NationalLibraryOfScotland/medical-history-of-british-india huggingface dataset:
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believed, lately been submitted by the present Superintendent, and
will receive immediate attention. A state of affairs which allows
almost all the liquid refuse that should be completely removed to
soak into the soil underneath and but little ever to reach the outlets
of the drains, some of which at the best only empty themselves into
a swamp generally above high-water mark close to windward of the
European wards, cannot but have a deleterious effect on the health
of the inmates of the Asylum. The over-crowding also, still com-
plained of notwithstanding recent additions made to the accom-
modation, prevents that proper classification of patients necessary
according to the most modern and improved methods of treatment
and a more general employment of them in the pursuit of gardening,
the great use of which is so abundantly shown in the Ahmedabad
Asylum. Still His Excellency in. Council is of opinion that notwith-
standing the admitted defects of the place more might be done in
this direction than has hitherto been the case, and looks with confi-
dence to the Superintendent's exerting himself to substitute pleasant
little gardens for bare cleanly-swept yards. Government will not
hesitate on proper representation to sanction any reasonable extra
cost that may be necessary to carry out this very desirable improve–-
ment.
Lunatic Asylum, Ahmedabad.
• 3. The number of patients under treatment was 116, of whom
15 were discharged, 12 were Transferred to friends, and 5 died.
Much credit seems due to Dr. Wyllie for his careful supervision of
this Asylum.
The case of the deaf mute said to have been reported by the
Visitors to be sane and fit to be discharged, should be specially
reported on, with a view to his release.
Sir Cowasjee Jehangeer's Asylum, Haidarxbad.
4. The insanes from the old Larkhana Asylum were removed
here in September 1871. The site is condemned by the Deputy
Inspector General as insalubrious, but the Commissioner in Sind, in
his review of Dr. Miller's report, does not concur with him, and
o b s e r v e s t h a t t h e s i t e w a s s p e c i a l l y s e l e c t e d b y a c o m m i t t e e a s t h e
best available, the propinquity of garden land being one of the
reasons for its adoption. Various suggestions for the improvement
of the Asylum made by Dr. Miller appear to have been fully con-
sidered by Sir William Merewether, who has issued orders for carry-
ing some of them out. The number of insanes treated was 136.
The number of deaths was 18, and of these no less than 16 occurred
at the New Asylum during the last seven months of the year, 10 of
these being from dysentery and diarrhœa,—facts which would seem
to support the view that the new site is not so healthy as the old. one.
Special notice of this point should be taken in next year's report.
(
3 )
Lunatic Asylum, Poona.
5. The number of patients was 76, of whom 14 were discharged
as cured, and 2 died. The Superintendent complains of the difficulty
of providing employment for his patients. If garden work could be
provided as suggested by him, the results would no doubt be very
beneficial. The Public Works Department should be requested
to prepare an estimate of the alterations in the buildings recom-
mended by the Superintendent, and to state whether the water
supply, which is reported to be deficient, will be capable of im-
provement when the new Kurrukwasla scheme for bringing water
into Poona comes into operation. If so, there will probably be no
difficulty in providing the garden recommended by the Superin-
tendent.
Lunatic Asylum, Dharwar.
6. The number of patients was 24, of whom 5 were discharged.
No deaths occurred.
7. Here, as elsewhere, the insufficiency of the accommodation
is complained of. Government will be prepared to take into consi-
deration any well-considered plan for increasing it that may be sub-
mitted accompanied by full statistics of the average number and
class of patients.
8. On a review of the report on these Lunatic Asylums,
Government cannot but recognise the necessity for a more compre-
hensive treatment of the whole subiect of the confinement and
treatment of the insane. In this report only five professed Lunatic
Asylums, viz., those at Bombay, Ahmedabad, Haidarabad, Poona, and
Dharwar, are dealt with, but all mention of the treatment of the
numerous insane persons throughout the country under the care of
Civil Surgeons either temporarily or permanently and the accom-
modation provided for such cases has been omitted. The situation
of the existing Asylums seems well calculated to facilitate the
formation of Central Asylums on a larger scale for the reception.
of the insane from Bombay and the Concans, from Gujrat, from
Sind, from the Deccan, and from the Southern Maratha Country
and Canara respectively. His Excellency in Council will be glad
to be favoured with the matured opinion of the Inspector General,
Indian Medical Department, on the subject, containing statistical
details such as those noted above, and suggestions for a complete
scheme for Central Asylums to meet the wants of the whole Presi-
dency. The Judicial and Revenue Departments, from the officers
in which the majority of cases of insanity is probably received in
the Asylums, should be addressed with a view to measures being,
taken for a description of each case being as far as possible
furnished to the medical authority to whose charge an insane person
may be committed, containing all information procurable relative
to the origin and causes of the malady.
