NationalLibraryOfScotland/medical-history-of-british-india huggingface dataset:
66.
TABLE
Table showing total admissions and deaths ratios per 1,000 of the strength for
with all
Stations with total admission ratios all causes, higher than
Stations.
M i r A l i .
D e h r a D u n .
R a z m a k .
J a b b u l p o r e .
B a n n u .
A m b a l a .
F o n t S a n d e m a n .
J h a n s i .
P o o n a .
M e e r u t .
All Causes :—
Admissions
.
.
812 1
688 . 3 652 . 2
639.1 607 . 5 557 . 9 531 . 7 513 . 4 511 . 7 507.4
.
.
Deaths.
8.21
4.04 4 . 47
...
6.23
1.25
2.31
1.32
2.90 0.89
A A. C. Sick .
. .
14 . 85 25 . 15 24 . 76
22.40 22.90 16.74 15.15 18.22 19.16 19.68
Malaria :
—
Admissions
.
. 290.8 177.7 190.9
180.7 159.7 155.6 199.3 99.4 178.2 174.0
Deaths
...
. . .
0.17
. . .
...
. . .
. . .
. . .
. . .
...
Sandfly fever :
—
Admissions
. 47.3
...
2.2
1.5
7.4
...
17.1
2.6
...
. . .
Deaths
.
. . .
. . .
. . .
. . .
. . .
. . .
. . .
. . .
...
...
Enteric group :
—
Admissions
.
.
...
1.5
0.3
. . .
0.3
0.4
1.4
0.3
...
0.9
Deaths
.
. .
. . .
0 . 3 7
. . .
...
. . .
. . .
0 . 4 6
. . .
...
. . .
Dysentery :
—
Admissions
.
12.6
15.1
30.8
26.7
24.8 16.7
3.2
35.3
17.9
14.3
Deaths
...
...
. . .
...
0.28
...
. . .
. . .
. . .
. . .
Diarrhœa : —
Admissions
. .
5.8
10.7
3.3
4.0
8.8
7 1
2.8
5.6
5.3
9 4
Deaths
.
...
. . . ...
. . . ...
. . .
. . .
. . .
. . .
. . .
Influenza : —
Admissions
.
.
0.5
13.6
1.0
..
...
...
0.9
10.2
...
...
Deaths
.
. .
...
. . . ...
...
. . .
...
. . .
. . .
...
. . .
Pneumonia Lobar and
Lobular : —
Admissions
5.3
5.5
3.0
3.0
8.2
7.5
5.1
3. 0
4.5
6.3
D Deaths
...
...
0 . 7 3
0.50
...
0.57
0.42
...
0.33
0.53
...
Venercal Discases : —
Admissions
.
.
2.4
7.0
4.0
13.4
7.6
7.5
2.8
3.0
21.8
13.4
Deaths
.
. .
. . .
...
...
...
. . .
...
...
. . .
. . .
...
Minor Septic Diseases :
—
Admissions
. .
23.7
94.7
32.1
70.8
38.8
51.4
24.9 50.2
34.2
39.8
Deaths
..
.
...
...
0. 17
...
. . .
...
...
...
. . .
. . .
Local Injuries : —
Admissions
.
.
69.6
73.4
74.7
86.6
75.0
66.9
45.8
86.9 63 . 2
6 9 . 4
Deaths
.
.
. 8.21
0.37
3.15
...
4.53
...
0 . 9 2
...
0.26
. . .
Heat Stroke : —
Admissions .
.
. . .
. . .
...
...
...
...
...
...
...
...
Deaths
.
.
.
. . .
. . .
...
. . .
...
. . .
. . .
...
...
...
Heat Exhaustion :—
Admissions
. .
...
...
...
...
...
...
...
. . .
...
. . .
Deaths
.
.
.
...
...
. . .
...
...
...
...
...
...
...
Ankylostomiasis : —
Admissions
. .
4.8
5.1
5.5
7.9
20.1
22.6
0.5
...
6.3
0.4
Deaths
.
.
.
...
. . .
...
. . .
. . .
...
. . .
...
...
. . .
