42
REPORT ON THE WORKING OF THE KING INSTITUTE, GUINDY
Enteric Fever.
There were 13 cases of enteric fever in the hospital, six of whom had come from the
annexe. Most of the cases had been diagnosed by widal reaction done at the King Institute.
We took over the bacteriological control of these cases, the results are given in the summary
of laboratory work done at the end of the report. No fresh cases of enteric have occurred
since July 3rd up to the time of our departure.
Dysentery.
There are 18 cases of dysentery in the hospital and 34 cases in the post dysenteric
gang. The stools of all admissions are now examined macroscopically every day for a month
before they are discharged into the general population of the jail by Sub-Assistant Surgeon
M. K. Menon who was trained in this work at Bellary Jail.
Laboratory work.
I commenced the following investigations which I left Assistant Surgeon Ramakrishnan
of this Institute to complete :
—
(1) Examination of all cooks for carriers of cholera and also the enteritis cases which
occurred before 14th May.
(2) Examination of all cholera convalescents and all the attendants on the cholera
cases to ensure their not being carriers when discharged from hospital.
(3) To try and trace how the water became infected by examining the engine driver
and all men who were working about the well.
(4) To regulate the dose of chlorine to be added to the water and to instruct the staff
in making the necessary tests.
(5) To assist in the diagnosis of the enteric fever cases at present in hospital.
(6) To assist in the diagnosis and control of dysentery cases.
The following is a short summary of the laboratory work done :—
I. Examination of cooks for carriers of cholera.—Twenty-three cooks from the main
kitchen and 13 from the annexe were examined on four different occasions involving a full
bacteriological examination of 144 specimens of fæces. All except one cook No. 7763 who
worked in the main kitchen proved to be negative. This man was found on three occasions to
be excreting a cholera like organism similar in every respect to the one found in the water.
He had been admitted to the jail on the 26th April and commenced to work in the kitchen on
2nd June. On Doctor Ramakrishnan's recommendations he was removed from the kitchen
and was isolated.
In addition, these cooks were all examined for carriers of dysentery cysts and enteric
organisms. All proved to be negative, this investigation involving 43 examinations of the
blood by widal test,—78 microscopic examinations of fæces, and 40 stools and urines
specially plated for enteric organisms. Seven men were examined for carriers of cholera,
enteric and dysentery before admission to work in the kitchen.
II. Examination of cholera convalescents and attendants .—Thirty-three men were
examined. All proved to be negative on four examinations. These cases were kept isolated
until the examinations were completed.
III. The engine driver and his two assistants were examined for cholera vibrios on five
occasions with negative results.
IV. The chlorination of the æromotor and annexe wells is working satisfactorily and
the staff were fully instructed in making the necessary chemical tests.
V. Enteric fever.—Eleven blood cultures were done for organisms of the entire group.
B. Typhosus was isolated from two cases and an atypical typhoid bacillus from one. Seven
cases were examined by widal test with a positive result in four.
Dysentery.
Sixty-one stools were plated and also examined microscopically. Entamœba histolytica
was found in 3 cases and dysentery bacilli in 6 of which 3 were Shiga and 3 were
Flexner.
General Laboratory work.
• In addition to the above, we undertook any other laboratory work necessary to assist
the Medical Officer in the diagnosis of the cases in hospital. Thirty-two blood smears were
examined for malarial parasites with negative results. Two fæces were examined for
ankylostome ova. One was positive. Four urine deposits were examined. One urine was
examined for tubercle bacilli.