NationalLibraryOfScotland/medical-history-of-british-india huggingface dataset:
12
Comparison is, of course, out of the question. In diseases of the
lungs the death rate is closer at the same hospitals—amongst
Natives 17.9, and Europeans and Eurasians 16.4. There has been no
mention this year of any of the applicants for relief having been sent
away from want of accommodation.
Surgical Ward.—The Senior Surgeon notes 207 admissions from
fractures, including 24 of fracture of the skull. Other surgical injuries
were in proportion. The sanitary condition of the wards was most
satisfactory, wounds healed kindly, and there was no pyœmia, except
in solitary cases.
Although there is a 2nd Surgeon, and a Sub-Assistant Surgeon, and
a spare Assistant Surgeon, if required to help in the management of
the surgical cases, the report of the surgical ward is most meagre,
whilst the work and general experience of the ward have been of a
singularly interesting description. Probably in no other large hos-
pital in the country have there been admitted 24 fractures of the skull
in the past year, yet they have been allowed to pass almost without
comment. One case is related which is of great interest and worthy
of permanent record.
The surgical practice has been successful as regards operations:
—
23 amputations, including 4 thigh.
2 deaths—1. thigh and 1 foot amputation.
Lithotomy
... 19 cases ... 1 Death.
Lithotrity
...
6 „
...
......
Knee amputation 2 „
...
......
The 3rd Physician contributes a report on the cases of poisoning
admitted during the year, in all 257. Of this number 156, or 65.82
per cent., were alcoholic, and 81, or 34.17 per cent., from other poisons;
opium, datoora, and arsenic being those most frequently used, and
in the order of frequency named.
20 cases proved fatal, or 8.43 per cent. Excluding the cases of
alcoholic poisoning, the mortality was 16.50 per cent.
Obstetric Institution.
The practice of this hospital every year proves how great is the
ignorance of the people, and how fatal is this ignorance.
There is no mention in the report of the effort to train a few
women in some elementary knowledge of the subject. There was
an attempt made, which it is believed was unsuccessful, and nothing
is said as to any further effort in the same direction.
Male and Female Dispensaries have both worked successfully. A
noticeable fact in the prevailing diseases of the Male Dispensary is
the number of cases of wounds and injuries—2,446, more than
double the number of the preceding year. The increase in the total
admission over the preceding year was 4,572.
There are a few points in connection with this hospital which I
desire to bring to the notice of Government—
13
(1.) The necessity, under existing arrangements, of the Jamsetjee
Jejeebhoy Hospital supplying the Ophthalmic Hospital with
diets, &c., and the reasonable complaint of the 1st Physician
on this point, and the ease with which the Ophthalmic Hospi-
tal can be made to supply itself with all its needs with-
out reference to the J. J. Hospital.
(2.) The system of store supply at this hospital, which is at pre-
sent objectionable, and which may be much improved.
I beg on this point to direct attention to the remarks of the
Deputy Inspector General in his Report on the hospital.
(3.) The store room, the darkness in which is not to be pene-
trated by an ordinary light; it requires gas.
(4.) The servants' quarters, which are at present, as reported by
the Deputy Inspector General, "so inferior, and in, very
way so objectionable as to call for early attention."
Cowasjee Jehangeer Ophthalmic Hospital.
Total treated 519. No death.
There were 565 operations performed. This institution maintains
its position of usefulness and success. Surgeon Sylvester, who has
done so much for the hospital, gave over charge of it to Assistant
Surgeon Maconochie on the 20th January 1872.
Lock Hospital.
Closed on the 31st March 1872. Total treated 700, with 5 deaths.
The working of the hospital was successful, and the class for whom
it was conditionally established, seemed to appreciate the benefit
of care and treatment received therein.
Byculla Schools.
General health of scholars good; one death from inflammation of
the pharynx. There was an epidemic of measles, and many slight
cases of fever.
Itch.—57 cases amongst the girls, and 20 cases only amongst
the boys, which speaks in favour of their superior cleanliness.
MOFUSSIL CIVIL HOSPITALS.
