Jtoe 1, 1878.]
CHANGE OF AIR WITH REFERENCE TO MOOLTAN.?BY F. R. HOGG.
14^
Where no water is available the place remains a desert. Near the banks of the Chenab river, three miles distant, and along inun-
ORIGINAL COMMUNICATIONS. CHANGE OF AIE WITH SPECIAL REFERENCE TO MOOLTAN.
dation canal cuts thence diverted, sugarcane, maize, indigo, wheat, barley, mustard flourish, as would vegetables, were not the soil too valuable, therefore supplies come from Lahore. Down
20 to 30 feet water is found of excellent quality so long as wells are covered, protected and kept clean. As comwith ancient days Europeans scarcely ever suffer from Greati.y appreciated is the privilege of having seen the silver- pared and the city wells are said to be periodically purified. boils, snow of the azure blue perpetual piercing lofty peaks glistening The dismal groaning creak of the Persian wheel never lulls and firmament, and to have watched the lower Himalayas gleaming in gardens grow peaches, plums, oranges, limes, grapes, guavas, ?with gold, else softly changing colour from shades of radiant opal, steel blue, grey, peacock, copper or emerald green, to rose strawberries, mulberries, bananas, pomegranates, figs, mangoes, almonds. Amongst trees, shrubs, plants, thorns or pink in the setting sun, as contrasted' with recollections of the plantains,
By
F. R Hogg,
Surgeon-Major,
A.M.D.
stupendous grandeur of the roaring foaming falls of Niagara. During the past five years duty has taken me to Delhi when Lord Northbrook held a Durbar there of Wales reviewed
troops lastly,
: when H. R. II. the Prince and danced in the ancient halls of the when the heralds with shrill trumpets
Great Moguls, and proclaimed Queen Victoria to be Empress of India. Opportunities have occurred of seeing the pearl white marble rocks at
the golden temples of Benares and Umritsur, the sepulchres of many illustrious personages, for instance of Akbar, the Taj at Agra so suggestive of a fleeting fairy palace of ivory or crystal, the Kootub near Delhi, the well at Cawnthe pore, the Residency at Lucknow, obscured by purple creepers, sacred shrines near Muttra, the pilgrims bathing in thousands at Hurdwar, the reputed home of cholera, the fertilizing perhaps fever-producing canals, the burning ghats at Benares, where the Ganges is believed to wash away all impurities, the botanical gardens at Saharunpore stocked with endless specimens, for instance, Eucalyptus globulus so far a sanitary failure, and the Lawrence Asylum on the hill of Sanawar intended to educate children there sheltered from most dangers of the plains. On business else on expensive excursions Allahabad, Meerut, Roorkee, Umballa, Loodiana, Kurnal, Ferozepore, Jullundur, Mean Meer, Lahore, Kussowlie, Subathoo, Simla, Nagkanda, Dehra Doon, Landour, and the beautiful lake at Nynee Tal have been visited. From green well-wooded Sealkote a tantalizing panorama was enjoyed of the blue hills backed by the distant snows of Cashmere, and the palaces at Jummoo nestled amidst river forest and mountain scenery, well repaid a dusty pilgrim-
Jubbulpore, palaces
or
age : yet horrible were the smells and wretched the appearance of famine-stricken peasants on the road. Travel enforces observation leading to research, if not to
better practical acquaintance with hygiene in connection with lessons learnt at camps of exercise, on marches, and in cantonment hospitals. Difficult is it, however, without libraries or medical societies, to ascertain what
Rooks, journals, periodicals,
too
professionally goes on heavy,
too
abroad.
costly to
carry on mules, elephants, camels, else by rail or bullock cart. Under such circumstances, it is unsatisfactory to discuss the subject of heat *nd moisture as affecting the human body for instance at Mooltan.
There
last cold
season
the
are
interesting
wOrk included
cases
of
pneumonia, bronchitis, rheumatism, dysentery, hepatitis, malarial fevers, ophthalmia, syphilis and oriental sores, contracted at Dera
Ismael Khan?formerly called Delhi boils. These painful sores Permanently scar the faces of women and children, and the Mooltan was occupied by the 70th regiextremities of men. ment, a battery of artillery, a regiment of Bengal cavalry, another of Native Infantry, a sprinkling of civilians and a few officials connected with the Indus Valley Railway, shortly open to Kurrachee. The train from Lahore requires a long tedious "ay to accomplish 214 dreary miles over arid desert (occasionally dotted with melancholy tamarisks, else castor oil plants) to reach this station, said to be the hottest in India. The soil 1s a stiff impervious clay, scarcely penetrated beyond a few inches by heavy rain, and to keep down suffocating dust the custom is to make paths of straw near houses. Mooltan natives say only boasts of beggars, church yards, heat and dust.
