NationalLibraryOfScotland/medical-history-of-british-india huggingface dataset:
52
27. Mental Diseases.
For British Troops the steady decrease of recent years has been continued,
the numbers admitted being the least shown for the past 6 years. Invaliding
although showing a reduction of 9 cases is still over 50 for the year.
Nearly 30 per cent. of the admissions were for Hysteria and of these only
9 were invalided.
TABLE 47.
Admissions for Mental Diseases.
British
Troops.
Indian Troops.
Admissions. Invalided.
Admissions.
1934
.
.
.
.
.
.
.
.
2.8
1.23
1.0
1935
.
.
.
.
.
.
.
.
3.3
1.01
0.8
1936
.
.
.
.
.
.
.
.
2.8
1.88
0.9
1937
.
.
.
.
.
.
.
.
2.5
1. 54
1.0
1938
.
.
.
.
.
.
.
.
2.5
1.51
0.9
1939
.
.
.
.
.
.
.
.
2.9
1.60
1.3
8. Other Diseases.
Cerebral Abcess.—A case was admitted and died of a cerebral abcess the
size of a golf ball in the temperosphenoidal lobe of his brain. The abcess with
walls 5 millimeters thick contained sterile pus. He had carried out his full
duties to within 10 days of his death without any signs of this serious condition.
Hydrophobia .—Unfortunately there were 2 cases both at Ranikhet ; one
was a R. A. M. C. Orderly who refused treatment although warned, because he
wished to be in time to sit a Corps examination. The other did not report
until symptoms developed.
Jaundice .—Many cases occurred in all Districts. Total admissions
numbered 257. Investigations have been repeatedly carried out over the pass
15 years to try to find a cause, but invariably the conclusion is reached that the
Jaundice is of the simple catarrhal type. A number of cases occurred during
the summer at Sialkot and the Medical Officer concerned commented that
the occurrence of cases is at such intervals as to fit the view that the Jaundice
is infective.
Kala-azar .—There were 2 cases amongst B. O. Rs.
One in the Simla Hills at Kasauli in the B. I. Regiment and in the British
Infantry unit stationed at Barrackpore. The Calcutta man was admitted
twice.
29. British Drafts for the Trooping Season, 1939-40.
The total strength of newly arrived men from Great Britain and from
stations overseas was somewhat lower than in pre-war years.
3.2 per cent. were found to be temporarily unfit on arrival in this country
but after necessary treatment all were rendered fit.
12 men were found to be permanently unfit. The causative diseases were
visual defects, hernia, bilateral rigid flat foot, pulmonary fibrosis and sclerotic
periostitis.
302 men were found to be unprotected against the enteric group and 876
men had not been vaccinated against smallpox. With present conditions of
service being what they are vaccination against smallpox and enteric are
voluntary. Practically all these men consented after persuasion by their
53
medical officers both to be given T. A. B. and to be vaccinated. The attention
of the War Office was drawn to this, particularly to the fact that on persuasion
practically all the men consented to be done. Steps were taken at Home to
rectify this matter.
A group of 8 men who were noted from Southern Command to weigh under
112 lbs. on enlistment were placed on special reports ; a follow-up showed that
they have now gained satisfactorily in weight.
The following list shows the principal disease from which young British
soldiers suffer during their first year in the country.
TABLE 48.
Details of principal names of sickness in soldiers under 20 years of age.
Dysentery-Diarrhœa
.
.
.
.
.
.
.
.
140
Tonsillitis, inflammation of fauces and pharyngitis
.
.
131
Minor septic diseases
.
.
.
.
.
.
.
.
123
Other diseases of the skin
.
.
.
.
.
.
.
1 0 9
Local injurie
.
.
.
.
.
.
.
.
.
102
Other digestive disease
.
.
.
.
.
.
.
6 5
Malaria.
.
.
.
.
.
.
.
.
.
6 5
Diseases of ear and nose
.
.
.
.
.
.
.
5 3
Venereal disease
.
