Statistics.
Attendance.
Phthisis.
Pneumonia.
Insolatio.
13
CALCUTTA. MEDICAL INSTITUTIONS.
23. Dr. Ewart goest most elaborately into the statistics of this last and the preceding
eight years in a series of ables, all of which are given in the appendix, and which possess
value and interest.
The total number treated is 2,723, against 3,443 in 1872 ; but it is in excess of all
previous years, and no doubt much, if not all, the difference between 1872 and 1873 is due to
epidemic of dengue, which was so prevalent in the former year.
Dr.Ewart shews that in only one year since 1865, viz. in 1871, when it was 36 . 52, has
the death-rate been so low as it was last year, 38 .9 ; and this holds good whether cholera be
—exculded or included.
24. Of cholera, 53 cases have been treated, and of these 18 died—a rate of 339 . 6 per
thousand. In 1872, 94 cases with 42 deaths, or a rate of 446 .8 per thousand, were recorded.
During this last year, therefore, there have been fewer cases and a much lower rate—an
unusually low rate, indeed, of mortality. In both these respects this hospital is in markedly
favourable contrast to the Medical College Hospital. Dr. Ewart is disposed to attribute the
fewer cases of the disease to the somewhat improved condition of the river-bank, and of the
sanitary state of the town generally ; and its less fatality, to the cases being sent for treatment at
an earlier stage, when alone it can influence the result. Dr. Ewart's opinion that, if the river
were embanked and the sewers properly trapped, there would ensue a diminution of cholera
among the floating population on the river, is one in which no one, I think, is disposed to
disagree. The latter requirement has indeed now been met, the engineer to the justices having
recently reported that all the openings of the sewers have been carefully trapped by the fixing
of a double set of flaps, which set close against their respective frames ; so that the back draught
emanations, considered to have such injurious influence, can no longer take place ; and, no doubt,
this is a most essential measure, which, with the arrangements whereby sewage is conducted
into the stream only when the tide is running out, reduces to a Minimum probably the evils
which must result from any portion of the sewage of a town being permitted to enter the river
flowing past it. It is satisfactory to learn that apparently some good has resulted from the
efforts already made to improve, however partially, the sanitary condition of the river-bank,
and much credit is due to Dr. Ewart in so persistently urging the importance of attention being
directed to it. More permanently satisfactory results will probably not be attained until the
time shall come when it will be possible (1) to divert entirely instead of partially, as at present,
the sewage of the town away from the river ; (2) to raise an embankment with perpendicular
masonry side, as in the Thames embankment, so that no mud can settle upon it ; and (3) to
appoint a port surgeon, whose duty shall be to see to the sanitary condition of the river
and of the shipping and of the vast floating population in the port. The position in the port
and town from which the 53 cases of cholera were brought is given.
Death-rate.
Cholera.
25. In this report the subject of remittent fever, to which Dr. Ewart is devoting special
attention, and of fevers generally, is brought prominently forward. A memorandum by
Dr. J. W. Palmer, on the cases of fever treated by him in the course of the year, is submitted,
and is accompanied by a transcript of the temperature observations recorded in a certain
number of typical cases of the several classifications of periodic fevers, of two cases of typhoid,
and of a case of " anomalous form of fever." The number of cases of typhoid fever has been
less than in all previous years (except 1869). Dr. Ewart again ur-ges the great importance of
a continuous and careful investigation into the nature of the different forms of fever treated
at this hospital, and solicits reconsideration of the suggestion lie made in 1872, that an officer be
placed temporarily at his disposal for this special purpose exclusively, and which I was unable
to support. He points out that the newly-arrived surgeons, who are ordered to do duty at the
General Hospital, do not remain long enough to be of any real service; and he considers moreover
that these young men are too inexperienced, and he proposes that a medical officer of some
Indian experience, well versed in animal chemistry and the use of the microscope, &c., should
be set apart for this object.
I regret that I am still unable to support such a request ; the exigencies of the service will
not, at present at any rate, permit of another medical officer being detached for such a duty.
Much, I think, may be done in the direction he indicates under his own supervision and that
of the first and second resident surgeons, with the aid of the newly-appointed surgeons, who
for the most part do remain long enough to be utilized with advantage (a number of the last
batch remained six months), and of the assistant surgeons who are sent to do duty
temporarily at the hospital.
26. Tables are given showing the sickness and mortality from phthisis, the admissions for
which have been about the average of the last eight years. but the mortality has been much lower.
27. Cases of pneumonia have been more numerous than usual.
28. Fifteen cases of insolatio are returned, of which four died. On the treatment of
thus affection, the surgeon's remarks are very practical.
Remittent fever.
Only seventeen operations have been performed, all of which were susuccessful.
Surgery.
30. Twenty-four confinements took place during the year,—a somewhat larger number
than in the two previous years. Two cases of puerperal fever and one of phlegmasia dolens,
one of the former proving fatal, have been treated. These cases, however, were not contracted
in the hospital, and happily none of the other lying-in women were affected. Perhaps this
affords as good proof as could be given of the general healthiness and the absence of
Midwifery.