NationalLibraryOfScotland/medical-history-of-british-india huggingface dataset:
30
16. Minor Septic and Local Injury Groups
This combined group of cellulitis and infected injuries, which are so inter-
connected as to be suitably regarded as one group, produces, as ever, a very
high rate of temporary inefficiency. The total admissions in the present year
number over 5,000 for British troops alone while Indian admissions were over
10,000. If considered as one, this group almost invariably heads the list of
causes of sickness ; hospital admissions are large and barrack treatment cases
even larger. From the nature of military training this must of necessity be so
to a considerable extent. From the preventive aspect, active measures consist
chiefly in ensuring as rapid cures as possible, for this purpose hospital admission
is often the most satisfactory method, and in the maintenance of good general
health by feeding.
The total inefficiency from this group for troops is best summarised in the
following table.
TABLE No. 35
Minor Septic and Local Injury over the past 10 years
British Troops
Indian Troops
Minor
septic
Local
Injury
Total
Minor
septic
Local
Injury
Total
1929.
.
52 . 4
56.8
109.2
24.4
37.4
61.8
1930
.
.
.
52.7
58.9
111.6
25.6
38.3
63.9
1931
.
.
.
59.0
61.7
120.7
30.0
41.2
71.2
1932
.
.
.
56.2
58.5
114.7
30.4
43.7
74.1
1933
.
. .
58.1
60 . 2
118.3
32.7
48.2
80.9
1934
.
.
.
57.9
62.3
120.2
17.5
49.0
66.5
1935
.
.
.
59.7
62.2
121.9
35.3
53.1
88.4
1936.
59.5
61.8
121.3
33.4
52.6
86.0
1937
.
.
.
54.6
57.6
112.2
31.4
52.0
83.4
1938.
.
59.2
62.7
121.9
33.4
58.7
92.1
Cellulitis still retains second place as a single cause of admission to hospital
and in spite of a reduction of 11 cases the rate for the year has increased from
41 . 3 of 1937 to 45-2 this year.
Boils show a slight reduction recently.
TABLE No. 36
The indicence of Boils
British
Indian
1936 . -
473
696
.
1937.
.
. . . . .
346
531
1938
.
..
.
. . . . .
333
645
Local injuries, which include sprains, abrasions, contusions and open
injuries, taken as a whole accounted for over 2,500 British admissions. There
were 25 deaths which is 7 more than in 1937 but 6 less than in 1936.
33
Complete rest appears to be an essential part of the treatment and. in army
cases, where this is practicable, the results are stated to be infinitely better than
cases in civil life which do not do so well. There is now also a tendency for the
Dermatologist under whom the majority of cases are treated to allow the
body to develop and build up its own resistance for a week before any drugs
are administered. Results by this method are stated to be definitely superior,
recovery is more rapid and relapses are fewer.
The total cases of venereal and its groups are shown in the following table.
TABLE No. 38
Venereal diseases for 6 years by groups —Ratios per 1,000.
Gonorrhœa.
Syphilis.
Soft
chancre
Total
venereal
diseases.
R.
R.
R.
R.
1933 B. O. Rs.
.
.
.
23.2
4.9
5.0
33.4
I. Os. & I. O. Rs.
.
.
4.7
3.9
2.2
10.8
1934 B. O. Rs.
25.2
4.5
4.1
34.1
I. Os. & I. O. Rs.
.
.
4.2
3.5
1.9
9.6
1935 B. O. Rs.
.
.
.
25.8
6.0
6.8
38.8
I. Os. & I. O. Rs.
.
.
4.6
3.7
1 . 8
10.1
1936 B. O. Rs.
25.7
4.1
4.6
34.4
I Os. & I. O. Rs.
.
.
4.8
3.4
1.6
9.8
1937 B. O. Rs.
.
.
.
28.4
5.8
5.7
40.5
I. Os. & I. O. Rs.
.
.
3.4
3.0
1.7
8.1
1938 B. O. Rs.
28.0
7.6
7.9
43.5
I. Os. & I. O. Rs.
. .
2.9
3.1
1.5
7.5
18. Small pox
The state of protection of all personnel remains at a satisfactorily high
figure, though there is a distinct tendency for the more senior ranks, and
their families, to lapse owing to forgetfullness. Cantonment populations
are relatively so immune from smallpox that the military inhabitants tend.to
forget the constant risk which lies outside.
TABLE No. 39
Half yearly state of vaccination of British troops and families.