.
.
.
.
.
.
.
3 8
Sandfly fever
.
. .
.
.
.
.
.
.
.
3 1
Jaundice
. .
.
.
.
.
.
.
.
.
2 0
30. Invaliding.
Although slightly reduced in the present year, partly due to alterations in
shipping and the disturbance of War, the rate has remained remarkably level
for British and for Indian troops : varying from 7 to 11 per 1,000 for the former
and 9 to 5.5 per 1,000 for the latter.
TABLE 49.
Invaliding.
Ratios Der 1,000.
British
other
ranks.
Indian
other
ranks.
1930 .
.
.
.
.
.
.
.
.
8.70
6.23
1931 .
.
.
.
.
.
.
.
.
9.76
8.73
1932 .
.
.
.
.
.
.
.
.
7.39
6.47
1933 .
.
.
.
.
.
.
.
.
9.15
5.68
1934 .
.
.
.
.
.
.
.
.
9.39
5.62
1935
.
.
.
.
.
.
.
.
.
6.90
5.54
1936 .
•
•
•
•
•
•
•
•
10.99
5.52
1937 .
.
.
.
.
•
•
•
•
10.97
5.49
1938
.
.
.
.
.
.
.
.
.
9.35
5.84
1 9 3 9
.
.
.
.
.
.
.
.
9 . 14
6.43
The principal diseases for which British other ranks were invalided are
shown below.
54
TABLE 50.
Invaliding British Troops.
Per 1,000.
Mental diseases other than Schizophrenia
.
.
.
.
1.28
Pulmonary tuberculosis
.
.
.
.
.
.
.
I.03
Diseases of joints .
.
.
.
.
.
.
.
.
0.58
Injuries other than fractures .
.
.
.
.
.
.
0.47
Fractures
.
.
.
.
.
.
.
.
.
.
0.42
Schizophrenia
.
.
.
.
.
.
.
.
.
0.28
Diseases of bronchi and bronchioles.
.
.
.
.
.
0.28
Diseases of urinary organs
.
.
.
.
.
.
.
0.25
Diseases of valves of the heart
.
.
.
.
.
.
0.25
Deformities of limbs
.
.
.
.
.
.
.
.
0.19
Tuberculosis other than pulmonary
.
.
.
.
.
0.14
Rheumatic fever .
.
.
.
.
.
.
.
.
0.06
Epilepsy
.
.
.
.
.
.
.
.
.
0.03
Disordered action of the heart
.
.
.
.
.
.
0.03
31. Deaths.
The death rate at 2.75 per 1,000 shows a slight decrease on the previous
year and the death rates over the quinquennial periods since the War 1914-18
show a steady decline to 2.54 per 1,000.
In Southern Command there were only 17 deaths compared with 29 of 1938
and this is first time for many years that the death rate has fallen below 2 per
1,000. There were two unusual deaths, a B. O. R. who was mauled by a tiger
near Deolali and another who was killed in shallow water by a shark at Madras.
One British soldier is considered to have died of Heat Stroke at Mount
Abu but the cause of death was uncertain as he died alone when lost from his
walking party in the hills.
In Waziristan the deaths increased to 19 but 15 of these were due to gun
shot wounds.
The principal causes of death were :
Per 1,000.
Local injuries including G. S. W.
.
.
.
.
•
•
0.78
Infectious diseases
.
.
.
.
.
.
.
.
0.58
General injuries .
.
.
.
.
.
.
.
.
0.39
Digestive diseases
.
.
.
.
.
.
.
.
0.36
Circulatory diseases
.
.
.
.
.
.
.
.
0. 19
Pneumonia .
.
.
.
.
.
.
.
.
.
0.14
32. Officers, British Service,
Special remarks and diseases.
As noted in paragraph 2, the admission rates for Officers has increased for
the last 3 years and stands at 435.1 per 1,000. This increase is due to rising
admissions in Northern and Eastern Commands, Western Independent District
and Southern Command showing definitely decreased rates.
