Principal
causes of
mortality.
Epidemics.
Cholera.
Causation.
MEDICAL AND SANITARY REPORT OF THE NATIVE ARMY OF BENGAL.
Eye diseases.—Most of these occurred at head-quarters, and were cases of simple con
- j u n c t i v i t i s , w h i c h s o o n r e c o v e r e d . T h e c a s e s o f p t e r y g i u m w e r e o p e r a t e d o n .
Respiratory diseases.—There were 23 admissions under this head; all, with one exception,
at head-quarters; many of them were from nasal and bronchial catarrh; which were
prevalent in the month of September, but not in a severe form. There were 3 admissions
from pleurisy and 2 from pneumonia, but no deaths.
Diseases of the digestive system.—Of 42 admissions under this head, 27 were in the
detachment at Barrackpore, and of these, 16 were cases of dysentery against 4 from this
cause at Lucknow. All the cases of diarrhœa occurred at head-quarters, most of them about
the time when cholera was prevalent.
Urinary diseases.—These were principally from gonorrhœa and its complications, and
most of them at head-quarters.
Cutaneous diseases.—These have not been either numerous Or important; they were
chiefly ulcers and boils, and most of them occurred at head-quarters.
Accidental diseases.— There were 74 admissions from this cause, of which only 10 occurred
in the detachment; most of them were contusions from falls from horses. The fractures were
of the clavicle and small bones of the hand. A recruit who remained under treatment from
last year for fracture of the thigh, was invalided by a special committee and granted a
pension.
XVII. Principal causes of mortality.— The only two deaths in the head-quarters' hospital
were from cholera. The death in the detachment hospital at Alipore was from dysentery,
apparently of short duration. It is not certainly known what was the immediate cause of
death of the man who died at his home whilst on sick leave. He had been sent on 6 months'
sick leave, on 28th December 1874, by my predecessor, and was then said to be suffering from
hepatitis and enlarged spleen; his death occurred on the 29th June.
X XVIII. Epidemics.—Cholera has been prevalent in Lucknow in an epidemic form twice
during the past year; first in April and May, and again in August, September, and the early
part of October; although, as regards the city of Lucknow, there was no very material
difference in the severity of the two visitations, as regards other communities there was. In
the one the disease was present to a great extent throughout the province of Oudh; in the
other to a far less degree and only in certain districts. In the one the native troops and
police were attacked whilst the Europeans escaped, in the other the native troops and police
were affected but slightly, whilst the Europeans suffered severely. It was only during the
first of these epidemics that this regiment suffered. There were in all two cases amongst
the sowars, both of which proved fatal; and two amongst the followers, both of which recovered.
The first case occurred on April 20th, and the last on May 19th. Diarrhœa was more prevalent
than usual during this time, and some of the cases were very severe. On the 6th April, when
the first alarm occasioned by the appearance of the disease in the station occurred, a tent was
pitched under a tope of trees, about 450 yards from the hospital, and all cases of cholera
were treated in this tent. The men's huts were cleaned and leeped, and their bedding was
exposed to the air. The regiment was not moved into camp, but as two cases of cholera
and one of severe diarrhœa had occurred in the lines of the 3rd troop, it was moved into the
vacant lines of the 1st troop on the 7th May, and remained there till 17th June, when it
returned to its own lines. No fresh cases occurred after this movement. Station orders were
issued, prohibiting men from visiting the city, and requesting commanding officers to keep
them within cantonment limits; these orders were in force up to May 24th. It was supposed
by some that the disease was imported into Lucknow by pilgrims returning from a fair on
the Ganges on the 5th and 6th April, but the returns published in the Oudh Gazette show
that 3 deaths occurred from cholera in the city of Lucknow in the week ending April 2nd.
In the report which I wrote soon after the disease had disappeared, I stated that I was unable
to find any evidence of the importation or propagation of the disease by human intercourse,
or infection from the sick, or of its arising from the use of water contaminated by cholera
discharges. I expressed my conviction then, as I have so often done before, that it did not
originate in this way, for the simple reason that all my experience has gone to show that no
germ, poison, or other material substance peculiar to cholera, and to which it owes its origin,
exists. My opinion is, that it was entirely due to the state of the atmosphere acting upon
persons whose vital condition had been lowered by original weakness of constitution, previous
sickness, or exposure to insanitary conditions, or by their habits and mode of life. None of the
persons who suffered in this regiment were in really good health at the time they were attacked,
and I believe, if careful enquiries were made, this would be found to be very generally the case
in all attacks. Quarantine measures did not appear to be of any avail in checking the progress
of the disease; the most strenuous advocate of them would not, I imagine, explain the
exemption of the European troops at Lucknow in the first epidemic, and of the native
troops in the second, to isolation or the action of quarantine. But an explanation of it is,
I think, to be found in the fact that the Europeans were probably in better health at the
commencement of the hot weather, being well clothed and well fed. They had been invigorated
and strengthened by the previous cold weather, and their large barracks, artificially cooled,
would prevent them from feeling the first burst of the hot weather to the same extent
as natives who had no such advantages. But the reverse of this would be the case at the
close of the hot season. The native, whose habits and mode of life are so suited to a hot
climate, would be likely to find his health improved, whilst that of the European would
be impaired by his confinement to barracks and freer mode of living.