NationalLibraryOfScotland/medical-history-of-british-india huggingface dataset:
38
STATE
Abstract of Cash Account of the Indian Mental Hospital, Kanke,
Years.
1
1938 ...
1937 ...
1936 ...
Establishment.
Total
cost.
2
Rs.
1,90,046
1,89,308
1,86,619
a.
1
7
2
p.
0
0
0
Cost per head of
average strength.
3
Rs.
141
143
142
a.
5
1
11
p.
0
7
1
Diet.
Total
cost.
4
Rs.
1,46,233
1,58,523
1,50,963
a.
5
0
12
p.
6
6
3
Cost per head of
average strength.
5
Rs.
108
119
115
a.
11
13
6
p.
9
3
10
Years.
1
1938 ...
1937 ...
1936 ...
Miscellaneous.
Total
cost.
12
...
...
...
Cost per
head of
average
strength.
13
...
...
...
Grand Total.
Total cost.
14
Rs.
4,18,174
4,36,024
4,26,569
a.
2
12
14
p.
11
4
0
Cost per
head of
average
strength.
15
Rs.
310
329
326
a.
15
9
2
p.
0
5
7
Charges on account of works done by
the Public Works Department.
Total cost.
16
Rs.
43,386
45,755
44,558
a.
10
8
12
p.
0
6
0
Cost per
head of
average
strength.
17
Rs.
32
34
34
a.
4
9
1
p.
2
6
2
39
MENT A
Ranchi for the year 1938 and the two previous years.
Bedding and clothing.
Total
cost.
6
Rs.
14,256
21,588
23,072
a.
8
15
9
p.
6
9
3
Cost per
head of
average
strength.
7
Rs.
10
16
17
a.
9
5
10
p.
7
1
3
Medicines.
Total
cost.
8
Rs.
5,756
4,859
5,946
a.
13
15
1
p.
3
3
6
Cost per
head of
average
strength.
9
Rs.
4
3
4
a.
4
10
8
p.
6
9
9
Contingencies.
Total
cost.
10
Rs.
61,881
61,744
59,968
a.
6
5
5
p.
8
10
0
Cost per
head of
average
strength.
11
Rs.
46
46
45
a.
0
10
13
p.
2
9
8
Rates and Taxes.
Total
cost.
18
Rs.
1,085
1,085
1,085
a.
0
0
0
p.
0
0
0
Cost per
head of
average
strength.
19
Rs.
0
0
0
a.
12
13
13
p.
11
1
3
Cost of printing and
stationery.
Total
cost.
20
RS.
863
813
450
a.
5
0
9
p.
2
6
0
Cost per
head of
average
strength.
21
Rs.
0
0
0
a.
10
9
5
p.
3
10
6
Total expenditure, including all
heads of expenditure.
Total cost.
22
Rs.
4,63,509
4,83,678
4,72,664
a.
2
5
3
p.
1
4
0
Cost per
head of
average
strength.
23
Rs.
344
365
361
a.
10
9
6
p.
4
9
6
40
STATEMENT B.
Statement showing the number of paying patients treated in the Indian Mental Hospital at Kanke (Ranchi) during he
year 1938, and the two previous years.
Year.
1938 ...
1937 ...
1936 ...
Remaining on 1st
January.
Male.
56
53
55
Female.
18
16
19
Total.
74
60
74
Admitted.
Male.
8
21
13
Female.
11
8
7
Total.
19
29
20
Re-admitted.
Male.
6
4
2
Female.
1
...
...
Total.
7
4
2
Total treated.
Male.
70
78
70
Female.
30
24
26
Total.
100
102
96
Discharged and
transferred.
Male.
25
21
17
Female.
10
6
10
Total.
35
27
27
Died.
Male.
2
1
...
Female.
1
...
...
Total.
3
1
...
Remaining on the
31st December.
Male.
43
56
53
Female.
19
18
16
Total.
62
74
69
Daily average
strength.
Male.
46.29
51.71
49.82
Female.
16.93
16.12
15.91
Total.
63.22
67.83
65.73
Remarks.
