NationalLibraryOfScotland/medical-history-of-british-india huggingface dataset:
130
" Regimental No, 2075.
Age last brith-day.—21 years.
Station.—Karáchi.
Name.—Thomas Blurton.
Completed years of service—2 years 5 months.
Time on Station.—7 months.
Day of Month
1881.
April 24th .
April 25th..
April 27th..
April 29th.
Particulars of Case and Prescriptions.
Disease—'REMITTENT FEVER'.
This man came to hospital on the even-
ing of the 22nd, complaining of feeling
very weak and with slight diarrhoea ;
the temperature was found to be 103° but
no urgent symptoms showed themselves ;
he had ol. ricini, mucilage, gum acac.
and opium in small doses which arrested
the purging of the bowels ; there was no
paroxysm of ague. No
urgent
symptoms being present, the case was
deemed to be one of febricula; but
the symptoms next morning were those
of remittent fever.
This patient had been in hospital for
seven days from 14th to 20th instant
suffering from an attack of slight
febricula, but no rise in temperature
worthy of record ; he had a purely milk
diet and seemed all right when dis-
charged from hospital on the 20th
instant. He is a delicate boy and since
his arrival in Karáchi has been in hos-
pital (5) five times with (3) three
attacks of ague, one of febricula, one of
remittent fever.
J. PErCIVAL HUNT, M.D., Surgeon,
Army Medical Department.
The patient seems a little better ; has
slept well and takes his milk diet well;
his pulse is good ; his tongue is moist
and fairly clean ; the temperature at night
103°, morning 102°. He is ordered a
tepid bath in the evening and tepid
sponging to the body 3 times a day, 15
min. of glycerine every 2 hours and 10
grs. of quinine at 4 P.M. ; also half an
ounce of ol. ricini at bed time to relieve
the bowels.
The temperature rose to 104° last evening
but fell this morning to 103°; the patient
seems restless and uneasy, but does not
complain of feeling any worse ; the skin
is moist ; the tongue clean. As the
quinine which had been given in in-
creased doses did not appear to reduce
the temperature, he is ordered 15 grains
of salicylate of soda at 4 P.M. ; to have
also a tepid bath and continue the
glycerine.
The patient seems growing rapidly
worse ; the salicylate of soda wasincreased
but no reduction of temperature. The
tepid baths had also no effect, and the
patient was delirious all night, the
pupils being dilated at morning visit.
Diet.
Milk.
Milk
...
Spoon ...
Spoon . .
Extras.
4 lbs. Ice.
Ice 4 lbs.
Milk 3 pts.
Milk 5 pts.
Ice 4 lbs.
Brandy 2 ozs.
RECORDS OF TEMPERATURE, PULSE AND RESPIRATION.
Regiment 98 th Regimental No. 2075, Rank and Name Private Thomas Blurton, Age 23, Service 2, Station Karachi.
Disease - Febris Remittent, Date of Attack 22-4-81, Result Death, Date of Result 30-4-81, Case Book No. 4, Folio 20.
B.
357.
Govt. Photozinco: Office, Poona 1883.
' 131
Day of Month.
1881.
April 30th.,
April 30th,
3 P.M.
April 30th,
11 P.M.
Particulars of Case and Prescriptions.
Ordered an enema to open bowels as he
could not be got to take medicine; to have
nutritious enemata with brandy every
4 hours and 2 ozs, of brandy by mouth in
24 hours.
The patient seems a little worse ; his
pulse however though weak and of low
volume possesses a certain amount of
resisting power ; a blister which had been
applied to the occiput the previous day
is removed ; he is ordered 4 ozs. of
brandy and 3 pints of beef tea.
The patient is weak but no immediate
signs of death present; he takes his milk
and beef tea, but continues in the
delirious state he has been for past two
days.
Patient has just died in a fit of con-
vulsions of an epileptiform character.
(Sd.) J. PERCIVAL HUNT, M.D., Surgeon,
Army Medical Department.
Post-mortem Appearances 8 hours
after death.
Body well nourished.
Brain. — Weight 2 lbs.and 13 ozs., healthy,
surface not congested, no subarachhoid
effusion, no abnormal fluid in ventricles.
no congestion of choroid plexus, sub-
stance normal.
