NationalLibraryOfScotland/medical-history-of-british-india huggingface dataset:
12
a rate which is far in excess of our capacity for biological
adaptation This accelerated tempo of living is productive of
enormous mental tension and fatigue. Again, modern life
stimulates conflict. The unsatisfied desires of the individual tend
to increase tension and to breed emotional conflicts. Where
democracy prevails it stresses equality of opportunity with the
result that the mass of less able individuals must always be
discontented with their lot. The failure to achieve reacts upon
the personality to cause feelings of insecurity and inferiority and
nothing is more productive of mental maladjustment than
prolonged feelings of this kind.
It may well be stated that the increasing prevalence of
mental diseases comes from the very nature of modern civiliza-
tion and as India is fast adopting all the methods of modern
Western civilization in order to be on equal footing with the
civilized nations of the world, it might as well also provide
ample facilities for the treatment of its mental and nervous
breakdowns. Like the Western countries India must also launch
a well organized programme of mental hygiene and all the Indian
corporations, municipalities and district boards must help to
make it a success. There are thousands of young people (misfits)
walking in the streets of India to-day who are unnecessarily
doomed to spend some of their time before they die either in jails
or in mental hospitals. It is only by appreciating such
staggering figures that it is possible to understand the necessity
for mental hygiene movement in India. Every country in its
onward march to civilization has a complete nation-building
programme, and mental hygiene takes a prominent place in such
nation-building departments. The following preamble which
I quote from the American foundation for mental hygiene will
convince any one who is conversant with India and its affairs of
the dire need of introducing mental hygiene in India as a means
effective to the end of promoting and conserving mental health and
ameliorating the scourge of mental ill-health in India :—
" PREAMBLE.
Science takes exception to the law that only those whom
nature deems the fittest shall survive. Nature has her hidden
remedies for the torture of a broken mind or body, and science is
upon the march in search of these remedies that they may
be re-dedicated to mankind. The knowledge so gained forms
a sacred trust of civilization for the maintenance of the strong,
for the refitting of the weak and sick to their health and oppor-
tunity, and for their deliverance to a useful life in the community
and that pursuit of happiness which is the proper promise of
creation.''
13
23. Suicide.—I am glad to be able to record that there was no
case of suicide during the triennium in spite of the fact that there
were approximately 80 suicidal patients in the hospital the
majority of whom are potential suicides.
It may be noted in this connection that suicide is practically
unknown in this largest mental hospital of India for the last
6 years and it is a distinct, indication of unremitting zeal, care
and supervision exercised by the attendant staff on duty in
these wards to whom I offer my best thanks for this happy
result.
24. Escapes.—In spite of a moderate amount of freedom
being given to the patients of this hospital one patient escaped
during the year 1932. The patient is still at large.
25. Autopsy.—During the triennium 69 post-mortems were
performed, viz., 24 in 1930, 26 in 1931 and 19 in 1932, and
interesting specimens were preserved for the hospital.
26. Sanitation.—The general sanitation of the whole area
of the hospital was satisfactory throughout the triennium.
There was no occurrence of epidemic diseases—except for about
2 months in 1931—when influenza broke out in a mild form.
It was checked in time and there was no loss of life.
In 1931 the Assistant Director of Public Health, Chota
Nagpur Circle visited the hospital several times with a view
to investigate the breeding areas of malarial mosquitoes and
advise ways and means to erradicate the mosquito nuisance.
The sanitary staff of the hospital under the direct supervision
of the 2nd Assistant Superintendent was kept busy throughout
the period under report to combat the malarial mosquitœs but
the vastness of the breeding grounds all round the hospital
and Kanke rendered the task very difficult and gives one an
idea that it is impossible to totally erradicate the breeding
places of these mosquitoes. However, we are doing our best to
keep the mosquito nuisance away from the hospital as far as
possible.
Throughout the triennium the thresh disinfector machine
worked efficiently in disinfecting the patients' clothing and
bedding.
27. Accidents and injuries.—During the triennium under
report the following two cases sustained severe injuries :—
(1) A patient died of fracture of skull—the result of a fall
brought about by a severe sudden epileptic fit.
14
(2) A very dependable patient suddenly struck another
patient without any provocation with an axe while
working in the garden. The injury was serious but
fortunately the patient recovered from his injuries.
Besides these, there were many minor cases of accidents and
injuries during the period under report.
