42
MEDICAL AND SANITARY REPORT OF THE NATIVE ARMY OF BENGAL.
Principal
causes of
sickness.
XVI. Principal causes of sickness —The following table shows the principal Causes of
sickness, during the past year, and the degree to which the same causes were active during
1875 and 1876.
Name of station, year.
Total
admissions. Fevers.
Dysentery.
Boils, a b s c e s s e s
a n d u l c e r s .
Bl
isters o f
feet.
Primary and secondary
syphilis.
Ophthalmia
and Conjunc-
tivitis.
Itch.
Morar 1877
.
.
1,174
870
50
43
21
19
17
17
Ditto and Lucknow
1876.
676
312
33
54
30
25
14
25
Lucknow 1875 .
.
491
148
32
62
52
38
12
2
Fevers.
Explanation
of excessive
prevalence.
Protective
influence of
good health.
Probable
future history
A glance at this table shows the vast preponderance of fevers (intermittent) amongst the
causes of sickness. This,excessive prevalence of intermittent fevers was not equally distributed
over the year, but, on the other hand, the seasons at which they specially prevailed had no promi-
nent feature in common to suggest itself as a cause. Thus in April' and May, both of them hot
months during which a hot wind blew, there was an extensive outbreak of these fevers. In April
they furnished 113 admissions, and in May 121. At the beginning of the cold weather, there was
again a large number of admissions on account of intermittent fever—in November 293 admis-
sions, in December 183. Since these are the same men who afforded only 148 admissions for fever
during a whole year at Lucknow, it is clear that the cause .of this great increase must lie outside
the men in their new climatic surroundings, and I think the following explanation both
accounts for the facts and reconciles the apparent contradiction in the seasonal features under
which the outbreaks have occurred; moreover, it is in consonance with what is known of the
etiology of these fevers.
In the first place, the cause of intermittent fever is always specially active at Morar. The
medical history of the station abundantly establishes this fact.
Secondly, a body of men newly arrived in the station in robust health are able for some
months to resist the operation of the cause of these fevers. This is merely a generalisation
of the well-known fact that any one in good health is much less obnoxious to fever than any
one in feeble health.
Thirdly, when this primary protective influence has been exhausted by a few months'
residence, nearly every one falls a victim to these fevers, their greater or less prevalence being
determined by the greater or less fluctuation in the diurnal temperature. This hypothesis is
in entire agreement with the medical history of this regiment. Since arriving at Morar in
November 1876, for the first four months the admissions for intermittent fevers were but little
in excess of those for a corresponding period at Lucknow ; but the protective influence of their
previous good health slowly wore off, and hence a large number of admissions in April and
May, admissions due it is presumable to influences imbibed during the cold months ; for as
noted in the Sanitary Report for May 1877, the same men presented themselves again and
again for admission. When a constant high daily temperature was reached, the activity of the
fever-producing cause subsided, to be again revived in November, when the difference in the
temperature of day and night became again wide. ( Note. It is impossible to say whether
a large daily variation of temperature caused an increased activity of the fever-poison or an
increased predisposition of the individual; probably it acts in both ways.)
Probable future history. —Lastly, an examination of the annual reports of regiments
previously stationed at Morar, shows what indeed our knowledge of the disease elsewhere leads
us to expect, that after the great number of admissions during the first year's stay" in the
Station, there is, in succeeding years, a steady and large decrease. The history of the 6th and
34th Regiments of Native Infantry illustrates this:—
6th Native Infantry ; t o t a l
admissions per cent. of
strength.
34th Native Infantry ; total
admissions per cent. of
strength.
Morar .
.
. .
.
.
.
.
. 1870
482.2
...
do.
.
.
. .
.
.
.
.
. 1871
303.1
304.3
do.
.
.
.
.
.
.
.
.
. 1872
178.4
2 3 4 . 8
do.
.
.
.
.
. . .
.
. 1873
136.2
162.2
Causes of the
special
unhealthiness
of Morar.
And this we may expect will be the case with the 41st Native Infantry. As year by year the
men become acclimatised, the number of cases of fever will become less and less.
Causes ,of the special unhealthiness of Morar .—Granting that these intermittent fevers
are the symptoms of poisoning by a specific agent generated outside the body, and admitting
further that this specific poison is specially abundant in Morar, it still remains to explain why
the residents are so unequally attacked ; why, for example, this regiment should have on one day
one hundred cases of ague in hospital, while a European Regiment in the same station and
on the same day has only one-tenth the number. Clearly there must be something in the