NationalLibraryOfScotland/medical-history-of-british-india huggingface dataset:
88
TABLE 6
Principal causes of invaliding for Indian Troops
Increase or decrease
as compared with
1937
Diseases.
Ratio per
1,000.
Increase. Decrease.
Pulmonary tuberculosis
1.43
..
0.03
Injuries
1.51
0.73
. .
Diseases of bones, joints, muscles, fasciae
and bursae
0 . 3 4
..
0.10
Mental diseases
0.37
..
0.01
Respiratory diseases
0.18
..
0.15
Diseases of the eye.
0.38
0.07
. .
Diseases of the nervous system
0 . 3 7
0.10
..
Circulatory diseases
0.14
..
0.07
Digestive diseases
0.07
0.14
Other tubercular diseases
0.18
..
0.01
Diseases of urinary organs
0 . 1 0
..
0.01
Diseases of ear and nose
0.09
..
0.01
Venereal diseases
0.05
. . 0.04
Diseases of blood
0.07
0.02
. .
It will be noted that once again Tuberculosis heads the list, pulmonary
tuberculosis accounting for 160 of the cases and the total Tubercular diseases
form nearly 1/3 of the total cases invalided.
The average number of constantly sick in hospital was 1768.29 or 15.78
per 1,000 of the strength compared with 15.15 in 1937.
The average sick time to each soldier was 5.76 days and the average dura-
tion of each case was 13.65 days compared with 5.53 days and 14.12 days of
1937.
Men under barrack treatment (out patients) were 1229.9 per 1,000 com-
pared with 1219.1 and 1343.3 of 1937 and 1936 respectively.
The combined ratio of constantly sick in hospital plus those constantly
under treatment in barracks was 33.22 per 1,000 compared with 33.00 in
1937 and 34.93 in 1936. This represents the total loss per 1,000 per day.
These statistics show that the health of the Indian Army has been satis-
factory throughout the year although the admission rate of 421.8 per 1,000 is
n excess by 30.1 over that of last year.
In Commands the features have been a marked decrease in admissions in
Western Independent District which offsets an increase in Northern Command.
In the former, with 804 fewer admissions, the admission rate was reduced by
58 per 1,000. This remarkable decrease is due to that of malaria. In the
latter there has been an increase of 58 per 1,000, but the health of troops is
regarded as satisfactory. Troops were out on road protection duties on the
Kohat-Bannu road from the beginning of June to the end of the year. The
comment is made that it is remarkable how fit troops keep under these semi
¬ w a r c o n d i t i o n , e v e n t h r o u g h t h e h e a t o f t h e h o t w e a t h e r .
The peak of the sickness curve for all India was in August. The peak in
Commands was in August in Northern, Eastern and Southern Commands ;
but in Western Independent District was in July and in Southern Command
there were two peaks in April and August.
89
The graph given below shows more clearly the general trend of sickness
throughout the year and for the principal diseases.
TOTAL ADMNS. A L L
C A U S E S . —
MALARIA•---- • ---.
DYSENTERY
& D I A R R H O E A — — — .
I. O. Rs. — 1938
RATIO PER 1000
JAN. F E B .
M A R .
A P L .
MAY. J UN. JUL.
A U G .
SEP. OCT.
NOV. D E C .
DYSENTERY
& DIARRHOEA
MALARIA
TOTAL
ADMISSIONS
ALL CAUSES
90
TABLE
Table showing admission and death ratios per 1,000 of the strength for
with all
Stations with total admission ratios all causes, higher than
Stations.
J h a n s i .
D e h r a D u n .
J u b b u l p o r e .
A b b o t t a b a d .
R a z m a k .
K o h a t .
M i r A l i .
P o o n a .
R o o r k e e .
All Causes:
—
Admissions . . .
667.7 569.4 558.0 540.3 538.5 530.4 518.9 472.3 468.9
Deaths . . .
