NationalLibraryOfScotland/medical-history-of-british-india huggingface dataset:
233
than this, they use one of the two privies which are close to each
other. I need hardly say I consider this to be in every way a most
objectionable arrangement, and would strongly recommend an addi-
tional matron being entertained, and the women at once removed
to their own proper quarters. Indeed, so faulty is the present
system, that they are handed over to the care of one of the male
warders during the temporary absence of the matron.
77. The building which is termed a “ casual ward for insane
Europeans,” is merely a small low-roofed, tiled bungalow, having
accommodation for 2 men, and there is nothing to distinguish it in
any way from an ordinary bungalow on a small scale. The win-
dows are all glass and unprotected. The doors are likewise without
protection ; are half wood and half glass, and open into a verandah
which surrounds the bungalow. With such arrangements there is no
possibility of shutting persons in or others out ; and unless it was
intended to provide a refuge merely for Europeans afflicted with
dementia, in which case they might equally well be taken care of
by their friends, I think the quarters most unsuitable as a residence
for ordinary cases of insanity as presenting itself in Europeans.
78. The next portion of the buildings I proceed to examine is a
large walled enclosure, divided into two unequal parts. The wall
which surrounds this is some 18 feet high. The larger division in-
cludes a space of 247 feet by 146, and it contains a barrack or ward
similar in design to the one already described, only smaller. It is
intended to accommodate 12 criminal lunatics, but in consequence
of there being a number of refractory patients in the asylum, and the
warders being limited, the Superintendent is obliged excessively to
overcrowd the place, by adding other 18 lunatics to those already
in the ward—some of these additional ones sleeping in the
verandahs.
79. As this mixing up of non-criminal with criminal lunatics
is obviously a most objectionable plan, and yet under existing cir-
cumstances cannot be remedied, it is very desirable that some special
arrangement, and that without loss of time, should be made for the
safe custody and control of violent or refractory lunatics. The
other division of the enclosure, which is quite empty, is most suit-
able for the purpose. In this might be built 2 cutcha flat-roofed
wards on the plan I have recommended, raised on 2 feet plinths,
and with verandahs 9 feet broad. They should be designed to ac-
commodate not less than 20 lunatics in each.
80. I now come to notice the hospital. The general plan of this
is similar to that of the first building described, and has a fire-place ;
but for some unaccountable reason the verandah posts are 13 feet
high, and as the verandah itself is only 6 feet 10 inches broad, the
shelter which the hospital walls receive is scarcely appreciable. Its
inner dimensions are 27 feet long, 21½ broad, and 14 feet up to the
springing of the roof. A small room under the same roof is attached
for storing and dispensing medicines. The hospital is situated
considerably apart from the other buildings.
234
81. There are 3 large sheds for the lunatics to work in, or to go
under for exercise in wet weather. Two of these are alike, measuring
75 feet by 20 in breadth. The other is smaller, being only 35 feet
long, the breadth being the same as that of the other. The posts
supporting the roof are again needlessly high, being 10 feet ; and,
moreover, the sides are quite open all round, the consequence of
which is that people inside have no protection, either from the sun,
which is inside the sheds nearly all day, or from the hot wind and
dust, which for some months are prevalent, or, again,from the cold
east winds in winter ; all these evils might be remedied by running up
a wall on the north and east sides, and throwing out an open veran--
dah on the other two sides.
82. The padded cells, of which there are 3, require considerable
alterations to render them really of use. In their present condition
they are quite unsuited for the confinement of violent and dangerous
lunatics. The padding and its covering reaches only . 5 feet from
the ground, and the whole is so flimsy and badly put together that even
a lad could pull the entire padding to pieces in a few minutes. There
is, moreover, communicating with each cell a small privy, which is
quite devoid of padding, so that, even were that of the cell itself in-
capable of being removed or destroyed, a lunatic bent on injuring
himself could effectually do so on the walls of the privy. Besides,
as has been pertinently remarked, if a lunatic is supposed to be sane
enough to go into a privy of his own accord for a natural purpose, he
is evidently not violent enough to be shut up in a padded cell ;
hence the privy is as much out of place attached to a cell of this des-
cription as is the lunatic in the cell under circumstances which sup-
pose him to require one.
