NationalLibraryOfScotland/medical-history-of-british-india huggingface dataset:
17
2. In addition there are small quantities of Radium in the hands of
private doctors. The Barnard Institute of Radiology, located at the
General Hospital, Madras, is by far the finest institute of its kind in
India, probably in the East. It has recently installed apparatus for the
manufacture of Radon with which it will be possible to utilize the curative
power of Radium to an increasing extent both in Madras and in outlying
districts. The Institute, which, to quote Sir Frank Connor's note on the
Madras Medical Department, "is a fitting memorial to the impatient
industry of Captain Barnard, the Director" undertakes training classes
for medical men, and proposals are under consideration for the establish
- m e n t o f a D i p l o m a a n d U n i v e r s i t y D e g r e e i n R a d i o l o g y .
3. The Tata Memorial Hospital, Bombay, which has been founded by
the Trustees of Sir Dorabji Tata Trust, and which will open early in 1939
will also have a large quantity of radium. It seems probable that there
will be a bomb for beam therapy and also a supervoltage machine capable
of producing neutrons as well as X-rays. In addition, several other therapy
and diagnostic roentgen machines of various types and capacities will be
maintained.
4. X-Ray facilities available in the various provinces can hardly be
regarded adequate, as will be seen from the figures set forth in the follow
- i n g t a b l e .
Province.
Major sets.
Minor sets.
Remarks.
Madras . . .
12
. . .
Figures for major
and minor sets
not given sepa -
rately.
Bombay. . .
10
1
Bengal . . .
22
9
United Provinces
9
*11
*Plus 2 private
owned sets and
3 minor sets.
Punjab. . . .
10
3
Central Provinces . . .
7
6
Bihar . . .
1
8
Assam . . .
3
. . .
Sind. . .
2
1
Orissa . . .
2
. . .
Delhi. . .
3
3
North-West Frontier Province . . .
1
4
Baluchistan . . .
. . . 1
Ajmer-Merwara . . .
1
. . .
B
9. BEDS FOR MATERNITY CASES AND NUMBER OF LABOUR
The following table gives an dea of the number of beds available for maternity cases and the number of labour
cases attended to in each province during the year 1937.
Normal.
Abnormal.
Normal.
Abnormal.
Normal.
Abnormal.
Madras
609
10,626
3,012
838
15,117
7,178
93
1,389
205
Bombay
413
11,471
1,579
836
4,416
1,434
1,386
17,482
1,982
Bengal
333
7,525
1,194
369
8,179
2,875
119
6,132
1,810
United Pro
¬ vinces.
40
881
251
388
3,806
2,937
45
194
19
Punjab
113
3,403
972
343
3,403
1,659
46
1,653
119
Central
Pro
¬ vinces and
Berar.
144
2,297
584
264
2,218
668
182
2,086
54
Bihar
92
*6,798
*2,763
143
Assam
47
510
165
64
99
50
9
†
†
Sind
Not fixed.
129
35
174
2,075
424
292
773
102
Orissa
33
‡1,384
‡190
19
Delhi
4
159
*2,111
*1,052
2
North-West
Frontier Pro-
vince.
99
‡1,070
‡400
165
Baluchistan
8
208
183
Ajmer-Merwara
9
20
11
261
184
26
393
106
Coorg
21
395
24
* Number of labour cases attended to in all classes of hospitals and dispensaries.
†The Sylhet Maternity Home has been opened very recently.
‡ Separate figures not given.
19
10. HONORARY MEDICAL OFFICERS.
The system of appointing honorary medical officers to Government insti
-tutions is in force in the provinces of Madras, Bombay, Bengal, the United
Provinces, the Central Provinces and Berar, Bihar, Orissa and Sind. A
résumé of the rules regulating such appointments in these provinces is
given below. The Bombay rules apply to Sind. In Orissa the rules
regulating such appointments are under preparation. For the present the
Madras rules are applicable to South Orissa.
MADRAS.
Scope of appointment. —All posts other than those mentioned below,
including teaching appointments in Medical Colleges and Schools, are
open to honorary medical officers as and when vacancies arise in the
Provincial and Subordinate cadres of medical officers and so far as suitable
persons are available for such appointments:
—
(i) Superintendents of Government Hospitals in the Madras City.
