NationalLibraryOfScotland/medical-history-of-british-india huggingface dataset:
FIG. 14.
FIG. 15.
FIG. 13. A
i v
group of red blood-discs agitated and distorted by a slender lashing
filament, which had become detached from a neighbouring flagellated
body, during its brief movements under scrutiny : the thrilling aspect
amongst the corpuscles was very evanescent, and being detected in two
or three separate parts of the field, it seemed, that more than one
flagellum was liberated or else after detachment one had continued to
travel. An appearance not very rare.
A phagocyte containing in its interior two pigmented spheroids.
Melanæmia. A group of pigmented structures seen together in the
blood, the day after ‘crisis’ of paroxysmal fever—CASE No. 6. At a
an enormous nucleated cell (? splenic endothelium) loaded with pig-
ment masses (‘melanine’, so-called), extra-nuclear in site and opaque-
black in tint : many such cells were present. At b an ordinary
smaller leucocyte ; also common. At c spheroidal, cylindrical, and
semi-lunar organisms (some red corpuscles also added), which were seen
in proximity and likewise not infrequent.
FIG. 6.
FIG. 7.
FIG. 8.
FIG. 9.
i i i
an evacuated Crescent, with the pigmented spheroid body, which had
thence become extruded ; fresh specimen non-febrile ; and numerous
free organisms also present, including the flagellate.
b.— The Spheroidal. Bare.
Pigmented spherules seen in fresh blood, during the stage of ‘rigor’—
Quartan ague.—CASE No. 1. a. a. Unaltered red discs. b. A spheroidal
body, at successive periods of 20 minutes watched. At * below, a
pigmented body with large nucleus, and a red-corpuscle with spheroid
apposed, observed in the same specimen : see also series A, figure 3, above.
A group of four spherules, from the same case, and taken at estimated
‘acme’ of the febrile paroxysm (t. 103.4°F.) Below, three other sphe--
rules taken four hours after cessation (spontaneous) of pyrexia. To
show amæboid and varying aspect of the spheres, and of their pigment
contents.
Other spheroids taken on day of expected relapse, before the setting in
of ‘rigors’ : magnified 1,000 diameters. Shows a tendency to partition
of Spherules, and to assumption of Crescent shape ?
Other spheroids taken at ‘hot’ stage of a paroxysm (t. 106°F.) ; showing an
apparent division or disruption of some bodies, with dispersion of the
dotted granules (? germs) thence resulting. CASE 1 : quinine not
given. At * a similar aspect of spontaneous partition, with separation
of the pigment, noted in CASE No. 2, at non-febrile state (quinine
administered).
FIG. 10.
FIG. 11.
FIG. 12.
Pigmented plasmoid particles frequently seen in the free state, and
seemingly indicative of one mode in which free spheroids may be
formed afresh ; namely, by direct growth of such freed particles.
Flagellate Organisms.
A flagellate or ciliated spherule, as seen in fresh blood. CASE No. 5,
non-febrile and without quinine ; the flagella were in very active
lashing movement, the central body oscillating slightly, and its pigment-
contents also much agitated. Whilst being watched, the organism was
seized by a wandering, coarse-grained Amæba; after a struggle
becoming involved ; and in the course of 20 minutes carried away,
as indicated by Figures a. and b.: this phenomenon being so frequently
witnessed as to appear not merely incidental.
Another flagellated body, from CASE No. 6, during convalescence on
eighth day after arrest of fever, and the blood thenceforth free from
visible contamination ; quinine exhibited. movements so active that
the number of flagella could hardly be surely ascertained : amæbæ here,
too, early made their appearance. At * is another pigmented body
belonging to a flagellated organism, introduced to show a striated
arrangement assumed by the agitated pigment-particles within, during
struggles against an invading and finally conquering amæba. At * *
three liberated and free-moving Flagella, somewhat resembling bacteric
spirillar organisms ; they are distinctly knobbed midway or at end.
FIG. 1
FIG. 2.
FIG. 3.
Description of the Illustrations in Plate IX.
THE BLOOD-ORGANISMS SEEN IN AGUE.
Magnifying Power—800–1000 Diameters.