Ratnagiri Civil Hospital.
Total treated 84, 4 died. The Civil Surgeon notes the antipathy
of the natives of the place to hospital treatment. Ratnagiri is
said to abound in lepers, but no allusion to them is made in the
report.
14
Tanna Civil Hospital.
Total treated 154, deaths 30, or 19.4 per cent. of deaths to treated.
The principal diseases were—
Total treated. Died. Per cent.
Fever
...
....
... 36
5
...
Scurvy
...
...
...
1
1
...
Dropsy class
...
...
2
1
. . .
Disease of lungs ...
...
5
2
...
Diarrhœa ...
. . .
...
5
5
...
Dysentery ...
...
.... 29
11
39.6
Disease of liver ...
...
2
2
...
Ulcers
. . .
...
...
4
2
...
Of the 5 cases of diarrhœa treated all died, and of 29 cases of dy-
sentery treated 11 died, or 39.6 per cent. The explanation of this
great mortality given by the Civil Surgeon is that most of the cases
were admitted in a most debilitated state from fever, scurvy, and
starvation. The Civil Surgeon brings to notice 12 admissions from
mania and dementia sent by the Magistrate for report as to their
future destination. A proper room is required for the reception of
insanes. One of them, when he was not watched, climbed up a tree,
and was prevented from hanging himself with the greatest difficulty.
Surat Civil Hospital.
Total treated 424, with 35 deaths, 8.2 per cent. 27 fatal cases occur-
red from old age and debility. The principal diseases treated were—
Total treated Died.
Malarious fever
...
...
. . .
103
...
Syphilis ...
...
...
...
43
1
Old age and debility ...
...
167
27
Injuries ...
. . .
...
...
60
5
There seems to have been considerable immunity in this hospi
tal from diarrhœa and dysentery ; but, on the other hand, there is so
large a number of cases of old age and debility, that it is probable
these include affections of the bowels also.
Broach Civil Hospital.
The new hospital was opened to the public on the 14th August 1871.
Total treated 318. Died 20, or 6.2 per cent. Principal diseases,
treated—
Total treated. Died.
Per cent.
Malarious fever
...
...
...
85
2
2.3
Syphilitic affections ...
...
... 21
3
14.2
Disease of lungs
...
...
... 16
...
..
Diarrhœa
...
...
...
... 26
2
7.7
Dysentery
...
...
...
... 18
5
27.7
Injuries
...
...
...
...
42
2
...
15 Carwar Civil Hospital.
The hospital accommodation is very indifferent, but there is a pros-
pect of improvement by the building of a new hospital.
Total treated 106, died 17, or 16 per cent. Principal disease
treated was malarious fever, the cases generally complicated with
diseased spleen and dropsy.
DISPENSARIES.
Including the dispensaries attached to civil hospitals there are
34 of these institutions in this circle.
No new dispensary has been opened during the year under
report. Some have been sanctioned by Government, and will re-
ceive notice next year. The number attending the dispensaries has
been large—182,420, and their public utility is every year increasing.
The particular history of the working of each dispensary is given in
an able and exhaustive manner by the Deputy Inspector General of
Hospitals, Dr. Johnstone. On looking over the table of diseases
treated, malarious fever as usual takes a prominent place—in this
division the most prominent—
Total treated. Died.
Fever
...
...
...
...
... 43,508
18
Rheumatism
...
. . .
...
... 7,644
...
Disease of eye ...
...
. . .
... 10,940
...
Ditto of lungs ...
...
. . .
... 13,572
11
Diarrhœa . . .
...
. . .
...
... 6,301
8
Dysentery
...
. . .
...
... 4,169
8
Others ...
...
...
...
... 3,070
7
Skin
. . .
...
...
...
... 24,171
...
Others ...
...
...
. . .
... 9,467
3
Injuries ...
...
...
. . .
