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of persons of the several races treated in past years, the increase appears to
have been most marked among the Mahomedans; whilst on the other hand,
there was a slight falling off in the number of Europeans and Eurasians treated.
4. As regards the nature of the prevailing diseases, the Lieutenant-Gover-
nor observes that the most noteworthy point is stated to have been the increase
as compared with the past few years, not only in the number of cases of
cholera treated, but in the intensity of the disease. The total number of
cases admitted to the various hospitals was 666, against an average of 450
in the four preceding years. In 509 cases out of a thousand the disease
resulted fatally, a ratio of mortality considerably above the average of six
preceding years, though somewhat less than that of 1873. As in 1873, the
number of cholera cases in the 1st and 2nd divisions of the town were
much fewer than in the other divisions. The records, however, are still too
defective for practical purposes, as the localities in which the disease was
contracted in the case of 181 patients has not been reported. It is only as
regards in-door patients that details of the diseases treated are given. As
c o m - p a r e d w i t h t h e p r e v i o u s y e a r , t h e r e w a s a n i n c r e a s e o f m o r e t h a n 5 0 p e r c e n t .
in the number of cases of dysentery, and of more than 60 per cent. in the number
of cases of remittent fever admitted. On. the other hand, there was a decrease
of more than one-half in the number of cases of continued fever, and of
phthisis, and of somewhat less in the number of cases of typhoid fever
admitted. The dengue fever has almost entirely disappeared from the returns.
The greatest number of deaths resulted from dysentery, cholera, and diarrhœa,
being 670, 339, and 285 respectively. The increase in the mortality from
dysentery is very marked, the number of deaths from this disease being 416
in excess of the number in 1873, and the death-rate per thousand of those
treated being 350. as against 238.
5. Of the 20,921 in-patients treated, 3,197 died, giving a death-rate of
152.8 per thousand, against 143 per thousand in 1873. The returns shew that
not only among all the diseases mentioned above as having increased, with the
exception of cholera, but also among those stated to have diminished, an
increased rate of mortality prevailed. The municipal, as well as the hospital,
returns continue to shew that the cold-weather months are the most fatal.
6. Medical College Hospital.—The Lieutenant-Governor is glad to observe
that the management of this great city hospital, which, during the entire
period under review, was ably superintended by Dr. Chevers, continues to merit
the warm praise of the Surgeon-General. The large increase in attendance at
the dispensary for women and children would seem to attest the growing
popularity of the institution; but on the other hand, His Honor notes that
there has been some decrease in the number of in-patients, and of persons treated
at the surgical and medical dispensaries. The mortality among in-patients
was 125.29 per thousand, or slightly less than in 1873. It continues to be very
much greater among native than among Christian patients, the ratio among the
former having been 61.81, and among the latter 174.96 per thousand. The death-
rate of patients after operation is stated at 235.29 per thousand; and the
Lieutenant-Governor regrets to learn that the best endeavours of the hospital
staff continue to be partially frustrated by causes which are ascribed to the
insalubrious situation of the institution. He last year called attention to the
pressing necessity for a separation of the surgical from the medical and obstetric
cases, and he is glad to learn that a scheme to effect this, by the erection of a
new surgical hospital, has been nearly matured.
7. Presidency General Hospital .—The number of Europeans treated
at this hospital during the year was 2,437, a number which is stated to have
been considerably less than in any year since 1867. It is satisfactory to find
that the death-rate has decreased to 45.95 per thousand. The Lieutenant-
Governor regrets, however, to observe that in the cases which came under treat-
ment typhoid fever was specially fatal. The number of patients treated at
the Out-door Dispensary, which has been newly opened, was 1,107 only. The
Lieutenant-Governor observes Dr. Ewart's suggestion that the services of the