NationalLibraryOfScotland/medical-history-of-british-india huggingface dataset:
9
CIVIL HOSPITALS.
PRESIDENCY DIVISION.
European General Hospital.
42. The number of in-patients is stated in different places to have
been 1,117 and 1,100. There were 516 out-patients. Deaths num
-bered 47. The cost was Rs. 89,122 against Rs. 85,826 in the previous
year, the receipts having fallen from Rs. 4,888 to Rs. 3,400. This
was probably due to the late Purveyor's frauds; and the careful super
-vision, which, it is hoped, will now be exercised, will tend to bring
down the cost in 1873-74. The care taken by the Medical Officers
of the patients seems to have been all that could be desired.
Jamsetjee Jejeebhoy Hospital.
43. The cases treated in the wards were 6,290 in number, of whom
1,015 died. The in-patients at this hospital increase in number every
year. There were also 35,220 out-patients; the net cost of the institu
-tion to Government was Rs. 2,04,292. The opening of the Goculdass
Tejpall Hospital will relieve this institution to a certain extent. The
management has been excellent, and deserves the acknowledgment
of Government.
44. The Public Works Department will, it is understood, be in a
position to carry out at least a portion of the improvements, recom
-mended at page 146 of the Report, in 1874-75.
45. Government will be glad to receive definite suggestions for
the improvement of the purveying system in this hospital. There
will be more chance of its being sanctioned, if the Surgeon General
sees his way to a reduction in branches of the staff, so as to provide
in part for the extra cost.
46. The more complete registration of medical cases which has
been commenced is a valuable measure, and should certainly be
carried out as far as possible. Government are of opinion that
arrangements can easily be made to ensure this being done with
fulness and accuracy by the present establishment.
Obstetric Institution.
47. There were 95 cases and 7 deaths. In 1871-72 there were
90 cases and 3 deaths. In time this branch of the hospital will,
there can be no doubt, be much more resorted to than at present.
The cost is included in that of the hospital.
Cowasjee Jehangheer Ophthalmic Hospital.
4 8 . T h e r e w e r e 6 , 2 5 9 c a s e s , o f w h i c h 3 6 4 w e r e i n - p a t i e n t s . T h e
popularity of this institution is evidently increasing with great
rapidity, and this is no doubt in a great measure due to the com
- m e n d a b l e e x e r t i o n s o f D r . M a c o n a c h i e a n d A s s i s t a n t S u r g e o n D e G a m a ,
the Medical Officers in charge. The cost was Rs. 12,939.
2 R
falling off is attributed to the introduction of the payment system.
The numbers of in-patients and out-patients have not been separately
stated, either for this or the other Civil Hospitals.
57. The Civil Hospitals at Kaira and Rajkot call for little remark.
The efficiency of the former has no doubt been much increased by its
removal into the new building. The latter has done much good,
and seems most popular. The want of a new surgical ward should
be brought to the notice of the Political Agent, who will, if he
thinks fit, report upon it to Government. When the new Guzerat
Vaccination Circle has received the sanction of the Government of
India, the Civil Surgeon will be able to devote his entire time to this
hospital. The Sadra and Dohud Hospitals do not require special
mention.
SIND DIVISION.
58. The reports of the state of the Civil Hospitals in Sind, especial-
ly that at Haidarabad, are satisfactory.
59. The falling off in the number of out-patients at Shikarpur
has not been explained. The amalgamation of this hospital with
the dispensary will be conducive of much benefit.
60. Government take great interest in the instruction of Native
women as midwives, and request that the results of Dr. Hohmstead's
zealous endeavours in this direction may be fully noticed every year.
They trust that the Surgeon General will be able to arrange with
some competent officer to commence a similar school in the older
provinces.
61. An additional Hospital Assistant to assist Dr. Leahy, at the
Sakkhar Dispensary, has already been sanctioned.
GENERAL RESULTS.
.
62. The aggregate total of patients treated at Civil Hospitals,
according to the table compiled by the Surgeon General, was as
follows :—
Males.
Females.
Children.
In-patients ...
... 16,832
3,834
9
Out do. ...
... 91,859
27,170
44,082
108,691 31,004
44,091
Unfortunately these figures are wholly irreconcilable with the
detailed statements submitted by the Deputy Surgeon General.
