NationalLibraryOfScotland/medical-history-of-british-india huggingface dataset:
201
The average daily sick did not amount to 1.
DISPENSARIES ESTABLISHED UNDER THE GRANT-IN-AID RULES, SUBSE
-
QUENT TO 1867.
Pen.
1. At the dispensary established at this apparently flourishing
salt town of 6,514 inhabitants, there were 2,856 patients treated in
the year, a very great decrease compared with the previous year, viz .,
3,168; 2,327 of these were discharged cured,or relieved, 478 absented,
13 died, and 38 remained on the register; of these there were
males 1,532, females 387, children 937. Hindus 2,574, Mussulmans,
223, other castes 53, Parsees 5, Christian 1; the above numbers
include in-door sick.
Under general diseases, Class A, 624 cases were treated; of these
611 were ague, giving a percentage to treated of 21.39.
Of class B. 221 were attended. Local diseases gave 1,861 in
which diseases of the respiratory system, of the eye and ear, of
stomach and intestines (particularly round worm), and skin diseases
were the most prominent.
Of local injuries there were 87 treated, occurring from accident
or caused by malice; these were chiefly fractures, dislocations,
wounds, &c. There were two dislocations of the jaw; in one of these
cases tie hospital assistant reports after unsuccessfully endeavour
- i n g t o r e d u c e t h e d i s l o c a t i o n ,s
e c u n d u m a r t e m ,
he tried the Electro
- G a l v a n i c m a c h i n e , w h e n s u c c e s s f o l l o w e d h i s e f f o r t s .
The surgical operations were generally of minor character, some,
however, possessing a certain importance.
Thirteen deaths are announced during the year; they were from
ascites, abscess of the bladder, dysentery (6), intestinal obstruction,
pneumonia, hypertrophy, and remittent fever.
It is seldom that dispensary records show deaths, and few give
any clue to the actual mortality amongst the patients; in this case
were we to take the number as a ratio to treated in all diseases it
would be 0.45.
This dispensary, as stated in my last report, is badly placed in
every respect; another house is under consideration for it, and will,
probably, be arranged for before next year; the best change would
of course be to a place built expressly for a dispensary; this it
appears at present cannot be considered.
The 2nd Class Hospital Assistant Hurree Row Powar under
-stands his work fairly; the number of treated is however small and
should be larger; the decrease is said to be duo to the payment
system.
202
In Pen there is a municipality, but the town is not a clean one;
the fish market or resort for selling fish, the meat market, the bye
-
streets are generally unsatisfactory. The tanks are foul from human
and cattle bathing, washing of clothes, and the like; the water of
these tanks is not used, as far as I could observe, for drinking pur
-
poses.
2. The water-supply becomes scanty during the hot season,
wells, where there are any, ceasing to afford it; at this time water is
brought from a distance for drinking purposes.
Vaccination is not successfully practised in Pen. There were 53
cases only successfully operated on.
Mandvi.
3. A place with a population of 4,256, and situated in a con
-
fessedly malarious district, has never had under treatment, at
the dispensary established in the town, more than 512, in one month,
patients; and the highest average daily attendance was in the month
of June 1871 when it was 58. At this dispensary during the year
under report there were 1,635 patients, being 2,430 less than in the
preceding year.
The decrease is ascribed to the payment system; it is not quite
correctly so ascribed, but to the want of proper instructions being
given by the civil authorities as to the scope and object of the
system. The hospital assistant in medical charge (who was, as
well as the native authorities, at the period of my visit in 1871,
carefully instructed by me regarding it) has reported in the follow
-
ing words:— "The usual charge of payment system in the month of
March 1872, made out a general row in the town and abroad. So,
in the first instance, people stopped attending the dispensary. After
-
wards when the information reached the public that this system is only
applicable to those who are rich the attendance commenced." Of
the above number 1,617 were fresh admissions and 18 remained
from the previous year, 1,002 were cured or relieved, 605 absented,
3 died, and 25 remained under treatment. The average daily
attendance during the year was 21, the lowest being 8, and the
highest 38. Of the treated 1,287 were Hindus, 217 Parsees,
129 Mussulmans, and 2 Christians. The diseases of most frequency
during the year have been in general diseases A, of which 521
cases were treated; these comprised a few cases of chicken-pox,
dengue, hooping-cough, and 501 cases of ague, giving, to the
total treated at the dispensary, 30.64 per cent. As regards the
district, I think I am not incorrect in stating that were fever
medicines in closer reach of the inhabitants of the jungle and hilly
lands about, during the malarial season, there would be an
immense amount of relief afforded which the number attending
gives no adequate idea of.
