NationalLibraryOfScotland/medical-history-of-british-india huggingface dataset:
I P / 6 / H G . 4
REPORT
ON THE
CALCUTTA MEDICAL INSTITUTIONS
FOR THE YEAR 1880.
BY
A. J. PAYNE, M.D.,
Surgeon-General for Bengal.
Calcutta:
PRINTED AT THE BENGAL SECRETARIAT PRESS.
1881.
REPORT
ON THE
CALCUTTA MEDICAL INSTITUTIONS
FOR THE YEAR 1880.
BY
A.J. PAYNE, M.D.,
Surgeon-General for Bengal.
Calcutta:
PRINTED ATTHE BENGAL SECRETARIAT PRESS.
1881.
REPORT
ON THE
CALCUTTA MEDICAL INSTITUTIONS
FOR THE YEAR 1880.
No. 1650½.
FROM A. J. PAYNE, ESQ., M.D.,
Surgeon-General for Bengal,
To THE SECRETARY TO THE GOVERNMENT OF BENGAL,
MEDICAL AND MUNICIPAL DEPARTMENT.
Calcutta, the 14th April 1881.
SIR,
I HAVE the honour of reporting as follows on the working of the
hospitals of Calcutta during the year 1880. I submit, by way of introduction,
a few remarks on the general health of the town, as shown in the mortuary
returns of the Health Officer, in respect of the most prevalent diseases.
Deaths from the most prevalent diseases in the Town of Calcutta.
Cholera. Diarrhœa an
dysentery. Fevers. Small-pox. Other causes. Total.
Ratio per
mille of
population,
census 1876.
1875
1,674
1,579
5,328
720
4,343
14,086
32.7
1876
1,851
1,864
4,361
71
4,785
12,964
3 0 . 1
1877
1,418
1,683
5,151
67
4,817
13,704
31.9
1878
1,338
2,010
6,086
1,495
5,385
16,396
3 8 . 1
1879
1,186
1,516
4,796
772
5,467
13,044
30.3
1880
805
1,267
3,797
114
5,698
11,681
27.1
2. The public health in 1880 is seen from these figures to have improved
greatly, not only on that of the year 1879, but on the condition of the
previous five years. The scarcity of cholera was remarkable. During the
entire period of municipal registration, one year only has produced similar
exemption—viz. the year 1871, when filtered water was first made generally
avai l abl e f or dr i nki ng. For t he l ast f our year s t he t own has made unbr oken
progress in respect of cholera. There was a fall of less degree in bowel
4
REPORT ON THE
only, and children at the rate of 85. The number of children treated was
small, and the adult death-rate was not much exceeded by the general rate in
consequence, but it was affected in some degree. In the Campbell Hospital
the adult death-rate was 234 per thousand, and that of children 150. This
difference would be expected from the condition of adults received into this
hospital. The children brought the general death-rate to 230.8. Being few
in number, the effect of their smaller mortality on the general rate was not
great. In the Mayo Hospital adults died at the rate of 142 per thousand, and
children at the rate of 155. The effect on the general rates was insignificant
from the numbers. At Howrah children died at the rate of 214 per thousand,
but the entire number was again too small to affect the total proportion.
The general death-rate among adults in all the hospitals was 138.6 per
thousand, that of children 133. The total death-rate given in the table is
138.17, and the fractional difference is now explained. At the same time it is
made clear that the large number of children entered in the second statement
were almost all of them treated as out-patients.
8. Some marked differences in the death-rates of male and female adults
will probably attract attention. The hospitals chiefly concerned are the
Campbell and Howrah Hospitals, which resemble each other in receiving large
number of wandering destitute people in the extremity of illness, among
whom males largely predominate.
STATEMENT No. V.
6
REPORT ON THE
DISEASES.
MEDICAL COLLEGE HOSPITAL.
GENERAL HOSPITAL.
MAYO HOSPITAL.
Europeans.
Natives.
Europeans.
Natives.
Treat ed.
Died.
Di e d p e r 1 , 0 0 0 .
Treat ed.
Died.
Di e d p e r 1 , 0 0 0 .
Treated.
Died.
Di e d p e r 1 , 0 0 0 .
Treat ed.
Died.
Di e d pe r 1, 000.
GENERAL DISEASES.
Order A.—Febrile or Zymotic
Diseases.