For instance, in the Poona Division, the total treated in-doors were,
according to the Surgeon General's statement, 3,057 males and
790 females—total 3,847. According to the Deputy Surgeon
General the total number was, Europeans 123, Natives 4,907—total
5,030. The out-door or dispensary patients were, according to the
first-named table, 26,926 males, 8,104 females and 16,399 children
— t o t a l 5 1 , 4 2 9 p e r s o n s . A c c o r d i n g t o t h e D e p u t y S u r g e o n G e n e r a l ' s
13
expenditure of the different Civil Hospitals cannot be commented
on. Taking, however, the figures compiled by the Surgeon General
to show the aggregate cost of each patient, (which, it is presumed,
includes both in-door and out-door patients,) it may be observed that
the cost per head varied from As. 10- 8 at Haidarabad to Rs. 53-5-4 at
the European General Hospital. At Kaladgi and Shikarpur, owing
to the falling off in the number of patients, it rose from Rs. 1-11-8
and Rs. 4-1-5 to Rs. 7-10-6 and Rs. 6-12-6 respectively, while there is a
marked falling off at the European General Hospital from Rs. 73-13-9
to Rs. 53-5-4, and at Dohud from Rs. 62-1-3 to Rs. 16-1-9. Govern-
ment however refrain from criticising these, as the accuracy of the
figures is not wholly to be depended on.
65. Government notice that, according to the statement just
referred to, the number of patients has risen markedly in the fol-
lowing hospitals :—
ln-door.
Out-door.
1871-72.
1872-73.
1871-72.
1872-73.
Jamsetjee
Jejeebhoy
Hospital...
7,647
34,128
35,578
Ratnagiri...
76
3,476
5,115
Sholapur...
121
148
2,160
2,892
Dhulia...
367
488
2,304
2,181
Kol hapur...
2 3 6
312
7,464
7 , 7 3 9
Rajkot...
538
786
13,118
1,598
Kurrachee...
412
472
6,736
8,293
Haidarabad
...
697
1,218
14,337
15,102
The following show a falling off :—
In-door.
Out-door.
1871-72.
1872-73.
1871-72.
1872-73.
Surat
-
428
575
7,943
6,121
Broach...
318
305
8,999
6,742
Aden
...
......
1,490
2,770
676
Sasso on.
. ..
1,531
1,567
13,083
11,564
Satara
. . .
505
299
5,378
5,554
Kaladgi
. . .
21
29
2,463
1,113
Ahmedabad
2,171
2,263
17,859
7,371
Sadra
...
41
45
4,264
3,255
Shikarpur
...
180
178
1,447
957
Sir Jamsetjee Jejeebhoy at Nowsari; six are supported by Native
States, and the remainder more or less supported by Government.
The total cost was Rs. 2,21,070-1-3, of which Rs. 1,48,451-13-2
were paid by Government. The grants to dispensaries have been
recently revised, on the more equitable principle that Government
should not pay more than one-half the cost, or Rs. 2,000, to any
single institution.
69. The number of persons relieved is stated to have been 3,327
in-patients and 380,321 out-patients. The first shows an increase
over 1871-72 of 236, and the latter a decrease of 4,424, which is
attributed to the payment system.
70. As far as the inspection of dispensaries by Civil Surgeons
is concerned, to which the Surgeon General has alluded at page 80
of the Report, Government are of opinion that great good will follow
wherever the arrangement can be carried out. Government Resolu
-tion No. 4589, dated the 2nd December 1872, has directed that,
when nothing but the fees and travelling allowance of the Civil Sur
-geons falls on the State, the inspections should continue; and Go
-vernment desire that in those cases the inspections should be duly
carried out. If this condition amounts practically to a prohibition
of inspections, Government trust that Dr. Thom will be able to
devise some means whereby, without much extra cost, the advantages
of the inspections may still be secured. Government will not object
to pass such charges, besides the fees and travelling allowance, as
may be within reasonable limits. Civil Surgeons should not be sent
to inspections, unless there is another qualified officer at hand to do
their work.
71. Government think, moreover, that it would be a good
measure if the Superintendents of Vaccination when on tour were
to be directed to inspect dispensaries other than those at civil stations
which may be in the way, and report the results to the Deputy
Surgeon General; and they desire, if the Surgeon General or Dr.
Pinkerton see no objection, that this may be done in future
.
72. The Deputy Surgeon General, Presidency Division, has given
a very careful report on the dispensaries in his circle, and Govern
-ment hope that the remarks he makes as to the want of accommodation
at Bhewndy and Kelvi Mahim for in-patients will receive attention
at the hands of the District Officers of the Municipalities concerned.
