NationalLibraryOfScotland/medical-history-of-british-india huggingface dataset:
3
During the year under review the ratio per cent of cases
cured to daily average strength was practically the same as in
1930. During the year under report we had 132 admissions as
compared with 99 in 1930 and 93 in 1929, The total discharges
were 87 in 1931 as compared with 81 in 1930 and 78 in 1929.
In spite of this progressive increase in discharges our ratio
per cent of cures to total admissions is low compared to 1930 and
1929. This is due to the fact that during the year under report
we had a large number of admissions (132) and majority of
them were chronic insanes who had been kept for a considerable
time either at their homes or in jails for want of accommodation
in this hospital. One, therefore, cannot expect cures from such
chronic cases within a year, hence the low percentage of cures
to total admissions.
11. Total duration of hospital life of patients discharged during the
year under review and in the previous year.
Period.
Under 2 months ... ... ... ...
Over 2 months and under 4 months ... ...
Over 4 months and under 6 months ... ...
Over 6 months and under 8 months ... ...
Over 8 months and under 1 year ... ...
Over 1 year and under 3 years ... ...
Over 3 years and under 5 years ... ...
Over 5 years and under 10 years ... ...
Over 10 years and under 15 years ... ...
Over 15 years and under 20 years ... ..
Over 20 years ... ... ... ...
1930.
2
18
8
10
8
14
8
7
1
2
3
81
1931.
3
13
7
5
6
10
10
17
9
5
2
87
4
12. Death-rate.—The percentage of deaths to daily average
strength during the year under report and the two previous years
is shown in the following table :—
Years.
1931
...
...
...
1930
...
...
...
1929
...
...
...
Male.
2.03
2.02
1.91
Female.
3.10
2.29
2.39
Total.
2.30
2.07
1.99
I am happy to be able to record that the death rates of
this largest mental hospital of India is the lowest of all the Indian
mental hospitals in India.
13. The chief causes of deaths among patients resident in
the hospital during the year under report are shown in the
following table :—
Causes of deaths.
Malaria ... ... ...
Pneumonia ... ...
Tuberculosis (lungs) ... ...
Diabetes ... ...
All other general diseases ...
Diseases of nervous system of
which pathological basis is not
known.
Diseases of the circulatory system
Diseases of respiratory system ...
All other diseases of
digestive
system.
Acute or chronic nephritis ...
Injury, general or local ...
Total ...
Male.
2
2
2
1
7
1
...
1
3
2
1
22
Female.
...
...
...
...
5
...
1
...
1
...
...
7
Total.
2
2
2
1
12
1
1
1
4
2
1
29
5
14. Duration of hospital life of those who died during the
year under report is shown in the annexed table :—
Period.
Under 6 months ... ...
Over 6 months and under one year.
Over 1 year and under 2 years ...
Over 2 years and under 3 years ...
Over 3 years and under 5 years ...
Over 5 years and under 7 years ...
Over 7 years and under 10 years ...
Over 10 years and under 15 years.
Over 15 years and under 20 years.
Over 20 years and under 25 years.
Over 25 years and under 30 years.
Over 30 years and under 35 years.
Over 35 years and under 45 years.
Total ...
Male.
3
2
...
1
...
2
3
1
5
2
3
...
...
22
Female.
2
...
...
...
1
3
...
...
...
...
...
...
1
7
Total.
5
2
...
1
1
5
3
1
5
2
3
...
1
29
The ages of the patients who died during the year under
report are shown below :—
Period.
Under 20 years of age ...
Between 20 to 40 years of age ...
Between 40 to 60 years of age ...
60 years and upwards ...
Total ...
Male.
...
7
13
2
22
Female.
...
4
1
2
7
Total.
...
11
14
4
29
6
15. Health of patients .—The general health of patients has
been good throughout the year under report except for about
two months in the year when influenza broke out in mild
epidemic form. The daily average number of sick treated in the
infirmaries for bodily ailments was 57.62 males and 2.84 females
total 60.46, as compared with 59.93 males 1.67 females total
61.60 in the previous year.
The important admissions in the infirmaries during the
period under report are shown in the subjoined table :—
Ankylostomiasis ... ...
Dysentery ... ...
*Malaria ... ...
Kala-azar ... ...
Influenza ... ...
Pneumonia ... ...
**T. B. Lungs ... ...
All other general diseases ...
