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CHRISTMAS AT THE LONDON HOSPITALS
52 DUNEDIN HOSPITAL. AN important inquiry has just been completed, and a valuable report published, on the sanitary condition of the Dunedin Hospital, New Zealand. In July Dr. Batchelor, one of the medical officers of the hospital, addressed a letter to the trustees
on the subject of two cases upon which he had operated, one of which died and the other made a very slow recovery, results which he believed to be " entirely due to unhealthy hospital influences." The trustees, conceiving that this statement reflected upon their administration of the hospital, though Dr. Batchelor disavowed any such intention, applied to his Excellency the Governor to appoint a commission to inquire into the subject. In compliance with this request Sir James Hector and Mr. E. H. Carew, R. M., were made a very thorough and nominated, and appear to have held nineteen meetings and inquiry, having impartial examined twenty-five witnesses, besides receiving documentary evidence and making a personal inspection of the various wards and offices. Dr. Datchelor and the trustees were each represented by counsel. The building had been erected in 1864 as part of a large group of Government and Parliamentary offices, and was used in 1865 for the New Zealand Exhibition; in 1866 it was The Commissioners after a converted into a hospital. careful inquiry reported that they " were satisfied that the complaints made have been largely supported by the testimony, and that some of the alleged defects are of a serious nature, and require immediate remedy." They have gone at some length into all the details, and have in a very clear and able report stated the grounds on which they based their conclusions. These may be briefly summarised. The site is objectionable, being situated on low ground in the most unhealthy part of the city, and the foreshore of the bay is in a very offensive condition; the original plan of the building was faulty ; the system of ventilation, lighting, and heating imperfect; the floors are much worn and full of open cracks, and were described by a witness as being " as good contrivances as could be got for harbouring germs "; the walls in many of the wards are rough and absorbent, and are periodically coated with whitewash containing size; the wards are overcrowded, and on this point the Commissioners make the following remark: " It was attempted to be shown that in such matters there is a theoretical and a practical standard, but in our opinien this is rot a fair statement of the circumstances. It is rather that the best results cannot be attained in the economical treatment and for the comfort of the patients in a hospital without perfect provision being made, but under some circumstances the administration must be prepared to expect less perfect results, and trust to extra diligence and precautions in the nursing and skilled treatment as a means of preventing epidemics and similar accidents. It is quite fallacious to suppose that there is one successful theory of safety and another successful practice of safety." There is no subsoil drainage of the hospital; the closets are only separated from the ward by double doors, and their ventilation is defective. There are no proper urinals. The baths and lavatories are actually in the wards only separated by a low screen ; there are no special wards for infectious diseases, and no special case rooms ; the kitchen is in the basement, is very unsuitable, and the arrangement for serving the food to the wards is described as "very crude and unsatisfactory"; the accommodation for the nurses is very defective, and there are no convalescent wards for patients. With such a list of defects the Commissioners were fully justified in condemning the hospital as insanitary, and it must be very satisfactory to Dr. Batchelor that the Commissioners state that the proofs from outside evidence " amply support the allegations of his own evidence." The Commissioners recommend the removal of the hospital to a better site; but if it be decided to improve the present building rather than construct a new one, they have made suggestions which would probably have the effect of rendering it more suitable for the purposes of a hospital, more sanitary, and therefore better adapted for the treatment of sick and wounded. We think Dr. Batchelor is entitled to much credit for having brought the subject under the consideration of the authorities, and the hearty thanks of the public of Dunedin and of the Government of New Zealand are due to the Commissioners for the able, exhaustive, and impartial manner in which they carried out the important duty confided to them.