0.89 2.12 0.98 4.05 4.97 1.63 2.51 1.64 0.97
23.51 19.88
1 1 . 1 4 15.52 13.74
Av. C. Sick . . .
20.66 25.70 20.56 14.07
Malaria: —
Admissions . . .
210.8 125.9 142.0 186.6 151.3 217.2 239.7 127.9 94.2
Deaths . . .
. . .
. . .
. . .
0.74 . . .
0.27
. . .
. . .
. . .
Sandfly fever:—
Admissions . . .
10.7
. . .
. . .
10.7
. . .
1 . 4
9.6
. . .
. . .
Deaths . . .
. . .
. . .
. . .
. . .
. . .
. . .
. . .
. . .
. . .
Enteric group:
—
Admissions . . .
0.4
0.6
. . . 0.8
0.5
0.8
1 . 2 1.4
. . .
Deaths . . .
. . .
. . .
. . .
. . .
0.15 . . .
. . .
. . .
. . .
Dysentery: —
Admissions . . . 48.5
8.1
25.4 13.2 44.1 14.3
4.6 28.0
4.4
Deaths . . .
. . .
0.30 . . .
. . .
. . .
. . .
. . .
. . . . . .
Diarrhœa: —
Admissions . . . 0.4 10.6
3.9
1.1 13.6 12.8 12.2
4.1 14.1
Deaths . . .
. . .
. . .
. . .
. . .
. . .
. . .
. . .
. . .
. . .
Influenza: —
Admissions . . .
. . .
4.8
3.4
4.8
1.1
. . .
. . . 43.0
. . .
Deaths . . . . . .
. . .
. . .
. . .
. . .
. . .
. . .
. . .
. . .
Pneumonia Lobar and
Lobular: —
Admissions . . . 1.8
4.5
3.4
9.6
5.1
5.2
3.8
1.9
4.4
Deaths . . . . . .
. . .
. . .
1.84 0.75 0.27 0.84
. . . 0.49
Venereal Diseases:
—
Admissions . . .
5.8 16.9 12.2
7.7
4.1
3.5
5.4 14.0
2.9
Deaths . . . . . .
. . .
. . .
. . .
. . .
. . .
. . .
. . .
. . .
Minor Septic Diseases:
—
Admissions . . . 57.6 66.0 46.3 48.6 31.3 26.6 26.0 30.1 65.0
Deaths . . .
. . .
. . .
. . .
0.37
. . .
. . .
. . .
. . .
. . .
Local Injuries:
—
Admissions . . . 106.3 87.4 74.1 53.4 76.6 56.2 61.6 62.2 101.5
Deaths . . .
. . .
0.91
. . .
. . .
2.71 0.81 0.84 0.82
. . .
Heat Strokes:—
Admissions . . .
. . .
. . .
. . .
. . .
. . .
. . .
. . .
. . .
. . .
Deaths . . .
. . .
. . .
. . .
. . .
. . .
. . .
. . .
. . .
. . .
Heat Exhaustion:
—
Admissions . . .
. . .
0.3
. . .
. . .
. . .
0.3
1.3
. . .
. . .
Deaths . . .
. . .
. . .
. . .
. . .
. . .
. . .
. . .
. . .
. . .
Ankylostomiasis:—
Admissions . . .
2.2
4.5
1.0
1 . 1
6.3
6.2
2.5
2.7
1.5
Deaths . . .
. . .
. . .
. . .
. . .
. . .
. . .
. . .
. . .
. . .
Pulmonary Tuberculosis:
—
Admissions . . .
2.2
2.1
. . .
2.6
0.5
4.3
2.1
3.0
1.9
Deaths . . .
. . .
. . .
. . .
. . .
0.15
. . .
. . .
. . .
. . .
91
7.
all causes and certain important diseases for important stations compared
India.
all India.
Stations with total admission ratios all causes, lower than all India.
