160

SKETCH OF THE MEDICAL HISTORY OF THE NATIVE ARMY OF BOMBAY.

as a rule though fever only makes its appearance once. Prostration of strength is not the
only thing that the patient suffers from at this stage of the disease: the pains in the joints
now become more severe than hitherto, occasionally, though being all but absent at this time.
Usually there is much stiffness accompanying the rheumatism, which is especially felt in the
early morning upon awaking, the pains being so capricious that they then attack parts without
any apparent cause, and gradually disappear as the day wears on; and this may go on for weeks
or sometimes months: there were patients of mine who, having been attacked with dengue
almost three months ago, still complained of pains in their joints at times. This protracted
effect of dengue is no doubt due, in a great measure, to the severity of the weather, which is
very cold here at this season of the year.

     In connection with dengue, it is remarkable that it seldom occurs amongst Europeans
without bringing in its train some other affection, which often proves more severe than dengue
itself: such for example as sorethroat, ague, dysentery, debility, dyspepsia, &c., and of course
these are attended by the rheumatic pains so peculiar to the disease. Dengue, no doubt,
induces a peculiar state of the system which lays it open to these complications, an effect
intensified by the cold weather and the malarious season.

     Regarding the treatment of dengue I find that, unless proper precautions be taken to
prevent the patient from catching cold during the fever, especially if the eruption happen to
be on at the time, agonizing pains, which before appeared to be comparatively mild, seize the
patient. These often prove to be obstinate. Some of the patients are difficult to manage;
in the irritability of the fever they throw off their bed cloths, and lay themselves open to the
unfavourable result just mentioned. In the first blush of the disease, if the stomach happened
to be foul, and this was very often the case, an emetic was given, followed by purgatives and
diaphoretics, the latter always afforded much relief to the patients, especially in cases where
fever was high. Quinine with iodide of potassium was also given with advantage; after the
fever had passed away, tonics and iron proved useful, and when the pains become chronic,
exercise and electricity seemed to do more good than almost anything else; friction, with
anodyne liniments, was always carried out, but it only gave temporary relief.

     The prognosis of dengue is extremely favourable: no deaths have taken place in the
Belooch regiment, neither have any occurred, to my knowledge, in Haidarabad. The subse-
quent effects ordinarily produced by an attack of dengue have just been mentioned as far as
my experience goes.

     Before closing these remarks upon dengue, I should like to add the following table show-
ing the number of cases which were admitted into hospital from the Belooch regiment, while
the disease prevailed:—

     The Water Supply .—Last year, owing to my having so recently arrived in the station, I
was unable to give a detailed account of the water-supply here, which is, I fear, inferior both
with regard to quantity and quality.

     The water-supply of Haidarabad is a question which ought to be of serious interest both to
the troops and to the other inhabitants of the cantonment and city. It has often been discus-
sed, and different plans have been proposed for obtaining a pure and wholesome supply from
the river Indus, or the Foolali, which is a branch of it: the former flows so close to the city,
that it seems marvellous how the matter should have remained dormant so long in so populous
and important a place as Haidarabad. I hear that now a scheme is being thought of by the
municipalty, which will probably be aided by Government to some extent, for conveying water
from the river; and if this be carried out, it will prove a great source of health and comfort,
not only to the troops, but also to the whole of the inhabitants of the station; and the outlay
which this would necessitate, must be attended by far more than a proportionate value, to the
people and the municipality, in a sanitary point of view.

     The source from which the water-supply is derived, for the use of the 2nd Belooch regi-
ment is from three wells: these must necessarily contain impurities, situated as they are near
the bank of a nullah which, after the fall of the Indus, contains stagnant water for months,
being more or less fed by soakage from this adjoining stagnant source. Thus it will be under-
stood that, unfortunately, this water, though impure, becomes, to some extent at least, a neces-
sity, serving as it does to replenish the wells, the supply of which, even with the aid of the