CHRISTMAS AT THE LONDON HOSPITALS UNIVERSITY COLLEUE HOSPITAL. ON New Year’s Eve a Christmas entertainment was given to the patients at this hospital. The wards werevery prettily decorated, and the presents to the patients A glee party visited were numerous and well considered. the various wards, singing in each a number of well-selected pieces. A concert was grven in the consulting room to the convalescent patients. There was a large number of visitors, the centre of interest being the children’s wards. LONDON HOSPITAL. Christmas week has passed very joyously for the patients. of the London Hospital. The resident staff have worked hard with the sisters and nurses to make the poor patients forget their sufferings as far as possible. On Christmas. Day the Committee dinner of roast beef and plum pudding was provided for all to whom the medical men could allow such a privilege. The latter part of the afternoon was. devoted to small entertainments in the separate wards, when magic lanterns, theatricals, and ventriloquism afl’orded great pleasure. The Christmas dinner of the nurses was provided on the 26th, and all appeared happy and bright. The wards throughout the building were most tastefully decorated with evergreens. The Chairman (Mr. E. Murray Ind) made a few remarks to the assembled guests. Amongst the gifts received were a large assortment of toys from Truth and from her Royal Highness Princess Mary of Teck.
WESTMINSTER HOSl’ITAL. At Westminster Hospital Christmas Day was kept as a. day of festivity. The resident medical ollicers, the matron, and the nurses devoted themselves to the entertainment of the patients, who appeared to enjoy themselves very thoroughly. With the sanction of the medical staff the ordinary diet table was suspended, and every patient was provided with a dinner of turkey or chicken, with plum pudding for those able to partake of it. In each ward a Christmas tree was provided, from which the men received a packet of tobacco, the women and children sweets and oranges and tos ; for every patient there were warm, useful articles of clothing. The number of patients in the hospital was 175, and, owing to the kindness of many friends,. ample provision was made for their comfort and happiness ; the presents received this Christmas having been more than usually numerous, and all of them most useful and appro-
priate.
ST. THOMAS’S HOSPITAL. On Christmas Day the patients had the usual dinner of roast beef and plum pudding, with oranges &c. for dessert. The treasurer and his family, with the other resident officers, visited all the wards, distributing cards aud saying a few seasonable words to the inmates. In the evening the carols in nurses the various wards, to the Nightingale sang delight of the patients and officers. On Wednesday evening there was a "tea," with music, and a large Christmas tree covered with presents for the children in Victoria Ward. Next week there will be an entertainment in one of the theatres for the amusement of such of the patients as are able to be moved from the wards, and later on the nurses’ concert in the governors’ hall. ST. GEORGE’S HOSPITAL. At the Convalescent Institution at Wimbledon, in connexion with this hospital, a large Christmas tree was provided through the kindness and liberality of residents in the neighbourhood, a sufficiency of presents being contributed for all the patients (about ninety), and all the A concert has also staff of nurses and servants. been provided to take place on Friday, when the gifts on the tree will be distributed. On Christmas Day the patients at the Convalescent Hospital were all supplied with roast beef and plum pudding &c., and a concert took place in the evening. THE GERMAN HOSPITAL. at the German Hospital, Dalston, annual festival The took place on Boxing Night, when a number of friends and subscribers visited the hospital for the purpose of witnessing the distribution of Christmas presents to the inmates, and a company of about 150 ladies and gentlemen attended the party. At the end of each ward was a monster Chlistmas tree literally covered with lighted candles and sparkling balls and stars of every imaginable colour,
