CALCUTTA MEDICAL INSTITUTIONS.
13
16. If on these figures the results of 1879 be examined, they will be
found unfavourable when compared with the previous year, but not nearly so
unfavourable as they appear in the general table, nor so unfavourable as to
disturb the inference of great improvement on earlier years. They may
indeed be regarded as quite within the range of natural fluctuation, even when
events are tending in one direction only. The great variations in the table, when
circumstances are apparently similar, is itself no mean proof of the number
and magnitude of causes and influences which are not tabulated. The
inherent defects of figures are obvious, such as comparison of dissimilar
numbers, disproportionate effect of small numbers on ratios, &c. These are
inseparable from all tables; but in this one the technical sources of error are
so many that the bare enumeration of them would form a long paragraph,
which would take the dimensions of a treatise if I should attempt to dis
entangle any particular thread of causation. I must indeed for such a purpose
analyse every case in every hospital, and spend more time in doing it than the
clinical clerk had spent in making his record.
17. It is in connection with the Medical College Hospital that the sub
ject of septic disease has assumed a public character here, and though the
events and researches of the last few years may fairly be considered to have
set that question at rest, I gather from the last resolution that the Lieutenant-
Governor still wishes the events of succeeding years to be considered with
reference to it. I subjoin therefore a table similar in form to the last, but
relating only to the working of the College Hospital.
STATEMENT No. IX.
THIGH.
LEG.
ARMS.
FOREARM.
Op e r a t i o n s .
Deat hs.
D e a t h s p e r m i l l e .
O p e r a t i o n s .
De a t h s .
D e a t h s p e r m i l l e .
O p e r a t i o n s .
Deat hs.
D e a t h s p e r m i l l e .
O p e r a t i o n s .
De a t h s .
D e a t h s p e r m i l l e .
1870 to 1877
. . . . . .
. . . . . . 667
. . . . . .
. . . . . . 467
. . . . . .
. . . . . . 364
. . . . . .
. . . . . . 211
1878
3
. . . . . .
. . . . . .
4
2
500
4
. . . . . . ......
3
1
333
1879
4
2
500
2
1
500
3
. . . . . .
. . . . . .
6
1
166
1880
10
2
200
1
. . . . . .
. . . . . .
5
2
400
4
1
250
18. Here again extravagant anomalies appear in the figures. In 1880 the
most fatal operations were performed with a success which would not have been
credible ten years ago, whereas less dangerous operations were unusually fatal.
Those who remember the earlier days of this hospital will remember that the
case of a man whose leg had been amputated through the thigh was regarded
as almost desperate then. In 1880 the mortality after this operation was the
lowest in the group. If we get rid of variations and contrasts by the ordinary
method of absorption in an average we shall have the following death-rates
on the whole group of operations in the last three years:—
1878.
1879.
1880.
Rate per thousand
...
... 214
266
250
and the latter- year in which antiseptic surgery has been more completely
practised than it was before, will bring the practice into discredit; yet such a
conclusion would be quite unfounded. I subjoin the account which the
Principal has given of the experience of the year.
19. Thirty-six cases of major operations remained from the previous year.
In 1880 there were 289 such operations performed. Of these, 230 were followed
by cure, 21 by partial relief, 4 persons were discharged otherwise, 48 died,
and 22 remained under treatment. Among the 325 cases, the mortality was
147 per thousand. In 1879 the proportion was 186 per thousand, 144 in 1878,
and 175 in 1877.
20. After detailing the operations and their results, as given in the seventh
statement, Dr. Coates comments on the removal of scrotal tumour. Forty-two
scrotal tumours, he says, were removed during the year, making, with those
remaining from the previous year, a total of 54. There were six deaths, or 11.1
per cent., against 12.3 in 1879, and 14.2 during the years between 1865 and