SERIES A.—INTRA-DISC FORMS.
Two red blood-discs, showing a minute pale body which at first seemed to be
pedunculated (upper disc) and then disengaged, when it began to dis
-play distinct amæboid movements attended with various marked changes
of form (represented at one instant in the lower disc ) , and some increase
of dimensions : at the end of an hour’s watching, no further alterations.
No pigmentation here, though present in other discs, near which were
apparently undergoing transitions to free pigmented organisms, both
spherules and crescents. Aspect not uncommon. From Case No. 7,
just after admission and during decline of fever (e.t. 100° F.), under the
influence of quinine (20 grains).
Two red corpuscles from the same patient, on the following day, e.t. 97 . 4° F. :
quinine continued. The plasmic body in the upper disc contains a dark
granule, active, and, with its containing space, changing form and site.
The lower disc presents four pale specks on its surface ; similar plasmic
specks were seen in the free state around : a notched appearance of the
edge of the disc not rare, is also shown.
A Series of four blood-discs from the same patient, selected as indicating
one mode in which pigmented Spherules may be formed ; namely, by the
gradual growth of a pigmented plasmic body, first attached near border
of disc, and in the course of a few hours invading its whole area ; blanch
- i n g a n d s o m e c o n t r a c t i o n i n d i a m e t e r o f t h e d i s c c o n s e n t a n e o u s l y
occurring. Free dotted, plasmic specks in the fluid medium around.
Date—the second day after arrest of fever by quinine, with continued
exhibition of the drug: the spleen enlarged and tender. For similar disc-
aspects, see also below series B, b, spherules bare, fig. 6 *, from another
patient.
FIG. 4.
FIG. 5.
A series of four blood-discs, from the same patient and at similar date ; in-
dicating one way, at least, in which pigmented Crescents may be formed ;
namely, by attachment and growth of a pigmented body, with
c o n s e n - t a n e o u s c o l l e c t i o n a r o u n d i t o f t h e c o l o u r e d p l a s m a o f t h e d i s c ; w h e r e b y ,
at the opposite pole of the disc, the stroma becomes blanched and finally
forms the fringe of the crescent. * Is a side view, showing the turgidity
and rather lessened diameter of the implicated blood-corpuscle ; see also
Series B, a, Crescents, Figure 3, below. Crescentic organisms being
persistent, continue to grow in dimensions after their formation as above.
A red blood-disc, with pale, active coccus -like bodies on its surface, which
on watching for some hours, did not show further development : the cor-
MELANÆMIA
FLAGELLATED ORGANISMS
PLATE IX.
BLOOD-ORGANISMS OF AGUE
A.
INTRA-DISC FORMS AND ASPECTS
B. FREE FORMS a . THE CRESCENTIC
b. THE SPHEROIDAL BARE
BOMBAY,
July—September 1887.
Lithographed at the Survey of India Offices, Calcutta, January 1888.
H. V. C. ad nat. del.
SCIENTIFIC MEMOIRS
BY
MEDICAL OFFICERS OF THE ARMY OF INDIA.
EDITED BY
SIR BENJAMIN SIMPSON, M.D., K.C.I.E.,
SURGEON-GENERAL WITH THE GOVERNMENT OF INDIA.
PART III.
1887.
1 .
—
Notes from the Biological Laboratory attached to the Office of the Sanitary
Commissioner with the Government of India.— D. D. Cunningham.
2. —Note regarding certain characters in the Sub-Soil of Calcutta.— D. D.
Cunningham.
3. — On a new Genus of the Family Ustilagineæ.— D. D. Cunningham.
4. —On an Entophytic Alga occurring in the leaves of Limnanthemum Indicum,
with notes on a peculiarly parasitic variety of Mycoidea.—D. D. Cun-
ningham.
5 . —
The Fly-catching habit of Wrightia coccinea.—A. Tomes.
6 . — Note on the occurrence of a minute Blood-Spirillum- in an Indian Rat.—
H. Vandyke Carter.
7. — On the lately demonstrated Blood-contamination and Infective Disease of the
Rat and of Equines in India.—H. Vandyke Carter.
