137
NORTHERN DIVISION OF THE ARMY.
248 additional cases had been received which, with 4 in July, made a total of 514 under treat
-
ment. On June the 5th, when there were 119 on the list, the epidemic culminated, and from
the day in question continued to decrease until the 30th idem, on which date only two
patients remained, and the disease may be said to have virtually died out, for thereafter the
cases were few and far between. Dengue was no exception to the singular law of exclusion
which obtains in epidemics generally, in virtue of which all other diseases are either in abey
-
ance or comparatively rare. Ague, which from January to May had been the prevailing
malady, only furnished four admissions in the latter month; so that on their discharge, June,
as regards intermittent fever, opened with a clean bill of health. Before its close and after
the epidemic had begun to abate, twenty patients had been admitted. In July 16 were
under treatment, which is one in excess of the average number (15) of ague cases met with from
January to July, May excepted. Including May, 16 is by a curious coincidence the average
for the first seven months of the year. The average strength of the regiment during the pre
-
valence of dengue was 627, and the number attacked as already stated was 514, the percentage
for admissions to strength was 82.2
The disease generally began abruptly, although in many cases premonitory symptoms occur
-
red, such as loss of appetite, obscure and wandering pains, tingling of the extremities, lumbar dis
-
tress, general langour, and malaise. The rule, however, in the majority was that of a sudden
invasion. During the febrile stage, with an average duration of 30 hours, the symptoms were
well marked, the pulse was accelerated, great thirst and excessive headache occurred, with
excruciating pains in the muscles and joints, which completely crippled the patient. As the
fever abated the severity of the pains diminished. In many cases a scarlatina-like eruption
was developed on the face, neck, chest, arms, and palms of hands. This symptom was invariably
present in all the Europeans who were attacked. A scorbutic taint occurred in most of the
sepoys affected. Relapses were occasionally met with. The convalescence of natives was in
marked contrast to that of Europeans; which in my own case and experience was tedious and pro
-
tracted. Dengue, however, is not a fatal disease. In hospital upwards of 500 cases were treat
-
ed and there were no casualties. The affection, in the words of Dr. Flint, although extremely
distressing and presenting not unfrequently severe symptoms, is rarely if ever fatal. Its appa
-
rent intensity is in striking contrast to its absence of danger. Whilst the epidemic was rag
-
ing among the sepoys themselves, their families in the lines, as already stated, were not passed
over by the prevailing malady. It is the opinion of many that the disease is contagious; I do
not think it is; for its speedy and almost simultaneous spread would appear to render the theory
of contagion untenable. From all I can gather the disease when epidemic seldom lasts
more than 7 or 8 weeks. The fons et origo mali, it were hard to determine. The malady
was known in Baroda 44 years ago: this fact was stated to me by old men who suffered from
the disease at that time. In those days there appears to have been less fever, but greater
severity of pains in the limbs and joints with spastic contractions. Recovery was perfect in
3 or 4 days, differing from the present epidemic which frequently left the patient crippled for
weeks and a martyr to boils and buboes. Children in a large majority of cases had
convulsions.
In treating the disease salines with colchicum were freely administered. Quinine and
iodide of potassium appeared to do much good. Hot fomentations, stimulating and occasion
-
ally anodyne liniments generally relieved the pains. Chloral was exhibited to induce sleep with
good effect in all cases.
When the disease was dying out in the Rifles, it next appeared among the men of the
Royal Artillery and attacked 13 out of 24, the strength of the detachment. Last of all the
employés of the B. B. and C. I. Railway Company were affected. By this time the atmospheric
condition with which at first the disease in its severest form was ushered in, was changing, for
the severity of these last attacked was mild compared with those which were met when
the epidemic commenced.
The following tables have been prepared to show the prevalence of dengue in the various
sections of the community in camp:—
Table showing dengue among the fighting men of H. M.'s 4th Rifles:—
Months.
Strength.
Average
strength.
No. of
cases ad-
mitted.
Percentage of
admission to
strength.
Pe r c e nt a ge of
treated to
strength.
Remarks.
May . . .
620
627
262
42.2
4 2 . 2
J u n e . . .
6 2 9
242
39.4
57.8
July . . .
634
4
0.6
0.9
T o t a l . . .
1,383
627
514
82.2
1 0 0 . 9
35 s