NationalLibraryOfScotland/medical-history-of-british-india huggingface dataset:
350
By means of carefully and well-planned manœuvres, expedients are
resorted to as counterplots—so to write—and since we have to deal
with a cunning enemy, the system adopted is to allow him to suppose
an over-reach; he falls into the trap and becomes a willing slave, and
this without any brute force.
Men like gardening, there is much in the work to divert the eye,
the faithful tell-tale of the mind, and this is encouraged largely. Man
goeth forth to his labour in the early morn, and is happier in so doing
than caged up.
17. Games, music, &c., are means resorted to towards restoration.
Amusements.
while some, as a reward, are entrusted with
a nominal supervision over their fellows, of
which they are proud, very proud indeed !
Like school boys, some, exceptionally well-behaved, get a half holi-
day and pocket money, visiting the bazar in company with a
warder, and this indulgence is not readily forgotten.
18. The report states that males rest under discipline far better
Labour—females.
than females, yet this is not a novel feature in
the latter sex, e'en in the sane. So long as we
get two women grinding at the mill all is well, but when the spell is
broken the mill is of a thing apart, yet these women willingly engage
in this office, and, as the Superintendent Dr. Wyllie states, it acts
"as a sedative in averting paroxysms of excitement."
It is unfortunate that out-door employment cannot be given to
women also, the labours of these are confined to the mill-stone and
rude loom within the building, in which is an open space, but the eye
becomes tired under monotony, e'en among native women, whose
habits, in the higher classes only, are secluded, but the classes we
have to deal with in the asylum are equal sharers with men as culti-
vators.
Percentage of varied labour.
19. There is a hopeful promise held out
for extension of varied labour, the percentage
at present, is as follows :—
Employed in gardening and irrigating
. . .
... 11.8
Levelling and removing old foundations .. .
... 21.6
...
Brickmaking ..
...
.
... 4 . 8
Driving and tending well bullocks...
... 5 . 0
Domestic service of asylum
• • •
..
•
3.2
Spinning (females)
• • •
...
...
1.3
Grinding grain (females)
• •
• .
. •
3.5
In the hot season the male lunatic sits under the shade of the vine
he has helped to cultivate, and labours hard to suppress the natural
inclination to taste of the fruit thereof,
351
20. Although the gross value of labour from garden products
reached Rs. 499, the net sum was but Rs. 93,
Value of production.
the balance being expended on purchase of
land in proximity, and which will admit of extension of the present
building when deemed necessary. Other requisite purchases have also
been made, such as bullocks, &c., from above named proceeds.
21 . Unrealized Value .—The unrealized value was Rs. 894, pro-
Rs. a. p. Rs. a. p.
Sale garden produce ...
... 432 9 7
From spinning (females)
...
6 2 5½
„ grinding
„
... 60 2 11
498 14 11½
UNREALIZED VALUE.
Vegetables for insanes
.. 95 0 0
Tobacco
do.
... 20 0 0
Gram for bullocks ...
... 20 0 0
Kurbee and grass for bullocks. 275 0 0
Brickmakiug ...
...
..125 0 0
Levelling
...
...
... 359 4 10
894 4 l0
Total...
...
1,393 3 9½
duce for maintenance
of cattle and supplies
of inmates. The total
is shown in the mar-
gin.
22. Treatment.—
Dose, hydrate of
chlo-ral in exceptional
cases, good feeding,
out-door exercise, half
holidays , and douceurs
de la l' berieo n c e a
week, with a small
sum to buy "Methaie"
this is the chief treat-
ment; since it must
be borne in mind that the disease is one of mental, consequently
physic is not required beyond aiding nature as in the sane.
23. Health .—Excellent ! no epidemic, not e'en dengue ; the
curse to all sane people, rendering them, for a time, incurable in
body and mind too.
24.
Building.— All appropriate and in good order, cleanliness
prevailing to an extent not generally observed.
There was an extension completed towards latter portion of 1872,
rendering accommodation equal to 108 ; there are 57 cells, 5 associ-
ated rooms where social conversations are held, a large convalescent
ward; in fact, rooms accommodated for all classes.
As, by the Superintendent's calculation, it will appear that, in
future, lunatics will be on the increase, the suggestion that a sepa-
rate asylum be built for the female portion, therefore, is a good one
and for which ground is abundant, purchased from the garden
pro-fits—as above stated—and I strongly acquiesce.
25. Well Water.—It is calculated that the new well—a great
desideratum—should cost Rs. 1,500, but both bricks and lime being
manufactured on the premises, it will be, possibly, completed for
Rs. 1,000 to be met from garden profit, the latter being increased
by additional land brought under cultivation.