Percentage protected.
On 30th
April.
On 31st
October.
British Officers .
.
.
.
.
.
.
. . .
99.45
99.76
British Other Ranks .
.
.
.
.
.
.
.
99.40
98.32
Women and Children
. . . . . . .
99.65
99.92
34
There were only 11 cases of smallpox in 1938 compared with 13 cases in
1937 and 8 cases in 1936. British other ranks produced 5 cases, one each in
Peshawar, Bareilly, Meerut, Cawnpore, Mhow, but there were no deaths.
British Officers and their wives and B. O. Rs' wives had no cases. Amongst
children there were 6 admissions with no deaths, the cases being 2 in Peshawar
the others at Meerut, Cawnpore, Ranikhet and Mhow.
19. Cerebrospinal fever
There were 2 cases, one of which died at Ranikhet, the recovery case
was at Razmak.
There were 23 cases amongst Indian other ranks and followers. The
majority of cases reported were in Northern Command and occurred in the
first quarter of the year.
20. Poliomyelitis
There were 6 cases amongst British and none amongst Indian troops.
Three of these were at Poona in July, August and September ; the others
were at Landikotal (April), Dinapore (August) and Jhansi (December).
21. Respiratory Diseases
These have shown a slight increase over the past 5 years for British
troops though Indian troops have shown a similar decrease.
TABLE No. 40
Respiratory Diseases by types—.Ratios per 1,000.
Diseases of bronchi
and broncheoles.
Diseases of larnyx
and trachea.
Pneumonia lobar
and lobular.
B. O. Rs. I. Os. &
I. O. Rs.
B. O. Rs. I. Os. &
I. O. Rs.
B. O. Rs. I. Os. &
I. O. Rs.
1934 . . .
14.8
15.0
1.0
1.0
3.9
6.0
1935 . . .
15.5
11.9
1.2
1.0
4.2
4.9
1936 . . .
16.8
11.9
0.8
0.9
3.5
5.4
1937 . . .
17.2
13.3
1.3
0.9
3.2
5.2
1938 . . .
18.2
12.7
1.3
0.7
3.3
5.0
Of the total of 1,062 cases for British troops, 108 were cases of Pneumonia
with 10 deaths compared with 101 cases and 2 deaths for 1937 and 132 cases
and 14 deaths in 1936. Lobular pneumonia and pleuresy with 35 cases with
3 deaths and 58 cases with no deaths respectively remained much the same as in
previous years and there were 4 cases of empyema. The monthly admissions
for the pneumonic group are shown in Table No. 41. Bronchitis with 741
cases was 33 less than in 1937.
TABLE No. 41
Monthly incidence of Pneumonia Group for 1938.
Jan. Feb. Mar. Apr. May June July Aug. Sept. Oct. Nov. Dec. Total.
Lobar Pneumonia —
B. O. Rs. .
16
5
7
7
12
8
12
3
3
5
14
11 103
I. Os. & I. O. Rs.
71
39
39
23
30
21
29
14
19
25
51
83
444
Lobular Pneumonia —
B. O. Rs. . .
4
2
6
2
1
...
3
1
2
2
1
4
28
I. Os. & I. O. Rs.
16
10
3
3
5
6
9
5
9
11
8
29
114
35
Influenza has not appeared in any epidemic form until the end of the year
when a definite epidemic diagnosed mild influenza appeared in Lahore District
and was continued on into the beginning of 1939. The majority of cases were
however Indian troops and were not admitted to hospital. Hospital admis
sions for all India totalled 570 cases as compared with 776 of 1937 and 646 of
1936.
Tonsillitis and Pharyngitis, which should be included in this group, pro
duced 1,453 and 444 admissions respectively. In Northern Command there is
an increase in general respiratory diseases of 11.16 up to a rate of 55 . 87 per
1,000, the highest since 1933. The increase is almost entirely due to the high
rates for Tonsillitis in Peshawar, Rawalpindi and Waziristan districts. Pneu--
monia has shown a slight decrease in the Northern area.
22. Tuberculosis
There were 50 admissions for Pulmonary tuberculosis and only 1 for
other tuberculosis in the present year, compared with 61 and 7 in 1937 and
57 and 9 in 1936. The cases were very evenly distributed throughout India
and no instance was noted of special prevalence in any one unit.