Pulmonary Tuberculosis : —
Admissions
.
0.5
1.1
1 . 3
1.5
2.8
0.4
0.9
1.7
1.8
4.0
Deaths
.
.
.
. . .
. . .
0.17
. . .
. . .
... ...
. . .
0.53
0.45
67
58
all causes and certain important diseases for the large stations compared
India.
all India.
Stations with total admission ratios all causes, lower than all India.
A l l I n d i a .
N o w s h e r a .
L a h o r e .
A b b o t t a b a d .
R a w a p i n d i .
K o h a t .
B a n g a l o r e .
S e c u n d e r a b a d .
W a n a .
Q u e t t a .
L a n d i k o t a l .
P e s h a w a r
J h e l u m .
475.9 472.2 464.2 454.0 433.9 419.6
414.2 387.9 360.3 357.1 344.7 329.1 264. 1
1.24
1.60
2.29
2.12
0.7
1.00
3.00
1.88 1.71
1.43 0.98
2.16
0.40
12.48 16.17 14.26 16.25 19.59 16.76 17.67 13.56 15.84 19.44 10.57 14.08
8.26
69.7 144.9 122.5 118.3 103.6 107 1
20.4 40.5
83.4 118.8 123.2
70.5
127.4
...
...
...
0.04
. . .
...
. . .
. . .
. . .
. . .
. . . 0.18
. . .
22.7
2.4
1.0
6.0
6.4
6.2
...
. . . 0.7
17.9
11.2
14.9
2.8
...
...
...
. . . ...
... ...
. . .
...
...
. . . ...
. . .
0.9
0.4
1.0
0.5
0.2
0.8
. . . 0.6
. . .
0.2
0.5
0.4
0.4
. . . ...
. . .
0.06
. . . ...
...
...
. . .
. . .
. . .
0. 18
. . .
8.7
12.4
4.9 17.1
28.9 13.4
14.4 25.7
2.7
15.0
8.3
28.2
8.5
. . .
. . .
. . .
0.01
. . .
...
. . .
0.31
. . .
. . .
. . . 0.36
. . .
12.1
10.8
3.3
6.3
4 . 5 19.5
11.3
5.0
5.4
7.4
5.4
4.7
2.0
. . .
. . . ...
. . .
. . .
...
. . .
. . .
. . .
. . .
. . .
. . .
. . .
8.1
11.6
3.9
3.7
4.7
...
0.4
5.0
19.5
. . .
3.9
...
0.4
0.31
. . . ...
0.00
. . . ...
...
. . .
. . .
. . .
. . . ...
. . .
3.4
7.2
4.9
5.4
10.4
4.1
2.6
1.6
5.1
5.7
6.4
4.3
7.7
...
0.80
0.33 0.29
. . .
...
. . .
. . .
0.24 0.24
. . .
0.18
0.4
2.8
4.4
4.9
8.5
8.8
2.3
20.0
18.8
1.2
7.1
0.5
5.6
7.3
...
...
. . . 0.00
. . .
...
...
. . .
. . .
. . .
...
0.18
. . .
70.3
40.0
58.5
36.8
26.5
28.0
43.1 25.4
37.1
11.4
14.7 33.8
13.7
. . .
. . .
. . .
0.00
. . .
... ...
...
. . . ...
. . .
. . .
. . .
63.8
62.4
44.4
57.0
43.8
70.6
77.5
49.9
61.0
25.7 39.1 37.0
25.8
0.31
0.40
0.33
0.63
0.24
0.26
0.76
0.94
. . .
. . .
. . . 0.36
. . .
...
. . .
. . . . . .
...
...
...
. . . ...
...
...
. . .
. . .
...
. . .
. . . . . .
. . .
. . .
. . .
. . .
. . .
. . .
. . .
. . .
. . .
3.4
. . .
. . . 0.2
0.5
0.3
. . .
. . .
. . .
. . .
. . . 0.9
. . .
. . .
. . .
. . .
. . .
. . .
. . .
. . .
. . .
. . .
. . .
. . .
. . .
. . .
