(3)
were more severe, as they were in the General Hospital of Calcutta. This points to sailors
as the chief sufferers.
In respiratory affections there was but a trifling difference from the previous year, either
in quantity or fatality, and the same is true of dysentery and diarrhœa. Parturient women
were treated in smaller numbers, and, on the whole, with results somewhat less favourable
than those of 1880.
4. In accordance with a suggestion made in the Report for 1880, and
approved by the Lieutenant-Governor, no detailed analysis has been made of
the statistics of operative surgery in the various hospitals. It is, however,
noticed that in the Campbell Hospital the number of deaths after operation,
which had been remarked by the Lieutenant-Governor as excessive in 1879,
has fallen from 326 per 1,000 in that year to 133.8 in 1880 and 90.9 in the
year under review. The death-rates after operation in the Medical College
and the Mayo Hospital were respectively 86.3 and 75.5. 5.
The Report contains an interesting account of the results of the
enquiry into the alleged prevalence of "hospitalism" in the Medical College
Hospital, and the steps taken during the past year to give effect to the recom
-mendations of the Committee appointed to report upon the matter. The facts
that were elicited in the course of the enquiry were altogether inconsistent with
the theory that the prevalence of septic disease was attributable to any radical
defect in the construction of the hospital. At the same time, however, the
Committee indicated several matters in which, in their opinion, improvement
was highly desirable. "The means of segregating dangerous cases were
qui t e i nsuffi ci ent ; space was i nadequat e t o meet t he demands on t he hospi t al .
The work of a large out-patient department was done on the ground-floor,
and the obstetric wards were under one roof with the rest." Much has been
done to remove all these defects. Out-patients are now treated in a separate
building at some distance from the hospital. A fine obstetric hospital has
been built, and was opened shortly after the close of the year. The space
thus set free has been utilized for the segregation of dangerous cases and for
the accommodation of the Physicians and Surgeons, while arrangements have
been made for an ample water-supply. The Lieutenant-Governor regards with
satisfaction the progress that has been made.
6. With regard to antiseptic surgery, the experience of the past 12 months
points in the same direction as that of former years. The true practical
value of Listerism can only be accurately measured after lengthened observa
-tion. Dr. Payne writes: "To measure with precision the merits of a new
method is seldom the simple task it may appear to be, for the adoption of
such a method is seldom unaccompanied by aids and accessories, which
contribute to results, and that this is true of Listerism is seen in the scrupulous
care with which cleanliness and other precautions have been enforced in the
treatment of wounds—matters which before would have been left to nurses
and dressers." The important part that is played by cleanliness and care in
dressing has been fully recognized by Dr. Cayley at the Mayo Hospital, where
the mortality, after operations, is, as it has been, exceptionally small.
Dr. Cayley writes: "I employ a modified form of Listerism, that is, I endeavour
as much as possible by cleanliness and a free use of antiseptics both in cleansing
and dressing to keep wounds aseptic, without always following the exact
details of Lister's methods." At the Medical College the First Surgeon carried
out the Listerian system in its entirety. The Second Surgeon, Dr. Raye, failed
in some cases to keep wounds aseptic by means of the treatment, and fatal
results ensued. Dr. Raye, however, had reason to believe that some of the
apparent failures were due to defects in the application of the method, and
that he had not attached sufficient importance to details. The results obtained
in the two wards were, so far as appears from the figures, about equally good.
It is to be noticed that at the Campbell Hospital only ordinary antiseptic
dressings are used, and Listerism is not attempted. The death-rate, after major
operations, was, however, only very little higher in this hospital than in the
Medical College Hospital. The evidence hitherto available affords no means of
determining how far the successful results obtained in the different hospitals are
attributable to the strict observance of Lister's system, how far to the use of
simple antiseptics and to the general improvement in cleanliness and care
which has resulted since attention was directed to the subject, and how far
to independent circumstances.