53 The course was attended by and Mr. Frederick Treves. iifty-four practitioners, of whom twelve entered for the full course and forty-two for the special hospitals. The total number of practitioners who entered in the year either for the whole or special courses thus amounted half-a-dozen of the little patients snfliciently convalescent to 121. Of these there were 105 holding British qualito be able to sit at a table and enjoy the multitude of good fications, including five medical officers of the army things that Santa Claus had sent them, whilst three little and one of the navy, two holding Indian qualifications, girls interested the visitors by singing a carol in German. seven colonial and seven American practitioners. Ladies With all the brightness that sympathising friends had been being qualified medical practitioners were admitted to the able to import to the wards, however, the sight was sad, classes at those hospitals of which the medical staff conand brought tears to the eyes of not a few of the visitors. sented to their attendance, and eleven ladies availed themEach ward was separately visited, and a carol having been selves of these opportunities. The total number of lectures sung in German by the nurses and the medical officers, and demonstrations was 221, given by forty-five lecturers, presents of clothing, together with cake and oranges, were nearly all of those belonging to the staffs of the hospitals mentioned. distributed to the adult patients. The committee regarded the number as very satisfactory, considering the novelty of the scheme CITY OF LONDON HOSPITAL FOR DISEASES OF THE CHEST. and the of making its operation widely known. difficulty Christmas Day was spent at this hospital in the usual The committee believed that the instruction and clinical manner. Appropriate Christmas cards, supplied by friends opportunities afforded by the course had been highly 0’f the institution, were distributed amongst the patients. appreciated, and many expressions of satisfaction with The wards were tastefully decorated. A large number of its working and good wishes for its success had reached the patients were able to sit up for dinner, and were regaled them. The recommendation of those who had attended with the customary roast beef and plum pudding, while and profited by the teaching would, they thought, do those in bed were furnished with a dinner of game or much to aid the progress of the scheme. The enlargement poultry. In the afternoon the patients’ friends were ad- of the scheme of instruction by the introduction of other mitted, and in the evening music was provided for the subjects than those included in the original programme A small fund had been was another amusement of all the inmates. point to which the committee desired to draw raised for the nurses and servants. The presents-as far as the attention of the meeting. It was announced that the possible useful ones-were distributed in the course of the lectures at the Bethlem Hospital would be resumed by day. Dr. Percy Smith and Dr. Savage. The committee had PADDINGTON GREEN CHILDREN’S HOSPITAL. also made arrangements for a course of lectures and On Friday there was a magic-lantern display, kindly demonstrations on Diseases of the Throat and Use of the given by Mr. R. Melvill Beachcroft, a Punch-and-Judy Laryngoscope at the London Throat Hospital during the first term of 1891. It was also announced that Mr. Hutchinson’s show, and a Christmas tree. on Diseases of the Skin would be given by permission lectures KING’S COLLEGE HOSPITAL. of the Laboratories Committee in the Lecture Theatre of 1. A Christmas dinner roast beef and plum pudding the Examination Hall of the Royal College of Physicians and the usual Christmas fare—was given to the patient and Royal College of Surgeons. Other subjects had been 2. On Boxing Day a Christmas tea was given, the wards as desirable additions to the course ; and the suggested being illuminated and decorated. The patients thoroughly committee were unable at present to provide instruction in enjoyed the Christmas cheer. Owing to the generosity of these subjects; they regarded the widening of the curriculum many friends, Christmas presents were given, with a good as an object to be kept immediately in view. In conclusion, supply of toys for the children. On the 15bh ult. the the committee expressed their high opinion of the valuable resident medical officers gave their annual Christmas of their secretary, Dr. Fletcher Little. The treaservices tree entertainment to the patients and friends in the surer’s report, stating the expenses, was then read. It was central hall. regarded by the committee as satisfactory and encouraging. On the motion of Mr. Brudenell Carter the report of the committee and the treasurer’s report were approved and LONDON POST-GRADUATE COURSE. adopted. After some further business, and votes of thanks to the president and secretary, the meeting separated. THE annual general meeting was held on Dec. 30th, at 15, Cavendish-square, Mr. Jonathan Hutchinson, F.R.S., LL D., President, in the chair. The report of the Committee of Delegates for the year 1890 was read. The committee reported that during the year three - courses of lectures and demonstrations, each of eight weeks’ duration, had been given. The first course, LOCAL GOVERNMENT DEPARTMENT. ’from Jan. 13th to March 8th, had consisted of seventytwo lectures given at the Hospital for Consumption, REPORTS OF MEDICAL OFFICERS OF HEALTH. Brompton, the Hospital for Sick Children, the Royal West Sussex Combined Districts.