Annual report of the Sanitary Commissioner with the Government of India.

  • India. Sanitary Commissioner
Date:
[1904]
Catalogue details

Licence: Public Domain Mark

Credit: Annual report of the Sanitary Commissioner with the Government of India. Source: Wellcome Collection.

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    per mille) as compared with 49 (66*2 per mille) among European troops, in Port Blair there were only 3 admissions (9^9 per mille) among native troops as compared with 15 (ioy9per mille) among European troops, and in Fort William and Madras no case of remittent fever was recorded among native troops as compared with 20 (19-3 per mille) and 6 (10*4 per mille) respectively among European troops. Simple continued fever is another disease in which a rising or falling rate cannot be regarded as indicating increasing or decreasing prevalence. In 1904 the admission-rate rose to 237 per mille as compared with 18-5 per mille in 1903 and 14-0 per mille in 1902. There is little doubt that the rise is due to the return under this heading of a class of case which in former years would have been returned under the heading of ague, and as in the case of remittent fever the practice of different medical officers varies greatly in this respect. At Lucknow 250 admissions were returned under this heading as compared with 116 under intermittent fever, at Quetta 215 as compared with 106 and at Rangoon 105 as compared with 119. In the previous year the corresponding figures for these stations were, for Lucknow, 121 and 260, for Quetta 99 and 246 and for Rangoon 10 and 235. At Rangoon 66 of the 119 admissions for intermittent fever were recorded during the first two and-a-half months of 1904, but after the arrival of a different medical officer who considered that “ cases of fever had previously been returned as ague without sufficient reason,’' only 53 more cases were returned under this heading during the remaining eight and-a-half months of the year. The remarks in the paragraph upon dengue may also be consulted in this connection. Malta fever. Table LIII. 9. There were six admissions (seven cases) recorded under the heading Malta fever during 1904 with three deaths against nine admissions with no death in 1903. The reporting stations were Murree, Thobba, Indore, Bareilly, Roorkee, Landour and Deolali, but these were not in all cases the stations at which it was supposed the disease was contracted. The patient at Murree had been transferred from Rawalpindi and was under treatment for syphilis when the disease developed. It was at first supposed that he was suffering from enteric fever and on the 13th day of the disease the Widal blood test gave a positive reaction in a dilution of 1 in 40 in less than half an hour. But he had suffered previously from enteric fever in South Africa, and, as his symptoms were not very characteristic of that disease, his blood was submitted on the 28th day to the test for Malta fever, the Sanitary Officer of the Punjab Command, who per¬ formed the test, reporting that it gave a well marked positive reaction in a dilution of 1 in 50 in less than 20 minutes. The diagnosis in the case of the patient at Thobba was made on clinical grounds only : in the case of the patient at Indore it was made on the grounds that the Widal test for enteric fever was negative, that large doses of quinine had no effect on the temperature, and that the serum test for Malta fever wras “ positive ” on two occasions. This patient died on the 26th day of the disease as a result of haemorrhage from the bowel. The patient at Bareilly was under treatment for gonorrhoea when the disease developed. The diagnosis was based chiefly on the results of the serum test, which it was said gave a “ distinct reaction ” on two occasions. In the case of the patient at Roorkee the diagnosis was confirmed by a serum test carried out at the Pasteur Institute, Kasauli, the report stating that “ the serum fives a reaction for Malta fever, 1 in 40 under one hour.” This patient was [29SC] E
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