NationalLibraryOfScotland/medical-history-of-british-india huggingface dataset:
87
In the Report for 1938 the number of recruits rejected for Trachoma
received some comment in view of the attention drawn to this by the District
Soldiers' Board in the Delhi Recruiting Area. The numbers rejécted for
Trachoma at the main recruiting centres during 1939 were as follows compared
to the two previous years.
TABLE 88
Quarter ending
Stations.
1937
1938
1939
Mar. June. Septr.
Dec.
T o t a l .
Mar. June. Sept. D e c .
T o t a l .
Mar.
June. Septr.
D e c .
T o t a l .
Peshawar . . .
12 5 4 10
31
4 7 8 14
33
3 3 7 76
86
Rawalpindi . . .
59 45 36 8 148
8 20 27 16
71
22 36 28 148 234
Lahore . . .
4 6 8 23
41
32 21
. . .
5
58
7 7 17 196 227
.Jullundur . . .
123 120 59 78 380
90 77 71 40 278
77 78 115 244 514
Delhi . . .
185 150 334 196 865
149 199 176 128 652
117 165 80 144 506
Lucknow . . .
1 3 7 6
17
8 4 6 2
20
7 10 29 17
63
. Ajmer . . .
1
. . .
. . . 1
2
. . .
1 . . . . . .
. . .
. . . 1 . . . . . . 1
Poona . . .
1
. . . 4
. . .
5
1 2
. . . 2
5
. . . . . . 1 2
3
It was observed on comparing 1936 and 1937 that the number rejected
in 1936 in the Delhi recruiting area was just over 9 times that of 1937. In
1938 the number was less, but still more than 7 times the figure of 1936. It
will be noted from the figures for 1939-40 that rejections at Delhi show a further
decrease, actual and relative in the two halves of the year. There is a very
marked jump in numbers rejected for this condition during the last quarter
of the year at Rawalpindi, Lahore and Jullundur; possibly due to previous
rejects trying again.
MILITARY COLLEGES AND SCHOOLS.
Royal Indian Military College, Dehra Dun.
The health of the cadets has been very good with no serious illness.
Mumps was introduced at the beginning of the autumn term but the infection
faded out. Coryza, malaria, a few cases of dysentery and a chronic cystitis
suspected of being tubercular comprised the medical cases and knee injuries,
fractures and 3 cases of otitis media formed the surgical cases. A multiple
fracture of the epicondyle of the humerus was the only unsuccessful surgical
case.
King George's Royal Indian Military Schools.
Ajmer.—A healthy year with a decrease in sick rates from 282 to
159.2 per 1,000. The principal diseases were tonsillitis, local injuries and
diseases of bones and joints. There were two cases of typhoid fever although
inoculation and vaccinations are kept well up-to-date.
The increase in weight has been normal. Two boys were invalided for
knock-knee.
Jhelum. —General health excellent with an average weight increase of 1
½
lb. per month. There were 10 mild cases of trachoma, and other diseases
were mild and normal. One unfortunate boy was invalided with Sarcoma
of the leg.
Jullundur.—General health has been good and the average weight in
-
crease has been nearly 2½ lbs. per month. Diseases have been normal with
trachoma in some evidence.
G
88
The Ghi issue was reduced to that required for cooking only. The saving
thus obtained was expended in providing a daily packet of one ounce of fresh
butter from the Government Military dairy to every boy.
At first received with doubt this issue subsequently became very popular.
60. Invaliding
There has been a definite rise in the invaliding rate during the year. This.
might well be expected in a year affected by the onset of war, but the amount
of the rise from a very steady rate of many previous years indicates that in
the case of reservists and many employed men medical examination for fitness
or unfitness in peace time may be too lax or lenient. At the outbreak of war.
with prospects of service overseas it became obvious that many an elderly
reservist or follower was not fit for general service. This is a point to which
strict attention is desirable in the future.
Invaliding
Ratio per 1,000
1935 . . .
5.54
1936. . .
5.52
1937 . . .