about
brambles several useful in medicine may be mentioned?datura, cannabis indica, oleander, senna, Arabian and Spanish jasmin,
mudar, karil, peepul, moringa, amultas, bael, babul, box wood, nim, bakam, sissoo. Natives worship many flowers and the date palms, said originally to have been planted by the army of Alexander, surpass all trees in graceful stately beauty, At the confluence of the Chenab with the Jhelum, this army of 135,000 men besides horses and elephants embarked and sailed
feathery
down the Indus to the
sea
in
November,
327 B.C.
The visitor
to-day will notice the monument erected to the memories of. Vans Agnew and Anderson, who, in April 1848, were barbarously "
They fell doing England's work, and sustained England's honor in their death." "When rebellion then broke out the climate was reported malignant, yet the force encamped murdered.
February continued healthy with only 4 per cent, September. In January Dewan Moolraj, who abetted the foul murder, at last surrendered. The morning opened with a severe storm of thunder and rain, but later the flag of old England was flying out in a fresh breeze and bright sunshine. The year 1848 was one of drought followed by a season of heavy rain in 1849. In August the most violent storm ever remembered occasioned the flooding of the Punjab rivers, when the fortress was swept away by the universal deluge. Only elevated 400 feet above sea level, any sudden rise in the Chenab may swamp the station, and the main drainage outfall is the channel introducing such water. Filth products are rapidly disinfected, and In damp about barracks the earth system answers admirably. weather there may be foul smells, especially in the direction of the city (about two miles distant) for a time until the blazing on the hard ground. Mooltan sun evaporates everything continues healthy so long as the atmosphere is not unusually moist. The station being placed on the borders of the northern limit of the south-west monsoon, is liable to much variety as to rainfall in different years, according as the monsoon of the season may or may not extend to this particular latitude. Reckoning Lahore as 18, Delhi 25, Agra 29, Lucknow 43, Benares 38, Calcutta 65, Bombay 70, Madras 48, Simla 83, Nynee Tal 100, Darjeeling 132, the average at Mooltan is about five inches of rain annually, the range extending from 2 to 17, and when the latter amount is reached, ague, dysentery, diarrhoea or scurvy may prevail, or fevers relapse in the cool season as in 1858 and 1863. In 1877 nearly 15 inches of rain were measured, about 9th September, when mud houses collapsed, and at Chrisraas coughs and colds became prevalent. Very extraordinary is it that so far cholera never spreads, and from 1856 to 1872 European troops scarcely suffered at all during five visitafrom
July
to
of sick in feverish
tions. Even in terrible 1867 and 1872 very few cases occurred in the district where the rainfall did not exceed six inches. No history of cholera importation or infection was traoeable in 1872, when locusts were spread by a south-east wind. Time
alone will shew whether or not, as trees spring up, rain will increase ; and whether, with drainage difficulties and more rail communication, this immunity will continue. The mean humidity but Dr. De Renzy at Mooltan has registered of Greenwich is
81,
only
19
to account for steel instruments Constitutional vigour and energy
degrees
from rust.
remaining free characterise tha
THE INDIAN MEDICAL GAZETTE.
142 inhabitants of hot and dry localities.
Burney Teo quotes Her-
[June
1. 1878.
minor conditions, all go to prove tliat almost a total abstainer, a vegetarian, should be the rule at Mooltan for the majority of persons in certain months. There is a furnace look about the place not diminished by the glare of the white double-
bert
almost
The 70th The natives about Mooltan are a fine class of men. regiment saturated with Peshawar fever were improving, also the sallow-washed-out women and children, and in spite of
praised by those who adapt themselves to the climate as regards eating, drinking, bathing, clothing, exercise, occupation, and judicious cooling appliances. As usual Bryden's tables are
Spencer that the earliest recorded civilization grew in Egypt, Babylon, Assyria, and Phoenicia, whilst from the rainless district extending across North Africa. Arabia, Persia, and on through Thibet into Mongolia camc all the conquerors of the old world.
