32
REPORT ON THE WORKING OF THE KING INSTITUTE, GUINDY
Cerebro-spinal fever.
An epidemic of cerebro-spinal fever had occurred previous to the Director's visit. At his
inspection, the Director had recommended
—
(1) Structural improvements in the dwelling huts of the convicts.
(2) Spacing out of the convicts.
These measures were promptly carried out, resulting in a dramatic cessation of the
epidemic. Only a few sporadic cases 6 in all occurred during the next six months. As this
disease is spread by healthy carriers and is always very liable to recur in aggregations of
people, the following precautions were taken to prevent a renewed outbreak of the disease
: —
1. Inoculation with a protective vaccine prepared at the King Institute from the orga
-nisms obtained at Bellary and Madras.
2. Medication of the naso-pharynx of each convict in the jail with a view to disinfecting
his throat on the supposition that he might he carrying the specific organism. In order to
carry out the throat disinfection on a large scale an atomising room was built and a special
atomising apparatus obtained on loan from the military authorities. The throat of each
convict was disinfected several times over.
3. As particular stress was laid by the Director on the prevention of over-crowding, a
strict watch was kept during "lock up" at nights to see that enough floor space was given to
each man.
4. As it has been found in England that epidemics of cerebro-spinal fever are preceded
by a rise in the percentage of carriers amongst the general population, and that such a rise
forms a useful means of foretelling the probable incidence of an epidemic, it was thought
advisible to search the jail population for such cases. It was manifestly impossible to examine
every individual in this way. Random samples of 600 of the population were therefore
selected for this purpose and smears from their throat examined microscopically and cultured
on three consecutive days. No case was found in which a specific organism was isolated
from the throat.
Chicken-pox.
This disease was rampant in Malabar during the time that the convicts were being taken
and a severe epidemic soon appeared in the jail. As an epidemic of smallpox also co-existed
in Malabar, it was feared that this disease would make its appearance in the jail with
disastrous results. The epidemic of chicken-pox was soon brought under control by suitable
segregation and disinfection. Vaccination and re-vaccination of each individual in the jail
was begun at once with lymph manufactured and supplied by the King Institute.
These measures ensured the freedom of the jail from the possibility of an undetected
outbreak of smallpox, occurring primarily under the guise of chicken-pox.
Fevers of the Enteric group.
The systematic examination of the blood of all cases admitted for fever, carried out
during the routine examination of the hospital pathological specimens showed that an
undetected and unsuspected epidemic of fever due to the enteric group of organisms was
also present. This finding was of considerable help in the treatment of the cases in hospital;
and of still greater importance is the fact that a knowledge of the type of fever prevailing
led the medical officer to adopt precautionary measures to prevent the epidemic assuming
dangerous proportions.
With this end in view all convalescent from the enteric group of fever were kept under
observation, and their excreta examined bacteriologically in the laboratory to prevent any
active carriers of the disease passing into the normal population.
Tuberculosis.
The sputum of all cases suspected to be suffering from tuberculosis was examined and
convicts found to be suffering from active disease were separated and formed into a special
gang. These were treated as hospital patients.
Leprosy.
The laboratory was helpful in establishing the diagnosis of this disease in a few doubt
-
ful cases.
Ankylostomiasis.
To form an estimate of the percentage of convicts infected with hook-worm, 600 men
were selected at random and examined. 561 or 93.5 per cent of these were found to be