8. — Observations on Bacteria in Cholera.— G. Bomford.
9. — On the Phenomena of Propagation of Movement in Mimosa Pudica.—
D. D. Cunningham.
10. —Note on some Aspects and Relations of the Blood-organisms in Ague.— By
H. Vandyke. Carter.
CALCUTTA :
PRINTED BY THE SUPERINTENDENT OF GOVERNMENT PRINTING, INDIA.
1888.
Price 3 rúpees.
REPORT
ON
SANITATION, DISPENSARIES, AND JAILS IN
RAJPUTANA FOR 1921
AND ON
VACCINATION FOR THE YEAR 1921-22
Published by Authority
CALCUTTA
SUPERINTENDENT GOVERNMENT PRINTING, INDIA
1922
Price Rs. 2 As. 12
REPORT
ON
SANITATION, DISPENSARIES, AND JAILS IN
RAJPUTANA FOR 1921
AND ON
VACCINATION FOR THE YEAR 1921-22
Published by Authority
CALCUTTA
SUPERINTENDENT GOVERNMENT PRINTING, INDIA
1922
No. 2200-C. of 1922, dated Camp Ajmer, the 7th September 1922.
From—Major H. R. N. PRITCHARD, O.B.E., I.A., Secretary to the Hon'ble the
Agent to the Governor-General, Rajputana,
To—The Chief Medical Officer, Rajputana, Ajmer.
I am directed to return, after approval by the Hon'ble the Agent to the
Governor-General, the final proof of the Report on Sanitation, Dispensaries
and Jails in Rajputana for the year 1921 and on Vaccination for the year
1921-22, which was forwarded with your letter No. 2566, dated the 21st August
1922.
XI—3—18
REPORT
ON
SANITATION, DISPENSARIES AND JAILS IN
RAJPUTANA FOR 1921
AND ON
VACCINATION FOR THE YEAR 1921-22.
SECTION I.—SANITATION AND VACCINATION.
METEOROLOGY AND ITS RELATION TO FOOD SUPPLY.
Rainfall in Ajmer.
1. During the year under report 11.51 inches of rain were registered, in
Ajmer against 21.98 inches in 1920, the
average for the previous six years being
26.39 inches.
2. The rainfall during the monsoon season from June to September wa9
11.22 inches as compared with 20.46 during the monsoon of 1920 showing a
decrease of 9.24 inches.
Rainfall in Indian States.
3. The rainfall recorded in Rajputana was on the whole below the normal;
owing to which the Kharif and to a lesser
degree the Rabi Crops were not satis-
factory ; Scarcity of Fodder prevailed in most of the Province.
VITAL STATISTICS, BIRTHS AND DEATHS.
Births in Ajmer-Merwara.
4. According to birth returns 15,418 births were registered in 1921 against
13,927 in the previous year, an increase of
1,491.
5. Of the total births registered 8,234 were males and 7,184 females. The
birth rate was 31.13 per mille of population against 27.77 per mille in 1920.
The percentage of male to female births was 114.62 as compared with 114.79
in the previous year.
6. The birth rate exceeded the death rate by 2.72 per mille as compared
with 2.06 per mille in 1920.
Deaths in Ajmer-Merwara.
7. The total number of deaths registered was 14,073 in 1921 against 12,892
in 1920, an increase of 1,181. This in-
crease is due to high mortality from Small-
pox and fevers.
8. The death rate per mille of population was 28.41 as compared with
25.71 in the previous year.
9. The mortality among children under five years of age was 46 per cent.
of the total deaths against 41 per cent. in the previous year.
10. 9,804 deaths from "Fevers" were reported against 9,497 in 1920, an
increase of 307 due to high mortality from tuberculosis.
SMALL-POX.
11. It appeared in December 1920 continued till July 1921. 724 deaths
were registered against 325 in 1920.
INDIAN STATES.
Small-pox.
12. Jaipur:—There were 126 deaths from Small-pox reported in Jaipur
city during the year as compared with 33 in 1920.
B
2
INDIAN STATES IN RAJPUTANA.
13. Mewar.—Jahazpur town reported 91 cases and 16 deaths from 10th
April to 10th May.
