NationalLibraryOfScotland/medical-history-of-british-india huggingface dataset:
xxi
PROVINCIAL STATEMENT A.
Abstract cash account for the year 1924 and the provincial totals for the two previous years.
Name of mental hospital.
1
Bhowanipore Mental Obser-
vation Ward.
Dacca Mental Hospital
..
Berhampur Central Mental
Hospital.
Total, 1924 ..
„ 1923 ..
„ 1922 ..
Establishment.
Total Cost.
2
Rs.
10,430
17,458
54,541
82,430
79,968
73,195
A.
0
6
14
5
6
3
P.
6
6
0
0
8
1
Cost per
head of
average
strength.
3
Rs.
3,476
54
83
84
84
76
A.
10
3
3
1
0
13
P.
10
7
9
0
7
7
Diet.
Total cost.
4
Rs.
797
31,092
62,073
93,963
1,01,948
1,12,531
A.
2
13
2
1
8
13
P.
0
9
0
9
3
10
Cost per
head of
average
strength.
5
Rs.
265
96
94
95
107
118
A.
11
9
11
14
2
2
P.
4
2
8
0
2
5
Clothing and bedding.
Total cost.
6
Rs.
1,006
2,071
8,882
11,960
20,364
16,685
A.
10
9
10
13
4
11
P.
0
0
6
6
9
9
Cost per
head of
average
strength.
7
Rs.
335
6
13
12
21
17
A.
8
6
8
3
6
8
P.
8
7
11
2
5
4
Medicine.
Total cost.
8
Rs.
271
476
2,179
2,927
2,675
3,359
A.
8
8
9
9
14
8
P.
0
0
6
6
9
9
Cost per
head of
average
strength.
9
Rs.
90
1
3
3
2
3
A.
8
7
5
0
13
8
P.
0
8
3
0
0
5
Name of mental hospital.
Bhowanipore Mental Obser-
vation Ward.
Dacca Mental Hospital
..
Berhampur Central Mental
Hospital.
Total, 1924 ..
„ 1923 ..
„ 1922 ..
Contingencies.
Total cost.
10
Rs.
3,190
2,362
10,284
15,837
15,458
19,498
A.
11
11
3
10
14
15
P.
6
3
9
6
9
6
Cost per
head of
average
strength.
11
Rs.
1,063
7
15
16
16
20
A.
9
5
11
2
4
7
P.
2
5
1
6
0
6
Miscellaneous.
Total cost.
12
Rs. A. P.
..
..
..
..
507
311
0
15
6
9
Cost per
head of
average
strength.
13
Rs. A. P.
..
..
..
..
0
0
8
5
6
3
Grand total.
Total cost.
14
Rs.
15,696
53,462
1,37,961
2,07,119
2,20,923
2,25,583
A.
0
0
7
8
1
4
P.
0
6
9
3
3
8
Cost per
head of
average
strength.
15
Rs.
5,232
166
210
211
232
236
A.
0
0
8
4
2
13
P.
0
5
8
8
8
6
Charge on account of
works done by Public
Works Department.
Total cost.
16
Rs.
11,665
7,942
5,942
25,549
83,755
70,192
A.
0
0
6
6
15
0
P.
0
0
3
3
0
0
Cost per
head of
average
strength.
17
Rs.
3,888
24
9
211
88
73
A.
5
11
1
4
0
11
P.
4
5
1
8
3
2
Name of mental hospital.
Bhowanipore Mental Obser-
vation Ward.
Dacca Mental Hospital
..
Berhampur Central Mental
Hospital.
Total, 1924 ..
„ 1923 ..
„ 1922 ..
Rents and taxes.
Total cost.
18
Rs.
2,285
1,680
2,588
6,554
6,132
5,657
A.
9
0
8
1
13
12
P.
0
0
9
9
6
3
Cost per head of
average strength.
19
Rs.
761
5
3
26
6
5
A.
13
3
15
1
7
15
P.
8
5
2
1
2
1
Cost of printing and stationery.
Total cost.
20
Rs.
51
70
302
423
577
711
A.
4
4
0
8
4
12
P.
0
3
0
3
2
8
Cost per head
of average
strength.