Diseases of the eye ... ...
Diseases of the respiratory system
Diseases of the intestine ... ...
All other diseases of digestive system
Other diseases of generative system
Diseases of organs of locomotion ...
Inflammation ulcerative ...
Other diseases of the skin ...
Injury general or local ...
Nervous system diseases of which
pathological basis is not known.
Nervous system diseases of which
pathological basis is known.
Acute or chronic nephrities ...
Acute or supurative inflammation
of lymphatic glands.
All other diseases of urinary system
Diseases of the areolar tissue ...
Diseases of the circulatory system
Male.
16
6
71
1
314
2
4
38
17
15
36
37
3
2
33
36
74
4
4
1
1
3
37
...
Female.
5
1
14
...
26
...
1
7
...
3
3
3
...
...
3
...
7
...
...
...
...
1
4
1
Total.
21
7
85
1
340
2
5
45
17
18
39
40
3
2
36
36
81
4
4
1
1
4
41
1
*Out of 85 Malaria cases 19 were Bacteriologically positive and the rest clinically
positive.
**Out of 5 Tuberculosis cases 4 were Bacteriologically positive and one clinically
positive.
7
Approximately 9,347 cases were treated as outdoor patients
for minor ailments such as ulcers, slight injuries, headaches,
constipation, etc.
16. Cases under observation.—There were 25 patients (16
males and 9 females) under brief periods of observation in this
hospital sent by the local Magistrates for the purpose of
certification, as compared with 24 cases (19 males and 5 females)
in 1930 and 27 cases (24 males and 3 females) in 1929. Out of
25 cases observed during the period under report 12 (3 males and
9 females) were certified and admitted. Four were discharged as
uncertified, and 9 were certified as harmless insanes and were,
therefore, not admitted owing to overcrowding in the male section.
They were ultimately discharged by the committing Magistrates.
17. Statement II.—Criminal patients.—The following table
shows the daily average strength of criminal patients during the
year under report as well as in the previous years :—
Year.
1931
...
...
...
1930
...
...
...
1929
...
...
...
1928 ... ... ...
Average number of cases.
Male.
433.47
450.63
464.64
528.05
Female.
34.22
34.13
34.69
40.53
Total.
467.69
484.76
499.33
568.58
In spite of 52 admissions of criminal patients during the
year under report against 30 in 1930, the average number of
criminal patients is less and the progressive decrease is due to the
special endeavour made throughout the year under report as well
as in the previous years to have the petty charges withdrawn by
the committing Magistrates and thus quite a number of the
so-called criminal patients were transferred to the non-criminal
class after their admission to this hospital.
18. Statement III shows the religion, sex and residence
of the patients admitted into the hospital during the year under
report and is self-explanatory.
19. Statement IV shows the previous occupations of patients
admitted during the year under report and needs no comment.
20. Statement V shows the ages of patients admitted into
this hospital during the year under report. It will be evident
8
from the figures given below that the largest number of patients
admitted every year was between the ages of 20 to 40. The ages
between 40 to 60 claim the next place in order of frequency :—
Ages.
Under 20 years ... ... ...
Between 20 to 40 years ... ...
Between 40 to 60 years ... ...
Upwards of 60 ... ... ...
1931.
12
98
21
1
1930.
7
69
19
4
1929.
8
67
16
2
1928.
6
86
18
1
21. Statement VI shows the types of insanity of the
patients admitted during the year under report. The following
were the principal types treated :—
(1) Manic depressive psychosis.
(2) Dementia praecox.
(3) Confusional insanity.
(4) Toxic insanity.
(5) Mental defectives.
(6) Epileptic insanity.
(7) Recurrent mania.
(8) Senile dementia.
(9) Secondary dementia.
22. Statement VII shows the aetiological factors and
associated conditions in the patients admitted during the year
under report.
As in the former years in few cases heredity, previous
attacks of mental diseases, sudden and prolonged mental and
physical stress, toxaemia and drugs, played an important role in
the causation of insanity either as predisposing or exciting
factors. Of the drugs, only alcohol and hemp specially ganja,
were responsible as predisposing and exciting factors in 22 cases
(vide Statement VII). In majority of cases no causes could be
assigned due to practically no information being supplied by the
police in the descriptive roll of the patients.
9
23. Paying patients.—During the year under report 86
patients (61 males and 25 females) were treated as compared
with 79 (60 males and 19 females) in 1930 and 60 (48 males and
12 females) in 1929.