14. Alwar.—In Alwar city the disease broke out in April and lasted till
the end of July, 56 cases and 42 deaths were reported.
INFLUENZA.
15. Ajmer.—404 cases with 12 deaths were reported from Influenza in
Ajmer City against 526 cases with 76 deaths in 1920, showing a decrease of 122
cases and 64 deaths.
16. There was a large number of deaths recorded from pneumonia some of
which were certainly Influenzal.
Indian States.
17. Marwar.—Influenza was reported from 3 villages in Marwar during
March and April, 219 cases and 95 deaths
having occurred.
18. Bharatpur.—There were 229 deaths from Influenza reported in the
Bharatpur State. Of the total mortality 217 were reported from two towns, i.e.,
Bharatpur city and Rupbas and the rest from one village. The disease lasted
from 1st January to 25th February.
19. Karauli.—229 cases were reported from Karauli City, out of which 97
proved fatal. The first case occurred on 15th January and the last on
7th March.
20. Mewar.—122 cases and 13 deaths were reported from 2 towns in
Mewar from February to April.
21. Kotah.—Influenza broke out in an epidemic form in Kotah City on
10th January and ended on 15th February.
22. There were in all 428 cases and 173 deaths reported including Kotah
City, in which 377 cases and 153 deaths occurred.
RELAPSING FEVER.
23. Kotah.—This epidemic was first diagnosed on 24th February 1921 in
Mochi Katra and its environs and ended on the 10th May 1921, causing 67
attacks and 42 deaths. A small dispensary was opened in Mochi Katra under
the supervision of the Assistant Health Officer and a whole time Vaccinator
was put therein.
24. The blood was examined microscopically and those found positive were
given injections (intermuscular) of Novarsenobillon. These injections proved
popular among the class infected.
25. All possible steps were taken to prevent migrating from one place to
another and to locate the disease.
Number of Cholera cases and deaths reported in Ajmer-Merwara and in
Rajputana during the year 1921.
Name of District or
State.
Ajmer Merwara.
Ajmer City...
Beawar Town..
Total Ajmer-Merwara
.
MAY.
Cases.
9
1
10
Deaths.
4
1
5
JUNE.
Cases.
5
...
5
Deaths.
2
...
2
JULY.
Cases.
...
...
...
Deaths.
...
...
...
AUGUST.
Cases.
4
1
5
Deaths.
4
...
4
SEPTEM¬
BER.
Cases.
26
...
26
Deaths.
18
...
18
OCTOBER
Cases.
...
...
...
Deaths.
...
...
...
TOTAL.
Cases.
44
2
46
Deaths.
28
1
29
Percentage
of deaths
to cases.
63.64
50.00
63.04
INFLUENZA AND SANITATION IN RAJPUTANA.
3
Number of Cholera cases and deaths reported in Ajmer-Merwara and in
Rajputana during the year 1921—contd.
Name of District or
State.
Rajputana.
Jaipur City...
Jaipur State...
Marwar State..
Udaipur City...
Mewar State...
Alwar City...
Alwar State ...
Tonk City...
Tonk State...
Bundi City...
Bharatpur State..
Dholpur State...
Karauli Town..
Kotah City...
Kotah State ...
Jhalawar State..
Bikaner State...
Dungarpur State..
Total.
GRAND TOTAL.
MAY.
Cases.
4
...
...
3
30
...
...
...
...
...
...
1
...
30
3
52
...
...
123
133
Deaths.
4
...
...
1
10
...
...
...
...
...
...
1
...
16
1
22
...
... 55
60
JUNE.
Cases.
6
48
1
...
158
5
401
...
...
...
14
...
...
344
455
297
9
...
1,738
1,743
Deaths.
6
40
1
...
74
1
333
...
...
...
8
...
...
151
197
110
4
...
925
927
JULY.
Cases.
4
132
24
1
109
1
49
...
...
...
69
...
...
...
402
72
26
142
1,031
1,031
Deaths.
4
103
11
1
63
1
33
...
...
...
45
...
...
...
160
36
14
15
486
486
AUGUST.
Cases.
34
6
...
77
11
326
...
...
...