intense heat all like the station in which a considerable amount of exhausting brain work is conducted at all seasons of the Indus Yalley Railway constructors. Some are pouryear by the ino- over abstruse calculations under the punkha, whilst others have to face the sun in the open. Yet apparently the Europeans are more contentedly inclined cheerfully to face climatic worries, and all even including the ladies pull well together as compared with the residents of places in the plains with a greater rainfall. The temperature in 1877, taking the highest in sun's rays, the highest in shade, the lowest in shade, recorded at the native
hospital by Dr. Penny's staff, ran as follows :?January 139-76-33, February 153-80-36, March 156-92-51, April 156-98-56, May 167-109-65, June 169-115-74, July 166-109-69, August 161-10874, September 160.106-70,October 155-99-54,November 146-86-46, December 140-78-39 ; the year comparatively cool. The thermometer may in January register only 17 on the grass, and near the jail quantities of ice are collected and stored. Other stations temporarily cool after the rains, but August or September may be very trying at Mooltan, where the annual mean temperature is 76, the absolute annual range between 90 and 100, the average diurnal range about 30 according to Blanford who from eight years tables gives the mean temperature in January as 54, February 58, March 70, April 79, May 89, June 95, July 91, August 88, September b6, October 76, November 66, December 56. The proportion of cloud is about 17 per cent, as compared wi.h Lueknow 37, and
alter the rains the Punjab skies become cloudless, allowing free radiation and rapid cooling. Piercing through a dry vapourless atmosphere, the vindictive sun blasts the hard white ground, and the superjacent air remains hot until the clear cloudless night, when such heat drains away towards the stars. During the day careful people shutting up their doors at 9 in the morning, and trusting to punkahs and thermantidotes can keep their houses down to 86. Tatties are very uncertain. Many persons careless or impecunious contrive At night some to exist in a temperature over 100 for months. sleep out in the open, else on the house top, or surrounded by wet matting with a punkah over head, and the floor covered with wet sand, out in the garden. Many dine very late, else take a light supper followed by whist or billiards, perhaps a drive, any thing to while away wretched hours until 12 o'clock, when a refreshing breeze blows across the Chenab river and brings the blessing of sleep. As explained by Tyndall the sun's rays falling on water are not arrested, but penetrating to a considerable depth heat the stream gradually, and the process of cooling is different to that on land. To this inequality refreshing breezes are due. Apparently as the heated air at night
almost
is evolved from the ground, the cooler currents from the Chenab again and again replace the hot vapour ascending. At other stations where no such breeze springs up, the all will continue
high,
and
temperature
at
night
Nowsbera the 70th lost several intemperate men under such circumstances. In the hospital wards there in 1867 Dr. Staples registered 99 at sun rise 10 a.m. and 3 P.M., compared with 102 at 10 p.m., whilst in the verandahs the temperature at the same hours recorded 98From June 21st to July 3rd hot winds con105-111-105. tinued. Total abstinence principles and the reduction of diet reduce the liability to heat apoplexy to an incalculable degree. It is popularly explained that, in a surrounding medium of
high bring-
temperature, the dilatation of the vessels of the skin, the ing of heat lost to a maximum, and heat production to a mini. jj*um, the arrest of oxidatiou or
wasting,
and a number of
storeyed barracks of
s
in-dried brick, and yet Mooltan is very
much
for statistics of disease from 1860 to 1869. The of European troops ranged from 774 to 1,117. During
consulted
strength
the 10 years only two cases of cholera, in the months of May and June, neither fatal; five cases of variola, none fatal; 7,413 of intermittent fever with 13 deaths most marked in September
1862, 1864, 1865, 1868, as compared with remittent or continued fevers 925 cases and 23 deaths mostly in July and in 1865. In July also heat apoplexy particularly noticed in 1860-1865, about 78 admissions, 6 deaths. Delirium tremens and dysentery in September. Hepatitis and diarrhoea in August, but few fatal cases recorded. Rheumatism troubles in January. Respiratory dis-
February accounted for 6 deaths out of 751 regards phthisis 57 admissions, 9 deaths, the highest figure in May. On this last heading the admissions were
eases
highest
cases,
and
in
as
strength, and out of each hundred cases treatstatistically the casualties. If the previous histories of men, their habits, occupations, the complications connected with exposure, malaria, drink or syphilis be all taken into consideration, these numbers really are not high. Mooltan, in the opinion of others as well as in mine, is likely to benefit consumptive invalids if well-selected cases with money and 6 per thousand of ed 15 represented
leisure at command could make up their minds for a voyage from England to Kurrachee, which is 200 miles nearer Suez than Bombay. From Kurrachee the Indus Valley Railway will convey the invalid to Mooltan, a pleasant sociable station, where
English faces, manners, customs, sympathy and hospitality will soften the bitterness of exile. For money good servants and suitable fairly-cooked food can be procured, and there would be no difficulty about obtaining the best European wines. Although
the native
but
indifferent, it is very easy to small library, and from Calcultta the newest books can be purchased. There are various religious communities ever ready warmly to "welcome brethren, whilst the ministers of 'he gospel will also do their best to cheer and comfort the minds of those desponding. To repair the poor fragile body, the local practitioners knowing all about the climate can utilize sound experience towards Arresting chest The friends who accompany the patient need never mischief. be dull; what with riding, walking, driving, dancing, theatrical dinner parties, badminton, lawu tennis, fishing, or shooting excursions. Nor need they be involved in the whirl of cold weather gaiety if indisposed. When Mooltan bccomes distressing, it would be easy by rail to Umballa, thence by comfortable tonghadak gharry or dooly to reach sub-tropical Subathoo (4,300 feet), recommended for equable climate, sheltered position, shops
get things from Lahore.