(ii) District Medical Officers and Superintendents of Government
District Headquarters Hospitals.
(iii) Chief Medical Officers in charge of Government Hospitals with
30 beds and over.
(iv) Resident Medical Officers who are also Assistants to Superin
-tendents of Hospitals.
(v) Appointments in the King Institute, Guindy, and Pasteur
Institute, Coonoor.
Designations.— The honorary medical officers are designated as :—
(i) Honorary House Surgeons and Physicians.
(ii) Honorary Assistant Medical Officers.
(iii) Honorary Surgeons and Physicians.
Qualifications.— (i) Licentiates are appointed as Honorary House
Surgeons and Physicians.
(ii) Graduates are appointed as Honorary Assistant Medical Officers.
(iii) Persons possessing qualifications like M.D., M.S., M.R.C.P.,
F.R.C.S., F.C.O.G., etc., are appointed as Honorary
Surgeons and Physicians.
B 2
20
Honorarium.—Honorarium is as shown below subject to such condi-
tions as the Local Government may prescribe from time to time :—
Rs.
(1) Honorary Surgeons and Physicians who have work in hospitals
and also teaching work . . .
100 p m.
(2) Honorary Professors who have only teaching work . . .
60 „
(3) Honorary Assistant Medical Officers who have work in hospitals
and dispensaries and also teaching work . . .
40 ,,
(4) Honorary Assistant Medical Officers who have no teaching work . . .
30 „
(5) Honorary Assistant Medical Officers who have only teaching work . . . 20
„
Duties.—(i) Honorary medical officers are required to perform such
duties as may be assigned to them by the head of the institution, in the
in-patients . department, out-patients department or both, or teaching work.
(ii) They are required to give at least three full hours of the best
part of the day for service in the hospitals to which they are appointed.
(iii) Honorary medical officers who have only out-patients in their
charge have to attend daily during the out-patients hours.
(iv) The hours of attendance are fixed by the heads of teaching institu
-tions, Superintendents of Hospitals or the District Medical Officers con--
cerned.
(v) Honorary medical officers possessing special qualifications are, as
far as possible, placed in charge of special departments but they may,
with the approval of the Superintendent of the institution, undertake
general work in the institution to which they are attached.
(vi) Honorary Surgeons and Physicians are placed in charge of a
specified number of beds for surgical and medical cases respectively and
they are entirely responsible for the treatment and care of the patients
in their charge. They are to visit the patients in their charge daily or
more than once daily should that be necessary, except on Sundays, and
answer all emergent calls relating to them on Sundays. The honorary
officers attached to hospitals run in connection with teaching institutions
are responsible for imparting such clinical instruction to students as may
be laid down by the Professor or the Superintendent of the institution.
(vii) Honorary medical officers placed in sole charge of Government
medical institutions are required to co-operate with public health staff in
epidemic work in their localities in the event of a sudden outbreak of an
epidemic.
Private Practice. —Honorary medical officers are free to undertake
private practice outside Government institutions but cannot (i) receive any
fee from patients seeking admission in Government hospitals, (ii) either
directly or indirectly admit or seek to admit in Government hospitals
patients from whom they have received fees, or (iii) discharge any patient
21
from the hospital for the purpose of treating him as a private patient.
It is, however, open to any honorary medical officer to take under his care
a patient who has been discharged from the hospital in accordance with
the rules governing the discharge of patients from Government hospitals.
Leave.—Casual leave is allowed up to 15 days in a year. Other leave
is granted only if arrangements can be made for carrying on the duties
of the honorary medical officer concerned without extra expenditure to
Government.
Age-limit —Service after attaining the age of 55 years is subject to
the production of a certificate of physical fitness.
In his note on the Madras Medical Department Major-General Sir
Frank Connor writes as follows:—
"The scheme of appointment of honorary medical officers was extended
during my term of office, particularly for the working of special clinics.
The scheme has worked fairly well and there is room for many more
honorary medical officers, particularly if a small but sufficient stipend is
sanctioned by Government; this would add to the sense of responsibility
of the officers concerned and make the appointments more attractive. In
my opinion any extension should be gradual and it should always be
provided that the nucleus of Government medical officers should be suffi
-ciently large and very carefully selected; it falls to the lot of these
medical officers to do all the administrative work and most of the resident
work, and therefore most of the responsibility rests on their shoulders.
