NationalLibraryOfScotland/medical-history-of-british-india huggingface dataset:
174
treated. In the case of fracture of thighs, the injury was self-inflict
-ed ; the man was accused (falsely) of robbery, and rather than re
-main under the accusation determined to kill himself ; climbing a
mango tree he precipitated himself from it, both thighs were frac
-tured, and other injuries were sustained ; he made good progress un
-der treatment and was discharged nearly well at his own request.
This dispensary hospital appears very useful, and might, perhaps,
in time, bear to be increased, as there is no medical institution within
a considerable distance.
Kalia Wadee—“ Victoria” Dispensary near Nowsari.
12. At this dispensary, there is good accommodation for in-patients ;
there were twenty-seven treated within the year, twenty-five were
fresh admissions, twenty-three were cured, one died, and three re
- m a i n e d . T h e p r i n c i p a l c a s e s w e r e — 2 r e m i t t e n t f e v e r , 1 e p i t h e l i a l
cancer on the big toe—amputation was resorted to, 1 secondary
syphilis, 1 fracture of the base of skull, 1 compound fracture of foot,
1 burn was treated, these were all discharged cured. The burn
was a case of malicious torture by red-hot iron ; the subject of the
case a boy, of about eleven years of age, suffered very much but
eventually recovered. 1 case of chronic dysentery in an emaciated
female was treated—she died a few days after admission.
Kamte Dispensary.
13. There is accommodation for in-patients here, and if it wag
greater, I believe it would be occupied. 102 patients were admitted
during the year. There were several cases of fever, chiefly remit
- t e n t ; o f d y s e n t e r y , s m a l l - p o x , s y p h i l i t i c a f f e c t i o n s , g e n e r a l d r o p s y ,
snakebite. A case of epithelial cancer was operated on, on the
left cheek ; the operation was not successful, for the fungoid growth
quickly re-appeared. Two cases of fistula in ano were operated on
successfully ; 3 cases of snakebite were admitted, 2 of these were
cured, the other died ; this latter was a case of Cobra-bite.
There were 18 cases which terminated in death, the causes were
small-pox, remittent fever, leprosy, anœmia, general dropsy, Bright's
disease, snakebite, fracture of laryngeal cartilages, caused by a buffalo
goring an aged female who died from shock.
The report of the Sub-assistant Surgeon in charge might have
been more elaborate, but it points out that a large amount of human
suffering is attended to, and that much good is performed in a care
-ful and well-instructed manner
.
Mandvi Dispensary.
14. Here there is fair and good accommodation for in-patients,
four only, however, were admitted during the year, two of these died,
175
one was cured and one remained ; they were all indigent poor.
Here, as at Bardoli, the hospital assistant is not likely to attract
patients.
Parak, near Surat .
15. This dispensary has good accommodation for in-patients—17
received admission ; of these 15 were discharged cured, one died, and
one remained.
Seventeen were fresh admissions—1 dengue ; 2 remittent fever ; 2
crysipelas ; 1 lipoma (this was successfully operated on, the tumor,
a very large one, was of 12 years' duration) ; 1 hepatic abscess (the
friends of this patient would not permit operative interference) ; 1
incontinence of urine ; 2 of urethral injuries, caused by the intro
-
duction of irritant drugs to cure gonorrhœa. The remaining cases were
syphilis primary 2, conjunctivitis 2, pericarditis 1, pneumonia 1,
wound of the thigh 1. Not many operations are reported at this
dispensary ; indeed, its best use is for outdoor sick, with occasional
in-patients, the civil hospital being available for in-patients requiring
operations, where, however, hitherto few, indeed, have been per-
formed.
Pardi Dispensary.
16. Here there is accommodation for in-patients—few, however,
seek it. Five cases were treated during the year, of which three were
new admissions, 2 of these were simple injuries, and one was a case
of dengue. The report of the hospital assistant gives no indication
of attention or interest.
K a l l i a n .
17. There is very fair accommodation at this dispensary for the
reception of in-door sick—not many desire, however, to seek the shel
-
ter of its roof, its position being so mach out of the way. Thirteen
admissions were registered, many of them of very serious character,
e.g., dysentery, abscess of liver, abscess of kidney and suppres
-
sion of urine. 7 wounds, concussion of the brain, contusion of
abdomen and rupture of kidney ; compound fracture of the arms ;
alcoholic poisoning. Five of these cases died, viz., 2 dysentery,
1 abscess of liver, 1 contusion of abdomen and rupture of kidney,
1 suppression of urine.
