NationalLibraryOfScotland/medical-history-of-british-india huggingface dataset:
192
for remittent fever, enteric fever gave 18 cases, mumps 17. The
ratio of ague cases to treated was 37.95. Fever most prevailed
amongst Christian farmers, Hindu labourers, and others employed in
field occupations. Amongst Mussulmans and women engaged in
household work, fever of the intermittent character was much rarer.
Quinine for this dispensary is supplied direct by Mr. Ardaseer
Wadia.
Under Division B, the cases, 484, were chiefly rheumatism and a
few cases of syphilis and anœmia. Under local diseases are compris
-
ed those of the nerves and nervous functional; of the eye and ear; the
respiratory and digestive and cutaneous systems. The first gave a
large number of brow ague in which periodicity of attack was very
distinct. Of bronchitis there were 374 cases; 1,464 were diseases of
the stomach and bowels—dysentery, diarrhœa, dyspepsia, and colic.
52 diseases of the spleen were treated.
The dispensary when I visited it, was in a much better condition
than it was at my previous inspection. In the general management
there was much to find fault with, as much had been left to the pupil
without any real overlooking on the part of the sub-assistant
surgeon. The native medical pupil is reported on favourably.
Bandora.
5. At the dispensary at this place, where there is a population of
4,282, there were treated in the year 1872-73, 5,434 cases of disease,
34 remained from the preceding year, and 5,402 were new
admissions.
Of these 2,469 were Christians, 1,937 Hindus, 884 Mus
-
sulmans, 140 Parsees, and 4 other castes. There were 4,853 cured or
relieved, 503 absented or unknown, 8 died, 70 remained under treat
-
ment. The deaths occurred from remittent fever, bronchitis, and
tetanus. Under general diseases, Division A, there were 2,307
cases, of which 2,302 were fevers; of these again 2,167 were ague,
more by 742 than in the previous year, giving a percentage of 39.87
to total treated. Many fevers are entered in the return as remit
-
tent, of which there were 135 with 4 deaths ascertained. Under
Division B, of general diseases, 354 were treated, chiefly suffering
from rheumatism chronic, 40 cases of primary and secondary
syphilis, of which 28 were males, 12 females. It is not unlikely that
many of the chronic rheumatism cases owed their origin to
syphilitic disease. Under local diseases there were 2,624 treated for
functional disease of nervous system; diseases of the eye and ear; of
the respiratory system—chiefly sufferers from bronchitis and
asthma; diseases of the stomach and intestines, amongst which a
large number received relief for dysentery and diarrhœa, (827.)
Spleen disease appeared less frequently here than at other places, ten
193
cases were treated. Gonorrhœa and its complications gave no less
than 94 cases, almost entirely amongst males. Are these venereal
diseases obtained in Bombay? If so, how much of evil is carried into
the surrounding country, spread amongst families, and an amount of
disease laid up for the future, much of which might be prevented
by a Contagious Disease Act and Hospital for Bombay? Cutaneous
disease, according to result of dispensary practice, is less prevalent
here than at other places where the larger number of patients are
Hindus—here Christians preponderate. General and local injuries
gave 64 cases, chiefly contusions and burns. The operations per
-formed here are of the most minor description.
Vaccination has been carried on, and the sub-assistant surgeon
reports that, with the exception of a few, at the period of report
— A p r i l — t h e r e w e r e n o u n p r o t e c t e d c h i l d r e n i n B a n d o r a .
Small-pox had appeared, however, in two cases in St. Joseph's
Convent in the end of March; these did not seem to have been
vaccinated—they were sent to Bombay.
6. The dispensary was in tolerable order when I visited it, the
out-buildings,however, are in complete disrepair, and no attention what
ever had been paid to them. This I brought to the notice, with
other matters, of the owners of the dispensary, and trust that it will
be attended to.
Sub-assistant Surgeon A. DeSouza, G.G.M.C., has now been in
medical charge of the dispensary for many years.
I was not satisfied with the amount of care and attention displayed,
especially in the medicine arrangements. This year the cost of medi
-cines has more nearly approached the presumed requirements for the
number of sick than it has ever done. At Mahim, not far distant, a
dispensary exists called the "Mahim Charitable Dispensary," which
is one carried on by the subscription and donations of a few gentle
-men. At this dispensary there is a licentiate in charge, and the poor
pay for their medicines, the dispensary receives about Rs. 40 to
Rs. 50 per month by this means, and averages a daily attendance
of 40; here at Bandora when everything is gratuitous the average
has been 57. I consider that the dispensary does not attract half
as many sick as it ought to do. A native medical pupil of very poor
attainments is attached.
