NationalLibraryOfScotland/medical-history-of-british-india huggingface dataset:
153
16. Opium .—The cases of poisoning from this drug were 32 in
number, of which 27 recovered, and 5 died, showing the rate of mor-
tality to treated as 15.62 per cent. The suicidal cases have been
20, where all have confessed to having taken the drug in conse-
quence of domestic quarrels. In one case a man is said to have
swallowed 135 grains of opium to kill himself, because his master
accused him of stealing pearls to the value of Rs. 850. He was not
brought under treatment until 17 hours afterwards, but he recovered.
In another instance of suicidal poisoning a young man swallowed
150 grains of bazar opium, because his father beat him ; he was
however, brought immediately to the hospital, and the stomach-pump
removed the whole as he did not become insensible but was merely
drowsy, and recovered on the following day. In another case brought
under treatment, 12 hours after the drug was taken, the patient was
in a state of total insensibility ; one pupil was contracted to a pin's
point, while the other was widely dilated : after the use of the sto-
mach-pump he recognized, regained consciousness, and ultimately
recovered. The quantity in this case was half a tola—about 90
grains. Five cases of poisoning were accidental, the subjects all
being children, and the opium in 3 cases was picked up by them and
eaten ; in the 4th case an over-dose was given to the child by its
mother who was in the habit of administering small quantities every
day. The last case was a sad. one—a baby, only a month old, was
left in charge of its brother, a boy 5 years old ; when the mother
returned, after several hours, the baby was found quite insensible,
and a tin box containing 5 grain opium pills was found in possession
of the elder child, who said he had given baby one. Nothing could
be done—baby died very shortly after admission. The remaining
four recovered. In two cases it could not be ascertained whether
the poisoning was accidental or suicidal. The treatment invari-
ably consisted of the immediate use of the stomach-pump or a zinc
emetic and very strong coffee frequently given, and the patient kept
constantly moving about where it was possible to do so ; cold affusions
to the head and chest, and faradization. Atropine was tried as a
remedy in one instance : a man who had taken a dose of watery
extract of opium (quantity unknown) was admitted at 10 A.M. or two
hours afterwards; the stomach-pump brought away a large quantity
of the drug, an hypodermic injection of atropine 1/160 of a grain was
used, the pupils which were previously contracted became somewhat
dilated, the change, however, lasted only for half an hour when they
again became contracted; at 2 P.M. the patient recovered conscious-
ness and spoke to the ward attendant; at 4 P.M. he relapsed into a state
of drowsiness, became comatose, and died shortly afterwards, almost
suddenly. No post-mortem was permitted by the friends. The three
remaining cases were admitted in a hopeless state, and in spite of
everything that was done to recover them, they died without regain-
ing conciousness.
154
17. Datura .-29 cases were treated during the year under report,
none died ; in fact during the whole period of my connection with
this hospital (nearly 20 years), I do not recollet a single death due to
datura poisoning, although some cases are received in an almost
apparently hopeless state, and are frequently 3 and 4 days under
treatment. The drug is usually administered for purposes of theft
from the person while in a state of unconciousness. The train of
symptoms noted during the year as collected from the cases are,
dryness of the throat, excitement, delirium, insensibility, dilatation
of the pupils (sometimes lasting 2 or 3 days), catching at imaginary
objects, picking at the bedclothes, extreme restlessness, giddiness
(this symtom is complained of before they become insensible, and
when they again recover conciousness), tenseness of the abdominal
muscles, tympanites and incoherent murmuring. The pulse averages
from 120 to 60, and the respiration averages from 15 to 28 in a
minute. Persons suffering from the early effects of the drug are
found by the Police wandering about the streets in a state of excite
- m e n t , o r d a n c i n g a b o u t t h e s t r e e t s i n a s t a t e o f n u d i t y , b u t a r e u n a b l e
to give any coherent statement as to how they became so affected,
and are sometimes objects of great merriment to the bystanders who
crowd around them. It is a common practice to administer the
drug in sweetmeats, seldom in food.
18. Arsenic.— Seven cases of poisoning were received during the
year, of which six were discharged and one died showing a percentage
to treated of 14.28. The fatal case was an homicidal one, the quan-
- t i t y i s n o t k n o w n ; t h e p a t i e n t d i e d a f e w h o u r s a f t e r a d m i s s i o n .