Thorax — Heart. — Weight 9½ ozs. perfectly
healthy, no white clots in cavities, no
disease of valves surface in appearance,
muscular fibers normal.
( Eight.— Weight )
Lungs,
}
Left-Weight
{health,
(
11b.
½oz.
)
float in water, are both congested and
filled with dark coloured blood.
Abdomen — Liver,— Weight 41bs 7ozs.,
healthy, no congestion beyond what
would be found as a post-mortem ap-
pearance ; no reaction with iodine.
Abdomen — Spleen. — Weight 11b. 14½ozs.,
very much enlarged, congested, soft,
and friable and of a dark appearance ; no
reaction with iodine, no rupture.
( Right.— Weight
)
6½ ozs.
Kidneys
Left.-Weight
Kid-
5¾ ozs., ) ners
perfectly healthy;no reaction with iodine
Diet.
Spoon . . .
Extras.
Tce 4 lbs.
Brandy 4 ozs.
Beef Tea 3 pts.
132
Day of Month.
Particulars of Case and Prescriptions.
Post-mortem Appearances.— contd.
Intestines.— The mucous coats of the bowels
all along their course had slightly inflam-
ed patches, but there was no varicosity
of the veins present ; the glands in the small
and the large intestines seemed to be im-
plicated very much in the same way,
being congested and in several instances
enlarged ; about the ileo-cœcal valve there
were 2 or 3 small glands that were im-
bedded in a layer of yellow gelatinous
mucus, and this could not be washed
from their surface; there was no attempt
however at ulceration of any of the
glandular structures, neither was there
any ulceration of any kind in the walls
of the gut ; the coats were normal as
regards their thickness, and were it no1
for the state of intumescence just noted
would be regarded healthy. No entozoa
present.
(Signed) J. P. HUNT, M.D., Surgeon,
Army Medical Department "
Diet.
Extras.
133
"Regimental No.—(Not stated.)
Age last birth-day.—24 years.
Station.—Karáchi.
Name.—W. Bagnell, 98th.
Completed years of service.—(Not stated.)
Time on the Station.—2 months.
Day of Month.
1880.
Nov. 16th.
Nov. 17th.
Nov. 18th.
Vesp.
Nov 19th.
Particulars of Case and Prescriptions.
Disease.—'REMITTENT FEVER'.
This patient was handed over to me by
Surgeon C. A. Webb yerterday. He
was admitted on the 14th instant under
the head of ague. He was put on low
milk diet yesterday and ordered quinine
grs. 5 twice a day.
His symptoms have now assumed a some-
what typhoid character. Pulse 120,
weak; dry, brown tongue; pain on pres-
sure in right iliac region; six yellow, loose
motions last night; has had epistaxis
twice in the last two days. Ordered
quinine grs. 5 and Dover's powders grs. 5
twice a day. Requires support and sti-
mulants
(Signed) JOHN NORTH, Surgeon,
Indian Medical Department
Temperature yesterday morning was 104°a
nd the same in the evening. Pulse
120 ; tongue moist ; cont. medicine.
Temperature yesterday morning 103 4°,
evening 102 6° ; was delirious during the
night.
This morning pulse 120, very weak
continue medicine ; requires more sup
port. Temperature 103° ; is very low
with muttering delirium ; dyspnoea
great. To have ammon. carb. grs. 4
in effervescing draught every four hours
poultice linseed and mustard to chest.
Temperature 102°; quite insensible and
apparently sinking ; cont. mixture.
Gradually sank and died at 5. A.M.
Post-mortem seven hours after death
Body fairly nourished. Rigor mortis well
marked.
Brain 48½ ozs., slightly congested
substance firm, ½ an ounce of fluid in
right ventricle, two drachms in left.
Heart 8½ grs. in weight, considerable de-
posit of fat on it, right side full of dark
fluid blood and small dark clots.
Lungs, right, 17 ounces in weight ; left, 14
ounces. Old standing pleuritic adhe-
sions on right side binding lung to chest
wall, much congestion at bases of both
lungs and partial consolidation wit]
evidence of recent pneumonia in right
lung, upper lobe emphysematous.
