CALCUTTA MEDICAL INSTITUTIONS.

43

cent of the latter. These figures, while disclosing the vast amount of disease which must
generally exist amongst the unregistered prostitutes, convey but a very slight idea of the extent
of the misery, or of the numbers of the male population who must become permanently
disabled by syphilis, aided, as it frequently is, by the improper treatment prescribed in the
bazars, and should impress on all concerned the urgent necessity there is of working this
section of the public health to the fullest extent sanctioned by the Contagious Diseases' Act.
Regarding the facts conveyed in the preceding table, Dr. Payne remarks as follows:—"This
table presents, as in former years, evidence of the effect of a system on the health of the
women subject to it. Of new-corners nearly one-third are diseased. This does not, however,
set forth the quantity amongst the women at large. The knowledge that their disease will be
detected has throughout been a chief inducement to resist the police; and of the newly-
registered, those who escape attendance do so largely for this reason. If, therefore, one-third
of those who after arrest submit themselves to treatment are diseased, the state of those who
evade it is possibly worse."

     8. As to the time required to effect a cure of the diseased women by regular treat-
ment in hospital, it appears from a table in Dr. Payne's report that the newly-registered
women had to remain in hospital for an average of 62.5 days; the defaulters, 59.2; and
those under regular inspection, 43.9. Under ordinary circumstances, 43, 59, or 62 days might
justly be considered lengthened periods for the treatment of what, in the majority of cases, can
only be considered as local diseases; and it is not mentioned whether the above periods were
required for the treatment of venereal cases only, or whether they included those other ailments
occurring amongst the women already under treatment in hospital. Dr. Payne supplies the
following explanation on this point, viz.—"As evidence of severity of disease among women
under surveillance, this statement, as I have said before, grows yearly less and less useful.
To make an average applicable to this purpose, chronic cases should be eliminated."

Average time in
hospital.

     9. The following table exhibits the statistics of the Lock-hospital in respect of the
nature, number, and disposal of the venereal cases treated during the past year:—

Statistics of the
Lock-hospital.

     10. Before reviewing the statistics contained in the foregoing table, I would suggest
the adoption, in future, of a uniform nomenclature of venereal diseases. Thus, while fully
agreeing with Dr. Payne that "the line between a soft chancre and a simple ulcer is not
very clear," I consider that in future returns the entry of "(859) simple ulcer," should be
altogether omitted, as it is quite inadmissible in a statistical table devoted to the record of
diseases of venereal origin. Cases now returned under the heading of simple ulcer would, if
of venereal origin, be more correctly entered under soft chancre, &c., as the case might be,
but when not considered to be so they should be rigidly excluded from the foregoing table.
I am well aware of the difficulty that is experienced in securing the adoption of a uniform
nomenclature by medical subordinates, and I am sure the Superintendent of the Lock-hospitals
only requires to have his attention drawn to a defect in the registration of venereal diseases
which tends to confuse and vitiate the valuable information conveyed in his statistical
tables.

The nomenclature
of simple ulcer
should be excluded
from a table of
venereal diseases.

     11. The admissions, 3,288, exceeded those of 1875 and 1874 by 640 and 1,261 respec-
tively, and the daily average number of sick in hospital was 295.6, or at the rate of 3.7
per cent. of mean strength.

Admissions.

     In explanation of the increased number of admissions, Dr. Payne writes as follows:—
"It is determined very largely by the prevalence of disease among the unregistered, since

Explanation of the
increased number
of admissions.