NationalLibraryOfScotland/medical-history-of-british-india huggingface dataset:
248
GENERAL REVIEW.
1. In-door European sick.—The general results of treatment in the
year 1872-73 amongst Europeans in civil hospitals, lunatic
asylum, jail hospitals, and marine hospitals were as follows : —
Civil Hospitals.—In these hospitals there were during the year
1872-73, 1,732 patients treated and 53 died; during the preceding
year there were 1,635 cases treated with 50 deaths. The operations
performed in the year were 18 major and 37 minor. The death
-rate per cent. to treated was in 1871-72, 3.05, in 1872-73,
3 . 6 8 .
Lunatic Asylum.—This is the only asylum for lunatics in the
Presidency Division. 55 Europeans were treated in it during the
year against 38 of the previous year 1871-72. There were no deaths.
Nearly all these men were soldiers passing from the various
European regiments stationed at places which communicate with
England via Bombay.
Jail Hospitals.—European prisoners are only lodged in the
Presidency prisons, the jail, and house of correction: 81 cases of
sickness were treated in hospital with no deaths: in the year
1871-72 there were 79 sick and two deaths. The strength and sick
of vagrants are included in the return. The death-rate per cent. to
treated was in 1871-72, 2.53, in 1872-73, 0.
Bombay Marine.—In the hospitals of these vessels there were 153
Europeans treated with no deaths; in the year 1871-72 there were
193 under treatment and one death. The ratio of deaths to treated
per cent. was in 1871-72, 0.51, in 1872-73, 0.
Of the total, including the lunatic asylum, there were 2,021
Europeans availed themselves of in-door hospital treatment and
there were 53 deaths. In the year 1871-72 the total treated was
1,945 and 53 deaths. The ratio of deaths to treated per cent. was
in 1871-72, 2.72, in 1872-73, 2.62.
2. In
door Native sick.—The general results of treatment in the
year under report in lunatic asylum, civil hospitals, charitable
dispensaries, police hospitals, jail hospitals, and Bombay marine,
were as follow :—
Lunatic Asylum.—Here there were 308 patients and 22 deaths
against 252 and 11 deaths of the previous year; the ratio of deaths
per cent. to treated was in 1871-72, 4.36, in 1872-73, 7.14.
249
No cause is shown for this increase, but the statistics of the
institution show that the mortality varies greatly year by year; thus,
in 1858 when there were 309 treated there were 19 deaths—6.3 per
cent. to treated—
Treated.
Deaths.
in 1859 . . .
311 . . .
24 . . .
7.71
1861 . . .
284. . .
43 . . .
15.14
1862 . . .
257. . .
16 . . .
6.22
1865 . . .
253 . . .
34 . . .
13.43
1871 . . .
227 . . .
3 . . .
1872-73 . . .
308 . . .
22 . . .
Civil Hospitals.—In these hospitals there were 7,884 sick treated
of which 1,161 died; in the previous year there were 7,966 in hospi
-tal with 964 deaths. The ratio of deaths to treated per centum was
in 1871-72, 12.10, in 1872-73, 14.91. Of the above deaths 1,015
occurred in the Jamsetjee Jejeebhoy Hospital, where too many are
taken—not to be cured or relieved but to be saved from the streets
or dhurmsalas and to die in peace. In all civil hospitals 802 major
operations were performed against 983 of the previous year.
In Charitable Dispensaries 294 in-door native sick were treated.
with 45 deaths, while in the previous year there were 402 and 37
deaths. The ratio of deaths to treated per centum was in 1871-72,
9.20, in 1872-73, 15.64. In last year's returns the in-patients of
Vengurla and Dapuli were entered in the dispensary list—this year
they take place in that of civil hospitals; the mortality is increased
owing to several deaths occurring from small-pox at Karwar.
