86
MEDICAL AND SANITARY REPORT OF THE NATIVE ARMY OF BOMBAY.
in such cases as were of formidable character: the fact that recurrences took place is not
therefore to be wondered at:—
Cases.
Names of Drugs and
Number of Cases treated
by each.
No. of
recurrence
after
admission.
P e r C e n t .
One
recurrence.
P e r C e n t .
More than
one
recurrence.
P e r C e n t .
Abandoned
for the use
of other
Drugs.
P e r C e n t .
Carbolic acid, 360 cases . . .
122
33.8
92
25.5
103
28.61
43
11.94
Quinine, 21 cases . . .
7
33.3
9 42.85
4 19.00
1
4.76
Cinchona alkaloids, 329
cases . . .
81
25.31
91
28.43
80
25
68
21.25
Carbolic acid, a drug which does not appear to have attracted great attention as an
antiperiodic and antipyretic, yielded most encouraging results. That these results would have
been still better I am convinced, had I employed the drug from the first in the manner which
experience subsequently pointed out. The doses to be effectual must be full and frequent; ten
minins of the carbolic crystals to the ounce of water, and one and half ounce of this mixture
repeated six times during the day. I never noticed any bad results under this treatment;
no vomiting or dyspepsia, though slight relaxation of the bowels was occasionally experienced.
If the smallest fullness or hardness of the pulse was noticeable, an ounce of this mixture, com
-
bined with a diaphoretic, was administered a similar number of times, the diaphoresis com
-
pelling absorption by diminishing the tension of the vessels. This plan was pursued whether
the patient was in the paroxism or entirely free from it, if the pulse seemed to indicate its advisability.
Eighty-five injections of quinine were performed, but seldom as a primary treatment. I
have therefore omitted it from the table. The, doses varied from 10 to 40 minims, more than
12 minims never being injected in one place; strength, 1 grain in 15 minims. Three cases
of abscess occurred, and chronic localised thickening of the cellular tissue invariably resulted.
In a case I have lately seen 4 grains in one spot produced a slough within four hours. Since
these cases, even though assisted by the internal administration of "alkaloids," only s h o w a
proportion of about 33 per cent. of absolute success, and considering the pain and disagreeable
results which may follow, I cannot think this measure will hold a very prominent position
as a treatment, except in those severe forms of malarial fever where the stomach resents
quinine and rectal administration is objectionable.
The cinchona alkaloids answered well in the milder forms of fever. Much of their
non-success is due to their nauseant properties, the dose being frequently vomited up five
minutes after administration. That this property is less marked when administered as a
draught than as a pill seems certain. Another peculiarity in their action appears to depend
on exposure to air and their age. At a time when 20-grain doses were being given thrice
daily with little effect, a circular passed round to the effect that 5 to 10 grain doses were
frequently successful, and this I certainly found to be true on receiving new supplies; but as
each new tin waned, the dose had to be increased, to be again diminished by the opening
of a fresh tin. Arsenic was frequently used as secondary to other drugs, and as such the
results were satisfactory; seven drops, well diluted, did not appear to cause any inconvenience,
though given when food could not have been present in the stomach. Salicine was admi
-
nistered in a few cases in which pyrexia was a marked symptom with the effect of reducing
the temperature, but exerting no appreciable influence over the recurrences.
Several cases of Sind ulcer came under treatment, and being novel to me, I employed
every form of remedy without much benefit, till, recognising that the, ulcer was due to chronic
congestion and enlargement of the sudoriferous glands by overwork and some determining
irritation, I employed cold and evaporating lotions with good results, the superficial portions
exfoliating in a horny mass, leaving a peculiar raw-looking cicatrix behind.
5th Regiment N. L. I.
KURRACHEE.—In medical charge of Surgeon-Major H. C. THORP, M.D., &c.
Average Strength . . .
780
Do. present . . .
768
Admissions . . .
1,060
Daily Sick . . .
23.4
Deaths in Hospital . . .
9
Do. out of Hospital . . .
3
Invalided . . .
36
Sick Leave . . .
8