NationalLibraryOfScotland/medical-history-of-british-india huggingface dataset:
210
No explanation is afforded of the great falling off in attendance;
it would appear to have had its origin in part with the introduc-
tion of the payment system; from March the average attendance
fell from 29 to 14, then to 9 and 7; in September it again rose to 26,
and in March last was 23. The dispensary itself, when I visited it,
was in fair order, but the Parsee in medical charge is not, I would
repeat, the person to attract the poor for treatment. The dispensary
is itself ill-placed and ill-arranged—taking it altogether, I do not
think it will yet bear the fruits expected from it on its establishment.
Kamte.
14. The dispensary at Kamte continued to be held in the old
hired place until July 1st 1872, when it was removed to the build
-
ing erected for it by the municipality.
The new dispensary is well situated both for the convenience of
the people, and in a sanitary point of view, being in a fairly open po
-
sition and favourably suited for the treatment of in-patients; it pos-
-sesses barely sufficient room—what there is, however, can be better
arranged than it was at first; this, 1 trust, the sub-assistant surgeon
in charge, Mr. Mackenzie, will manage to have done. Externally
the dispensary is neat without ostentation, and presents with its
garden, which is well taken care of, a very creditable appearance.
The interior accommodation would have been improved, had the as
-
sembly-place for patients been separate and distinct front the pre
-
scribing officer; as it was when I inspected it, the patients seen and
to be seen, the medical officer, and the dispensary of medicine, all
were together. The building faces east and west, has the central
general room abovementioned, 20 by 20 feet; a ward on the north
side for male patients, 20 by 15, and one on the south, of similar
dimensions, for females; in front there is a verandah and one behind
where small rooms, such as bathrooms, examination and operating
room, storeroom, and room for native medical pupil are situated.
The out-houses are, at present, a cook and a bathroom; the other
out-houses have to be built, including a dead-house.
15. Kamte Municipality has a population of 11,640 and includes
the out-lying villages of Nelikerry, Vicknullee, Chotragee, Vurmul
-
lee, Hoanmow, Herowtee, and Munkee. A total of 6,116 patients
were treated, 6,004 were fresh admissions and 112 remained from the
year 1871-72; of these 5,840 were discharged, cured or relieved, 73
absented, 19 died, and 184 remained under treatment. There were
3,988 males, 978 females, and 1,150 children. In-door sick are not
There were 4,999 Hindoos, 739 Christians, 375 Mussulmans, 2
Pasees, and 1 other caste. Under general disease, Division A, 1,213
were treated; of these 1,016 were ague cases, giving a percentage of
211
16.61 to all other diseases. There were also 106 persons treated for
remittent fever; others for febricula, small-pox, chicken-pox, enteric,
fever, and hooping-cough. The number of fever cases far from repre
-
sents the amount of the disease in the district; the people treat
themselves and manage "to pull through on the instinctive under
-
standing that the disease wears itself out." The sub-assistant sur
-
geon states that quinine is badly borne by many, and that he is very
often obliged to associate it with other medicines; for instance, the
Tinospora Cordifolia, the "gulo" of the bazars, of the natural
order menispermaceœ, well known to contain plants possessing bitter
and tonic principles. Under B, 543 cases were brought under treat
-
ment, the chief of these were syphilis—primary, secondary, and here
-
ditary—epithelial cancer, leprosy, anœmia, dropsy, and phthisis; of
this latter there were 14 cases. Under local diseases 3,724 came for
relief; of these a considerable number were from nervous diseases,
chiefly of brow ague and neuralgia; there were 5 of epilepsy. Eye
disease caused many to attend for conjunctivitis, opacity, cataract,
choroiditis, iritis, and catarrhal ophthalmia. Simple inflammation of
the ear gave 112 and functional deafness 11. There were 1,384
cases of diseases of the stomach and intestines, 666 of which were of
intestinal worms. The sub-assistant surgeon considers it would be
accurate to say that the whole population suffer from this parasite.