-This extensive district London Ophthalmic Hospital, the Hospital for Diseases of the Skin, and the Hospital for the Paralysed and Epileptic, includes four urban and seven rural sanitary districts, which by members of the staff of each hospital. The coarse was taken collectively had during 1889 a general mortality of attended by thirty-three practitioners, of whom nineteen 12-6 per 1000 living, the rates varying from 9’3 in West ’entered for the whole course and fourteen for special hos. Worthing to 17’0 in Arundel. But taking the whole pitals. The second course, from May 5th to June 27th, district the rate was lower than in any previous year. The ,consisted of eighty-eight lectures given at the five original vital statistics are discussed at considerable length by Dr. Charles Kelly, who shows, amongst other things, that the hospitals and two other institutions, the Bethlem Hospital for Lunatics and the Paddington Infirmary. At zymotic rate for the whole area last year reached the lowest the Bethlem Hospital a course of lectures and clinical de- known point-namely, 08 per 1000. Taking the mean monstrations on Mental Diseases were given by the resident zymotic rates far 1880-89, the highest have been : Steyning, .physician, Dr. Percy Smith. At the Infirmary 1-9 ; Thakeham and Arundel, 1’6 ; and Worthing, 1-5. The a course of lectures on Clinical Medicine and Surgery was various meteorological conditions that have prevailed are given by Dr. Broadbent and Mr. J. Hutchinson, and set out in tabular form, as are also records of soil tempesupplemented by pathological demonstrations by Dr. Savill, rature ; and a detailed account of the various sanitary the medical superintendent. This course was attended by circumstances, the prevalences of disease, and the thirty-three practitioners, of whom eleven entered for the sanitary measures adopted is set out as regards each full course and twenty-two for special hospitals. The third sanitary district separately. Amongst the occurrences course, from Oct. 13th to Dec. 6th, consisted of seventy-two of disease deserving attention was an outbreak of diphtheria lectures given at the five original hospitals and at the in the autumn of 1889, which seemed to begin at Pulborough, Paddington Infirmary. The lecturers on Clinical Medicine whilst its chief incidence was in the small parish of West and Surgery at Infirmary were Dr. Bristowe, Chitlington. The people of this locality live chiefly in an Dr. Cheadle, Mr. Jonathan Hutchinson, Mr. R. Harrison, area in which there is much low-lying brook-land, but it was
The fixing of the decorations had to be left
chiefly
to
officers, most of the patients, numbering about 120, being too ill to leave their beds. Special care was bestowed upon the children’s ward, in which there are a number of distressing cases. There were, however, some the
-
____________
Public Health
Royal
Paddington
the Paddington
and
Poor Law.
on the subject of two cases upon which he had operated, one of which died and the other made a very slow recovery, results which he believed to be " entirely due to unhealthy hospital influences." The trustees, conceiving that this statement reflected upon their administration of the hospital, though Dr. Batchelor disavowed any such intention, applied to his Excellency the Governor to appoint a commission to inquire into the subject. In compliance with this request Sir James Hector and Mr. E. H. Carew, R. M., were made a very thorough and nominated, and appear to have held nineteen meetings and inquiry, having impartial examined twenty-five witnesses, besides receiving documentary evidence and making a personal inspection of the various wards and offices. Dr. Datchelor and the trustees were each represented by counsel. The building had been erected in 1864 as part of a large group of Government and Parliamentary offices, and was used in 1865 for the New Zealand Exhibition; in 1866 it was The Commissioners after a converted into a hospital. careful inquiry reported that they " were satisfied that the complaints made have been largely supported by the testimony, and that some of the alleged defects are of a serious nature, and require immediate remedy." They have gone at some length into all the details, and have in a very clear and able report stated the grounds on which they based their conclusions. These may be briefly summarised. The site is objectionable, being situated on low ground in the most unhealthy part of the city, and the foreshore of the bay is in a very offensive condition; the original plan of the building was faulty ; the system of ventilation, lighting, and heating imperfect; the floors are much worn and full of open cracks, and were described by a witness as being " as good contrivances as could be got for harbouring germs "; the walls