In the case of contusion of the abdomen opiates, fomentations,
catheterismus were used ; but the patient died the second day after
admission and the same after the injury : the post-mortem examina-
-tion revealed rupture of the right kidney with much extravasation
of blood into the cellular adipose tissue.
In the case of suppression of urine, the patient died comatose,
thirteen hours after admission ; on post-mortem examination an
abscess of the left kidney was found, and the right one was entirely
176
absent. Some of the injuries admitted were somewhat severe;
concussion of brain occurred to a railway hamal who fell from the
top of a waggon, and some severe contusions were sustained.
Kelvi-Mahim.
18. This dispensary, opened in August 1872, has very meagre
accommodation for in-patients. The number of admissions was 19,
and the treatment of these cases reflects much credit on the Sub-As
-
sistant Surgeon in charge. The cases were of long standing, anœmia,
ulcer of cornea, dysentery, diarrhœa, enlargement of the prostate,
ovarain dropsy, parotidœan tumour ; the two latter cases required
operations, which terminated favorably.
18 a. Arsenical poisoning occurred in a man and his wife, the
man had himself prepared some sweetmeat and both partook of it,
symptoms of arsenical poisoning followed ; they both died ; the man
in his dying declaration stated that he had bought arsenic for rats,
but did not say he had mixed it with food—collateral evidence gave
no clue. Could this case have happened had the arsenic been
coloured? An Act for the colouring of certain poisons sold retail
to the public should be passed.
The establishment of this dispensary will very much benefit
the surrounding country, giving facility for the examination and treat
-
ment of judicial cases. The performance of necessary operations,
and confidence to the people, that for serious ailments there is aid at
hand.
The Sub-Assistant Surgeon, Mr. Tribovandass Moteechundsha, is
well up in his professional knowledge, and only requires experience
of the ways of the people to make himself appreciated.
In-patients, Honowar Dispensary.
19. At the dispensary at Honawar there were 8 in-patients
treated during the year; there is fair accommodation for them.
Patients when admitted here are not allowed by some rule of the
President of Local Funds to remain longer than a few days under
treatment ; if in that time recovery does not take place or death ap
-
pear imminent, the patient is removed to the charitable dispensary at
Kamte.
The persons admitted are generally wandering poor. Out of eight
admitted one died.
The cases treated were one of what is termed Ghat fever—this
patient died. Three cases of dysentery were transferred to Kamte
in consequence of the above order; one case of enlarged spleen and a
case of contused knee joint were discharged.
At my inspection of the dispensary there was one in-patient who
was very ill and one policeman with fractured thigh.
177
DISPENSARIES ATTACHED TO CIVIL HOSPITALS.
The Jamsetjee Jejeebhoy Dispensary for Males.
1. An analysis of the annual report, and of the return forwarded
by the Acting First Physician, shows that of male patients 557 re
-mained from the previous year and 20,163 were fresh admissions ;
10,623 were Mussulmans, 8,204 Hindus, 1,096 native Christians, and
797 Parsees.
There were 12,999 cured or relieved, 7,306 entered as absented or
unknown—no deaths are shown—and 415 remained under treatment.
The average daily attendance was 163.
Under general diseases, Division A, 2,929 were treated ; of these
2,701 were cases of intermittent fever, chiefly quotidian, giving 13
per cent. to total treated. Under Division B, 1,412 sufferers from acute
and chronic rheumatism received aid ; of syphilitic affections
there were 1,331, almost as common a disease as rheumatism; if
gonorrhœa and its complications, which are brought under local
diseases, were added, the total applying for relief, in males, would
amount to 2,251—a larger number than has been attended to for
many years.
2. Does this number, in a single dispensary, shew that a Con
- t a g i o u s D i s e a s e H o s p i t a l a n d a C o n t a g i o u s D i s e a s e A c t a r en
o t
wanted? It is almost unnecessary to point out that every dispensary in
and around Bombay, and every medical practitioner in the place, have
patients suffering under these diseases, and that numbers, probably,
treat themselves, as doubtless infected women do. It is, I believe,
known that while the Contagious Disease Act was in operation private
practitioners were in constant demand by diseased women, but now
these have no fear, are careless of consequences, and seldom seek fur
- t h e r r e l i e f t h a n d h a e s a n d " w i s e w o m e n " c a n a f f o r d .
