In 1876 the nursing care of the institution was undertaken by a certain sisterhood[[19]] of nurses and associates, under the superintendence of their head, Sister Louise, and it is impossible to speak in terms of too high commendation either of her management or of that of Sister Henrietta, who succeeded her, and who still retains that office and administers its important duties in a manner which I cannot too highly praise.
The hospital received considerable addition in 1876, and again in 1882 had a large wing, an isolation ward and an extensive native ward added. The medical tax, passed by the legislative council of Griqualand West (No. 2, 1874) of one shilling per month payable by each native, was received by the diggers, when it became law, with much disapprobation. It was consequently allowed to remain in abeyance by the Griqualand West government, until hospital matters came under the management of the local board, which I have before mentioned, in 1882. Then it was revived, and has been since paid by the diggers and companies, without demur, the amount being as a general rule deducted from the natives’ wages. The amount has varied from £10,000 in 1882 to £6,000 in 1885. The Kimberley hospital is now larger than any institution in the colony, its working staff numbering over fifty, and it contains sixty-six surgical[[20]] and forty-two medical beds for natives, twenty-nine for poor whites, twenty for paying whites, and an isolation ward with four beds. The number of cases treated here is enormous, the capital operations for the last quarter in 1885 counting forty-four, and the admissions amounting, during the same year, to 709 Europeans and 1,019 natives.
Returning to the early days of field life, the quacks soon found it advisable to take flight, as a steady influx of regularly qualified men was appearing on the scene, the only one retaining any kind of ground being a non-qualified homeopath. This quack was always, however, cautious enough to consult with qualified practitioners when his cases were in extremis, and by this means he escaped any penalty of the law, and procured a death certificate in proper order.
It seems passing strange, that in a sparsely populated though widely extended country or congeries of States, that a man possessing indubitable qualifications for the exercise of his profession, should be put to such frequent and utterly unnecessary annoyance in the matter of medical registration as sometimes occurs in South Africa. A physician or surgeon before he can legally recover his fees in every part of South Africa, requires, as there are five separate States, to be registered in no less than five different places. I was early taught this in a rather rough way; one of the advantages which confederation would bring being vividly placed before me in a very practical manner. In 1873 I attended a man and his family at Du Toit’s Pan, and as I found that no inclination existed to pay my fees, amounting to some eighty guineas; I sued for the amount, but was non-suited by the magistrate, on the exception being raised, that I was not a legal medical practitioner in that part of South Africa, not being registered in Griqualand West or the Cape Colony. As I was registered in England and Natal, I had neglected to comply with this form in Griqualand West, and consequently had to suffer.
The law courts of this territory have also decided another important point in medical law, agreeing in their judgment with English precedent. A medical man whose only qualification was the diploma of the Edinburgh College of Surgeons sued a patient for his attendance, who pleaded that he being a simple surgeon could not charge for a medical case, and the High Court sustained the exception. To the astonishment, however, of nearly all the faculty in South Africa, the medical board in Capetown after this, decided, entirely ultra vires, to grant permission to “Edinbro’” Surgeons, to practice medicine; consequently South Africa now is an Alsatia, to which all semi-qualified men can flee who find it impossible to enter the army or navy, or even obtain any poor-law appointment in England. Feeling myself interested in this matter, and being desirous of obtaining authoritative news from the “head centre” I telegraphed on May 23d, 1884 to the late Dr. Ebden, who held the position as president of the medical board in Capetown, to inquire “if the board intended to doubly qualify simple surgeons,” and received the astounding reply: “Board considers Edinburgh surgeons entitled to practice medicine.” It would be curious to fathom the reason why this preference was given to men holding Scotch diplomas! Quite independently of the fact that this abnormal announcement is contrary to all law, and contrary to the powers vested in the medical board, it is an injustice to the colonists themselves, and unfair to the rising generation of the country. In Europe there are at the present time more than one hundred and fifty medical students, sons of South African colonists, the majority of whom are receiving a university education. Can it be fair to these that they should be pitted against semi-qualified English adventurers?
The necessity of a medical act in South Africa, with proper penal clauses, becomes every day more apparent. The South African Medical Journal in 1884, on giving a resumé of that year’s events of interest, drew public attention to one glaring instance, which had to pass unpunished. In mentioning the case of two medical men, this journal observes: “The latter, a L. R. C. S. of Edinburgh only, had been practicing as a physician, although gazetted as a surgeon only. He had aggravated this by repeatedly signing his name with M. D. and F. R. C. P., a proceeding which was not only mendacious, but dishonest.” But yet this dishonesty had to remain without the infliction of any fine. This case is one among many, which shows the urgency of legislation in this direction.
Since the creation of a municipality in Kimberley in 1878, and the consequent introduction of sanitary regulations, duly enforced by law when necessary, the death-rate has very considerably diminished. The late Dr. Shillito and the writer, in March, 1879, prepared an exhaustive report for the mayor and town council on the sanitary condition of Kimberley. The death-rate at that time was enormous, as can be seen from the following table, which is a copy of that which we then furnished:
| Total population | 14,169 | Deaths | 867 | Rate per 1,000 | 61.014 |
| Europeans | 6,574 | „ | 236 | „ „ „ | 40.005 |
| Other than Europeans | 7,595 | „ | 604 | „ „ „ | 79.052 |
At that time Kimberley was perfectly honeycombed with cesspools. We drew attention in our report to the evil effects of the existing system, and to the manner in which these had revealed themselves two years before, when an epidemic of puerperal fever and erysipelas robbed the community of many valuable lives, and we further showed that there was always existing a remitten fever of a dysenteric and typhoid tendency, which could in some measure be attributed to this defective sanitary condition. Our report led to the adoption of the “Pail system,” and the night-soil is now taken away regularly and buried some distance from the town, the consequence of which is that the death-rate from disease has diminished more than one-third, and the sanitary condition of Kimberley is to my own knowledge as good as that of any town in South Africa.
Kimberley, notwithstanding its improved sanitary condition, was in 1883 and 1884 visited by a disastrous outbreak of disease, which cost the community much, both in life and money. In May, 1882, small-pox was brought to South Africa by the steamship Drummond Castle, and spreading, proved very fatal in the Capetown Peninsula (Capetown to Simon’s Town), 4,000, less or more, succumbing to its ravages. Great apprehension was felt in Kimberley lest the disease might be communicated by the passenger wagons coming up from Capetown. Terror seized upon the digging community, and a quarantine station was immediately established at the Modder River, some thirty miles from the mines. Every care was taken, and all passengers were fumigated with sulphur before they were permitted to enter Kimberley. As the result, seven cases of small-pox were detected and detained for treatment, and all those traveling by the same wagons were kept in quarantine twenty-one days.