The perpetrator of the deed has not been discovered. In the six
cases which recovered (all suicidal), the symptoms in four were mild,
and they were quite well in 3 or 4 days—the quantities taken were
stated to be very small. In the fifth case the man said he had partaken
of some of the cake by which the d'Ga family were poisoned ; he was
not brought to hospital until 16 hours afterwards ; the symptoms
were of a very severe character, and he was under treatment for 5
days, when he was discharged according to his own request—he was
in a very debilitated state at the time. The 7th case was a Parsee
priest who had swallowed about 8 grains of arsenic, and was brought
to hospital 5 hours afterwards. He attempted self-destruction in
consequence of a quarrel with his relatives. This man was under
treatment from the 27th May to the 13th June ; he nearly sank from
the effects of the drug, which were severe and protracted; and at the
time of his discharge the following note was made on his case :—
" C o m p l a i n s o f g e n e r a l p a r a l y s i s — c a n m o v e h i s l i m b s b u t c a n n o t
stand on his legs nor grasp anything with his hands, owing
to loss of muscular power in arms and legs ; complains also
of loss of sens ation in upper and lower extremities."
155
The treatment adopted for arsenic has been the same as used hitherto,
viz., two drachms doses of the freshly prepared hydrated peroxide
of iron every 5 minutes, wheaten flour, milk,and water given frequent
-ly, ice, and sinapisms to the epigastrium and calves of the legs in
severe cases, and stimulants if prostration is imminent.
19.
Cannabis. —Eleven cases have been admitted during the year;
all of them were discharged within 48 hours. There are three prepara
- t i o n s o f I n d i a n h e m p , v i z . c h u r r u s , a r e s i n o u s e x h u d a t i o n f r o m l e a v e s
stems, and flowers ; ganja is the dried flowering tops of the female
plant, from which the churrus has not been removed; and bhang the
large leaves and capsules. The first is never used for poisoning pur
- p o s e s , t h e t w o l a t t e r a r e v e r y o f t e n — b h a n g f o r s m o k i n g a n d g a n j a
for administration internally. Of the eleven admissions noted, nine
have been from ganja and two from bhang. The symptoms in both
are nearly alike—great excitement, great exhilaration of spirits, laugh
-ing, crying, singing, dancing, and the use of the most abusive lan
- g u a g e ; i n s o m e i n s t a n c e s g i d d i n e s s a n d d r y n e s s o f t h e t h r o a t a r e t h e
chief symptoms, but the pulse sometimes is very rapid, and the coun
- t e n a n c e s h o w s e i t h e r a w i l d , f r i g h t e n e d a p p e a r a n c e o r e x p r e s s i o n o r
the reverse—an apathetic despondency; when the drug is given in
great excess, semi-consciousness not delirium is produced, with full
dilatation of the pupil. I have met with no fatal case from the ad
- m i n i s t r a t i o n o f t h i s p o i s o n . T h e t r e a t m e n t a d o p t e d h a s b e e n z i n c
emetics, cold douches, some food in the shape of conjee and milk, and
the patient is allowed to sleep off the effects of the drug.
20. Mercury.— There were throe cases treated, and all had been
salivated by some native hakim outside. The inflammation of the
dental periosteum was severe in all the cases, and they were several
days under treatment.
21.
Copper. —Three cases received on one day, all of whom had
partaken of some coffee in a public coffee-house, and all were seized
simultaneously with symptoms of copper-poisoning—vomiting, purg
- i n g , c r a m p s i n t h e s t o m a c h , a b u r n i n g s e n s a t i o n a l o n g t h e c o u r s e o f
the æsophagus, a small quick pulse, and a lessened temperature; the
symptoms were speedily relieved by the exhibition of milk and eggs,
and they all left the hospital on the following day.
22. Poisonous Fish.—Poisoning by eating fish does not arise here
as in England from eating diseased oysters,shell-fish, &c., but from the
use of fish in a state of decomposition, a practice which is common
amongst the poor classes. The symptoms from direct toxæmic
poisoning are very severe and simulating those of poisoning by arse
- n i c ; t h u s , i n t h e f o u r c a s e s u n d e r r e p o r t , t h e y w e r e a l l a d m i t t e d o n o n e
day after partaking of a meal consisting of rice and fish curry. The
21 M D
156
symptoms of poisoning presented themselves alike in each case an
hour afterwards, and were at first so severe that the Police took
charge of the cases, under the impression that arsenic had been used
to poison the whole of them; they were not brought to the hospital
until 14 hours afterwards—a man, two women, and a little girl; by
this time the effects of the poison had probably passed away, and the
poison itself was eliminated by natural means. The history of the case
was taken from each individual, and excepting some milk and sago
which was given, no other treatment was considered necessary; they
were discharged on the following day.
23.
