14

REPORT ON THE

Surgical operations.

      11. At the end of 1874 there were remaining in hospital 26 patients who had under-
gone operations, and 110 important operations were performed during 1875, giving a total
of 136; of these, 83 recovered, 2 were discharged relieved, 3 were discharged unrelieved,
31 died, and 17 remained under treatment at the end of the year.

Death-rate after
operations

      12. The death-rate of patients after operation, whose cases were treated to a termin-
ation, was 260.50 per mile. This rate is higher than that of any year since 1866, with the
exception of 1873.

Deaths from
hospitalism.

      13. Dr. Chevers states that out of the 31 deaths which occurred after operations, there
were 3 from septicæmia, 3 from erysipelas, and 2 from pyæmia,—"Altogether 8, or 25.80
per cent. of those who died after operation. The average of the six years ending with
1869 was 31.06 per cent."

Nosocomial
Register.

      14. Dr. Chevers remarks that the "Nosocomial Register," alluded to in last year's
report, has been very carefully kept up, and that in it note is immediately made whenever
a patient is attacked with either of the diseases which are usually ascribed to " hospi-
talism."

Hospitalism.

      15. It appears that no form of "hospitalism" presented itself in the medical wards,
but there were 28 cases of it in the surgical and obstetric wards, of which 8 proved fatal.

Obstetric ward.

      16. The Obstetric Physician treated 993 patients during the year; the numbers
treated in the six preceding years were 1,004, 943, 1,063, 745, 747, and 662.

Death-rate.

      17. The death-rate in the obstetric wards, 64.45 per mille, was less than that of any
of the six previous years.

Confinement.

      18. There were 230 women delivered in hospital during the year. This shows a
marked and steadily progressive increase on the numbers of former years.

Race of women
confined.

      19. Of the women confined, 21 were Europeans, 74 Indo-Europeans, and 135 natives.

Puerperal fever.

      20. During the year there were four cases of puerperal fever. Dr. Chevers observes that
three of these cases were classed as puerperal phlebitis, and one as a case of pelvic cellulitis.

Relation between
erysipelas and
puerperal fever.

      21. At the end of the first week in June, in consequence of the slight outbreak of
puerperal fever, some separate accommodation was supplied for Dr. Charles' lying-in patients.
The building so made over was occupied from the 12th June to the 11th August. Regarding
the relation between erysipelas and puerperal fever Dr. Chevers writes thus:—"This, I feel, was
no mere coincidence. It was a clear development of that immutable law in disease which
teaches us that when erysipelas is prevalent puerperal fever is threatened." But he also
writes:—"It is worthy of note that in the three cases of puerperal phlebitis there were
complications which were sufficient to account for the disease. Thus, the first was a case of
placenta prævia, the second had a severe fall before her confinement, and the third was
a woman who had been in very bad health for many months."

Children treated.

      22. One hundred and seventy-four children, under seven years of age, were treated in
the female wards; of them 24 died, or at the rate of 137.93 per mille of total treated.

Ophthalmic
in-patients.

      23. In the ophthalmic hospital 541 in-patients were treated; the numbers of the five
preceding years were 590, 545, 535, 507, and 527 respectively. Of the 541 patients, 309 were
cured, 102 were relieved, and 89 were discharged "otherwise."

Medical and
surgical out-door
dispensaries.

      24. There were 18,833 persons treated in the medical and surgical out-door dispensaries
during 1875; of these 11,069 were medical cases and 7,764 surgical. It was mentioned in
last year's report that the number of patients attending the medical and surgical dispensaries
attached to this hospital had decreased (in the former department considerably, in the latter
to a trifling extent), but during 1875 this falling off has been still more marked, and
amounted in the medical dispensary to 422 persons, and in the surgical to 2,644. The total
numbers attending the medical and surgical dispensaries in each of the preceding five years
were 21,899, 24,758, 24,644, 26,252, and 23,082. No explanation has been offered as to
the falling off in the number of out-door patients at these departments. In addition to the
out-door patients above enumerated, 1,564 persons obtained advice in the admission-room.

Minor operations
in surgical
dispensary.

      25. The number of minor operations performed by the resident surgeon was 2,705,
which is a very satisfactory increase on those (1,476, 1,553, 1,301, 1,348, 1,964, and 2,216) of
the six preceding years.

Dispensary for
treatment of women
and children.

      26. The increase in the numbers attending the dispensary for women and children has
been well marked, but there has been a decrease in the number of minor operations performed
in this department.

Ophtalmic
dispensary.

      27. The attendance at the ophthalmic dispensary has increased very considerably,
and exceeds that of 1874 by 680 patients.

Dental dispensary.

      28. The popularity of the dental dispensary is evidently increasing, as there were
3,442 persons treated during 1875, against 1,828, 580, 1,047, 1,184, and 1,261 in the
preceding five years respectively. The number of operations performed in this department
was 3,108.