Police Hospitals.— There were 2,509 patients received into these
during the year, amongst whom there were 24 deaths; in the preced
- i n g
year 2,026 were treated and 28 deaths, the ratio per cent. to
treated was in 1871-72, 1.38, in 1872-73, 0.95. The increase in
number treated is probably due to cases being now admitted into
dispensaries when the patients are unable to do duty; the diminished
death-rate, perhaps, to being treated timely at these dispensaries.
Jail Hospitals .—There were 1,661 prisoners average strength in
jails in the Presidency Division, and 1,367 patients were treated in
the hospitals—40 deaths occurred; during the previous year there
were 1,366 cases treated with 37 deaths; the percentage of deaths to
treated was, in 1871-72, 2.70, in 1872-73, 2.92. The jail hospital. at
Aden, had a strength of 2 Europeans and 90 natives—3 of the former
and 63 of the latter were treated with no deaths; the percentage of
treated to strength was Europeans 150, natives 70; of deaths to
treated none.
250
Bombay Marine.— In the vessels, and at the station of Bassadore,
668 cases were treated with 3 deaths; during the previous year there
were 589 under medical care with 2 deaths; the death-rate to treated
per cent. was, in 1871-72, 0.33, in 1872-73, 0.44.
Out-door Relief.
3. Europeans.—During the year of report there were 1,804 Euro
-
peans treated with no deaths recorded; in the year 1871-72, 168
cases were under treatment and no deaths. It is necessary to remark
here that during 1871-72 no record of attendance of Europeans was
separately kept—it has been so during the year under review; the en
-
deavour has been to show the number of Europeans who have re
-
ceived medicines gratuitously in the division. The 168 of the pre
-
vious year were out-patients of the Cowasjee Jehangeer Ophthalmic
Hospital. This out-door relief has been afforded by the European
General Hospital, the Jamsetjee Jejeebhoy Hospital, the Cowasjee
Jehangeer Ophthalmic Hospital, the Dockyard Dispensary, and
wherever asked for in the mofussil.
4.
Out-door native sick .—The relief afforded, as shewn in the
Table 8 Appendix "Charitable Dispensaries" including the dispen
-
saries of civil hospitals and that of the Dockyard, to native sick in
the year 1872-73, amounted to 166,018 with 110 recorded deaths; in
the previous year there were 181,844 and 89 deaths, showing a de
-
crease of 15,826 during the year of report; this decrease is in 21 dis
-
pensaries, in 9 of which, previously carried on gratuitously the pay
-
ment system wasi naugurated—vide "Payment system" p. 221. The
above number does not, however, show the real amount of decrease
over the previous year, for the new dispensaries of Bassien, Kelvi
-
Mahim, and Panwel in which 5,711 patients were treated must be
removed from the calculation, so that really the decrement stands at
21,537. In the 9 dispensaries in which the payment for medicines
was arranged, the falling off amounted to 18,307; it was, though
general enough, particularly shown in the dispenraries of Anklesar
(Broach), Penn (Alibagh), and Mandvi and Bardoli (Surat).
On the In-door sick.
5. Europeans and their diseases.— I have shown that 2,021 re
-
ceived in hospital treatment during the year and that 53 died; to
complete the history it is necessary to give a general abstract of the
chief diseases which necessitated hospital aid being sought. In the
Division A, of general diseases, 488 persons were treated for fevers
with 5 deaths, 190 of these were of ague, 67 eruptive, and 205 under
the class continued; the deaths were 3 from eruptive and 1 from
continued fever. In the previous year 429 cases were treated
with a larger number of deaths—7. Ague cases were 172, eruptive
182, continued 175. The average number of sick noted under
251
continued fever in both years is considerable, but under this
head in the return are placed febricula, which really constitutes a
large amount, the greater part of which occurred in the children of
the Byculla schools.
