NationalLibraryOfScotland/medical-history-of-british-india huggingface dataset:
9
(ii) BOVINES.
55. The post of Veterinary Inspector was held by Mr. M. W. Mirza
from 1st July 1941 to 10th July 1941 and from 14th to 31st March 1942 and by
Mr. J. R. Banna during the interval, viz., 11th July 1941 to 13th March 1942.
The Veterinary Inspector was on tour for 189 days and travelled 6,051 miles
by rail and 1,907 miles by road as against 91 days spent on tour and 3,747
miles by rail and 247 miles travelled in the year 1940-41. He inspected all
the veterinary dispensaries, visited also the Agricultural Farms and Pinjrapoles.
56. Eight Veterinary Field Compounders continued to work in the
department. Of these three were temporarily placed in charge of Itinerating
Veterinary Dispensaries and 5 worked under Veterinary Assistant Surgeons.
They attended outbreaks of Liver Fluke, Parasitic gastritis, Foot-and-Mouth
disease, Mange and treated other simple cases. They also carried out castra-
tions of bulls by Burdizzo method. The work done by these men has on
experience proved to be very beneficial in the rural areas.
Three Veterinary Compounders maintained by the District Local Board
and placed in charge of dispensaries in Thar Parkar district are also included
in Table X.
57. The office establishment in spite of presure of work due to the
expansion of the department under the supervision of the Head Clerk who is
due for retirement in the beginning of 1943 has performed their duties most
satisfactorily.
V.—EXPENDITURE.
58. Table IX.—The total expenditure of the department for the year
under report was Rs. 1,65,134 as against Rs. 1,53,041 in the preceding year.
VI.—VISITOR.
59. Mr. P. M. Kharegat, C.I.E., I.C.S., Vice-Chairman, Imperial Council
of Agricultural Research, visited the Province in April 1941 and discussed
various interesting problems with the Director.
VII.—GENERAL REMARKS.
60. The cadre of Veterinary Field Compounders could not be expanded
during the year under report for want of funds.
61. The Societies for the Prevention of Cruelty to Animals at Karachi,
Hyderabad, Sukkur and Shikarpur were accorded full co-operation of the
department.
62. There were no imports of live stock from overseas at the Port of
Karachi during the year.
L (IV) 1825—2
10
63. Sind depends upon Agriculture as its main source of livelihood and
Agriculturists are entirely dependent upon their live stock. Obviously, there-
fore, the importance of cattle wealth can hardly be exaggerated. To eradicate
the various contagious and parasitic diseases which cause a great deal of
mortality and degeneration in live stock every year, the need for having an
efficient veterinary organisation, viz., providing veterinary aid at each taluka
cannot be over emphasised.
64. Greater facilities than are available at present for conducting
research and laboratory work with a view to deal with the control of disease
more efficiently and promptly are urgently required.
65. To cope with the office work due to the expansion of the depart-
ment the present clerical staff is inadequate, an increase in this cadre is
absolutely necessary.
66. It is gratifying to note that the Government has recently passed
orders for the introduction of Cattle Disease Act which will be brought into
effect shortly and it is hoped by systematic application the measure will prove
effective in checking the incidence of some of the serious type of contagious
diseases of cattle and thus prove beneficial to live stock owners in the province.
67. Before concluding this report the Director on behalf of the staff
desires to express gratitude to Mr. J. H. G. Jerrom, M.R.C.V.S., I.V.S., who
proceeded on leave preparatory to retirement from the 20th January 1942 for
his kind and sympathetic treatment and efficient administration of the Depart-
ment for a long period of 21 years.
Karachi, 27th August 1942.
BACHAN SINGH,
Director of Veterinary Services, Sind.
KARACHI: PRINTED AT THE GOVERNMENT PRESS.
IP/QB.10
No. 13
( NEW SERIES. )
SCIENTIFIC MEMOIRS
BY
OFFICERS OF THE MEDICAL AND SANITARY DEPARTMENTS
OF THE
GOVERNMENT OF INDIA.
ORIENTAL OR DELHI SORE.
BY
CAPTAIN S. P. JAMES, M.B., I.M.S.
ISSUED UNDER THE AUTHORITY OF THE GOVERNMENT OF INDIA
BY THE SANITARY COMMISSIONER WITH THE GOVERNMENT
OF INDIA, SIMLA.
CALCUTTA:
OFFICE OF THE SUPERINTENDENT OF GOVERNMENT PRINTING, INDIA.
1905.
Price Annas 10 or 1s.
* ADVOCATES LIBRARY
3942672
No. 13.