Owing to the time which this disease takes to manifest itself it is very
difficult to assess the source of infection, a problem which frequently arises
in pension cases, particularly in the case of Indian troops. There is a general
impression that tuberculosis, and pulmonary at that, is on the increase in
India. Military figures which may be regarded as reliable do not bear this out
as shown in the following table ; or rather show that as far as cantonment popu-
lations are concerned there is no obvious increase.
TABLE No. 42
Incidence of Tuberculosis amongst British and Indian troops over a 5 year
period (actuals).
Year.
British
troops.
Indian
troops.
1934
.
.
.
.
.
.
.
. . .
.
64
253
1935
.
.
.
.
.
.
.
.
69
2 75
1936
.
.
.
.
.
.
.
.
.
.
•
66
233
1937
.
.
.
.
.
.
.
.
.
.
.
68
194
1938
.
.
.
.
.
.
.
.
.
.
.
51
212
23. Diphtheria
There has been an increase in the numbers of diphtheria cases from
all commands so that the all India figure has risen from 40 last year to 53 this
year for other ranks. There were no epidemics amongst adults, though
Poona had 9 cases, but there were three definite epidemics amongst children at
Sanawar, Solon and Barian in Northern Command. These are described
in paragraph 28 under children.
36
The general incidence is best shown by the following table.
TABLE NO. 43
Diphtheria by Commands in categories—British Service.
Northern
Command.
Western
(I.) Dist.
Eastern
Command.
Southern
Command.
Total
1938
Total
1937
Officers .
.
.
3
..
..
..
3
5
Other Ranks .
.
18
11
9
15
53
40
B. 0. Rs. wives
.
..
..
6
8
3
B. 0. Rs. children .
15
2
9
38
54
51
Total 1938
.
.
38
13
18
59
128
..
Total 1937
.
.
23
13
18
4 5
..
99
Amongst Indian troops there were only 6 cases altogether, the contrast
being nearly as great as in 1937 when there were only 2 cases.
The incidence of diphtheria over the past 5 years is shown below. The
contrast between British and Indian is considerable.
TABLE NO. 44.
Admissions for Diphtheria over 5 years (actuals)
British
Indian
Troops.
Troops.
1934.
.
.
.
.
.
.
.
6 8
10
1935
.
.
.
.
.
.
.
.
.
66
3
1936
66
6
1937
.
.
.
.
.
.
.
.
40
2
1938
.
.
.
.
.
.
.
.
.
5 3
6
24. Effects of Heat
There has been an increase of thirty per cent. in admissions for heat
¬stroke and cases of heat exhaustion have been nearly doubled this year. As a
cause of death these two conditions rank high, the All India percentage being
nearly 13 per cent. while that for heat-stroke alone is over 27 per cent. In
Northern Command with 49 admissions the death rate was 14 per cent. of
cases. The results over the past three years are shown below.
TABLE NO. 45.
Effects of Heat.
Heat stroke.
Heat exhaustion.
Total effects.
Cases.
Deaths.
Cases.
Deaths.
Cases.
Deaths..
1936
.
.
.
13
3
39
1
52
4
1937
.
.
•
15
6
37
2
52
8
1938
.
.
.
22
6
65
6
88*
12
*In the present year there was also one case labelled " Sunstroke " from Jubbulpore
in which a B. O. R., with 6 months service in India, is stated to have developed a severe-
headache with abdominal pain, a furred tongue and constipation after 6 hours out in the.
sun.
The majority of these cases were in the northern half of India, Northern
Command having 49 and Eastern Command 13 cases. In the former Command
there was a very definite increase from 1.43 up to 3.40 per 1,000. This was
entirely due to increases in the Peshawar district which produced 23 cases
against 11 of the previous year and in the Lahore District which had 22 against
14 cases of 1937.
38
The seasonal incidence of these cases of heat stroke and heat exhaustion are
shown below.
TABLE No. 46
Seasonal incidence of Heat Effects. (British Troops).
Jan.
A.D.
Feb.
A. D.
Mar.
A. D.
Apr.
A. D.
May
A. D.
June
A. D.
July
A. D.
Aug.
A. D.
Sep.
A. D.
Oct.
A. D.
Nov.
A. D.
Dec.
A. D.
Heat stoke.
„ exhaus
¬tion . .
.. .. .. .. 1 .. .. .. 6 1 4 1 1 1 5 2 1 1 .. . . 1 .. ..„ ..„
.. .. 1 .. .. .. 2 .. 3 .. 7 .. 22 4 15 1 4
.. . . . . ..
.. .