are
There is
a
absence of great diurnal range of temperature, besides the advantage of being extremely pleasant during the rains so wretched at higher Himalayan retreats. Comparatively little dysentery, hill diarrhoea or liver derangements lurk about Subathoo, as compared with the cold hills up above or the hot down below. lies angustice
Another class of invalid requires too many sick bread winners in this country to defer until too late the search for health. Apart from appalling expenses, a trip to England would be extremely distasteful to many a broken down man, who, having India unavoidably so long to represent his home, shudders at
steaming plains consideration,
compel
the idea of
parting with the comfortable bungalow, the useful old servants and many happy local associations. Might not a particular station in the plains, some retreat in the hills, or a sea trip relieve dysentery, diarrhoea, asthma, renal or pulmonary mischief? Could not liver abscess be arrested, or cerebral symptoms
GLEANINGS FROM A MOFUSSIL PRACTICE.-BY E. A. BIRCH.
June 1, 1878.]
checked without returning
England and resigning appointeagerly snapped up. The king is dead, long live the king. Sir J. Fayrer advocates short trips in a steamer across the Bay of Bengal, a run down to the Sandheads, or an excur-
ments
to
so
sion to Madras and back for certain
cases
;
whilst for
others
a
"voyage to Burmah or Singapore will be only waste of money. The old system of three years' furlough is praised, and even if years have been spent without sickness in the plains, the year may be the last straw unless a trip home be undertaken. Chronic dysentery, enlarged spleen, doubtful hepatic abscess, ma-
seven next
larial cachexia, anaemia, neuralgia, debility after sun-stroke, cholera, or tropical fevers too often necessitate change to Europe.
According
to the
same
authority Darjeeling, Mussouri. Simla, to be compared with Ootacamund
Murree, are not therapeutically
and Conoor. It may be advisable for an invalid at Mooltan td embark at Kurrachee on a journey combining sea and mountain
advantages by terminating at the Neilgherries Sea air containing ozone, aqueous vapour, bromine, and iodine will be pure, free from organic particles, and have comparatively more equable temperature. As regards the dust ofMooltan, it cannot be denied that, if the bronchial mucous membrane be irritable, an invalid cannot tolerate a dry warm atmosphere. Many cases have no 8uch irritability. Under the treatment by inhalations of carbolic acid, creosote, tincture of benzoin, aided by diet including milk, eggs, bacon, and tripe, a climate-stricken phthisical invalid eventually started for Bombay in a very satisfactory condition. Praising antiseptic inhalations Dr. Clifford Albutt would place consumptive cases in a permanently aseptic atmosphere at an elevation of 5,000 feet; for instance, Davos, an upland valley in the Grisons, where although pneumonic inflammations occur, the morbid secretions do not foul, and phthisis is unknown. The remarkable immunity from phthisis enjoyed by the scholars at Sanawar, Murree and other Himalayan schools, are facts proved beyond dispute. Heat, moisture, and change of air in India are inexhaustible subjects for study and investigation, and it is a pity that the influences of tropical climates are not recorded as in the days of Sir llanald Martin. This paper is finished at the conclusion of 15 days' marching in April with invalids and other from Sealkote to Dalhousie, about 133 miles. "What with fording streams, crossing the Ilavee in boats under a hot sun, what with thunder, lightning, wind, hail aud rain swamping encampments, the journey proved trying. Yet the sick did not retrograde. At cocl Dalhousie elevated from 5,377 to 7,687 feet the snows still continue on adjacent hills, and breathing pure air, drinking most delicious Water, the ear pleased by rustling pines or murmuring streams, and the eye charmed by exhilarating scenery, the invalids will gradually recover health aud strength amidst green oaks, grand horse chestnuts, and graceful deodars, amidst bule bells, cowslips, ferns and ivy-clad damask rhododendra.
