64
SKETCH OF THE MEDICAL HISTORY OF THE NATIVE ARMY OF BOMBAY.
was treated by diaphoretics and morphia at bed time. On the 15th of February, there was
considerablehæmorrhage, and as this continued after my arrival, I decided upon opening the
wound to its whole extent. Having got the hospital assistant to take charge of the axillary
artery, I administered chloroform, then introducing a director into the wound, I divided the
deltoid muscle right across. The bleeding vessel, not the same as had been previously liga
-
tured, was found close to the humerus, underneath and behind the great tuberosity, and must
have been a branch of the posterior circumflex. This was ligatured, the wound well sponged
out with carbolic acid lotion, and the edges brought into apposition by sutures and plasters.
Cold water dressing was applied, for which a light poultice was afterwards substituted to
promote granulation. The patient made a rapid recovery, and was discharged from hospital
in May.
Acute rheumatism gives 10 admissions. All the cases were treated by a succession of
small blisters near the affected joints, and internally iodide of potassium and bicarbonate of
potash was administered, to which treatment the disease rapidly yielded.
The remaining admissions were caused as follows : conjunctivitis 8, diarrhoea 6, dys
-
pepsia 5, chronic rheumatism 4, boil 4, malignant cholera 3, lumbago 3, neuralgia 3, eczema 3,
whitlow 3, bronchitis 2, fistula in ano 2 (one patient twice admitted), gleet 2, abscess 2, and
debility 2 ; measles, primary syphilis, general dropsy, paralysis, sciatica, pleurisy, inflammation of
the gum, bubo, stricture, scabies, dracunculus, each gave one admission.
There were two deaths, one from cholera in May, the other from diarrhœa on the 31st
December. The last was entered under this head as it was the immediate cause of death.
The man had been at Baroda on detachment duty for the last two years, and left that on the
25th November to join head quarters. After the first four days' march, lie was continuously
sick, and arrived at Seroor on the night of the 30th December, completely worn out and
ex-hausted. There was a syphilitic history, and while at Baroda he was treated on several
occasions for oœdema of the face and lower extremities, dependent, no doubt, on some organic
disease; but he was in so weak a state on arrival as to preclude the possibility of a minute
exam i nation.
The circumstances most deserving of record in the medical history of the regiment,
during the past year, is the outbreak of cholera in the adjoining village, and the comparative
immunity of the inhabitants withi n cantonment limits. Previous to the appearance of cholera
the atmospheric changes were obvious. From the 23rd April to the 4th May the temperature
ranged from 100° to 102° inside the hospital, and from 110° to 112° in the verandah. This is
considered a very high temperature for Seroor. During the first three days of the month, the
sky was overcast for the greater part of the day, there being a stagnant, close, hot, and oppres-
sive condition of the atmosphere. On the 4th, 6 cents of rain fell, but the quantity was much
greater in the vicinity of Seroor. This reduced the temperature about 3 degrees and rendered
the air moist, a condition which is, I believe, favourable to the development of cholera. .
From the 1st to the 4th May several cases of diarrhœa were treated in the lines. The
first case of cholera was admitted into hospital on the 5th and the last on the 18th May, so
that the disease did not break out in the cantonment until two days after its appearance in
the adjoining village, where no fewer than 13 cases had been registered from the 2nd to the
5th May, and 10 of these proved fatal. In camp the first death occurred on the 7th and the
last on the 23rd May. The population of the cantonment is about 1,000, among which there
occurred 11 cases of cholera, of these 3 were enlisted men and 8 followers; of them former, 1 died,
and of the latter 5.
It is worthy of remark that none of the women or children in the lines were attacked.
The syces, who are very indifferently fed, clothed, and housed, suffered most. The only
enlisted man who died was a very confirmed opium eater. One sweeper was attacked, and a
syce, who formed one of a burial party, was seized almost immediately on his return.
The following is the only satisfactory conclusion, which I can arrive at, as to the origin of
this outbreak. Several pilgrims passed through Seroor during the latter end of April, and
rested for the night in a temporary dhurumsalla. Although I have been unable to trace the
direct origin of the epidemic to this source, still, it is only reasonable to infer that these
pilgrims had come from an infected district—they imported the germs of the disease into
Seroor, and from thence it spread to the lines.
The greater part of the water-supply, for both cantonment and village, is procured from
the river Goor, in which there is a continuous flow. The water filters through the sandy bed
of the river, and appears to be comparatively free front impurities. I shall forward specimens
to Bombay for analysis during next hot season. Two peons are stationed on the bank of the
river to prevent the villagers polluting the stream above a certain point. Previous to the
outbreak of the epidemic at Seroor, no case of cholera, so far as I can ascertain, had occurred,
for at least nine months, in any part of the valley drained by the river Goor, or its tributaries.