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altar of popular enthusiasm, yearly vie in a Homeric struggle suitable to their wind and
The Prize Distribution has been fixed for June 26th. The presentations will be at the hands of Mr. Rider Haggard, and the official portion of the programme commences at 3 p.m. A band will be in attendance in one of the quads. (or should it be courts?); there will be "tea on the terrace," and the Hospital and Medical School will be thrown open for the general inspection.
We publish in this month's Gazette the conclusion of Dr. Mott's paper on "Alcohol and Insanity." We have to acknowledge his courtesy for the permission so afforded, and also his kindness in allowing us to make use of his beautiful microphotographic illustrations of the changes detectable in the central nervous system in cases of alcholic polyneuritic psychosis. These, together with his appended descriptive account, form a most valuable addition to the paper.
A word of explanation, perhaps, is due to account for the sudden alteration in the external appearance of the Gazette-this has been occasioned by a change in the arrangements for its production. During the last few years the printing and general style have left nothing to be desired, but with a necessarily limited circulation it was felt that a new move in the nature of financial reorganisation had become imperative. Every effort will be made to produce the remaining numbers of this year's issue in entire conformity with those that have already been published.
The third round of the Golf Competition has now been concluded without any outbursts of superlative excitement. In Cricket, the first eleven record so far stands won 3, lost 2, drawn 1. The Tennis VI have not been altogether happy in their choice of results; perhaps they have not been fully represented. The Rifle Club appears to be going strong.
A former servant in the Department of Morbid Anatomy, now enjoying a pension, was widely known under the soubriquet of "Punch." The Postmaster-General wishes to know to whom he transmitted his title, as a telegram despatched on May 22nd to "Punch,' St. Thomas's Hospital," could not be delivered. The addressee apparently has a friend of the same name at Petersfield.
The following is an extract from a letter from Dr. J. L. Prain (H.S. in 1896), who nearly lost his life in the recent earthquake in Chile':-Valparaiso, Chile, S.A.--I have tried several times to draw a verbal picture of our experiences, but it has on each occasion ended in a ghastly failure, and so I am not going to try it again. Men have been known to juggle with words and become famous as poets, etc., and men have juggled with harmony and live on in our memories as musicians, but I refuse to believe that the man lives (or has lived) with the power of describing a bad earthquake!!! In the first place, terror fortunately dazes one's senses, and only after a lapse of time can one begin to realise all one went through, heard, and saw. This fact alone is a stumbling block to giving a description such as would convey to your mind (or anybody's) the awful hideousness of an earthquake of the greatest magnitude. My fate, I consider, was very hard. Only about 20 months before I had taken charge of the English Hospital, and all my energy, work, etc., had been spent in getting it into first-rate order. I wished the place to be the best here, and by these means repay myself for all my toil and expense. Things were going famously. I had a new operating room (quite as good as yours, I guess, except for the flooring, as I could not afford such a luxury as those Thomasian stone floors). I had new baths, new dispensary, new pantries, new kitchen, and was almost one-quarter the way through the renovation of the wards, when in a few brief seconds (that seemed hours) the whole place is broken up. I had at that time 18 patients on the premises, and 'tis God's mercy alone that forbade their deaths. I had the day before the earthquake taken in an acute mania case, and was at the moment interviewing the friends when the shake began. We tried to get out of the building, but we could not at first get the door open. Rats in a trap thought we! However, we eventually got out, the friends rushing off hatless to look for their own kith and kin, and I to see after my patients. I had not got very far before I was knocked off my feet, and then decided to turn the gas off at the meter. Easier said than done. I was on my hands and knees digging to find the key which was buried beneath bricks, dust, mud, coals, etc., when one of my boys (male nurses) hurried up, and between us (still digging as the dog does) we eventually found the key. Then we found that
the gas pipes had been bent and the gas could not be turned off. Then I had to bring brute force to bear on the pipes, and succeeded to the extent of cutting off the gas. The hospital was now in darkness.
I now started after my patients, having ascertained that 16 had been accounted for by the nurses meanwhile (14 of them had decamped on their own"), and two more still missing. I found the 17th (a boy whose toes I had amputated—all his toes except one), and managed to carry him out, having in the meanwhile almost been thrown into the open court in the middle of the hospital building. The banister was broken against my arm by the force of the impact, but thanks to carrying him I kept my feet. Having got him out, I returned by myself to look for the last, but never found him; at last I got out myself with a prayer of gratitude on my lips after the terrible experience I had gone through. The missing patient had, it appears, rushed for an exit in the dark, but as the walls had fallen out, the floor was no longer level but on the slant. Much to his astonishment he had (involuntarily) assumed a sitting position (with a huge proportion of "bump" in it), and thus slid out into the garden, falling on the debris of the wall. Curious way of getting out of a building where there was a brick wall two or three minutes before, is it not? That's how we manage things in Chile! In England you would have had to get out by the door, or not at all, so you see we are ahead of you in some respects. As none of us dared to go into the building again we spent the rest of the night in the garden in the rain. My lunatic escaped, but (unfortunately) turned up the next day, and before I got him to the asylum he led me "the devil of a dance."