No approach to correct statistical information can be offered from
the above, but it may not be a quite incorrect inference to draw
t h a t 1 o r 2 p e r c e n t . o f t h e a d u l t m a l e p o p u l a t i o n l a b o u r u n d e r s o m e
form or other of contagious disease or its consequences.
3. Under this Division B, leprosy, scurvy, anœmia, scrofula,
phthisis—diseases indicating low vital energy—are entered—1,019
were treated, of whom 328 left off attending ; of scurvy there were
437 and of phthisis 90 cases. Such diseases it is to be feared cannot
often be benefited by dispensary medicine alone.
Under local diseases 11,210 sought relief, diseases of the nervous
system numbered 286—apoplexy, paralysis, epilepsy, neuralgia, and
hemicrania chiefly. One case of mania absented, one of melancholia
was cured or relieved. Ear disease was common, affections of the
respiratory system gave 1,349—chiefly chronic and acute bronchitis.
178
Derangement of the digestive system occurred in 3,088 persons,
a large number being treated for dysentery, diarrhœa, dyspepsia,
hepatitis, and splenitis. Diseases of other systems, e.g ., the uri-
nary, and of other organs such as those of locomotion, gave a large
number for treatment—amongst them were 920 cases of gonorrhœa
and its complications. Of the cutaneous system and cellular tissue
there were 4,670 applicants for relief. Of poisons 26 cases were
received—1 of opium and 25 of alcohol. Of general injuries, 51
were burns and scalds; local injuries which were contusions, wounds,
dislocations, and simple fractures, amounted to 2,089.
Part of the establishment of the Jamsetjee Jejeebhoy Hospital are
employed, according to the regulations, for the working of the dis-
pensary. Assistant-Surgeon Lyon, until 30th October 1872, was 3rd
Physician to the Jamsetjee Jejeebhoy Hospital, when he was per-
mitted to resign that office ; his duty was to attend the dispensary
aided by sub-assistant surgeons ; since his removal an assistant
apothecary and two sub-assistant surgeons attend.
The attendance throughout the year has been very large, and one
of the sub-assistant surgeons being proficient in Persian, many of
the Parsee refugees came for medical aid.
4. There is one thing peculiar in the return—this is the great pre
- p o n d e r a n c e o f M u s s u l m a n s t r e a t e d o v e r e v e r y o t h e r c a s t e . O f H i n d u s
the population is 372,215—the treated of this caste were 8,204; of
Mussulmans the population is 137,644—the treated at the dispensary
were 10,623 ; the rate to the population in the first being 2.20 in tho
second 7.78.
This is probably due to the very large number of Mussulmans
residing in the neighbourhood of the hospital. As affording aid,
therefore, we may be led to conclude that the large amount of good
done by the Jamsetjee Jejeebhoy Dispensary is chiefly confined to
the thickly-populated quarter in which it is placed.
Jamsetjee Jejeebhoy Dispensary—Females and Children.
5. The out-patients, women and children, under ten years of age,
attend at the obstetric institution every morning, and are prescribed
for by Surgeon-Major Ward, Obstetric Physician to the hospital.
There remained from the previous year 313, and there were fresh
admissions 14,187, making a total of 14,500, of which 5,929 were
women and 8,571 were children.
There were of Mussulmans—women 3,153, and 4,692 children ;
Hindus—women 1,680,.children 2,765 ; Christians—women 488, chil-
dren 572 ; Parsees—women 608, children 542.
6. I pointed out that amongst males the attendance of Mussul-
mans was greater than that of any other religion, and the same pro
- p o r t i o n a p p e a r s t o o c c u r i n t h e f e m a l e d i s p e n s a r y a l s o .
179
Of the total there were 3,917 women and 6,296 children cured or
relieved,1,699 women and 1,991 children absented or unknown. There
were no deaths recorded—313 women and 284 children remained.
The average daily sick of both was 122.91, or of women 58.30 and
children 64.61.
There was an increase in the total treated over last year and in
the daily attendance.
7. Under general diseases, Division A—amongst womenthere were
1,210 treated, of which 1,181 were fever cases—776 of these were of
quotidian ague, 43 cases of remittent fever ; no small-pox ; 22 were
affected with mumps.
Of children under Division A, there were 674 cases of ague and a
large number of febricula, 687 ; there were also a few remittent fever
patients ; 41 cases of hooping cough presented.
Under Division B, amongst women 1,189 were treated—584 for
rheumatism, 105 for syphilis ; scurvy, anœmia, and scrofula gave 411,
and phthisis 86.
