NationalLibraryOfScotland/medical-history-of-british-india huggingface dataset:
No. 762/C. C.
FROM
DOCTOR H. M. CANNON, M. B.,
DEPUTY SURGEON GENERAL,
INDIAN MEDICAL DEPARTMENT,
LUCKNOW CIRCLE,
To
THE SECY. TO THE CHIEF COMMISSIONER,
OUDH.
Dated Lucknow, the 28th April 1876.
SIR,
I HAVE the honor to submit the Annual Report, with Statements I.
II. and III. of the Charitable Hospitals and Dispensaries in the province
of Oudh, for the year 1875.
Abbreviation of report.
2. Agreeable to instructions contained in para. 8, Home Depart ment / Medi cal letter
No. 564, dated 25th August 1875, I have on this occasion omitted alto-
gether the submission of reports on the Jails and Police Hospitals, as well
as those of the Lunatic Asylum and Balrámpur Medical School.
No. 68-2837, dated 21st
November 1874, Home De-
partment.
3. With reference to the order quoted in margin, I have en-
deavoured, in preparing the Annual Reports, to limit myself to general
statements gathered from a careful perusal of those of the several institu-
tions in the province.
I have, however, found it necessary to deviate in several instances
from a strict adherence to this rule, more especially as regards the
Branch Dispensaries, many of which I have had neither the time nor oppor-
tunity of inspecting within the year.
In such instances I have been obliged to quote freely from the
reports of Civil Surgeons, as I am anxious on this occasion to bring pro-
minently to the notice of the Chief Commissioner the question as to the
utility of increasing or limiting the amount of in-door relief afforded by
these institutions.
Inspections.
4. During the year under review I have visited and reported on 47
Sadr, Branch, Jail, and Police Hospitals and Dispensaries. The Branch
Dispensaries, with the exception of Jais, have all been visited at least
four times by the District Medical Officers.
The remarks made by me on the occasion of my inspections have
been added to this report, where I have considered them necessary.
NUMBER OF DlSPENSARIES.
In 1874.
6 First-class.
6 Second-class.
31 Third-class.
43
In 1875.
6 First-class.
6 Second-class.
35 Third-class.
47
5. The statement in the margin shows that the number of Charitable
Dispensaries in the province con-
tinues to increase; at the close of
1874 there were 43, and at the close of
1875 in all 47 Dispensaries.
New Dispensaries.
6. Of the latter number three third-class Dispensaries were opened
during 1875, viz., Mohán in Unao and Dalmau and Jais in the Rae
Bareli district.
( 2 )
Comparative attendance
7. The following is a summary of the working of the Oudh Hospitals
and Dispensaries for the year 1875. It will be observed on reference to
statement No. 2 that as many as 243,045 patients received surgical and
medical aid in the Dispensaries of this province during 1875, against
207,547 in 1874, showing an increase of 35,498 in the attendance of in
and out-door patients.
*RESULTS :
In-door ...
Out-door ...
Total ...
601
519
1,120
8. Of the total number 243,045 that applied for medical and surgical
aid, 6,121 were in-door, 236,924 were out-door; of these 191,890 were cured,
20,765 relieved, 973 incurable,* 1,120 died, 25,673 result unknown,
and 2,624 remained under treatment at the end of the year.
Mortality.
9. The estimate of the percentage of deaths amongst the total number
treated must continue unsatisfactory so long as any attempt is made to
report on the casualties among out-patients, which I again request may
be omitted from future reports by all Medical Officers.
On reference to comparative statement attached to the report of each
Dispensary will be found the proportion of deaths to the number of in-door
patients treated; but these also are in one respect faulty, as the "moribund"
cases brought in by the Police do not give a fair percentage of mortality
to the numbers that have actually been under medical treatement.
Operations, capital and
minor.
