44

REPORT ON THE

the proportion of cases brought on the list and inspected for the first time is much greater
than that of the class under regular control. During the year there were newly registered
913 women, and among them 266 were found to be diseased. In 1876, as in 1875, the
increase has fallen on the minor affections. Under every heading but that of "simple ulcer,"
that is, under any disease due to contagion, the number of admissions has fallen. The fall
is particularly striking in the instance of infecting syphilis. Although the quantity of
hard chancre admitted in 1875 was itself much less than in former years, that of 1876 is
less than a quarter of the former, and presents a figure which must be considered remarkably
small in so large a collection of venereal cases." "In soft chancre also a great reduction
is noted. Here no doubt some variation will be due to nomenclature. Diagnosis is now
made by the same medical officer and on an uniform system, whereas formerly differences
arose from accepting the names assigned separately by each of three examiners. Never-
theless, in females, the line between a soft chancre and a simple ulcer is not very clear;
and though such want of definition will not account for so large a difference as the tables
present, some allowance should be made for it.

Owing to want of
accommodation,
gonorrhœa has not
been thoroughly
controlled.

      "With regard to gonorrhœa also, as I said in former reports, the working of the Act
in Calcutta probably produces no more and no less effect on its prevalence than in Europe,
and the reduction of its quantity in 1876 is, in respect of this working, accidental. Doubtful
vaginal discharges—many of them infective, though not demonstrably so—are not regarded as
grounds of detention, unless there be some special reason. During the past year it became
on one or two occasions necessary to exercise unusual vigilance in the sections frequented
by the soldiers, but the scarcity of accommodation in the hospital restrained us, and
we were seldom able to do as much as otherwise might have been done for the control of
gonorrhœa."

Cases of
"intercurrent
illness."

      12. It appears that 384 cases of "intercurrent illness" occurred during the year
amongst the women under treatment in hospital for venereal diseases. Of these the
principal were in order of frequency: intermittent fevers 185, dysentery 52, metritis 52,
menorrhagia 18, diarrhœa 18, congestion of the spleen 17, pneumonia 7, remittent fever 6,
phthisis 4, cholera 1, &c., &c.

Deaths.

      13. There were 14 deaths during the year, or at the rate of 17 per cent. of mean
strength. The deaths were caused by the following diseases, viz.—phthisis 3, dysentery 3,
pneumonia 2, cholera 1, puerperal fever 1, congestion of the spleen 1, peritonitis 1,
ascites 1, and debility 1.

      In the previous reports it has been brought to notice that the registered women are in
the habit of causing ulcers on the genitals in order to obtain admission into the Lock-hospital
when suffering from diseases other than venereal, as they appreciate the treatment and
attention bestowed on them in it, and know that they will be well cared for there so long as
they are prostrated by sickness. It certainly does not seem to be an unreasonable desire of
these women that their last home should be in a hospital in which they are associated only
with others of their own class, perhaps with friends, and in which they are enabled to have
their last days of suffering relieved by kind attention and skilful treatment, instead of, as
might happen under other circumstances, having the painful fact impressed on them that as
they lived as outcasts of society, so must they die.

Freedom from
cholera in Lock-
hospital.

      14. It speaks well for the sanitary arrangements and cleanliness of the Lock-hospital
to notice that while cholera was very prevalent all around, there was only one case amongst
the women in it.

Improvements in
the buildings.

      15. The endeavours made to improve the hospital accommodation have at last been
successful. Dr. Payne reports that "a sum was allotted from the public funds, which, supple-
mented by a grant from the surplus funds of the fire-brigade, has been sufficient for the
construction of two large masonry buildings, and for the rebuilding on a better plan of all
the hospital sheds. The masonry buildings are completed. One of the new sheds is in use
and otherwise in progress. The whole available space has been utilized."

A probable decrease
in venereal cases.

      16. If the total number of venereal cases which have been treated in the Calcutta
medical institutions during the past year can be accepted as a proof of the increase or decline
of the disease, it would appear that there has been a trifling decrease in these cases by 457,
as compared with the numbers of 1875. It is also satisfactory to notice that there has been
a decrease in the admissions from primary syphilis by 613, and this decrease was noticeable
in all the medical institutions with the exception of the Park Street Dispensary, in which
there was an increase of 96 cases, and regarding the cause of which Dr. Payne expresses
himself unable to offer any explanation.

Increase of venereal
diseases in garrison
owing to the arrival
of a new regiment.

      17. It is stated that "the state of the European garrison of Fort William was less
satisfactory in 1876 in respect of venereal disease than it had been since 1872, and for the same
reason which gave to the latter year its unfavourable character, viz. the importation of disease
by a newly-arrived regiment which was not inspected on arrival." During the year 12.6
per cent. of the garrison of Fort William were affected with venereal diseases of various kinds,
and 2.7 per cent. suffered from primary syphilis. There was a total of 23 cases of syphilis
and 82 of gonorrhœa recorded as having been observed in the garrison during 1876.