R a w a l p i n d i . N o w s h e r a .
A l l I n d i a .
F o r t S a n d e m a n .
L a h o r e .
T r i m u l g e r r y .
B a n g a l o r e .
W a n a .
Q u e t t a .
P e s h a w a r . A m b a l a .
M e e r u t .
462.1 430.5
421.8 416.2 376.0 368.3 363.4 354.6 351.2 346.9 336.8 284.6
3.02 2.77 2.21 0.92 3.47 1.89 2.22 1.02 2.98 2.46 1.21 3.37
18.26 14.27 15.78 12.32 16.21 13.25 18.75 13.87 17.87 15.39 12.98 13.73
159.8 53.4 109.7 168.1 87.2 19.6 22.2 100.2 82.5 106.0 40.2 64.5
. . . . . .
0.05 0.46
. . .
. . .
. . .
. . .
. . .
. . .
. . .
. . .
5.8
4.7
4.6
1.4
. . .
. . .
. . .
. . .
7.6 22.6
. . .
. . .
. . . . . .
. . . . . .
. . .
. . .
. . .
. . .
. . . . . .
. . .
. . .
0 . 6 0.8
0.7
0.5
1.7
0.4
1.1
0.3
1.5
0.4
0.4
1.7
0.23
. . .
0.07
. . .
0.43
. . .
. . .
. . .
. . .
. . .
. . .
0.84
19.1 11.9 17.3 15.7 16.5 24.2 13.9
7.2 25.2 22.2 16.4 15.6
0.23
. . .
0.03
. . .
. . .
. . .
. . .
. . .
. . .
. . .
. . .
. . .
4.4
6.3
7.5
5.5 14.7
8.7
8.9
9.7 10.8
5.1
4.0
7.2
. . . . . .
. . .
. . .
. . .
. . .
. . .
. . .
. . .
. . .
. . .
. . .
3.3
3.2
4.4
. . .
. . .
11.0
0.7
5.9
. . .
0.8
. . .
. . .
. . . . . .
. . .
. . .
. . .
. . .
. . .
. . .
. . .
. . .
. . .
. . .
9.3
6.3
5.0
1.8
7.4
0.8
3.3
5.6
3.7
5.1
7.6
3.8
1.16 0.40 0.43
. . .
0.43
. . .
. . .
0.26 0.69 0.57 0.40
. . .
7.2
3.6
7.5
4.6
7.8
8.7 22.2
3.3
8.7
7.2
6.8
7.2
. . . . . .
. . .
. . .
. . .
. . .
. . .
. . .
. . .
. . .
. . .
. . .
32.3 58.2 34.1 27.3 36.4 34.0 39.1 36.6 10.3 23.1 37.4 13.9
. . .
. . .
. . .
. . . . . .
. . .
. . .
. . .
. . .
. . .
. . .
0.42
46.0 56.2 59.8
56.8
54.2 91.4 80 . 1 85.3 40.8 34.9 68.3 43.0
0.23 1.58 0.54 0.46 0.43 0.76 0.37 0.76 0.46 0.19
. . .
0.84
. . . 0.4
0.0
. . .
. . .
. . .
. . .
. . .
. . . 0.2
. . .
. . .
. . . . . . 0.01
. . .
. . .
. . .
. . .
. . .
. . . 0.19
. . .
. . .
. . .
2.9
0.2
. . . 0.4
. . .
0 . 4
. . .
. . .
. . . 0.4
. . .
. . . . . .
. . .
. . .
. . .
. . .
. . .
. . .
. . .
. . .
. . .
. . .
10.7 11.1
4.3
2.3
1.7
2.3
2.6
1.8
8.7
1.9
8.4
3.4
. . . . . .
. . .
. . .
. . .
. . .
. . .
. . .
. . .
. . .
. . .
. . .
3.0 0.8
1.7
2.3
2.6
1.9
0.4
0.3
0.9
1.9
2.4
. . .