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Civil Hospitals and Dispensaries.
9. The total number of Civil Hospitals is 33 and of Dispensaries
121. The latter are classified as follows :-
Charitable
60
Attached to Civil Hospitals
30
Wholly supported by Government
30
S elf -supportig
.
1
A decrease is reported of 348 in the number treated in the
M o - f u s s i l C i v i l H o s p i t a l s d u r i n g t h e y e a r , w h i l e t h e r e w a s a n i n c r e a s e o f
89,387 in the number of patients at Dispensaries.
10. During the year under report the most prevalent diseases
have been malarious fevers and diseases of the stomach, such as
diarrhœa and dysentery, whereas there has been an unusual immunity
from cholera, under which there is only one death recorded in the
Jails, three in the Poona Division among the admissions to the Civil
Hospitals, and twelve in the Jamsetjee Jejeebhoy Hospital, the
Police showing only three cases treated.
11. The percentages of the three most prevalent diseases to the
total number of cases in the different institutions and the mortality
were as follows :—
MALARIOUS FEVER.
DIARRCEA.
D Y S E N T E R Y .
Cases. Deaths. Cases. Deaths.
Cases. Deaths.
Jails
3 9 . 3 1
1 . 5 9
5 . 8 9
5 . 8 6
3 . 7 1
4 . 8 2
Police
4 7 . 6 0
. 6 9
3 . 4 8
. 8 3
2 . 3 9
6 . 7 0
Civil Hospital
1 5 . 3 8
5 . 0 4
3 . 5 5
2 8 . 1 1
4 . 2 5
2 9 . 0
Dispensaries
2 0 . 8 6
. 0 8
2 . 6 3
2 . 3 4
1 . 9 4
. 5 7
(It is observed that in calculating these last percentages the In-
spector General has taken them inclusive of the cases treated in the
Ophthalmic Hospital.)
12. It is quite evident from these figures that the statistical re
- turns from the Dispensaries are quite unreliable as regards the treat-
ment of out-door patients : these probably come for medicine once or
twice and go away, and no information subsequently reaches the medi-
cal men in charge of what becomes of the cases. Another point promi-
nently brought out is the great mortality in Civil Hospitals from
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and Jamsetjee Jejeebhoy Hospitals in Bombay, which stand as
follows :—
Syphilitic. Gonorrhœa.
European General Hospital
80
42
Jamsetjee Jejeebhoy Hospital
309
83
Total
389
1 2 5
The returns do not show whether any Europeans were treated at
the latter hospital,. but the fact of 514 cases in all having been admit-
ted adds to the regret with which His Excellency in Council has felt
himself under the necessity, from the refusal of the Bench of Justices
to share the cost of the institution, of closing the Lock Hospital. The
temporary good that may have been done by its maintenance during
the year under report will ere this have disappeared, and Government
will be much surprised if the returns of the current year do not show
a large increase in the number of cases under this head. It is hoped
that under the new Constitution about to be introduced, the Corpo-
ration and Town Council will. take a more correct view of their duty
towards the citizens, and contribute in a fair proportion towards the
cost of a hospital, as is done elsewhere.
14. It is interesting to observe that according to Statement B.,
Statistics of Life, appended to the Bengal Administration Report for
the same year, the percentage of mortality in the principal hospitals
of that Province under the heads of Fevers, Diarrhœa and Dysentery
is respectively 9.19, 38.91 and 36.47, which are all considerably in
excess of those in the Bombay Presidency shown above. Bengal also
shows the remarkable mortality of 48.82 per cent. in cases of
phthisis. The total percentage of deaths to cases treated according
to the same statement is 16.32 as compared with 8.73 of the Civil
Hospitals in this Presidency.
