Part III.]
DISPENSARIES IN THE CENTRAL PROVINCES.
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Fifteen cases of the whole were unsuccessful, 4 each at Nagpore and Raipur, 2 each at
Nursinghpur, Nimar and Sumbulpore, and 1 at Wardha; 11,682 minor operations were
performed, or 584 less than the previous year's returns; of these 76 are shown as unsuc-
cessful; of the latter Sagor gives 66, but no explanation is given in the report regarding this
large number.
It is much to be regretted and it is difficult to conceive how so much
confusion existed in the face of the explicit instructions which have been
departmentally issued. In commenting upon the remarks which have been
above extracted, the Chief Commissioner observes :—
All diversity should cease, and if you are in doubt as to the classification of any operation
or class of operations, you should refer the question to the head of the medical department.
Public health.
The public health was above the average and the Sanitary Commissioner's
returns exhibit a diminished death-.rate. Cholera visited two districts, Nimar
and Sambulpore, causing happily only 127 deaths. Small-pox visited every
district, and, as before observed, fevers and bowel-complaints were less numer-
ous. Dengue prevailed extensively in Nagpur, Chanda and Wardha.
The Inspector-General of dispensaries writes—" Perfunctoriness in dealing
with the health of a district characterised some of the reports; others con-
tained remarks on the public health unsupported by evidence of statistics."
Rainfall and food.
supply.
The rains set in late and ceased early. Nearly everywhere the rainfall
was below the average; in two districts (Nursingpur and Hoshangabad) it
was close on the average, and in one (Dumoh) it was a little above the
average. Notwithstanding this the crops rendered a fair out-turn, and there
was no actual scarcity of food although prices were high in the Chattisgurh
division.
Finances.
The total receipts of the dispensaries amounted to Rs. 1,23,420, and the
disbursements to Rs. 1,13,783. The floating balance at the end of the year stood
at Rs. 24,452, or Rs. 4,678 in excess of the previous year. Government con-
tributed Rs. 40,721, or Rs. 306 in excess of 1872, and local funds contributed
an exactly similar amount. Subscriptions amounted to Rs. 22,886. Natives
contributed slightly more, and Europeans slightly less.
The report then notices each dispensary in detail and contains much that
is interesting to the local Government and to individual medical officers.
Juice of pawpaw
fruit
Dr. Eves, the civil surgeon of Seoni, has employed the milky juice of
the pawpau (Oarica Papya) fruit in the treatment of splenic and hepatic en-
largements, and with good results.
Gauge of popularity
of a dispensary.
Dr. Cullen, civil surgeon of Hoshungabad, argues that the popularity of
a dispensary should be gauged by the out-door rather than by the in-door
attendance. He writes:—
But the attendance of females and children for medical aid undoubtedly shows in favor
of the hospital assistant in charge, yet the out-door attendance is the only real criterion by
which to judge whether a hospital is popular or otherwise, as these we know go merely for
medicines, and beyond the relief of their ailments have nothing to gain.
Hypodermic
injection of quiniue.
Dr. Rice of Jubbulpore has employed hypodermic injections of quinine
largely in the treatment of intermittent fevers, but he considers its employ-
ment unsuited to dispensary practice, as the people so object to the trifling
pain that they will not attend. He speaks highly of the utility of liquor
arsenicalis in these cases, in half drachm doses immediately after a full meal.
Deputy-Surgeon.
general's report.
Deputy Surgeon-General J. T. C. Ross, F. R. C. S., of the Sagor circle, fur-
nished a detailed inspection report. There were 79 dispensaries under his
administration. Of these 39 (9 main and 30 branch) belonged to the Central
Provinces, and 40 (12 main and 28 branch) to Central India. Speaking of the
Central Provinces institutions:
Inspections by superintendents were satisfactorily carried out except
in the Dumoh and Sagor districts, and there were special circumstances which
in the case of the latter prevented the civil surgeon from leaving the
sudder station. The subordinate staff consisted of 2 assistant surgeons,
34 hospital assistants and 3 native doctors, and worked satisfactorily. Of
the 39 dispensaries, 27 received house patients. Mr. Ross considers the
out-patient attendance to be one of the best tests of utility and popularity
of a dispensary. Females were treated in a proportion of 14.8 per cent.
of the total.