(3)

is ordinarily much higher than among Europeans and Eurasians, but, strangely
enough, during 1872 cholera, diarrhœa, liver abscess, and bronchitis were
more fatal among the latter than among the former. Indeed the cholera death-
rate in this hospital was last year unprecedentedly high, being for Christian
patients 692.3 per mille as against 321.4 in 1871, and for natives 607.4 as against
431.5. The absolute number of cholera patients has no doubt fallen greatly
of late years, owing, it is universally admitted, to the improved conservancy and
water-supply of the city; but the remarkable fatality of the cases in the Medical
College Hospital last year is deserving of attention. The General Hospital
returns for Europeans do not exhibit this feature, a fact which, unless explained,
would seem to point to local causes affecting the Medical College Hospital
rates. From page 68 it seems that of 132 cases, 1.5 came from ships in the
river, 14 from Bow Bazaar, 12 from Chitpore, 11 from the suburbs of Simla,
and 10 from Bara Bazaar. The Health Officer of the Municipality should
have his attention drawn to these facts of locality as soon as they come to
notice during the year, that inquiry may be made while the matter is fresh.

     10. From the analysis of results in surgical cases given by Dr. Smith, it
seems that though not so low as in 1871, 1868, and 1863, the death-rate was
less than in any of the other years of the decade, and cases of death by
pyæmia and septicæmia were very few, six in all. But nevertheless the figure
last year was much higher than in 1870 or 1871. So that it would almost
seem as though, notwithstanding the general improvement on an average of
years, there had been at work last year some special morbid influence making
pyæmia more common. The following table compares the mortality after
major surgical operations in the various hospitals. The freedom of the General
Hospital from pyæmia is very noticeable.

        11. The management of the various branches of the hospital, the lying-in
ward, the ophthalmic hospital, the out-door dispensaries, and the dental
dispensary, was, as usual, satisfactory.

        12. Dr. Brown remarks that no progress has been made during the year
towards building a new hospital or providing the present building with the
additions which are considered necessary. The idea of erecting a new building
had to be abandoned for want of sufficient funds. It was found that a new
hospital and college on an approved plan and on a new site would cost not
less than 15 lakhs of rupees. As the funds at the disposal of Government
would not admit of so large an outlay, an ineffectual appeal was made to the
native public through the British Indian Association and to the Justices of
the Peace to contribute a portion of the required expenditure. Nothing has
yet been done towards improving the present buildings owing to the objections
raised by the Medical College authorities to any plan that could be under-
taken with reasonable means. The requirements of the college and hospital
are, however, steadily increasing, and the Lieutenant-Governor has no option
but to do what he can with the money he can make available. He has