171

SIND DISTRICT OF THE ARMY.

criterion of the extent of the disease. Two men suffering from gonorrhœa did not come to
the hospital until a severe attack of orchitis had supervened in one case, and retention of
urine in the other. There is a great want of a lock-hospital in this station, as the prostitutes are
not under medical surveillance, it cannot, therefore, be well ascertained how far the disease
may extend amongst them.

     Two cases of acute nephritis attended with general œdema were admitted into hospital
and are now progressing favourably. A case which was admitted into hospital as an ordinary
case of fever, was treated as such for a couple of days, when it was ascertained that the fever
was continuous, and that the patient complained of dull pain in the right lumbar region, which
led to the examination of his urine. The urine was slightly albuminous, however, the sedi-
ment, which was very copious, had all the appearance of chyle or pus. In the absence of a
microscope, the pus was readily detected by a simple chemical test. The abscess having
found an outlet in the ureter and the treatment being simple, recovery has been perfect.

     The number of admissions for contusions, although great, appears to be less than in the
preceding year; they have been generally of a slight nature. The only serious accident which
seems to have occurred, was a compound fracture of both bones of the leg opening into the
ankle joint. Erysepelas supervened, but after running a course of six or seven days, subsided.
The case is now progressing favourably.

     No operation of any importance seems to have been performed during the year. Causes
of death seem to have been from exhaustion supervening upon debility and diarrhœa, and from
asphyxia.

     The lines of the regiment appear good and well suited to the climate.

SANITARY REPORT BY THE SENIOR MEDICAL OFFICER OF THE STATION OF JACOBABAD.

     In my reports of this station for the years 1869-70-71, I have mentioned the principal
points worth noticing. The deductions to be drawn are plain, viz., that Jacobabad is the most
unhealty station in the Bombay Presidency: that the troops stationed here are much below
par in health, and succumb easily when attacked by diseases of the vital organs: that they are
predisposed to contract low and fatal forms of disease, and that they annually die in large
numbers: that a large number of men become prematurely old, that many European officers
of the different regiments have had to give up lucrative appointments or have lost health
permanently, or have died. Were sanitation of the station attended to, to its utmost, still this
station will remain very unhealthy owing to natural and irremediable causes; still proper
sanitation is nevertheless necessary. That troops thus situated might prove (without any
fault of their own) unequal to a prolonged and severe campaign is self evident, and does not
require medical men to foretell it. But I consider it my duty to beg of the Inspector General,
Indian Medical Department, and the Sanitary Commissioner of the Bombay Presidency, to
represent to the proper authorities the state of health of the local troops, with the object of
obtaining for them change of stations in their tour to healthier places, as that is the only
remedy. During the year 1872 the deaths amounted to 33 per cent. exclusive of those that
died while on outpost duty and on leave. During the years 1869-70-71-72 the total strength
of the garrison and the deaths amounted, respectively, to 5,905 and 199, or in the proportions
of 100 to 3.37. The average mortality of the Native Army (in which the high death rate of
the garrison is included) from 1865 to 1871 inclusive is 94. In other words, for every two men
that die in the Native Army generally (inclusive of this garrison) seven men die out of the
troops stationed at Jacobabad. This state of things is altogether owing to the effects of the
permanent location of these regiments in the most unhealthy station in the presidency.

     During the year 1872 the total admissions amounted to 3,056 or 188 per cent. to strength.
Of these 1,765 were from malarious fevers or 108 per cent. to strength. This station is placed in
the centre of one of the most malarious regions: it is 40 feet below the level of the bed of the
river Indus, the ground gradually rising to the east; on the north and west about 60 miles
off are high ranges of hills; on the south, but at a greater distance, are also high ranges of
hills which have the effect of cutting off the south-west trade winds; as a rule the atmospheric
movements are slight, except when dust storms occur. From July to September inundations
occur, making the country around a hotbed of malaria. These annual inundations were of
unusual extent in the months of July and September 1872. Jacobabad was surrounded by
water on all sides and was saved with great difficulty from total submergence; as it was, it
found its way into the lines of Jacob's Rifles, doing much damage; it got on the parade ground
in front of the Sind Horse lines. This station was thus cut off from all others, the Post bags
and travellers had to come and go in boats. Added to these natural defects there are artificial
causes which I have noticed in former reports. I addressed a letter, No. 9 dated 17th Septem-
ber 1872, to the Brigade Major, pointing out certain defects in the station in a sanitary point