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cases the patients died. The deaths from septicœmia were eight, or 25 per
cent. of the total deaths from operations. It is, however, by no means
clear that even most of these deaths were due to hospitalism, and it appears to
be conclusively shown that in many cases in which deaths have hitherto been
attributed to hospitalism, mortification had set in and blood-poisoning declared
itself some days before the patients were admitted to the hospital. Dr.
MacConnell, the resident physician, has traced out the 30 septicemic post m o r t e m
surgical cases which were dissected in 1873 and found that 14 of them
were admitted into hospital actually suffering from the disease to which they
succumbed. As Dr. Coates observes, the septicæmia was imported and not bred
in the hospital. There can, the Lieutenant-Governor believes, be no doubt that a
considerable portion of the mortality at this hospital which has been ascribed to
hospitalism has been due to causes external to the hospital and not debitable to
it. The question of the defective construction of the Surgical Wards is one
which has been fully and exhaustively treated by the Committee on medical
expenditure. Their opinion, which was generally concurred in by the surgical
staff of the hospital, is entirely opposed to the extreme view expressed
by Dr. W. Palmer regarding the defective construction of these wards.
Dr. Palmer's views, morover, appear to be entirely unsupported by the figures
upon which he founds them, and they are also opposed to the views of his collea-
gues. The Principal in noticing the fact that though there were isolated cases
of erysipelas the disease did not spread or infect other patients says that this is
a very strong proof of the healthy quality of our hospital air, notwithstanding all
that has been said about faulty construction. The whole subject has, however,
been fully discussed in a separate correspondence with the Government of India,
and there is no doubt whatever that the Surgeons have from time to time attri-
buted ill-success in surgery to hospitalism. The Lieutenant-Governor must here
repeat the opinion which he has already recorded in submitting the memorandum
of the Committee to the Government of India that, after the improvements
recommended by the Committee have been carried out, the hospital though
not perfect, will be to all intents and purposes a practically good and
efficient hospital, as well adapted for the treatment of surgical cases as the great
majority of European hospitals. The number of out-door patients who
attended the dispensaries was higher than in any of the preceding five
years, there being 47,506 cases treated against 44,679 in 1876. Dr. Irving
gives the latter number as 44,556, but he appears to have compared the
number of persons treated in 1877 as shown in the general statement in
paragraph 2 of the report with the number of new cases in the previous year.
The erection of a new out-door dispensary, which is much wanted, has been
ordered from the funds bequeathed for the purpose by the late Baboon Choonee
Lall Seal. The dispensary is to be erected on a plot of land adjoining the
Medical College grounds, and will be called 'Choonee Lall Seal's Charitable
Dispensary.' Some of the minor improvements suggested in the 14th para-
graph of the report both at this and other hospitals have already been
sanctioned. Such recommendations should, however, form the subject of special
reports, as they cannot be conveniently dealt with in a review of the adminis-
tration for the past year.
13. General Hospital.— The in-door patients treated during the year
were 5,144, including 531 natives; the numbers in 1876 being 3,569
Christians and 430 natives. The death-rate of the Christians was 4.05, and that
of the natives 7.72 per cent. The great increase in the number of patients has
been already explained as mainly due to the large number of sailors in port.
During August, September and October a severe type of malarious fever
prevailed, resembling dengue in many of its symptoms, and frequently accom-
panied by an eruption. The attack lasted for a few days and was often
followed by one or more relapses. There were altogether 410 more cases of
malarious fever in 1877 than in 1876, and an excellent opportunity was thus
afforded for testing the value of the mixed cinchona alkaloids manufactured
at the Government Plantation at Rungbee. It is satisfactory to find that
Dr. Raye considers that the experience of the year justifies the conclusion
that the cinchona febrifuge may be confidently administered instead of quinine
in the great majority of ordinary malarious affections. In the low forms of
intermittent fever, Dr. Pilcher of the Howrah Hospital maintains that the