The number of paying patients is steadily increasing.
During the year several applications from paying patients for
accommodation had to be refused for want of accommodation in
the male section.
24. Suicide.—I am glad to be able to record that there was
no case of suicide during the year under report and the previous
four years in spite of the fact that there are always more than
72 potential suicides in the suicidal wards of this hospital.
During the year under review several attempts were made by
some potential suicides to end their lives but their efforts were
frustrated due to the strict vigilance of the attendant staff of
the suicidal wards.
25. Accidents and injuries —With the exception of one
epileptic patient who died from fracture of skull due to a fall dur-
ing an epileptic fit, there was no other case of serious accident or
injury, although many minor cases of accidents and injuries such
as falls, simple fractures, sprain of ankle joints, wrist joints and
injury caused by foreign bodies, etc., were treated throughout
the year under report.
26. Escapes.— There was no escape during the year under
report and in the previous year although a fair amount of
freedom is allowed to patients of this hospital which consists
of a large number of convicts and other criminal patients.
27. Autopsy.—During the year under report 26 post-mortems
were performed and interesting specimens were preserved in the
hospital laboratory for the purpose of demonstration to students
and others.
28. Sanitation.—The general sanitation of the whole area
of the hospital was satisfactory.
During the period under
review the Assistant Director of Public Health, Chota Nagpur
Circle, visited the hospital several times with a view to investi-
gate the breeding area of malarial mosquitos and advise ways
and means to eradicate the mosquito nuisance. Every effort
has been made by the sanitary staff of this hospital under the
direct supervision of the Second Assistant Superintendent to
combat against the malarial mosquitos but the vastness of the
breeding grounds all round the hospital area and Kanke render
the task very difficult and gives one an idea that it is impossible
10
to eradicate totally the breeding places of these mosquitos.
However, we are doing our best to keep the mosquito nuisance
away from the hospital as much as possible.
The '' Thresh disinfector " machine worked efficiently in
disinfecting patients' clothing and bedding throughout the year
under report.
29. Treatment of mental conditions.—(i) Hydrotherapy.—
During the year under report 102 cases were given this treat-
ment as against 69 in the previous year. The average number
of hours of emersion per patient was 77.60.
It is a very active therapy department and is worked to its
fullest capacity at all times. During the year under report 10
continuous baths have been in operation daily and were chiefly
instrumental in allaying excitement and insomnia in highly
excited and boisterous cases. There was a great rush on the
baths during the year as we had 132 admissions and most of
them were chronic refractory cases.
(ii) Diet.—Particular attention is paid to the dieting of the
patient with the result that the majority of the patients gained
in weight during the year under report.
Artificial feeding was resorted to 730 times during the year
under report only in cases exhibiting active refusal to food.
(iii) Occupational therapy.— This form of therapy still
remains here as the sheet anchor of our treatment. It was
vigorously carried out throughout the year under report and
patients of both sexes were employed in various occupational
therapy departments.
A very brief outline of the work done in these departments
is as follows : —
Weaving, cane and bamboo work, smithy, carpentry,
tailoring, cobbling, mending clothes, mattress and
pillow- making, lace-making, knittings, embroidery
work, durrie-making, gardening, domestic and office
work, joss-stick-making, etc.
All the articles manufactured are generally utilized by the
hospital, in fact articles are manufactured with a view to make
this large mental hospital partly self-supporting in its various
demands, but again this is of secondary importance to the
beneficial effect that the occupation itself has upon the mental
condition of the patients. It is the policy of this hospital ever
since its inception to make the occupational therapy depart-
ments, which serve as excellent Therapeutic agents, to be useful,
both to the patients as well as to the State.
11
The percentage of partients to daily average strength use-
fully employed on various works of the hospital during the year
under report was 67.35 males and 59.18 females.
(iv) Drugs.—(1) Sulphur injections.— A mention was made
in the last year's report about this therapy. We tried sulphur
injections (1 per cent. solution of sulphur in olive oil) on 100
cases of different types of mental diseases over a period of
sixteen months. The temperature recorded at each injection was
103° to 104° and in some cases 105°. The average was 102°.
The following table shows the results of our experimental study
on 100 cases with sulphur injections :—
Number
of
patients.
37
44
2
2
1
2
4
8
Types of mental diseases.
