NationalLibraryOfScotland/medical-history-of-british-india huggingface dataset:
131
officers left memoranda. Surgeon Bruce assumed charge on the 8th
December 1872. This officer's duties are considerable, as in his dis
-trict almost altogether reside warrant officers and serjeants belonging
to the Ordnance, Commissariat, Gun Carriage, Barrack Department,
and Bombay Marine. Medicines for these are supplied from the
European General Hospital, Dockyard Dispensary, and the
Hospital of the Marine Battalion. 139 cases were treated.
42 officers were sent to England by the standing medical com
-mittee, 8 went on leave to the Deccan or Matheran, 1 death occurred,
in the case of Lieutenant Barnard, Barrack Master, at the Presidency.
Women and children and many men are treated, the latter when not
off duty, are not entered on the returns.
15. The third presidency surgeon, who holds medical charge of
the Byculla Schools, Hospitals, the Jail and House of Correction, and
Elphinstone College, has the same general duties to perform as those
of the other presidency surgeons. During the year 1872-73, 82 civil
and military officers have been on the sick list of the 3rd district.
They were British officers 10; Indian, of Bengal Army, 14, ditto of
the Bombay Army 26, ditto of the Madras Army 16. Civilians from
Bengal 2; ditto from Bombay 3. Of the Ecclesiastical Department 1.
Uncovenanted Service of Bengal 10. Most of these appeared before
the standing medical committee.
There is no record of the families of officers who come under treat
-ment during residence in Bombay or passing through it.
Elphinstone College.
16. Under Resolution of Government, No. 713, G. D., 13th March
1871, the sick of this educational institution are attended to by the
presidency surgeon in whose district the college is. The students are
resident and non-resident.
Amongst the students many have been treated, some for long
periods.
No register has been kept by the surgeon, who, however, thinks
that from time to time, about 17 students have required relief.
Some of them over and over again. Many are delicate and weak,
and overwork their powers in preparation for examinations. Several
suffer from choroiditis. These cases are generally myopic. Great
straining of the eyes at night produces congestion and increases the
disease. These eye diseases are the only affections which seem to be
brought on by study. A few cases of diarrhœa and spermatorrhœa
were treated.
T a n n a
C i v i l
H o s p i t a l .
17. The persons treated in this hospital, during the year, have been
generally paupers, sent in by the Police, suffering from ague, ulcers,
dysentery, and diarrhœa. From the return of the civil surgeon it
18 M D
132
appears that 138 were inmates of the hospital during 1872-73, 3
remained from the previous year, and 125 were fresh admissions. Of
these, 88 were discharged, 36 died, and 4 remained. The percentage
of death is thus shown as 28 to treated.
18. Under general diseases, A, 38 cases were treated, 36 were of
ague, contracted chiefly by persons employed at Tulsi, and 2 of
small-pox; of these 28 were discharged and 9 died. Under B, there
were 6 cases and 2 deaths—one from phthisis. Under local diseases
54 patients were admitted, the chief diseases being dysentery, of
which there were 23 with 14 deaths, being 60 per cent. Of diarrhœa
8 cases and 3 deaths. In the months of November, December 1872,
January 1873, most of these cases and those of ague were sent, many
in a dying state, from Tulsi. On receiving the death reports, I
addressed the Municipal Commissioner on the subject; he informed
me that the contractors employed a medical man. If these miserable
beings were servants of the contractors, little more overlooking of the
arrangements for their food and work should have been instituted;
in fact in all contractors' works the care of the poorer workmen should
be insisted on; the skilled handiscraftman is looked after, as a rule,
but the native "navvy" is pretty well left to himself.
The hospital has been attended to very carefully, and the civil
surgeon reports favorably on the character of the subordinates who
have served under him. The medicines and instruments are nowhere
so well looked after as here.
Surat.
During the year 1872-73, 571 patients were treated in the
civil hospital of this crowded city, being an increase over the previ
-ous year of 143; 28 remained at the end of the year and 543 were
fresh admissions. Of these 481 were discharged, 47 died (a percentage
of 9.77), and 43 remained under treatment—the average daily sick in
hospital was 35. The casualty list of this hospital discloses the fact
that 36, out of the deaths occurred in persons broken down, and,
frequently, sent in dying, or in a dying state, to hospital.
