NationalLibraryOfScotland/medical-history-of-british-india huggingface dataset:
122
the number rose to 226, remaining at the end of the year, with an
average daily number of 223. The greatest number treated in One
year was 313 in 1870, then 311 in 1859, and 308 in 1858, and the
same in 1872-73. The greatest numbers cured were in 1857 and
1869. The greatest number of admissions was in the years 1855,
1856, 1857, 1858, 1859, 1868 and 1870, the least number in 1871-72.
7 . I d o n o t c i t e t h e s e s t a t i s t i c s t o s h o w t h a t t h e s t a t e m e n t s s o
often made are not without foundation, as to the necessity for new
and increased accommodation for the insane of the country, concern
- i n g w h o s e n u m b e r s , I f e a r , h o w e v e r , w e a r e n o t a b l e a s y e t t o f o r m
a correct estimate, but to endeavour to modify somewhat the
character for "overcrowding" which has been too freely given to
the asylum.
8 . T h e r e i s n o d o u b t t h a t t h e s l e e p i n g a r r a n g e m e n t s o f t h e
asylum are not as they ought to be, and that the old building is
rotten and worn out ; the new wings are, I regret to say, badly
arranged and ill-finished—these, though costly enough, were only
planned as a "temporary arrangement" ; also there is no doubt that
if the Colaba Asylum is to be compared with asylums in England,
every part must be condemned. All this, however, cannot be altered
now, nor does it seem necessary, as the attention of Government has
been given for some years to the general state of the present asylum ;
and the plans for a new one, it is supposed, are under consideration.
A site for the new asylum, after laborious investigation by a com
- m i t t e e , w a s r e c o m m e n d e d a t M a t o o n g a .
9 . T a b l e 5 g i v e s t h e c a u s e s o f t h e d e a t h s w h i c h o c c u r r e d d u r i n g
the year. Under general disease—A and B—none took place ; there
were 5 from diseases of the nervous system, 1 from meningitis, 4
from epilepsy. Diseases of the respiratory system 3 ; digestive
system 8, four of which were from diarrhœa. Of disease of the
organs of locomotion, 3 are entered under exhaustion, which, I think,
should have been more correctly entered under nervous disease.
1 d i e d f r o m l e p r o s y a n d 2 f r o m d e b i l i t y . I n t h i s t a b l e i t i s s h o w n
that bodlly disease caused death at the rate to total residents 9.64.
1 0 . T a b l e 6 i s n o t p e r h a p s o f m u c h v a l u e f o r o n e y e a r ; i t s h o w s
that the greatest number of deaths occurred in lunatics from 3 to
5 years' residence, then from 5 to 7, then in those from 3 to 6 months
and of under one month. It is curious that more deaths do not
occur at the earlier period of residence. The greatest number of
recoveries were from 3 to 6 months, at which period 19 were dis
- c h a r g e d , t h e n f r o m 6 t o 9 m o n t h s ; a f t e r t h i s p e r i o d b e t w e e n 2 a n d
1 r e c o v e r i e s o c c u r r e d a t i r r e g u l a r p e r i o d s o f r e s i d e n c e . T h e n e x t
table shows the ages of deaths and recoveries ; at the age from 15 to
20, 4 recovered and one died ; at from 20 to 30, 20 recovered and 4
123
died; from 30 to 40, 8 males only recovered and 7 died; from 40 to
50, 30 recoveries and 5 deaths; in what, may, in India, be called old age
from 50 to 60, 3 recovered and 2 died; and from 60 to 70, 3 died.
11. Table No. 9 shows the single, married, and widowed. No
conclusions or inference can be drawn from the table alone. The
next Table No. 10, gives an abstract of the causes of the state of
mind for which persons were admitted during the year, the largest.
number are "unascertained," 42; indulgence in Gunja caused the
admission of 14; from the insanity produced by this 7 recovered.
Intemperance led to 8 cases; 7 cured from this cause were dis
-
charged. Poverty, fever, and recurrence of the disease were the
next most frequent causes. Moral causes do not appear to have
given many admissions: grief 2, loss of money 2, religion 1. Ill-
treatment is a cause, no admission from it took place, but one was
discharged relieved. Under hereditary insanity one was admitted,
two recovered.
