40. The comparative unhealthiness of the Sirhind Division is due to the
high figures contributed by the 12th Native Infantry at Jullundur, whose de-
tachments at Ludhiana and Phillour have been, as usual, very unhealthy. The
men also suffered from bowel-complaints at Delhi, owing apparently to impure
water. The 41st Native Infantry at Morar suffered severely from fever ; and
this explains the position of this command in the sick list. The circumstances
and causes of this fever are very intelligently discussed by Surgeon Lewtas, the
officer in medical charge.
The Sirhind
:and Gwalior
commands.
38. The Lahore Division comes next in order of sickness, but ranks sixth
in order of mortality. The high sick-rates were contributed mainly by the
two Infantry regiments at Meean Meer, which suffered severely from fever.
This seems an inevitable ordeal both in this station and at Morar. The quar-
ters occupied by both the 9th and 26th Regiments are reported to be very
inferior. The 1st Goorkhas at Dharmsala were also unhealthy ; fever being
the main cause. Fever is conspicuous among the diseases causing sickness ;
but the proportional prevalence of chest and bowel complaints and rheumatism
is also high. Spleen disease gives a high, but not extreme, figure.
The, Peshawar
District.
The Lahore
Division.
Diseases.
39. The Peshawar District, though ranking fifth as regards constant sick-
ness, comes first in respect of number of admissions, and appears unprecedently
low in the death list. The past year was, indeed, a favorable one for Peshawar.
The troops suffered from fever to a great extent, but its amount fell short of pre-
vious years, and its type was mild. The 7th, 14th, and 22nd Infantry Regiments
were the least healthy. The two latter proceeded on service towards the close of
the year. The accommodation of some of the Infantry regiments is inferior,
and the water-supply liable to contamination. The Peshawar District is facile
princeps, even in the past healthy year, as regards the prevalence of malarious
fevers. The figure for spleen disease is also high. Rheumatism, chest diseases,
and bowel complaints also exhibit high figures.
Diseases.
xxii
The Punjab
Frontier
Force.
Diseases
causing sick-
ness and
mortality.
37. The Punjab Frontier Force occupies the third place in order of con-
stant sick, the fifth as regards admissions, and the fourth in mortality. The 1st
Punjab Infantry at Quetta gives the highest sick-rates ; but all the regi-
ments in this command manifest a high standard of sickness, and most of
them a considerable mortality. This is due mainly to the unhealthy stations
occupied and the trying climate of the Frontier generally. Some of the regi-
ments suffered from the hardships of service, as I have already stated. Chest
diseases are the most conspicuous speciality of the Punjab Frontier ; but fevers,
rheumatic affections and bowel complaints also present high figures. The morta-
lity was due principally to chest-diseases, remittent fever, ague and bowel
complaints.
Itch and
guinea-worm
in central
India.
The cinchona
febrifuge.
The disproportionate prevalence of itch in the Bheel Corps is noticeable,
and the large number of cases of guinea-worm in Rajputana and Central
India. Efforts are being made to train the Bheels to greater personal cleanliness.
The prevention of guinea-worm is a more difficult problem. It is, however,
a comparatively rare disease in this Presidency, though there have been occasion-
ally striking instances of extraordinary prevalence of it among the Native
troops, notably in a wing of the 15th Native Infantry at Khytul in 1843.
1 -
41. During the year herein reviewed the " cinchona febrifuge," in sub-
.,
stitution of quinine, in the treatment of intermittent fever, has been largely
introduced into the practice of all Native hospitals, and with perfectly satis-
factory results.
There is really no difference of opinion as to its entire suitability in the
vast majority of fevers ; in fact, the cases have been very exceptional where
complete reliance was not placed on its antiperiodic power. This was to be
fairly anticipated, since I only ventured to recommend the drug as an efficient
remedy after extensive and special experiments with it had been carried out
most loyally by a large number of medical officers in civil as well as in
military employ.
Though the economic advantage of the substitution of this cheap sub-
stance in lieu of quinine is one well worthy of being considered, it is by no
means the chief one.
The satisfaction of feeling that we have always at our command locally
a medicine of undoubted efficacy in the great mass of the cases in which
quinine was supposed to be the sole remedy can hardly be overstated,