20. Under general diseases, Division A, 163 received medical aid
—17 of these were dengue, 6 cholera (with 3 deaths), and 140 of ague.
Under Division B, 32 were treated, 23 of these were syphilitic cases.
Under local diseases, 14 cases of disorder of the intellect occurred.
Diarrhœa and dysentery gave 34 cases, but the greater number of
diseases under one head, were under "conditions not necessarily
connected with general or local disease;" this head was debility—224
were admitted and 35 died. These cases arc simply debility from
want, too far gone fer relief.
133
The injuries received for treatment were confined to burns and
scalds, fractures, contusions, and wounds, and numbered 56. No
capital operations were performed in hospital. No alterations have
been made in the hospital. The establishment was reported on favora--
bly. At my inspection I regretted to be obliged to observe the
extreme inattention displayed in the care of medicines, surgical instru--
ments, and stores, generally. The civil surgeon's attention was
particularly drawn to an alteration in the system of leaving everything
to be looked after by the hospital assistant, and that the correctness
of his hospital books he was responsible for.
Karwar.
21. The very heavy fall of rain registered at thisplace in the monsoon
of 1872, amounting to 135 inches—32 over the average of many years
— d o e s n o t , a c c o r d i n g t o t h e c i v i l s u r g e o n , a p p e a r t o h a v e a f f e c t e d
the general health of the people.
The hospital accommodation I need not again allude to. I may
say however, that a grant by Government has, I believe, been
conditionally sanctioned for a new hospital. In case of this being
built the present police hospital might be reduced.
During the year 1872-73 only 95 cases were treated—2 remained
from the previous year, and 93 were fresh admissions. Of these 77
were discharged, 12 died, and 6 remained. The average daily sick
was 7.
22. Under general diseases, Division A, 30 cases received medi--
cal aid—27 of these were of ague, of which 2 died. Under
B, 19 were treated, the chief of which were syphilitic diseases. The
civil surgeon remarks that this disease is very common. Under
local diseases, affections of the respiratory, digestive, and cutaneous
systems were the most prominent—bronchitis and asthma, dysentery,
diarrhœa, and ulcers.
One case of accidental poisoning occurred from eating the fruit of
" the Shree Maudle."
No capital operations were performed during the year.
The mortality was 12, which to number treated gave a ratio of
12.63. Many of the cases died the day of their admission or one or
two days after—persons for whom treatment could be of no avail.
The hospital was in excellent order, and the civil surgeon report--
ed favorably on the character and behaviour of the assistant.
Ratnagiri.
23. At the civil hospital at this station, 2 patients remained at
the end of the year, and 72 were fresh admissions; of these 64 were
discharged, 4 died, and 7 remained under treatment.
134
The average daily number in hospital was 5.
24. Under general diseases, Division A, 7 cases only were treat--
ed, and 4 of these were ague. In the dispensary report of this
place the freedom from much fever is alluded to.
Under B, 9 cases received treatment. Amongst these were
rheumatism, syphilis, cases of leprosy, colloid, and lupus. Under
local diseases, there were5 of the nervous system, two of which died
— o n e w a s a c a s e o f m a n i a . D i s e a s e s o f t h e d i g e s t i v e s y s t e m g a v e 1 2
cases. Bright's disease 3. There were other diseases treated,
such as affections of organs of locomotion, of cellular tissue, and of the
cutaneous system. One case of Phoorsa snakebite occurred. Inju
-ries amounted to 12—burns, wounds and concussions, fractures and
dislocations—5 major operations were performed—one for mycetoma.
Of the deaths (4) one each occurred from apoplexy, disease of
cerebral artery, chronic cystitis, and debility.
The surroundings of the hospital were in anything but a cleanly
or orderly state when I visited it; and there was a want of care
displayed in the way in which the hospital stores were kept. A few
alterations and improvements were recommended, and the civil sur--
geon was requested to endeavour to make arrangements for them.
Dr. C. Joynt gave the hospital establishment generally an excellent
character; a little more looking after would, in my opinion, not be
thrown away on them.
Sawantwari.
25. The civil hospital of this Native State is in the town of
Wari, the population of which is 10,000. The year is reported to
have been a healthy one, and that there was no unusual prevalence of
fevers and no cholera. There remained at the end of the year 1872-73,
2 in hospital, and there were fresh admissions 34; out of the total
number 36, there were 32 discharged, 4 died, and none remained.
