HAWKE'S BAY PROVINCIAL HOSPITAL. – REPORT FOR THE YEAR 1866.

Hawke's Bay Herald, Volume 11, Issue 828, 19 February 1867, Page 3

HAWKE'S BAY PROVINCIAL HOSPITAL. - REPORT FOR THE YEAR 1866.

y ':•-' ;.y ..•.:':.'- V (From the Provincial Govermvent Gazette.) THEiriiujnber. of patients admitted into the Hawke's Bay Proviucial hospital during the year 1866, was 67, aijd the number of deaths has been 11, or about 1$ pc? -'pent, of the whole total treated. Of this mortality all except four were caß^ot long staiiding, and of a kind necessarily fatal— cases usually sent to a hospital after other treatment has failed, aud the funds of the patient have become/exhausted.). Subjoined is a list of the deaths ;— Jamesß. Ferguson—Apoplexy. ' . ' ■ „*-.,.,. WilHam Garety-r-Softening ofthe brain from long aud hard drinking. Daniel LuoasrrAn old man, for many years afflicted with mental imbecility and broken down health. . ■ Robert Jews— Pulmonary consumption. This man had just arrived from ; !. jtluckland. Simon^Curtis— Malignant disease of stomach. John Nelson— An old fisherman at the Spit, admitted in a dying state ap-par-ently from liver disease. Robert Dane— Serous apoplexy, with extensive liver disease of loiig standing. Elizabeth Moore— Typhus. fever, preceded by dysentery. Henry Morrison— From gunshot wounds received in action. Hamiona— ditto ditto ditto Mbhi-- ditto ditto ditto They other cases treated need no particular remarks, with the exception of one of carcinoma of the whole globe of the eye, which had reached the ulcerative stage and presented a very large protrusion in front of the orbit. The whole eye^was extirpated, leaving the orbit quite empty save the cut end of the optic nerve, which could be seen in its proper site. The mau left the hospital within a moriili, and the disease has up to this time not returned. One of the sailors of the ship Strathallan, just before arriving at this port fell from the fore-top on to the deck. His fall being slightly brokeu by some of the rigging, the' injuries he sustained were fracture of the t lower jaw bone at the symphysis and fracture of the palatine plate of the upper jaw. There was some bleeding from the ear. He was admitted into hospital immediately on arrival here, and.is now doing well. . : The hospital in its present enlarged form has ample accommodation tor 17 beds ■ ; but its capacity, and resources were 1 called into sudden aud unwonted activity in October last, after the engagement at Omarunui, by having (in addition to its usual average of inmates,) to receive within its walls over twenty wounded Hau'&aus and four or five wounded of the Militia and Volunteers. The emergehcy j ™ met on the part of the Government, by providing immediately a supply of competent assistants, and, although the hospital was crowded to excess'everything was done in the way of attention to the dressing of the wounded, whether European or native, and to their dietary. It was found necessary to draft off .some to the. Goal aud elsewhere immediately, aud others followed as their wOtinds-s healed, for the purpose of safe custody. si 3?he gunshot wounds presented the usual variety of such casualties, whetheriasto locality or the importance of the parts involved. More thau half weVey^ounded in more places than one, and in about the same proportion were complicated with comminuted fracture of some one or more bones. The wounds in our own men contrasted favourably with those of the Hau Haus, as the latter prated: at the polu* oteii o£ the Enfield bullet, a terribly jagged appearance, wliiist *in the former, the .wound being caused by smooth round bullets, preseritedno such formidable appearance. : > The wounds may, for clearness and conciseness, be divided into the diflerent regions of the body where they occurred, commencing with the L „: „ ... HEAD AND! FACE. There were two cases of gunshot wound of the face, one in which the ball entered just below the right ala ofthe nose, and, passing to the left, broke to pieces the whole of the left upper maxillary bone, aud the coronoid process of the lower iaw bone passing out near the latter. A large portion of the upper maxilla was dissected away* and, during- the healing process, several pieces of bone of different sizes were exfoliated. The wound was dressed with Condy's fluid, and the case has dave well. The other was a wouud of the body of the lower jawbone at- its inferior part on both sides, lacerating the whole of the soft structures between the skin and inside of the mouth. There was in this case great exfoliation of the bone and exteusive sloughing ofthe soft parts, the external wound communicating directly with the interior of the mouth. :iV; There were two wounded in the neck, one with a slight grazing of the front ofthe thyroid cartilage. In the other the ball entered at the upper part