NationalLibraryOfScotland/medical-history-of-british-india huggingface dataset:
APPENDIX XXII—contd.
British Troops.
Indian Troops.
Diseases
British officers
(B. S.).
B. O. Rs.
B. O. Rs.
(Wives.)
B. O. Rs.
Children.
British officers
(I. S.).
V. C. Os. and I. O. Rs.
A.
D.
In-
valids.
A.
Average
con-
stantly
sick.
D.
In-
valids.
A.
D.
A.
D.
A.
D.
In-
valids.
A.
D.
In-
valids.
Average
con-
stantly
sick.
Diseases of the female organs
of generation.
Abortion.
.
.
.
...
...
...
...
...
...
...
22.0 0.33 ...
...
...
...
...
...
...
...
...
Affectionconnected with
pregnancy and parturition
and consequent on partu-
rition.
...
...
...
...
...
...
...
29.0 0.66 ...
...
...
...
...
...
...
...
...
Diseasesof the ovary
.
...
...
...
...
...
...
...
...
...
...
...
...
...
...
...
...
...
...
Diseasesof the fallopian
tube.
...
...
...
...
...
...
...
4.0 ...
...
...
...
...
...
...
...
...
...
Displacements and distor-
tions of the uterus.
...
...
...
...
...
...
...
7.3 ...
...
...
...
...
...
...
...
...
...
Dysmenorrhoea
.
...
...
...
...
...
...
...
1.7 ...
...
...
...
...
...
...
...
...
...
Endometritis.
.
.
...
...
...
...
...
...
...
5.3 ...
...
...
...
...
...
...
...
...
...
Haemorrhage connected with
parturition.
...
...
...
...
...
...
...
...
...
... ...
...
...
...
...
...
...
...
Inflammationof vagina
.
...
...
...
...
...
...
...
...
...
0.5 ...
...
...
...
...
...
...
...
Menorrhagia.
. .
...
...
...
...
...
...
...
4.7 ...
0.2 ...
...
...
...
...
...
...
...
Metrorrhaegia .
.
.
...
...
...
...
...
...
...
2.1 ...
...
...
...
...
...
...
...
...
...
Pelvic peritonitis
.
...
... ...
...
...
...
...
...
...
...
...
...
...
...
...
...
...
...
Other diseases peculiar to
women.
...
...
...
...
...
...
...
19.0 ...
...
...
...
...
... ...
...
...
...
Diseases effecting child.
Asphyxia of child
.
...
...
...
...
...
...
...
...
...
0.2 0.49 ... ...
...
...
...
...
...
Injury to child..
.
...
...
...
...
...
...
...
...
...
...
...
...
...
...
...
...
...
...
Premature birth..
.
...
...
...
...
...
...
...
...
...
0.7 0.49 ...
...
...
...
...
...
...
Still-birth
.
.
...
... ...
...
...
...
...
...
...
...
...
...
...
...
...
...
...
...
Diseases of bones, joints, fas-
ciae and bursae.
Arthritis .
0.5 ...
...
0.7
0.09 ...
0.06
0.3 ...
...
...
1.6 ...
...
0 . 8 ...
0.14
0.04
Diseases of the spine .
.
...
...
...
0.1
0.01 ...
0.06
...
...
...
...
...
...
...
0.1 ...
0.04
0 . 0 0
Flat foot .
.
0.5 ...
...
0.5
0.02 ...
...
... ...
... ...
... ...
...
0 . 0 ...
0.02
0 . 0 0
56
APPENDIX XXII—concld.
British Troops.
Indian Troops.
Diseases.
British Officers
(B. S.).
B. O. Rs.
B. O.Rs.
(Wives).
B. 0. Rs.
Children.
British Officers
(I. S.).
V. C. Os. and I. 0. Rs.
A.
D.
In-
valids. A.
Average
con
stantly
sick. D.
In-
valids. A.
D. A. D.
A
D.
In-
valids. A.
D.
In-
valids.
Average
con
stantl
y sick.
General Injuries.
Burnsand scalds.
...
...
...
...
...
...
...
...
... ... ... ... ...
...
...
...
... ...
Effectsof anti-rabic treat
ment.
... ...
. . .
...
...
...
...
...
... ...
. . . ... ...
...
...
. . . ...
. . .
Effects of inoculation
0.5 ...
...
0.4 0.01 ... ...
0.3 ... ... ... ... ...
...
0.1
. . . ...
0.00
Heat-Exhaustion
.
1.0 ...
...
4.9 0.13 0.15 ...
...
...
0.5 0.24 2.3 0.26 ...
0.3
. . . ...
0.00
Heat-stroke . . .