143
CHANGE OF AIR WITH REFERENCE TO MOOLTAN.?BY F. R. HOGG.
14^
Where no water is available the place remains a desert. Near the banks of the Chenab river, three miles distant, and along inun-
ORIGINAL COMMUNICATIONS. CHANGE OF AIE WITH SPECIAL REFERENCE TO MOOLTAN.
dation canal cuts thence diverted, sugarcane, maize, indigo, wheat, barley, mustard flourish, as would vegetables, were not the soil too valuable, therefore supplies come from Lahore. Down
20 to 30 feet water is found of excellent quality so long as wells are covered, protected and kept clean. As comwith ancient days Europeans scarcely ever suffer from Greati.y appreciated is the privilege of having seen the silver- pared and the city wells are said to be periodically purified. boils, snow of the azure blue perpetual piercing lofty peaks glistening The dismal groaning creak of the Persian wheel never lulls and firmament, and to have watched the lower Himalayas gleaming in gardens grow peaches, plums, oranges, limes, grapes, guavas, ?with gold, else softly changing colour from shades of radiant opal, steel blue, grey, peacock, copper or emerald green, to rose strawberries, mulberries, bananas, pomegranates, figs, mangoes, almonds. Amongst trees, shrubs, plants, thorns or pink in the setting sun, as contrasted' with recollections of the plantains,
By
F. R Hogg,
Surgeon-Major,
A.M.D.
stupendous grandeur of the roaring foaming falls of Niagara. During the past five years duty has taken me to Delhi when Lord Northbrook held a Durbar there of Wales reviewed
troops lastly,
: when H. R. II. the Prince and danced in the ancient halls of the when the heralds with shrill trumpets
Great Moguls, and proclaimed Queen Victoria to be Empress of India. Opportunities have occurred of seeing the pearl white marble rocks at
the golden temples of Benares and Umritsur, the sepulchres of many illustrious personages, for instance of Akbar, the Taj at Agra so suggestive of a fleeting fairy palace of ivory or crystal, the Kootub near Delhi, the well at Cawnthe pore, the Residency at Lucknow, obscured by purple creepers, sacred shrines near Muttra, the pilgrims bathing in thousands at Hurdwar, the reputed home of cholera, the fertilizing perhaps fever-producing canals, the burning ghats at Benares, where the Ganges is believed to wash away all impurities, the botanical gardens at Saharunpore stocked with endless specimens, for instance, Eucalyptus globulus so far a sanitary failure, and the Lawrence Asylum on the hill of Sanawar intended to educate children there sheltered from most dangers of the plains. On business else on expensive excursions Allahabad, Meerut, Roorkee, Umballa, Loodiana, Kurnal, Ferozepore, Jullundur, Mean Meer, Lahore, Kussowlie, Subathoo, Simla, Nagkanda, Dehra Doon, Landour, and the beautiful lake at Nynee Tal have been visited. From green well-wooded Sealkote a tantalizing panorama was enjoyed of the blue hills backed by the distant snows of Cashmere, and the palaces at Jummoo nestled amidst river forest and mountain scenery, well repaid a dusty pilgrim-
Jubbulpore, palaces
or
age : yet horrible were the smells and wretched the appearance of famine-stricken peasants on the road. Travel enforces observation leading to research, if not to
better practical acquaintance with hygiene in connection with lessons learnt at camps of exercise, on marches, and in cantonment hospitals. Difficult is it, however, without libraries or medical societies, to ascertain what
Rooks, journals, periodicals,
too
professionally goes on heavy,
too
abroad.
costly to
carry on mules, elephants, camels, else by rail or bullock cart. Under such circumstances, it is unsatisfactory to discuss the subject of heat *nd moisture as affecting the human body for instance at Mooltan.
There
last cold
season
the
are
interesting
wOrk included
cases
of
pneumonia, bronchitis, rheumatism, dysentery, hepatitis, malarial fevers, ophthalmia, syphilis and oriental sores, contracted at Dera
Ismael Khan?formerly called Delhi boils. These painful sores Permanently scar the faces of women and children, and the Mooltan was occupied by the 70th regiextremities of men. ment, a battery of artillery, a regiment of Bengal cavalry, another of Native Infantry, a sprinkling of civilians and a few officials connected with the Indus Valley Railway, shortly open to Kurrachee. The train from Lahore requires a long tedious "ay to accomplish 214 dreary miles over arid desert (occasionally dotted with melancholy tamarisks, else castor oil plants) to reach this station, said to be the hottest in India. The soil 1s a stiff impervious clay, scarcely penetrated beyond a few inches by heavy rain, and to keep down suffocating dust the custom is to make paths of straw near houses. Mooltan natives say only boasts of beggars, church yards, heat and dust.
