48

REPORT ON THE WORKING OF THE KING INSTITUTE, GUINDY

     4. The Director had laid special stress on the prevention of over-crowding. Every
convict had the proper amount of air space and at night special care was taken to see that their
heads were kept a minimum of one yard apart and a strict watch was kept to prevent the
closing up of the space. In the sheds where convicts were chained, it was so arranged that
every other convict was on the opposite side of the chain.

     Only 5 sporadic cases of Cerebro-spinal fever occurred during the stay of the laboratory
at Cannanore. Three of these occurred in the clearing Jail and two in the sub-jails. All the
five cases were detected in the quarantine itself within 48 hours of their arrival, as a result of
the prompt adoption of the methods recommended by the Director. The cases were diag-
nosed by microscopical and cultural examinations. The Cerebro-spinal fluid in each case was
removed by Lumbar puncture. Smears showed gram-negative intra and extra cellular dip-
lococci. Cultural methods gave meningococci types 1 and 2 in four cases. 1,463 naso-
pharyngeal swabs were examined for meningococci but all were negative although no
difficulty was experienced in obtaining this organism from the cerebro-spinal fluid when it
was present in the fluid. In 400 of these, a detailed examination was made of every colony
in the culture tube but in no case was the specific organism present. Fresh supplies of
special culture media from the King Institute were sent for this work every week.

Chicken-pox.

     Chicken-pox was prevalent in epidemic form at the time of starting the laboratory.
It was however immediately brought under control by proper segregation and disinfection.
Vaccination and revaccination of every convict in the Jail was done side by side so as to
ensure the freedom of the Jail from the possibility of an undetected outbreak of smallpox
occurring in the guise of chicken-pox.

Tuberculosis.

     The sputum of every case suspected to be suffering from tuberculosis was examined and
convicts found to be suffering from active disease were separated out and treated as hospital
patients in a separate tubercular ward. In all 26 cases were sent into this ward at various
periods, Five of these had died by the time, I left Cannanore.

Leprosy.

     The laboratory established the diagnosis of this disease in one case out of six cases
examined.

Ankylostomiasis.

     As most of the Mappillas in the jail looked very anæmic, 966 men were examined for
Ankylostomiasis and 95.2 per cent were found infected. Hence every convict during his
stay in the quarantine the first fortnight, was given a routine course of Thymol which was
repeated within a fortnight in most of the cases. This procedure helped very materially to
improve the general condition of the convicts.

Pyorrhœa.

     Several of the Mappilla prisoners coming into hospital were found to be suffering from
advanced pyorrhœa and jail stomatitis. It was therefore considered desirable to start a special
pyorrhœa gang and this was done in January 1923. All the convicts in this gang had their
teeth scaled and were given detailed special instructions in Malayalam, regarding the care of
their teeth, the enclosed leaflet being read out to them and hung up in the block. A special
kind of brush made of coir fibre was supplied to them. The results obtained by the use of this
brush with tooth powder and KMnO₄ C1_² gargles were most excellent and the pyorrhœa
cases soon began to diminish. Cultural examinations were made in several of the cases and
the usual pyorrhœa organisms were found. A few cases showed large numbers of spirochaetes
and amoebæ. The cases showing these forms were put on specific treatment.

Convict examination card.

     The most important work done by the unit during its stay at Cannanore, was the intro-
duction of the card system originated by Major Cunningham to facilitate the proper working
of the quarantine system. This card is known as the convict examination card and every
convict was to have a card stating the results of the various examinations made at the Canna-
nore clearing jail. It accompanied him on transfer and notes as to future diseases such as
attacks of Dysentery or Cerebro-spinal fever were to be noted therein and the card returned
to the King Institute at the end of the year, on release of the convict or at death, whichever
occurred first. If a convict was detected to be a "carrier " of disease it did not necessarily
prevent his transfer to other jails. On the evidence available on his card he was, however, to
be admitted directly into the respective gang opened for each disease in the jail to which he