5.49
1938 . . .
5.83
1939 . . .
6.43
The principal causes of invaliding are shown in paragraph 35, Table 4 of
Section II.
Special Cases.—From Waziristan District two cases were invalided for
D. A. H. with extra systole. This may relate to the strenuous hill work which
troops have to do in this area.
Invaliding by Commands.— The invaliding rates from Commands has been
as follows during 1939 :—
Ratio per
1,000.
Northern Command . . .
5.89
Eastern Command . . .
6.97
Southern Command. . .
8.75
Western Independent District . . .
3.88
61. Deaths
Death rates have fallen slightly and although not down to the level of
the year 1937 is only just above the rate for this quinquennium.
Deaths
Ratio per 1,000
1935. . .
2.15
1936 . . .
2.16
1937 . . .
1.77
1938 . . ..
2.21
1 9 3 9 . . .
2.12
Deaths in Commands.—The ratio per 1,000 have been as follows during
1939 :—
Northern Command . . .
2.29
Eastern Command
2.01
S outhern Command. . . .
1.99
Western Independent District . . .
1.67
The principal causes of death and comment thereon are given in para-
graph 35 and Table 56.
89
6 2 . O f f i c e r s
S p e c i a l d i s e a s e s a n d r e m a r k s
The admission rates for Officers has increased by 75 per 1,000 to 462.1
a figure which is in excess of any for the past 10 years but is not as great as the
average for the quinquennium 1925-29.
Digestive diseases, injuries and malaria as in previous years form the
three principal causes of sickness, the first shows an increase of 27 per 1,000
but malaria has slightly decreased.
Invaliding . at 12.36 per 1,000 has returned to a more normal figure com-
patible with the past 10 years and deaths at 3.84 show the lowest figure for
many years. (See paragraph 33, Tables 53-A and B and paragraph 34.)
In Northern Command there is an increase in admission rates, the rate
is about normal, but deaths have satisfactorily decreased for British and
Indian officers. In the latter there were none, and in the former 2 out of 3
were due to gunshot- wounds. In Rawalpindi District 187 per 1,000 of the
710.38 per 1,000 were due to digestive diseases and minor septic groups. Pesha
-
war District showed a marked reduction in malaria and sandfly fever. In
Waziristan at Bannu there was one case of enteric fever, the classical case
of an officer who did not wish to be inoculated and acquired the infection on a
train journey.
In Southern Command the disease rates were higher than in the previous
year, but there were no deaths from disease. Two of the notified deaths were
from mawling by tigers.
F o l l o w e r s
The admission rate at 323.2 per 1,000 is considerably more than that of
1938 and higher than any year for 10 years, except that for the unhealthy year
of 1933.
The principal diseases of Followers with their annual variations are shown.
below.
TABLE 89.
Admission for followers.—Ratios per 1,000
Year.
Total
admis-
sions.
Malaria.
Sandfly
fever.
Venereal
diseases. Pneumo-
nia.
Dysentery-
diarrhoea
group.
Tuberculo-
sis, Pul
-
monary.
1929 . . .
302.6
128.1
11.5
12.4
12.7
12.3
2.4
1930 . . .
250.6
86.3
6.4
11.3
11.9
14.5
2.6
1931 . . .
285.8
94.2
9.4
10.9
12.2
12.9
2.3
1932 . . .
266.4
90.7
7.4
10.3
9.9
1.3
2.2
1933 . . .
332.9
143.1
6.2
11.1
8.7
13.0
1.6
1934 . . .
287.6 102.5
4.4
10.5
10.3
12.6
1.9
1935 . . .
302.9
106.6
4.2
10.3
7.5
11.6
1.6
1936 . . .
279 . 1
84.1
8.6
9.8
7.8
9.2
1.7
1937 . . .
279.0
77.1
7.8
10.6
7.8
10.9
1.6
1938 . . .
272.0
74.9
4.3
9.6
7.2
12.5
1.8
1939 . . .
