Europeans. Natives. Other
classes.
Septicæmia
...
2
6
...
Terai fever
...
1
...
. . .
Heart disease ...
1
...
...
Anæmia
...
2
1
1
Do. with kid-
ney disease
...
1
...
...
Exhaustion ...
...
2
2
Pyæmia
...
1
. . .
...
Tumour of brain
1
. . .
. . .
Moribund
...
...
4
. . .
Total ...
9
13
3
or three days after admission.
22
REPORT ON THE
care being taken of the patients. The report gives in detail particulars of every
fatal case, which need not be repro-
duced, but may be summarised so far as
deaths after delivery are concerned, as
shown in the table. Of 22 additional deaths
among European women, 5 were due to
puerperal complications after confine
-ment in their own homes, 2 were moribund
on admission, 4 occurred from fever and
anæmia, 4 from malignant disease, and the
remainder from a variety of causes. Of
the 20 deaths in native women not follow-
ing delivery in hospital, 3 were returned
as moribund, but no less than 14 others
were practically so, and died within two
39. The death-rates among children of all classes are very high, but
this is due to a large proportion of them being brought to hospital in a
dying condition. This is clearly brought out in the deaths among native
children, where 14 out of 15 occurred within three days of admission, and of
28 deaths in European children 19 occurred within three days. Two out
of the five fatal cases among children of "other classes" were admitted
moribund.
40.
Septicœmia.—Twenty-four cases had septic symptoms on admission,
Europeans.
Natives. Other classes.
Cases. Died. Cases. Died. Cases. Died.
Admitted with septicæmia
after confinement out-
side the hospital.
5
3
7
4
...
...
Confined in
hospita.
Septic
on
admission.
1
1
11
5
...
...
Became sep-
tic in hos-
pital.
2
0
5
1
. . .
. . .
Total
8
4
23
10
...
...
and seven developed the
disease in hospital. The
total, 31, was the same as last
year. Details are given in
the table on the margin.
A large number of cases are
admitted every year in the
most deplorable condition,
after having been many
hours or days in labour and
undergone severe treatment
at the hands of well-intentioned but ignorant dhais. A large proportion of these
die, and every such case is a source of danger to others. The means of isolating
them are at present deficient, and in spite of the most anxious care and every
possible precaution, seven patients became infected in hospital. This is two less
than in 1892, and only one of the seven died. The proposal to build a special
ward where such cases can be thoroughly and effectively isolated is still under
consideration, successive plans having been rejected as unsuitable; but it is
hoped the difficulties have been surmounted and that the ward may shortly be
supplied. Till it is such cases must occasionally recur, for the best plans
and most careful precautions are at the mercy of an act of thoughtlessness or
carelessness, and it is very difficult to enforce the unceasing observance of trou-
blesome details by people who do not appreciate how much depends on them.
41. Major operations—numbered 337 with 31 deaths, against 365 with 35
1892. 1893.
Delivery by Forceps
. . . 67 5 2
„ „ Turning
. . . 23 11
„ „ Cæsarean section
1
...
„ „ Craniotomy ...
1
5
„ „ Embryotomy ...
...
4
,, ,, Cephalotripsy . . . 1
4
Removal of placenta
...
16
7
Ovariotomy
. . .
8
8
Colotomy
. . .
1
3
Hysterectomy
...
. . .
3
Laparotomy
. . . 14
33
Recto-vaginal fistula
...
13
...
Vesico-vaginal fistula
...
9
6
Perineorraphy
...
...
14
Operations for cancer
...
8
15
deaths in 1892. The diminution was due
to a smaller number of obstetric operations
being necessary, although the number of
confinements was larger. The most import-
ant operations were as noted in the margin.
Seven of the forceps cases ended fatally, but
the operation had no share in the results.
One of the cases in which turning was per-
formed died. The presentation was com-
plex and the patient had been two days in
labour before admission. Three of the
craniotomy cases died; all were in a very
bad condition on admission. The operation
enabled delivery to be effected, but was too late to save life. Death followed in