110
DISPENSARIES IN THE CENTRAL PROVINCES.
[Part III.
exceed the total of the sums paid under the existing system by which the
salaries are fixed in each appointment, and it not unfrequently happens that a
young 3rd class hospital assistant, who is only entitled to Rs. 20 as the pay of
his rank, draws Rs. 40, or double the pay of his rank.
To the unsystematic employment of Baids and Hakeems, Dr. Tresid.
der strongly objects, but he thinks they might be probably employed if first
instructed at the local dispensary, and obliged to pass some sort of minor
examination; " but" he adds, " no effort should be spared in trying to secure the
sons of these men being sent to our medical schools for training". The
practice of treating the police sick in dispensaries is very strongly objected to
for obvious reasons.
DISPENSARIES IN THE CENTRAL PROVINCES.
Surgeon-Major J. F. Baxter officiated as Inspector-General of dispen-
saries and submitted the report.
Number of
institutions.
New buildings.
At the close of the year there were 78 medical institutions in operation.
A new dispensary was opened in the fortress of Asirgurh, and one was closed
in the Raipur district. The new city hospital buildings at Jabalpore and
Nagpore made satisfactory progress. Other original works in progress were
the city dispensary at Burhanpur, and a dispensary at Gudarwara.
Number treated.
A grand total of 3,21,987 persons were treated, an increase on the number
of the previous year of over 2.5 per cent., and, observes the Chief Commissioner,
" This increase occurring, as it does, in a year in which the public health was good, and
in which the price of ordinary food grains was in the three divisions of the province cheaper
than in the previous year, so that disease was not aggravated by want, seems a fair and
adequate proof that our dispensaries are becoming more and more appreciated, and that the
prejudices in favor of native methods of treatment are gradually disappearing.
Sex of those treated.
Both sexes participated in this increase, but there was a falling off of no
less than 6.6 per cent. in the attendance of house-patients as compared with
1872. The reason of this does not very clearly appear in the report, though
in the case of each dispensary which exhibits a decrease some local cause,
sometimes far-fetched, is assigned. The total number of in-door patients who
were treated was 9,763, and of out-door 312,224. The aggregated total re-
presents a proportion of 4.4 per cent. of the total population, a ratio far in
advance of any other province save the Punjab.
Diseases treated.
Fewer persons were treated for fevers and bowel complaints, and the
Sanitary Commissioner's returns show that these ailments were less prevalent
than usual. Only 84 cases of small-pox were treated, though the affection pre-
vailed severely. Dengue gave 1,047 admissions, rheumatism 16,609, and
diseases of the eye and of the respiratory organs contributed a large quota.
Classification of
operations.
Notwithstanding the very precise instructions which have from time to
time been issued by the head of the medical department, it is unsatisfactory
to observe that diversity of practice regarding the classification of operations
under the heads of major and minor still exists; for instance, some civil sur-
geons have excluded both the " reduction of dislocations" and the " setting
of fractures,'' whilst others have retained the one and rejected the other, and a
third set have included both; so with the "removal of tumours," extreme
latitude seems to have been taken, for, as Dr. Baxter observes, as some of these
tumours weighed but half an ounce, it is presumed their removal did not
constitute what is termed a "major operation." Table No. 1 exhibits 392
major operations as having been performed in the Central Provinces during
the year, but, writes the Inspector-General of Dispensaries—
If from these be deducted 84 fractures, the number will be reduced to 308, and if 91
dislocations be also deducted, it will stand at 216, and this would probably admit of still
further reduction were the "removal of tumours" classified according to the official list;
thus of 50 tumours removed, the large hospitals of Nagpur and Raipur give none, Jubbulpur
and Hoshungabad give 3 and 1 respectively, yet Sambulpur shows 24 weighing from 1 pound
to half an ounce, Wardha shows 9 and Chanda 7.
Perhaps I am not wrong in saying that about 187 major operations were performed
during the year, that is, operations of magnitude or danger, or those involving important
structures. Raipur heads the list with 50 successful out of 53 cases of lithotomy; the returns
of Bhandara, Balaghat and Upper Godavari are blank.