323.2
98.4
5.1
10.2
8.1
9.1
1.7
Malaria accounts for a large part of the general increase but the other
diseases remain remarkably constant in their effect on this class of personnel.
Pneumonia as usual remains the principal cause of deaths but there has
been a satisfactory reduction in the deaths rate from this cause which is halved
compared to that of 1938.
90
TABLE 90.
Principal diseases and causes of death—Ratio per 1,000
.
.
.
.
.
Pneumonia . . .
0.63
.
.
.
Infectious Diseases . . .
0.42
Circulatory diseases . . .
0.38
Digestive diseases . . .
0.17
Injuries . . .
0.13
0.17
Other respiratory diseases . . .
0.17
The death rate is less this year, viz ., 2.50 per 1,000 compared with 3.62,
3.96 and 3.58 per 1,000 for 1938, 1937 and 1936. This is still somewhat
higher than the death rate for Other Ranks.
.
.
.
I.
O.
Rs.
.
.
.
2.12
Followers . . .
2.50
This figure probably gives a somewhat erroneous idea of the relative
mortality amongst this class of personnel because followers as a whole and
the sweeper class in particular, tend to avoid admission to hospital until
necessity compels, so that only the really seriously ill form the bulk of the ad
-
missions.
There is moreover the generally lower scale of feeding and clothing adopted
for this class which does not enhance their powers of resistance when ill.
The Labour Camp and Hospital Quetta.
TABLE 91.
Consolidation of the monthly returns of the sick and wounded of labourers treated
in Labour Camp Hospital at Quetta during 1939.
Disease.
Admissions.
Deaths.
Cerebro-spinal fever . . .
1
. . .
2
. . .
Dysentery, Bacillary . . .
Dysentery, exudate . . .
. . .
. . .
Dysentery, protozoal . . .
. . .
. . .
Dysentery, clinical . . .
1
. . .
Typhoid fever . . .
. . .
. . .
1
. . .
Typhoid fever, para A . . .
1
. . .
Typhoid fever, para B . . .
Typhoid fever, para C . . .
. . .
. . .
Enteric group . . .
. . .
. . .
375
Malaria . . .
. . .
Oriental sore . . .
37
. . .
Pneumonia (Lobar and Lobular) . . .
8
66
. . .
Local injuries . . .
184
All other causes . . .
2
Total . . .
676
4
Average strength of labourers
Actuals Ratio per 1,000.
Admissions . . .
676
405.02
17.32
10.38
Average daily sick . . .
Deaths . . .
4
2.39
91
The Labour Camp Hospital, Quetta, was closed on 31st August and there
after the Labourers were treated in the Indian Military Hospital, Quetta.
Workers in Arsenals .—Special attention has been drawn and paid to the
conditions of work for certain classes of employees in Arsenal Workshops.
Improvements are being made in the work of Welders and Painters. The.
main defect in many places is that of " lighting on the plane of work ". This
extremely important point for efficiency of production and prevention of
accident is often grossly neglected partly from habitude, partly from want of
attention, and partly from economy. A point which is certainly not recog
-nised in India is that " you cannot get good work from bad lighting ". This
applies to all classes of work and is particularly obvious in the numerous head-
quarters offices and stores of the Army in India.
93
PART I
SECTION III.
SPECIAL SUBJECTS.
99
Arrangements have now been made for issue of filled cream containers on a
25 per. cent basis for all troops and of the cream itself on an as-required scale
to all military personnel and their families, to troops on the move, to families
travelling, to touring officers and to all personnel proceeding on leave. Con
- tainers may be purchased full of cream at 3 annas each by all military person-
nel not entitled to the free issue.
(c) Removal of reservoirs of infection. "Prophylactic treatments."
(i) Treatment of new arrivals, returning leave men, called up reservists,
etc., forms a method which has been successfully employed. This method is
of use on two counts in that potential malarial patients are forestalled by a
full course of treatment and secondly chronic infective foci are removed from
the lines before they can pass on their parasites to the local mosquitoes and
to their fellow men. A full treatment is much more satisfactory than a half-
- h e a r t e d t r u n c a t e d c o u r s e .
