12 REPORT ON THE
MEDICAL COLLEGE HOSPITAL.
DR. D. B. SMITH reports as under.
Dr Coates was in office, as Principal, from the beginning of the year till the 19th of
November, the date on which I assumed charge. As I have thus personal experience of the
working of the hospital for only six weeks of the period now under report, I am unable
to do more than furnish the statistics and facts bearing on the past year.
In-door patients.—The total number of in-door patients treated during the year, not
including those treated in the Eye Infirmary, was 4,602: of these, 2,541 were Christians and
2,061 natives. There was thus an increase of 171 over the previous year.
Mortality. —There were 624 deaths, shewing a rate of mortality of 135.59 per 1,000, as
compared with 108.32 in 1877, 136.19 in 1876, 152.74 in 1875, 125.3 in 1874, 128.5 in 1873,
115.8 in 1872, 126.28 in 1871, and 138.78 in 1870. The death-rate among Christian
patients was 70.8 per 1,000, as compared with 48.85 in 1877, 71.91 in 1876, 59.81 in 1875,
61.81 in 1874, 59.50 in 1873, 56.7 in 1872, and 55.8 in 1871. The death-rate among
native in-patients was 215.4 per 1,000, against 166.36, 193.27, 222.56, 174.96, 180.7, 168.7,
a n d 1 8 5 . 2 i n t h e s e v e n p r e c e d i n g y e a r s . O f t h e t o t a l 6 2 4 d e a t h s w h i c h o c c u r r e d i n h o s p i t a l ,
124, or 19.8 per cent., occurred in moribund patients. Excluding these, the death-rate was
111.6 per thousand, as compared with 91.3, 103.5, 128.48, 95.46, and 105.05 in the six
preceding years. There were 567 cases of fever among the Christian in-patients, of which 20
died, or 35.2 per 1,000. Seven of these cases were moribund on admission. Excluding these,
the death-rate was 23.2 per 1,000. Of 20 cases of cholera nine died, or 4.50 per 1,000. Of
265 cases of dysentery and diarrhœa 27 were fatal, or 101.9 per 1,000. Among native
patients there were 203 cases of fever, of which 41 died, or 201.9 per 1,000. Excluding seven
of these, which were moribund, the mortality from this cause was 173.4 per 1,000. Ninety-
seven cases of cholera were admitted with 58 deaths, or 597.9 per 1,000. Twenty of these
cases died within six hours of admission ; if these are excluded, the death-rate from cholera
was 493.5 per 1,000. Of 185 cases of dysentery and diarrhœa 51 died, or 275.6 per 1,000.
If eight of these cases, which were moribund, are excluded, the death-rate from these
disease swas 242.9 per 1.000
The following table shows the death-rate per 1,000 from these causes in 1878 :—
Diseases.
Christians. Natives.
Fever
. . .
...
...
... 35.2
201.9
Dysentery and diarrhœa
...
. . .
. . .
... 101.9
275.6
Cholera
. . .
. . .
...
. . . 450.0
597.9
Vital Statistics according to Race and Sex
Adults t r e a t e d .
Died.
Deaths to
treated per 1,000.
EUROPEANS—
Male
. . .
. . .
. . .
. . . . . .
...
...
...
867
55
63.43
Female
...
...
...
...
...
. . .
. . . ...
163
9
55.21
EURASIANS—
Male
. . .
. . .
. . . ...
...
...
...
...
355
21
59.15
Female
...
. . .
. . . ...
...
. . .
...
...
805
65
80 7
NATIVES—
Male
...
...
. . .
. . .
. . .
. . .
...
... 1,349
311
230.54
Female
. . .
. . .
. . .
. . . ...
...
. . . ...
604
111
183.677
SURGICAL OPERATIONS.
Thirty-four cases of major operations remained under treatment at the end of 1877.
During 1878 150 capital operations were performed, making a total of 184. Of these, 127
recovered, three were relieved, three were discharged before treatment was concluded, 22 died,
and 29 remained under treatment at the end of the year. The death-rate was 119.56
per 1,000, as compared with 170.30, 218.09, 227.2, 197.53, and 259.2 in the five preceding
years.
The causes of death in the 22 fatal cases were as follow :—Tetanus five, peritonitis one,
pericarditis one, pneumonia two, gangrene two, erysipelas one, diarrhœa one, shock four,
uræmia one, other causes four : total 22.
MAJOR AND MINOR OPERATIONS.
Ophthalmic hospital.—In the ophthalmic hospital 16 cases were under treatment at the
end of the year 1877. During the year under report 242 operations were performed, giving
a total of 258. Of these, 156 were cured, 37 relieved, 42 unrelieved, and 23 under treatment.
Obstetric wards for women and children (up to the age of seven years). —The number of
patients treated by the obstetric physician was 1,238, against 1,109, 1,053, 993, 1,004, 943,
and. 1,063 in the preceding six years. There were 264 women delivered in hospital during
the year, against 260, 250, 226, 216, 191, and 146 in the six preceding years. This shews
a marked and steadily progressive increase on the numbers of previous years. Of the women