendations were made for improvements in all these
respects. The Hospital Surgeons "agreed generally with the conclusions of the
Committee, and thought that the improvements would make the hospital fairly
adapted to the treatment of surgical diseases, provided strict rules were enforced
to prevent overcrowding."
19. The Governments of Bengal and of India were satisfied of the
soundness of the views expressed, and the recommendations were approved.
Since that time much has been done towards carrying out the proposed
changes. The out-patient department has now a separate building at some
distance from the hospital. A fine obstetric hospital has been built at a
longer but not inconvenient distance, and within a few weeks it will be
occupied. A portion of the old obstetric ward will be available to the
Physicians and Surgeons, and will supply the space and means of segregation
B