Santonine, so useful in this disease, is now sold by the native shop
-
keepers in sweetmeat tablets. Diseases of the respiratory organs oc
-
cur to a considerable extent, chiefly amongst children. Here, as else
-
where, cutaneous disease is very frequent—there were 1,063 appli
-
cants for relief.
A few cases of poisoning were treated, one from taking crude
mercury. One from datura with which an Arab sailor was dru-
ged in the house of a courtezan, one from eating largely of the
Koda grain, the paspalum scrobiculatum, which caused mechanical
obstruction, there was one case of lead colic. Of injuries there were
295—amongst them fractures of the base of the skull, of the femur,
forearm, ribs; dislocations of the jaw, radius, elbow, and hip;
besides these the surgery of this dispensary comprised 38 major and
239 minor operations; amongst the former were lithotomy, tracheo-
tomy, iridectomy, artificial pupil, removal of tumors. In obsteric
medicine and surgery assistance is often asked for, and several
serious cases were attended by the sub-assistant surgeon in
charge.
The dispensary at Kamte since its establishment, has had the
good fortune to have had for its medical officers two sub-assistant
surgeons of character, the consequence has been that much good
beyond the ordinary run of dispensary practice has been accom
-
plished. The institution is well worthy of the support of the towns
-
people; the work of the year has been well performed.
28M D
212
Vaccination has been attended to with care—636 operations were
performed, of which 553 were successful. The report of the character
of the native medical pupil has not been favourable.
Kelvi-Mahim.
16. Two towns in the Collectorate of Tanna, situated about 60 miles
distant from Bombay, north, on the coast, and 6 miles southwest of
the Palgur station of the Bombay and Baroda Railway. The
unhealthy character of the place and the surrounding country led
the Collector of the District to propose the establishment of a charit
-able dispensary on the grant-in-aid system; the proposal was sanc
-tioned by Government, and a grant of Rs. 1,862 was allowed, the
municipality giving Rs. 500 and the house rent of Rs. 120, the
local funds granted Rs. 1,200.
16a . In company with the Assistant Collector I visited Kelvi
-Mahim, and arranged for the alteration and improvement, as far as
possible, of the only available house in the place, and on the 25th
August 1872 it was ready and opened for the treatment of the
sick of the place and surrounding villages, under the medical charge
of Sub-assistant Surgeon Trebowandass Moteechundsha, a licen
-tiato of medicine of the University of Bombay.
Mahim is situated on the north side of a karee or inlet of the sea,
which bounds it on the south—on the north-west it is open to the sea,
Boats come up close to the bunder near which the old Portuguese
fort and the dispensary are situated.
Kelvi is separated from Mahim by the said karee, being south
about a mile distant from Mahim. On account of the proximity of the
two towns the names are conjoined, and the place is known as "Kelvi
-Mahim." The population of Mahim is 6,334 and of Kelvi 3,400,
consisting chiefly of Hindus and a very few Mussulmans. The com
-mon food of the people is rice, with the toor dall, c ajanus indicus.
Fish also enters into the diet of all but Brahmans.
The sanitation of the place is by no means in progress; there are
few if any private latrines—fields and the seashore are used; by a
few, pits are dug in their compounds, and when filled they are closed
without removal of the contents; the bye lanes are generally dirty,
and, diverging beyond the main way, unmistakeable smells assail the
passers-by. There is not, I believe, a single sweeper family in the place.
Since the period of the opening at the end of September up to the
31st March 1873, there were 1,543 patients treated; these were ad-
missions also and include in-door sick.
The average daily number was 35, the highest number attending
was 50, the lowest 27; of the above treated, 1,348 were cured or re
-lieved, 169 were absented or unknown, 17 died, and there were 9 re-
213
maining; 1,459 were Hindus, 80 Mussuhmans, 3 Christians, and 3
other castes.
