the unfortunate battle of Maiwand in which native troops were lost being included.
626
of the
Bombay
The report of the Health Officer for the port of Calcutta for the year 1S81, indicates improvement in the health of the sailors. The number of the European floating population remaining unchanged, the admissions into hospital amounted to 1,709 against 2,005 in 1880, 2,126 in 1879 and 3,292 in 1878. 65 deaths occurred against 49, 61, and 80 in the three preceding years. 33 of these deaths were due to cholera, which was more prevalent than usual in the port as well as the town. The figures for town and port are as follows 1881. 1879. 1880. 1878. 1601 1079 762 1232 Town 25 33 14 29 Port The correspondence in the rise and fall of cholera No case of mortality in town and port is very remarkable. 9 cases of sunstroke were small-pox occurred in 1881, onlywhich no death occurred. admitted into hospital, among Three deaths are said to have arisen from this cause on board ...
...
^
ship. Dr. Lynch points out many sanitary disadvantages under which seamen labour and which go to account for the high death-rate prevailing among them. The foreshore in some taken to remedy these places is filthy; steps are being The accommodation which the sailor has allotted to dcfGcts him is not suited for the tropics his food is bad and his habits on shore too often ruinous to health. A very sensible an awning under which the men suggestion is made to provide rain or mist when driven on from may sleep without danger deck by the stifling atmosphere " of the forecastle. The Lieutenant-Governor believes that the most effective check will be found in the provision on drunkenness and debauchery of places of innocent and healthy recreation to which seamen may resort when on shoie.
Furnell, Sanitary Commissioner
for Madras, lecture on "Water and its effects on " in which he bore the following striking testimony health to the. to the influence which the supply of pure water in diminishing the prevalence town of Madras has exercised Dr. M. C.
recently
MEDICAL TOPICS.
The mortality of the Native Army of India in 1880 amounted to 4M2 per 1000 against 37*79 in 1879, 21*02 in 1878 and 13-38 in 1877 ; the sick rates were somewhat lower than in the preceding year> but these were strikingly and exceptionally high. The cholera death-rate was very low?only 053 per 1000 against 4-Gl, 2-06 and l-53 in the three preceding years. The death-rate of the Madras Army was very moderate?15'57 per mille. The Regular Native Army of Bengal rendered a death-rate of 57'39 including and 33'85 excluding Afghanistan, and the Native Army of Bombay 5697 inclusive and 10*44 exclusive of Afghanistan. The irregular native regiments show better rates, the Punjab Frontier force furnishing a death-rate of 36-74 excluding and 24'03 including Afghanistan, the Central India Regiments of 25'08, and the Hyderabad Contingent of 7-86. From these data it is evident that even if field and service incidents are excluded, the Cantonment of native was
large.
mortality
troops
lamentably
The death roll is as usual mainly made up of fevers, bowel complaints and chest diseases. These last exhibit an unusually high figure owing to the hardship and exposure entailed by field service. The deaths out of hospital are also unusually numerous. These embrace sepoys killed in action,
a
Years*' a^o
when cholera visited Southern India, Madras of its favourite halting places. It numbered here This year, although it was the its victims by thousands. visited it found its old quarters second place in point of time on to other places. It came not so congenial, and passed with Madras from surrounding acrain and again?the traffic it never took firm root ; towns is, of course, so great,?-but the people, at least the mass and the reason I take it is this, drink ordinary tank water, but of the people, now do not this is so laid on that although I use Red Hills water, and often at the taps, the water see men washing themselves cannot run back again and contaminate the rest. cholera was The table you see before you showing how : you will see the distributed in Madras is very which water Hills Red have parts in red ink?the parts written in laid on They suffered very slightly, the parts it was there the black ink have no Red Hills water, and cholera did the most mischief. that of Madras The experience of Calcutta coincides with in a very remarkable manner. "
was
CURRENT
deiivered
one
interesting _
in tijese words : Another case in point is related ? Guntur is another most encouraging instance. Many years centre, as the Fenians would call it, ao-o it was a sort of head the Head Quarters.) The of cholera (Bengal is always there and if you read in the disease was nearly always Report for 1879 the account Sanitary Commissioner's Annual of what went on in the town, ?iven by the Rev. Mr. Unangst at it. Presently there came to the one need not wonder ot the was town Dr Bigg wither who to made Vice-President clem this Augean stable. Municipality. He set to work and Of course, he was strongly opposed, misrepresented is some chronic inevitable law of maligned It seems there and dimes should wish to nature that men in all countries however ; he laid down stone their prophets. He persevered, the roads, lanes, drains and rules as regards cleaning above all he was very houses, clearing away prickly pear; the water supply. I will read what particular ia guarding
136
THE INDIAN MEDICAL GAZETTE.