1.5 ... ...
1.2 0.06 0.06 ...
...
... ... ...
0.3 ...
...
0.0 0.02 ...
0.00
Sun-stroke
. . .
...
...
...
... ...
...
...
...
... ... ... ... ...
...
...
. . .
...
...
Other injuries . . .
1.5 0.50 ...
1.6 0.08
0 . 3 1 ...
...
... 0.2
. . . 0.5 ...
...
0.3 0.07 0.01 0.01
Local injuries.
Abrasions
3.0 ...
...
3.4 0.10 ...
...
. . . ... 0.2
. . . 2.1 ...
...
2.5
. . . ...
0.06
Burns and scalds
. .
... ...
...
1.6 0.08 0.06 ...
0.7 ...
1.0
. . . 1.6 ...
...
1.6 0.00 ...
0.05
Concussions
. . .
8.4 ...
...
2.7 0.14 0.03 ...
...
...
1.0
. . . 2.8 ...
...
0.4 0.01 0.01 0.02
Contusions
. . .
7.4 ...
...
11.1 0.33 ...
...
1.7 ...
1.7
. . . 10.3 ...
...
12.2
. . .
0.09 0.35
Dislocations and displace
ments.
2.0 ...
...
1.6 0.09 ...
0.03
0.3 ...
0.2
. . . 1.0 ...
...
0.6 0.00 0.08 0.02
Fractures . . . .
12.9 ...
...
13.5 0.90 0.28 0.12
2.3 ...
3.9
. . . 13.5 ...
...
8.9 0.16 0.93 0.58
Sprains and strains . .
12.4 ...
...
12.6 0.38 ... ...
2.3 ...
1.0
. . . 9.3 ...
...
7.0
. . .
0.04 0.17
Wounds gun-shot .
1.5 0.50 ...
2.0 0.35 0.62 0.43 ... ...
...
. . . 1.8 1.03 ...
1.5 0.46 0.13 0.13
Wounds other . . .
4.0 ... ...
7.2 0.27 0.06 ...
0.7 .... 3.6 0.49 4.1 ...
...
10.2 0.04 0.12 0.35
Injuries self-inflicted . .
...
1.00 ...
0.0 0.00 0.06 ...
. . . ... ...
. . . 0.3 0.26 ...
0.0 0.02 ...
0.00
Other injuries . . .
1.0 ...
...
2.7 0.14 ...
0.06 0.3 ...
1.2
. . . 2.1 ...
...
0.7 0.05 0.13 0.03
Tumours and cysts.
Carcinoma
0.5 0.50 ...
0.0 0.00 0.03 ...
2.0 0.33 ...
. . . 0.3 ...
0.26
0.0 0.01 0.01 0.00
Cysts.
. . .
1.5 0.50 ...
1.3 0.04 ...
1.7 ... 0.5
. . . ... ...
...
0.8
. . . ...
0.03
Sarcoma . .
...
...
...
... ...
... ...
...
... 0.2 0.24 ... ...
...
0.0 0.01 0.02 0.00
New growths malignan
t (other cases).
... ...
...
0.3 0.02 0.06 0.09 ... ... ...
. . . ... ...
...
0.1 0.00 0.01 0.00
New growths non-malignant
Malformations
...
... ...
0.7 0.04 ... ...
0.3 ...
0.2
. . . 2.1 ...
...
0.4
. . .
0.08 0.02
..
...
...
0.0 0.00 ...
...
. . . ... 0.7 0.24 ... ...
...
0.1
. . .
0.04
0 . 0 0
58 58
Poisons.
Alcohol .
.
.
.
...
...
...
...
...
...
...
...
...
...
1.0 ...
...
0.0 ...
...
0.00
Arsenic .
.
.
.
...
... ...
...
...
...
...
...
... ... ... ... ... ...
0.0 ...
...
0.00
Choloroform .
.
.
...
...
... ...
...
...
... ...
...
...
... ... ...
...
... ...
...
...
Other chemical poisons .
...
... ...
0.1
0.00 ...
...
0.3 0.33 ...
...
... 0.26
.
.. .
0.1 0.03 ...
0.00
Opium .
.
.
.
...
...
... ...
...
...
...
... ...
...
...
...
...
...
0.0 ...
...
0.00
Venom of insects
.
. ... ...
...
0.0
0.00 ...
...
... ...
...
... 0.8 ... ...
0.0 ...
...
0.00
Venom of Ophidia (snake
bite).
0.5 ...
...
0.0 0.00 ...
... ...
...
...
... 0.3 ...
...
0.1 ...
...
0.00
Other poisons .
.
.
...
...
...