J. E. DHUNJIBHOY, LT.-COL., I.M.S.,
Superintendent,
Indian Mental Hospital,
Kanke (Ranchi)
BGP(IMH) 1—544—18-1-1940—HCDG and others.
THE ANNUAL REPORT
of the
Ranchi Indian Mental Hospital,
Kanke, in Bihar, for the year
1939
BY
LT.-COL. J. E. DHUNJIBHOY, M.B., B.S., F.C.P.S., I.M.S.,
Superintendent, Indian Mental Hospital, Kanke (Ranchi).
SUPERINTENDENT, GOVERNMENT PRINTING,
BIHAR, PATNA.
1940.
[Price—annas 11.]
THE ANNUAL REPORT
of the
Ranchi Indian Mental Hospital,
Kanke, in Bihar, for the year
1939
BY
LT.-COL. J. E. DHUNJIBHOY, M.B., B.S., F.C.P.S., I.M.S.,
Superintendent, Indian Mental Hospital, Kanke (Ranchi).
SUPERINTENDENT, GOVERNMENT PRINTING,
BIHAR, PATNA.
1940.
Priced Publications of the Government of Bihar
can be had from—
IN INDIA.
The Superintendent, Government Printing, Bihar,
Gulzarbagh, P. O.
(1) MESSRS. THACKER, SPINK & Co., Calcutta.
(2) MESSRS. W. NEWMAN & Co., Calcutta.
(3) MESSRS. S. K. LAHIRI & Co., College Street, Calcutta.
(4) MESSRS. R. CAMBRAY & Co., 6 and 8-2, Hastings Street, Calcutta.
(5) MESSRS. THOMPSON & Co., Madras.
(6) MESSRS. D., B. TARAPOREVALA SONS & Co., 103, Meadow Street, Fort, Post
Box
No. 18, Bombay.
(7) MESSRS. M. C. SIRKAR & SONS, 75, Harrison Road, Calcutta.
(8) PROPRIETOR OF THE NEWAL KISHORE PRESS, Lucknow.
(9) MESSRS. M. N. BURMAN & Co., Bankipore
(10) BABU RAM DAYAL AGARWALA, 184, Katra Road, Allahabad.
(11) THE STANDARD LITERATURE Co., LTD., 13-1, Old Court House Street, Calcutta.
(12) MANAGER OF THE INDIAN SCHOOL SUPPLY DEPOT, 309, Bow Bazar Street,
Calcutta.
(13) MESSRS. BUTTERWORTH & Co., LTD., 6, Hastings Street, Calcutta.
(14) MESSRS. RAM KRISHNA & SONS, Anarkali Street, Lahore.
(15) THE OXFORD BOOK AND STATIONERY COMPANY, Delhi.
(16) MESSRS. DAS BROTHERS, Nouzerkatra, Patna City.
(17) THE BOOK COMPANY, 4/4(a), College Square, Calcutta.
(18) MR. K. L. MATHUR, Guzri, Patna City.
(19) MESSRS. RAGHUNATH PRASAD & SONS, Patna City.
(20) THE GRANTHA MANDIR, Cuttack.
(21) BABU MADAN MOHAN SINGH, PROPRIETOR, MESSRS. R. P. SINHA & BROTHERS,
Guzri, Patna City.
22) MESSRS. SAMPSON WILLIAM & Co., 127-B, The Mall, Cawnpur.
(23) THE NEW BOOK COMPANY, Publishers and Booksellers, ' Kitab Mahal', 192,
Hornby Road, Bombay.
(24) PROPRIETOR SARESWATI PUSTAKALAYA, Booksellers and Stationers, Daltonganj,
(Palamau).
(25) MESSRS. R. S. TOMARA & SONS, Publishers and Booksellers, Opposite Fort
Gate, Delhi.
(26) MESSRS. HEM CHANDRA NEOGY & COMPANY, Bankipore, Patna.
(27) PROPRIETOR, KAMALA BOOK STORE, Bankipore, Patna.
IN EUROPE AND AMERICA.
THE OFFICE OF THE HIGH COMMISSIONER FOR INDIA, Public Department, India
House, Aldwych, London, W. C. 2.
