46
REPORT ON THE WORKING OF THE KING INSTITUTE, GUINDY
Dysentery.
Diagnosis.— The chief disease that was prevalent at the time was dysentery. The total
jail population on the day we commenced work was 1,361 of whom 87 were in hospital either
sick or convalescent. Thirty of these cases were suffering from dysentery. In this disease
the amoebic, bacillary and mixed forms were present, the bacillary form preponderating.
The diagnosis of bacillary cases during the first was based on serum alone. The Director
during his visit on 21st September 1922 gave orders that the bio-chemical reactions, must also
find a place in the routine examination. These orders, were promptly obeyed and all subsequent
examinations included these bio-chemical tests. Five organisms which gave negative or
doubtful reactions with serum were, by the use of sugars, found positive. These cases would
otherwise have remained undiagnosed.
Latent Dysentery.—The programme of work carried out for the detection of latent
dysentery cases was based on the original work carried out by Major Cunningham, in the
Bengal Jails and was faithfully followed in every detail. By this means, it was possible to
sort out the abnormals namely, the men suffering from Dysentery in a latent form from
amongst the normal or healthy population which came into the clearing jail. The abnormals
were promptly isolated in what has conveniently been termed the "Bowel Gang," where
they were placed under the routine treatment recommended by Major Cunningham in part III
of his Report on the Dysentery Enquiry in the Bengal Jails. It usually took a fortnight to
complete a detailed bacteriological examination of each set admitted into this gang. Such of
those who showed the presence of amoebic cysts were given specific treatment.
The advantage of this sorting out was demonstrated in a short time after the introduction
of the system. (Table I. a, b, and c.) Two factors must be considered in examining these
figures. It must be remembered that there was no alarming epidemic of dysentery at the
time the Bowel Gang was started. The results cannot therefore be so dramatic as they would
have been, had this been the case. In the second place, I was dealing with a population which
was constantly being swelled by the addition of the emaciated and sickly convict, the normal
healthy population being shifted by transfer to other jails. This factor would tend to swell
the number of cases suffering from dysentery ; notwithstanding this, however, there was a
marked fall in the admissions for dysentery into the hospital which was undoubtedly a result
of this measure. (See Graphs I and II.) The full measure of benefit conferred by this
scheme should however be apparent in the statistics of the other jails to which the prisoners
were detailed after treatment. It is not possible at the present moment to estimate this benefit
on the incidence of disease in these jails. When the statistics asked for, are received at the end
of the year, we will be in a position to estimate the full value of the laboratory in controlling
the disease in the other jails. Be this as it may, the Inspector-General of Prisons reports
already that the sick and mortality rates in other jails, not to speak of the clearing jail itself,
have been definitely reduced.
TABLE I.
M o n t h .
Total number
of convicts
exposed to
infection.
Daily average
jail population
for the month.
Total sick
in hospital for
Dysentery.
Number of
admissions for
Dysentery.
(a) Before formation of Bowel Gang.
July ...
...
...
2,827
1,485
80
66
August
...
..
2,733
1,822
97
46
September
...
...
2,084
1,411
73
27
(b) During formation of Bowel Gang.
October
...
1,961
1,393
62
28
November
...
2,248
1,376
6 4
30
December
2,088
1,479
57
27
(c) After formation of Bowel Gang.
January
...
...
1,703
1,395
45
16
February
...
...
1,944
1,635
37
15
March
...
...
2,107
1,662
37
12
From this table it is clear that there was a marked fall in the number of admissions for
Dysentery into the Jail hospital as soon as the population was sorted out into the normal and
abnormal. This decrease was most marked when the Bowel Gang was fully formed.