Manie depressive psychosis
Dementia praecox ...
Paranoia and paranoid reac-
tions.
Psycho-Neurosis ...
Dissiminated schlerosis ...
Encephalitis lethargica (Par-
kinsonian type).
Stupors ... ...
Epileptic insanity ...
Total ...
Stationary
or no
improvement.
15
20
1
...
1
2
1
8
48
Improved.
16
20
...
...
...
...
3
...
39
Recovered,
6
4
1
2
...
...
...
...
13
= 100
It will be observed from the above table that 13 cases
recovered and were discharged home as cured. Thirty-nine cases
improved out of which 18 have since relapsed and 21 have still
maintained the improvement. Forty-eight cases did not show
any improvement. This shows that the results of our experi-
ment were quite encouraging and the sulphur injections, in my
opinion, are well worth a trial in all fresh admissions. It gives
better results in early cases of psychosis as well as in psycho-
neuroses, although its effect is not discouraging, even in chronic
cases.
12
(2) Bacteriophage.—During the year under report dysentery
cases were treated with bacteriophage. The treatment is still
under trial. The phage was very kindly supplied by Captain
C. Pasricha, I.M.S of the School of Tropical Medicine and
Hygiene, Calcutta, for experimental purposes.
(3) Epilepsy and Snake Venene.— During the year under
review, we experimented on 2 epileptic patients with intra-
muscular injections of detoxicated venene from South Africa.
This venene has a reputation for curing early as well as late
cases of epilepsy and is specially prepared in South Africa, where
they maintain a large snake farm for the purpose. The venene
is expensive, a full course of treatment for one person cost Rs. 40
and the cost of two such courses was defrayed by a charitably
disposed father of a well-to-do epileptic paying patient of this
hospital to whom my best thanks are due for this gift. The
results of our experiment will be fully stated in our next report
as the treatment is still under trial.
(1) Organotherapy.—Many
patients were treated with
different glandular compounds during the year under review with
indifferent results.
Anæmic patients were fed throughout the year under review
on whole liver therapy with marked improvement. Raw liver
from ½ pound to 1 pound per day per patient was prescribed over
a period of 6 months or more in highly anæmic cases with
encouraging results. The minced raw liver is generally mixed
with cooked food such as curries and is relished and digested by
the patients.
(v) Physiotherapy.—(1)
During the year under report
physiotherapy was carried out as actively as before.
The
following number of specimens were examined by the hospital
laboratory during the year :—
Blood
...
...
...
...
Urine
...
...
...
...
Stool
...
...
...
...
306
474
730
(2) Syphilis.—During
the year under report 158 blood
specimens were sent to the Prince of Wales' Medical College,
Patna, for Wasserman test, of which 18 cases were positive and
they were given anti-syphilitic treatment.
(3) Teeth.—During the year few paying patients requiring
attention to their teeth were treated by the local dentist on
payment of fees by their relatives. Necessary extraction of
13
teeth as well as attention to oral hygiene were carried out by the
medical staff in cases of few non-paying patients.
(4) Leprosy.—During
the year under report, we had to
treat 3 bacteriologically and 3 clinically positive leper cases in
the hospital. In the last Annual Report I had pointed out that
to treat such leper cases in a mental hospital where there is no
proper provision of special leper ward was obviously undesir-
able and had requested the Government of Bengal to reserve few
beds for this hospital in the Albert Victor Leper Hospital,
Gobra, where for years, I have transferred leper mental patients
for treatment from Berhampore and Ranchi. I am now definitely
informed by the Government of Bengal that in future no mental
leper cases will be transferred to the Albert Leper Victor
Hospital as there is no proper staff in that hospital for nursing
and controlling insane patients.
This matter is now under
consideration.
30. Sports and amusements—(a)
Games.—(i) Various out-
door games were played by a large number of patients and they
were found to take more lively interest in the matter of outdoor
games than before. Football, hockey, badminton and tennis
were played by patients throughout the year and 5 hockey and
4 football matches were also played with outside teams.
(ii) Indoor games, such as chess, dice, cards, carrom,
ludo, ping-pong were played every evening by the patients of
both sexes in the amusement halls of their respective sections.
(iii) During the X'mas week the annual sports were held
and hundreds of patients of both sexes took part in it and
carried away many prizes On the New Year's eve there was
a display of fireworks which was immensely enjoyed by the
patients.