21
Rs.
17
0
0
0
0
0
A.
1
3
7
6
9
11
P.
4
4
4
11
8
10
Total expenditure
including all heads
of expenditure.
22
Rs.
29,697
63,154
1,46,794
2,39,646
3,11,389
3,02,144
A.
13
4
6
8
1
13
P.
0
9
9
6
11
7
Cost per head
of average
strength.
23
Rs.
9,899
196
224
244
327
317
A.
4
2
0
7
3
3
P.
4
7
3
7
9
7
4
xxii
PROVINCIAL STATEMENT B.
Statement showing the number of paying patients treated in the Mental Hospitals in Bengal during the year 1924 and the
provincial totals for the two previous years.
Name of mental
hospital.
1
Bhowanipore
Mental
Observation Ward.
Dacca
Mental Hos-
pital
Berhampur
Central
Mental Hospital.
Total for—
1924 .. ..
1923 .. ..
1922 .. ..
Remaining
on 1st
January.
Male.
2
..
..
18
18
19
23
Female.
3
1
..
2
3
3
3
Total.
4
1
..
20
21
22
26
Admitted.
Male.
5
3
2
11
16
7
8
Female.
6
..
..
2
2
4
2
Total.
7
3
2
13
18
11
10
Re-admitted.
Male.
8
..
..
2
2
1
2
Female.
9
..
..
..
..
..
..
Total.
10
..
..
2
2
1
2
Total treated.
Male.
11
3
2
31
36
27
23
Female.
12
1
..
4
5
7
5
Total.
13
4
2
35
41
34
38
Discharged
and trans-
ferred.
Male.
14
3
1
5
9
7
14
Female.
15
1
..
1
2
4
1
Total.
16
4
1
6
11
11
15
Died.
Male.
17
..
..
2
2
2
..
Female.
18
..
..
..
..
..
1
Total.
19
..
..
2
2
2
1
Remaining
on the 31st
December.
Male.
20
..
1
24
25
18
19
Female.
21
..
..
3
3
3
3
Total.
22
..
1
27
28
21
22
Daily average
strength.
Male.
23
.08
.50
18.99
19.57
18.77
20.21
Female.
24
.04
..
2.83
2.87
2.48
2.88
Total.
25
.12
.50
21.82
22.44
21.25
23.09
B. G. Press—17-7-1925—285M—213—J. N. B. & others.
HOOKWORM DISEASE
And how to prevent it
By MAJOR CLAYTON LANE, M.D., I.M.S.
Published under the authority of the Director-General,
Indian Medical Service.
On behalf of the
Indian Research Fund Association.
CALCUTTA
SUPER ENTENDENT GOVERNMENT PRINTING, INDIA
19X4
HOOKWORM DISEASE AND HOW TO
PREVENT IT.
A pamphlet written for those living in Indian Villages.
In India, and also in many other parts of the world; there exists a
disease caused by certain small worms, half an inch or less long, which
live in the bowel and feed on its delicate lining. These worms are call-
ed hookworms or ankylostomes, and the disease they cause is called
hookworm disease or ankylostomiasis. The chief symptoms of the
disease are paleness, indigestion, a feeling of being easily tired ; the
feet often swell, and sometimes the first symptom of all to be noticed is
that itching sores appear on the legs and feet. With all these troubles
the spleen is not enlarged unless some other disease, such as malaria, is
present as well.
Any one with symptoms such as these should go to a doctor and ask
him whether he does not think that they are due to hookworms ; and if
they are, he should immediately take medicine and get rid of the worms.
At the same time he must remember that these worms hold on tightly
with their teeth to the inside of the bowel, so that it may not be easy
to get them away. In fact if there are many of them, the medicine may
have to be given several times before they all come away. While the
Worms are coming away there may be a feeling of some weakness and
giddiness, and some burning in the stomach. This is uncomfortable,
but it is certainly worth while to have a little trouble of this kind and
then to get well and strong again, rather than to get worse and worse
and possibly die.
But after all it is far better to prevent these worms from getting
into the bowels at all, rather than to let them get in and make the per-
son ill, and then to drive them out.
