MEDICAL COLLEGE HOSPITAL.

23

amongst those treated to a termination. The corresponding numbers for last
year were 106.2 and 109.7, respectively.

       Of the above in-patients, 2,198 were Christians. Under this head are
included Europeans and Indo-Europeans or Eurasians. Of these 125 died, or
56.7 per thousand. The number is 426 in excess of the preceding year; and
the death-rate is also greater by 0.9 per thousand; that for 1871 being 55.86
per thousand.

Death-rate of
Christian pa-
tients.

        Of these 125 deaths, 25 occurred within 24 hours of admission. If these
were excluded, the death-rate would be 46.01 per thousand of cases treated. But
only 2,106 of the above number were treated to a termination. Of these, 59.3
per thousand died; but, excluding moribund cases, the death-rate of these cases is
only 47.4 per thousand amongst Christians. The corresponding numbers for
the previous year were 59.2 and 49.0, respectively.

        The mortality amongst Christian inmates of this hospital was 65.3 in
1870, 78.9 in 1869, 87.3 in 1868, and 67.39 in 1867. In the preceding fifteen
years the rate was 95.52 per thousand.

        The number of native in-patients was 2,430, being 314 in excess of the
preceding year. Of this number 410 died, or 168.7 per thousand. The corres-
ponding number was, in 1871, 185.2; in 1870, 198.2; in 1869, 253.4; and in
1868, 255.94; and for the past 15 years, 235.5.

Death-rate of Na-
tive patients.

      Of the above number of native patients, 89 were moribund on admission,
and died within 24 hours. Deducting these, the rate of mortality is only
136.6. But of the total number, only 2,284 were treated to a termination,
giving a mortality of 179.5 per thousand, or, on deducting the moribund cases,
146.2 per thousand, as the result of treatment in hospital.

        With regard to the rate of mortality, it is necessary to state that only
cases dying within 24 hours are returned as moribund on admission; but, besides
these, many patients, especially natives, are admitted in the most advanced
stages of organic disease of vital organs; and though they linger for four, seven,
or ten days, they are hopeless from the first, and in reality only come into
hospital to die. It is impossible to eliminate these cases in a general return,
but the fact is one to be remembered in estimating the causes of the higher
rate of mortality amongst natives in this hospital.

Definition of
"moribund."

       The following tabular statement of the rate of mortality per thousand
of the decade is of great interest, as showing the great diminution this has
undergone of late years, amongst both christians and natives treated in this
hospital. The total number of cases treated, as well as the number of moribund
cases admitted, during each of the last ten years, are given, in order to show
that this decrease is not due to an increased popularity of the institution, and a
consequent admission on that account of a larger number of cases of a milder
type, and therefore more amenable to treatment, but that other causes must be
sought. It is to be observed that the most marked, and an increasing, diminu-
tion in mortality has taken place during the last three years of the series,
corresponding with the introduction of the municipal water-supply to Calcutta
in point of time. This coincidence would seem to point towards the conclusion
that the habitual use of pure water has lessened generally the gravity and
fatality of the diseases of the class of people from which the patients of this
hospital are derived. It will also be shown that the number of admissions for
cholera (though not the mortality of the cases), and the deaths by pyæmia
after operation, have also been diminished during the same period.

Mortality rates
during the last
decade.