in many of the wards are rough and absorbent, and are periodically coated with whitewash containing size; the wards are overcrowded, and on this point the Commissioners make the following remark: " It was attempted to be shown that in such matters there is a theoretical and a practical standard, but in our opinien this is rot a fair statement of the circumstances. It is rather that the best results cannot be attained in the economical treatment and for the comfort of the patients in a hospital without perfect provision being made, but under some circumstances the administration must be prepared to expect less perfect results, and trust to extra diligence and precautions in the nursing and skilled treatment as a means of preventing epidemics and similar accidents. It is quite fallacious to suppose that there is one successful theory of safety and another successful practice of safety." There is no subsoil drainage of the hospital; the closets are only separated from the ward by double doors, and their ventilation is defective. There are no proper urinals. The baths and lavatories are actually in the wards only separated by a low screen ; there are no special wards for infectious diseases, and no special case rooms ; the kitchen is in the basement, is very unsuitable, and the arrangement for serving the food to the wards is described as "very crude and unsatisfactory"; the accommodation for the nurses is very defective, and there are no convalescent wards for patients. With such a list of defects the Commissioners were fully justified in condemning the hospital as insanitary, and it must be very satisfactory to Dr. Batchelor that the Commissioners state that the proofs from outside evidence " amply support the allegations of his own evidence." The Commissioners recommend the removal of the hospital to a better site; but if it be decided to improve the present building rather than construct a new one, they have made suggestions which would probably have the effect of rendering it more suitable for the purposes of a hospital, more sanitary, and therefore better adapted for the treatment of sick and wounded. We think Dr. Batchelor is entitled to much credit for having brought the subject under the consideration of the authorities, and the hearty thanks of the public of Dunedin and of the Government of New Zealand are due to the Commissioners for the able, exhaustive, and impartial manner in which they carried out the important duty confided to them.
CHRISTMAS AT THE LONDON HOSPITALS UNIVERSITY COLLEUE HOSPITAL. ON New Year’s Eve a Christmas entertainment was given to the patients at this hospital. The wards werevery prettily decorated, and the presents to the patients A glee party visited were numerous and well considered. the various wards, singing in each a number of well-selected pieces. A concert was grven in the consulting room to the convalescent patients. There was a large number of visitors, the centre of interest being the children’s wards. LONDON HOSPITAL. Christmas week has passed very joyously for the patients. of the London Hospital. The resident staff have worked hard with the sisters and nurses to make the poor patients forget their sufferings as far as possible. On Christmas. Day the Committee dinner of roast beef and plum pudding was provided for all to whom the medical men could allow such a privilege. The latter part of the afternoon was. devoted to small entertainments in the separate wards, when magic lanterns, theatricals, and ventriloquism afl’orded great pleasure. The Christmas dinner of the nurses was provided on the 26th, and all appeared happy and bright. The wards throughout the building were most tastefully decorated with evergreens. The Chairman (Mr. E. Murray Ind) made a few remarks to the assembled guests. Amongst the gifts received were a large assortment of toys from Truth and from her Royal Highness Princess Mary of Teck.
WESTMINSTER HOSl’ITAL. At Westminster Hospital Christmas Day was kept as a. day of festivity. The resident medical ollicers, the matron, and the nurses devoted themselves to the entertainment of the patients, who appeared to enjoy themselves very thoroughly. With the sanction of the medical staff the ordinary diet table was suspended, and every patient was provided with a dinner of turkey or chicken, with plum pudding for those able to partake of it. In each ward a Christmas tree was provided, from which the men received a packet of tobacco, the women and children sweets and oranges and tos ; for every patient there were warm, useful articles of clothing. The number of patients in the hospital was 175, and, owing to the kindness of many friends,. ample provision was made for their comfort and happiness ; the presents received this Christmas having been more than usually numerous, and all of them most useful and appro-
priate.