How are the worms to be prevented from getting into the bowels
of yourself or of any one else ?
Before you can answer this question you must know the answer to
several other questions which I will ask and answer for you. The first
question is this :—
2
In what way do thewornis actually get into the bowels
I have told you that the hookworms live in the bowels of men,
women and children. They are what are called parasites, that is to say,
they cannot live except inside the body of some other creature, who is
called their host. If they leave the body of their host, they die. It is
quite clear from this fact that these worms cannot pass directly from one
person to another. The manner in which they enter the body of a host
is indeed quite different. It happens in this way. The hookworms
living in the bowels of some person lay eggs there, and the eggs pass
out of their host's body with his excrement. These eggs are so small that
they cannot be seen except with the help of an instrument called a
microscope ; but a doctor who has a microscope can tell you whether
your excrement has got these eggs in it, or not. As the excrement lies on
the ground a tiny Worm grows inside each egg, and after a few hours it
hatches oat. After it leaves the egg-shell it stays in the excrement and
there it lives and grows for one or two weeks. During this time it is
fairly easily killed, for instance it will die if it dries up, and it will die
if it gets into water. After it has grown in the excrement to a certain
size, it cannot grow any more without again entering a human being and
becoming a parasite. It is still so very small it cannot be seen except
with a microscope. It now leaves the excrement and can live in water,
or in moist earth. It can climb up the stalks of grass, if these are wet
with dew ; and it is very hard to kill. It is ready to enter the body of a
human being if it gets the opportunity. If you are walking with bare
feet and your skin touches the wet grass or earth in which these tiny
worms are living, they will immediately bore through your skin and get
into your bowels, and will grow there. The worms are so small that
they do not usually cause pain when they pierce the skin, though
perhaps they may produce a little itching, and afterwards some sores
may appear.
The usual way then in which the hookworms get into the bowels is
by piercing the skin when they are very young and very small. No
doubt if they are swallowed in water they will get into the bowels, but
this is not very likely, for these tiny worms cannot swim. They sink to
the bottom of water and live in the mud there, so that if you drink the
clear water without stirring up the mud you cannot get infected by the
tiny hookworms, even if many of them are lying in the mud below.
8
We have seen how the hookworms eater the body and probably you
will think that all that is required to prevent yourself from being
infected is that the excrement of every person in your village, who is
sick from hookworm disease, should be so treated that the eggs or the tiny
worms are killed. Unfortunately this is not so, and before we can
answer our first question we must answer yet two more.
The first of these is :—
Can people have hookworms in their bowels without
being ill ?
The answer is that they most certainly can. In some parts of India,
8 out of 10 healthy people have hookworms in their bowels. This may
seem surprising, but it is quite true, and the explanation is that whether
hookworms in the bowels cause illness or not, depends a great deal on
how many are living there. If there be only a few, no illness at all is
caused. If there be a great number, then the host is ill and has the
symptoms mentioned at the beginning of this paper. If there be a
moderate number the host will not be actually ill, but he will probably be
weakened and be made more likely to fall ill with some other sickness,
and, if he fall ill, to die from it, than he would be if he had no hook-
worms in his bowels. It is very important to remember that a person
with only a few hookworms in his bowels is not made ill by them, but
that nevertheless his excrement does contain some eggs ; and that most
people living in the country in India have got a few hookworms in
their bowels.
If you think about this you will see that it is really a most important
thing. Suppose, as is probably true, that 8 out of 10 healthy p30ple in
your village have a few hookworms eggs in their excrement and that they
are passing their excrement in damp places where the tiny worms can
form in the eggs and hatch, and suppose this goes on for six months.
At the end of that time there -will be enormous numbers of the tiny
worms in the earth and in the water ; so many that if they can enter
two or three people they can make them so ill that they will probably
die. Remember that a healthy person who happens to have only a few
hookworms in his bowels is a dangerous person, because he may cause
illness in someone else.
The second question that we must answer is this :—•
4
is it possible that a human being couid get Hookworms
from the excrement of an animal ?
