28

REPORT ON THE

     In explanation of this great mortality, Dr. Bird remarks that as all the moribund cases
have been included in the returns, the death-rate has been unduly raised, and also that the
sequelœ of malarious poisoning (combined with poverty), such as anæmia, anasarca, jaundice,
enlarged spleen, ascites, and hepatic abscess, contributed 69 to the total number of deaths.

Christian and
native out-door
patients.

     6. The following table shows the number of Christian and native patients (out-door)
treated in this hospital during 1875:—

   The numbers of Christian out-
door patients were slightly under
those of 1874, but the marked in-
crease (2,454) in the number of
native out-door patients during the
year 1875, when no epidemic disease was prevalent, seems to be a good proof of the increasing
popularity of the hospital among the native population.

Cholera.

      7. There were but 22 Christian in-door patients treated for cholera during the year;
and it is a curious fact that the rate of mortality of these cholera patients was nearly double
what it was in 1874, while in 1874 the admissions from cholera were almost double of what
they were in 1875. This excess in the mortality of Christian patients from cholera is most
probably attributable to the numbers of Europeans who were admitted into hospital in a
dying state.

     Amongst the native patients the reverse of this was observed, as during 1875 there was a
greater number of admissions (110 against 83 in 1874,) and a considerably smaller death-rate
of those treated. Dr. Bird, in explaining this latter circumstance, remarks that "the disease
among natives was of a mild type, and all cases of choleraic diarrhœa were regarded as cases
of cholera, as undoubtedly they are."

Localities from
which cases of
cholera were
admitted.

     8. Cases of cholera occurring amongst the Christian and native in-door patients were
received from the following localities:—

Dysentery.

      9. As to the type and treatment of dysentery met with during 1875, Dr. Bird remarks
as follows:—" The disease is not confined to the big gut, but extends also to the small intestines,
and is of an intermitting nature. It is also characterized by violent gripes. Ipecacuanha
used alone is not so successful in the cure of this form of the disease, but combined with
bromide of potassium and belladonna its administration is usually followed by the desired
effect."

Surgery.

      10. Dr. Bird remarks that a good deal of useful surgery was done in the year, although
none of it was of a striking nature. The amputations, of which there were 10, were
followed by very fatal results, no fewer than four of them proving fatal, or at the rate of
400.00 per mille of those operated on. However this high rate of mortality is stated by
Dr. Bird as mainly due to this cause, viz. the amputations were mostly secondary ones,
consequent on injuries, and gangrene supervening after the operation was followed by the
death of the patient.

      There were 864 minor operations performed.

Management.

      11. The hospital has been under the control of a committee composed of Government
officials, the superintendents in the different railway departments, of medical officers engaged
chiefly in practice on the river, of men who are influential in the direction of industrial
companies, and of some of the leading natives of the place. These gentlemen, Dr. Bird
remarks, are all well disposed towards the institution, and in any emergency are always ready
with their counsel and practical help; but for the transaction of the ordinary routine business,
there has occasionally been difficulty in collecting a number of members sufficient to consti-
tute a quorum.

Bath-room and
latrine.

      12. The bath-room and latrine arrangements, which were mentioned in last year's report
as being "as objectionable as can well be imagined," still remain in statu quo, andit seems