28. Treatment of mental condition.—The progress made
in the treatment of the sick in mind all over the world during
the last quarter of a century has been amazing. Ever since the
inception of this modern mental hospital the question of
treatment of patients has always engaged our serious attention
and we introduce all the latest approved Western methods of
treatment with due regard to Eastern conditions. On my return
from leave in 1930, I introduced many forms of new treatment
which I had picked up during my second study tour in Europe
and America in pursuit of knowledge in Psychological Medicine.
I.—DRUGS.
The following drugs were tried :—
(a) Sodium Luminal.—Heroic doses of sodium luminal
Gr. VI to XII per day per month were tried in several D. P.
and M. D. P. cases with acute excitement and intractable
insomnia. The results were encouraging in some cases but the
benefit was temporary.
(b) Paraldehyde.—Deep intra-muscular injections of paral-
dehyde 3III in the buttocks were tried in several cases suffering
from acute excitement with insomnia. In some cases the injec-
tions worked like a charm but failed in others.
(c) Bromo-chororal-Co.—This mixture was found to be very
useful in some cases where other hypnotics had failed to produce
good results.
(d) Soneryl.—This drug was also found to be a good
hypnotic and produced good results in some cases of excitement
and insomnia.
(e) Sodium amytal.—It did not give such satisfactory
results as a hypnotic as it gave in allaying pre-operation fear
and apprehension. This drug was largely used in all our
steinach operation cases for the above stated purpose with good
results. One capsule of sodium amytal (gr. iii) is given at bed
time on the night previous to the operation to be followed by
another capsule the next day two hours before the fixed time of
operation.
15
(f) Nembutal.—This drug is a powerful hypnotic and
sedative. It is still under trial and the results will be given in
our next report.
(g) Sulphur injections in mental disorders.—An experi-
mental study of 100 cases with sulphur injections was fully
described in my last annual report (1931). Since then we
have experimented with another 40 cases and the table
appended below now shows the results of our experiment on 140
cases, with sulphur injections throughout the triennium under
report:—
Number
of
petients.
62
58
2
3
1
2
4
8
140
Type of mental diseases.
Manic depressive psychosis
Dementia praecox
Paranoia & paranoid reactions
Psycho-Neurosis
Dissiminated schlerosis
Encephalitis
lethergica
(parkinsonian type).
Stupors
Epileptic insanity
Stationary
or not
improved.
28
25
1
...
1
2
1
8
66
Improved
25
28
...
1
...
...
3
...
57
Recovered.
9
5
1
2
...
...
...
...
17
It will be observed from the above table that 17 cases
recovered and were discharged as cured ; 57 cases improved, out
of which 25 have since relapsed and 32 have still maintained the
improvement. 66 cases did not show any improvement. This
shows that the results of our experiment were quite encouraging
and the sulpher 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 the psycho-neurosis while its effect is
not discouraging even in chronic cases. This theraphy is now a
routine treatment in this hospital in all newly admitted cases.
It is gratifying to note that since the publication of my articles
16
on Sulphur Therapy in the " Lancet " and the " Indian Medical
Gazette "we have received many letters from private practitioners
in India making enquiries about this therapy with a view to try
on their cases. Recently we experimented with sulphur injection
in three cases suffering from the following skin diseases : —
(1) Impetigo;
(2) Eczema,
and the above diseases entirely disappeared. We are now ex-
perimenting with this drug in other skin diseases and the results
of our experiments will be fully stated in our next report as
this is still under trial.
(h) Snake venene.—As fully stated in my last report (1931)
we tried detoxicated venene from South Africa on 2 Epileptic
cases. The results were thoroughly disappointing.
(i) Bacteriophage.—It
proved very efficacious in two
cases of Bacillary Dysentery.
II. ORGANOTHERAPY.
Many patients were tried with different kinds of Glandular
Therapy during the period under report but with few exceptions
the results were not encouraging.
(i) Liver Therapy.—Anaemic patients were fed throughout
the period under report on the whole Liver Therapy with very grati
fying result. Raw liver from ½ lb. to 1 lb. per day was prescribed
per patient over a period of 3 to 6 months. The minced raw
liver is generally mixed with cooked food such as curries and is
relished and digested by the patients.
Similarly, injections of Colloidal Calcium with Ostelin—D
were also found to be very useful in treatment of anaemic condi-
tions specially in women.
