CALCUTTA MEDICAL INSTITUTIONS.
1892, the fall being due to fewer instruments being required. The whole cost,
except Rs. 231-6-8 received as interest, was borne by the Calcutta Municipality.
70. Howrah General H ospital —treated 6 fewer in and 2.31 more out-patients
daily than in 1892. Its total expenditure, Rs. 26,564-3-8, was Rs. 2,327-11-5
less, and the cost to Government Rs. 622-1-6 less. The decrease was mainly
due to a diminished expenditure on diets Rs. 1,851-15-11, medicines Rs. 234-10-6
and miscellaneous charges Rs. 642-5-3, owing to their being fewer European
and paying patients and to lessened cost of clothing. There was a n increase
31
Rs. A. P.
Howrah Municipality ... 3,600 0 0
Interest on investments
936 3 0
Subscriptions, European 7,154 6 0
Ditto, Native ... 100 0 0
From paying patients ... 3,867 8 0
From Port Funds
13,260 0 0
28,918 1 0
of Rs. 641-7-1 for repairs. The income from
local sources was as given in the margin. The
European subscriptions were Rs. 2,564-12-11
less than in 1892, but the receipts for that
year were swollen by the proceeds of a concert.
Receipts from ordinary paying patients fell
by Rs. 282-8, owing to fewer patients, but those
from the Port Trust for the board of sick
seamen rose by Rs. 7,104. The percentage to total cost borne by Government
fell from 17.02 to 16.17. Rupees 3,000 were invested during the year,
the capital now standing at Rs. 27,000, and the cash balance was increased by
Rs. 3,650-6-2.
The Howrah Hospital is the most nearly self-supporting of the Calcutta
medical institutions, and great credit is due to successive Civil Surgeons of
Howrah, who have laboured gratuitously in its interests for years. The
Superintendent points out that while it is most liberally supported by the Euro-
pean community, both of Calcutta and Howrah, natives of this country give
practically nothing, though the native department of the institution is a very
heavy strain on its resources. This department costs about Rs. 750 a month,
yet the municipality, which has an income of Rs. 2,73,957-6-5, more than half
of which is paid by Europeans, and which keeps up or subscribes to no other
medical charity, gives only Rs. 300 a month.
71. Several of the institutions were inspected by Surgeon-Colonel Pilcher,
and all by myself. All are doing good useful work and are carefully managed.
There is, however, considerable scope for future improvement, especially in the
direction of more numerous dispensaries. This has been recognized, a new
dispensary has been opened at Chitpur by the Cossipore-Chitpur Municipality,
and plans for a South Calcutta Hospital at Bhawanipur are in preparation.
It is no matter of congratulation that the Chandney Hospital treats 313 out-
patients daily. This gives 156 to each of the two medical officers, far more
than they can do proper justice to. Giving five minutes to each patient, it
would represent 13 hours' work. Of course all patients do not require five
minutes, but many require much more if their cases are to be properly diagnosed
and followed, and with hundreds waiting their turn, a loose and perfunctory
method is apt to be acquired. I hope that one result of an increased number
of dispensaries may be to decrease the numbers at those now at work, but so far
this result has not been observed.
There has been very marked progress of recent years in the general
efficiency of the Calcutta medical institutions. The work has been better
done, material improvements have been everywhere introduced, the comfort
of the patients has been improved, the death-rate lowered, and the cost
both to Government and in total has diminished. Since 1877, for instance,
to take the year before Sir Ashley Eden's Hospital Committee sat—Chuni
Lal Seal's Dispensary, the Eden, Ezra, and Shama Charn Law's Hospitals
—all involving additional establishment and large periodical expenditure for
repairs—have been added to the list, while only the North Suburban Hospital,
the Alipore and Aratoon Apcar Dispensary—all institutions of comparatively
trifling importance—have been removed. The number of cases treated has
probably increased, but as the average daily attendance is not given in the
report for 1877, it is difficult to be sure. There were 25,358 in-patients in
1877 against 26,058 in 1893, and nominally 300,204 out-patients against
252,059. The records are, however, much more carefully kept now than then,
and there is less tendency to count " attendances " as " patients." The total
expenditure was Rs. 4,76,901-14-1, instead of Rs. 5,09,337-7-6, a decrease of