Government will look in the next report to see whether a better re
-turn is given of the numbers of in-patients at Bardoli, Baisar, Elao,
Mandvi, and Pardi. Looking at the accounts of the various dis
-pensaries, they are quite convinced that, generally speaking, where
there are few or no in-patients, it is the fault of the Medical Officer,
and they will judge of his zeal and proficiency by the results he can
show and the reports that are made of him. Now the results at Mandvi
and Bardoli are especially bad, the attendance having fallen from
4,058 and 3,520 to 1,631 and 973 respectively. On the other hand,
the Assistant Surgeons at Bassein, Kumpta, Kelvi Mahim, Uran, and
the Hospital Assistant at Tanna deserve credit for the good accounts
that are given of them.
73. The Surgeon General has, it is presumed, given the neces
-sary orders in respect of the Hospital Assistants at Randier and
Hansot, as well as the other officers both in the Presidency and the
other divisions, who have been unfavourably reported on.
74. The attention of the Collectors of Tanna, Kolaba, and Broach
should be called to the accounts of the towns of Tanna, Pen, and Pardi
given by Dr. Johnstone and to the bad water-supply of those towns.
The remarks which have been recorded as to the advisability of estab
-lishing a small hospital at Bushire should be communicated to the
Political Department.
75. The Collector of Bombay should be asked to report on the
piece of ground near the Byculla Schools reported to be prejudicial
to health, and the Collector of Broach as to whether the building at
Unklesur, referred to by the Deputy Surgeon General as being fit
for a dispensary, is available as such.
76. Government fully concur in the views expressed by Dr. John-
stone, and which are also repeated by Dr. Maitland, that a Hospital
Assistant should not, if it can be avoided, be put in charge of a
dispensary when fresh from college, but that he should learn disci
-pline and practical experience first in a large hospital.
77. The report on the dispensaries of the Poona Division is
meagre. In the report of 1873-74 it is hoped that detailed remarks
as to the efficiency of each individual officer and institution, with
such general remarks as may occur, may be given in the same way as
has been done for the Presidency Division. Government are glad to
learn that the Deputy Surgeon General found the dispensaries gene-
rally well and economically worked, and that he was satisfied with
the way in which the Medical Officers conducted their duties. At the
same time Dr. Maitland records some remarks on the unnecessarily
large expenditure on medicines and surgical instruments, which have
the full approbation of Government; they have lately been glad to
learn that the Surgeon General has taken the necessary measures to
check undue expenditure in this respect.
78. Dr. Maitland's observations on the unnecessarily liberal scale
of dieting that prevails under the present scale will, Government have
no doubt, receive the full consideration of the Surgeon General,
whose attention has recently been prominently drawn to this subject.
79. Dr. Turner's remarks on the dispensaries of the Northern
Division are founded almost wholly on the reports which have been
made to him by the Medical Officers in charge, and need no de
-tailed review. The payment system appears to have been an especial
failure in the division. The District Officers concerned should have
their attention drawn to the wants noted at Mahoodha and Borsad.
Government note that the Medical Officers at the Becherdass, Gogo
and Sadra and Bhuj dispensaries are well reported on.
80. Dr. Miller's inspection of the dispensaries in his division has
apparently been of a very thorough character.
81. Government cannot undertake to make the necessary addi-
tions to the Kurrachee Dispensary which are recommended. The
17
Commissioner in Sind will perhaps see his way in time to having
them done from local sources. The additions to the dispensary at
Manora must be put off till the Public Works Department have funds
to carry them out with.
82. The Deputy Surgeon General should consult with the Civil
authorities as to whether no allowance can be made to the Apothecary
at Tatta for his services there. Government would be glad to have
a report on this subject, with the Surgeon General's opinion upon
it. It should, of course, be noted how many other officers there are
in a similar position who would have equal claims.
83. The new buildings at Mehur and Larkhana will contribute
greatly to the efficiency of the dispensaries there.
84. Government feel sure that Sir William Merewether will give
every consideration to the many thoughtful suggestions for sanitary
and other improvements with which Dr. Miller's report is full, but
which do not call for detailed notice from Government.
F. S. CHAPMAN,
Chief Secretary to Government.