Poisonous Grain.—Cases of poisoning from using deteriora
-
ted grain are very common, but the symptoms following its consump
-
tion are not so severe as to induce them to come to the hospital for
relief. The solitary case under report has been one in which a greater
quantity, than in other cases, had been taken. The symptoms consist
-
ed of vomiting and purging, which a few doses of soda, bismuth,
and laudanum relieved, and he was discharged on the following day.
24.
Poisoning by pounded glass. —This was an attempt to com
-
mit suicide in a female who had been a great sufferer from bowel
complaint, and not having the means of purchasing some of the well
-
known poisons, she took off her bangles, pounded them, and swal
-
lowed the fragments—no bad symptoms resulted. She was, however,
brought to hospital by the Police when she made the above state-
ment. Eggs and milk were given followed in a few hours by a dose
of castor oil. Excepting a general tenderness of the abdomen, she
made no other complaint, she was discharged on the 2nd day after
her admission.
I am indebted to the Senior Surgeon for the surgical report of the
year.
25. During the year ending 31st March 1873, the arrangements
for the treatment of the surgical patients were the same as in the
previous year; about 120 beds have been occupied by surgical cases.
220 cases of fracture were treated including 21 of the skull. Of the
total number no less than 108 were fractures of the lower extre
-
mities; a considerable number of patients coming to the hospital
with fracture of the upper extremities who were formerly admitted
are now treated as out door-patients; nevertheless the total number
of fractures treated in hospital (220) is larger than any of the
previous five years. Eleven cases of dislocation were admitted—4
of the upper extremity and 7 of the lower.
The sanitary condition of the surgical wards has been satisfactory.
26. Wounds have healed well. Carbolic acid has been constantly
used, and the experience of the past year has fully confirmed its realm
in the treatment of abscesses by the antiseptic plan: in the treatment
of suppurating sores, oakum has been used as recommended by Pro
-
fessor Lister with marked success.
157
27. Tetanus.—I am happy to say that traumatic tetanus has been
less common when compared with the previous year, as seen in the
following table:—
Year ending.
R e m a i n e d .
A d m i t t e d .
T o t a l .
D i s c h a r g e d .
D i e d .
R e m a i n i n g .
T o t a l .
31st March 1872 . . .
1
33
34
12
20
2
34
31st March 1873 . . .
2
16
18
7
11
. . .
18
It is interesting to observe that the total number of cases of " Idio
- p a t h i c T e t a n u s " a d m i t t e d d u r i n g t h e y e a r s ( 1 8 7 2 - 7 3 ) u n d e r r e v i e w
was exactly alike, viz., 22.
28. The list of operations annexed will show the number an
variety:—
List of the Principal Operations performed at the Jamsetje Jejeebhoy
Hospital during the year from 1st April 1872 to 31st March 1873.
Names.
Number.
Amputation of shoulder joint . . .
1
Do.
arm . . .
2
Do.
forearm . . ..
3
Do.
fingers. . .
12
Do.
penis . . .
6
Do.
thigh . . .
1
Do. k n e e - j o i n t . . .
4
D o . l e g . . .
3
Do. foot . . .
2
Circumcision . . . 34
Condylomata . . .
3
Catheters and sounds passed . . . 1,825
Dislocation of thumb . . .
1
Do. shoulder . . .
5
Do. elbow . . .
1
Do.
jaw . . .
1
Division of cicatrix . . .
2
Deligation of external iliac . . .
1
Do.
carotid . . .
1
158
Operations—continued.
Number.
Number.
Dilatation of stricture ...
...
27
Extraction of foreign body from thigh
Do.
do.
teeth
...
...
615
Evulsion of toe nail
...
...
6
Excision of radius
...
...
1
Elephantiasis scroti
... ...
4
Do.
labia
...
1
Forcible extension of joints
...
...
5
Fistula in ano
...
...
19
Gouging for necrosis and caries
...
...
1
Galvanic cautery
...
...
6
Ganglion
...
...
1
Holt’s operation for stricture
...
...
1
Hydrocele tapping
...
...
193
Hernia strangulated
...
...
7
Hœmatocele slitting...
... ...
16
H a r e l i p . . .
1
Lithotomy
...
...
16
Ligature of internal piles
...
...
6
Do.
nœvus
...
2
Lithotrity
...
...
1
Lithectasy
...
...
1
Opening abscesses
..
319
Do.
of liver
...
...
2
Perineal section
...
...
3
Paraphymosis
...
...
7
Plastic operations, urethra
...
...
1
Do.
nose
...
...
1
Do.
ear ...
...
1
Prolapsus ani
...
...
...
3
Paracentesis abdomiuis
...