Small-pox
...
...
...
...
...
...
1 ...
...
...
...
...
Malarious fever, ague, and remittent
450
22
48.88
191
28
146.6
415
5
12.04
532
43
80.82
Cholera
7
6 857.14
51
29 568.62
21
13 619.04
137
61 445.25
Other diseases of this order
34
2
58.82
3
2 666.66
292
6
20.54
9
1 111.11
Total
491
30
61.1
245
59 240.81
729
24
32.92
678
105 154.86
Order B.—Constitutional Diseases.
Rheumatic affections
31
. . .
...
25
. . .
...
168
. . .
...
61
1
16.4
Syphilitic ditto
46
...
...
38
1
26.31
139
...
...
20
. . .
...
Scrofula
5
1
200.
. . .
... ...
...
...
...
1
. . .
...
Anæmia
4
. . .
...
7
3 128.57
5
. . .
...
3
1
333.3
Leprosy
. . .
. . .
...
1
...
...
...
...
...
1
...
...
Phthisis
62
14 225.8
55
18 327.27
76
17 233.68
21
10 476.19
Dropsy
3
1
333.3
17
2 117.64
3
...
...
9
3 333.33
Other diseases of this order
55
6 109.1
9 4
10 106.38
22
1
45.45
34
3
88.23
Total
209
22 105.26
237
34 143.46
413
18
-
43.58
150
18 120.
LOCAL DISEASES.
O p h th al m i a
5
...
...
2
. . .
...
9
...
...
14
...
...
Inflammation of the external ear
3
...
...
1
. . .
...
19
...
...
2
1 500.
Goitre
. . .
...
...
1 ...
...
1 ...
...
...
...
...
Respiratory affections
147
13
88.43
128
35 273.43
158
7
44.3
173
43 248.55
Heart diseases
26
4 153.84
15
3 200.
48
9 187.5
4
2 500.
Dysentery
90
11 122.22
140
48 342.85
178
3
16.85
124
28 225.8
Diarrhœa
134
11
82.1
50
4
80.
157
4
25.47
57
10 175.43
Worms
4
. . .
...
2
...
...
22
. . .
...
1
. . .
...
Liver diseases
48
7 145.83
55
14 254.54
59
5
84.74
13
1
76.92
Spleen ditto
54
3
55.5
64
4
62.5
56
2
35.71
51
. . .
...
Gonorrhœa and its complications
16
...
...
16
...
...
112
...
...
13
1
76.92
Abscess, boils, and whitlow
67
3 44.77
77
7
90.9
104
2
19.23
89
4
44.94
Skin diseases
15
...
...
5
. . .
...
39
1
25.64
1
...
...
Ulcer
34
1
29.41
23
1
43.48
114
2
17.54
28
1
35.71
Labour, premature, natural, and difficult
151
8
52.98
174
13
74.71
43
...
...
2
...
...
Other local diseases
669
44
65.77
560
128 228.57
582
17
29.21
336
61
181.54
Total
1,463
105
71.77
1,313
257 195.73
1,701
52
30.57
908
152 167.4
CONDITIONS NOT ASSOCIATED WITH
GENERAL 0R LOCAL DISEASES.
-
Debility and old ago
128
...
. . .
26
...
...
78
1
12.82
5
...
...
Poisons and poisoned Wounds
57
4
70.17
71
22 309.86
75
...
...
39
5 128.2
Injuries
78
8 102.56
255
47 184.31
172
7
40.69
350
25
71.42
Total
263
12
45.62
352
69 196.02
325
8
24.61
394
30
76.14
GRAND TOTAL
2,426 169
691(0
2,147
419 195.15
3,168 102
32.19
2,130
305 143.19
STATEMENT No. VII.
27
CALCUTTA MEDICAL INSTITUTIONS.
96. The aggregate sickness and mortality in the Europeans and Natives
are shown in the following table :—
YEARS.
EUROPEANS AND EAST INDIANS.
NATIVES.
Treated.
Died
(in-door).
Ratio
per 1,000
of deaths.
Treated.
Died
(in-door).
Ratio
per 1,000
of deaths.
In.
Out.
I n .
Out.
1 8 7 7 . . .
953
4,998
38
39.87
1,510
252.31
14,329
381
1878 . . .
