( 2 )
increased from 1553.14 to 1671.98, and that of indoor patients from 1202.93 to
1205.67. During the year an outdoor department was opened at the Eden
Hospital, and though the attendance was not as large as might have been
expected, there is every reason to believe that it will improve as the dispensary
comes to be more generally known.
Of the total number of patients, both indoor and outdoor, treated in all
the hospitals during the year, 153,705 were men, 34,678 women, and 56,753
children. The corresponding figures for the previous year were 143,722,
33,017 and 55,696. More than 50 per cent. of the patients treated were Hindus,
next in order coming Muhammadans, Eurasians, Europeans, and other classes.
Fewer Europeans sought relief at the hospitals during 1891 than in the
previous year.
3. The death-rate among all the patients under treatment during 1891
was 127 per mille against 124 in 1890, excluding the patients treated for
eye-diseases. This includes deaths from cholera, without which the death-rate
would be 113 against 114 per mille. The average death-rate in English hospi-
tals is stated to be 80 per thousand, and in French hospitals 95. In 1882 the
death-rate in St. Bartholomew's Hospital in London was as high as 120, the
Edinburgh rate being 105. As in the previous year, the death-rates were
highest in the Howrah and Campbell Hospitals, which is natural, seeing that
these are the refuges to which emigrants taken ill in the depôts, moribund
cases found in the streets, and pauper patients generally are sent. Last year's
Report and Resolution drew attention to the fact that the death-rate in our
hospitals was persistently higher among girls than boys. This year this
inequality has been removed, as the following statement shows :—
ADMISSIONS.
DEATHS.
DEATH-RATE PER MlILLE.
Boys.
Girls.
Boys.
Girls.
Boys.
Girls.
1888
...
662
647
74
73
111.7
112.8
1889
...
797
776
77
99
96.6
127.5
1890
...
950
701
78
99
82.1
141.2
1891
... 1,006
793
110
86
109.3
109.2
The combined ratio of 109.3 per thousand is very little in excess of 108, the
ratio of mortality among children in French hospitals during 1885.
4. There were only 21 cases of small-pox treated during the year, against
321 in the previous year ; all the cases were admitted into the Campbell
Hospital, and five proved fatal. The number of admissions for cholera was
761 against 528 in 1890 ; nearly half of this number were treated in the
Campbell Hospital. In 455 cases, or 59.7 per cent. of the whole, the disease
proved fatal. The number of cholera cases treated in the Presidency General
and Howrah Hospitals was comparatively small. The Inspector-General states
that there was no outbreak of the disease, such as occurred in 1890, among the
patients under treatment in these hospitals, and claims this as due to the
improvement in the drainage system. Cholera has, however, shown itself since
the close of the year under report, and this has led to the discovery of further
defects in the sanitary arrangements at these hospitals. The Lieutenant-
Governor trusts that the matter will be made the subject of careful investiga-
tion. The cause of the prevalence of cholera in the Campbell Hospital is
said to have been traced to the bad quality of the milk used by the patients,
the theory being that the supposed germ of cholera is communicated by means
of water used to adulterate the milk. The Inspector-General, however, thinks
that the defective condition of the latrines may have had something to do with
it. He maintains that the occurrence of an outbreak of cholera in a hospital
among the patients under treatment for other diseases is always an indication
of grave sanitary defects of some kind or other, thus implying that if the
cause is removed the effect can also be prevented and his opinion must neces-
sarily carry great weight with the profession. There is, however, another
school which holds that cholera is communicated through the air, and its
supporters sometimes go so far as to maintain that it is as idle to seek for
the causes of cholera as to enquire why the bullets of the garrison strike down
one man rather than another on the glacis of a besieged fort. However
this may be, the fact remains that the cause of cholera has not yet been con-
clusively traced. Attention has been drawn by the Inspector-General to " the
practical immunity of the European residents of Calcutta of late years from