In . Northern Command there has been a jump of 90 to the year's rate of
497.01 per 1,000. This actually is about normal for the Command except in
the " low " years 1937, 1938. This is due chiefly to Lahore District where the
rate increased to 521 per 1,000 due to similar causes as for the Troops. The
death rate has, however, decreased and, at 1 only, is lowest for 8 years. Kohat
District is noteworthy in having an exceptionally low sick rate at 375 per 1,000
in spite of the long trying hot weather which was experienced there.
55
Eastern Command, though less in actuals, shows some increase in the
admission rate. There was considerable Dysentery in Meerut, and Dengue
and Sandfly fever in Lucknow District. There were 3 deaths in young officers
including two young R. A. M. C. officers, one of poliomyelitis and one of tuber-
culosis.
Southern Command shows a reduction in sickness, 6 per 1,000 and no
deaths. Dysentery at 52 per 1,000 was the most prominent feature and also
minor septic diseases.
Western Independent District too showed a marked drop in admissions, the
actuals being halved and the rate reduced by 200 per 1,000. There were no
invalids and no deaths.
The D. A. D. H. remarks:
" It is undoubtedly a fact that Officers particularly are paying more
attention to protecting themselves and their men from malaria,
sandflies and the pollution of food by flies."
The principal causes of sickness amongst Officers were as follows :—
TABLE 51.
Per 1,000.
Malaria
.
.
.
.
.
.
.
.
.
.
36.8
Dysentery .
.
.
.
.
.
.
.
.
.
36 . 8.
Jaundice Catarrhal
.
.
.
.
.
.
.
.
29. 9
Cellulitis
.
.
.
.
.
.
.
.
.
.
26.2
Sandfly fever
.
.
.
.
.
.
.
.
.
25.1
Tonsillitis .
.
.
.
.
.
.
.
.
.
20.8
Diarrhœa
.
.
.
.
.
.
.
.
.
.
19.8
Fractures
.
.
.
.
.
.
.
.
.
.
11.2
Common cold
.
.
.
.
.
.
.
.
.
8 . 5
Contusions .
.
.
.
.
.
.
.
.
.
8.0
Influenza
.
.
.
.
.
.
.
.
.
.
7 . 5
Appendicitis
.
.
.
.
.
.
.
.
.
6 . 9
Concussion
.
.
.
.
.
.
.
.
.
5 . 9.
Sinusitis
.
.
.
.
.
.
.
.
.
.
5. 3
It is worth noting how prone Officers appear to be to Jaundice.
PART I
SECTION II
ON THE HEALTH OF INDIAN ARMY.
58
SECTION II
ON THE HEALTH OF INDIAN ARMY
33. General
The health of the Indian Army has n the whole been satisfactory. There
have been no pidemics of any note and such increase as there has been, viz .,
32.2 per 1,000 in admission rates an be fully accounted for by conditions of
war service.
Large numbers of eservists returned to their units, there was a consid
erable influx of recruits and many defensive posts had to be manned in re-
latively unhealthy areas.
Death rates have decreased to 2.12 per 1,000 and invaliding has increased
to 6.43 per 1,000.
The average constantly sick figure has increased to 16.25.
TABLE 52
General health statistics of the Indian Troops in India during the year 1939.
Ratios per 1,000 of strength
Admissions.
Deaths.
Invalids sent
to United
Kingdom.
Invalids
discharged
in India.
Constantly
sick.
Officers . . .
.
462.1
3.84
12. 36
...
14. 75
Indian Other Ranks
.
454.0
2.12
...
6.43
16.25
Followers
.
.
.
323.2
2.50
...
4.23
11.45
Others‫٭‬
.
.
.
2321
17
. . .
86
. . .
* Includes Reservists, Indian Territorial Forces, Royal Indian Marine, Indian
States Forces, R, A. F., Civilians and Pensioners.
N.B.—The figures below the horizontal line represent actuals.