(b) Musical and other entertainments.—As
the chances of
building a permanent amusement hall appear to be remote at
present due to financial stringency, every effort was made
during the year to make the present temporary amusement hall
as attractive as possible. With this object in view alterations
and improvements have been made by which this old Hall
compares very favourably with any public amusement hall.
Patients were entertained throughout the year under review
by the hospital band party and by the music master. More-
over, several musical soirees were got up by the combined efforts
of the staff and patients.
14
During the year under review the following were engaged
to entertain the patients :—
(1) Physical feats by Allah Bux, on 9th January 1931.
(2) Magic by Mr. N. K. Ghosh, on 9th January 1921.
(3) Theatrical performances by staff, on 19th January,
10th March, 26th March and 28th August 1931.
(4) Magic lantern, on 10th March 1931.
(5) Variety performance by Prof. Mukerji, on 8th April
1931.
(6) Magic by Mr. W. Vincent, on 27th May 1931.
(7) Magic by D. D. Andre, 31st August 1931.
(8) Jatra performances by Sricharan Bhandari Opera
Company of Calcutta, on 23rd and 24th October
1931.
(9) Variety performances by W. R. Denver and Company
on 5th and 12th November 1931.
(10) Egyptian dance by the Egyptian Dancing Troupe, on
19th November 1931.
(11) Bhagbat Katha by Pandit Surju Dutt Shastri, on 7th
and 8th December 1931.
(12) Comic Caricature by Prof. N. C. Haldar, on 23rd
December 1931.
The music master also teaches those patients who are
anxious to learn music. As in the former years frequent use is
made of gramophones in the wards. Besides, the Radio Set is
another source of amusement to the patients but the atmos-
pheric disturbances do not allow us to enjoy the Radio throughout
the year. The socials of this hospital were well patronised
throughout the year by respectable ladies and gentlemen of
Calcutta and Ranchi including non-official visitors of both sexes
and some members of the managing committee of the hospital.
I wish to express my appreciation on behalf of my patients to all
the friends of the hospital for their genuine help and interest
in the hospital socials as well as to all the staff concerned for
their noble endeavour to make the lives of the unfortunate
patients more pleasant by helping at the socials.
I am also highly indebted to my friend M. Tutu Ghose of
Calcutta who during the Puja socials, on special request, enter-
tained the patients with humorous sketches and dances.
15
Cinema.—I am happy to be able to record that the benign
Government have at last on the recommendation of the manag-
ing committee sanctioned the purchase of a cinema machine
during the year under report. Unfortunately the sanction came
too late to make the purchase within the financial year. The
Government was also pleased to sanction during the year under
review the purchase of a frigidaire for the hospital and a machine
was installed at a cost of Rs. 1,250. The frigidaire now partly
supplies the ice and cold drinks to the patients during the hot
weather and preserves our sera vaccines and other perishable
food stuff throughout the year.
(c) Feasts.—As in the former years, special feasts were
given on festive occasions such as Puja, Holi, X'mas, Id, etc.
(d) Religious sentiments of patients are respected and
special arrangements are always made for due observance of
their respective festivals. They are also allowed to go outside to
attend prayers, pujahs, kirtans, etc., with the staff.
Attention to patients' religion.— Hindus.—More than 800
patients attended the Durga Puja which was celebrated with
much pomp by the staff and public of Kanke outside the
hospital.
Muhammadans.—On request of Muhammadan patients
a small spare rcom was converted into a mosque for their prayers
and a maulavi who happens to be on our staff conducts the usual
Jumma and other prayers regularly.
Christian patients.—During the year under report arrange-
ments were made on request from the Roman Catholic patients
with the Rector of the Roman Catholic Mission, Ranchi, for
holding regular divine service for the patients belonging to the
Church of Rome which hitherto did not exist. My warmest
thanks are due to the Rector for so kindly acceding to my
request for holding divine service in this hospital.
My thanks are also due to the Chaplain of the Church of
England, Rev. A. C. Chatterji, who held divine service through-
out the year under report.
During X'mas elaborate arrangements were also made for
special church service and the festivities of the season were
enjoyed by a large number of patients including non-Christians.
(e) Picnics.—Hundreds of patients were taken out from
time to time to the nearest hills, riversides, gardens, etc., with
the hospital band for picnic. A few selected patients were also
taken to a lunch picnic at the Hundru Falls.