PRESIDENCY DIVISION, ADEN, AND BOMBAY MARINE.
During the outbreak there where 345 admissions, giving an' average number of six days:
under treatment ; beside these a few suffered from mild attacks, and consequently did not pre-
sent themselves at hospital. As a rule the disease exhausted itself in the first attack, however,
it will be seen from an analysis of the total admissions, that a second attack occasionally
happened, but that a third or fourth was of rare occurrence. Of the 345 admissions, 274 men
were admitted once, 32 twice, 1 three times, 1 four times ; making a total of 345.
The leading characteristic symptoms of this disease are, severe fever usually preceded by
lassitude and headache, and followed by pain and stiffness of the joints, especially those of the
knee, shoulder, and fingers ; the fever is, in most instances,. attended with foul dirty tongue,
bitter taste in mouth, and almost complete aversion to food ; constipation, nausea, and vomit-
ing are occasionally present in some instances—the latter symptom is very distressing.
This disease differs in some particulars in the European and native communities.
1st.—As a rule the fever shows a tendency to recur after an interval of a day or two in
Europeans ; in natives it generally exhausts itself in the first attack.
2nd.—The rash is usually present in European cases ; the exception among natives.
3rd.—The joints in Europeans are invariably swollen and enlarged ; in natives they are
sually of the normal size, but equally painful in both cases.
4th.—Swelling and painful sensations in the glands of the sub-maxillary and parotid
regions are more common among Europeans than natives.
The patients were generally treated during the first stage of the disease with aperients,
diaphoreties, and quinine, with satisfactory results, and when the fever began to subside,
with infusion of chiretta combined with dilute sulphuric acid ; and, as it assumed a more
chronic form, the pain and stiffness of the joints seemed to be most relieved by the treatment
usually pursued in chronic rheumatism.
This disease told severely on the general health of the men, as they had not sufficiently
recovered from the debilitating effects of ague which had been so prevalent during the pre-
vious year, and who were, therefore, unable to resist its influence.
The disease as a rule is not fatal, however, five deaths occurred among the families, viz.,
two women and three children.
Contusions furnished 71 admissions, they were usually of a trival nature, and chiefly shoe-
bites. Sixty-nine were admitted with chronic rheumatism ; the cases were generally old sepoys,
a number of whom have been invalided. One fatal case occurred from this disease, complicated
with scurvy ; the patient was aged about 47 years, and had suffered frequently from ague in
Nasirabad, from the effects of which he never completely recovered.
Diarrœa gave 50 admissions, and boils forty-four ; they were all of an ordinary nature,
and require no particular remarks. Thirty-six cases of dysentery were admitted ; some of these
were of a severe type—one proved fatal. Twenty-five cases of conjunctivitis were treated ; they
were all of a mild character, and yielded readily to treatment. Twenty-seven cases of bronchitis
and two of pneumonia, were admitted during the year. One death occurred from pneumonia.
Cholera.—In the latter part of July, cholera made its appearance in the city, but the
camp remained undisturbed by it to the night of the 9th August, when a sepoy was suddenly
attacked in the lines, and died on the following morning. From this until the end of the
month, ten other cases occurred, and these together with two in September, gave a total of 13.
One of these cases was a European who recovered, four were sepoys, two of whom died ; seven
occurred amongst the families, of these three were fatal ; the remaining case was a follower
who recovered. Tents for the reception of cholera cases were pitched about 3/4 of a mile from
camp, on the most suitable place procurable ; but, owing to the extreme flatness of the sur-
rounding country and the heavy falls of rain in the latter part of August and beginning of
September, the patients and those attending on them, were put to great inconvenience on
account of the dampness of the ground, both in and around the tents.
On two or three occasions this ground, even in the tents, was completely covered with
rain-water to the depth of some five or six inches ; and when it is taken into consideration
that this is some days in drying up, owing to the retentive nature of the soil and want of
sufficient fall for the water to escape, it cannot be disputed, but that this must exert a most
injurious effect on those located on it : consequently, I would beg to recommend that either a
temporary or permanent building with raised foundation be erected for the accommodation of
persons suffering from infectious diseases, whom it might be thought advisable to segregate.
Directly this disease was reported in the city, the strictest measures were adopted to prevent
its appearance in camp, and on the occurrence of the first and subsequent cases, they were
immediately removed from the lines, and treated in tents set apart for their reception. All
houses in which cases occurred were carefully disinfected with carbolic acid and MacDougall's
powder, and lime-washed.
4 s