No. 12991/ H-71-40.
FROM
THE INSPECTOR-GENERAL OF
CIVIL HOSPITALS, BIHAR,
To
THE SECRETARY TO THE GOVERNMENT OF
BIHAR, LOCAL SELF-GOVERNMENT DEPARTMENT.
Dated Patna, the 3rd September 1940.
SUBJECT.—Annual report on the working of the Ranchi Indian Mental
Hospital for the year 1939.
SIR,
I HAVE the honour to submit for the information of
Government, the Superintendent's report on the working of the
Ranchi Indian Mental Hospital for the year 1939, together with
the annual returns in prescribed forms. The institution worked
with high efficiency and the reputation of past was thoroughly
well maintained.
I have the honour to be,
SIR,
Your most obedient servant,
H. STOTT,
O.B.E., M.D., F.R.C.P., D.P.H., V.H.S., COL., I.M.S.,
Inspector-General of Civil Hospitals, Bihar.
THE FIFTEENTH ANNUAL
REPORT
OF THE
Ranchi Indian Mental Hospital,
Kanke, in Bihar, for the year
1939.
1. Administration.—I held charge of the hospital throughout
the year under review except for a short period on leave from
the 17th October 1939 to the 14th November 1939, when the first
Assistant Superintendent, Dr. S. A. Mozaffar, M.B., officiated in
my place.
2. Provinces served.—The hospital continues to receive
patients from the Provinces of Bengal, Bihar and Orissa. The
allocation of beds to the Provinces being the same as in the
previous years, viz., Bengal 75 per cent, Bihar 20 per cent and
Orissa 5 per cent.
3. Accommodation.—The sanctioned accommodation of the
hospital, including the emergency beds was the same as in the
previous years, viz , males 1,108, females 272, total 1,380.
4. Patients—Statement no. I.—The number of patients resi-
dent in the hospital on the 1st January 1939 and the two
previous years is shown in the table appended below:—
Year.
1939
..
..
1938 .. ..
1937
..
..
Male.
1,096
1,068
1,062
Female.
262
256
256
Total.
1,358
1,324
1,318
5. The total population of the hospital as per statement no. I
during 1939 and the two previous years was as follows :—
Year.
1939
..
..
1938 .. ..
1937 .. ..
Male.
1,180
1,203
1,184
Female.
298
296
288
Total.
1,478
1,499
1,472
2
6. The maximum number of patients resident in the hospital
on any one night during the year 1939 and the two previous
years was as follows :—
Year,
1939 .. ..
1938 .. ..
1937
..
..
Male.
1,103
1,102
1,086
Female.
266
264
258
Total.
1,369
1,366
1,344
7. The daily average strength of the patients during 1939
compared with the two previous years was as follows :—
Year.
1939 ..
1938 ..
1937 ..
Male.
1096.94
1086.23
1067.40
Female.
263.33
258.65
255.53
Total.
1360.27
1344.88
1322.93
8. Total admission.—The following table shows the admis-
sions during the year 1939 and the two previous years :—
Year.
1939 ..
1938 ..
1937 ..
Male
84
135
122
Female.
36
40
32
Total.
120
175
154
9. The ratio per cent of cases recovered to the daily average
strength during the year 1939 and the two previous years is
shown below:—
Year.
1939 ..
1938 ..
1937 ..
Male.
4.56
5.98
6.37
Female,
9.87
6.57
6.16
Total.
5.58
6.10
6.35
10. The following is the ratio per cent of cases recovered to
total admission for the year 1939 and the two previous years : —
Year.
1939 ..
1938 ..
1937 ..
Male.
26.19
28.15
27.87
Female.
30.56
27.50
31.26
Total.
27.50
28.00
28.57
As stated in my previous reports, majority of the so-called
" new admissions" during 1939 were also chronic cases beyond
any hopes of recovery and so long as this state of affairs exist
there is not much hope of improving the recovery rate of these
so-called " new admissions " in spite of our giving them all the
known modern scientific treatment of mental disorders.