DISPENSARIES WHERE THE MEDICAL ESTABLISHMENT IS PAID BY
GOVERNMENT.
Balsar Charitable Dispensary.
7. The dispensary at this large town, with a population of 11 or
12,000, up to September last, was placed in a hired house in a cen
-tral locality, ill adapted, however, for the purpose: in this month it
was removed to the handsome building erected for it by the Collec
-tor of Surat at the expense of Mr. Dinshaw Manockjee Petit.
194
The new dispensary is well situated, has good accommodation for
a few in-patients. With a little re-arrangement of details and a
few slight alterations, which have been suggested, and may, perhaps,
be carried out, it will well fulfil all requirements.
The attendance at this dispensary has, as I observed in a former
report, been greater in daily attendance than relatively in numbers
of fresh admissions. It is unlike most dispensaries in this respect,
and the fact is difficult to account for, but will be the subject of
enquiry at my next visit to Balsar.
The average daily number of patients is put down at 136, while
the total treated is 5,545, which number includes in-patients.
Compared with dispensaries showing somewhat similar numbers
treated, I find that the average attendance was—
Treated.
Average
attendance
Absented.
Ratnagiri . . .
5,026
21.1
1,538
Ophthalmic . . .
5,781
171.3
1,030
Coorla . . .
6,018
40.3
588
Alibagh . . .
4,611
37.
1,973
Parak . . .
6,613
71.7
216
Randier . . .
5,138
51.21
1,378
Kamte . . .
6,116
67.7
73
Honore . . .
2,966
20.
9
Nausari . . .
6,315
63.6
323
There were treated during the year 5,545—5,464 were fresh admis
-
sions and 81 remained from previous year. 2,690 were Hindus, 1,576
Parsees, 1,271 were Mussulmans, and 8 Christians. 4,397 were cured
or relieved, 1,088 absented or unknown, 17 died, and 43 remained.
Under general diseases A there were 2,165 cases, of which 1,760
were of ague, and 320 remittent fever. Half the number of ague
cases were in males, the other half being divided between women
and children. 40 cases of cholera were treated, of whom 15 died, none
are shown to have absented, so that the percentage of recoveries
would appear to be 62.5. There were a few cases of dengue treated;
for this disease it is curious to see that, here as elsewhere, the people,
for some reasons, accepted it quietly, and few sought for remedies for
t. Under B there were 95 treated—the cases of syphilis were few,
nearly all amongst males. Rheumatism was much less under treat
-
ment than in other localities. Local diseases gave 3,213 cases, the
chief of which were diseases of the eye, of the respiratory system, of
the stomach and intestines; there were 696 cases of parasitic disease.
Of skin diseases, as usual, a large number applied for aid. Of inju
-
ries there were not many: they were fractures, wounds, and contu
-
sions; the operations performed were chiefly of minor character, but of
a kind pointing out the utility of such institutions.
1 9 5
8. It will be observed that dengue and cholera were treated at
the dispensary, the former prevailed in epidemic form in May, June,
and July. In August and September, cholera appeared in the town
and neighbouring sea-coast villages; in September part of the town
was flooded; after the subsidence intermittent fever prevailed to a
great extent; the daily attendance at the dispensary being in conse
- q u e n c e s o m u c h a s 2 2 5 . T h e s u b - a s s i s t a n t s u r g e o n i n m e d i c a l
charge lives close to the dispensary, in a house provided by the
municipality. As far as I could observe the routine duties as medi
- c a l o f f i c e r a r e c a r r i e d o n s a t i s f a c t o r i l y , i t w o u l d , h o w e v e r , b e p e r h a p s
as well if a change was made.
A native medical pupil is attached, who was reported on favour
-ably.
Parak.
9. It is several years since this dispensary was opened to the pub
- l i c , a n d s i n c e i t w a s r e m o v e d t o t h e v e r y e x c e l l e n t b u i l d i n g i t n o w
occupies. The sub-assistant surgeon in charge, Mr. Dosabhoy
Pestonjee, G.G.M.C., states that the most gratifying circumstance
in connection with its year's history, is its increasing usefulness and
the greater confidence and popularity with which it has been looked
upon by the inhabitants, the total number of patients having been
greater than at any time since its opening.
