42. Of the special epidemic of ague which prevailed in 1878, the medical
officers of the Army give no novel description. Its origin is commonly ascribed
to the heavy rainfall, the flooding of rivers, swamps and inundations, and sub-
sequent exhalation. It was most widely prevalent through the Punjab,
although in absolute sick rate no regiments suffered more largely from the
disease than the 38th Native Infantry at Barrackpore and Meerut, and the 41st
Native Infantry at Gwalior (Morar). The medical history of both has been
fully described in former annual reports. The 38th Native Infantry has
unfortunately, since its arrival at Meerut, had to experience a second malari-
ous influence which has been so widely distributed over the North-West Pro-
vinces during the present year. The health of the troops which were sent
to Malta remained very good until they were transferred to Cyprus later in the
autumn, when all the regiments, more particularly those stationed at Larnaka,
contracted malarious ague largely, and retained it till long after their return
to India. The medical officers of the 13th Native Infantry, writing from Agra
in January of the present year, considered the Cyprus ague as peculiar, its bilious
symptons being very marked, and the relapses obstinately frequent; but the
general evidence leaves little doubt that the modifications of malarious ague were
not greater in Cyprus than may be met with in widely separated districts of
India itself.
43. It is perhaps unnecessary to remark that the 13th, 38th, 41st, 31st
and many frontier regiments are only exaggerated instances of a type of
disease which has been almost universal. The percentage of admissions shows
how general it has been, while the primary mortality is little higher than
that of previous years. In 10,000 admissions from fevers, there died 32, 46,
28, 43, 50 from 1874 to 1879 respectively; but if the intimate relation recog-
nised to exist between a malarious taint of constitution and the liability to
pneumonia is considered, it is evident that the secondary mortality from bron
chitis, from splenic affections and from dysentery is a very serious matter, and
one which is apt to be lost sight of when the figures of ague alone are taken
into account; and from the annexed statement, No. XIII, the proportions of
admissions and deaths from pneumonia and allied respiratory disease shows a
very grave increase in both the number and the mortality of admissions. I
repeat that the explanation of the large increase is to be found in the great
number of men who, with a taint of malaria, had to face exposure in the field
in a country especially trying to men accustomed to the plains of India, and
under circumstances which often found them ill-protected against the cold; and
that the real significance of this large augmentation of respiratory disease can
never be properly appreciated except in reference to the previous medical history
of many of the regiments and the climate of Kabul combined. Good cloth-
ing, good food, and a sound constitution are all essential to a native of Hindus-
tan rendering efficient service in Afghanistan.
STATEMENT No. XIII.
Showing the number of cases and deaths due to chest diseases.
YEARS.
BRONCHITIS AND
BRONCHIAL
CATARRH.
PNEMONIA.
PLEURISY.
OTHER DISEASES.
TOTAL.
Admitted. Died. Admitted. Died. Admitted. Died. Admitted. Died. Admitted.
Died.
1872
.
.
.
.
1,909
61
498
103
187
3
353
16
2,947
183
1873
.
.
.
.
1,792
52
536
87
238
13
307
9
2,873
161
1874
.
.
.
.
1,749
25
544
111
209
8
248
7
2,750
151
1875
.
.
.
.
1,769
18
701
177
189
11
263
5
2,922
211
1876
.
.
.
.
1,960
19
421
87
175
9
253
10
2,809
125
1877
. .
. .
2,415
35
454
95
237
3
313
10
3,419
143
1878
.
.
.
.
2,949
61
803
230
242
9
376
9
4,370
309