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of two young officers who had recently landed and who stayed in hotels widely
separate are well marked cases of enteric fever.:—
" Abstract of Case of Lieutenant W. G. G., 2nd Somersetshire Regiment.
Age—21 years 10 months. | Service—10 months.
Fever s. c. (Typhoid).
Arrived in Bombay from England on the 17th November 1882 and resided at the
Adelphi Hotel, Byculla. He dated his illness to the 30th November 1882, suffering from
diarrhoea and feverishness.
On the 5th December he sent for the District Surgeon, whose history was that he
suffered from persistent pyrexia, temperature varying from 102° to 103 9°, pulse 82 to 95,
intolerance of light with severe headache, insomnia nightly, congestion about the whole head,
and patient complaining of having felt slightly off his head, diarrhoea, anorexia, thirst, foul
tongue, offensive breath and cough ; aching in his loins and limbs. He seemed to think
that the illness was due to mental worry about private affairs.
On arrival at the Officers' Sanitarium, Colába, on the evening of 8th December, he com-
plained chiefly of intense headache with intolerance of light and had high fever. The
symptoms continued much the same ; stools unhealthy, looking like pea-soup, on© or two
in the 24 hours.
On the 12th December he complained of pain and tenderness over the abdomen,
especially right iliac region. The stools became more frequent, of same character, and there
were some suspicious-looking spots on the abdomen.
On 15th December and three following days the temperature increased and the stools
changed in appearance to a light coloured flaky fluid.
On the 18th December stools became more greenish, bilious-looking, and next day
looked like green paint. Muscular twitchings began on the 25th.
On the 19th evening temperature had fallen from 103°, in the morning to 101°, but rose
next day to 103 6°, and on following day to 106° at 2 P.M. with severe rigors. The liver be-
came enlarged and very tender on pressure, the belly tympanitic; passed 2 stools like beef-tea.
The acute hepatic symptoms subsided and the headache which had been lately aggravated.
There was crepitation with friction sounds over the lower portion of right lung, probably
from continuity with liver.
On the 25th December about noon there was a fresh accession of fever, temperature
rising from 101 6° to 105 8° by evening, which indicated inflammation of lower portion of left
lung with crepitation, friction sounds, and rusty coloured sputa.
On the 31st December he passed the first healthy solid stool, and his temperature was
normal all the forenoon, progressing favourably.
In the afternoon, however, the temperature rose to 105 2°', this time notifying an increase
of inflammation of left lung, involving the lower half. The inflammation gradually subsided,
the physical signs improved, and the rusty sputa disappeared after the 5th January 1883 ; the
temperature was for the first time normal on the morning of the 8th since the last attack
of inflammation, but did not become permanently normal till the 13th January.
He continued to convalesce, but there still remained a little enlargement of the liver
with tenderness under the false ribs. He was very emaciated, almost skin and bone, and so
weak that his taking a little extra exertion on the 12th January temporarily raised his tem-
perature to 102 6°.
He passed an Invaliding Board on the 19th January and left for England by troop-ship
on the 21st January on sick leave for six months.
Treatment for Fever.—Shaving scalp ; blisters to nape of neck and back of head
dressed with ung. hydrarg; diaphoretics, hydrobromide of quinine, resorcine, bromide of
potassium and Dover's powder at bed time occasionally.
For Hepatitis.—Chloride of ammonium with occasional large doses of ipecac.
For Pneumonia.—Tinct. aconite, bark and ammonia, stupes. Port wine, eggs, milk
and soups.
Good nourishment and tonics when convalescent.
B. KEITH, M.D., Surgeon-Major, A. M. D.,
In Medical Charge, Officers' Sanitarium, Colába, Bombay."