The health statistics of Officers and Indian. Other Ranks for the quin-
quennial periods from 1925 are shown in the following comparative tables.
TABLE 53-A
Quinquennial comparative table of sickness for Officers and Other Ranks.
Ratio per 1,000.
Period.
Admissions.
Invalids.
Deaths.
King's
Commis-
sioned
Officers.
Indian
Ranks.
King's
Commis-
sioned
Officers.
Indian
Ranks.
King's
Commis-
sioned
Officers.
Indian
Ranks.
1925-29 .
. 498.0
385.6
5.22
10.8
4.74
3.48
1930-34 .
. 336.7
453.3
12.47
6.55
5.37
2.63
1935-39 .
. 383.8
423.3
10.72
5.76
6.05
2.08
59
TABLE 53-B
Annual comparative table of sickness for Officers and Other Ranks.
Ratio per 1,000.
Admissions.
Invalids.
Deaths.
Period.
King's
Commis-
sioned
officers.
Indian
ranks.
King's
Commis-
sioned
officers.
Indian
ranks.
King's
Commis-
sioned
officers.
Indian
ranks.
1935
.
.
.
346 . 8
422.7
6.82
5.54
7.31
2.15
1936
.
.
. 364.3
426.5
5.34
5.52
4.37
2.16
1937
.
.
.
359 . 0
391.7
9.23
5-49
4.35
1.77
1938
.
.
.
386 . 8
421.8
19.86
5.83
10.40
2.21
1939
.
.
.
462.1
454.0
12.36
6.43
3.84
2.12
34. Officers
•
The admission rates for officers which has shown a steady upward tendenc
for the past 10 years is this year again conspicuous for a rise of nearly 80 per
1,000 but is still below the quinquennial figure for 1925-29 but the rates for
invaliding at 12.36 per 1,000 and for deaths at 3.84 per 1,000 have decreased.
The increase in admission rates is due partly to the return to India of a
number of retired and in many cases elderly officers after the outbreak of war
and partly to the arrival of a number of very junior officers without experience
of life in East.
The principal causes of sickness were as follows :—
TABLE 54
Principal causes of sickness for Officers
Diseases.
Ratio per
1,000.
increase or decrease as
compared with 1938.
Increase.Decrease.
Digestive diseases other than tonsillitis,
appendicitis and diarrhœa .
.
.
75.0
27.2
. .
Local injuries
.
.
.
.
.
57.1
8.9
. .
Malaria
.
.
.
.
.
.
37.9
. .
2.8
Minor septic diseases
.
.
.
.
24.7
3.4
..
Sandfly fever .
.
.
.
.
22.6
3.2
..
Ear and nose .
.
.
.
.
.
20.9
8.6
..
Diarrhœa
.
.
.
.
.
.
20.9
5.3
..
Tonsillitis
.
.
.
.
.
20.5
5.4
..
Dysentery
.
.
.
.
.
.
15.8
..
13.5
Respiratory diseases
.
.
.
.
06.6
. .
5.1
Appendicitis
.
.
.
.
.
14.9
3.6
. .
Diseases of bones, joints, muscles, fasciae
and bursae . . . . .
14.9
2.1
. .
Influenza
.
.
.
.
.
.
11.9
4.3
..
Urinary diseases
.
.
.
.
.
10.2
1.7
. .
Common cold
.
.
.
.
.
8.1
0.1
..
60
CHART No. X.
Ratios per 1,000 Admitted to Hospital, Invalids, Constantly sick, and average sick
time to each soldier from 1921 to 1939. (Indian Troops.)
ADMISSION TO HOSPITALS.
INVALIDS.
CONSTANTLY SICK.
61
Of the total deaths 4 were due to injuries, a cause which as usual heads the
list of causes of deaths. Of the remaining, deaths due to sickness the diseases
were : Haemorrhagic meningeal effusion, Aneurysm, Bronchitis, Nephritis
and Carcinoma, each 1 case.
