Syphilis.
Lock hospital.
MEDICAL AND SANITARY REPORT OF THE NATIVE ARMY OF BENGAL.
men who, as soldiers, were not really worth their pay, could then be let go, either by th
commanding officer's or medical officer's opinions, without the grievance of a special dis
charge on a doubt.
There were no less than 59 admissions from primary syphilis in the regiment during 1874,
of which 39 occurred in the detachments in Tirhoot, where, doubtless, the famine augmented
the temptation and disease. Sixteen cases occurred at Roorkee, but very few of them were
contracted here ; and four at Peshawur. There were also 20 admissions from secondary symp-
toms, 13 at Roorkee, nearly all being men of famine district detachments. No doubt,
the end of this disease, as regards military efficiency, has not yet arrived. The men who have
this year been admitted for syphilis will, in a majority of cases, be the rheumatic patients of
following years ; and, if the system of short enlistments, as advocated above, were introduced,
I should, as a rule, reject men for re-engagement whose medical history sheets showed a pro-
nounced syphilitic taint. The hospital assistants who were in medical charge of detachments
in the famine districts seem to have signally failed in their treatment. Prolonged stay in
hospital, indolent hard chancres and sequelæ appear to have generally resulted from infection.
It is possible that the virus may have been locally very bad ; but, so far as I could learn, the
treatment was entirely palliative, and very seldom constitutional.
There is a lock hospital at Roorkee under my care ; but the registered and examined
women do not include the class with whom the sepoys are intimate, and hence there is no real
protection against the disease in respect of them. Nevertheless, there is not any very severe
type of the disease at Roorkee. I gather from different sources that the sepoys are much in
the habit of avoiding hospital treatment and trusting to country practitioners for an ordinary
soft chancre. The cleanly habits, temperate diet, and abstemiousness generally make the cure
a very easy matter.
Nervous di-
seases, &c.
Digestive di-
seases.
Error in di-
agnosis.
Rupture of
gall bladder.
The succeeding group of local diseases, viz ., nervous, eye, ear, respiratory, have all been
few and mild. A case of' valvular disease of the heart in a young Pathan at Peshawur appear-
ed due, in the beginning, to an injury sustained at Chuckrata four years previously, from a
heavy clod of earth striking him on the back. The Peshawur detachment furnishes by far the
largest proportion of lung disease, bronchitis, pleurisy, pneumonia, asthma, and phthisis, most
likely due to ague complications in weakly men.
Diseases of the digestive system are increased this year, giving 161 admissions. There
were 52 cases of dysentery and 60 of diarrhœa. Only 5 of the former and 4 of the latter
occurred at Roorkee. For several years I have had occasion to remark on the singular immu-
nity this station enjoys in respect of bowel complaints, owing, in my opinion, entirely to the
original good quality and sustained purity of the water-supply. The detachments in Tirhoot
were often, for short periods, much straitened in procuring good water. They had 13 admis-
sions from diarrhœa, which I learnt were nearly all due to bad water, but the men very soon
got to dig wells of their own, and grew chary of drinking the water of tanks. Peshawur gives
20 admissions from dysentery and 17 from diarrhœa, most probably due to ague complications.
I find it a very common habit among hospital assistants who have independent
charge to enter every admission as one of dysentery if there is " blood in the stool." I
rather suspect that nine out of ten of them, if asked the symptoms of dysentery, would reply
"blood in the stool." And in this way cases which are simple hemorrhoidal congestion, due
to an obstructed portal circulation, swell the entries of dysentery ; and they are inveterate
still in clinging to the sugar of lead and opium treatment. It is one thing to get a correct
nomenclature, and quite another thing to ensure the proper diagnosis of disease in connection
with it.
A valued non-commissioned officer died of peritonitis caused by rupture of the bladder
and escape of the gall. The duct was found choked with a typical cocked-hat-shaped stone
weighing 11 1/2 grains. The whole tract of alimentary canal was spread with food in process of
digestion of a peculiar slaty tint, quite free from bile. It seems strange that this colour of
his motions had not excited apprehension ; but it appears he felt no inconvenience or pain
until the sharp sting set in as the gall-bladder gave way. From the quantity of bile effused
I should fancy it must have been enormously distended before rupture. The deceased was
41 years of age.
Skin diseases.
Debility.
Skin disease shows 17 varieties, and 100 admissions. Nearly all can be traced to irritation
due to the natural secretion and exhalations being aggravated by climate or clothing ; none were
either very interesting or very severe.
General debility has given 18 admissions, of which the great majority could be explained
by attacks of ague in weak constitutions. The men become inert, spiritless and weak, lose
flesh and appetite. Five were sent on sick leave to their homes. No medicine is of any good.
In fact, the men are not ill so much in body as in mind to begin with, and require mostly relaxa-
tion and enjoyment to recover tone of both.
Injuries.
No convales-
cent list.
In conclusion I have to repeat the remarks made in para. 13 of my annual report for
1873, viz ., that the large number of admissions into hospital for wounds, bruises, sprains, &c.,
is the result of the peculiar duties of the men, which necessitate the use of heavy tools, and
many men working close together. There appear to have been over 150 injuries received on
works by the men,—not many of them severe, but from their nature preventing a man from
wearing uniform or going to parade
.
And here I venture again to call attention to the fact, that in this corps there are no men
on the convalescent list, that is, sick men not in hospital. The number of admissions and the