The Gazetteers Department

The growth of medical and public health services and facilities is a recent phenomenon as for a pretty long time the incidence of diseases was ascribed to evil influences rather than considering them as physical disorder. The resultant cure was very clearly based upon propitiating the evil spirit rather than providing medical assistance in whatever way it was available.

The ayurvedic system of medicine which was considered as an integral part of Indian culture and civilization was predominant through centuries. However, the system of medicine known as the unani system of medicine existing in Arabia and neighbouring countries made its inroads with the advent of the Muslim rule in the Indian sub-continent.

Both the ayurvedic as also the unani systems of medicine were akin to each other and were based upon the medicinal properties of rare herbs and plants. The skill of the vaidyas was an admixture of an inherited knowledge from their forefathers and their practical experience. The fact that ayurveda incorporated the knowledge of chemistry is clearly borne out by the mention of different rasas and bhasmas in early Sanskrit treatises such as Ashtangahridaya, Sushruta, Charak, etc. Though the vaidyas as also the hakims had limited knowledge of anatomy, their diagnosis was mainly based upon reading the pulse (nadi pariksha) and other symptoms of the diseases.

The vaidus also provided medical facilities to a certain extent. Though their diagnosis was based only upon the symptoms, they possessed a good knowledge of rare herbs with rich mineral and medicinal properties. They moved from place to place and used to treat domestic animals in the absence of specialised veterinary practitioners.

In the absence of specialised knowledge of gynaecology and obstetrics, the practical experience of suinis and of elderly ladies in a family proved of immense help. They also used to treat minor ailments with small stocks of medicines that they always maintained and which were known as the medicines from ajibaicha batwa.

The change in the outlook of the people from attributing the disease to an outside evil influence to considering the same as a physical disorder evolved gradually with the spread of Western education. The health consciousness among the people also increased with the strides made in the field of scientific research.

The following account reproduced from the old Akola District Gazetteer published in 1910 gives information about the medical and public health services prevailing then.

Medical statistics: "Medical statistics for the area forming the present District are available only from 1905 to 1908. Difficulties in diagnosis and imperfections in recording occur here as elsewhere, but according to the reports the average annual number of deaths is 37,000 (49 per 1,000); of which dysentery and diarrhoea caused 8,500, fevers, 6,500, plague 3,200, respiratory diseases, 3,100, cholera 1,400, injuries 300, smallpox 300, measles and chiekenpox 200, and miscellaneous causes 13,700. The total number of deaths varied between 26,000 (35 per 1,000) and 44,000 (58 per 1,000). Nearly all the deaths from cholera occurred in the single year 1906 (5,000); plague rose to 6,200 in 1907 and fell to 500 in 1908; other causes vary to a less extent."

Diseases: "The heat is considerable in the cold weather and intense in the hot weather, but the rainfall is not heavy, a cool breeze generally prevails at night, and the climate is not on the whole unhealthy. The rate of mortality in the "salt tract" appears to be slightly higher than that elsewhere; this is an area extending for some miles on each side of the Purna river in the north-east of the District. One theory is that this region was once a great salt lake, and that when its waters found an outlet and the Purna drained the valley the saline deposits remained in the soil. However, this may be, the water is so impregnated with soda salts as to be almost undrinkable. Sweet wells are in fact often found close beside brackish ones, but there is no means of knowing-whether good or bad water will be found. The higher death rate in this tract seems to be chiefly due to bowel diseases, but the birth rate is as high as elsewhere in Berar and the neighbourhood is not seriously unhealthy."

In Akola District, as over the greater part of India, the months of July, August, and September form the most unhealthy period; malaria and bowel diseases are most prevalent then. Infant mortality is high and is chiefly due to these causes. The malaria is chiefly of the "benign" and "malignant" tertian types. It is naturally most common towards the end of the rains and in the beginning of the cold weather, because the anopheles mosquitoes have at that time the best chance of breeding in the pools. The District, however, sutlers much less than some others in the Provinces from malaria, and the parasite is curiously hard to find. Enlarged spleen in children, which, is common in malarious regions, is comparatively rare here and the endemic, index is low. Mortality from bowel diseases is high throughout Berar and is naturally highest in the rains. The District has always been subject to violent outbreaks of cholera; these occur at short intervals and cause enormous mortality; thus in 1906 the death from this cause alone amounted to close upon 5000, a ratio of 6� per mille. The outbreaks seem generally to be due to importation, especially from such gatherings as the Pandharpur fair, but there can be no doubt that cholera is endemic throughout Berar. For some unascertained reason which must be sought in the life history of the organism the disease lies dormant or shows only a little activity, and then for some equally unknown reason it breaks out again. The town of Akola has of late years been given a piped water supply brought from Kapsi, 10 miles away and this has certainly provided an irresistible weapon against severe epidemic outbreaks in the town itself. As this water supply is improved it may be hoped that Akola town will be practically freed from cholera. Smallpox has always been prevalent, but its ravages have decreased considerably of late years; vaccination is efficiently carried out, 3� per cent of the population being protected every year. Neither cataract nor stone is very common."