26. Under general diseases, Division A, 13 were treated, 6 of
these cases were of ague, and 7 of remittent fever. Under B, there were
3 cases of anæmia and dropsy. Local diseases gave 4 cases, and in
-juries, general and local, were 16; they were penetrating wounds of
chest and abdomen, contused wounds and fractures, simple and com-
-pound. The deaths were 2 from penetrating and incised wounds,
of abdomen 1 from penetrating wound, of the lung 1, and 1 from ge--
neral dropsy. There were ten operations performed—2 major and 8
minor.
I found the hospital, stores, medicines, and arrangements, gene-
-rally, better looked after than on my previous visit, when I found it
necessary to caution the sub-assistant surgeon in charge.
27. The hospitals of Vengurla, Dapuli, and Alibagh, have been
treated of in the report on dispensary in-patients.
135
Broach.
28. The civil hospital at this station has been under the medi
-cal charge of three different medical officers during the year under re
-port. From the 1st April to the 30th September, Assistant Sur
- g e o n H . C o o k , M . D . , w a s t h e c i v i l s u r g e o n . T h i s o f f i c e r w a s
allowed to exchange his appointment with Surgeon Johnston, who
relieved Dr. Cook and was civil surgeon up to the 28th February
1873, when he went on furlough to Europe. From the 28th February
till the end of the official year, Surgeon Lawrance has been Acting
Civil Surgeon.
Each officer has submitted a report for the period in charge.
Dr. Cook states the mortality to be high, owing to the cases being
either of hopeless injuries or of disease beyond remedy. The repairs
of the hospital are still the subject of discussion as to who is to pay.
Only one capital operation during the period was performed.
Surgeon Johnston merely gives statements of treatment, and
Surgeon Lawrance's remarks for the month of March terminates the
report for the year. A few operations were performed by him,
amongst which was amputation, and the reduction of a primarily
undetected dislocation of the hip.
29. The total number of cases treated in the hospital of this
busy city was 300 against 318 of the previous year, 20 remained,
and 280 were fresh admissions. Of the total, 250 were discharged, 35
died, and 15 remained. Under general diseases, Division A, 70 were
treated, of which 64 were ague. Under B, 29 cases received aid,
nearly the half of these were from primary and secondary syphilis,
the remainder rheumatisms and cachexia. Under local diseases, there
were 5 of the nervous system and 6 of the intellect ; of the eye and
nose 3 ; of the heart and its membranes 3. Diseases of the respira
- t o r y a n d d i g e s t i v e s y s t e m s t h e r e w e r e 6 5 , c h i e f l y c h r o n i c a n d a c u t e
bronchitis in the one, and dysentery, diarrhœa, and splenitis
in the other. 15 diseases occurred in the urinary and generative sys
- t e m s ; a n d i n t h e d i s e a s e s o f t h e c e l l u l a r t i s s u e a n d o f t h e c u t a n e o u s
system there were 37 cases. Of poisons none. General and local
injuries 59 were brought in ; these consisted of burns, compound
fractures of the skull, arm, and thigh, simple fractures, dislocation,
contused and lacerated wounds. The operations performed were
5 major and no minor. A cataract was extracted, amputations of
hand and leg, removal of fœtus, and reduction of dislocation were
performed.
The deaths were 4 of ague, 1 of secondary syphilis, 1 of paralysis,
3 of remittent fever, 1 of heart disease, 2 of phthisis, 1 of tonsillitis,
9 of dysentery, 3 of diarrhœa, 2 of hepatitis and jaundice, 2 of ulcers,
2 of fractures of the skull, 1 punctured wound, and 1 of fractured thigh.
136
The condition of this hospital, when I visited Broach, was any
-thing but satisfactory in regard to cleanliness and certain repairs;
the stores, too, were kept in a state of disorder—some of the books were
not kept as they ought to have been. It was evident that advantage
had been taken of the failing health of the medical officer in charge,
sufficient care not having been bestowed on the general management.
The civil surgeon, Dr. Johnston, was directed to endeavour to restore
order, and Surgeon Lawrance will doubtless keep up the required
discipline.
Aden.
30. There is a very good civil hospital at Aden, situated at the
camp, on a rising ground, looking over the town and cantonment.