In Division B, 191 were treated and one died, the greatest part of
these were cases of rheumatism and syphilitic disease—70 of the
latter were patients of the European General Hospital. Of local
disease the total that received aid was 1,342 (this includes 55 insanes)
with 47 deaths; the diseases treated were chiefly nervous diseases,
101 with 5 deaths. Lung affections with 7 deaths, stomach and bowel
diseases 146 with 8 deaths, other diseases of this class gave 110 and
3 deaths. Liver disease, diseases of the skin, ulcers and other di--
seases 342 and 7 deaths. Poisons, nearly all by alcohol (mostly
treated in the European General Hospital) 133 with 1 death. Injuries
118 and 2 deaths. Debility 35 and 2 deaths.
Indoor Sick of Natives and their Diseases.
6. 13,110 cases of sickness with 1,297 deaths, giving a ratio of
9.8 to treated, were received into hospitals, charitable dispensaries,
and lunatic asylums. In civil hospitals, wholly maintained by Govern-
ment for poor, 7,884 were treated, in the lunatic asylum 308, in
charitable dispensaries there were 294, in police 2,589, jails 1,367,
Bombay marine 668. In the first named hospitals under general
diseases, Division A, 1,441 were treated and 174 deaths; fevers,
the chief diseases, gave 234—eruptive with 30 deaths, malarial fevers
1,117 with 112 deaths, cholera 46 with 12 deaths. In Division
B, there were 1,361 and 190 deaths, giving a ratio of nearly 14 per
centum; in these 2 classes there are many diseases received too late
for more than palliation; they have been chiefly the patients of the
Bombay hospital. In Division B, 370 in-patients were treated for
syphilitic disorders. Local diseases, by far the most numerous, were
5,082 and 797 deaths, giving a still higher ratio than in the other
classes, namely, 15.68.
Treated. Death P.C. death to treated.
Diseases of nerves, &c. . .
253
67
26.48
Insanity . . .
52
2
. . .
Of the eye . . .
354
1
. . .
do. heart . . .
43
17
39.53
do. lungs . . .
408
95
23.28
Diarrhœa . . .
272
81
29.77
Dysentery . . .
535
212
39.62
Other diseases . . .
212
14
6.79
Of the liver . . .
146
35
23.98
do. spleen . . .
50
4
. . .
Gonorrhœa . . .
111
. . .
. . .
Abscesses . . .
109
13
. . .
33 M D
252
Treated.
Death P.C. death to treated.
Guinea-worm . . .
39
1
. . .
Ulcers . . .
300
23
7.66
Of the skin . . .
1 0 0
. . .
. . .
Other diseases . . .
601
56
9.31
Debility . . .
420
91
21.66
Poisons . . .
277
14
. . .
Snakebite . . .
1
. . .
. . .
Injuries . . .
79
69
. . .
The ratio of deaths to treated in some of these important diseases
here shown, it may be interesting to observe; at the same time it
must be borne in mind that very many of them are brought for relief
when the period for that has passed from the power of the physician.
In-door treated in Charitable Dispensaries.
7. Charitable dispensaries admit a few patients in the year, they
are chiefly police cases, accidents, &c, Under general diseases, Division
A, 84 were treated with 17 deaths; of these 11 died from small-pox at
Karwar, and malarial fevers which gave 47 had 3 deaths. Under B,
there were 13 of syphilitic disease. Local diseases which numbered 173
with 23 deaths were chiefly dysentery; of which there were 20 with 10
deaths, and skin diseases There were 75 injuries with 4 deaths treated.
There were few poison cases and few snakebites.
In-door treated in Police Hospitals.
8. The police sick of the various taluk corps are treated either in
hospital at head quarters or at the charitable dispensaries near to
where the detachments are posted; from the latter there are now
received monthly reports of the sick, and, consequently, a more correct
view of the state of health is obtained; however, as many men annually
are discharged, and possibly many of these in consequence of ailments,
a perfectly correct statement cannot be assured—2,509 cases were
treated. Under general disease, Division A, there were 447 sick,
chiefly of malarial fever—the deaths from this disease were 9; continued
fever, too, gave many cases, there were however no deaths. B Division
gave 152 cases, chiefly of rheumatism and syphilis; of local diseases
there were 1,910. Diseases of the stomach and intestines and lungs
were the prevailing disorders and gave most mortality, viz., 7 injuries
were 99 and 2 deaths.