15. This report is incomplete, inasmuch as it does not embrace
the finance of the Medical Department, a point of great interest now
that the expenditure is in the hands of the Local Government. A
supplementary report should be submitted giving full details of the
cost of general superintendence, with that of each separate institution,
(inclusive of diet, clothing, &c.,) and the amount contributed by
Government and by public bodies and private individuals, whether
by direct contributions in the shape of endowments, or buildings, or
in payment for advice and medicine, or returns for labour, as in some
of the Lunatic Asylums. These should all be compared with similar
statistics for the previous year, so as to afford a clear view of the
growth of the scientific European system of treatment, which His
Excellency in Council trusts is martially shown by the increase of
89,387 in the number of attendants at Dispensaries given above.
16. Dr. Johnstone, the Deputy Inspector General, Presidency
Circle and Bombay Marine, has submitted very full reports regarding
the several institutions within his charge pointing out such changes
and improvements in them as he considers to be necessary. Copies
of his report and of those of the other Deputy Inspectors General
should be sent to the several district officers for consideration, in
order that steps may be taken, where feasible, for the improve
-ment of the Dispensaries. Government n otice with much regret that
the grant-in-aid rules are unpopular, and that in some instances a
falling off in the number of patients is reported since the introduc
-tion of the payment system. The effect of the new rules is to be
carefully watched, and the results noted in the reports for the en
-suing year. In the meanwhile it is the desire of Government, as they
have before observed, that a very liberal latitude should be exercised,
and that payment for medicines and advice should be taken only from
those persons who are clearly in a position to afford it.
17. The remarks of the Deputy Inspectors General show that
many of the Hospital Assistants and some of the Sub-Assistant Sur
-geons in charge of Dispensaries do not give as much satisfaction as
could be desired. The remedies suggested by Dr. Wright have the
full approval of Government, and he has already been informed by
this Department that in future the rule is to be strictly enforced, that
no one shall be appointed to the post of Sub-Assistant Surgeon who
has not passed out of the Grant Medical College in the First Class.
The transfer of the officers who have been unfavourably reported on
by the Deputy Inspectors seems very desirable, and should be carried
out in whatever manner may seem best to Dr. Wright. As regards
the training of Hospital Assistants, Government are not at present
prepared to abolish the vernacular class in the Grant Medical
College.
18. The proposals of the Inspector General for altering the
system of store supply at the Jamsetjee Jejeebhoy Hospital, for
lighting the store room with gas and for adding a waiting room to
the Male Dispensary, should be submitted separately to Government.
As long as the question of building outhouses for the Ophthalmic
Hospital remains unsettled, it would seem that there is no other
course but to obtain diets from the Jamsetjee Jejeebhoy Hospital.
The alteration in the system of supply of medicine to the Ophthalmic
Hospital, and the relieving the First Physician of the Jamsetjee
Jejeebhoy Hospital of the charge of the Dead Stock of the Ophthal
- m i c H o s p i t a l , a s r e c o m m e n d e d b y t h e D e p u t y I n s p e c t o r G e n e r a l ,
might be at once carried out.
19. In a recent report Dr. Wright noticed the inadequate sup
-port given by the Bench of Justices to the Hospitals in the City of
Bombay, and. a copy of his remarks was sent to the Municipal Com
-missioner for communication to the Bench. Government trust that
the whole cost of the establishment of the new Goculdass Tejpall
(8)
Hospital, with the exception of the pay of the Surgeon in charge,
will be borne by the Municipality.
20. The Inspector General has not included in his report any
general review of the proceedings of the Vaccination Department
during the year, although very important changes have taken place
in its constitution. The chief of these is the transfer of the cost of
all Vaccinators from Provincial to Local Funds, and the appointment
of an Assistant Superintendent of Vaccination to each District at the
expense of the former, for the purpose, as stated by Dr. Turnbull, of
itinerating throughout the year, inspecting the work and lymph of
the Vaccinators, and thus ensuring better work and more reliable
returns. The general result as far as expenditure is concerned has
been an increase of Rs. 37,021 to Local and a decrease of Rs. 22,614
to Provincial Revenues. As the understanding on which Govern
-ment assented to the change of system was that what might be
saved in the cost of Vaccinators should be made available to pay for
better local superintendence over their proceedings, any pro posal
which the Superintendent General may think fit to submit for an
increase in the staff of Superintendents of Circles not involving a
greater expenditure than the sum saved will be favourably entertained.
