8
MEDICAL AND SANITARY REPORT OF THE NATIVE ARMY OF BENGAL.
Principal
causes of
sickness.
The only tangible cause operating to produce such a high sick and mortality rate in the
past year, was that detailed in paragraph IX. Probably some unknown causes may have been in
operation in the production of so much sickness, as also mental depression. All the men in
the regiment suffered from extreme depression mentally, and a large number of them were very
anxious to leave the regiment, not caring to have further service in Bengal. The only conclusion
I can arrive at is, that much, if not the greater proportion, of the sickness was due to malarial
poison acting on men in a weak bodily condition and suffering from great mental depression.
What I think supports this view is the fact, that the poor and badly nourished inhabi
-tants of the district suffered in the same manner as the sepoys of the regiment.
XVI. Principal causes of sickness .—The diseases which caused the greatest number of
admissions were, ague 573 cases, general debility 354, hypertrophy of spleen 114, dysentery
73, diarrhea 28. Other diseases in the Return were of the usual ordinary nature and require
no notice. The cases of ague were of a mild character, except where complicated with anæmia
and scorbutic symptoms. Under general debility are classified a number of cases in which
there was great emaciation and general weakening of the vital power, without the specific
symptoms of any particular disease. Some of the cases followed on long-continued illness from
ague, others, and the majority from the use of au insufficiently varied diet. Under hypertrophy
of spleen are placed cases of simple enlargement, which were unaccompanied by febrile or local
symptoms. Recruits chiefly suffered from this disease, and few of them escaped. The cases of
dysentery and diarrhœa were usually of a very severe character, and they were almost
invariably accompanied with anæmia or a scorbutic taint. The scurvy cases were simply the
result of abstention from fresh vegetables.
Deaths.
Recommenda
-tions.
Remarks.
Recruits.
Enteric
fever.
There were 33 deaths in hospital during the year, and from the diseases as under—
Enteric fever . . .
1
486 Colic . . .
1
15 Ague . . .
4
524 Splenitis . . .
1
54 Scurvy . . .
1
528 Hypertrophy of spleen . . .
8
466 Dysentery . . .
4
905 General debility . . .
7
484 Diarrhœa . . .
6
In the case of enteric fever, death took place from perforation of the gut. Adhesions had
taken place between the gut and parieties, but had become separated during an attempt the
patient made to get out of bed. In the case of scurvy there was infiltration of the cellular
tissue followed by ulceration and gangrene. In all the cases of ague and general debility
prior to death, there were symptoms of embolism, and on examination after death the heart's
cavities were found to contain clots of decolorised fibrin. When death occurred suddenly and
with convulsions, the left cavities contained the clots, and when death took place slowly and
with much oppression of breathing, the right cavities contained them. In some of the latter
cases, complete tubular casts of the pulmonary artery and its branches were obtained. In
hypertrophy of spleen, death was preceded by diarrhœa, or most frequently diarrhœa and
hæmorrhage from the infesfinnl
tract.
XX. Recommendations .—The chief recommendations made during the year were with
regard to the dieting of the men. The recommendations made and the system introduced
into the hospital have been detailed. The system when fully carried into effect was followed
by a marked improvement in the condition of the sick. I do not know what, if any, means
were adopted to ensure that the men dieted themselves properly in the lines.
XXI. Remarks .—The large amount of sickness in this regiment is supposed by several
of the officers to be due not to the use of an improper diet, but to other causes : 1 st, it is
supposed that a long residence in Bengal is sufficient to account for much, if not all, of the
sickness. It may here be remarked that out of a total number of admissions at head-quarters
of 1,140, 503 admissions took place among men of two years' service and under. The recruits
alone contributed no less than 282 admissions during the year. Hence it would appear that a
residence of any duration, however short, would prove equally injurious. The recruits were on
joining a healthy body of men and of good physique. 2 nd, sickness was due to the bad con
- s e r v a n c y a r r a n g e m e n t s a n d d r a i n a g e o f g r o u n d i n t h e v i c i n i t y o f t h e l i n e s . T h i s m a y p r o b a b l y
be the case ; but if so, the active agent in the production of disease could only have come
into operation in the past year, and it must have lain dormant in previous years, as the
conservancy arrangements were then the same. Succeeding regiments will stiffer from this
agent now that it is operating. During the year, there were two cases of enteric fever, and
both men were previously resident in Dum-Dum. 3 rd, the duties were supposed to cause a
large amount of sickness. The nights in bed were certainly shewn to be very few, but the
labor exacted was not of a very arduous character, nothing beyond a few hours on general duty
in the twenty-four. No other labor of a severe nature appears to have been undertaken by the
men. If one or any of these agents operated in the causation of disease in this regiment,
they certainly did not operate to any appreciable extent in the production of disease in the
other regiments quartered in the station. The 39th Regiment, and Detachment 19th Bengal
Infantry, both under my care, were not affected in the same way. Both were comparatively
healthy, and it was very rarely their recruits were found in hospital. A detachment of the
18th Bengal Cavalry did suffer in a similar manner. They were, however, weakly and
scorbutic, and it became necessary to issue rum and lime juice to them.
Inspection.
The Deputy Surgeon-General of the Presidency Circle inspected the
hospital and sanitary arrangements of this regiment on the 25th November