In children under Division B, 433 only were treated, 16 of which
were for hereditary syphilis, 23 for rheumatism, no less than 200 for
anœmia, 149 for scrofula, and 23 for phthisis.
Under local diseases, women were chiefly treated for hysteria, neu
- r a l g i a , e a r d i s e a s e ; 7 8 2 w e r e f o r d i s e a s e s o f t h e r e s p i r a t o r y s y s t e m ,
chiefly bronchitis : a large number received aid for diseases of the
digestive system, especially for dyspepsia, dysentery, diarrhœa, con
-stipation, hepatitis, splenitis. Parasitic disease gave nearly one hun
- d r e d c a s e s : t h e r e w e r e 3 0 c a s e s o f g o n o r r h œ a . 3 0 0 c a s e s o f f e m a l e
disease applied for treatment. Skin diseases were not nearly so
numerous as might have been expected ; of scabies there were only
292. Of poison there was only one case alcoholic, and one poison
- e d w o u n d , r a t b i t e .
The injnries received were burns or scalds, wounds, contusions,
simple fractures, and dislocations—one of them of the jaw.
Of children, under local diseases, a difference is shown in the
kinds of ailments ; in nervous diseases there were five of tetanus,
19 of convulsions. Discharges from the ear were more than double
the number of the same disease in women. Of the respiratory system
there was as much bronchitis as in both males and females attend
- i n g . S t o m a t i t i s g
ā v e 7 7 c a s e s . O f t h e d i g e s t i v e s y s t e m a l a r g e
number of cases must be expected. There were no less than 1,009 of
intestinal parasites ; not so many cases of dysentery but 672 of
diarrhœa. A few cases of spleen and liver affections. 5 of gonorrhœa.
Many required treatment for abscesses and cutaneous disease. A very
large number with scabies are brought for relief.
24 M D
180
Injuries received by children are, what might be expected, burns
and scalds, wounds and contusions of the upper and lower extre
m i - t i e s .
8. I have thus divided the work of the dispensary of the
Jamsetjee Jejeebhoy Hospital, to show more clearly the diseases
to which the sexes and children are most prone. The same sort of
proportion, under treatment, of sexes and children runs through
all dispensaries.
In the two dispensaries the total treated was 35,220, of which
23,212 were cured or relieved, 10,996 absented or unknown. No
deaths are recorded and 1,012 remained.
There was a larger number treated by 1,570 than in the previous
year.
Ophthalmic Dispensary.
9. Patients suffering under diseases of the eye and its append
- a g e s , o f a l l c l a s s e s , r i c h a n d p o o r , a t t e n d a t t h i s d i s p e n s a r y ; a n d
during the year, under report, the number has been unusually large.
The report of Assistant Surgeon Maconachie, M.D., the Acting
Ophthalmic Surgeon, gives a clear account of the successful working
of the institution.
The number of persons treated was 5,895, of which 5,781 were
natives and 114 Europeans ; this shows an increase of 254 over the
previous year.
Diseases of the conjunctiva gave the largest number treated, viz.,
2,651, of which 2,502 were from granular conjunctivitis. There
were Only 23 cases of purulent ophthalmia—14 children. 1,448
diseases of the cornea occurred. Giving opium to children and paint
-i ng t he eyel i ds wi t h ant i mony, Dr. Maconachi e consi ders t he chi ef
sources of corneal disease.
There were 195 diseases of the iris. On the subject of dis-
ease of this part of the eye, the acting ophthalmic surgeon remarks:
" S i n c e t h e e a r l y t r e a t m e n t o f t h e s e c a s e s b y a t r o p i n e h a s b e e n
insisted on so strongly, practitioners are able to treat their cases
satisfactorily, and the necessity for the operation of iridectomy is not
by any means so frequent as formerly ; this has been remarked in
England ; and in Bombay, where all native practitioners, who have
medical training, have to attend ophthalmic courses and hospital
practice, many affections of the eye are treated very intelligently, and
the necessity for operative interference does not so often occur.
As many of the present dispensary patients could pay native
practitioners, it is to be hoped that the work of the ophthalmic
surgeon may be reduced by the consultation rooms of their
c o u n t r y - m e n
b e i n g f r e q u e n t e d b y t h e m . "
Diseases of the cornea and retina gave no less than 337 patients;
these cases come chiefly under ophthalmic medicine, and are not so
satisfactory as those treated by surgery ; for instance, many of the
diseases of the optic nerve were but symptoms of advanced disease
of the brain, ending, probably, often in paralysis and death.
