LOCK HOSPITAL ADMINISTRATION IN 1871. In
our
iesuo for November J 871,
wo
gavo
a
short account of
Hospital administration in this presidency for the year 1870. Wo have now beforo us an able digest of the results for 1871, drawn up by Surgeon-Major J. M. Cuninghani, the results of Lock
M.D., and the resolution of Government thereon. There werfl 37 Cantonment Lock Hospitals in existence throughout the presidency in 1871. These have been established, under tho rules framed in accordance with Act XXII of 1861.
There
July 1,
THE ABOO LAWRENCE SCHOOL.
1873.]
191
results in Madras and Bombay in 1871 have been more hospitals wbicli hare been established under than in Bengal, namely, 180 and 174. We shall Act XIV of 1868. The general result for tho year, as satisfactory notice the Madras report in our next. Dr. Cuningham regards European troops, for whose benefit these institutions discusses various important matters connected with venereal have been established, was 208 cases of venereal disease of disease in the British Army and its prevention. He shows that all sorts per 1,000 of strength, against 202 per 1,000 in mucli of it is really not preventible, namely, what is 1870, 200 in 1869, 199 in 1868, and 167 in 1867. These very on the march and contracted beyond cantonment limits. The tfgures are disheartening ; but general figures are always liable of large native cities proximity imports a serious difficulty into in all such cases to doubt and fallacy, and it becomes necessary the matter. ^Registration and examination are being extended to subject them to a careful analysis and to read along with to these. Again, the difficulty of embracing all women, who ?^hem the written reports which support, modify, or explain are liable to infect soldiers, in the Lock Hospital system is alluded them. On analysing different stations a great diversity of Some steps are being taken to meet this obvious source of to. results is disclosed. In some, as at Barrackpore and Gwalior, failure, 'llie necessity of looking after the men and their the ratios are under 100 (99 and 87), while in others, as at habits, as well as the women, is also urged. The report shows Cawnpore and Umritsur, they exceed 500 (500 and 546). that next to intermittent fever venereal diseases are the principal Again, results vary in the same cantonments in different years : causcs of sickness in the Army, taking the number of admissions thus, while in 1869 the ratios at Lucknow, Fyzabad, and as the standard; and that, while the average number of men in in 1871 they were Seetapore were 163, 93, and 5-4, respectively, during the year was 1987, 460 of these were there for 266, 209, 133- "These striking differences," as Government hospital 458 for venereal. These facts add force to the and fevers " remarks, at any rate require explanation." Why should not of Government that Civil and Military injunctions strong results obtained in one station or in one the also
are
some
favorable
year
be obtained in all stations and in all
Success depends
of local detail.
on
years?
This is
a
matter
very numerous conditions
to tho circumstances of tho
cantonment, and the relating practice pursued by medical and commanding officers, with regard both to Lock Hospitals and regiments. The conditions or practices, under which success is obtained, should be carefully examined and described, and prominently published for guidance. All, however, depends on the scrupulous care with which details of administration and practice are locally and habitually carried out. Again, an analysis of the diseases wliich go to constitute the general ratio is of the utmost importance, and here we think Dr. Cuningham has not been sufficiently detailed. The prevalence of gonorrhoea or syphilis mean very different things as regards health, and the varieties of syphilis should abo be distinguished. Primary syphilis and local venereal sores are, according to modern pathology, very different diseases, and should be carefully separated. Here again general statistical statements are full of uncertainty. under the new nomenclature Dr. Cuningham observes that of diseases cases of venereal disease are very apt to be lost sight of." Ho justifies this remark by two illustrations. All we have got to say to this is that, properly used, the new nomenclature provides for a system of complete and separate "
registration
and return of venereal diseases such
furnished.
nomenclature has
ever
nomenclature
followed,
are
causation, immediate "
syphilis" (43) Dr. Cuningham
or
"
evert/
as
no
other
If tho directions of the case
of venereal
origin
or
remote, should appear under either gonorrhoea and its complications" (585, &c.) or
must take his figures as he gets them ; but it behoves medical officors, who are responsible for the registration of disease, and tho statistical officers of tho British and Indian
Medical Departments, who are responsible for examining and checking returns, to adhere strictly to the nomenclature, which, excellent in all respects, is particularly excellent in this special matter of venereal diseases. It is not promising to find that the proportion of venereal sores is larger in Bengal than in home stations where the Contagious Diseases' Act is in operation. The ratios per 1,000 hoea is,
the other
are
proportion of gonorragainst 108. Taking both
73 and 61. The
hand, less, together tho ratio is exactly the on
96
same,
namely, 169.
