112
SKETCH OF THE MEDICAL HISTORY OF THE NATIVE ARMY OF BOMBAY.
•
The regiment enjoyed excellent health during the first eight months of the year ; ague
furnished only 37 admissions during that period, the daily average
State of the regiment.
number of sick being only 25 ; but I regret to say that, during the
last four months of the year, ague prevailed to an extent. unprecedented in the memory of any
officer or man in the regiment ; no fewer than 522 cases of the disease were admitted during
that period ; and the fever, although not fatal, was of a very prostrating type, and left the men
exceedingly feeble and shattered in health for along afterwards.
In the month of October alone the total admissions were 223, of which 197 were due to
ague, and the daily average number of sick, was 115 .3 ; but these numbers alone give no idea
of the state of inefficiency to which the regiment was' temporarily reduced, as a number of
men who were not sick themselves were granted leave for the purpose of attending their wives
and children, many of whom were also fever-stricken ; and even those men who had been dis-
charged from hospital were so weak that parades were altogether out of the question.
In the month of November the admissions from ague were fewer, being 140 only, but the
daily average number of sick was much higher, being 163 . 7 ; this was owing to the reduced
state of the men, most of , whom had been in hospital twice, and some of them four times, during
the previous 3 months ; and their convalescence was so slow and tedious, that I was obliged to
keep them a long time in hospital after the fever had ceased to recur.
In December the health of the regiment began to improve, the sick list on the 1st of the
month being 159, and on the 31st only 48 : the number of ague cases admitted during the
month were 59, of which 34 occurred during the first half of the month.
During the early part of the month of October when my supply of quinine was limited,
I treated many of the cases with arsenic, bebeerine, solution of quinoidine, and such other
drugs possessed of antiperiodic virtue as I happened to have in store ; and when these were all
expended (except a very small supply of quinine which I kept in. reserve for special cases),
was obliged to fall back upon kreat and decoction of nimbark, (made every morning accord-
ing to the directions in the Indian Pharmacopeia—the bark being obtained from a tree in the
hospital compound) ; with these latter many cases recovered and were discharged, but the
proportion of re-admissions from among them was very discouraging. I afterwards adopted the
hypodermic injection of quinine ; my first attempts were made with a solution, containing 3
grains of quinine in 20 minims of water, with a sufficiency of tartaric acid ; I found that
this had the desired effect upon the fever, but in two cases (out of eleven) it resulted
in abscess, and in all the others the pains and s we l l i n s we l l i n g a t t h e s e a t o f p u n c t u r e we r e s u c h ,
that the men remained longer on the sick list than
swelling
would otherwise have done. I.
next employed a solution recommended by Dr. Tuson, of the Bengal Army, in the Indian
_Medical Gazette, namely, 3 grains of quinine and 6 grains of citric acid in 20 minims of
water ; I injected some cases with this solution and it prevented the recurrence of the fever ;
but finding that many of the men suffered from great pain, heat, and swelling at the seat of
puncture, I cast about for a new solvent for the quinine, and at last I hit upon dilute phosphoric
acid of the British Pharmacopeia. I found that 20 minims of this acid holding 5 grains of
quinine in solution formed a most efficient injection, one operation being in most cases suffi
cient to prevent a recurrence of the fever ; I employed this solution in more than 100 cases,
and the results, with respect to the fever, were most encouraging ; but I am bound to admit
that I was obliged to keep many men on the convalescent list long after they were cured of
their fever, in consequence of stiffness in the left arm, which prevented them from holding a
musket : there were, however, no cases of abscess or ulceration, and, I think, that the proportion
of stiff arms, resulting from the employment of this solution, was on the whole less than from
the citic or tartaric acid solutions. In the absence of the soluble sulphate, I do not think
there is a better solvent for the disulphate than dilute phosporic acid of British Pharmaco
-peial strength, half an ounce of which takes up one drachm of quinine, At first I selected the
left arm for operation, but subsequent experience taught me that it is better to inject the
right arm in naiques and sepoys, and the left in havildars, buglers, and musicians, as being
less likely to incapicitate them afterwards. On the 23rd November, the extra supply of medi-
cines which I had indented for having arrived, I suspended operations and re-commenced the
administration of quinine by the month, to the great satisfaction of my patients, who showed
much repugnance to, the method of treatment by injection, although, I will do them the
justice to say, they submitted themselves cheerfully to it as long as there was any occasion for
economizing my supply of quinine.. I afterwards obtained a small supply of the soluble sul-
phate of quinine from Bombay and used it in a few cases ; but I have not had sufficient expe-
rience with it to justify the expression of any opinion as to its superiority over the disulphate.
My opinion, with regard to the hypodermic injection of quinine, drawn from the experience
above related, is that the drug when administered subcutaneously is more certain in its.
action, but in some cases the pain and swelling at the seat of puncture is such that the man
is not able to use his arm for sometime afterwards, while in others the local effect of the.
operation is very slight and soon passes away.
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