Liver, large and congested, weight 6 ozs.
Spleen much enlarged and soft, weight
19½ ozs., capsule thickened.
Kidneys, right, weight 6½ ozs.; left, 7 oun-
ces : both much congested.
Intestines.—Duodenal mucous membrane
congested and showing tendency to
hœmorrhage for six inches from stomach
Ileum much congested for 2½ feet from
ileo-cæcal valve.
Colon.—Transverse portion in same condi-
dition as ileum; no ulceration in any
part of intestine ; no entozoa. The above
condition of the intestine taken in con
nection with some of the symptom
suggests a scorbutic tendency.
(Signed) JOHN NORTH, Surgeon,
Indian Medical Department."
Diet.
L. Milk ...
Spoon ...
Extras.
P. Wine 6 ozs.
Beef Tea 2 pts.
Milk 1 pt.
Lemonade 2 bottles.
P. Wine 12 ozs.
Beef Tea 2 pts.
Milk 3 pts.
Lemonade 2 bottles.
Lime-juce 2 ozs.
a
B 357—34
134
" Regimental No. 643.
Age last birth-day.—26 years.
Station.—Karáchi.
Name.—George Lamb.
Completed years of service—4 years.
Time on the Station.—1 month.
Day of Month.
1880.
19th October ...
23rd
26th
27th
29th
"
31st
1st November ...
2nd
"
3rd
3rd
"
4th
5th
6th
"
7th
Particulars of Case and Prescriptions.
Disease.—'REMITTENT FEVER'.
Admitted into hospital with gonqr-
rhœa on the 6th September ; since
under treatment he became very
hot ; complained much of thirst ;
temperature 103° ; appears low;
pulse weak ; tongue furred. Mistura
salinge diaphor.
Complaining much of frontal head-
ache ; skin cool ; pulse stronger.
Much better
Handed over the case to Surgeon
Major Oughton.
(Sd.) H. M. MACBETH, Surgeon Major.
Much better ; temperature normal
this morning. To have quinine grs.
10 every morning.
Fever less ardent; still complains
much of frontal headache. Quinine
grs. 15.
Temperature normal ; frontal head-
ache still severe. Quinine grs. 15
this morning.
Had no fever yesterday. Repeat
quinine grs. 10.
Free from fever; headache. Omit
quinine to-morrow.
To have quinine grs. 10 this morn-
ing.
No fever, but frontal headache
still severe. States that he suffer-
ed much from this in Malta. Order-
ed pot. bromid., pot. iodid. grs. 10
of each, sp. ammon. aromat. ms.
15, aq. menth. pip. 1 oz.
Much the same. Ordered Warburg's
tincture 1 fluid drachm statim, mist.
diaphoret c. ainrnon. carb. grs. 4.
Sweated very profusely after the
Warburg, but is rather worse.
Temperature this morning 101 4°.
Ordered blister to nape of neck.
Quinine grs. 10 statim.
Temperature continues very high
and headache no better ; spleen en-
larged ; has had slight hæmate-
mesis ; to have quinine grs. 15 a1
once and diaphoretic mixture dur-
ing fever; wants an air bed, bu
there is not one.
Diet.
B. Tea.
Do.
Do.
L. Pudding.
Continue ex-
tras.
L. P.
L. P.
L. P.
L. P.
L. P.
L. P.
L. M.
Extras.
Port Wine 8 ozs.
2 Lemonade.
Milk 4 pts.
Port Wine 8 ozs.
Chicken Broth 2 pts.
Do.
Do.
Do.
Do. add Lemonade
2 bottles, Ice 2 lbs.
Do.
135
Day of Month.
1880.
8th November ...
9th
„
10th
„
12th
„
14th
Particulars of Case and Prescriptions.
No improvement ; stomach extremely
irritable; temperature 101°; omit
quinine ; to have small blister at pit
of stomach, chloral hydrate grs.
20 at bed time.
Slept fairly last night ; temperature
101°; stomach less irritable ; to have
grs. 20 of neutral sulphate of quinine
and potassæ bicarbon grs. 20
at once, chloral hy. grs. 20 h.s.
Better ; to have quinine as yesterday
and chloral hydrate at bed time.