16b . Under general diseases A, 253 sought relief; of these 243 were
from fevers, 183 being cases of ague. Fevers are not so prevalent
as they used to be, and in the year under report the people appear
to have been peculiarly free from it. Under B, there were 155, chiefly
suffering from acute and chronic rheumatism; in this class no less
than 30 cases of phthisis pulmonalis came under treatment, some of
whom were benefited, others did not continue their attendance. Of
local diseases there were 1,032 treated: nervous diseases, diseases of
the eye and ear, of the respiratory and digestive systems, and of the
cutaneous provided the largest number, the chief being bronchitis,
dysentery, diarrhœa, the intestinal parasite and constipation, and
scabies.
Of poisoning and poison wounds; there were of the latter 4
dogbites, and one snakebite. There were 93 cases of local injuries,
wounds, fractures, dislocations, and sprains, cleft ear, and cleft nose.
Of operations 52 were performed—several of them important; and
their results tending to dispel the fear which exists amongst these
people regarding our surgery, of which they are quite ignorant.
17. There are several "vainds" or native doctors at this place, their
surgical operations are not carried beyond what is observed in all the
outlying villages; for instance "pot" a chronic ulceration set up
by first burning, and then keeping up irritation by means of the
asclepias cotton, found in the pod of this plant; also by issues kept
open for years or for life, leeches, the actual cautery, ligature,
and scarification or native cupping. A child was seen at this dispen
-
sary with stone, an issue in each leg, and marks of cautery on the lions
were observed.
"Pot" and issues were used for chronic chest diseases, dyspepsia,
dysentery rheumatism, eye disease. The cautery, in points, for joint
diseases and sprains, in lines for tumours, enlarged liver and
spleen, and down the back for tetanus; and marking nut, semi-carpus
anacardium, for any disease in which pain is present, and applied to
fresh wounds to prevent the coming on of tetanus. Venesection is em
-
ployed in many diseases, and periodical bleeding in small quantities is
not uncommon, a remnant probably of the practice left by the Portu
-
guese who once held this town and neighbourhood.
18. Vaccination does not proceed satisfactorily here. When I
visited the dispensary in operation, there was small-pox in the place,
— 1 7 c h i l d r e n w e r e d e a d f r o m i t , a n i n o c u l a t o r h a d b e e n a t w o r k .
The mamlutdar would not have his children vaccinated; they
were attacked luckily mildly, and the patel of the village or town
had his children inoculated—these facts were reported to the
214
collector. One curious circumstance was told to me, namely, that
these inoculators are in the habit of inoculating after the manner of
vaccinating, on the outside of the arm: if this is true, it is probably
to hide the fact of inoculation having been practised, and might ac-
count for children having marks of small-pox and presumed vaccina-
t i o n m a r k s c o - e x i s t i n g .
19. The dispensary accommodation is undoubtedly small, but
this is a matter that cannot be helped at present; it has already done
much good in the place, and I look confidently to the present incum
-bent, Sub-assistant Surgeon Tribowandass Moteechundsha, L.M., be-
coming very popular, as he is in every way qualified to receive the
confidence of the sick.
One native medical pupil is attached to the dispensary, there is
no dead-house, a want greatly felt.
Bassien.
20. The establishment of a dispensary at Bassien, under contem
-plation for some time, was sanctioned by Government Resolution
No. 3554, dated 1st December 1871, under the grant-in-aid rules.
The dispensary was opened on the 28th May 1872, at first under the
medical charge of a 2nd class hospital assistant who remained until
6th October, when the present incumbent, Sub-assistant Surgeon
Vishram Ramjee Gholay, was appointed. For three months, when
this sub-assistant surgeon was on leave, Sub-assistant Surgeon
Bulwant Gopal Bhate held charge.
The site of the place at present used for a dispensary is in the
centre of the main street of Bassien, and forms part of what is called
the Sircarwadee or offices of Government—part of the building is
inhabited by the police and part of the upper floor as offices of the
subordinate judge. A large lower room of this building is used as
the dispensary; a verandah in front serves as a waiting room, but
the inner room is preferred, and, consequently, patients crowd round
the prescriber. Some little off-shoots of rooms in bad repair serve
for in-patients, for the accommodation of the native medical pupil,
and for private examination; above, two rooms are the quarters of
the sub-assistant surgeon;
disrepair prevails. In the ten months
during which this dispensary has been opened, 3,592 persons have
been treated, 2,409 of whom were Hindus, 738 Christians, 296 Mussul-
mans, 143 other castes, and 6 Parsees. 2,530 were cured or relieved,
800 absented or unknown, 1 died, and there were 261 remaining.