83. There is great room for improvement in the matter of the
conservancy as existing at present in the asylum. Six privies are not
required. Three would be quite sufficient. Another sweeper also
should be entertained, as there is but one male and one female
sweeper to look after the conservancy of the whole establishment,
and the system of disposing of the night-soil, as is so admirably
carried out in the Haidarabad jail, should be adopted, i.e ., burying
it daily in small trenches at a convenient distance from the asylum.
Ample experience has proved that by this plan all nuisance is
obviated, and the best of all manures without labour or cost thus
prepared.
84. The water, as I have . previously observed, is of good quality
and abundant. It is derived from 4 wells, but as yet no efficient
means exsist for bringing it to the surface. It would be very desir-
able that, whatever means are adopted for obtaining this end,
provision also should be made for covering over, as much as possible,
the mouths of the wells, as an open yawning well is a great temp-
tation to some lunatics in certain moods to precipitate themselves or
others into it.
85. There have been no arrangements provided for the lunatics
bathing themselves ; and it is most essential that for this class of
persons, who are proverbially dirty and filthy in their habits, suitable
235
acccommodation in this respect should be afforded without delay.
Hot and cold shower baths have been proposed, but as these are
expensive to erect and keep in order, it would, I think, be sufficient
in the meantime to have a small tank partly hid by a screen, con-
structed near one of the wells, which could be filled and emptied as
often as might be considered necessary.
86. Considering the extent of the ground and the number of
buildings spread over it, the present establishment of warders, which
consists of one 1st class, two 2nd class, and four 3rd class attendants,
and one female keepeer, is, I think, totally inadequate to maintain any-
thing like discipline and order among 100 lunatics, 12 of whom
are criminal, and 18 more or less violent and dangerous. And even
when the other two wards recommended to be built in the empty
walled enclosure are ready, the number of persons capable of exer-
cising supervision, will not then be sufficient.
87.
Having now made all the observations which, in the dis-
charge of my public duty, I think is required of me, with reference
to the situation of the new institution at Giddu-ka-Tanda, and the
description and style of the various buildings which give it the
name, after its benevolent founder, of the “ Cowasjee Jehangeer
Lunatic Asylum,” I need only add that, on completion of the
buildings at Giddu, the lunatics were removed on the 31st of
August last from the old fort at Larkhana, where hitherto they had
been kept, and proceeded under an escort of Police to Fooloo Bunder,
a distance of 7 miles from the town. There they were embarked on
one of the Indus Flotilla Company’s steamers. They arrived at Kotri
on the 3rd September, and at once proceeded to take possession of
the new premises at Giddu.
88. It will, I imagine, be unnecessary for me to go into the purely
medical history of the asylum. I shall content myself, therefore, by
saying that during the past year there have been 43 admissions :
these, added to the 93 who were in the asylum at the close of the
year, make a total of 136. Of this number, 18 have died and 18
were discharged cured, leaving 100 under treatment. The medical
officer at present in charge is a Sub-Assistant Surgeon, who is also
Superintendent. He appears to have been judicious and careful in
the management and treatment of the people entrusted to him. A
change of management, however, is likely soon to occur, Govern-
ment having appointed the Civil Surgeon at Haidarabad to the medical
charge, and the Sub-Assistant Surgeon to the dispensary at Larkhana.
But these movements are, I believe, contingent on the Municipality
at Larkhana being in a position to meet the increased expenses
attendant upon the transfer of the Sub-Assistant Surgeon.
89. This concludes the observations I have to make on the civil
medical establishments in this province.
I have the honour to be,
Sir,
Your most obedient Servant,
J. R. MILLER,
Deputy Inspector General of Hospitals.
236
COPY.
No. 679 OF 1872.
GENERAL DEPARTMENT.
FROM
COLONEL SIR W. L. MEREWETHER, K.C.S.I., & C.B.,
Commissioner in Sind;
To
THE DEPUTY INSPECTOR GENERAL OF HOSPITALS,
Sind District, Kurrachee.
Commissioner’s Office,
Kurrachee, 15th June 1872.
SIR,
In acknowledging the receipt of your letter No. 415 of the 21st
ultimo, I have the honour to make the following observations on the
valuable report with which you have favoured me.