203
Of general diseases B, 93 cases were treated, chiefly rheumatism
and anœmia (probably the result of old fevers). There were of local
diseases 72 of the eye, 65 of the ear, 96 of the respiratory system,
nearly all bronchitis, 42 of the mouth, gums, palate; 366 of diseases
of the stomach and bowels—dyspepsia, dysentery, diarrhœa, colic
and constipation were the chief. Ascaris lumbricoides was almost
absent here. Of congestion of the spleen 27 cases were treated, point
-ing out the severity of the fever of the country. Skin diseases gave
422 cases for treatment, scabies as usual the chief.
Injuries were few and the operations only minor.
Vaccination was performed on 211 children, of which 203 were
pronounced successful operations.
The 3rd Class Hospital Assistant Govind Keshew, General. No. 520,
has been in medical charge of the dispensary since its commencement;
he was translated at once from the schools to a medical charge, a
practice I cannot but think objectionable and, in a measure, unfair to
the assistants. As far as I was able to observe Govind Keshew
attended to the sick tolerably correctly, but in his management
of medicines and some of his books I found much to be displeased
with.
Chickli.
4. There has been no alteration in this dispensary; a site has
been selected, and the new building will probably be commenced with
before long; the plans were sent for approval and a few alterations
s u g g e s t e d .
The people in the place and around do not seem to take advantage
of the dispensary to the extent that might be expected. There were
2,960 cases only treated, 16 remained from the previous year and
2,944, were fresh admissions; 2,164 were Hindus, 604 Mussulmans,
105 Parsees, and 87 other castes; a falling off is shown in the at
-tendance during the year of 494, owing, it is said, to the application
of the payment system. I have only to repeat my opinion that had
the object of this system been properly pointed out to the people,
the error which entered into the minds of the poor would not have
occurred, and they would not have abstained from attending.
The average daily attendance was 32.
There were 2,693 cured or relieved, 194 absented or unknown,
I died, and 72 remained under treatment.
Under general diseases A, 1,307 sick were treated, of which number
1,296 were ague yielding a percentage of 43.78 per cent. to total
treated.
27 M D
204
Under B, there were 136, of which rheumatism, anœmia, and
syphilis were the chief ailments. Local diseases gave 1,432 cases.
Diseases of the eye, ear, respiratory system, stomach and bowels,
gonorrhœa and its complications, and diseases of the cutaneous sys
-
tem chiefly presented for treatment.
Of poisons and poisoned wounds 6 cases were treated; 3 of these
were snakebites—2 were cured, 1 absented—1 from the marking nut,
1 from alcohol, and 1 dogbite.
The injuries—general and local—amounted to 79; these chiefly con
-
sisted of contusions, wounds, foreign bodies in the passages, frac
-
tures of thigh, patella, ribs, humerus, dislocation of radius. The
surgical operations amounted to 76 all minor.
5. The Hospital Assistant at present in medical charge, General
No. 551, Chintamon Bullal, understands very little English, the dis
-
pensary has not done well under him, he has been always desirous of
leaving, though he has not been at Chickli more than 7 months, and
is working unwillingly in it; the assistant would be better placed on
general duty for a time, where he could learn how to perform his
work generally, be disciplined, and be made more useful than he
now is. If possible the charge of dispensaries should be filled by
selection: I am not of opinion that because a youth has been passed
out of the Grant Medical College by an examining board of native
lecturers, that he should be at once put into the serious medical
charge of a dispensary. A native medical pupil is attached, he also
is as unwilling as he can be to remain, and will be changed, as he has
been some time at the dispensary.
