NationalLibraryOfScotland/medical-history-of-british-india huggingface dataset:
81
The mortality, taken from the Civil Surgeon's returns, from these
diseases—fevers, diarrhœa and dysentery—was 23, the total mortality
being 30, or 19.48 per cent. to treated.
Another circumstance in connection with the Tanna Hospital is
the apparent necessity for a small ward being made for keeping in-
sane patients, until they can be properly disposed of.
At my visit of inspection there were two of this class—one, whom
the Civil Surgeon had been obliged to put into a small room, had
managed with his hands to undermine the whole of one side in endea-
vouring to escape.
Each civil hospital should possess a properly constructed room for
such cases, also, as stated in the dispensary report, a place for private
examinations to be carried on is much required.
The total treated during the year was 154; of these 9 remained
from previous year, 145 were fresh admissions, 30 died, giving a
percentage of deaths to treated 19.48; and 3 remained.
At my inspection there appeared to be considerable amount of
care and attention bestowed on the treatment of the sick in this
hospital. The Civil Surgeon reported favourably on the subordinate
establishment.
There was no bedding or clothing for the poor sick: this was direct-
ed to be supplied to a limited extent.
Some alterations in the latrines, servants' houses, &c., were much
required, and I will direct the Civil Surgeon to consult with the Exe-
cutive Engineer on the subject, in view to some steps being taken
towards carrying out such as are really required.
Sur at.
The Civil Surgeon, Surat, in his annual report of this hospital gives
a short history of its origin, from which it appears that it was built
at the cost of Sir Cowasjee Jehangier, C.S.I., at an expense of
Rs. 75,000, and was opened to the public in 1864.
Amongst the several public buildings which have within the last ten
years given to Surat an appearance of considerable importance, none
have presented a more imposing aspect than the Civil Hospital: it is
situated on one side of an open space, with the Castle and Church
close beside it, and some of the Municipal improvements in its
neighbourhood.
The description of the building given by Mr. Gane, points to some
defects. These are evidently defects of design. In the upper floor
the omission of latrines, and sufficient lavatory arrangements, the
omission of means of water supply.
In the lower portion one of the wards is an opthalmic ward, the
windows of which, four in number, are large and of white glass.
There is no lavatory to this ward.
The windows of both upper and lower stories are large, they open
immediately on large arches, and the wards are consequently exposed
82
to the full action of the sun's glare during the dry season, and to the
wind and rain of the monsoon.
The Civil Surgeon considers venetians are required to the arches,
and I quite agree in the desirability of this and other matters being
attended to. Suggestions to this effect were made by the predecessor
of the present Civil Surgeon in 1864.
I will quote a remark made by the Civil Surgeon concerning the
mortality, which amongst in-patients was 35 out of 428, or 8.17
per cent. to treated : " With reference to the mortality I need only
remark that a large portion of the patients who seek admission into
the hospital do so as the only means they have of obtaining food.
From the severity of their diseases they are pronounced incurable by
the Hakeems, and when they are disabled from begging food in the
streets, many merely come into hospital as a place where they know
they can die in tolerable comfort."
22 of the deaths out of 35 occurred from debility, that is in persons
brought to hospital in a dying state.
From the annual return I gather that there were treated as in-pa-
tients of the Civil Hospital 428, of whom 45 remained from the pre-
vious year's returns, 383 were fresh admissions, of these 365 were
discharged, 35 died, 28 remained under treatment.
The temperature registered in this hospital was highest in the
month of April, when it was 94°, the lowest in January, when it was
64. The rainfall was 22 in. 80 cents, the average fall for 10 years
was 34 inches.
At my inspection the hospital was in a satisfactory state, except in
the points noted at the commencement of the review of the Civil
Surgeon's report.
The subordinate establishments were effective, and no complaints
were made.
Broach.