... 7,323
5
Struck by the prevalence of fever in several parts of this circle,
and the inability of the dispensaries already established to reach
many of the villages therein located, the Deputy Inspector General
of Hospitals has recommended a system of village dispensaries. Cer-
tainly some plan for the supply of simple medicines, quinine espe-
cially, to the villages peculiarly subject to fever, is highly desirable.
But in many of these villages, not in intimate communication with
dispensary towns, it is very probable that the people have no experi-
ence of the value of quinine, and, if so, they would be indifferent
as to obtaining it. Of the gross aggregate number treated, 182,420,
26 died; of these, to take an instance, 13,572 were treated for
diseases of the lungs with 11 deaths. As is the case at all our dis-
pensaries for out-patients, so many "absent" themselves for various
reasons, and some notably with the gravest forms of disease, that, for
statistical purposes, the figures are not to be relied upon; all that can
be said is that they serve as a reliable guide to the comparative fre-
quency of various classes of disease, and direct attention to any one
disease which may be prevailing in excess.
16
JAILS.
Common Jail, Bombay.
Total treated
12 Europeans
... No death.
261 Natives
... 8 died, or 3.06 par cent.
Principal Diseases.
Total treated. Died.
Per cent.
Fever
...
...
...
... 71
. . .
. . .
Diseases of nervous system
...
8
1
...
, ,
h e a r t
...
...
1
1
. . .
, , l u n g s
. . .
... 22
2
9
Diarrhœa ...
...
...
... 33
3
9
Dysentery ...
...
...
. . .
13
1
. . .
The diet of both Europeans and Natives has been reduced.
House of Correction, Bombay.
Total treated
Europeans 67 ... 2 died.
Natives 72 ... 3 „
Jail healthy. During the year vagrants have been admitted into
a vacant yard in the jail. There has been a good deal of sickness
amongst them. 68 was the largest number at one time. 24 remained
at the end of the year. The diet of both Europeans and Natives has
been reduced experimentally without bad effect.
Tanna Jail.
Average strength 632; total treated 475; 15 deaths, 2.93 per
cent. of treated.
Principal Diseases.
Total treated.
Died.
Per cent.
Fever ...
...
...
... 195
5
2 . 5
Dropsy ...
...
. . .
...
4
2
...
Diarrhœa
. . .
. . .
...
7
1
...
Dysentery
...
...
...
46
4
8.7
Disease of liver
...
...
2
2
...
In this jail there have been 82 admissions of guinea-worm.
Period in Jail.
3 Months.
6 Months.
9 Months.
12 Months.
18 Months.
2 Years.
43.
13.
3.
7.
3.
2.
3 Years.
Upwards.
3.
8.
The presence of the parasite would appear to be due to the un clean
state of a well in the centre of the jail, which had not been cleaned
as usual.
Surat Jail.
Average strength 234; total treated 330; 7 died, 2.1 per cent.
17
Principal Diseases.
Total treated. Died.
Per cent.
Fever
... ... ... ...
114
...
J a i l h e a l t h y .
Disease of liver ...
. . .
...
8
1
Diarrhœa ...
...
. . .
. . .
32
1
Dysentery ...
...
...
...
32
...
Old age and debility
...
.
. . .
11
4
Ratnagiri Jail.
Total treated 48, with one death. Jail healthy. The fatal case was
that of an old Malay life-prisoner, probably over 80 years of age.
Kárwár Jail.
Total treated 145, with 3 deaths. Health of the jail satisfactory.
One death accidental, the other two from chronic disease.
Sáwantwári.
Total treated 35; no deaths.
Total treated in the division—
Europeans
...
...
79 ...
2 deaths ... 2.5 per cent.
Natives ...
...
... 1,366 ... 37 deaths ... 5.6 per cent.
POLICE HOSPITALS.
Total treated in the whole force in the division 2,026, with 28
deaths, or 1.2 per cent. Principal diseases—fever, diarrhœa, dy-
sentery, and various affections of the surface including injuries. The
force generally has been healthy, with the exception of the corps at
Tanna, which has suffered from malarious fever.
THE BOMBAY MARINE.
