53
J . FIELD HYGIENE AND SANITATION : TRAINING AND INSPECTION.
Reports indicate progress in the standard of knowledge of camp sanitation
and elementary Hygiene amongst officers and men, but there is still much room
for improvement. The first essential is that the officers of a unit shall under--
stand the principles of sanitation and firmly believe in its importance, both in
peace and war. Only by this means can the sanitary chaos of troop concen--
trations and movements be avoided. In Northern Command special courses
of lectures by the Deputy Assistant Director of Hygiene, or a specially selected
officer, was arranged for all officers additional to the training laid down in
Regulations for the Army in India, Instruction 341.
A combined pamphlet on sanitation, water duties and first aid has now
been published and issued to all.
Hygiene inspections.—All Assistant and Deputy Assistant Directors of
Hygiene have made frequent tours round their areas during the year. Apart
from the normal notes and reports, these tours of inspection are of great value
in the personal contacts which these officers make and the personal knowledge
of local conditions which they acquire.
33. Pathology.
The routine work again showed an annual increase during 1938. A total
of 2,21,784 specimens were sent for laboratory examination during the year,
20,079 more than last year. A larger number of examinations was also carried
out in clinical side rooms of hospitals in connection with malaria, dysentery
cases and chemical examinations. In last year's report it was pointed out that
a considerable number of examinations at present carried out in laboratories
could be done equally well in clinical side rooms if their equipment was slightly
increased. Every endeavour was made to obtain sanction for this extra equip--
ment but owing to financial stringency this proposition was temporarily drop--
ped. It is hoped to take up this matter again in the near future.
Enteric Group of fevers and Salmonella infections. —Repeated widal tests
were carried out on " bacteriologically undiagnosed " so called enteric group
cases. A total of 69 cases were diagnosed " group " infection throughout the
year which represented 30 British and 39 Indian. Of these, 21 were
serolo-gically negative and were diagnosed on clinical grounds only. The great
majority of the cases were mild with little or nothing beyond pyrexia, slow
pulse, headache, constipation and bronchitic signs. The average pyrexial
period for the above cases was 16 days.
It is felt that in the absence of definite serological findings, the diagnosis of
" enteric group " is too readily made, frequently on the slenderest of clinical
grounds. To quote from the annual report of the Assistant Director of Hygiene
and Pathology, Northern Command : " It should be very rare that in a case of
enteric fever bacteriological evidence ( i.e ., from blood, faeces, or urine) cannot
be elicited. The only logical procedure when bacteriological evidence is nega--
tive, Serological evidence doubtful and clinical signs indefinite is to designate
the case P. U. O. Provided the case has been thoroughly investigated, no
stigma attaches to such a diagnosis. On the contrary it is a scientific con-
-clusion."
The employment of " H " suspensions for agglutination tests was discon--
tinued in July 1938 and from that date TO and AO suspensions supplied by the
Enteric Laboratory Kasauli were used by all laboratories, Felix's technique of
agglutination being employed. Owing to frequent inoculation it is universally