(NEW SERIES.)
SCIENTIFIC MEMOIRS
BY
OFFICERS OF THE MEDICAL AND SANITARY DEPARTMENTS
OF THE
GOVERNMENT OF INDIA.
ORIENTAL OR DELHI SORE.
BY
CAPTAIN S. P. JAMES, M.B., I.M.S.
ISSUED UNDER THE AUTHORITY OF THE GOVERNMENT OF INDIA
BY THE SANITARY COMMISSIONER WITH THE GOVERNMENT
OF INDIA, SIMLA.
CALCUTTA:
OFFICE OF THE SUPERINTENDENT OF GOVERNMENT PRINTING, INDIA.
1905.
Agents for the Sale of Books published by the Superintendent of Government
Printing, India, Calcutta.
IN ENGLAND.
ERNEST LEROUX, 28, Rue Bonaparte, Paris.
MARTINUS NIJHOFF, The Hague, Holland.
E. A. ARNOLD, 41 and 43, Maddox Street, Bond
Street, W. London.
IN INDIA.
CONSTABLE & CO., 16, James Street, Hay Market,
W. London.
THACKER, SPINK & Co., Calcutta and Simla.
P. S. KING & SON, 2 & 4, Great Smith Street,
Westminster, London, S.W.
NEWMAN & Co., Calcutta.
S. K. LAHIRI & Co., Calcutta.
KEGAN PAUL, TRENCH, TRÜBNER & CO., Charing
Cross Road, London, W.C.
R. CAMBRAY & CO., Calcutta.
HIGGINBOTHAM & CO., Madras.
BERNARD QUARITCH, 15, Piccadilly, London, W.
V. KALYANARAMA IYER & CO., Madras.
B. H. BLACKWELL, 50 and 51, Broad Street, Oxford. G. A. NATESAN & CO., Madras.
DEIGHTON BELL & CO., Cambridge.
THACKER & CO., LD., Bombay.
A. J. COMBRIDGE & CO., Bombay.
D. B. TARAPOREVALA, SONS & CO., Bombay.
RADHABAI ATMARAM SAGOON, Bombay.
ON THE CONTINENT.
N. B. MATHUR, Superintendent, Nazair Kanun
Hind Press, Allahabad.
R. FRIEDLANDER & SOHN, 11, Carlstrasse, Berlin,
N.W.
RAI SAHIB M. GULAB SINGH AND SONS, Mufid-i-Am
Press, Lahore.
OTTO HARRASSOWITZ, Leipzig,
Superintendent, American Baptist Mission Press.
Rangoon.
KARL W. HIERSEMANN, Leipzig,
ORIENTAL OR DELHI SORE.
T HIS paper contains an account of my work upon the subject of the etiology
of Oriental or Delhi Sore, for the investigation of which I was placed on
special duty in April 1904.
I have examined specimens from twenty sores diagnosed by Civil Surgeons
either as Delhi Sore, Lahore Sore, Sind Sore, or Frontier Sore, according
to the places in which they originated, but I was able to see only five of the
eighteen cases from which the specimens were obtained. Specimens from
the remaining thirteen cases were sent to me by Civil Surgeons—three
from Quetta, three from Shahabad in the Punjab, and seven from Dera Ismail
Khan.
The appearance of some true Oriental or Delhi Sores is by no means so
characteristic as one would expect it to be from the descriptions given in books,
and I found that Civil Surgeons whose experience of the disease was considerable
were often unwilling to express a definite opinion as to whether a given sore
was really an Oriental Sore, or whether it was an example of the ordinary chronic
ulcer so common among natives of India. When I say that the first example
of an Oriental Sore seen by me in Delhi appeared, at a superficial examination,
to be more like a ringworm than anything else, and that I at first considered
another Oriental Sore to be an ordinary "shoe-bite," it will be apparent that I
have felt a similar difficulty in diagnosis. I draw attention to it in the hope that
a knowledge of the fact that Oriental Sores do not always present very dis-
tinctive characters may be of assistance to those who are searching for
examples of this disease in parts of India where there is, at present, no record
of its occurrence.
I will now give brief notes of the eighteen cases and of the results of my
examinations of specimens from them.
Case 1.—Seen at Delhi. Name—Mool Chand. Occupation —Student.
Age—21 years.