10. On reference to the following abstract statement, it will be ob-
served that the capital or major operations have increased from 364 in
1874 to 593 in 1875, and the minor from 9,205 to 11,474 in the year under
review; and although the trustworthiness of some of the returns from
Branch Dispensaries under this heading may be viewed with suspicion,
especially in the Hardoi and Unao districts, where severe fractures and
dislocations have been included, it is impossible to deny the fact that the
relief afforded by surgical operations alone during the year 1875, at these
institutions, has been very great and very important.
11. The following comparative statement shows the number of
capital and minor surgical operations in each district of the province for
1874 and 1875 :—
District.
Lucknow ...
Bara Banki ...
Unao ...
Rae Bareli ...
Partabgarh ...
Sultanpur ...
Fyzabad ...
Gonda ...
Bahraich ...
Sitapur ...
Kheri ...
Hardoi ...
Total ...
1874.
Capital.
52
51
11
20
28
16
48
23
15
8
15
77
364
Minor.
2,008
368
224
435
482
161
459
518
1,010
734
601
2,205
9,205
Total.
2,060
419
235
455
510
177
507
541
1,025
742
616
2,282
9,569
1875.
Capital.
51
45
115
24
21
22
82
24
17
13
15
164
593
Minor.
2,737
1,150
447
601
567
546
782
824
654
710
711
1,745
11,474
Total.
2,788
1,195
562
625
588
568
864
848
671
723
726
1,909
12,067
REMARKS.
Capital operations, '74
Do.
do.
'75
Increase ...
Minor operations, '74
Do.
do.
'75
Increase ...
Total Capital and
Minor operations, '74
Do.
do,
'75
Increase ...
264
593
229
9,205
11,474
2,200
9,569
12,067
2,498
( 4 )
"Again, in a moral point of view, many of these lads are taken away
from the supervision of their parents and families and posted to Regi-
ments and Civil Dispensaries, where they have a greater amount of liberty
than is desirable, and associate with sepoys and Hospital establishments
far senior to them in years, and in many instances there is no accom-
modation provided; so they are forced to find lodgings in the bazárs and
cities, which must sooner or later end in demoralization and ruin, and
render every attempt useless to again bring them under discipline, as is
amply proved by the numbers annually dismissed from the Hospitals
and several Medical Schools."
Requirements.
16. Several of the Sadr Dispensaries are rendered inefficient for the
want of a properly constructed dead-house and contagious disease ward,
and I trust the Chief Commissioner will move the local authorities to
add these buildings where they do not exist, as soon as the local funds
are prepared to meet the expense.
Financial statement.
17. Statement No. I., attached to this report, gives at a glance the
receipts and expenditure of all the Hospitals and Dispensaries in Oudh,
under the several headings, for the year 1875.
18. It is satisfactory to note that although the number of patients
treated rose from 207,547 to 243,045 and 3 new Branch Dispensaries were
added to the list, the total cost of 47 Dispensaries in 1875 was only
Rs 93,004-2-9 against 84,034-4-10 in 1874.
19. The cost of dieting each in-door patient in the 47 Sadr and
Branch Dispensaries in the province averages about 7 pie per diem during
the year under review.
20. In concluding this report, I beg to offer for the consideration
of the Chief Commissioner the following remarks and suggestions after
more than 2 years' experience as administrative Medical Officer in this
province.
* Unao.
Kheri.
Baru Banki.
Sultanpur.
Hardoi.
21. Of the 12 Sadr Hospitals and Dispensaries in Oudh, the 5* noted
in margin are in charge of Hospital Assistants only, and I beg to
urge that however competent and trustworthy these men may be consider-
ed individually, they are not as a rule sufficiently qualified to render such
important surgical and medical aid as the public have a right to expect
at a Sadr Dispensary, and which is absolutely necessary to make these
expensive institutions more useful and popular than they are at present.
