CLIMATE.

OWING to the elevation of the district, the trap formation of the surrounding country, the absence of alluvial deposits, and the general prevalence of westerly sea breezes and good water, the Poona climate is dry and invigorating and suits European constitutions better than that of most other parts of India. The air is lighter, the cold more bracing, and the heat less oppressive. There are several hill sanitariums, Sinhgad, Purandhar, Khandala, and Lonavla. Poona is the seat of the Government during the rainy season and is the resort of many rich Bombay families, and was once intended to be made  the permanent  seat of the  Bombay Government and of the Viceregal court.  [Deccan Scenes, 10. The Earl of Elgin intended to come round to Poona for the wet season of 1865. 400 acres of ground were taken and a palace was to be built for the Viceroy's residence. The lamented death of the Earl, however, put a stop to these arrangements and the next Viceroy did not concur in his predecessor's views.] Poona may be said to be healthy all the year round, but if one time is more unhealthy than another it is the period between June and November. The languor, which in almost every season of the year is found in most parts of India, is hardly experienced in Poona even in the hot weather.

DISEASES.

The prevailing diseases, which are chiefly of the endemic class, are fever, ague, and diseases of the liver and bowels, and violent colds and catarrhs. The thermometer sometimes varies from twenty to thirty degrees in the course of the day and night, and at the breaking up of the rains there is a succession of cool breezes and hot sunshine which cannot fail to be injurious to those who are obliged to endure the full force and rapidity of the changes. It is at this period that all those complaints symptomatic of a deranged state of the liver are most prevalent. During October and November, owing to the cessation of the rainy season and the elevated temperature, remittent and intermittent fevers with viscerial diseases prevail and are the cause of greater mortality than any other disease. Fevers of the ephemeral and intermittent classes are more prevalent than those of the remittent type. Simple continued and typhoid fevers are very rare. Dysentery and all bowel complaints are prevalent at the commencement and during the rainy season. Cholera as epidemic is rare though sporadic cases occur annually. During the hot season small-pox, chicken-pox, and measles prevail among the native population and eruptive and other forms of fever among Europeans.

HOSPITALS.

1882.

Besides the Sassoon General Hospital, the Roman Catholic Orphanage, and the Charitable Infirmary and Leper Hospital at Poona, the district had in 1882 one endowed and nine grant-in-aid dispensaries. Of 74,100 patients treated 71,507 were out-patients and 2593 in-patients. The total cost was £4744 (Rs. 47,440). The following details are taken from the 1882 report:

Sassoon General Hospital.

The Sassoon General Hospital has a building of its own. The commonest diseases treated were malarious fevers, lung diseases, syphilis, bowel complaints, and poisons and injuries. Cholera appeared sporadically from May till October and eleven cases were reported, all of which proved fatal. Small-pox broke out in an epidemic form in February and 126 deaths occurred from this disease alone. There were fifty-one major operations performed, all important ones, including seven amputations and fourteen lithotomies; two were discharged cured, fifteen were relieved, and four died. The diseases which principally caused the mortality were malarious fevers, lung and bowel complaints, cholera, syphilis, and poisons and injuries. 12,542 out-patients and 1933 in-patients were treated at a cost of £3289 (Rs. 32,890).

Roman Catholic Orphanage.

The Roman Catholic Orphanage has a building of its own. The general health of the children was fairly good. With the exception of a slight outbreak of chicken-pox in March and one case of small-pox in December, no epidemic occurred. The commonest diseases were bronchial catarrh, ague, colic, diarrhoea, and dysentery. The total number of patients was 530 and the cost was £139 (Rs. 1390).

DISPENSARIES.

Sasvad.

The Sasvad dispensary has no building of its own. The most prevailing diseases were malarious fevers, conjunctivitis, respiratory affections, bowel complaints, and skin diseases. There was no epidemic. 243 children were vaccinated. 5287 out-patients and fourteen in-patients were treated at a cost of £132 (Rs. 1320).

Jejuri.