It must be borne in mind that in a country like England, where most of
the hospitals are worked on an honorary basis with voluntary funds,
there is a steady tendency to replace honorary medical officers by a State
medical service. The enormous medical organization of the London
County Council is now officered by permanent paid medical officers, helped
by a very few distinguished consultants. This whole-time paid service is
expensive, but has proved very efficient. In the case of clinical teaching
appointments, however, it is essential that the professors and teachers
should have had the additional experience which can only be gained by
private practice; a. professor of medicine or surgery is not paid to teach
students merely medicine or surgery, but how to practise these sciences,
and much of the knowledge required for this purpose can only be obtained
outside the wards of a hospital."
BOMBAY.
Scope of appointment.—Honorary medical staff is appointed to all
hospitals where facilities exist for their employment. All appointments are
made by Government. Vacancies are notified in the press and applications
received are submitted to Government with the recommendations of the
head of the institution concerned and of the Surgeon General with the
Government of Bombay.
22
Qualifications .—In the case of Hospital appointments in Bombay,
except those with which teaching duties are combined, the minimum quali
-fication required is the M.S. or M.D. degree of Bombay, but preference
is given to those candidates who have obtained the F.R.C.S. or M.R.C.P.
For special appointment in Ophthalmology, Ear, Nose and Throat Surgery,
Radiology, etc., candidates are required to produce evidence to show that
they possess special proficiency or qualifications suitable for the appoint
-ment. For ordinary appointments the candidates must be graduates of
Bombay or of any other recognised University. When suitable graduates
are not available, Government may, on the recommendation of the Surgeon
General, appoint licentiates to such appointments.
Duties and tenure of appointment .—Honorary appointments which
carry teaching duties are tenable for 5 years, subject to termination by three
months' notice on either side, the first two years being probationary period.
The tenure of appointments which involve the duties of imparting clinical
instruction only, is three years, terminable by three months' notice on
either side, the first year being the period of probation. Non-teaching
appointments are tenable for two years terminable by one month's notice
on either side, the period of probation being one year.
Leave .—The Surgeon General with the Government of Bombay is
empowered to grant leave to honorary medical officers without any hono
-rarium up to 6 months and to appoint suitable substitutes during leave
period in such cases.
Age limit.—Honorary medical officers must ordinarily retire on attain
-ing the age of 55 years. Retired honorary medical officers may be appoint
- e d C o n s u l t i n g P h y s i c i a n s a n d S u r g e o n s b y G o v e r n m e n t . S u c h o f f i c e r s a r e
not ordinarily required to do any duty at the hospital but are accorded all
such general privileges as are granted to members of the medical staff.
Government medical officers may, after retirement, be appointed by Govern
- m e n t , i n s p e c i a l c a s e s a n d s t r i c t l y o n g r o u n d s o f m e r i t , a s C o n s u l t i n g
Physicians and Surgeons.
BENGAL.
Scope of appointment .—Honorary medical staff is employed in the fol
lowing institutions:—
(1) Medical College Hospitals, Calcutta.
(2) Hospitals attached to the Medical Schools.
(3) Shambhu Nath Pandit Hospital, Bhowanipore.
Designations .—In No. 1 the honorary medical officers are designated
as:—
(a) Honorary Clinical Assistants.
(b) Honorary House Surgeons and Physicians.
(c) Honorary Surgeons and Physicians.
(d) Honorary Junior Surgeons and Physicians.
In No. 2, honorary appointments are styled as Honorary House Sur
-geons and Physicians and Registrars.
23
In No. 3 the members of the honorary staff are designated as (i) House
Surgeons, (ii) House Physicians, (iii) Honorary Surgeons and (iv) Hono
-
rary Physicians.
Qualifications. —Appointments as Honorary Clinical Assistants and
Honorary House Surgeons and Physicians at the Medical College Hospitals
are made from amongst the newly passed students of the Medical College,
Calcutta, the tenure of appointment being 6 months, which is generally
not extended. Suitable candidates are appointed on a tenure basis as
Honorary Surgeons and Physicians and Honorary Junior Surgeons and
Physicians, preference being given to those who have undergone post
-
graduate training and possess foreign qualifications.
