NationalLibraryOfScotland/medical-history-of-british-india huggingface dataset:
148
hospitals ; and had it not been for the unhealthy state of the detach
ments located in the Kanara jungles, whose percentages of sick
ranged from 70 to 170 to strength, the police would have shown a
still more favourable return.
By far the largest number of admissions to hospital took place
from malarious fever. The total treated from this cause alone was
1,100, for I include the Kolapore cases, or 45 per cent. of the
whole cases treated. It was observed that although many cases of
fever were of a persistent charater, few were complicated, and death
only resulted in 5 of them.
Dr. Carter appends some tables to his report purporting to show
the comparative treatment of intermittent fever, but I am inclined
to think that the experiments made by him are on too limited a scale
to be of much practical value.
Rheumatic affections, syphilitic or otherwise, among this class of
men, usually bear comparatively a high proportion of the cases treat-
ed ; but it has not been so last year, for there were only 161 ad-
missions, one-third of which occurred at the Satara Hospital.
Cases of guinea-worm are not unfrequently met with in a police
hospital. The reason assigned is that the men when in the dis-
tricts are compelled to drink all kinds of water, and no doubt in
many instances from wells containing the germs of the guinea-worm;
but be that at is may, all the Medical Officers affirm that the disease
is not contracted during the patient's residence at head quarters,
where the water is supposed to be pure and free from animalculi.
In the surgical practice of the hospitals not much has taken place
worthy of especial notice in this report. Two cases of severe
sword-cut wounds, detailed by Dr. Sylvester, and one of which prov-
ed fatal, may be mentioned, together with a successful operation per-
formed by the same officer for the radical cure of hernia.
Vaccination has been performed when necessary by the Medical
Officers during the year, and I am happy to state few cases of small-
-pox in the hospitals are recorded. At Kohlapur measles occurred
in the month of November last. The epidemic was confined chiefly to
the families of the police sepoys.
CHARITABLE DISPENSARIES.
(From the date of their establishment to the year 1871-72.)
Preliminary Remarks.— In the Poona Division there are 26 dispen-
saries which may be divided into three classes : Government Dispen-
saries, State Dispensaries, and Dispensaries supported partly by Gov
ernment and partly by Municipalities.
Government dispensaries, of which there five, are all situated in
North Kanara, and at the following stations :—
Halial.
Soopa.
Mondegode.
Sirsi.
Ilapur.
149
The charitable dispensaries of the 2nd Class are 3, and entirely
supported by the States of Akalkot, Peynt, and Mudhole.
In the 3rd Class there are 18 dispensaries, termed, for the sake of
distinction, " Municipal Dispensaries," although they are in part
supported by Government. They are widely spread over the Poona
Division and Southern Maratha Circle, and, under the provisions of
para. 14 of the revised rules, are now placed under the immediate
supervision of the Civil Surgeon of the collectorate in which they are
situated. They may be taken in the following order:—
Poona Collectorate
3
Poona.
Juner.
Indapur.
Sholapur
do.
3
Sholapur.
Pandharpur.
Barsi.
Satara
do.
3
Wai.
Karar.
Islampur.
Belgaum
do.
3
Belgaum.
Gokak.
Athni.
Dharwar
do.
2
Hubli
Gudduck.
Kaladgi
do.
2
Bagalkot.
Bijapur.
Nasik
do.
1 ............................... Yeola.
Dhulia
do.
1
............................. Irandol.
During the past year three new dispensaries have been opened, viz.,
Islampur, Bijapur and Athni. They have only just commenced
operations, and consequently their returns are not incorporated in
the general one submitted.
Before I proceed to give a brief history of each dispensary, I am
desirous of bringing prominently to notice that but few dispensa-
ries in this division meet the requirements specified in para. 4 of
the revised rules.
Even the 1st Class dispensaries, such as Poona, Belgaum, and
Sholapur, are lamentably deficient as regards the accommodation
quarters for Hospital Assistants and subsidiary buildings.
The Poona dispensary consists of two narrow, ill-ventilated rooms
underneath the office of the municipality, together with an open veran-
dah for the reception of in-door patients, and capable of containing
two or three cots. Quarters for Sub-Assistant Surgeon, Native
Medical pupils, and servants, cook-room, latrines, or a dead-house,
there are none.