On the ophthalmoscopes issued from the medical stores, Dr.
Maconachie remarks that they are not by any means of first quality,
and are liable to become easily damaged when used by a large
number of students.
There were 400 cases of disease of the lens and capsule.
11. The applicants for relief at this institution are of all countries
—Arabs, Persians, Canarese, Guzerathis, Seedees, Marathas, &c., &c.;
fortunately, though the assistants help much in interpretation,
ophthalmic practice is one where observation alone is, in most
cases, sufficient.
The dispensary is held in two rooms of the Cowasjee Jchangeer
Ophthalmic Hospital.
The staff of the hospital consists of one first class hospital assistant
and one native medical pupil ; this the acting ophthalmic surgeon
does not think sufficient. I am, however, of opinion, with such extra
aid as can be generally afforded by the department, there is at pre
-sent no absolute need to increase it.
DISPENSARIES ATTACHED TO CIVIL HOSPITALS IN THE MOFUSSIL.
Tanna.
1. Out-patients attend daily at the civil hospital at this station;
during the year under report a less number by 283, have availed
themselves of its benefits. There were 1,261 who received medical.
aid—488 were Hindoos, 415 were Christians, 234 Mussulmans, 113
Parsees, and 11 other castes; 1,120 were cured or relieved, 121 absent
-ed, none died, and 20 remained.
Under general diseases, Division A, 611 came under treatment—601
of these were cases of ague, giving a percentage of 47.76 to total
treated.
Under Division B, there were 36 sick; the chief diseases were
rheumatism and phthisis, of which latter there were 8 relieved.
Under local diseases, there were 547 sought medical aid—22 of
these were nervous diseases such as paralysis, convulsions, neuralgia,
&c. Affections of the eye and of the ear were chiefly
conjunctivitis and external inflammation.
Diseases of the respiratory, digestive, and cutaneous systems gave
the greatest additional numbers for treatment—bronchitis, dyspepsia,
dysentery, constipation, and ascaris lumbricoides were the chief
182
diseases ; a case of tœnia solium occurred, in which the bark of the
pomegranate root was successfully used. Gonorrhœa in the male
gave a few cases. Of skin diseases, eczema and scabies were the
most frequent.
2. Local injuries were contusions, a few wounds, fractured bones,
and one dislocation. The operations performed were minor. The
average daily number of sick 15. A case of spider sting (bite ?)
being curious, I may shortly notice : " A gentleman had seen the
lad immediately after a spider had crawled over his body, the irri-
tation was intense, there were large blisters all up the front of the
chest, each nearly the size of the palm of the hand." No treatment
was required.
Vaccination is carried on by the municipal vaccinator. According
to the civil surgeon's observation, small-pox would appear to be never
really absent from Tanna. The establishment is kept up for the
civil hospital ; beyond medicines and a very small share of petty
supplies, there is, consequently, no extra cost to Government.
Surat.
3. Out-patients attend generally in considerable numbers at the
Civil Hospital, Surat. During the year 1872-73, there has been, how
- e v e r , a g r e a t f a l l i n g o f f ; t h i s t h e c i v i l s u r g e o n a t t r i b u t e d i n a g r e a t
measure to the improved sanitary arrangements carried out in the
city and partly to the increased number of native practitioners. The
former of these reasons cannot, I should imagine, be correct, as the
attendance at the Parak Dispensary has during the year consider-
ably increased; it may be owing to an increase in number of native
doctors ; but even this must be doubtful, as the civil hospital dis
- p e n s a r y i s g r a t u i t o u s , a n d a l l p r a c t i t i o n e r s , s o c a l l e d , l o o k w e l l a f t e r
their small fees.
The civil surgeon also states that patients generally come when
in a hopeless state. The patients I saw were the average dispensary
attendants, and the number of cured and relieved would not imply
the contrary.
The report of the civil surgeon is extremely meagre, but from
the returns I find that 6,012 patients were treated against 7,943, of
the year 1871-72, pointing to a decrease of 1,841. 3,097 were
Hindus, 1,467 Parsees, 1,391 Mussulmans, 55 Christians, and 2 other
castes.
87 remained of the previous year and 5,925 were fresh admissions.
The average attendance was 73 against 80 of 1871-72. 4,786 were
cured or relieved, 1,139 absented or unknown, 3 died, and 84
remained.