I therefore trust the Government will agree with me as to the necessity
of appointing a well-qualified Assistant Surgeon to every Sadr Hospital
and Dispensary in Oudh, so as to ensure the presence of an efficient
Medical man at the head-quarters of each district during the absence of
the Civil Surgeon on privilege leave, sanitary inspections, and other duties.
22. The Branch Dispensaries should, in my opinion, with very
special exceptions, be confined to affording medical advice to out-door
patients only, and where an exception is made, a well-qualified 1st class
man should be posted to the charge ; at present many of these outlying Dis-
pensaries are in the hands of young, untried, 3rd-class Hospital Assistants.
( 5 )
23. All severe and important Surgical and Medical cases should be
induced, if possible, to go into the Sadr Dispensaries of their District
for treatment.
This arrangement would result in a great saving in many ways in
useless monthly outlay in diet, ward furniture, bedding, and other con-
tingencies for house-patients, not unfrequently incurred by untrust-
worthy Native Doctors and young Hospital Assistants, where the funds
will not admit of higher-graded men of tried character being enter-
tained.
24. These Branch Dispensaries for out-patients only might then be
entrusted to 3rd-class Hospital Assistants and passed Balrámpur Medical
School pupils on very reduced salaries, and the Sadr institutions would
then be sought for when necessary, where superior surgical and medical
aid was required.
25. It would not be a bad arrangement out of the savings caused by
closing in-door relief at many of the Branch Dispensaries to institute a
small fund for the carriage of severe and helpless cases to the Sadr Hos-
pital of each District for treatment; which system, if encouraged and
thoroughly carried out, would render these institutions of immense
value and importance throughout the province.
Conclusion.
26. I have endeavoured to limit my report as much as possible to
a careful review of the statistics and a few remarks on subjects of interest;
but I trust the Chief Commissioner will consider it sufficiently full to illus-
trate clearly the working of all the Charitable Dispensaries under review.
27. I regret it has not been in my power to visit several of the Branch
Dispensaries; but it must be remembered the Lucknow Circle includes
Rohilkhund and Kamaon, which contain 11 Regimental and 9 Lock-Hos-
pitals, and that in addition to the legitimate duties of a Deputy Surgeon
General, I have added the work and responsibility of an Inspector General
of Dispensaries, which renders it absolutely impossible for me to visit
more than three-fourths of my civil charge in Oudh during the year,
although I commenced my inspections as early as the month of September.
I have the honor to be,
Sir,
Your most obedient servant,
H. M. CANNON, M. B.,
Deputy Surgeon General,
Indian Medical Department,
Lucknow Circle.
King's Hospital, City Lucknow.
1. This institution still holds its own as one of the most popular and
best-managed medical institutions in the Province.
2. The total number of persons treated were 9,956 in 1875 against
9,834 in 1874. The increase is not confined to out-door patients, but is
also observed among those seeking in-door relief.
3. The total number of in-door patients was 453 against 438 in 1874,
showing an increase of 15; of these 329 were cured, 76 died, 12 left while
under treatment, and 36 remained at the end of the year.
4. There have been 27 capital and 901 minor operations; of the
former, 8 were performed by the Civil Surgeon, and 19 by the Assist-
ant Surgeon Nobin Chunder Mitter; of these 26 were successful. The
above include several fractures and dislocations which are not registered
as operations.
5. Country medicines have been extensively used at this institution.
The Gurjun oil treatment of leprosy was tried during the year, regarding
which a special report has been submitted, and, although the number of
cases so treated is small, its efficacy in arresting the progress of the
disease, in several instances, warrants further and more extended trial.
It is yet to be seen how much success is due to improved living, com-
fortable quarters, and the employment of friction, and how much to the
employment of the specific remedy.
6. The total expenditure, including the cost of European medicines,
was Rs. 7,334-9-9 against Rs. 7,505-0-4 in 1874 ; the decrease is mainly
attributable to the cheap rate of articles of diet which prevailed
last year.