...
5
Removal of tumors
...
...
31
Do.
nasal polypi
...
...
4
Do.
calculus from urethra ..
...
5
Do.
OS calcis
...
...
1
Do.
necrosed bone
...
...
7
Do.
cysts
...
...
2
Do.
nails
...
...
1
Do.
epulis
...
...
2
Do.
foreign body from foot
...
...
3
Do.
do.
do.
nose ... ... ...
2
159
Operations—continued.
N a m e s .
Number.
Removal of polypus from pharynx . . .
1
Do . " ear . . .
1
Do. foreign body from ear . . .
3
Ranula . . .
1
Slitting sinus . . .
4
Talipes varus . . .
3
Tenomy . . .
3
Tracheotomy . . .
2
29. The following list will show the number of cases treated as
nut-door patients :—
List.
Contusions . . . 797
Wounds . . . 1,044
F r a c t u r e s . . .
81
Burns and scalds . . .
30
R e t e n t i o n o f u r i n e . . .
37
Removal of foreign body from nose . . .
9
Do. do. ear . . .
1
Do. do. finger . . .
1
Do. do. throat . . .
1
Reduction of hernia . . .
11
Do. of dislocation . . .
13
Tooth extraction . . .
7
Tapping hydrocele . . .
1
Opening abscess . . .
2
JAIL HOSPITALS.
Her Majesty's
Common Jail.
1. In Her Majesty's Common Jail, Bombay, the average strength
of European male prisoners has been 5, females none. Of native
males 203, females 16=219. Of the sick of Europeans none remained;
there were 10 admissions and 10 were discharged—8 to work and two
otherwise. There were no deaths.
Of natives, nine remained under treatment from the previous year,
162 were admitted: total treated 171. Of these 154 were discharged to
work, eight otherwise, four died, and five remained under treatment.
The average daily sick of Europeans was 0.4 and of natives—males
7.1, females 0.1.
Deaths amongst natives occurred from chronic hepatitis two,
chronic diarrhœa 1, phthisis 1.
There have been no epidemics in the jail.
160
Several operations have been performed by the Surgeon in charge
on native prisoners.
The hospital of the jail is not a good one ; it consists of a set
of small cells apparently only for natives. On an upper story
there are eight of these cells which are ill ventillated ; they would
hold, at a superficial space of 90 feet per man, 10 sick ; but as two
men are never allowed to occupy one cell, the accommodation in each
must be given to one, who would have more than the requisite space,
or to three who would have too little. Should infectious disease find
admittance there is no ward for the treatment of cases. I look upon
the hospital arrangements as very defective and requiring amend
-
ment.
The general health of the prisoners has been good ; the labor is
carried on under cover ; the cleanliness of the jail and hospital is
carefully attended to, and there has been no overcrowding allowed.
House of Correction.
2. The average strength in this jail during the year was 85 Euro
-
pean males and 209 native males—294.
Of Europeans five remained from the previous year and 66 were
fresh admissions : total 71. 64 were discharged to work, none died,
and seven remained under treatment.
The average daily number of sick was 4.65.
Under general diseases, Division A, 18 were treated, 16 of which
were cases of ague, one case of small-pox (transferred to European
General Hospital, Small-Pox Ward), and one of mumps. Under
general diseases B, eight were of rheumatism, two of syphilitic disease,
one of anœmia. Of local diseases there were 38 treated, the chief
diseases being those of the eye, respiratory, digestive, urinary, and
generative systems. Two operations for strabismus were performed.
The average strength of the European inmates is made up to 85 by
32 vagrants, the prisoners being 53.
Out-patients are attended to ; the hospital accommodation for
natives and Europeans for this jail is peculiarly small and ill arranged
in every way.
Of natives—three remained from the last report, and 90 were fresh
admissions=93. Of these 84 were discharged to duty, two died, and
seven remained under treatment. The average daily number of sick
was 6.13. Under general diseases, Division A, there were 12 cases of
ague. Under Division B, four were syphilitic affections, two scurvy,
one from anœmia. Of local diseases 10 were affections of the eye.
The respiratory and digestive systems gave the largest number of
diseases ; gonorrhœa and its complications, hydrocele and abscesses
161
followed. There were only two of disease of the skin. Injuries were
infrequent ; there were five operations ; two tumours were removed
and three of iridectomy performed.
Surat.
3. The average strength of the prisoners was 193, males
183, females 10, 10 remained in hospital from the previous year, and
265 were fresh admissions=275 ; showing a decrease of 55 compared
with 1871-72. Average daily number of sick was 8.1—7 males,
1 f e m a l e .