12. Table No. 11 gives a combined abstract statement, for the
year, of Europeans and natives. Regarding the former I will make
reference to the tables concerning them subsequently, and regarding
the latter, the foregoing remarks convey all the necessary informa
-
tion, except as regards the bodily sickness of the residents, of which
Table 12 treats. Under general diseases A—123 were treated for
febricula. Under Division B—4 for rheumatism, 2 for scurvy, and 2
lumbago and syphilitic affection. Of diseases of the nervous system
—14 remained suffering under epilepsy and 4 were admitted, 2 of
these were discharged and 4 died.
1 case of meningitis was admitted and died. There were a few
diseases of the eye; of diseases of the respiratory system there were
27 cases treated—3 of these died, namely, 2 from pneumonia and 1
from bronchitis. There were 46 cases of diseases of the digestive
system, of which 8 died, 4 from diarrhœa, and 1 from each of
the following:—Dysentery, intussusception, hepatitis , and cirrhosis.
One case in a female had gonorrhœa on admission. Of diseases of
locomotion there were 7—3 of these under the head of "exhaustion"
died. Of cutaneous diseases there were 4—a case of leprosy died.
Of other conditions 1 from old age died; 20 laboured under debility,
2 died. Of injuries 1 fracture occurred, the result of accident. From
the tables of statistics it is shown that the ratio of treated for bodily
disease, to the total of the year under lunatic cure, was 85.05, and
the cured to number treated was 80.53; that the deaths to treated
for bodily disease gave a ratio of 8.77, and the deaths to average
number of residents 9.86, and to total under lunatic treatment 7.14.
The percentage of cured of insanity to total under treatment, was
15.58. The percentage of cured has varied during the 23 years
(shown in Table 3) from 23 down to 6.
17 M D
124
13. The medical statistics, amongst Europeans in the lunatic
asylum are shown in tables; previous to referring to them, the fol
-
lowing remarks of Dr. Niven are worthy of notice:—
"The insane Europeans are mostly soldiers, sent to the asylum
for a few days or weeks, to wait for a passage to England
in the overland troopships. Insane Europeans of the civil
population are generally in destitute circumstances, and are
also sent to England at Government expense, if they do not
recover within 6 months or at most one year; therefore, it
must be obvious that our European tables are not of much
value for comparison with those of other asylums.
"The legal and medical papers required by the regulations of
the army and the rules of the asylum, appear not to be
well understood or else are disregarded by army medical
officers; for frequently insane soldiers are sent to this
asylum with informal documents, and not seldom without
any documents at all. The documents and papers of insane
soldiers seem always to go astray, and to be going different
routes, away from the soldier to whom they belong.
"It has hitherto been the custom, in rendering the statistics of
this asylum, to consider Indo-Europeans and other mixed
races as natives, and this plan is followed in the present.
"In the general management, however, the mixed races are treated
as Europeans, to whom they are alike, as regards care and
maintenance, trouble and expense."
14. A portion of the new male wing has been reserved for from
15 to 20 European soldiers, who may arrive at any time during the
year. Dr. Niven remarks, "it would appear to be settled thus that
the military authorities have a permanent claim for 20 beds for
European soldiers. It will be important to bear this in mind, as I
have no doubt that the asylum will be quite full in two or three
years." This is not a new circumstance—military lunatics have
always been accommodated in the asylum, and the average daily
sick of these has, I believe, been considerably greater than it was
last year.
15. There remained in the asylum on the 31st March 1872, 2 males
and 1 female. There were admitted during the year 50 males and 1
female, 1 male re-admitted: total 53 males, 2 females. Of these 4
males were discharged recovered, 1 male relieved, 2 males not re
-
lieved, and 42 males were sent to Europe. No female Europeans
were discharged. No deaths occurred. Thus, there were remaining
in the asylum on the 31st March 1873, 4 males, 2 females = 6: the
average daily number of residents was 3 males and 2 females.
125
16. Table 2 gives statistics for 13 years and a broken period of
3 months; it shows that admissions have varied (11 the lowest
number in 1864) from 24 in 1861 to 52 in 1872-73, while in 1871-72
there were 13. The total under treatment also varied from 42 in
1861 to 55 in 1872-73; and those sent to England from 22 in 1861
to 42 in 1872-73. The average daily number of European residents
has never been so small as in 1872-73, when it was 5.15; in pre
-
vious years it has been as many as 21, 20, 19, 16; in 1861 it was 11,
in 1865 the same, in 1870 it was 16, in 1871-72 it was 10.7.
17. For a short period each year the transport of military insanes
may cause some trouble and difficulty, but such as are harmless, and
the histories are sufficient to show this class, might easily be accom
-
modated, if necessary, in the Colaba sanitarium, I am not apprehen
-
sive of overcrowding.