0.1 0.00 ...
...
...
...
...
... 0.3 0.26 ...
0.0 0.01 ...
0.00
No appreciable disease
.
3.0 ... ...
3.3 0.15 ...
...
7.3 ...
4.4 ... 2.1 ...
...
1.7 ...
0.00 0.05
All other causes
1.5 ...
...
0.7 0.06 ...
...
0.3 ... 0.7 ... 1.0 ...
...
1.0 ...
...
0.04
GRAND TOTAL . 533.5 4.96 9.92 1034.3 30.97 2.76 6.81 348.9 2.67 374.9 14.82 468.4 5.17 2.33 549.0 2.11 11.86 17.52
C. 59. )1
GIPD—M 621 A. Army—30-1-42—600,
IP/QB, 10
m . 9 1 . b .
(NEW SERIES.) No.
47.
SCIENTIFIC MEMOIRS
BY
OFFICERS OF THE MEDICAL AND SANITARY DEPARTMENTS
•
OF THE
GOVERNMENT OF INDIA
Dysentery and Liver Abscess in
B o m b a y
BEING THE REPORT OF AN ENQUIRY CARRIED OUT BY
MAJOR E. D. W. GREIG, M.D., D.Sc., I.M.S.,
AND
CAPTAIN R. T. WELLS, M.A., M.B., I.M.S.
Under the direction of the Director, Central Research Institute, Kasauli
ISSUED UNDER THE AUTHORITY OF THE GOVERNMENT OF INDIA BY THE
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No. 47.
SCIENTIFIC MEMOIRS
BY
OFFICERS OF THE MEDICAL AND SANITARY DEPARTMENTS
OF THE
GOVERNMENT OF INDIA
Dysentery and Liver Abscess in.
Bombay
BEING THE REPORT OF AN ENQUIRY CARRIEID OUT BY
MAJOR, E. D. W. GREIG, M.D., D.Sc., I.M.S.,
AND
CAPTAIN R. T. WELLS, M.A., M.B., I.M.S.
Under the direction of the Director, Central Research Institute, Kasauli
ISSUED UNDER THE AUTHORITY OF THE GOVERNMENT OF INDIA BY THE'
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CONTENTS.
PART I.
PAGE.
I.—INTRODUCTION.
.
.
.
.
.
.
1
II.—GENERAL RESULTS
.
.
.
.
.
2
III.—BACILLARY DYSENTERY
.
.
5
IV.—AMŒBIC DYSENTERY
.
.
.
.
.
.
.
7
(a ) Methods and Plan of Work
.
.
8
(b) Seasonal Prevalence of Amœbæ
.
.
9
(c) Characters of Amœbæ
.
.
.
13
(d) Amœbæ in Water
.
.
.
19
(e) Distribution of Amœbæ in Healthy Animals
.
.
.
20
(f) Experimental Observations on Animals
.
23
(g) Experiments with Monkeys.
.
.
.
2 3
V.—CLINICAL STUDY OF AMŒBIC DYSENTERY AND LIVER ABSCESS
29
VI.—DIAGNOSIS OF AMŒBIC INFECTION .
.
. . . 49
VII.—GENERAL CONCLUSIONS
.
.
.
.
.
52
PART II
1. TABLE I SHOWING RESULTS OBTAINED BY OBSERVATIONS ON CASES OF BACILLARY DYSENTERY
.
55
2. TABLE II SHOWING VARIOUS SOURCES AT BOMBAY FROM WHICH AMŒBÆ WERE CULTIVATED
.
64
3. TABLE III SHOWING THE RESULTS OF THE EXAMINATION OF THE STOOLS OF A NUMBER OF HEALTHY
MONKEYS FOR AMŒBÆ
.
65
4. DESCRIPTION OF PLATES
.
.
.
.
. . .
77
ILLUSTRATIONS.
1. CHART NO. 1 SHOWING AMŒBIC PREVALENCE IN DYSENTERY CASES AMONGST THE CIVIL POPULA
-TION AND THE TEMPERATURE CURVE
9
2. CHART NO. 2 SHOWING AMŒBIC PREVALENCE IN DYSENTERY CASES AMONGST THE MILITARY POPU-
LATION AND THE TEMPERATURE CURVE
.
.
10
3. CHART NO. 3 SHOWING AMŒBIC PREVALENCE IN DYSENTERY CASES AMONGST THE CIVIL POPU-
LATION AND THE HUMIDITY CURVE
.
10
4. CHART NO. 4 SHOWING AMŒBIC PREVALENCE IN DYSENTERY CASES AMONGST THE MILITARY POPU-
LATION AND THE HUMIDITY CURVE
.
