NationalLibraryOfScotland/medical-history-of-british-india huggingface dataset:
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13. The general health of the patients was good throughout
the period under report. The daily average number of sick
treated in the infirmaries for bodily ailments was 59.93 males,
1.67 females and 61.60 total against 53.95 males, 3.47 females
total 57.42 in the previous year.
The important admissions to the infirmaries during the
period under report are shown in the following table :—
Table showing important admissions to the infirmaries.
Name of disease.
Dysentery ... ... ... ....
Malaria ... ... ... ...
Influenza ... ... ... ...
Pneumonia ... ... ... ...
Tuberculosis of the lungs ... ... ...
All other general diseases ... ... ...
Diseases of the eye ... ... ...
Diseases of the respiratory system ... ...
Diarrhœa ... ... ... ...
All other diseases of the digestive system ...
Other diseases of generative system ... ...
Diseases of organ of locomotion ... ...
Inflammation ulcerative ... ... ...
Other diseases of the skin ... ... ...
Injury, general or local ... ... ...
Number of cases
Male.
6
40
85
3
4
50
10
89
80
82
7
10
28
31
63
Female.
4
13
10
...
1
14
1
7
4
2
...
...
2
1
...
Total.
10
53
95
3
5
64
11
96
84
84
7
10
30
32
63
14. Statement no. IA.—Cases under
observation.—There
were 24 cases (19 males and 5 females) under brief periods of
observation in this hospital as compared with 27 cases (24 males
and 3 females) in the previous year. Out of 24 cases sent for
observation during the period under review only 7 cases (2 males
and 5 females) were certified and admitted, 8 cases (males)
were suffering from mild types of insanity and were not con-
sidered by the committing Magistrates as eligible for admission
on account of congestion of the male section. One case under
observation died suddenly of diabetic coma on the second
day of his admission. Eight cases (males) were discharged as
uncertifiable.
7
15. Statement no. II.—Criminal
patients.—The
following
table shows the daily average strength of criminal patients
during the year under report as well as during the last three
years :—
Years.
1930 ... ... ... ...
1929
...
...
...
...
1928
...
...
...
...
1927
...
...
...
...
Average number of cases.
Male.
450.63
464.64
528.05
56.116
Female.
34.13
84.69
40.53
44.66
Total.
484.76
499.33
568.58
605.82
The progressive decrease is due to admission of lesse
number of such patients as well as transfer of several patient
to the non-criminal class after their admission here on accoun
of the trivial nature of their offences.
16. Statement no. III shows the religion, sex and residence
of the patients admitted into this hospital during the period
under report.
17. Statement no. IV shows the previous occupations of
patients admitted during the year under report.
18. Statement no. V shows the ages of patients admitted
into this hospital during the year under report. It will be
noticed from the figures given in the following table 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 10 to 60 years ... ...
Upward of 60 years ... ...
1930
7
69
19
4
1929
8
67
16
2
1928
6
86
18
1
1927
17
208
52
5
8
19. Statement no. VI shows the types of insanity of the
patients admitted during the year under report. Mania,
melancholia, dementia præcox, toxic insanity and confu-
sional insanity were the principal types treated.
20. Paying patients.—Seventy-nine patients (60 males and
19 females) were treated during the year under report as com-
pared with 60 (48 males and 12 females) in 1929. During the
year under report as well as in the last two years several appli-
cations for the admission of paying patients had to be refused
for want of accommodation in the male section.
The scheme for the construction of paying patients' wards
has been deferred by Government owing to the financial strin-
gency. In the meantime, the arrangement of keeping the paying
patients of the male section in a separate ward of one of the quiet
patients' blocks is continuing. A few suitable patients are also
given single rooms from time to time when available. In the
female section, although there is no separate paying patients' ward,
first class paying patients are given separate rooms and other
classes of patients are kept in separate wards in the infirmary
block. This comfort for female paying patients is possible at
present, as there is no overcrowding in the female section.
21. Suicide.—I am glad to be able to report that there was
no case of suicide during the year under report and the previous
three years in spite of the fact that there are more than 70
suicidal patients in the hospital, the majority of whom are
potential suicides. Several serious attempts were made by
potential suicides to end their lives generally by trying to
strangle or hang themselves.