The Jejuri dispensary was opened in 1872. The prevailing diseases were malarious fevers, ophthalmia, diseases of the stomach and bowels, respiratory affections, and skin diseases. Cholera appeared in the month of April, and out of ten persons attacked four died. Eighty-seven children were successfully vaccinated. 4170 out-door and five in-door patients were treated at a cost of £99 (Rs. 990).

Baramati.

The Baramati dispensary was established in 1873. The prevailing diseases were malarious fevers, ophthalmia, bowel complaints, intestinal worms, and skin diseases. Cholera appeared towards the end of the year and there were thirty-two cases with seven deaths. 161 primary vaccinations were successfully performed. 3103 outpatients and ten in-patients were treated at a cost of £99 (Rs.990).

Indapur.

The Indapur dispensary was opened in 1870. The commonest diseases treated were malarious fevers, ophthalmia, ulcers, and skin diseases. No epidemic occurred in the town, but cholera appeared in the surrounding villages. 157 children were successfully vaccinated. 4419 out-patients and twenty-three in-patients were treated at a cost of £129 (Rs. 1290).

Junnar.

The Junnar dispensary was established in 1869. It has a building of its own in good repair. Malarious fevers, ophthalmia, worms, and skin diseases were the commonest complaints. Cholera, made its appearance in the district but no cases occurred in the town. There were 150 vaccinations. 7475 out-patients were treated at a cost of £78 (Rs. 780).

Khed.

The Khed dispensary was founded in the year 1876. The commonest diseases were malarious fevers, eye affections, skin diseases, and worms. There was no epidemic. 5358 out-patients and three in-patients were treated at a cost of £72 (Rs. 720).

Talegaon Dabhade.

The Talegaon Dabhade dispensary was opened in 1876. Ophthalmia, malarious fevers, skin diseases, ulcers, and worms were the commonest diseases. Two cases of small-pox were observed, but there was no cholera. Seventy-eight children were successfully vaccinated. 6083 out-patients and thirteen in-patients were treated at a cost of £101 (Rs.1010).

Talegaon Dhamdhere.

The Talegaon Dhamdhere dispensary was established in 1876. It is held in a hired building. Skin diseases, ophthalmia, malarious fevers, and bowel complaints including intestinal worms were the prevailing diseases. There was no epidemic. Primary vaccination was successfully performed in 188 cases. 4758 outpatients and four in-patients were treated at a cost of £51 (Rs. 510).

Alandi.

The Alandi dispensary was established in 1882. It is held in a dharmshala or rest-house, which is however totally unsuited and in bad repair. The principal diseases treated were malarious fevers and respiratory and bowel affections. There was no epidemic. 1677 out-patients were treated at a cost of £77 (Rs. 770).

Khan Bahadur Pestonji Sorabji.

The Khan Bahadur Pestonji Sorabji endowed dispensary at Poona was opened in 1851. It has a building of its own in good repair. The prevailing diseases were malarious fevers and diseases of the stomach, eyes, chest, and skin. Small-pox and measles prevailed in the city and cantonment. 16,635 out-patients and fifty-eight in-patients were treated at a cost of £478 (Rs. 4780).

INFIRM PEOPLE.

According to the 1881 census, 4164 persons (males 2406, females 1758) or 0.46 per cent of the population were infirm. Of the total number, 3991 (males 2296, females 1695) were Hindus, 153 (males 99, females 54) Musalmans, 13 (males 7, females 6) Christians, 5 (males 2, females 3) Parsis, and 2 (males) Jews. Of 4164 the total number of infirm persons, 257 (males 174, females 83) or 6.17 per cent were insane, 2363 (males 1143, females 1220) or 56.75 per cent were blind, 456 (males 271, females 185) or 10.95 per cent were deaf-mutes, and 1088 (males 818, females 270) or 2613 per cent were lepers. The details are:

Poona Infirm People, 1881.

VACCINATION.

In 1883-84, under the supervision of the deputy sanitary commissioner the work of vaccination was carried on by seventeen vaccinators with yearly salaries varying from £16 16s. (Rs. 168) to £28 16s. (Rs. 288). Of these operators fourteen were distributed over the rural parts of the district, two were employed in Poona city, and one in the Poona and Kirkee cantonments. Besides the vaccinators the medical officers in charge of the nine grant-in-aid dispensaries carried on vaccine operations. In 1883-84 the total number of persons vaccinated was 25,746 exclusive of 780 revaccinated, compared with 13,601 in 1869-70. The following statement shows the sex, religion, and age of the persons primarily vaccinated:

Poona Vaccination Details, 1869-70 and 1883-84.

