11

CALCUTTA MEDICAL INSTITUTIONS.

unable to give an explanation for the increase of these affections unless it be
that many of the persons suffering from these diseases may have had syphilis
or gonorrhœa previously, but refused to admit the fact that they ever suffered
from either of these specific diseases." This explanation is scarcely correct, how-
ever, because we all know that Calcutta is most favourable to the prevalence
of these diseases, particularly among aged persons.

      29. The other diseases shown in the return indicate the usual variations
that occur from year to year.

      30. The annual return of sickness used for the dispensaries having been
fully adopted this year for the Calcutta medical institutions, it will be possible
in future to form an estimate of the prevalence of the several diseases in
the Calcutta institutions, but for the present this is impossible until the returns
of two years at least have been supplied:—

      31. Enteric fever.—There were 20 cases of this disease at the Presidency
General Hospital, and three cases at each of the Medical College and
Howrah Hospitals. Of those at the General Hospital seven died. At the
Medical College Hospital there were three cases, of which two died. Dr. Birch
remarks that the two cases which died were in a hopeless condition when
admitted. They were in so low a state that no previous history could be
obtained. The morbid appearances after death were such as to remove
any doubt of their being true enteric. Dr. Crombie remarks that the results of
treatment in enteric fever have not been so good as in the previous year. In
two or three cases death occurred from a relapse after apparent recovery. At
the Howrah Hospital all the three cases recovered, and all were Europeans.

      32. Enteric fever is a disease confined chiefly to Europeans and has
now got a microbe of its own which will eventually enable a more accurate
diagnosis to be made. A disease which resembles it much is remittent fever
which has a different cause and from which a large proportion of the patients
of the Campbell Hospital suffered. The proportion of such cases in the
Campbell Hospital increased in 1891 coincidently with a rise of fever cases
among the general population. Of 770 cases admitted, 235 died, or at a
rate of over 30 per cent. Dr. Mackenzie says that this was due to the type of
the disease being more severe and of a low nature. In the other hospitals there
was little variation in the numbers treated for this affection. The following
table shows the number of cases of enteric fever treated in the Military Hospi-
tals for British troops in Bengal:—

* This case remained from 1889.

      33. Cerebro-spinal fever.—There was no case treated at any of the hospitals,
it being a disease which is mostly confined to jails.

B 2