There were 4 discharged cured and transferred to their friends.
Of these Table 6 shows the length of residence in the asylum of 3 to
have been under 1 month and of 1 from 3 to 6 months. Table 9
shows that of the admissions, 43 males were single (3 cured, 38 re
-
moved), 6 males and 1 female married (1 male cured, 5 removed) 2
were widowers, these were removed.
18. The causes giving rise to mental affections, in the admissions
of the year under report, are shown in table 10. 45 were "unascer
-
tainable," and may have been moral or physical—2 were from exposure
to the sun, 1 from each of the following:—Head injury, intempe
-
rance, onanism, constitutional in males, 1 from want, in a female.
19. During the year 5 insanes made their escape, 3 of these—2
Europeans and 1 Parsee—scaled the railings on the sea front; these
were recovered; 1 cooly escaped and has not been since heard of,
and a criminal lunatic effected his escape on the 17th March 1872:
he was brought back in February 1873. This man's history shows
that he was, previous to admission into the asylum, a criminal con
-
fined in jails from which he managed to escape: he is considered a
very dangerous character ; his insanity has been doubted; and the
superintendent has not considered it advisable to remove the leg
chains with which he was shackled when re-admitted.
20. The new wings were occupied by the females on the 9th
September 1872, and by the males on the 15th of the same month.
Consequent upon the above the harmless patients were brought back
from the bungalow outside the lunatic asylum walls, which is now
occupied by the second overseer and the purveyor.
21. Dr. Niven presents 8 tables relative to the finance of the
asylum, that is of expenditure. With the result shown in these
tables, the actual cost of the asylum to Government in the year, as
prepared by me from the data provided by the Accountant General
126
and other sources, differs as shown in statement appendix:—1st,
the causes of difference are first in the superintendent debiting the
actual articles of bedding, clothing, &c., used by the asylum; this is
certainly correct in one way, but as the indents for clothing are
annual, it is perhaps hardly required; 2nd, the superintendent has
added to his expenditure Rs. 500 for wear and tear of furniture; this,
I presume, is not to be an item required to be noticed, as the value of,
public stock is kept in another department. The receipts for the
year from various causes are also shown in appendix statement.
CIVIL HOSPITALS.
Presidency Division and Aden.
BOMBAY.
European General
Hospital,
Surat,
Broach,
Jamsetjee Jejeebhoy
Hospital,
Ratnagiri,
Karwar,
Cowasjee Jehangeer
Opthalmic Hospi
-tal.
Alibagh,
Dapuli,
Vingurla,
Tanna,
Aden.
2. The reports of the three Presidency Hospitals for the year
1872-73, it will, perhaps, be as well to print in extenso. I, therefore,
with a few remarks beg to submit them for that purpose.
3. In the year under report the most particular point to notice is
the amount of small-pox treated in the European General and
Jamsetjee Jejeebhoy Hospitals, far in excess of previous years.
Small-pox is one of those infectious diseases that is never absent
from Bombay; and which under conditions, as yet undiscovered, at
intervals of two and three years, is developed into the most alarming
activity. This period of epidemicity has, I believe, been longer
delayed, or rather the endemic conditions, which may favour the
spread of the disease, have been longer dormant than usual. But in
the year 1872, notwithstanding the efforts to increase vaccination,
during the period that has elapsed since the last visitation, there have
been actually more deaths from small-pox than the statistical records
of the Health Department have ever shown. In the European
General Hospital, 40 cases of small-pox—18 in excess of the highest
number of the last 4 years—were treated, and 2 died, giving a death
-
rate of 5 per cent. Many of the cases, the surgeon of the hospital
states, even some of the worst, bore marks of vaccination. In the
Jamsetjee Jejeebhoy Hospital, 215 cases were treated—37 died, giving
a death-rate of 17.20 per cent.
4. It has been the practice for several years, under instructions
from the Inspector General, to enter in the daily small-pox reports,
the state of each person admitted, as regards previous vaccination or
127
non-vaccination. The following results appear in the year under
report from the two hospitals above mentioned:—
Hospitals.
European
Chris-
tians.
Native
Chris-
tians.
M u s s u l -
mans. Hindus. Parsees. Total.
D e a t h s . R a t i o o f d e a t h s t o t r e a t e d .
V. N.V. V. N.V. V. N.V. V. N.V. V. N.V. V. N.V.
European General
Hospital . . . 35 5 . . . . . .