In 1883-84, the total cost of these operations, exclusive of those performed in the dispensaries, was £870 (Rs. 8700) or about 8⁵/8. (5¾ as.) for each successful case. The charges included the following items: supervision and inspection £309 12s. (Rs. 3096), establishment £502 10s. (Rs. 5025), and contingencies £57 18s. (Rs. £79). Of these the supervising and inspecting charges were met from Government provincial funds, while £413 2s. (Rs.4131) were borne by the local funds of the different sub-divisions, £81 18.s (Rs. 819) by the Poona municipality for the services of the two vaccinators in the city, and £65 8s. (Rs. 654; by the committee of the Poona and Kirkee cantonments for the services of the one vaccinator in the two cantonments.

NATIVE PHYSICIANS.

[Rav Saheb Vishram Ramji Ghole, Assistant Surgeon, Poona.] The native physicians of Poona may be divided into two classes. The first class includes those who have studied the native medical sciences from the Sanskrit works on the subject. The second class includes all quacks who pretend to medical skill which they do not possess. The persons of both classes are indiscriminately called Vaidyas. The scientific practitioners hold a good position in society, are much respected, and all honor due to great learning is paid to them. Their advice is much sought after and valued and they derive a good income. Those holding the best position, on an average, realize about £20 (Rs. 200) a month. The medicines they use are generally prepared by themselves, with the exception of decoctions of herbs and other easily made concoctions, which are left to the patients or their friends to prepare, the Vaidyas giving the necessary directions. The system of remuneration is either by a small fee for each visit, a fixed annuity, or a bargain is struck for the cure of a certain disease, the moiety being paid down and the balance remaining to be paid on the recovery of the patient, and the Vaidyas supplying the medicine without extra charge. The quacks as a rule occupy an acknowledged inferior position in society, their advice is not much valued, their practice is limited, and they are generally poor. Most of them are herbalists and some aspire to the position of specialists for the cure of certain diseases only.

There is another class of persons called Vaidus who may be grouped with the quacks. These men are from Talegaon Dabhade, form a distinct race, and appear to be the aboriginal practitioners, and have an obscure history. There are about a hundred families of these men living about Ganesh Khind who come daily into Poona to sell their herbs and medicaments. They are found scattered over every part of the district during the fair weather, returning to their homes in the rainy season. Their remedies consist mostly of herbs and a few metallic compounds and reduced metals. They generally practise their art among the ignorant classes of people. The diseases which they principally pretend to treat are gonorrhoea, rheumatism, syphilis, ulcers, fevers, abscesses, impotence, and sterility. Their surgical knowledge is limited to the opening of abscesses and extracting guineaworm, in which latter complaint they display considerable skill. Their pretensions are great, and they have special remedies for every ailment.

There are some Hakims or Musalman physicians in the city. Their condition and customs are similar to those of the Vaidyas. They derive their education from Persian medical works.

The number of scientific practitioners is small and they are gradually disappearing owing to the natural neglect of native medicine. There are now (1882) twenty-four Vaidyas and three Hakims practising in the city of Poona, but of the quacks who daily parade the virtues of their nostrums in the streets there is no count, the scientific practitioners or Vaidyas are all Brahmans by caste. The larger number of the quacks are Brahmans, a few being Sonars, Marathas, and others. The Vaidus are a distinct race or caste by themselves. The native practitioners' forte lies in medicine; their surgical practice has not been studied to the same extent, as the Sanskrit treatises on that subject are very imperfect. Their doctrines are based on humoral pathology. They state there are three chief humors in the body, choler or bile, phlegm, and wind, and a disorder or vitiation of any of them constitutes a disease. The Hakims occasionally undertake surgical cases, couch cataracts, extract stone from the bladder, and attempt rhinoplastic operations. The Vaidyas and Hakims make use of reduced metals or ashes of metals, metallic compounds which are prepared by themselves, and vegetable roots, barks, seeds, and oils. Many of the Vaidyas and Hakims have commenced to use English medicines, which they disguise to deceive their patients. The position and emoluments of these practitioners in large cities, where native graduates, apothecaries, and hospital assistants practise, have lately suffered much. But even in the city of Poona some of the Vaidyas are extensively consulted and sought after even by the best educated natives.

