CALCUTTA MEDICAL INSTITUTIONS.
25
MAYO AND CHANDNEY HOSPITALS AND BRANCH DISPENSARIES.
THESE were under the superintendence of Surgeon-Major H. Cayley during the year.
Finance.—The statement given in the annual return shows the income and expenditure
of the institution during the year. There is no separate income for the hospital and the
several dispensaries, but all are supported from one common fund. The subscriptions and
donations received during the year were as follow:—From Europeans Rs. 5,350, from natives
Rs. 2,145, besides a donation of Rs. 10,000 from Baboo Kallikissen Tagore, which has been
invested in Government paper. In 1877 the donation and subscriptions were from Europeans
Rs. 2,946, from natives Rs. 2,265.
During the year, and included in the above, Rs. 115 were received as donations from
well-to-do patients.
MAYO HOSPITAL AND DISPENSARY.
OF expenditure, Rs. 7,000 was paid towards building the new story to it for medical
officers' quarters, leaving Rs. 3,000 still due on this account.
The dieting of in-patients, including stimulants, cost Rs. 4,882 for an average of
96.8 patients, giving a cost of annas 2-2.4 for each diet. Rum alone was given as an alcoholic
stimulant.
The hospital buildings, now four and a half years old, are in good repair.
Patients, in-door.— The total treated was 1,873, and the daily average strength 96.8.
These numbers were in 1877, 1,821 and 82.1 respectively. Of the patients, 242 were women
and. 69 children; a separate children's ward is kept up.
The total deaths were 253, or 13 . 5 per cent. of treated, of which 65 were from cholera,
36 from fever, 32 from injuries; 30 from tetanus (all these were admitted with the disease),
24 from diarrhœa and dysentery, and three from poisons. Thirty-five moribund cases were
admitted (exclusive of cholera), which are included in the total of deaths.
The most prevalent class of disease was fever: 545 cases treated and 36 deaths. These
fevers were all of a malarious type, and prevailed especially in the last four months of the
year.
Many of the cases were complicated by inflammation of the lungs, dysentery, and lesion
of other internal organs, and in many there was a tendency to delirium and coma, but there
was not a single case of real enteric typhoid fever. Out of the hospital I have seen several
cases of genuine enteric fever during the year, but chiefly in the European quarters
of Calcutta. For some months past one ward of the hospital has been chiefly occupied
by Cabulis suffering from the very worst forms of malarious fever, and they seem to
be especially liable to pneumonia as a complication of fever. These Cabulis do not
generally acquire fever in Calcutta, but they travel about as traders in all the neighbouring
villages and districts, and then either return with fever, or are attacked soon afterwards.
Of the fever cases 36, or 6 . 6 per cent. died. I do not think the fever last year was so
severe in Calcutta or so fatal as in 1874, when out of 165 cases in the Mayo Hospital 19,
or 11.4 per cent., died.
One hundred and forty-six cases of cholera were treated, and 65, or 44.5 per cent., died.
In 1877 there were 131 cases and 77 deaths, or 59 per cent. A mortality of 41.5 per cent.
taking the year: this is a very low one indeed. In a disease of so varying a nature as cholera
one cannot very safely form any conclusion on the point; but I may notice that the whole of
the cases last year (1878) were treated practically without any internal medicine, and alcoholic
stimulants were entirely withheld. The system of treatment was ice-water, linseed-tea as much
as possible, barley-water, milk and water, or lime-water, mustard poultice over the stomach
and, where vomiting, restlessness, or cramp were severe, very small subcutaneous injections
of morphia or chloral, seldom more than one, or at most two, in any one case. In some
cases a few minims of chloric ether in camphor water were given, but in too small doses
to have any effect for good or evil. After long experience and experiments with almost
every method of treatment that has ever been suggested, I have come to the conclusion
that some such plan as the above is the most successful. Of course great care and attentive
nursing are of the utmost importance.
Of nine cases of liver disease, four were extensive abscess in the liver, all of which were
treated by free incision: of them one died and three recovered.
Tetanus, as usual, added greatly to the mortality. Out of 43 treated, 30 died, of these
13 were moribund. on admission.
The operations gave very good result. Of 122 major operations there were 12 deaths,
or 9.8 per cent. I do not think what we may call hospitalism had any part in these deaths.
Many very severe injuries were treated, as the number of deaths, 32 out of 310 cases,
shows.
Out-patients.—The total number treated was very large-52,571—and the daily average
attendance 416.2.
There was nothing very special in the character of the more common diseases, but a
considerable number of cases of what seemed to be a new type of disease—a sort of general
acute dropsy or œdema of the cellular tissue—sometimes confined to the legs, in other cases
spreading over the whole body generally, ushered. in by fever or diarrhœa, and not accom-
panied by albuminuria. In some cases the attacks lasted many weeks.