We know of three different kinds of hookworms which live in human
beings, two of them are common and the third very rare. So far as we
know the two common ones do not live in any other creature to be
found in India except human beings. The third one lives in many cats
and dogs ; and though we do not yet really know very much about it, it
is probably correct to say that it is very rarely found in human beings,
and even then in such small numbers that it cannot cause illness. We
need not then trouble about the dog and cat hookworms, but only
about those which one human being gets from the excrement of another.
You have learnt then so far that you get hookworms from the excre-
ment of other people, that the worms nearly always get into your body by
piercing your skin while they are very young and very small, so small
indeed that you cannot see them ; that they grow up in your bowels
and, if there be enough of them, make you ill ; and lastly that you can
be made ill by worms hatching from the excrement of persons who seem
quite well. So we can come back to the first question which we
asked, namely :—
How are the worms to be prevented from getting
into the bowels ?
As you have learnt a good deal since that question was put at the
beginning of this pamphlet, we are able to put the question much more
definitely and to ask :—
How is it possible to prevent the very young and very small
worms from entering the skin ?
You will remember that first the eggs and small worms live in excre-
ment. Next that the small worms leave the excrement and live in earth or
mud, and lastly that when they get the opportunity they leave the earth
or mud and pierce the skin. In the same way there are three methods
by which we can prevent the small worms from entering the skin.
First we can attack them while they are still in the excrement; and
in order to do this it is first necessary that all the excrement should be
passed in one place and not scattered about in the fields and jungle. Unless
5
people will be clean and do this, it is quite impossible to kill all the eggs
and all the young worms, and to prevent them from getting into the
soil. When the excrement has been collected it is not very difficult to kill
the eggs and young worms and there are several ways in which it can
be done. One is by burning the excrement and another is by taking it
away to some distance from your village and burying it two feet deep
in dry earth. Yet a third way is to keep it in a concrete pit for six
months ; but if this be done there must be water in the pit, and it must
be screened so that flies cannot get to it. In some such way as one of
these all the eggs in the excrement of every one in the village can be
destroyed, and there will be no chance of any hookworms getting into
the soil.
Secondly, as regards attacking the young hookworms in the soil.
This cannot be done, but at the same time the soil can in time be made
clean by collecting all the excrement and destroying it in one of the ways
mentioned. If this be done and no more hookworms be allowed to get
into the soil, those already in the soil will die in time. We know that
they can live for over a year ; so that it takes probably two years
of clean habits in the village before the soil round the village becomes
quite clean.
The third way in which the young and small worms can be
prevented from getting into the skin is by preventing water from the
soil from touching the skin.
This is a difficult thing to do, for you must remember that these tiny
worms are great climbers; even if you wear boots they must be quite
water-tight, for if any water is able to get through your boots the
worms can come through with it. This is not then a very satisfactory
way of keeping out the worms, although, as a help, it is better than
walking about in bare feet.
You will understand from what I have written that hookworm
disease is a serious thing; that most people living in the country in
India have got at least a few hookworms in their bowels without being
ill, but that probably these few hookworms weaken them and make
them more likely to die if some other illness attack them ; and that, if
all excrement be properly dealt with, no more hookworms can enter into
any one in the village. You have the destruction of hookworms in your
6
own hands ; and if you can persuade or compel every one in the village
to be clean in his habits, you can within 1½ or 2 years have a village
which is quite free from hookworm disease, and in which the people will
be far healthier and live considerably longer than they do at present.
Surely this is worth your while.
CALCUTTA : PRINTED BY STPDT. GOVT. PRINTING, INDIA, 8, HASTINGS STREET,
REPORT
OF AN
INVESTIGATION INTO THE CAUSES OF
MALARIA IN BOMBAY
AND THE MEASURES NECESSARY
FOR ITS CONTROL
BY
CHARLES A. BENTLEY, M.B., D.P.H., D.T.M. & H.,
Officer on Special Duty.
BOMBAY
PRINTED AT THE GOVERNMENT CENTRAL PRESS
1911
[Price—Rs. 4-4-0 or 6s. 6d.]
OFFICIAI AGENTS FOR THE SALE OF INDIAN
OFFICIAL PUBLICATIONS.
In England.
E. A. Arnold, 41 & 43, Maddox Street, Bond Street, W., London.
Constable & Co., 10, Orange Street, Leicester Square, W. C, London.
