TABLE X.-Average Admissions, Deaths, and Mortality, in the Months and Quarters, of Eleven Years and two-thirds, ending in 1839. Taking the months in the usual groups or seasons, and allowing for the inequality in the number of the months (column 5), we have the following average of admissions, viz. :— 1st Quarter, January to March 3rd Quarter, July to September 4th Quarter, October to December 728.5 per cent. ,, According to these figures, there was an excess in the admissions for the first quarter of the year, and without any correction on account of February, over each of the middle quarters, of 14 to 15 per cent., and an excess for the last quarter over each of the two preceding quarters of about 7 per cent. When we direct attention to the mortality of the months, we find the results different, in some cases widely, from that of the admissions. As to deaths January stands again at the head, viz., 1 in 7.1, or nearly 14 per cent. on the admissions. Next comes February (which taken at 28 days was but the 8th in the order of admissions), with a mortality of 1 in 7.3, or 13.5 per cent.; then follows April, with 1 death to 8.1 admissions, or 12.2 per cent. Next to April was December, with deaths 1 to 8.3 admissions, or about 12 per cent. No other month gave more than 10 per cent. mortality, except May, which gave 11 per cent. Now taking the mortality in quarters, we obtain the following results, viz. : 1st Quarter, January to March 12 per cent. 4th Quarter, October to December 10.6 3rd Quarter, July to September TABLE XI. Abstracted from Returns made Quarterly to the Board of Guardians Quarterly Admissions, whence, and to what Wards; the Discharges, whether Cured Number in the Wards, Medical and Surgical; the Average Stay in the Wards, 1,740 1,047 2,789 2,150 478 40 2 2,670 145 7,436 16 according to a Plan adopted at the recommendation of the Author, and giving the or otherwise; the Deaths, whether under Physicians or Surgeons, the Average Medical or Surgical; and other particulars. 1,497 1,173 1,172 1,111 334 43 102 101 263 26.8 469 242 348 345 310 245 814 552 593 206 75 8 134 101 26 33 57 369 152 19 126 5116.5 29 31.75 Totals. 1844 Quarter to 31 Mar. 31 June. Totals. From the table given on the two foregoing pages, I subjoin the admissions and deaths for the quarters respectively of the 6 years ending with June 1844: According to this table the largest admission and mortality were both in the first or January quarters, and the least admission and mortality were both in the third or July quarters. The other two groups of quarters, viz., the second and fourth, had almost the same rates of mortality, viz., 12.4 and 12.3 per cent. The principal difference between this table and the preceding is a higher rate of mortality in every quarter of this latter table. In each we observe the highest and lowest rates fall on the same quarters, viz., the first quarters highest and the third quarters lowest. In each the second quarters stand next to the first in mortality, and the fourth quarters between the second and fourth. Some years since, my brother, George Clendinning, B.M. (now withdrawn from the profession) made an analysis of the old journals of the infirmary for 14 years ending in 1835, in aid of inquiries I had then on foot, and obtained results which appear to differ from the preceding. The following table shows the contrasted results. The sum total of deaths from all causes was in the 14 years 3756; and in the 63 years (adding th to the third quarter's deaths), the total loss by deaths was 2410: Sufficient reason, however, for this difference exists to explain it without impugning either the calculations of my brother or myself. It is this: we divided the year differently. He took the natural groups of months constituting seasons, beginning with March, April, and May as the spring quarter, and so of the rest of the year; whereas I took the civil year, beginning, of course, with January as the first month of the first quarter. My results analysed on my brother's plan would give (on a total mortality something above 3400) 23-4 for spring, 21-2 for summer, 22.2 for autumn, and 32.8 for winter, per centages of mortality. From this same table* it appears that in the 6 years there were admitted under the physicians, exclusively of the physician accoucheur, 9880 patients, and under the surgeons 7904, together 17,784, or 2634 annually of both classes; and that the admissions from the W. H. (work house) = * See Table XL pp. 304 and 305. were 12,001, and those from O. D. (their own homes) were 6430; together 18,431. It will be observed that the total of admissions under the physicians and surgeons falls short of those from W. H. and O. D. together by between 600 and 700 (658). This difference represents principally "casuals" or cases officially admitted to the W. H., but placed in the first instance for a time in the sick-house or infirmary under observation. Such are usually not entered in the common way as patients unless found to labour under some complaint, but are commonly transmitted to the other side in a day or two after admission. On the 6 years the admissions under the physicians were nearly 57 per cent., and those under the surgeons 43 per cent., of the whole regular admissions. The cures on both classes (physicians' and surgeons' patients) together were nearly 66 per cent. on the admissions, and 80 per cent. on the discharges of all sorts, exclusively of deaths. The relieved or incurable (which, by the bye, ought not to be thus confounded) were, on both classes of patients, nearly 15 per cent. (146 on the admissions, and 17.5 on the discharges,) exclusively of deaths. The discharges " by desire, uncured" were about 1.8 per cent. on the admissions; the irregular were something less than 4th per cent. The puerperal cases (which are not included in any of the totals above given) were about 150 per annum; they amount at present to 200 per annum. The puerperals (or lying-in cases) were until lately received on the W. H side, and counted, therefore, O.D. cases: the mode of recording them formerly in use still continues, and they are not above included in the admissions under the physicians. A presumable and increasing disproportion between the domestic accommodations of the parochial establishment and the general parochial population has been already adverted to, and the apparent increase of mortality in the wards of the infirmary has been conjecturally referred in part to that circumstance, and the necessity thence arising for narrowing the way into the infirmary and exercising a less indulgent superintendence and control as regards the granting of "doctor's orders" (i. e. the overseers' orders to the resident medical officers to examine applicants for medical relief, whether at their homes or at the infirmary), and a less lenient system of admission into the sick-house or infirmary. With a view to test the accuracy of that supposition, I have calculated the proportion of the admissions coming from the W. H. and O. D. (their own homes) respectively; and the following table gives the result so far as materials exist and are at my disposal :: |