NationalLibraryOfScotland/medical-history-of-british-india huggingface dataset:
106
remittent fever and 249 of febricula. There were no in-patients,
there being no room for their treatment.
The meteorological register kept at Bhewndy shows that the
months of greatest heat were May and June, thermometer 94° and 95º,
the lowest temperature was 60° in January and February.
The rainfall was 67 inches 72 cents, about half the average, an
unusually small registration—the month of greatest fall was July.
At my inspection I was very well satisfied with the manner in
which I found the duties performed by Mr. Shamrao Juggunath,
and wish much that the dispensary he has charge of could be moved
to a more central and larger building, one in which he could increase
his sphere of usefulness. The present place is ill-suited for such an
institution, there is no place for in-patients, and consequently opera-
tions cannot be performed. A plot of ground has been set apart by
the Deputy Collector, but funds are not forthcoming for a build-
ing, at least not at present.
Six cases, illustrative of practice, accompany the annual report.
There were 6 post-mortem examinations. 56 minor operations were
performed during the year.
Surat.
Paruk Dispensary. —In 1864 the sum of Rs. 24,000 was offered
by Mr. Cursetjee Furdonjee Paruk for the establishment of a 2nd
Class Dispensary, to defray all expenses, save those attending the
pay of the Sub-Assistant Surgeon and Native medical pupil. This
offer was accepted by Government, and the dispensary was accord-
ingly opened in 1865 in a house situated in the centre of the city
of Surat, in this respect, but in no other, being satisfactory. From
time to time the otherwise unsuitable character of the building was
brought to notice. In 1866 the gentleman above named found it
impossible to conclude the agreement made, owing to his embarrassed
position; the Municipality and Local Funds did not, however, allow
the undertaking to collapse, and continued to defray the usual expenses
till March 1867, when the President of the Local Funds withdrew
their assistance. The Municipality from this time have borne the
expenses of the institution for medicines, menial servants, con-
tingencies, &c.
In this year also it was determined to erect a building for the dispen-
sary, and the foundation stone was laid in October, the cost being
Rs 12,500, paid for as follows:—
Mr. Cursetjee Furdonjee Paruk... ... ... Rs. 6,500
Municipality... ... . . . ... ... ... ... ... „ 3,000
Local Funds... ... ... ... ... ... ... ... „ 3,000
The building was completed and opened to the public in June 1868.
It is commodious, well built, and in every way well suited for its
purpose, situated in a central position of the city and on the public
road, it is easily accessible to the people, while it forms one of the
most ornamental features of the town.
107
Since its formation it has been of benefit to the people.
The number of admissions during the official year under report
was 4,323, a number much too small for this city and the crowded
part about where the dispensary is situated; the total treated being
4,361,* of which 38 remained from previous
year; of this number, 4,152 were cured or
relieved, 152 absented, 2 died, and 55 remained.
The number of in-door patients treated was 19, of whom 17 were
discharged and 2 died. These are included in the above.
The chief diseases treated were of the febrile and cutaneous clas-
ses, of which 877 were from intermittent fever, giving a proportion
of 20.27 per cent.; there were 25 cases of remittent fever. The
daily average was 77.5, being 6 less than in the preceding year.
There were 530 successful vaccination operations performed.
The meteorological registers show that the greatest heat experien-
ced was in the month of March and April, thermometer 98º, and
the minimum temperature was 70º in December and January.
At the annual inspection of the dispensary I was, to a certain
extent, satisfied with the conduct of the duties by Sub-Assistant
Surgeon Dossabhoy Pestonjee, who holds a high place in the estima-
tion of the Civil Surgeon, and is a zealous member of the municipality
in sanitary matters.
In the annual report there is nothing stated as to the detailed
character of the diseases under treatment, but the diaries of a few
cases are submitted which illustrate the practice of the Sub-Assistant
Surgeon, none of which possess any particular interest.