0.23
. . .
0.12
. . .
. . .
. . .
. . .
. . .
0.23 0.57
. . .
0.42
s 2
92
PRINCIPAL DISEASES AFFECTING THE INDIAN ARMY
40. Principal interesting features of the year
(a) The remarkably small admission rates in Waziristan although war
conditions were in operation practically throughout the year.
(b) The continuance of the low admission rates for malaria. There
has however been an increase on the very low rate of the pre
vious year.
(c) The continued downward trend of sandfly fever and the remark-
able reductions achieved in Northern Command particularly at
Landikotal.
(d) Although cholera spread into epidemic proportions in eastern and
northern India, extending from Assam to the Afghanistan
border, the number of army cases was limited to 42 of which 38
cases occurred in a sudden outbreak amongst troops travelling
into Waziristan.
(e) Scabies shows an unusual figure of 10.47 per 1,000 in Northern
Command being an increase of 3 per 1,000. The all-India
figure is 11.2.
(f) Climatic conditions have not been markedly unfavourable except
for the late warm weather which carried malaria far into the
autumn, the rainfall in Southern Command which appears to
have been extremely favourable to malaria round Mhow and the
absence of rain in the Quetta area which though favouring large
scale mosquito breeding was accompanied by a marked fall in
malarial incidence in military and civil populations.
41. Malaria
Amongst Indian troops the admission rate has been 109.7 per 1,000
compared with 97.9 of 1937 and 121.3 of 1936.
From over 12,000 cases there were 6 deaths compared with 4 of the
previous year and 8 of 1936.
The reduction in this disease over the past 10 years is well shown in the
table.
TABLE 8
Annual admission for malaria—Indian troops
Over 10 years
Ratio per 1,000.
Year.
Admissions.
Invaliding.
Deaths.
1929 .
.
.
.
.
175.3
0.22
0.15
1930
.
.
.
.
.
.
153.4
0.06
0.13
1931
.
.
.
.
.
.
.
.
149.4
0.08
0.10
1932
.
. .
145.1
0.07
0.10
1933
.
.
.
.
.
.
.
.
212.2
0.05
0.06
1934.
.
. .
156.5
0.06
0.05
1935.
.
.
.
.
125.9
0.03
0.08
1936 .
.
.
.
.
.
.
.
123.1
..
0.07
1937
97.9
..
0 . 0 4
1938 .
.
.
.
.
.
109.7
0.04
0.05
93
The incidence of the various types of malaria by Commands is shown
below :—
TABLE 9
Admissions and deaths for malaria by Commands
Ratio per 1,000.
Admissions and Deaths.
Commands.
B. T.
M. T.
Quartan.
Clinical.
A.
89.4
33.7
0.5
7.7
Northern Command
.
.
D.
..
0.05
..
. .
A.
61.9
21.0
..
4.0
Western (I.) District
.
.
D.
..
0.09
..
..
A.
60.4
23.8
..
5.9
Eastern Command .
.
.
D.
..
0.04
..
0.04
A.
52.4
18.9
0.1
6.7
Southern Command
..
D .
..
..
..
..
A.
73.4.
27.5
0.3
6.7
All India
.
.
.
.
D.
..
0.04
..
0.01
The principal stations in which the admission rates were over 100 per 1,000
are shown in the following table which gives large stations and small stations.
TABLE 10
Stations with malarial ratio over 100 per 1,000
Large stations.
Small stations.
Mir Ali
.
.
.
.
239.7
Jhelum
.
.
.
.
309.8
Kohat
.
.
.
.
217.2
Thal .
.
.
.
.
264.1
Jhansi
.
.
.
.
210.8
Baroda
.
.
.
.
239.4
Abbottabad
.
. .
186.6
Shagai
.
.
.
.
231.8
Fort Sandeman .
. .
168.1
Mhow
210.2
Rawalpindi
159.8
Bannu
.
