ti
28
REPORT ON THE WORKING OF THE RING INSTITUTE, GUINDY
In most of the stools examined hanging drop preparations showed the specimen swarm-
-ing with pleomorphic organisms resembling spirobacilli. Ninety cases were examined in all.
In all of them this spiro-bacillus was found. Samples of cooked rice from the kitchen
onwards down to the plates from which they were eaten by the convicts all showed this spiro
bacillus on cultural examination. No evidence of the pathogenicity of this organism had
been obtained. However, at the suggestion of the Director the sera from recoverd cases
were sent to Guindy to be tested against this organism as well as against cholera. No posi-
tive result was obtained. By serological and by animal experiments this organism was proved
to be non-pathogenic and was found to bear no relationship to the present epidemic nor could
Whitmore's bacillus be incriminated as the causative agent.
On 20th November 1923 Dr. Theodore arrived at the Alipuram From his previous
bacteriological experience in this jail and his observations on the then existing cases of
gastro-enteritis, I was able to derive much help in planning out my work. Ho suggested that
B. Dysenteric; should be eliminated first from the probable causes. The following plan was
Adopted :—
1. Microscopical examination of stools of the whole of the epidemic camp with a view
to eliminating any dysenteries latent or acute. A similar examination of the case in the obser-
vation camp, which was made up of all cases of mild diarrhoea and. the contact of gastro-
enteritis cases. In going through this survey previous histories of the cases were also obtained
with special reference to their having been in the bowel gang on account of latent dysentery.
A spot map prepared under instructions from the Director was of great help.
2. A serological test against B. Dysenterice of all the convalescent gastro-enteritis
•eases.
3. An examination of the stools of the Kitchen staff for probable carriers of dysentery.
These examinations were carried out by me with the following results :—
I. Out of 167 cases of gastro-enteritis admitted 36 or 21 . 56 per cent came direct from
the hovel gang, i.e., had dysentery recently and were still not free from latent symptoms
when they were attacked with gastro-enteritis and 95 or 72 . 5 per cent came from the barracks
but had been in the bowel gang once, twice or thrice as latent dysenteries and only 36 or
21'56 per cent had never been in the bowel gang. The discharge figures also showed a
similar relationship to latent dysentery,. Excepting 51 cases which still remained in the
gastro-enteritis camp, or had gone into the general ward or died the rest 116 or 69 . 1 per cent
went either into the dysentery ward or into the bowel gang as latent dysenteries.
A microscopic examination of the stools of mild diarrhceas that were admitted into a
-preliminary segregation camp as a control for admission into the gastro-enteritis camp,
:showed a remarkable relation to latent dysentery. Out of 431 admissions 63 or 14'62 per cent
came from the bowel gang directly and 52 indirectly through the barracks. One hundred
and sixty-four were still in the segregation camp at the time the figures were obtained. Two
hundred and forty-one or 56 per cent were eliminated into the bowel gang as latent dysen-
teries-21 developed actual dysentery, i.e., (50 . 79 per cent showed dysentery either actual
or latent. It is also of interest to note that most of gastro-enteritis cases came from this
camp after its formation.
Admissions.
Discharges.
To bowel
ward for
dysentery.
Deaths.
From
Total.
bowel
gang.
From barrracks.
Still
Once
Twice Timer Never
in
in
in
in
C0 nip.
B G.
B.G.
• To
To
bowel general
sang.
ward.
167
36
33
7
83
11
1.
26
42
1S1
167
83
2
167
Dio,rrho2a cases.
431
63
1
...
52...
' 316
161.
21
431
241
5
Bacteriological examination of 96 stools of convalescent and acute cases of gastro-enteritis
cases gave in 12 instances organisms of the Flexner group as found by serological examina-
tion. Excepting in 4 cases which gave true Flexuer reactions the rest were late lactose
fermenters. True Flexner was not obtained in any cases during the acute stages. One
case which had three attacks of gastro-enteritis (7,224) Flexner bacillus was obtained only
during the last of four successive examinations when the stoola were actually dysenteric.