he says in this point before he came: "No attention was to keep the water in the tanks, reservoirs, and wells clean. When 1 came here in December 1870 I was astonished to see the natives polluting the water supply everywhere, but particularly in the reservoirs." " Here were found people washing their mouths of a morning, spitting the foul-water out of them into the reservoir, washing their soiled cloths, bathing their persons and doing other dirty acts which the authorities ought not to have allowed. The tank banks in the wet, and the beds in the dry weather were converted into privies by people of all classes. The intelligent Brahmin, the ignorant Pariah, the Government official, and the poor cooly were all found defaecating on the banks, and the beds of the tanks which supplied their reservoirs with drinking water. Most of the wells of the town had no parapet walls, and as the natives, especially Komatee and Brahmin women, resorted to them for bathing and washing their soiled linen, all the impurities contained in their persons and in their foul clothing were carried back into the well with the spilled water. During the prevalence of cholera cloths stained with cholera discharges were no doubt washed here, and the water At present the thus poisoned was drunk by thousands. reservoirs and tanks are watched by men appointed by the Municipality to see that no pollution of the kinds enumerated is made by the people who resort to them for water, &c.
paid
What Surgeon Biggwither so well commenced, Dr. Tyrrell, his successor, maintained and extended ; and now what is the result of all these sensible efforts ? Guntur has been free from cholera since 1868?a place mind you, that always suffered when cholera found its way into our Presidency? one of its most congenial haunts. Now, if the cholera were a goddess, as many of your countrymen believe, don't you think she would have settled with these Doctors long ago, for thus interfering with her right and prerogatives 1 She must be a very poor goddess indeed to be beaten by a Doctor. At any rate, if she dees allow herself to be thus beaten, let us go over to the side of the Doctors, or rather to the goddess of cleanliness?that is the goddess I should like to see started. Let us keep our house?, drains and surroundings clean ; above all, let us keep our vater supply uncontaminated and unpolluted, and as far at in us lies, from the possibility of being polluted, and then laving like brave men done all that prudence and common-sense dictates, we can calmly sit down and await the attack of the enemy, in the words of the old " 'Tis not in mortals to command success, play, saying but well do more, Semprouius, we'll deserve it."
Avery interesting ceremony took place on Wednesday, the 19th April, on which tlate the new Eden Hospital for women and children was formtlly opened by the Lieutenant-GoverThis hospital closely adjoins the Medical nor of Bengal. College Hospital, of which it may be considered an adjunct. Its erection is the outcome of a long controversy regarding the best method of improving the condition of the parent institution. On one side it was maintained that the present hospital is unfit owing to faults of construction for the treatment of sick of any kind,?medical, surgical, or obstetric, and it was held that nothing short of abandonment and reconstruction would suffice to remedy its sanitary defects ; the cost of this measure was such as to be absolutely prohibitive. The alternative view was that the hospital under proper and possible sanitary arrangements was well enough suited for the treatment of medical cases, not for surgical and obstetric cases. A minor dispute arose as to which of these classes most needed larger and better accommodation. The improved results obtained under antiseptic management weakened the hands of the advocates for a new surgical hospital, and a scrutiny of fatal cases and comparison with other hospitals proved that the hospital could not be held responsible for more thln a fraction of the septic cases which found in it a fatal ending, and that the statistics of operative surgery were no worse?were indeed in many cases better than those of hospitals constructed in accordance with the most recent sanitary principles. At last it was decided that the most urgent wants were a new hospital for women and children and a set of isolated wards in which infectious surgical cases, such as erysipelas, might be treated. When this decision was arrived at Sir Ashley Eden at once determined to put it into effect, and granted from provincial revenues the funds necessary for its realization. It was very fitting that on the eve of his laying down his satrapy and ?
[May 1,
1882.
leaving India he should bears his
name
be asked to open the hospital which and is now rapidly approaching completion.