...
46
...
...
3
551
52
...
...
1,106
1,111
Deaths.
34
3
...
57
11
194
...
...
...
...
29
...
...
2
237
23
...
...
590
594
SEPTEM¬
BER.
Cases.
23
...
...
73
1
54
109
351
...
236
8
...
64
...
244
37
...
...
1,200
1,220
Deaths.
23
...
...
37
...
32
44
133
...
127
8
...
64
...
120
21
...
...
609
627
OCTOBER.
Cases.
...
...
...
...
...
...
...
...
81
...
...
...
10
...
8
...
...
...
99
99
Deaths.
...
...
...
...
...
...
...
...
43
...
...
...
10
...
3
...
...
...
56
66
TOTAL.
Cases.
71
186
25
154
309
386
559
351
81
236
137
1
74
377
1,663
510
35
142
5,297
5,343
Deaths.
71
146
12
96
158
228
410
133
43
127
90
1
74
169
718
212
18
15
2,721
2,750
Percentage
of deaths
to cases.
100.00
78.49
48.00
62.33
51.13
59.07
73.35
37.89
53.08
53.81
65.69
100.00
100.00
44.83
43.17
41.56
51.43
10.56
51.37
51.47
26. The above table shows the total number of Cholera cases and deaths
reported in Rajputana during the year 1921.
Ajmer-Merwara.
27. During the year 46 cases of Cholera with 29 deaths were reported.
Of these 44 cases and 28 deaths occurred
in Ajmer City and 2 cases with 1 death
in Beawar town.
28. This epidemic was carried to Ajmer City by the pilgrims proceeding
to Pushkar from Ujjain where it was in an epidemic form in the second half of
May 1921.
29. All precautionary measures were adopted.
Indian States.
30. During the year 5,297 cases of Cholera and 2,721 deaths were reported
from the Indian States of Rajputana,
against 564 cases and 298 deaths in 1920.
These can mostly be traced to Ujjain Fair.
31. Jaipur.—There were in all 257 attacks and 217 deaths reported in 17
towns and villages including the Jaipur City and the Jaipur Mayo Hospital,
from 7th May to 20th September 1921.
32. Marwar.—25 cases and 12 deaths were reported in 1 town and 2
villages during June and July.
33. Mewar.—463 attacks and. 254 deaths were reported between May and
September including Udaipur City, in which 154 cases with 96 deaths occurred
from 11th August to 30th September. The number of towns and villages
infected were 19.
B2
4
SANITATION AND VACCINATION IN RAJPUTANA.
34. Alwar.— Cholera made its appearance in the State early in June, and
lasted till middle of September. During this period 386 cases were reported
from the City, of which 228 died, while from the district 559 cases were reported
with 410 deaths.
35. Tonk.—432 cases and 176 deaths were reported during September and
October: of these 351 cases and 133 deaths occurred in Tonk City.
36. Bundi.— 236 cases and 127 deaths were reported in Bundi City during
September.
37. Bharatpur.—137 cases and 90 deaths were reported in 1 town and 7
villages from 13th June to 4th September.
38. Karauli.—74 cases with 74 deaths were reported in Karauli City
during September and October.
39. Kotah.—Cholera broke out in an epidemic form in Kotah City on 24th
May. Many inhabitants of Kotah City, Baran and other towns and villages on
the Railway line had been to Ujjain Fair where Cholera was raging. Later
the disease spread, 2,040 attacks with 887 deaths were reported in 76 towns and
villages, including 377 cases and 169 deaths in Kotah City. The disease lasted
in the State till October.
40. Jhalawar.—Cholera prevailed in the Jhalawar State during the
months of May to September. 510 cases with 212 deaths were reported in 30
towns and villages.
41. Bikaner.—35 cases with 18 deaths were reported in Nohar town
during June and July.
42. Dungarpur.—142 cases with 15 deaths were reported in Sagwara town
during June and July.
43. The usual precautionary measures for its eradication were taken
throughout Rajputana.
44. No Cholera Map is necessary.
SANITATION.
Ajmer City.