I am glad to observe this, for it appeared to me very inconsistent
that an institution of the kind, with a medical officer at its head, so
well spoken of, should have had fewer patients than dispensaries of
far less pretence.
The total number of patients treated during 1872-73 amounted to
6,613—3,402 were males, 1,674 females, and 1,537 children. The
average daily attendance was 71.7, ranging between 57 in October
1872 to 124 in February 1873; they were in order of number 4,069
Hindoos, 1,359 Mussulmans, 25 Christians, 1,159 Parsees; other caste 1.
Out of the treated (6,613) the large number of 6,314 were dis
-charged, cured or relieved, 216 absented, 1 died, 82 remained.
The number absenting, that is, not returning, either disappointed,
relieved, cured, or died, is small. Under general diseases, Division A,
2,059 cases were treated, the chief diseases were fevers, ague having
given 1,891 or 29.35 per cent. to other diseases.
The sub-assistant surgeon shows that dengue and cholera pre
-vailed in the town during the year; the returns show that 119 cases
of the former only were treated at the dispensary and one of the
latter; it is understood, however, that visits were paid to houses by
the sub-assistant surgeon, and that proper sanitary precautions were
adopted under the direction of the Civil Surgeon of Surat in conjunc
-tion with the Municipality Sanitary Committee.
2 6 M D
196
Under B, of general diseases, rheumatism was common, and of
syphilis—primary and secondary—102 cases were treated—78 were
males and 24 females; of this disease there were more admissions
than in the previous year.
Under local diseases those of the eye, ear, of the respiratory and
digestive systems were the most common : of gonorrhœa and its
complications 187 cases were treated. Diseases of the skin were
as usual prevalent—amongst the latter was a case of fibroma, which,
in consequence of being an object of great curiosity to the other
patients, left off attending. The case appeared to have been a well
marked one, the face, chest, arms were studded with pedunculated,
sac-like growths, of varying sizes; the patient had been subject to the
disease since boyhood, probably congenital. It is to be regretted
that the case could not have been kept under observation and treat
-ment and its history more completely recorded.
Vaccination is performed by the municipal vaccinator.
At my visit to this dispensary I was pleased with the state in
which the dispensary was kept, and the attention that had been paid
to suggestions made at my previous visit, having reference to the
crowding of the patients and the ease with which they could go about
the whole dispensary. The dispensary can be of still more use as
the number of sick in a place like Surat must be very large indeed.
The operations were chiefly of minor character.
The injuries were 102, 52 of which were due to burns and scalds,
the remainder were wounds, contusions, and two fractures.
The conduct of the two native medical pupils was well reported
on, and they appeared to be intelligent and diligent.
Bhondi.
10. At the charitable dispensary at Bhondi in the year 1872-73, the
number receiving medical aid amounted to 4,806 against 4,222 of the
previous year, showing an increase of 584 treated. 67 remained
from the previous year and 4,727 were fresh admissions. 3,038 were
Mussulmans, 1,554 Hindus, 75 Parsees, other caste 17, and 2Christians.
3,025 were cured or relieved, 1,691 absented or the result was un
-known, 2 died, and 88 remained.
The average daily number of sick was 63.
Under general diseases, Division A, 833 cases received medical
aid ; of these 812 were fevers, 622 being ague or intermittent, giving
a percentage of 12.69. The sub-assistant surgeon states the "fever
season" commenced later this year and terminated later. Mumps in
children made up the remainder of the cases. In Division B, 598
came under treatment, chiefly for rheumatisms and anœmia, 13
cases of phthisis, 26 of syphilis. Leprosy and scurvy were also
treated.
197
Local Diseases .—Nervous disease, chiefly functional, gave 45; there
were affections of the eye 129, and 147 of the ear. Derangements,
of the respiratory system were numerous, amounting to 323, chiefly
bronchitis, catarrh, and asthma. Diseases of the digestive system
gave 1,355 cases; the greatest number of diseases were ascaris
lumbricoides. 7 cases of tœnia solium were treated, five of
whom appear to have been discharged; there was a considerable
number of gonorrhœa cases, 52. Of diseases of the cellular tissue
and cutaneous system there were 936 cases treated, ulcers, abscesses,
inflammation, and many skin diseases, including 491 of scabies. Of
poisons and poisoned wounds, there were one snakebite cured, 12
dogbites, 2 ratbites. Of general injuries there were 22, all burns
and scalds. Local injuries were contusions, wounds, sprains, foreign
bodies in passages, fractures, and dislocations. The fractures were
one of the base of the skull, three of the clavicle, five of the forearm,
one of the phalanges, one dislocation of shoulder, one fracture of
femur.
