8
REPORT ON THE
11. PARTICULAR DISEASES.—Small-pox had greatly decreased in 1891. The
total number of patients treated from this cause was 21 against 321 in the
previous year. All the cases in the past year were treated in the Campbell
Hospital. Dr. Mackenzie remarks in his report that the diminution was due to
there having been no epidemic of this disease during the year under report,
and probably to more efficient working of the Vaccination Department in
the Town and Suburbs. The following are the particulars of the 21 cases
treated in the Campbell Hospital as compared with the previous year :—
1890.
1891.
Confluent
. . .
. . .
63
4
Simple
. . .
. . .
62
10
Semi-confluent
...
. . .
166
5
Hæmorrhagic
. . .
...
6
. . .
Modified
. . .
. . .
4
2
Total
. . .
301
21
12. Cholera.—It has been mentioned that the prevalence of this disease
among the general population is always reflected in the hospitals. A very
large number of this affection was treated at the Campbell Hospital in 1891, and
the explanation given by Dr. Mackenzie is in accordance with that recorded by
Dr. Simpson, the Health Officer of Calcutta, viz., that the increase was due to
the Ardhodoy Jog festival. In the Presidency General Hospital the "vagus"
treatment was tried, as well as that recommended by Brigade-Surgeon Ross, but
with no satisfactory results. The total death-rate per cent. from this disease was
59.78 against 55.11 in 1890. In my annual report for 1890 I referred to the
outbreak of cholera among patients under treatment at the Howrah General and
Presidency General Hospitals, and I suggested that it was due to some insanitary
condition in the hospitals themselves, and it is gratifying to report that with the
improvement in the drainage system of these two hospitals, there has been no
similar outbreak in 1891. This is attributed by the Superintendent of the
Presidency General Hospital to the substitution of open for closed drains through-
out the compound. There was an outbreak of cholera last year among the
patients suffering from other diseases at the Campbell Hospital, which I reported
as being free from this disease in 1890. Dr. Cobb, the late Superintendent, it is
said, had traced the cause to the milk used by the patients, in the sense that the
cholera germ is communicated by means of water used to adulterate the milk,
but be this as it may, it is worthy of notice that the latrines were out of order,
and did not work properly during a great part of the year. Probably this may
also have had something to do with the cause.
13. The spread of cholera is attributed greatly to personal intercourse,
and most of the civil authorities and not a few Civil Surgeons are firm believers
that it has scarcely any other means of communicating itself. Thus, during
the Ardhodoy Jog festival, the disease was implicitly believed to have spread
by contagion, but there was no clear evidence that the disease spread itself in
this way at Noakhali, Bhágalpur, and other places, to which my attention was
more particularly directed, or that the pilgrims gave it to the people.
14. The occurrence of an outbreak of cholera in a hospital among the
patients under treatment there for other diseases must always be regarded
as an indication of grave sanitary defects of some kind or other. It
may be in the water-supply or in the milk, or in the drainage, or in the
disposal of the night-soil or of the cholera dejecta, in the ventilation or
general condition of the wards or compounds. These institutions and all their
arrangements for food-supply ought to be such that, although they are
situated in the endemic area, they should certainly command that immunity
which is ensured among the European population of Calcutta. I need not say
that when such an outbreak takes place it becomes the subject of the most
anxious enquiry by those responsible for the well-being of the sick who come
for treatment.
15. The gradual improvement of the sanitary condition of our large
hospitals is the outcome of this anxiety. Those who can recollect as I can
the Presidency General Hospital in 1857, when it was little better than a