(3)
The three hospitals which treat out-door patients—the Medical College,
Mayo, and Howrah Hospitals—all shew a decrease in the average daily attend-
ance, which indicates sickness of less severity among out-patients generally
during 1882. This is somewhat remarkable, as being at variance with the
mortality record of the in-patients treated at the hospitals, and also with the
death returns of the town at large.
4. The following statement shews the mortality in each of the Calcutta
hospitals during the last eight years :—
YEARS.
All diseases except cases treated
in Eye Infirmary.
Cholera.
Death-rate,
excluding
cholera.
Number of
deaths regis-
tered by the municipality. Rate per
mi l l e of popul at i on.
Treated.
Died.
D i e d p e r m i l l e .
Treated.
Died.
Died per
mille.
1875 ... ... ...
22,062
3,641
165
728
371
509
153
14,086
3 2 . 7
1 8 7 6 ... . . .
. . . 21,087
3,064
145
695
369
530
132
12,964
3 0 . 1
1877 ...
. . .
. . . 23,977
3,172
132
545
284
521
123
1 3 . 7 0 4
3 1 . 9
1878 ... ... ...
27,908
4,518
161
579
323
557
153
16.396
38.1
1 8 7 9 ...
. . . ...
22,197
3,602
1 6 2
634
351
553
150
1 3 , 0 4 4
3 0 . 3
1 8 8 0 ...
. . . ...
21,032
2,906
138
3 5 6
183
514
131
1 1 , 6 8 1
27.1
1881 ... ... ...
20,156
2,876
142
589
304
516
131
13,030
3 0 . 0
1 8 8 2 ... ... ...
20,078
2 , 8 8 6
143
859
468
544
125
13,177
30.4
The death-rate, excluding cholera, was remarkably low, being only 125
per 1,000, against 131 in each of the two previous years. Even if deaths from
cholera are included, the rate was only .1 per cent. higher than that of 1881.
As already pointed out, the death-rate of the town, as distinguished from that of
the hospitals. was high, though the rate of increase above the figure of 1881
was less. The following table shews the true death-rate among natives, when
deaths from cholera and moribund cases are excluded :—
Campbell
H o s p i t a l .
M e d i c a l
College
Hospital.
Howrah
Hospital.
Mayo
Hospital.
Police
Hospital. TOTAL.
True native deaths, excluding cholera ... ... ... ... 1,269
409
227
226
26
2 , 1 5 1
Moribund persons . . .
. . .
. . .
. . .
. . .
. . . . . .
191
120
54
38
3
406
Difference ... 1,078
289
173
188
23
1,751
True death-rate per mile, excluding cholera and moribunds 204.32
120.87
223.8
1 0 3 . 9 8
9.51
138.26
This shews that, except in the Mayo Hospital, where there seems to have
been a considerable and unexplained accession of fatal disease, the true death-
rate was in every case slightly below that of the previous year.
5. The Surgeon-General makes the following remarks regarding the pre-
valence of particular diseases during the year :—
The town was exceptionally free from small-pox in 1882, only 17 deaths appearing
on the municipal register. As 28 cases were treated in hospital with only three deaths, the
disease must have been mild as well as scarce. If it were fatal in the same ratio in town,
the recorded deaths would represent 158 cases, shewing that less than one-fifth of the cases
appeared in hospital. The proportion was probably larger than this, as it may be presumed
that fatality was greater outside the hospitals. The quantity of fever treated in hospital
was less by 693 cases than in 1881. In all the hospitals, except the Police, fever was much
more fatal in 1882 among natives than in the previous year, and less so among Europeans
in all but Howrah. Cholera increased, and its death-rate was higher than in 1881. There
were 589 cases treated in 1881 and 859 in 1882. Dysentery fell both in quantity and
severity. Diarrhœa shewed an increase in quantity and in fatality. The distribution of
these affections in the several hospitals shews that the figures largely represent final stages
of general exhaustion rather than distinct diseases.
6. In the Report for last year, and the Resolution recorded upon it, the
Listerian method of treatment, and the alleged prevalence of hospitalism in
the Medical College Hopital, were treated at some length. It was then stated
that "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 antisep-
tics and to the general improvement in cleanliness and care which has resulted
since attention was directed to the subject, and how far to independent cir
-cumstances." So far as the abstract value of Listerism is concerned, there is
nothing of importance to add to the above. The Surgeon-General is, however,