Handed over the case to Surgeon
Major Macbeth.
(Sd.)
JOHN NORTH, Surgeon,
Indian Medical Department.
This man is not so well; appears
very low.
Passed about one pint of blood and
died soon afterwards.
(Sd.) H. M. MACBETH, Surgeon Major.
Post-mortem Appearances 5 hours
after Death.
Rigor mortis well marked. Body
fairly nourished.
Head. —Brain congested, pia mater
very hard and showed as if he had
suffered previously from menin-
gitis, 2 drachms of fluid in lateral
ventricle, weight 56 òunces.
Thorax. —Apex of right lung adher-
ent. Both lungs congested poste-
riorly ; right 11½ ozs., left 9 ozs.
Heart.—The internal surface was
covered with fat, otherwise healthy
weight 9½ ozs.
Spleen was much congested and
friable, weight 13 ozs.
Liver was much enlarged and con
gested and* studded with innumer
able small ulcers, the kind generally
found in scorbutic dysentery, and
which accounts for the hœmorrhage
before death. There were also
a few ulcers in lower portion of
ileum close to ileo-cæcal valve
No entozoa.
Kidneys.—The right kidney was
much enlarged and the left of a
pale colour. A small quantity of pus
was found in the pelvis of each
kidney ; weight—right 5½ ozs., left
6 ozs.
(Sd.) H. M. MACBETH, Surgeon Major,
Army Medical Department."
Diet.
L. M.
L. P.
Extras.
Milk 4 pts.
P. Wine 8 ozs.
Chicken Broth 2 pts.
Lemonade 2 bottles.
Ice 2 lbs.
Do. Omit Ice.
* See Dr. Macbeth's remarks on this case on page 126.—T. G. H.
186
"Regimental No. 1039.
Age last birth-day.—21 years,
Station.—Karachi.
Name.—P. W. Hewitt, 98th Regiment.
Completed years of service.—5 years.
Time on the Station.—5 months.
Day of Month.
1881.
18th January
20th
„
21st
„
22nd
„
23rd
„
24th
„
..
Complet-
ed day
of
Disease.
5th
7th
8th
9th
10th
11th
Particulars of Case and Prescriptions,
Disease.—' AGUE'.
This patient has had a good deal of
ague since his arrival in India and
is now suffering from a fever which
is of a remittent type. This
evening the temperature is about 3
degrees above that of the morning.
Temperature last night 104° ; tem-
perature this morning 101°. There
is a great deal of weakness and
prostration, and the fever seems to
be taking an asthenic turn. There
is at present no diarrhoea ; abdomen
not tympanitic; spleen not much
enlarged ; no rash on abdomen ; pulse
rather weak ; appetite bad. There
is a good deal of thirst.
(Sd.) J. G. S. LEWIS, Surgeon,
Army Medical Department.
Temperature at night is still high ;
there is a good deal of weakness ;
pulse rather feeble ; temperature last
night 105° ; temperature this morn-
ing 101°.
There is a great deal of weakness
and prostration ; tongue covered with
white fur and tremulous ; spleen
enlarged. There is some diarrhœa
and a great deal of muscular weak-
ness ; the hand trembling on the
slightest exertion. Morning tem-
perature 103° ; evening temperature
101°. He is now taking brandy and
egg mixture every hour, but as he
seems to have a difficulty in keeping
it on his stomach, effervescing mix-
ture with dil. hydrocyanic acid was
ordered.
There is a great deal of weakness
and prostration and patient is in a
dangerous condition. There is some
cough and well marked crepitation
over the bases of both lungs posterior-
ly. Pulse rapid and feeble, some ten-
dency to drowsiness. Tongue dry,
covered with yellow fur and tremu-
lous. There is no diarrhoea or rash on
abdomen ; no pain on pressure on
right iliac fossa ; slight gurgling in
this situation. Temperature, morn-
ing, 105° ; temperature,evening,103°P
oultices are to be applied to the
chest and a stimulating expectorant
given.
In a very precarious condition ; rales
can be heard on both lungs, espe-
cially at the base of the left pos-
teriorly. Temperature last night
104°; temperature this morning 103°V
ery prostrate ; is in a drowsy state
with occasional violent fits of
coughing ; there is some difficulty
is getting the patient to take his
food ; anything in the shape of
brandy is rejected by the stomach
There is well marked small crepita-
tion over the left base posteriorly.