Considering that this institution has now been in operation for
some years past, and the size, importance, and wealth of the city, I
think this state of things reflects anything but credit on its
municipality.
19 M D
150
GOVERNMENT DISPENSARIES.
Kanara Collectorate.
The oldest established Government dispensary is that at Sirsi.
I t i s
a town situated, like all other towns at which Government dispen-
saries are fixed, deep in the Kanara jungles. It contains 5,329
i n - h a b i t a n t s , m o s t o f w h o m a r e o f t h e a g r i c u l t u r a l c l a s s , t o g e t h e r w i t h
a few sowcars and shop-keepers.
The old dispensary building was originally a detachment hospital
built for the accommodation of Madras Troops, when North Kanara
(Bala Ghaut) was under that Presidency. On the troops being with-
drawn, it merged into a dispensary, and has remained so since 1862.
In 1868 the municipality of Sirsi allotted the sum of Rs. 400 for
the support and maintenance of in-door patients, and in 1869 erect-
ed, at a cost of Rs. 6,000, the present dispensary hospital, converting
the old detachment hospital or dispensary into quarters for the Hospi-
tal Assistant.
As I have before stated, this is one of the few dispensaries, the
building of which meets all the requirements laid down by Govern-
ment, and this is to be attributed partly to the liberality of the
municipality and partly to the fact, that the subsidiary buildings
were already provided for when the detachment hospital became a
dispensary.
This dispensary is entirely supported by Government.
To this report a table is annexed showing the working of this dis-
pensary, commencing from the date of its establisment in 1862 up to
the present official year, from which it will be seen that after the first
two years, the number of total sick treated considerably increased,
but of course fluctuated according to the sickness which prevailed in
each year.
The return for the past official year, 1871-72, shows that the daily
average number of persons attending the dispensary is 31. The
total sick treated 3,439, and 13 deaths ; but it must be understood
that this return not only includes the townspeople, but many persons
from the adjacent villages, who, with their families, gladly avail
themselves of the medical aid and medicines hitherto afforded to them
gratuitously from the dispensary.
But whilst fully aware of the benefits of European medicines and
medical treatment, I regret to say that vaccination does not meet
with that reception it deserves—indeed, the well-to-do-people are
positively adverse to its introduction, and do all they can to thwart
the medical officer of the dispensary in his endeavour to carry it out.
These remarks apply not to the inhabitants of Sirsi only, but also
to the people in all other towns and villages in North Kanara, nor
is it surprising when we find them still wedded to gross supersti-
tious rights and ceremonies imposed upon them by their religion.
It was only in the month of February last, and just before my arrival
at Sirsi on tour of inspection, that the great biennial feast of Mordi
151
had been held in honour of the goddess Devi. It lasted 8 days, during
which period many thousands of people had collected to witness the
ceremonies to be gone through, and which terminated in the slaughter
of 9 bullocks, 1,000 sheep, and double that number of cocks, in order,
as they said, to appease and propitiate the deity.
The town and neighbourhood of Sirsi is well supplied with water,
both for washing and drinking purposes, derived from mountain
rivulets, tanks, and wells, the latter are fed by springs.
The average rainfall is about 95 inches.
Small-pox appears to be endemic throughout the whole of the Bala
Ghaut.
It was certainly very ripe in the months of February and March
this year, when I was travelling through those districts.
The limited assistance afforded to the vaccinator by native authori-
ties has been the subject of frequent complaints made to me, both
orally and in official reports.
I was much pleased with the manner in which the work of the
dispensary has been carried on, and consider Mr. 1st Class Hospital
Assistant Benjamin Sullimanji very efficient, and from special
enquiries made during my inspection I have every reason to believe
that he has gained the confidence and good-will of the people
entrusted to his charge.
The following table will show the daily average number of attend-
ance and the total number of sick treated, and deaths from 1862 up
to 31st March 1872 :—
Y e a r s .
Daily average
No. of attend-ance in each
year.
Total No. of
Sick treated
in each year.
Total No. of
Deaths in each
year.
1862 ...
...
...
...
...
