STATISTICS OF THE JAIL POPULATION OF BENGAL FROM 1859 TO 1876.
[Section III.
196
"Twelve cases of acute dysentery (typhoid) remained from last week, and ten were
admitted into hospital during this week: of the former five
have since proved fatal. Four of those were men admitted
during the present epidemic, and one was a patient attacked in hospital.
" Four cases of dysentery have been attacked with symptoms of acute hepatitis during the
week. Three of these cases suffered from the epidemic form
of the disease, and were convalescent when attacked. The
patients who do get over the acute symptoms are so reduced that their convalescence is very
slow.
" Two men have died during the week returned under the head of Hepatitis. In both cases
a large abscess was found in the left lobe of the liver. The type
of the epidemic has undergone a marked change during last
week. The alvine discharges containing more feculent matter and less blood. The great
prostration of strength and insomnolency formerly dwelt on, is now seldom observed, and all
the cases at present under treatment are doing well. "
The objection which naturally suggests itself is not altogether inconsistent with the possi
-
bility of typhus poisoning in this instance. Change of type might
be anticipated with manifestation at an abnormal season; just
as the pneumonic type predominates in the spring in Northern.
India, so in the season normal for the development of bowel complaints, we should not be
surprised to see the typhus—here called remittent fever—attended with dysentery as the leading
feature, and the one which would tend destroy the identity of other symptoms. It is right
to mention that several of our worst outbreaks of contagious fever have shown themselves as
early as August in the Punjab; for example, the Umballa outbreak of 1861. And again, as I
have had occasion to show, a typhus poison introduced in the spring, which is, to become the
parent of a great outbreak six months later, smoulders, but does not die; its manifestation is
kept back, but the effects are shown although in an
a b o r t e d f o r m .
The case of the jail of this station, Amritsar, which suffered in 1864, affords a perfect
illustration of the introduction of the poison, of its repression
and of its coming forward in power with the typhus season in
October. And what is also most worthy of note is, that this
poison was the offspring of a pure relapsing typhus, the same so thoroughly and well described by
Dr.Gray. It was imported direct from the Lahore Jail, and it put on a distinctly dysenteric
type, approximating in its character to the disease of the detachment of the 19th Regiment in
1863.
Dr. Atcheson, Civil Surgeon of Amritsar, writes:
" As early as May last, I protested against the system of transfers, and brought it to the
notice of the authorities of Amritsar, warning them of the consequences which the sequel too
fatally exhibits. As early as June last, I noted the peculiar character of the fever admissions,
and imparted my suspicions as to their nature to the inspector General of Prisons. But it was
not until October that the fever became jail typhus of a virulent and infectious character.
"The prisoner attacked had a listless, haggard look, wan eye, and great and rapid loss
of muscular power; a thick-coated tongue, dry harsh skin, which soon put on a yellowish tinge,
and this with a deeply-coloured conjunctiva showed that the liver and intestines were attacked.
Dysenteric purging, often of pure blood, followed, and the patient rapidly sank without an
attempt at rallying.
"The post-mortem appearances were sloughing of the intestines, particularly the
c a p u t c a c u m
; i n m a n y c a s e s t h e w h o l e l a r g e i n t e s t i n e w a s n v o l v e d w i t h d e e p u l c e r s , v e r y o f t e n
with perforation and peritonitis."
Some of the worst dysenteric outbreaks of former times in our European regiments
may, I think, be traced to unsuspected poisoning by typhus. The following I take to be such
a case. It must be kept in mind, that at the time of its occur
-
rence, 1852-53, the relapsing fever was epidemic over Northern
India, and typhus was prevailing in Rohilcund. In the same
year, which was not a malarious year, the Lahore jail lost 158 prisoners from fever, and 44
more died before the outbreak terminated in the spring of 1853. From bowel complaints,
probably sequelæ, 161 died. Thanesur jail lost 61 prisoners from fever and dysentery; Delhi,
54; Goorgaon 31 and Sirsa. a very healthy jail, 20 prisoners from fever.
Her Majesty's 96th Regiment was the regiment which was stationed at Meean Meer in
these years, and the following extracts are taken from the annual
reports of 1852 and 1853:—
"After attacks of remittent fever the men remained jaundiced; but still it was thought
that recovery would be accelerated by removing them from a hospital crowded to excess. Many
in this state contracted dysentery. Out of 344 cases treated 40 have had a fatal termination;
but it is to be borne in remembrance, that in these cases the healthy European soldier was not
the subiect of treatment. but the weakly and debilitated convalescent from fever.
"The remittent and continued type of fever has been of a low typhoid character, deserving
the name of low typhus. The tongue is black and dry; the skin
is at times hot, and the face bathed with cold perspiration;
the powers of life are depressed; the skin is sallow or jaundiced;
there is bleeding at the nose and the stools are melanotic.*
* Petechial patches on the skin are also noticed.
Week ending 21st August.
Week ending 28th August.
Week ending 4th September.
The possible significance of con
-tagious dysentery.
Dysenteric typhus of the Amritsar
Jail, 1864.
Contagious dysentery and fever in
Her Majesty's 96th Regiment at
Lahore, in 1852 and 1853.
Her Majesty's 96th Regiment,
Meean Meer, 1852.
Her Majesty's 96th Regiment,
Meean Meer, 1853.