Grindlay & Co., 54, Parliament Street, S. W., London.
Henry S. King & Co., 65, Cornhill, E. C, London.
P. S. King & Son, 2 & 4, Great Smith Street, Westminster, S. W.,
London.
Kegan Paul, Trench, Trubner & Co., 43, Gerrard Street, Soho, W..
London.
B. Quaritch, 11, Grafton Street, New Bond Street, W., London.
T. Fisher Unwin, 1, Adelphi Terrace, London, W. C.
W. Thacker 8c Co., 2, Creed Lane, London, E. C.
Luzac & Co., 46, Great Russel Street, London, W. C.
B. H. Blackwell, 50& 51, Broad Street, Oxford.
Deighton Bell & Co., Cambridge.
On the Continent.
Friedlander 8c Sohn, 11, Carlstrasse, Berlin.
Otto Harrassowitz, Leipzig.
Karl W. Hiersemann, Leipzig.
Ernest Leroux, 28, Rué Bonaparte, Paris.
Martinus Nijhoff, The Hague.
In India.
Higginbotham 8c Co., Madras.
V. Kalyanarama Iyer 8c Co., Madras.
P. R. Rama lyar & Co., Madras.
Thacker, Spink & CO., Calcutta.
W. Newman & CO., Calcutta.
S. K. Lahiri & CO., Calcutta.
R. Cambray & Co., Calcutta.
Thacker & Co. (Ld.), Bombay.
A. J. Combridge & Co., Bombay.
Superintendent, Government Central Press, Bombay.
D. B. Taraporevala, Sons & Co., Bombay.
Sunder Pandurang, Bookseller, etc., Bombay.
Gopal Narayen & Co., Booksellers, etc., Bombay.
N. M. Tripathi & Co., Booksellers, etc., Bombay.
Mrs Radhabai Atmaram Sagoon, Bookseller, etc., Bombay.
Ramchandra Govind & Son, Booksellers, etc., Bombay.
N. B. Mathur, N. K. H. Press, Allahabad.
7
To
The Chairman, Malaria Investigation Committee,
The Surgeon General with the Government of Bombay,
The Sanitary Commissioner for the Government of Bombay,
The Municipal Commissioner for the City of Bombay,
The Director, Bombay Bacteriological Laboratory,
The Commissioner in Sind,
The Commissioner, N. D.,
The Commissioner, C. D.,
The Commissioner, S. D.,
All Collectors, including the Collectors and Deputy Commis-
sioners in Sind,
The Political Resident, Aden,
The Remembrancer of Legal Affairs,
The Health Officer of the Port of Bombay,
The Secretary, Sanitary Board,
The Oriental Translator to Government,
The Accountant General,
The Chairman, City of Bombay Improvement Trust,
The Chairman, Bombay Port Trust,
The Political Department,
The Public Works Department,
The Legal Department,
The Separate Department (for the reading room for the
Members of the Legislative Council),
The Editors' Tables and Editors of Newspapers,
The Non-official Members of the Legislative Council,
With
cop
of the report.
The Agent, G. I. P. Railway Company,
The Agent, B. B. & C. I. Railway Company,
The President, Municipal Corporation, Bombay,
The Chamber of Commerce, Bombay,
Dr. Charles A. Bentley, M.B., D.P.H., D.T.M. & H.,
W. C. Symes, Esq.,
By
letter.
A. C. Rumboll, Esq.,
Dr. T. S. Jackson,
The Under Secretary of State for India,
The Government of India.
No.
of 1911.
Copy forwarded for information and guidance to
APPENDIX.
436. Hongkong.—The anti-malarial measures adopted in Hongkong appear to have-
been only partial ones. Dr. Clark, the Medical Officer of Health for Hongkong, gives the
following figures regarding the admissions to hospitals from malaria and the mortality from
this cause. The improvement recorded is ascribed to the anti-malaria measures that have
been adopted in the city:—
Admissions to Hospitals.
Year.
1896
1897
...
1898
1899
...
1900
1901
1902
1903
1904
1905
Government Civil
Hospital.
516
450
344
475
679
787
349
347
221
266
Tung Wah Hospital.