11.1
447
4
1863 ... ...
...
...
...
22.1
1,344
3
1864 ... ... ..
. ... ...
41.9
2,776
7
1865 ...
...
...
...
...
36.9
2,562
9
1866 ...
...
...
. . . . . .
24.9
2,118
7
1867 ... ... ... ... ...
37.4
2,676
6
1868 ... ... ... ... ...
30.1
2,490
3
1869 ... ... ... ... ...
21.7
2,400
8
1870 ... ... ... ... ...
12.3
1,577
6
1871-72 ...
...
...
... ...
43.3
3,740
12
CHARITABLE DISPENSARIES.
In the general return submitted with the report are incorporated
the annual returns of 22 charitable dispensaries. It shows that the
aggregate number of persons treated at these institutions during
the past official year was 69,914 ; of these 172 died, 10,154 absented,
58,539 were discharged cured, and there remained attending the
dispensaries on the 31st March 1,047 persons.
152
There are two points here which cannot be passed over without
observation, and they are, the very low rate of mortality as given in
this table, and the very large number of persons returned under the
head of absented. In what exact relation they stand to one another,
of course I am not prepared to say, but I am afraid not a few of
those who are classed under the latter head ought to be included in
the former.
The ratio of deaths to treated is 3.4 perm i l l e
, b u t e x c l u s i v e o f
cholera, it is only 2 per thousand. After a very careful study of the
reports and returns presented by the medical officers of these dis-
pensaries, I am forced to the conclusion that there is very little in
their past medical history worth recording
The vast majority of cases treated were of a very ordinary nature,
and presented no feature of any interest.
The most prevalent diseases during the period under review were
malarious fever, diseases of the stomach and bowels, and cutaneous
diseases. These three diseases then, with others of their class, com-
prise a total of 44,397, or 63 per cent. of the total sick treated.
From malarious fever 14,501 persons sought medical aid at the
dispensaries, and proportionatily the greatest sufferers were those
residing in the Kanara Districts. The percentages of sick have, to
whole cases treated, ranged from 55 to 68 per cent. The deaths
from this cause were 24, or 16 per thousand.
Diarrhœa and dysentery do not give a high ratio to total sick treat-
ed. From the former 1,424 cases are recorded and 16 deaths. Of
the latter 956, and a mortality of 15. This is certainly a high death
rate for a dispensary nearly 13 per thousand, whereas the ratio of
deaths to treated from all causes is 3.4 ; but exclusive of cholera
only 2 per mille. Other diseases of this class, principally indigestion
and colic, largely help to swell these returns. 13,236 cases have been
treated with only 7 deaths.
Cutaneous affections, as usual, in dispensary practice, present a very
large proportion of cases treated. During the past twelve months
15,700 persons have applied for relief, and 4 died.
The districts may be said to have been remarkably free from epi-
demic during the year.
Cholera has not appeared in an epidemic form. Only 79 cases
have occurred, and the mortality from the same was 31, or about the
usual average.
But few cases of small-pox have been treated at the dispensaries,
and the majority of these occurred in the Kanara Districts. The re-
turns show 59 cases, with 4 deaths. The fatal cases were patients
suffering from the disease in a confluent form and unprotected.
In the surgical practice of these dispensaries little or nothing of
any importance or interest has transpired.
Of injuries 2,465 cases were treated. The great majority no doubt
of these being of a simple nature, as the deaths resulting were
153
The only operation of any moment performed was lithotomy. It
was performed in two instances at the Poona dispensary on children
under 10 years of age, and with success.
On taking a review of these charitable dispensaries, as regards the
buildings themselves, their establishments, and the work performed
by them, since they were first established, I have come to the con-
clusion that a great deal has yet to be accomplished before they can
be said to be in a satisfactory condition.
In respect to buildings, many of them are too small, and in no way
meet the requirements necessary for a dispensary, whilst others,
though well and substantially built, are deficient in subsidiary build-
ings and in quarters for the medical officers in charge. But to this sub-
ject I am particularly desirous of drawing the attention of the In-
spector General, as I find that in the rules of 1861 no conditions are
laid down, nor indeed is any mention made of the accommodation
necessary for Sub-Assistant Surgeons or Hospital Assistants, and
consequently advantages are being taken of this omission by Munici-
pal Committees of dispensaries (formed before the revised rules of
1871 came into operation), to decline providing the requisite
accommodation.