The following observations by an experienced officer on the subject of
malarial infection and enlarged spleens is worth recording from a Frontier
station.
1. Moderately enlarged spleens disappear in the cold weather, reappear
-ing in ever increasing numbers from March onwards. The appearance of en--
larged spleens from apparently nowhere and at a time when there are no mos
- quitoes was a disconcerting feature.
2. If untreated, these spleens increase in size, fluctuating from time to
time.
3.Enlarged spleens retreat under treatment only to reappear again on
discontinuing treatment.
4.Marked fluctuations in size occur frequently under treatment so much
so that I suspected my palpating hand in the earlier days.
5.I frequently picked out men at Medical inspections who had fever with
parasites in their blood. These men stated that they had no complaints and
felt well. Hence it would appear that the number of admissions to hospital
may not truly represent the malarial state of a garrison. It may also explain
why one comes across enlarged spleens with no previous history of an attack.
I am inclined to believe that for each admission to hospital there is at
least one "sub-clinical" case in the lines.
(ii) The treatment of Followers and particularly of women and children
at Welfare Centres and Indian troops family hospitals has also been noted as
having a definite anti-malarial effect.
Unfortunately we have not yet been able to provide Followers with net
protection though trials of a less expensive net for this purpose are under
way.
An indication of the relative safety of cantonments is given by the follow--
ing Spleen Index figures taken in an area of average endimicity.
Percentage enlarged
spleens.
Indian children in cantonments
7.8
Indian children in villages just outside cantonments
29.0
Indian children in surrounding districts
4 5 . 0
102
for provision of a suitable training area in each brigade station and for the use
of these as part of the general training of units and for their maintenance from
training-grant funds. Demonstration areas are already being established
at a number of stations : Lucknow, Karachi, Jhelum, Sialkot, Peshawar,
Jubbulpore and so on. In addition in each Command pamphlets of instruc
-tion have been revised and issued to all medical officers.
To reach its proper place in the training of all personnel training in field
hygiene must be treated as a part of the normal training programme of the
year. It is hoped that by the means mentioned above satisfactory results
will now be obtained.
Rest camps and training camps are often the obvious source of infection
and admission to hospital of quite large numbers of men. Special attention
has been directed to the use of all available preventive measures in such camps
as a means of conserving man-power and preventing waste.
F. Food and its control.
This has been receiving special attention during the year particularly
since the commencement of war which has called for large demands from un
- usual sources and new types of materials or foodstuffs.
The routine inspection of food supplies and of issues has been very thorough
and a most excellent supervisory control is maintained through the Director
of Contracts, Director of Supplies and the Military Food Laboratory, Kasauli.
Few people, other than those intimately concerned, realise what a valu
-able part this Food Laboratory plays in the maintenance of our high standard
of foodstuffs for the Army. A summarised report of the work done through
the year is given below and conveys some idea of the scope of the work covered.
This work includes the control of ghi supplies which are prepared at the Ghi
Heating Centre at Agra. Throughout the year and particularly in the last 4
months after the onset of war this laboratory under able and highly skilled
personnel has examined and checked samples of supplies of all kinds. At
times the checking may appear to be severe, but there is no doubt that the
slightest relaxation of control or standards means immediate deterioration of
quality.
(i) The Military Food Laboratory, Kasauli. Summary of work carried out
during 1939.
(a) There has again been an increase in the work done during the year,
a record total of 20,328 samples having been examined. The total includes
work done at the Ghi Testing Laboratory, Agra.
The following table gives the figures of the previous three years :—
TABLE 92
1936 . . .
13,058
1937 . . .
15,320
1938 . . .
18,012
There was a rush of work soon after the declaration of a state of emer
-gency. All this large amount of work has been achieved without additional
staff but at the expense of considerable strain on the existing staff who had
already been working increased hours. To cope with the increasing work the
necessity for augmenting the staff was keenly felt and necessary action is in
hand.
