198
MEDICAL AND SANITARY REPORT OF THE NATIVE ARMY, OF BENGAL.
the 5th Punjab Infantry, and of a very mild one in the 5th Goorkha, Regiment at
Abbottabad during the past winter, are as follows:
—
The 5th Punjab Infantry left Dera Ghazi Khan on the 15th October 1874 and reached
to Abbottabad on the 23rd of November. They had a few cases of pneumonia on the line of
march, and admissions from this cause rapidly increased after their arrival at this station.
Seizures and deaths continued frequent until the middle of March, when, having carried off
between 20 and 30 victims, the epidemic finally subsided. It is worthy of notice that the
1st Punjab Infantry, which took the place of the 5th Punjab Infantry at Dera Ghazi Khan,
also suffered severely from pneumonia at the latter station. From the 24th November 1874
until the middle of March 1875, while the 5th Punjab Infantry was rapidly losing men,
there was only one admission in the 5th Goorkha Regiment from any disease even resem
- b l i n g p n e u m o n i a . D u r i n g t h i s p e r i o d t h e h e a l t h o f t h e G o o r k h a s w a s e x c e l l e n t , a n d a t h i s
inspection the Brigadier-General Commanding the Punjab Frontier Force remarked on the
robust, healthy appearance of the men.
In the middle of March, when winter had given place to a mild and genial spring,
a bania, or flour merchant, in the Goorkha bazar was attacked with pneumonia, and shortly
after his seizure 13 cases and 3 deaths occurred among the men of the regiment; 5 of
these cases were admitted between the 21st and 31st of March, 7 between the 1st and
23rd of April, and one on the 10th of May. None of these men dealt with the bania who
was first taken ill, and their seizures after this was merely a coincidence,—a post, but not a
pr opt er hoc. The hospital dresser, whose duties kept him in constant attendance on the pleuro
- p n e u m o n i a c a s e s , h a d a l s o a s h a r p a t t a c k o f t h e s a m e d i s e a s e . I n m o s t o f t h e s e c a s e s t h e
disease was mild in type and undistinguishable from ordinary pneumonia. Pleuritic pain
was generally present and often severe in character. The portion of lung actually hepatized
was limited in extent, and the apices, or middle of the lungs, were affected quite as frequently
as their bases. The three men in whom the disease proved fatal were weakly subjects, and
would probably have succumbed to any acute disorder. One of them was a dissipated bandsman,
another a man who under-fed himself, and the third a youth whose health was completely
undermined by constitutional syphilis.
During the epidemic I had only one opportunity of witnessing a post mortem examina-
tion after death from pleuro-pneumonia. The case was that of a young, well-nourished Sikh,
camp follower of the 5th Punjab Infantry. This man died very suddenly. The entire surfaces
o f p l e u r æ a n d p e r i c a r d i u m w e r e c o v e r e d w i t h a d e n s e c o a t i n g o f y e l l o w l y m p h . B o t h l u n g s w e r e
intensely congested, but actual hepatization was limited to a third or even less of anterior
and middle of left lung; this part was solid, heavy, and in the condition recognized as grey
hepatization. The heart chambers on both sides were blocked up with decolorized clots, which
extended some distance into the vessels. The spleen was a little enlarged, and other abdominal
organs normal.
In another case of sudden death from this cause, which I had an opportunity of investi
- g a t i n g s o m e y e a r s a g o , t h e r e w e r e , i n a d d i t i o n t o t h e p n e u m o n i a a b o v e d e s c r i b e d , p l e u r i t i c
effusion on one side, and congestive enlargement of the solitary glands in the small intestines.
The main facts of the outbreak at Abbottabad are briefly these:—
1st.—Pleuro-pneumonia was introduced by the 5th Punjab Infantry, and for upwards of
three months was exclusively confined to that corps.
2nd.—It then spread in a mild but distinctly epidemic form to the 5th Goorkha Regi
- m e n t , a n d t h e h o s p i t a l d r e s s e r w h i l e a t t e n d i n g o n t h e s u f f e r e r s w a s s t r i c k e n w i t h i t . T h e s e
seizures took place in spring, when ordinary pneumonia is not prevalent.
If the hypothesis of contagion be accepted in reference to pleuro-pneumonia, it would
at once account for all the circumstances attending this outbreak. But very strong argu
- m e n t s c a n b e u r g e d a g a i n s t t h e t h e o r y o f c o n t a g i o n w h i c h w o u l d t e n d t o m a k e t h e f a c t s
observed correspond with admittted principles. Thus it may justly be asserted that the 5th
Punjab infantry was transferred to a cold climate from a sub-tropical and malarious station at
an unfavorable season of the year, and that the sudden change naturally provoked pneumonia
and other diseases of the respiratory system in men who were weak and anæmic from previous
attacks of fever. But this does not explain why the Goorkhas suffered in spring when the
men of the 5th Punjab Infantry, who had previously shown their liability to the disease, en-
j o y e d c o m p l e t e e x e m p t i o n f r o m i t . T h e e t i o l o g y a n d c l i n i c a l h i s t o r y o f t h i s d i s e a s e h a v e y e t t o
be studied, and the foregoing facts, although bald and meagre in themselves, may, in conjunc
- t i o n w i t h t h o s e f u r n i s h e d b y o t h e r o b s e r v e r s , a s s i s t i n t h r o w i n g s o m e l i g h t o n a v e r y i n t e r e s t i n g
subject.
V a c c i n a t i o n .
XIX. Vacci nat i on. —The system of carrying on vaccination described in last year's re
- p o r t i s u n a l t e r e d . T h e e f f i c i e n c y o f w o r k d o n e u n d e r t h i s h e a d w a s s u b j e c t e d t o a s e v e r e t e s t
last year, when small-pox was prevalent for several months in the civil station and neighbour-
ing villages. During the progress of the epidemic, only one out of 200 children residing in
the Goorkha lines and married quarters suffered from the disease.
Inspection.
Mr. Banister inspected this regiment on the 10th May. He reports that the
lines were efficiently drained, free from overcrowding and in admirable order.
All the arrangements bore evidence of great judgment and care, and could not
have been improved on. The accommodation allotted to the regiment in the
garrison hospital barely suffices for a healthy season, and in winter, when the
verandah rooms are too cold and draughty for occupation, some amount of