ANNUAL MEDICAL REPORT.

In drawing up Medical Reports, especial attention ought to be paid to the fatal cases, as well on account of their peculiar interest as from their affording the best means of judging of the propriety of the practice pursued.

On referring to the accompanying Tabular Return of Patients treated in the Auckland Provincial Hospital, it will be seen that the mortality has been considerable, amounting to about 12 per cent., a result, however, which will not surprise any one who takes the trouble to read the following remarks:—

The records of the Hospital for the year 1859 fully confirm the truth of the observation that "Fever" is comparatively a rare disease in Auckland; the cases treated amounting only to 4 or 1 in 60 of the total admissions. These, were however of a typhoid type, and somewhat protracted in their duration, 3 have perfectly recovered; and 1 remains at the end of the year convalescent.

Under the head of "Anthrax" is a fatal case, that of a man advanced in life who had borne the brunt of the disease at a sawing station, where he had no attention; and was removed to Auckland in so debilitated a state that he survived only a few days.

Referring to diseases of the Eyes, it may be observed that the operation of couching was performed on a young man, who was the subject of double cataract, but owing to the gelatinous softness of the lens, without the effect of restoring vision.

Seven cases of Delirium Tremens have been treated during the year, all of them successfully.

Two fatal cases of Pneumonia, or Inflammation of the Lungs are returned, of the particulars of which I am ignorant, my entrance upon office having been subsequent to their occurrence.

Three fatal cases of Heart disease appear in the return; one was prior to my time, and the remaining two were admitted into Hospital in a dying state, a circumstance of constant recurrence, and explaining in part our high rate of mortality.

For the reason assigned above, I am unacquainted with the fatal case of diseased Liver which is returned.

One case of fatal injury of the Kidneys was admitted since my appointment. The unfortunate man (a Portuguese) was crushed between two heavy pieces of timber and lingered a few days in great agony. The Abdomen was found after death filled with extravasated blood.

The most prolific heading in our return is "Rheumatism," under which, although not generally a fatal disease, two deaths are recorded. One such case occurred in my time, and was that of a man admitted for Rheumatism, but who subsequently took Erysipelas in the Hospital and died of the latter affection. He was a very infirm subject and of advanced years.

To the three cases of Erysipelas, which were admitted into Hospital from without, we must add other three, which appeared in Patients in Hospital under treatment for different complaints and all proved fatal. One was the case referred to above; the second occurred in a man who had an Ulcer on his leg, and who had for many years laboured under organic disease (as proved by dissection) of the Heart and Pleura. The third was a most interesting case—a man was admitted for an Ulcer on his leg, which in due time had almost healed, and his recovery was so far advanced, that he was advised to return to his situation as a domestic servant, but preferring to remain, he unfortunately became the subject of Erysipelas, under which he sunk after a fortnight’s illness.

It is incorrect to suppose that Erysipelas has been epidemic in the Hospital alone, numerous cases having occurred in both town and country. One case at present remains under treatment far advanced in convalescence, who had been attended in town for several days by a private practitioner, and sent to Hospital in a very critical state.

In the cases of Pulmonary Consumption that have been treated, the largest number of deaths has occurred, a circumstance which will not surprise any one who remembers that such cases are generally sent to Hospital in the last and hopeless stage.

Two fatal cases of Dysentery are recorded, the first occurred previous to my superintendency, the second was admitted in a dying state and sank in a few days.

Of the two fatal cases of Apoplectic affection, one was very unexpected and sudden in its invasion. It occurred in an old man, who had long been an inmate of the Hospital, on examination rupture of vessel and extravasation of blood were found in the brain. The other case was that of an old woman, who sank through exhaustion after a lingering illness.

Of the two fatal cases of Dropsy, the first occurred on the night of her admission. The other was a sailor brought to Auckland from the Feejees in the last degree of exhaustion, who died within a week after his admission.

The fatal case of Syphilis was that of a man who had been for years in hospital hopelessly labouring under disease of the most loathsome and painful character.

Under Burn is the fatal case of a woman whose clothes took fire while she was drunk, and who was literally roasted alive.

Under Ulcer are two cases proving fatal by Erysipelas, which have been noticed above.

Under the head of Fracture is one fatal case, a compound comminuted fracture of the right leg, extending into the knee-joint, and attended at the time of its occurrence, by so great loss of blood, as to preclude all hope of saving life by Amputation. The patient did not rally for three days, and sank exhausted in about three weeks after admission.

Under diseases of the Skin, is the case of an old man who contracted a violent Bronchitis after having been several weeks in Hospital and died of Suffocation.

Under General Debility is the fatal case of a man who was found by the Police in a house in town, sick and destitute, and was sent to Hospital in a dying state.

In reference to the Surgical Branch it may be mentioned, that upwards of 50 cases of accident have been treated during the year, all