The laboratory has proved its usefulness and importance beyond doubt
on many occasions throughout the Year.
103
TABLE 93
Summary of samples received, accepted or rejected
Source of sample.
Percentage
of rejec
¬tions.
No. of
samples
received.
No. of
samples
accepted.
No. of
samples
rejected
1. T/(a) For registration of con
¬tractors
From abroad
.
.
.
27.8
36
26
10
From India
.
.
.
42.3
584
323
247
2. T/(b ) For tenders from approv
¬ed firms
From abroad
.
.
.
30.2
63
44
19
From India
.
.
.
30.1
468
317
141
3. T/(c ) For special report to the
Director of Contracts
From abroad
.
.
.
28.2
85
37
24
From India
.
.
.
38.8
1,047
669
406
4. A. For check before final accep
¬tance of bulk supplies
From abroad.
. .
. .
221
221
..
From India
.
.
.
12.1
2,257
1,984
273
5. C/( c/e) Emergency
supplies
purchased without prior re
¬ference to the M. F. L.
From abroad
.
.
. .
86
86
. .
From India
. .
. .
19
19
. .
6. H. Samples of articles submit
¬ted by medical officers not
R. I. A. S. C. supply.
7.8
128
44
1 0
7. D. Supplies
received fro
m sources
outside
India,
I. S. D., London.
. .
1 , 0 4 1
1,041
. .
8. W/P. Samples from Government
controlled mills.
..
650
650
. .
9. C/P. Samples for comparison
with local prices.
5.0
40
16
2
10. G/BS. Samples of grain from
bulk.
..
584
584
. .
11. G/ SA. Samples of grain set
aside by agents.
12. 6
246
197
31
12. G/A. Samples of grain for ap
¬proval.
1.1
643
624
7
13. G/GR. Samples of grain issued
to supply depots.
0.1
1,378
1,377
1
14. C. Samples of complaints from
source.
13.8
1,548
1,260
213
15. C/(c/b ). Samples received from
Army in Burma.
. .
2
2
. .
16. R. Comparison samples of ghi
from Ghi Testing Laboratory,
Agra.
..
86
86
. .
17. Samples of ghi analysed at Ghi
Testing Laboratory, Agra.
. .
6,127
6,127
18. T/Y. Samples from stocks half
yearly.
1.8
2,932
2,602
54
NOTE.—In certain cases no report was rendered. Some were " repeat" samples.
(b) The main causes of rejection under the three groups T (a), etc., were
mainly :—
From abroad .—The stock old, or incorrect and unsatisfactory pack.
From India .—The fact that Indian manufacturers have not as yet
realised the quality and pack required, show lack of business
104
acumen and fail to realise that a specification is meant as a
standard and not merely as a guide and that standards must be
maintained beyond the original sample.
The articles affected were :—
From abroad.—Milk tinned, jam and cornflour.
From India. —Rice, sugar, lime juice or lime juice cordial, jam, pickles,
chutneys, vinegar, tobacco B. T., oil cooking, biscuits fancy,
rum, flour.
With the above exceptions, and tinned-butter, cheese, and fruit, and sauce
table, there exist in India adequate supplies of indigenous foodstuffs.
(c)
Group A.—Is the check maintained on bulk supplies before final
acceptance and indicates the real quality of the articles available for supply.
The samples from abroad were mainly from Australia and continue to be
of excellent quality with no rejections.
In some of the Indian products appreciable improvements have been
effected but some continue to be unsatisfactory, e.g. , Rice, Sugar.
(d)
Under Category H.—Are miscellaneous samples (except water and
sewage) sent by various civil and military authorities and are not articles of
R. I. A. S. C. supply.
It is the first time that an accurate report under this head has been made
available and some of the samples were unusual, e.g.—
Halwa (sweetmeat).
Vomit (tongue and tomatoes).
For arsenic contents to be traced but
none was found.
Canvas.—For indigenously manufactured canvas for water tanks. A
satisfactory proofed cotton canvas was evolved.