828
4,100
46
55.55
1,674
16,305
580
346.47
1 8 7 9 . . .
594
3,876
32
53.87
1,176
14,400
391
332.48
1880 . . .
612
4,368
18
29.41
945
8,977
275
292.1
97. More than one-fifth of the Native deaths occurred during the first
24 hours after admission to hospital. The character of the more fatal diseases
was milder during 1880 than in the previous year. Fevers caused two deaths
in 8 cases among Europeans and East Indians, and 33 deaths in 99 cases
among Natives, being more fatal among the latter class than in the former.
Dysentery and diarrhœa caused the largest number of deaths, the cases being
neglected in their early stages before admission, both as regards medicine and
food among a poor population. Twenty-five major operations in Natives and
seven in Europeans were performed during the year. The minor operations
recorded were 63 among Europeans and 1,162 among Natives.
98. The Superintendent reports favourably on the water-supply, drainage,
and conservancy of the hospital. The new latrine, connected with the north
verandah by a covered way, proved to be a great comfort to the sick, but still
the hospital is defective in this important detail.
99. Building .—The new native ward was completed. The old moribund
ward was removed, and a large factory shed was fitted for the reception of
this class of patients. A range of new servants' quarters has been erected, and
other improvements effected.
I have the honour to be,
SIR,
Your most obedient servant,
A. J. PAYNE, M.D.,
Surgeon-General for Bengal.
iv
in an annual return as having suffered from septic poisoning. For instance,—a
patient is admitted suffering from abscess; he gets mild cutaneous erysipelas for a few
days while under treatment for the abscess. Such a patient would appear only as a
case of abscess, and the erysipelas would not be noticed any more than if he had
had diarrhœa for a day or two.
The inclusion of such cases swells the table appended considerably.
Excluding milder cases, which must, I fear, always be expected to appear from time to
time in hospitals, the severer cases numbered 17. These 17 cases are of two classes—
those occurring primarily in the hospital, of which there were eight; and those admitted
already suffering from blood poisoning, numbering nine.
Of the eight severe cases which originated in the hospital, two were wholly beyond
control,—namely a lithotrity and a lithotomy case, both affected with "surgical kidney," and
neither therefore capable of being saved by any hygienic or antiseptic means. This
reduces the number of possibly preventible severe cases occurring in the wards to six.
In conclusion, although I would never hope to absolutely prevent septicæmia—for it
occurs even in cases in which there is no wound nor injury—yet I think that a careful use
of antiseptics, combined with hospital cleanliness, may reduce the number of cases occurring
in hospital to smaller figures.
D. O'C. RAYE ,
Offy. Second Surgeon.
MEDICAL.
CALCUTTA, THE 26TH MAY 1881.
RESOLUTION.
READ—
The Report on Calcutta Medical Institutions for 1880.
The public health of Calcutta was much better in 1880 than in any one
of the five previous years. Deaths from cholera were less than half as numer-
ous as in 1875 or 1 876, and numbered only two-thirds of the deaths from this
cause in 1879, itself the healthiest of the five years. In diarrhœa and dysentery,
and in fevers, the mortality was also much lower in 1880 than in any of its
five immediate predecessors. The general death-rate per mille was only 27.1,
against 30 . 1 in 1876 and 30 . 3 in 1879, 31 . 9 in 1877, 32'7 in 1875, and 38.1
in 1878. Under these circumstances, it might be expected that the returns
would show a falling off in the number of persons resorting for treatment to
the Calcutta hospitals during the year. Such, however, is not the case. The
following statement shows the number of deaths recorded in the town since
1875, and the number treated in the hospitals in each year :—
Total number of
d e a t h s .
.
Total number treated
at the Calcutta
hospitals.
1875
14,086
267,035
1876
12,964
267,914
1877
13,704
277,707
1878
16,396
263,575
1879
13,044
248,972
1880
11,681
258,123
2. The number of in-door and out-door patients treated during the past
two years at each of the hospitals, whose working is reviewed in the report,
was—
MEDICAL INSTITUTIONS.
1880.
1879.
TOTAL TREATED.
TOTAL TREATED.
N u m b e r .
In-door. Out-door.
Total.
Died per
mille of
treated.
In-door.
Out-door.
Total,
Died per
mille of
treated.