The advantages of the new hospital were thus summed up the Lieutenant-Governor in his speech : " We have the new Obstetric Hospital what was wanted ; constructed in accordance with the latest teachings of science, with provision for all the classes who can wish to resort to it, and for the completeness of the building we are indebted to Dr. Charles, who would, I am sure, have rejoiced to see it opened to-day. We shall have a home for sick children which Calcutta has never possessed, and a school for practical midwifery which no training institution can surpass. The appearance, design and arrangements of the building are such that any Government may be justly proud of it. We have a good building, apart from the old for the. reception of the daily crowd of out-patients. We have room for the segregation of infectious cases, and we have a fine separate building for the accommodation of The State thus liberally supplies all the wants of nurses. the institution and its inmates, find it will meet a demand which has lately arisen for nurses in Military Hospitals by training the wives of soldiers in our wards and schools." We hope to give in an early number a full account of the
by
"hospital,
hospital.
His Honor took occasion to say a few words in justification of the hospital policy which he has pursued and which has been the subject in some quarters of so much and so keen adverse criticism. He appeals to the death-rates, the satisfaction of medical officers and to the appreciation of the hospitals by the public as evidence that the policy of economy with efficiency has not resulted in starving the sick or depriving them of any tiling necessary for their comfort and recovery. His remarks were as follows " Concerning the death-rates, we had in the Medical College Hospital, from 1875 to 1877, an average death-rate of 132 per thousand. The average rate of the four years of reform is 122. At the Campbell Hospital the three previous years' average was 252 per thousand ; the average of the four years of reform was 2-15. It cannot be said that the changes were due to improved public health, f?r the late period includes two very unfavourable years, and in the local hospitals untouched by Government the death-rates rose instead of falling. At the Mayo Hospital, for instance, the earlier average wag 121, and the later figure 143. At Howrah the earlier deathrate was 158, and the later 173. At the General Hospital, Calcutta, the expenditure was very largely reduced. The average death-rate of the first three years was 55 per thousand and that of the last four years was 3D. At the Police Hospital also there was a marked reduction of expenditure, and the average death-rate fell to 11 per thousand in the later years from 22 in the former. It is clear from these facts that, 60 far as results of treatment are concerned, the sick have not suffered from anything that has been done. The words that have fallen from the Principal afford better evidence tlxan anything I can say as to whether medical officers have been satisfied with the money provision made. I can only add that the sums were fixed by the officers themno one were most and was invited to selves who concerned, under-estimate his own wants, or likely to do so. At the I have to increase the been throughout same time, prepared provision if it was found desirable. I have taken many the opinions of mediopportunities of ascertaining cal officers on the subject, who have been asked to express them freely, and have done so. No one has even hinted at insufficiency. If at any time indirect complaints have reached me of the quality or cooking of food, they have been made the subject of prompt enquiry ; and if I except those accidents which occur everywhere, or carelessness of servants, corrected as soon as discovered, no rational ground has been found for any complaint. Anonymous complaints in newspapers have been similarly treated, with the result that is common in cases of the kind. I have had full information also through the ladies of the Nurses' Committee of all possible sources of dissatisfaction, so that I must be allowed to speak with some authority on this part of my subject even to those whom I am
personally
addi-essing. The saving of public expenditure of the four hospitals has amounted in the two items of diet and English drugs aloneto one lakh of rupees. Besides this, other charges have fallen and receipts have risen under better management, and pro-
May 1,
1882.]
THE CALCUTTA MEDICAL SOCIETY.
mise to rise still further, so that the saving altogether of public money will not be less than 1J lakhs of rupees, and this has all been saved, not from the genuine service of the sick or any ministration of charity, but from sheer waste and
misapplication.
With regard to the public appreciation of the hospitals, I turn again to facts for my evidence. The wards of the College Hospital are always full, and the total number of housepatients in a year depend greatly on the severity of cases, that is on the duration of detentions. They have been as full The as ever in the last four years,? and could not be more so. out-patient list has steadily increased. This of course shows and other comforts, but it shows nothing with respect to diets abundance of medicine and all other requirements of the kind increased them. demand for with Perhaps the strongest evidence that could be given of the value now attached to the comforts of the hospital is the statement made by the Principal of the increased revenue from paying patients, and the demand for accommodation by that class. It is most satisfactory to notice that among our improvements, and simultaneously with the introduction of hospital economy, our officers have introduced, and are keeping pace with, a new movement which in England aims at making hospitals available for those who are not paupers, but are yet unable to pay for the services of physicians and surgeons of the highest repute.
