147

NORTHERN DIVISION OF THE ARMY.

REPORT BY THE DEPUTY INSPECTOR GENERAL OF HOSPITALS, NORTHERN AND
MHOW DIVISIONS, 1872.

     A review on the sanitary state of our Indian native troops, is a thing apart from that of
the European element with which I have served in this land; climate exercises its modified
influence on each constitution—habits, &c., are at variance; the one self-fed and thrifty, inade-
quate at times and when a family man, at others some special object is in contemplation; the
other by the State, largely on meats, &c., and stimulating drinks, hence the more frequent
organic diseases and fatality in the latter by comparison: indeed, in reporting on the former,
we may almost confine our remarks to the three or four diseases chiefly constituting, or adding
largely to the swelling up, the annual records of admissions, deaths, and invalids.

     2. These I shall deal with separately; and firstly fevers.

Fevers.

     3. They hold the most prominent position among the admissions into all hospitals, and
are generally, though improperly I conceive, attributed to what is
termed local malaria; in the same manner that an undiagnosed case
is entered under the head of Dyspepsia, a very convenient disease indeed. Local malaria
would seem to have its location in all military cantonments, notwithstanding the unwearying
efforts of commanding and staff officers to combat with the insidious will-o'-the-wisp, if we
are to give heed to regimental and other returns in re.

     4. Fevers are rife, and average of sick greater, where ranges in temperature reach their
culminating points; nor do they prevail usually in the summer or hot season, unless heavy
cold dews obtain at night.

     5. The two most prominent types are remittent and intermittent; the former affecting
indirectly the circulating system positively, the latter negatively—the one from exposure to
the sun's rays during the day, the other from reflected cold and moisture towards evening and
at night, in damp localities; and this is what is vaguely termed local malaria, a subtle, im-
aginary something, incapable of analysis, and of which we absolutely know nothing.

     6. The above remarks have been made mindful during my late tour of 3 1/2 months' dura-
tion through the chief portion of the Northern and entire Mhow Divisions of the Army, in
the recent cold season, and from perusal, subsequently, from opinions of the several medical
officers. Yet of the numerous cases of fever I saw—and I saw, by comparison, but few other
diseases—many might have been classed as ephemeral, the cause, probably, from sudden
alternations in temperature, affecting primarily the capillary circulation, and on such, I fear,
a very large amount of quinine is unnecessarily expended annually, but this wholesale ex-
penditure, in consultation with the several medical officers, I have endeavoured to suppress;
since more simple and inexpensive country remedies are equally efficient.

     7. In calculating the statistics under head of fever and other simpler diseases to be found
in the wards of a native hospital during the autumnal season, and when the cooler weather is
setting in, we must not omit to remember that at this season the drill commences and many
shirk this extra duty.

Dengue.

     8. This epidemic is a fever resulting from excessive primary neuralgic irritation, affecting
the tendinous origins and insertions of certain muscles in the vicinity of
joints, and secondarily the muscles themselves, and had its wave origin
in this presidency, at Aden in Arabia, commencing in the last week of June 1871; and of this
outbreak my opinions have been recorded and published during my administrative duties as
Medical Superintendent of the Garrison; since which it has nearly passed through the length
and breadth of our Indian possessions, laying prostrate for a long period 8/10ths of the fight-
ing manhood of England and her native army: and, without doubt, its peculiarly exhaustive
enervating effects propitiated the advent of another wave of which or from whence—as with
the Burdwan epidemic—we wot not; yet it was recorded as fever of a severe type, prevailing in
all arms throughout Guzerat and Mhow Divisions in the months of September and October
1872.

Rheumatic.

     9. In the native arm this class of disease is usually second on the list in reference to
numbers: " hath paung dukhta," are well known to medical officers
of the Indian Service, also " cumber dukhta," as favourites with the
sepoy—more especially a few months prior to the invaliding season, when men, holding no
chance for promotion get as good a pension as in after years, resort to every kind of stratagem,
even to half starving. In such—and there are many instances I fear—it is hard to tell who
fares the worst, the patient or doctor, since the one is troubled in body by successions of
blisters and daily potations of colchicum, iodine, &c.—vide summaries of treatment at invaliding
boards—whilst the other is puzzled in mind what to do in order to get rid of his troublesome
patients; the finale, probably, in consultation with the adjutant and commanding officer—a
resort to the invaliding board.