about
brambles several useful in medicine may be mentioned?datura, cannabis indica, oleander, senna, Arabian and Spanish jasmin,
mudar, karil, peepul, moringa, amultas, bael, babul, box wood, nim, bakam, sissoo. Natives worship many flowers and the date palms, said originally to have been planted by the army of Alexander, surpass all trees in graceful stately beauty, At the confluence of the Chenab with the Jhelum, this army of 135,000 men besides horses and elephants embarked and sailed
feathery
down the Indus to the
sea
in
November,
327 B.C.
The visitor
to-day will notice the monument erected to the memories of. Vans Agnew and Anderson, who, in April 1848, were barbarously "
They fell doing England's work, and sustained England's honor in their death." "When rebellion then broke out the climate was reported malignant, yet the force encamped murdered.
February continued healthy with only 4 per cent, September. In January Dewan Moolraj, who abetted the foul murder, at last surrendered. The morning opened with a severe storm of thunder and rain, but later the flag of old England was flying out in a fresh breeze and bright sunshine. The year 1848 was one of drought followed by a season of heavy rain in 1849. In August the most violent storm ever remembered occasioned the flooding of the Punjab rivers, when the fortress was swept away by the universal deluge. Only elevated 400 feet above sea level, any sudden rise in the Chenab may swamp the station, and the main drainage outfall is the channel introducing such water. Filth products are rapidly disinfected, and In damp about barracks the earth system answers admirably. weather there may be foul smells, especially in the direction of the city (about two miles distant) for a time until the blazing on the hard ground. Mooltan sun evaporates everything continues healthy so long as the atmosphere is not unusually moist. The station being placed on the borders of the northern limit of the south-west monsoon, is liable to much variety as to rainfall in different years, according as the monsoon of the season may or may not extend to this particular latitude. Reckoning Lahore as 18, Delhi 25, Agra 29, Lucknow 43, Benares 38, Calcutta 65, Bombay 70, Madras 48, Simla 83, Nynee Tal 100, Darjeeling 132, the average at Mooltan is about five inches of rain annually, the range extending from 2 to 17, and when the latter amount is reached, ague, dysentery, diarrhoea or scurvy may prevail, or fevers relapse in the cool season as in 1858 and 1863. In 1877 nearly 15 inches of rain were measured, about 9th September, when mud houses collapsed, and at Chrisraas coughs and colds became prevalent. Very extraordinary is it that so far cholera never spreads, and from 1856 to 1872 European troops scarcely suffered at all during five visitafrom
July
to
of sick in feverish
tions. Even in terrible 1867 and 1872 very few cases occurred in the district where the rainfall did not exceed six inches. No history of cholera importation or infection was traoeable in 1872, when locusts were spread by a south-east wind. Time
alone will shew whether or not, as trees spring up, rain will increase ; and whether, with drainage difficulties and more rail communication, this immunity will continue. The mean humidity but Dr. De Renzy at Mooltan has registered of Greenwich is
81,
only
19
to account for steel instruments Constitutional vigour and energy
degrees
from rust.
remaining free characterise tha
THE INDIAN MEDICAL GAZETTE.
142 inhabitants of hot and dry localities.
Burney Teo quotes Her-
[June
1. 1878.
minor conditions, all go to prove tliat almost a total abstainer, a vegetarian, should be the rule at Mooltan for the majority of persons in certain months. There is a furnace look about the place not diminished by the glare of the white double-
bert
almost
The 70th The natives about Mooltan are a fine class of men. regiment saturated with Peshawar fever were improving, also the sallow-washed-out women and children, and in spite of
praised by those who adapt themselves to the climate as regards eating, drinking, bathing, clothing, exercise, occupation, and judicious cooling appliances. As usual Bryden's tables are
Spencer that the earliest recorded civilization grew in Egypt, Babylon, Assyria, and Phoenicia, whilst from the rainless district extending across North Africa. Arabia, Persia, and on through Thibet into Mongolia camc all the conquerors of the old world.