The average
daily sick was 57. It commenced with 11, in October
it was 68, in November 100, and in March was 76. This is a dispen
-sary which commenced with the payment system, and has so far
flourished under it. I believe, had it remained under the charge
of the hospital assistant, the dispensary would not have prospered as
it has done as a medical institution. Indoor sick are included.
215
Under general diseases, Division A,720 patients were brought under
treatment, of which 706 were for fevers, 655 being for ague, giving
a percentage to total sick of 18.23. This percentage of ague treat
-
ed, would seem to indicate a less prevalence of the complaint than
in many other places in the Tanna district. Under B, 353 received
aid; of which 244 were for rheumatisms of kinds, 11 cases were of
phthisis, 31 were of leprosy, 23 of anœmia. Under local diseases
there are entered 2,310. Diseases of the nervous system, such as
local paralysis, paralysis, convulsions, &c., gave 127 cases; of the
eye 154; of the ear 110; of the respiratory system 314, chiefly bron
-
chitis; of the digestive system 824, owing mostly to dyspepsia,
dysentery, diarrhœa, colic, constipation, and the ascaris lumbri
-
coides in children chiefly: 53 of the above number were cases of
derangements of the spleen. This, more than the actual number treat
-
ed for fever, may give some idea of the character of the disease, and
that in many cases it had probably not undergone any treatment.
A few cases of Bright's disease are noticed: diuresis and retention
of urine; gonorrhœa 38 cases; diseases of the locomotive system
were few. Under diseases of the cellular tissue and cutaneous
system, there were 399 entered, the chief of these were non-malig
-
nant tumours, scabies, ulcers, and a variety of skin diseases. Poisons
and poisonous bites were few. 152 injuries were received consisting
of contusions, foreign bodies, wounds, simple fractures, and dislo
-
cations. 86 operations were performed, chiefly by Mr. Vishram
Ramjee Gholay—many were delicate operations on the eye, others
important, and the remainder minor—paracentisis abdominis num
-
bered the most.
The dispensary is well attended to, and under its able management
will be likely to continue in its present beneficial progress.
A native medical pupil is attached to the dispensary. At Bassien
a native gentleman, belonging to the place, has offered, as a gift, a
house for the purpose of a dispensary.
Vaccination 105 operations were performed; of which 77 only
were successful.
Panwel.
21. A well-known town of considerable size, and, before railway
communication, a place of much importance, in connection with Bom
-
bay and Deccan traffic, and possessing even now a population of
upwards of 10,000 persons, the chief of whom are Hindoos, next
Mussulmans, and a sprinkling of Jews, Parsees and low castes. It is
situated on the opposite or south-east side of the harbour, at the
termination of a large karee, and is 43 miles from Bombay. The
journey to it was formerly tedious, made by sailing boats at suit
-
ing tides, but now it is reached by steam-ferries which stop at
Ulwa from which place there is a good made road to Panwel.
216
The establishment of a dispensary at this town has been
thought of for years, and at last has become a fait a ccompli. It
was sanctioned by Government in their Resolution No. 4011, dated
16th October 1872, in the General Department, under the grant-in
-aid rules, its expenditure being thus provided for—
Grant-in-aid Rs. 884
Municipal
Local Funds
The expenditure is disbursed by the dispensary committee.
No regular building being provided, a house belonging to a Mus
-sulman was offered for rental for the purpose; on inspection I
found it favourably situated, and the owner promising to put it
into proper order and to fulfil recommendations for certain altera
-tions, the house was taken. On completion of all the requirements, the
dispensary was opened on the 14th of January 1873, and 3rd class
Hospital Assistant Krishna Dadajee, No. 483, who resides on the pre-
mises, was placed in charge. The municipality appear to take a
considerable interest in the institution.