There was a large number of operations, the chief of which were
minor.
Vaccination did not progress during the year.
When I visited the dispensary I saw the average number of
patients, and there was every appearance of satisfaction evinced at
the treatment they received. The dispensary was in good order. The
native medical pupil posseses a good character, his general number
is 775.
Kalian.
11.
At this dispensary there were 3,675 patients treated, against
4,334 of the previous year, showing a falling off of 659. The number
treated here is very small compared with the population of the town,
and the whole arrangement of a dispensary in the position it is, is
most unsatisfactory, so much. so that even for the small number
treated, a kind of fiction, as regards actual attendance, takes place;
for instance, persons coming from the town are generally supplied
with two days' medicine, as few will return the day following, each
person thus receiving two days' medicines is entered as a daily attend
-
ant for those two days. At my visit I directed this system to be
stopped, or at most to be very carefully acted on. There were 101
remained from the previous year and 3,574 fresh admissions—2,087
were Hindus, 813 Parsees, 634 Mussulmans, 81 other castes, and 60
Christians. 2,099 were cured or relieved, 1,484 absented or unknown,
14 died, and 78 remained: in-patients are included.
Under general diseases, Division A, there were 772 received
medical aid, 752 were fevers, and of them 691 were sufferers from
ague, giving, for that complaint, 19.33 per cent. to total treated.
3 cases of cholera were treated. Under Division B, there were
198
280 received aid, chiefly for rheumatism, syphilis, anœmia, and
scrofula. Local diseases— 2,393 were treated chiefly under affections
of the nervous system, of the eye and ear, of the respiratory system,
(419 mostly bronchitis), of the digestive system, chiefly of the sto
-mach and bowels, 1,811; dysentery, dyspepsia, obstruction, diar
-rhœa, and most of all the intestinal parasite—ascaris lumbricoides.
There were 41 cases of gonorrhœa and its complications, and 34
of spleen congestion; affections of the cellular tissue and cutaneous
disease amounted to 722; opium poison, alcohol, and scorpion wound,
each one case; injuries received amounted to 113; they were burns
and scalds, wounds, contusions, fractures, one dislocation of the jaw.
Most of the operations were minor, some of them were of more
importance.
Vaccination was carried on by the sub-assistant surgeon, and 207
cases were successfully operated on, giving an increase over the pre
-ceding year of 13; there is and always has been much opposition to
vaccination in Kalian.
Ascribing chiefly to distance of the dispensary from the town of
Kalian the fact of so small an attendance, I should be wrong in
again stating that the sub-assistant surgeon displays a certain want
of activity. Under the circumstances it would be incorrect to press
the subject, as his general character, as far as I know of it, is good,
and his professional qualifications very fair. A native medical pupil,
General No. 706, has been attached during the year, and has been
well reported on.
Randier.
12. The report rendered by the hospital assistant in medical charge
of this dispensary, affords little to commentupon; he states the dispe
n- sary has kept up its reputation, and that there is constant attendance
from the neighbouring villages.
There were 5,138 cases treated during the year, showing an increase
of 560 over the preceding year; the average daily attendence had
increased from 38 in 1871-72 to 51 in 1872-73. There were Hindus
2,679, Mussulmans 2,256, Parsees 201, Christians 2.
Of 5,138 cases, there were remaining from the previous year 115,
new admissions gave 5,023; total 5,138. Of these 3,678 were cured or
relieved, 1,378 absented or unknown, none died, and 82 remained.
There were 1,894 males, 1,283 females, and 1,961 children.
Under general diseases A, there were 1,981 cases, of which 1,816
were of ague, being 35.37 per cent. to total treated. Of remittent
fever 26 received aid, of dengue there were 121. Under B, 228 cases,
of which 136 were rheumatism, 26 were of secondary syphilis;
there were 6 cases of phthisis pulmonalis. Local diseases 929 were
treated; of these, diseases of the air passages and lungs numbered
199
324—bronchitis, hooping-cough, &c. ; there were 808 treated of
diseases of stomach and bowels, chiefly diarrhœa, intestinal worms,
&c. Skin diseases gave 1,026.