7. I made my annual inspection of this hospital on the 17th January
1876. The conduct and professional qualifications of Assistant Surgeon
Nobin Chunder Mitter are too well-known for me to say more, than
I have had no reason to alter the high opinion I have always entertained
of him in every respect.
8. First Class Hospital Assistant Meer Nasur Ali, and the three
Native medical pupils attached to this hospital have conducted themselves
to my satisfaction, and the latter have made fair progress in their
studies.
9. The new Bengal dispensary forms were introduced on the 1st
January, and are found much simpler and quite as useful as those of the
North-Western Provinces.
( 2 )
10. The comparative statement is published below :—
KING'S HOSPITAL AND DISPENSARY, LUCKNOW.
Remaining under treatment on the 1st of January ...
In door Patients admitted... ... ... ...
Out-door Patients admitted ... ... ...
Total ...
Relieved and cured
In-door Patients
...
...
Out-door Patients ... ...
Ceased to attend ... ... ... ... ...
Died ...
Remaining
In-door Patients ... ..
Out-door Patients ... ...
In-door Patients ... ...
Out-door Patients ... ...
Total ...
Daily average attendance of In-door Patients ...
Do.
do.
Out-door Patients
...
Total ...
1874.
223
408
9,203
9,834
319
7,605
1,629
70
...
29
182
9,834
38.11
131.54
169.65
1875.
211
424
9,321
9,956
329
7,994
1,277
76
1
36
243
9,956
35.90
136.05
171.95
Surgical operations.
Surgical operations
Capital
...
...
...
Minor ... ... ...
Total
26
886
912
27
901
928
Receipts.
RECEIPTS.
Balanee in hand on 1st January … … …
European Subscriptions … … … …
Native
ditto … … … …
Government Allowances ... … … …
Other sources
…
…
…
…
…
Total
…
Rs. As. P.
…
...
…
…
7,505
7,505
0
0
4
4
Rs.
As. P.
...
…
…
…
7,334
7,334
9
9
9
9
Disbursements.
DISBURSEMENTS.
Establishment
…
…
…
…
…
Dieting In-door Patients … … … …
Europe medicines ... ... ... ...
Bazaar medicines
…
…
…
…
…
Contingencies … … … … …
Total …
Cost of dieting each In-door Patient
…
…
4,991
1,055
486
322
650
7,505
0
0
5
8
1
0
0
1
0
6
6
5
6
4
2 4/5
4,992
805
552
334
648
7,334
0
0
14
14
12
15
9
1
0
6
0
10
8
9
0.16
CIVIL DISPENSARY
HAZRATGANJ, LUCK-
NOW.
11. I inspected this dispensary on the 17th January 1876.
12. The out-door patients have been principally the public and
private servants of the civil community who subscribe to the institution.
Here are dispensed the prescriptions of all the covenanted and uncove-
nanted officers of the civil station.
13. 31 patients remained at the close of 1874. During the year
5,462 persons applied for treatment, making a total of 5,493 out-patients ;
of those 13 died.
14. 210 minor and one capital operation were performed, the latter
by Dr. Cameron : this was a case of lithotomy.
15. The daily average number of out-patients was 32.7.
16. Rs. 1,125-6-0 were subscribed by the European community,
add to this Rs. 2,014-9-7, the balance remaining at the end of 1871, and
the Government allowance of Rs. 1,056, making a sum total of Rs.
4,195-15-7.
( 3 )
17. Of this were paid for establishment Rs. 1,056, for bazar
medicines Rs. 631-3-0, for contingencies Rs. 239-5-0, total Rs. 1,926-8-0.
There still remains to be paid the bill for Europe medicines, not yet
received from Allahabad. This will probably be about Rs. 450. The
balance in the Treasury at the end of 1875 was Rs. 2,269-7-7.
18. Three patients were treated with Gurjun oil for leprosy; but
they did not attend regularly for their rubbing, and did not do it them-
selves at their own homes. The anæsthetic patch on the left thigh of one
of the patients was benefited, the rest showed no sign of improvement.