The accommodation for in-patients is, as usual, when houses are
rented for dispensaries, very limited.
A dead-house has been built. During the period from 14th January
to 31st March 600 patients attended, 381 of these are reported
discharged, cured or relieved, 174 absented, 2 died, and 43 remained.
The numbers admitted bear a fair proportion to the chief castes
—454 Hindoos, 142 Mussulmans, 3 Parsees, and 1 Christian. Under
general disease, Class A, there were 91 cases; of which 77 were ague
and 10 remittent fever. The percentage of ague cases was 14.50.
The dispensary being only opened in January, the chief fever
months had passed, but there is little doubt it prevails to a consi
-derable extent in the districts around, where the chief cultivation is
rice, and as, in addition to ague and remittent fever, the hospital
assistant reports 12 cases of enlargement of spleen due to ague
and other diseases, giving evidence of malarious origin.
Under Class B, general diseases, there were 62, chiefly rheuma
-tism, pneumonia, and secondary syphilis; also 6 cases of phthisis.
Syphilitic disease is met with amongst high and low, and the hos-
pital assistant states that, besides the dispensary cases, many come
under his private observation; the existence of this disease here is
doubtless owing to the town being still a frequented halting-place to
and from Bombay.
Local diseases gave 464 cases, amongst which bronchitis, neural
-gia, ophthalmia, asthma, dyspepsia, dysentery, colic, intestinal
worms, guinea-worm, were the chief diseases under this division
remaining.
217
treated at the dispensary. Of injuries 35 were admitted, chiefly
fractures, dislocations, wounds, contusions—none of these cases
were of great importance. The hospital assistant performed a few
operations—during the period two tumours were removed.
22. The hospital assistant is a man of whom I know little, he
has been transferred from another division: there was an appearance
of willingness and desire to attend to his duties when I was present;
but I was sorry to see he was suffering badly under secondary or ter
-tiary syphilis, and, in my opinion, should he not quickly recover, he
should be relieved, as I do not consider he could fairly carry on his
duties with such a complaint; in the report called for he stated his
health had improved.
There is no medical pupil attached to this dispensary; but, as soon
as possible, and the emergencies of the department permit, one will
be sent.
DISPENSARIES WHOLLY SUPPORTED BY GOVERNMENT.
Honowar .
22a. At this place there is a population of about 4,845; the dispensary
afforded relief to 2,966 persons, being 1,096 less than in the previous
year; there were Hindus 2,136, Mussulmans 261, Christians 569. 17
cases remained from the year 1871-72 and 2,949 were new admis
-sions; of the total number 2,947 were discharged, cured or relieved, 9
absented, 3 died, and 7 remained under treatment. Under general
disease, Class A, there were 647 cases; of which 633 were ague, giving
a percentage of 21.34 to total treated. Of this fever the hospital as-
sistant states there are two varieties—one where the patient has con-
tracted the disease above the ghaut, the other below it. The former
is difficult to recover from; for in it enlargement of the spleen and
a n œ m i a f o l l o w , a n d t h e p a t i e n t s a r e g e n e r a l l y i n a l o w s t a t e o f h e a l t h ;
the most serious cases are in those men who are employed in the jungles
cutting wood and in other occupations. The water used in the jungle
is said to be one of the causes of fever. The disease is persistent and
requires a long course of quinine and iron with nourishing diet. The
fever contracted below the ghaut is easily amenable to treatment. A
few cases of hooping-cough occurred: in-door sick are not included.
Under Class B, the chief diseases observed were rheumatism, an
œ - m i a , a f e w c a s e s o n l y o f s y p h i l i s .
Under local diseases, diseases of the stomach and bowels gave
1,476 cases; of which 1,021 were treated for constipation. Rice of an
inferior description being much used in the native dietary, is always
supposed to be the cause of this complaint. Diarrhœa is common
among the fish-eating community, and prevails most when fish is
plentiful and cheap.