35. Soldiers
There has been a marked rise in admission rates, nearly 33 per 1,000 to
454.0, a rate higher than any shown by the past quinquennial periods.
This increase is due in greater part to four main preventable diseases,
viz ., malaria, dysentery, scabies and sandfly fever. In all of these diseases
and in many others shown in the table below any relaxation of disciplinary
control and laxity in the recognised measures of prevention will produce an
increased number of cases. This has been in part, the cause of this year's
increase and is due to the disturbing influence of the onset of war, unusual
journeys, overcrowding in barracks, manning of defensive posts scattered
throughout unhealthy areas away from the protection of cantonment life,
increased training and other activities. But is also due to the importation
of infected personnel in the form of Reservists called up from their villages,
numbers of recruits infected before acceptance and auxiliary troops arriving
from civilian life.
The principal causes of admissions to hospital were :—
TABLE 55
Principal causes of admission
Diseases.
Increase or degrease
as compared With
1938.
Ratio per
1,000.
Increase. Decrease.
Malaria
. .
.
.
.
. 118.3
8.6
. .
Local injuries .
.
.
.
.
57.0
. .
2.8
Minor septic diseases
.
. .
.
36.8
2.7
. .
Pharyngitis .
. .
. .
.
24.1
4 8
..
Dysentery
.
.
.
.
.
.
17.1
. . 0.1
Common cold
. .
.
.
.
15.7
4.1
. .
Bronchitis .
.
.
.
.
.
13.2
0. 8
. .
Scabies .
.
. .
.
.
.
11.9
0.7
..
Venereal diseases .
.
.
.
.
8.5
1.0
. .
Conjuctivitis .
.
.
.
.
.
7.3
1.0
..
Mumps
.
. .
.
.
.
7.0
2 . 3
. .
Diarrhœa
.
.
.
.
.
.
6.3
. . 1.2
Ankylostomiasis .
.
.
.
.
6.2
1.9
. .
Sandfly fever
. . .
.
.
6.0
1.4
. .
Tonsillitis
.
.
.
.
.
.
5.5
..
0.6
Pneumonia (lobar and lobular)
.
.
5.4
0.4
. .
Dermatitis
.
. .
.
. .
5.1
1.3
..
Indigestion .
. .
. .
.
4.5
. . 0.7
Constipation
.
.
.
.
.
4.0
1.4
. .
Tineas
.
. .
.
.
.
3.8
. . 1.0
Influenza
.
. .
. .
.
3.7
. . 0.7
Otitis media .
.
.
.
.
.
3.4
0.4
. .
Synovitis
.
.
.
.
.
.
3.1
0.1
. .
Myalgia
.
. .
. .
.
2.9
0.3
. .
Jaundice catarrhal .
.
. .
.
2.8
1.1
. .
Eczema
.
. .
. .
.
2.4
. .
..
Anaemia secondar
.
. .
.
2.2
..
. .
Appendicitis
.
.
.
.
.
2 . 1
0 3 ..
Trachoma .
. .
.
.
.
2.1
0 . 3
..
Pulmonary tuberculosis .
.
.
.
1.9
0.2
. .
62
T A B L E 5 5 —
C o n t d .
Principal causes of admission
Increase or decrease
as compared with
1938.
Diseases.
Ratio per
1,000.
Increase. Decrease.
Rhinitis .
.
.
.
.
.
.
1.8
0.4
. .
Piles .
.
.
.
•
. .
.
1. 8
. . ..
Pleurisy
.
.
.
.
.
.
1.7
..
0.6
Dracontiasis.
.
.
.
.
.
.
1• 6
. .
0.2
Coryza .
.
.
.
.
.
.
1.5
0.1
..
Colic .
.
.
.
.
.
.
1.5
0.1
. .
Lumbago
.
.
.
.
•
.
1. 4
0.3
. .
Measles
.
.
.
.
.
.
1 . 3
. .
0.4
Renal colic
.
.
.
.
.
.
1 . 3
0.1
..
Chicken-pox .