137
626
of the
Bombay
The report of the Health Officer for the port of Calcutta for the year 1S81, indicates improvement in the health of the sailors. The number of the European floating population remaining unchanged, the admissions into hospital amounted to 1,709 against 2,005 in 1880, 2,126 in 1879 and 3,292 in 1878. 65 deaths occurred against 49, 61, and 80 in the three preceding years. 33 of these deaths were due to cholera, which was more prevalent than usual in the port as well as the town. The figures for town and port are as follows 1881. 1879. 1880. 1878. 1601 1079 762 1232 Town 25 33 14 29 Port The correspondence in the rise and fall of cholera No case of mortality in town and port is very remarkable. 9 cases of sunstroke were small-pox occurred in 1881, onlywhich no death occurred. admitted into hospital, among Three deaths are said to have arisen from this cause on board ...
...
^
ship. Dr. Lynch points out many sanitary disadvantages under which seamen labour and which go to account for the high death-rate prevailing among them. The foreshore in some taken to remedy these places is filthy; steps are being The accommodation which the sailor has allotted to dcfGcts him is not suited for the tropics his food is bad and his habits on shore too often ruinous to health. A very sensible an awning under which the men suggestion is made to provide rain or mist when driven on from may sleep without danger deck by the stifling atmosphere " of the forecastle. The Lieutenant-Governor believes that the most effective check will be found in the provision on drunkenness and debauchery of places of innocent and healthy recreation to which seamen may resort when on shoie.
Furnell, Sanitary Commissioner
for Madras, lecture on "Water and its effects on " in which he bore the following striking testimony health to the. to the influence which the supply of pure water in diminishing the prevalence town of Madras has exercised Dr. M. C.
recently
MEDICAL TOPICS.
The mortality of the Native Army of India in 1880 amounted to 4M2 per 1000 against 37*79 in 1879, 21*02 in 1878 and 13-38 in 1877 ; the sick rates were somewhat lower than in the preceding year> but these were strikingly and exceptionally high. The cholera death-rate was very low?only 053 per 1000 against 4-Gl, 2-06 and l-53 in the three preceding years. The death-rate of the Madras Army was very moderate?15'57 per mille. The Regular Native Army of Bengal rendered a death-rate of 57'39 including and 33'85 excluding Afghanistan, and the Native Army of Bombay 5697 inclusive and 10*44 exclusive of Afghanistan. The irregular native regiments show better rates, the Punjab Frontier force furnishing a death-rate of 36-74 excluding and 24'03 including Afghanistan, the Central India Regiments of 25'08, and the Hyderabad Contingent of 7-86. From these data it is evident that even if field and service incidents are excluded, the Cantonment of native was
large.
mortality
troops
lamentably
The death roll is as usual mainly made up of fevers, bowel complaints and chest diseases. These last exhibit an unusually high figure owing to the hardship and exposure entailed by field service. The deaths out of hospital are also unusually numerous. These embrace sepoys killed in action,
a
Years*' a^o
when cholera visited Southern India, Madras of its favourite halting places. It numbered here This year, although it was the its victims by thousands. visited it found its old quarters second place in point of time on to other places. It came not so congenial, and passed with Madras from surrounding acrain and again?the traffic it never took firm root ; towns is, of course, so great,?-but the people, at least the mass and the reason I take it is this, drink ordinary tank water, but of the people, now do not this is so laid on that although I use Red Hills water, and often at the taps, the water see men washing themselves cannot run back again and contaminate the rest. cholera was The table you see before you showing how : you will see the distributed in Madras is very which water Hills Red have parts in red ink?the parts written in laid on They suffered very slightly, the parts it was there the black ink have no Red Hills water, and cholera did the most mischief. that of Madras The experience of Calcutta coincides with in a very remarkable manner. "
was
CURRENT
deiivered
one
interesting _
in tijese words : Another case in point is related ? Guntur is another most encouraging instance. Many years centre, as the Fenians would call it, ao-o it was a sort of head the Head Quarters.) The of cholera (Bengal is always there and if you read in the disease was nearly always Report for 1879 the account Sanitary Commissioner's Annual of what went on in the town, ?iven by the Rev. Mr. Unangst at it. Presently there came to the one need not wonder ot the was town Dr Bigg wither who to made Vice-President clem this Augean stable. Municipality. He set to work and Of course, he was strongly opposed, misrepresented is some chronic inevitable law of maligned It seems there and dimes should wish to nature that men in all countries however ; he laid down stone their prophets. He persevered, the roads, lanes, drains and rules as regards cleaning above all he was very houses, clearing away prickly pear; the water supply. I will read what particular ia guarding
136
THE INDIAN MEDICAL GAZETTE.
