NationalLibraryOfScotland/medical-history-of-british-india huggingface dataset:
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after 18 days' treatment. At Haidarabad civil hospital 5 lunatics
were admitted. Of these, 1 died three days after admission : 1 was
sent to the asylum, and the remaining 3 were discharged greatly
relieved. In the jail at that town, 3 cases of mania were treated, one
being a female. They all recovered. Three insanes were taken to
the civil hospital at Kotri for treatment, but the Medical officer
transferred them to the lunatic asylum at Haidarabad without sub
- j e c t i n g t h e m t o t r e a t m e n t . A t S a k k h a r , t w o p e r s o n s w e r e t r e a t e d
at the civil hospital. One was delivered over to his friends who gave
security that they would take proper care of him. The other, a case
of puerperal mania, was made over to her friends, no benefit having
resulted from the treatment received at hospital. Four persons were
treated at the Sakkhar Dispensary for insanity. Two of them were
given up to their friends on their furnishing security that they would
be properly looked after. Another was discharged on being found
to be perfectly harmless. And the fourth, a female, who had been
brought by her relatives to the dispensary, discontinued attendance
on finding no immediate benefit from treatment. Three cases were
admitted for treatment at the Rohri Dispensary. They were dis
-charged cured. At Umarkot, one man brought by the police under
- w e n t t r e a t m e n t f o r a m o n t h , b u t n o i m p r o v e m e n t t a k i n g p l a c e i n h i s
symptoms, he was forwarded to the asylum at Haidarabad. One man
was reported by the Medical Officer of the Khelat Agency to be suf-
fering from melancholia. He was in the employ of the Khan of
Khelat, and was taken charge of by the Shagazie and sent to his
friends.
17. Civil Hospitals.—These number 5 and are situated at Kurra
- c h e e , K o t r i , H a i d a r a b a d , S a k k h a r , a n d S h i k a r p u r . I n A p p e n d i x
A are shown the number of in-door patients treated and died in
the civils hospitals for the past official year with the corresponding
numbers for the previous one. The admissions for the year 1871-72
numbered 1,768, which, added to those remaining on the 31st March
1871, amounted to 1,868 persons treated. For the year under report
there were 2,068 admissions, making with the remaining a total of
2,162 patients. This shows, an increase of 300 in-door patients, the
bulk of which were received into the Civil Hospital at Haidarabad.
The deaths were 153 for the past year against 152 for the previous
one, giving a percentage of 7.0 deaths to treated against 8.1 for
1871-72.
18. In the matter of out-door patients in the above hospitals the
increase, as will be seen from the annexed table (Appendix B), is
still more apparent. This table shows 30,120 persons to have been
treated during the past year, against 26,581 for the previous one.
The increase here of 3,539 patients has occurred chiefly at the hospi
- t a l s a t K o t r i , K u r r a c h e e , a n d S a k k h a r , i n t h e o r d e r m e n t i o n e d , w h i l e
a considerable falling off has been witnessed at Shikarpur. For the
401
past year, the foremost place among the prevailing diseases at the
civil hospitals in Sind, is held by malarious fevers, which with den
- g u e c o m p o s e d u p w a r d s o f o n e - t h i r d o f t h e w h o l e a d m i s s i o n s . N e x t
under the head of important complaints come, in point of frequency,
diseases of the lungs; then diarrhœa and dysentery; after which
rheumatism and affections of the eye. Diseases of the spleen and
liver are rather numerous, especially at Haidarabad. Ulcers have
been abundant, and a large number of cases of disease of the cellular
and cutaneous systems have been noticed, as also injuries.
19. I am glad to have to report a more satisfactory state of things
with respect to the Civil Hospital, Kurrachee, for the past year than I
was able to do for the preceding one. The former surgeon had left
too much in the hands of his apothecary, who abused the confidence
placed in him, took to irregular habits, and sadly neglected his duties.
On the succession of Dr. MacDougall, I took the opportunity of
getting rid of the apothecary: under this officer's careful supervi
-sion,aided by the present efficient and excellent Apothecary, Mr. Bryce,
a vast improvement has taken place in the well-being of the patients,
and the management of the hospital generally.
