8
REPORT ON THE
years from 1871 to 1876, and three only in the succeeding three years. Remittent
fever was much more prevalent during the latter period. In the General
Hospital the numbers of typhoid cases were uniformly high, and those of
remittent fever low. At Howrah typhoid did not appear in the records till
1877, when the management of the hospital passed into new hands. At the
Mayo Hospital there is record of the disease during five consecutive years and
none for the last three years, when remittent fever has been at its highest
point. The most remarkable cases are those of the Campbell and Police
Hospitals. In three years the Campbell Hospital recorded an extraordinary
number of typhoid cases. The disease then ceased suddenly, and simultane-
ously remittent fever rose largely. In the Police Hospital, where only the
sick of the police force are received, the number of typhoid cases recorded
was very high, and remittent fever did not appear for seven years. In 1878
the management changed hands and the order was reversed.
17. It seems clear from the foregoing that the general record of typhoid
fever in the Calcutta hospitals does not present the history of a distinct
disease, and that if the specific fever has existed, of which there is little doubt,
it is impossible to say how much or how little of it is represented in the
returns. One physician, finding that a case entered in his books as malarial
fever presents, during life or after death, some of the appearances which attend
the specific disease, will record the case as specific; another, recognizing the
fact that the clinical and pathological phenomena which make up the typhoid
co ndition often attend severe fever of other origin and are seen in disease
not usually classed as febrile at all, will not employ a name which has come
to signify a fever caused by filth alone, unless he have other evidence of
specific character.
18. Again, the records of the year in these large hospitals may, in the
public interest, be usefully examined for evidence of the progress which
the employment of the mixed cinchona alkaloids, as a substitute for quinine,
is making in large centres of medical practice. The evidence which I propose
to submit is not that of written opinion, for in truth the subject is not
mentioned in any of the hospital reports as a matter of opinion, but the
new drug has been largely used, and I infer from this that the medical officers
consider its value no longer open to discussion.
Expenditure of Quinine and Cinchona Alkaloid in the Calcutta Medical Institutions.
1876.
1877.
1878.
1879.
lb oz. dr.
lb
o z .
dr.
lb
o z .
dr.
l b oz. dr.
Medical College ...
Quinine
...
...
. . .
...
48 0 0
2 4 1 1 0
20
1 2 0
5 11 6
f o r 7 m o n t h s
Cinchona alkaloid ...
...
3 0 0
41 14
8
General Hospital ,..
Quinine ui
... ....
39 8 0
24 2 0
19 1 4 0
9 10 2 ½
... Cinchona alkaloid.....
:::
1 0 0
1 8 0
27 0 0
40 11 0
Campbell Hospital
Quinine
56 3 4
25 10 3
1 2 4
1 12 4
Cinchona alkaloid :::
.::
. .
22 6 7
36
8 4
34 4 2
Police Hospital
Q u i n i n e
6 12 0
7 0 0
0 5 1½
0 0 6 ½
Cinchona alkaloid
: :
......
1 0 0
7 0 . 4
3 10 6
Mayo Hospital
...
Quinine
24 0 0
6 8 0
3 3 0
3 13 0
C i n c h o n a a l k a l o i d
: : :
: : :
.
14 0 0
20 0 0
20 14 0
Howrah Hospital
Quinine
20 15 0
13 5 4
3 11 11
1 15 5
Cinchona alkaloids
:::
......
9 0 0
19 0 0
24 0 0
Tot al
Quinine
195 6 4
101 4 7
49 0 ½
22 14
8
... Cinchona alkaloid :::
:::
1 0 0
47 14 7
132 8 8
165 6 0
19. Finance.— The financial table which follows is prepared in accordance
with orders. I think it must have been originally intended that capital and
revenue accounts should be separately stated. This has not been done,
however, and the "total income," as it is presented, consists chiefly of capital
in some of the hospitals. The mode of balancing accounts has been such as
to present wrong statements of total expenditure and of Government outlay.
Thus money received from paying-patients and remitted to the treasury has
been entered as an item of miscellaneous charge, to balance the whole sum drawn
from Government, instead of allowing it to produce its effect on income and show-
ing, as Government payment, the amount drawn to cover expenditure, over and
above other receipts, which in fact it is. The want of information in former years
as to the cost of medicines, instruments, forms, &c., supplied from the Medical