It is satisfactory to note that there was no case of serious
accident or injury during the year under report in spite of the
fact that all patients admitted during the year were sent here as
definitely dangerous. There were a few minor accidents and
injuries but none were serious. This result can fairly be attri-
buted to the kind treatment meted out to this class of patients
in this hospital as already stated in my annual report of 1928.
22. Escapes—In spite of the maximum amount of freedom
allowed to patients of this hospital, there was no escape during
the year under report.
23. Autopsy.—During
the year under report 24 post-
mortems were performed and interesting specimens have been
preserved for demonstration purposes.
9
24. Sanitation.—The general sanitation of the whole area
of the hospital was satisfactory. There was no epidemic disease
of any kind either in the hospital or in the staff lines.
Infestation by bugs caused some trouble but this trouble was
successfully overcome.
Throughout the year under report the " Thresh Disinfector "
machine worked efficiently in disinfecting patients' clothing and
bedding.
25. Treatment of mental conditions. —(i) Hydrotherapy
(prolonged bath).—During the year under report 69 cases were
given this treatment as against 43 in the previous year. The
average number of hours of immersion per patient was 146.
The result of the treatment was most encouraging. A special
Hydrotherapy Ward has not yet been provided for want of
which this important form of therapy could not be more
extensively used.
(ii) Dietetic.—Special attention is paid to the proper dieting
of patients of this hospital as a well-balanced nourishing diet
largely helps the recovery rate. The weight charts of the
patients showed a general rise throughout the year under report.
The average gain in weight per patient during the year under
report was 2.00 lbs. per every male patient and 0.85 lb. per
every female patient.
Artificial feeding.—Cases refusing food were spoon-fed by
nurses and attendants, recourse to artificial feeding being resorted
to in the few special cases exhibiting active refusal to food.
We have many stuporous cases of various degree which often
require artificial feeding by tube either per nose, mouth or
rectum, and I should like to mention one case of benign stupor
that was kept alive for 3½ years by nasal feeding twice daily.
(iii) Occupational therapy.—This therapy is the sheet-
anchor of our treatment in this hospital, and has been carried out
as vigorously as before. Patients of both sexes are suitably
employed chiefly in gardening, weaving, cane and bamboo work
smithy, carpentry, tailoring, cobbling, mending clothes, mattress
and pillow-making, lace-making, knitting, embroidery work,
domestic and office work, etc., etc. The patients' labour is fully
utilized towards supplying the needs of the hospital. Jharan s,
dusocti cloth, bandage cloth, asans and many other useful
articles required for the hospital are manufactured in the occu-
pational therapy classes. The weaving section in the female
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section was considerably expanded during the year under report
but the progress was hampered for want of a weaving instruc-
tress, the post of which was sanctioned by Government but no
appointment was made for want of funds. The vegetable garden
of this hospital is entirely run by the patients' labour and the
hospital is entirely self-supporting as regards its vegetable and
fruit supply. The following table shows the total income derived
from the garden during the year under report, and in the
previous two years :—
Income.
Details.
Supply of vegetables, fruits, onion,
garlic, ginger, chillies, etc., to
hospital.
Supply of fodder to the hospital ...
Sale of surplus vegetables, etc. to
the staff and public.
Total ...
1930.
Rs.
20,605
316
2,120
23,044
a.
9
4
5
2
p.
6
0
3
9
1929.
Rs.
25,092
547
2,985
28,624
1928.
Rs.
21,553
358
1,519
23,430
Expenditure.
Pay of coolies, laying-out cost, cost
of manure, seeds, plants, imple-
ments tools, and miscellaneous
articles.
6,672 2 9
5,902
7,381
The reason for the reduced income shown in 1930 in
comparison to the previous years is that the prices of the
vegetables supplied to the hospital were reduced in accordance
with the decrease of the market prices of these commodities,
although the quantity supplied in 1930 was more than the
previous years.
The average daily number of patients employed in the
vegetable garden was 139 in 1930, 145 in 1929 and 142 in 1928.
