85
NEEMUcH.
This Cantonment has been the subject of an especial report in which the
causes of the disease which has rendered Neemuch by far the most unhealthy
station in the Bombay Command are discussed.
The Vital Statistics of the European army in India had not reached me
when this report was written, but I learn from the tables in them that during
the 10 years, 1870—79, Neemuch had the highest death rate from cholera (12 91
per 1,000 of strength) among all the stations in India, although some stations
in Bengal come very close to it. The admission rate for the same disease
though not the highest in India, yet attained the enormously high figure of
16 9 per 1,000 of strength, whilst the rate for enteric fever. 5 4, is the 3rd
highest in the Presidency; the admission rate for malarial fevers, 1,305 7 per
1,000, though not as high as at Baroda during the 6 years ending 1881, where
it attained the enormously high rate of 1,576 4 per 1,000, was yet far higher
than any other station named in the vital statistics; and the rates for
diarrhoea, 100 0, hepatitis 55 4, spleen diseases 5 6, respiratory diseases 67 8,
were also very high.
The admission rate for all causes attained the extremely high rate of
2,242 5 per 1,000 of strength, whilst the daily sick rate was 74 2 per 1,000, and
the death rate, the very serious one, of 29 11 per 1,000. These rates are re-
spectively the highest among all the stations of the Bombay Presidency, and are
the strongest argument I can use as to the necessity of abandoning the station
for European troops, for the sanitary defects in and outside the station are
too great to admit of any effectual remedies being applied.
Nor had I received the following interesting account of an outbreak of
enteric fever which took place in the autumn of 1876 in E/2 R. A. at Neemuch
and which is referred to by Dr. Bryden.—See page 6 of this report. This out-
break appears to have been clearly due to defective iron pans in a latrine, and
forcibly illustrates the necessity for substituting some other kind of receptacle
for night soil :—
"The following are some of the principal facts with regard to the outbreak of enteric
fever which took place in the autumn of 1876 in E/2 Royal Artillery while stationed at
Neemuch :—
The battery arrived in Neemuch early in the year from Kirkee. No case of the disease
occurred while the battery was at Kirkee: and there is no mention in any of the records
of the battery that any case of enteric fever occurred at Neemuch during the period
immediately preceding the outbreak in the battery.
The first case occurred about August 10th and the last of the 13 cases in the February
following.
Of the first five cases, all came from the same barrack (No. 1), and all used the same
latrine (of which mention will be made presently). The 6th and 7th cases came from No. 3
barrack, and did not use the latrine of No. 1 barrack; but both of these men had been in
attendance on the cases of enteric fever in hospital, and most probably contracted the
disease by direct contagion. Cases 8, 9, 10 were all men who used the unhealthy latrine at-
tached to No. 1 barrack.
The case No. 11 was admitted into hospital two days after the battery had changed
into new barracks, more than 1\1/2\ miles from the old ones. The case was clearly contracted
in the old barracks.
No other case occurred until November 5th (i.e. six weeks after the battery had moved
into the new barracks). In this case no cause could be given for the attack. He had
never been near any of the previous cases and had not been in hospital for sis months
previously, nor had he used the unhealthy latrine.
No. 12 case was admitted on November 22nd and resembles the last case. No cause
can be assigned for the attack. He had never been near any of the former cases. He had
however been a good deal about in the neighbouring villages shooting.
The 13th and last case occurred while the battery was in practice camp in the follow-
ing February.
It occurred in a man who had been in India a very short time (about sis weeks) and
no explanation of the origin of the disease can be given.
The following is the description given by the Medical Officer there in charge, of the
defective latrine already referred to :—
' The latrines are two in number. The latrine behind No.1 block has about eight
seats.
B 357—22