III. PHYSIOTHERAPY.
Strictest attention is paid in this hospital to correct all
physical defects before an attempt is made to explore the
psychological defects. On admission of a patient all physical
avenues which are belived to contribute small or large shares in
the causation of mental diseases are thoroughly explored. The
following number of specimens were examined by the hospital
laboratory during the triennium under report :—
Blood ...
Urine ...
Stool ...
Sputum ...
1932
355
610
496
167
1931
306
474
730
123
1930
319
328
141
109
17
(a) Teeth.—The baneful effects of oral sepsis on general and
mental health of an individual are now universally recognised.
Throughout the period under report the oral sepsis of the
patients who required immediate attention were attended to by
the medical staff. Paying patients requiring attention to their
teeth were treated by the local dentist on payment of fees
by the guardians.
(b) Syphilis.—The blood and in special cases the Cerebro-
spinal Fluid of all newly-admitted cases are sent as a routine
measure to the Prince of Wales' Medical College, Patna, for the
Wassermann Test. During the triennium under report 712
such specimens were sent for this test and those who were
reported positive were given full course of Anti-Syphilitic
treatment.
IV. HYDROTHERAPY.
During the triennium under report 407 cases were given
this treatment—the average number of hours of emersion per
patient was 63.
There was a great rush on this department throughout the
period under report and many patients were denied this useful
form of therapy for want of accommodation. Hydrotherapy is
chiefly instrumental in allaying excitement and insomnia in
highly refractory cases. The scheme of building a Hydrotherapy
Ward could not be taken up for want of funds.
V. OCCUPATIONAL THERAPY.
This therapy is now universally acknowledged as a recog-
nized form of treatment in modern mental hospitals and it still
remains as the sheet anchor of our treatment. A very brief
outline of works done in this department is as follows:—
Weaving, Cane and Bamboo work, Smithy, Carpentry,
Tailoring, Cobbling, Mending clothes, Mattress and
Pillow making, Lace making, Knitting, Embroidery
work, Durrie making, Gardening, Domestic and
Office work, Joss stick making, etc.
It is our policy to make the Occupational Therapy depart-
ments of this hospital, which serve as excellent Therapeutic
Agents, to be useful both to the patients as well as to the State.
29. Sports and amusements.—All modern Psychiatrists are
of opinion that the introduction of congenial amusements in
mental hospitals is another valuable factor in the treatment of
mental conditions.
18
I belong to this school of thought and did my best to provide
as many and as varied amusements for the patients as funds
could permit. Approximately 200 patients attend daily the
temporary Amusement Hall of both sections and play various
indoor games. As heretofore the Hospital Band continued to
entertain the patients in the Amusement Hall, and the Gramo-
phones in the Wards for the amusement of those patients who
were unable to attend the Amusement Halls. During the
triennium, many Foot-ball and Hockey matches were played
with outside teams of Kanke and Ranchi and the hospital team
won many such matches. The annual sports of the hospital
were held every year during the Christmas week and many
patients of both sexes took part in it and carried away many
prizes. On New Year's eve we arrange a display of Fireworks
every year which the patients look forward to and enjoy
immensely.
During the period under report the hospital staff staged 17
Theatrical shows, and 6 Vaudeville shows were staged by the
combined effort of patients and staff. Moreover when any
Theatrical, Magic and variety show of repute visit Ranchi we
always try to engage them for the patients. The following were
engaged to entertain the patients :—
9 Magic shows by well-known Magicians.
7 Vaudeville shows.
2 Comic Caricatures,
3 Theatrical shows by the famous Corinthian Theatrical
Company of Calcutta.
2 Jatra performances by the well-known Sricharan
Bhandari Opera Company of Calcutta.
I owe a deep debt of gratitude to all those kind-hearted ladies
and gentlemen who often graced the Socials of this hospital by
their presence, and also to all the staff for their noble endeavour
to make the lives of my unfortunate patients more pleasant by
staging various performances from time to time.
Cinema.—I am happy to be able to record that the Govern-
ment on the recommendation of the Managing Committee sanc-
tioned the purchase of a Cinema machine at a cost of
Rs. 2,120-5-6. The machine was purchased from Messrs. Pathe
India, Bombay, and the Cinema gave its first performance on the
29th March 1933.
19
Babu Durga Charan Sarkar, the Reference Clerk of the
hospital, voluntarily offered to operate the Cinema machine.