.1 Male Keeper.
1. Female do,
9 'Warders,
Dhobie.
2 Cooks.
2 Sweepers,
352
26. Establishment.
A e
por margin.
27. Visitors.—'.These have
been regular in their attend
once.
CIVIL HOSAPITALS.
Ahmadabad Circle.
Kaira Circle,
Civil dispensary and Kakra
Civil and Dispensary.
Pait Subsidiary.
Jail.
Jail.
Police.
Police.
Mehmudabad Dispensary.
Bachardass Dispensary
naiad
do.
Raipur
do.
Borsud
do.
Sanund
do.
Muhuda
do,
Virumgaum
do.
Dakore
do.
Dholka
do.
Kapadvanj
do.
Dhanduka
do.
Dhollera
do,
Gogh,
do.
Purantij
do.
28. Of the
various charit-
able institu-
tion s within
the Northern
Division of the
Army, margin-
ally noted, the
Hutteesing and
Premabhaie, or
civil hospital
stands pre-emin-
ent.
' 29. We may premise all are for treatment of natives only, and may
quote Dr. Wyllie the Superintendent's opening remarks on this
Hospital. It " is equal to the reception of 90 patients. It has an
endowment of some Rupees 62,000, the interest of which scarce suf-
fices to cover the cost of establishment, X11 other charges in connec-
tion with its maintenance are defrayed by Government, the institu-
tion being simply the civil hospital of the district,"
Although the dispensary attached to this hospital, and other dis-
pensaries to be noticed hereafter, afford considerable relief, still an
hospital that can offer but room for 90 beds is scarcely equal to half
the requirements of this very largely populated city, which, with its
environs, amounted, by last census, to 125,499.
In consequence of the demand being greater than the allotted space
within the wards, there are two subsidiary buildings temporarily to
meet this, and known as " Kakra Pait." These are outside the city,
and afford room for lepers—variola, &c., yet no establishment in
the second class is allowed.
A hospital assistant should be appointed.
Within the civil hospital compound is sufficient space for building
purposes.
353
Ahmadabad City
7.7
Guzerat (British)
19.2
do Native chiefs 20.2
Mahrwar
18.2
Hindustan
17.2
Deccan and Concan 4.0
Goa
1.0
Afganistan and Pun-
jab
5.7
Police and Lascars
7 . 0
30. Admissions. —In the annual report it is
shown that the city gives but 7 . 7 per cent.
a d m i s - i o n s , t h e r e s t b e i n g p i l g r i m s , n o m a d s ,a
n d
others, as marginally noted.
31. Government aid.—Under these circumstances, I respectfully
conceive Government should step forward in aid, since it cannot be
expected the municipality will, under above circumstances, take the
initiative—they may meet Government.
32. Beggars, &c.—The mendicant and pilgrim class represent some
75 per cent. of the above admissions, and, with rare exceptions, des-
titution and neglect are prominent cause and effect, since chiefly in
such persons all forms of disease are aggravated—scurvy specially
rendering such uncontrollable at times.
Pilgrims seeking shrines, not over the water, largely depend on
alms en route—restrictions, though evaded at times, are put on this
class when leaving our Indian ports for Jedda—the sea-port of the
great shrine of Mecca in the Red Sea—hence the long period under
treatment ending in great mortality, many arriving at the hospital in
time to die.
33. Diseases—Fevers, and Splenic Diseases.—Observation points to
increased prevalence during 1872-73, from diseases of what is usually
t e r me d a ' ma l a r i o u s ' c h a r a c t e r y e t n o o n e k n o ws f r o m wh e n c e t h i s
Will-O'-the-Wisp comes, or whether it has any existence.
This observation is noted, also, in all civil and military reports
from Baroda to Bhuj, and from hence to Deesa, Nusseerabad—via
Neemuch—to Mhow.
34. Respiratory. —These diseases, in excess of last year, are—and
fairly so I think—attributed to climatic causes, viz., larger amount of
rain and prolonged cold season.
35. Dengue. —Has to account, in chief, for a large class of ad-
missions, but the disease is not fatal when uncomplicated.
So much has been written on dengue, and so many unconnected
with our profession having experienced its effects personally, I refrain
from further infliction on this point.
It is reported to have been sent up, by rail I presume, from Surat.