The Treasurer's Report.
HE Treasurer's report for the year ending 1906 has just been issued. The report is largely a financial statement for the past year, but it also details information as to the number of patients treated within the Hospital, and the number of out-patients and of casualty patients during the same period, together with other statistics of a similar nature. We shall not attempt to submit the report to a general review, but at the same time we think that a brief summary of its leading features will not be without its interest.
For the reception of ordinary patients 531 beds were available throughout the year. If to these be added the 30 Victoria beds (which were not used last year) and the 42 beds available for paying patients in the Home, we arrive at a grand total of 603 beds.
Of the 531 ordinary beds, only 150 are appropriated for the use of purely medical (adult) cases. The corresponding number on the surgical side is 232! And yet, the number of medical beds is from time to time still further reduced by the habit of retaining post-operation cases on the medical side instead of transferring them automatically. The average daily number of patients in the Hospital was 475: this is the highest number on record. Their average duration of stay was 26-2 days, the same as last year, and a slight increase on the four previous years. The total Hospital mortality for the year works out at 10 per cent.
With regard to the monetary side of the question, the ordinary income during the year amounted to £51,588, of which only £1,615 is accounted for by subscriptions, donations, and the contribution of the Hospital Saturday Fund (£180). In addition to this the legacies during the year totalled a value of £11,000, which is slightly in excess of the average.
The total cost (calculated on the average daily number of patients, 475, and the ordinary expenditure, £56,627) comes to just about £119 a bed. This sum of course includes the cost of the out-patient department as well, and is a reduction of £18 a bed since 1904. It is useless to give here the statistics of other London institutions similar to our own, as the calculations of no two hospitals can be regarded as strictly comparable.
During the year two more beds were endowed at a cost of £1,000 a piece—one in Charity, the Clara bed, and the other in Clayton, the Croft bed, in memory of the late Surgeon to the Hospital.
Rates and taxes cost the Hospital £2,600, and we believe this sum is about to be still further increased.
Victoria awaits the commencement of the policy of the open door, and the two wards which up to January of this year constituted the
Home are also available for use as general wards. So that, were the money for their maintenance forthcoming, instead of 531 beds for general use 621 beds might be so utilised. We might point out that the removal of the existing call on the Hospital funds for rates, etc., would in itself be almost sufficient to provide the necessary outlay in this respect for the entire year.
The report also furnishes a table of the Hospital dietary, revised to April, 1907. This does not differ markedly from the one published in the Hospital Pharmacopoeia. Fever diets are unaltered. The exact weight of the meat and fish allowed to the patient in the dinners for the full and fish diets respectively is now definitely specified, similarly the amount of milk for breakfast or supper. Batter and suet disappear from the "full" dinner, and gruel once again finds a place as one of the supper events.
Quite recently an old printed copy of a dietary of the Hospital, of unknown date, came unexpectedly to hand. In those days the cheese and beer combination was evidently in great demand. We print this diet sheet in full :
Breakfast.-Milk Porridge 4 Days, Water Gruel 3 Days.
Dinner.-Three Days lb. boil'd Mutton, and two Days Beef; the other two Days 4 oz. Butter, or 6 oz. Cheese.
Supper.-Broth one Pint, on Meat Days.
Bread 14 Oz., Beer 1 Quart in Winter, and 3 Pints in Summer.
MIDDLE OR LOW DIET.
Breakfast.-Milk Porridge 4 Days, Water-Gruel 3 Days.
Dinner. Six Oz. of Mutton or Veal five Days, the other two Days as above, viz., Cheese or Butter.
Supper.-Milk Porridge 4 Days, Water-Gruel 3 Days.
Bread 12 Oz., Beer 1 Quart.
Breakfast.-Milk Porridge 4 Days, Water Gruel 3 Days.
Dinner.-1 Pint Rice Milk, or 8 Oz. of Pudding (if possible) three Days.
Drink one-part Milk and two Water; a Quart in Winter, three
Breakfast.-2 Oz. Cheese, or 2 Oz. Butter.
Dinner.—The same as the Full Diet, Till it can be determined about pudding. Supper.-2 Oz. Cheese, or 2 Oz. Butter.
5 Sea-Biscuits or Bread.
Beer 1 Quart a Day.
Barley Water, Water-Gruel, Panado, thin Broth, Milk Porridge, Rice Gruel, Balm or Sage Tea, when ordered.