CALCUTTA MEDICAL INSTITUTIONS.

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daily average sick amounted to 182.25. Dr. Elliot also states that "notwithstanding an
absence of epidemic disease from Calcutta and its Suburbs during the year, there has been
an excess of admissions during the past over any preceding year on record, attended with a
decided decrease in the rate of mortality."

Moribund patients.

        4. Dr. Elliot, in his memorandum No. 326, of the 26th January 1877, to the address of
the Deputy Surgeon-General, Presidency Circle, reports as follows regarding moribund
patients:—"Has the honor to state that, as a rule, Native moribund cases are not admitted into
this institution for medical treatment. During the year 1876 the number of such cases
unavoidably admitted is noted in the margin, and, besides
these, about 40 Natives, who were considered to be moribund,
were sent to the Campbell Hospital for treatment for want
of accommodation in the hospital."

Chief causes of mortality of Christian patients.

        5. In the following table those diseases are shown which were the more common causes
of sickness: mortality amongst the Christian patients (male and female), as well as the propor-
tion of deaths from them to the numbers treated and to the total mortality of each sex.

Diseases most fatal amongst the male and female patients.

Cholera.

Enteric fever.

        6. From the foregoing table it will be gathered that apoplexy, tetanus, cholera,
remittent fever, phthisis, and enteric fever, were the most fatal diseases amongst the male
patients; but that cholera, phthisis, and dysentery, contributed the largest proportions of the
total mortality. Similarly amongst the female patients it will be noticed that remittent fever,
cholera, phthisis, pneumonia, and dysentery, were the most fatal diseases; but that phthisis,
remittent fever, cholera, and dysentery, formed the highest percentages of the total mortality.
Debility was very fatal, and, after phthisis, formed a large proportion of the total mortality;
but the diseases of which it may be presumed it was a symptom have not been specified.
The disturbing influence which cholera has exerted on the statistics of sickness and
mortality in this hospital has been frequently noticed, and the year under review was not
exceptional in this respect, since 32.50 per cent. of the total deaths of Christian patients were
caused by it. The disease, too, must have been of a very virulent type, as the table shows
that 50 per cent. of the males and 67 per cent. of the females, who were treated for it,
died. Of 17 cases of enteric fever treated, but 2 died, or at the rate of 11.76 per cent.
Regarding enteric fever, Dr. Elliot makes the following remark:—"The ratio of mortality
under this head is small in comparison with that of previous years, which leads me to the
conclusion that the cases. treated were of a mild nature. In the returns of this hospital for
the last ten years the mortality has varied from 71.4 per thousand in 1870 to 750 in 1869.
The average for the past ten years ending 1875 was 429.97."

Cholera.

        7. It has been mentioned in the preceding paragraph that cholera caused 32.50 per
cent. of the total mortality of Christian patients. If it was excluded from the statistics, the
death-rate of this class would fall from 4.48 per cent. of total treated to 3.11. Dr. Elliot
records his experience of the cholera cases which came under observation in the General
Hospital during 1876 as follows:—"Of the above (102) admissions, 15 died within six hours
after they were placed under treatment, which means that 15 per cent. of the cases admitted
under this head were moribund when they reached hospital, or at least in so hopeless a state
of depression and collapse that medical treatment and good nursing were of no avail.
Their chances of recovery were thus reduced to a minimum. Several cases were received from
ships in the port in the condition above described; and it is probable that a large portion of
the other cases, who were admitted from various parts of the town, were in a very advanced
stage of the disease by the time they were brought in for treatment. In many instances, too,
the class of people with whom we had to deal had to contend against the depressing effects
of previous fits of intemperance and exposure in addition to the poison of cholera in the
system, which materially lessened their chance of recovery."