10
REPORT ON THE
the first, has also run its course. If we accept the theory on which the process
rests, analogy leads to the hope that it will prove effective. The theory has so
far found more favour in Europe than in India, but as it can only be proved or
disproved experimentally, efforts should be made to induce as many persons as
possible to submit to inoculation. The process crede experto involves one or
two days discomfort, and nothing more.
12. Dysentery—shows a very large increase over last year, the figures
being as given in the margin. The death-rate was
1892. 1893.
In-patients
... 1,104 1,513
Out-patients
... 4,450 6,336
5,554 7,849
also higher, 30.53 against 28.44. This is an
enormous proportion, but it must be remembered
that a large number of the cases are examples of
chronic and neglected disease admitted in a practi-
cally hopeless condition. This is specially the case
at the Campbell and Howrah Hospitals, and in them
the death-rate for native patients was 39.63 and 60.30,
worn-out and half-starved pilgrims from Puri contributing largely to the death-
rate at Howrah. At the Mayo it was 27.08, at the Medical College Hospital
18.06 for natives and 14.28 for Europeans and Eurasians ; among the better class
of those treated at the General Hospital it was 5.88 ; while in the Police Hospital,
where sick men are admitted at once and promptly and properly treated, it was
only 2.22. These figures afford a good illustration of the inability of mean
averages to convey any useful information. It would be quite misleading,
though arithmetically true, to say that the death-rate from dysentery in Calcutta
hospitals is over 30 per cent. when the mean includes such variations as 2.22 and
60.30. In the one case as in the other the death-rate is the outcome of special
conditions and environment ; the low death-rate of the Police Hospital warrants
no assumption of special care and skill in the treatment of the disease, and the
high death-rate at Howrah no evidence of want of skill or proper attention to
the miserable wretches who come to hospital to die. All that can be done for
them is done, but the majority are beyond the reach of medical aid on
admission.
13. Diarrhœa—was also much more prevalent than in 1892, as shown in
the margin. The death-rate was 39.58; and similar
remarks apply as in the case of the dysentery
figures. The Mayo, Chandney, Police and Dufferin
Hospitals had no deaths from diarrhœa, while the
rates elsewhere varied from 4.91 among Europeans
and Eurasians at the Medical College Hospital,
10.74 at the Presidency General Hospital, to
47.31 at Sealdah and 48.66 among natives at Howrah. The bulk of the cases
at the last two hospitals, are old cases of chronic diarrhœa, often of a dysenteric
character.
14. Malarial Fevers .—The figures for the two years show a marked
increase in these diseases in 1893. With the excep-
1892. 1893.
In-patients
... 1,278 1,551
Out-patients
... 5,776 6,713
7,054 8,264
1892. 1893.
In-patients
... 3,799 4.629
Out-patients
... 37,403 44,451
41,202 49,080
tion of a small diminution among both European
and native patients at the Medical College Hospital,
Europeans at Howrah and natives at Park and
Sukea's Street dispensaries, all the institutions share
in the increase, but the greater part of it is at
the Campbell Hospital, where 8,177 fever cases
were treated against 4,774 in 1892. The Chandney Hospital had an increase
of 2,060. As usual, out-patients outnumber in-patients by nearly ten to
one, the great majority of the cases not requiring admission. Several of
the reports note that the type of the disease was unusually severe and required
very free resort to quinine. The general death-rate among the in-patients,
7.88, is nearly 3 per cent. below that of 1892, 10.52. It was 2.37 among
Europeans and Eurasians and 9.03 among other classes, and varied from 1.72
at the Chandney to 22.48 among native patients at Howrah.
15. The cause of the great increase in bowel-complaints and fevers
is undoubtedly to be found in seasonal and climatic conditions. The heavy
and prolonged rainfall, by water-logging the soil, rendered people more