353
XI-SURGICAL OPERATIONS.
HEPATIC ABSCESS.-There were no cases operated on during the year, the one fatal case was operated on in the previous year and the particulars were published in last year's report.
Two other cases were under treatment, these both recovered the abscesses bursting through the lungs. MAJOR AMPUTATIONS.-There were nine during the year, one of the thigh, four of the leg and four of the forearm, with three deaths, in two of these the fatal result was due to the excessive hemorrhage which had occurred before the patient's admission, in the third the patient though fre- quently urged had refused to give his consent until gangrene had set in and then amputation was simply performed as a dernier ressort, in this case there had been extensive injury to the ankle and foot. The only other point worthy of note is the greater number of gunshot wounds admitted, six out of the eleven however came from the S.S. Namoa. Of these six two were Malays, two Chinamen and two European officers, of the Malays one (referred to in paragraph X) died shortly after admission, the other was shot through the hip the bullet having entered anteriorly midway between the anterior superior spine of the ilium and the pubes, it passed through the ilium and emerged close to the left sacroiliac joint, this case was somewhat protracted owing to the extensive injury to the bone, ultimately however he made a good recovery.
The two Chinamen were shot through the thigh, in one the bullet had to be extracted, in neither of these cases fortunately was the bone or important vessels injured.
In the case of the two European officers, both were shot through the right forearm. In one the bullet entered on the posterioraspect of the wrist close to the lower end of the ulna, passed up the forearm between the two bones and energed in the inner side just below the elbow, intense cellulitis supervened, free incisions were made, ultimately the patient was discharged with free use of his limb. In the other case the bullet passed right through the lower end of the forearm just above the wrist joint and seriously injured the lower end of the radius, severe ostitis set in with synovitis of the wrist joint and several counter incisions had to be made; eventually these all healed, but I fear this patient will have more or less impaired use of that joint.
(xii.) FRACTURES AND DISLOCATIONS.-There were 45 cases as against 19 last year with two deaths, one of these being that of a Chinamen, cet. 78, with fracture of the neck of the femur, the cause of death being evidently exhaustion; the other was one of compound fracture of the forearm caused by dynamite explosion, in this case the patient was admitted in a state of collapse brought on by excessive haemorrhage which had occurred, he died a few hours after admission.
The cases were as follows:
Compound Fracture of the frontal bone....
>>
>>
11
"}
13
""
59
97
21
femur.
1
tibia and fibula 2 fibula....
1
ankle joint....... 1
Fracture of Inferior maxilla
1
"}
严家
humerus
4
ulna
3
>>
"
radius
6
};
**
femur.
.11
รา
31
22
patella
1
tibia and fibula
""
"
•
>>
fibula.. ribs
2
5
>>
+
"}
"
olecranon thigh...
1
1
Dislocation of humerus (subcoracoid )
17
(xiii.) ALCOHOLISM.-There was a large increase in this class of cases, there being 74 admitted as against 44 in the previous year.
POISONING. There were 21 cases under treatment as against 11 in the previous year, with one exception the agent used was opium and eleven proved fatal.
20. SMALL-POX.-There were only two cases under treatment in the Temporary Sinall-Pox Hos- pital, these both recovered.
21. There were 30 Post Mortem Examinations made during the year.
22. In an appendix are the notes of some cases of medical and surgical interest.
23. The total amount of fees received from patients during the year was $16,115.32; of this the Board of Trade paid $2,414.50 and the Police $1,128.76. This is an increase of $4,670.83 on that of the previous year or two-fifths as much again.
I take this opportunity of again thanking the several members of the staff for the assistance rendered during the past year and I have also to record my indebtedness to many residents of this Colony for the interest they have taken in the patients under my charge and for the numerous visits, presents of books, newspapers, flowers, &c. they have made to the Institution.
Dr. PH. B. C. AYRES,
I have the honour to be,
Sir,
Your obedient Servant,
J. MITFORD ATKINSON, M.B., Superintendent of the Government Civil Hospital.
Colonial Surgeon.
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