CAT PLAGUE.

In 1883 a curious epidemic occurred among the cats at Sirur. From the 1st to the 21st of June 1883, 125 cats died. The chief symptom noticed was vomiting. Cholera was prevalent at Sirur at the time. The disease among cats had, as far as could be ascertained by the medical officer Surgeon Stewart, never appeared before at the place. On the 19th of May 1883 cholera broke out at Sirur, and about the 1st of June cats died at the rate of twelve a day. Cholera ceased on the 22nd of June and the worst part of the cat epidemic was over by the 18th of the same month, although the disease continued to prevail among the animals to a slight extent for two or three weeks afterwards. Altogether about 300 cats died during the epidemic, that is fifty per cent of the total number of cats in the town. Out of nine cats examined which died of the disease, eight gave evidence of symptoms resembling each other. The ninth cat suffered from by far the most severe type of the disease. The cat first became restless, not sitting for any length of time in any one place but shifting about. As it walked it staggered in its gait. Some of the cats cried very loudly and incessantly as if in great pain. All food and drink were refused from the commencement of the illness till death took place. In one case brought to Surgeon Stewart's knowledge a cat recovered after three days' illness. Great salivation and foaming at the mouth were invariably present. The matter vomited was usually yellow, but sometimes green, and in one case it was observed to be white. Throughout the illness there was no diarrhoea. All the people who handled the cats said that there was great heat and fever. As the disease progressed, the features of the animals became pinched and shrunken and the eyes sunk in the head. This was a marked feature of the disease. The state of the conjunctivae was noticed by one man and he said that he saw a yellow tinge. Gradually the cats either assumed a comatose or lethargic condition, or else attacks of convulsions set in; and after a time, varying from ten to thirty-six hours death occurred, the cat either dying quietly or during an attack of convulsions. No cases of cholera had occurred in the houses where the nine cats were examined, but in several instances such cases bad occurred within a few yards of the neighbourhood. The owners of two out of the nine cats said that the animals changed colour, one of them which was white becoming somewhat darker, and some of the hair of the other which was of a brindled sandy colour becoming white. [A similar plague occurred at Ahmadnagar in 1881. Here also cholera prevailed from about the beginning of July till the middle of August. During the first part of this period a great mortality occurred among the cats of the city. About 750. cats died from the first to the 25th of July 1881. The symptoms of the disease were almost the same. A day or two before the cat died it appeared inactive, took no food, and tried to find some cool place where it could rest. The throat of the animal became swollen and choked and when it died it foamed at the mouth]

In the second or severe type of the disease, a cat, which was a very strong black animal and was well when it was let out of the house at six o'clock in the morning, died within six hours. It showed signs of illness shortly after re-entering the house and vomited at least twenty times, the vomit being black like coffee grounds. A thick slime ran from the animal's month and it had two white watery stools. The eyes were so sunken that it was only with difficulty that they could be seen when open. The animal was extremely restless, moving about from place to place. It refused all food and drink, cried a little during the first hour of its illness but not afterwards, was not lame from cramps when it walked, but staggered in its gait and seemed quite stupid. It had no convulsions and died quite peaceably. The cat was said to be colder than was natural during illness, and after death it became very rapidly cold. The colour changed from black to rusty brown, and so great was the change that the owner recognised it with difficulty.

On the whole, the disease from which the animals suffered was in Surgeon Stewart's opinion a malignant epidemic disease of the most virulent type, resembling cholera in some points, but in others much more resembling what one would expect to find in cases of yellow fever, a disease in which acute atrophy of the liver forms one of the leading features. Charbonous fever without eruption is the only disease known to veterinary science closely resembling the one described above. This affection differs widely from cholera in many of its symptoms.