The junior appointments (Clinical Assistants, House Physicians or Sur
-
geons), in Hospitals attached to the Medical Schools are reserved for the
newly passed students of Medical Schools ( i.e., candidates with L.M.P.
qualifications), the tenure of appointment ranging from 6 months to 1 year.
The honorary staff for the Bhowanipore Hospital is appointed on the
recommendation of the Superintendent by the Board of Governors subject
to the approval of the Surgeon General with the Government of Bengal.
The tenure of appointment is terminable at any time without notice by the
Board of Governors.
Duties.—In the institutions mentioned at Nos. (1) and (2) above, the
members of the senior honorary staff frequently visit the out-patients
department on appointed days. The members of the junior honorary
staff work in the out-patients department on their senior's days and their
duties there consist of (i) imparting practical instruction and giving clinics
to students (ii) advising on the diagnosis and treatment of out-patients
referred to them by Resident Medical Officer (iii) continuing in attendance
until the work in the out-patients department is completed and (iv) report
-
ing immediately to the Principal, the Superintendent and the Senior Staff
any unusual occurrence that may take place in the out-patients depar
t -
ment. The junior honorary staff also attends on emergent cases in the
hospital when required and carry out the senior's work when the latter is on
short leave.
In the Shambhu Nath Pandit Hospital, Bhowanipore, honorary medical
officers attend the hospital on appointed days. Those who have beds allot
-
ted to them have professional charge of all cases admitted under their care
and in addition to their regular visiting hours answer all emergent calls to
these cases at any time.
The House Surgeon and House Physician are responsible to the Hono
-
rary Surgeon and Physician respectively for the care of their cases in their
absence and have to attend them on their visits to the hospital. When not
so employed they perform any duty they may be called upon to do in the
hospital, such as giving anaesthetics or preparing returns, etc., and take
their turn of emergency duty.
24
UNITED PROVINCES.
Scope of appointment .—Honorary medical officers are appointed to
hospitals maintained or aided out of State or local funds in the United
Provinces. A candidate for appointment as honorary physician or surgeon
or honorary medical officer should have been in the active practice of his
profession for at least three years and for at least one year in practice in
the place of the honorary appointment, and must be registered under the
United Provinces Medical Act. The Inspector General of Civil Hospitals.
United Provinces, selects candidates for honorary appointments on the
recommendation of the Commissioner and the Civil Surgeon and publishes
their names in the Government Gazette.
Designations.—There are three classes of honorary appointments, viz.,
(1) Honorary Physicians and Surgeons.
(2) Honorary Medical Officers.
(3) Honorary Clinical Assistants.
Qualifications. —(1) Honorary Physicians and Surgeons are of consultant
status, may be appointed to any sphere of hospital activity and must
possess higher medical and surgical qualifications, such as M.D., M.S.,
F.R.C.S., M.R.C.P., etc., for ordinary appointments and for special
appointments either of these or some special qualifications in the subject,
such as D.O., D.L.O., D.M.R.E., etc.
(2) Honorary Medical Officers may be appointed to attend to out
-
patients only and must have held a resident appointment in some hospital
prior to their honorary appointment.
(3) Honorary Clinical Assistants are appointed from among the ordinary
graduates of the Lucknow University who have not settled in practice, to
the various departments of larger hospitals, tenure being six months.
After 5 years continuous service as an honorary medical officer in the
same hospital, an honorary officer becomes entitled to appointment as
Honorary Physician or Surgeon without the necessity for holding higher
academic qualifications.
Duties and tenure .—Honorary appointments are tenable in the first
instance for two years, the first 6 months being probationary period. The
Inspector General of Civil Hospitals, United Provinces, may confirm the
appointment or not and renew it in due course for further periods of three
years at a time at his discretion, but the Local Government reserve to
themselves the right to cancel the appointment for any sufficient reason.
An honorary physician and surgeon is, on request, assigned beds to him
in a ward of medical or surgical cases where he can treat patients eligible
for admission to the hospital. He can admit only such patients as are
entitled to gratuitous hospital treatment under the rules. He is entirely
responsible for the treatment and care of patients in his wards, subject only
to the general control of the Civil Surgeon and is expected to visit them
25
once daily and oftener, if necessary, and to answer all emergent calls relat
-ing to them. Except at the special request of the Civil Surgeon or in
his absence of the Senior Assistant, the honorary officer may not deal with
cases not assigned to him or with other miscellaneous work of the hospital.
