STATISTICS OF THE JAIL POPULATION OF BENGAL FROM 1859 TO 1876.
[ Section III.
194
which came on about the third or fourth day, and sometimes on the fifth or sixth day of the
attack. In several instances, within a few hours, the pulse sunk so as to be barely perceptible;
and the features became dark and sombre, and of a cadaveric appearance. On these symptoms
followed subsultus of the tendons, tremors of the tongue, hiccough, incessant vomiting of a
bilious watery fluid, and occasionally attacks of sudden and severe epistaxis. In other cases
again, the fever continued from day to day with barely a trace of remission; the tongue was
dry and parched; there was continued vomiting, and the heat of the skin was intense. The
pulse was small and feeble; and it gradually became tremulous and indistinct, and extremely
quick; and with this, the patient would be seized with sudden and acute pneumonia or bron
-chitis. In another series of cases, the attack was exceedingly sudden. The patient was seized
all at once while in the performance of some duty. For example, a man in most robust health,
was attacked whilst drawing water from a well; another who on the previous evening was
able to perform his duties as a soldier, was seized in the morning and before night was a
corpse, and this man was considered one of the strongest in the regiment.
"The rigour which in such instances marked the onset of the disease, was rapidly followed
by intense and ardent heat of skin, severe pains in the limbs and loins, frontal headache
with vivid flushing of the face, suffusion of the eyes, throbbing of the carotids, extreme
thirst, and exceedingly rapid pulse. Soon to these symptons were added vomiting of a bitter
watery fluid, evidently in some cases containing bile. The vomiting in some cases was so
frequent as greatly to harass the patient; and it was accompanied by extreme tenderness on
pressure, both in the epigastrium and right hypochondrium. Gradually jaundice ensued, first
faintly traceable in the conjunctivæ, but afterwards suffusing the entire surface of the body.
"For the most part the febrile action never entirely intermitted, though in nearly all the
eases a remission occurred about 4 o'clock every morning, and continued
about two hours.
This remission was followed by an exacerbation of all the symptoms.
"From day to day the patient lost strength; the pulse became weaker, and more and
more quick; the tongue lost its moisture and became brown and fissured; sordes formed upon
the teeth; the jaundice deepened; the burning heat of skin rather increased than diminished;
the vomiting grew more urgent; tenderness and enlargement of the liver and spleen continued;
the bowels remained constipated, and the loss of appetite amounted to absolute loathing of
food.
"Sometimes this downward progress was so extremely quick as to afford little or no
opportunity for the intervention of medicine. For, as above stated, one man died of the
disease certainly within 36 hours after the attack; and in another man, three days sufficed
to bring the disease to a fatal termination."
"But a remarkable feature of the disease, not however constantly exhibited, was a spon
-taneous subsidence of all the symptoms on certain days; which after a time, I began to regard
as critical days, namely, the 5th, 7th, 9th, 14th, and 21st. The patient expressed himself as
quite well, though feeling weak. But while the patient would apparently be convalescing in the
most satisfactory manner the symptoms of the disease would return without any cause, and
continue, though much less severe than during the primary attack. These secondary attacks
likewise terminated within 7, 9, 14, or 21 days ; ordinarily, however, they lasted no more than
5 days.
"I should remark that the spontaneous resolution of the disease was generally accom
-panied by profuse sweating. It was further characterised by a remarkable coldness of the skin;
which seemed to the touch as if the body had just been removed after a long immersion in very
cold water. With this, the pulse fell so as to be about 50 per minute, and it was so feeble and
flickering as to excite the greatest alarm for weak subjects; and the countenance also was
expressive of extreme exhaustion. In fatal cases not the faintest trace of perspiration was
perceptible during the course of the disease; and, what was very remarkable, the burning heat
of skin continued when the pulse at the wrist had ceased, and for some little time after death.
In one case there was delirium with great restlessness and jactitation; in another, the deli--
rium was followed by sleepnessness, and the patient remained without ever closing the eyelids,
for upwards of 72 hours. The same man was obstinately silent, and endeavoured constantly to
get out of bed, and he refused to take anything except from my hands. That he was con
-scious was shown by his ready obedience to my orders, and by his invariably selecting me when
I came to his bedside.* "
The fever simultaneously going on in the same cantonment is referred to by the Surgeon
of the 7th Fusiliers, in these terms:
" After the arrival of the Regiment at Ferozepore and until the weather began to get hot
the cases of fever were in no way peculiar. But towards the
end of May, the fevers were observed to be much more obstinate,
and to present unusual symptoms denoting great constitutional
debility. In the cases of remittent fever the symptoms were the most serious. Such fever
commenced as intermittent, and became remittent after a few days. From the time of admission
the pulse was very feeble, and the bodily strength entirely prostrated. The heat of the body was
* Compare the case of Herophon, as given by Hippocrates :
"He was seized with an acute fever, aggravated on the 5th day and attended with distension of the hypochondrium
and spleen, and by constipation. He was delirious and deaf.
"On the 9th day he sweated; the crisis took place, and the fever ceased.
"On the 5th day afterwards the fever relapsed, and the spleen became swollen. On the evening of the 3rd day after
- w a r d s b e s w e a t e d , a n d t h e s p l e e n d i m i n i s h e d ; a n d f i n a l l y t h e c r i s i s t o o k p l a c e o n t h e 1 7 t h d a y , H e h a d n o d i s o r d e r o f
the senses during the relapse."
7th Fusiliers, Ferozepore 1864,
Surgeon Hendley.