.
•
.
. .
•
1.3
0.4
. .
Gastritis
.
.
.
.
.
.
1.2
0.1
..
Sciatica
.
.
.
.
.
.
1.2
. .
..
Keratitis ulcerative .
•
.
.
.
1.2
. .
0.1
Dengue
•
•
.
•
.
.
1.1
. .
. .
Otitis externs
.
.
.
.
.
1.1
. .
0 . 1
The death rate shows a decrease of 0.09 per 1,000, the rate now being
2.12 per 1,000 and the fall shown over the past 15 years has been steadily
maintained. " Injuries " with over 70 deaths again heads the list of causes
and produces more than double the number caused by the dreaded pneumonia.
Injuries and pneumonia between them produced four more deaths than
all the other causes put together. The principal causes of death were :—
TABLE 56
Causes of death for Indian Troops
Diseases.
Ratio per
1,000.
Increase or decrease
as compared with
1938.
Increase. Decrease.
Local injuries
.
.
. .
.
0.63
0.09
. .
Pneumonia (Lobar and lobular)
.
.
0.29
..
0.14
General injuries
.
.
.
.
.
0.16
0.08
. .
Circulatory diseases
.
.
.
.
0. 15
. .
. .
Digestive diseases .
.
.
.
.
0.13
. .
0.06
Norvous diseases .
.
.
.
.
0.10
0.04
..
Pulmonary tuberculosis .
.
.
.
0.06
..
0.06
Enteric group of fevers .
.
.
.
0. 06
. .
0.01
Meningococcal infection
.
.
.
0.04
. .
0.03
Tuberculosis (other than pulmonary)
.
0.04
..
. .
Dysentery .
.
.
.
.
.
0.04
0.01
..
Malaria.
.
.
.
.
.
0.04
..
. 01
Urinary disease .
.
.
.
0.03
. . 0.01
Invaliding.—The invaliding rate at 6.43 per 1,000 is 0.60 more than
last year and 0.12 less than the rate over the past 14 years. The rate now is
half of that of the quinquennial period 1925-29.
63
The main diseases for which invaliding was necessary are shown below.
TABLE 57
Principal causes of invaliding for Indian Troops
Increase or decrease
as compared with
1938
Diseases.
Ratio per
1,000.
Increase. Decrease.
Pulmonary tuberculosis .
.
.
.
1.70
0.27
. .
Injuries
.
.
.
.
.
.
1.08
. . 0.43
Diseases of the bones, joints, muscles,
fasciae and bursae .
.
.
.
0.53
0.19
. .
Mental diseases .
.
.
.
.
0.48
0.11
..
Diseases of the nervous system
.
.
0.38
0.01
. .
Diseases of the eye
.
.
.
.
0.36
..
0.02
Diseases of the respiratory system .
.
0.34
0.16
. .
Diseases of the Digestive system
.
.
0.27
. 2 0
Other tubercular disease
.
.
.
0 . 21
0.03
..
Diseases of the Circulatory system .
.
0.16
0 02 ..
Diseases of teeth and Gums
.
.
.
0.11
0.10
. .
Diseases of ear and nose
.
.
.
0.09
.
. .
Diseases of urinary organs
.
.
.
0 07
..
0.03
Diseases of blood .
.
. .
.
0.07
..
..
Venereal diseases.
.
.
. .
0.04
..
0.01
It will be noted that once again Tuberculosis heads the list, pulmonary
tuberculosis accounting for nearly 200 of the cases and the total tubercular
diseases again form nearly 1/3 of the total cases invalided.
The average number of constantly sick in hospital was 16 . 25 per 1,000
of the strength compared with 15.78 in 1938 and 15.15 in 1937.
The average sick time to each soldier was 5.93 days and the average
duration of each case was 13.06 days compared with 5.76 days and 13.65
days of 1938.
Men under barrack treatment (out patients) were 1,296.5 per 1,000 com-
pared with 1,229.9, 1,219.1 and 1,343.3 of 1938, 1937 and 1936, respectively.
