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The following careful and able account of an outbreak in June 1882 of
enteric fever among the civil population at Abu by Surgeon Major Spencer, the
Superintendent General of Dispensaries and Vaccination in  Rájputána, is a real
addition to our knowledge on the subject, and shows in the most forcible language
that even under the most favourable conditions of climate, mode of life, &c.,
the neglect of sanitation is surely the cause of disease and death. I trust
that the sad gloom thrown over this station by this preventible death will not
be allowed to be forgotten and that the suggestions made by the committee which
was convened to devise measures for the sanitary improvement of the hill will be
carried out. Especial care should be taken not to allow latrines for Natives to be
placed in such deadly situations as ravines, but they should be built on heights as
recommended by the committee; and much greater attention should be paid
to the sanitary condition of houses and their surroundings, especially regard-
ing the servants' houses and privies, &c., as well as with reference to the disposal
of wastage water, &c. This course is imperatively demanded, or else it is easy to
foresee that some day an epidemic of enteric fever will occur which will sweep
off those predisposed to it by youth and recent arrival. But the sanitation of
Mount Abu must always be attended with difficulty, as in the first place the hill
belongs to a Native State, and, secondly, the broken condition of the ground
renders supervision a difficult matter, whilst at certain seasons of the year there
is a large influx of visitors and at others of pilgrims, the latter of whom ought, at
all hazards, to be compelled to pay more attention to cleanliness:-
"Enteric Fever on Mount Abu from 1st January to 1st September 1882.
Case No. 1.
The first person attacked was a Pársi boy aged 12 years, of delicate appearance, though
he has never suffered from any ailment but slight attacks of malarious fever.    He took to
his bed on the 9th of June.    This boy who formerly lived at Abu with his  father has  been
at a school in Bombay during the past year and returned here for his holidays on the 1st of
May.    Enquiries are now being made as to whether any of his school-fellows  suffered from
prolonged fever  after arriving at their homes.    This boy's home  (marked  1 in the map
attached)  adjoins the bázár, but I have not been able to discover, that either previous or
subsequent to his attack any resident in  the bázár suffered from the disease.    The house in
which he lives is a good one with a well kept garden in front of it, and though the sanitary
conditions connected with it are not of a high order, still they are relatively high, and vastly
superior to those under which most of the community to which he belongs live and flourish.
The chappatis which the boy ate were  made of flour of wheat ground in the house.     Their
own cows supplied the household with milk both for drinking and for butter.    The chickens
were home-fed.    Mutton  was procured from a butcher who supplies with meat at least six
other families.    Up to the end of May water  was drawn from the 'Telegraph well,' which
is one of the best in the station and consequently largely used.    Early in June, I cannot
unfortunately fix the exact date, but it was probably about 1st or 2nd June, this well became
dry and water was drawn from a well in the compound  which was recently  deepened.    The
water is clear and bright and pleasant to drink, but the well is now 70 feet deep and may be
affected by percolation and drainage from the bázár.    This water has however been used by
many families for drinking purposes without, so far as can be seen,  any bad result, and
notably by a European family which arrived in India in November 1879, and includes among
its members 4 children,  whose ages vary from 20 to 6 years.    The mother of this family
however tells me that no water is drunk by her children which has not previously been boil-
ed and filtered.    The Pársi family contains 8 members aged respectively 47, 39, 21, 19, 12,
10 and 21/2 years, and a baby of five months old.    The boy of 12 alone  was attacked.    The
other members, so far as can be ascertained, lived under precisely the same conditions as re-
gards air, water, food, clothing, and surroundings generally, as this boy.
Case No. 2.
The second person attacked was a young lady 191/2 years of age, who had been 11/2 years
in the country, and 7 weeks at Abu. She comes of a strong healthy family and up to within
a few days of taking to her bed on the 10th of June, had been in excellent health. When
a child she had measles, and of late years has been habitually constipated. The family oc-
cupied the house marked No. 2 on the map, and consists of a father and mother, of middle
age, and an infant in addition to the patient. This household ate club mutton, home-fed
fowls, and bread from the baker, whom nearly every one employs. They kept their own
cows. Water was obtained from what is known as the club well, the drinking water being
carefully filtered, but while playing tennis, water from the same well was frequently drunk
unfiltered. The patient was ailing for some 5 days before taking to her bed, her mother at-
tributing the indisposition to the girl having eaten a toast made of doubtful anchovy sauce.