B
2
On the skin of the right cheek, over the angle of the lower maxilla, there is a
patch of small papules covering an area of about a square inch. The whole patch
is somewhat raised above the general surface of the skin, and the area
around it is distinctly indurated. At the summit of each papule there is a
crust of papery scales. One of the papules has ulcerated and is exuding a clear
fluid. The patient says that the lesion began a year ago as a single small spot
which caused no irritation or pain ; he thinks he contracted it by cutting himself
whilst shaving. He has tried many native remedies, and says that the sore was
" burnt away " three times but formed again. The Civil Surgeon considers it to
be a true example of a Delhi Sore, basing his diagnosis chiefly upon its long
duration, its resistance to all remedial treatment, the appearance of the fluid
exuding from the ulcerated surface, and the induration which can be felt for
some distance round the lesion.
A small piece, including one of the papules and the edge of the ulcer, was
cut from the sore. Films were made by smearing the cut surface of this piece
of tissue upon glass slides, and sections were cut from it after it had been fixed
in alcohol.
In both the films and sections numerous very characteristic bodies, indis-
tinguishable in appearance from the parasites recently discovered in the spleen
and other organs of certain cases of tropical splenomegaly, were found. These
bodies which I shall allude to in future as parasites, will be fully described later.
Bacilli were not seen in any of the specimens. Films were made from the clear
fluid exuding from the ulcerated surface, but in these the characteristic bodies
were not found.
The peripheral blood of the patient was examined on several occasions, but
nothing abnormal was found. Six months later this case was seen again. The
sore had decreased in size and all signs of ulceration had disappeared. A number
of papules still remained, and there was a good deal of induration round the
margin of the lesion.
A small piece, from which films and sections were prepared, was removed
from the sore, but on this occasion none of the characteristic parasites could be
found. At a second examination a few days later, a similar negative result was
obtained. The sore was evidently healing slowly, but had it been seen for the
first time at this period it would, in all probability, have been regarded as a fairly
typical Delhi Sore, and for that reason the negative result of the subsequent exa-
minations was important.
It was interesting that at this second examination of the case an enlarged
gland about the size of a haricot bean was detected in the anterior triangle of the
neck below the sore. Enlarged glands had been carefully searched for at the
former examination of the case, but none had been found. Unfortunately the
3
patient refused to have the enlarged gland excised. Throughout the eighteen
months during which the sore had lasted he had not suffered from fever or any
other constitutional symptom, and at none of the examinations was any enlarge-
ment of the spleen nor anything abnormal in the peripheral blood, detected.
Case 2. —Seen at Delhi. Name—Urjan Singh. Occupation—Policeman.
Age—32 years.
The patient has an ulcer, about two square inches in size, on the left
scapular region. He says it commenced three months ago as a hard lump
which afterwards broke down and formed an ulcer. The edges of the ulcer are
ragged and thickened, and its base is covered by indolent granulations. There
is an inflammatory areola round its margin. In my opinion the ulcer presents
few or no characters suggesting a diagnosis of Delhi Sore, but the Assistant
Surgeon in charge of the hospital, who has had considerable experience of these
sores, assures me that it is one. The Civil Surgeon would not give a definite
diagnosis, but inclined to the opinion that it was a Delhi Sore.
Films were made from scrapings obtained on the 12th and 18th of April, and
on the latter date sections were cut from a piece of the tissue which had been
fixed in alcohol, but in none of the specimens could parasites similar to those met
with in Case 1 be found.
Case 3.—Seen at Delhi. Name—Ranji Lal. Occupation—Shopkeeper.
Age—33 years.
The patient has come to hospital for the treatment of what he says is a
Delhi Sore on the knuckle of his right hand. The Assistant Surgeon and Civil
Surgeon both agree that it is a typical Delhi Sore. The lesion, which has lasted
1½ years, is about three-quarters of an inch in width and presents a hard nodular
crust which has split open, exposing a shallow raw ulcer. On one finger of
the same hand there is the scar of what from the patient's account was a similar
sore. The scab of the sore on the knuckle was removed and smears made
from its under surface and from the raw surface of the ulcer. Sections were
prepared from a piece of tissue cut from the edge of the ulcer.
In all the specimens enormous numbers of large cocci, both free and
enclosed in leucocytic cells, were present, but no parasites similar to those
found in Case 1 were detected. Apparently the coccus was present in pure
culture, and when viewed in thick sections it gave a dotted appearance to
the cells in which it was present similar to that given by the parasite found in
Case 1; if only sections had been examined it is possible that a mistake might
have arisen.
Case 4. —Two slides sent from Quetta. The only particulars received with
the slides were that they had been obtained from a Sind Sore which had been
present for three months on the hand of a European lady.
B 2
4
In both slides numerous parasites similar to those found in Case 1 were
present.