45. The sanitary condition of Ajmer City remains very bad. Some efforts
have been made to improve it: but the
struggle is against lack of funds and of a
Sanitary Education of the people and a congested City.
46. It is a mystery to me why the death rate is not higher and why
epidemics once started ever cease. .
47. Previous remarks against the Birat system still hold good. It is
thoroughly bad.
48. With regard to work done, a lorry for removing rubbish has been
purchased, it does excellent work but upkeep expenses are very high. These
will have to be reduced very considerably and 2 more lorries purchased.
49. An excellent set of new bullocks have been bought and the old ones
weeded out, the stock are now fat and strong and more fit for work.
50. With regard to work proposed, the whole system of Treaching is being
examined with a view to replace it with incineration. If successful this would
save a great deal of money now spent in the Tramway, etc.
51. The number of public latrines is too small and private ones are not
kept in good condition.
52. Villages in the Suburbs are increasing and there is no system in the
regulation of the building of the huts: narrow lanes and filthy insanitary
Latrines being the rule.
53. Many lanes and streets require repaving.
54. I hope that the Slaughter house will be improved this year. Butcher
Shops are as bad as ever : but there is an idea of making at least one small
market, in which all these shops will be collected for one quarter at least.
6
DISPENSARIES IN RAJPUTANA.
General operations in Indian States.
70. The vaccination returns from the Indian States show a decrease in
numbers during the season under report
owing to non-receipt of the figures from
Jaisalmer, Dholpur, Karauli and Kushalgarh. The total number of Primary
vaccinations in Indian States was 221,903 of which 206,129 were successful
as compared with 234,803 Primary and 219,617 successful operations in
1920-21. Re-vaccination rose from 507 in 1920-21 to 1905 in the year under
report.
71. There were 183 vaccinators against 182 vaccinators in 1920-21, 2
additional vaccinators having been employed in Marwar and 1 in Kushalgarh
resigned. No vaccinator was employed in Deoli Cantonment during the
season; vaccinations were performed by the Sub-Assistant Surgeon attached to
the Agency Hospital there.
72. 20.99 per thousand of the population in the Indian States were
successfully vaccinated against 20.85 in 1920-21.
Expenditure on Vaccination in Ajmer-Merwara.
73. The total expenditure on vaccination in Ajmer-Merwara was
Rs. 4,671-11-2 against Rs. 4,363-8-4 in
1920-21. An increase of Rs. 308-2-10
is due to an increase of pay of vaccinators and in rate of travelling allowance.
The average cost of each successful case was 75 pies against 61 pies in 1920-21.
Expenditure on Vaccination in Indian States.
74. The total expenditure of Indian [States was Rs. 54,402-7-4 as com-
pared with Rs. 50,041-4-0 in the previous
season, the increase in cost being due to
pay and travelling allowance to vaccination staff. The average cost of each
successful vaccination in different States varied from 897 pies in Abu to 20
pies in Sirohi.
75. The following table shows the number of towns and villages inspected
and vaccinations seen by Residency or Agency Surgeons in Indian States:—
Designation.
The Residency Surgeon, Western Rajputana States, Jodhpur.
The Principal Medical Officer, Bikaner State....
The Residency Surgeon, Mewar, Udaipur....
The Agency Surgeon, Kotah & Jhalawar....
The State Surgeon,
Alwar......
Number of towns
and villages
inspected.
21
2
9
263
294
Number of vac-
cination cases
seen.
3,041
2,057
246
2,020
2,861
76. The Indian Superintendents of vaccinations and other inspecting
officers in Indian. States inspected 66,896 vaccinations, against 74,436 in
1920-21. The percentage of cases found successful among the total number
seen in 1921-22 was 95.14 against 91.34 in the previous season.
77. Lymph is maintained throughout the year in most of the States.
Glycerinated lymph was obtained during the year from the Government
Lymph Depôts and was satisfactory.
SECTION II.—DISPENSARIES.
STATEMENT A.
Number of Dispensaries.
78. During the year the number of hospitals and dispensaries remained the
same as in the previous year, viz., 184. The Travelling dispensary in Marwar
was opened on 2nd July 1921 and the Bareta dispensary in Bharatpur was
closed on the 11th February 1921.