He was trained by the Company's Mechanic and now works the
machine like a competent Cinema Operator. He is helped by
an attendant who has also some training in working Cinema
machines.
Band.—The Hospital Band which was organized in 1928
continues to maintain progress under the conductorship of Naik
Charan, one of the Hospital Attendants. The Band now
numbers 12 performers, all members of the staff. The Band
provides the patients with a pleasant form of entertainment and
keeps the place cheery. During the period under report
a few musical instruments were purchased for the Band.
Dietetics.—As in former years great attention was paid to
the diet of the patients. A well-balanced nourishing diet largely
helps the recovery rate. All patients are weighed once a month
and those who steadily lose weight are segregated in the
Infirmary with a view to ascertaining the cause and are fed on
special diet until they regain their original weight. The weight
charts of patients showed a general rise.
Feasts.—During the period under report several special
feasts were given to the patients on festive occasions such as the
pujas, Holi, Christmas, Id, etc.
Religion.—Due respect is paid to the religious sentiments
of the patients and arrangements are always made for
the due observance of their respective religious festivals.
They are allowed to go out on these days to attend prayers, pujas,
kirtans, etc. The Muhammadan patients regularly attend the
Juma prayers under the Maulavi who is one of the Jamadars of
this hospital.
The Hindus often attend the Kirtans whenever a Pandit
calls at Kanke and the Christian patients attend the Divine
services under the Roman Catholic and Anglican Chaplains.
My best thanks are due to the following gentlemen for
holding Divine services for the benefit of my patients through-
out the triennium under report :—
1. Rev. Father G. Martin, S. J.
2. Rev. A. C. Chatterji.
3. Maulavi Abdul Rahim.
Picnics.—Picnics are a notable feature of amusement for the
patients and provide a change in surroundings which is much
appreciated by the patients.
20
Parole.—Throughout the triennium many patients were
granted local as well as Ranchi parole with or without attendants.
Patients seem to enjoy this liberty and the privilege is not
abused and it has a salutary effect on their general health.
Motor Drives.—The hospital cars were kept busy through-
out the triennium on drives. Patients of both sexes go out daily
for drives by turn and are also allowed to shop at Ranchi on
their return journey from drives.
Libraries.—Several books and magazines for the patients
and staff libraries were purchased during the triennium under
report. The patients as well as the staff made good use of the
libraries. I wish to accord my thanks to the owners of the
following newspapers and magazines which were supplied free
of cost on my request for the benefit of the patients of this
Hospital:—
1. Statesman ... ... ...
2. Amrita Bazar Patrika ... ...
3. Vishwamitra ... ...
4. Searchlight ... ... ...
5. Patna Times ... ... ...
6. Basumati (Vernacular) ... ...
7. Illustrated Times of India ...
8. Bharatbarsha ... ...
9. Pribasi ... ... ...
Daily.
Tri-weekly.
Weekly.
Monthly.
30. New works and maintenance of, and repairs to, roads and
buildings, etc.—During the triennium under report the following
new works were completed:—
(1) Construction of 4 wells in the vegetable garden.
(2) Construction of two Sentry Boxes near the Refractory
Blocks.
(3) Construction of godowns, stores and bullock shed
in the vegetable garden.
(4) Providing fly-proof doors to the kitchens.
All the hospital buildings, staff quarters and roads have
been maintained in an efficient state of repairs.
21
31. Sospital garden.—The vegetable garden supplied the
full demand of the hospital (12 maunds a day). The garden is run
with patient labour and the average number of patients employ-
ed throughout the period was 200. The garden saves thousands of
rupees to Government, but again this is of secondary importance
to the beneficial effect that the garden work itself has upon the
mental condition of patients.
The table appended below shows the total return of garden
produce during the triennium under report:—
Details.
Supply of vegetables, fruits,
onion,
garlic,
ginger,
chillies, etc., to
the
hospital.
Supply of fodder to the
hospital.
Sale of surplus vegetables,
etc., to the staff and
Public.
Total
1932.
Rs.
23,547
214
1,993
25,754
a.
4
0
10
14
p.
8
0
3
11
1931.
Rs.
21,721
470
1,217
23,409
a.
13
4
3
4
p.
9
0
0
9
1930.
Rs.
20,605
318
2,120
23,044
a.
9
4
5
2
p.
