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A point which arises in carrying out full treatment is that it is especially
difficult to ensure that family-patients continue their treatment to its end.
They are exceedingly inclined to stop as soon as fever and symptoms subside.
(It might be mentioned that British Officers and their families are not exactly
exemplary in this respect).
Dysentery-Diarrhœa Group.—As usual this plays a very large part in the
sickness of children. Laboratory diagnosis is difficult in these cases due to
difficulties in obtaining appropriate specimens. The tendency then is to
diagnose diarrhæa and not dysentery and to treat the condition lightly;
whereas the majority of cases, especially in the fly season, are probably a
dysenteric infection. The prevalence of the group during the fly season is
specially noted from Shillong, Poona, Fategarh, Jullundur, Abbottabad,
Lucknow, Almora and Roorkee.
It is difficult to get parents to bring their children in time for treatment.
Dysentery and pneumonia are the two conditions for which children are too
often brought up in a moribund state.
Enteric Group.—There are surprisingly few admissions for this group.
This can only be attributed to T. A. B. inoculation and to protected water
supplies in cantonments. T. A. B. protection is given to a large number of
women and children: in some stations 50 per cent are protected, in others
almost 100 per cent is claimed.
Tuberculosis.—The toll of this condition continues and nearly all the
larger stations record 2 or 4 cases of the pulmonary type proved by laboratory
findings. Unfortunately little can be done for them. They are a danger and
cannot be kept in the lines, few will consent to go to Sanatorium treatment
even if it could be obtained; and so perforce they have to be sent away to their
homes where they must be a serious menace in the village life.
This is an aspect of family welfare which needs future attention. Of
the non-pulmonary type cases of successful treatment by operation and spinal
plaster jacket are recorded from several stations.
Eye diseases.—These bulk very largely in the treatment of families. Dust
smoke in their quarters and close contact with infected cases are given as the
reasons.
In the north, particularly in the Delhi-Jullundur-Jhelum area and in
- c l u d i n g C h a k l a l a , T r a c h o m a h a s b e e n v e r y p r e v a l e n t . T h e t y p e i s m i l d , b u t
the infective qualities are there and spread of the infection throughout the
whole family is noted.
In the south, eye diseases are not so common but conjunctivities is pre
- v a l e n t i n t h e m o n s o o n p e r i o d a n d w a s a l s o n o t e d a t t h i s t i m e i n t h e U . P . ,
particularly at Lucknow where 375 cases were treated.
At Abbottabad 1,161 cases of eye diseases were treated. The majority
were in September and October which were dusty. The numbers were en
- h a n c e d , c h i e f l y a m o n g s t G u r k h a f a m i l i e s , b y a n e p i d e m i c o f K o c h - W e e k e s
infection.
Ear diseases.—There was no high incidence of these except that at Fateh
-garh bathing in the Ganges is given as a cause of marked prevalence of Otitis.
The water is stated to be very dirty.