Vaccination was performed on 100 children, and the operation prov
-
ed successful on 94—there were 2 unsuccessful re-vaccinations.
6. Situated about 2 miles west from the railway station of that name,
on the Bombay and Baroda Railway, is a town of about 4,000 inha
-
bitants; in its vicinity are several small villages to the sick of which
the dispensary affords medical aid. Pardi is situated on rising ground,
and escaped suffering from the disastrous floods of the Daman Gunga
and Par rivers during the monsoon of 1872. At this dispensary
4,174 persons were treated during the year 1872-73 against 5,539 of
the previous year: errors in the mode of registration by the previous
incumbent account for some of this; it is not mentioned by the hos
-
pital assistant that the payment system did so at all; it may, however,
be considered that in the first few months of this system, for it is in
these months the falling off took place here as elsewhere, misunder
-
standing affected the attendance which was soon, however, restored
to its former numbers, sometime before the summary stoppage put to
the system by the Collector of Surat.
Of the 4,174 there were remaining 80 from the previous year, and
4,094 were new admissions. Of these 3,212 were cured or relieved,
792 absented, 1 died, and 169 remained under treatment. There
were 3,378 Hindus, 452 Mussulmans, 343 Parsees, and 1 Christian.
In-door sick are included in the above.
The average daily sick was 40—it has been as high as 64 and as
low as 33. Of the above, 5 in-patiens were treated.
Under the head of general diseases, Division A, there were 1,286
cases; of these 1,227 were ague, giving to the total of treated a per
-centage of this disease of 29.39. In B Division of general diseases,
151 were treated chiefly rheumatism. Local diseases brought under
treatment 2,603, the chief of these were affections of the respiratory
system and stomach and intestines. Here again the ascaris lum
-bricoides appears, 397 cases of which were treated. There were 839
cases of skin disease—only one case of snakebite came for relief.
87 cases of injuries, including fractures, dislocations, wounds, &c.,
were treated.
The operations were minor.
Vaccination.—There were 155 cases operated on, 144 of which were
successful.
The 2nd Class Hospital Assistant, Hurree Pandoorung, General
No. 432, has conducted his medical duties generally fairly; in his office
work he is somewhat careless and superficial. I trust to see next
year that his attention to the poor sick will be better known and his
usefulness extend. A native medical pupil is attached to the dispen
-sary and is reported on favourably.
7. Pardi depends on a few wells for its supply of drinking water;
the water is brackish, and if left standing for some time becomes
covered with an oily or greasy-like film or coat. This water has
not been analysed—it is considered by the inhabitants as unhealthy.
There is a tank which is used for general purposes, the water of which
is in consequence foul in the extreme.
Hansot.
8. The dispensary still carries on its business in the hired house in
the centre of the village or town of Hansot; the house is about as
poor a one as could be for the purpose, but no other is available, and
there is not, as far as I am aware, any likelihood of a dispensary
being built.
The population of the place is 4,152 or thereabouts, Mussulmans
forming the largest number.
206
The situation of Hansot and adjoining villages, lying within a
short distance of the Nerbudda estuary, would have led me to sup-
pose that much fever would prevail—this is borne out by the percen-
tage of ague to all other diseases treated at the dispensary.
The number of treated here was 2,796, a decrease of 2,303 on the
previous year, nineteen remained from the year 1871-72 and 2,777
were fresh admissions. There were 1,858 Mussulmans, 1,302 Hindus,
and 136 Parsees; 2,525 were discharged, cured or relieved, 253 absented
or unknown, no deaths are recorded, and eighteen remained under
treatment.
Under general diseases A, there were 935 cases; of which 904 were
ague and nine remittent fever; the percentage of ague to all other
diseases is 39.25. Under B, rheumatism and syphilis were the chief
diseases out of forty-five. Local diseases: of these, diseases of the
nervous system (neuralgia), of the eye, ear, respiratory system,
stomach and intestines were the chief; no parasitic disease was
treated, and skin diseases were the most prevalent. There were
seventy-nine injuries; they consisted of contusions and wounds, and
one dislocation of the jaw. The operations were of the most minor
description.
