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Remarks by the Hon'ble the Agent to the Governor General, Raj¬
putana and Chief Commissioner, Ajmer-Merwara.
The year under report has been marked by a deficiency of rainfall and an
abnormally high death-rate owing to an outbreak of influenza of a very
virulent type. On the other hand there was a marked decrease in the
mortality from plague, there being 16,268 deaths in the whole of Rajputana,
including Ajmer-Merwara, against 98,192 deaths in the preceding year.
As regards Sanitation, the condition of Ajmer City is still indifferent and
the interior portion of the town is in urgent need of improvement. This
question continues to engage the attention of the authorities but owing to
the congested nature of the town it is a very difficult one to deal with.
Vaccination did not show any satisfactory progress during the year owing
largely to the influenza epidemic. The charge of the post of Chief Medical
Officer in Rajputana has been assumed by Colonel Haig, to whom and to whose
predecessor (Colonel Macwatt) as well to the other medical officers in
Rajputana my thanks are due for the energy and ability with which they have
carried out their duties in an exceptionally trying year.
End.—I. E. C.
REPORT
ON
SANITATION, DISPENSARIES, AND JAILS IN
RAJPUTANA FOR 1918
AND ON
VACCINATION FOR THE YEAR 1918-19.
SECTION I.—SANITATION AND VACCINATION.
METEOROLOGY AND ITS RELATION TO FOOD SUPPLY.
Rainfull in Ajmer.
1. During the year under report 5.88 inches of rain were registered in
Ajmer against 48.30 inches in 1917, the
average for the previous six years being
2201. The rainfall during the Monsoon season from June to September, was
only 5.63 inches as compared with 19.83 inches during the Monsoon of 1917,
showing a decrease of 14.20 inches. Although it did not provide sufficient
water in all the tanks and wells throughout the district, on the whole there was
an ample water supply on account of the heavy rainfall in 1917.
Rainfall in Native States.
2. The rainfall recorded in Rajputana was unusually deficient owing to
which the Khariff crops were a complete
failure and the Rabi crops were also
poor ; scarcity of fodder prevailed throughout the province. There was no rain
in Jaisalmer during the year under report.
VITAL STATISTICS, BIRTHS AND DEATHS.
Births in Ajmer-Merwara.
3. According to Birth returns 13,214 births were registered in 1918,
against 18,455 in the previous year, a
decrease of 5,241.
4. Of the total births registered 7,185 were males and 6,029 females. The
birth rate was 26.35 per mille of population against 36.81 per mille in 1917.
The percentage of male to female births was 119.17 as compared with 111.10
in the previous year.
5. The death rate exceeded the birth rate by 88.43 per mille against 66.15
in the previous year.
Deaths in Ajmer-Merwara.
6. The total number of deaths registered in this Division was 57,553 in
1918 against 51,623 in 1917 an increase
of 5,930. This increase was due to a
severe epidemic of Influenza. The death rate per mille of population was
11478 as compared with 102.96 in 1917.
7. The mortality among children under five years of age was 19 per cent.
of the total deaths against 41 per cent. in the previous year. 47,803 deaths
from " Fevers " were reported against 34,300 in 1917 an increase of 13,603,
due chiefly to the out-break of Influenza.
NOTE ON INFLUENZA EPIDEMIC.
8. The epidemic of Influenza occurred in October and November affect-
ing the whole of Rajputana.
9. Accurate statistics of the number of deaths in Native States are not
available; the mortality was very large.
All the Native States adopted relief measures to deal with the epidemic.
2
VITAL STATISTICS, NOTE ON INFLUENZA EPIDEMIC IN RAJPUTANA.
10. In Ajmer-Merwara, the death rate during the epidemic is shown in
the accompanying table.
11. The chart shows the daily death rate in Ajmer City during the
epidemic.
12. Such preventive measures as were possible were adopted.
13. In Ajmer all schools and colleges were closed.
14. General instructions were issued as to the avoidance of infection, and
simple methods of treatment were described.
15. The Municipality opened a camp for patients, and made arrange-
ments for the free distribution of milk and medicines to the sick.
16. The Sewa Samity gave assistance in the treatment of patients and
disposal of dead bodies.
