( 4 )
9. The foregoing statement exhibits all the deaths, whether the patients
were classed as moribund on admission or not. In previous years it was
customary to class as " moribund " all patients who died within 24 hours of
admission, and to make deductions from the total mortality on this account.
Dr. Payne, however, holds that cholera deaths occurring within 24 hours of
admission should not go to swell the numbers of so-called moribund cases. If
cholera be excluded, the moribund cases are almost entirely native, and their
effect should only be looked at with reference to the native death-rate. The
result in 1879 is shown in the following table, the figures in which cannot
unfortunately be compared, as regards totals, with those of former years,
except in the case of the Medical College Hospital :—
Campbell Hospital.
M e d i c a l C o l l e g e H o s p i t a l . Howrah Hospital. Mayo
Hospital. Police
Hospital. Total.
Total native deaths, excluding cholera
1,981
365
362
197
29
2,934
Moribund persons, ditto
181
84
60
29
3
357
Difference
1,800
281
302
168
26
2,577
True native death-rate per mille, excluding cholera, and.
_ ______ ____ _ _
_
moribund cases
235'2
140'6
287'07
9r8
91
169'5
Examining the working of each hospital with reference to the fore-
going tables and the more detailed statements in the Report, the Lieutenant-
Governor finds that, in the Medical College Hospital, the general death-rate of all
races in 1879 was 130 per 1,000, against 135, 108, 136, 152, and 125 per 1,000
in the preceding five years. Excluding moribunds, the rate was 93 as
compared with 111, 91, 103, 128, and 95 per 1,000 in the previous years.
The results were thus, on the whole, better than average. Male European
patients died at the rate of 57 per 1,000 treated, against 63 in 1878
females at 39, against 55. Of Eurasians, 79 males died per 1,000, against 59
in 1878 of females, 31 against 80. Of Natives, 201 per 1,000 males died,
against 230 in 1878; and 129 females, against 183 per 1,000. Both the general
and the European death-rates of the hospital were unfavorably affected by
the large reduction in the number of European sailors treated (380 against 867
in 1878), nearly all seamen being now sent to the General Hospital. This
reduces the number of European recoveries materially, sailors being admitted
to hospital freely, while European residents are only admitted as in-patients
when dangerously ill. Of the total number of deaths (559), fever accounted
for 52, cholera for 55, phthisis for 37, other respiratory affections for 52,
dysentery for 41, diarrhoea for 18, liver diseases for 15, parturition for 22,
unspecified local diseases for 147, poisons and poisoned wounds for 18, and
injuries for 50. The death-rate among natives was lower than in 1878, 1876,
and 1875, and higher than in 1877 or 1874.
The Surgeon-General has excluded from the body of the Report the
detailed lists of surgical operations and their results which used formerly to be
given, considering these only useful for office record, and out of place in an
administration report submitted to lay criticism. Dr. Payne's views of the
functions of an administration report are no doubt, strictly speaking, correct.
But it must be remembered that the Report of the Calcutta Medical Institutions
is supplied to many medical authorities both here and in Europe, and they would
certainly prefer that some detailed account should be given of the surgical work of
these hospitals, about which many disputed questions of practice have grouped
themselves. The Lieutenant-Governor himself would have been glad to have
had some detailed information as to the progress of antiseptic surgery in the
Medical College Hospital. The Surgeon-General gives, it is true, in an appendix
a list of major operations performed, with a return of the deaths after operation;
but it would have been interesting to know how far the deaths and the operations
were directly connected. The subject of hospitalism is, however, noticed in a
separate paragraph of the Report, from which it appears that Dr. McConnell's
investigations have now placed it beyond dispute that, in 64 cases of hospitalism
occurring within the past six years, the disease was, in no fewer than 41
imported into the hospital by the patients that is, the patients when admitted
had some form of putrefactive disorganization already existing in their system.
Although only those cases of hospitalism could be investigated which reached