ENTERIC FEVER IN BURMA. The report
-which
on
-we
so liberally drawn for the inpreceding article contains very subject of enteric fever. Statistical
have
formation
contained in the
important
data
the
on
and other researches of late years have made it certain that enteric fever is a most prominent cause of mortality among
European soldiers
in
five years, 1871?75,
deaths,
466 or
9'05
India.
we
find
Taking the statistics of the that, of an aggregate of 5,147
per cent were due to this cause?the ad-
missions per
1,000 of strength being 3-58 and deaths 1'59. In British Burma, in a garrison of 2,020 men, 27 cases and 8 deathg were returned under the head of typhoid fever, or at the rate of 2'67 admissions and '79 deaths.
While the existence of the
disease to such a considerable extent among British troops has been rendered quite certain, evidence regarding the prevalence of the
malady among natives of the country has been meagre. statistics of the native army of Bengal which, as the work of competent medical officers, may be considered quite The
reliable
as
as
those of the British army, give the following
result for the same five years:
Strength, 53,425
;
?
admissions,
68 ;
death?,
The annual ratio of admissions and deaths
28.
were
thus
:
0"25 and
respectively?considerably below the figures rendered by the returns of British troops. A large amount of detailed evidence has been recorded in these pages regarding the existence of the ?15
natives, which would go to indicate that, while undoubtedly exists in this country among its indigenous inhabitants, it is by no means common. The statistics of jails in Bengal during the period 1871?75 give the following figures:? Strength, 20,708; admissions, 34; deaths, 18; which give an annual ratio per 1,000 of -32 and 0*17. Dispensary statistics are not sufficiently reliable for the purpose of showing how far the disease prevails among the general native population, but the statistics of the large hospitals of Calcutta, which are under the charge of specially selected medical officers, give the following information for the years 1871?75 :? Total admissions, 90,316 ; admissions for enteric fever, 360 ; deaths, 257. The circumstances of Calcutta, however, where an elaborate system of underground drainage exists, are unique in India, and cannot be accepted as representative of the country at large. In Burma it would appear, from the figures above cited, that the disease is not so prevalent as elsewhere. This renders the information recorded by Dr. Crombie all the more valuable. He gives detailed histories and charts of three cases disease among the disease
of undoubted enteric fever which came under his observation in the Rangoon jail hospital. The lesions peculiar to the disease were, moreover, discovered in each case by post-mortem examination. Details are given of another case observed in the town by Dr. Dr. Crombie claims to be the first to establish the fact that enteric fever exists among the natives of Burma, and the value and substantiality of the postulate must be conceded. The
Gregory.
peculiar
cutaneous
eruption
was
not observed in any of the
; but they presented all the other essential signs and lesions of the disease. Dr. Crombie hints that " mild or abortive" instances of the malady exist which escape diagnosis and are
cases
!
registered
under other names, and that many fatal cases
tered
malarious and continued fevers
as
enteric feyer.
This may
or
may
regisreally case3 of not be true, but the suggestion are
Febeuaey 3,
FEVEE AND DRAINAGE.
1878.]
must be substantiated
by
admitted. Dr.
in his Treatise
that all tbe
Lyons,
severe
detailed
proof on
before its truth
can
be
Relapsing Fever, argued
types of continued fever possess milder forms
recognised and registered as aguej febricula," &c., but he has failed in commending his views to general belief. Such opinions should not be lost sight of in future research, but the duty of investigating and recording undoubted instances of genuine cases of enteric fever in its unmistakeable form is a primary one, and Dr. severe and Crombie has earned a title to our gratitude in establishing the "
of manifestation, which are
existence of these in Burma among natives. his data
Dr.