11
5. CHART NO. 5 SHOWING THE MONTHLY VARIATIONS FROM THE MEAN OF THE ADMISSIONS FOR DYSEN-
TERY INTO THE JAILS OF BOMBAY
.
12
[ i i )
6. TEXT FIGURE NO. 1 SHOWING LIFE CYCLE OF AMŒBÆ
.
.
.
.
16
7. CHART NO. 6 SHOWING LEUCOCYTE AND TEMPERATURE CURVES OF CASE NO. 215
.
37
8. CHART NO. 7 SHOWING LEUCOCYTE AND TEMPERATURE CURVES OF CASE NO. 78 .
39
9. CHART NO. 8 SHOWING LEUCOCYTE AND TEMPERATURE CURVES :OF CASE NO. 194
.
.
.
41
10. CHART NO. 9 SHOWING LEUCOCYTE AND TEMPERATURE CURVES OF CASE NO. 204
.
.
.
42
11. CHART NO. 10 SHOWING LEUCOCYTE AND TEMPERATURE CURVES OF CASE NO. 85.
.
44
12. CHART NO 11 SHOWING LEUCOCYTE AND TEMPERATURE CURVES OF CASE NO 208
.
46
13. CHART NO 12 SHOWING LEUCOCYTE AND TEMPERATURE CURVES OF CASE NO 216
.
48
14. PLATE NO 1
.
.
.
.
.
.
.
77
15. PLATE NO 2
.
.
.
77
16. PLATE NO 3
.
.
.
.
.
.
.
.
.
78
An Enquiry on Dysentery and Liver Abscess
in Bombay.
PART I
I.—Introductory.
I ND e c e mb e r 1 9 0 8 a n e n q u i r y i n t o t h e c a u s a t i o n o f d y s e n t e r y i n I n d i a wa s
undertaken by the Central Research Institute, Kasauli, under the direction
of Lieutenant-Colonel D. Semple, M.D., Director of the Institute. Major E. D.
W. Greig, M.D., I.M.S., and Captain R. T. Wells, I.M.S., were deputed from
the Central Research Institute to carry out the investigation which was com
- me n c e d a t Bo mb a y . L a b o r a t o r y a c c o mmo d a t i o n f o r t h e wo r k e r s e n g a g e d i n
the enquiry was obtained at the Bombay Bacteriological Laboratory, Parel, and
the Superintendent of the Laboratory very kindly gave every facility for the work
to be carried out.
Cases of dysentery were examined in the Hospitals, both Civil and Military,
in Bombay.
It became evident in the course of the enquiry that the distance of the Labor
- a t o r y f r o m t h e H o s p i t a l s ( f i v e m i l e s ) w a s a d i s t i n c t d i s a d v a n t a g e f o r t h e p u r p o s e
of examining cases clinically and making post mortem examinations ; accordingly
it was decided that Captain Wells should devote his attention to the examination
of the cases at the Hospitals and arrange to send the material for investigation to
the Laboratory at Parel. Although a number of fatal cases occurred only a few
post mortem examinations were permitted. Major Greig is responsible for the
mode of presentation of the Report.
The plan of work included a detailed clinical examination of the cases on
admission with notes of their subsequent progress, and the results of the post
mortem examination when obtainable ; the systematic working out of the material
sent to the laboratory, namely, stools from dysentery cases, pus from liver
abscesses, and blood for Widal reaction ; a study of the various strains of
B
2
B. dysenteriæ isolated ; the investigation of amœbæ found in stools, liver pus, etc.
The following methods were adopted for the examination of the stools :—(1) The
reaction of the stool to litmus was tested. (2) A microscopic examination was
made for the presence of amœbæ, ova of intestinal worms, etc. (3) A portion
of the stool was plated on Drigalski-Conradi medium ; the composition of this
medium, the method of plating, and examining the colonies have been fully des-
cribed by one of us1. (4) The mucus was stroked, also, on plates of the agar
medium of Musgrave and Clegg,2 for the cultivation of amœbæ. The liver
pus, which was collected in sterile test tubes, was examined microscopically for
amœbæ, and culturally, both on ordinary agar, to determine whether or not it
was sterile as regards bacteria, and on the agar medium of Musgrave and Clegg to
obtain a growth of amœbæ. The temperature and humidity records for the year
were obtained from the Meteorological Department, Bombay. During the in-
vestigations it became apparent that the number of cases of bacillary dysentery
was small, and, consequently, in Bombay we were not afforded opportunities of
studying the various problems connected with this type of dysentery. On the
other hand a number of cases of dysentery associated with amœbæ in the
stools came under our observation : therefore this variety of dysentery and its
hepatic complications were studied in detail.
