186 AROUND THE WORLD VIA INDIA. 



large square court which they inclose. The income 

 from pay patients is not large, but the government ap- 

 propriations are liberal. All of the employes are sal- 

 aried;, including physicians, internes and nurses. Dr. 

 Thomasz, one of the two attending surgeons, receives 

 4,000 rupees a year. He conducted me through the dif- 

 ferent wards and showed me many interesting surgical 

 and medical cases. The nursing is in care of thirteen 

 Anglican sisters and a number of women nurses, grad- 

 uates from the Lady Havelock Hospital. A corps of 

 unlive men and women act as helpers. The wards are 

 airy, well lighted and furnished plainly but comfortably. 



Echinococcus, so common in Australia, is not seen 

 here; on the other hand, elephantiasis is quite common. 

 Dr. Thomasz has operated on a number of cases of 

 scrotal elephantiasis with success. The natives are 

 not very good subjects for prolonged major operations, 

 as they are very liable to inordinate shock. Chloroform 

 is used as a general anesthetic, and in several thousand 

 anesthesias only two deaths occurred. The operating 

 room is old and not up to modern requirements. The 

 equipments and appliances also leave much to be de- 

 sired. Asepsis has not succeeded here as well as could 

 be desired and the many failures to obtain primary 

 wound healing having finally led to the abandonment of 

 buried absorbable sutures of any kind. Silk is used 

 almost exclusively and the sutures are removed from 

 three to seven days after the operation. The same prac- 

 tice is followed in the Kandy General Hospital. In the 

 outdoor department I watched an interne dress two 

 recent wounds. He did not remove his coat, and a 

 basin with some antiseptic solution was relied on in 

 performing primary disinfection. Not much time or 

 effort was expended in preparing the wounds for su- 

 turing, and T have little doubt that the sutures rather 

 retarded than assisted Nature's efforts in repairing the 

 wound. 



Ovarian tumors arc quite common, but myofibroma 