13.4
6.8
7.2
6.2
6.9
18.0
3.0
1.6
2.2
6.0
1.5
1.6
6.0
. . .
. . .
. . .
. . .
. . .
. . .
. . .
. . .
. . .
. . .
. . .
. . .
. . .
1.9
1 . 6
1. 6
1.9
2.8
2.8
0.8
0.6
1.7
1.9
2.4
1.3
2.4
. . .
. . .
. . . 0.06
0.24
. . .
. . .
...
. . .
. . .
...
...
. . .
68
36. Followers.
Admission rates for followers at 323.2 per 1,000 show an increase of 51.2
over 1938. The death rate has been 2.50 and invaliding rate 4.23 per 1,000.
The following table shows the sickness rates for followers during the
past 5 years. Sick rates for followers are usually on a much lower level than
for troops partly because they are less likely to report sick as long as they
can carry on with their work.
TABLE 59.
Sick rates for Followers
Ratio per 1,000.
1935
.
.
.
.
.
.
.
.
.
.
.
302.9
1936
.
.
.
.
.
.
.
.
.
.
.
279.1
1937
.
.
.
.
.
.
.
.
.
.
.
279.0
1938
.
.
.
.
.
.
.
.
.
.
.
272.0
1939
.
.
.
.
.
.
.
.
.
.
.
323.2
The principal diseases are similar to those for I. O. Rs. as below :—
Diseases of Followers
Rate per 1,000.
Malaria
.
.
.
.
.
.
.
.
.
.
98.4
Venereal diseases .
.
.
.
.
.
.
.
.
10.2
Dysentery .
.
.
.
.
.
.
.
.
.
9.1
Pneumonia .
.
.
.
.
.
.
.
.
.
8 . 1
Sandfly fever
.
.
.
.
.
.
.
.
.
5.1
Pulmonary tuberculosis
.
.
.
.
.
.
.
1. 7
In all Commands there have been similar increases in the sick rates of
these personnel. In Northern Command there has been an increase of 21
per 1,000 to 312 per 1,000, a good average figure. The principal causes of
sickness have been malaria which has risen due to increases in Kohat and
Waziristan Districts ; pneumonia which is slightly higher than last year but
in 124 cases there were only 9 deaths ; the dysentery-diarrhœa group which
has decreased Slightly ; sandfly fever with a marked decrease to the lowest
recorded figure of 5 . 88 per 1,000 ; cholera one suspected case and 35 cases of
mumps.
In Southern Command too there has been a marked rise of 126 per 1,000.
Two factors are concerned firstly that followers are not provided with mosquito
nets and malarial admissions jumped 284 to the high figure of 659 actual cases,
secondly in peace time there is too much leniency towards elderly, debilitated
followers who are allowed to serve on although unfit for field service and
who on the outbreak of war justifiably went sick. There were increases also
in dysentery, venereal and pneumonia.
•
Western Independent District also showed an increase, 50 per 1,000,
with malaria and sandfly fever as the chief causes.
In Quetta the Labour Reconstruction Camp Hospital closed in August
as an economy and the Indian Military Hospital took on its work. There
was an increase in sandfly fever and malaria, but a decrease in dysentery in
this community. Daily local inspections and treatment were continued as
described for 1938.
69
37. Principal interesting features of the Year.
(See paragraph 5.)
(a) The declaration of War and the preparation and despatch of over-
seas troops and replacement of units was the outstanding feature of the year.
Subsequently there was much movement of troops ; Territorial Forces were
embodied ; protective posts over widely scattered and often unhealthy areas
were manned ; Reservists and returning leave men arrived in large numbers
from malarial infected areas and Recruiting Centres were flooded with eager
applicants.
(b) Tetanus Toxoid immunisation was carried out for. Indian Troops of
overseas forces and has been arranged now for the whole Army in India.
(c) Operations were carried out in the Shaktu Valley in Waziristan, at
Cuttack in Orissa in the east and at Sukkur in Sind in the west. The health
of troops remained remarkably good.
(d) Hospitals had to be expanded in certain stations to meet require-
ments of increased garrisons.
(e) Drought conditions prevailed in Rajputana and the Eastern Punjab.
