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Remarks by Lieutenant-Colonel J. Manners Smith, V.C., C.V.O.,
C.I.E., Hon'ble the Agent to the Governor-General, Rajputana,
and Chief Commissioner, Ajmer-Merwara.
The year under report has been marked by an abnormally high mortality
owing to the outbreak of plague and a virulent type of fever. These outbreaks
were directly connected with the phenomenally heavy rainfall. With the
advent of the hot weather plague has died down and it is hoped that the epi-
demic will not revive in the present year to anything approaching the same
extent.
One satisfactory feature is the increasing popularity of inoculation, to
which the public are now largely resorting both in Ajmer-Merwara and in
many of the States.
The epidemics have thrown much extra work on Colonel MacWatt and
the other medical officers in Rajputana whose services I desire to acknowledge.
The introduction of sanitary reforms in Ajmer continues to engage the
attention of the authorities. The Municipal Regulation is being remodelled
with a view to increasing the effective control of the Committee in sanitary
matters. The chief obstacles in the path of progress, however, are difficulties
of a financial nature: these difficulties can hardly be expected to diminish
during the war.
REPORT
ON
SANITATION, DISPENSARIES, AND JAILS IN
RAJPUTANA FOR 1917
AND ON
VACCINATION FOR THE YEAR 1917-18.
SECTION I.—SANITATION AND VACCINATION.
METROROLOGY AND ITS RELATION TO FOOD SUPPLY.
Rainfall in Ajmer-Merwara.
1. During 1917 in Ajmer-Merwara the rainfall was abnormally heavy.
Frequent and good showers occurred
throughout April and May, the result
being a very mild hot weather. The monsoon arrived early in June and lasted
long. In Ajmer 48.30 inches of rain were registered, against 28.30 inches in
1916; being 23.34 inches above the average of the previous six years. All the
tanks and wells throughout the district received more than a sufficient supply.
Rainfall in Native States.
2. The rainfall recorded in Rajputana generally was excessive, and
practically continuous from June to the
end of October. Almost all the tanks
throughout Rajputana filled rapidly ; and much damage was sustained by the
breaching of many of the Bunds. The water level in the wells rose consider-
ably ; nearly to the old water level. Owing to heavy and continuous rain the
Kharif crops were greatly damaged and in many places spoiled altogether.
Grass has been fairly abundant. The Rabi crops are excellent.
VITAL STATISTICS, BIRTHS AND DEATHS.
Births in Ajmer-Merwara.
3. 18,455 births were registered in Ajmer-Merwara in 1917, against 19,398
in 1916, a decrease of 943.
4. Of the total births registered, 9,835 were males and 8,620 females. The
birth rate was 36.81 per mille of population against 38.68 per mille in 1916.
The percentage of male to female births was 114.10 as compared with 108.96 in
the previous year.
Deaths in Ajmer-Merwara.
5. In Ajmer-Merwara 51,623 deaths were registered, against 20,296 in
1916; an increase of 31,327 due chiefly to
plague and malaria which existed in
severely epidemic form throughout the district, and to the prevalence of Small-
pox. The death rate per mille of population was 102.96, compared with 40.48
in 1916.
6. The mortality from Small-pox was 1,275, against 705 the previous year,
an increase of 570. The disease appeared in January, and was most prevalent
in April when 297 deaths were reported. The mortality among children under
5 years of age was 41 per cent. of the total deaths, against 57 per cent. in 1916.
7. 34,300 deaths from " Fevers " were reported, as compared with 15,350
in 1916 : accounted for by the heavy rainfall and the consequent outbreak of
Malaria in epidemic form.
8. 1,187 deaths were recorded from Bowel diseases against 851 in the pre-
vious year, an increase of 336, due no doubt to the wetness of the season.
9. The percentage of male to female deaths was 99.77 against 106.45 in
1916.
2
VITAL STATISTICS IN AJMER-MERWARA.
Number of Cholera cases and deaths reported in Ajmer-Merwara and in Rajputana during the year 1917.
Name of District or State.
Ajmer-Merwara
Ajmer City .
District .
TOTAL .
Jaipur
City
.
.
State . .
Bharatpur
.
.
.
.
Karauli .
.
.
.
.
TOTAL .
GRAND TOTAL .
MARCH 1917.
Cases.
...
...
...
1
...
...
...
1
1
Deaths.
...
...
...
