(5)
affection is clearly established. Whether that decrease has or has not resulted
from the employment of Professor Lister's system proper is not so clear.
Dr. McLeod treated to conclusion 20 cases of scrotal tumour—11 on Lister's
system, and 9 otherwise. Of the former 2, and of the latter 1, ended
fatally. Dr. Raye treated 14 cases with ordinary dressings, and of these
3 resulted in death. The Surgeon-General reports that the strict antiseptic
system compared with the results of the five years 1875 to 1879, when modified
antiseptics were used, represents a mortality in excess of the latter by 3.72 per
cent. The comparative merits of the two systems can only be established by
lengthened experience. Meanwhile, there can be no doubt that antiseptic
practice has brought about great improvements in regard to general care and
cleanliness in dealing with cases. So long as it is found that difficult cases can
be successfully treated under the old system with due attention to these points,
it will not be sufficient, in order to establish the efficacy of strict Listerism, to
show that similar cases are also successfully treated according to it. Dr. Raye
admits that Lister's dressings are very valuable in certain cases, and it appears
that he uses them in all severe operations But there is much practical truth
in what he says in defence of his use of a less elaborate system, combined with
cleanliness, in minor cases. It is important to bear in mind that the hospital is
a teaching institution. Most of the students will be called upon in the course
of their practice to treat a class of patients who will not be able to afford the
expensive appliances required for strict Listerism. For the purposes of
these students, it will be of little advantage that they should learn how to
cure people with such means only as must in the majority of cases be out of
their reach. Dr. Raye says: "For minor cases I used the ordinary and less
elaborate dressings commonly employed in surgery partly because I did not
consider antiseptics needed in such cases, partly also because the cases in the
wards being used for teaching purposes, I thought it desirable that the students
should learn the more simple methods, and not imagine that no wound would
heal without antiseptics, and with the object of impressing upon their attention
that manipulative skill and cleanliness were in reality all that was necessary
in most cases to secure perfect results." Without desiring in any way to fetter
the discretion of the surgeons of the hospital in the use of appliances for the
relief of the sick, or the pursuit of science, the Lieutenant-Governor considers
that the practical view of the case should not be lost sight of. As regards septic
disease generally, it appears that 56 cases of blood-poisoning in its various forms
were treated in the surgical wards. Of these, only 17 originated in the Hospital
— n i n e i n D r . M c L e o d ' s w a r d , a n d e i g h t i n D r . R a y e ' s w a r d . O f t h e f o r m e r , f o u r
were cases of scrotal tumour. Of the latter, two were wholly beyond control, both
being affected with "surgical kidney." Of the number of deaths after operation,
6, or 12.5 per cent, as against 20.9 per cent in 1879 were due to blood-poison,
and in one of these the disease was present when the patient was admitted.
13. The number of patients treated by the Obstetric Physician shows a
steady increase. The figures are—1875,1,004; 1876, 1,153; 1877, 1,109; 1878,
1,238; 1879, 1,204; 1880, 1,277. There were 296 deliveries against 247 in
1879 and 216 in 1875. Of the women confined, 23 were Europeans, 88 East
Indians, and 185 natives. On the recommendation of Dr. Charles, who admi
-nistered the Obstetric Hospital for many years with remarkable success, the
Lieutenant-Governor has decided to establish a certain number of stipends
to enable women to study midwifery in the wards. There can be little doubt
that the want of trained nurses in the interior of the country is severely felt.
14. The Ophthalmic Hospital shows a slight decrease in the number of
in-patients and a considerable increase in the number of out-patients. The
former numbered 516, against 523 in 1879 and 546 in 1878. The latter
numbered 6,312 against 6,054 in 1879. The figures of results of opera
-tions which the Surgeon-General gives include apparently all eye operations at
the different hospitals. It will be better to examine the statistics of the
Ophthalmic Hospital only in future.
15. Enteric fever only appeared in the General and the Howrah Hospitals
during the year. There were 6 cases in the first-named hospital against 11 in 1879,
and 13 the average of the previous eight years. In Howrah there were 2 cases
against 4 in 1879, 2 in 1878, and 4 in 1877. Before 1877 no cases of fever were
recorded as enteric in this hospital. In the Mayo and Chandney Hospitals there