Zaldecide.—An insecticide to ascertain its composition.
Unknown substances.—A number of samples of "secret" remedies were
sent to A. H. Q. after the outbreak of war, by various Indian
gentlemen. Examinations revealed that the articles were not of
any therapeutic or food value, viz., Gum Tragacanth, Dried
leaves, Animal Charcoal and a sure cure for Malaria—found
to be (Sodium Chloride) Common salt.
Powder from Ice.—For suspected foul play—contained nothing more
than Calcium Carbonate.
Oil cooking.—For Stallions for increasing their fertility—identified as
cotton-seed oil.
(e)
Groups D. W. C. G. & T. —Include samples which control actual bulk
supplies obtained through the India Stores Department or those of Government
controlled mills and of whole or crushed grains, dhalls, atta, etc. The general
results continue to be satisfactory. In particular the complaints in respect
of I. S. D. supplies have been entirely eliminated and in most cases these have
outlasted their warranty. The system introduced last year of a second examina
-tion at the port of arrival is responsible for this improvement.
(f)
Emergency supplies.—To meet emergent requirements of supplies for
forces overseas and in India, certain articles have had to be purchased from
Australia and India without prior reference to the Laboratory. Such articles
are classed under "C/E."
105
In a number of cases the articles did not conform to R. I. A. S. C. speci
-ffications but the defects were not such as to render them unfit for issue.
With the exception of Bacon all articles purchased from Australia were
satisfactory.
(g) The table above does not include the following two categories:
—
Category " W ".—" Water"—Sewage and water analysis samples.
No. of samples.
Water.
Sewage effluent. Sewage.
27
6
5
Category "K".—Development of indigenous supplies
The number of samples received, upon which special reports were issued,
was 19.
This category was devised to provide a complete record of samples sub-
m i t t e d t h r o u g h t h e D e p a r t m e n t o f S u p p l y o r b y f i r m s d i r e c t , d u r i n g t h e p e r i o d
immediately after the commencement of war but has since been discontinued.
(h) Special work and Research .—The vitamin "C" work was completed
and it was established that Ascorbic Acid tablets manufactured by Messrs.
Glaxo, Ltd., were active both chemically and biologically. Further work
was also done on Vitamin "B" and the Vitamin "B-complex." "Vege
-time," "Bovite," and "Thiamax" were examined biochemically and found
to be active. Lengthy analysis and investigations were performed on certain
articles.
(i) R. I. A. S. C. Specifications and M. F. L. Pamphlet. —As a result of
the issue of revised R. I. A. S. C. Specifications, in which the pamphlet is now
embodied, a great deal of unnecessary work and reduplication of reports has
been stopped.
Certain slight defects in the procedure have come to notice and these are
being remedied.
(k) Ghi Testing Laboratory—Ghi Heating Centre, Agra. —The ghi issued
from the Centre this year has been of high quality throughout. The mainte
nance of a "9.0 point" acidity limit, will undoubtedly remove all complaints
of "over-acidity".
The usual high standard of technical ability and efficiency has been main
-tained.
The number of samples was 6,127. There were no rejections for high
acidity. 92 samples had to be re-heated.
(ii) The Quality of Ghi.—The acidity of Ghi is always a very vexed ques
-tion on which the price and supply is based. Army supplies are bought from
certain firms and centralised for blending, purification and packing at the
Ghi Heating Centre at Agra. Quality is strictly controlled for every batch
by repeated sampling at the Laboratory attached to the Centre. The work
done by this Centre and Laboratory is of immense importance to the Indian
Army and to the Indian soldier. One of the main difficulties about Ghi issues
is the rise in acidity during the periods over which it is kept, particularly in
hot weather. Blending of stocks of ghi of various acidity is utilised to produce
a final acidity down to a specified figure.
This specified figure of acidity is given in "points" in relation to the
percentage of fatty acids present, considered as Oleic acid. The figure selected
for maximum acidity when the ghi leaves the Centre is 9 points, and 11 points
of acidity was considered to be the maximum for issue to troops