SIND DISTRICT OF THE ARMY.

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progress of the fever, considering the quick and steady manner in which it was spreading
amongst the other classes of the native community, where these rules were not observed; but
I soon found, to my great disappointment, that the admissions from dengue began to increase
with astonishing rapidity, until a large number of men in the regiment had fallen victims to
it. I believe that the disease must have been imported from Kurrachee, most probably pro-
pagated by means of the natives passing to and fro' between these two stations; this is,
however, of little import, as of course such intercourse is unavoidable, and there are other
sources of contagion with regard to dengue than those of mere personal infection, the fountain-
head of which might be profitably sought after, so as to enable us to grapple with the disease,
should it again present itself. Is there any reason, for instance, to suppose that dengue may
not help to spread itself through the medium of water, as we know that cholera does? If so,
isolation of the patients alone can be of little avail so long as the water is open to pollution.
With regard to this, it is worthy of remark, that while dengue prevailed as it did in this regi-
ment, the detachment 66th Regiment, consisting of 3 companies, and a battery of royal artil-
lery, stationed here, were almost free from it, when it was raging everywhere else; this will be
seen by the following statement:—

     Number of cases of dengue, which appeared during the outbreak, in the 66th Regiment
and in the Battery 18th Regiment Artillery, up to the 14th of December 1872.

     Thus it will be seen that only 10 cases have occurred amongst the European troops
stationed here, and these after the severity of the outbreak had expended itself. A table is
appended showing the admissions into the Belooch hospital.

     This immunity from the disease in the European hospitals is owing, no doubt, principally
to their purer supply of water, and also to their better food and superior accommodation, in
addition to the strict isolation to which the soldiers were subjected.

     According to my experience, the premonitary signs of an attack of dengue are those of
ague, excepting that, as a rule, the patient experiences rheumatic pains in one or more parts
of the body, sometime before the fever makes its appearance; however, I have noticed in many
instances that the disease comes on suddenly (as it did in my own case, the first warning I got
being a seizure of rheumatism in the back, while out walking); the other symptoms quickly
follow, with pains more or less severe in the wrist, ankles, knees, &c., generally, but the most
severe pains were felt in the forehead and loins: the patient then begins to feel chilly, par-
ticularly in the back, along the course of the spine; the face becomes pale, presently the
slight sensation of cold and shivering begins to alternate with flushes of heat, followed by
severe headache and suffusion of the eyes; pulse—full, strong, and rapid; urine—scanty and high-
colored; the patient is uncomfortable and restless; in short at this point of the disease it very
nearly resembles a mild attack of ague in the hot stage. In nearly all cases, a mild perspira-
tion was easily produced, and sometimes profuse perspiration ensued. Sleeplessness is, I may
say, invariably present, the patient sometimes complaining more of this than of anything else.
The fever is of short duration, generally disappearing in the course of from one to three days,
sometimes four, leaving the patient weak and prostrated, suffering very frequently from loss
of taste, with dyspepsia, and occasionally also from numbness of one or more limbs.

     The eruption, which is not always present, makes its appearance about thirty to seventy
hours after the beginning of the fever. I have noticed that it breaks out just as the fever is
leaving: in the natives it is sometimes difficult to distinguish, on account of the color of the
skin, but in the European it is well marked generally, and resembles the rash of the measles;
some say that it usually commences upon the extremities; as far as my experience goes, however,
I have more frequently seen it begin upon the chest and lower part of the neck; it appears,
and disappears and reappears, and may continue in doing so, frequently repeating itself in
this manner for some days. This recurrence, too, is often to be noticed with regard to the fever;