1 Medical College Hospital
5,089
57,875
6 2 , 9 6 4
128.58
4 , 8 1 4
51,208
56,022
130.27
2 General Hospital..
...
3,168
3,168
32.19
3,115
3,115
45.58
3 Mayo Hospital and Dispensary
2,130
1 8 0 , 2 5 7
182,387
143.19
2,045
1 7 6 , 8 1 4
178,859
1 3 9 . 3 6
4 Campbell Hospital
6,881
......
6,881
230'78
8,293
......
8,293
260'09
5 Municipal Police Hospital ...
2,723
......
2,723
11'01
2,683
.....
2,683
13'41
Total Calcutta Hospitals ...
-
19,991
238,132
258,123
134.17
20,950
228,022
248,972
155.62
6 Howrah General Hospital ...
1,557
13,345
14,902
188'18
1,770
14,276
1 6 , 0 4 6
238.98
GRAND TOTAL
...
-
21,548
251,477
273,025
138'17
22,720
242,298
265,018
162.2
An increase is shown in the number of in-door patients at all except the
Campbell and the Howrah hospitals. The decrease in the former was due
to the reduction of the available space while the buildings were under repairs.
Probably this circumstance contributed to the increase in the Medical College
Hospital, but it is stated that the wards of the latter institution are
nearly always full. Fluctuations in the actual number of persons treated must
therefore depend very much on the severity or mildness of disease, and the
consequently longer or shorter period of the average stay in hospital. At
Howrah the decrease is attributed to improved public health, and to care in
the selection of patients for admission. This hospital is not controlled by
Government. At the two Calcutta hospitals which receive out-door patients
there was an increase in the attendance—6,667 at the Medical College
( 8 )
because a check was placed upon wasteful expenditure, may be seen from the
following figures. The year 1877 is omitted as it was one of transition:
—
EUROPEANS.
Medical College and General Hospital.
Treated.
Died.
Treated.
Died.
1874
4,190
214
1878
6,705
318
1875
4,578
268
1879
5,241
289
1876
5,364
289
1880
5,594
271
Total
14,132
771 or 54.5 per mille.
Total
17,540
878 or 50 per mille.
NATIVES.
Medical College and Campbell Hospital.
Treated.
Died.
Treated.
Died.
1874
9,667 2,271
1878
13,062 3,204
1875
10,124 2,684
1879
10,824 2,537
1876
8,663 2,054
1880
9,016 2,005
Total
28,454 7,009, or 246 per mille. Total
32,902 7,746, or 235 per mille.
Both 1875 and 1878 were unhealthy years. On the other hand the
Campbell Hospital was partly closed in 1880 for repairs, and there was
consequently a decrease of 1,190 in the number of indoor patients. The
following are the figures under the head of diet and stimulants. Separate
figures are not available for 1874. The cost of medicines in each hospital was
not regularly given in the earlier reports, so that materials for exhaustive
comparison under this head are wanting.
Diet and Stimulants.
1875.
1876.
1878.
1879.
1880.
Rs.
Rs.
Rs.
Rs.
Rs.
Medical College
48,209
46,303
30,945
30,884
29,753
General Hospital
35,833
45,431
29,205
23,908
28,418
Campbell "
35,222
31,822
23,876
24,086
24,363
Total
1,19,264
1,23,556
84,026
78,878
82,534
Thus, while the number of patients increased and the ratio of deaths
decreased in the three years 1878-80, there was a large decrease, instead of a
corresponding increase, in expenditure.
ORDER.—Ordered that a copy of this Resolution and of the Report be
submitted for the information of the Government of India, in the Home,
Revenue and Agricultural Department.
Ordered also that a copy of this Resolution be forwarded to the Surgeon-
General, Bengal, for information and guidance.
Ordered also that a copy of this Resolution and of the Report be forwarded
to the Chairman of the Corporation of the Town of Calcutta, and to the Com
-missioner of Police, Calcutta, for information.
Ordered also that the foregoing Resolution, together with the reports from
the First and Second Surgeons of the Medical College Hospital on the subject of
Antiseptic Surgery, be published in the Calcutta Gazette for general information.
By order of the Lieutenant-Governor of Bengal,
COLMAN MACAULAY,
Offg. Secretary to the Govt. of Bengal.
( 9 )
No. 650.