For the first time the Deputy Inspector General of Hospitals has
noticed this charge in his annual report. It consists of certain vessels
of the Bombay Marine, 12 in number, with a strength (aggregate)
of 79 Europeans and 502 Natives ; the small naval station of Bassa-
dore; and the Dockyard dispensary. One of the vessels of the Bom-
bay Marine has been the subject of a good deal of correspondence
during the year, on account of the appearance on board of a contagi-
ous and infectious disease, "dengue," now so well known. It was
considered, on imperfect grounds, that the disease was imported at
Aden ; but the clear and able report of the Deputy Inspector Gene-
ral makes it very plain that this was a mistake. The disease was
evidently acquired and imported into the vessel in Bombay Har-
bour. The history of the measures taken to disinfect the ship prove
that no partial cleansing or surface painting is of any avail. The
ship had to be regularly laid up, and was thoroughly and minutely
disinfected, after which there was no further appearance of the
disease. This case calls attention to the necessity of always being
prepared to take active and immediate steps on the appearance of
contagious and infectious disease on board of vessels in the harbour.
3 M D
18
POONA CIRCLE.
CIVIL HOSPITALS.
There are ten—Poona, Sátára, Kaládgi, Dhúlía, Belgaum,
Násik, Sholápur, Kolhápur, Ahmadnagar and Dharwar.
Poona Sassoon Hospital.
This is the largest and in every way the most important civil
hospital in the circle. Total treated 1,531; died 128, or 8.8 per
cent. The number of in-door patients steadily increases, and of
out-door patients also ; the increase of the former over the preceding
year being 245, and of the latter 1,824.
A large number of Europeans received the benefits of the hospital,
181 having been treated, or 44 more than in the preceding year.
The principal disease treated has been malarious fever. The
hypodermic method of exhibiting quinine was tried in 57 cases with
success, but not with so much success as to make it a popular remedy.
The two diseases which were at the same time frequent and very
fatal were dysentery and diarrhœa. 55 cases of dysentery treated,
and 19 died, or 34.5 per cent. ; 88 cases of diarrhœa treated, and 33
died, or 37.5 per cent.
The police sent 43 dead bodies for post-mortem examination, and
in 50 cases evidence was necessary before the Magistrate.
The surgical operations have been few, but of interest.
Sátára.
There has been a high mean temperature, connected probably with
diminished rainfall-wind, and Dr. Carter thinks it likely that the
monsoon of the year 1872 will be a heavy one, on account of the
greater indraught of moisture-laden air from the Indian Ocean, the
result of excessive rarefaction over the land.
Dr. Carter remarks that meteorological observations in India are
commonly neither taken nor utilized as they ought to be, the range
of and materials for study being considerable enough to afford ample
data in aid of determining several most important and highly interest-
ing problems in meteorology. He adds—"The sanitary authorities
might fitly consider the subject, and by plans and instructions could
greatly facilitate this branch of inquiry." Total number treated 505,
with 22 deaths, or 4.3 per cent.
Cholera was absent from the town of Sátára, but prevailed in the
districts.
One case of small-pox was treated, 11 dead bodies were examined,
and in 93 cases a skilled opinion was called for by the Magistrate.
The surgical practice has been important and successful. Dr. Carter
relates the death of a child after lithotomy, the only fatal case in 40
patients.
19
368 cases treated, 44 died, or 11.9 per cent. Those admitted
consisted of travellers to a large extent. Comparatively few
females were treated, owing greatly, no doubt, to the inferior accom-
modation in the hospital, and the impossibility of securing any privacy
for them. 4 cases of cholera were treated with 1 death. The surgical
practice is important, and conducted with skill, as proved by the re-
sults ;19 cases of lithotomy were operated on, and all were successful.
Dr. Bainbridge has operated upon 65 cases of stone in the bladder
during his tenure of his present appointment : so that the disease
would appear to be very prevalent in Khandesh.
Medico-legal.—A large number of cases were investigated, and
reported upon.
The year 1871-72 has been one of extreme drought. Fodder and
water for cattle have been very scarce, and the latter have died in
thousands from starvation. Grain has not been excessively dear owing
to large importations from the Central Provinces and other parts.