Case 5. —Two slides sent from Quetta. The only particulars received were
that the slides were obtained from the raw surface of a Sind Sore occurring on
the face of a native boy aged 13.
In both slides numerous parasites similar to those found in Case 1 were
present.
Case 6.—Two slides sent from Quetta. They were obtained from a sore
on the head of a native woman who had previously suffered from syphilis,
and the Civil Surgeon was doubtful as to the correctness of the diagnosis of Sind
Sore.
Numerous bacilli were present in the films, but none of the character-
istic parasites found in films from the other cases and from Case 1 were
seen.
Case 7 .—Two slides sent from Shahabad in the Punjab. The only parti-
culars received with the slides were that they were obtained from scrapings of an
Oriental Sore occurring on the middle finger of a native man aged 20.
Numerous parasites similar to those found in Case 1 were present in both
films.
Case 8. —Two slides sent from Shahabad . The only particulars received
were that the slides were obtained from what was presumed to be an Oriental Sore
occurring on the shoulder of a man aged 30.
The slides were crowded with bacilli and cocci, but none of the characteristic
parasites of Case 1 were present.
Case 9. —Two slides from Shahabad. They were said to have been obtained
from an Oriental Sore occurring on the fore-arm of a native girl aged 14.
In both slides numerous parasites similar to those found in Case 1 were present.
Case 10. —Seen at Karnal in the Punjab. Name—Ram Singh. Occupa-
tion —Sepoy. Age
—28.
The patient came to hospital complaining of having three ulcers on the left
foot. The following history was obtained : About a month ago his attention
was drawn, by a feeling of itching, to a pimple which had formed on the upper
and inner aspect of the base of the second toe. As a result of frequent scratching,
the skin over the pimple peeled off, leaving an ulcer surrounded by a red swollen
area. About a fortnight later a similar ulcer formed on the base of the great toe
opposite the first sore, and about the same time a third sore started on the front
of the ankle.
When looked at in a superficial manner the three sores appeared very like
ordinary " shoe-bites," but when carefully examined they presented the following
distinctive characters.
5
The oldest sore was covered with a thin white scab, from underneath which
a little clear fluid could be squeezed out. Over an area of about a square inch
round the sore the upper layers of skin had peeled off and the surface was smooth,
red, and raised as if by a deposit of new tissue beneath it. Considerable indura-
tion could be felt round the area covered by the scab. The sore on the great toe
was a small open ulcer surrounded by an inflammatory areola. At the centre of
the third sore (on the front of the ankle) there was a small open ulcer from which
clear fluid could be squeezed out. Over an area of about a quarter of a square
inch round the ulcer the skin surface was raised in small irregular patches as if
by deposits of new tissue beneath it, and outside this a reddish areola extended
for about an inch in every direction.
The facts that two of the sores, though on different toes, were almost touch-
ing each other, and that the sore on the great toe had commenced some time
after that on the second toe, made it probable that the former had been con-
tracted by accidental inoculation from the latter.
Films made from scrapings obtained from each sore showed the presence of
numerous parasites similar to those found in Case 1, and sections prepared from a
piece of tissue removed from the oldest sore presented the same appearances as
had been observed in sections from the sore of that case.
The patient suffered from no constitutional symptoms and no enlarged gland
was detected. Nothing abnormal was found in his blood, examined on several
occasions.
Case 11. —A child about 12 years of age. Examined at the city dispensary
in Karnal. The sore, which is situated on the right cheek, was contracted in
Lahore four months ago and was diagnosed as a Lahore Sore by the Assistant
Surgeon in charge of the dispensary. It is covered by a thick scab and is about
an inch in diameter. There is the characteristic red areola and induration round
it. The scab was removed and smears made from the granulations scraped from
the raw surface of the ulcer. Numerous parasites similar to those found in pre-
vious cases were present in the films.
The child's spleen was not enlarged, and nothing abnormal was detected in
his peripheral blood.
Cases 12 to 18. —Slides from seven cases of Frontier Sore occurring among
the men of the native cavalry regiment at Dera Ismail Khan. The medical
officer of the regiment, when sending the slides, informed me that Frontier Sores
always occur on the exposed parts of the extremities, and that the patients
almost always give a history of their origin from mosquito bites. All the sores
from which the films were made had lasted a considerable time before the admis-
sion of the men into hospital and they had all been treated more or less
vigorously.
6
The cases may be tabulated as follows :—
Case.
NAME AND CASTE.
Age.
Position of the sore.
Length of time
under t r eat ment when t he sl i de was t aken.
Result of examination
of the film.
12
Latchman Singh
(fat).