Vaccination .—Sixty-three cases only were vaccinated, of which
fifty-nine were stated to be successful. The work has never pros
- p e r e d i n t h i s p l a c e .
The dispensary has been since its commencement under the charge
of Hospital Assistant, General No. 556, Abbajee Bapoojee; the period
has, I think, shown that it would be as well that the medical charge
should be given to another. The number of patients during the
last year has decreased by 2,303—no explanation is given for this
great falling off—I can only surmise that it may be partly owing to
the payment system; the attendance certainly fell in the first
months after the rules were promulgated, but in September it again
rose and equalled the attendance of the previous year; it may also
be partly owing to their being less fever than usual in the district.
There is no native medical pupil, but one will be attached as soon
as the circumstances of the department will allow of it.
9. Great carelessness was observed at this dispensary in the
care of medicines, in the correct ascertainment of quantities in hand,
and in the keeping of the books. The hospital assistant should, I
think, be changed.
Elao.
10. The village of Elao has a population of only 1,975 souls.
The dispensary situated in this place affords medical aid to many
surrounding villages, and there are cotton-ginning mills in the
vicinity. During the year under report there were 4,877 patients
treated which shows a decrease of 2,083 compared with the previous
year; this is laid at the door of the payment system.
207
There were 1,937 males, 1,235 females, and 1,705 children under
ten years. At the end of 1871-72 there remained forty-five
cases and 4,832 were fresh admissions, 4,396 were cured or re-
lieved, 403 absented, 1 died, and 77 remained; 2,629 of these were
Parsees, 2,008 Hindus, 240 Mussulmans. The average daily sick was
forty-four, in March it was fifty-two, equalling the average of the
same months of the dispensary in the three years of its existence.
In-patients are included in the above.
The prevailing diseases treated at this dispensary were first in the
class of general diseases A, 2,431 cases being treated, of these 2,324
were of ague, being 47.65 per cent. of the whole
Of B, including rheumatism, syphilis, leprosy, 190 were treated.
In local diseases those of the eye, ear, respiratory, digestive,
cutaneous systems were the chief ; there were of the stomach and
bowels 693 cases, the chief of which were constipation, diarrhœa,
and dysentery.
A few cases of congestion of spleen presented themselves.
Gonorrhœa gave forty-five cases; there were 739 cases of diseases
of the skin, the chief of which were from scabies.
Venomous animals—under wounds—by these are thirteen cases of
scorpion stings.
Vaccination has been successfully carried on in 91 persons
out of 101 vaccinated.
For a few months in the years 1871-72, 1872-73, when the payment
system was first established, the attendance fell very greatly indeed,
the number of admissions falling from 600 to 200. This was not of
long duration; in September the tide began to turn, and in October
there were more admissions than in the same month of the previous
year—by more than 200. Five months, however, in which misunder-
standing as to the system existed caused the decrease alluded to.
The water-supply is from wells, and is reported on as good, and not
affecting the health of the people; at this place there is no report of
the presence of the ascaris lumbricoides, though a few cases of
thread worm have been treated.
The Hospital Assistant, Luxumon
Anunt, 3rd Class, General
No. 552, I have every reason to consider is fairly fitted for the post
he holds, and I think that he is well appreciated by the people of the
villages who seek his assistance.
Elao and the neighbouring villages lie in a labyrinth of rivers, and
the locality is essentially a malarious one, evidenced by the number
of cases treated at the dispensary.
208
The dispensary when I visited it required some repairs—a note of
these was left with the hospital assistant; the building is reported
to leak much. There is no dead-house—there were no bodies
examined during the year, sent in by Police.
Bardoli.