I wonder how it got to this latter city ! It was said to have reached
Aden by boats, via Cape Guardafui and Berbera, from Zanzibar,
where the disease originated in 1871, and in the teeth of the south-
354
west monsoon ; yet conflicting opinions must ever be, so long as the
professi on remai ns ' i n nubi bus' from whence, possi bl y, i t s hi di ng
place.
36. Small-pox.—At the date of dengue appearing, this disease
was not ! but on the former ceasing, variola prevailed and has con-
tinued, though not in an epidemic from, up the end of March, and
with but comparatively small mortality, and chiefly mild in type.
May it not be assumed that the recent exertions put forward, in
order to checking this horrible disease by vaccination, have had their
reward in palliating if not dispersing ?
37. Like dengue, this small-pox is said to have been imported
by immigrants, still I cannot but think atmospheric changes have
something to be spoken for, in the form or etiquette of introduction
to our city, indeed, the civil surgeon writes in his report:— "This
disease, small-pox, it may be expected, will finally disappear by the
end of next month, in accordance with its ordinary course," a period
when atmospheric changes largely exist—changes in monsoon.
Seldom do we find cholera and small-pox co-existing to any great
extent.
Every precautionary measure towards hygiene is resorted to.
38.
Pluviometer.—Inches 33 cents 24, were gauged against an
average 28 inches 39 cents, the average annual fall for the decennium.
39. Thermometer.—Max . Thermometer 140.5 against 102.
40.
Diarrhœa and Dysentery.—Diarrhœa and dysentery are dis
- e a s e s n o t i n f r e q u e n t l y i m p u t e d t o a ' m a l a r i o u s ' o r i g i n ; b u t i n s u c h
admissions as those into civil hospital, exposure, privation, scorbutic
taint, age, and broken health—these die from exhausted nature and,
probably, loss of opium, which drug tends largely in superseding, as
the chewing of tobacco does in temporarily allaying hunger and
thirst.
41. Nervous. —This disease is not common among natives, and
shown only of severity in the traumatic returns ; it would seem that
cases of simple headache are usually returned by subordinates in
charge as neuralgia.
42. Lepers .—These are provided for at " Kakra Pait," as observed
before, the subsidiary low range of buildings surrounded by a wall,
within which are extensive grounds and trees, and here also the
small-pox cases are treated.
43. Treated .—113 cases against 105 last year, the daily average
extending to 40—a terribly large per cent. for this loathsome disease
in the wandering outcast.
44. Casualties .—There were 6 deaths of this class.
355
45. Treatment.—The most satisfactory treatment has been found
by Dr. Wyllie to be in the outer application of dilute hydroch: acid
M X X X t o a q u a 3 1 d a i l y , c o d l i v e r o i l o r m a r g o s s a o i l , i n t e r n a l l y ,
conjointly with dilute nit: acid, yet few are the cures.
Phosphorus has also been given, and promising results expected.
This form of vagrancy might be dealt with by Government.
46. Poisoning—Metallic and Vegetable.—Arsenic and its prepara
-tions are common modes—opium—Indian hemp—are of the vegetable
kingdom.
47. Surgical Operations.—These are given below
:—
Capital Operations.
5 Amputation of arm.
1 do. forearm.
2
do. fingers.
2 do. leg.
1 do. ankle joint.
2 do. thigh.
1
do. (secondary) thigh.
5 Lithotomy.
1 Lithotrity
40 Minor Operations.
2 Dispensary servants,
1 Matron,
4 Ward coolies,
2 Cooks,
2 Bhisties.
2 Peons,
1 Dhobee,
1 Leechman, and
1 Barber,
2 Sweepers,
48. Establishment.—
Second class servants
marginally and re
-ported ample for pre
-sent requirements
.
Kaira
49. Civil Hospital.—This is a very poor affair, in fact a make
-shift; but the new hospital is a very appropriate building, and, when
completed, will accommodate, as a temporary measure, the sick of
the police also, its hospital being reported unsafe.
50. Treated.—128 cases have been under treatment, a slight in
-crease on 1871-72—121 being new admissions, and of this total, 115
males, 13 females.
51. Diseases.—Like in all civil hospitals, the diseases are of the
same type, and many of a serious character, owing to a low condition
in physique, and which influences the mortality largely.
52. Average.—The daily average has been small 4.2.
53. Fatal cases.—Fatal cases 13, percentage of deaths to treated
7.5.
54. Admissions.—Most of these were nomads sent in by the Police
n hopeless stages.
356
55. Dengue.—By reason of dengue the town and districts—like
in other towns and districts where this peculiar disease prevailed—are
reported to be less healthy than during 1871-72.