3
11. Death-rate.—The percentage of deaths to daily average
strength during the year 1939 and the two previous years was as
follows:—
Year.
1939 ..
1938 ..
1937 ..
Male.
2.19
2.95
2.90
Female.
3.42
348
3.13
Total.
2.43
3.05
2.95
I am happy to be able to state that the hospital has continued
the reputation of maintaining the lowest death-rate since its
inception amongst the Indian Mental Hospitals in India.
12. Causes of death during the year under report were as
follows :—
1. Dysentery, 2. Diarrhœa, 3. Enteric, 4. Cerebral Mala-
ria, 5. T. B. Lungs, 6. Heart failures, 7. Cirrhosis of Liver,
8. Leprosy, 9. Exhaustion and 10. Senile Debility.
13. Duration of hospital life of those who died during the
year is shown in the following table :—
Period.
Under 6 months .. .. ..
Over 6 months and under 1 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 .. ..
Over 45 years .. .. ..
M.
..
...
1
..
1
2
1
2
6
1
3
2
4
1
24
F.
..
..
..
2
1
1
1
1
1
..
..
1
1
..
9
T.
..
..
1
2
2
3
2
3
7
1
3
3
5
1
33
14. The ages of patients died are shown below:—
Age.
Under 20 years of age .. .. ..
Between 20 and 40 years .. ..
Between 40 years and 60 years .. ..
Upwards 60 years
..
..
..
M.
..
2
16
6
24
F.
2
1
4
2
9
T.
2
3
20
8
33
4
15. Health of patients.—The general health of patients was
good throughout the year under report. There was no serious out-
break of any kind of epidemic diseases during the year except
that a mild form of Influenza Epidemic broke out in the month
of September 1939 and many cases of Malaria were also admitted
into the Infirmaries during that month. In the month of May
1939 there were sporadic cases of Chicken Pox.
During the period of the Influenzal epidemic a very inter-
esting clinical observation was brought to our notice that those
patients with latent malaria in them also suffered from Malaria
during the Influenzal attack showing that the latent malaria
was actually lighted up in those cases by Influenza. However,
I am happy to be able to record that no death took place during
the epidemic although more than 300 patients were down with
Influenza and Malaria.
16. Sickness.—The daily average number of sick treated
for physical ailments during the year 1939 and the two previous
years is shown below : —
Year.
1939
..
..
1938 .. ..
1937 .. ..
Male.
70.83
59.48
60.63
Female.
26.50
13.80
13.50
Total.
97.33
73.28
74.13
The slight rise in sickness during 1939 was due to the out-
break of Malaria and Influenza in a mild epidemic form amongst
the patients as fully stated under paragraph 15.
The following were the main types of physical disorders
treated in the Infirmaries during 1939 :—
Amoebic Dysentery, Malaria, General Diseases including
Debility, Areolar Tissue, Ankylostomiasis, Skin Diseases, Influ-
enza, Diseases of other Digestive System, T. B. of Lung,
Ulcerative Inflammation, Pyrexia of Uncertain origin, Scabies,
Injuries.
Besides, 2,829 patients of both sexes were treated at the
outdoor departments of the hospital for minor injuries, ailments,
etc., during the year under report.
17. Statement no. II.—Cases under Observation.—The total
number of patients held under remand for brief periods of
observation was 2 males; of which one was certified and admit-
ted and one was discharged as uncertifiable.
5
18. Statement no. III— Criminal patients.—The daily
average strength of criminal patients for the year 1939 and the
two previous years is shown below :—
Year.
1939
..
..
1938 .. ..
1937 .. ..
Male.
438.95
439.86
433.69
Female.
44.72
44.13
41.24
Total.
463.67
463.99
474.93
The following table shows the number of criminal patients
admitted during the year 1939 and a classification of the crime
committed by them :—
Crimes.
Murder .. ..
Culpable Homicide .. .. ..
Hurt and Grievous Hurt.. ..
House-breaking and theft ..
126 Railway Act .. ..
Kidnapping .. ..
Selling minor girl for prostitution ..
Total ..
Male.
5
3
3
5
1
..
..
17
Female.
3
1
..
..
..
1
1
6
Total.