II.—General Results.
The following table shows the various Civil Hospitals attended in Bombay
and the number of cases examined in each :—
Name of Hospitals.
Number of cases
examined.
J. J. Hospital .
.
.
.
.
.
117
G. T. Hospital .
.
.
.
.
.
82
Northcote Police Hospital
.
.
.
77
St. George's Hospital
.
. .
.
105
Miscellaneous cases
.
.
. .
.
16
TOTAL
.
397
1 Methods employed in the campaign against Typhoid.—Captain E. D. W. Greig.
2 Bureau of Government Laboratory, Manilla, No. 18, October 1904.
3
The following table shows the various Military Hospitals in Bombay and the
number of cases examined in each:—
Name of Hospital.
Number of cases
examined
Colaba Station Hospital .
.
.
.
46
116th Marathas ditto
.
.
.
.
70
109th Infantry ditto
.
.
.
.
49
Native details ditto
.
.
.
.
23
TOTAL
.
188
The following table shows the total number of cases of dysentery examined
amongst the Civil population and the presence or absence of amœbæ or dysentery
bacilli in the stools :—
No. of cases of dysentery.
A m œ b æ
observed in
B. dysente-
r i æ o b -
served in
Europeans
.
.
. 121
47
2
Indians
.
.
. . 248
114
4
The following table shows the total number of cases of dysentery examined
amongst the Military population and the presence or absence of amœbæ and
dysentery bacilli in the stools of each :—
No. of cases of dysentery.
Amœbæ
observed in
B. dysente-
riæ ob-
served in
Europeans
.
.
. 43
36
1
Indians .
.
. . 142
84
6
B 2
4
The following table shows the total number of cases of dysentery examined
amongst the Civil population and the presence or absence of Trichomonas and the
ova of intestinal worms in the stools :—
No. of cases examined.
Tricho-
monas.
Strongy-
loides.
OVA OF WORMS.
Oxyuris.
Ascaris. Trichoce-
phalus.
A n k y l o s - t
o m a .
Europeans .
.
.
. 121
13
1
0
2
2
1
Indians
.
. .
. 248
38
6
3
22
12
7
TOTAL
.
369
51
7
3
24
14
8
Percentage .
.
13.8
1.9
0.8
6.4
3.7
1.8
The following table shows the total number of cases of dysentery examined
amongst the Military population and the presence or absence of Trichomonas and
the ova of intestinal worms in the stools :—
No. of cases examined.
Tricho-
monas.
Strongy-
loides.
OVA OF WORMS.
Oxyuris. Ascaris. Trichoce-
phalus.
Ankyl os-
toma.
Europeans .
.
.
. 43
2
0
0
2
2
0
Indians
.
.
.
. 142
28
0
3
13
3
3
TOTAL
.
185
30
0
3
15
5
3
Percentage .
.
16.2
..
1.6
8.1
2.7
1.6
The following table shows the reaction of the stool in the cases of dysentery
tested amongst the Civil population :—
No. of cases examined.
REACTION OF STOOL.
Acid.
Alkaline.
Europeans
Indians
.
.
.
.
.
.
.
.
59
122
19
68
40
54
5
The following table shows the reaction of the stool in the cases of dysentery
tested amongst the Military population:—
No. of cases examined.
REACTION OF STOOL.
Acid.
Alkaline.
Europeans .
.
.
. 19
5
14
Indians .
.
.
. 115
51
64
The following table shows the number of cases of liver abscess examined
amongst the Civil population and the presence or absence of amœbæ in the pus
and stools of each:—
No. of cases examined.
AMŒBÆ IN
Pus.
Fæces.
Europeans . .
.
.
4
1
0
Indians
. .
.
. 24
8
11
The following table shows the number of cases of liver abscess examined
amongst the Military population and the presence or absence of amœbæ in the
pus and stools of each:—
No. of cases examined.
AMŒBÆ IN
Pus.
Fæces.
European
. .
. 3
1
0
Indians
.
. .
. 0
0
0
III.—Bacillary Dysentery.
As already stated the number of cases of this condition, which were recog-
nised bacteriologically in the course of our investigations at Bombay, was limited.
The method employed for the detection of dysentery bacilli in the stools was as
follows:—The mucus from a dysentery case was spread on three large plates of
Drigalski-Conradi medium, which were allowed to dry, then set aside in the
incubator at 37º for 24 hoursl. They were examined carefully next day for
suspicious colonies, which were tested with a high titre agglutinating polyvalent
1 Methods employed in the campaign against Typhoid.—Captain E. D. W. Greig, I.M.S.