11. The attendance at this dispensary, Taluka Bardoli Zilla Surat,
fell during the year under report from 3,520 to 976, being a decrease
of 2,544 patients. As I have before mentioned the falling off in these
dispensaries cannot, I think, be due to the "rich" denying themselves
the benefit of the institution, for the rich are few; it is simply due to
the misconception and ignorance on the subject which met with no
active efforts whatever to correct it.
In March when the payment system was set on foot—it was suppos
-ed with clear explanations of the object, according to the orders of
Government—the daily number attending fell from between forty-five
and twenty-three to five and eleven. In the course of time it began to
gradually dawn on the slow minds of the poorer people that the order
did not affect them, and in November the attendance rose to 16,
December 21, January 1873 to 33, February to 42, and March 46.
In January the Collector of Surat, apparently in consequence of
some stipulations with some original donators, who could, without
d i f f i c u l t y , h a v e p a i d f o r t h e i r m e d i c a l a d v i c e a n d t r e a t m e n t , s t o p p e d
the payment system at this dispensary. The number treated, 976,
were fourteen remained from the previous year and 962 fresh
admissions; 632 were Hindus, 246 Mussulmans, and 84 Parsees.
Of the 837 were cured or relieved, 116 are entered as absented
or unknown, 7 died, and 16 remained under treatment: in
-patients are included. Under general diseases, Division A, 450
received treatment, of which 439 were fevers, 422 of these ague
43.23 per cent. to total treated, the remainder were cases of hooping
-cough. Under Division B, 35 chiefly persons labouring under
rheumatism and syphilis; there were two cases of phthisis.
Under Local Diseases 437 received aid; the greatest number of
cases occurred in the respiratory and digestive, those of locomotion
and cutaneous systems.
Only one snake-bite was treated. There were 34 injuries
received; they were wounds, contusions, fractures of upper and lower
extremities, and burn.
The operations performed were minor and few.
The Hospital Assistant, General No. 869, is not sharp, and not
likely to gain any reputation in the country. The manner in which
the medicines were kept, betrayed much want of care.
The medical pupil appeared to be very inefficient. The result of
my two years' observation is, that I consider the dispensary would be
better managed if an assistant of more intelligence can be appointed.
Anklesar.
12. At the dispensary of this place, with a population of about
10,000 persons, the average daily attendance has been only 11.
There remained from last year sixteen and there were admitted
2,541, making a total of 2,557, which compared with the previous,
year shows a decrease of 3,227.
Out of the above number there were cured 2,478, absented 67,
died none, and there remained 12: total 2,557.
As regards castes or religions there were Hindus 1,217, Mussulmans
1,009, and Parsees 331. Under general diseases A, there were 1,258
treated, of which 1,226 were ague and 32 dengue, giving of
the former a percentage of 48 to the total treated. The situation of
Anklesar and neighbouring villages, may, in part, account for the
prevalence of this disease during the season following the monsoon;
much, however, is to be set against the town itself and its general
foulness.
Under B, 72 cases came under treatment, chiefly rheuma
-
tism, syphilitic affections, and anœmia. Of local diseases 1,227
received treatment, amongst the chief of these were diseases of the
respiratory system, cutaneous and digestive systems; of the
respiratory system 106 diseases presented; of the digestive
384; of which 14 were diseases of the spleen, which the
native doctor states occur chiefly in the Rajwara or Gaikowar's
territory. Diseases of the cutaneous system were, as usual, frequent;
there were 398 of these, 30 of syphilitic disease, 65 diseases
of the eye.
Local injuries were not many and all accidental.
13. The native doctor in medical charge, Mr. Heerjee Ardaseer,
is not, I venture to consider, a proper person to have charge of a
dispensary in so populous a place. I have recommended his removal,
or that he should be examined as to his qualifications in Bombay;
for the sake of the dispensary I should prefer the former course.
The dispensary is, as I before stated, situated in one of the worst
parts of the town. Its removal to a better position was recommended
by me, but no steps have been taken to carry my suggestion into
effect—the change should, if it is feasible, be arranged for.
Vaccination was performed but to no great extent for so populous
a town; 67 operations, with 64 pronounced successful was the result.