The establishments, with few exceptions, are sufficient, but to all
the larger dispensaries I think two Native pupils should be appointed.
One of these should always be an advanced pupil, for occasions so
frequently arise of the medical officer in charge being called away
to give evidence in the Judicial Courts. This is more particularly
needful where only one pupil is attached, for unless he is competent
to undertake the duties during the absence of the Hospital Assistant,
the dispensary is virtually closed.
The operations, as carried on by the 3rd Class Hospital Assistants
and others in charge of dispensaries, I am of opinion are, on the
whole, progressive and satisfactory, and I am in hopes that when
suitable dispensaries are built, and several are now in course of erec-
tion, still further improvements will take place both in respect to
the numbers relieved and importance of cases treated.
From all I can learn on the subject, I have every reason to believe
that these dispensaries are, as a rule, highly appreciated by the
native community, and that they have been the means of benefiting a
large class of persons who could not otherwise perhaps have received
the benefits of medical aid and European medicines. But the
cr uci al t est of al l t hi s, no doubt , wi l l be t he amount of suppor t t hey
will afford to these institutions when the paying system comes
into force.
Yellapur—Kanara Collectorate.
The town of Yellapur, like Sirsi, is surrounded by jungles. It is
on the high road from Dharwar cotton districts to Karwar, and a few
miles from the Arbyle Ghaut. It is a small but rather important
town, containing by last census 1,431 inhabitants.
154
This dispensary was opened by order of Government in 1863.
The subjoined table will serve to show the extent of its operations
during the past 9 years :—
1863
1864
186518661867186818691870 F r o m 1 s t J a n u a r y t o 3 1 s t M a r t c h 1 8 7 1
F r o m 1 s t A p r i l 1 8 7 1 t o 3 1 s t M a r c h 1 8 7 2
T o t a l
Daily average No. of attend-
ance throughout the year . . 23.1 21.6 18.0 15.0 268 443 346.3 215.5
2 4 . 0
2 2 . 7
1 3 9 7 . 2
The total No. of sick treated
in each year .................
3,227 3,452 1,137 1,269 1,662 1,832 1,582 1,956 575 1,804 18,496
The total No. of deaths in
each year .................
3
1
7
7
5
5
12
11
3
8
6 2
It appears to have commenced with a large number of daily attend-
ance, and the totals treated in the first two years of its existence is
much higher than the subsequent ones—why this should have been
the case I cannot say, but the work carried on since that time,
making allowances for healthy and sickly years, as they may have
occurred, is uniform and satisfactory.
The present dispensary building, I understand, owes its existence
to the zeal and liberality of Mr. Elphinstono, Major Peyton, and
other gentlemen connected with the districts. They subscribed
largely themselves towards the undertaking, and by calling public
meetings of the towns people, and by their personal influence, collect-
ed a large sum of money which, together with, I believe, a Govern-
ment grant, was found sufficient to erect a suitable and substantial
building.
The dispensary contains a ward large enough to hold 6 beds, a
surgery, quarters for the Hospital Assistant, bath-room, with cook-
house and latrine. It is proposed to build a new surgery which,
when ready, the present one can be converted into a female ward.
There is likewise a capacious hut, constructed in February last, for
the reception of patients suffering from contagious diseases. This
additional building will no doubt prove a great boon to the indigent
class seeking admission to the hospital.
The only building now required to complete the dispensary is a
dead-house. Ono is much needed, as bodies are not infrequently
brought to this dispensary for examination and report.
Yellapur is fortunate in its water supply. For drinking purposes
it is derived from wells—it is usually abundant and of good quality.
Two large tanks outside the town furnish an ample supply of water for
washing and other purposes.
155
The returns from this dispensary show the number vaccinated
during the year was 203—a fair proportion, Sad the persons vacci-
nated all belonged to the town or neighbourhood; but 82, or 41 per
cent., were Christians from Goa, seeking employment on the railway
or public works during the fair season.
