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Chapter III. ] EPIDEMIC FEVERS OF INDIA AND THEIR RELATION TO JAIL MORTALITY.
the station they lost nearly 400 men. The former corps is stated to have had 519 in hospital
at once, and to have buried 21 persons, including women and children, in one day, and
upwards of 90 of its number within a mouth. This is a degree of mortality far exceeding
anything on record in the medical annals of Bengal."
This sickness, I find, went on up to the end of the year, when it abated. In November,
the 66th Regiment lost 55 men, and the other three regiments 45 between them.
Delhi and Saharunpore in those days represented our North-Western Frontier, but from
an incidental observation contained in the Bombay reports, the usual provincial distribution
much further to the west, may be inferred. In the same month, November 1816, it is stated
that at Hyderabad in Scinde the population were then dying at the rate of sixty and seventy
a day.
The fever, no doubt of the same epidemic, progressing on the southern epidemic tract,
seems to have reached Guzerat in the year before. The history of Cawnpore is repeated at
Surat. Dr. Kennedy writes :
—
"In 1815, I saw Her Majesty's 47th Regiment nearly destroyed by bilious remittent fever.
The corps was below 500 strong, but was in every respect healthy and effective; but when the
fever broke out, scarcely any escaped. The casualties were at least 40 per cent.; for the Com-
manding Officer, who died himself of the fever a few weeks after the conversation I allude to,
told me the regiment had buried more than a third of its strength."
Just as in l859 relapsing fever broke out in the jails of the North-West towards the end
of 1816. I find the following account of what is evidently
relapsing fever, in the records of the Medical Board for 1817.
In the Moradabad Jail sixty-four prisoners had died within a
short time, and a report was called for. The fever was evidently
considered contagious, for we find the Magistrate, in calling
for the report, reminding the Civil Surgeon that three instances had occurred in which prisoners
had died who had gone into hospital perfectly well for the purpose of attending upon the sick.
The Civil Surgeon states, that, although Moradabad has recovered its salubrity, in many parts
the sickness, so universal in the previous year, still continues, and that this may have been one
originating cause of the local sickness. To dread of the hospital he gives an important place,
but only as influencing the nervous susceptibilities of the patients. The prisoners themselves,
however, connected the hospital with probable chance of contagion. The report states: "Great
sickness prevailed at the time of removing the patients into the new hospital, and the deaths
which soon after occurred were very numerous. The prisoners began to connect this mortality
with something contagious in the hospital itself; and the unusual circumstance of three
individuals dying suddenly, who were previously in perfect health and had been sent there
merely to attend upon the sick, gave such colour to this notion, that a general alarm and
aversion to going into the hospital was entertained throughout the jail. This unfortunate
impression could not fail to prove injurious; and there can be no question that the sickness, and
consequent mortality, were considerably increased by it, by deterring those who fell sick in the
wards from disclosing their complaints, so that some actually died who have never been known
to be ill, and others died not reporting themselves sick until too far gone for recovery."
Exactly the same observation was made when typhus broke out in the Moradabad Jail
twenty years later; and in many of the outbreaks of 1859-65, the same mistake has been made,
of presuming that the prisoners were concealing their illness for fear of being sent to hospital.
Instantaneous onset and sudden severity of the first symptoms, and the absence of a period of
malaise is characteristic of the relapsing typhus.
The report continues:— "In some cases even where the patients after their admission into
the hospital were in a fair way of recovery, this impression continued with unabated force, and
showed itself in the most restless inquietude, and in daily petitions to be allowed to return to
their wards. In consequence of these earnest solicitations, and apprehensive also lest this feeling
of dejection and alarm should bring on a relapse, it was sometimes thought expedient to comply
with their request to be discharged from hospital. This change, however, in many instances
proved fatal. For these deluded wretches, overjoyed at their escape from hospital and return to
their associates in the wards, gave loose to that inordinate appetite so frequent after recovery
from sickness, and soon brought on that very relapse which they so much dreaded in their late
abode, which they called the "house of death."
A few points in this paragraph call for explanation.
Relapse in relapsing typhus has in more than one narrative been ascribed to hospital in
-
fection, with which it has no connection whatever.*The fever recurs after apparent recovery
as certainly in isolated cases as in a crowded hospital.
It is curious also to note, that the voracious appetite in the interval between the relapses,
which is also a characteristic of relapsing typhus, has also often been noted as the cause of
relapse, and of the fatal symptoms frequently attending it.†
The disease was not jail cachexy; for we read further on, that some of the deaths were so
sudden as to induce suspicion of means having been used to bring about a fatal termination.
There is still another allusion to this fever of 1816 in the records of the Medical Board.
The Jail Inspection Report of the Saharunpore Jail contains the following :—"I understand
* "So infections did it become, from concentration of the effluvia, during the coldest months, that if a patient
shook it off for a day or two, he was almost certain of a relapse."—Moradabad Jail Fever of 1836-37. Dr. Stuart to
Mr. Playfair, Superintending Surgeon, Rankin's Report, p. 210.
† "There is a ravenous desire for food, the indulgence in which is generally fatal; this bulimia continues up to the
moment of dissolution."—Bareillv Jail Fever of 1836, p. 212.
Relapsing typhus of the same
period. Illustrated from the records
of the jails at Moradabad, Saharun
-
pore, and Allahabad.
2 Y