he says in this point before he came: "No attention was to keep the water in the tanks, reservoirs, and wells clean. When 1 came here in December 1870 I was astonished to see the natives polluting the water supply everywhere, but particularly in the reservoirs." " Here were found people washing their mouths of a morning, spitting the foul-water out of them into the reservoir, washing their soiled cloths, bathing their persons and doing other dirty acts which the authorities ought not to have allowed. The tank banks in the wet, and the beds in the dry weather were converted into privies by people of all classes. The intelligent Brahmin, the ignorant Pariah, the Government official, and the poor cooly were all found defaecating on the banks, and the beds of the tanks which supplied their reservoirs with drinking water. Most of the wells of the town had no parapet walls, and as the natives, especially Komatee and Brahmin women, resorted to them for bathing and washing their soiled linen, all the impurities contained in their persons and in their foul clothing were carried back into the well with the spilled water. During the prevalence of cholera cloths stained with cholera discharges were no doubt washed here, and the water At present the thus poisoned was drunk by thousands. reservoirs and tanks are watched by men appointed by the Municipality to see that no pollution of the kinds enumerated is made by the people who resort to them for water, &c.
paid
What Surgeon Biggwither so well commenced, Dr. Tyrrell, his successor, maintained and extended ; and now what is the result of all these sensible efforts ? Guntur has been free from cholera since 1868?a place mind you, that always suffered when cholera found its way into our Presidency? one of its most congenial haunts. Now, if the cholera were a goddess, as many of your countrymen believe, don't you think she would have settled with these Doctors long ago, for thus interfering with her right and prerogatives 1 She must be a very poor goddess indeed to be beaten by a Doctor. At any rate, if she dees allow herself to be thus beaten, let us go over to the side of the Doctors, or rather to the goddess of cleanliness?that is the goddess I should like to see started. Let us keep our house?, drains and surroundings clean ; above all, let us keep our vater supply uncontaminated and unpolluted, and as far at in us lies, from the possibility of being polluted, and then laving like brave men done all that prudence and common-sense dictates, we can calmly sit down and await the attack of the enemy, in the words of the old " 'Tis not in mortals to command success, play, saying but well do more, Semprouius, we'll deserve it."
Avery interesting ceremony took place on Wednesday, the 19th April, on which tlate the new Eden Hospital for women and children was formtlly opened by the Lieutenant-GoverThis hospital closely adjoins the Medical nor of Bengal. College Hospital, of which it may be considered an adjunct. Its erection is the outcome of a long controversy regarding the best method of improving the condition of the parent institution. On one side it was maintained that the present hospital is unfit owing to faults of construction for the treatment of sick of any kind,?medical, surgical, or obstetric, and it was held that nothing short of abandonment and reconstruction would suffice to remedy its sanitary defects ; the cost of this measure was such as to be absolutely prohibitive. The alternative view was that the hospital under proper and possible sanitary arrangements was well enough suited for the treatment of medical cases, not for surgical and obstetric cases. A minor dispute arose as to which of these classes most needed larger and better accommodation. The improved results obtained under antiseptic management weakened the hands of the advocates for a new surgical hospital, and a scrutiny of fatal cases and comparison with other hospitals proved that the hospital could not be held responsible for more thln a fraction of the septic cases which found in it a fatal ending, and that the statistics of operative surgery were no worse?were indeed in many cases better than those of hospitals constructed in accordance with the most recent sanitary principles. At last it was decided that the most urgent wants were a new hospital for women and children and a set of isolated wards in which infectious surgical cases, such as erysipelas, might be treated. When this decision was arrived at Sir Ashley Eden at once determined to put it into effect, and granted from provincial revenues the funds necessary for its realization. It was very fitting that on the eve of his laying down his satrapy and ?
[May 1,
1882.
leaving India he should bears his
name
be asked to open the hospital which and is now rapidly approaching completion.