The garrison of Nasirabad had to be reduced because of water shortage.
(f) In P. & A. and Meerut Districts there were increased sick rates in all
the six principal diseases : Malaria, sandfly fever, dysentery, venereal disease,
influenza and minor septic diseases but in contrast Rawalpindi district showed
decreases in malaria, minor septic diseases, sandfly fever, scabies and venereal
diseases.
38. Factors which have affected the incidence of disease amongst troops.
(a) The changed distributions of troops due to the War ; the manning
of defensive posts in out-of-the-way and often unhealthy areas ; the frequent
moves ; the crowding of barracks and quarters with recalled leave men, with
reservists and with recruits many of whom must have been heavily infected
with malaria and other communicable diseases were important factors.
(b) There was a prevalence of cholera in the East and Central India ;
plague in the South ; small-pox round Abbottabad, Lahore, Ambala and
Meerut ; Malaria in the U. P. and the Bombay area.
(c) An excess rainfall in the Agra-Lucknow area on the 6th September,
11.26 inches in one day, which caused much destruction in the former, pro-
duced an epidemic of sandfly fever.
(d) Anti-insecticide spraying has been considerably developed and arrange-
ments were made for manufacture of the pyrethrum spraying solutions from
Kenya grown flowers prepared in the Military Medical Store Depots.
(e) Active operations in the Shaktu Valley in February and March with
col d, rai n and snow ; ' Ci vi l di sturbance ' forces i n Ori ssa at Cuttack and at
Sukkur in Sind. In all the health of the troops remained remarkably good.
(f) Estforce.—A small force, some British but mainly Indian troops, had
to be sent to Orissa early in January 1939. This force assembled at Cuttack
and was finally withdrawn early in August being gradually reduced after
june.
Orissa has a hot moist climate with high humidity, the villages are poor
and a great deal of squalor exists. Flies and insects abound and fly-borne
diseases are common. The following diseases are endemic : Malaria, Dysentery
Small-pox, Cholera, Filariasis, Hookworm and Anthrax.
70
Measures for the preservation of the health of the troops had to be exten
sive and these would appear to have been well carried out because the inci-
dence of sickness under these adverse conditions was satisfactory.
During the period the following were the principal admissions for Indian
Troops :—
Malaria
.
.
.
.
.
.
.
.
.
.
.
14
Dysentery .
.
.
.
.
.
.
.
.
.
.
3
Scabies
.
.
.
.
.
.
.
.
.
.
.
16
Local injuries
.
.
.
.
.
.
.
.
.
.
17
Septics
.
.
.
.
.
.
.
.
.
.
.
4
Enteric group
.
.
.
.
.
.
.
.
.
.
1
Syphilis
.
.
.
.
.
.
.
.
.
.
.
1
Pharyngitis
.
.
.
.
.
.
.
.
.
.
1
Jaundice .
.
.
.
.
•
•
•
.
.
.
3
T. B. Lungs
.
.
.
.
.
.
.
.
.
.
2
All others .
.
.
.
.
.
.
.
.
.
.
17
TOTAL
.
79
Barrack Treatment.— An average of about 100 each month. 2 deaths
occurred.
As these troops were moving about in mechanized transport it was re
ported that severe discomfort from dust was experienced causing inflammed
eyes and a feeling of cold in the head. Goggles had eventually to be issued.
PRINCIPAL DISEASES AFFECTING INDIAN ARMY TROOPS.
39. Malaria.
Amongst Indian troops the admission rate has been 118.3 per 1,000
compared with 109.7 of 1938.
From nearly 14,000 cases there were fewer deaths than the 6 of the pre
vious year.
The reduction in this disease over the past 10 years is well shown in the
table and graphs below.
TABLE 60.
Annual admission for malaria—Indian troops.
Over 10 years.
Ratio per 1,000.
Year.
Admissions.
Invaliding.
Deaths.
1929 .
. .
.
.
.
.
.
175.3
0.22
0.15
1930 .
.
.
.
.
.
•
.
153.4
0.06
0.13
1931
.
.
.
.
•
.
.
.
149.4
0.08
0.10
1932
.