20. The in-door patients show an increase of 25 compared with
the previous year. In deaths there is a decrease of 5, which gives a
lower percentage of 2.4 to number treated than for 1871-72. The
total deaths amounted to 58 out of 467 persons treated, or at the rate
of 12.4 per cent. This is a high mortality, but the patients who
contribute so largely to increase the death-rate are usually brought
into hospital by the police in a dying condition, and very often suc
-cumb to diarrhœa and exhaustion.
21. The out-door patients during the past year have exceeded by
1,137 the numbers treated in 1871-72. Of this number 487 were
due to dengue. Very few operations of consequence have been per
-formed, owing, as Dr. MacDougall states, to the small number of
cases presenting themselves. It is to be hoped, as the people come
to know the hospital better, now that the administration is improved,
operations of importance will become the rule in place of the excep
-tion as at present.
22. While on the subject of medical relief afforded to the inhabitants
of Kurrachee through the medium of the civil hospital, I would take
this opportunity of noticing the great civil, in a medical and sanitary
point of view, entailed upon all classes of the community by the
absence of a liberal supply of good water. That this is a want which
has been long felt, is sufficiently shown by the numerous schemes
— a m o u n t i n g t o 1 0 — w h i c h s i n c e t h e y e a r 1 8 4 5 h a v e b e e n p r o j e c t e d t o
obtain it; but which, after more or less discussion, and hopes held
out of seeing one or other of the number carried into effect, have been
all laid aside, chiefly on the score of expense. During the visit of
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the Viceroy to Kurrachee in November last, the municipality brought
to His Excellency's notice this pressing necessity of supplying the
town and camp with pure water, and trusted Government would be
induced to help them in carrying to completion some well-digested
scheme for supplying this desideratum. Lord Northbrook's reply
was sufficiently encouraging to afford reasonable hopes that ere long
this reproach to Kurrachee will be removed.
23. The Kotri Civil Hospital has been working well under the
care of Dr. Murphy, who gives great attention to his duties, and has
been the means of drawing an increased number of patients to the
hospital. He has made several good operations, among which were
four successful cases of stone. Last year was a peculiarly trying one,
owing to the heavy rain and the sudden inundation from a neigh
-bouring river, which flooded the town and caused much damage to
house property. This was succeeded by a large amount of sickness,
of which fever, diarrhœa, and dysentery, were the most commonly
observed. No remedy has as yet been devised for disposing of the
refuse water which continues to be thrown from the upper verandah
to the ground below, which in consequence is always wet, and in this
condition is highly objectionable to have close to an hospital. The
local engineer, on being referred to, made objections to the proposal
of having a pipe from the hospital to the drain below; but he did
not suggest any plan in its stead, and so the nuisance still exists.
I understand that a new court-house has been sanctioned for Kotri.
If the present hospital should be deemed suitable, it would be very
advisable to make it over for this purpose, and erect a new hospital
in a more appropriate spot. And not only do I recommend this on
sanitary grounds, but if the site was well chosen, the townspeople
—especially women and children—would be induced more readily to
resort to it than they do to the present one, owing, as I believe, to
its propinquity to the European community and workshops of the
Flotilla and Railway. In anticipation of an arrangement of this kind
being thought desirable, I inspected the outskirts of the town, and
found an excellent spot, open and raised, lying to the south-west of
the town, and between it and the European grave-yard.
24. At Haidarabad the civil hospital continues to keep up its
deservedly high reputation-under the able and excellent management
of Dr. Holmested. The in-door patients have exceeded those of last
year by 400, while the percentage of deaths to treated have decreased
4.7, being the death-rate compared with 6.3 for 1871-72 The out
- d o o r p a t i e n t s s h o w a n i n c r e a s e l i k e w i s e o f 7 6 3 p e r s o n s t r e a t e d . A s
it has been stated that dengue fever attacked fully two-thirds of
the inhabitants, it is to be inferred that a considerable number o
f cases of this disease were treated at the hospital, and so it proved
; 1 , 2 6 6 a d m i s s i o n s f r o m t h i s c a u s e a l o n e a p p l i e d f o r t r e a t m e n t , a n d
without being followed by a single casualty. Much malarious fever
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likewise prevailed, which is to be attributed (1) to the heavy rain-fall
and inundation of the river; and (2) to the sanitary defects which
abound in the town and neighbourhood.
