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in a few instances, there was room for improvement. This is specially
the case in the civil hospital at Kurrachee. This hospital being situated
in the largest and most important town in Sind, is the one of all others
where it would be natural to expect that everything connected with
it might be held up as a model of administration, discipline, order, and
efficiency. I regret to say that my knowledge of it leads to a some-
what different conclusion. A reference to the table . of admissions,
which is generally a fair test of the amount of work performed, and
the estimation in which an hospital or dispensary is held by the
natives, is disappointing. They are less than half the numbers
shown in the civil hospital at Haidarabad. In making this statement
I do not forget that at Haidarabad there is no separate dispensary to
carry off patients as there is at Kurrachee; but taking the popu
-lation of the two places, Haidarabad at 40,000 and Kurrachee at 80,000,
and deducting the 12,308 admissions at the Kurrachee dispen
-sary, the total of in-door and out-door patients, excluding the Police
treated at this hospital, amounting to 7,180, are very few compared
with similar totals for the same period at Haidarabad, which number
15,034. Even to non-professional eyes the contrast must be strik
-ing ; but when matters below the surface are looked into the
explanation is not difficult. Had the medical officer in charge
bestowed the time and attention on the various duties and details
necessarily belonging to an institution of this magnitude and
importance, I cannot help thinking that the results would have been
different. But when visits are often hurried and superficial, when
orders given are imperfectly carried out, when unbounded but mis
-placed confidence is reposed in the apothecary, whose only aim
seems to have been the securing of his own private interests, when,
in short, supervision is lax, and interest in the thorough and efficient
working of the establishment is not the centre from which the whole
surroundings should be influenced, the machine speedily gets out of
order, works heavily, and the results are unsatisfactory.
19. From this view it is pleasant to examine the working of a
similar hospital—the one at Haidarabad. Here at every turn there
is evidence not only of a well educated and intelligent Surgeon (Dr.
Holmested), but of a hard-working and painstaking man, who, by
spending several hours daily in his hospital, thoroughly going into
every detail in succession, not merely ordering matters to be done,
but seeing his orders carried out, and thus by his own example
keeping every subordinate up to the mark, renders his hospital and
everything connected with it a model of excellence, and causes his
aid and advice to be sought after by the natives for miles around.
What volumes does not the following fact disclose. In the Kurrachee
hospital during the past official year there have been, excluding
the ordinary minor ones, only 8 operations of surgical importance,
whereas in the Haidarabad one, for the same period, there have been
84 of a like nature.
20. The civil hospital at Kotri has suffered from the frequent
changes of its medical officers. No fewer than three have been in