The advantages of the new hospital were thus summed up the Lieutenant-Governor in his speech : " We have the new Obstetric Hospital what was wanted ; constructed in accordance with the latest teachings of science, with provision for all the classes who can wish to resort to it, and for the completeness of the building we are indebted to Dr. Charles, who would, I am sure, have rejoiced to see it opened to-day. We shall have a home for sick children which Calcutta has never possessed, and a school for practical midwifery which no training institution can surpass. The appearance, design and arrangements of the building are such that any Government may be justly proud of it. We have a good building, apart from the old for the. reception of the daily crowd of out-patients. We have room for the segregation of infectious cases, and we have a fine separate building for the accommodation of The State thus liberally supplies all the wants of nurses. the institution and its inmates, find it will meet a demand which has lately arisen for nurses in Military Hospitals by training the wives of soldiers in our wards and schools." We hope to give in an early number a full account of the
by
"hospital,
hospital.
His Honor took occasion to say a few words in justification of the hospital policy which he has pursued and which has been the subject in some quarters of so much and so keen adverse criticism. He appeals to the death-rates, the satisfaction of medical officers and to the appreciation of the hospitals by the public as evidence that the policy of economy with efficiency has not resulted in starving the sick or depriving them of any tiling necessary for their comfort and recovery. His remarks were as follows " Concerning the death-rates, we had in the Medical College Hospital, from 1875 to 1877, an average death-rate of 132 per thousand. The average rate of the four years of reform is 122. At the Campbell Hospital the three previous years' average was 252 per thousand ; the average of the four years of reform was 2-15. It cannot be said that the changes were due to improved public health, f?r the late period includes two very unfavourable years, and in the local hospitals untouched by Government the death-rates rose instead of falling. At the Mayo Hospital, for instance, the earlier average wag 121, and the later figure 143. At Howrah the earlier deathrate was 158, and the later 173. At the General Hospital, Calcutta, the expenditure was very largely reduced. The average death-rate of the first three years was 55 per thousand and that of the last four years was 3D. At the Police Hospital also there was a marked reduction of expenditure, and the average death-rate fell to 11 per thousand in the later years from 22 in the former. It is clear from these facts that, 60 far as results of treatment are concerned, the sick have not suffered from anything that has been done. The words that have fallen from the Principal afford better evidence tlxan anything I can say as to whether medical officers have been satisfied with the money provision made. I can only add that the sums were fixed by the officers themno one were most and was invited to selves who concerned, under-estimate his own wants, or likely to do so. At the I have to increase the been throughout same time, prepared provision if it was found desirable. I have taken many the opinions of mediopportunities of ascertaining cal officers on the subject, who have been asked to express them freely, and have done so. No one has even hinted at insufficiency. If at any time indirect complaints have reached me of the quality or cooking of food, they have been made the subject of prompt enquiry ; and if I except those accidents which occur everywhere, or carelessness of servants, corrected as soon as discovered, no rational ground has been found for any complaint. Anonymous complaints in newspapers have been similarly treated, with the result that is common in cases of the kind. I have had full information also through the ladies of the Nurses' Committee of all possible sources of dissatisfaction, so that I must be allowed to speak with some authority on this part of my subject even to those whom I am
personally
addi-essing. The saving of public expenditure of the four hospitals has amounted in the two items of diet and English drugs aloneto one lakh of rupees. Besides this, other charges have fallen and receipts have risen under better management, and pro-
May 1,
1882.]
THE CALCUTTA MEDICAL SOCIETY.
mise to rise still further, so that the saving altogether of public money will not be less than 1J lakhs of rupees, and this has all been saved, not from the genuine service of the sick or any ministration of charity, but from sheer waste and
misapplication.
With regard to the public appreciation of the hospitals, I turn again to facts for my evidence. The wards of the College Hospital are always full, and the total number of housepatients in a year depend greatly on the severity of cases, that is on the duration of detentions. They have been as full The as ever in the last four years,? and could not be more so. out-patient list has steadily increased. This of course shows and other comforts, but it shows nothing with respect to diets abundance of medicine and all other requirements of the kind increased them. demand for with Perhaps the strongest evidence that could be given of the value now attached to the comforts of the hospital is the statement made by the Principal of the increased revenue from paying patients, and the demand for accommodation by that class. It is most satisfactory to notice that among our improvements, and simultaneously with the introduction of hospital economy, our officers have introduced, and are keeping pace with, a new movement which in England aims at making hospitals available for those who are not paupers, but are yet unable to pay for the services of physicians and surgeons of the highest repute.
137
