The cholera
patients met with
in hospital
represent the
gradations of the
general population.
Future prospects
regarding cholera
more hopeful.
CALCUTTA MEDICAL INSTITUTIONS.
5
Statement No. V.
YEARS.
ALL DISEASES.
CHOLERA.
Death-rate,
excluding
cholera.
Number of
deaths regis-
tered by the
Municipality.
Rate per mille
of population.
Treated. Died.
Died
per mille.
Treated.
Died.
Die
d p e r mi l l e .
1868 16,996 3,386
199
1,224
563
461
179
13,736
32
1869
18,035 3,043
169
1,144
558
487
147
12,795
29.8
1 8 7 0 15,816 2,250
142
605
258
426
131
10,462
24.4
1 8 7 1 17,325 2,288
132
255
112
439
127
10,299
24
1 8 7 2 20,805 2,761
132
448
217
484
125
11,923
27.8
1 8 7 3 18,896 2,706
143
492
264
536
132
11,558
26.9
1874
20,331 3,197
157
666
339
509
145
12,641
29.4
1 8 7 5 22,806 3,815
167
787
405
515
154
15,069
35
1876
*21,832 3,226
147
740
399
539
134
12,904
30.2
* Excluding 534 patients in the Eye Infirmary.
On a further analysis of the figures given in this statement, it is found that the number
of in-door patients treated during 1876 exceeded the average of the eight preceding years
by 2,955, and was also in excess of the number treated in any one of those years, with the
exception of 1875. The death-rate, too, from all diseases was 7.36 per mille lower than the
average of the eight preceding years, and was lowert han that of any year of this period,
with the exception of 1870, 1871, 1872, and 1873.
13. Of cholera, as observed among the hospital patients, it may be said that there
were fewer cases treated in 1876 than in 1875, but considerably more than in any year
from 1870 to 1874 inclusive. The large number of cholera cases treated in 1868 and
1869, with a comparatively small death-rate (considering the class of native patients who
are admitted into hospital), and the marked decrease in these cases after 1869, with a still
lower, but again increasing, mortality, will no doubt attract attention. In the absence of
any satisfactory explanation regarding this extraordinary fluctuation in the admissions and
mortality from cholera, I shall merely observe that the decreasing number of admissions in
1869, 1870, and 1871 appears to have been coeval with the introduction of a pure water
supply and an improved system of drainage ; but it is less easy to account for the gradual and
slight increase noticeable since 1872, unless it may have been dependent on an increased day
or working population brought in from the suburbs and from even greater distances.
The mortality from cholera as observed in the Calcutta hospitals during the past nine
years has varied considerably, viz. from 426 per mille of tile number treated in 1870 to
539 per mille in 1876. I cannot believe that the disease has of late years assumed a more
virulent type, and that the increased mortality from it may be thus accounted for ; on the
contrary, I consider that the hospital death-rate cannot be accepted as affording a crucial proof
of a more fatal type of disease, but rather because the ratio of mortality depends much on the
width of the area of attacks.
14. From an examination of the reports of each hospital, it will be found stated in
paragraph 9 of that of the Medical College Hospital that the number of Christian patients
admitted with cholera during 1876 was 42 below the average of the ten preceding years,
and in paragraph 10 of the same report that the admissions of native patients were likewise
very much below the average of the same period. In the Campbell Hospital (paragraph 11
of the summary) there were fewer admissions from cholera than in either of the two preceding
years. In the Police Hospital (paragraph 10) there was a marked decrease in the number
and severity of the cholera cases admitted as compared with the average of the five
preceding years. In the Mayo and Chandney Hospitals there was a slight decrease in
the number of cholera cases treated, and the same remark holds good for the Howrah
General Hospital.
15. The patients treated in the hospitals enumerated in the preceding paragraph
represent pretty fairly the several gradations of the Calcutta native population—from the
police, who are well clothed, well fed, and well cared for in every way, to those poor wretches
who, homeless and suffering from the combined effects of poverty and sickness, find their way
into the Campbell and other hospitals, there to die. Between these two classes there are
many grades and conditions, and I consider it to be a matter of encouragement and of
hopefulness for the future to find that there has been from all such classes a decrease in the
number of cholera cases treated in these hospitals. We may therefore hope that the freedom
from cholera which is now generally acknowledged to exist within the Fort and that
portion of the city occupied by the European population (and which may fairly be ascribed to
the combined effects of pure water supply, good drainage, and generally improved sanitary
arrangements), will be extended gradually—very gradually even though it may be—to the
native city and the suburbs ; and that, acting on the valuable suggestions put forward
from time to time by the Health Officer for the removal of those foci of pestilential disease
from the immediate vicinity of their dwellings, it will at some future time be possible to
report that epidemic cholera amongst the native population has become a much rarer disease,
Cholera.
Mortality from
cholera.
Decrease in the
number of cholera
cases treated in the
hospitals.