MILITARY DEPARTMENT, 18TH SEPTEMBER 1878, No. 4838.
bazaars and villages abound possessing a water-supply of doubtful character, it is
impossible to trace out the poison of enteric fever." He further states—"The
combined absence of proper rain with high temperature which obtained for nearly
eighteen months had no doubt a predisposing influence, if it was not the actual cause,
of the enteric cases under consideration." Since the rain set in in the latter part of
August, there had been no fresh case in this corps.
Particulars of these cases are given in my published report.
I have carefully examined the records, and thus summarise my views concern
-ing them, viz.—
1 Ardent fever from direct exposure.
1 Irregular remittent, non-specific.
1 Febricula.
3 Ardent fever.
1 Continued fever passing into intermittent.
1 Continued fever with hepatic congestion.
Relative to the occurrence of enteric fever at Secunderabad, the Principal
Medical Officer of the Circle expresses himself as follows :—"That true typhoid
presents itself at this station is beyond doubt, and that it existed here during the
past year is equally unquestionable." "Nevertheless, the conditions that are held
to give rise to this form of fever cannot be recognised as existing here ;" "the
question forces itself on attention whether an ailment similar in symptoms, in
course and in consequence to that observed in temperate latitudes can originate
within the tropics or in highly-heated regions from causes not generally found
outside the boundaries of such localities—a solution offers ; the natural home of
dysentery lies within the malarious zone, and may possibly accommodate another
inmate with a strong family resemblance—the one disease is febrile in character
and has a pronounced tendency to manifest its presence by seizing on the greater
gut, the other is even more fervid but takes possession of the other portion of the
intestinal tube. That there are many distinctive symptoms in each cannot be
overlooked, but that the malarious influence that gives origin to the one may
initiate the other offers a fair subject of inquiry, and takes the question into new
ground. To call the ground, however, new is scarcely exact, as the marsh poison
that paralysed the action of the British Army in the expedition to Walcheren in
1809 gave rise to fevers which, in symptoms and in manifestations before and after
death, had a significant resemblance to those present in the disease now classed as
enteric fever."—See special report, paragraph 18, page 17.
Of the cases recorded at Secunderabad and examined by me, there is in reality
not one that comes up to the standard of specific enteric fever as laid down by
recognised authors.—See my published report, paragraph 2, page 2, and Note 1,
page 156.
Relative to the eleven cases of so-called enteric fever—three fatal—recorded at
Wellington, the officer in medical charge remarks that there was nothing insanitary
about the neighbourhood of barracks, water, or food which could be considered a
cause. He states—"Many of them commenced as ordinary cases of continued fever
or of febricula from malaria poison, and the enteric symptoms supervened ; these
attacks of febricula and continued fever I am inclined to conclude were caused by
true malaria." The result of a careful personal examination of the records of these
cases is as follows, viz. —
1 Endemic continued fever.
1 Adynamic remittent fever.
1
do.
non-specific fever.
1 Ardent fever passing into intermittent.
2 Continued fever.
3 Febricula.
1 Continued fever passing into non-specific typhoid condition.
1 Non-specific adynamic or typhoid endemic fever.
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