56. Small-pox.—This has been more than usually prevalent, yet
mild in type and few fatal.
Rajkot.
57. Hospital.—This institution upholds its former well-deserved
repute amongst the peasantry of Kattywar, but it is seldom that other
but medical cases of severity are received into hospital, others resort--
ing to the dispensary as out-patients, hence the large numbers of
surgical cases by comparison.
Large numbers of Hindoo devotees and Mussulman Hadjis pass
through Kattywar towards their special shrines, many, in a destitute
condition, contribute to the number of sick, and many—as in other
reports—in the last stage of exhaustion, generally proving fatal, after
a few hours, from enteric diseases.
58. Diseases—Bright's disease and Diabetes.— Save two cases of
each, the diseases treated have been of the usual type, those of the
intestines—from causes above mentioned—being of extreme severity,
and of 23 cases of dysentery and diarrhœa 9 proved fatal.
59. Mycetoma .—Mycetoma would seem to be prevalent in Katty--
war, though less than preceding year, being 20 in number, all re--
quiring surgical aid, and all cured.
60. Surgical Operations.—During the year 83 capital operations
were performed by Doctors Butler, Blanc, and Sexton ; the first is in
medical charge, but his duties as Superintendent of Vaccination, &c.,
render it necessary that he should pass the chief portion of his time
in the districts, at which time his duties, as a temporary measure, de--
volve on others.
61. Special Ward.—The hospital is in great need of a special
ward, since numerous cases are brought for relief ; and it is in sur--
gical results, chiefly, that European skill is reflected on the mind of
the native, and, therefore, every means should be resorted to in order
to strengthen this.
All civil hospitals shouldhave a separate ward each for ophthalmic
cases, and an examining room.
61. Special Ramaks.—I would suggest consideration on remarks
by Doctor Blanc for the year 1871-72.
" I respectfully beg to submit that the present arrangement
might, with advantage, be somewhat modified. The civil hospi-
tal, Rajkot, is a very important one, and the number of patients
who proceed there, from all parts of Kattywar, on account of sur-
357
gical. diseases is very considerable, and should it, at any time, hap
- p e n t h a t t h e
l o c u m t e n e n s
b e
n o t
a good operator, or an unwill
- i n g o n e , t h e g o o d n a m e o f t h e h o s p i t a l w o u l d s o o n c e a s e , a n d i t
would require years, perhaps, to raise again its fame to the pre
- s e n t s t a n d a r d . "
DISPENSARIES ATTACHED TO CIVIL HOSPITALS.
63. Hutteesing and Premabhaie Dispensary, Ahmadabad.— This
forms the large room of the civil hospital of similar name, and, prior
to the introduction of payments last year, the monthly average treat
- e d w a s b e t w e e n 1 , 6 0 0 a n d 2 , 0 0 0 , o r a d a i l y a v e r a g e o f 1 6 5 .
The system, perhaps misunderstood, possibly from other motives
not fathomable to European minds, was
responded to by reducing the number of
applicants to nearly half per mensem, the daily average being 66.6
only, and the same rules at all similar system institutions.
64.
Health.—The state of public health was less satisfactory than
in the previous year—dengue the cause ; yet agues and diseases of
the chest were more prominent also, account-
ed for by a protracted rainfall, followed by
a more than ordinary cold season, both being
well-known incentives to diseases of the res
-piratory organs ; finally, small-pox claiming
a more than usual average, but such diseases
may be registered as climatic they come and go dependent on meteo-
rological changes ; consequently, it is not in the power of the physician
to prevent them, science alone can alleviate.
From experience, from former statistics, the largest number treated
was during the months of October and November, when electrical
changes are mostly manifest, and the least in May, prior to telluric
disturbances in the fight of the monsoons.
65. Thermometer and Pluviometer. —These are given in the civil
hospital report.
66. Remaining and Admissions.—There were 75 patients remain-
ing at the date of last report and the number admitted during the
year was 7,206. The total treated was 7,371, of whom 6,143 were
cared or relieved, 1,143 absented, 5 died, and 80 remained under
treatment. Of the aggregate, 4,453 were male adults, 1,307 females,
and 1,611 children of both sexes.
67. Skin Diseases.—32.4 per cent or one-third of the treated—
filthy habits and coarse living engendering, specially when meteo
- r o l o g i c a l c h a n g e s p r e v a i l — n o t h i n g n e e d b e f a r t h e r o b s e r v e d o nt
h e s e
affections among the poor, patent to all. observers in eastern lands.
45 M D
Payment.
