10

REPORT ON THE WORKING OF THE KING INSTITUTE, GUINDY

     (3) a travelling railway laboratory for the examination of railway water-
supplies (reference No. 2560, dated 12th August 1924)
are awaited.

(v) INVESTIGATION UNITS.

     A second investigation unit was sanctioned in G.O. No. 1766-P.H., dated
26th October 1923. Both of these units were engaged in investigations in the
field for the greater part of the year. They were utilized on four separate
occasions:—

       (1) To investigate a serious outbreak of cholera at Vaniyambadi.

       (2) To investigate the epidemic of relapsing fever at Ootacamund in the
Nilgiris.

       (3) To investigate a severe outbreak of gastro-enteritis in the Alipuram
Jail, Bellary.

       (4) To make a malarial survey of the Sappal Hills at Olavakot in the
neighbourhood of the Forest department exploitation area.

     1. The outbreak of cholera at Vaniyambadi.—This unit was placed in charge of
Assistant Surgeon, N. Seshadrinathan. The unit left Madras on 13th June 1923
and returned on 22nd July 1923. The epidemic proved to be a severe one.
Two hundred and thirty-six persons were attacked with 105 deaths. The disease
was soon shown to be true cholera by the discovery of the cholera vibrios in a
considerable proportion of the cases examined. The epidemic was traced to its
source and its spread was found to be due to contamination of the wells.

     By means of appropriate measures the epidemic was rapidly brought to a
close. (See Appendix II for report.)

     2. Investigation into relapsing fever at Ootacamund.—This investigation was
in charge of Dr. Krishnan and lasted from 14th July 1923 to 3rd April 1924.
The unit took up its quarters at the Municipal Isolation Hospital and assisted the
Municipal authorities in the diagnosis and treatment of the disease. The large
number of cases brought to the hospital afforded ample opportunity for experi-
mental investigation into various aspects of the disease. Numerous transmission
experiments with lice were performed which fully corroborated the work previously
carried out by Mackie, Nicolle and Cragg in other places. Other observations
of considerable interest in connexion with symptoms and treatment were also
made. The control which was finally gained over the disease within the municipal
limits owed much to the work of the unit. The subsidence of the epidemic
brought the investigation to a close. Dr. Krishnan's interesting report, which
gives in detail the work done by this unit, is too big for inclusion as an appendix
and is being forwarded to Government separately.

     3. The outbreak of gastro-enteritis at the Alipuram jail.—This unit was sent
to the Alipuram jail at the request of the Inspector-General of Prisons. Cases
of severe gastro-enteritis had been occurring for some time previously and the jail
authorities were very anxious to discover the cause of the continued prevalence of
the disease. There was also considerable anxiety lest the disease should in reality
prove to be cholera. Assistant Surgeon N. Seshadrinathan was placed in charge
of the unit which arrived at Bellary on the 12th of October 1923. The unit
remained there until 7th May 1924. When Dr. Seshadrinathan arrived no
cases of the disease were actually occurring. The opinion of the jail officers
was decidedly in favour of a diagnosis of cholera. Severe diarrhœa, vomitting
and collapse were the essential symptoms. The actual death rate, however,
was small. When cases began to occur the stools were carefully examined
for vibrios. Eight cases examined in this way gave negative results. As
the Assistant Surgeon in charge of the unit was unable to find any definite
cause and no headway was being made, Assistant Surgeon Theodore was
deputed to proceed to Bellary and report on the situation. He soon recognized
the cases to be similar to those he had seen when in charge of the Institute unit
which had previously investigated the dysentery epidemic in 1922 and he
immediately took steps to investigate the problem from this point of view.
Bacilli of the dysentery group were soon established as the true cause of the