. . . . . . . . . . . . . . . . . . . . . . . . 2 5
J. J. Hospital . . . . . . . . . 10 114 2 35 2 21 . . . 2 16 186 37 17.20
Total . . . 35 5 10 114 2 35 2 21 . . . 2 16 186 39
Two conclusions may perhaps be allowed to be inferred from this
statement, namely, 1st, that the death-ratio was largely influenced by
vaccination; and 2nd, that re-vaccination, especially in India, is
necessary; for, though powerful for good, the primary vaccinations
did not, in those Europeans treated in the European General Hospital,
prevent the reception of the disease. Small-pox, to all intents, is, under
a careful system of vaccination and re-vaccination, a thoroughly pre--
ventible disease.
In the year 1872, some 98 years after Jenner's discovery, it has
laid the heavy hand of death on 1,854 persons in this city—the great
majority of these being children of from 7 months to 4 years of age—
simply from vaccination not being carried out. How many of those
who have survived the disease have lost health and strength or some
valuable sense cannot be known; the account, however, must be a
heavy one, for it may be computed that 10,000 as the least number
must have suffered more or less in the period. How much longer,
then, must Bombay stand pre-eminent among cities laggard in insist--
ing on the carrying out of one of the most essential of sanitary pre-
cautionary measures, as well as one of the most beneficent that has
ever been entrusted to our charge.
5. In the Jamsetjee Jeejeebhoy Hospital the daily number of
sick residents have been too many; not one more should ever be
admitted than there is ample superficial space for. The institution
is one which is carried on at a very heavy expenditure to Government,
and it is not reasonable, nor is it just, that dying paupers should be
thrust upon a hospital of this description. When it is shown that
213 deaths occurred in the past year within 24 hours after admission,
94 within 48, and 60 within the third day, little more need be said
to indicate that such patients are in no sense those for whom the
hospital should provide.
128
6. The acting first physician, in one portion of his report in
- c l u d e s t h e s i c k o f t h e C o w a s j e e J e h a n g e e r O p h t h a l m i c H o s p i t a l : t h i s
is simply to show the number for which the stores of the Jamsetjee
Jejeebhoy Hospital are required to provide. The vital statistics of
the hospital do not include the sick of the Ophthalmic.
7. In the obstetric ward or hospital, of which Surgeon-Major
Ward has the charge, there were 95 labour cases treated, concerning
which that officer gives the following table:—
Classification of Cases and No.
RESULT TO
MOTHERS.
RESULT TO
CHILDREN.
charged. Died. Dis-
charged. Died.
Natural . . .
59
58
1
56
3
Difficult . . . 9
5
4
. . .
9
Preternatural . . . 14
13
1
5
9
Complex . . .
4
3
1
3
2
Premature . . . 9
9
. . .
1
8
Total . . . 95
88
7
65
31
51 of the cases were Christians, the remainder being Hindus 33,
Mussulmans 5, and Parsees 6. 15 of the Christians were Europeans.
8. Dr. Ward gives a second table showing the character of the
labors according to castes and results to mother and child:—
Classification of Labours.
Christians. Mussulmans. Hindoos.
Parsees.
Died.
Died.
Died.
Died.
No. M. C. No. M. C. No. M. C. No. M. C.
Natural . . . 45 1 1
. . . . . . . . . 13 . . . 1 1
. . . 1
Difficult . . . . . . . . .
. . .
1 3 5 3 5 1
. . . 1
Preternatural . . . 1 . . . . . . 1 . . . 1 8 1 6 4
. . . 2
Complex . . . . . . . . . . . . . . . . . . . . . 4 1 3
. . . . . . . . .
Premature . . . 5 . . . 5 1 . . . 1 3 . . . 2 . . . . . . . . .
From this it appears that in Christians the percentage of fatal
cases to mothers was 1.9, to children 13.72: in Hindus, the per
- c e n t a g e o f m o t h e r s ' d e a t h s w a s 1 3 . 3 3 a n d o f t h e c h i l d r e n ' s 3 6 . 3 6 ;
the percentage in Mussulmans was 20 to mothers, to children 100
per cent., and in Parsees, to mothers no deaths occurred, to children
66.6.
129
These results are accounted for by nearly all Christian women
going voluntarily to the hospital for their accouchements, while other
castes are only brought in when the cases are at the extremity that
requires other interference than that obtainable from the persons they
employ. A few indigent Hindoo women form an exception to this.
