68
MEDICAL AND SANITARY REPORT' OF' THE NATIVE ARMY OF BOMBAY.
1. Private Goordutsing, aged 20, occasionally using spirits-freely, came to hospital on the
17th March, complaining of pain in the abdomen and symptoms of indigestion. No organic
disease being. discovered at the time after a careful examination, his complaint was attributed
to dyspepsia. About a month after admission, signs of ascites Were noticed, when I suspected
that the symptoms were due to cirrhosis of the liver. As the enlargement of the abdomen
went on increasing in spite of all treatment, and caused much dyspnœa and discomfort,
paracentesis abdominis was performed on the 19th May, and 100 ounces of a yellowish watery
fluid were drawn off, by medium sized trocar and canula. Due care was exercised in the
performance of the operation and subsequent management of the case. After paracentesis
the abdominal organs were carefully examined, when a considerable diminution in the area
of hepatic dulness and slight enlargement of the spleen were noticed. This confirmed my
suspicion regarding the cause of the ascites and dyspeptic symptoms. Though the patient
was free from pain in the abdomen after the operation, fever of a remittent type and compli
-
2.
cated with typhoid symptoms set in on the 20th, and brought on a fatal termination on the 23rd;
maximum temperature was 105 . 6° Farh. On post-mortem examination, a small quantity of
yellowish serous fluid was found in the peritonial cavity, but no signs of inflammation were
discovered, and the wound had closed up on both sides. The liver was greatly contracted
a n d g r a n u l a r , a n d we i g h e d 1 l b . 1 4 o z s . Th e s p l e e n wa s s l i g h t l y e n l a r g e d a n d c o n g e s t e d .
3. Lance Naique Nuthey Khan, aged 32, using spirits habitually and subject to
recurrences of ague, and twice before in hospital for congestion of the liver, was admitted
on the 24th September for slight pain and uneasiness in the hepatic region. On examina
- t i o n t h e l i v e r w a s f o u n d t o b e e n l a r g e d , t h e a r e a o f h e p a t i c d u l n e s s e x t e n d i n g f r o m t h e l o w e r
border of the fifth rib to about an inch below the costal margins. The local and constitu
- t i o n a l s y m p t o m s o f i n f l a m m a t i o n b e i n g a b s e n t , t h e e n l a r g e m e n t w a s s u p p o s e d t o b e d u e t o
congestion. Three days after admission he suffered from diarrhœa, which exhausted him,
and continued more or less troublesome till his death. The evacuations were at first tinged
with blood, but latterly they were of a dark brown colour, watery, and offensive. On the
7th November, he complained of severe pain in the right hypochondrium for the first
time. Had a dry cough, but was free from febrile excitement. A slight increase in the area
of hepatic dulness was noticed on the 8th. The pain continued more or less till the
14th, when a slight bulging of the affected side with fulness towards the epigastrium and
below the costal margin was noticed, and hepatic dulness extended from the upper
border of the fourth rib to about two inches below the costal margin. There being no longer
doubt of the existence of an abscess, the pneumatic aspirator was employed on the 15th with
the patient's consent, and 31 ounces of red-coloured pus were let out. He experienced con
- s i d e r a b l e r e l i e f a f t e r t h e o p e r a t i o n , a n d e n t e r t a i n e d h o p e s o f r e c o v e r y , b u t h i s p u l s e w a s v e r y
feeble and evening temperature below normal. In spite of all restorative measures, his pulse
continued feeble, and he became languid and depressed, with collapsed and anxious counte
- n a n c e , c o l d e x t r e m i t i e s a n d d r y t o n g u e , a n d d i e d o n t h e 1 8 t h N o v e m b e r a t 4 A . M .
On autopsy, the liver was found considerably enlarged. In the right lobe, which
adhered firmly to the diaphragm, there were two large abscesses communicating with one
another by a small irregular opening in the firm cartilaginous wall separating them and con
- t a i n i n g 3 2 o u n c e s o f r e d - c o l o u r e d p u s . T h e l i v e r w e i g h e d 4 1 / 4 l b s . a f t e r t h e p u s w a s r e m o v e d .
The left lobe was congested. The mucous membrane of the small intestine presented
patches of redness.
11.There were 24 deaths in hospital during the year against 12 in 1878 and 3 in 1877.
This shows that while the number of admissions in hospital
Mortality, and its causes. during the year has been less, the mortality has been higher
than the previous two years. The high death rate was directly or otherwise due to debility
caused by malarial fevers and scurvy contracted at Nusseerabad.
The following were the causes of mortality:—Ague 8, remittent fever 3, cholera 4, pneu
- m o n i a 4 , b r o n c h i t i s 1 , d y s p e p s i a a n d a s c i t e s c a u s e d b y c i r r h o s i s o f t h e l i v e r 1 , d i a r r h œ a 1 ,
syphilis 1, and hepatic abscess 1.
In addition to these, two deaths occurred out of hospital, one man was drowned while
bathing in the river Moosum, and one died while on furlough (cause unknown).
12.There were none in the Regiment. Though cholera was prevalent in the town of
Malegaon and the surrounding villages, not a single:case occur-
Epidemics.
red in the regimental lines, as the men were prevented from
going into the town, and arrangements were made to relieve the treasury guard weekly.
instead of daily, and to keep the men relieved from guard in quarantine tents for three days,
before they were allowed to move into the lines.
Amongst the unfortunate men on treasury guard in the town, there were five cases of
cholera and one of diarrhœa. The first case occurred on the morning of the 20th June, and
proved fatal the same day at 1-20 P.M. This. casualty having occurred out of hospital, has not
been included in the returns. On the 1st July there were four cases, which were treated in two.