19. Establishment.—First Class Hospital Assistant Shaikh Deedar
Buksh continues to merit the good opinion which has always been enter-
tained regarding him.
20. Native medical pupils Gunesh Singh and Shaikh Abdul Guffoor.—
Both these boys have behaved well and made a reasonable advance in the
elements of medical knowledge.
21. The medicines and poisons I found carefully kept under lock
and key, and the surgical instruments in good order.
22. The books and records were written up to date. The quarterly
sheets and circular orders are complete and bound up to the close of 1874.
23. The Bengal forms of dispensary records and registers have
been introduced since the 1st January 1876.
24. The following comparative statement is submitted for easy
reference :—
CIVIL DISPENSARY, HAZRATGANJ.
Remaining under treatment on the 1st of January …
Out-door Patients admitted ... ... ...
Total ...
Relieved and cured … … … …
Ceased to attend … … … …
Died … … … … …
Remaining … … … … …
Total …
1874.
24
3,115
3,139
3,021
76
11
31
3,139
1875.
31
5,462
5,493
5,353
88
13
39
5,493
Surgical operations.
Daily average
attendance
…
…
…
Surgical operations ...
Capital … … …
Minor ... ... ...
Total ...
27
...
102
102
327
1
210
211
Receipts.
RECEIPTS.
Balance in hand on 1st January … … …
European Subscriptions … … … …
Native
ditto … … … …
Government Allowances … … … …
Other sources … … … … …
Total …
Rs.
1,799
878
20
1,056
As.
5
0
0
0
P.
0
0
0
0
...
3,753 5 0
Rs.
2,014
1,125
As.
9
6
P.
7
0
...
1,056 0 0
...
4,195 15 7
Disbursements.
DISBURSEMENTS.
Establishment
…
…
…
…
…
Europe medicines … … … …
Bazaar medicines … … … …
Contingencies
…
…
…
…
…
Total …
1,056 0 0
Accounts
509
173
1,738
1
10
11
5
0
5
1,056 0 0
not rendered.
631
239
1,926
3
5
8
0
0
0
( 4 )
BALRÁMPUR HOS-
PITAL, LUCKNOW.
25. On reference to the annual returns of this institution, it will be
found that the total number of persons who received treatment during
the year rose from 10,161 in 1874 to 11,076 in 1875, and that the
increase was among the out-patients only, as the number of in-door
patients fell from 718 to 667.
26. Of these, 486 were discharged, cured, or relieved, 11 left the
hospital while still under treatment, 143 died, and 27 remained in hospital
at the end of the year.
27. Of the 10,409 out-patients 138 remained under treatment at the
close of the year, and 8,857 were cured or relieved. In the case of the
1,414 out-patients who ceased to attend the result is unknown.
28. Among the total treated during the year are 658 Europeans and
Eurasians, 44 of whom were treated as in-door patients and 5 died, and
614 as out-door patients, who were discharged cured or relieved.
29. There were 23 capital and 1,626 minor operations performed
during 1875 ; of the former, 2 were by the Civil Surgeon, and the remain-
der by Assistant Surgeon Ishan Chunder Roy, M. B.; all the cases
proved more or less successful, none died.
30. In addition to the above, there were about 100 fractures and
dislocations, and 62 cholera cases treated in hospital during the past year.
31. I made my annual inspection of this hospital on the 20th Janu-
ary 1876, and found everything in connection with the building, conser-
vancy, and medical arrangements in excellent order. The instruments
and medicines were carefully kept, the book accounts and records were
complete and written up to date.
32. Third Grade Assistant Surgeon Ishan Chunder Roy has been
in resident medical charge during the whole year ; he has conducted his
duties satisfactorily, and his qualifications are of a high order.