A former Collector of Surat has stated that Mr. Dossabhoy Pes-
tonjee has a large practice in Surat. This is satisfactory as showing the
estimate he is held in by those who are able to pay him, but does it
not lessen the good he should be able to do in his dispensary? I
think it must to a certain extent.
12 minor operations only were performed during the year.
Looking at the numbers treated at the Paruk Charitable Dispen-
sary, and comparing them with the largeness of the city, possessing a
population of 90,000, and the amount of work carried on in far
smaller towns, I confess that I am surprised at the smallness of
the outturn, and must conclude that hardly sufficient time and
attention are bestowed on the dispensary practice.
If the public confidence is placed in the zeal and interest the
Medical Attendant takes in such a dispensary, double the number
might be at the very least expected to resort to it.
Tanna.
The chief town of the Collectorate of that name has a population
of 10,581.
In 1865 Mr. Rustomji Ardasir Wadia offered the sum of Rs. 25,000
to Government to be invested for maintaining a charitable dis-
* Including 19 in-patients.
108
pensary, the interest of this sum to be used for the purpose ; this
gentleman also gave a small house for the dispensary and residence
of the Hospital Assistant, whose pay, with that of a Native Medical
Pupil, was to be defrayed by Government.
Since its opening this dispensary has well fulfilled its mission,
and notwithstanding its proximity to the civil hospital and Govern-
ment dispensary, is always well attended.
In the year under report 5,408 cases were treated, of which 5,347
were fresh admissions, and 61 remained from the previous year;
4,849 were cured or relieved, 498 absented, 3 deaths were reported,
and 58 remained; of the total, 1,757 cases were of intermittent fevers,
giving a percentage of 32.48 to treated. There were 27 cases of
remittent fever. The temperature was at its highest in June, when
the thermometer stood at 95º, lowest in the month of December,
when it was 60º, in which month also there was the greatest range,
27º; the rainfall guaged was 62 inches 80 cents, the greatest fall in
July. The dispensary stands at the northern side of the town,
and is tolerably convenient for the people. I was satisfied with
the attendance and with the intelligence displayed by the Hospital
Assistant, and consider him well fitted for the work he has to per-
form. I am inclined to think that if the liberal founder of this dis-
pensary, Mr. Ardasir Wadia, could be induced to change the present
building to a larger one, the necessity for keeping up the civil dis-
pensary, which is close at hand, would be obviated, the patients of
which only amounted during the year to 1,519.
The Hospital Assistant resides at the dispensary, but there is no
accommodation for the Native Medical Pupil or for servants.
I submit six cases illustrating the practice of 2nd Class Hospital
Assistant, Ramjee Bapoojee, General No. 429, of whose character
and attainments I entertain a favourable opinion—there being a Civil
Surgeon, he does not perform post-mortem examinations.
4 major and 107 minor operations were performed.
Kalian,
A large town or city on the main land in the Tanna Collectorate,
is situated on the branch of a large creek or arm of the sea, which,
winding from the Bombay harbour, encircles the Island of Salsette,
completing its course at Bassein on the north. The branch creek,
or "Caree,'' on which Kalian stands is one of considerable size, ad-
mitting the navigation of tolerably large native boats.
The country for some distance between Tanna and Kalian is in-
tersected by larger or smaller tidal creeks, and much wet land is
thus exposed to the action of the sun's heat.
Mr. Munguldass Nutabhoy, appreciating the medical wants of the
poor of the locality of his people, offered the sum of Rs. 40,000 to
Government, of which he desired Rs. 20,000 should be used for
building a dispensary, and the remainder to be funded for its main-
tenance, Government paying for establishments.
109
The situation selected for the dispensary was a most unfortunate
one; selected on such grounds as the following: 1st, that the dispensary
should be near the railway station in case of accidents occurring,
2ndly, on account of its locality, where free ventilation and pure air
can be had, and lastly it was considered that such a handsome build-
ing as the one proposed by Mr. Munguldas Nutabhoy would be thrown
away if built "in the dirty village of Kalian," whilst if erected on
the site indicated "it would present a very fine appearance to the
passengers by railway."