It is pleasing to record of this flourishing municipal town, with a
population of 36,479, that at last its new hospital, alike a most use-
ful structure and an ornament to the place, is completed; it was on the
14th August 1871 opened to the public. I am not acquainted with
the manner in which it was arranged that a new hospital should be
erected, but the cost of the building was Rs. 67,000, and this sum
was met from the following sources :—
Grant from Governent
...
...
... 25,000
Donation from Mr. Sorabjee J. Jejeebhoy ... 25,000
Local Fund Grant ...
...
...
... 4,000
From 1 per cent Income Tax Balance
... 10,000
Municipal Grant
...
...
...
... 3,000
Rs. 67,000
The hospital is situated on the best part of Broach, on the old
fortifications, and well exposed to all breezes : it faces west.
83
The description of the building is given by Assistant Surgeon Cook,
M.D., in Medical charge. At my visit of inspection I was satisfied
with most of the arrangements ; a few, however, were so obvi-
ously defective that they could not help being observed, and recom-
mendations for their alteration have been or will be submitted.
The defects are noticed by the Civil Surgeon in his report, I will
reproduce the most important here.
It is evident that the
original plan was not fol-
lowed, for in it the female
ward is separate.—T.B.J.
1.—The ward for female patients is next
to that of the Police constables, and there is
no impediment to easy communicaiton be-
tween the two, the verandah in front being
in no way guarded between the doors of
entrance of each.
2.—Quarters for a Hospital Assistant were arranged for in two
small rooms in the centre of the hospital. These, besides the situation
being entirely out of place, are insufficient for the accommodation
of such an official, probably with a family.
In the first case I have asked the Civil Surgeon to represent the
circumstance, and in the second the Hospital Assistant has betaken
himself (and N. Medical pupil) to the quarters originally designed
for 2nd class servants, who having residences near prefer to occupy
them. It is, I am afraid, unlikely that new quarters will be built for
the 1st class establishment or for the second ; the plan cannot, I
think, have been examined by the Medical Department or these de-
fects would have been noticed.
The total number of cases treated in the civil hospital as in-patients
was 318, of this number 15 remained from previous returns, and 303
were fresh admissions: 20 died, 278 were discharged, and 20 remained.
Average daily sick 15. Average of deaths to treated 6.2.
The chief diseases were ague, local injuries—on this head it may
be necessary to state that Broach has many cotton-ginning manufac-
tories, and many of the accidents are probably sustained at these-
dysentry and diarrhœa, skin diseases, &c.
Dr. Cook remarks on the mortality from dysentry, 18 of which
were treated and 5 died, giving a death rate of 27.77 per cent. to
treated of that disease : " These cases are usually brought into hospi-
tal in very advanced stages of the disease and are suffering under
extreme exhaustion which often renders all treatment hopeless."
The operations were major and numbered nine with only one death.
This was an operation for dystoria or removal of fætal remains in a
case brought for aid too late.
As I have pointed out in several parts of this report, the probable
cause of the mortality being large in civil hospitals, amongst Natives,
and in-patients of dispensaries, the following remarks of the Civil
Surgeon will be found apropos : "With regard to the class of cases
treated, it is to be observed that the great majority are made up of
the following :—
Homeless beggars, pilgrims, &c., who are stricken by serious
disease while passing through the town, or rendered unable to
84
proceed by aggravation of disease previously contracted. They
are brought to hospital, as a rule, in a state which renders treatment
a very serious matter, and very often all but hopeless: amongst this
class dysentery, diarrhæa, ague, remittent fever are commonly found ―
"2nd (showing want of small dispensary)—People from the vil-
lages in the district suffering from some serious disease or injury,
who, having tried all available remedies in vain, come to the hospital
as a last resource."
The highest temperature registered was in April, 100°, in May and
June 99° the lowest 56° in January and February. The rainfall was
19 in. 14 cents., a registration which is said to have been scanty. No
epidemic dieases prevailed.
An active Medical Officer here has, soon, as much as he can do in
medicine and surgery, particularly the latter, and I trust to see, un-
der Dr. Cook's charge, a great addition to the good previously done
by the civil hospital dispensary, as there is now this excellent build-
ing open for the reception of the sick of the district.