The records of the Aden medical superintendence have not
reached me yet. They were despatched by Surgeon-Major Shepherd
in the steamer "Neera," soon after the medical administration was
given over to the Presidency Division, but up to this time the in
-quiries concerning them have been fruitless. At the civil hospi
-tal here, it has been the custom to club together out and in-patients,
and to give the total as the treated in hospital. This has been put
a stop to, and the out-patients have been arranged under those receiv
-ing dispensary relief, and the in-patients as such, the arrangement
and statistics of each being necessarily different and distínct.
The civil surgeon at Aden disputes, in his report, the correct-
ness of this division, and frames his annual report on the conjunct
patients. He has, however, had the wisdom to forward separate
returns upon which I have been able to arrange the following
statements :
—
At the end of the year 1871-72 there are stated to have been
remaining in hospital 95 in-patients. There were 544 fresh admis
-sions, 146 deaths, and 43 remained under treatment. The treated
were Mussulmans with the exception of a few native Christians,
Hindus, and Jews. Under general diseases, Division A, 62 were
treated, and of these 39 wore ague, 15 were cases of small-pox.
Dengue gave only 4 admissions. Under Division B, 59 were treated,
chiefly suffering from rheumatism, secondary syphilis, and scurvy. Of
local diseases there were 404 ; the nervous system and disorders of
intellect gave 8, of which 2 were mania. Disorders of the eye, &c.,
were few. Of the respiratory system there were 71, chiefly bron
-chitis and pneumonic phthisis, of which latter there was the large
number of 32 with 21 deaths. I was not previously aware of the
prevalence of this disease in Arabia. Of diseases of the digestive
system 95 were treated, dysentery and diarrhœa the chief, numbering
61 with 22 deaths. Splenitis gave 9 cases. Diseases of urinary
system, &c., gave only 12 cases, and those of organs of locomotion 17.
137
Under diseases of the cutaneous system 180 are shown as suffer--
ing from ulcers. Aden ulcers, camelbites, dogbites, and human-
bite have been entered under poisoned wounds. General and local
injuries received were 73; amongst these were burns and scalds,
asphyxia from drowning, concussion and compression of the brain,
w o u n d s , c o n t u s i o n s , f r a c t u r e s , o f t h e p e l v i s , r i b s , f o r e a r m , l e g , t h i g h ,
arm, skull, dislocation of the hip and elbow, &c.
Twenty capital operations were performed.
When I visited the hospital, Surgeon-Major James, M.D., had
j u s t r e t u r n e d a n d t a k e n o v e r c h a r g e f r o m A s s i s t a n t S u r g e o n H a y . I
was glad to observe that preparations were being made for very
necessary improvements in the flooring of the hospital by asphalt, by
which its sanitary character would be greatly improved. In August
1872 the superintendence of the Medical Department at Aden was
directed to be handed over to the Deputy Inspector General of Hospi--
tals, Presidency Division, and in December the station was visited.
The want of the records prevents me entering into the history
and general arrangements of this hospital more fully.
EUROPEAN GENERAL HOSPITAL.
Annual Report for the year commencing 1st April 1872, and
ending 31st March 1873.
1. The total treated during the past year were . . . 1,100
Number of out-door patients . . . 546
Daily average number of sick . . .
63
Number of deaths . . .
47
Percentage of deaths to treated . . . 4.27
2. The diseases from which most fatal cases occurred were, in
their order of fatality,—
1 s t . —H e p a t i c A b s c e s s ,
2
n d .
— B r i g h t ' s d i s e a s e ,
3rd.—Dysentery.
The following table shows the number of deaths which occurred
in each month.
A p r i l 1 8 7 2 .
M a y .
J u n e .
J u l y .
A u g u s t .
S e p t e m b e r .
O c t o b e r .
N o v e m b e r .
D e c e m b e r . J a n y . 1 8 7 3 . F e b r u a r y .
M a r c h .
T o t a l .
1
1
8
4
3
6 8
3
5 1
4
3 47
138
3. Thus, June and October show the maximum of mortality;
September is next in order, then December, July, and February
bracket together, as do August, November, and March; April, May,
and January show only one death in each.