.
.
.
•
.
..
145.1
0.07
0.10
1933 .
.
.
.
.
•
•
.
212.2
0.05
0.06
1934
.
.
.
.
•
.
.
156.5
0.06
0.05
1935
.
.
.
.
.
.
.
.
125.9
0.03
0.08
1936 .
.
.
.
.
.
.
.
123.1
..
0.07
1937
•
•
• ,
97.9
..
0.04
1938
. .
•
.
.
.
.
.
109.5
0.04
0.05
1939
. •
.
.
•
.
. •
•
118.3
0.02
0.04
The monthly incidence during the year is shown in Chart III.
71
The incidence of the various types of malaria by Commands is shown
below.
TABLE 61.
Admissions and deaths for malaria by Commands.
Ratio per 1,000.
Commands.
Admissions and Deaths.
B. T.
M. T.
Quartan. Clinical.
Northern Command
.
.
.
A.
89.3
29.0
0.2
4.4
D.
..
0.03
..
0.02
Western (I.) District
.
.
.
A.
94.7
18. 9
0.09
6 . 0
D. .
..
..
..
..
Eastern Command .
.
.
. A.
58.3
36.5
0.4
6.2
D.
..
0.04
. .
. .
Southern Command
.
.
.
A.
71.8
39.3
0.2
2.9
D.
. .
0.05
. .
..
All India
.
.
.
.
.
A.
79.9
31.5
0.2
4.7
D.
..
0.03
..
0.01
The principal stations in which the admission rates were over 100 per
1,000 are shown in the following table which gives large stations and small
stations.
TABLE 62.
Large stations.
Small stations.
Mir Ali
.
.
.
.
290.8 Baroda
.
.
.
.
237.5
Fort Sandeman. .
•
.
199.3 Thal .
.
.
.
.
225.3
Razmak
.
.
.
.
190.9 Mhow
.
.
.
.
188.8
Jubbulpore
.
.
.
180.7 Almora
.
.
.
.
188.4
Poona
.
.
.
.
178.2 Ahmedabad
.
.
.
179.8
Dehra Dun
.
.
.
177.7 Lansdowne .
.
.
.
163.2
Meerut
.
.
.
.
174.0 Dharamsala
.
.
.
162.0
Bannu
.
.
.
•
159.7 Bakloh
.
.
.
.
138.3
Ambala
.
.
.
.
155.6 Malakand .
.
.
.
100.7
Lahore
.
.
.
.
144.9 Shillong
.
.
.
.
103.2
Jhelum
.
.
.
•
1 2 7 . 4
Abbottabad
.
.
.
122.5
Landikotal .
.
.
.
123.2
Quetta
.
.
.
.
118.8
Kohat
.
.
.
.
107.1
Rawalpindi
.
.
. 103.6
Increases are shown by all Commands except Northern. This increase
however was not great except in parts of Southern Command and in most
instances did not exceed the rates of the normal years.
In Western Independent District there was an increase of 24 per 1,000
but the rate is 59 per 1,000 less than any preceding year except that of the
exceptional 1938. Civilian figures on the other hand show an increase of 30
per cent. The incidence was late into the autumn, viz ., to the end of Novem
ber in Chaman, due to high humidity and temperature and to returning leave
parties. Karachi showed a remarkable fall in figures the distinction made
here between " Fresh " and " Relapse " cases as given is illuminating.
72
Karachi
Fresh.
Relapse.
B. T. cases . . .
5
23
4
8
M. T. cases. . .
3
21
Clinical . . .
52
12
Total
or a relapse rate of 81 per
cent.
One can only comment from these results that either the figures are entirely
fallacious or the methods of treatment are extremely inefficient.
It was owing to the obvious inaccuracies in distinction between " Fresh "
and " Relapse " cases amongst Indian troops from very many stations that
it was decided to abandon this distinction for Indian troops. The distinction
was inaccurate, grossly misleading and used as a cloak of self complacency by
officers who showed that all cases in their station were " Relapse " cases from
elsewhere and that there was no malarial infection present in their's. From
the end of 1939 malaria for Indian troops will be recorded as " total " malaria.