.
.
.
208.2
RaZILak
.
..
151.3
Bakloh
.
.
.
.
174.8
Jubbulpore
142.0
Dharamsala
.
.
.
172.6
Poona
.
.
. .
127.9
Ahmedabad
164.2
Dehra Dun
125.9
Malakand .
.
.
.
1 5 7 . 3
Peshawar .
. . .
106.0
Mardan
.
.
155.9
Wana
100.6
Almora
.
.
.
.
139.9
Quetta
.
.
.
.
82.5
Midnapore .
.
.
.
124.7
Nowshera .
. . .
53.4
Lansdowne
111.7
Shillong
.
.
.
.
111.3
The influence of the 1937 Waziristan operations on the malaria in distant
stations is shown by the increase in malarial relapse at Jhansi and Jhelum.
At the latter there was a marked contrast in relapse incidence amongst troops
which had been in the station all last year and others who had returned from
the Waziristan operations, there being a sharp rise in the relapse admissions
in the latter. In Northern Command in general there was a rise of 34 per 1,000
in admissions, but the rate is still the second lowest in the past 10 years. There
is however no tendency to obtain the spectacular drop recorded for British
troops in whom the rate is one fifth that of 15 years ago. The greater oppor-
tunities for infection away from the shelter of barracks and from the relative
safety of cantonments must account for this.
94
The wave of incidence was prolonged into the autumn in Northern Com-
mand owing to abnormal warm weather. In Eastern Command there was a
similar delayed fall in the occurrence of cases.
In Southern Command malaria was the commonest of all diseases in 9
out of 13 stations.
In Western Command admissions have fallen below 100 per 1,000 for the
first time on record, the rate being 86.9 per 1,000 in place of 161.89 per 1,000
of the previous year. Hindubagh gives a good example of what can be done,
the admissions being reduced from 471 to 232 by concentrated, intelligent
action and the expenditure of Rs. 100. Spraying played a prominent part in
this. It was remarkable this year how malarial admissions fell away in August
and September.
1937.
1938.
Admissions in August .
.
.
.
.
32.0
14.5 per 1,000.
Admissions in September
.
.
.
.
54.8
13.6 „
„
The fall is attributed to concentrated anti-malarial measures in which
spraying played a large part. It should be noted however that there was a
marked decrease in malaria in the civil population.
42 . Sandfly fever
With the admissions for this disease down to 517 for the whole of
India there has been a continuation of the downward trend. The incidence
in the principal districts affected by this disease has been as follows.
TABLE 11
Comparative Table of Sandfly fever in Districts
Ratios per 1,000.
1937.
1938.
Rawalpindi District
.
•
.
.
.
18.0
7.6
Peshawar District.
.
.
.
.
15.6
14.2
Sind Brigade
.
.
.
.
.
.
12.7
7.3
Zhob Ind. Brigade
.
.
.
.
.
10.9
4.4
Kohat District
.
.
.
.
.
.
8.0
1.8
Baluchistan District
.
.
.
.
.
7.1
5 . 8
It is observed that the reduction has been in the Northern Command,
particularly in Rawalpindi District, and the Command figures over 10 years
are worth quoting.
TABLE 12
Sandfly fever in Northern Command
1929
.
.
.
.
.
.
36.04 per 1,000.
1930
.
.
.
.
.
.
21 .5 4
1931
.
.
.
.
.
.
27.46
1932
.
.
.
.
.
.
27.56 Spraying and fumigation as an
anti-malarial measure in cer
-
tain stations.
1933
.
.
.
.
.
.
16.53
1934
.
.
.
.
.
.
14.85
1935 . •
.
.
.
.
.
18.83
1936
.
.
.
.
.
.
18.43 Spraying campaign intensified as
an anti-sandfly and anti-mos
quito measure.
1937
.
.
.
.
.
10.65
1938 .
.
.
-.
.