It is almost useless to repeat the story of frightful mismanagement
that occurs in the practice of native midwives. Dr. Ward's report
should, I venture to think, be sent to the Medical and Physical
Society, as illustrating some of the practice of this obstetric institution.
9. The returns of the Cowasjee Jehangeer Ophthalmic Hospital
show a smaller number treated as in-patients than usual. This is
accounted for by Dr. Maconachie not admitting, as was formerly
the custom, persons suffering from slight or chronic ailments, or
beggars affected with blindness. Dr. Maconachie also states that
many operations are now performed on persons, as out-patients, who
can continue to reside at their own homes, but who, until recently,
were made inmates in the hospital.
Byculla Schools.
1 0 .
T h e h o s p i t a l o f t h e B y c u l l a C e n t r a l S c h o o l s , t h e m e d i c a l c h a r g e
of which is held by Surgeon Major Partridge, has had in the year
292 boys and 187 girls as patients—the strength was, of boys 150,
of girls 117; the average daily number of sick was boys 7, girls 6;
this points to a considerable number of re-admissions, more of boys
than girls. 283 boys and 171 girls were discharged cured, 8 of the
former and 17 of the latter remained under treatment. Under
general disease A, 105 boys and 72 girls suffered from fevers; they
had more ague when on their holiday at Khandala, and it is just
possible that this periodical change does not afford all the good that
it is desired should arise from it.
Under local diseases those of the eye are observed. The occurrence
of inflammation of the eye in children's schools in England, is, at
present, attracting very much attention. The Byculla Schools are,
I believe, seldom free from it, and the children were known to pro
-
duce the disease themselves to escape the tedium of the school. This
year it occurred chiefly in infants, so some other cause must be looked
for, for its origin.
11. A case of leprosy, referred to in the last report, is interesting,
as it is one which illustrates the use of the external application of
the cashew-nut oil. As Dr. Partridge's estimate of its utility differs
somewhat from that of a sub-assistant surgeon, to whom has been
entrusted the treatment of lepers in the hospital for incurables, I
cite the remarks of each upon the employment of this oil, which is
the local mainstay of Dr. Bauperthy's treatment, and which was
considered of such importance at home.
130
Surgeon-Major Partridge.
" A large part of the body still
remained more or less anæsthetic.
In July last I stopped her oil
(Bhow Dajee's) and began the
oil of cashew-nut and alkaline
treatment. I applied the oil to
a limited portion of the body;
and when the resulting blister
was healed, I repeated the appli
-cation to another part, until
every part, where there was loss
of sensibility, was completely
restored, and continues so up to
the present time."
9 months—31st March 1873.
Surgeon-Major H. Cook, M.D.
By Sub-Assistant Surgeon
Succaram Arjoon—
"As a part of treatment the
external use of the cashew-nut
oil needs but short notice. Re
- p e a t e d a p p l i c a t i o n s o f t h e d r u g
have been used to patches of an
anæsthetic case * * * the
sensibility which is generally
impaired in such patches is
slightly restored towards the
circumference, these effects are
augmented, though slightly, by
repeated applications, but the
central parts continue to be
anæsthetic * * * as an ad
- j u n c t t o c o n s t i t u t i o n a l t r e a t m e n t
it may be looked upon as of some
service.
"It appears to have been em
-ployed in this one case only."
At my visits to these hospitals, I have always found them in good
order, the matrons attentive, and the hospital establishment and
hospital assistant efficient.
12. There are threepresidency surgeons in Bombay, from none of
whom hitherto have any reports been submitted. This year a short
statement has been received from each.
13. The first presidency surgeon, Surgeon-Major Ward, also
Professor of Midwifery in the Grant Medical College and Physician
to the lying in hospital of the Jamsetjee Jejeebhoy Hospital, not
having kept any regular register of sick during the year, his return
is somewhat imperfect; but 26 military and civil patients have been
on the sick report. Many of these have been sent home on sick
certificate and others were discharged to duty. The above number
points only to cases off duty, or who have been sent down on pre
- p a r a t o r y c e r t i f i c a t e s ; m a n y c a s e s r e q u i r i n g t r e a t m e n t n e c e s s a r i l y d o
not appear in the lists, and wives and families of officers entitled to
gratuitous aid are also not reported.
The fatal case was in a lady who died from dysentery.
14. The second presidency surgeoncy to which is attached the
marine surgeoncy and dockyard, has been held during the year by
several officers; at first by Surgeon Major Rogers, then, officiating,
by Surgeon Hojel, and Surgeon Cameron MacDowall. None of these