( 5 )
the dead-house for post mortem examination, the facts prove, as the Surgeon-
General argues, the magnitude of the error which in past years attributed all
septicæmic deaths to the defective construction of the hospital. The advocates
of antiseptic surgery claim for it that it prevents hospitalism almost entirely.
The Lieutenant-Governor hopes that in future reports the experience of the
Surgeons of the Medical College Hospital, in connection with this question, will
be brought out and examined by the Surgeon-General so as to be on record in
an easily accessible form. Meantime an examination of the statistics given in
the appendix and in former reports brings out the following facts, which were
certainly, in the Lieutenant-Governor's opinion, deserving of some detailed
examination:—
Number of important
operations, exclusive
of eye cases.
Deaths.
Deaths per
mille of
operations.
1879
222
39
175.6
1878
1877
181
191
22
39
121.5
2 0 4 . 1
1876
149
38
255.0
1875
105
31
295.2
1874
155
31
200.0
It is by no means certain that the same standard is applied year by year in
determining what cases shall be included among the more important operations,
and hence the necessity of professional criticism of the returns by the Surgeon-
General. If the same class of cases appear in the return yearly, it should be
explained, if possible, why the results of operations were less favorable in
1879 than in 1878. It is satisfactory, however, to note that they were more
favorable than in any of the four years preceding 1878. The increased
mortality of the operations in 1879 is a feature common to the returns of all the
hospitals, including the Mayo Hospital. It would seem therefore to be referable
to some general cause. The number of minor surgical operations ought also to
be shown, and the working of the out-patient department examined with
reference to the number of surgical and medical cases treated there. Again,
the working of the ophthalmic department is deserving of special notice. All
that can be gathered regarding it in the present year is that 336 operations
were performed as against 288 in 1878.
12. In the General Hospital there are now no native patients. The death-
rate among Europeans was higher than in 1878, 1877, 1876, and 1874, but lower
than in 1875. The rate (45.5) was, however, but little higher than the average
rate of the past ten years, viz. 44.9; and when it is remembered that from
the resident population only cases really calling for in-door treatment are now
admitted, the slight increase is fully explained. Liver disease, dysentery, and
d i a r r h œ a a c c o u n t e d f o r 4 0 o f t h e 1 4 2 d e a t h s ; c h o l e r a f o r 2 5 ; p h t h i s i s f o r 1 1 ;
unspecified local diseases for 25; poisons and injuries for 8. There were only
2 cases of heat apoplexy—the smallest number for many years. The cases of
cholera were fewer than in any previous year since 1871. The death-rate of
males was 39 per 1,000, of females 56 per 1,000, and of children 108 per
1,000. Many children are said to have been brought to hospital in a hopeless
state—a fact which seems to render the discrimination of mortality with refer- -
ence to age in the reports of other hospitals desirable. There were 61 important
surgical operations during the year (excluding three eye operations). The
deaths were 11, giving a rate of 180.3 per 1,000. In 1878 there were 37
operations with five deaths, or at the rate of 135.1 per 1,000.
13. In the Mayo Hospital and its dependencies (which are not Govern
- m e n t i n s t i t u t i o n s ) t h e r a t e o f m o r t a l i t y w a s s l i g h t l y h i g h e r t h a n i n 1 8 7 8 a n d
1874, and a good deal higher than in any of the other years in the statement.
Of the 285 deaths, 24 were due to fevers, 88 to cholera, 6 only to phthisis,
23 to other respiratory affections, 26 to dysentery and diarrhœa, 62 to other
local diseases, 34 to injuries, 5 to poisons; 36 cases (including apparently
cholera cases) were moribund on admission. There were 206 operations with
21 deaths, as against 154 with 12 deaths in 1878, the rate per mille being
101.9 against 77.9.
14. In the Campbell Hospital the admissions, though less by 2,794 than in
1878, were more numerous than in any previous year. The average daily
number in the wards was nearly equal to that of 1878; and although no persons