Recomme
n-dations.
Special obser
-vations and
remarks.
79
MEERUT DIVISION.
wound, homicidal, and the other not known. One officer, Colonel H. King, commanding the
corps, died at Malta, of 39-306 a, gouty bronchitis; and another, Surgeon-Major Verchere,
of diarrhœa, contracted at Cyprus. His death occurred however at Aden, where he was left
behind.
XX. Recommendations. —On finding, in the beginning of November, that many of the
cases debilitated from fever were suffering from gum scurvy, I proposed a subscription among
the officers to supply them with plantains as an extra article of diet. This was liberally
responded to, and had, together with plenty of fresh limes, a very good effect.
XXI. Special observations and remarks. —Surgeon-Major M. Verchere, during the
months of June and July at Malta, has noticed a number of cases of inflammation of the
mucous membrane of the mouth, caused (he states in the weekly return, dated 12th July) by
the presence of a fungus growth, resembling the fungus Oidium albicans, or thrush-mould,
This was specially reported on by that officer, so does not require description here. As there
are no cases appearing among the admissions to hospital, it could not have been severe.
With regard to the presence of gum scurvy alluded to in last paragraph, my time was so fully
occupied with from 150 to upwards of 180 sick of my own and a number of cases left behind
by the 8th Native Infantry, that I had but little, if any, to devote to special observations.
I am unable, therefore, to do more than approximately estimate the number of men thus affected
which I take to be fully one-third of the cases then (October and November) in hospital.
Appended here is a nominal list1 of forty men who were getting lime-juice and plantains
on this account; but it is certain rather than probable, that some few have escaped observa
- t i o n , a n d t h a t m o r e h a v e b e e n o m i t t e d f r o m t h e l i s t w h i c h w a s s u b s e q u e n t l y m a d e o u t f r o m
my pencilled notes on the men's admission and discharge tickets. Though they have very
much improved in this respect, there is still some of this disease remaining, e.g., a case being
admitted as scurvy a few days ago with considerable hæmorrhag from the gums and soft
palate, &e. I should be inclined to attribute this affection quite as much to the debilitated
state of the corps from fever as to any error of diet. As far as can be ascertained, the same
general conditions prevailed on the homeward voyage as on the outward (durin which latter
the men were remarkably healthy), Viz, good, roomy, well-ventilated vessels and varied
and sufficient supply of food. In addition to the scale on the outward voyage, 10 ounces of
meat was given twice a week to all the meat-eating castes, which was not done on the
former.
Under this paragraph I wish to draw attention to a form of rheumatism2 which has
hitherto not come under my observation, accompanied by severe burning pain hi the soles of
the feet, which indeed was the chief symptom (swelling or pain of joints there was none), and
which was contracted at Ban (Cyprus). There seems to be a strong tendency, in the low,
malarious sea-board of Cyprus, to irritation and disturbance of the brain and nervous centres,
and through them, in some cases, to the peripheral nervous system. As elsewhere noted, the
fever cases had a marked tendency to head symptoms ; all the deaths that have occurred there
- f r o m h a v i n g b e e n p r e c e d e d b y c o n g e s t i o n w i t h d e l i r i u m , a n d h e a d a c h e h a s b e e n a n a l m o s t
invariable accompaniment. Brow ague too has very frequently co-existed, and among others two
young officers were admitted with this complaint, in one weekly return, during the first outbreak
of malarious disease at Baffo. The three cases Of admissions under hyperœsthesia belong to the
peculiar form of neuralgia or rheumatism 1 have noted. These men, all young and stalwart,
complained of " flying pains" in the limbs ; but more especially of severe burning pain in the
soles of the feet. I am informed that Surgeon R. Murphy, then in medical charge, suspected
these men of malingering, and at first refused them admissions to hospital. After retaining
them for a day or two under the beading hyperœsthesia he discharged them, to be however
re-admitted almost immediately under "chronic rheumatism." Whilst under my observation,
in the beginning of October, I must confess to have been doubtful for a few days as to the
reality of their ailments, but after paying special attention I came to the conclusion, from
their pained expression of face and injected conjunctiva, that their complaints of loss of sleep
were real and this was substantiated by their comrades in the contiguous beds, who said they
were awakened and disturbed by the cries of pain of these their neighbours. They were treat
-ed with antiperiodics, quinine, cinchona febrifuge, &c., also opiates very freely administered,
morphia, chloral, &c. One man recovered under treatment; the other two were sent to their
homes for change of air. Up to date of penning these lines, 20th February, one has returned
fit for duty, though he tells me he still suffers to a less degree. The other, a fine, strong
-framed, young Goojur named "Jewan Ram," who had been reduced to a crippled skeleton, has
not rejoined, his three months' leave not yet having expired. Besides the above cases, the senior
hospital-assistant (a steady, intelligent man named Kaseem-ood-deen) tells me; that among the
cases of chronic rhéumatism here entered, several more suffered from those symptoms, but had
recovered before I took charge. In conclusion, judging from the severe outbreak of sickness
here recorded in a corps which landed in a healthy condition, the long continuance of such
sickness (so as to affect very materially the statistics of 1879), and the large number of men it
has been found necessary to send on sick leave (55), I cannot but deduce that such places as
Baffo, situate on the low, malarious sea-board of Cyprus, are so unhealthy as to be unfit for
human habitation. The decrease in the population of the island, and the state of the people
remaining in the part of it under report, would point to the same.
1 .
N o t p u b l i s h e d .
2 A most common affection after severe malarious fever at Wazirabad in the years 1850 and 1851.