Chapter III.] EPIDEMIC FEVERS OF INDIA AND THEIR RELATION TO JAIL MORTALITY.
199
(Delhi) at the time 100 prisoners left here for Umballa, on the 1st of April last year.*
On or about the 15th April my predecessor records a suspicious case or two, and from that
time till the end of June it prevailed. It was relapsing fever, and jaundice occurred in a
good many cases. It was in no respect typhus or typhoid. It was infectious beyond all doubt,
and deadly to a degree.' This was Dr. Penny's answer.
Dr. Newton, Civil Surgeon of Kurnaul, writes, dating 4th February 1865: "I recollect
very well the two prisoners left here to die from the gang which left Delhi for Umballa on
1 s t A p r i l l a s t . T h e y w e r e a d m i t t e d i n t o j a i l o n 1 4 t h A p r i l 1 8 6 4 , o n e w i t h d e c i d e d j a u n d i c e
and remittent fever, and the other had symptoms nearly the same. Neither had typhus
eruption.
"The Umballa jail was in fair healthy condition up to the time of the arrival of this
Delhi gang. The Delhi gang started off the remittent fever, which continued till it merged
into the relapsing fever. The epidemic broke out in the rainy season, or just at its close. The
prisoners at this time were sleeping very close together, and from the depressing effects of
the rains were physically at the minimum of ability to resist the epidemic influence. Their
air was humid and stagnant. To sum up: the Umballa jail sickness of 1864 notably increased
on the arrival of the Delhi gang, two of whose original number had died on the way of a
yellow remittent fever; about the time these two were dying, relapsing fever had commenced
at the place they came from; the first three cases of remittent fever here in 1864 were from
this Delhi gang, and the remittent fever never ceased up to its merging into relapsing fever.
From all this I come to the conclusion, that the specific disease was brought by the Delhi gang,
and the foul air of the dormitories during the sultry humid August was the propagating
medium."
In the outbreak 123 prisoners died.
The germ of an outbreak introduc-
ed months before is apt to be over-
looked in consequence of the tempo-
rary decay of the typhus poison.
The Lahore jail outbreak of 1863-64, in which 335 prisoners were lost, illustrates
typically the method of working of the zymotic agent. This
outbreak was looked on as due to the degeneration of a malari-ous remittent prevalent during the rains.† It repeats, however, the history here given of the Umballa and Amritsar jails. The
germ is introduced in March; the fever makes head in April and May; it dies to a minimum
and changes its character in June, July and August; it gains strength and shape in September,
and having infected the whole community maintains its ground until the following hot
weather:
—
March. April. May. June. July. August. Sept. Oct. Nov. Dec.
1863
Deaths
1
5
7
2
2
6
23
31
51
67
January.
February.
March.
April.
May.
1864
Deaths
46
56
29
6
2
Before the end of 1864 the fever again became manifest; and in the early months of
1865 it was again epidemic:—
January.
February.
March.
April.
May.
June.
1865
Deaths
10
12
20
19
8
1
Sir James McGregor, speaking of the typhus of Egypt, indicates the season of preva-
lence to be the same as in Upper India; and the fever follows,
as with us, similar laws of variation with season and change
of character in subordination to local conditions. He writes:
" The plague made its appearance in the middle of September,
and from its early appearance the natives were very much alarmed and prophesied a dreadful
season of plague. They have observed that, when it breaks out before December, they have
always a generally prevailing and a very destructive disease. * * * The natives of Egypt
denominate the season of plague from November or December of one year to June of the year
following; they observe that the disease constantly stops at the period of the summer solstice.
* * * If it be true that the extreme of heat stops the progress of the contagion, it did not
appear to be so in the Army in Egypt in regard to cold: the period at which the plague raged
the most was in the cold months.
"The plague is seen as varied in its appearance as the different fevers described by Syden
-ham to prevail in different years, and under different constitutions of the air in England.
"When the disease first broke out in the Indian Army the cases were from the com
-mencement attended with the typhoid or low symptoms.
"When the army was encamped on the marshy ground at El Hammed the cases were
all of the intermittent or remittent type.
* This is an erroneous statement. The mortality of the Delhi jail ran thus:
January.
February.
March.
April.
May.
June.
July.
1
3
5
8
5
†Dr. Gray says that perhaps on its first appearance in August or September the fever was generally, if not entirely,
malarious in character, but that as the season advanced, whether in consequence of unknown atmospheric influence
or as the result simply of the powerfully depressing effects of malaria, in combination with other causes, operating on
the health of the prisoners, a fever of quite a different type was generated, continued and infectious in character.
Influence of season on manifesta
- t i o n . T h e c o n t a g i o u s f e v e r s o f
India run parallel in season with
those of Egypt.