Table IV shows the causes of admission to Hospital, of the different cases, and the deaths. Table V shows the rate of mortality among the different sections of the community admitted to Hospital; in all of which there is a considerable decrease, especially among the Chinese. The Superintendent in his Report remarks upon their dislike to stay in Hospital, and attributes the decrease of the mortality to many being carried away in a dying state by their friends, but this has also been the case in foriner years, and I am not aware of any increased dislike to staying in Hospital this year more than in former
years.
Table VI shows the number of admissions and deaths in the different months, and as usnal the summer months are most sickly, and the mortality greatest. Table VII shows the number of dend bodies brought to Hospital for examination. There is an increase of 18, as compared with 1875. The increase was among adults, the number of children's bodies being exactly the same.
All things considered, I think this institution has done very well; the admissions are about the same, the deaths among all sections of the community greatly decreased.
1874, 1875,
1876,
Admissions.
829... .1,010.. .................1,001...
Deaths.
.................................................... 92.
.35.
There were 17 adinissions to the Sinall-pox wards during the year and one death. Some of the cases were very severe, and in spite of all efforts to the contrary, left the patients badly scared. The Small-pox wards are separated from the Government Civil Hospital, being situated near the old Civil Hospital, and to these I have attended myself as they are close to the Lock Hospital and do not take me any distance out of my way, as they would the Superintendent of the Government Civil Hospital. When the new Hospital is completed, these wards will form a separated portion of it, and come under the charge of the Superintendent.
One woman in labour was brought to Hospital. As a rule such cases would not be admitted to an ordinary Hospital, but some cases which require operative interference are better in Hospital than in the filthy, ill-ventilated rooms of their own houses; at any rate the risk of a fatal termination is no greater, if so grent.
During the past year, great changes have been made in the staff of this Hospital, and it remains to be seen how the new system will work; as far as it has gone it seems to act well, but time will be required to instruct the new Chinese nurses in their work and sharp supervision to see that it is pro- perly done.
There has, in the last three years, been great trouble with the staff of this Establishment. I am in hopes the present plan will prove successful, and that we shall have no more troubles of the sort in future. I was in charge of the Hospital in the month of October, during the Superintendent's absence on leave, and I think it works as well as can be expected; better than night have been, considering its defects.
TUNG WAH HOSPITAL.
In my Report for 1874, I said all that could be said for this Institution. As a matter of fact, the Chinese have a rooted objection to going into a Hospital at all, whether it is presided over by their own Native Doctors or by European Surgeons. It will be a work of time to overcome this prejudice. I am frequently called in by Chinese of the better class, and there is not much difficulty with them, if you explain carefully what you hope to be able to do and the chances of success, but if an operation is re- quired and the chances of success are small, or the deformity resulting is great, they decline to submit to it. Their objections, in part the result of their religious belief, are not to be overcome by force or de- priving them of their Native Doctors, charlatans though they may be in a European point of view. I have explained, in a special Report, the difficulties in the way of educating Native Doctors as is done in India, because the Government would require only a few and they would be useless in their native land. In India, where Dispensaries are established by Government all over the Empire, Native Doctors educated in European ideas are a necessity. The prizes in the way of appointments offered to them are great and medicines are supplied gratis by the Government. Supposing Government Dispensaries were established here, there is only a limited demand, and the school set-up must close as soon as this demand is furnished, for the men thus educated would be useless in their own country, where they could not procure the drugs they were taught to use, or only at heavy cost. The objection among the Chinese to the use of the knife, is the same with inany castes in India, and in no case would the Govern ment permit offence to be given to the natives by a Surgeon operating against their wishes. Even among Europeans it is customary to consult the wishes of the patients, or their friends, and if an Englishman preferred to die to being operated upon with a chance of recovery, I know of no law to prevent it. So, however absurd the treatment of their Native Doctors inay seen, I cannot see anything to be gained by doing away with them. For the natives have not sufficient confidence to come to us, und such a proceeding, in the present state of affairs, would do more harm than good.