. 18 years On the arm . 14 days .
. A considerable number of
parasites present.
13
Kanhiya Singh
(fat).
. 21
„
„
foot
. 70 „
.
. No parasites found.
14
Amrao Ali Khan
(Rangar).
. 18
,,
,,
,,
. 14 ,,
.
. Parasites present but in
small numbers.
15
Hazrat Gool .
(Pathan).
. 27 „
,,
leg
.
2 „
.
. A large number of parasites
present.
16
Ismail Khan .
(Rangar).
. 24 ,,
,,
ankle . 21 „
.
. No parasites found.
17
Latchman
.
(fat).
. 18
„
„
leg . 14 „
.
. Parasites present in small
number.
1 8
Suleiman Khan
(Rajput).
. 19 „
„
foot
. 72 „
.
. No parasites found.
I will now describe the appearances presented in films and sections obtained
from the tissues of some of the sores referred to above.
Description of films.—Most of the films were made by smearing upon glass
slides the granulations freshly scraped from the surface of a sore. They were
stained either with Romanowsky's double stain or with Leishman's modification of
that stain or with the alcoholic hæmatin stain mentioned below. Under a low
power of the microscope they are seen to contain red and white blood corpuscles
and an enormous number of large mononuclear cells many of which, even under a
2/3rds inch objective, present a dotted appearance from the presence in their pro-
toplasm of small bodies which look like micrococci. Most of these cells are
much larger than the ordinary large mononuclear leucocytes seen in blood films,
and in thick parts of the smear they are crowded together and apparently joined
to one another in the manner shown in figure 1. Under the same power of the
microscope non-nucleated masses of protoplasm containing the micrococcus-like
bodies can be seen, and a large number of the same bodies not contained in cells
are scattered throughout the film. When the 1/12th inch objective is turned on, the
small dots in the large cells and the micrococcus-like bodies scattered throughout
the film at once strike the eye as bodies of very definite appearance and structure.
They are usually so numerous and their structure is so characteristic that it is
almost impossible to doubt that they are the cause of the lesion from which the
film was made. If the bodies lying free among the cells be examined, it will be
seen that most are oval in shape, but slightly broader at one end than at the other ;
7
a good many, however, are quite round, and some are pointed at both ends so as
to resemble in shape minute torpedoes. The bodies vary considerably in size, but
the length of the majority is about half the diameter of a red blood corpuscle.
Their circumference is remarkably regular and distinct as though they were provided
with a definite capsule. The greater part of their substance stains a faint blue, but
near the centre is a large unstained (? vacuolic) area sometimes divided into two
by a streak of the blue-stained body-substance. In the interior of each body two
masses of chromatin will be seen. One of these is of large size, more or less
rounded in shape, and usually situated near the centre—but always touching one
edge—of the oval and torpedo-shaped forms, and at the broad end in the forms
which are broader at one end than at the other. The second chromatin mass
varies in shape from a dot to a comparatively long thick rod. In the latter case
it usually lies near the centre and at right angles to the long axis of the parasite
(figure 2 a , e). It stains more deeply than the large chromatin mass. In some
parasites I have seen a third mass of chromatin, the presence of which has
not been observed in the parasites obtained from cases of splenomegaly.* It is
a fine rod-shaped piece usually situated near the more pointed end of the para-
site and at right angles to the second rod-shaped chromatin mass (figure 2, h).
It is thicker at one end than at the other, and tapers in the direction of the
second chromatin mass into a fine point. It is present in only a few of the para-
sites in each film.
In the large cells which occupy so great a portion of the film as many as
70 to 100, or more, parasites are frequently seen, and unless the cell has been some-
what broken up in making the film they appear more rounded in shape and of
smaller size than when free. The two chromatin masses can, however, always be
made out in each parasite, the smaller one being at some little distance from, and
usually at right angles to, the larger one.
In addition to the forms described above there will be seen in films :—
(1) Protoplasmic masses containing sometimes a few, sometimes a great
many, parasites. These masses are often of remarkably regular
shape, and when small and round they look something like red blood
corpuscles in which parasites are contained. That they are not so
is shown by the fact that in well-stained slides their substance is of
the same colour as the bodies of the large mononuclear cells, and
they are obviously portions of such cells which have been torn off
in making the smear. They are not present in sections. Two
* Since the above was written Lieutenant Christophers has described a similar third mass of chromatin as
being present in some of the parasites obtained from cases of enlargement of the spleen in Madras. (Scientific
Memoirs by officers of the Medical and Sanitary Departments of the Government of India, New Series
No. 11.)