25. And in connection with this, the great scarcity of water, and
for two months of the year its extremely bad quality, cannot be too
frequently commented upon. As at Kurrachee, various plans for
obtaining a pure and plentiful supply of water have been at different
times put forward. And when it is remembered that the Indus is
within 4 miles, and a branch—the Foolaile—not half that distance,
it is a marvel that hitherto nothing has been done to supply this
great want; one that not only presses heavily on the troops at the
station, but likewise on the inhabitants of this, the second largest
town in Sind.
26. The surgical cases treated at this hospital and the operations
performed there have been most important, and constitute a grand
feature in its history. The success which has attended them, and
especially the resulting low rate of mortality—must, when due con
-sideration is given to the wretched condition most of the patients are
reduced to through long suffering—be attributed to good surgery
and subsequent management. I omit all notice of minor operations,
which were numerous, and will give a concise notation of the most
important cases. They offer a very favourable record of the results
of the operations performed, and may be summarized as follows:
—amputation of leg, 6; of arm, 7; excision of elbow-joint, 1; calculus
vesico, 65; cataract and iridectomy, 18; tumours and diseased growth
10; necrosis, 5; genito-urinary organs, 5. Out of these only 9 deaths
have occurred, all cases of stone, and many of them most unfavour
-able for operation. In connection with this hospital, and in con
-formity with the practice prevailing in some parts of Bengal, the
Civil Surgeon, at the request of the Commissioner in Sind, has
opened a class for the instruction of native women as midwives: 9
women have already been instructed, and 7 more are about to join.
In a few years the benefits resulting from this undertaking will
doubtless be experienced by many women who, from position or
other circumstances, are now beyond the reach of receiving efficient
help during labour.
27. The in-door patients of the Shikarpur Civil Hospital number
within two those for the previous year. The percentage of deaths
to treated are 8.4 against 7.7 for 1871-72. A great falling off is
shown in the number of the out-door patients, which is all the more
striking when taken in connection with the unhealthiness of the
past year. The total treated of this class has amounted to 957 only,
compared with 1,447 for the previous one. With the exception of
7 operations for calculus vesico, which proved fatal in 3 cases, no
others of importance are recorded.
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28. As I mentioned in a former report, this hospital is little else
than a Police Hospital. The in-patients are nearly all destitute,
half-starved paupers seeking food, clothing and shelter, and are glad
to avail themselves of the greater conveniences afforded by this
hospital than they can obtain at the dispensary ; but for other
classes who are differently circumstanced this hospital is very incon
-
venient, owing to its distance from the town ; and every year it will
be less resorted to. To maintain this hospital simply for the use of
the police, is not only an unnecessary expense, but experience daily
shows that, even for this purpose, it is very unsuitable. The lines
of the police are at a considerable distance from it, whereas they are
close to the dispensary in the town. I would strongly urge therefore
that the present Civil Hospital be abolished, and a new ward added
to the dispensary for the police. The Civil Surgeon would then be
able to conduct the entire duties of the dispensary and police with
the help of a good Hospital Assistant, which would save the expense
of the present apothecary. And by this arrangement also, a further
reduction of expenditure would be effected and that to a considerable
extent. The whole set of instruments, medicines, and stores in the
Civil Hospital would be at the disposal of Government, and the
entire establishment be discharged.
29. The Sakkhar Civil Hospital shows a slight diminution in the
number of the in-door patients as compared with the previous year.