of the left bladeboue, fracturing this at its upper costa, aud, passing inwards and forwards beneath the sterno-cleido-mastoid and other muscles, made its exit by perforating the oesophagus, -and was vomited or spat out of his mouth at the time. "From the entire absence of auy symptoms warranting a belief in this eccentric course ofthe bullet, either in the throat or the wound, his statement was scarcely' credited, but, after a week or two, fluids administered by the mouth found" their way out at the dorsal opening. There was not a single untoward symptom followed, and the wounds were healed in a month. SHOULDER AND ARMS. There were 19 wounded in this region ; and, in three cases both scapula a£d humerus, and, in- five, the humerus with the bones forming the elbow joint ■were shattered. During the course of the treatment a great deal of bone was either : extracted or came away. In nearly all, a tolerably useful joint was obtained,, which, at some future time, might in a few cases be still further improved by; resection— one of the novelties of modern surgery. i^ -'The remainder of the cases presented no feature of special interest. ii'-XX'X... CHEST AND TRUNK. There were six cases of woundß in this region, two only of which were of a dangerois /nature, aud both terminated fatally after the patient lingering for a week or teii days. In the one, the ball entered near the spine, taking an oblique direction through the scapula and ribs, and, after passing through the left lung, made its^ih the axilla. In the other, the ball passed directly through the right lunwifrom before backwards about four inches from the mesial line, and bet&fetfce fpurth and fifth ribs. There was constant oozing of frothy mucus, tinged with blood, from the wounds, with escape of air at each act of expiration. Tight bandaging and drawing the edges of the wounds together seemed to give t£taptoary relief. Both subjects were old men and of an enfeebled habit of body.' •■••• . ,';, HIPS AND LOWfiR EXTREMITIES. TJaere were 15 cases, several of which were mere flesh wounds aud only required time and simple applications. There were four cases of comminuted fracture of the femur, two of which (oue Europeau and one Native) terminated fatally, and the other J two are still under treatment. These cases are among the most severe casualties of the battle field. The primary shock to the system and the subsequent details connected with the injury and its treatment, call for a large amount of constitutional vigour, whilst the pain and suffering, with the exhaustive nature of the discharges from generally so extensive a suppurating surface, iv spite of allaid^rMedical, Surgical, or dietitic— is a greater charge on the system than it can-usually bear, and a large proportion of such cases termiuate fatally. lam of opinion that in these cases uo union takes place, for many weeks or mouths after the occurrence ofthe injury, and too much importance is, in the early stage, o£ten attached to the position of the limb at the expense of the comfort and mere safety of the patient. * I may add that simple water dressing sufficed iv the majority of the cases, followed afterwards by escharotics and other treatment. There were wounded at Omarunui 33 natives (inclusive of three women.) Three have died, 23 have gone to the Chatham Islands, and four remain uuder treatment. The women were permitted, when their wounds had healed, to go whither they pleased. There is in the hospital a friendly native (Honi), who was wounded at the Wairoa more than a twelve month ago, aud has been under medical treatment tfeere^ptil /three months ago, when he was sent here for further advice. This is a bad case of fracture of the femur. There is now great shortening and deformity , of : 'the.- limb, ; and several serous openings connected with masses of necrosed Bone.* He has improved vastly whilst here. .''iThehospitai is visited regularly by two Justices ofthe Peace, and often by {^e^uperintendent, as well as by ministers of religion of all denominations. A. j.ri_ali ; library owes its existence to the liberality of a few persons, and all are reminded, that any. addition thereto will be thankfully received. mm'vui"...". .-.-..■.. LUNATICS. £lWrk have been 10 certified cases of lunacy under treatment this year. Five haye' been discharged, and five remain. Three ofthe five discharged had beeu drinking heavily, aud, after a temporary confinement of a few weeks, they re- j covered. . ii ! A'xnTh& five that remain seem cases of a permanent character. They- often become Violent and require coercive measures, disturbing the rest of the prisoners. Except ih this particular, I have not noticed any injurious result from the admixture of the lunatics with the prisoners generally. • THOMAS HITCHINGS, W-- >;:-'• ;,., Proviucial Surgeon. -hiX January, 1867.