The construction of four wells in the garden area for the
purpose of irrigation was taken in hand during the year under
review by the Public Works Department and the work is
expected to be completed in 1931-32.
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(iv) Drugs.—(a) On my return from leave I introduced
what I had seen in Zurich Hospital the treatment popularly
known as Zurich treatment. It consists of heroic doses of
Sodium Luminal gr XII per day given per mouth or by deep
intramuscular injections in the buttock. It is continued for
over a fortnight. It is very beneficial in cases of acute
excitement with intractable insomnia. We tried in several of
our cases of this type and the results were very encouraging but
unfortunately the benefit was temporary.
(b) Deep intramuscular injections of Paraldehyde.
Paraldehyde zi was also injected daily in the buttocks for
a period of a fortnight in highly excited cases. The results were
very encouraging but the benefit was temporary.
(c) During the year under review Bromo-Chloral Co was
also prescribed by me to some mild as well as intractable cases
of insomnia. In some cases the drug acted like a charm but
failed in others.
In fact all the above drugs tried in the way described above
during the year under report have come to stay on our register
of drugs for insomnia and general excitement.
(v). Organotherapy.—Nineteen
patients were treated with
different glandular compounds during the period under review
but the results were not very encouraging. Thyroid was
found to be a very good activating agent when given in large
doses for a period of 10 days in acute melancholia and mild
stupor cases.
(vi) Physiotherapy.—Strictest
attention is paid in this
hospital to correct all physical defects before an attempt is
made to explore the psychological defects. Tonsils, nasal sinuses,
adenoids, eyes, ears, etc., are contributory causes to mental
derangement when they are defective. Therefore on admission
of a patient all physical avenues which are believed to contribute
smaller or larger share in the causation of mental diseases are
thoroughly explored.
Teeth.—(a) The services of a wholetime dentist on the staff
are desirable but funds have not been forthcoming.
Throughout the year under review and the previous years,
Dr. D. R. Choudhury, one of the sub-assistant surgeons on our
staff, treated the teeth of a number of the patients.
12
(b) Similarly, Dr. P. C. Das, M.B., who is happily also an
eye specialist, did excellent work with ophthalmoscope and
operated on some cases of cataract among the patients,
(c) Syphilis.—During
the year under report, 425 blood
specimens were sent to the Pathological Laboratory of the
Prince of Wales Medical College, Patna, for Wasserman test
and suitable anti-syphilitic treatment was given to positive cases.
(d) Leprosy.—During the year under review we were
obliged to treat three highly-contagious positive cases of leprosy
in the hospital as those cases were not admitted in the Albert
Victor Leper Hospital, Gobra (Calcutta), for want of accommoda-
tion. This is admittedly a serious state of affairs which would
be remedied if the Government of Bengal could arrange to reserve
a few beds for this hospital in the Albert Victor Leper Hospital
at Gobra for the treatment of such acute cases. To treat highly-
contagious leper cases in mental hospital is undesirable for
obvious reasons.
(vii) Malarial therapy.—During the year under review four
patients were given malarial therapy with indifferent results.
(viii)—Sulfosin therapy.—On my return from leave during
the latter part of the year under report I have injected a few
selected cases with sulfosin (which is 1 per cent. solution or
suspension of sulphur in olive oil). Dr. Knud Schrœdor, an
eminent physician of Denmark, in 1929 claimed to produce
pyrexia by injections of sulphur in olive oil better than that
produced by malarial therapy. So far we agree with his claim
as our patients have shown a steady rise of temperature up to
103 degrees after every injection. The results of our experiments
will be fully given in our next annual report as at the time of
writing this report the treatment is still under trial and not yet
completed.
(ix). Psychotherapy.—A case was admitted from Calcutta
as a case of complete paralysis of both legs with mental excite-
ment. The patient was brought into the hospital on a stretcher.
On examination the cas3 was diagnosed as a case of " con-
version hysteria " and the patient, who was treated as a case
of paralysis of the legs for three months outside, was made to
walk within eight days of his admission and was discharged
cured within two months, and he went to Goa—his native
place—which is a distance of 1,500 miles from Ranchi on
his own.
13
We rarely see such early cases admitted into this hospital.
