( 6 )
were admitted for blindness or absolutely incurable conditions, and the orders
of Government restricting the number of patients to 467 (subject to certain
exceptions) were attended to as far as possible, there were at one time 508
persons under treatment. There are still many incurable cases of old standing
in the wards. Of the 32 European deaths, 12 were caused by small-pox, 10 by
dysentery and diarrhœa, none by cholera. Of the 2,125 native deaths, 81 were
due to small-pox, 323 to fevers, 144 to cholera, 93 to phthisis, 165 to dropsy,
49 to respiratory affections, 978 to dysentery and diarrhœa. The cholera
admissions were more numerous than before (227 against 117), owing to the
transfer to this hospital, under Government orders, of cholera cases from the
inland labour transport depôts. In the depôts these cases died at the rate of
80.6 per cent in 1878; their death-rate in the hospital was 64.7. The death-rate
from all diseases was 260 per 1,000 against 253 in 1878. The difference is
entirely due to the increase in depôt cholera cases. Excluding these, the rate
was 252 per 1,000, or very nearly the same figure as in 1874, 1876, 1877 and
1878, and very much below the mortality of 1875. Small-pox accounts for the
slight excess of this rate over that of the year preceding. Excluding cholera,
small-pox, and moribunds, the general death-rate was 199 per 1,000. Even
including all these, and notwithstanding the excess of cholera and small-pox,
the rate was, taking all classes of patients together, nearly 20 per mille less
than in 1875, when there were fewer cases of small-pox by 100, and of cholera
by 79. There were 95 operations during the year, with 31 deaths, as against
38 with 9 deaths in 1878, the rate per mille being 326.3 against 236.9. The
very heavy mortality in surgical cases in this hospital seems to require
explanation.
15. The statistics of the Police Hospital admit of no comparison with
those of other hospitals. Trivial cases are freely admitted, and incurables are
allowed to take leave or retire to their homes.
16. In the Howrah Hospital the European death-rate of the last two years
had been very high, as compared with that of 1877, 1876, 1875, and even 1874.
It is said that trivial cases are now more rigorously excluded. Of the 32
European deaths, 8 were from fever, 3 from cholera, 4 from phthisis, 6 from
liver disease, dysentery, and diarrhœa, 6 from other local diseases, and 2 from
debility and old age. Among the native admissions, the proportion of hopeless
and moribund cases is greater in this hospital than in any other, and has increased
largely within the last two years. Half the native in-patients are now said to
be "serious cases of injury and moribunds." More than one-fifth of the
deaths last year occurred within 24 hours of admission, and more than a third
within three days. Dysentery and diarrhœa caused 222 of the 391 deaths,
cholera 29, fever 29, phthisis 11, debility and old age 26, injuries 15. The
native accommodation of this hospital has been largely extended by converting
part of the old jail to hospital uses; so that it now serves the same purposes as
the Campbell Hospital in respect of receiving moribund and destitute native
patients. There were 38 important surgical operations with 6 deaths, against
53 with 9 deaths in 1 878, the rate per mille being 157.8 against 169.8.
17. In paragraphs 14 to 17 of the Report, the Surgeon-General examines
the evidence presented by the hospital returns on the question of the increase
or decrease of enteric or typhoid fever. It appears that no conclusion as to
the prevalence of this specific fever can be drawn, owing to the similiarity which
it presents in many (of its phases to malarial remittent fever, and the idiosyn-
crasies of different officers in deciding questions of classification as between
these two diseases. One very serious fact is, however, established by the
Surgeon-General's figures, and that is the great increase of remittent fever and
typhoid taken together. Thus the hospital returns show
—
Typhoid
fever.
Remittent
fever.
Total.
1871
116
290
406
1872
126
381
507
1873
53
421
474
1874
30
731
761
1875
23
847
870
1876
43
806
849
1877
35
1,128
1,163
1878
13
1,284
1,297
1879
18
918
936