4. As compared with that of the preceding year, the most
remarkable feature in the return, is the great increase of small-pox
and of simple continued fever. Of the former 40 came under treat-
ment—the deaths were 2 (5 per cent.), but of these one was due to
the patient having during delirium precipitated himself from the
verandah of the small-pox ward on to the ground below. Means
have been adopted to prevent a recurrence of such a catastrophe.
In some of the most severe cases of confluent type, distinct marks of
vaccination were observed.
5. Some well-marked cases of dengue occurred. In one, the
eruption resembled measles interspersed with lichen tropicus. The
crescentic patches continued present a long time, and the discolora
- t i o n r e m a i n e d u p t o t h e t i m e o f t h e p a t i e n t l e a v i n g h o s p i t a l .
The temperature also was somewhat higher than that usually
observed in this disease. The patient having been sponged with
vinegar and water, a thick crop of vesicles (Sudamina) large as
split peas appeared, and remained for many days unchanged in
appearance, the contained fluid continuing clear; I found tinct : aconite
with liquor quiniæ amorph: useful in this disease—occasionally I
added tinct : arnica or prescribed the aconite with acid nitric dil.
6. Of the simple continued fevers, some were of a type not pre
- v i o u s l y o b s e r v e d b y m e i n t h i s c l i m a t e , a n d r e s e m b l e d m o r e n e a r l y
the continued fever of colder latitudes than any febrile diseases I
had hitherto seen—a few were prolonged to the fifth or sixth week,
Some of those cases were from the Parel district (B. B and C.I. R
workshops). Can the cutting of the Suez Canal have somewhat altered
the geography of disease ? Of the febricula some ran a course of
ten days.
7. The admissions from ague were fewer than those of the pr
e-ceding year.
8. Four cases of remittent fever and one of enteric are registered.
No death occurred from fever of any sort during the year, except the
two mentioned above from small-pox.
One case of malignant cholera was admitted during the year—
the patient was brought to hospital in collapse—the case proved fatal.
9. Two deaths occurred from encephalitis, and one from white
softening. In the latter case the patient had had a premonitory
attack of paralysis, from which having recovered he left hospital
contrary to advice, was re-admitted after some time with symptoms
of softening, and died.
139
Two cases of paraplegia proved fatal. One was the result of
syphilitic taint in the system and one of accident.
The fatal case of tetanus occurred as follows :—A woman whose
constitution was badly tainted with syphilis had been affected for a
considerable time with extreme contraction of the lower extremities.
Her great anxiety to regain the use of her limbs, induced me to try
forcible extension, patient being under chloroform. The forcibly
extended limb was put up in a Liston's splint; a slough soon
formed in the popliteal space, which on separation showed a healthy
granulating surface. When the wound was nearly healed tetanus
supervened; it was kept at bay for a time by cannabis indica, but
ultimately proved fatal.
10. Under diseases of the circulatory system five deaths are
registered, two from valve disease were of interest—mitral insuffi
-
ciency,with its usual concomitants was present in each. One from
fatty degeneration was the result of long abuse of alcohol. Of the
two fatal cases of aneurism, one was of the abdominal aorta. The
patient having derived benefit from treatment left hospital contrary
to my advice, returned in a short time much worse, and died by the
bursting of the aneurismal sac. The fatal cases of lung disease
were usually associated with more or less degeneration of kidney.
11. A fatal case of hœmatemesis is registered—so named from the
most urgent symptom—but the chief condition on which it depended
was cirrhosis of the liver. A large hard mass could be felt during
life in the epigastric region. On examination of the stomach, this
was found to be a kidney-shaped clot of blood which must have
nearly filled a partially contracted stomach, and thus accounted for
its great irritability for the last few days of life.
12. Under diseases of the intestines, dysentery holds its usual
fatal pre-eminence. Of 64 cases treated, 7 (about eleven per cent.)
died—serious hepatic or renal complications existed in all; in some
there was syphilitic taint.
13. Towards the end of the year admissions from bowel affections
became frequent, and in some cases intractable, probably, from the
poisonous effluvia, wafted by the prevailing wind, from the Sonapore
drain.
14. Of two cases of intussusceptio, one proved fatal.
15. Hepatic abscess was very fatal. In some cases tapping and
injecting by means of the aspirator was practised without benefit.
The only case that recovered was one in which the contents of the
abscess was discharged through the lungs. The patient was an
old woman and of intemperate habits.
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