In Eastern Command there was an increase of 373 actual fresh infections.
It was estimated that 60 per cent of all Indian troops' malaria was acquired
out of cantonments. A definite decrease in Jhansi was surprising at first
sight, but was accounted for by troop movements. Meerut and Dehra Dun
were particularly affected by imported malaria and infections on outpost
duties on Bridges.
In Southern Command the increase was due to malaria in Bombay, Saugor
and Jubbulpore ; in all there was quite an epidemic of infections. In Bombay
there were 10 cases of Quartan fever. The majority of cases were from small
defensive posts scattered in unhealthy areas in the autumn. Difficulties were
experienced in net-suspension because in barracks net-wires are provided and
poles were not available or were not used. It is essential that proper means
of suspension for mosquito nets should be provided wherever space permits.
Steps are being taken to secure this provision for the future.
In Northern Command Malaria continues to produce double the admis--
sions of any other disease, but in this year it has actually decreased 9 per 1,000
and gave the best year for 11 years. There is however no marked tendency
to progressive fall as for the British over the past 15 years, this being due to
recruits arriving infected, chronic cases with tolerance living in the lines,
bazaar life and infection while on leave. For all such cases the use of the full
therapeutic course is decidedly the most effective method for stopping ad--
missions and draining the reservoir. Spraying campaigns are said to have
produced most satisfactory results at Sialkot, Dharamsala, Bakloh, Jhelum,
Rawalpindi, Nowshera and Peshawar.
At Jhelum special attention was paid to freeing from infection families
living in the lines. The very low incidence of malaria amongst the men is
attributed to this.
In Waziristan District there are two remarkable contrasts. Mir Ali
with an admission rate of 230 per 1,000 due to cases at the groups of piquet-
in the Shinki defile which are surrounded by areas over which anti-malarial
control cannot be maintained and Wana at which the admission rate is 83
per 1,000 and is lower even than the remarkable result of 1938. At Wana
and Damdil an extensive trial of prophylactic Atebrin was undertaken during
the uatumn—seep a r a . 6 4 - B .
73
The progressive fall in Peshawar District is also worth noting.
137 . 82 163 . 34
94.98
97.14
78.07
In this district mosquito proofing is provided at Chakdara but the proof
-ed rooms are too hot to use.
In all reports it is noted that the best results are invariably obtained and
the greatest freedom from malaria achieved in those places and in those units
in which the greatest attention is paid to the details of prevention. Wherever
there is personal interest by the commanding officer and by company and
platoon commanders in the supervision of nets, use of cream, in regular and
painstaking spraying and in lectures and talks, there the malarial incidence
is relatively least. Where
such interest is lacking preventive measures are
neglected. For example an A. T. Company returned from the Frontier heavily
infected and was housed in a large station next to another A. T. Company.
When a flood of infections were noted in the latter it was discovered that
nets were not being properly used by either company and no active anti-
-malarial measures were being carried out.
In Western Independent District the localisation of malarial cases is
interesting.
Quetta.
Travel.
Camp 47 miles Camp
away.
Khauozai 46 miles
away.
41
1
23
15
40. Sandfly Fever.
With the admissions for this disease now at over 700 for the whole of India
there has been a break in the recent downward trend. The all-India annual
incidence is shown in the following table :—
TABLE 63.
Sandfly Fever.
Ratio per
1,000.
1934
.
.
.
8.3
7.5
1935
.
.
.
1936
.
.
.
10.6
1937
.
.
.
6.0
4.6
1938
.
.
.
6.0
1939
.
.
.
The incidence in the principal districts affected by this disease has been
as follows :—
TABLE 64.
Comparative Table of Sandfly fever in Districts.
Ratio per 1,000.
1938.
1939.
Rawalpindi District . . .
7.6
3.6
14.2
13.1
. . .
Peshawar District
Kohat District . . .
1.8
12.9
5.7
13.7
Western (I) District . . .
5.4
1.7
: Delhi (I) Bde. Area . . .
3.3
12.8
Lucknow District . . .