POLICE HOSPITALS.
Tanna.
Colaba.
Ratnagiri.
Vengurla.
Surat.
Sawantwari.
Carwar.
Honore.
Broach.
Tanna.
The Tanna police hospital adjoins the Tanna civil and regimental
Hospitals, and is provided with medicines, attendance, and medical
requisites from the civil hospital.
The strength of the Police on the 1st April 1871, was 1,118.
Died in hospital
...
...
10
Sent on sick certificate... 2 2
Discharged at their own request ... 62
Transferred ...
...
...
1
Discharged by C. 0. ...
... ...
25
Invalided... ... ... ...
3
123
I extract this table from the Civil Surgeon's report, to point out
how much any medical statistical data of police must be vitiated where
the causes of so many discharges from the corps are unknown.
The strength shown to remain is 826, which does not tally with
the remainder of the table given by the Civil Surgeon.
As usual ague was the chief disease treated.
There remained from previous returns 18, there were 419 fresh ad-
missions, total treated 437 ; of these 414 were discharged, 10 died,
13 remained under treatment.
85
In his history of diseases under treatment the Civil Surgeon states
of one, abcess of the liver, which recovered after early puncture,
that it is "the only case on record of an abscess pointing towards
the ribs that has been opened and has recovered."
Guinea-worm appears to be somewhat frequent due, the Civil
Surgeon states, to using the well-water of the districts where
dracuaculus is endemic.
Surgeon Atkins states the health of the Police was not so good as
in the previous year.
The corps is employed over the Tanna Collectorate, many parts
of which are highly malarious, and there are, doubtless, many who
suffer attacks of fever who do not show their diseases ; to assist such
I had recommened that they should be made to attend at dispen-
saries when sick and receive treatment.
Ratnagiri.
The strength of this corps at head quarters was 373: there were
151 treated, of whom 6 were remained from previous return, and
145 were fresh admissions ; of these 145 were discharged, 2 died,
and 4 remained. There is no discharge history of the corps such as
given by the Civil Surgeon, Tanna ; in all such corps many men are
discharged during the year, some probably for sickness which, as I
stated in the analysis of ratio of sickness and deaths to strength,
would enhance the police returns of sick.
The chief diseases were as usual ague, one case of which termi-
nated fatally.
Next in point of number were diseases of the stomach and intes-
tines, chiefly diarrhœa, one case of quinsy the Civil Surgeon treated
successfully with guaiacum, which he states "has never disappointed
him during the last two years."
Two cases of snake-bite which presented constitutional symptoms
terminated in recovery.
The police hospital is a ward of the civil hospital, and at the time
of inspection was in perfect order.
Surat.
The report of the Police shows that there was not much sickness
prevailing, In the review of the Mandvie dispensary it is noted that
it is strange so few cases of fever are recorded. The Civil Surgeon
states that most of the cases treated were received from the districts,
particularly from "Mandvee " and the "dang jungles," places noted
for severe form of fever. The number treated during the year was
167, of whom 7 remained from the preceding year, and 190 were fresh
admissions ; of these 179 were discharged, 3 died, and 15 remained
under treatment.
The chief disease was ague, from which 145 were treated, or 73.65
per cent. to total treated.
11 M D
86
The mortality was 3, one from ague, two from debility.
The police hospital is a ward of the civil hospital and is alluded to
in the report.
Kárwár.
K á r w á r .
The police hospital of the North Kanara Police Corps is a separate
building, situated at a considerable distance from the civil hospital
and jail, at the opposite side of the town of Kárwár, on the sandy
plain to the south of the Kallee Nuddee, near the town. The lines of
the police are in close proximity to it.
At the period of my visit to Kárwár there were far more sick than
the hospital was destined to contain. The hospital was built after
a design of a Police Superintendent, the Medical authorities not
being consulted: it is imperfect and peculiar.
The Civil Surgeon reports that the police force has been more
healthy in the year under report than usual.
