INTERMITTENT fever, the prevailing disease, is commonest in July,
August, and September. The lower classes, with scanty and poor
food and much exposure to rain, suffer severely from fever. Some
years ago Bankot was so feverish that the mahalkari's office had tobe moved to Mandangad. Of late, without any apparent cause, the
climate has become more healthy.
Leprosy is commoner than elsewhere, especially in the inland parts
of the centre and north. In 1871 there were more than 1600 lepers, or one to every 636 of the population and five for every four villages. More than one-third were bad cases with mutilation of hands and feet. The proportion of male to female sufferers was four to one. Their ages, especially among the females, were advanced, and there were few leper children. Musalman lepers are very few, while among Hindus, the chief classes are Maratha and Kunbi cultivators, and next to them Mhars. Heredity is more marked than usual. [Surgeon H, V. Carter, M.D., Trans. Med. and Phys. Soc Bom. XI, 162-167.]
Cholera rages every year more or less severely in some part of
the district. The epidemics of 1820 and 1837 are mentioned as specially widespread and fatal. In 1869, 1871 and 1872 there were serious outbreaks at Vengurla. Except in 1877, the town of Ratnagiri has enjoyed a remarkable freedom from cholera.
Small-pox is very common in the town of Ratnagiri. Both in
1871 and 1872, the disease was of a very deadly type.
During the rainy season dysentery is very fatal. In 1873, there
were 257 deaths in Vengurla and Malvan.
Especially in the south of the district the people suffer much from bilious attacks which often take the form of intermittent fever and cholera biliosa. Disease of the nervous system, showing itself in mental alienation and paralytic affections, is a not uncommon result of the habitual use of naVcotic drugs, kuchli, Strychnos nux vomica, thorn-apple, dhotra, Datura hummatu, and a coarse kind of spirit called pheni distilled from toddy. Itch and other forms of skin disease are common along the coast. Scurvy, sometimes observed among prisoners, presents symptoms somewhat different from those of the sea scurvy.
Worms is a very general disease. They are passed in large
numbers both by young and grown-up persons.
The district is ill supplied with hospitals and dispensaries. There are only three civil hospitals at Ratnagiri, Dapoli, and Vengurla camp. In 1878, there were in all 9655 treated in the three hospitals, 283 of them in-door and 9372 out-door patients. The total amount spent in checking disease in the same year was £2510-1-4 (Rs. 25,100-10-8). The following working details are taken from the 1878 hospital reports.
The Ratnagiri civil hospital, originally built and used as a
criminal jail, is some distance from the town. It is well built
and airy and has room for forty patients. It has one large ward
for men, and smaller wards for women and for insanes. Additional accommodation is much needed. There are no quarters for servants,
and those for the hospital assistant and medical pupil are badly placed.
In 1878, 166 in-patients and 2828 out-patients were treated, most
of them for malarious fevers and bowel affections. There were seven
deaths chiefly from injuries. Seven major and fifty-seven minor
surgical operations were performed. The total cost of the institution
ammounted to £1090-4-9 (Rs. 10,902-6-0) or 7s. 2⅝ d. (Rs. 3-9-9) a
The Dapoli civil hospital, established in 1860, has a building of
its own, formerly the storeroom for the arms and ammunition of the Veteran Battalion. Well situated in the centre of the camp, it has but one ward with eight beds and no separate compartment for women. In 1878, the chief diseases were malarious fevers, respiratory affections, diarrhoea, and skin diseases. The total treated in the year were twenty-eight in-door and 2715 out-door patients. There were sixty-five successful vaccinations. The cost of the hospital was £844-11-5⅝ (Rs. 8445-11-9) or 6s. 2d. (Rs. 3-1-4) a patient.
The Vengurla civil hospital has a building of its own, a massive
structure supposed to have been raised by the Portuguese or Dutch. It has two wards with ton cots and two end rooms, one used as an office and store, the other as an operating room. The roof is tiled and the floor stone-paved. There is a good plinth and sufficient ventilation. Except during the last two years, 1877 and 1878, the attendance has been very meagre with generally not more than two in-patients and twenty-nine out-patients. During the last two years, from the prevalence of malarious fevers, attendance has considerably increased. In 1878, the chief diseases were malarious fevers, rheumatism, respiratory affections, and skin diseases. The total treated were eighty-nine in-patients and 3829 out-patients. Nine deaths occurred among the in-patients due to bowel diseases and injuries. There were sixty-eight successful vaccinations. The cost of the hospital was £575 5s. 1¼d. (Rs. 5752-8-10) or 2s.
11⅛d. (Re. 1-7-5) a patient.