17. A travelling dispensary was instituted.
18. Owing to war conditions and the failure of the Monsoon, there was
general scarcity and the prices of food and clothing were high.
19. It is probable that owing to the privations so caused, the population
was generally in a reduced state of health and specially liable to fall victims of
an epidemic.
20. Smallpox was not prevalent in the district during 1918, the reported
deaths from it were only 27 against 1,275 in the previous year.
21. The percentage of male to female deaths was 98.43 against 99.77 in 1917.
F=ed.—J T C
VITAL STATISTICS IN AJMER-MERWARA.
3
Deaths registered from different causes in the Districts of Ajmer and Merwara during the months of October and November 1918.
1
No.
1
2
2
Districts and Towns.
Ajmer .
.
.
.
Towns . . .
Rural areas . .
Merwara . . .
Towns . . .
Rural areas . .
TOTAL
3
Population according to Census
of 1911.
380,384
112,389
267,995
121,011
22,800
98,211
501,395
4
Cholera.
...
...
...
...
...
...
...
5
Small-pox.
...
...
...
...
...
...
...
6
Plague.
37
37
...
...
...
...
37
7
Fevers.
21,090
1,020
20,070
8,490
1,205
7,285
29,580
8
Dysentery and Diarrhœa.
81
81
...
2
2
...
83
9
Respiratory diseases.
97
97
...
2
2
...
99
10
INJURIES.
Suicide.
Male.
2
1
1
...
...
...
2
Female.
2
...
2
...
...
...
2
Wounding or accident.
20
7
13
5
1
4
25
Snake bite or killed by
wild beasts.
2
...
2
1
...
1
3
Total.
26
8
18
6
1
5
32
11
All other causes.
3,073
3,070
3
1
...
1
3,074
12
Total deaths from all causes.
24,404
4,313
20,091
8,501
1,210
7,291
32,905
13
RATIO OF DEATHS PER 1,000 OF POPULATION.
Cholera.
...
...
...
...
...
...
...
Small-pox.
...
...
...
...
...
...
...
Plague.
10
.33
...
...
...
...
.07
Fevers.
55.44
9.08
74.89
70.15
52.85
74.18
58.99
Dysentery and Diarrhoea.
.21
.72
...
.02
.09
...
.17
Respiratory diseases.
.26
.86
...
.02
.09
...
.20
Injuries.
.07
.07
.07
.05
.04
.05
.06
All other causes.
8.08
27.32
.01
.01
...
.01
6.13
From all causes.
For the year.
64.16
38.38
74.97
70.25
53.07
74.24
65.62
Mean ratio of pre-
vious five years.
...
...
...
...
...
...
...
14
REMARKS.
VITAL STATISTICS AND SANITATION IN RAJPUTANA.
5
Number of Cholera cases and deaths reported in Ajmer-Merwara and in Rajputana during the
year 1918.
NAME OF DISTRICT OR
STATE.
Ajmer-Merwara ..
Total .
Rajputana—
Jaipur
Marwar
City ..
State ..
Jodhpur City
State
Total
GRAND TOTAL .
MARCH
1918.
Cases.
...
...
...
1
1
...
2
2
Deaths.
...
...
...
1
1
...
2
2
APRIL.
Cases.
...
...
...
1
...
...
1
1
Deaths.
...
...
...
...
...
...
...
...
MAY.
Cases.
...
...
...
...
...
...
...
...
Deaths.
...
...
...
...
...
...
...
...
JUNE.
Cases.
...
...
...
...
...
...
...
...
Deaths.
...
...
...
...
...
...
...
...
JULY.
Cases.
1
1
...
...
...
...
...
1
Deaths.
...
...
...
...
...
...
...
...
AUGUST.
Cases.
1
1
...
...
...
...
...
1
Deaths.
1
1
...
...
...
...
...
1
TOTAL.
Cases.
2
2
...
2
1
...
3
5
Deaths.
1
1
...
1
1
...
2
3
PERCENTAGE OF
DEATHS TO CASES.
50.00
50.00
...
50.00
100.00
66.67
60.00
22. The above table shows the total number of Cholera cases and deaths
reported in Rajputana during the year 1918.
Ajmer-Merwara.