Wisdom was not wanting to disapprove this very startling opinion
as to a site for a charitable dispensary. The Revenue Commissioner,
addressing the Collector, remarked "the desire of Mr. Munguldass
Nutabhoy to build a dispensary is highly to be applauded. I wish he
could be persuaded to build it in the town instead of near the rail-
way station, where not one-eighth part of the good will be done,
which might be effected if its establishment were in the heart of this
crowded city."
The building was commenced in 1865, finished in April 1869, and
opened in May, the cost of the erection alone being Rs. 31,000; its
medical history goes far to verify the opinion of the Revenue Com-
missioner and the Collector; the dispensary for Kalian is evidently
too far off, as was observed by me on my visit of inspection, when I
found that persons desirous of advice were nearly always obliged to
hire carts for conveyance to the dispensary, and consequently many
would not repeat their visits. For a dispensary of such pretensions,
with a Sub-Assistant Surgeon in medical charge, the total treated
is small, though the number was slightly increased during the past
year. In the year there were 4,254 new
admissions (against 3,892 of the previous 12
months), and a total treated of 4,351,* of
which 97 remained from the previous year; of this number, 2,998
were discharged, cured or relived, 1,226 absented—a very large num-
ber, and which I can only at present attribute to the difficulty of
access—26 died, of which 6 were from cholera, and 101 remained;
the average daily attendance was 37 against 46 of previous year.
From ague alone there were 1,149 cases treated, giving a proportion
of 26.40 on the whole. 17 in-patients were returned, of whom 7 died,
these are included in the above.
The temperature was at its highest in May, when the thermometer
was 97°, the lowest register was 63° in December. Rainfall was 59
inches 81 cents, in July 18 inches 20 cents was guaged. At my
inspection of the dispensary, I regret to state I was not satisfied with
the activity of the medical officer in charge.
A good deal of the apparent want of success of this institution is
undoubtedly owing to the situation, but there also appears a certain
want of energy. I feel sure if Sub-Assistant Surgeon Dhunjeebhoy
were more active and would rouse himself he would double the work
now done. The annual report is merely a set of routine notes of
very routine practice.
14 M D
* Including 17 in-pa-
tients.
110
Six cases of practice are forwarded with the annual report.
I most emphatically endorse the opinion of my predecessor, which
is as follows :—" I think it would be well if, with the sanction of the
founder, this building could be disposed of to the Railway Company,
and another erected in a locality more suitable. "
Cholera was epidemic in this town in August, September, and
October. From the annual report it is apparent that everything
was performed that could be to arrest progress and help the sick.
The town of Kalian has a population of 12,000 increasing, and
though it boasts a Municipality, it is, except in one or two main
streets, a place where very much sanitary attention is called for.
No operations were performed during the year. 26 post-mortem
examinations were performed by Sub-Assistant Surgeon N. Dhun-
jeebhoy.
The Dispensaries of Coompta,
Elao,
Bardoli,
Mandvi,
Anklesar,
Hansot,
Pardi,
Chikli,
Pen,
have been established on the principle enunciated in Government Re-
solution No.1448, dated 1 4th August 1867, viz., that Government shall
pay only a share of the entire cost of a dispensary according to popula-
tion, the remaining charges being defrayed by the founder, municipality,
or by public subscription, as the case may be. Thus the Government
grant-in-aid for towns with a population of 10,000 and upwards
shall not exceed Rs. 2,000 a year : Rs. 1,200 for towns with a popu-
lation of less than 10,000, Rs. 600 in smaller towns.
To the last 8 towns mentioned the grant of Rs. 600 has been
made, to Coompta Rs. 1,200.