The year shows a satisfactory increase of 22,417 in the number of
vaccinations, and the total number vaccinated, viz., 5,49,118, con
-trasts most favourably with that of ten years ago, when it was only
244,792. The proportion of successful operations also, viz., 95.6 in
primary vaccinations and 70.4 in re-vaccinations, leaves little to be
desired in this respect.
21. The system of supervision of Vaccinators by Assistant
Superintendents of Collectorates had not been in operation sufficiently
long for any decided opinion to be formed of its practical efficiency.
It is hoped the current year's experience will have enabled the heads
of the department to form a better judgment on this point. The pay
of these Assistants and the class from which they are mostly drawn
are not stated in the report, but His Excellency in Council would be
glad of information on these points, with a view to determine whether
it would not be advisable to place the appointments on such a footing
as to attract the services of men who might be useful to the Collectors
in advising them with regard to the sanitary arrangements of the
villages which they„would in the course of their tours of superinten--
dence constantly have to visit.
22. The acknowledgments of Government are due to the offi--
cers named in the penultimate paragraph of Dr. Wright's report for
their good services during the year, and also to Dr. Johnstone, the
Deputy Inspector General, Presidency Circle.
23. Government regret to have to notice a great want of per
-spicuity in the arrangement of this report, which it is trusted the
administrative ability of the Inspector General will enable him here
-after to rectify both in his own office and in those of his Deputies, and
(9)
thus save Government the labour of wading through large masses of
correspondence, sent up without order and without any index of their
contents, to find out what should be shown in a few paragraphs in the
Inspector General's own summary. if it can be done without much
loss of time, Government would wish these reports sent up in a printed
form in future.
R A V E N S C R O F T ,
Acting Chief Secretary to Government.
To
The Inspector General, Indian Medical Department (with the
papers received),
The Public Works Department of the Secretariat,
The Judical Department of the Secretariat,
The Educational Department of the Secretariat,
The Revenue Department of the Secretariat,
The Military Department of the Secretariat,
The Acting Municipal Commissioner for the City of Bombay,
All Collectors, including Collectors and Political
Superintendents in Sind, and the Assistant
With cop
-
Collector in charge Punch Mahals,
ies of the re
-
The Revenue Commissioner N. D.,
( ports refer
-
The Revenue Commissioner S. D.,
red to in pa
-
The Commissioner in Sind, ragraph 16.
The Sanitary Commissioner.
2 m d
IP
I P / 1 3 / M B . 3 K A N N A
ANNUAL ADMINISTRATION
AND PROGRESS REPORTS
OF THE
INDIAN MEDICAL DEPARTMENT, BOMBAY.
For the Year 1872-73.
BOMBAY :
PRINTED AT THE GOVERNMENT CENTRAL PRESS.
1874.
4
I P / 1 3 / M B 3
ANNUAL ADMINISTRATION
AND
PROGRESS REPORTS
OF THE
INDIAN MEDICAL DEPARTMENT, BOMBAY.
For the Year 1872-73.
BOMBAY :
PRINTED AT THE GOVERNMENT CENTRAL PRESS.
1874.
No. 3094 OF 1873.
Bombay, 4th October 1873.
FROM
THE INSPECTOR GENERAL
Indian Medical Department,
To
THE SECRETARY TO GOVERNMENT,
General Department.
SIR,
I
have the honour to forward the Annual Administration and
Progress Report of the Indian Medical Department for the year
1872-73.
2. It is arranged in. sections, each section with tables relating
to it at the end.
3. The reports of Deputy Surgeons General, with tables, are
also forwarded.
4. Government expressed a wish that this report should be pre-
sented in a printed form, but the delay which would result, has in-
duced me to send it in, in manuscript.
5. Notwithstanding the considerable delay that has already
occurred, I have been unable to complete the Financial Statements of
Dispensaries ; those in Sind, which are wanting, will be forwarded
with the least possible delay.
I have the honour to be,
Sir,
Your most obedient Servant,
A. WRIGHT,
Surgeon General,
Indian Medical Department.
SECTION I.
LUNATIC ASYLUM.
C O L A B A A S Y L U M .