2. I quite concur with you in thinking that the returns for the
year show how the popularity of dispensaries is increasing, and what
beneficial results they are conferring on the people at large.
3. It is to be lamented that the prevalence of malarious fever,
combined with the extremes of heat and cold in the province, is the
cause of so many deaths. In time perhaps the people will learn to
take more care of themselves. I quite agree with you in thinking
that there is nothing contagious in the diseases which carried off so
many persons in the last cold season.
4. Your account of the causes which lead to the prevalence of
stone in the bladder in Sind is very clear. I may add that when the
people use wells or springs for drinking purposes the water is always
largely impregnated with phosphates. The unusual success with
which this disease leas been operated for at Haidarabad and elsewhere,
will give the people great confidence in European surgery and have
the best results.
5. It is to be regretted that the percentage of deaths in the Sind
jails is so large. I fear it can but be attributed to the severity of
the climate.
6. I am sorry to receive such an unsatisfactory account of the
Kurrachee Civil Hospital. I would, however, ask your opinion whether
the Civil Surgeon has not so many calls on him in Kurrachee that he is
unable to do justice to this important charge, and whether, therefore,
it would not be well that he should have the assistance of an Assist-
ant Surgeon under him to whom the hospital should be specially
entrusted.
237
7. Dr. Holmested’s zeal I have already had great pleasure in
noticing. It is a great boon to the people of Haidarabad to have
the presence of so able and indefatigable an officer. I would here
draw your attention to the circumstance that the numbers of opera--
tions at Kurrachee, as compared with those at Haidarabad, have not
been given in para. 19 of your report. I would request the favour of
your letting me have the amounts, and that the numbers of patients
attending the Mehur and Sakkhar Dispensaries (paras. 32 and 34)
may also be given.
8. Copy of your remarks on the necessity for clearing out the
drain at the Kotri Civil Hospital will be sent to the Collector and
President, Kotri Municipality, when, I dare say, the necessary funds
will be forthcoming.
9. With reference to your observations on the desirability of
doing away with the Civil Hospital at Shikarpur, I would ask if you
would advise abolishing the Civil Surgeon also. I do not conclude
fromwhat you say that this your intention, but I should be glad of your
opinion on this point. In the mean time the measures for increasing
the ventilation of the hospital can be easily carried out if the Civil
Surgeon will apply to the Executive Engineer of the district.
10. I quite agree with you that the Manora Dispensary should
be enlarged so as to provide accommodation for the number of pa
- t i e n t s m e n t i o n e d . I n A u g u s t 1 8 6 9 G o v e r n m e n t d e c l i n e d t o s a n c t i o n
the construction of two additional rooms to this dispensary for want
of funds. I should be glad to refer the question for reconsideration,
but before doing so I will request the Superintending Engineer to
send you the plan and estimate for the rooms formerly proposed, and
if anything further is desired, your suggestions could be communi--
cated to that officer, who will then forward the plans and estimates
to me for disposal. I will also apply for the dispensary servant,
but to satisfy Government of the necessity for such aid, your reasons
should be recorded in detail. The rate of pay to be assigned should
also be given.
11. I will communicate your views on the subject of providing
quarters for the Sub-Assistant Surgeon in charge of the Kurrachee
Dispensary to the Municipality, who will perhaps be able to make a
suitable arrangement. I will also address the Collector and Presi
- d e n t o f t h e T a t t a a n d K h e t t y M u n i c i p a l i t i e s , w i t h a v i e w t o t h e e v i l s
you have noticed at the dispensaries of those towns being removed.
It is trusted that both municipalities may soon find themselves in a
position to meet these urgent requirements.
12. The question of transferring the Sihwan Dispensary into the
present school building has been under consideration for some
time. The matter has, however, been dropped at present until
final orders as to the constitution of the dispensary shall be received.
13. I will bring the state of the Hala Dispensary to the notice of
the Collector and President, Hala Municipality, and I hope he will
be able to arrange for the necessary improvements being made. I
30 M.D
238
have communicated your views concerning the periodical visits of
Mr. Wright to Adam-ka-Tanda and other towns to the Collector of
Haidarabad. I have no doubt that the Deputy Collector in charge
of the division will do his best to induce the people to go to Alhyar,
and that the Collector will gladly support the move ; but for the
present occasional visits to the other places seem unavoidable. The
question of having a dispensary at Adam-ka-Tanda is well worthy of
consideration.
