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5. Summary of interesting features of the year.
(a) The outstanding feature of the year was the political tension during
the summer culminating in the declaration of War against Germany on
September the third.
(b) The preparation and dispatch of overseas troops and replacements in
India went on a pace after the beginning of September ; Territorial forces were
embodied ; protective posts and defence areas were manned at all important
points, posts and areas which in many cases were outside cantonments and
in highly malarious or unhealthy districts were occupied.
(c) Although officially it was peace, Waziristan again had troubles and
operations were carried out in the Shaktu Valley in February and March in
cold, wet weather and there were continuous columns throughout the year.
There were remarkably low admission rates for sickness considering the condi-
ions.
(d) Tetanus toxoid immunisation was introduced during the year. At
first limited to External Defence Troops and later provided for all troops pro-
ceeding abroad, provision of Tetanus toxoid is now being made to immunise
the whole army. The possibilities of indigenous manufacture of the Toxoid
were closely examined but early success was impracticable and indigenous
provision was abandoned for the time.
(e) There has been a general increase in sick rates for both Officers and
men, though there have been no serious epidemics. Invaliding rates have
increased appreciably for Officers, but slightly decreased for Other Ranks and
death rates have decreased for both. The 4 quinquennial periods since the
last war have shown a steady decrease in sickness and death both for Officers
and men.
(f) Malaria was not severe except in certain areas in the south and east,
but in the north, while not extensive in amount, it extended late into the
autumn due to a prolonged warmth. The general trend of the graphs of
malarial incidence remains satisfactory.
(h) The dysentery-diarrhoea group shows no signs of decrease in the
numbers of cases and continues to exact a heavy toll in all Commands.
(i) Enteric fevers although showing a slight rise in admission rates is held
satisfactorily in check although there is ample evidence that it is widely spread
around many of our cantonments.
(j) Dengue and Sandfly fever were both much in evidence in Eastern
Command, the former at Calcutta in the summer, the latter at Agra after
abnormal rains in September.
(k) Spraying as a defensive measure against all insect borne diseases has
been continued with increasing vigour and often with success, particularly in
Northern Command, against the Sandfly. Arrangements are now well in hand
for production of pyrethrum spray solutions in our own Medical Stores Depots
from Empire grown pyrethrum flowers from Kenya.
(1) With the advent of War frequent offers of help with special remedies
to cure some or all of the ailments of the soldier were received. Some were
patriotic and without personal advantage to the offerer, others were on a com-
mercial basis. Many were completely useless as for example that of the
gentleman who offered to cure all malaria with a few doses of his special
medicine which on examination proved to be nothing but common salt.
6. Factors which may have affected the incidence of disease amongst Troops.
(a) Climatic conditions.—In the north the year has been dry and dusty
with a late warm autumn while in the south conditions have been ave rage