1
...
...
...
1
1
APRIL.
Cases.
...
...
...
...
...
...
...
...
...
Deaths.
...
...
...
...
...
...
...
...
...
MAY.
Cases.
...
...
...
...
...
...
...
...
Deaths.
...
...
...
...
...
...
...
...
...
JUNE.
Cases.
7
...
7
83
...
7
...
40
47
Deaths.
5
...
5
32
...
...
...
32
37
JULY.
Cases.
3
...
3
1
...
...
...
1
4
Deaths.
3
...
3
1
...
...
...
1
4
AUGUST.
Cases.
1
...
1
1
...
...
...
1
2
Deaths.
1
...
1
1
...
...
...
1
2
SEPTEMBER.
Cases.
...
...
...
...
...
25
11
36
36
Deaths.
...
...
...
...
...
14
5
19
19
OCTOBER.
Cases.
...
...
...
...
1
9
...
10
10
Deaths.
...
...
...
...
1
5
...
6
6
NOVEMBER.
Cases.
...
...
...
...
...
...
...
...
...
Deaths.
...
...
...
...
...
...
...
...
...
DECEMBER.
Cases.
...
...
...
...
...
...
...
...
...
Deaths.
...
...
...
...
...
...
...
...
...
TOTAL.
Cases.
11
...
11
36
1
411
11
89
100
Deaths.
9
...
9
35
1
19
5
60
69
Percentage
of deaths
to cases.
81.82
...
81.82
97.23
100.00
46.34
45.45
67.42
69.00
6
VACCINATION AND DISPENSARIES IN RAJPUTANA.
53. The cost of each successful vaccination in this division was 49 pies
against 34 pies in 1916-1917.
Expenditure on vaccination in Native States.
54. The total expenditure on vaccination in Native States was R34,919-
15-1 as compared with R33,312-15-9
in 1916-1917 : the increase is due to the
fact that glycerinated lymph was obtained on payment from the Government
Bovine Lymph Depôts. The cost of each successful vaccination in different
States varied from 18 pies in Kotah to 166 pies in Jaisalmer.
55. The following table shows the number of towns and villages inspected
and Vaccination seen by Residency or Agency Surgeons in Native States:—
Designation.
The Residency Surgeon, Western Rajputana States
. .
The Residency Surgeon, Mewar .
.
.
.
.
.
The Principal Medical Officer, Bikaner State .
.
.
.
The Agency Surgeon, Eastern Rajputana States .
. .
Number of towns
and villages
inspected.
1
8
6
8
Number of vac¬
cination cases
seen.
180
491
2,975
1,184
56. The Officiating State Surgeon of Alwar inspected only 445 vaccinations
in Alwar City as he could not go out in the district owing to prevalence of
plague in the Capital. 1,210 vaccinated children were inspected by the
Assistant Surgeon, Jhalrapatan.
57. The Native Superintendents of Vaccinations and other inspecting
officers in Native States inspected 69,388 vaccinations against 94,591 in 1916-
1917. The percentage of inspected cases found successful among the total
number seen in 1917-1918 was 98.39 against 98.69 in 1916-1917.
58. Lymph is maintained throughout the year in most of the important
States by arm to arm vaccinations. Glycerinated lymph was obtained during
the year from the Government Lymph Depôts and was generally satisfactory.
SECTION II.—DISPENSARIES.
STATEMENT A.
Number of Dispensaries.
59. During the year there were 179 Hospitals and Dispensaries in
Rajputana against 178 in the previous year. The Jodhpur-Bikaner Railway
Dispensary at Luni in Marwar was opened on the 27th January, 1917.
60. The dispensaries are classified as under :—
I. State Public. . . . . . . . .
II. State Special . . . . . . . . .
V. Private non-aided (i.e.) Native States
.
.
.
. .
Total .
8
13
158
179
61. Besides these there are now six Mission Dispensaries and one Hospital
and 8 Dispensaries of the Bombay, Baroda and Central India Railway within
the limits of Rajputana.
Structural improvements.
62. Jaipur.—The sum of R727 was spent in effecting improvements
and additions to the buildings of the Mayo
Hospital.
63. Marwar.—The new hospital preliminary plans have been made by
Mr. Wittet, Government Architect, Bombay ; and when they are approved by
DISPENSARIES IN RAJPUTANA.