The treated to strength . . .
66.25
Deaths to strength . . .
0.63
Deaths to treated . . .
0.95
The greatest number of daily sick was in Tanna, next in Surat and
Karwar; the greatest ratio of treated to strength was in Alibagh,
Broach, and Surat.
253
In-door treated in the Bombay Marine.
9. The number treated in the marine was 668 and 3 deaths. Under
general diseases, Division A, 162 cases received treatment,148 of these
were cases of ague. B Division gave 76 ; of which 57 were of rheuma-
-tism—there were only 3 cases of scurvy. Of local diseases there were
430 ; the chief affections were of the lungs ; of which 1 died ; of the
stomach and bowels 1 death ; and of the skin; of abscesses and injuries
there were 130.
The strength of natives is put down at 372, a ratio of treated to
strength is therefore obtainable, and is 179.5, the deaths to strength
0.53 and to treated 0.44.
Jail Hospital—In-door Sick Native Prisoners.
10. 1,367 cases were treated in the jail hospitals of the Presidency
dvision. Under general diseases A, 457 cases came under treatment,
439 of these were malarial fevers which gave 7 deaths. In B Division
there were 67 cases and 8 deaths, 24 of the diseases were of rheuma
- t i s m a n d 2 5 o f s y p h i l i s . L o c a l d i s e a s e a p p e a r e d c h i e f l y i n a f f e c t i o n s o f
the lungs, stomach and bowels, guinea-worm (Tanna jail),skin diseases
and injuries ; the deaths in this class were 25 ; arising from lung dis
-ease 9, from diarrhœa and dysentery 7, from liver disease 4, from in-
juries 2, insanity 1, and 2 of other diseases. The strength of the
jails was 1,661, the ratio of treated per cent to strength, was 82.29,
deaths to treated 3.88, to strength 3.44. The greatest average daily sick
was at Tanna ; the greatest ratio of treated to strength was at Surat ;
Tanna and Karwar next. Fevers prevailed most to strength in Surat
Jail; indeed, this jail according to medical statistics has been the least
healthy of all ; it will be remembered—in the abstract report, para-
graphs 3 and 6—I mentioned Surat and Tanna having more inmates
than there was space for.
Out-door European Sick and their Diseases.
11. There were 1,804 cases treated during the year and no deaths.
In dispensaries in Bombay there were 989—516 of these received aid at
the European General Hospital, 40 of whom were cured or relieved, the
rest absented or did not return, 359 were patients at the Jamsetjee
Jejeebhoy Dispensary ; all were cured or relieved ; 114 attended at the
Cowasjee Jehangeer Ophthalmic Hospital,and all were cured or reliev
- e d . I n t h e D o c k y a r d D i s p e n s a r y t h e r e w e r e 6 8 0 a p p l i c a n t s f o r r e l i e f ,
many of these were readmissions, 669 were cured or relieved, At Dapuli
and Vengurla there were 116 admissions and readmissions; these were
chiefly residents of the place, who procured their medical requirements
from the dispensary. In the Mandvi Dispensary a solitary European
wanderer had medicine, and at Kalian 61 received treatment Under
254
general diseases, Division A, there were 310, the chief of which were
fevers, 233 were malarial, 194 in Bombay—81 of these occuring in
dockyard employés. There were 70 cases of continued fevers, chiefly
febricula. Division B gave 167 cases, these may be summarised as
rheumatism, syphilis, and other diseases of the class. Of local diseases
there were 1,327, the chief of these were diseases of the stomach and
bowels, 406 receiving treatment with no deaths. Lungs affections gave
the large number of 202—no deaths recorded. 85 were diseases of
the nervous system and 123 diseases of the eye, which were treated in
the ophthalmic hospital. There were 67 injuries, 38 of which
occurred in the dockyard, the result of out-door treatment has been
satisfactory.
