CALCUTTA MEDICAL INSTITUTIONS.
15
Septic disease was represented by four deaths.
Erysipelas caused three deaths in 1885. The disease first appeared in the
month of November in the First Surgeon's Wards, and subsequently spread by
infection. The total number of cases attacked was six. The disease was
happily, quickly stamped out by the early precautions and sanitary measures
adopted. Dr. Coates reports that, Erysipelas first attacked a Mrs. C., who was
suffering from a carbuncle. This was on the 10th November. Her husband,
who visited the hospital daily, was in attendance at home on a sister-in-law
labouring under erysipelas. The disease was evidently conveyed into the
hospital by this man.
42. Dr. McLeod has kindly furnished me with the following particulars of
the outbreak, &c.—"The exact medium of infection I cannot specify. In two
of the cases the disease made its appearance the next day after operation. The
contagium must have effected its entrance at the time of operation, for the
wounds were in both cases antiseptically occluded. All the cases occurred on
the same side of the hospital, and two of them in private rooms near the ward
in which the first case appeared. We do not use sponges in dressing, but pieces
of cloth wrung out of an antiseptic lotion, and we Listerise every case in which
it is possible to do so. In most of the cases that took the erysipelas "Strict
Listerism" was impossible in consequence of the situation of the wound. It died
out when we adopted the usual measures, viz., segregation of the infected,
emptying, scouring, and disinfection of the wards in which they lay, and
thorough purification of dressers' instruments, &c. I do not consider that the
construction of the hospital had anything to do with the outbreak. The
disease was accidently introduced into the hospital. Erysipelas cases are often
sent for admission. I have had one other case of infection—not fatal—since
the November outbreak. Prompt measures were adopted, and the disease did
not spread. We try and keep every wound aseptic with Bichloride of mercury,
iodoform, and boracic acid, &c., and succeed in the great majority of cases."
43. Not long since, owing to the continual prevalence of " hospitalism " in
this institution, the entire destruction of the hospital was urged upon the Gover
n - m e n t . S i n c e t h e n c a r e f u l e n q u i r y h a s e l i c i t e d t h a t a l a r g e n u m b e r o f t h e c a s e s
of so-called "hospitalism," attributed to the faulty construction of the building,
could be traced to importation ; and that, the more general adoption of
antiseptic surgery, with a stricter attention to sanitation, septic disease has
well nigh ceased to weigh with the surgeon in the selection of cases for
operation, or perplex him in the after-treatment.
44. The gratifying feature in this account of the introduction and eradica
- t i o n o f e r y s i p e l a s — t h e o n c e d r e a d e d a n d p e r h a p s m o s t f a t a l o f a l l f o r m s o f
hospitalism—at the Medical College Hospital, is presented to us in the
abundant evidence that the spread of that disease, even when imported among
a large number of surgical cases, is completely under control, while its
specific action can readily be destroyed or rendered harmless by antiseptic
surgery and effective sanitary measures.
45. It will be in the recollection of those who were here at the time, how
the terrible condition of things at this hospital obtained in 1874-75. Erysipelas
was in those days a constant motor to be reckoned with in the management of
almost every case of surgical disease admitted into it. With rare exception,
an operation terminated successfully. Tents were borrowed from the Fort
William Arsenal on two occasions, and all cases were put out into the com-
pound. All wounds did badly in those days, and the surgeons feared to
approach a patient with a knife.
46. The Government may well congratulate the present hospital staff, who
have done so much in conclusively proving that the amount of "hospitalism"
formerly met with in this institution bears no relation whatever to the construc
-tion of the building as a hospital; and that by refuting, by positive results, anti
-quated and hastily-drawn conclusions, the State has been saved the destruc
- t i o n o f a f i n e b u i l d i n g a n d a n e n o r m o u s o u t l a y o f p u b l i c m o n e y .
47. Thus, we have seen what can be and is still being done by downright
fighting with sanitary weapons against adverse circumstances. The only places
in this hospital, however, in which to segregate contagious cases are the
basement cell wards. They are dismal places and cannot be improved.