ST. THOMAS’S HOSPITAL. On Christmas Day the patients had the usual dinner of roast beef and plum pudding, with oranges &c. for dessert. The treasurer and his family, with the other resident officers, visited all the wards, distributing cards aud saying a few seasonable words to the inmates. In the evening the carols in nurses the various wards, to the Nightingale sang delight of the patients and officers. On Wednesday evening there was a "tea," with music, and a large Christmas tree covered with presents for the children in Victoria Ward. Next week there will be an entertainment in one of the theatres for the amusement of such of the patients as are able to be moved from the wards, and later on the nurses’ concert in the governors’ hall. ST. GEORGE’S HOSPITAL. At the Convalescent Institution at Wimbledon, in connexion with this hospital, a large Christmas tree was provided through the kindness and liberality of residents in the neighbourhood, a sufficiency of presents being contributed for all the patients (about ninety), and all the A concert has also staff of nurses and servants. been provided to take place on Friday, when the gifts on the tree will be distributed. On Christmas Day the patients at the Convalescent Hospital were all supplied with roast beef and plum pudding &c., and a concert took place in the evening. THE GERMAN HOSPITAL. at the German Hospital, Dalston, annual festival The took place on Boxing Night, when a number of friends and subscribers visited the hospital for the purpose of witnessing the distribution of Christmas presents to the inmates, and a company of about 150 ladies and gentlemen attended the party. At the end of each ward was a monster Chlistmas tree literally covered with lighted candles and sparkling balls and stars of every imaginable colour,
53 The course was attended by and Mr. Frederick Treves. iifty-four practitioners, of whom twelve entered for the full course and forty-two for the special hospitals. The total number of practitioners who entered in the year either for the whole or special courses thus amounted half-a-dozen of the little patients snfliciently convalescent to 121. Of these there were 105 holding British qualito be able to sit at a table and enjoy the multitude of good fications, including five medical officers of the army things that Santa Claus had sent them, whilst three little and one of the navy, two holding Indian qualifications, girls interested the visitors by singing a carol in German. seven colonial and seven American practitioners. Ladies With all the brightness that sympathising friends had been being qualified medical practitioners were admitted to the able to import to the wards, however, the sight was sad, classes at those hospitals of which the medical staff conand brought tears to the eyes of not a few of the visitors. sented to their attendance, and eleven ladies availed themEach ward was separately visited, and a carol having been selves of these opportunities. The total number of lectures sung in German by the nurses and the medical officers, and demonstrations was 221, given by forty-five lecturers, presents of clothing, together with cake and oranges, were nearly all of those belonging to the staffs of the hospitals mentioned. distributed to the adult patients. The committee regarded the number as very satisfactory, considering the novelty of the scheme CITY OF LONDON HOSPITAL FOR DISEASES OF THE CHEST. and the of making its operation widely known. difficulty Christmas Day was spent at this hospital in the usual The committee believed that the instruction and clinical manner. Appropriate Christmas cards, supplied by friends opportunities afforded by the course had been highly 0’f the institution, were distributed amongst the patients. appreciated, and many expressions of satisfaction with The wards were tastefully decorated. A large number of its working and good wishes for its success had reached the patients were able to sit up for dinner, and were regaled them. The recommendation of those who had attended with the customary roast beef and plum pudding, while and profited by the teaching would, they thought, do those in bed were furnished with a dinner of game or much to aid the progress of the scheme. The enlargement poultry. In the afternoon the patients’ friends were ad- of the scheme of instruction by the introduction of other mitted, and in the evening music was provided for the subjects than those included in the original programme A small fund had been was another amusement of all the inmates. point to which the committee desired to draw raised for the nurses and servants. The presents-as far as the attention of the meeting. It was announced that the possible useful ones-were distributed in the course of the lectures at the Bethlem Hospital would be resumed by day. Dr. Percy Smith and Dr. Savage. The committee had PADDINGTON GREEN CHILDREN’S HOSPITAL. also made arrangements for a course of lectures and On Friday there was a magic-lantern display, kindly demonstrations on Diseases of the Throat and Use of the given by Mr. R. Melvill Beachcroft, a Punch-and-Judy Laryngoscope at the