F 2
74
It is observed that the reduction has been in the Northern Command,
particularly in Rawalpindi District, and the Command figures over 10 years.
are again worth quoting.
TABLE 65.
Sandfly fever in Northern Command.
1929 . . .
36.04 per 1,000.
21.54
1930 . . .
27.46
1931 . . .
1932 . . .
Spraying and fumigation as an
anti-malarial measure in cer -
tain stations.
27.56
1933 . . .
16.53
1934 . . .
14.85
1935 . . .
18.83
1936 . . .
18.43 Spraying campaign intensified as
an anti-sandfly and anti-mos -
quito measure.
1937 . . .
10.65
1938 . . .
7.10
1939 . . .
7.80
The figures for Landikotal, that hot bed of sandfly fever, are perhaps
even more remarkable.
TABLE 66.
Sandfly fever in Landikotal.
1934 . . .
224 cases.
1935 . . .
239
„
1936 . . .
97
„
1937 . . .
27
„
1938 . . .
19
„
1939 . . .
23
„
Peshawar District shows a progressive fall to the present 13 . 13 per 1,000.
Rawalpindi District now has the very low rate of 3.65 per 1,000 attributed to
spraying campaigns: On the other hand Damdil, a typical perimeter camp
at medium altitude with mud walled huts and perimeter wall, produced a mass
of cases. One Gurkha battalion had 120 cases during the summer whereas
the next door battalion had practically none.
At Mir Ali there were 109 cases of fever all of the Sellar type, as also at
Wana, but as Sellar fever does not appear in the nomenclature of diseases these
have been diagnosed sandfly fever.
In Western Independent District, Indian troops in contrast to British
have given an increase of 94 cases. This incidence is due to heavy infection.
at Quetta, Loralai and Fort Sandeman whereas there was a decrease at Karachi.
Eastern Command figured prominently this year with many cases from
Lucknow and from Agra. The Lucknow cases occurred in June when the
disease was prevalent amongst all troops and in the autumn when there was an
influx of recruits and reservists and it was noted that Indian troops suffered
more than usual.
At Agra torrential rains in September did much damage in the city and
villages and this was followed by an epidemic of sandfly fever.
75
41. Dengue.
The all-India incidence has remained at 1.1 per 1,000.
TABLE 67.
Dengue.
1934
.
.
.
2.5 per 1,000
1935
.
.
.
3.4
1936
.
.
.
2.6
1937
.
.
.
5.0
1938
.
.
.
1.1
1939
.
.
.
1.1
The stations chiefly affected were in Eastern and Southern Commands.
1938.
1939.
Dacca
.
.
.
. . .
21.4 per 1,000.
Alipore
.
.
.
. . .
39.6
Bangalore . . . 10.2
29.5
P. & A. District and Madras District were the areas affected this year.
In the former, of 47 cases 34 cases occurred at Alipore at the time when there
were 268 cases amongst British troops for the disease. In Southern Command
there were no cases either in Bombay or at St. Thomas Mount, Madras; a fact
remarkable enough to deserve mention. Of 81 cases in Madras District 78
were from Bangalore. Here mosquitoes of all kinds were prevalent and
Dengue increased a pace. Indian troops had 78 cases compared to 25 of the
previous year and British 8 compared with 3 of 1938.
42. Fevers of the Typhus Group.
There were 42 cases amongst Indian troops compared with 38, 43, 48, 45
and 51 of the previous years. The details have been considered in paragraph
10 of Section I.
43 . Enteric Group of fevers.
The comparison of these diseases has been considered under paragraph
11, Section I. The decline in incidence has been maintained for Indian troops,
the admissions rate being 0.5 this year.
TABLE 68.
Case incidence of Enteric Group fevers.
Ratio per 1,000.
1934
.
.
.
1.9
1935
.
.
.
1.4
1936
.
.
.
0.7
1937
.
.
.
0.9
1938
.
.
.
0.8
1939
.
.
.
0.5
This steady decrease in case incidence for Indian troops who must often
quite definitely be subject to the possibilities of severe or mass infection is
i ndeed most satisfactory, and is one of our outstanding successes in preventive
medicine.