Duties.—The duties and hours of attendance of the honorary staff are
fixed by the Civil Surgeon in consultation with the honorary officer and the
medical officer in charge of the hospital.
Leave.—Members of the honorary staff have to apply for leave to the
head of the hospital and cannot absent themselves from duty or alter the
time of attendance without his permission.
CENTRAL PROVINCES & BERAR.
Scope of appointment.— Honorary appointments are made from among
local medical men who apply for the posts.
Designations. —The honorary appointments are styled as:—
(i) Honorary Physicians and Surgeons.
(ii) Honorary Specialists.
(iii) Honorary Anaesthetists.
(iv) Honorary Tuberculosis Officers.
(v) Honorary Assistant Surgeons.
Tenure and Duties. —All honorary posts are tenable for one year, the
incumbent being eligible for reappointment.
Honorary Specialists must not interfere with the internal economy of
the hospital in any way, nor with the work of executive staff. The beds
allotted to them are provisional and may be filled up, if vacant, by the
executive staff at any time. The use of operation theatre, dark room, X
- R a y r o o m o r l a b o r a t o r y , e t c . , i s r e s t r i c t e d t o t w o d a y s a w e e k f o r e a c h
specialist. On these days he is "on duty" and liable to be called upon for
emergencies during that period.
BIHAR.
Scope of appointment. —Honorary medical officers are appointed by
Government on the recommendation of the Inspector General of Civil
Hospitals, Bihar, and in consultation with the Superintendent of the in
- s t i t u t i o n c o n c e r n e d .
Designations.— The honorary staff is designated as:
—
(i) Honorary Physicians and Surgeons.
(ii) Honorary Medical Officers.
26
Qualifications. —Ordinarily honorary medical officers are selected from
among those who have held appointments affording special opportunities
for acquiring special skill and experience of the kind required and have had
special academic and post-graduate study or are generally recognised by
other practitioners in the area as possessing special proficiency and expe
-rience.
Tenure and duties. —The tenure of honorary staff is in the first instance
two years, renewable by Government after consultation with the Inspector
General of Civil Hospitals and terminable by one month's notice on either
side.
Honorary officers are required to conform to the rules in force in the
hospital in which they are working. They are placed in charge of specified
number of beds and held entirely responsible for the care and treatment of
the patients in their charge. They visit patients daily once, or more than
once should that be necessary, except on Sundays and answer emergent
calls relating to them.
Honorary medical officers have no professorial duties in the College
but they are responsible for imparting clinical instruction to students in
connection with the beds in their charge in accordance with such plan as
may be laid down by the Professor or Lecturer in charge of the Unit.
Honorary medical officers who have only out-patients in their charge may
attend daily but need not attend more than three days a week with the
consent of the Superintendent of the hospital.
The entire management and control of the hospital and the discipline
of the staff are vested in the respective medical officers in charge. Hono
-rary officers are expected to observe all rules in force and to report all in
- s t a n c e s o f n e g l e c t o r i n a t t e n t i o n o r b r e a c h e s o f d i s c i p l i n e t o t h e G o v e r n m e n t
Medical Officer in charge to deal with them.
Leave.—Honorary medical officers may be granted casual leave up to
15 days by the Superintendent of the hospital and leave of absence other
than casual leave by the Inspector General of Civil Hospitals, Bihar, pro
-vided he can make arrangements for carrying on their duties without any
extra expenditure to Government.
11. POST-GRADUATE TRAINING FOR ASSISTANT AND SUB
-ASSISTANT SURGEONS.
The system of imparting post-graduate training to Assistant and Sub
-Assistant Surgeons obtains in all provinces except Madras, Delhi, Baluchis
- t a n a n d C o o r g . P o s t - g r a d u a t e t r a i n i n g o f 3 m o n t h s ' d u r a t i o n e a c h t i m e
is given in Bengal to Assistant as well as Sub-Assistant Surgeons between
the 4th and 7th year of service and again between the 11th and 14th year of