7
the Durbar he will proceed to the detailed plans. The buildings will be erected
on a plot of ground between the Railway Station, Jodhpur and the City.
64. Bharatpur.—A special Eye ward is under construction at the Victoria
Hospital, Bharatpur in memory of His Majesty the late King-Emperor
Edward VII.
65. New buildings for the Sikri Dispensary are nearly complete and will
be occupied shortly.
66. Alwar.—By permission of His Highness the Maharajah of Alwar
Shah Ram Gopal of Rajgarh constructed a new ward at the Rajgarh
Dispensary to commemorate the memory of his deceased father Shah Kanahia
Lal, with accommodation for 8 male and 6 female patients, a Female Dressing
room, a small orchard and a Masonry Dispensary well at a total cost of
Rs. 5,757-13-3.
67. Kotah.—Quarters for the Assistant Surgeon, Baran, have been com-
pleted and occupied.
68. Mewar.—A proposal has been submitted to the Durbar for building a
new Dispensary at Chhoti Sadri, with in-door accommodation as the present
building is unsatisfactory.
STATEMENT B.
Attendance at Hospitals.
69. During the year under report the number of patients treated at
State Public, State Special, and Private non-aided (i.e., Native States) Dispen-
saries and Hospitals amounted to 1,862,753 against 1,645,798 in 1916, an
increase of 216,955. The year has been an unhealthy one and the people have
freely availed themselves of the benefits of Hospital and Dispensary treatment.
70. Of the total number of patients 19,343 were in-door and 1,843,410
out-door, as compared with 19,876 in-door and 1,625,922 out-door in 1916.
The number of deaths rose from 700 in 1916 to 799 in 1917, and the ratio of
mortality rose from 3.52 to 4.13 in 1917.
STATEMENTS C (i) and C (ii).
Diseases treated.
71. In Statement C (i) the number of deaths under each head of diseases
treated in the in-door department is shown; 19,343 in-patients were treated
amongst whom 799 proved fatal; against 19,876 in-patients and 700 deaths in
the previous year. The difference of 148 patients between columns 8 and 53
of Statement B and C (i) respectively is due to 148 out-door Labour cases
being included in Statement C (i).
72. 146 Normal confinements with no deaths and 155 Abnormal confine-
ments with 6 deaths were reported from various Hospitals ; against 175 with
2 deaths, and 111 with 4 deaths respectively in 1916.
73. 1,843,410 out-door patients treated in 1917 are shown in statement
C (ii) against 1,625,922 in 1916.
74. The cases treated in the Hospitals and Dispensaries under each chief
disease during the years 1915, 1916 and 1917 are as follows :—
Diseases.
Malarial Fever .
.
.
.
.
.
Diseases of the eye
.
.
. . .
Dysentery and Diarrhœa
.
.
.
.
Ulcers
.
.
.
.
.
.
.
Skin diseases
.
.
.
.
.
.
Syphilis
.
.
.
.
.
.
Injuries
.
.
.
.
.
.
.
Tubercle of the Lung .
.
.
.
.
Abscess of the Liver
. . . . .
1915.
153,148
249,316
48,263
137,1125
201,221
114,845
47,663
1,596
157
1916.
251,309
279,295
66,819
146,083
187,001
15,271
45,860
1,598
130
1917.
460,599
267,410
60,642
152,353
183,883
13,604
43,487
1,469
250
8
DISPENSARIES IN RAJPUTANA.
Scurvy.
75. 555 cases of scurvy were treated against 820 in 1916 and 966 in
1915.
Leprosy.
76. 379 Lepers received treatment as compared with 430 in 1916, and 566
in 1915. The Jaipur Residency Surgeon reports that 32 Lepers were treated
with Leproline. Some were treated with Sodium gynocardate according to Sir
Leonard Rogers' method; patients treated thus derived the same benefit as the
others from Leproline.
Plague.
77. The year from 1st April, 1917 to 31st March, 1918, was marked by
a very severe outbreak of plague throughout the Province ; and the disease
still prevails.
78. 116,168 Plague seizures and 98,192 deaths were reported in 2,101
towns and villages infected in Ajmer-Merwara District and in the Native
States of Rajputana against 1,633 cases with 1,285 deaths in 59 towns and
villages in 1916-1917.
79. The percentage of total plague deaths to population was 2.26 as shown
in Table attached, as compared with 1.39 in the previous year.