The percentage of mortality is slightly increased, being 4.8 against
4.1 for 1871-72. The out-door patients however show an increase
of 772. In addition to the various classes of persons who come
upon the returns of this hospital, and were enumerated in last year's
report, there are now engineers, non-commissioned officers, and subor
-
dinates, who have been lately attached to Sakkhar by the works in
connection with the Indus Valley State Railway. These when sick fall
under the care of Honorary Assistant Surgeon Leahy, in charge of
Sakkhar. As many of these persons live scattered over the place,
which is extensive, and require medical aid at their own quarters,
Mr. Leahy's duties have been considerably increased and his time is
consequently so much occupied, that, with the very inadequate as
-
sistance he has, he is not able to keep up his clerical work, and many
of his returns are in arrears and incomplete ; nor do I very well see
how, under existing arrangements, he can insure their being exact
and punctually rendered. Mr. Leahy is a well informed, hard working
man, but he has far too much to do. He occupies a position similar to
that of a Civil Surgeon, but with this difference, he has charge of a
large dispensary in addition to that of a civil hospital, a jail, and until
only lately, the Punjab Flotilla ; and yet the subordinate assistance
allowed him by the regulations is most meagre and inadequate, and
not in keeping with that sanctioned to Civil Surgeons. It is impos
-
sible, therefore, that Mr. Leahy can do justice to his multifarious
405
duties and at the same time be accurate and punctual in conducting
the paper work connected with his various charges. Sanction ought to
be given to an hospital assistant being permanently attached under
him at the civil hospital, and another at the dispensary.
30. I have not yet received the returns or report of the civil
Hospital; only the numbers treated and died; but when I visited
Sakkhar in December last, I found Mr. Leahy had during the pre
-vious nine months performed several important operations, among
which were 4 cases of lithotomy, 3 of them having been successful.
31. In my report for last year, when commenting on the health
of the police, I remarked that, owing to the system hitherto pursued,
of including such of them as fell sick when on out-post duty in the
general list of patients attending dispensaries, no accurate informa
-tion could be obtained regarding either the number of sick, their
ailments, ratio of deaths to strength or to treated, save such as were
recorded under these heads in the police hospitals of the collectorate
towns. With the view of remedying this evil, it was ruled about a
year ago, that medical subordinates in charge of dispensaries should
forward me a register of all policemen treated by them, for trans
-mission to the Inspector-General Indian Medical Department, to
enable him to compile statistics of the entire Police Force. I am
thus able to show in a separate Return (Appendix C) the state of
health for the past year of various detachments of police which have
had the advantage of medical aid from dispensaries in their neigh
-bourhood. From this table it will be seen that—so far as one year
is of value—the state of health of these detachments—with the excep
-tion of the one at Sakkhar, which is abnormally high—stands in ra
-ther favourable contrast to that of the same class at Sudder Stations.
After Sakkhar those located at Larkhana and Sihwan show the high
-est rate of mortality to strength, being 1.6 & 1.5. The rest with three
exceptions recorded no deaths. At the Police Hospital, Kurrachee,
possessing the best climate, the mortality reaches the highest of any
(with the exception already mentioned), the death-rate per cent. to
strength being 2.2, and which is scarcely altered from that for the
previous year. The total treated, 685—strength being 524—ex
-ceeds that in the previous year by 51; but if the cases of dengue,
which numbered 167, are excluded, it would fall short of the number
for 1871-2 by 116. The Haidarabad Police Hospital also records
a higher rate than that of the detachments save one; it is to be noted
however that the total numbers treated are just twice as many for
this year as for the previous one. But the Hospital at Shikarpur,
which in 1871-72 returned a mortality of 3.6 per cent. to strength,
shows a very marked improvement for the past year—0.8 being an
extremely low ratio: and this is from a number treated exceeding by
110 that for the preceding year. Of the 12 deaths which occurred
at the Head Quarter Hospital, Kurrachee, 4 were due to malarious
406
fever, 4 to diseases of the lungs, and only 1 to affections of
the digestive organs. At Haidarabad, where the strength
averages 871, there were 5 deaths from malarious fever, 6 from
lung disease, and 2 from abdominal affections, out of a total of 16
casualties. The deaths at the Shikarpur Hospital amounted to 3
only, out of an annual strength of 366, and were due to one cause,
viz., pneumonia.
