184
SKETCH OF THE M'EDICAL HISTORY OF THE NATIVE ARMY OF BOMBAY.
while diseases of the spleen show a total of 30 without any death. Diseases of the urinary
system and organs, and of the generative system, may be noticed together. These have
yielded 81 cases and no deaths, which favourably contrasts with the admissions of the previous
year, which numbered 132. There only remains to notice diseases of the organs of locomotion
of the cellular and cutaneous systems and injuries. These of course furnish a considerable
number of admissions; in all 1,068, and the deaths have amounted to 8, of which 5 were
occasioned by debility. In the year before last 1,200 admissions are recorded from the
above causes, but followed by only 2 deaths, also from debility.
14. Before dismissing the subject of the diseases which have affected the troops in Sind
as a body, I must mention one which, although in certain forms is of common occurrence
all over the Bombay Presidency, yet in this province, and partially so in Cutch, is not only
more prevalent, but frequently assumes such peculiar characteristics, as to have earned for itself
a distinct name of " Sind Sore." In the regimental returns these are entered under the
general head of Boils and Ulcers; for even in the worst and most intractable form of this
affection, it commences generally as a painful boil: and, after a period more or less protected,
leaves an ulcer having certain peculiarities in its appearance, progress, duration, and, especi-
ally, resistance to remedies. In 1871 boils and ulcers numbered 359: during the past year
they have amounted to 419. For the most part, these were ordinary boils and ulcers not
distinguishable from those met with elsewhere, except, perhaps, in the matter of , general
irritability and sluggishness of action. But the others, of which I wish now to speak, the
Sind sore par excellence, though at its commencement, and for sometime after, differing
little from an irritable and ill-conditioned boil, yet becoming influenced by climate and local
circumstances, also by the constitution or habit of body of the patient, it must, in its progress
and subsequent course, be regarded rather as a distinct disease, and in this stage presents all
the chief characteristics of the Delhi sore.
15. My attention has been lately directed to this matter by the Commissioner in Sind
having forwarded me copies of correspondence on the subject of Delhi Sores from the
Government of India. These included a despatch from H. M.'s Secretary of State, conveying
a letter from General Lord Mark Kerr, stating that, as the result of his experience at Delhi,
he believed that planting of trees and grass alleviate the disease known under the name of
Delhi sore; and information was called for, as to how far the presence of trees, grass, and
vegetation, generally, with judicious draining, would similarly alleviate the disease in this
province called Sind sore.
16. In reply I stated that to some extent it was a matter for regret, that a disease
concerning which information is sought should be named after a locality instead of being
described and classified in accordance with its pathological history. And this was the more
unfortunate, inasmuch as without this well-established method of recognition, other diseases
of a kindred kind were liable to be confounded with it. Another source of difficulty was
experienced in the fact that ulcers and boils of an obstinate and untractable character are not
confined to Delhi, but are more or less spread over India and eastern cities generally. This
would indicate that there is nothing in the complaint specially referable to Delhi, but that the
cause must be searched for over a wide extent of country, exhibiting every shade and variety
of topographical character, and with climates very dissimilar. With respect to the obstinate
sores met with in Sind, there appears to exist much difference of opinion as to there being
identical with the Delhi sore. Some consider them alike, others that they are nearly so, but
modified by climatic influences; but the general verdict seems to favour the opinion that the
ordinary Sind sore is essentially different from the Delhi one, at least in its earlier stages
and during a portion of its subsequent course. At the outset and for sometime after, the
disease usually presents the appearance of an ill-conditioned boil having many of the character-
istics of carbuncle, attended with acute suffering, and remaining in a highly inflammatory
and irritable condition frequently for several successive weeks. In this respect it is quite unlike
the commencement and course of Delhi sore, which is not painful until after a considerable
breach of surface has taken place, and even then the pain is comparatively insignificant, and
never approaches that met with in the earlier stages of the Sind sore, which is of an intense
lancinating character. And it is when this inflammatory condition has been reduced by appro-
priate treatment that the peculiar disintegration of the tissues occurs. And then commences
the intractable and obstinate condition which in all its main features corresponds to the descrip-
tions usually given of the Delhi sore. This is my opinion; and, I think, it is borne out by the
observations of most of the medical officers who of late years have served in Sind and given their
attention to the subject. Dr. T. Farquhar, a retired Surgeon Major of H. M.'s Bengal Medical
Service, who has had considerable experience in Delhi sores and in those peculiar to Sind,
also states that while the Delhi sore may exist separately in Sind, he considers the disease
known as Sind sore to be " furunculus"—a severe form of the boils that are so very frequent
in the rainy season all over India.