Ont-door Native Sick and their Diseases.
12. There were 166,018 persons treated at the dispensaries in the
Presidency Division, 110 deaths are recorded. 227 major operations
were performed with one death, and 3,687 minor operations. The
major operations consisted of 156 on the eye at the ophthalmic
dispensary, the remainder 71 being performed at the various dispensa
- r i e s i n t h e m o f u s s i l , c o n s i s t e d o f r e d u c t i o n o f d i s l o c a t i o n s , e y e
operations, paracenteses, amputations, lithotomy, &c.
13. At the Presidency city.—35,220 patients were afforded relief
at the Jamsetjee Jejeebhoy Dispensary and 5,781 at the Cowasjee
Jehangeer Ophthalmic Dispensary. Of the first under general diseases,
Division A, there were 5,580 attended, of which number 4,339 were
subjects of malarial fever, giving a percentage to total treated of 12.31.
Under Division B, 5,454; of this number 1,452 were of syphi
-litic disease, 601 of scurvy, of dropsies 58, and 1,323 of other diseases
of this class. Syphilitic disease (not including gonorrhœa) gives a
percentage to all other diseases treated of 4.12—this is but the dispen
-sary experience of one part of Bombay. Local diseases gave 18,401;
the chief ailments were of the digestive system, including dysentery,
diarrhœa, and ulcers; skin complaints and other diseases of the class
of the former there were 5,902 of the latter 8,509. Diseases of the
lungs gave very large number of 4,116, chiefly bronchitis; diseases
of the eye gave 5,781; there were 956 cases of gonorrhœa—nearly all
male patients. Injuries attended to were 2,438—no deaths are
attempted to be recorded nor minor operations which are performed
in the hospital. Judging from the dispensary treatment, the dis
-eases of the poorer classes appear to be, in chief, fevers, diseases of
the stomach aud bowels, lung diseases, and above all, diseases of the skin.
14. Of mofussil sick, in the Tanna Collectorate, in eleven dispen
- s a r i e s 3 6 , 0 1 6 w e r e t r e a t e d ; t h e g r e a t e s t n u m b e r r e c e i v i n g a i d i s s e e n
to have been at Bandora, Coorla, and "Rustomjee Wadia," Tanna,
dispensaries; then at Bhondi, Kallian, Bassein, and Uran. The
recorded deaths in this practice in the Collectorate were 42.
255
Under general diseases, A, were 10,596, of which 10,285 were
malarial fevers, yielding a ratio to total treated of 29.42. There were
six cases of cholera, none traceable directly to any primary conta
-
gious influence.
Under B, 2,939 were treated, rheumatism and syphilis chiefly;
1,996 of the former and 219 of the latter, mostly observed in Bandora,
Kalian, Panwel, Bassein, and Bhondi. Under local diseases 22,481
received treatment; there is not much difference in the chief classes
of disease attended to from those in Bombay; the percentage
of malarial fevers is far greater, so also is that for diarrhœa and
dysentery; the former nearly 5 and the latter nearly 4. Spleen
disease was also slightly greater. Of gonorrhœa there were 383
chiefly observed at Coorla, Bandora, Bhondi, and Tonna.
