Part III.]
DISPENSARIES IN BRITISH BURMAH.
117
Akyab and Sandoway; and at Henzada, diarrhœa in a serious form, the result
of the excessive heat of the weather, prevailed. Dr. Duff gives the following
account of the outbreak of cholera :—
Cholera.
Cholera in an epidemic form made its appearance in the town of Moulmein in February,
by the direction of the wind—prevailing while the wind was north-easterly with a murky
state of the atmosphere, and subsiding when the direction of the wind changed to south-east.
The disease declined in May, and re-appeared, but in a milder form, in October. It finally
ceased in December. It is reported to have prevailed in the district of Moulmein from
January until July.
Of six Europeans admitted into hospital with the disease, four died; all these are said
to have been brought to hospital in a late stage of the disease, and the patients never rallied.
At Toungoo the disease appeared in the latter end of March, and declined in April.
A second invasion occurred in August, and ceased in November. The greatest mortality
occurred in September, when 39 deaths were reported. The outbreak here occurred imme-
diately on the return of the inhabitants from the celebration of a large festival; and it would
at first sight appear that it was imported by the people who were present at the feast; but
no information is afforded as to whether the disease was prevailing at the time in the locality
where the festival was held. The Burmese, it is said, were at first reluctant to avail them-
selves of European aid and medicine; but towards the cessation of the epidemic they used
with benefit the cholera-pills which were freely distributed to the several police stations.
In April cholera broke out at Kyeektaw, about 65 miles south-west of Rangoon. The
weather was at the time intensely hot during the day, with slight showers, accompanied by
thunder and lightning in the afternoon.
Early in August several cases were reported in the town of Rangoon; the disease,
however, did not spread, and by the end of the month it had disappeared.
In October it again broke out in town, and 40 cases were admitted into the cholera
pavilion attached to the civil dispensary; of these 24 died.
At Bassein 26 cases were treated among the out-door patients of the civil dispensary.
One was admitted into the hospital and died. In the outbreak in the town of Bassein,
115 deaths were reported.
At Prome the disease appeared about the end of February and ceased at the end of March.
Only six cases were received into the dispensary; but many were attended at their own homes.
The man first attacked being a Burman cooly who had just returned from the Bassein district,
where the disease was prevailing at the time, the medical officer is disposed to attribute the
invasion to importation from Bassein; but the locality in which the patient resided, and from
which he was brought to hospital, is described as one possessing the conditions capable of en-
gendering the malady. The number of seizures and deaths reported in the town during the
prevalence of the epidemic was 69 and 38, respectively. Of the three individuals who died in
hospital, and of whom all were received in a dying condition, one was a passenger by the
Ashley Eden from Bassein. The man, a Hpeongyee, was attacked on board, and when
brought to the dispensary was in a state of extreme collapse.
From Prome the disease appears to have travelled to Thayetmyo. It made its appear-
ance in the lines of H. M.'s 45th Regiment on the 10th April, and about the same time a
case occurred in the jail in the person of a prisoner received from Prome. This case was at
once isolated, and the disease did not spread within the precincts of the jail. In the mean-
time, however, it had extended to other parts of the cantonment, and returned to the jail
77 days after its first appearance there. On the day following its re-appearance in the jail,
it established itself in the Burmese town in the immediate vicinity. Although the fact that
the first case which occurred at Thayetmyo was in the person of a prisoner who had been
received directly from an infected locality, would seem to indicate importation as the cause
of the outbreak, yet to this cause cannot be attributed the invasion in the jail which occurred
so many weeks after the Prome prisoner was admitted.
Diseases treated.
Compared with the previous year the admissions from fever were 6.18 less,
and injuries show a diminution of 4.59 per cent. Among the out-door patients
the admissions for skin diseases increased from 5.09 in 1872 to 14.74 in 1873.
With these exceptions, the ratios of diseases to admissions have varied very
little from previous results.
Surgical operations.
There were 57 major and 291 minor operations performed; among the
former were 11 amputations, 2 lithotomies, 2 operations for the radical cure of
hernia. Amusat's operation was performed once and 12 large tumours were
removed.
Peculiarities of the
Burmese.
It would seem that the Burmese have an objection to be treated by natives
of India, and for this reason the Chief Commissioner is anxious for the speedy
opening of a medical class in connection with the Rangoon high school as
contemplated.
Midwifery.
A midwifery ward was established at Rangoon, but the experiment has
not succeeded.
e e