80. 90,948 Anti-plague Inoculations were done during the year under
report at the following places :—
Ajmer City
.
.
.
.
.
.
.
.
.
Ajmer District .
.
.
.
.
.
.
.
.
Jaipur City
.
.
.
.
.
.
.
.
.
Kishangarh City
.
.
.
.
.
.
.
.
Marwar State
.
.
.
.
.
.
.
.
.
Bikaner City
.
.
.
.
.
.
.
.
.
Sirohi (Abu Road)
.
.
.
.
.
.
Alwar
.
.
.
.
.
.
.
.
.
.
Tonk
.
.
.
.
.
.
.
.
.
.
Shahpura .
.
.
.
.
.
.
.
.
.
Kotah . .
.
.
.
.
.
.
.
.
.
Jhalawar .
.
.
.
.
.
.
.
.
.
Mewar
.
.
.
.
.
.
.
.
.
.
Banswara .
.
.
.
.
.
.
.
.
.
Bundi
.
.
.
.
.
.
.
.
.
.
Deoli Cantonment
.
.
.
.
.
.
.
.
Kherwara Cantonment.
.
.
.
.
.
.
.
Bharatpur
.
.
.
.
.
.
.
.
.
Dholpur .
.
.
.
.
.
.
.
.
.
Karauli
.
.
.
.
.
.
.
.
.
.
TOTAL .
3,666
279
14,028
1,017
16,790
2,945
628
4,000
1,865
885
8,000
2,968
10,508
1,684
10,579
4,018
3,270
2,909
574
335
90,948
Ajmer-Merwara.
81. In the Ajmer-Merwara District 13,213 seizures and 9,670 deaths
were reported in 271 towns and villages
against 856 attacks and 643 deaths in 15
towns and villages in 1916-1917, of these 11,281 cases with 8,194 deaths
occurred in 193 towns and villages in Ajmer District and 1,932 cases and 1,476
deaths in 78 towns and villages in Merwara District. In Ajmer city there
were 4,910 attacks and 3,330 deaths in 1917-1918, including 2 cases and 1
death in the Ajmer Central Jail, and 5 cases and 2 deaths in the Depot 44th
Merwara Infantry, and in Beawar Town 1,025 and 642 respectively from the
2nd April, 1917, the date on which indigenous plague appeared :—
(1) Pamphlets in English, Urdu and Hindi regarding plague prevention,
etc. were freely distributed.
12
PLAGUE IN RAJPUTANA.
118. In the infected towns and villages of the Native States, evacuation,
disinfection, inoculation and segregation were carried out, Evacuation was
the most popular of the methods employed against the disease.
119. Pamphlets in English, Hindi and Urdu regarding the prevention
and spread of plague were freely distributed throughout the towns and villages.
120. In some places measures for rat destruction were adopted but the
majority of the people in Native States were against it.
121. A plague map showing the districts where outbreaks occurred, the
date of the first and last cases and the death rate per 10,000 of population is
attached.
Snake Bite.
122. Calmette's Anti-Venene is kept in stock in most of the main
dispensaries and used for the treatment of snake poisoning when opportunity
offers. No special report has been received on the subject.
STATEMENT F.
123. Shows the classes and sexes of both in-door and out-door patients
treated in the dispensaries of Ajmer-Merwara and of Native States. This
calls for no comment, as it is merely introduced for statistical purposes.
STATEMENT G.
124. During the year under report 78,692 operations were performed on
78,313 persons in Ajmer-Merwara and in Native States against 80,084
operations done on 79,783 persons in the previous year. Of these cures
amounted to 77,010, the number relieved 796, discharged otherwise 194 and
110 as compared with 78,549, 653,232 and 114 respectively in 1916; while 203
remained under treatment at the end of the year.
125. Of the operations performed, 1,907 were extractions of the lens for
Cataract, of which 1,684 or 88.30 per cent. were reported successful; 64
Lithotomies, 224 Litholapaxies, and 202 Amputations against 2,464 lens
extractions, 61 Lithotomies, 211 Litholapaxies, and 226 Amputations in 1916.
126. 604 Abdominal operations were done, of which 28 proved fatal, as
compared with 548 operations with 34 deaths in the previous year. Of these
464 were Paracentesis of Abdomen with 13 deaths, 13 Abscess of the Liver
with no death, and 25 Laparotomies with 4 deaths.