We are only called upon to treat all chronic cases whose relations
and friends have kept them in their homes for years under
treatment of every one but a psychiatrist, and are only sent to us
when they become unmanageable and dangerous at home. This
is further aggravated by the present unavoidable congestion
of the hospital with the result that cases are allowed to
remain in jails or houses untreated until such time accommoda-
tion is available. In spite of all these difficulties I am happy to
be able to report that our percentage of cure to so-called " new
admission " as well as to average strength of the total population,
can proudly be looked upon as extremely reasonable and good.
I tender my best thanks to Rev. A. C. Chatterji, the Church
of England Chaplain, who was kind enough to give religious
suggestions to my above stated patient of conversion hysteria.
26. (x) Sports and Amusements.—(a) Games.—Both indoor
and outdoor games were played by quite a large number of
patients and they all seemed to take more active interest in the
matter. Several football and hockey matches were played by the
hospital team consisting of staff and patients against several
other units at Kanke and Ranchi. Several patients of both
sexes played tennis and badminton.
Indoor games such as cards, chess, dice, carrom, ludo, ping-
pong, etc., were played every evening in the Amusement Hall by
a large number of patients.
The hospital annual sport which is held every year during
Xmas was largely attended this year and many patients took part
in it and won many prizes.
(b) Musical and other entertainments.—In the absence of
a proper Amusement Hall, which is a pressing need of the
hospital, one of the dormitories of a quiet patients' block, is
utilized for the purpose. Twelve theatrical performances both
Hindi and Bengali and several musical soirees got up yb the staff
and patients were staged during the year under report, to the
great enjoyment of patients of both sexes. A few well-known
magicians entertained the patients. Besides, the patients of
both the sections were entertained by the musical entertainer on
every alternate day. Gramophones are played by the patients
every evening in different wards by turn. The radio set, which
was installed in 1929 out of special donation made for the
purpose by Raja B. D. Birla, was a source of great amusement
to patients. The concert party of the hospital which was only
14
organised a couple of years ago played both Indian and English
music throughout the year and afforded another source of great
pleasure to patients. Its existence and the maintenance of the
high standard of music are entirely due to the enthusiasm and
perseverance of Sub-Assistant Surgeon Dr. Dhaniraj Choudhury.
The band also played at patients' " games " and theatricals.
A few musical instruments were purchased during the year.
My best thanks are due to all those kind ladies and gentle-
men of Ranchi who often graced the social functions of this
hospital by their presence and I assure them that the patients
very much enjoy their visits on such occasions and often look
forward to it.
(xi) Feasts.—Special feasts were, as usual, given to the
patients on festive occasions, such as Poojah, Holi, Xmas, Id,
etc., and were greatly appreciated. The religious sentiments of
the patients are respected and special facilities are afforded to
Hindu, Muhammadan and Christian patients for due observance
of their respective festivals.
(xii) Picnics.—During
the fine weather large number
of patients picnicked out to the nearest hills, riversides, gardens,
etc., with the hospital concert party. Those outings were very
much enjoyed by them.
(xiii) Parole.—Many dependable patients were granted
full " local " and " Ranchi " paroles. Others were allowed out
both morning and evening for walks with attendants. None of
the patients granted parole abused the privileges, and the number
of patients on parole is increasing every year. The effect on the
health of patients has been striking.
(xiv) Drives.—Patients
of both sexes were sent out
regularly by turn throughout the year for motor drives both
morning and evening in the hospital cars.
(xv) Libraries.—(i)
Patients'
Library.—A
few
more
Bengali, Hindi, Urdu and Oriya books were purchased during
the year under report according to the budget grant for the year.
Many literate patients made good use of this library.
The following newspapers and monthly magazines were
supplied free of cost for the patients' library by the kind and
sympathetic publishers to whom my best thanks are due :—
(1) Statesman.
(2) Amrita Bazar
Patrika.
15
(3) Searchlight.
(4) Biswamitra (vernacular).
(5) Basumati (vernacular).
(6) Utkal Dipika (vernacular).
(7) Illustrated Times of India.
(8) Bharatbarsha (monthly).
(9) Prabasi (monthly).