7.10
95
The figures for Landikotal, that hot bed of sandfly fever, are perhaps even
more remarkable.
sandfly fever in Landikotal
1934
.
.
.
.
.
.
.
.
.
.
.
224 cases.
1935
.
.
.
.
.
.
.
.
.
.
.
239
„
1936
.
.
,
.
•
•
•
-
-
•
9 7
„
1937
.
.
.
.
.
.
.
.
•
•
27
„
1938
.
.
.
.
.
.
.
.
.
.
.
19
„
This startling reduction amongst Indian troops may, to some extent, be
due to the fact that those forming the garrison during the year came from
other parts of the Peshawar district and were presumably “ salted ” troops,
but more of the decrease is really attributable to the use of “ Pyefly ” spray-
ing in barracks, to the whole hearted co-operation of the troops in anti-sandfly
measures and to the replacement of the old mud buildings by good modern
stone or concrete and the canalisation and making “ pukka ” of nullahs where
feasible.
The all-India incidence is shown below.
TABLE 13
Sandfly fever
Ratios per 1,000.
1934
..
.
.
.
.
.
.
.
8.3
1935 .
.
.
.
.
.
.
.
.
.
.
7.5
1936
.
.
.
.
.
.
.
•
.
10 . 6
1937
.
.
. .
.
.
.
.
6.0
1938 .
..
•
•
-
•
.
.
4.6
43. Dengue
The all India incidence has fallen to 1 . 1 per 1,000.
TABLE 14
Dengue
1934 .
.
.
.
.
.
.
.
.
.
.
2.5 per 1,000.
1935 .
.
.
.
•
.
.
.
.
.
3.4
1936 .
.
.
.
.
.
.
.
.
.
.
2.6
1937 .
.
.
.
.
.
.
.
.
.
.
5.0
1938 .
.
.
.
.
.
.
.
.
.
.
1.1
The stations chiefly affected were in Eastern and Southern Commands.
1937.
1938.
Dacca
.
.
.
.
.
.
.
. 548 . 7
..
per 1,000.
Alipore
.
.
.
.
.
.
.
137 . 6
..
Bangalore
.
.
.
.
.
.
.
.
30 . 8
10.2
Madras
.
.
.
.
.
.
.
.
31 . 1
170.9
There was no epidemic in Bengal this year, but the rise in Madras is
remarkable.
96
44. Fevers of the Typhus Group
There were only 38 cases amongst Indian troops compared with 43,
48, 45 and 51 of the previous years. In all there were 52 cases amongst
Indian personnel, 29 of which were from Northern Command and 14 and 9,
respectively from Southern and Eastern Commands. The details have been
considered in paragraph 9 of Section I.
45. Enteric Group of fevers
The comparison of these diseases has been considered under paragraph
10, Section I. The decline in incidence has been maintained for Indian
troops, the admissions being 86 this year.
TABLE 15
Case incidence of Enteric Group of fevers—Actual admissions
1934 .
.
.
•
•
•
•
•
•
•
•
224
1935 .
.
.
.
.
•
.
•
•
•
•
166
1936 .
.
.
.
.
.
.
•
•
•
•
78
1937 .
.
.
.
.
.
.
•
.
•
88
1938 .
.
.
.
.
•
•
.
•
.
•
86
From these 86 cases there were 8 deaths the case mortality being 9.3 per
cent. compared with a case mortality of 10.2 and 6.4 for the two previous
years.
The inoculation state of Indian troops is satisfactory, the figures of the
half-yearly return in October being :
—
Percentage protected : B. Os. 92.0, I. O. Rs. 97.8, Followers 98.8.
The relative incidence, deaths and case mortality amongst protected co
m-pared with unprotected is given below.
TABLE 16
Comparison of incidence in Protected and Unprotected
Ratios per 1,000.
Cases.
Deaths.
Case
mortality
Protected
.
.
.
