Sessional_Paper_1898 — Page 413

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At my morning visit I examine all new cases in the Receiving Ward, deal with all dead bodies in the Mortuary, and carefully inspect the whole hospital. At my afternoon visit I give attention chiefly to new admissions and dead bodies, and to any special matters that may have arisen during the interval, occasionally timing my visit so as to be able to inspect the food supplied to the patients at their afternoon meal.

THE RECEIVING WARD AND THE MORTUARY.

Each patient is on admission asked by a head coolie whether he prefers Chinese or Western treat- ment, it being explained that the latter will be carried out by a Chinaman, Dr. CHUNG. Having made his choice, he is temporarily treated in the Receiving Ward by the doctor under whose care he is to be, until the time of my visit. In that ward every case is examined and diagnosed by Dr. CHUNG, whether to be treated by himself or not, and at my own visit I confirm or modify his diagnosis before it is entered on the register. Cases of pronounced Small-pox, Bubonic Plague, etc. Dr. CHUNG sends on without delay to Kennedy Town Hospital. Suspicions cases are isolated by means of screens in a corner of the ward until I see them. After my visit all cases are removed to ap- propriate wards, such diseases as septicemia, erysipelas, etc.. being isolated in some of the Ko Fong small wards, and not being admitted to the general wards. When an infectious case has been in the Receiving Ward, efficient means are adopted to disinfect the ward after its removal.

In the Mortuary as in the Receiving Ward I reconsider Dr. CHUNG's reports regarding all cases. In the case of persons who die in the Hospital, there is the diagnosis made during life to go upon in arriving at an opinion as to the cause of death. In the case of bodies brought to the Hospital Mortuary already dead, the standing order is that the friends shall be retained until they have been interviewed by Dr. CHUNG, and delivery of a dead body is not taken by those in charge of the Mortuary until this has been done. He examines and cross-examines them as to the symptoms and duration of the ill- ness that preceded death, and reports to myself; and as a general rule one can from such report, together with a consideration of the appearance of the body arrive at a fairly accurate idea as to the cause of death for purposes of the Hon. Registrar-General's statistics. If the case seem obscure, Dr. CHUNG requests the friends of the dead person to return about the usual time of my next visit to be further cross-questioned by myself regarding the circumstances preceding death. On account of the very strong prejudices the Chinese entertain against any interference with the dead body, I have acted on the policy of making as few post-mortem sections as possible, limiting such internal examinations to specially obscure cases, cases accompanied by suspicious circumstances, and cases in which the in- terests of the public health or the order of the Coroner left no alternative.

The arrangements for the burial of the dead are sufficient and satisfactory, and I have sought to have them carried out with due respect for the dead.

THE HOSPITal Buildings.

Two new wards have been built on the site of certain of the Ko Fong wards next to the Mortuary, and have been used as Surgical Wards since they were opened in April. This set free the two ground floor wards of the North Block, which, being somewhat shut in by other buildings and dimly lighted, were less suitable for purposes of ordinary treatment, to be used for the accommodation of destitutes and certain chronic and incurable cases that being without relatives or means of support cannot be got rid of. The ventilation of these destitute wards has been improved by the cutting of several openings in a wooden partition on the side next the gateway, and by substituting bamboo blinds for a fixed wooden venetian screen which formerly completely closed in the verandah of these wards on the east side.

The housing of destitutes is a not unimportant part of the work of the Tung Wa Hospital. Ship-wrecked sailors and fishermen picked up at sea, poor Chinese making their way back to their native districts from the Straits Settlements and elsewhere, outcasts found in the streets by the police, find here a shelter and food until the Directors are able to arrange for their being handed to their friends or transferred to their own villages on the mainland.

I have re-measured all the wards in the Hospital, and limited the number of patients in each to allow a minimum of 800 cubic feet per patient, counting only twelve feet of the height. If the whole height to the roof be taken into account, the space allowance per patient is in some of the wards con- siderably greater. The number of patients permitted is painted on a board at the door of each ward, and is never under any circumstances exceeded, except occasionally in the wards for destitutes when an unusually large number have been sent in.

Formerly no classification of diseases was attempted, excepting the crude Chinese separation of external diseases from internal diseases, but the Directors readily consented to my suggestion that the various wards should be devoted to the accommodation of patients suffering from special classes of disease. The re-arrangement was made in March, and now, while overflow is necessarily permitted from one ward to another when occasion requires it, the general plan of the Hospital is as follows:---

West Block :

First Floor,

Ground Floor,

Name of Ward.

Beds.

Fuk

15

Shau

15

·

Hong

15

Ning

15

Diseases.

Malarial Fevers. Lung Diseases.

Diarrhoea and Dysentery. General Medical Cases.