2
REPORT ON THE
5. As I remarked last year, this report deals mainly with the adminis-
tration, &c., of our hospitals, and not with the prevalence of disease in
their neighbourhood and general vital statistics. I shall confine myself
therefore, to a few comments on the salient features in this return, which
occur to me as bearing on the mortality in the Medical Institutions of
Calcutta, casually alluding to the sanitary state of things in the city in
connection therewith.
6 General mortality of the town.—From the statistics published at the
close of the year 1885 the annual death-rate averaged 29.3 per 1,000: it
was 30.5 in 1884. Cholera caused 1,603 deaths, and diar rhœa and dysentery
together 1,655. Last year the figures were 2,272 and 1,209 respectively.
The deaths from the less fatal forms of bowel disorders exceeded those
from cholera, while in the previous twelve months, when the latter disease
was epidemic in some of the wards of the city, the total mortality from the
former fell short of that from the latter by 1,063 deaths. Here it is noticeable
that, as a rule, when cholera becomes more fatal, diarrhœa and dysentery
are less so, and vice versâ. Allowing for the greater accuracy in the
nomenclature and correctness of the record observed in our hospitals, the
effects of this oscillation in the mortality of one or other of the forms of
bowel-complaints are reflected in them, the fluctuations corresponding suffi-
ciently closely to exhibit the condition of things outside, or among the
general population.
7. The recorded death numbers from these diseases of the “digestive
system” therefore, may possess considerable significance as hospital figures.
The highest mortality under this “order” occurred in the Campbell Hos-
pital, viz., 919. There were 148 deaths from the same causes in the Medical
College Hospital, 197 in the Howrah, and 96 in the Mayo. The salubrity of
a community, whether urban or rural, is certainly measured by the prevalence
of bowel affections and their fatality in it. But here we find that the increase
of these diseases was confined to certain sections of the community rather
than spread over the whole area of the city. In the year 1885, 12,707 deaths
were registered in Calcutta. The death-rate per mille, as I have already
s t a t e d , w a s 2 9 . 3 i n 1 8 8 5 a g a i n s t 3 0 . 5 i n 1 8 8 4 . T h e d e c r e a s e w a s d u e t o
a general decline in the deaths among some of the principal zymotic diseases,
the largest fall being referred to small-pox and cholera. The deaths from
fevers, chiefly of a malarial origin, increased from 3,618 in 1884 to 3,831 in
1885. Looking to the hospital return, we find the highest mortality from
fevers in the Campbell Hospital.
8. Small-pox.—T h e
l a s t g r e a t e p i d e m i c o f s m a l l - p o x o c c u r r e d i n 1 8 7 8 - 7 9 ,
when the registered deaths in the town totalled 1,495 in the former year and
772 in the latter. The late epidemic reached its culminating point in 1884,
giving a total of 478 deaths; while in 1885 the fatal cases declined to a
total of 155 only. That this disease, which periodically assumes the form
of an epidemic outbreak, should have in its more recent visitation given so
reduced a death record is encouraging. The Vaccination Department may
be congratulated on having effected much good, for there is no question
that the fatality of small-pox has been sensibly mitigated by diligent resort
to preventive measures—a degree of success which we could hardly have
looked for, considering the difficulties attending the vaccination of thousands
of unprotected persons who swarm into the city seeking work. The depart--
ment must not rest contented with this evidence of its usefulness, but by
renewed activity and unflagging perseverance extend the prophylactic to all
classes that, when the periodic recurrent wave of the disease overtakes us. such
a mortality as we have lately experienced from it may again be an impossibility.
It should not be lost sight of that, re-vaccination in adult life, to be of any real
value, should be universal. Save in times of epidemic outbreaks re-vaccination is
rarely demanded, and then the poor and ignorant are not of the number who
ask to have themselves protected.
9. The study of all the circumstances of the greater prevalence of fever,
diarrhœa, and dysentery in the city during 1885 shows that there has been an
excessive incidence of these diseases among certain classes. The excess occurred
among the very poor. That numbers of indigent persons crowd together in the