COPY, with copy of the Report, submitted to the Government of India, in
the Home, Revenue and Agricultural Department, for information.
No. 651.
COPY forwarded to the Surgeon-General, Bengal, for information and
guidance.
No. 652.
COPY, with copy of the Report, forwarded to the Chairman of the Corpora
-tion of the Town of Calcutta for information.
No. 653.
COPY, with copy of the Report, forwarded to the Commissioner of Police
Calcutta, for information.
By order of the Lieutenant-Governor of Bengal,
RAJENDRA NATH MITRA,
Asst. Secretary to the Government of Bengal.
CALCUTTA,
The 26 th May 1881.
W, H. & others—Reg. No. 1950C–224–17-6-81.
IP
REPORT
ON THE
CALCUTTA MEDICAL INSTITUTIONS
FOR THE YEAR 1881.
BY
A. J. PAYNE, M.D.,
Surgeon-General for Bengal.
•
PRINTED AT THE BENGAL SECRETARIAT PRESS.
1882.
REPORT
ON THE
CALCUTTA MEDICAL INSTITUTIONS
FOR THE YEAR 1881
.
BY
A. J. PAYNE, M.D.,
Surgeon-General for Bengal.
Calcutta:
PRINTED AT THE BENGAL SECRETARIAT PRESS.
1882.
REPORT
ON THE
CALCUTTA MEDICAL INSTITUTIONS
FOR THE YEAR 1881.
No. 3249.
FROM A. J. PAYNE , ESQ., M.D.,
Surgeon-General for Bengal,
To THE. SECRETARY TO THE GOVERNMENT OF BENGAL,
MUNICIPAL AND MEDICAL DEPARTMENT.
Calcutta, the 18th April 1882.
SIR,
I HAVE the honour of reporting as follows on the state of the
Medical Institutions of Calcutta in the year 1881. The condition of the town
itself, in respect of the most prevalent diseases, is shown in the subjoined
table:—
Deaths from the most prevalent diseases in the Town of Calcutta.
Cholera, Diarrhœa and
Dysentery.
Fevers.
Small-pox. Other causes.
Total
Ratio per
mille of
population.
1875
1,674
1,579
5,328
720
4,785
14,086
3 2 . 7
1876
1,851
1,864
4,361
71
4,817
12,964
30.1
1877
1,418
1,683
5,151
67
5,385
13,704
31.9
1878
1,338
2,010
6,086
1,495
5,467
16,396
3 8 . 1
1879
1,186
1,516
4,796
772
4,774
13,044
30.3
1880
805
1,267
3,797
114
5,698
11,681
27.1
1881
1,693
1,491
3,765
133
5,948
13,030
3 0 . 0
2. General Mortality of the Town .—The fact most worthy of note is that,
after passing through four years of steady progress and reaching in 1880 a point
almost the lowest on record, the town in 1881 produced a quantity of cholera
which is among the largest recorded since the introduction of filtered water.
This necessarily affected the hospitals and the death-rates among patients.
There was increase of death in the town from bowel complaints over the previous
year, but not over ordinary numbers. Fever was not more fatal than in
1880, and much less so than in other years. This is worthy of attention
with reference to the great fever mortality in several districts of the province,
and with especial reference to that of the neighbouring district of Nuddea.
The deaths recorded in Calcutta, as is now well known, are only a portion of
those which are caused there, and afford no measure of the salubrity of the town.
Sick natives, who do not speedily recover or die, betake themselves to their
A
CALCUTTA MEDICAL INSTITUTIONS.
3
in 1881, if the influence of the new dispensary be admitted in full as the cause
of that in 1880. In 1881, moreover, the Mayo Hospital showed an increase over
1880 nearly as large as was shown in 1880 over 1879, and much larger than
the increase at the Medical College.
6. The total number of new cases treated as out-patients at the Medical
College in the medical and surgical dispensaries, was 26,363 in 1881. Of
these 15,219 were medical and 11,144 surgical cases. In addition to these
13,752 persons were treated in the admission room, and 4,198 in the consulting
room.
7. The out-door practice of the Mayo Hospital and its dependencies was
thus distributed:—Mayo Hospital, 48,059; Chandnee Hospital, 68,592; Chitpore
Di spensary, 19, 908; Park St reet Di spensary, 31, 282; and t he Sukea' s St reet
Dispensary, 15,513.
