7

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says that the attack from which he found her suffering was so acute that it must have been of very recent origin, and the question is therefore whether she must have been at the time of her leaving the Hospital in such a state that ordinary care and observation on the part of the doctor or nurse could not fail to reveal the fact that a serious attack of illness was even then coming on. I cannot say that the evidence on the whole convinces me that this must have been the case, although, had she been discharged without or against her own concurrence and desire, I should have thought it culpable negligence to omit a careful examination. But it would be going too far to apply the same rule to a patient who is anxious to leave, and who, moreover, was convalescent from the particular complaint for which she had been under treatment. However much, therefore, this unfortunate case is to be lamented, I do not think it would be just to pronounce the House Surgeon guilty of a clear neglect of his duty. This completes the charges of cruelty, indifference, and neglect against the House Surgeon, and we may proceed to other allegations. 9. " That the House Surgeon issued an order to ' squirt' water in children's faces." He issued no such order, but on one occasion he himself performed this formidable operation, with the result that the child was temporarily cured of a violent fit of screaming, and the nurses, we may hope, learned something of the character of reflex action caused by a sudden impression on the fifth pair of nerves. I have not heard that any one was much the worse for the performance. 10. " That the House Surgeon has been under the influence of liquor and drunk while in charge of the Hospital." The only instance in which the House Surgeon is charged with being so far under the influence of liquor as to incapacitatate him for the proper discharge of his duties is that in which Francis O'Neill describes how the doctor came at night to see a patient named Bowley, and how he staggered and fell over the man's chest. Now, the fact is that this patient, Bowley, had that evening had his foot amputated, that under chloroform his respiration had failed, and that artificial respiration had to be resorted to. This again happened when the patient was brought into the ward, and the same process had to be repeated. The operation of artificial respiration was, I suppose, what O'Neill considered to be tumbling over the man's chest. At all events, the evidence of Dr. Meares, who was present in the ward for two hours, ought to be conclusive, and he says that the House Surgeon was perfectly sober. But the other evidence of a witness who sees so imperfectly, and so misinterprets what he sees, must be taken with very large allowances when uncorroborated. There are two or three other witnesses who speak of the doctor's manner as having been on some occasions "funny," " excited," &c, which they attribute to the influence of liquor. On the other hand, there is an overwhelming preponderance of witnesses who testify to the habitual sobriety of the doctor. And this is not merely negative evidence, for a large number of these witnesses, from their opportunities of judging, must have known if the doctor had been addicted to liquor. Without attempting the tedious task of analysing the evidence, I shall be content with saying that I think the charge of being under the influence of liquor is not proved, and the charge of being drunk is disproved. 12. " That the matron has been guilty of cruelty in dealing with applicants for admission." (This is No. 17 in the other paper.) It seems that whilst some repairs were going on at the Hospital the pathway to the back-entrance, by which patients are usually brought in, was littered with bricks and rubbish. On one occasion, a patient being brought to the front, the matron told the bearers to go the other way, and they went accordingly. On another occasion, when a remonstrance was made, the matron at once consented to their coming in by the front way. There is no reason to doubt that if the state of the path had been brought to the matron's notice the first time she would have allowed the front-entrance to be used whilst the obstacles remained, although the other is the best and most suitable entrance for patients who are carried in. 13. "That the matron has constantly administered ether and chloroform, the House Surgeon only being in attendance." Read "frequently" for " constantly," and the statement is quite true, and the practice justifiable. It seems to be forgotten that a school of trained and skilled nurses has sprung up within the last few years, and that tuition in the administration or anEestheties forms a part of their training. 14. "That the matron has been inattentive and neglectful of duty, particularly as to visiting wards at night." My conclusion from the evidence generally is that this charge is not true. 17. " That, while the patients have been stinted of food, there has been otherwise waste and extravagance of the food-supplies." Ido not know what specific circumstances this refers to, but of course bad food and bad cooking imply waste, and that both of these causes have sometimes afforded just grounds of complaint must be admitted. 18. " That there is no proper system of checking the administration of the steward as to (a) the consumption of medical comforts, (b) the amounts due by and received from patients, (c) the effects of patients." 19. " That no control is exercised over the Destitute Patients' Fund." (These are No. 15 in the other paper.) The discussion on these 'subjects has to a great extent resolved itself into the question whether it is right that the duties of secretary and treasurer should be conjoined, as they now are. Theoretically considered, it is perhaps desirable that they should be separated, but to do this would present difficulties in practice, chiefly on the ground of expense. I think that, with regard to the matters mentioned, there is not an adequate system of checking and controlling the administration and the accounts of the steward, but no abuse in practice has been alleged, except the specific one which I shall next mention, and which stands in one of the papers of charges as No. 16. 16. " Part only of charges made in many cases for burials from the Hospital was paid to the undertaker; the remainder was retained by the secretary." This allegation means that the contractor for the Hospital funerals, for which the deceased's friends are not able to pay, takes them at so low a rate as to incur a considerable loss on every one: that by way of compensation he engages the interest of the secretary to procure for him the funerals of those who can pay, and