The combined ratio of constantly sick in hospital plus those constantly
under treatment in barracks was 34.60 per 1,000 compared with 33.22 in
1938, 33.00 in 1937 and 34.93 in 1936. This represents the total loss per 1,000
pe day.
•
These statistics show that the health of the Indian Army has on the whole
been reasonably satisfactory throughout the year although the admission rate
of 454.0 per 1,000 is in excess by 32.2 over that of last year.
All Commands show an increase in sick rates with Malaria and Sandfly
fever being the chief causes. In W. I. District there was an increase of 60
per 1,000 due to malaria and sandfly fever. In Eastern Command the sick
rate, though not so adversely affected as in the case of British Troops, at
455.3 per 1,000 gives the highest rate for 6 years, sandfly fever, malaria and
dengue being the causes. Southern Command too has produced increases
due in the main to malaria of which there were 2,416 admissions compared
with 1,609 of the previous year. There was a good deal of overcrowding in
Bombay at one period.
In Northern Command, where there was a general increase of 19 per 1,000,
a curious feature was the contrast between Lahore and Waziristan districts
with higher rates and the other three districts, Kohat, Peshawar and Rawal-
pindi districts with the lowest sick rates ever recorded. The general decrease
64
in malaria and sandfly fever was partly offset by increases in mumps, pharyn
gitis and ankylostomiasis. In Waziristan district in spite of operations in the
Shaktu Valley in February and March with cold, rain and snow and pro-
longed columns the general health has remained good. Kohat district with
a reduction of 75 per 1,000 in sickness has the healthiest year for 4 years.
In Peshawar district with still further reductions the admission rate at 353
per 1,000 is the lowest for at least 15 years ; there were only 19 cases of malaria,
1 of sandfly fever and 1 of venereal diseases per 1,000 of strength. In this
district the progressive fall in insect borne diseases is of interest.
1934. 1935. 1936. 1937. 1938. 1939.
Insect borne disease
group
. . .
50 . 6 39 . 6 47 . 9 30 . 0 30 . 1 25.6 per cent of the total
admissions.
From Rawalpindi district the following observations are recorded. From
the 1st September onward all the factors which tend to increase sick rates
were operative, reservists were called up in large numbers, recruits arrived
in batches, Territorial battalions were raised and leave men were recalled
from and through malarious areas. The sanitary discipline of these was
naturally not so good as it is in the trained troops. Men were undergoing
intensive training, there was some overcrowding and many outposts and secu-
rity points were manned.
In spite of all these factors the sick rate was lower this year compared
with 1938 and would have been better still but for these abnormal activities
after war was declared.
Barrack treatment and high rates of sick.
The remark is noted from reports that of all the factors given to account
for high sick rates in barracks, the personality of the medical officer is one of
the most important. Frequent changes of medical officer, the presence of
newly joined, ignorant medical officers and soft hearted elderly medical officers
are all conducive to specially high sick-rates in the medical inspection rooms.
I.O.
Rs.
1939.
RATIO PER 1,000.
CHART No. XI.
TOTAL ADMISSIONS, ALL CAUSES.—
MALARIA.
—
DYSENTERY & DIARRHOEA.—
T h e p e a k o f t h e s i c k n e s s c u r v e f o r a l l I n d i a w a s i n O c t o b e r . T h e p e a k i n C o m m a n d s w a s i n A u g u s t i n N o r t h e r n , E a s t e r n a n d s o u t h e r n C o m m a n d s ; b u t i n W e s t e r n I n d e p e n d e n t D i s t r i c t w a s i n J u l y a n d S o u t h e r n C o m m a n d s t h e r e w e r e t e o p e a k s i n A p r i a l a n d A u g u s t .
T h e g r a p h g i v e n b e l o w s h o w s m o r e c l e a r l y t h e g e n e r a l t r e n d o f s i c k n e s s , t h r o u g h t h e y e a r .
65