268 were discharged, three died, and four remained. The ratio of
deaths to treated was 1.09 of deaths to strength 1.6. The deaths were
from sun-stroke one, dysentery one, hepatitis one.
The prisoners were thirty-six town and two nomade Mussulmen,
ninety-four town and fifty-six nomade Hindus, three untried,
and two Parsees. The admissions were thirty town Mussulmans and
15 noma de s ; 146 t own a nd 72 noma de Hi ndus ; t wo Pa r s e e s ;
this points to many re-admissions. Under general disease, Division.
A, 125 were cases of ague, three of dengue. Under B, rheumatism
and syphilitic disease. Local diseases were cheifly represented by
bronchitis, dysentery, diarrhœa, gonorrhœa (four cases), abscesses (23
cases), guinea-worm (5), and skin diseases, of which 13 were scabies.
Local injuries were 13 contusions. Surgical operations were five—all
minor.
3 a. There was no epidemic disease during the year, though dengue
and cholera visited the city. The healthy character of the prison is
reported on by the Civil Surgeon, but there was more sickness in it
than in other jails—vide Review paragraph 10. The jail and hospital
were in perfect order when I visited them, at which time there were
more prisoners in occupation than the space sanctioned.
.
4. The average strength was 665 males and 37 females :
total 702. Of the sick 11 remained in hospital from the previous
year and there were 592 fresh admissions=603 ; of these 569 were
discharged, 25 died, and nine remained. There was an increase of 125
admissions on the year 1871-72. The average daily sick was 22.96
—22.62 males and 0.34 females. The ratio of treated to strength was
85.8, that of deaths to strength 3.5, and to treated 4.1.
The increase in admissions is due to a large number of guinea
-
worm cases and local injuries occurring. The prisoners in jail
were of the following general castes :—33 native Christians, 50
town and 33 nomade Mussulmans, 198 town and 35 nomade
Hindus, 1 Jew, 1 Parsee, and 3 Chinamen, and 32 other castes.
The admissions to hospital 21 native Christians, 49 town and 24
a n o m a d e M u s s u l m a n s , 2 2 5 t o w n a n d 1 8 8 n o m a d e H i n d u s , 1 o f e a c h — J e w
162
Parsee, and Chinaman, 24 Burmese, and 6 other castes,
Under general diseases, Division A, 186 cases of ague were treated,
In Division B there were rheumatism, syphilitic disease, and scurvy,
Of local diseases the chief were bronchitis, dysentery, diarrhœa,
guinea-worm (120), and general injuries (88)—only one operation was
required, amputation of the forearm. A number of these injuiries
were in Burmese ; in an attempt to escape from the jail, they trusted
to thin ropes which broke ; in the fall one fractured his thigh, one
dislocated his elbow, another fractured his lower jaw, and eight were
severely contused. The amputation was in a convict who, while
being brought from Nasik, threw himself from a railway carriage
when in motion ; while lying on the ground the opposite train came up
and went over his left wrist, severing it—the arm was amputated
above the injured part by the railway surgeon.
5. The Civil Surgeon ascribes some of the increase in the mortality
about 1.30 per cent, to strength to the nature of the wards occupied
by the transports for the Andamans, as well as by others, and to their
lengthened detention. Another cause is the accumulation of men
who have reached as far as Tanna, on their way to the Andamans,
and who have been there stopped in consequence of age and infirmity.
There were seventeen of this class, of whom three died. Seventeen
men died who were occupants of the "transport ward."
6. On the presence of guinea-worm an enquiry has been instituted
and a report prepared. When I visited the jail thrice during the year
it was in as good order as it could be, the building of the new jail
was rapidly proceeding, the number of men was considerably above
that which space sanctions.
Karwar .
7. The average strength of the prisoners in this jail was 147 males
and six females=153, being 45 more than in the preceding year.
Of the sick four remained in hospital at the end of 1871-72 and there
were 126 fresh admissions during the year; of these, 122 were dis
-
charged, one being liberated, six died, and two remained under treat
-
ment. The average daily sick was 3.08. The ratio of treated to
strength was 85, deaths to strength 3.9, and deaths to treated 4.6.
The admissions were ten less than in the previous year, and the
death-rate is higher, but the diseases of all, but one, which caused
the mortality, were of long duration previous to admission to the jail
The strength of prisoners consisted of the following castes:—Native
Christians eight, Mussulmans town 16, and Hindus town 125—there
were two Chinamen and Malays; of these there were admitted to
hospital four Christians, eight Mussulmans, 112 Hindus, and two
Chinese.