The
Officers should co-operate to realize the intention of these rule9 and institutions to the utmost; everything depends on the
thoroughness
of local exertions.
our
iesuo for November J 871,
wo
gavo
a
short account of
Hospital administration in this presidency for the year 1870. Wo have now beforo us an able digest of the results for 1871, drawn up by Surgeon-Major J. M. Cuninghani, the results of Lock
M.D., and the resolution of Government thereon. There werfl 37 Cantonment Lock Hospitals in existence throughout the presidency in 1871. These have been established, under tho rules framed in accordance with Act XXII of 1861.
There
July 1,
THE ABOO LAWRENCE SCHOOL.
1873.]
191
results in Madras and Bombay in 1871 have been more hospitals wbicli hare been established under than in Bengal, namely, 180 and 174. We shall Act XIV of 1868. The general result for tho year, as satisfactory notice the Madras report in our next. Dr. Cuningham regards European troops, for whose benefit these institutions discusses various important matters connected with venereal have been established, was 208 cases of venereal disease of disease in the British Army and its prevention. He shows that all sorts per 1,000 of strength, against 202 per 1,000 in mucli of it is really not preventible, namely, what is 1870, 200 in 1869, 199 in 1868, and 167 in 1867. These very on the march and contracted beyond cantonment limits. The tfgures are disheartening ; but general figures are always liable of large native cities proximity imports a serious difficulty into in all such cases to doubt and fallacy, and it becomes necessary the matter. ^Registration and examination are being extended to subject them to a careful analysis and to read along with to these. Again, the difficulty of embracing all women, who ?^hem the written reports which support, modify, or explain are liable to infect soldiers, in the Lock Hospital system is alluded them. On analysing different stations a great diversity of Some steps are being taken to meet this obvious source of to. results is disclosed. In some, as at Barrackpore and Gwalior, failure, 'llie necessity of looking after the men and their the ratios are under 100 (99 and 87), while in others, as at habits, as well as the women, is also urged. The report shows Cawnpore and Umritsur, they exceed 500 (500 and 546). that next to intermittent fever venereal diseases are the principal Again, results vary in the same cantonments in different years : causcs of sickness in the Army, taking the number of admissions thus, while in 1869 the ratios at Lucknow, Fyzabad, and as the standard; and that, while the average number of men in in 1871 they were Seetapore were 163, 93, and 5-4, respectively, during the year was 1987, 460 of these were there for 266, 209, 133- "These striking differences," as Government hospital 458 for venereal. These facts add force to the and fevers " remarks, at any rate require explanation." Why should not of Government that Civil and Military injunctions strong results obtained in one station or in one the also
are
some
favorable
year
be obtained in all stations and in all
Success depends
of local detail.
on
years?
This is
a
matter
very numerous conditions
to tho circumstances of tho
cantonment, and the relating practice pursued by medical and commanding officers, with regard both to Lock Hospitals and regiments. The conditions or practices, under which success is obtained, should be carefully examined and described, and prominently published for guidance. All, however, depends on the scrupulous care with which details of administration and practice are locally and habitually carried out. Again, an analysis of the diseases wliich go to constitute the general ratio is of the utmost importance, and here we think Dr. Cuningham has not been sufficiently detailed. The prevalence of gonorrhoea or syphilis mean very different things as regards health, and the varieties of syphilis should abo be distinguished. Primary syphilis and local venereal sores are, according to modern pathology, very different diseases, and should be carefully separated. Here again general statistical statements are full of uncertainty. under the new nomenclature Dr. Cuningham observes that of diseases cases of venereal disease are very apt to be lost sight of." Ho justifies this remark by two illustrations. All we have got to say to this is that, properly used, the new nomenclature provides for a system of complete and separate "
registration
and return of venereal diseases such
furnished.
nomenclature has
ever
nomenclature
followed,
are
causation, immediate "
syphilis" (43) Dr. Cuningham
or
"
evert/
as
no
other
If tho directions of the case
of venereal
origin
or
remote, should appear under either gonorrhoea and its complications" (585, &c.) or
must take his figures as he gets them ; but it behoves medical officors, who are responsible for the registration of disease, and tho statistical officers of tho British and Indian
Medical Departments, who are responsible for examining and checking returns, to adhere strictly to the nomenclature, which, excellent in all respects, is particularly excellent in this special matter of venereal diseases. It is not promising to find that the proportion of venereal sores is larger in Bengal than in home stations where the Contagious Diseases' Act is in operation. The ratios per 1,000 hoea is,
the other
are
proportion of gonorragainst 108. Taking both
73 and 61. The
hand, less, together tho ratio is exactly the on
96
same,
namely, 169.
The
Officers should co-operate to realize the intention of these rule9 and institutions to the utmost; everything depends on the
thoroughness
of local exertions.
