NationalLibraryOfScotland/medical-history-of-british-india huggingface dataset:
122
Maconachie, the Acting Opthalmic Surgeon, joined on the above
date, and appears to me to be succeeding well.
H. M.'s Dockyard Dispensary .
The dispensary for the attendance on the sick employés of the
Dockyard is a small, ill-built, ill-situated place, in which, according
to the Surgeon in charge, the "delicate operations of auscultation"
can with great difficulty be carried on, owing to the many noises
incidental to mechanical work which is performed too close to the
dispensary. The number of men employed in the Dockyard has
been decreased this year by 287. The number treated in the year
under report was 3,848, of whom 46r emained from last return, and
3,802 were fresh admissions; of these, 3,779 were discharged, cured
or relieved, 9 died, 22 absented, and 38 remained under treatment.
There were 638 cases of intermittent fever, giving a ratio of 16.34
per cent. to treated. Dengue fever gave 174 cases, and febricula
209 cases.
The following I extract from Surgeon Roger's report: "As might
be expected from the climate and the work in which the men are
engaged, rheumatic affections figure largely in the return, no fewer
than 216 cases having been treated during the year. The disorders
of the nervous system, too, indicate the severity and trying nature of
the labour the men perform, 165 cases of sickness, exhibiting more
or less derangement of the nervous centres, have been treated, and
out of that large number one from idiopathic tetanus and one
from paralysis proved fatal.
"Injuries of greater or less extent must naturally be looked for in
an extensive establishment, where large and heavy machinery is al-
most constantly in operation, and we have 458 cases given under the
heads of general injuries, but it is satisfactory to be able to record
that only one casualty occurred from personal injuries received, the
majority of which appear under the head of contusions.
"One case proved fatal in the person of a boiler-maker who was
treated by a general practitioner, the nature of the disease from which
he suffered I am not aware of. With reference to the casualty just
noticed, I have every reason to believe that the man's illness was en -
tirely caused by the unnecessary and terribly severe physical strain
which he underwent working hard in a ship's hold for 12 consecutive
hours without proper rest Another man, a boiler-maker, who was
permitted to act in the same suicidal manner, was dangerously ill for
some weeks, and very nearly added to the list of casualties.
"The men, I am clearly of opinion, should have regular hours for
work, and unless very pressing exigencies call for it, should not be
obliged, or even permitted to work for longer than 8 hours, with rest
for one hour, during that time, when food and other refreshment
might be indulged in, except in the hot season, when time for rest
should be extended to two hours, the working hours being from 8
till 11.30 and from 1.30 to 5."
123
These statements and suggestions founded on them, appear deserv-
ing of further notice, particularly that where death is shown to be
"entirely caused by unnecessary and terribly severe physical strain."
During the year 6 men and officers have been sent to England,
and 8 have been invalided.
There is no place for in-patients. The Apothecary was appointed
to attend the dispensary and, as far as I can learn, be present during
the working hours. His work has been since extended to attendance
at the dwellings of many of the European employés, and in conse-
quence the earlier rules of the appointment have been departed from,
as to enable him to do this and meet their wishes, he has to absent
himself from the Dockyard. His hours of attendance were from 10
till 4—this, if correct, should leave him ample time to attend on such
employés only as are not entitled to the Marine Surgeon's visits. 78
minor operations were performed.
Alibag
Is a municipal town situated on the sea coast about 19 miles
south of Bombay, with a population of 4,500; it is the chief station
of the district, and the various civil officers reside in it. For a
description of the place itself and the neighbouring country I cannot
do better than refer to the annual report of the Sub-Assistant in
medical charge.
The dispensary is hardly worthy of the name; it is a small single-
roomed erection, with one verandah room and open verandahs, built
on a sort of high stone platform, originally to enable the Ranee to
view the taboots unmolested by the crowd. This is situated at the
north-western end of Alibag, in the midst of the residences of the
European inhabitants.
The place where in-patients are treated, at a little distance from
this, is an old building possessing small accommodation of any kind,
but here the sick of the Police, Police cases, and country people are
treated. Beyond these is the fort, in which is a jail for untried or
short-term prisoners; the cells are small, there is no latrine, and the
prisoners are walked out morning and evening under a guard.