14. I quite concur in your remarks as to the advisability of re-
taining medical subordinates of the same rank as at present at
Alhyar and Tatta.
15. The Collector of Shikarpur will be addressed with a view
to a new dispensary being erected at Larkhana on a better site than at
present. Your observations on the Sakkhar Dispensary will also be
communicated to him.
16. The Jacobabad Dispensary is, as you remark, a very valuable
institution. The construction of a new hospital with subsidiary and
auxiliary building costing Rs. 10,000, has already been sanctioned, and
will, it is hoped, be completed in the current year. This work was
sanctioned by Government owing to the peculiar circumstances of
the Sind. Frontier and the political advantages connected with the
establishment of a hospital and dispensary at Jacobabad. I concur
in the favourable opinion you have expressed of Dr. Behramji.
17. Turning to what you state concerning the Kurrachee jail,
I have the honour to inform you that I consider the site altogether
faulty. It is not only of necessity very damp, but after heavy rain
the water remains close to the surface of the ground pressed up by
percolation of sea water at spring tide ; but a still greater objection
is that the increasing town is rapidly crowding round it. Its removal
to a higher and more open site is very desirable, and might, I be-
lieve, easily be arranged, as the present site would command a good
price. The matter is now receiving attention.
18. I have sent a copy of what you say concerning the water-
supply in the Haidrabad jail, and the ventilation of that at Shikar-
pur, to the Inspector General of Prisons, and I trust that your sug-
gestions may be speedily carried out. I have also recommended the
construction of a latrine for the Bukkur jail. The scheme for sup-
plying Haidarabad with water from the Indus is, I may inform you, not
abandoned, but is still under consideration.
19. Your remarks on the insufficiency of sleeping accommodation
at the Umarkot jail I have read with great attention, and will see
what can be done towards adding to the space in the building.
I am glad to notice your opinion that the Narra j ail is well suited tothe
requirements of the prisoners, and that the medical officer shows so
much zeal and ability.
20. Since you visited Sihwan the wall of the subordinate jail
there has been pierced, and two windows let into it, but I will address
the District Magistrate with a view to the number of openings being
239
still further increased. The Magistrate of Haidarabad will be re
-quested to remedy the defect you noticed in the murderers’ cell at
Tarusha, and similar instructions will be given to the Magistrate
of Shikarpur as regards the jail at Larkhana.
21. Copies of your remarks on the defects in the sanitary
arrangements of municipalities will be circulated to all district
officers. Progress in this respect is in every country very slow, but I
have no doubt that in time a great improvement will be observed.
22. I quite concur with you in thinking that a judicious thin-
-ning of trees where they exist in large numbers is very desirable, and
was glad to observe that it had been commenced at Jacobabad before
I left that station. I will draw the attention of the Collectors and
Political Superintendents to your observations on this subject.
23. The Municipal Vaccinator at Kotri was, I am informed, dis-
missed on a report by the Superintendent of Vaccination, that he had
sent in false returns, and the Municipality did not fill up his place,
as a vaccinator paid from Local Funds has now been appointed to
the taluka, which was not the case before. The Superintendent of
Vaccination is, I believe, of opinion that, under the circumstances, a
new vaccinator need not be appointed.
24. Your suggestion as to the appointment of native medical
pupils to each dispensary is a very good one, and I hope it may be
carried out. I have sent a copy of your 58th para. to the district
officers. I believe that, as a rule, the Mooktyarkars and native officials
are not backward in assisting vaccinators.
25. I regret that your opinion of the site and buildings of the
Cowasjee Jehangeer Lunatic Asylum is so unfavourable. As regards the
former I may observe that the site was the best that could be chosen,
and the propinquity of the garden led to the buildings being placed
where they are. The place was selected by a committee, of whom
the Deputy Inspector General of Hospitals for the time was one.