London Throat Hospital during the first term of 1891. It was also announced that Mr. Hutchinson’s show, and a Christmas tree. on Diseases of the Skin would be given by permission lectures KING’S COLLEGE HOSPITAL. of the Laboratories Committee in the Lecture Theatre of 1. A Christmas dinner roast beef and plum pudding the Examination Hall of the Royal College of Physicians and the usual Christmas fare—was given to the patient and Royal College of Surgeons. Other subjects had been 2. On Boxing Day a Christmas tea was given, the wards as desirable additions to the course ; and the suggested being illuminated and decorated. The patients thoroughly committee were unable at present to provide instruction in enjoyed the Christmas cheer. Owing to the generosity of these subjects; they regarded the widening of the curriculum many friends, Christmas presents were given, with a good as an object to be kept immediately in view. In conclusion, supply of toys for the children. On the 15bh ult. the the committee expressed their high opinion of the valuable resident medical officers gave their annual Christmas of their secretary, Dr. Fletcher Little. The treaservices tree entertainment to the patients and friends in the surer’s report, stating the expenses, was then read. It was central hall. regarded by the committee as satisfactory and encouraging. On the motion of Mr. Brudenell Carter the report of the committee and the treasurer’s report were approved and LONDON POST-GRADUATE COURSE. adopted. After some further business, and votes of thanks to the president and secretary, the meeting separated. THE annual general meeting was held on Dec. 30th, at 15, Cavendish-square, Mr. Jonathan Hutchinson, F.R.S., LL D., President, in the chair. The report of the Committee of Delegates for the year 1890 was read. The committee reported that during the year three - courses of lectures and demonstrations, each of eight weeks’ duration, had been given. The first course, LOCAL GOVERNMENT DEPARTMENT. ’from Jan. 13th to March 8th, had consisted of seventytwo lectures given at the Hospital for Consumption, REPORTS OF MEDICAL OFFICERS OF HEALTH. Brompton, the Hospital for Sick Children, the Royal West Sussex Combined Districts.-This extensive district London Ophthalmic Hospital, the Hospital for Diseases of the Skin, and the Hospital for the Paralysed and Epileptic, includes four urban and seven rural sanitary districts, which by members of the staff of each hospital. The coarse was taken collectively had during 1889 a general mortality of attended by thirty-three practitioners, of whom nineteen 12-6 per 1000 living, the rates varying from 9’3 in West ’entered for the whole course and fourteen for special hos. Worthing to 17’0 in Arundel. But taking the whole pitals. The second course, from May 5th to June 27th, district the rate was lower than in any previous year. The ,consisted of eighty-eight lectures given at the five original vital statistics are discussed at considerable length by Dr. Charles Kelly, who shows, amongst other things, that the hospitals and two other institutions, the Bethlem Hospital for Lunatics and the Paddington Infirmary. At zymotic rate for the whole area last year reached the lowest the Bethlem Hospital a course of lectures and clinical de- known point-namely, 08 per 1000. Taking the mean monstrations on Mental Diseases were given by the resident zymotic rates far 1880-89, the highest have been : Steyning, .physician, Dr. Percy Smith. At the Infirmary 1-9 ; Thakeham and Arundel, 1’6 ; and Worthing, 1-5. The a course of lectures on Clinical Medicine and Surgery was various meteorological conditions that have prevailed are given by Dr. Broadbent and Mr. J. Hutchinson, and set out in tabular form, as are also records of soil tempesupplemented by pathological demonstrations by Dr. Savill, rature ; and a detailed account of the various sanitary the medical superintendent. This course was attended by circumstances, the prevalences of disease, and the thirty-three practitioners, of whom eleven entered for the sanitary measures adopted is set out as regards each full course and twenty-two for special hospitals. The third sanitary district separately. Amongst the occurrences course, from Oct. 13th to Dec. 6th, consisted of seventy-two of disease deserving attention was an outbreak of diphtheria lectures given at the five original hospitals and at the in the autumn of 1889, which seemed to begin at Pulborough, Paddington Infirmary. The lecturers on Clinical Medicine whilst its chief incidence was in the small parish of West and Surgery at Infirmary were Dr. Bristowe, Chitlington. The people of this locality live chiefly in an Dr. Cheadle, Mr. Jonathan Hutchinson, Mr. R. Harrison, area in which there is much low-lying brook-land, but it was
The fixing of the decorations had to be left
chiefly
to
officers, most of the patients, numbering about 120, being too ill to leave their beds. Special care was bestowed upon the children’s ward, in which there are a number of distressing cases. There were, however, some the
-
____________
Public Health
Royal
Paddington
the Paddington
and
Poor Law.