A new hospital has to be erected, the site has not yet been quite
settled on, and I have to visit Alibag for the purpose; the plan has
been prepared, but it has not been subjected to the inspection of the
medical authorities.
At the dispensary there were treated 5,260 patients; 40 were
remaining from last year, and 5,220 were new admissions; of these,
4,042 were cured or relieved, 1,183 absented; none died, and 35
remained under treatment. The admissions have increased from
2,922 in 1869-70 to 5,231 in 1871-72, and the daily attendance
from 25 to 38.
In-door patients 11 were treated, not included in the above, one
of whom remained. These are entered under Civil Hospital.
124
Of the treated 1,227 were from ague, giving a ratio of 23.27 to
treated. Intestinal worms and rheumatism were prevalent com-
plaints ; cholera appeared in several parts of the district of Alibag,
to which the Sub-Assistant Surgeon in medical charge proceeded ; his
account is very clear, and traces the source of the disease.
It occurred twice at a place called Roha-Ushtumee, situated on a
tidal creek. At the first visit, in March 1871, its source was traced
to Junjeera, the chief town and fortress of the " Hubshee," from
which place a person with cholera had arrived. This attack was
short, and only a few died—4 out of 7. In
April it again broke out : 15 persons in one
house were attacked and 10 died. This
appeared to bo traceable to drinking-water
from a well pronounced dangerous by the Chemical Analyzer; and
from overcrowding. The well was closed, and the house which had
been overcrowded was closed and fumigated, the disease was arrest-
ed, and did not return. Cholera next appeared at Mhar, in Decem-
ber 1871, and was distinctly traced to the returning pilgrims from
" Alundee Jutra, " its course was clearly mapped by cases from
village to village up to Mhar.
The disease was soon checked, and was not productive of much
mortality.
Vaccination.— 257 cases were successfully operated on.
Rainfall was 40 inches 26 cents, the greatest fall being in July and
Septmber ; the whole fall was less than half the average of the ten
preceding years, which is 8.7.
The thermometer registered 92° in April, the lowest temperature
was 63°, which was registered in December. The position of the
thermometer was not represented.
This dispensary and the place for in-patients have been in exist-
ence for very many years ; they are entirely supported by Govern-
ment. Alibag is a civil station under the medical charge of Sub-
Assistant Surgeon Pereira, whose duties are performed satisfactorily,
both as medical officer and as member of the municipality.
When a civil hospital is built it may perhaps be a subject for con-
sideration whether Alibag should be made into a second class civil
surgeoncy and the dispensary about to be raised at Mhar, be made
the residence of a Sub-Assistant Surgeon.
There were 49 minor operations performed, and eleven post-
mortem examinations for medico-legal purposes were conducted.
Tanna.
The dispensary attached to the civil hospital at Tanna, entirely
supported by Government, has been of fair use in the year under
report. There were 1,557 treated, of whom 18 remained from
previous return, 1,519 were fresh admissions, 1,305 were cured
or relieved, 208 absented, none died, and 24 remained under treat-
57 per cent.
66 per cent.
125
ment; 713 cases were of ague, giving a ratio of 46.67 per cent. to
the whole, being even a greater ratio than shown in the returns of the
charitable dispensary in the same town and for Coorla and Bandora.
The Civil Surgeon in charge considers that the year under report
has been very productive of hepatic ailments, 15 cases having occur-
red in the dispensary practice; but hepatic ailments, Surgeon At-
kins observes, have equally presented themselves in all the charges
under him to a greater extent than he has ever known before. I
quote passages from the Civil Surgeon's return:
—
"It appears from the enclosed tables that 13 cases of hepatic en-
largement and hepatitis have occurred with no deaths. 10 cases
of hepatic abscess, seven of which proved fatal, in which six post-
mortems were held; in two of these the abscess was solitary, in
4 the abscesses were numerous. Diarrhœa was present only in
three, absent in the remaining seven, vomiting in two cases,
absent in six.
"Was similar increase observed in other places?" Dr. Atkins
sends an interesting table of 10 cases of abscess of the liver.
The rainfall is not given, nor is the temperature shown.
Vaccination has been fairly attended to, but perhaps in no place
more than in the Tanna Collectorate is it so persistently objected to.