A very similar disease attacked some of the cattle at Sirur, principally young healthy buffaloes. Of nineteen buffaloes and five cows owned by three individuals examined by Surgeon Stewart, ten buffaloes and one cow were attacked with the disease and died. Six of the animals were attacked between the 18th and the 21st of July, three on the 23rd, the 28th, and the 29th of July, and two on the 2nd and the 7th of August 1883. All were young and healthy animals, only one being of medium age. Death occurred within fourteen to eighteen hours. The symptoms were panting, salivation, running from the nose and mouth, restlessness in some cases, and rapid death.  [Memorandum on the ' Cat-plague' at Ahmadnagar in 1881 and at Sirur in 1883.]

BIRTHS AND DEATHS.

The total number of deaths shown in the Sanitary Commissioner's yearly reports for the eighteen years ending 1883 is 321,918 or an average mortality of 17,884, that is, according to the 1881 census, of about twenty in every thousand people. Of the average number of deaths 11,297 or 63.2 per cent were returned as due to fevers, 1485 or 8.3 per cent to cholera, 1434 or 8.0 per cent to bowel complaints, 580 or 3.2 per cent to small-pox, and 2816 or 15.8 per cent to miscellaneous causes. Deaths from violence or injuries averaged 270 or 1.5 per cent of the average mortality. An examination of the death returns shows that fever which during the eighteen years ending 1883 caused an average yearly mortality of 11,297 or 63.2 per cent was below the average in the six years ending 1871 and in 1874,1879, and 1880, and was above the average in 1872,1873, in the four years ending 1878, and in the three years ending 1883. The five years ending 1870 had less than 8000 deaths from fever, the lowest total being 5545 in 1867; the two years 1866 and 1869 had between 6000 and 7000 deaths; 1870 had between 7000 and 8000 deaths. The three years ending 1873, 1875,1876, and the four years ending 1883 had between 10,000 and 15,000 deaths, and the two years ending 1878 had between 15,000 and 21,000 deaths. Of the deaths from cholera which amounted to 26,736 and averaged 1485, 5279 or 19.7 per cent happened in 1883, 4646 or 17.4 per cent happened in 1875, 3673 or 138 per cent in 1877, 3613 or 13.5 per cent in 1872, 3601 or 13.5 per cent in 1878, and 1706 or 636 per cent in 1869. Of the twelve years below the average, 1881 had 1412 deaths, 1876 had 719 deaths, 1868 had 686 deaths, 1880 had 461 deaths, and 1870 1871 and 1882 had between 200 and 300 deaths; 1879 had 100 deaths; and 1866 had 161 deaths. Of the remaining three years 1873 was free from cholera and 1867 and 1874 had less than ten deaths. Of the deaths from small-pox which amounted to 10,447 and averaged 580, 2121 or 20.3 per cent happened in 1872, 1599 or 15.3 per cent in 1868, 1312 or 125 per cent in 1877, 1225 or 11.7 per cent in 1883, and 1000 or 96 per cent in 1867. Besides these years one year 1876 with 886 deaths had a more than average mortality from small-pox. Of the years below the average 1871 and 1882 had between 560 and 500 deaths, 1869 and 1873 had between 300 and 400; 1866, 1874, and 1875 had between 100 and 200; 1870 had ninety-one deaths; 1878 and 1879 had less than fifty deaths; and the remaining two years 1880 and 1881 were free from small-pox. Deaths from bowel complaints which amounted to 25,820 and averaged 1434, varied from 706 in 1866 to 2270 in 1877. Injuries with a total mortality of 4867 and an average mortality of 270 varied from 177 in 1869 to 340 in 1878. Other causes with a total mortality of 50,695 and an average mortality of 2816 varied from 1625 in 1879 to 4808 in 1872. During the thirteen years ending 1883 for which birth returns are available, the number of births was returned at 243,078, the yearly total varying from 11. 40 in 1878 to 25,705 in 1883 and averaging 18,698, or according to the 1881 census about twenty-one in every thousand people. The details are given overleaf:

Poona Births and Deaths, 1866-1883.

[The death returns are believed to be fairly correct and the birth returns to be incomplete.]