The report of the hospital assistant does not speak much for his
diligence in preparing it, and arranging, from the data in his posses
- s i o n , s t a t e m e n t s s h o w i n g m o r e c l e a r l y h o w h i s w o r k w a s p e r f o r m e d .
We must, however, accept the increase of attendance as indicative of
his being in a measure useful.
32. Injuries were received, 15 of which were burns and scalds,
the remainder fractures, of which there were 2 wounds and con
- t u s i o n s .
The operations were all minor.
Nothing is said about vaccination; it was, however, successfully
performed in 191 cases. Hospital Assistant Bhasker Sitaram was
removed from Chickli last year, and if he could be for a time
placed on general duty, he would, probably, be made to understand
his position and several other matters which he is now extremely
deficient in.
Native Medical Pupil General No. 944 has been attached to the
dispensary: he is reported to be of good character.
Tanna, Rustomjee Wadia Dispensary.
13. This dispensary, situated at the northern side of the town of
Tanna, is tolerably conveniently placed for the people.
During the year there were 5,370 patients treated against 5,480
of the previous year, showing a decrease of 110.
There remained from the year 1871-72, 58 and there were 5,312
new admissions; 4,591 were cured or relieved, 691 absented, 2 died,
and 86 remained; of these 3,872 were Hindus, 585 Mussulmans,
440 Christians, 441 Parsees, and 32 other castes.
The average daily attendance was 64.
The diseases, which occured under the head of general diseases,
numbered 2,276, and of these 1,890 were treated for ague, showing
a percentage of 35.18. There were 28 cases of mumps and a few
of hooping-cough under Sub-Division A. Under B, the chief
diseases were rheumatism. Of the next heading of local diseases
and injuries there were 3,094 treated; the cases treated consisted
chiefly of diseases of the respiratory system and of the stomach
and intestines; of the former bronchitis and asthma, of the latter
diarrhœa, dysentery, colic, dyspepsia, and constipation. The
ascaris lumbricoides did not give many cases. Of congestion of
the spleen there were 29 treated. Skin diseases of kinds as usual
gave many cases.
200
Injuries amounted to 128; they consisted of fractures, dislocations
foreign bodies in passages, wounds and contusions—fractures were
of forearm, jaw, tibia, ribs, clavicle, femur.
There were 128 operations performed during the year, amongst
which were craniotomy, reduction of dislocation of jaw, hydrocle,
removal of tumors, &amp;c.
Vaccination was performed at the dispensary in 92 operations,
showing an increase of 50 over the previous year. Thirty-one of
these vaccinations were performed in February on the children of
educated people, whose practice it is to take protective measures
only when the epidemic is actually in their immediate neighbour
-hood: they then voluntarily bring their children to the dispensary.
At other times, if the assistant even goes to their houses, they
procrastinate. Great opposition to vaccination is felt here, especially
amongst the lower classes.
The Hospital Assistant, General No. 431, 2nd Class, is intelligent
and deserving, and does a very great amount of good amongst the
people of Tanna; the civil surgeon gives him a good character.
The dispensary was in good order—drugs and instruments well kept.
A Native Medical Pupil, General No. 937, is attached to this dis
-pensary, whose progress and character are reported on favorably.
Matheran.
14. At this hill-sanitarium the classes of resident natives
throughout the year are confined to a few dwellers on the hill
- s i d e s a n d i n t h e b a z a r ; t h e m a l l e e s o r h o u s e c u s t o d i a n s , t h e
hospital assistant, and certain officials also reside. After the
monsoon is over the temporary native residents begin to make
their appearance, they consist chiefly of coolies or bigarrees—male and
female—shop-keepers, palquee bearers, tattoo wallahs, servants, &amp;c.
The palquee bearers and coolees have hard work of it while
employed, the toil up seven miles of hill, much of it steep, with
heavy burdens being very great. These people generally arrive in
good health and seldom present themselves for treatment.
The number treated during the year was 84, being less by 52
than in the preceding year. The difference is said to be owing to the
year being healthier, and this is ascribed to a smaller rainfall and
to the institution of a system of latrines which had not been pre
- v i o u s l y c o n s i d e r e d n e c e s s a r y . W i t h t h e s e t h e m e d i c a l o f f i c e r i n
charge states a better conservancy is enforced.
There remained 4 and there were 80 new admissions; of these 80
were cured or relieved, 1 absented, and 3 remained. 56 were
Hindus, 15 Christians, 11 Mussulmans, 1 Parsee, and 1 other caste.