30
REPORT OF THE KING INSTITUTE, GUINDY
obtained in only half the cases. Unlike the cases at Pennadam, ankylostome infestation was
not observed to be prevalent.
Not one case in this series could be presented as typical of Sprue ; but the clinical
condition of several of them resembled Sprue more closely than any other disease. There
was a chronic diarrhœa, with copious, foul frothy, fermenting stools, progressive emaciation,
severe anæmia with a colour index above unity and a raw, glazed or furrowed tongue. I
was also told that the response of these cases to treatment with calcium lactate and parathy
-
roid extract and liver extract had been most encouraging. The remaining cases could more
properly be relegated to the class which has been variously styled as "Pre-Sprue" or
"Asthenic diarrhœa of Indians."
Repeated examinations of the stool were made, at least three for each case. Micros
-
copical examination did not reveal any cause. Ankylostome ova were found in one and E.
colicysts in six cases. E. histolytica was conspicuous by its absence. From cultures of
stools, a non-agglutinating B. dysenteri Flexner was isolated from one case, B. morgani
from a second, B. enteritidis from a third and B. pseudo carolinus from four others. Strept
-
ococci, either alone or in combination with the others were found in seven cases. Monilia
were grown from the stools of ten cases, but these with two exceptions, belonged to the
maltose-non-fermenting or wild yeasts type. The two maltose-fermenting yeasts are being
investigated. Agglutination tests were performed with the sera of these cases against B.
dysentery Shiga and Flexner ; with one exception of a patient who was actually passing
blood and slime at the time, all were negative.
The bacteriological findings are in agreement with those of Lieut.-Col. Acton, I.M.S.
(vide Annual Report of the Calcutta School of Tropical Medicine for 1929, page 28) who
attributes these cases of chronic enterocolitis to a secondary invasion by these feebly
pathogenic organisms. The failure to bring out bacteriological or protozoological evidence
of the causative organism of dysentery even in the cases which gave a history of previous
dysentery is undoubtedly due to the fact of the examinations having to be made after these
patients had been treated for long periods with emetine, E.B.I. yatern and antiseptic bowel
washes.
Towards the close of the investigation I visited some villages along the Trichy
-
Villupuram Chord Line, where Ubbumariyayee was reported to have been prevalent, includ
-
ing a brief visit to Pennadam. I examined the agglutination reaction of the sera of some
of these cases. A report on this is being submitted separately.
Dr. J. H. Theodore, M.B.E., visited the unit on 12th July 1930 and after reviewing the
work agreed with me that the work of the investigation should be suspended for the present
and renewed later on.
I have to thank Dr. Norman for providing laboratory accommodation for the unit and
otherwise helping the investigation from time to time ; also the officers at the Central
Hospital for much valuable help.
(C) REPORT ON THE EXISTENCE OF BOWEL COMPLAINTS IN GOLDEN ROCK
BY
DR. J. H. THEODORE, M.B.E., D.T.M ., I.M.D.
From an examination of the Hospital figures both of the out-patient and in-patient
departments for the present as well as for the previous years it was seen that investigation
was concerned not with an epidemic giving rise to dramatic outbreaks, but with a disease
of high endemicity which though not of sufficient severity to attract attention ordinarily,
nevertheless levies a high toll of a constantly sick rate.
A high "constantly sick" figure is usually a matter of importance in working concerns
such as the Golden Rock Colony where this necessitates duplicating of daily paid wagerers;
As a single entity "bowel complaints" contributes a relatively higher proportion to the
constantly sick figure than any other single disease, especially so, if we include under the
heading of bowel complaints the symptoms Syndrome commonly associated with chronic
bowel complaints, such as anæmia, debility, neurasthenia, wasting and gastric disorders,
where the bowel disorder, on account of its chronicity, is lost sight of.
Dr. Norman, Chief Medical Officer, South Indian Railway, requisitioned the investiga
-
tion unit to go into the question of a diagnosis and suggest remedial measures with a view
to reducing the incidence of bowel complaints. A detailed report of cases in hospital and
on such cases as could be brought up for inspection from among the sub-acute, convalescing,
and convalesced cases is being submitted by Dr. Venkataraman.