29
MEDICAL COLLEGE HOSPITAL.
solicited. The mortality, however, in the European wards had never been so remarkably
high as in the Native side of the building, and therefore less benefit could be expected from
the administration of better food or a more liberal use of extras there.
7. The Inspector-General will find by a reference to different documents bearing on
the subject that it was in 1869 when attention was first called to the importance of the
supply question to the hospital in its bearing on the treatment of disease and its results,
and it was during the year 1870 that a decided change took place for the better in the
statistics of the Medical College hospital,—the full measure of success, however, being only
discoverable in the return of 1871.
8. That good has resulted from the notice which has been taken of this question is
abundantly apparent, and if the Inspector-General will turn to the report submitted by
Surgeon Ewart in the last year on the medical and surgical transactions at the General
Hospital, he will find that officer affirming his belief in the absolute value of a well
arranged and liberal food supply to the sick in this exhausting climate.
9. The College Hospital on my recommendation was directed in 1870 to supply itself
with all articles of food, clothing, &c., by public contract, and the Chief Medical Officer
informs us in his report that this system was introduced in August last, and I allude to
it here to express my belief that if that system be fairly and carefully carried out the
expense for dieting and clothing the sick (with the enhanced rates for the former) will
not be in excess of the expenditure of past years, while the efficient support and the
management of the sick will be more effectually within the Surgeon's grasp and control.
10. Dr. Chevers shows us in his tables the gradual but small reduction of the cholera
death-rate from 1866 to 1871; but strange to say we find under the head of fever that the
mortality has increased from 9.9 and 16.2 per cent. in 1869 and 1870, to 18.3 per cent. in
1871, though the general death-rate has been so much lower all round.
11. I am under the impression (though the statistics are not before me) that the
heaviest rate of mortality in all classes of disease treated at the College Hospital in past
years came under the head of bowel affections,—scorbutic diarrhœa and dysentery; and if
so, it would have been interesting to have had a comparative table for the last three years
under this as under the other classes of disease; but it has not been exhibited.
12. Dr. Chevers again calls attention to the fact, as exhibited in the wards of his
hospital, that those diseases which depend so much on climate and are the most preva-
lent in this country, are the most deadly to those whose vitality is lowest in the scale. In other
words, the native of Bengal suffers from slow indigenous disease and dies in larger number
from its effects than the unacclimatized European,—another proof, if any were wanting, to
show that the condition of the people is of far greater consequence in relation to the ultimate
results of disease than anything else of which we are cognizant.
13. The Inspector-General will notice with satisfaction that there has been a consi-
derable lowering of the death-rate in the cases which have been operated on during the year
under review,—15.5 per cent. as contrasted with 20 per cent. in the two preceding years.
Only 4 cases of pyæmia having been recorded out of a total of 199 cases operated on,
this would lead us suppose that the so-called hospital influences have been more under the
control of the Surgeons of the hospital in 1871 than in any previous year, except perhaps 1870.
14. It has always appeared to me that (as regards accommodation) cases operated on
in the College Hospital are placed under rather favorable conditions for recovery, and are very
much removed from any of those influences which are considered to induce septic disease,
by the care and skill of the Surgeons; and the question has arisen in my mind, Have not
the actual conditions of the sick themselves previous to their coming into the Surgeon's hands
had a more potent influence in the development of pyæmia than even the specialities of the
hospital itself?
Benefit of liberal
dieting.
System of supply.
Higher death-rate
of fevers.
Greater mortality
among Natives.
Reduction of death-
rate in surgical
cases.