The Civil Surgeon, Surgeon Atkins, considers that if he had a room
built for private examination; much good would result in the increas-
ed attendance of gynæceial diseases and their treatment; at present
females hold back, but not so much so as before. At my visit I was
surprised to see no satisfactory arrangement of this kind, and I do
think that, were this branch of disease more carefully attended to,
much more confidence would be given to dispensary treatment as a
whole.
There were 44 operations performed, all of minor description.
Post-mortem examinations are performed by the Civil Surgeon at
the hospital.
Surat.
The dispensary patients are seen daily by the Civil Surgeon in the
dispensary room of the Surat Civil Hospital, which is very well
adapted for the purpose; there is another room or ward used as a
waiting room.
The total number treated in the year was 7,943, of which 70 remained
from previous year, and 7,893 were fresh admissions; of these 7,208
were cured or relieved, 648 absented, none died, and 87 remained.
The chief disease treated was ague, 2,298 of this disease received
treatment, giving an average of 22.89 to general total.
The disease next in number was bronchitis, it gave 553 cases.
Disease of the stomach and bowels followed, of which 499 received
treatment. There were 264 cases of purulent ophthalmia; these cases
are said to frequently attend after a prolonged course of native
16 M D
126
treatment, with eyes completely destroyed: it occurs chiefly in children
and the young Bunia females.
Of remittent fever 31 cases were treated
.
Rheumatism gave many cases, 413.
There is nothing remarkable in the treatment of dispensary
disease by the Civil Surgeon. Comparing the number treated with
that of the charitable dispensary (Paruk) it appears that a larger
number, by 3,582, have been treated at the Government dispensary,
and the average daily number of sick is also greater by 2.5.
No surgical operations of more than minor interest were perform-
ed—of these 24 only.
Broach.
This dispensary is wholly supported by Government; it is
attached to the new civil hospital of the place.
The attendance during the year has been considerable. There
were 8,999 treated, of which 120 were the remained from last year,
and 8,879 were fresh admissions; of the total treated, 8,959 were cured
or relieved, none absented, none died, and 40 remained.
2,140 of these were cases of ague, giving a ratio of 24 per cent.
Only 2 other cases of fever were treated; they were: 1 remittent,
1 simple. Chronic rheumatism, simple conjunctivitis, and inflam-
mation of the meatus of the ear were frequent.
The highest temperature during the year was registered at 100°,
the lowest 56°.
Rainfall, considered scanty, was 19 inches 14 cents.
The expense of this institution must be taken with that of the
Civil Hospital and Police Hospital, as medicines, petty supplies,
attendance, &c., are all arranged for from those received on their
account.
Dr. Henry Cook, Assistant Surgeon, is in permanent civil charge
since the original incumbent, Surgeon Glen, was relieved, being
seriously ill, on the 28th July 1871. Assistant Surgeon Haliday acted
until relieved by Dr. Cook, who joined on the 8th February 1872.
Surgeon Glen died soon after he left Bombay for England.
The annual report of the operations of dispensary practice is very
meagre, but I trust to see this dispensary under its present medi-
cal officer doing a great amount of good.
There are many private dispensaries in Broach. Dr. Cook, in
commenting on the prospect of a payment system, says: "With regard
to the class of persons treated it may be observed that a considerable
number are well able to afford to pay the cost of medicines supplied
to them, and in many cases for advice as well.
"Perhaps about 1/3rd are unable to pay at all. During the
period embraced in this report a dispensary has been opened near
the hospital by a Parsee. At this dispensary a charge of 2 annas
127
is made for the medicine. The attendance is good, and many of
those who would otherwise attend the Government dispensary now
attend there." This remark is curious; it must mean either people
prefer to pay, or they have more confidence in the treatment pro-
vided by the Parsee!
During the year 28 minor operations have been performed.
Ratnagiri.
The dispensary here is attached to the civil hospital, and under
the present Civil Surgeon has had a much larger number of
attendants than usual. During the year under report 3,476 cases
were treated; of these 35 remained from previous year, 3,441 were
fresh admissions, 2,367 were cured or relieved, 1,095 absented, 2 died,
12 remained. In the preceding 12 months 2,614 applied for treat-
ment, in 1868 they amounted to only 1,113. A considerable part of
the increase was in the female attendance; this is very important to
notice. The daily average has also arisen from 6.7 to 15.