In the same Resolution, however, para. 1, Government qualify the
above by stating that "in no case whatever will Government pay more
than half the entire cost of any charitable dispensary (including
salaries, medicines, diets, and contingencies), the remaining half being
defrayed by Municipal or Local Funds, or from other private sources.
Coompta,
An important town in North Canara, situated on a winding tidal
creek, at each fall of the tide large mud banks are left exposed, some
of which no doubt prove a source of much malaria. The town is
situated about a mile from the sea, there is no harbour, but a high
head-land to the north shelters the road-stead during the prevalence
of the north-west winds.
During the south-west monsoon the position is an entirely exposed
one.
111
The population is about 6,824, but including several villlages
embraced in municipal limits, it amounts to 11,640. There are three
or four English residents connected with banks and cotton, and a
Municipality is in existence, which has largely aided in the establish-
ment of this dispensary.
The dispensary at Coompta was opened in 1869. On the 22nd
April 1868, the Municipal Commissioners, feeling much the want of
a medical institution, requested, through the Collector, the sanction
and aid of Government in establishing one. To the maintenance
of the dispensary, Government gave a grant-in-aid of Rs. 1,200
per annum, the Municipality defraying all expenses beyond that sum.
The dispensary was opened in February 1870, and placed in the
medical charge of Sub-Assistant Surgeon Vishram Ramjee Gholay,
a most intelligent and most painstaking officer, under whom the
dispensary, as a medical institution, has prospered, that is to say,
a large amount of suffering has been relieved, and the reputation
gained by Mr. Vishram has extended considerably beyond the
limits of the Coompta Municipality.
The number of cases treated at the dispensary amounted to 7,335,*
7,232 were new admissions and 103 remained
† Including 131 in-pa-
tients.
from previous year; of these, 1,746 were cured
or relieved, 29 died, 48 absented, and 112
remained. There were 131 in-patients treated, of which 19 died.
These are included in the above. The daily average number of
sick was 93, and the prevailing disease was ague, of which 1,236
cases were admitted, giving a proportion of 17 per cent. to total. A
considerably smaller proportion to treated than is shown to occur in
the dispensaries of the Northern Koncan. Of other fevers there were
simple fever 84, enteric 7, remittent 120.
The meteorological register shows the greatest heat to have been
in the months of March, April, May, and June, 91º, the minimum be-
ing 70º in January and February. The rainfall was 43 inches 45
cents, less by 12 inches and 18 cents than in the previous year;
the fall was scanty and insufficient. At my inspection of the Coompta
dispensary I could not but condemn the spot in which the Muni-
cipality had placed it.
It is the worst and meanest I have seen, and it is indeed to be
hoped that the new dispensary will soon be ready to take its place.
The position of the new dispensary is in all respects satisfactory.
I suggested alterations in the place which have been attended to.
There are no quarters in the new dispensary for the Medical
Officer; this is very much to be regretted, but it cannot otherwise
be arranged, as more money could not be obtained; the Sub-Assistant
Surgeon will live as near as possible to the dispensary.
Six cases are forwarded showing the practice of Mr. Sub-Assistant
Surgeon V. R. Gholay, whose work as an operative surgeon and
successful medical practitioner cannot be too highly praised by me,
as it is justly appreciated by those amongst whom he is placed.
112
Mr. V. R. Gholay is one of the very few Sub-Assistant Surgeons in
my division who, in operative surgery, show that, under much diffi-
culty, they have taken advantage of the education and practice
afforded at the Grant Medical College and Jamsetjee Jejeebhoy
Hospital.
Major operations 29, and 295 minor were performed during the
year; only two post-mortem examinations were performed for legal
purposes.
Elao,
A small town of the Broach Collectorate, Hansot Pergunnah,
situated on a branch of the Keem River, from which it is distant
about one mile in a north-east direction. The population of this
place was estimated at 1,975; it is probable that under the recently
taken census it may have somewhat increased. This dispensary
was established in November 1870, at first in a private house, as
a temporary arrangement, pending the completion of a dispensary
building provided by the liberality of Mr. Ardaseer Hormusjee
Wadia, into which the removal took place in November 1870. The
dispensary is well situated in a clear, open space somewhat outside
the town at the entrance from the Keem road.
