CALCUTTA MEDICAL INSTITUTIONS.
9
9. PARTICULAR DISEASES.— Small-pox.— I n 1 8 9 3 t h e r e w e r e b u t 3 9 d e a t h s
from this disease in the town, the amalgamated area and Howrah, and only 49
cases were admitted to the special wards at Sealdah. In 1894 the deaths num-
bered 416, and 177 were treated in hospital. Cases occurred throughout the year,
and the disease threatened to become epidemic both in the city and suburbs, but
was checked for a time by prompt vaccinations. In the town of Calcutta cases
became more and more prevalent through the autumn. The disease attained
epidemic force in December, and is still spreading. The disease in Calcutta
assumes epidemic dimensions every five or six years as a fresh population of un-
protected persons allows it to make head. The last outbreak was in 1889-90,
Cases. Deaths. Ratio
per cent.
Confluent
...
37
28
75.67
Semi-confluent ...
68
31
45.58
Discrete
...
51
4
7.84
M odified
...
12
...
...
Hæmorrhagic ...
8
7
87.5
when there were nearly 800 deaths, and
the present epidemic will probably be worse
than that, as a large number of the cases are
of unusual virulence and as such possessed of
greater infectious power. Those admitted
into the small-pox hospital are classified
in the margin, and the general death-rate,
39.77 per cent., is sufficient proof of the extreme. virulence of this disease.
It was only 26.53 per cent. in 1893. One case was treated in the infectious
ward of the Medical College Hospital with the object of giving an opportunity
to the students of seeing the disease. The patient was cured.
One hundred and twenty-one out of the 177, or 68.36 per cent., were
unprotected. Of these, 56, or 46.28 per cent., died ; the rate in 1893 was 27.77.
One had had small-pox before and recovered. Five had been inoculated, one of
whom, or 20 per cent., died. Fifty were said to have been vaccinated, of whom
13, or 26 per cent., died—a very heavy rate for post-vaccinal small-pox, yet little
more than half that of the unprotected. Four of the 13 fatal cases, however, had
no scars and were practically unvaccinated persons; seven had indistinct scars ;
two only had distinct scars, and in one of these they are described as superficial.
In only one of the fatal cases were typical scars present. In 18 non-fatal
cases there were distinct scars, 6 were semi-confluent, 2 discrete, 9 modified
and 1 hæmorrhagic. Every effort is being made to control the pestilence
by vaccination, and special efforts are being made to ensure a high standard
of vaccine work. The small-pox hospital, which has accommodation for 39
Europeans and 38 natives, stood the strain upon it fairly till the end of the
year. Temporary sheds for both natives and Europeans have since had to be
provided, but the discussion of the further progress of the epidemic must be
left to next year.
10. Cholera, although much more prevalent and fatal than in 1893, was
not nearly so bad as in many previous years. In Calcutta the mortality was
higher in 7 out of the previous ten years, in Howrah in four, while, except
in 1893, the suburban figures have never been so low. The admissions to
hospital were 567 against 431, 709, and 761 in the three previous years. There
were 323 deaths, or 56.9 per cent., a high rate, which, however, as the table shows,
has been frequently exceeded. Europeans and Eurasians had the enormous
death-rate of 72.72, but they seldom suffer except in isolated cases, and it has
long been notorious that a very large proportion of such cases are fatal. The
numbers, too, are so small—22 cases, 16 deaths in all—that averages are
misleading.
The death-rate among all other classes was 56.33. One hundred and seventy-
six cases were treated at the Mayo Hospital, 145 at the Campbell, and 114 at the
Medical College Hospital. There were 13 cases with 9 deaths at the Presidency
General Hospital. At the Chandney Hospital there were two non-fatal cases ;
percentage of mortality nil; at Howrah three Europeans admitted died ; mortality
100 per cent. No cases originated in any hospital except Howrah and Sealdah.
At the latter there were between the 21st July and 10th August no less than 14
cases, 9 of which were fatal. They were distributed over all parts of the building,
and no special cause could be assigned for the outbreak. There was some over-
-crowding at the time, and no more cases occurred after this was relieved by the
transfer of a number of patients to the Help ward. There is no evidence that
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