148 cases were of ague, giving a ratio of percentage of 4.29. This
is extremely small and difficult to give a reason for, unless it is that
the dispensary is not visited by persons living at any distance from
the place. The situation of the civil hospital is not a good one for
the dispensary, which would be of much more benefit were it located
in the town below.
Between Ratnagiri and Dapuli, a distance of 55 miles to the north,
and to Vengurla to the south, a distance of 70 [?] miles, there is no
medical aid available.
The operations were all minor, 149 in number.
The earliest record of this dispensary in possession is for May 1849,
in which month the admissions were 23.
Surgeon C. Joynt, M.D., deserves credit for bringing up the dis-
pensary practice. I hope to see it still improve; the good these in-
stitutions are able to afford depends so much on the zeal and activity
of medical officers that, where these are evident, the favourable notice
of the Inspector General should be shown.
Dapuli.
Originally the position of a military brigade, subsequently, the
brigade being done away with, the station was used for the Native
Veteran Battalion which sent detachments to the various treasuries
in the Tanna and Ratnagiri districts; this battalion being broken
up, Dapuli was converted into a civil station for the Mamlutdar's
and Moonsiff's Courts, which were removed from Hurnee. The town
has gone considerably off since its abandonment as a military post.
The invalid officers and their families have died or departed, and
the European element is now confined to three or four families, in-
cluding the Honorary Assistant Surgeon in medical charge.
128
Dapuli, 600 feet above the level of the sea, is nine miles inland
from Hurnee on the coast, where a company of European veterans
was located formerly.
There is no harbour, and the place is shut out from approach dur-
ing the monsoon. Hurnee is a fishing village in proximity to the
old Mahrattee forts of "Sooverndroog," which shelter the road-stead
a little from north-west winds. From Hurnee, after passing along
the sands for about 1 mile southwards, a good road winds up the
Ghaut to Dapuli.
In this district many native pensioners reside, and during the year
1857-58 some companies, composed of pensioners, were formed,
dressed, and equiped for active duty in the Koncan.
The dispensary here is very small, but affords space for three or
four in-patients from the Police detachments in the district, or occa-
sionally from the people.
This dispensary gives the nearest medical aid from Alibag on the
north, 60 miles, and Ratnagiri in the south, 55 miles.
The total number of cases treated at the dispensary in the year
Including 59 in-door pa-
tients.
was 1,784,* of which 24 were remaining on
last return, and 1,760 were fresh admissions ;
of this number 1,614 were cured or relieved,
140 absented, 3 died, and 27 remained. The increase is 293 cases over
previous year, 367 cases of ague were treated, giving a ratio per
cent. of 20.56 ; of other fevers there were 152 of febricula, and 2
of remittent fever.
There were 59 in-door patients treated, these are included in the
above statement : 3 died, 2 from remitent fever and one from diar-
rhœa. One was a Chief Constable of Police and one Collector's
servant, both of remittent fever, the third from diarrhœa, a sepoy
of the 21st Regiment, N. I., on sick certificate, whose leave had expir-
ed and he was unable to rejoin, he lived only a few days after ad-
mission, all these are included in the above. Vaccine operations were
carried on favourably during the year ; 224 succesful operations were
registered.
One capital operation was performed : amputation of lower limb
in consequence of injury. The patient died from tetanus.
Honorary Assistant Surgeon Pollard is in medical charge, and
is a useful and intelligent medical officer.
Should the dispensary progress, as I trust it will, I would re-
commend the attachment of a Native Medical Pupil to assist, and at
the same time to learn his business.
118 minor operations were performed.
Vengurla,
A seaport town of 10,000 inhabitants, in the Collectorate of
Ratnagiri, situated at the mouth of a small river and on the bay of
129
Vengurla, which is sheltered from all winds except the south. The
town is distant from the landing place, built for landing cargo and
for shipping, about ¾ths of a mile ; there is a small customs bungalow
on a peak of rock close to the landing. Vengurla is distant from
Bombay 250 miles south, and the British sanitarium of Rairee is 6
miles off. A Native Regiment, or a Wing, was formerly quartered at
the station, which is about 1½ or 2 miles from the town, and the
hospital of the abandoned camp, where there are a few bungalows still
standing, is the dispensary and the so-called civil hospital of Vengurla;
it receives a few in-patients from the large detachment of Police
quartered at the camp and in Vengurla, mendicants and passing
sepoys often sick, sometimes having overstayed leave, requiring
certificates. As a dispensary its utility is not much more apparent.
