76
A SKETCH OF THE MEDICAL HISTORY OF THE NATIVE ARMY OF BOMBAY.
to going on duty he complained to a comrade that he felt unwell, and had an acute pain in the
small of the back: his friend suggested he should go to hospital; he replied "I will be all right
tomorrow. " On the morning of 2nd, at 5-30, he was sitting in a chair under the porch of the
bungalow, when he suddenly became giddy and faint, and fell out of the chair to the ground. I
saw him where he lay at 6 A. m.; he was then semi-conscious, and was supported with his body
bent forwards; his abdomen pressed firmly against his flexed thighs and knees. He was deathly
cold and pallid, with a cold clammy perspiration over his face, neck, and body; his pulse was
small, weak, and rapid; he made signs which indicated that the cause was in the abdomen
high up. On placing my hand over the upper part of right side of abdomen there was a dis
-tinct, loudly, pulsating tumour. I had the man conveyed to hospital, and had cold applications
kept constantly applied to the part; he was so faint I had to give him stimulants almost
every 10 minutes; he died at 4 P. M. the same day. On post-mortem examination, made 2
hours after death, the following notes were recorded:—Body in good condition, slight ecchy
-mosis of both lungs, otherwise healthy. About 1½ ounces of serum in the pericardium; heart
slightly fatty, otherwise healthy; cavities almost empty. Abdomen, peritoneum looked as if
dyed with blood; cavity of abdomen, especially on left side, filled with huge clots and fluid
blood; left lobe of liver lesser curvature and tesophageal, end of stomach and left kidney unit
-ed by a large mass of fibrinised blood; on removing the liver, stomach, and intestines, the
aorta showed, immediately after its escape through the aortic opening in the diaphragm, a large
aneurism which had burst. Remittent fever gave only 1 admission; first admitted with
ague of the quotidian type on the 25th September. Notwithstanding large doses, first of sul
-phate of cinchonidine, then quinine, the daily periodical attacks increased in duration and inten
-sity until the 6th October, when the fever became purely remittent and of a typhoid character;
the man died on the 13th October. In the month of December a few interesting cases were
under treatment at the hospital, viz., 1 of asthma without any evident heart complication,
in which the distressing symptoms were relieved by night draughts of the tincture of bella
-donna (minims xx in each ounce of water), and drachm doses of ipecacuanha wine three or four
times during the day. The recruit, who presented all the symptoms of a severe attack of
acute rheumatism, made a very good and rapid recovery under the bicarbonate-of-potash
treatment. 1 case of scurvy threatened to prove fatal; but with a liberal supply of fresh.
meat, lime-juice, and stimulants, nearly every unfavourable symptom has disappeared. On the
2nd of December, when Surgeon R. H. Batty held the regiment, Private Amrootrow Miray
was admitted into hospital with symptoms of pleurisy over the right chest. The conclusion
arrived at after the subsidence of the above symptoms, was that the patient showed signs of
approaching destruction of the tissue of the right lung; he had a persistent, troublesome, dry
cough, and daily attacks of hectic fever. On the 29th, about 4 o'clock in the afternoon, he
was suddenly seized with a violent fit of coughing, which terminated with a sudden gush of a
large quantity of pus resembling that found in an hepatic abscess and syncope. This slight
-ly offensive matter continued to ooze through the mouth and nostrils till 5-30, when he died.
At the post-mortem examination, about 12 hours after death, a large abscess was found, involv
-ing 7/8 ths of the substance of the right lung, the contents of which were lung debris, livery
-looking pus, and an unattached, free, globular cyst, about the size of an ordinary orange. The
cyst had no attachments or adhesions of any kind; its wall was smooth and of a creamy
white colour, soft in some parts, firm and elastic in other portions. To the naked eye it
showed two easily separable coats, the external one being rather firm and of a fibrous structure.
The longitudinal and transverse fibres were most beautifully shown in some of the specimens
under a powerful microscope. By the 1/5th-inch glass, tuberculous deposits were easily re
-cognised between and on some of the longitudinal fibres. The internal coat, which was soft and
semi-transparent under the 1/5th inch glass, displayed the air-cells of the lung, the epithelial
lining of the cells, the fibres of elastic tissue, and the very fine, delicate membrane which
forms the cell-wall, to perfection. I am sorry I have not the time to give a correct drawing
and further details of the microscopical appearances presented by sections of the cyst, which, to
my mind, is purely of lung origin. No hydatids could be detected in the contained serous
fluid. In the substance of the left lung were miliary tubercles, and on its surface a few
blebs about the size of a coriander-seed. The liver was healthy. Contusions of the lower
extremity, chiefly due to badly-fitting shoes, gave 29 admissions. The cases of debility 12,
the majority of which, due to length of service and old age, have been invalided. There were
only 3 admissions from dysentery. The febrile, bowel, and hepatic symptoms were easily
overcome by the ipecacuanha treatment.
5. There were 5 deaths during the year, 4 in and 1 out of hospital: the first from
exhaustion, due to extensive syphilitic ulceration of the penis
and scrotum, which thepatient had concealed for several months;
the second, from rupture of an abdominal aortic aneurism; the third, from suicidal drown
- i n g ; t h e f o u r t h , f r o m r e m i t t e n t f e v e r ; a n d t h e f i f t h , f r o m a b s c e s s o f t h e l u n g . 2 8 m e n w e r e
sent before the invaliding committee on account of old age and length of service; 3 of these
returned to duty. The deaths were—3 Hindus and 1 Mussulman in hospital, and 1 Hindu
out of hospital.
Mortality.