PRESIDENCY DIVISION, ADEN, AND BOMBAY MARINE.
9
Dengue.—200 admissions. This epidemic commenced on the 6th August and ceased On
the 17th September, and although 200 were the number that came into hospital, yet, I
have reason to believe that almost every man, woman, and child suffered from it more or less.
There were no deaths. At first I was inclined to attribute the symptoms to malarious fever, as
I had never seen the disease before. It rapidly appeared in the wing, so that the weekly
admissions from it became as high as 66, and at the end of August the number amounted to
172, after which it began to lessen, and it ceased entirely on the 17th September 1872. It
was characterised by a sudden paroxysm of high fever, so sudden that some of the patients
complained of it in the middle of the night, after going to rest quite well. They awoke with
high fever, violent pains of the limbs, and cramping pains of the muscles of the extremities.
The temperature rose as high as 104 and 105 ; the head and body were generally of a burning
heat, and racked with pain, especially in the back, hips, ankles, fingers, and toes, and were
generally stiff and slightly swollen.
The conjunctivæ were injected in some cases, tongue coated with a thick fur, the pulse
r o s e a s h i g h a s 1 1 0 a n d 1 3 0 , a n d v e r y f u l l , w i t h s l i g h t i r r i t a b i l i t y o f s t o m a c h i n t w o c a s e s ;
respiration hurried somewhat. These were the symptoms the first day. On the 2nd day, the
pulse became slower, and the headache and temperature lessened. On the 3rd day less so ;
and, generally, after 70 or 80 hours the temperature became normal, though the pulse was
somewhat quicker than natural, the pains of the limbs remained troublesome for 8 or 10 days.
Eruption.—Sometimes the surface of the body was covered with red blotches simulating
scarlet fever. It was present on all the Europeans that suffered, and only twice observed in.
the natives. It lasted for 24 or 30 hours, and then subsided—there was no desquamation so
far as I could observe. There were 10 relapses. After being free from fever for a day or two,
and sometimes much longer, a relapse frequently set in with a return of the pains of the
limbs, especially about the ankle and waist, accompanied with much debility. The skin was
of normal temperature.
Complications.—They were all of a mild nature, being accompanied with dysentery and
diarrhœa in 8 cases, and by bronchitis in 7 cases ; mania 1 case.
Treatment.—I am very sceptical of any benefit being derived by medicine beyond.
emetics and purgatives to relieve the intestinal canal. Theoretically quinine and aconite would
appear to be indicated on account of the high temperature, but I cannot say that I observed
any benefit from its administration. To relieve the pains of the limbs, after the temperature
had become normal, potass iodidum with colchicum and Dover's powder were given, but it
appeared to me that beyond keeping the secretions regular, no benefit was derived from it.
I am unable to trace out its origin and cause, and how it was introduced into the wing ;
it was said to have been epidemic in Bhewndi for some time previously, but there was no
communication that I could hear of between these two towns. It is worthy of remark, how
confined it was to the wing, and although the hospital was so close to the police lines, yet
there was not a single case among them, and only a very few in the town ; and also it appears
that there have been no cases amongst the police stationed in the districts, where it is said to
have been prevalent.
The lines were inspected immediately on the outbreak being recognised. After consulta-
Sanitary recommenda-
tion.
tion and in company with my Commanding Officer, we thought
would be best ; 1st, to limit its extension as much as possible by seclu-
sion ; 2nd, to eradicate the germs of the disease by antiseptics. As
regards the former, there did not appear to be any means of carrying it out with reference to
the town, there being no regimental bazar ; so that the sepoys had to go into the town to
purchase their daily food. At the same time orders were issued by the Commanding Officer
to prevent all strangers from coming into the lines, excepting those who were returning from.
leave from their country ; as for the police, there happened to be but little or no communica-
tion between them and the wing, as they had not been long enough in the station to form
acquaintances amongst them. Lastly, remains the jail. The sentries on the watch fortunately
never came in contact with the prisoners. 2ndly, as regards the eradication of the germs of the
disease, I recommended lime-washing all the huts (and had all the materials ready for its
application) if it could have been accomplished. But it was considered objectionable to make
the wing encamp during the rains in tents ; besides which the huts are composed of wattle
and mud, and the sub-divisions only consist of carwee, with little or no mud, 4½ feet high, so
that the lime washing would have been applied to bare sticks. Under these circumstances
we considered it would be better to use the free application of Macdougal's powder over all
the infected huts after they had been well cleared out.
As the hospital only accommodates 16 sick, and even with the verandah only 12 more,
Hospital accommodation. it becomes a matter or difficulty how to accommdate a large number
of patients in a sickness like the epidemic in question, during the
3s