The town itself being so distant and the groups of villages, all more
or less mixed up in business with the town, it could not be expected
that many sick would attend, and the result is as might be anticipa-
ted. 696 cases only were treated, the daily average attendance was
19, being nearly twice as many as in the previous year, 677 were
fresh admissions, and 19 remained from the last return; 676 of these
were cured or relived, 1absented, 4 died, and 15 remained.
147 were cases of intermittent fever, giving a ratio of 20.9 per
cent. to the whole. The in-patients were 78, with one death. These
are included in the return for dispensaries, and in the above state-
ment.
Vaccination was carefully attended to, but was not very successful
for so large a place as this ; as in the whole matter of civil hospital
and dispensary, the distance renders the performance of duties
difficult.
There is no doubt a dispensary, with accommodation for a few in-
patients, would be of the greatest material benefit in the town of
Vengurla—this is the opinion of every one with whom I have spoken,
the subject has been frequently brought to notice. Mr. Venayek
Wasodeo is willing to give a sum of about Rs. 5,000 towards building
a dispensary, the local funds might perhaps come forward with an
annual sum towards maintenance, and the Government contribution of
Rs. 1,200 or 2,000 would complete the matter. I think the subject
is one most worthy of being again taken up, as, besides the good to
be done, it is a pity that the services of an intelligent apothecary
should be not fully utilized, as the necessity exists for his being
stationed here.
At my visit there were 3 or 4 sick visitors at Vengurla.
The Senior Apothecary Mr. Munday is on leave in England, his place
is at present occupied by Apothecary Underwood, who is active
and intelligent, and appears to have given much satisfaction. This
Apothecary has assisted me in endeavouring to get the people to come
forward to aid in the establishment of a dispensary ; but neither to
found a dispensary, to raise a municipality, or to keep up an Anglo-
Vernacular school will the better classes make one step forward.
130
There are several Government buildings in progress in Vengurla,
a Post Office, School, and Telegraph Office..
Separate inspection reports are submitted for civil dispensary and
police by Apothecary Underwood, but in the annual return made out
by me, the two former are included under dispensary, except 6 Euro-
pean patients.
Maximum temperature registered was in April 93°, minimum in
January, 69°.
The fall of rain guaged was 76 inches 69 cents, the greater fall
was in July, when 30 inches 68 cents fell.
This dispensary is entirely supported by Government
No operations were performed or recorded ; two post-mortems,
1 egal, were conducted during the year.
K a r w a r .
At the civil hospital, Karwar, out-patients are attended to by the
civil surgeon daily, very few attend the place ; it is out of the way,
difficult of access, and there are no arrangements for waiting-room,
&c., indeed there are no arrangements of any kind suitable.
The total treated during the year was however 1,334, of which 20
remained from the previous year, and 1,314 were fresh admissions,
being 104 increase over previous year; 1,312 were cured or re-
lieved, 8 absented, none died, and 14 remained under treatment.
There were 523 cases of ague, 99 in excess of previous year, giv-
ing a ratio of 40 per cent.
The expenses of this dispensary are merged into those of the civil
hospital, which is here quite distinct from that for the Police.
Surgeon J. Davies is in medical charge. Three operations were
performed, all minor.
Honore.
The remains of a large town and military station in North
Kanara, the chief town of the taluka of the same name. It is
situated on the bank of an extensive inlet of the sea forming a largo
expanse of sea lake, dotted with small islands covered with trees,
and forming a most lovely scene when viewed from the elevated
rocks on shore.
At its southern extremity the " Gairsoppa " river empties itself.
Honore is 340 miles south-east from Bombay, and is the southern
limit of the Presidency medical circle of superintendence. It has a
population of about 2,000, but no municipality.
Deserted as it is, there are still a few bungalows standing ; the
dispensary occupies the old court-house of the Sudder Ameen.
Its expenses are entirely paid for by Government. There is ample
room in the dispensary for the reception of in-putients, of which a
few only take advantage.