TO
THE SURGEON GENERAL, INDIAN MEDICAL DE
-PARTMENT,
THE JUDICIAL DEPARTMENT of the SECRETARIAT,
THE POLITICAL DEPARTMENT of the SECRETARIAT,
THE PUBLIC WORKS DEPARTMENT of the SECRE-
TARIAT,
ALL COLLECTORS and MAGISTRATES, including
COLLECTORS and POLITICAL SUPERINTENDENTS
in SIND, and the FIRST ASSISTANT COLLECTOR
in CHARGE PANCH MAHALS,
THE COLLECTOR OF BOMBAY (with reference to para.
75).
THE COMMISSIONER in SIND.
THE REVENUE and POLICE COMMISSIONER, S. D.,
THE REVENUE and POLICE COMMISSIONER, N. D.,
THE ACCOUNTANT GENERAL.
THE FINANCIAL DEPARTMENT of the SECRETARIAT.
THE MILITARY DEPARTMENT of the SECRETARIAT.
THE GOVERNMENTS OF MADRAS, BENGAL, THE
NORTH-WEST PROVINCES AND PUNJAB, AND THE
CHIEF COMMISSIONERS OF THE CENTRAL PRO-
VINCES, OUDH, AND BRITISH BURMAH (by letter).
With Copies of Report.
3 R
311
The normal season of its invasion or reproduction in these districts,
is during the hot season and commencement of the rains, and last
year was no exception to the rule; for at the end of March cholera
was reported to have broken out at Pandharpur, at Nasik in May,
and at Poona in June.
The town of Pundharpur may be said to be never free from
cholera. But it is in the months of April and July, or at the time
when the principal juttras or fairs are held, that great outbreaks of
cholera frequently occur, as exemplified in the history of the last
epidemic.
It was on the 23rd March, and very soon after the commencement
of the Chytre fair, that cholera broke out amongst the pilgrims, and
continued, with more or less severity, until the end of June when
it abated, only, however, to break out with greater virulence on
the occasion of the following and principal juttra, which took place
in July and was prolonged until September, after which no further
cases were reported.
Although systematic sanitary efforts and arrangements for con
-servancy have been adopted for some time past at Pundharpur,
stil a good deal more requires to be done in order to bring the
town to a proper sanitary condition.
The principal defects which at present exist are the want of a
proper system of drainage and a plentiful
supply of pure water. No doubt the town
is cleaner than formerly, but the cleanli-
-ness and drainage, within dwellings and courts attached to them,
are still very defective. During the period in which fairs are held the
town receives an immense accession of population. On some occasions
I am creditably informed that 40,000 people, over and above residents,
are allowed to take up their abode within the walls of the town.
Last year, owing to the presence of cholera, the attendance was
comparatively thin, and only 25,000 had to be accommodated. This
was considered so great a falling off, that the authorities did not
consider it necessary that the dhurumshalla at Gopalpur should
be occupied. The overcrowding, therefore, must have been very
great, and the facilities which existed for fouling the air, the
earth, and the water, must necessarily have been far greater than
at any other time; and it is in this way, I
believe, that cholera poison hitherto dormant
is roused into activity, and is diffused
amongst a population, the majority of whom, from previous fatigue,
privation, and exposure are rendered peculiarly susceptible to its influ
-ences.
Sanitary condition of the
town.
Overcrowding and appar
-ent results.
173
at this dispensary have not been of importance, and the report does
not reflect any particular credit on the Sub-assistant Surgeon then
in temporary charge. Of the numbers, 16 were cases of ague,
one of which died, two of remittent fever ; a case of chronic
diarhœa ; save this death all were discharged cured.
Elao.
9. At this dispensary, where there is good accommodation for
a few in-patients of both sexes, only four cases were admitted. The
cases were all injuries ; one wound of face, two simple fractures ; two
took place during intoxication ; the fourth case was one of serious
injuries sustained by the falling in of a house, at which the man, a
Goundee, was working. I was present at the dispensary when the
patient was brought in, and personally attended to his wounds ; he
died soon after from shock. I am rather surprised that so few
in-patients desire to enter this and similar dispensaries, where the me-
dical aid, as it is here, is fair—doubtless after the experience of a few,
more will seek in-door relief.
Vingorla.
10. At this dispensary or hospital, where there is ample room,
18 cases were admitted as in-patients. The cases generally were of
no great importance, amongst them, however, were 5 cases of mania
—4 males and 1 female.
Two " Police cases " were admitted, they were of no importance
and were discharged cured. Two deaths took place in patients suf-
fering from dysentery and hepatitis.
Dapuli.