.•
0.6
0.05
8.33
Unprotected.
.
.
.
.
.
.
5.6
0.80
14.29
There was a small outbreak of 6 cases in a training battalion at Sialkot.
No source of infection was traced.
One very interesting case of a very persistent carrier was treated with
antogenous vaccines in Quetta. His discharge was being contemplated until
the vaccine cleared him.
46. Dysentery, Diarrhœa, Colitis and Amoebic Hepatitis
This group shows little signs of real reduction. As with British troops,
so with Indian the proximity of bazaar areas, suddar and municipal, plays
a predominant part in these fly borne infections. Indian troops frequent and
buy food stuffs in these bazaars, but have the counteracting factor of relative
immunity compared with British personnel.
97
TABLE 17
Dysentery, Diarrhœa, Colitis and Hepatitis
Ratios per 1,000.
Dysentery. Diarrhœa. Colitis.
Total. Hepatitis.
1933
.
.
.
. .
15.3
7.9
0.3
23.5
0. 6
1934 .
.
.
.
.
13.9
6.3
0.2
20.5
0.7
1935 .
.
.
.
.
12.2
5.6
0.2
17.9
0.5
1936
.
.
.
.
.
11.0
6.9
0.3
17.5
0.6
1937 .
.
.
.
.
12.4
5.4
0.4
18.3
0.5
1938 .
.
.
. .
17.2
7.5
0.2
24.9
0.6
Admissions for different types of dysentery remain very much the same.
They are given below.—
Actuals.
Percentage
of
cases.
Dysentery, protozoal .
.
.
.
.
88
4.56
Dysentery, Bacillary, proved .
.
.
.
1,183
61.26
Dysentery, Bacillary, exudate
.
.
.
248
12.84
Dysentery, Clinical
.
.
.
.
.
412
21.34
The case mortality on the total of admissions was 0 . 15 per cent. The
distribution by Commands is given in the table below.
TABLE 18
Dysentery by Commands
Ratios per 1,000.
Commands.
Amœbic.
Bacillary,
proven.
I3acillary,
Exudate.
Clinical.
Northern .
.
.
.
.
0.7
9.9
2.1
4.2
Western .
.
.
.
.
0.5
10.1
2.6
5.6
Eastern .
.
.
.
.
1.0
11.6
1.8
2.1
Southern .
.
.
.
.
1.0
11.3
2.9
3.1
In Southern Command at Bangalore of 38 cases 17 or 45 per cent. were
protozoal in type.
Jhansi had the highest incidence for Indian troops in Eastern Command
as for British troops and the cause is again stated to be due to fly infestation.
In Northern Command at Razmak an epidemic occurred from the middle
of April to the end of May, coincident with the break down of the refuse des-
tructor and a depletion of sanitary personnel owing to " Columns ". Strict
sanitary control was established early in May, and the epidemic reaching its
peak on 7th-8th May subsided, but tended to reappear throughout the year.
In all there were 293 cases here.
At Ambala the regimental bania was found to be a strong carrier of B.
dysenteriæ Flexner.
98
47. Cholera
In spite of the wide spread and in places, severe epidemic amongst the
civilian population, (see paragraphs 5 and 40), there were in all only 42 cases
amongst Indian military personnel. In the previous 10 years there have only
been 1 or 2 cases in each year and the present group of cases is due to one isolat-
ed outbreak in Waziristan.
The Waziristan outbreak .—Forty-one cases with 2 deaths occurred in a
Gurkha battalion on their arrival at Razani from Abbottabad on the 15th
August. The outbreak was dealt with by an isolation camp on the spot and
exceedingly energetic, preventive measures ; and was completely controlled
by the 20th. The cases were scattered throughout the unit, not confined
to one company. Careful investigation throughout the whole course of the
j o u r n e y f a i l e d t o d i s c o v e r t h e s o u r c e .
