29
REPORT OF THE KING INSTITUTE, GUINDY
soreness of the mouth and especially the actual inflammation of the edges as I noticed in a
few cases is unusual in that disease ; and further the incidence of ankylostome infection.
among the cases investigated, viz., 75 per cent is not so high for a rural community as to
make this diagnosis alone tenable on epidemiological grounds in the absence of more definite
evidence.
Dietetic deficiency, especially general protein deficiency, and deficiency of vitamins in
the normal diet of the people could explain, and doubtlessly contributed, to some of the
features in the clinical picture of many of the cases. But, it does not cover all the points,
as for instance, the epidemic onset of the disease which in a majority of the cases was limited
to just those two months of last year. Unsuitable diet is still offered as a possible explanation
of the condition especially in view or the fact that the people in the villages have not had
sufficient time to adjust themselves to an altered diet of rice, which has only recently be
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come the staple article among most of them; and the month of maximum prevalence coincid
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ing with the period of harvesting of ground-nuts may have had something to do with the
setting up of digestive disturbances in many of the cases.
6. Conclusions.—In view of the fact that the investigation was not undertaken till after
the epidemic had almost subsided, and the number of typical cases examined was very few,
no definite conclusions could be drawn regarding the real nature of the disease. It is su
g -
g e s t e d t h a t a l o o k - o u t s h o u l d b e k e p t f o r a r e c r u d e s c e n c e o f t h e d i s e a s e i n t h e s a m e a r e a s o r i t s
occurrence in other areas so that the investigation could be carried out under more favourable
conditions.
7. Acknowledgments.—My thanks are due to Dr. M. S. Lakshmanan, District Health
Officer, South Arcot, fox arranging for the accommodation of the Unit, and placing his Health
Inspector at my service during the enquiry ; and to the President, Taluk Board, Vriddha
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chalam Taluk, for placing the Board School building at my disposal.
Remarks by the Director.
I agree in thinking that we should not come to a definite conclusion yet. Although
there is good deal of evidence for the existence of either a deficiency disease or a toxemia
from the infection of rice before consumption, yet these may be only accessory to a chronic
infection like Flexner Dysentery. The fact that the disease started more or less at the same
time in most cases rather points to an infection. I propose sending the unit to Pennadam
again after the rains break to observe conditions then.
(B) REPORT ON SPRUE IN GOLDEN ROCK
B Y
DR. K. V. VENKATARAMAN, M.D.
I have the honour to report that according to verbal orders of the Director, King Insti
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tute, Guindy, I proceeded to Trichinopoly on 20th July 1930 to investigate a Sprue-like
disease said to occur among the Railway employees at the Golden Rock Colony, and thought
to resemble somewhat the disease described under the name of "Ubbumariyayee" at
Pennadam in South Arcot District investigated by me four weeks ago. It was felt that an
investigation of this condition would throw further light on the nature of " Ubbumariyayee."
The material for this investigation was furnished by 16 cases examined by me at the
Central Hospital, Golden Rock. Of these four were undergoing treatment as in-patients in
the Hospital at the time of my arrival, and two more were readmitted during my stay. The
remaining ten had previously been treated for the disease at the hospital, and had recovered
enough to be able to attend to their work; they were recalled for the purpose of this invest
i -
gation and presented themselves as out-patients. It has to be remarked that none of these
were recent cases nor were they all of the same duration, showing that I was not dealing
with an epidemic of the disease, a view confirmed by an examination of the statistics of the
Hospital, which show a more or less constant number of monthly admissions for Diarrhœa,
Dysentery and Sprue.
The resemblance of this condition to Ubbumariyayee was not very close. Apart from
backing the epidemic nature of the latter disease, there was not the same distressing flatulent
distension of the abdomen in the Golden Rock cases. Indeed, no one complained of this
symptom, though on careful interrogation, the majority admitted a certain amount of discom
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fort from this cause. The diarrhœa was not of the same recurrent type, being more inclined
to be persistent with exacerbations from time to time. An actual history of dysentery was