HOWRAH GENERAL HOSPITAL.
75
Moribunds.
DISEASES.
Mori-
bunds.
2
days.
3
days.
4
days.
5
days.
6
days.
7
days.
8
days.
9
days.
11
days.
12
days.
20
days.
Total.
Dysentery, chronic
27
7
11
8
6
4
3
...
...
2
1
1
70
Cholera
1 4 5 ...
. . .
. . .
. . . ...
. . .
. . .
. . .
. . .
. . .
1 9
Anasarca
5
2 ...
1
1
1
. . .
1
1
...
...
...
12
Diarrhœa, chronic
2
1
...
. . .
. . .
. . . 1 ... . . .
...
...
...
4
Phthisis pulmonalis
1
1 ...
. . .
. . .
. . .
. . .
. . .
. . .
. . . ... ...
2
Fever remittent
3 . . . ...
. . .
. . . . . .
. . . . . .
. . .
. . .
. . .
. . .
3
Other causes
12
1 2
2
3 ...
1
. . .
. . .
. . .
. . .
. . .
2 2
Total
64
17
13
11
10
5
5
1
1
2
2
1
132
Moribunds.
In the above table is shown the number of moribunds admitted during the year.
According to the official definition of the word "moribund," only 64 of the patients included
in the table were in a moribund state when admitted ; the remaining 68 cases were, however,
admitted in a hopeless condition, and, as it will be seen, lingered only for a short while.
On October 24th I was directed by the deputy surgeon-general to furnish a special
report explanatory of the high death-rate amongst the Native patients treated in this hospital
in 1872. In accordance with this request the following remarks were made :
— H i g h d e a t h - r a t e
a m o n g n a t i v e
p a t i e n t s e x p l a i n e d .
"The high death-rate in this hospital is mainly to be attributed to the large number of
moribund patients received into the wards. By moribund patients I not only mean those
who die within 24 hours after admission, but those other cases which linger on a few days,
their condition at the time of admission being hopeless all the same. Very many of the
other patients who may not be called moribund when admitted are in such a reduced state
that the mortality amongst them is necessarily very large.
"Many men come from remote districts in the hope of being employed in the work
-
shops and factories at Howrah. Whether they succeed in their object or fail, they live in
lodging-houses of one sort or another, where, if they fall sick, they are badly attended to, or
not attended to at all. If their sickness is severe, they get from bad to worse, and when
about to die, are brought to hospital by the neighbours. The neighbours appear to do this
much partly through fear of the police, and partly to escape the trouble and cost of burning
the bodies after death. Many of those who come to Howrah seeking work are disappointed
in getting it. Destitution is the consequence, and sickness results from bad feeding and
exposure. A large number of the moribunds are drawn from this class ; not a few travellers
by rail reach Howrah sick—travellers to Midnapore, Orissa, Calcutta, &c., &c.—and some of
these find their way to the moribund ward. Whether the travellers from the upper provinces
came by rail or by road, the hospital here naturally catches those who are sick when they
arrive. This would not be the case if Calcutta were not separated from the north by the
Hooghly.
"Howrah swarms with prostitutes ; this is the result of so many of the workmen about
the place leaving their wives and families at a distance. These women (the prostitutes) are
on the whole indifferently paid. When well and attractive, they may thrive ; but when they
get sick, many of them become utterly destitute. Most of the female moribunds admitted
are by profession prostitutes. Again, it occasionally happens that a male moribund is
brought direct from a prostitute's house. When he was well and had money in hand he was
cared for; having become sick and poor, he is neglected and abandoned.
"Poor dependents in the house of well-to-do relatives, when they get sick, are often neglected
till about to die, when they are brought to hospital. Their patrons appear to have recourse
to this measure with the double object of shifting the responsibility of the deaths and of
escaping from the cost of burning the bodies. Some years ago, when the practice of throwing
dead bodies into the river was suppressed, the number of moribund admissions largely
increased. It was then found that the poorer classes, who had formerly flung their dead
into the river, now brought their dying relatives to the hospital, not for treatment, but that
their bodies after death might be burned at the cost of the municipality. The matter was
brought to the notice of the magistrate, and the abuse checked. This practice has, however,
by no means ceased. It is still to be asked, "How does it come about that the patients do not
seek medical aid when they first fall sick ?" This delay, it appears to me, is partly owing to
many of the class which mainly supplies the moribund having more faith in charms and
magic than in medicine, and partly to the innate apathy of the Native character. When
sickness has got sufficient possession of them, many Natives would rather die than make an
effort to save themselves.
" What measures can be proposed to lessen the number of moribunds in Howrah ?" This
question is a difficult one to answer. Indeed, if the causes above assigned for the prevalence
of moribund cases are correct, I do not see what measure could well be adopted in the hope of
its having the desired effect. What measure could be adopted to overcome the prejudices or
to drive out the apathy of the persons most concerned ? The police might be directed to
admonish the people to bring the sick earlier to the hospital, but it is very evident that this
measure would create more evils than it would cure. The whole matter is one which would