Part III.]
DISPENSARIES IN THE NORTH-WESTERN PROVINCES.
103
in the Colvin Hospital, Allahabad, against 70 in 1872. Dr. Walker observes
that " the operation, when successful, will do more to raise the reputation of
a dispensary than almost any other," and expresses a hope that civil surgeons
will devote more attention to the subject. The civil surgeon of Agra in
his report makes the following observation, which, no doubt, other medical
officers could confirm; yet it is much to be desired that the subject be not
lost sight of, and it must be admitted that there is room for increased exertion
on the part of medical officers in the field of operation,—ophthalmic surgery.
Dr. Christison writes:—
Regarding cataract, I have been most anxious to make progress, but there is a class of
native operators by " depression" who are very popular here, and the process of gaining
approval of the operation of extraction is proving a very slow one. It is far from easy to
convince people that this cutting operation is superior to the apparently simple one with the
needle, which for the time being restores the sight at once. Were I to take to the operation
of depressing, there is little doubt the cases would be numerous, but that would not be
scientific, and it seems best to wait. I wish it to be understood, then, that though few
operations of this kind appear on the list, it is not because the subject has been at all neglected
here.
Mortality of those
operated on.
The mortality per cent, among all the principal operations is shown in
Statement No. XXXI to be 4.4 per cent.
Self-dieting
patients.
A larger percentage of voluntary patients dieted themselves than in the
previous year, 39.6 against 33.6. The Inspector-General of dispensaries urges
increased attention to this by no means unimportant matter, and the Govern-
ment resolution thus comments upon the point:—
The returns show that these institutions are apt to run in grooves. When it becomes
the established rule in a dispensary, as it is in some, and should be in all, that all patients
who are able to do so should pay for their own diet, the probability is that the exceptions
will become fewer year by year. There are comparatively few families which would not
supply diet to a fever-stricken or injured member while in the dispensary, unless it was
understood that he would receive his food as a matter of course at the expense of the State.
Where, on the other hand, this idea has taken root, it is very difficult to break through it,
though some slight improvement is visible in the past year. The following cases illustrate
this:—
Percentage of patients who
dieted themselves.
Meerut ... ... ... ...
Bareilly ... ... ... ...
Cawnpore ... ... ... ...
Benares ... ... ... ...
Allahabad ... ... ... ...
Agra ... ... ... ...
1872.
57.9
52.
12.
12.
1.8
1.6
1873.
67.1
56.
13.2
13.9
5.4
9.9
There are 15 dispensaries where all the voluntary patients dieted themselves. The rule
that patients are to do this when they can, must be enforced. Dispensary funds are thus
set free to be devoted to their proper object, that of affording medical relief, and the risk
of pauperising the patients is avoided.
Finances
In Table No. II appended will be found recorded the chief matters of im-
portance regarding the financial position of the civil medical institutions in the
North-Western Provinces. The charge to Government underwent increase owing
to increase of establishment consequent upon the larger number of dispen-
saries in operation. The cost of diet was higher than in the previous year,
because of the dearness of provisions. There was an increase of Rs. 5,933
in contributions from municipalities, an increase of Rs. 626 in the interest
realized from investments, and a slight increase of Rs. 400 in the combined
subscriptions of Europeans and Natives. In 1872 there were four districts
in which the local income was below the amount required to be raised under
the rules, but this year they have all retrieved themselves except Jhansi.
New scale of pay for
hospital subor-
dinates.
Iuspention duties of
superintendents.
Female medical edu-
cation.
A scale of increasing pay for length of service in the grades of com-
pounder and dresser, which was proposed by the Inspector General of dis-
pensaries, has been sanctioned by Government, and promises useful results.
It is recorded that superintendents of dispensaries gave closer attention
to their inspection duties than in the former year.
It is not necessary to enter into an elaborate description of what has been
done in these provinces in the way of female medical education during the