There were 525 treated, of whom 19 remained from the previous
year, and 506 were fresh admissions; of these 509 men were discharg-
ed, 4 died, and 12 remained under treatment. The chief cause of
admission was ague, of which 121 were under treatment, giving a
ratio percentage to treated of 23.04.
Diseases of stomach and intestines gave 28 cases and 3 deaths.
The total mortality was four; giving a ratio of 0.7 to treated and of
1.3 to strength.
The hospital was carefully attended to and clean. A Hospital
Assistant is attached to it.
Broach.
In the report of the Broach Police submitted by the Civil Sur-
geon, Assistant Surgeon Cook, M.D., he states that the strength
from which he receives patients into his hospital is 281, the total
being 358; the sick from the remaider are supposed to receive
medical aid at the various dispensaries. The sick treated at
Broach are admitted into the police ward of the new civil hospi-
tal, which was opened on the 14th August, where there is cubic
space for 8 beds.
There were 142 treated in the year, of which 4 remained from the
previous year and 139 were fresh admissions; of these 135 were dis-
charged, 3 died, and 4 remained.
Dr. Cook states: "The discipline of the police ward has been very
bad, the sick have been in the habit of leaving the hospital for their
food, and receiving their friends and their visitors at all hours at the
hospital, which bids fair to become a lounge for all the idlers in the
lines and vicinity. This has been in a great measure stopped by the
aid of the Police Superintendent and in a short time still greater im-
provements may be accomplished."
87
The chief disease was ague. The highest temperature was 100º in
April, the lowest 56º in January and February. The rainfall was 19
inches 14 cents, the greatest fall was 2 inches 34 cents in August.
Dr. Cook reports the lines where the police live to be imperfect.
Kolala—Alibag.
There is no police hospital and the sick are, as far as possible,
accommodated in the place used as a civil hospital, alluded to under
dispensary, Alibagh: they are also treated in their own lines or
houses. The lines are too small to contain all the police. On the
opening of the season a new civil and police hospital will be com-
menced.
The health of the force has been reported on satisfactorily. Mr.
Sub-Assistant Surgeon Pereira states "the actual amount of disease
cannot be correctly estimated, as all the sick do not come under treat-
ment from the distant parts of the district for ordinary complaints.
Valuable time is sometimes lost in not sending the sick soon to
hospital, and sometimes by the length and trouble of a journey."
Mr. Pereira also remarks that the sick should be treated at the
"Penn dispensary when near it, and the new dispensary at Mhar."
This should be a particular function of all dispensaries in the dis-
trict, but though this has been shewn to be necessary, it is to be
questioned whether the orders on the subject are correctly carried
out by the Police Native authorities in the districts.
The number treated in the year was 242, of whom 5 remained
from the previous year's returns and 237 were fresh admissions; of
these 235 were discharged, 4 died, and 3 remained under treatment.
The chief disease was ague. There were four deaths, two from
phthisis, one from heart disease, and one from C. dysentery.
Vengurlá.
A detachment of the Kanara Police, of the strength 172—part
occupy old Regimental lines and part live in the town—the sick are
treated in the ward of the dispensary, under the medical charge of
Apothecary Underwood, set apart for in-patients, and at their lines
and houses.
There were 58 treated, of whom 1 remained from previous year's
returns and 57 were fresh admissions; of these 55 were discharged,
1 died and 2 remained. There was 1 death in a constable from out-
post duty, 50 miles off, where he had been suffering constantly from
fever; he died soon after admission. I note this case only to show
the necessity there is for early treatment. Ague was the chief disease.
Honore.
Detachment of North Kanara Police, the sick of which are treated
at the Honore dispensary, under the medical charge of 2nd Class
Hospital Assistant Gungadur Venayek, General No. 347, since reliev-
ed by 3rd Class Hospital Assistant Vittul Biccajee, General No. 866.
88
The strength of the detachment was 52 ; there were 69 treated, of
which 1 remained from previous year, 68 were fresh admissions ; of
these 68 were discharged, none died and 1 remained.