Ahmadnagar.
The report of the Civil Surgeon consists of professional matter.
No information as to the number treated, nor any remarks on the
hospital or its accommodation.
There appears to have been no surgical practice, and medico-legal
cases have no mention.
Sholápur.
121 cases treated, 12 deaths, or 9.9 per cent : the high rate of
mortality explained by the extreme exhaustion of some of the
cases when admitted into hospital. No epidemic of cholera, but a
few cases of small-pox treated.
Medico-legal.—A great number of dead bodies brought for exami-
nation.
Násik.
176 cases treated, 20 died, or 11.4 per cent.; cholera and small-pox
prevalent during the year. 12 of the deaths resulted from anœmia
and diarrhœa, the patients being travellers.
The rainfall has been smaller than for the past 20 years.
Belgaum.
Total treated 370, with 38 deaths, or 10.2 per cent. The Civil
Surgeon remarks that there is a gradually increasing confidence in
the efficacy of European practice, particularly in surgical cases, the
beneficial effects of improved methods of treatment in this class of
ailment being more obvious than in strictly medical cases.
The good effects of chloroform as an anæsthetic is also becoming
known amongst the Native community, and there have been frequent
20
application for surgical operation, stipulation being made that chlo-
roform shall be administered during the performance.
Cholera has been absent both from the town and districts of
Belgaum.
Dr. Sylvester states : " An epidemic of cholera has, I believe, never
been known in the town of Belgaum ; but 3 talukas in the neighbour-
hood are notoriously subject to it, the disease appearing in the hot
months and disappearing after a few heavy falls of rain.
84 surgical cases treated, some of a serious nature. No mention
made of medico-legal cases.
Kolhápur.
236 treated, 19 died, 8.1 per cent. Many of the cases brought to
hospital in a dying state. Fever the most common disease, and but
1 case of small-pox.
Seven cases of leprosy were treated, but they do not represent
more than a fraction of the cases applying for admission, but which
cannot be received into hospital from the want of accommodation.
Diarrhœa the most fatal disease : 21 admissions, 9 deaths, or 42.8
per cent.
Kaládgi.
Treated 21, deaths 4. The one ward of which the hospital consists,
is generally filled with patients from the Poona Horse and Police.
There is no ward for women, and the six female patients who were
admitted were all cases about to be tried in the civil courts. They
were separated from the male patients as well as circumstances
would permit.
No epidemic occurred.
Remarks by the Deputy Inspector General.— The Poona Circle of
medical administration is a very extensive one, including 9 Collec-
torates. At the Sudder station of each Collectorate there is a civil
hospital with its dispensary for out-patients, and there are in addition
26 dispensaries dispersed over a vast area of country.
Meteorological and Sanitary. —The monsoon of 1871 was an excep-
tional one. The rainfall was not only one of the scantiest on record,
but it came at irregular and unseasonable periods in a great measure.
This circumstance no doubt accounts for the high mean temperature
experienced throughout the year, and the sickness which has very
generally prevailed.
The presence of ozone in the air was observable during the first seven
months of the year, from April to October. In the five remaining
months no trace of it was detectable, and this is worthy of note, for
it was observed that in these latter months the mortality in the
hospitals was greatest with a decrease in the general sickness, and
the reverse obtained in those months in which ozone was present.
21
In the Poona Circle civil hospitals 3,603 persons were treated and 315
died, or 12 per cent. The death rate at each hospital was as follows:—
Total treated.
Died.
Per cent.
Poona
. . .
...
...
1,531
128
8.3
Sátára
...
. . .
. . .
505
22
4.3
Kaládgi
...
...
...
21
4
19.04
Dhúlía
...
...
. . .
367
43
11.7
Belgaum ...
...
. . .
370
38
10.2
Násik
. . .
. . .
. . .
176
20
11.3
Sholápur ...
. . .
. . .
121
12
9.9
Kolhápur ...
...
...
236
19
8.0
Ahmadnagar
. . .