15. In the Surat Collectorate a total of 39,276 patients received
aid at nine dispensaries, those at Surat ("Parak"), Nausari
("Victoria"), Surat (Civil), and Bulsar affording the largest number;
Bardoli, Chickli, and Mandvi afford the least. Under general
diseases, Division A, 13,589 were treated; of these 12,475 were
malarial fevers, giving a ratio to total treated of 31.76 greater than in
the Tanna Collectorate. The greatest number of ague cases appeared
at the Balsar, Surat (Civil), Surat (Parack,) next at Randier, Pardi,
Chickli, and Nausari, and least at Bardoli and Mandvi. At Ba
l -
sar, cholera was prevalent for a time in the months of August and
September; it succeeded immediately on dengue, and commenced
apparently in fishing villages along the coast; its advent was attri
-
buted to the supply of fish being beyond the common and to its
being used as food in a decomposed state; no reports were received
from the civil authorities on the subject; 40 cases were treated at
the dispensary and 15 died. Division B gave 2,076 cases, the chief
of which were rheumatism and syphilis; of the latter disease, as
might have been expected, the greatest number were treated at the
two Surat dispensaries and at Nausari (Victoria). Of local dis
-
eases there were 23,611. Diseases of the eye prevailed more than in
the Tanna districts; of the lungs about the same; a great difference
appears in diseases of the stomach and bowels, 1,033 cases less of
diarrhœa, and 630 less of dysentery being treated. Diseases of the
liver were less than half the number; of the spleen somewhat less; go
n -
orrhœa more; skin diseases were twice the number; in other diseases
there was no very great difference.
16. In the Broach Collectorate there received medical aid at four
dispensaries 16,962 persons, the greatest number were treated at the
Broach Civil Dispensary and at Elao, the least at Anklesar and
H a n s o t . U n d e r g e n e r a l d i s e a s e s A , t h e r e w e r e 7 , 0 0 4 , o f w h i c h 6 , 7 5 2
were ague, giving a ratio to total treated 39.84, much the same as in
Surat; the greatest number of ague was treated at Elao, next at
256
Broach, the smallest number at Hansot. Division B gave 824 cases,
the chief of which were rheumatism and syphilis, the latter chiefly
observed at Broach and Elao. Local diseases gave 9,134; diseases
of the lungs were 456; of the stomach and bowels in much the same
proportion as in the Surat dispensaries. 62 spleen diseases giving a
much smaller proportion to treated than in Tanna or Surat; in other
diseases nothing calling for particular notice presents itself—no cho
-
lera and no small-pox were reported and none treated.
17. In the Alibagh District there were 7,462 patients treated in
two dispensaries, two-thirds were treated at Alibagh, and this year
only 2,851 at Pen. The number of cases treated under general dis
-
eases, Division A, was 1,703, of which 1,607 were ague, giving a per
-
centage to treated of 21.53 less than in Tanna, Surat, and Broach:
this is, however, no criterion of the state of health of the district, as
two dispensaries, wide apart, only exist. Under Division B, 462
came for treatment, chiefly rheumatism, other diseases, and syphilis.
Diseases of the lungs did not vary much from the treated in other
districts, but in diseases of the stomach and bowels the proportion
was greater than in Surat and Broach, but still less than in Tanna.
Diseases of the spleen bore much the same proportion as in Broach.
The guinea-worm disease is more prevalent in this district than in
the others.
18. In the Ratnagiri Collectorate in three dispensaries there were
7,420 cases treated, one only of these institutions can be said to
be in a position to afford full aid to the districts, and that one is
at Ratnagiri; even there far more might be done were the dispen
-
sary situated below the European lines. Of general diseases A,
1,053 were treated—719 of these were malarial and 300 simple conti
-
nued fever; there were 8 cases of small-pox. The ratio per cent. to
treated of ague was so small as 9.55, being less than in Bombay and
the other districts. In the resumés of reports of civil hospitals, dis
-
pensary, jail, and police hospitals of Ratnagiri, this apparent freedom
from malarious fever is alluded to. Division B gave 263, chiefly
rheumatism and other diseases. Of local diseases there were 6,104
attended the dispensaries; there were not many cases of diarrhœa or
dysentery, but other diseases of the class gave 3,398, chiefly at
Ratnagiri itself, mainly due to the parasite round worm, which here
and there, throughout the country, is very prevalent. Diseases of the
skin and other diseases were the next most frequent complaints
—judging from the returns the district has been very healthy.
19. In the Canara Collectorate there were 14,190 treated in four
dispensaries, the greatest number were received at Kamte, then at
Karwar Charitable, at Honore, and the least at the Civil Dispensary
Karwar. Under general diseases A, 3,704 attended, of which 3,423