Nothing of importance appears to have occurred during the year.
Sawantwari Local Police Corps.
The sick of this Corps are treated in the very excellent civil
hospital under the medical charge of Sub-Assistant Surgeon Burjorjee
Ardaseer.
Strength of the Corps 466 ( 1 European ).
The number treated was 205, of whom 7 remained from the preced-
ing year, and 198 were freshadmissions; of these 199 were discharged,
1 died, and 5 remained. The chief disease was ague, 111 cases of
which were treated. There was one death in the year from remittent
fever.
The police ward was at the period of my inspection in good order.
JAIL HOSPITALS.
The Jail Hospitals in the Presidency Division are—
H. M.'s Common Jail Bombay.
House of Correction
Jail Tanna.
,, Ratnagiri.
,, Surat.
,, Karwár.
,, Sawantwari—Independent State
.
H. M.'s Common Jail.
The Annual Report of the Common Jail does not call for any
lengthy comment. The healthy character of the jail has been as
usual favourable.
The chief diseases have been fever and diseases of the stomach
and intestines. The deaths, Surgeon Partridge states, have been
more than usual, but the cause has been due to the state of the men,
one of whom was of broken-down constitution, some were opium
eaters, and one was sent in a dying state from the Poona Jail.
The most remarkable feature in the medical report is the perform-
ance of many operations, amongst these 23 cases for radical cure
of hydrocele, 5 cases of removal of hæmorrhoids, 1 for stricture,
Holt's operation.
The hospital was clean, the jail in good order. The Hospital
Assistant bears a high character and I was satisfied, at my inspection,
of the attention shewn in all matters connected with the healh
of the place.
House of Correction.
In the House of Correction the health of the prisoners was good.
89
Here also operations were performed with success.
There were treated in the House of Correction hospital 67 Euro-
peans, 72 Natives; with 2 deaths European, 3 Native.
During the year vagrants have been accommodated, and the sick-
ness amongst them was considerable; a ward of the hospital was set
apart for some, whilst others were treated as out-patients. 24
vagrants at the end of the year were in the work-house.
The urgent need for a contagious disease ward still exists. During
the year one or two cases were obliged to be sent to the Jamsetjee
Jejeebhoy Hospital.
In both the Jail and House of Correction the diets have been ex-
perimentally reduced, both in Europeans and Natives, without any ill
result. The sanitary character of the House of Correction was attended
to carefully.
Tanna.
Strength, average, 632; average sick 17.34 daily.
Total treated 475; of these 449 were discharged, 15 died, one out
of hospital.
The percentage of treated to strength was 75.63 and of deaths to
treated 2.93.
The chief diseases were intermittent fever, of which there
were 195 with 5 deaths. The ratio of fever cases per cent. to
strength was 30.85 or to total treated 41.05. Dysentery and diarrhœa
caused 5 deaths, hepatic abscess 2, other diseases gave 4, viz.,
phthisis 2, debility 1.
The Civil Surgeon states that the increase of fever was coincident
with the appearance of increase in other charges. Guinea-worm
caused 82 admissions: it appeared in men of from 9 years to
3 months residence in jail; cause stated to be a well which had not
been cleaned before the previous monsoon.
The new jail built by jail-labour is fast tending to completion:
and a new hospital is to be built in place of the present one, which is
ill-suited for treatment of the sick. I went over all the jail and
hospital twice and was satisfied with my inspection that every care was
bestowed on the sick prisoners and the health of the jail attended to.
Ratnagiri.
The jail has been in a very satisfactory sanitary condition during
the year. There were 48 cases treated, 1 remained from previous
returns and 47 were new admissions.
Of these 48, there were 47 discharged and 1 died, and none re-
mained.
Surat.
The sickness and mortality in the Hospital Jail, Surat.
There were 330 treated, of which 6 remained from previous re-
turn, 324 were fresh admissions; of these 7 died, 313 were dis-
charged, and 10 remained.