158
SKETCH OF THE MEDICAL HISTORY OF THE NATIVE ARMY OF BOMBAY.
people ; he became suddenly faint one day, and sank rapidly from exhaustion ; this man had
suffered from extreme debility for months previous to his death ; a post-mortem examination
would have been of much interest in his case, but this was out of the question, as the man's
friends would have objected to it.
Invaliding
.—Eleven men were pensioned off, and five were discharged the service : four
obtained sick leave to their native country.
Operations.—Two operations performed : one was the removal of a fibro-adipose tumour of
long standing, which grew from the sheath of the masseter muscle ; after the operation, there
was little or no disfigurement, and the tumour did not reappear. The other was a case of
fistula in ano ; this latter patient was sent to me to be invalided, as he was incapable of per-
forming his duty, but a fortnight or so after the operation, he was discharged quite well, and
a different man as far as appearance went. There were also other minor operations performed.
Fevers .—There were 605 admissions from fever during the year under review, the large
majority of which occurred after the fall of the Indus, when the water was still lying stagnant
upon the ground. As there is no ummixed good, so even the great undertaking of the irriga-
tion of Sind has its drawbacks, for the inundations of the Indus, while they scatter fertility
over the country, sow at the same time, with a liberal hand, the seeds of disease which yearly
carries off a great number of the inhabitants of Sind ; the swamps and marshes giving rise to
remittents and intermittents. This year proved an unusually unhealthy one for the regiment
during the autumn months ; but up to September, notwithstanding the intense heat of the
summer months, the corps was very free from sickness ; indeed, at first the change from Kur-
rachee to this station appeared to be of benefit to the sepoys, as shown by the monthly returns.
The sickness I believe to have been somewhat increased this year by a crop of jowaree having
been sown near the cantonment, the watering of which must, more or less, increase the
malaria—an effect which should be avoided, in this station especially, where the fever prevails
to such a great extent. An inevitable evil, unfortunately, is the existence, close to the sta-
tion, of several canals and tanks, the emanations from which are most deleterious to the health
of the troops ; the municipality, at a heavy outlay, succeeded in partially filling up one of
these tanks—that which was reported to have been the most offensive—and, I think, with very
favourable results, as far as the remedy went ; it is needless to say how profitably laid out
money would be, for this purpose, as the tanks are a great source of sickness to the station.
Of the number of cases admitted, very many of the patients were weak and debilitated,
requiring the administration of arrack and mutton broth to sustain them through the fever ;
many also suffered from congestion of the liver, a fact which I have constantly noticed amongst
the Europeans, owing, no doubt, to the sudden variations of the temperature, which are very
marked, taking the people by surprise as it were. When this congestion exists, diarrhœa
almost invariably accompanies the fever, and the discharges are then commonly mixed with blood,
from obstruction to the portal circulation. This, if not promptly checked, terminates usually
in dysentery, which is very likely to become chronic ; upon enquiry I find that this is also the
experience of the other medical officers here. Amongst the sepoys many suffered from the
remittent type of fever. In many cases of intermittents, the intervals between the paroxysms
were not true to themselves ; the malaria, which become so prevalent here, often established
itself in the most capricious and anomalous manner, making one almost hesitate in the belief
that it is necessary at all times to classify ague by the terms quotidian, tertian, and quartan.
Sickness became so universal in the regiment, that I thought it highly advisable to recom-
mend a diminution in the number of parades, which was promptly carried out by the com
m a n d i n g o f f i c e r , a s w a s a l s o t h e p o s t p o n e m e n t o f t h e d r i l l s e a s o n , a s t h e h e a l t h o f t h e r e g i m e n t
was inadequate to the amount of work which this would involve, suffering as they were at the
time from the effects of fever and dengue.
Capillary Bronchitis often made its appearance, as a complication of fever, endangering
the lives of the patients, or, if not, greatly retarding their recovery.
Fever
.—The cases of fever were, as a rule, of a mild type, usually of not more than three
to five days' duration, but relapses were very frequent ; disordered and enlarged spleen and liver
were occasionally observed amongst the cases.
The ordinary treatment for fever was adopted, in addition to which the hypodermic
syringe method of injecting quinine was freely used, and with very good results : for enlarged
spleen, quinine and iron, or bromide of potassium were given ; the ointment of the biniodide
of mercury was found to be very efficacious as an external application.
Dengue.—This disease made its appearance at Haidarabad in August last, when cases
were spoken of as having occurred in the native bazar and in the city ; it confined itself for
some time to these localities, spreading gradually until it reached the regiment, and in Sep-
tember 11 cases were admitted into hospital. When this outbreak occurred, tents were pitched
for the accommodation of the patients, at some distance from the hospital and lines, so as to
cut off any communication with the other sepoys, in the lines and in the hospital, and strict
orders were enforced with regard to this. These precautions seemed at first to check the