The reason why the second site named by you could not be chosen,
was that there was a fort in it in which some Fakirs had erected a
shri ne cal l ed t he Shát h Makái . These men l i ved at t hi s pl ace from
the time of the Ka1horá dynasty, and it was feared they could not
be induced to give up the site for any consideration. I certainly
think that the privies near the road might be removed, or at any
rate be disused, as there are others in the grounds. The hedge,
moreover, can be rendered thick and impervious, and I will call the
special attention of the Board of Visitors to this. The erection of
a wall, however, has been forbidden by Government. I do not quite
agree with you in thinking that the asylum is peculiarly exposed
to malaria, as during the cold season the wind is from the north,
while the damp ground lies to the east and south. I will invite the
attention of the District Magistrate to the necessity of regulating
music and other noises in the village of Giddu-ka-Tanda as much
as possible.
240
26. As far as the buildings are concerned, I have the honour
to inform you that upon the recommendation of the visitors, I have
lately submitted propositions to Government for the improvement of
the cook-rooms and work-shops, the erection of additional wards in
the fort, the building of baths for the lunatics, and for a large
increase to the number of warders. You observe that the walls of
most of the buildings are too thin and admit the heat rapidly, but
then it must be remembered they also allow the heat to escape
rapidly, which thick cutcha walls do not admit of. Further, during
part of June, and in July, August, and September, the monsoon
breeze reaches these buildings and has a favourable effect in keeping
them cool.
27. I agree with you in thinking that the sleeping blocks should
be removed, and I will have it done. The faulty arrangements for
the accommodation of female lunatics ought to be remedied. I will ask
the Collector of Haidarabad to submit additional proposals to
remedy this, and such other inconveniences as may not already have
been provided for. The mouths of the wells ought certainly to be
covered in.
28. In conclusion, I have to return my best thanks to you for
your most interesting and thoroughly exhaustive report. I cordially
j oin in the commendations you have passed on the several officers,
most of whose excellent working I have had much pleasure in
favourably noticing during my tour. I would beg you to return my
thanks especially to Doctor Holmested and Honorary Assistant Sur-
geon Leahy, whose successful labours and unwearying zeal have been
so conspicuous. Mr. Apothecary Wright at. Adam-ka-Tanda and
the Apothecary at Tatta are also deserving of favourable mention.
I have, &c.,
(Signed)
W. L. MEREWETHER, Colonel,
Commissioner in Sind.
No. 737 OF 1872.
GENERAL DEPARTMENT.
Commissioner's Office,
Kurrachee, 24th June 1872.
True copy with original report submitted to Government.
W. L. MEREWETHER, Colonel,
Commissioner in Sind.
PRINTED AT THE GOVERNMENT CENTRAL PRESS, BOMBAY.
Administration Reports.
No, 1202.
GENERAL DEPARTMENT.
Bombay Castle, 3rd April 1873.
Letter from the Inspector General, Indian Medical Department, No.
2775, dated 14th August 1872—Submitting, with reference to
Government Resolution No. 1738, dated 23rd. April 1872, and
anterior and subsequent correspondence, Administration Report
of the Medical Department for 1871-72, with appendices and
original reports from Deputy Inspectors General of Hospitals
and the Superintendent General of Vaccination, and requesting
that all the reports when no longer required may be returned to
his office, as time and the limited number of office establishment
did not permit of copies of them being retained for office record.
Memorandum from the Compiler General, Administration Report, No.
115, dated 29th October 1872—Forwarding the above papers.
RESOLUTION.—The Report is divided into the following heads:—
•
Lunatic Asylums.
Civil Hospitals and Dispensaries.
Police Hospitals.
Jail Hospitals.
L u n a t i c A s y l u m , C o l a b a .
2. Under the first head Government observe that at the Colaba
Asylum the number of Europeans treated was 38, of whom 2 re
– c o v e r e d , a n d 3 3 w e r e i n v a l i d e d t o E u r o p e . T h e n u m b e r o f N a t i v e s
treated was 252, of whom 22 recovered, 5 were returned to their
friends, and 11 died. The cost of head per treatment was Rupees
13-5-8 per mensem, or Rs. 4-1-3 more than at the Asylum in Madras.
It is satisfactory to note that the Deputy Inspector General reports
that the management of the institution reflects credit on the Super-
–intendent.
Owing to circumstances beyond the control of the latter officer,
however, the Asylum cannot be said to be in a satisfactory condi-
tion.. A report on the imperfect nature of the drainage has, it is
1 m d