Incumbency
.—This asylum has been in the charge of several Medi
-
cal Officers during the year. Drs. Shepherd, Weir, Hunter, Trestrail
and, finally, for a few days before the close of the official year, Dr.
Nven, the permanent incumbent of the appointment, upon whom has
devolved the compilation of the Annual Report and returns from the
office records of the asylum.
2. Increased accommodation.— The principal event of the year has
been the addition of two wings to the asylum, largely increasing the
available accommodation, and permitting the absolute separation of
female from male lunatics, which was not suitably arranged for in. the
old buildings, in which the windows of the female wards commanded
a portion of the airing-court of the male insanes.
3.Classification.—With the additional accommodation it was
hoped that some classification of the patients would be carried out.
And there has been an attempt in this direction. But the Superin
-tendent states that there are great difficulties in Indian asylums, as
compared with English, in carrying out a classification, according to
the form of mental disorder, on account of the variety of castes and
races. Further progress is anticipated if a new airing court be add--
ed to the asylum
.
4.
Statistics.—During the year 363 lunatics have been under
treatment, of whom 146 were fresh admissions. Of the total treated
55 were Europeans, 42 of whom were sent to England, 7 were dis
-charged in this country, and 6 remained at the end of the official year.
There were no deaths. 308 natives were treated, of whom 94 were
fresh admissions, including 8 re-admissions; of these 47 were cured,
5 discharged improved to friends, together 52, showing that 16.9 per
cent. of the total treated received benefit. There were 22 deaths
or 7.1 per cent. of the total treated, three patients dying of exhaus
-tion after continued and persistent maniacal excitemen
t .
5. Escapes.—Five insanes escaped from the asylum during the
year, and of those, one, a convalescent cooly, has not been heard of
again.
6.
Bodily Disease .—Diseases of the body have been frequent
during the year, chiefly affections of the chest and bowel complaints
with slight attacks of fever.
1 M D
2
7. Cost per head per annum.— The average cost (without deduc-
tions) of each European insane was Rs. 371-1-6 per annum or Rs.
30-14-9 per month, and that of each native insane was Rs. 281-5-0
per annum or Rs. 23-7-1 per mensem;
in 1871-72 Rs. 425-12-7 per
annum or Rs. 35-7-8 per mensem, showing a decrease in the cost of
each lunatic per mensem of Rs. 12-0-7 for the year under review.
8. Cause of decrease.—The decrease has been effected chiefly on
the contract price for provisions having been cheaper and the num-
ber of Europeans less during the year, and from the fact that the
cost of European and native are shown separately this year, the
custom previously having been to include both classes in calculating
the average cost.
AHMEDABAD ASYLUM.
9. Statistics.—One hundred and thirty-two cases have been treat
- e d
i n t h i s a s y l u m , 4 8 o f w h i c h w e r e f r e s h a d m i s s i o n s . O f t h e t o t a l
treated, 17 were discharged cured, 4 transferred to friends, 3 died,
and 108 remained at the end of the year.
10. Of the aggregate number (132) 114 were maintained by the
State, 3 by native states, and 15 were wholly or partially maintained
by friends.
11.
Employment.—In
this asylum, the Superintendent has always
been singular in the care and attention paid to the subject of the em-
ployment of insanes. The average daily number employed was 51.2
as follows :—
Employed in gardening and irrigating
11.8
do.
in levelling grounds and removing old foundation
2 1 . 6
do.
in brick-making
4 . 8
do.
in driving and tending the well bullocks
5.0
do.
in the domestic service of the asylum
3.2
do.
in spinning (females)
1.3
do.
in grinding grain
3.5
12. Purchase of ground from profits of Asylum labour.— A novel
circumstance in the history of our asylums may be stated with re-
gard to this institution, viz., that out of the profits of the garden, 4
beegahs of land have been purchased, making the grounds of the
asylum 24 beegahs.
13. Accommodation in a separate building for females.— The Su-
perintendent Dr . Wyl l i e adds: " The newf i e l d
thus added will here-
after form an eligible site for the construction of separate accom-
modation for the female insanes. A measure that must soon be un-
dertaken in the increasing demand for room." So that the purchase
of this field is not only a trophy of asylum labour, and in this sense
notable and praiseworthy, but testifies also to the forethought of the
Superintendent in remembering the future needs of the asylum.