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REPORT ON THE WORKING OF THE KING INSTITUTE, GUINDY
disposal of the unit the services of a lady Sub-Assistant Surgeon,
Miss Pushpam Aaron, for examining the gosha women as well as for
collecting the various kinds of biting insects from their rooms. The
unit carried on this investigation work in Tinnevelly and R ā mn ād
districts from 24th August 1924 to 12th February 1925. In all the places
visited it was found that the Muhammadans contributed the greatest
number of kala-azar cases; the Christians living in the villages of
Akkamadam and Tangachimadam were also found to be equally heavily
infected, while the Hindus, although they formed the minority in most of
the places visited, did not show the same percentage of infection as
Muhammadans or Christians. The Muhammadan houses were kept in an
insanitary condition. Their court-yards and brackish water-wells served
as breeding places for many of the common biting insects; they had
moreover a peculiar custom of spreading a layer of sand in every room in
their houses which appears to breed a large number of fleas. The report
of the unit's work which is very important and valuable, is being
forwarded to Government separately. The following is a summary of the
unit's investigations:
—
(1) The inquiry established the prevalence of kala-azar in the
districts of Tinnevelly and Rāmnād. Fourteen villages were visited in
the two districts and all of them, viz., Kāyalpatnam in the Tinnevelly
district and the undermentioned 13 villages in the R āmnād district, were
found to be endemic areas for kala-azar:—P āmban, Akkamadam, Tanga--
chimadam, Rāmēswaram, Mandapam, Vedalai, K īlakarai, Tirupallani,
Pakkarai, Devipatnam, Panaikulam, Alagankulam and Puduvalasai.
(2) In all, 216 cases were established as kala-azar, the majority by
liver or spleen puncture.
(3) The villages are all situated along the sea coast and are populated
mostly by Muhammadans. The incidence of kala-azar among the
Muhammadans was 6.1 per mile and among the non-Muhammadans, 2.5
per mille.
(4) From the detailed histories gathered from 73 individual cases
it has been found that the onset of the disease corresponds with that of
the monsoon.
(5) Close contact with kala-azar cases seems to be a common cause
for the spread of the disease in these areas. In 86 cases or 40 per cent,
the infection could be traced to a member of the family suffering from
kala-azar and living in the same house. In six cases the whole family
consisting of 3 to 6 members, was found to be suffering from kala-azar.
(6) Thirty-one definite cases of symptomless kala-azar and four
definite cases of spontaneous recovery were recorded. All these cases
were found to harbour the Leishman-Donovan body and were very
probably active foci of infection. The question arises whether these act as
kala-azar carriers.
(7) Dissection of the various insects collected in the kala-azar
houses and the examination of smears of the mid-gut contents, showed
that the phlebotomus (sand flies) and cimex rotundatus (bed bugs) alone
appeared to harbour suspicious flagellate-like bodies.
(8) Phlebotomus and cimex rotundatus fed on kala-azar cases, and
then dissected and examined at varying intervals, yielded negative
results.
(9) Animal experiments to prove the problem of transmission by
subcutaneous injections of crushed phlebotomus, cimex-rotundatus and
pulex irritans, yielded negative results. The pup and monkey were the
animals experimented upon.
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