127. 1,348 Operations were performed at the Victoria Hospital, Ajmer
with 3 deaths against 1,878 operations with 8 deaths, a decrease of 530 chiefly
due to Plague and Malaria which existed in severely epidemic form throughout
the District. Of these 68 were Extraction of the lens for Cataract, 4
Lithotomies, 14 Litholapaxies, 3 Amputations, 3 Ovariotomies, 19 Radical
cure of Hernia and 4 Laparotomies, as compared with 105 extractions of the
lens for Cataract, 9 Lithotomies, 21 Litholapaxies, 6 Amputations, 8 Ovario-
tomies, 8 Radical cure of Hernia and 1 Laparotomy in 1916 as shown in the
Table below:—
Operations.
Excision of Cysts
.
.
.
.
.
.
.
.
Amputations .
.
.
.
.
.
.
.
.
Artificial pupils
.
.
.
.
.
.
.
.
Iridectomies .
.
.
.
.
.
.
.
.
Extraction of lens
.
.
.
.
.
.
.
.
Opening Mastoid Antrum
.
.
.
.
.
.
Laparotomy
.
.
.
.
.
.
.
.
.
Carried over .
1916.
22
6
25
12
105
7
1
178
1917.
11
3
7
12
68
8
4
113
OPERATIONS IN RAJPUTANA.
13
Operations.
Brought forward .
Colotomy
.
.
.
.
.
.
.
.
.
Excision of Appendix
.
.
.
.
.
.
.
Radical cure of Hernia
.
.
.
.
.
.
.
Lithotomies
.
.
.
.
.
.
.
.
.
Litholapaxies .
.
.
.
.
.
.
.
.
Prostatectomy .
.
.
.
.
.
.
.
.
Ovariotomy
.
.
.
.
.
.
.
.
.
Hysterectomy .
.
.
.
.
.
.
.
.
Total .
1916.
178
3
1
8
9
21
3
8
3
234
1917.
113
...
2
19
4
14
...
3
...
155
128. 3,323 operations of all kinds were performed at the Mayo Hospital,
Jaipur, with 13 deaths as compared with 2,670 operations with 20 deaths in
1916. Of these, 457 were extractions of the lens for Cataract, 1 Lithotomy,
65 Litholapaxies and 22 Amputations; all of which were done by Rai Bahadur
Assistant Surgeon Daljang Singh Khanka.
129. 7,823 surgical operations were performed in Bharatpur State institu-
tions against 7,675 in 1916. Of these, 380 were extractions of the lens for
Cataract, 7 Lithotomies, 8 Litholapaxies and 32 Amputations as compared
with 624, 8, 7 and 21, respectively in the previous year. Of the Cataract
operations mentioned above, 5 were performed by Sub-Assistant Surgeon
I. A. Solomon, Bayana and the rest by the Assistant Surgeon, Victoria Hospital,
Bharatpur.
130. 2,138 operations were performed in the Dholpur State institutions
against 2,028 in 1916. Of these, 372 lenses were extracted for Cataract.
131. 2,436 operations were performed at the Alexandra Hospital, Alwar
against 2,118 in 1916. Of these, 112 were extractions of the lens for Cataract,
31 Lithotomies and 18 Litholapaxies.
132. The Residency Surgeon, Jaipur states that the treatment of Tuber-
cular diseases of the following varieties by means of Tuberculin Bacillary
Emulsion (Koch) was continued with satisfactory results :—
Tubercular diseases of bones and joints
.
.
.
.
.
Ditto of glands . . . . . . .
Ditto
of lungs .
.
.
.
.
.
.
Ditto of abscess . . . . . . .
Ditto
of ulcer
.
.
.
.
.
.
.
Total .
18
34
100
5
8
165
STATEMENTS H AND J.
Financial Statements.
133. Statement H shows the income and expenditure of the Government
Dispensaries and Hospitals, and only expenditure on those in Native States.
134. The total income of Hospitals and Dispensaries in Ajmer-Merwara
was R25,538 against R25,050 in 1916, this increase is due chiefly to the grant
of R500 by the Bombay, Baroda and Central India Railway Company and the
recovery of the arrears of contribution from the Beawar Municipality. The
invested capital of the Dispensaries in this division remained the same as in
1916. The sum of R500 the amount of invested capital of the Deolia Dis-
pensary has been transferred to the Victoria Hospital, Aimer.
c2