33. Third Class Hospital Assistant Ram Tahal is well qualified
professionally, and possesses a competent knowledge of English ; he has
conducted himself to Dr. Whishaw's satisfaction.
34. The three medical pupils Ahmed Khan, Prag Singh, and Laltoo
Ram have all conducted themselves properly, and made satisfactory pro-
gress in their medical studies.
35. In the following comparative statement it will be seen that the
receipts and disbursements of 1874 do not agree with the figures given in
my last annual report. In the former accounts only those sums were
entered which actually passed through the hands of the officer in charge
of the hospital: no notice, for example, was taken of a loan made from
the hospital funds to the Balrámpur Medical School; this has been
corrected and the present account shows the real state of the finances.
There is this difference too in the disbursements, the former accounts
showed what was due for the year, the figures now submitted show what
was actually spent during the year. Thus, salaries for December 1873,
paid in January 1874, are now shown under 1874, and those for December
1874, disbursed in January 1875, appear under 1875.
( 5 )
36. A considerable decrease in expenditure will be observed under
the following headings :—
Government allowances.—The decrease under this heading of
Rs. 170-12-10 is owing to a Third instead of Second Class Hospital
Assistant being entertained during the year under review.
European medicines.—The great decrease of Rs. 798-14-7, is owing
to that sum having been required during 1873-74 for the purchase of
expensive surgical instruments and appliances which will not require
renewal for some time to come.
BALRÁMPUR HOSPITAL AND DISPENSARY, LUCKNOW.
Remaining under treatment on the 1st of January ...
In-door Patients admitted … … …
Out-door Patients admitted … … …
Total
…
…
Relieved and cured, In-door Patients
...
...
Out-door Patients
...
...
Ceased to attend
...
...
...
...
Died ...
Remaining
...
In-door Patients ... ...
Out-door Patients ... ...
In-door Patients ... ...
Out-door Patients ... ...
Total ... ...
Daily average attendance of In-door Patients ...
Do.
do.
Out-door Patients ...
Total ...
1874.
160
670
9,331
10,161
509
8,990
326
148
...
40
148
10,161
47.974
126.907
174.881
1875.
188
627
10,261
11,076
486
8,857
1,425
143
...
27
138
11,076
42.29
134.78
177.07
Surgical operations.
Surgical operations,
Capital ... ... ...
Minor ... .. ..
Total ...
26
1,222
1,148
23
1,626
1,649
Receipts.
RECEIPTS.
Balance in hand on 1st January
…
…
Do. at the debit of the Balrámpur Medical School ...
European subscriptions .. .... ...
Native
do. ... ... ...
Government Allowances ... ... ...
Balrámpur Fund ... ... ... ...
Other sources
…
…
…
…
Total ...
Rs.
2,675
2,106
As.
11
2
P.
4
7
...
...
3,150
8,310
778
17,020
0
0
3
1
3
0
3
5
Rs.
5,174
1,739
As.
1
9
P
6
0
...
...
2,981
4,200
163
14,257
0
0
0
10
5
0
0
11
Disbursements.
DISBURSEMENTS.
Investment
…
…
…
…
Establishment ... ... ... ...
Dieting In-door Patients ... ... ...
Europe medicines and instruments ... ...
Bazaar medicines
…
…
…
…
Furniture and clothing ... ... ...
Contingencies … … … …
Total …
Cost of dieting each In-door Patient … …
1,548
4,411
1,121
1,837
429
335
422
10,106
0
5
5
15
4
1
13
9
6
0
4
7
3
9
11
0
1
11
12.12
...
4,240
911
1,038
406
159
387
7,l44
0
8
12
6
7
11
14
12
0
9
9
2
3
0
6
5
11.3
UNAO SADR DISPENSARY
37. The dispensary is in very good order, the roof having been re-tiled
with a double set of tiles; the verandah also has been renewed. There
has been no accommodation found for the hospital assistant, native
medical pupils, or dresser.