19

CALCUTTA MEDICAL INSTITUTIONS.

of Natives in this hospital, from the nature of the cases received, must necessarily be high,
and the reasons he gives are deemed to be sufficient to account for it.

      60. Remittent fever and cholera have caused nearly half of all the deaths among
Europeans; among Natives, dysentery, the disease of privation and misery, was the immediate
cause of death in nearly half the cases.

Causes of mortality.

      61. Dr. Bird submits a table shewing the admissions, deaths, and rates of mortality from
cholera during the last ten years. It will be seen by it that the disease has markedly
diminished during the last four years. This corresponds with the experience of Calcutta, and
seems to shew that these years have been simply noncholeraic years. In this table it is
curious to observe that in the first half of the decade, one year excepted, the rate of mortality
from cholera was much higher among Europeans than Natives; in the last half, one year
again excepted, the very reverse has been the case.

Cholera.

Rate of mortality
in last 10 years.

      62. Remittent fever was unusually prevalent and fatal last year among Europeans,
as compared with the previous ten years. In 1865 two more cases were treated, viz. 48;
but of these only 2 died. In 1873, 46 cases with 6 deaths have been recorded; in
1872, 8 cases with no deaths occurred; in 1871, 3 cases, all fatal, were registered. But
there has evidently been some difference observed in the mode of returning deaths from
this disease by the several medical officers who have successively held charge of this hospital,
some recording the death under an organic affection which others would consider only as a
complication of the fever.

Remittent fever.

      63. Only one European died from dysentery out of 34 cases. Dr. Bird is of
opinion, and his figures seem to prove that this disease has been both less prevalent and of
a milder type during the last four years. The mortality has been much lower with the
same treatment.

Dysentery.

      64. Sixteen European women have been confined; no Native woman.

Midwifery.

      The education of Native dhaies as midwives has not yet been commenced, but the matter
is held in view, and Dr. Bird thinks something may be done when the new Native ward is
opened. With European patients only, it is certain that nothing in this direction can be
attempted.

Education of Native
dhaies not yet
commenced.

      65. Twenty-eight major and 563 minor operations were performed in 1873, as against 13
and 374 respectively in 1872. Among the major operations 3 deaths occurred, viz. 1 from
pyæmia, 1 from metro-peritonitis, 1 tracheotomy in a case of cut throat.

Surgery.

      66. The contract system, which was introduced into this hospital towards the end of
1872, and which, in the first instance, was reported on favorably by Dr. Elliot, is not considered
by Dr. Bird to be now working well; but he states that, on the whole, the articles of diet
supplied have been of satisfactory quality.

Dieting.

      67. During the year the hospital buildings have been put in good repair, and gas has
been laid on in all the wards. A new Native ward is being built, and is nearly finished.
This, when completed, will add much to the efficiency of the institution.

Repairs, &c.
New Native ward.

      68. Dr. Bird reports very favorably of Mr. Apothecary FitzGibbons, v.c., and
Assistant Surgeon Gopaul Chunder Roy, in the European and Native departments
respectively.

CALCUTTA LOCK HOSPITALS.

      69. Dr. Payne, in his report on the working of the Lock hospitals under his superintend-
ence during the past year, enters very fully into the question as to the beneficial influence of
Act XIV on the health of the population of Calcutta and the garrison in the Fort; and he
appears to prove by figures taken from the returns of all the large medical institutions, that
the amount of disease within the limits comprised in the Act has been, in fact, diminished one-
half since 1867, the year before it came into operation; and he also shews by the returns
from the European garrison in the Fort, that the percentage of venereal cases to strength
among the British troops has been reduced in the same period from 25.08 to 7.4. These results
are highly satisfactory. On the other hand, the amount of disease existing outside the limits
of the Act would seem, judging from the returns of those hospitals, which record the locality
of the patients registered, to be on the increase, 922 cases of imported syphilis having been
received in 1873, against 509 in 1872. It is to be regretted, however, that all the medical
institutions do not record separately disease contracted within and without the limits of the
Act, in order that more definite and reliable results may be obtained. I purpose directing
that this very important distinction shall for the future be made in the register of all hospitals
and dispensaries in the town and suburbs.

Effects of Act XIV.

      70.It appears nevertheless from table VIII of Dr. Payne's report that the number of
admissions for primary syphilis in these institutions, after due allowance has been made for
imported cases, has been slightly greater in 1873 than in 1872.

Primary syphilis