. . .
148
20
13.5
Dharwar ...
...
. . .
128
9
7.0
Excluding Kaládgi, the number treated there being very small (21),
Ahmadnagar was the highest death rate, 13.5, and Sátára the lowest, 4.3.
The various diseases and the number of deaths from them were as
follows:—
Total treated. Died.
Per cent.
Eruptive fever ...
. . .
...
27
2
. . .
Continued „ ...
. . .
...
40
1
. . .
Malarious ,,
. . .
. . .
...
674
27
4
Malignant cholera
...
. . .
10
3
...
Others of this class
...
...
14
1
. . .
Rheumatism ...
...
... 328
1
. . .
Syphilitic affection.
...
... 201
6
. . .
Scorbutic ,,
. . .
. . .
12
1
...
Dropsies
...
...
...
48
18
. . .
Others of this class ...
...
56
8
. . .
Disease of nervous system
...
79
14
...
Insanity
. . . . . .
...
...
70
3
. . .
Disease of heart
...
...
14
5 . . .
, , l u n g s
. . .
... 229
39
17
Diarrhœa
. . .
. . .
... 186
72
38.7
Dysentery
. . .
...
... 125
38
30.4
Others of this class
...
... 113
4
. . .
Disease of liver
. . .
. . . 48
10
. . .
, , s p l e e n
...
...
37
2
. . .
Ulcers ...
...
. . .
... 179
4
. . .
Others of this class
...
... 291
13
. . .
Old age and debility ...
...
52
10
19.2
Poisons ...
. . .
...
...
29
6
. . .
Injuries
. . . ...
. . .
... 514
27
5.2
Malarious fever is the most prevalent disease, with a moderate
death rate—4 per cent.
Diarrhœa, dysentery, and diseases of the lungs are the most fatal
affections; the death rate of diarrhœa and dysentery, 38.7 and 30.4
in each hundred persons treated, being very heavy, though it is so
fully accounted for by the circumstances and condition of patients
22
when brought to hospital. On the surgical practice of the hospitals
the Deputy Inspector General remarks: "Few hospitals in this country
can produce a greater number of interesting cases treated, or perhaps
show more successful results of the more formidable operations."
DISPENSARIES.
There are 26 dispensaries in this Circle
—
5 Government dispensa-
ries supported by Govern-
ment entirely.
Haliál, Súpa, Mandgud, Sirsi, and
Yellapur.
3 Native States, i.e., sup-
ported by Native States
entirely.
Akalkot, Point, and Mudhol.
18 Grant-in-aid dispensa-
ries, i.e., supported partly by
Government and partly by
local bodies.
Poona Collectorate. 3
Poona.
Juner.
Indápur.
Sholápur ...
... 3
Sholápur.
Pandharpur.
Reri.
Sátára ...
... 3
Wai.
Karar.
Islampur.
Belgaum ...
... 3
Belgaum.
Gokák.
Athni.
Dharwar ...
. . . 2
Hubli.
Gaddak.
Kaládgi ... ...
2 Bágalkot.
Bijápur.
Násik
. . .
... 1 Ioli.
Dhúlia ...
... 1 Irandol.
During the year 4 new dispensaries have been opened—Akalkot
in May 1871; Athni, December 1871; Bijápur, December 1871; and
Islampur, January 1872.
The Deputy Inspector General reports that there are but few dis-
pensaries which meet the requirements specified in paragraph 4 of
the revised rules of November 1871.
Even the 1st class dispensaries, such as Poona, Belgaum, and Sho-
l á p u r , a r e l a m e n t a b l y d e f i c i e n t a s r e g a r d s t h e a c c o m m o d a t i o n
quarters for Hospital Assistants and subsidiary buildings.
The five purely Government dispensaries are all in North Kanara.
The oldest established Government dispensary is at Sirsi, a town
of 5,329 inhabitants, most of whom are of the agricultural class, with
a few soucars and shop-keepers. The dispensary building is one
of the few which meet all the requirements laid down by Govern-
ment.