208

CAUSES OF DEATH.

Fever—Typhoid, 12; Bilious Remittent, 2. Dysentery, 6. Hepatitis, 3. Disease of Heart (Organic), 2. Phthisis Pulmonalis, 3. Chronic Bronchitis, 1. Erysipelas, 1. Paralysis, 1. Compression of Brain, 1. Chronic Inflammation of Brain, 1. Hepatic Dropsy, 1. Cardiac Dropsy, 1. Renal Dropsy, 1. Pneumonia, 2. Angina Pectoris, 1. Ischaria Renalis, 1. Lumbar Abscess, 1. Metritis with Abscess of Ovaries, 1. Medullary Cancer of Liver, 1. Stricture of Urethra, with Urinary Fistula, 1. Fracture of Skull, 1.

Of the total number of patients treated, viz. 539, 511 were males and 28 females.

Of the males no less than 380, or nearly 75 per cent., were miners, and this class came here from every part of the district. One poor fellow, who died on the second day after admission, was admitted at the beginning of the week; he had come all the way from Fox’s, having been refused admission to the Grey Hospital. About 15 per cent. came from the town of Hokitika.

Of the 28 females treated two were prisoners from the gaol, and were confined, one of a female, and the other of a male child. The prevailing diseases are, as usual, Fever, of which there were 98 cases; Dysentery, of which there were 47 cases; and Rheumatism, of which there were 46 cases. The most obstinate diseases are Rheumatism and Chronic Dysentery. In the case of Rheumatism no sooner is the disease driven from one part of the body than it attacks another. A patient, for example, will come in with Rheumatic Sciatica which will yield to treatment in from a week to six weeks, when he will be attacked with Rheumatic Ophthalmia, or inflammation of the fibrous or sclerotive tunic of the eye. In one case it attacked the membranes of the brain secondarily, and the patient died; the only death from this disease.

Chronic Dysentery, or ulceration of the bowels, is more obstinate still. I have at present in the Hospital two patients who have suffered from this disease, the one for three years, and the other for upwards of two years. The latter case has been under treatment in three hospitals, as well as under the private treatment of several practitioners in Melbourne and elsewhere.

It will be seen we have had 45 deaths, or a little more than 7 per cent. Considering the gravity of the diseases treated, this is a small per centage. By last year’s Report of the Hospital Surgeon, Nelson, it appears that the mortality there was upwards of 9 per cent. Of the 45 deaths, moreover, six were admitted in articulo mortis, and died either within or a little over 24 hours, and seven within three days. Two of the deaths occurred among the females, but in one of the cases death took place 12 hours after admission. In most instances, the cases of Fever and Dysentery, the most valuable time for treatment has passed before the patients come under treatment, as comparatively few are admitted before the disease has existed from a fortnight to a month. The absence of the means of classifying the patients militates much against the chances of recovery, of Fever patients especially, and I have again to draw attention to the subject.

The elevated situation, the sandy soil, the shelter from prevailing winds, the close proximity to the sea, with its cooling breezes in summer and its milder temperature in winter, and its air highly charged with ozone, the great scavenger of the atmosphere, and its ample grounds for exercise, combine to render this a most delectable spot for the Hospital, and have a most beneficial influence on the sick, and in restoring the convalescent to his pristine health and strength.

Notwithstanding the frequency and severity of accidents in the district, as will be seen from the circumstance of 32 cases of fracture having been treated, only two capital operations have been performed, one the removal of the arm above the elbow, and the other the removal of a portion of the upper jaw, both of which were successful.

The fact of 13 cases of Delirium Tremens having been treated in the Hospital, besides three in the Lunatic Asylum, where such cases will in future be treated, indicates the habits of a class of the community, and accounts for the unusual number of lunacy cases which occur in the district.

In my last Report I referred to the doubt which appears to exist among the medical profession in the Colony regarding the type of Fever which exists here, and I promised, having a large field for observation, to do all in my power to throw light upon the subject.

In almost every case reported to have died from Typhoid Fever I have made post mortem examinations, and have found the characteristic lesion of Typhoid Fever, viz., ulceration of the intestinal glands in every case except two, in both of which the patient was carried off by an intercurrent attack of Pneumonia at an early stage of the disease: but even in these cases the glands were found inflamed, and only required time to become ulcerated. In two cases there was complete perforation of the bowel near the ilio cecal valve.

In my last Report I referred to a Fever, which I called Bilious-remittent—or relapsing of which I had a few cases—it appears in this Report as Bilious-remittent, or Yellow Fever, of which there have been eight cases, two of which died. It is therefore the most fatal of the diseases which have occurred in the district. In both cases there were haemorrhages from mouth, nose, and, in one case, the ears, black vomit, and one died in convulsions.

These are the characteristic symptoms of the worst form of Yellow Fever as it occurs in the Tropics.