intense heat all like the station in which a considerable amount of exhausting brain work is conducted at all seasons of the Indus Yalley Railway constructors. Some are pouryear by the ino- over abstruse calculations under the punkha, whilst others have to face the sun in the open. Yet apparently the Europeans are more contentedly inclined cheerfully to face climatic worries, and all even including the ladies pull well together as compared with the residents of places in the plains with a greater rainfall. The temperature in 1877, taking the highest in sun's rays, the highest in shade, the lowest in shade, recorded at the native
hospital by Dr. Penny's staff, ran as follows :?January 139-76-33, February 153-80-36, March 156-92-51, April 156-98-56, May 167-109-65, June 169-115-74, July 166-109-69, August 161-10874, September 160.106-70,October 155-99-54,November 146-86-46, December 140-78-39 ; the year comparatively cool. The thermometer may in January register only 17 on the grass, and near the jail quantities of ice are collected and stored. Other stations temporarily cool after the rains, but August or September may be very trying at Mooltan, where the annual mean temperature is 76, the absolute annual range between 90 and 100, the average diurnal range about 30 according to Blanford who from eight years tables gives the mean temperature in January as 54, February 58, March 70, April 79, May 89, June 95, July 91, August 88, September b6, October 76, November 66, December 56. The proportion of cloud is about 17 per cent, as compared wi.h Lueknow 37, and
alter the rains the Punjab skies become cloudless, allowing free radiation and rapid cooling. Piercing through a dry vapourless atmosphere, the vindictive sun blasts the hard white ground, and the superjacent air remains hot until the clear cloudless night, when such heat drains away towards the stars. During the day careful people shutting up their doors at 9 in the morning, and trusting to punkahs and thermantidotes can keep their houses down to 86. Tatties are very uncertain. Many persons careless or impecunious contrive At night some to exist in a temperature over 100 for months. sleep out in the open, else on the house top, or surrounded by wet matting with a punkah over head, and the floor covered with wet sand, out in the garden. Many dine very late, else take a light supper followed by whist or billiards, perhaps a drive, any thing to while away wretched hours until 12 o'clock, when a refreshing breeze blows across the Chenab river and brings the blessing of sleep. As explained by Tyndall the sun's rays falling on water are not arrested, but penetrating to a considerable depth heat the stream gradually, and the process of cooling is different to that on land. To this inequality refreshing breezes are due. Apparently as the heated air at night
almost
is evolved from the ground, the cooler currents from the Chenab again and again replace the hot vapour ascending. At other stations where no such breeze springs up, the all will continue
high,
and
temperature
at
night
Nowsbera the 70th lost several intemperate men under such circumstances. In the hospital wards there in 1867 Dr. Staples registered 99 at sun rise 10 a.m. and 3 P.M., compared with 102 at 10 p.m., whilst in the verandahs the temperature at the same hours recorded 98From June 21st to July 3rd hot winds con105-111-105. tinued. Total abstinence principles and the reduction of diet reduce the liability to heat apoplexy to an incalculable degree. It is popularly explained that, in a surrounding medium of
high bring-
temperature, the dilatation of the vessels of the skin, the ing of heat lost to a maximum, and heat production to a mini. jj*um, the arrest of oxidatiou or
wasting,
and a number of
storeyed barracks of
s
in-dried brick, and yet Mooltan is very
much
for statistics of disease from 1860 to 1869. The of European troops ranged from 774 to 1,117. During
consulted
strength
the 10 years only two cases of cholera, in the months of May and June, neither fatal; five cases of variola, none fatal; 7,413 of intermittent fever with 13 deaths most marked in September
1862, 1864, 1865, 1868, as compared with remittent or continued fevers 925 cases and 23 deaths mostly in July and in 1865. In July also heat apoplexy particularly noticed in 1860-1865, about 78 admissions, 6 deaths. Delirium tremens and dysentery in September. Hepatitis and diarrhoea in August, but few fatal cases recorded. Rheumatism troubles in January. Respiratory dis-
February accounted for 6 deaths out of 751 regards phthisis 57 admissions, 9 deaths, the highest figure in May. On this last heading the admissions were
eases
highest
cases,
and
in
as
strength, and out of each hundred cases treatstatistically the casualties. If the previous histories of men, their habits, occupations, the complications connected with exposure, malaria, drink or syphilis be all taken into consideration, these numbers really are not high. Mooltan, in the opinion of others as well as in mine, is likely to benefit consumptive invalids if well-selected cases with money and 6 per thousand of ed 15 represented
leisure at command could make up their minds for a voyage from England to Kurrachee, which is 200 miles nearer Suez than Bombay. From Kurrachee the Indus Valley Railway will convey the invalid to Mooltan, a pleasant sociable station, where
English faces, manners, customs, sympathy and hospitality will soften the bitterness of exile. For money good servants and suitable fairly-cooked food can be procured, and there would be no difficulty about obtaining the best European wines. Although
the native
but
indifferent, it is very easy to small library, and from Calcultta the newest books can be purchased. There are various religious communities ever ready warmly to "welcome brethren, whilst the ministers of 'he gospel will also do their best to cheer and comfort the minds of those desponding. To repair the poor fragile body, the local practitioners knowing all about the climate can utilize sound experience towards Arresting chest The friends who accompany the patient need never mischief. be dull; what with riding, walking, driving, dancing, theatrical dinner parties, badminton, lawu tennis, fishing, or shooting excursions. Nor need they be involved in the whirl of cold weather gaiety if indisposed. When Mooltan bccomes distressing, it would be easy by rail to Umballa, thence by comfortable tonghadak gharry or dooly to reach sub-tropical Subathoo (4,300 feet), recommended for equable climate, sheltered position, shops
get things from Lahore.
