8
REPORT ON THE
23. Particular diseases —Small-pox. —For the last two years there have been
very few cases of small-pox in Calcutta, viz., 11 in 1886 and 18 in 1887, from
which it may be inferred that the operations of the Vaccination Department
have of late been very successful, but outbursts of this disease are apt to occur
periodically every five or six years ; and before pronouncing a final judgment
on the point, it would be well to wait a little longer to see whether the present
immunity is going to continue.
24. Hitherto patients suffering from this disease have been treated in all
the hospitals, but it has been proposed that in future they should be admitted
into the Campbell Hospital only, where arrangements might be made for their
accommodation and complete isolation. By this means the risks of the disease
spreading by contagion from several centres will be obviated, while a great
saving of expenditure will be effected by rendering unnecessary any special
measures for the reception of cases of this kind, except at one hospital.
25. Cholera.—The figures in the return relating to this disease approxi--
mate very closely with those of 1886. Six hundred and twelve cases were
treated in the hospitals during 1887 with 341 deaths, giving a mortality of 557 per
mille. It cannot be said that the disease was of a worse type than usual, and
indeed if the returns of the last four years be scrutinised, it will be found
that, roughly speaking, about one-half of the cases admitted into the hospitals
terminate fatally. It is observable also from the returns for that period that the
mortality among the European patients treated for this disease has been much
greater in the General Hospital than in that of the Medical College—a cir-
cumstance for which I am unable to account. The difference is not likely to
be due to any particular mode of treatment adopted at either of these insti-
tutions, but probably to the more virulent character of the disease among the
class of patients admitted into the General Hospital.
26. During the past year no cases occurred among the patients under treat--
ment in the General Hospital for other diseases—a result which Dr. Birch,
the Superintendent, "attributes to the precautions in the matter of the milk and
butter supply and the purity of the water," but how far this conclusion is to be
accepted as correct remains to be seen.
27. When cholera makes its appearance in a hospital among those who
were not admitted for that disease, it is reasonable to suppose its presence to be
due to some local insanitary condition, for it is well known that attendants and
others who come in contact with cholera patients in a well-managed hospital
rarely contract the disease. Dr. Birch has therefore acted wisely in establish--
ing in the compound of the hospital a dairy over which the strictest super--
vision can be kept, and from which butter and milk of the purest quality can
be obtained for the sick. A similar arrangement has been in force for some
years at the Medical College Hospital, where I am told cholera has never,
except on two occasions, attacked any patients while under treatment for other
diseases.
28.
Dysentery
.—This affection which is now placed in the zymotic order
of diseases in accordance with the classification followed in the last edition
of the nomenclature of diseases, has been somewhat more prevalent, though less
fatal, than usual. There were 1,703 cases treated with 447 deaths against 1,601
and 455 in 1886.
29. From the returns it would seem that Europeans suffer less from
dysentery in proportion to their numbers than natives do, and the mortality
from it is much greater among the latter. This may be accounted for by the
fact that natives as a rule live in more unhealthy localities, are often badly
nourished, and do not come under treatment in the hospitals until the disease
has reached an advanced stage.
30. Malarial Fevers .—These are the most common of all the diseases
treated in the hospitals, but have not been unusually prevalent or fatal during
the year.