23. During the year under report Ajmer-Merwara District was free from
Cholera with the exception of 2 cases and
1 death in Ajmer City in July and August.
Native States.
24. Only 3 cases with 2 deaths were reported from .the Native States of
Rajputana, against 89 cases and 60 deaths
in 1917, of these 2 cases with 1 death
occurred in Jaipur State in March and April and 1 fatal case in Jodhpur City
in March.
25. All necessary precautions and preventive measures were adopted.
SANITATION.
Ajmer City Conservancy.
26. The sanitary condition of the city is indifferent. The Municipality
does not employ sweepers for cleaning
purposes.
27. The sweepers in the city all work under the Birat system and are not
under any effective control.
28. They are supposed to convey sewage, foul water, etc., from houses to
the Municipal collecting stations, and to clean the roads in their mohallas.
29. The supply of vessels for the removal of sewage, etc., is defective. It
has been recommended that the Municipality provide hand carts for the use of
the Birat sweepers, and arrangements have been made to supply some, the
result will be observed.
30. The Birat system is very defective and until it is abolished, and the
sweepers are brought directly under Municipal control, and their work orga-
nised and supervised, no improvement can be expected. A conservancy tax
to meet the expenses of this organisation will be necessary.
31. The Municipality provides carts to remove the sewage, etc., brought by
the Birat sweepers to the collecting stations. These Municipal carts are also
the only means for the removal of sullage water from the city.
B
8
VACCINATION AND DISPENSARIES IN RAJPUTANA.
General operations in Native States.
65. The vaccination returns from the Native States show a considerable
decrease under all heads due to the severe
epidemic of Influenza throughout Rajpu¬
tana during the season. The total number of Primary Vaccinations in
Native States was 150,923 of which 144,916 were successful as compared with
190,290 Primary and 184,179 successful operations in 1917-1918. Re-vacci-
nation rose from 228 in 1917-1918 to 1,181 in the year under report. No
vaccination was done in Jaisalmer during the season owing to the prevalence
of Influenza and Famine.
66. There were 161. vaccinators against 163 vaccinators in 1917-1918,
1 less in Kotah and Banswara, respectively.
67. As vaccinations were performed entirely by the Sub-Assistant Surgeons
attached to the Agency Hospital, Deoli, no vaccinator was employed in
Deoli Cantonment during the season.
68. 13.73 per thousand of the population in the Native States were
successfully vaccinated against 17.47 in 1917-1918.
STATEMENT II.
Expenditure on vaccination in Ajmer-Merwara.
69. The total expenditure on vaccination in Ajmer-Merwara was
R3,240-11-4 against R3,181-15-4 in 1917-
1918, an increase of R58-12-0 due to
increased pay.
Expenditure on vaccination in Native States.
70. The total expenditure in Native States was R33,808-0-3 as compared
with R34,919-15-1 in the previous season,
the decrease in cost being due chiefly to
pay and travelling allowances to vaccination staff. The average cost of each
successful vaccination was in different States varied from 21 pies in Kotah
to 87 pies in Marwar.
71. The following table shows the number of towns and villages inspect-
ed and vaccination seen by Residency or Agency Surgeons in Native
States :—
Designation.
The Principal Medical Officer, Bikaner State ...
The Agency Surgeon, Eastern Rajputana States ...
The Residency Surgeon, Mewar
Number of towns
and villages
inspected.
3
80
16
Number of vac-
cination cases
seen.
2,165
2,131
658
72. The State Surgeon, Alwar, inspected 78 villages and saw only 396
vaccinations in Alwar City as he could not go out in the District owing to
prevalence of Influenza. The Assistant Surgeon, Kotah, inspected 324 villages
and saw 1,602 vaccinated children. 989 vaccination operations were seen by
the Assistant Surgeon, Jhalrapatan.
73. The Native Superintendents of Vaccinations and other Inspecting
officers in Native States inspected 59,030 vaccinations against 69,388 in 1917
1918. The percentage of inspected cases found successful among the total
number seen in 1918-1919 was 98.16 against 98.39 in the previous season.
74. Lymph is maintained throughout the year in most of the States by arm
to arm vaccinations. Glycerinated lymph was obtained during the year from
the Government Lymph Depôts and was satisfactory.
SECTION II—DISPENSARIES.