Dengue and other dis-
eases.
Small-pox.
358
They are amenable to treatment generally, but recur with incen-
tives.
68. Alimentary Canal .—Such are represented by 845, chiefly un-
-der head of colic or constipation, and mostly trivial.
69. Dysentery and Diarrhœa.—Dysentery 131, mostly of severity,
and for reasons assigned above in reference to great poverty or scor--
butic taint.
Serious cases, both in this disease and diarrhœa, are made inmates
of the hospital when room permits.
70. Syphilis.—Reported as less prominent.
71. Eye .—These are chiefly infantile diseases : sometimes, by rea--
son of delay or neglect, defective nutrition, or scrofulus taint, perma--
nent lesions to the organ result.
72. Deaths. —Five only have been registered, as per margin, and
these, when incapable of attending at the
dispensary, were cared for at their homes.
This small percentage of mortality is stat
-ed to be untrustworthy, and for the reason
of the large number of absentees, 1,143 or
upwards of a seventh of treated.
73. Attendance. —This was tolerably steady, yet much impeded by
trivial circumstances as ‘ tumashas,' market-days, &c., and almost
identical with number, under this head, quoted in previous year.
74. Fees.
— T h e civil surgeon writes in reference : " Aggregate
amount of fees recovered during the year was Rs. 379-8-0, as
marginally shown. The amount appears small, but with two kin-
dred institutions in the city sup-
plying medicine and advice
gratis, the Hindoo element of the
community, at least, (however
well to do) is not likely to indulge
in the extravagance of payment
here, for what as rate payers
they have a right to elsewhere,
and thus the realizations have
been chiefly from Mussulmans,
Parsees, and Europeans. More-
over, it is to be remembered that nearly 30 per cent. of the patients
of this dispensary consist of Government servants and their families,
and are thus exempt frem the payment system.
1. Enteric fever.
2. Phthisis
complicated
with variola
1. Addison's disease.
1. Pneumonia.
Number
paying.
Rate of Fee.
A g g r e g a t e
recovered.
42 Each Rupee 1
42 ...
. . .
148
Do. annas 4
37 ...
. . .
2,440
Do. do.
2 300
8
...
Total... 379 8
...
359
"Throughout, the utmost care has been taken to protect the privi--
lege of the poor to gratuitous medicine and medical aid, and in no
instance has any fee been ever levied unless the ability to pay has
been clearly established and acknowledged.
" That the payment rule is regarded as an unpopular innovation,
is sufficiently seen in the action of this (Ahmadabad) municipality,
the native members of which—themselves patrons of the gratuitous
system—have willingly elected not only to meet the increased cost
of the Rajpur Dispensary, but also to make good the deficiency oc--
curring from the small endowment in the case of the Bachurdass one.
Public feeling is equally expressed in the circumstance that, in all
the dispensaries in this collectorate, where payment has been adopt--
ed, the attendance has very materially declined. But this unpopu--
larity is unquestionably due, in part, to the hesitancy with which the
new rules were put in operation, furnishing, as it did, grounds for
interested opposition. Time, however, will doubtless soon remove
this, trifling as the charges now are, since the fact of medicines being
obtainable for the rich at a cost of from ½ to 1 anna, cannot long re--
main unappreciated, unless we suppose that they have become de-
moralized by a long course of the gratuitous system, any return to
which should therefore be deprecated as antagonistic to the aims and
efforts of modern progress and education, in inculcating habits of
self-dependence and of self-respect."
Kaira Dispensary.
Non-payment.
75. With regard to attendance at the dispensary, considering
that no charge is made for advice or medicine, it must be considered
small as compared with population, and this is attributed, almost
entirely to the fact that the dispensary is not situated in the town,
an opinion which is, to a certain extent, supported by the fact that
the popular hospital assistant, who was formerly attached to the
civil hospital prior to invaliding, has established a private dispensary
in the town, on his own account.
76.
Population of Town.—12,681—males 6,374, females 6,307
nearly equal; sanitary condition of town good.
77. Thermometer.— Maximum 106°, minimum 41°.
78.
Pluviometer. —Rainfall 36 inches 61 cents—5½ inches fell
middle of July.
79.
Treated.— 3,237 cases, an increase only of 9 on 1871-72; of
this number 2,206 males, 634 females—of the latter a marked in-
- c r e a s e — a n d 5 9 7 c h i l d r e n ; d a i l y a v e r a g e 1 7 .
80. Diseases. —Characteristic of the country.
81. Casualties.— One reported, but there were 99 absentees.