8. Concerning the out-door patients of the Howrah Hospital, the Super
-intendent writes:— "In former years there cannot be a doubt that the register
was kept inaccurately, and attendances were counted as fresh cases." * * *
"The figures given this year are nearly correct." This practice was by no
means confined to the Howrah Hospital. In district dispensaries it was
almost universal, and though every effort has been made to stop it, I cannot
hope that it has yet come to an end.
9. The daily average numbers of patients were as follows:—
In-door.
Out-door.
Medical College
276.7
385.4
General Hospital
136.4
...
Mayo Hospital, &c.
97.3
1,349.4
Campbell Hospital
372.3
...
Police Hospital
98.7
...
Howrah General Hospital
63.2
110.4
STATEMENT No. II.
_Race and Sex of Patients.
Total for
1880.
Males.
Females.
Children.
Total for
1881.
Europeans
9,077
6,117
1,696
1,883
9,696
Eurasians
33,872
11,281
7,344
15,588
34,213
Mahomedans
91,191
53,739
10,497
27,783
92,019
Hindoos
127,854
91,415
17,182
20,527
129,124
other races
11,031
3,393
2,490
4,779
10,662
Total
273,025
165,945
39,209 70,560
275,714
10. Race and Sex .—The numbers treated of all specified races have increas
-ed. The statement is devoid of interest or value except in respect of sexes.
STATEMENT No. III.
Deaths in Calcutta Hospitals in 1881.
YEARS.
ALL DISEASES EXCEPT CASES
TREATED IN EYE INFIRMARY.
CHOLERA.
Death rate
excluding,
cholera.
Number of
deaths regis-
tered by the
Municipality.
Rate per
mille of
population.
Treated.
Died.
Died per
mille.
Treated.
Died.
Died per
mille.
1874
19,490
3,037
155
628
311
495
144
11,527
26.8
1875
22,062
3,641
165
728
371
509
153
14,086
32.7
1876
21,087
3,064
145
695
369
530
132
12,964
30.1
1877
23,977
3,172
132
545
284
521
123
13,704
31.9
1878
27,908
4,518
161
579
323
557
153
16,396
38.1
1879
22,197
3,602
162
634
351
553
150
13,044
30.3
1880
21,032
2,906
138
356
183
514
131
11,681
27.1
1881
20,156
2,876
142
589
304
516
131
13,030
30.0
11. Mortality.—The general death-rate was very slightly in excess of that
of the year 1880, and if cholera be excluded, the excess disappears, leaving a
rate of 131 per thousand in each year, notwithstanding the greater mortality
4
REPORT ON THE CALCUTTA MEDICAL INSTITUTIONS.
in the town at large, and the fatality of fevers in the hospitals which is not
represented in the town figures.
STATEMENT No. IV.
Deaths of Men, Women, and Children in 1881.
MEN.
WOMEN.
CHILDREN.
Treated.
Died.
Treated.
Died.
Treated.
Died.
Male. Female. Male. Female.
Medical College Hospital*
2,407
369
1,847
203
275
244
23
25
General Hospital
2,341
106
345
19
84
90
4
8
Campbell Hospital
4,401
998
1,419
418
158
9 6
1 2
14
Police Hospital
2,681
35
. . . . . .
. . . . . .
. . . . . .
. . . . . .
. . . . . .
. . . . . .
Mayo Hospital
1,745
271
285
3 9
6 6
2 9
10
7
Howrah Hospital
1,289
225
287
82
40
24
6
2
* Medical and surgical wards, exclusive of Eye Infirmary.
12. In the Medical College Hospital the death-rate of mixed adults was
134 .4 per mile, that of children 92.4, which reduced the combined rate to 129.8.
At the General Hospital the adult rate was 46.4; that of children 69 perm i l e .
The small numbers of children have raised the death-rate only 1.4 per mile.
At the Campbell Hospital adults died at the rate of 243.3 per mile and children
at the rate of 102.3, reducing the combined rate to 237.4. At the Mayo Hospital
the adult death-rate was 152.7; that of children 179. Here again the small
numbers produced but little effect on the combined death-rate. At Howrah
there was the same insignificance of total numbers. The adult rate here was
194.8; that of children 125, which somewhat reduced the combined rate.