STATEMENT A.
Number of Dispensaries.
75. On the 1st January 1918, there were 179 hospitals and dispensaries
of all classes open ; and on the 31st December 1918, there were 178, i.e., one
DISPENSARIES IN RAJPUTANA.
9
less as compared with the previous year. The Railway Dispensary at Marwar
Junction in Marwar was closed on 1st February and the Southern Rajputana
States Agency Hospital at Neemuch temporarily on 29th June 1918, during the
absence of the Political Agency. The Masuda Dispensary in Ajmer District
was opened on 5th February 1918. The Government Charitable Dispensary at
Abu Road was handed over to the Sirohi State from the 6th May 1918.
76. The dispensaries are classified as under :—
I.
II.
III.
State Public
........
State Special
........
Private Non-aided
.......
TOTAL .
8
12
158
178
77. Besides these there are now seven Mission Hospitals and Dispensaries
as in 1917, and 9 dispensaries of the Bombay, Baroda and Central India
Railway within the limits of Rajputana against 8 in the previous year. This
represents a gain of one by the opening of a new dispensary at Sewaie Madho¬
pur in 1918.
Structural improvements.
78. Jaipur —The sum of R1,670 was spent in effecting improvements
and additions to the buildings of the
Mayo Hospital.
79. Bikaner.—A complete Bacteriological and Pathological Laboratory has
been sanctioned for the Bhagwan Das Hospital, Bikaner—Apparatus has been
ordered.
80. Apparatus has also been sanctioned and ordered to bring the X-Ray
apparatus up to date and for electrical and vibratory treatment.
81. Bharatpur.—The special Eye ward at the Victoria Hospital, Bharatpur,
and the new dispensary buildings at Sikri were completed and occupied.
82. Kotah.—A Post Mortem Room at Antah is under construction.
83. Mewar.—The proposal for building a new dispensary at Choti Sadri
with in-door accommodation is still under the consideration of the Darbar.
84. A proposal has also been submitted to the Darbar for building a new
dispensary at Hurra.
85. The medical supervision of the Residency Surgeon, Mewar, over the
dispensaries in Banswara and Kushalgarh was withdrawn from 1st October
1918.
STATEMENT B.
Attendance at Hospitals.
86. During the year under report the number of patients treated at State
Public, State Special and Private Non-aided (i.e , Native States) Dispensaries
and Hospitals amounted to 1,550,144 against 1,862,753 in 1917, a decrease of
312,609 which is attributable to the continuance of plague from the previous
year and prevalence of Influenza in epidemic form throughout Rajputana and
Ajmer Merwara District.
87. Of the total number of patients treated 17,370 were in-door and
1,532,774 out-door as compared with 19,343 in-door and 1,843,410 out-door in
1917. The number of deaths rose from 799 in 1917 to 1,051 in 1918 and the
ratio of mortality per cent. of total treated rose from 4.13 to 6.05 in 1918.
STATEMENTS C(i) AND C(ii).
Diseases treated.
88. In Statement C(i) the number of deaths under each head of diseases
treated in the in-door department is shown ; 17,370 in-patients were treated
amongst whom 1,051 died against 19,343 patients and 799 deaths in the
10
DISPENSARIES IN RAJPUTANA.
previous year. The difference of 188 patients between columns 8 and 53 of
Statements B and C(i) respectively is due to 188 out-door Labour cases being
included in Statement C(i).
89. 130 Normal confinements with 2 deaths and 181 abnormal confine-
ments with 3 deaths were reported from various hospitals, against 146 with no
deaths and 155 with 6 deaths respectively in 1917.
90. 1,532,586 out-door patients treated in 1918 are shown in Statement
C(ii) against 1,843,262 in 1917.
91. The cases treated in the hospitals and dispensaries under each chief
disease during the years 1916, 1917 and 1918 are as follows :—
Diseases.
Malarial Fever
.....
Diseases of the eye
....
Dysentery and Diarrhœa
....
Ulcers
.......
Skin diseases
......
Syphilis
......
Injuries
......
Tubercle of the Lung
....
Abscess of the Liver
.....
1916.
251,309
279,295
66,819
146,083
187,001
15,271
45,800
1,598
130
1917.
