( 24 )
From the above table it will be seen that the total number of admissions
during the year is much higher than last year, or indeed then the three previous
years :—
1877.
1878.
1879.
1880.
Total admissions ...
...
... 950
941
805
1,129
But, at the same time, it will be seen that the number of cases of primary syphilis
has diminished :—
1877.
1878.
1879.
1880.
Primary syphilis...
... 600
562
499
471
There is an increase of 25 in secondary syphilis and 25 in gonorrhœa. The
great increase is almost wholly due to certain uterine discharges, regarding
the contagious character of which there might be differences of opinion : these,
discharges occur frequently among all classes of women, and their contagious
character would depend as to whether the subject was a syphilitic one or not:
these discharges I have included under the head leucorrhœa ; they are non-puru-
lent, the one is similar to ordinary extreme leucorrhœa ; but by far the , most
frequent is a profuse glary discharge like the white of an egg, due to chronic
endometrictis or chronic inflammation of the lining membrane of the womb.
To always determine exactly whether it was a case of syphilitic leucorrhœa or
endometritis at the examination would be difficult or impossible. But, in my
opinion, among this class of women the safest and best plan is to admit all who
have an abnormal discharge, even believing as I do that a good many of them are
probably not contagious. Whether all these cases were admitted last year under
the head of gonorrhœa and secondary - syphilis I cannot say, but, judging from
what the resident medical subordinate said, they were not. I was led to be
more careful regarding these discharges by a letter from the medical officer of
the British troops complaining of the increase of venereal diseases ; and I was also
led to examine the uterus more carefully, as I became aware that the women
were carrying on a system of syringing away all discharges immediately before
presenting themselves for examination, and thus frequently, if the examination
was carelessly made, no discharge was seen, whereas a little more care. detected
a purulent discharge from the womb, which was still further confirmed on admis-
sion. A glance at the above table shows the month when it was strictly carried
out to detain women with abnormal discharges. Without this being the case, I can
give no other reason for the sudden increase in admissions under the heads of
gonorrhœa and leucorrhœa. All purulent discharges, whether from the vagina
or uterus, have been entered under the head of gonorrhœa, though, I may say, a
good few ought to have been rather entered under the head of leucorrhœa.
Leucorrhœa includes all other abnormal discharges.
Much the same may be said of the ulcers or rather abrasions of the os uteri,
for most of them were so. I do not think they were specific, but simply abrasions,
as often seen in other females ; those that were evidently specific were entered
under the head of primary syphilis. Whether anything has been gained by
keeping in hospital all those with such abnormal discharges it is difficult to say,
but if we glance at the table of admissions among the British troops for each month,
the notable diminution of admissions among the troops during the latter half of
the year over the first half Would lead one to think so, seeing that the admissions
up till the end of May were 104 and from beginning of June till the end of
December 49. The character of the disease has been very mild during the year ;
with only a few exceptions. The majority of the cases belonged to the sup-
purating syphilitic sore or local sore. The majority of the cases of gonorrhœa
were uterine gonorrhœa.
The following table shows the number of cases treated at the lock-hospital ;
also British and Native troops, jail and geheral dispensary :—
Lock-hospital: British troops. Native troops.
Jail.
General
dispensary,
Venereal diseases
. . .
1,129
153
24-
72
1,268