The Ratnagiri leper hospital, established in 1875, has buildings costing about £2700 (Rs. 27,000) and with room for 100 patients. They stand about two miles from the station on an isolated part of the rocky eastern table-land. Most, of the funds were provided by the liberality of Mr. Dinsha Manikji Petit, a Parsi gentleman of
Bombay, whose name the institution bears. The balance was met from the district local funds supplemented by minor popular contributions. The hospital is maintained by a yearly grant of £250 (Rs. 2500) from Government and £200 (Rs. 2000) from the district local funds. There is a resident hospital assistant and the civil surgeon of the station, in whose charge the institution is, visits it three times a week. The general affairs of the hospital are managed by a local committee of which the Collector is ex-officio president. The number of patients varies considerably, being always greater during the rainy months (June to October).
Native medical practitioners, Vaidyas, whose number is on the decrease, use a variety of seeds, roots, barks, and leaves in the cure
of disease. They are somewhat partial to counter irritants, using
for this purpose especially the acrid juice found under the cuticle
of the cashewnut. They frequently have recourse to the actual
cautery scoring with no tender hand the integuments both of man
and beast. The acrid juice of cashew, mixed with molasses, gul, is
also prescribed internally for worms. Hemp seed, opium, and green
tobacco are generally administered in cases of dysentery. Chunanl
plaster is considered a specific for headaches of all sorts, and chillies
and nux vomica for cholera. Senna leaves and castor oil are
used as purgatives, while water and salt is their only emetic.
Small doses of opium are frequently administered to enable children
to sleep quietly at night. They admit the efficacy of quinine and
some other English medicines, and recommend vaccination. [Bom. Med. and Phys. Soc. Trams. IV. 77.]
The cattle foot disease is prevalent in the rainy season in most
villages of the Ratnagiri, Dapoli, Rajapur, and Khed sub-divisions. The animal suffers for two or three days from fever. Saliva flows from its swollen mouth and all appetite is lost. When the fever abates the hoofs swell and then burst out and gangrene. This disease in some cases causes death. In another disease called peya, observed in the hot season, the stomach of the animal swells; and in a third, a rarer and contagious sickness called bhovya, the animal turns round and round, refuses to chew the cud, grows weak, and dies within about a week. Some of these diseases and colic and rheumatic affections of the joints, to which cattle are very liable in the rains, are treated by branding with a hot iron. Dysentery among cattle, attributed to an ulcerated condition of the intestines, is said to prevail during epidemics of small-pox. The sharp, bitter, and somewhat astringent seed-pods of the wild balsam, terda, Impatiens balsamina, are often, used in this complaint. In the rains cattle are sometimes stricken with paralysis, kakshavayu, of the legs, and sheep with rot in the hoof. Domestic poultry are, especially in the hot season, at times infested by small fleas, so worrving and hard to get rid of, that fowls often scratch themselves to death. The best remedy is an ointment of oil and turmeric. Turkeys, when young, are subject to a pustular disease about the head and wattles. This and sudden apoplexy are often fatal.
In 1879-80, the work of vaccination was, under the supervision
of the Deputy Sanitary Commissioner, Konkan Division, carried on
by thirteen vaccinators distributed over the district, with yearly
salaries varying from £16 16s. (Rs. 168) to £28 16s. (Rs. 288).
The total number of operations was 22,911, besides 3289 re-vaccinations, compared with 22,231 primary vaccinations in 1869-70.
The following abstract shows the sex, religion, and age of the persons vaccinated:
Above one year.
The total cost of the operations in 1879-80 was £758 4s. (Rs. 7582) of about 8d. (5⅓as.) for each successful case. The entire charge was made up of the following items: Supervision' and inspection £364 2s. (Rs. 3641), establishment £375 12s. (Rs. 3756), and contingencies £18 10s. (Rs. 185). Of these the supervising and inspecting charges were wholly met from Government provincial funds, whilst the other charges were borne by the local funds of the different sub-divisions.
The total number of deaths in the five years ending 1879, as
shown in the Sanitary Commissioner's Annual Reports, was 97,552
or an average yearly mortality of 19,511 or, according to the 1872 census, 1.9 per cent of the total population. Of the average number of deaths, 10,642 or 54.45 per cent were returned as due to fevers; [In 1879, there were 19,955 deaths due to fever as compared with 10,667 is the previous year.] 1796 or 919 per cent to bowel complaints; 963 or 493 per cent to cholera; 534 or 2.73 per cent to small-pox; and 5176 or 26.49 per cent to miscellaneous diseases. Deaths from violence or accidents averaged 432 or 2.21 per cent of the average mortality of the district. During the same period, the number of births was returned at 76,047 souls, 39,552 of them males and 36,495 females, or an average yearly birth-rate of 15,209 souls or, according to the 1872 census, 14 per cent of the total population of the district. [The figures are incorrect; for while the population of the district, is increasing, the returns show a birth-rate less by 4334 than the death-rate. The explanation probably is that nearly all the deaths and not nearly all the births are recorded.]