183
SIND DISTRICT OF THE ARMY.
ing to the regiments—Sind Horse—compared with their numerical strength, I remarked that in
consequence of the latitude permitted to the men—and which is of long standing—none but
cases requiring to be kept in bed come to hospital, but that this system, bad for many reasons
as it obviously is, compensates for the deficiency of accommodation. By this arrangement,
however, many cases of syphilis altogether escape detection and record. The men have re-
course to native remedies; in most of them the disease is patched up for a time, only to break
out years afterwards in one or other of its Protean forms: while others, deeming themselves less
fortunate, become daily more incapable of performing their duties, until at length they can no
longer conceal their complaint, and are received into hospital in an advanced stage of the
disease. From what I learnt from the medical officers at Jacobabad, I have every reason to
believe that syphilis is as rife among the men of the Sind Horse as it is in those of the Belooch
regiments, and the statistics of this particular disease as it affects them are consequently
worthless.
11. Diseases of the "Nervous system" require no special remark; neither do those of the
"Eye," beyond mentioning that conjunctivitis prevailed to a considerable extent, 110 cases
having been recorded. But this need excite no surprise, considering the constant glare, dust,
and sudden changes of temperature peculiar to the climate.
12. The diseases of the "Respiratory" and "Digestive systems," however, are next to
those of malarious origin, the most important that have occurred. In the former, bronchitis
takes the lead: 106 cases are recorded and 5 deaths. But the most fatal of any belonging
to this class is pneumonia: 81 cases have been met with, out of which 21 deaths have occur-
red. No single disease which has affected the troops in this division has been followed by
so severe a loss and which amounts to a ratio of 24.7 to the number treated, and to 0.7 to the
total strength. Almost the entire force of this disease has fallen on the Jacobabad regiments.
In this Brigade alone 77 cases are recorded and 19 deaths, being the insignificant number of
4 cases and 2 deaths to the Belooch regiments at Kurrachee and Hydrabad. This is almost
a repetition of what happened in the previous year. The two Belooch regiments showed only
5 cases of pneumonia and 1 death, while the ones at Jacobabad returned 89 cases and 22
deaths; and the resemblance becomes still more apparent on comparing the ratios to death to
treated and to strength, which gives precisely the same figures, viz., 24.7 and 0.7 as are obtain-
ed for the year 1872. The greater amount of cold which prevails in the early morning during
the winter months at Jacobabad than at either Kurrachee or Haidarabad, quite fails to account
for the immense disparity witnessed in the frequency and attendant mortality of this disease
between Upper and Lower Sind; and which two successive years—the one remarkable for its
absence of rain and the ordinary cold season, the other equally so on account of an unusually
heavy fall succeeded by a very mild winter—place beyond dispute. The extremes of tempera-
ture, from a high solar heat to often below the freezing point, which usually prevail at Jacoba-
bad in the winter months, cannot, therefore, taking into consideration the dissimilar climatic
conditions of the last two years, be made solely responsible for the much greater prevalence of
diseases of the lungs, attended with fatal consequences at that station than in those nearer
the coast. That it is an exciting cause, and a powerful one in ordinary seasons, cannot be
doubted, but without the existence of a very strong predisposing one, it would be compara-
tively harmless. In both years, however, as for many previous ones, this predisposing
agent has been ever present and unceasingly at work undermining the constitutions of a
large proportion of the men composing the Brigade; and slowly, but no less surely, inducing
that peculiar cachexia, marked by anœmia, loss of muscular strength, and nervous prostration,
which render those thus affected especially susceptible to existing causes of disease, the most
common of which are atmospheric influences; and inflammatory action once set up in such sub-
jects invariably assumes a low adynamic type, in which the best recognised medicines, with
a free use of stimulants, are too often found to be powerless in averting a fatal issue. I need
hardly add, that this subtle predisposing agent which thus saps the health of the soldier in
Upper Sind is malaria, and which, as I endeavoured to show in my last year's report, may
be mitigated but can never be eradicated. The remaining diseases of the respiratory system
still to be noticed, are few and unimportant. Pleurisy has been the most prominent but, as
was the case in the previous year, has been confined chiefly to the 27th Regiment N. I., at
Kurrachee; 2 casualties out of 9 admissions have occurred in that hospital from this disease.
13. Among the affections of the digestive system, dysentery is the most important.
It has yielded the highest number of admissions under this class of diseases, 89; but the morta-
lity has been low, amounting to only 4; while the two Belooch regiments show almost the
same number last year as for the previous one: those at Jacobabad have nearly doubled
theirs. But this is not difficult of explanation after the account I have given in the 4th
paragraph concerning the state of the station and surrounding districts, caused by the inun-
dations of the Indus. Diarrhœa, likewise, has, owing to the extreme dampness of the past
season, returned a larger number of cases than usual. From this disease, 2 casualties have
occurred out of 78 admissions. Hepatitis furnishes only two cases, but both of them were fatal;