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been put forward to account for its prevalence, especially in Upper
Sind, but none of these are very satisfactory. I think, however, the
difficulty is met by remembering that springs of fresh water, the
product indirectly of a regular are nearly unknown in Sind,
and that almost the entire supply of drinking-water used by the
people is derived from the Indus or through some of its numerous
canals and cuttings. This great river passing over in its course exten
-sive beds of limestone and other saluble earthly salts, holds large
quantities of these in solution. Every time a native drinks he
swallows also a certain quantity of these earthly salts, which, were he
in rebust health, well-fed, and suitably clothed, he would get rid off
by the natural outlets. But the malarious poison in which he lives
lowers his vital energy and his ability to resist morbid actions in his
system ; and the extreme and sudden changes of temperature to
which he is exposed, and which are specially observable in Upper
Sind, still further help in the half-fed, scantily clothed native, to
throw extra work on some organs at the expense of others, the
result of which is frequently seen primarily in the kidneys, and sub
-sequently in the bladder, which participates in the general vital depres
-sion of the whole system. A crystal or slight deposit is retained, which
serves as a nucleus, around which one or more calculi are gradually
formed. Nearly all the cases of stone which apply for relief at the
hospitals and dispensaries are according to this theory from the
districts north of Haidarabad. In the southern portions of Sind, where
the climate is more equable, and a freer action of the skin is main
-ained, this affection is not so frequently witnessed.
14. Haidarabad being the general centre to which so many natives
resort for business or pleasure, it is but natural to expect a larger
number of cases would be met with there than elsewhere, especially
as the present Surgeon, Dr. Holmested, has a name among the people
for his skill and attention. And such is the case. As many as 55
operations for stone have been performed at the Haidarabad Hospital
during the past official year, of these 7 terminated fatally. Few opera
-tions, comparatively, for this disease, have been witnessed in the other
hospitals or dispensaries, with the exception of Alhar-ka-Tanda,
where the Apothecary, Mr. Wright, has had several, and been toler
-ably successful. Success in operations for this complaint, especially
where the patients are well known and come from a distance, proves of
great general benefit ; others suffering in like manner are encouraged
to come in, and if they also succeed in obtaining permanent relief,
the advantages of surgical operations come to be widely known and
appreciated.
15. The total strength of the Police, as is shown from the hospi
-tal returns of the Collectorate towns, amounts to 1,681 ; but as these
are scattered all over the province, and when sick are absorbed in
the general mass of patients attending dispensaries, it follows that,
according to the system adopted until lately, very little concerning
their ailments, number of sick, ratio of recoveries to treated, or of
deaths to treated can be statistically ascertained. The returns from
27 M D