Diet.
M.
...
M.
...
*
M.
...
M.
...
Extras.
Port Wine ozs. 6.
Do.
Brandy ozs. 9.
Eggs 6.
Port Wine ozs. 8.
Eggs 4.
Sugar ozs. 2.
Milk pts. 2.
137
Day of Month.
1881.
24th January
,
25th
„
26th
„
27th
28th
„
30th
„
31st
„
1st February
2nd
„
Complet-
ed day
of
Disease.
11th
12th
13th
14th
15th
17th
18th
19th
20th
Particulars of Case and Prescriptions.
Pulse very weak, 100 per minute.
Temperature last night 105°; tem-
perature this morning 103°. There
is a good deal of muscular tremor.
Powers are at a very low ebb, in-
deed ; tongue dry and brown ; great
tendency to drowsiness ; throughout
last night there was muttering deli-
rium . Temperature last night 102°;
temperature, morning, 101°. Head
to be blistered.
Very prostrate and weak ; tongue dry,
small and tremulous ; pupils dilated ;
lungs evidently very much affected,
in consequence of which the breath-
ing is shallow and hurried, but
does not seem to have enough power
to get rid of phlegm. Pulse 120,
weak and compressible. Tempera-
ture last night 102°; temperature
this morning 101°.
Much in the same condition; coughing
up a little more phlegm than he
formerly did. There is no streaking
of the sputa with blood. Tempera-
ture last night 104°, morning 102°.
There has been muttering delirium
during the night; yesterday evening
there was carphology ; hands tremu-
lous ; respiration 30 per minute ;
pulse can scarcely be counted, and
is weak and fluttering. Blisters were
applied to the temples ; this had the
effect of rousing his mental facul-
ties for a short time, but this morn-
ing he is apparently dying. Tem-
perature 103°, this morning 103°.
Yesterday patient passed about ¾ths
of a pint of blood in the evening and
during the night he was violently
delirious, constantly throwing off
the clothes. This morning he seems
to be in a comatose and is exhaust-
ed by his previous struggles. Pulse
is now reduced to a feeble flutter.
Temperature 100·6°.
Still in the same precarious state ;
there has been some noisy deliri-
um ; pulse a little improved ; prog-
nosis very unfavourable. Tempera-
ture last evening 100·6, this morn-
ing 102°. A small dose of qui-
nine has been tried without any
good result.
In a drowsy state, semi-conscious
condition ; slept a little better last
night ; delirium is now low and
muttering. Temperature last nigh
101·8°, this morning 102·4°.
Still in the same precarious state
there is evidently some mischief
going on in the lungs. Linseed meal
poultices to be applied to both sides
of the chest. Temperature last night
100° ; this morning 102°. Quinine
to be continued. Repeat stimulat-
ing expectorant.
Diet.
M.
-
M. ...
M. ...
Spoon...
Spoon...
Extras.
Port Wine ozs. 8.
Eggs 4.
Sugar ozs. 2.
Milk pts. 2.
Do.
Do.
Port Wine ozs. 12.
Eggs 4.
Sugar ozs. 2.
Milk pts. 3.
Chicken broth pts.
3.
Port Wine ozs. 12
Eggs 6.
Chicken broth pts.
3.
Beef Tea
Oranges 6.
Sugar ozs. 2.
B 357—35
138
Day of Month,
1881.
3rd February ...
4th
6th
"
7th
8th
"
9th
10th
Complet-
ed day
of
Disease.
21st
22nd
23rd
25th
26th
27th
28th
Particulars of Case and Prescriptions.
There has been a good deal of de-
lirium; during the night patient
slept badly ; to-day pulse is weak,
but a little stronger than yesterday;
food and drink are taken well.
Temperature last night 100°, this
morning 102° ; tine. Warburg's
to be given in the morning and
quinine grs. 10 in the evening.
Last night patient was wildly deli-
rious. Syrup hydrate chloral was
given in a 3 drachm dose. This
morning there is slight improve-
ment. Temperature 101 2°; pulse
much stronger ; takes nourishment
well.
