27
EASTERN FRONTIER, DISTRICT.
for 13 cases, There were 80 cases of febricula, i . e
. , o f o r d i n a r y f e v e r i s h c o l d . T h e s e c a s e s
were readily distinguishable from ague by the absence of the cold stage of spleen compli
-cation and of the general appearance of malarial cachexy. The history of each case and
the temperature also furnished a sure guide to a correct diagnosis. A very large proportion
of the fever and dysentery was no doubt due to the recent change of the regiment from the
plains to the hills. The men were readily subject to chill, and attacks of ague and dysentery
were the result. Now that the men are acclimatised by a year's residence in Shillong I expect
the sick rate in 1879 will be much reduced. Still, notwithstanding the recent change from
the plains the health of the men in Shillong has been fairly good, the admission rate being.
only 128, and the death rate 1.8 per cent. The men of the regiment are chiefly hillmen, 650
out of 850, or about 70 per cent being Goorkhas; they are therefore, unlike Sikhs and Up
-countrymen, eminently suited to this climate. Many cases of ague occurred amongst men
who had recently joined from furlough or leave in the plains. In fact, a journey between Shillong.
and Gauhati in the rains is inevitably followed by an attack of either malarial fever or dy
-sentery.
Causes of
mortality.
XVII.C auses of mortality—The deaths were—
1 from Dysentery . . .
in the Kohima detachment.
1"
Remittent fever . . .
1 "
Cholera . . .
3 " Phthisis pulmonalis . . .
at Head-quarters.
2 " Dysentery . . .
2 " Diarrhœa . . .
1"
Abcess of liver . . .
The three cases of phthisis were Goorkhas. They all died of rapid consumption within a few
months of the supervention of the disease. The history of the case in each instance was the
same, viz., first a reduced condition of health induced by fever, and then congestion of the
lungs attended by hæmoptysis, after which the symptoms of tubercle became unmistakable.
It is curious why this malady should affect only Goorkhas. It is most rare to find either a
Hindustani or the people of any of the tribes who inhabit Assam, or the surrounding hills,
suffering from it. In the three Assam regiments the conditions under which the Hindustanis,
Sikhs, Goorkhas, and Jerwahs (hill Assamese) live are precisely the same, still the Goorkhas are
pre-eminently the sufferers from phthisis. Their susceptibility to this disease can only, in my
opinion, be accounted for by hereditary taint.
XVIII. Epidemics.— A very singular and unusual epidemic of acute œdema has been pre
-vailing in Shillong since the middle of October (1878). Three cases occurred amongst the
sepoys and others amongst the followers of the regiment. Several cases occurred in the 42nd
Regiment, and some 60 or 80, chiefly amongst the Bengalis, in the civil station. The disease
appears to me to be a mild form of beri-beri as described by Morehead. It owes its origin pro-
-bably to an anæmic and scorbutic state, the result of the great dearness of provisions during
the rains. In the rainy months owing to the badness of the roads and the difficulty of, import-
-ing supplies, rice rose to the extraordinary price of 4 seers for the rupee, and everything else
was dear in proportion. Accordingly natives with small pay and large families could not
afford a full supply of food. I have little doubt but that in other years anæmia and scurvy
prevailed, though in a less degree, still they were not accompanied by œdema until 1878. The
other factor in the causation of the malady would appear to be the general unhealthiness of the
season and cold caused by the lateness of the rains. As mentioned in a former paragraph, the
rains in this province in 1878 were prolonged into November. The symptoms of the disease
as they commonly occur are (1) derangement of the digestive system, viz., want of appetite,
slight diarrhœa and flatulence; (2) slight feverishness at night, temperature usually rising to be--
tween 99° and 100°. In some cases, however, in which the œdema was well marked, there was
positively no rise in temperature at any time of the day; (3) well marked œdema usually extend
-ing from feet to knees, but often affecting the entire body; (4) the urine is very rarely albumin--
ous, so rarely indeed, that albuminous urine cannot be called a sign of the disease; (5) most of
the cases have been associated with anæmia,—many with scurvy, but in some neither the one nor
the other could be detected. Thus, seeing people of all ages, and some well-to-do and apparently
healthy, affected by the disorder, one was almost induced to regard it as contagious. A further
fact in support of the theory of contagion is, that in many cases it affects entire households.
I have seen as many as ten cases together in one Babu's compound.
Epidemics.
Inspection.—The Head-quarters, 44th Native Infantry, Shillong, was in
-spected by Deputy Surgeon-General A. C. DeRenzy on the 24th October 1878.
The situation of the lines, the construction of the huts, and the general drainage
are all commended. The head-quarters of the corps are stationed at Shillong
for the first time this year. The water-supply is very pure and wholesome at its
origin, but liable to pollution from the filthy habits of natives. There are no
latrines. The hospital and its equipment are all found in good order. "The
case-book contained a number of well-recorded, interesting cases."
Inspection.
44th Regiment, (Splhet) Light Infantry—Left Wing—Gauhati.
I. Medical Offi cers.—Surgeon E. G. Russell, M.B., Civil Surgeon, Gauhati,
held medical charge of the left wing in addition to his civil duties, except for
Medical
Officers.