48. Diseases of the Digestive System
There were 5,794 admissions for this group of diseases with 21 deaths
and 8 invalids compared with 4,426 admissions and 9 deaths in the previous
year.
The most important diseases of this group were :—
TABLE 19
Admissions for diseases of Digestive system.—Actuals
Admissions.
Deaths.
Invalids.
Pharyngitis .
.
.
.
.
.
.
2,163
..
. .
Tonsillitis
.
.
.
.
.
.
.
682
. .
. .
Diarrhœa
.
.
.
.
.
.
.
842
. .
. .
Indigestion .
.
.
.
. .
.
584
. .
. .
A comparison Of some of the principal diseases over the past three years
is given below.
TABLE 20
Diseases of the Digestive system
Ratios per 1,000.
Tonsillitis. Pharyngitis.
Gastritis.
Dyspepsia. Jaundice.
1936
.
.
.
5.9
20.6
1.3
3.7
2.2
1937
.
.
.
5.8
16.1
1.0
4.1
1.9
1938
. .
.
6.1
19.3
1.1
5.2
2.1
There were 234 cases of jaundice this year, the cases being of the catarrhal
type with no obvious infective cause.
Taenia infections.—The number of admissions for infection by the tape
worms was 42 this year compared with 40 of last year. In the present year
the main types were T. saginata 29 cases and T. solium 7 cases. The greatest
number of cases of T. solium viz . 4 were admitted in Eastern Command.
Ankylostomiasis.—There were 483 admissions for this, the majority being
in Northern Command at Nowshera, Peshawar, Kohat, Rawalpindi, Ambala,
Sialkot, Jhelum, Razmak and Bannu.
99
At Nowshera in Peshawar District recruits in a Sikh Regiment
were found to be very heavily infected on routine examination. Treatment
was carried out for all and in 62 men the average increase in weight was 91/2 lbs.
with marked improvement of the condition of the trained recruits sent to
their units. The Director of Public Health of the Punjab was informed and
arrangements were made by him for an anti hookworm campaign in the
Ludhiana area and chlorination of certain wells in the Campbellpore District
from which these infected recruits had come.
49. Cysticercosis
There were no admissions during the year amongst Indian troops or
Followers.
r s s f d f x g d h f f j
50. Oriental sore
There were 95 admissions for this condition, but a large number are
treated as out-patients. This has been referred to in paragraph 15, Section I.
In Quetta the condition had given rise to serious anxiety after the heavy
incidence of 1936 and a special grant of Rs. 2,000 was made for preventive
measures.
The incidence in three years has been :—
British
troops.
Indian
troops.
1936 .
.
.
.
.
.
.
.
.
63
448
1937 .
.
.
.
.
.
.
.
.
37
165
1938 .
.
.
.
.
.
.
.
.
53
391
A strenuous spraying campaign is to be carried out during 1939 to endea-
vour to control this very considerable cause of inefficiency, while protection
of sores from sandflies or other flies is being ensured by means of plaster cover
ing.
A method of treatment by means of infra-basal injections of atebrin
beneath the sore is said to have given good results amongst the labourers at.
the Coolie camp.
TABLE 21
Oriental sore : admissions over 10 years.—Actuals
1.929.
1930.
1931.
1932.
1933.
1934.
1935.
1936.
1937.
1938..
28
53
150
58
53
103
67
172
135
95
1.
51. The Minor Septic and Local injuries Group of diseases
This prolific combined group produced a total of 15,577 admissions in the
year for British and Indian troops.
TABLE 22
Annual comparison of Minor Septic and Local injury Group
Ratios per 1,000.
Year.
Minor
Septic
diseases.
Local
injuries.
Cellulitis.
Boils.
1936 .
.
.
.
. .
.
33.4
52.6
24.5
6.0
1937 .
.
.
.
.
.
31.4
51.8
23.5
5.4
1938 .
.
.
.
.
.
34.1
59.8
25.5
5.9