Plague: "Plague first appeared in 1902 and has recurred every year. The chief outbreak in Akola town was in 1905, when the deaths amounted to 1,468. In 1907 the total number of deaths in the District from plague was 6,160, or 8 per mille. The people are very slow to have recourse to inoculation, only 1,700 being done in the 7 years from 1902 to 1908; villages are evacuated fairly promptly when the discovery of dead rats shows that plague is coming, but villagers say, that the idea of inoculation is still too novel for them. On the other hand a Teli in the north of Berar who a few years ago professed without any qualifications to protect from plague soon had a large following; but the disease broke out among the crowds who attended him, and he ran away. During January and February 1909 about 1,600 people were inoculated in Akola town, and this may possibly mark a turning-point in the public attitude, but much of the enthusiasm was certainly due to the fact that Re. 1 was being given to each patient; when the payment was reduced to As. 8 about 500 people who were waiting in the hospital compound turned without a word and walked away; one hears of people-trying to squeeze the serum out of their arms when they have received their reward. The greater part of the population is it present (February 1909) living outside the town and coming in daily for business; well-to-do families have put up small bungalows of tin, or with tiled roofs; 195 deaths from plague have occurred within the two months, but only one case, and that not fatal, has happened among those inoculated. An energetic campaign against rats has been carried on since 1907, but it is impossible to give accurate statistics; for instance, for 100 poisoned baits laid down it is very rare for more than 3 dead rats to be found, but one municipality reported that nearly 6,000 rats were collected for 7,000 baits; it was afterwards explained that 6,000 baits had disappeared and were considered equivalent to so many dead rats found. People of the middle class, the large number who are not very poor but are not highly educated, are far less willing in Akola District than in other Provinces to accept skilled medical advice; the very poor are generally less reluctant, but a beggar who has been blind from his infancy will sometimes not permit a simple operation which would probably restore his sight."

Medical Practices : "Enquiries made in several villages about infant mortality showed that it is quite common for 20 per cent of children to die in the first year, while over 50 per cent sometimes die. When a child is born it is not put to the breast for two or three days, but is fed on sulache pani, sugared water, sahad, honey, and the like, and a few drops of castor oil are given it; the mother does not take any food for a day or two. A child is generally suckled for a year and often, if there is no other claimant, for two or three years, and sometimes longer still. When it is weaned it is given cow's or goat's milk by well-to-do people, but the bulk of the people give it no further milk; it is fed on jawari bread, alone or mixed with tur flour, and on rice, sugar, sweetmeats, and so on. Medical knowledge is very scanty. People with broken limbs usually go now to a hospital, but they used to call in a Dhangar who might have gained expedience in binding up the legs of his flocks and herds. It is said that he would apply bamboo splints for about a week, and then remove them permanently, having the leg rubbed with tilli or castor oil. The process was apt to be unsatisfactory but the principle is akin to that of very recent surgery. A mortified finger may be plunged into boiling oil; cobwebs are used to stop excessive bleeding and chuna, lime, and leaves are applied to cure a wound; but magic is largely relied on to give the motive power of healing-a string with a certain number of knots being tied, for instance, round the neck, and mantras recited meanwhile, to prevent tetanus. Sometimes people's eyesight is ruined by the application of absurd remedies. A kind of fever called kapsi mata, cotton disease, is mentioned in all parts of the District; something that looks like cotton fluff is said to collect at night under the patient's bed; the disease generally occurs in the cold weather, but its real nature is not clear. Native doctors, vaidyas, of various degrees of pretension are found in the larger villages; they are generally very ignorant and sometimes deliberate impostors; they not infrequently secure payment in advance. Their medicines are usually pills, which are dissolved in honey or the juice of a lime, an onion, or wet ginger; powders are taken in cow's milk or hot water; and infusions are occasionally brought. Vaidyas like to recite shlok, texts, from various sources and make a great point of feeling the pulse, though without using a watch. Men who have been compounders in a Government hospital sometimes make great profit out of their fallacious knowledge." [Central Provinces and Berar District Gazetteers, Akola District, 1910. pp. 69-74.]

At the time of the Census of 1911 Akola was hit by plague. In 1910 again plague was prevalent in the district. In 1918 were recorded 94,625 deaths due to Influenza.

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