11. There is very little space in the small building used as a dis-
pensary and civil hospital for in-patients, but during the year 16
cases were admitted. Four of them were " Sick-leave native soldi-
ers," one was a " Sick-leave" Tent lascar, two were prisoners, five
were "Police cases"—wounds and injuries, and the remainder were
villagers.
Twelve of these patients recovered, three died, one remained.
The deaths were two of " Sick-leave" native soldiers ; the disease
of one was phthisis—he came to the dispensary simply to die, as he
could not rejoin his corps. The second was a case of disease of liver,
from the 21st Regiment ; he got rapidly worse after leaving Bom-
bay, and by the time he reached Dapuli his case was hopeless—it was
probably one of abscess; the third death was that of an aged female,
the subject of a murderous assault.
Diarrhœa, hydrocele, encysted dropsy, chronic rheumatism (na-
tive soldiers) fever, burn, cut-throat in delirium from fever, fracture
of ribs, fracture of both thighs, and fracture of both legs were
MEDICAL AND SANITARY REPORT
ON THE
NATIVE ARMY OF BOMBAY
FOR THE YEAR
FRAMED ON THE MONTHLY AND ANNUAL RETURNS, ON THE REPORTS OF
REGIMENTAL MEDICAL OFFICERS, AND ON THE INSPECTION REPORTS
OF DEPUTY SURGEONS GENERAL.
WITH STATISTICAL TABLES.
Compiled in the Office of the Surgeon General, Indian Medical Department.
PRINTED AT THE
EDUCATION SOCIETY'S PRESS, BYCULLA.
1878.
MEDICAL AND SANITARY REPORT
ON THE
NATIVE ARMY OF BOMBAY
FOR THE YEAR
1 8 7 7 -
FRAMED ON THE MONTHLY AND ANNUAL RETURNS, ON THE REPORTS OF
REGIMENTAL MEDICAL OFFICERS, AND ON THE INSPECTION REPORTS
OF DEPUTY SURGEONS GENERAL.
WITH STATISTICAL TABLES.
Compiled in the Office of the Surgeon General, Indian Medical, Department.
PRINTED AT THE
EDUCATION SOCIETY'S PRESS, BYCUL LA.
1878.
Bombay Presidency.
Years.
Average
strength.
Average
dail
y
sick.
Average
daily sick
per cent.
to aver-
age daily
strength.
Admis-
sious.
Deaths
1872 ... 22,903 1,040.0
4.54
36,209
226
1873 ... 22,967
876 .2
3.82
29,035
165
1874
. . . 22,750
835 .7
3.66
26,601
176
1875
. . . 22,819
772.7
3.38
25,475
213
1876 ... 22,583
856.8
319
26,918
247
1877 ... 22,561
788. 3
3.49
25,130
215
No. S. B./ 208 OF 1878.
FROM
THE SURGEON-GENERAL,
INDIAN MEDICAL DEPARTMENT,
To
THE SECRETARY TO GOVERNMENT,
MILITARY DEPARTMENT.
Bombay, July 1st, 1878.
SIR,—I have the honour to submit, for the information of His Excellency
the Governor in Council, the Medical and Sanitary Report of the Native Army of
Bombay for the year 1877.
2. The separate regimental reports, drawn up in the first instance on a
revised plan, have been carefully gone over, and those portions of their contents only
which possess practical value have been printed. The tables placed at the
beginning of the reports will, I think, be found a useful addition, as showing at a
glance the more important of the general statistical facts connected with the
health of each corps.
3. The total average strength of the Bombay Army, as will be seen from the
table in the margin was 22,561, nearly
b 5
the same as that for 1876—only 22 less.
The average daily sick has diminished
by 68.5, and is 33.4 below the average
of the preceding three years ; the percen-
tage of daily sick to average strength
has also declined. The total admissions
show a satisfactory reduction of 1788
as compared with those of the last twelve
months, and are actually fewer than
they have been in any of the previous
six years. The percentage borne by
admissions to strength was 111. 3; that
for 1876 was 119.2.
4. During the year under report the total number of deaths was 310, or 14
more than in the preceding year. Of these, 215
took place in hospital, and 95 out of hospital and on
leave. The mortality per thousand of strength was 13.7, that for the year
previous having been 13.1. There were 1057 sepoys invalided for discharge
from the service, equal to a percentage on average strength of 4.68. Last year
the total number and percentage were 1013 and 4.48 respectively. The men
sent on sick leave numbered 476.
Mortality and Invaliding.
Am