was a healthier one, and the deficit is most largely contributed to by the Mayo Hospital which is under

private management, and has not been in any way affected by the recent Government proceedings or orders. The total number of out-door

patients

treated was

242,298 against 258,028 in 1878, and of in-door 22,720 against 28,454. The reduction in the latter case is probably in part due to greater care exercised in the selection of

cases

suitable for

hospital

treatment

trivial cases. It and the denial of admission class of persons a that exists there is well known who make a livelihood of some treasured infirmity to

mostly of an incurable kind, and who migrate hospital to hospital in ostensible search for cure, but really to obtain lodging, food, and clothing. A hospital is not the place for such, nor should public charity be dispensed to those who are able to pay. It is satisfactory to find that the Calcutta Hospitals are beginning to provide accommodation for paying patients. A movement of this kind is, as we lately showed, becoming universal in the civilized world, and from

we

THE CALCUTTA HOSPITALS. The prominence into which these institutions have been forced of late by the somewhat heated discussion which has taken

place in and out of India regarding points connected with their management, invests Report on the Calcutta Medical Institutions"

certain the

"

for the year 1879, and the Government resolution thereon, with a special interest. The Report is, as

might be expected from the ability, literary and administrative, of its author, Surgeon-General A. J. Payne, M. D., eminently clear and comprehensive, and the resolution breathes tlie same spirit which all the utterances of

fested,

an

Government

anxious desire to

on

this

provide

subject

have mani-

for the sick poor

of this great city all the relief which their circumstances reasonably demand coupled with a strenuous determination to

put down

those abuses

which,

is

exercised, are apt administration of charity ail over most

vigilance

unless the

ut-

to contaminate the the

world,

and in

this country very specially. The general impression which the unbiassed reader of this Report and Resolution will gain that there

is,

has been very little difterence between it and ones as regards the transactions of the

previous

Metropolitan

Fluctuations in statistics and minor changes in administrative arrangements are inevitable, but the

Hospitals.

indicate such striking departures report does not of from the rule past years as the assailants of the policy and action of the present Government would by their violent declamation lead one to expect. The number of sick treated has certainly fallen off as com-

pared with

the four

preceding

years ;

but the year

observe that

London, namely reception

for the

one

of the

principal hospitals

in

Thomas's, has made arrangements of paying patients. It is a move-

St.

ment that commends itself to

the

practical

sense

of

the present day which demands that discrimination shall be combined with generosity, and recognises the

charity. We should by the Calcutta of for the patients. The paying hospitals reception death rate among in-door patients (among out-door this is not ascertainable) was 162 per 1000 inclusive, These figures fall and 150 exclusive of cholera. of within the fluctuations previous years. On this truth that

like to

point

the

giving

mere

see

is not

increased facilities offered

has the

Surgeon-General

following comment,

"Though the number of sick persons in hospital was less in 1879 than in the previous very unhealthy year, it

was

still

a

high number,

The

and in the

Campbell

of small-pox treated were even than those of 1878, and though

cases

rous

Hos-

exceeded the numbers of ordinary years.

pital greatly

became less fatal for 94 deaths.

as

the

more

epidemic expired,

Cholera, though

less

nume-

the disease it accounted

prevalent

in the

generally, showed some slight excess in the hospitals, and caused 28 additional deaths. This was due to the reception into the Campbell Hospital in town

for the first

time, emigration depots suffering 1879,

less

fatal

of coolies from from cholera.

suburban

Malarious

than in

1878, as well as less as antemia and condition, prevalent. debility, were of equal prevalence, but much less fatal in 1879. Dropsies were presented in usual number, fevers

were

Diseases of low

but were very fatal. It does not appear that the name includes cases of the 'acute oedema' which has created some sensation lately ; indeed no thin is said

THE INDIAN MEDICAL GAZETTE.

218

of this affection in the

hospital reports of the town. Respiratory affections, equal prevalence, were less with

Cases of dysentery and diarrhoea

fatal than in 1878.

less

were

showed

tery is

a

very

no means

noted among the seamen, but it confined to them. A high death-

the year under the town and suburbs."

dysentery distinguished

rate from view

high

particularly

by

was

in the former year, but death-rate. A fatal form of dysenthan

numerous

throughout

The record of

surgical operations

evidence of continued

the

report gives important department of practice, and

general

to

to

in this

activity

but it is too meagre scientific use. There is

much

be of

appended

re-

important paragraph on Hospitalism, from which it appears that the majority of cases of this kind occurring in the Medical College Hospital are

however

an

imported from without, and do not originate in the hospital. l)r. MacConnell, found as the result of a special investigation that of 64 cases of hospitalism he had examined post-mortem, 41

which

admitted "with

had been

form of

putrefactive disorganization already existing." Government has, we are glad to observe, called for a special report on hospitalism, more especially with reference to the power which the practice of antiseptic surgery exercises, oris alleged to exercise, in preventing it. Dr. Payne

some

concludes from

statistics of enteric fever

that,

to

an

examination of the

rendered

by quote the Government resolution, as

the "

hospitals conclu-

no

prevalence of this specific fever can be drawn owing to the similarity which it presents in many of its phases to malarial remittent fever and the idiosyncrasies of different officers in deciding questions sion

as

to the

"

of classification

as

between these two diseases."

together, there has been a decided increase Calcutta, of late years. The question of diagnosis between enteric and remittent fevers is at present undergoing discussion in the Epidemiological Society of London, and seems to be as far from satisfactory Taken

in

solution return in

as a

To this

ever.

future number.

subject

we

shall

perhaps point

Another interesting

noticed in the report is the increased consumption of the " Cinchona Alkaloid" in the Calcutta hospitals. In 1876 the consumption of quinine was 195 lbs., and of the Cinchona Alkaloid 1 lb., in 1879 the amounts used

were

respectively

22

in favour of the

testimony indigenous product.

We have but touched

and

195.

therapeutic

on a

few of the

This is strong value of the more

salient

and

interesting topics discussed in this report. It is evident that these large and important institutions continue to fulfil a great purpose of benevolence and and

are convinced from the perusal of from personal knowledge that in the execution of this purpose Government will neither

usefulness, this

record and

we

[August 2,

grudge nor deny its officers what they necessary to and working of

or

and the

cure

secure

1880.

consider desirable

the ends which the existence

hospitals imply?the

of disease.

relief of distress