There are many surrounding villages, and at certain seasons mala-
ria prevails owing to the proximity to the river and its branches.
My predecessor, in his last inspection, found the Hospital Assistant
living in the town and the Native Medical Pupil in the dispensary.
Matters were reversed at my inspection: the Hospital Assistant in-
habited the upper room of the building and the Native Medical Pupil
lived in the town.
The dispensary is as regards plan satisfactory, but in its building
it has not met with justice, the bath-rooms have mud floors and no
exit for water; the doors and windows have been made of green
wood which now splits and warps, and the flooring of the rooms has
been most carelessly prepared. These defects were apparent.
The total number of cases treated in the year under report was
* Including 5 in-patients.
6,960*; of these, 6,919 were new admissions,
and 41 remained from previous year; of
these 6,577 were discharged, cured or relieved, 337 absented, 1 died,
and 45 remained. The average daily sick was 45. There were 2,280
cases of ague, giving a proportion of 33 per cent. to total; of other
fevers there were 10 cases of remittent fever. There were 5 in-door
patients treated, 1 died. These are included in the above.
The maximum temperature reached was 94º and minimum 76º.
The minimum must be incorrect as the temperature in the cold
months in Gujrát is well known to fall below this very much.
Vaccination was performed on 94 children, 51 males, 43 females;
of these, 87 cases were reported as successful, 7 unsuccessful, 2 un-
known.
113
The operations, with the exception of reduction of four disloca-
tions, have been of minor character.
I was satisfied with the 3rd Class Hospital Assistant Luximon
Anunth in medical charge.
Six copies of cases in the practice of Elao Dispensary are for-
warded.
This dispensary is one of those in which the new payment system
has been carried out. In March it commenced and the sum of
Rs. 22 was realized, but the attendance at once fell from a daily
average of 45.14 to that of 3.42. 130 minor operations have been
performed.
Bardoli,
A town in the Surat Collectorate, in the Pergunnah of Bardoli,
with a population of about 4,020. The population of the taluka
is 44,534, this town is distant from Surat about 20 miles, lying in
an easterly direction. The chief trade is in timber.
The dispensary was opened in the year 1869, and was built entire-
ly by Local Funds under the grant-in-aid system, Government pay-
ing according to population Rs. 600 per annum. It is a well plan-
ned, very neatly kept dispensary, infinitely better built than that
at Elao. It is situated a little to the outside of the village on a
clear, open space; it is, however, quite close enough for all the pur-
poses of such an institution.
The number of cases treated during the year amounted to 3,528*;
of these, 3,472 were fresh admissions and
56 remained from previous year; of these,
3,258 were discharged, cured or relieved,
6 died, 250 absented, and 14 remained. The number of cases of ague
treated were 933, or 26.44 per cent. of the whole. There were 48
cases of remittent fever, 8 in-patients were treated, 2 died. These
are included in the above.
The temperature recorded cannot be trusted, and the rainfall is
not given.
Six cases are forwarded, only two of which are written by the pre-
sent Hospital Assistant in charge; both these cases appear never to
have returned for further treatment!
95 minor operations were performed.
The Hospital Assistant at present in charge, Gopall Hurree, Gene-
ral No. 869, appears to me to be a well-behaved man, but he had not
then gained the confidence of the people. I saw few patients while
I remained at Bardoli. Gopall Huree's acquaintance with English
is of the slightest description, his medical attainments are tolerable,
his books, as far as they went, were tolerably kept, but not quite
correctly; he is not much assisted by his Native Medical Pupil,
Damoder Madeo, General No. 823, who is backward.
After a longer residence I shall be able to judge better as to
the advisability of the Hospital Assistant being kept at this place.
* Including 8 in-door
patients.