5
0
3
8
32. Finance—(a) Receipts.—The receipt from all sources
amounted to Rs. 24,765-3-1 in 1932 as compared with Rs. 23,879
in 1931 and Rs. 21,668 in 1930.
The following table shows the total amount of realization
from paying patients and also the miscellaneous receipts which
includes the sale proceeds from vegetables and other articles
manufactured by the patients in the Occupational Therapy
Departments:—
Heads.
Receipts
from
paying
patients.
Miscellaneous receipts ...
1932.
Rs.
20,640
4,124
a.
15
4
p.
0
1
1931.
Rs.
21,704
2,174
a.
0
0
p.
0
0
1930.
Rs.
18,274
3,394
a.
0
0
p.
0
0
The decrease in receipts from paying patients during the
year 1932 was due to the fact that the number of patients
admitted was less than in 1931.
22
The increase in miscellaneous receipts in 1932 was due to
more surplus vegetables sold to the public than in the previous
year and also due to large sale of surplus manufactured articles
to the public.
(b) Expenditure.—The
total expenditure exclusive of
amounts received from paying patients and miscellaneous receipts
was Rs. 4,80,459-7-9 in 1932 as compared with Rs. 5,16,898-5-9
in 1931 and Rs. 5,70,175 in 1930
The progressive decrease in the total expenditure was due to
general depression which enabled us to purchase all articles
required for the use of hospital at unprecedented cheaper rates, less
Public Works Department expenses as compared with 1931 and
1930 and the enforcement of the strictest economy in all depart-
ments of the hospital.
(c) Annual average cost per patient.—The following table
shows the annual average cost per head during the year 1932 and
two previous years :—
Years.
1932 ... ... ...
1931 ... ... ...
1930 ... ... ...
Annual cost per
head including
Public Works
Department
charges.
Rs.
377
410
453
a.
7
6
3
p.
11
9
0
Annual cost per
head excluding
Public Works
Department
charges.
Rs.
345
372
390
a.
7
12
5
p.
5
0
9
The progressive decrease in the cost per head including and
excluding Public Works Department charges was due to the
same causes as mentioned above in paragraph (b).
33 Staff.—Statement IX shows the sanctioned establish-
ment of the hospital as it stood at the end of 1932.
(i) Attendant staff.—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 by the
senior sub-assistant surgeon throughout the triennium under
report.
(ii) Medical and nursing staff.—The medical and nursing
staff were allowed to attend by turn a full course of training
with clinical demonstrations in psychological medicine which is
given to the students of the Prince of Wales' Medical College,
Patna, at Ranchi.
23
(iii) Health of staff.—During the period under report the
incidence of sickness among the staff was on the increase.
Malaria was responsible for this increase and influenza during
the time it broke out in a mild epidemic form, Sporadic cases of
small-pox and chicken-pox were detected among the staff's
children and were adequately dealt with and the spread of
infection was checked by taking stringent sanitary measures.
Some of the staff on their own request were treated in the
hospital either as in or out-patients.
34. Commendation.—I am glad to be able to record that
the conduct and the work of the staff on the whole has been
satisfactory and I owe a deep debt of gratitude to all of them for
their loyalty and co-operation.
35. Committee of visitors.— Both ladies and gentlemen of
the Board of Visitors took a keen interest in the welfare of this
hospital and worked throughout the triennium with unremitting
zeal.
During the period under report, the number of lady
visitors were increased by the Government from 6 to 12 and 6
ladies including one Lady Doctor were accordingly appointed.
To every member of the Board of Visitors, I tender, on
behalf of the hospital, my best thanks for their help, sympathy
and advice.
36. Managing Committee.—Six meetings of the Managing
Committee were held during the period and the Committee
advised the Government on various important matters.
37. The hospital was visited by the following during the
period under review, the majority of whom have recorded their
appreciation of the work of the Institution in the visitors'
book :—
(1) The Hon'ble Sir J. D. Sifton, K.C.S.I., K.C.I.E., I.C.S., as
Member of the Executive Council, Bihar and Orissa.
(2) The Commissioner, Chota Nagpur, Ranchi.
(3) The Inspector-General of Civil Hospitals, Bihar and
Orissa.
(4) The Inspector-General of Prisons, Bengal.
(5) The Inspector-General of Prisons, Bihar and Orissa.
(6) The members of the Managing Committee.