8
4
3
5
1
1
1
23
The following is a list of criminal patients resident on the
31st December 1939 and the crimes committed by them :—
Crime.
Murder .. ..
Culpable Homicide ..
Hurt and Grievous Hurt ..
Attempt at Murder and Suicide
House-breaking and theft ..
Other petty offences ..
Rape
..
..
Mischief by fire .. ..
Exposure and abandonment of a
child.
Total ..
Male.
248
62
83
12
17
20
3
13
..
458
Female.
26
3
2
4
2
2
..
1
2
42
Total.
274
65
85
16
19
22
3
14
2
500
6
19. Statement no. IV.—Shows the religion, sex and resi-
dence of the patients admitted during the year under report
and is self-explanatory.
20. Statement no. V.—Shows the ages of patients admitted
during the year.
As in the previous years, a glance at Statement no. V will
convince any one that the toll of mental diseases is greatest
between the ages of 20 to 40.
21. Statement no. VI.—Shows the forms of mental disorders of
those admitted during the year and needs no comment.
22. Statement no. VII.—Shows the probable causes of
insanity in those admitted during the year and is self-explana-
tory.
23. Paying patients.—The following number of paying
patients were treated during the year under report and compared
with those of the two previous years :—
Year.
1939
..
..
1938 .. ..
1937 .. ..
Male.
55
70
78
Female.
13
30
24
Total.
78
100
102
For want of accommodation we had again to refuse many
applications for admission of paying patients during the year
under report.
24. Injuries and Suicide.—During the year under report
no cases of serious accidental injuries took place except a few
cases of minor injuries and accidents.
It is very gratifying to record here that there was no case
of suicide during the year under review although several serious
attempts were made by some of the potential suicides of this
hospital numbering about 160. I owe a deep debt of gratitude
to all the staff of the Suicidal Wards of the hospital whose day
and night hawk-like watch on suicidal cases have enabled me
to write this happy result.
25. Absconding.—There was no case of escape during the
year under report, although a considerable amount of freedom
was afforded to the patients.
26. Autopsy.—Post-mortem examinations were held on 19
cases during the year under report, and interesting specimens
were preserved in the hospital Laboratory.
7
27. Conservancy and Sanitation.—The general sanitation of
the whole area of the hospital as well as that of the staff lines
was satisfactory throughout the year under review.
28. Methods and treatment of patients—Ever since the
inception of this, the largest and one of the most, modern
Mental Hospitals in India neither expense nor trouble is ever
allowed to stand in the way of the employment of the latest
treatment in the field of Psychological medicine if thereby the
patients can in any way be benefited. In the Reception Wards
of the hospital all newly admitted patients on admission are
subjected to a thorough systematic examination both physical
and psychological, and later they are given the benefit of
whatever special treatment is needed in individual cases.
(i) Occupational Therapy.—The Occupational Therapy
continues to be the sheet anchor of our treatment. The average
number of patients employed in useful tasks was 80 per cent of
the population throughout the year under review. Every effort
is made to provide various occupations for the patients and the
patients are allowed to choose their own occupations and those
who want to learn new crafts are also encouraged. The detailed
list of works carried out in the Occupational Therapy Depart-
ments was fully dealt with in my previous reports and
a repetition is therefore unnecessary.
(ii) Hydrotherapy.—This department was kept busy
throughout the year under review. Eighty-two male and 26
female (total 108) patients were given this treatment during
1939 with gratifying results. The average hours of immersion
per patient were 97.5 hours.
As my pattern of bath tubs is cheap and easy to manipulate
we had many requests from institutions as well as private
individuals to supply them with the plan of this tub and one
of the Institutions even placed an order with us for the tubs.
I therefore make it clear that we do not sell these tubs, but
I have no objection to supply the plan of the tub free of charge
to any one who applies for it as the tub can be easily made
anywhere.
(iii) Drugs.—From the dim past mental patients have
been subjected to various forms of treatment with the object of
creating a shock to their central nervous system ; some of these
methods were no doubt barbarous in the extreme. In more
recent times Shock Treatment has been greatly elaborated.
