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Updated: June 14, 2025
Among the cases in which hospital care is not practicable are those of chronic invalids, of patients too sick to be moved, and of patients able to be treated as "out-patients" in the dispensaries. Confinement cases, where there are children in the family who must be placed temporarily in institutions if the mother leaves home, are best treated in the home.
In those days, the future doctor began by being apprenticed to a regular practitioner; he picked up a great deal from compounding medicines, watching out-patients in the surgery, and attending simple cases, especially if he had a capable man to work under. At the same time he prepared for his future examinations, and got ready to walk the hospitals.
In the spring Philip, having finished his dressing in the out-patients' department, became an in-patients' clerk. This appointment lasted six months. The clerk spent every morning in the wards, first in the men's, then in the women's, with the house-physician; he wrote up cases, made tests, and passed the time of day with the nurses.
Philip attended now lectures on medicine and on surgery. On certain mornings in the week he practised bandaging on out-patients glad to earn a little money, and he was taught auscultation and how to use the stethoscope. He learned dispensing.
At the hospital the out-patients were sitting in the dark, narrow little corridor waiting to be seen by the doctor. The nurses and the attendants, tramping with their boots over the brick floors, ran by them; gaunt-looking patients in dressing-gowns passed; dead bodies and vessels full of filth were carried by; the children were crying, and there was a cold draught.
The physician in charge of the out-patients' department at University College Hospital said there was lung-trouble, and a man at the printing-office who had never been there, said South Africa was the cure for that.
This is about the toughest nut he's ever had to crack, but he's cracked it all right." Then Philip heard nothing more of her at all. She vanished into the vast anonymous mass of the population of London. At the beginning of the winter session Philip became an out-patients' clerk. There were three assistant-physicians who took out-patients, two days a week each, and Philip put his name down for Dr.
Indeed, as I discovered before the day was over, he had quite a little hospital at the back of the house in which were four or five beds occupied by Kaffirs and served by two male native nurses whom he had trained. Also numbers of out-patients visited him, some of whom travelled from great distances, and occasionally, but not often, he attended white people who chanced to be in the neighbourhood.
Then, at the main door of the Infirmary, helped by the stalwart, hospital porter, he got down from the dog-cart, and subsequently raked by curious eyes, saluted by hardly repressed tittering from the out-patients waiting en queue for admission to the dispensary he made his slow way along the bare, vault-like, stone passage to the accident ward, in the far corner of which a bed was shut off from the rest by an arrangement of screens and of curtains.
There is an infirmary also in the castle, of which the average annual number of in-patients is about thirty-five of out-patients above one thousand. There is an ample granary, from whence, in time of scarcity, the poor are supplied on low terms.
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