Ague and spleen.
Causes.
11
PRESIDENCY DISTRICT.
Ague and hypertrophy of the spleen formed the principal admissions, but the number of
the former was only half that of the preceding year, while the number of cases of enlarged
spleen increased twelve-fold. The attacks of ague were of a persistent nature, and more
severe than in 1876, when they were of a mild but recurrent form. The causes of the
excessive sickness of the regiment were described in the report for last year, and these still
exist, viz.,. (1) original inferior physique of the sepoy on enlistment, but this has been in a
great measure remedied by a careful selection of well-developed, healthy recruits ; neverthe-
less, recruits still suffer to a large extent; (2) three years' residence at Baxa Duar, Bhutan,
in 1873, 1874, and 1875, where, owing to climatic and dietetic causes, all diseases were of au
asthenic or scorbutic type; (3) then a change to a damp malarial station like Barrackpore ;
(4) unhealthy, low-lying, and badly-drained lines; (5) the very heavy duties ; (6) a dislike
on the part of the men for service in Bengal, and the resulting depressive effect ; (7) the
•unvaried ration of the native soldier, and his abstinence from animal food. The regiment was
inspected on the 3rd December 1877 by Deputy Surgeon General R. Cockburn, with the
result given below:- Inspection.
Number of recruits
present.
Caste.
Number suffering
from enlarged spleen.
Men in the ranks,
present.
Company.
Number suffering
from spleen.
20
Aheers
6
2 5
A
1 3
46
Goorkhas
1 0
2 0
B
9
26
Koormies
5
1 7
C
1 0
80
Jats
1 1
1 5
D
7
2 1
E
1 0
3 9
F
1 0
3 1
G
1 0
1 8
H
6
Total .172
. . .
3 2
1 8 6
. . .
7 5
18 of the Jats were enlisted in 1876 and 62 in 1877.
25 of the Goorkhas were enlisted in 1876 and 21 in 1877.
24 of the Koormies were enlisted in 1877.
None of the sick in hospital were included in the above examination, only the men off
duty. It was then seen that 18 per cent. of the recruits, and 40 per cent. of the men in the
ranks, were suffering from enlarged spleen. In the previous year there were only 12 admission
for enlargement of the spleen ; but in 1877 the very large number of 146 was admitted for this
affection. On the day of inspection the gums of all the men were carefully examined. Most
of them, in fact nearly all, were of a livid hue, and presented some of the appearances of scurvy.
In no case, however, was there actual scurvy ; although the condition attending this state of
the gums was closely akin to that disease, yet it might more naturally be attributed to malari--
al cachexia conjoined with dietetic causes. There is no doubt that the regiment is suffering
very severely from malarial cachexia, and it can be seen from the returns that the sickness has
been steadily increasing. Every effort has been made by the regimental authorities to counter-
act this. tendency to disease, but the wished-for result has not been attained. The men's diet
and clothing have been carefully looked after ; their accommodation in barracks and in
hospital were frequently reported on; cinchona febrifuge in 10-grain doses, dissolved in
lime juice, was served out as a prophylactic to all the men off duty every morning. Sick
leave, too, was freely granted, 54 men having been sent to their homes. Seventy-eight men
were invalided during the year ; 41 of these were of long service.
XVII Principal causes of mortality.--The following table shows the causes of death :—
DIED.
A g u e .
S p l e e n .
D a b i l i t y .
Ch o l e r a .
D y s e n t e r y .
R e m i t t e n t f e v e r .
P h t h i s i s .
B r o n c h i t i s
I n d i a n h e m p .
S y p h i l i s .
L u m b a g o a n d d e - b i l i t y .
M i t r a l v a l v e d i s - e a s e o f h e a r t .
C a n e r u m o r i s .
Unknown causes.
Total.
In hospital
2 2
1 2
7
4
4
3
2
2
1
. . .
1
1
1
. . .
6 0
Out of hospital
2
2
1
. . .
1
. . .
. . .
. . .
. . .
1
. . .
. . .
. . .
1 2
1 9
T o t a l
. . .
. . .
. . .
. . .
. . .
. . .
. . .
. . .
. . .
. . .
. . .
. . .
. . .
. . .
7 9
Prevalence of
spleen disease.
Scurvy.
Principal
causes or
mortality.
The mortality has been principally due to ague and enlargement of the spleen. One man
died suddenly from rupture of the spleen ; the notes of the case were sent to the Indian
Medical Gazette. Fifteen post-mortem examinations were made during the year. In all these
cases the spleen was found enlarged ; one spleen weighed 4lbs. 4 oz. Nineteen men died out
of hospital ; of these, the cause of death was unknown in 12 cases : among them is included
one death that occurred in 1876, but the report was not received until 1877.