No record.
1,021
865
780
1,220
1,294
568
433
419
The admission of malaria among the Police.
Year.
1896
1897
1898
1899
1900
1901
I902
...
1903
I904
1905
Total average
number of
Police.
63I
630
630
770
929
920
919
921
993
1,018
Total admission
of malaria.
203
160
121
639
390
407
176
167
107
127
Ratio per 1,000.
301
254
192
310
419
442
191
l8l
107
124
Deaths from malaria in Hongkong.
Year.
1896
1897
1898
1899
1900
1901
1902
1903
1904
I905
Deaths in the city.
290
302
280
218
242
281
189
152
90
87
Total in Colony.
533
554
530
546
555
574
425
300
301
287
Dr. Clark states regarding these figures—
" The rapid fall in the number of deaths from malaria within the city during-
the second quinquennium is most gratifying, for it is naturally here that most of the
anti-mosquito work has been carried out. . . . "
437. Rio de Janeiro.—Mr. M. R. Pestana, the author of " Comment on assainit
un pays," gives the following figures as the recorded mortality from malaria at Rio de
Janeiro, before the commencement of the anti-mosquito work there:—
1900
... 1,019 deaths from malaria.
1901
...
932
„
„
„
1902
... 1,217
„
„
„
Genl 483-A
2
Anti-mosquito measures were commenced in 1903 and the recorded mortality has steadily
•diminished since that year.
1903
1904
1905
1906
1907
••»
...
...
...
...
772
433
295
266
239
deaths
,,
,,
,,
,,
from
,,
,,
,,
,,
malaria.
,,
»»
The author adds that owing to the fact that the city possesses many large and modern
hospitals, which are greatly resorted to by patients' from the interior, many of the deaths
from malaria shown as occurring in Rio de Janeiro are of cases that did not contract their
infection in the city.
438. Havana.—In the " Sanidad y Beneficencia " Dr. J. Le Roy y Cassa gives the
following figures which show the mortality from malaria before and after the anti-mosquito
measures commenced by Gorgas early in 1901, and continued since then :—
Years.
1896
1897
1898
1899
1900
1901
1902
I903
1904
1905
1906
I907
1908
1909
Total
mortality.
11,762
18,135
21,252
8,153
6,102
5,720
5,832
5,465
5,583
5,832
6,144
6,708
5,994
5,988
Malaria
mortality.
450
811
1,907
909
325
151
77
51
44
32
26
23
19
6
Co-efficient
of malaria
mortality.
1.95
3.46
8.00
3.76
1.30
0.55
0.29
0.19
0.16
0.11
0.08
0.08
0.06
0.01
439. Ismailia.—The following table gives the record of cases of malaria at Ismailia
since 1877 as given by Dr. Pressat. Malaria has disappeared since the introduction of
anti-malaria sanitation:—
Years.
1877
1878
1879
1880
1881
1882
1883
1884
1885
1886
1887
1888
1889
1890
...
1891
1892
Cases.
300
400
500
400
450
480
550
900
2,000
2,300
I,8oo
1,400
1,450
1,900
2,590
2,050
Years.
1893
...
1894
1895
...
1896
1897
...
1898
1899
1900
1901
...
1902* ...
1903
...
1904
...
1905
..
1906
1907 . ...
1908
Cases.
1,750
1,000
1,350
1,150
2,089
1,545
1,545
2,284
1,990
1,551
214
90
37
No fresh cases.
No fresh cases.
No malaria contract-
ed in Ismailia.
* Anti-malaria work was begun in 1902.
440. Panama.—Since
the commencement of work at Panama there has been an
extraordinary reduction both in the total amount of sickness and mortality, and that recorded
from malaria. Gorgas describing the present conditions, says :
"Our death-rate for the total population on the Zone has fallen from a
maximum of 67.72 per 1,000 in July 1906 to 21.52 in December 1909. The rate
for 1905 was 49.94 ; 1906—48.37 ; 1907—33.63 ; 1908—24.83; 1909—18.19 (per
thousand). The death-rate among employees from • disease has fallen from a
maximum of 62.15 in July 1906 to 10.13 in December 1909."