Insulin, Cardiazol, Triazol, etc., have all had their turn and even
these have had their risks and terrors. However, in the present
8
state of our knowledge of mental diseases any treatment that
gives encouraging results must be tried with a hope of cure or
amelioration of the patients' mental conditions, and the shock
therapy in spite of its being expensive and highly specialised no
doubt gives encouraging results and is worth trying.
(a) Cardiazol treatment.—During the year under review 61
patients were tried with Cardiazol Shock treatment with the
following results :—
Diseases.
1
Manic Depressive Psychosis
Chronic Schizopherenia ...
Recent cases of Schizo
pherenia.
For diagnosis of Epilepsy
Psychoneurosis (Anxiety
Neurosis).
Total ...
Recovered.
2
7
...
10
...
...
17
Temporary
remission.
3
5
1
4
...
1
11
Improved.
4
2
3
3
...
...
8
Stationary.
5
7
10
5
...
...
22
Otherwise.
6
...
...
...
3
...
3
Total.
7
21
14
22
3
1
61
(b) Treatment of highly excited patients with sub-shock
Nitrogen Gas Inhalation.—Newer treatments for Schizophrenics
have attracted much interest and attention during the past
few years. Two methods of shock treatment, Insulin and
Cardiazol have proved to be of therapeutic value. Studies of the
physiological changes occurring during this treatment by
Dr. G. Edward Hall, M.D , and his co-workers of the Department
of the Medical Research, Benting Institute of the University of
Toronto, Canada, have revealed that in both cases there exists
a marked decrease in cerebral metabolism. The diminished
cerebral oxygen consumption (anoxia) decrease in frequency of
cortical rhythm and the appearances of neurological disturbances
are all indicators of depressed cerebral metabolism. Dr. G. Edward
Hall, M.D., Professor of Medical Research, Toronto University,
on analysing his results suggested that similar physiological and
biochemical changes can be induced more readily and with less
hardships to patients, by producing anoxia as a result of breath-
ing high nitrogen—low oxygen inhalations. Dr. Hall studied
9
this problem in normal individuals. He found that, by having
the individual breathed N-O 2 mixtures with the O 2 gradually
decreased from 20 per cent to 17, 13, 10, 9 he can produce a
gradual anoxia with sleepiness being a predominant feature.
After studying the literature on the subject I decided to experi-
ment with this treatment and 40 patients were subjected to this
treatment during the year under review. I must admit that we
failed to produce convulsive shocks by this method, but what
emerged out of the experiment was a ray of hope that by given
nitrogen inhalation to highly excited patients for five minutes
the patients not only quietened down in their excitement but
were also able to sleep for hours. Highly excited patients after
five minutes inhalation of nitrogen slept for ten minutes to two
hours after inhalation and they remained quiet throughout the
day and slept for five to seven hours in the night, and some
remain quiet after this treatment for some days. Each patient
was given this treatment every alternate day until the excitement
was abated and natural sleep produced. The maximum period
per patient for this treatment was three months and the minimum
one week. Our success with Nitrogen Gas Inhalation in excited
cases was so great that for some time we temporarily closed down
our Hydrotherapy Wards and all old and new highly excited
patients with marked insomnia were submitted to this treatment
with encouraging results. The results of my experiment were
communicated to Dr. Hall and he wrote us a very encouraging
letter as follows:—
'' I think the work which you have done on the use of
nitrogen is extremely interesting and the responses which you
obtained in the highly excited cases are of considerable value.
This work of yours should be continued."
The treatment is still in the experimental stage and the full
results of our experiment will be published in our next Annual
Report.
(c) The prolonged continuous sleep treatment by Medinal and
Luminal.—This treatment is now largely in vogue in most of the
Mental Hospitals and Nursing Homes of America, and is cheaper,
better and less deleterious in its effects as compared with con-
tinuous sleep treatment by Somnifene which is largely used in
Europe.
Technique of treatment.—Before starting the treatment each
patient is given a cleansing enema. He is then given the
standard sleep mixture, each dram of which contains one grain
of Luminal and five grains of Medinal, dissolved in peppermint