It will be observed that the preponderance of cases of heat exhaustion is
towards the end of the hot weather period when the drain of salt from the body
is likely to be having its greatest effect.
The admissions for the Effects of Heat over the past 5 years is shown below.
TABLE No. 47
Effects of Heat (Actuals).
British
Troops.
In dian
Troops.
1934
90
23
1935
90
18
1936
52
19
1937
60
27
1938
88
45
25. Mental Diseases
The admissions for mental diseases in recent years is shown most
simply as a table.
TABLE No. 48
Admissions for Mental Diseases
British
Troops.
Indian Troops:
Admissions. Invalided.
Admissions.
1934
.
.
_
.
152
67
120
1935
.
.
.
..
.
.
173.
53
93
1936
.
.
.
145
73
104
193
.
.
.
, .
.
118
51
95
1.938
.
.
109
65
93
Of the 109 admissions 26 were for Hysteria and 15 of these were invalided.
From Southern Command the report of the Mental Specialist includes
the following interesting note which refers to cases about which a few records
have been published from time to time in the Journal of the Royal Army
Medical Corps.
" Cases have been seen where the exciting cause of the mental breakdown
appeared to be impacted wisdom teeth. This point is also the subject of special
investigation. In quite a number of cases the presence of impacted wisdom
teeth would appear to be causal rather than coincidental and removal of the
suspected tooth has secured a dramatic cessation of the symptoms."
26. The Dental condition of the Troops.
(a) General.— The general dental condition of the troops may be con
¬ s i d e r e d a s v e r y f a i r a n d e v e r y e f f o r t i s m a d e t o p r o v i d e r o u t i n e i n s p e c t i o n
and the necessary treatment of as many men as possible. The treatment
received by units and drafts before departure from the United Kingdom
39
continues to be generally excellent, only small unavoidable departures from
this standard having been reported. The suspension of any dental standard
on enlistment however means that a certain number of even poorer material
than in the past, both in number and structure of the teeth, is beginning to
arrive who will require even more attention and care than has hitherto been
necessary. The proportion of artificial dentures requiring supply or upkeep
must also increase.
(b) Oral Hygiene.— This continues to be uniformly excellent. It is one of
the most gratifying and encouraging results of the efforts of the Dental Officers.
The pride of the troops in their personal condition and in so frequently, volun-
tarily seeking treatment must be unequalled in any similar walk of life,
Refusals of treatment, while officially permissible, are negligible.
(c) Dental Treatment.—The high standard of treatment, remarked in
previous reports, is more than maintained and officers show much interest in
acquiring the latest operative methods.
(d) Observations on the results on Dental treatment on the general health of
soldiers.—The elimination of dental sepsis from practically the whole of the
military personnel is a factor of the greatest importance in achieving maximum
resistance to disease and in the high recovery rate of those who do fall sick.
In debilitating diseases such as malaria, dysentery and enteric fever the physi-
cian can dismiss this complication and in acute surgical conditions, particularly
abdominal, the surgeon can equally do so. Further in all cases of fracture of the
jaw the field is immediately ready for operative treatment, there being no pre-
existing dental sepsis.
(e) Other information regarding Dental treatment.—The Army Education
Authorities of the General Staff have represented the desirability of the routine
dental treatment of all children attending Army Children's Schools, as is the
case at Home ; but, however desirable, this is impossible without a considerable
increase in establishment.
27. Invaliding.
The rate has remained remarkably level over a number of years ;
varying from 7 to 11 per 1,000 over the past 10 years. It remains to be seen
whether there is any effect noticeable from the alterations of certain physical
standards which were made in 1936 and introduced in 1937. The rate for
the present year is 9.35 compared with 10.97 of the previous year.
Pulmonary Tuberculosis with 62 cases and Mental diseases 51 cases again
head the list of principal causes. In 1937 there were respectively 51 and 47
cases for these diseases.
Invaliding rates for B. O. Rs. during the past 10 years are shown below.
TABLE No. 49.
Invaliding. (Ratios per 1000).
British other
ranks.
Indian other
ranks.
1929
.
.
.
.
.
.
.
.
9.78
10.20
1930
.
.
.
.
.
.
.
.'
8.70
6.23
1931
.
.
.
.
.
9.76
8.73
1932
.
.
.
.
.
.
.
.
7.39
6.47
1933
.
.
.
.
9.15
5.68:
1934
.
.
.
.
.
.
.
9.39
5 . 6 2
1935
.
