244
MEDICAL AND SANITARY REPORT OF THE NATIVE ARMY OF BENGAL.
Principal
causes of
sickness.
Blistered feet.
1874. The number of men invalided is very small; I anticipate it will be much greater nex
year. There are several old men in the regiment getting near their full service, and there are
also a few young and weakly men who have not quite sufficient service to entitle them to any
pension. Of the four men sent on sick leave, three died. I have now almost set my face
against granting sick leave from this station; the difficulties of the journey to Calcutta are too
great for a man in a weak state even with a man to attend him.
XVI. Principal causes of sickness. —Malarious fevers account for 402, or close on 50 per
cent. of the total admissions, a percentage less than in 1874, and much less than in 1873.
Bowel affections have been rather more frequent than in 1874, the principal entries being under
dysentery, diarrhœa, and dyspepsia, which show 52, 39, and 18 admissions, respectively.
Rheumatic affections give 54 admissions, a number almost identical with that of last
year. There were 53 admissions for blister of feet. There were 25 admissions for chest
diseases, a number considerably less than in last year; these include five cases of pulmonary
phthisis. Diseases of the cutaneous system gave 41 admissions against 53 last year. Finally,
venereal doseases gave 17 admissions as compared with 18 last year.
Principal
causes of
mor
Epidemics,
XVII. Principal causes of mortality .—Of the ten deaths in hospital, three were due to re
-
mittent fever, one of these being complicated with pericarditis, and perhaps with some myocar
-
ditis; one was due to chronic enlargement of the spleen and malarious cachexia; one to general
debility; one to dysentery; one to diarrhœa; one to secondary syphilis (death in this was induced
by mercurial poisoning), one to cholera, and one to pulmonary phthisis. Of the eight deaths
out of hospital, two occurred in Cachar, and were due, one to syncope and one to accidental
drowning; three were of men on sick leave, the cause in two being general debility and one
pulmonary phthisis, The remaining three deaths were of men on furlough; two were due to
cholera; the cause of the other is unknown.
XVIII. Epidemics.—None. I may mention, however, that three cases of cholera occurred
during the year. I need not say that every precaution was taken when the above-mentioned
cause of cholera occurred.
Vaccination.
Small pox.
Recommenda
-tions.
Special obser
-vations.
Mercurial
poisoning.
XIX. Vaccination .—In my report for 1873 I mentioned that the regiment was not
protected against small-pox. This opinion requires modification, or rather explanation; it
referred to the protection afforded by vaccination. The great majority of the men have either
had small-pox, or been inoculated in early life. During the year I vaccinated , 16 recruits (be
- s i d e s s e v e r a l b a z a r c h i l d r e n ) , s e l e c t i n g t h o s e w h o m I t h o u g h t l e a s t p r o t e c t e d . T h e r e s u l t s
were not satisfactory, at least as far as vaccination is concerned ; nine were complete failures,
and none of the others were very good. In no instance was I enabled to perform arm-to
- a r m v a c c i n a t i o n . P r o b a b l y t h e l y m p h w a s n o t v e r y f r e s h . T h e t w o c a s e s o f s m a l l - p o x w h i c h .
occurred during the year were both at Manipur; both were mild cases. One of the men
had distinct marks of previous small-pox; the other man says he had small-pox as a child:
the marks, if any, are very faint.
XX.Recommendations .—(a) In May and June there was a very fatal epidemic
amongst horned cattle. ; the river was polluted with stinking carcasses. I therefore recommended
that the men should be cautioned as to the danger of drinking this water. Enquiry
showed that they did not use it for drinking purposes, and but rarely for washing. ( b.) In
July, having satisfied myself that several cases of disorders of the digestive system, especially
flatulent dyspepsia, were due to the use of inferior grains, I brought the subject to the notice of
the regimental authorities: the practice was discontinued. ( c.) When the cases of cholera
occurred, I recommended that the men should be warned not to delay in the lines when the
slightest symptoms of diarrhœa appeared; the recommendation was acted on immediately.
XXI. Special observations .-1. Some cases are shown under the head of "General Debility"
for want of a better term. The history of these cases is pretty much as follows: loss of
appetite and dyspeptic symptoms, wasting and loss of strength and spirits, occasional fever,
which may become severe, more or less looseness of the bowels, with occasional diarrhœa; symptoms
of spurious scurvy, viz., pain in the gums and teeth, with loosening of the latter; the gums
are usually swollen and pallid, not markedly soft, and but rarely bleed; there may be ulceration
of the gums, especially along the edges, with falling out of the teeth. I have seen a tooth
break off short, leaving a blackened fang in the alveolus; the tongue may be dry and
glazed, in other cases moist, with a whitish hue; in one instance gangrene of a considerable
portion of this organ occurred; the breath is usually foul, sometimes excessively so;
there is rarely any marked enlargement of either liver or spleen. In the heart a functional
murmur (basic systolic) is usually found, but there is no anasarca, only a little puffiness of the
insteps and
under the eyes, and that not always. The proper dietetic treatment of these cases
is a great difficulty
.
2. Chronic mercurial poisoning is rarely seen now-a-days, I had one marked case of it
— t h e c a s e o f s e c o n d a r y s y p h i l i s w h i c h t e r m i n a t e d f a t a l l y ; t o h i s d y i n g d a y t h e m a n n e v e r t o l d
who administered the drug to him, though I had strong suspicions myself as to where it came
from. For some 12 hours previous to death , there was evidence of the formation of a clot in
the heart; death was very sudden—I had almost said instantaneous. The patient squatted
down to urinate rose an suddenly, and fell back dead.
Cholera
3. In two cases of cholera I tried the treatment by hypodermic injection of chloral
hydrate. One case recovered, but remained in hospital a very long time, owing to very nasty
slough
'
which formed at the seats of injection; the other case terminated fatally. Still the
chloral was not without its value; it certainly diminished the intensity of the cramps and
pains.