32. During the past year there have been no changes in the num
-
ber of the dispensaries in Sind. They stand as they did at the date of
forwarding my last report, and are 23. Considerable alarm was occa
-
sioned on the receipt of Government Resolution No. 597, of 6th
February 1872, introducing the system of payment for medi-
cines and advice at dispensaries to all except the really indigent and
pauper class. Had this order been applicable to the dispensaries in
this Province, it would have had the effect of drawing away the bulk
of the applicants for relief, and those who still attended would for the
most part have represented themselves as entitled to the exemptions
made in favor of the indigent class. A system likewise which includ
-
ed payments being conducted between the applicants and medical
subordinates in charge, would have placed temptations in the way of
both parties often too powerful to be resisted, and opened a door for
gross abuse and irregularities. But as the resolution of Government
decided that payment should be enforced only in such dispensaries as
were opened under the rules of 1867, and as all those in Sind, with
the exception of the one at Kippra, were established prior to these
rules and consequently did not come under their operation, all fears
quickly subsided, and the people resorted to them as freely as before.
The one at Kippra, though established in 1868 and receiving from
Government a grant-in-aid, was likewise exempted on the ground of
its being situated in a wild part of the Thar and Parkur District.
33. I append a table (Appendix D) showing the numbers admit
-
ted and treated as in-door patients in the dispensaries for 1872-73
compared with similar numbers for the previous year; from this
table it will be observed that there is a total of 1,515 patients treated,
of whom 155 have died; and that while on the one hand there is a
diminution of 117 persons, there is on the other a considerable
increase in the rate of mortality, which gives a percentage of 10.2
deaths to treated for the past year against 7.0 for 1871-72. The
bulk of the casualties have arisen from malarious fevers 23, diseases
of nervous system 7, diseases of the lungs 30, diarrhœa and dysen
-
tery 36, and injuries 28.
34. As regards out-door patients, however, the results, in so far
as they refer to the number of applicants, are more satisfactory.
These show an increase of 7,928. This has been distributed among
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the dispensaries at Jacobabad, Sakkhar, Mehur, Taroosha, Sihwan,
Alharka-tanda, and Nuggur Parkur. I subjoin a table (Appendix E)
giving the number treated for the two past years.
35. As in the case of civil hospitals so in that of dispensaries, no
record of deaths occurring among the out-door patients can be
furnished. The reasons for this I enumerated in para. 7 of my
Report for last year. But there is abundant evidence from the
returns of the several Collectors and Political Agent, Thar and
Parkur, that the mortality throughout the province has been very
high for the past year; the chief causes of which I have indicated in
an earlier part of this report.
36. The surgical operations of importance come under the head
of in-door patients. They number 119, and nearly all of them, that
is 99, were performed at the 3 dispensaries of Jacobabad, Sakkhar and
Alharka-tanda. The casualties for the year amounted to 7; the total
of operations for stone were 78.
37. The Kurrachee charitable dispensary has relieved 12,461 persons
during the past year. This is an increase of 153 compared with the
previous one. The average daily attendance has been 148.6, exceed
-
ing by 10 that for the preceding year. This dispensary has done
good service, and was of considerable use during the prevalence
of "dengue," 424 persons having received aid for this disease.
38. I had hoped by this time I should have had to report that
quarters had been built for the sub-assistant surgeon in charge, in
the neighbourhood of the dispensary, so that the provisions of para.
18 of the new rules might now be carried out. But no steps have
as yet been taken to supply this desideratum. For want of a pro
-
per house near the dispensary, the sub-assistant surgeon lives two
miles away, and the benefits this dispensary is capable of affording
are, in consequence, not as fully developed as they otherwise would
be, especially as an evening visit is now enjoined by the new rules.
39. The total expenses of this dispensary for the past year have
been Rs. 6,105, of which Government have contributed Rs. 4,807 and
the Municipality Rs. 1,298. In 1871-72 the expenses were greater
by Rs. 342.
40. The Government dispensary at Manora is still in the same
unsatisfactory condition as at the date of my last report. The plans
and estimates, as intimated by the Commissioner in Sind, were for
-
warded to me by the Superintending Engineer. I recommended cer
-
tain alterations and additions which appeared necessary to render the
building suitable to the requirements of Manora. But I am sorry to
learn from Government Resolution dated 4th November last, and
which is the latest on the subject, that the Government regret there
are no funds available for the work. This is greatly to be deplored,
as the working of this dispensary is sadly crippled, owing to the
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