.
.
.
.
.
.
6.90
5.54
1936
.
.
.
.
.
.
.
.
10.99
5.52
1937
.
.
.
.
.
.
.
.
10.97
5.49
1938
.
.
.
.
.
.
.
.
9.35
5.84.
40
The principal diseases for which British other ranks were invalided are
shown below.
TABLE No. 50.
Diseases for which men were invalided. (Actuals)
1937.
1938.
Pulmonary tuberculosis .
.
.
.
.
.
.
62
51
Mental diseases other than Schizophrenia .
.
.
.
51
47
Fractures
.
.
.
.
.
.
.
.
.
34
12
Diseases of joints .
.
.
.
.
.
.
.
27
26
Injuries other than fractures .
.
.
.
.
.
27
32
Diseases of bronchi and bronchioles .
26
12
Schizophrenia
.
.
.
.
.
.
.
22
18
Epilepsy
.
.
22
11
Deformities of limbs
18
4
D. A. H.
.
.
.
13
8
V. D. H.
12
6
Rheumatic fever .
.
.
.
.
.
.
.
11
9
Otitis media .
.
.
.
.
.
.
.
.
11
3
Diseases of Urinary organs
.
10
11
Other T. B. .
.
.
.
.
.
.
.
.
6
8
28. Women and children—Childwelfare.
A. The number of women admitted to hospital has decreased in the
past three years. The admission, death and invaliding rates are shown.
TABLE No. 51.
British Other Ranks' wives.
Casualties over 10 years. Ratios per 1,000.
Year.
Admissions. Deaths. Invaliding.
1929
.
. .
.
.
.
.
.
.
.
321 . 1
2.30
14.79
1930
'
..
.
.
.
328 . 6
5.30
10.83
1931
.
.
.
.
.
.
334 . 4
5.75
17.02
1932
.
.
.
.
.
.
.
.
.
292.3
4.17
13.20
1933
.
.
.
.
.
.
.
.
.
313.2
2.75
11.45
1934
.
.
.
.
..
.
.
.
.
311 . 6
2.23
12.50
1935
.
.
.
.
.
.
.
.
.
312 . 4
3.35
9.33
1936
.
.
.
.
.
. .
.
.
337 . 6
3.21
10.85
1937
.
.
.
.
.
.
.
.
.
319 . 7
3.62
10.13
1938
.
.
.
.
.
.
.
.
.
311 . 8
3.84
9.99
The principal causes of admission were the same as in last year, viz. :—
Abortion
.
.
.
.
100
It should be noted that the combined
dysentery-diarrhoea group, 141 admis-
sions, is really the commonest cause of
admission.
Malaria.
78
Dysentery .
.
.
.
77
Tonsillitis
.
.
.
.
71
Diarrhoea .
.
.
.
64
Cellulitis
.
.
.
.
38
Appendicitis
.
.
.
30
Bronchitis .
.
.
.
30
Common cold
.
.
.
28
Pyelitis
.
.
.
.
25
In addition 834 women were admitted to hospital for confinement.
There were 15 deaths (3.84 per 1,000) among women, two less than the
previous year.
In Northern Command the admission rate increased and the death rate
was definitely higher. In all the other commands there was a decrease.
41
The number treated as out-patients was 3,179 or 814.5 per 1,000.
B. Of children the admissions, deaths and invaliding are shown below.
TABLE No. 52.
British Other Ranks' children: Ratios per 1000.
Year.
Admissions.
Deaths. Invaliding.
1929
.
.
.
.
.
.
.
.
274.3
1 4 . 1 2
2.27
1930
.
.
.
.
.
.
.
.
284.4
12.29
0.92
1931.
.
.
.
.
.
.
.
286.4
12.08
3.32
1932
.
.
.
.
.
.
.
.
299.1
1 2 . 7 2
2.09
1933
.
.
.
.
.
.
.
.
281.9
11.05
1.42
1934
.
.
.
.
.
.
.
.
299.6
11.83
2.31
1935
.
.
.
.
.
.
.
.
334.3
9.66
2.15
1936
.
.
.
.
.
.
.
.
335.4
13.40
3.23
1937
.
.
.
.
.
.
.
.
358.3
12.83
2.60
1938
.
.
.
.
.
.
.
.
353.4
9.75
2.74
The principal causes of admission were :—
.
Dysentery.