are
There is
a
absence of great diurnal range of temperature, besides the advantage of being extremely pleasant during the rains so wretched at higher Himalayan retreats. Comparatively little dysentery, hill diarrhoea or liver derangements lurk about Subathoo, as compared with the cold hills up above or the hot down below. lies angustice
Another class of invalid requires too many sick bread winners in this country to defer until too late the search for health. Apart from appalling expenses, a trip to England would be extremely distasteful to many a broken down man, who, having India unavoidably so long to represent his home, shudders at
steaming plains consideration,
compel
the idea of
parting with the comfortable bungalow, the useful old servants and many happy local associations. Might not a particular station in the plains, some retreat in the hills, or a sea trip relieve dysentery, diarrhoea, asthma, renal or pulmonary mischief? Could not liver abscess be arrested, or cerebral symptoms
GLEANINGS FROM A MOFUSSIL PRACTICE.-BY E. A. BIRCH.
June 1, 1878.]
checked without returning
England and resigning appointeagerly snapped up. The king is dead, long live the king. Sir J. Fayrer advocates short trips in a steamer across the Bay of Bengal, a run down to the Sandheads, or an excur-
ments
to
so
sion to Madras and back for certain
cases
;
whilst for
others
a
"voyage to Burmah or Singapore will be only waste of money. The old system of three years' furlough is praised, and even if years have been spent without sickness in the plains, the year may be the last straw unless a trip home be undertaken. Chronic dysentery, enlarged spleen, doubtful hepatic abscess, ma-
seven next
larial cachexia, anaemia, neuralgia, debility after sun-stroke, cholera, or tropical fevers too often necessitate change to Europe.
According
to the
same
authority Darjeeling, Mussouri. Simla, to be compared with Ootacamund
Murree, are not therapeutically
and Conoor. It may be advisable for an invalid at Mooltan td embark at Kurrachee on a journey combining sea and mountain
advantages by terminating at the Neilgherries Sea air containing ozone, aqueous vapour, bromine, and iodine will be pure, free from organic particles, and have comparatively more equable temperature. As regards the dust ofMooltan, it cannot be denied that, if the bronchial mucous membrane be irritable, an invalid cannot tolerate a dry warm atmosphere. Many cases have no 8uch irritability. Under the treatment by inhalations of carbolic acid, creosote, tincture of benzoin, aided by diet including milk, eggs, bacon, and tripe, a climate-stricken phthisical invalid eventually started for Bombay in a very satisfactory condition. Praising antiseptic inhalations Dr. Clifford Albutt would place consumptive cases in a permanently aseptic atmosphere at an elevation of 5,000 feet; for instance, Davos, an upland valley in the Grisons, where although pneumonic inflammations occur, the morbid secretions do not foul, and phthisis is unknown. The remarkable immunity from phthisis enjoyed by the scholars at Sanawar, Murree and other Himalayan schools, are facts proved beyond dispute. Heat, moisture, and change of air in India are inexhaustible subjects for study and investigation, and it is a pity that the influences of tropical climates are not recorded as in the days of Sir llanald Martin. This paper is finished at the conclusion of 15 days' marching in April with invalids and other from Sealkote to Dalhousie, about 133 miles. "What with fording streams, crossing the Ilavee in boats under a hot sun, what with thunder, lightning, wind, hail aud rain swamping encampments, the journey proved trying. Yet the sick did not retrograde. At cocl Dalhousie elevated from 5,377 to 7,687 feet the snows still continue on adjacent hills, and breathing pure air, drinking most delicious Water, the ear pleased by rustling pines or murmuring streams, and the eye charmed by exhilarating scenery, the invalids will gradually recover health aud strength amidst green oaks, grand horse chestnuts, and graceful deodars, amidst bule bells, cowslips, ferns and ivy-clad damask rhododendra.
143