Has been in exactly the same con-
dition ; since last entry he has rarely
or never been rational. Yesterday
two bed sores appeared, one being
situated in the neighbourhood of
the sacrum and the other over the
right trochanter ; they are both to
be dressed with tinct. benzoin co. ;
there is an enormous amount of
emaciation, the body being reduced
to a mere skeleton. Nourishment is
taken well. Temperature morning
100 2°, evening 102 6°; pulse 130,
very weak and fluttering.
There is a very slight improvement
to-day. Temperature has fallen 99°;
tongue small and tremulous; lips and
teeth are covered with sordes ; there
is a wonderful amount of emacia-
tion. Morning temperature 99° ;
evening 106°.
In consequense of the high tempera-
ture of last night, tinct. Warburg's 4
drachms was given and repeated in
half an hour; this morning tem-
perature has fallen to 100 6°; pulse
hardly perceptible.
Last night temperature rose 105°,
in consequence of which tinct.
Warburg's was ordered in two doses
of drachms 4 given with an interval
of half an hour between each dose.
This morning the temperature has
fallen to 100° for the first time ; he is
a little rational and seems to under-
stand what is said to him ; pupils
are assuming their natural dimen-
sions ; pulse fluttering and only just
to be felt. Continue all treatment.
All the bad symptoms seem to have
returned this morning ; patient has
been rambling
and
shouting
throughout the night; there has
been delirium. Morning temperature
102°, evening 100°.
Diet.
Spoon...
Extras.
%
Port Wine ozs. 8.
Chicken broth 4
pts.
Oranges 6.
Sugar 2 ozs..
Brandy 8 ozs.
Ginger Beer 4.
Ice 4 lbs.
139
(
Day of Month.
1881.
11th February ...
12th
13th
Complet-
ed day
of
Disease.
29th
30th
Particulars of Case and Prescriptions.
Tongue not so dry as it was last
night ;still seemsinclined to wander;
slept a little last night ; pulse still
weak and fluttering.
Is now in a dying state ; pulse scarce-
ly perceptible ; great difficulty in
breathing.
Patient sank and died at 10-15 P.M.
Post-mortem performed 10 hours after
death.
Body. — Emaciated. One bed sore
situated over the sacrum and the
other over the trochanter.
Brain. — Surface congested, substance
normal ; all the ventricles contained
an abnormal amount of fluid ; no
trace of tubercles ; deposits in the
pia mater : weight of brain 3 lbs.
Heart. — No fluid in the pericardium,
muscular tissue pale, valves and
arteries normal.
Right Lung. — Lower lobe congested.
upper and part of middle lobe in
a state of fibroid consolidation.
The upper lobe contained two cir-
cumscribed abscesses, the size of a
marble.
Left Lung. — Lower lobe congested,
upper lobe in a state of carnification.
No trace of abscess in its substance
From the amount of fibroid tissue
in both lungs the consolidation is
evidently not of recent date. Weight
of right lung 1 lb. 9 ozs.; weight of
left lung 1 lb. 2 ozs.
Liver. — Right lobe slightly congested,
otherwise healthy ; weight 4 lbs
8 ozs.
Spleen. — Slightlyenlarged, otherwise
healthy ; weight 11 ozs.
Kidneys. — Both congested but norma
in structure ; weight of each 7 ozs
Intestines. — The cæcum presentee
some patches of ulceration of an
angular shape with raised edges
Their bases did not appear thickened
and were formed by the muscular
coats of the intestines. In the res
of the extent of the alimentary
canal there were numerous patches
of congestion but there was no
enlargement nor ulceration of
Peyer's patches or of any other
gland structure. No entozoa were
found.
(Sd.) J. G.S. LEWIS, Surgeon,
Army Medical Department."
Diet.
Extras.
Regiment 19th Regiment No. 1460, Rank and Name Private Bhissoo Rawool, Age 20-9, Service, 2-9, Station Malegaon.
Disease - Typhoid Fever, Date of Attack 29 th March, Result Died, Date of Result 15 th April, Case Book No........, Folio .........
B. 357. Govt. Photozinco: Office, Poona 1883.