225
The preponderence of the dysentery-diar
-rhoea enteritis group is again marked
with 434 cases or 21 per cent of the total
admissions. Diphtheria at 64 cases is an
increase of 25 per cent.
.
.
Tonsillitis.
192
Diarrhoea
..
163
Hypertrophy of Tonsils .
.
148
B Bronchitis ..
143
Malaria.
70
Cellulitis. .
.
68
.
Constipation.
66
Diphtheria..
.
,
64
Common cold.
58
There were 57 deaths amongst children. The principal causes of death
were pneumonia 11 and enteritis 10. Twenty-six per cent. of deaths were due
to the dysentery-diarrhoea and. enteritis groups.
In Quetta there were 3 cases of infection with T. saginata in young child-
ren. In Ranikhet the intestinal group of infections is still regrettably high.
Diphtheria.—In addition to sporadic cases, definite outbreaks occurred
at the Lawrence Royal Military School, Sanawar, at Solon and at Barian.
The Sanawar outbreak commenced in April when a boy, who was a patient
in the infectious ward for measles, developed laryngeal diphtheria. Two boys
who were probably responsible had already had a long history of having been
chronic carriers in Poona, one for nearly nine months as a carrier of the virulent
organism. He was then to have been invalided, but was reconsidered owing to
numerous negative examinations. He appears to have been the focus of this
epidemic.
The epidemic was stopped by immunisation of the whole School and all
new arrivals with T. A. F. and the two boys appear to have been finally cleared
of infectivity by tonsillectomy in September.
The Solon outbreak occurred in August. 6 carriers were found including
an officer's servant. Mucidan gargles and voluntary immunisation with T. A. F.
cleared the epidemic.
The Barian outbreak was in July to September. Eight cases and seven
carriers were found. The cause was not discovered, but infection may have
been spread by sucking milk through straws.
Child Welfare Centres .—For British families Centres exist at all large and
medium sized stations. Relatively they are not so well patronised as at Home
and tend to take the form of Mothers Unions. There is a tendency to bring
42
sick children to be seen by the Medical Officer, if he is there, instead of taking
them to the hospital, with consequent loss of time in starting treatment of the childern.
Funds are obtained from regimental subscriptions—special collections—
grants from the Maternity and Child Welfare Bureau—and by sales of work
and jumbles.
The work of the Centres consists of Home visiting and meetings are held
fortnightly with lectures, advice and comparison of babies and help given by
means of cheap baby foods, milk and. materials for clothes.
An annual report and budget request Form A. G. 25 is submitted by all
Centre Committees to Army Headquarters and to the Maternity and Child
Welfare Bureau which is proving of value.
29. Schools.
Generally speaking these are noted as being satisfactory. They vary
considerably and there are many minor defects, structural and in furnishings.
Inspections are made and reports rendered annually on the Schools and the
condition of the children defects are being remedied steadily as money be-
comes available. There is no doubt that the hygienic standard of Army
Children's Schools has greatly improved during the past 10 years. Minor
improvements are being constantly made and completely new schools have been
provided for Half moon Barracks, Ranikhet and at Chakrata. The sanitary
accommodation has been much improved.
Overcrowding in schools in hill stations in the summer is often a defect
with which it is difficult to cope owing to gross fluctuations in child-population
in these stations.
Enlarged tonsils and dental caries are noted as the main physical defects
of the children. No doubt most of the caries is in the temporary teeth, but
even so the impression one gets is that the oral hygiene of the children of soldiers
is definitely neglected.
Two epidemics are worth a note, they were however in civilian schools.
At Lawrence College near Murree there was an outburst of Typhoid at the
and of May with 20 severe cases and 2 deaths. All children are said to have
had T. A. B. inoculation. The cause of the outbreak was suspected to be milk,
but was not traced. At Murree in a large girls school an acute outbreak of
dysentery was traced to extremely faulty sanitary and cookhouse arrange-
ments and management.
In Southern Command attention has been drawn to the matter of eyesight
and school work. The importance of keeping the head up and eyes at least one
foot away from the work has been stressed. This point and the closely con-
nected points of proper desk and seating accommodation and of lighting on the
plane of work are being taken up for all schools.
In Quetta a temporary school has had to be used, but with an increase in
families the school has proved to be much too small : outdoor classes have
bean used in the summer, but are obviously quite unsuitable for a Quetta winter
and one teacher cannot teach in two separate huts.
Each child in the Western Ind. District schools gets a 1/2 pint of milk and
a straw for 1 anna a day.