The inhabitants of the town and villages, as I am given to under-
stand, exhibit the same apathy and prejudiced to vaccination as the
people at Sirsi.
In my late inspection of this dispensary, I was perfectly satisfied
with the manner in which the hospital duties had been conducted by
Mr. Balwant Saccaram, the Hospital Assistant in charge. He seems
a zealous, painstaking man, and appears to be appreciate and
respected by the native portion of the community. He has likewise
gained the confidence of the officers, both military and civil, who
are occasionally located at Yellapur.
This dispensary is entirely supported by Governmep4.
Supa—Kanara Oollecorate.
The exact date of the establishment of this dispensary is not
known, but in the year 1863 it was located at Juggle Peit and.
transferred in the following year to Supa, which is a small town,
about 6 miles distant from the former place.
Supa is the residence of a Manilutdar and other Native function-
aries, and a station for a strong detachment of police, in consequence
I presume, of its proximity to the Goa territory. It is situated at the
junction of the Kallee and Pandry Rivers, and. surrounded by dense
jungle.
Supa itself contains only about 500 inhabitants, but the popula-
tion of the whole petta or district is nearly 21,000.
The records of the dispensary commence from the year 1863, and
have been regularly kept down to the present period. The subjoined
table will give a fair idea of its operations :—
Bears.
The total
No. of Sick
treated in
each year.
The total
No. of. Deaths
in each
year.
Daily are-
rage No. of
attendance
in each year.
1863
...
...
...
...
...
473
1
9.6
1864
...
...
...
...
...
754
2
19.4
1865
...
–
1,008
......
9.4
1866
...
...
•••
...
•••
679
.....
5.6
1867
...
..
6 7 9
......
7.6
1868
...
...
...
...
...
1,040
......
10.8
1869
...
.,.
•••
•••
...
1,496
......
11.6
1870
...
...
...
...
...
1,507
......
9.5
1st January to 31st March 1871
•••
447
......
11.7
1st April 1871 to 31st March 1872
...
1,661
......
13.3
156
From this statement there is no reason to doubt but that the
dispensary work has been steadily increasing, and the reports sub-
mitted show that the people are gradually availing themselves of the
benefits the institution holds out.
The patients attending the dispensary are composed of three classes :
the Karcoons attached to the Kutcherry and their families, with the
families of police sepoys. The inhabitants of the town and sur-
rounding villages, and the coolies employed by the Public Works
Department.
Although I have not been able to extend my tour of inspection,
so far west as Supa, I am fully aware of its necessities.
In a conversation with the Assistant Collector at Yellapore he
informed me that it is proposed to build a dispensary as soon as
funds are available—a difficulty, which I trust will soon be overcome,
as the place which serves for dispensary is a small room (15 feet by
7) in the Kutcherry building.
The site chosen for the new building if, as I understand, on the
other side of the river from the town, is objectionable, owing to the
impassable state of the river during the monsoon flood.
This has been explained to Mr. Ebden, the Assistant Collector,
with a request to be furnished with a plan of the building before
building operations were commenced.
The subject of vaccination is not alluded to in the reports, either
from the dispensary or police—a circumstance which leads me to
believe that it has been neglected, and therefore very little can be
said abont it, however an explanation has been called for from the
medical officer in charge.
The water-supply is good and abundant. It is obtained from Kallee
Nuddee, which river runs close under the houses of the town.
Mondegode—Kanara Collectorate.
Mondegode is a very small town, and owes its importance per-
haps to the circumstance that it is the official residence of a Mahal-
kary. It contains only 1,012 inhabitants, but it is surrounded by
villages which, of course, are all in constant communication with and
in a manner dependent on it. The town is situated on the high road
between Dharwar and Sirsi, and which formerly was the only one to
the coast for cotton and other merchandise.
The dispensary was established by Government at a period when
the North Kanara Districts were being transferred from the Madras to
the Bombay Government, and at a time in which a good deal of sick-
ness existed throughout the Kanara Districts. Fever of a peculiar
and deadly type already prevailed in the southern districts, and was
fast approaching towards the north, when Government, actuated by
the dictates of humanity and sound policy, determined to establish
dispensaries throughout the Bala Ghaut. The places fixed on for