(xvi) Medical Library.—The
Medical Library was also
replenished by some new books and by few journals of medicines
and mental science.
The library is largely used by the medical staff as it keeps
them well informed of the rapid advancement in the field of
psychological and general medicine.
27. Maintenance of and repairs to the buildings.—All the
buildings of the hospital have been maintained in an efficient
state of repairs. Quadrennial repairs to some of the old buildings
of the hospital were carried out during the year under review.
28. Finance.—(a) Receipts.—The receipts from all sources
amounted to Rs. 21,668 in 1930 as compared with Rs. 20,066
in 1929 and Rs. 18,257 in 1928.
The following table shows the total amount realized from
paying patients, and also miscellaneous receipts which include
the sale-proceeds of articles manufactured by patients in the
Occupational Therapy classes, and of vegetables grown in the
garden of the hospital:—
Receipts from paying patients ...
Miscellaneous Receipts ... ...
1930
18,274
3,394
1929
Rs.
16,029
4,036
1928
Rs.
15,676
2,580
The progressive increase in the receipt is due to the larger
amount of fees realized from paying patients.
16
(b) Expenditure.—The total expenditure exclusive of the
amount received from the paying patients and miscellaneous
receipts was Rs. 5,70,175-4-7 during the year under report as
compared with Rs. 7,60,978-7-1 in 1929 and Rs. 6,34,085-1-6
in 1928.
(c) Annual average cost per patient.—The following table
shows the annual average cost per head during the year under
report and two previous years :—
Year.
1930 ... ... ...
1929 ... ... ...
1928 ... ... ...
Annual cost per head
inclusive of Public
Works Department
charges.
Rs.
453
605
475
a.
3
5
14
p.
0
3
3
Annual cost per head
exclusive of Public
Works Department
charges.
Rs.
390
418
357
a.
5
7
3
p.
9
4
2
The less annual cost per head excluding the Public Works
Department charges in 1928 as compared to 1929 and 1930 is
due to the fact that the total expenditure of the hospital was
divided by larger number of patients and hence the cost per head
was less.
29. Staff.—Statement no. IX shows the sanctioned establish-
ment of the hospital at the end of the year under report.
Attendants.—The standard of work of the attendant staff
is steadily improving every year. Classes were held to train the
new recruits in first aid and mental nursing.
Health of staff.—The general health of the staff was good
throughout the year under report.
30. Commendation.—Before I was granted long leave, the
question of my successor was seriously discussed by local
Government. I strongly recommended my First Assistant
Superintendent, Dr. P. C. Das, whom I considered quite capable
to officiate for me and the Government was pleased to accept
my recommendations. I am pleased to be able to record that
17
Dr. P. C. Das shouldered the heavy responsibilities of the post
with commendable zeal, energy and ability to the entire
satisfaction of all concerned.
Dr. Das was ably and loyally assisted by all the staff during
his tenure of office.
I have very little to add about the conduct of the staff to
what it was my pleasure to record in my last annual report of
1928. However, I would like to record my deep appreciation
of the work of all staff who so ably and loyally helped me in
the administration of this large hospital during the period
under review.
31. General.—The hospital was visited by the Inspector-
General of Civil Hospitals, Bihar and Orissa, several times
during the year under report.
The following also visited the hospital :—
Commissioner, Chota Nagpur Division, Ranchi,
Members of the Managing Committee of the hospital,
Several members of the Bihar and Orissa Legislative
Council,
Colonel H. Suhrawardy, O.B.E., M.D., F.R.C.S.I., D.P.H., L.M.,
Vice-Chancellor, Calcutta University,
Besides, numerous sympathetic visitors of both sexes,
European and Indian, visited the hospital from time to time.
32. The Committee of Visitors.— Both ladies and gentlemen
of the Board of Visitors have taken keen interest in the welfare
of the institution and have worked throughout the period
under review with unremitting zeal.
Twelve monthly meetings and one extraordinary meeting of
visitors were held during the year under report in the male
section, and 12 monthly meetings were held in the female
section.
The proposal of increasing the number of lady visitors
from 6 to 12 is under the consideration of Government.
33. Managing Committee.—The
Committee met twice
during the year under report and advised Government on
various important propositions.