460,599
267,410
60,642
152,353
183,883
13,604
43,487
1,469
250
1918.
225,524
243,256
46,304
133,202
168,728
11,661
37,952
1,535
157
Scurvy.
92. 551 cases of Scurvy were treated; of these 162 cases in Marwar and
118 in Mewar against 555 in 1917 and 820 in 1916.
Leprosy.
93. 416 lepers received treatment in 1918; of these 165 in Jaipur as
compared with 379 in 1917 and 430 in 1916. The Residency Surgeon, Jaipur,
reports that 29 lepers were treated with leproline which is much liked by the
patients under treatment.
Tubercular Diseases.
94. The Residency Surgeon, Jaipur, writes that the treatment of tuber-
cular diseases by means of tuberculin Bacillary Emulsion (Koch) was con-
tinued with satisfactory results.
95. The following table shows the different varieties of this disease
treated :—
Tubercle diseases of bones and joints
.....
Do.
glands
......
Do.
lungs
.......
Do.
Abscess
......
Do.
Ulcer
.......
TOTAL .
63
66
61
18
24
232
DISPENSARIES IN RAJPUTANA.
11
Plague.
96. During the year from 1st April 1918 to 31st March 1919, 18,972
plague seizures and 16,268 deaths were reported in 667 towns and villages
infected in Ajmer-Merwara District and in the Native States in Rajputana
as compared with 116,168 plague cases an d 98,192 deaths in 2,101 towns and
villages in 1917-1918.
97. The percentage of total plague deaths to population was 2.41 as
shown in table attached as compared with 2.26 in the previous year.
98. 3,572 anti-plague inoculations were performed during the year
under report at the following places :—
Ajmer City
.........
Marwar State
.........
Bikaner City
.........
Bikaner State
.........
Udaipur City
.........
Mewar State
........
TOTAL
366
710
1,758
546
163
29
3,572
99. In the Ajmer-Merwara District 307 attacks and 244 deaths were
reported in 39 towns and villages against 13,213 cases and 9,670 deaths in
271 towns and villages in 1917-1918; of these 238 seizures with 176 deaths
occurred in 23 towns and villages in Ajmer District and 69 cases and 68 deaths
in 16 towns and villages in Merwara District.
100. In Ajmer City there were 34 attacks with 18 deaths and in Kekri
town 84 cases and 55 deaths in 1918-1919 against 4,910 cases with 3,330
deaths in Ajmer City and 553 cases with 346 deaths in Kekri town respective-
ly in the previous year. It re-appeared in Kekri town in September 1918 and
lasted in February 1919.
101. In Beawar town in Merwara district only 4 cases with 2 deaths were
reported in April 1918, as compared with 1,025 and 642, respectively in the
previous year.
102. Disinfection of infected houses was carried out as necessary in April
and May 1918.
103. Jaipur.—The disease lingered from the preceding year until 7th
June 1918 when it totally subsided.
104. 4,157 attacks with 4,083 deaths were reported in 145 towns and
villages including the Jaipur City and Plague Camp in which only two fatal
cases occurred in April 1918.
105. Marwar.—The epidemic of plague was prevalent in this State from
the preceding year and totally subsided by the first week of June 1918, and
since then no case or death was reported. 2,693 seizures and 2,464 deaths
were reported in 116 towns and villages ; of these 238 cases and 237 deaths
occurred in Jodhpur City.
106. The Residency Surgeon, Western Rajputana States, reports that on
account of the prevalence of plague in Jodhpur City, Nagaur and Bilara
Dispensaries remained closed from 31st January to 13th February, and 31st
March 1918, respectively. The Sub-Assistant Surgeons in charge of these
dispensaries were placed on special plague duty at Jodhpur.
107. Sirohi.—Only one fatal case of plague was detected at Abu Road
in April 1918, otherwise it was free from the disease throughout the year.
108. Bikaner.—Plague persisted from the preceding year and was in
existence till the 31st May 1918, and again broke out from 4th to 31st Decem-
ber 1918. 1, 560 seizures and 1,420 deaths were reported in 6 towns and
villages during the year under report, the mortality was 1,420 ; of these 1,006
cases and 886 deaths occurred in Bikaner City, 414 fatal cases in Churu town,