Kelly, the Sanitary "Many of the exciting causes of enteric fever exist in the towns and villages of this province, such as filthy and stagnant drains and cess-pits in close proximity to sources of water-supply, and it is only reasonable to Accepting
Commissioner of the
as indisputable, province, observes:
suppose that deaths do occur from it, which are attributed to fever, especially when the marked nature of some of
remittent
important symptoms is considered, and that it has been a jai^, the sanitary condition of which is far superior to anything to be hoped for amongst the general population of towns and villages." The inquiry regarding the existence, its most
found to exist in
extent
and
causation of enteric fever among the native popuinfancy, and we would commend
lation of India is still in its
Dr. Crombie's careful and instructive researches for imitation.
49
-which
on
-we
so liberally drawn for the inpreceding article contains very subject of enteric fever. Statistical
have
formation
contained in the
important
data
the
on
and other researches of late years have made it certain that enteric fever is a most prominent cause of mortality among
European soldiers
in
five years, 1871?75,
deaths,
466 or
9'05
India.
we
find
Taking the statistics of the that, of an aggregate of 5,147
per cent were due to this cause?the ad-
missions per
1,000 of strength being 3-58 and deaths 1'59. In British Burma, in a garrison of 2,020 men, 27 cases and 8 deathg were returned under the head of typhoid fever, or at the rate of 2'67 admissions and '79 deaths.
While the existence of the
disease to such a considerable extent among British troops has been rendered quite certain, evidence regarding the prevalence of the
malady among natives of the country has been meagre. statistics of the native army of Bengal which, as the work of competent medical officers, may be considered quite The
reliable
as
as
those of the British army, give the following
result for the same five years:
Strength, 53,425
;
?
admissions,
68 ;
death?,
The annual ratio of admissions and deaths
28.
were
thus
:
0"25 and
respectively?considerably below the figures rendered by the returns of British troops. A large amount of detailed evidence has been recorded in these pages regarding the existence of the ?15
natives, which would go to indicate that, while undoubtedly exists in this country among its indigenous inhabitants, it is by no means common. The statistics of jails in Bengal during the period 1871?75 give the following figures:? Strength, 20,708; admissions, 34; deaths, 18; which give an annual ratio per 1,000 of -32 and 0*17. Dispensary statistics are not sufficiently reliable for the purpose of showing how far the disease prevails among the general native population, but the statistics of the large hospitals of Calcutta, which are under the charge of specially selected medical officers, give the following information for the years 1871?75 :? Total admissions, 90,316 ; admissions for enteric fever, 360 ; deaths, 257. The circumstances of Calcutta, however, where an elaborate system of underground drainage exists, are unique in India, and cannot be accepted as representative of the country at large. In Burma it would appear, from the figures above cited, that the disease is not so prevalent as elsewhere. This renders the information recorded by Dr. Crombie all the more valuable. He gives detailed histories and charts of three cases disease among the disease
of undoubted enteric fever which came under his observation in the Rangoon jail hospital. The lesions peculiar to the disease were, moreover, discovered in each case by post-mortem examination. Details are given of another case observed in the town by Dr. Dr. Crombie claims to be the first to establish the fact that enteric fever exists among the natives of Burma, and the value and substantiality of the postulate must be conceded. The
Gregory.
peculiar
cutaneous
eruption
was
not observed in any of the
; but they presented all the other essential signs and lesions of the disease. Dr. Crombie hints that " mild or abortive" instances of the malady exist which escape diagnosis and are
cases
!
registered
under other names, and that many fatal cases
tered
malarious and continued fevers
as
enteric feyer.
This may
or
may
regisreally case3 of not be true, but the suggestion are
Febeuaey 3,
FEVEE AND DRAINAGE.
1878.]
must be substantiated
by
admitted. Dr.
in his Treatise
that all tbe
Lyons,
severe
detailed
proof on
before its truth
can
be
Relapsing Fever, argued
types of continued fever possess milder forms
recognised and registered as aguej febricula," &c., but he has failed in commending his views to general belief. Such opinions should not be lost sight of in future research, but the duty of investigating and recording undoubted instances of genuine cases of enteric fever in its unmistakeable form is a primary one, and Dr. severe and Crombie has earned a title to our gratitude in establishing the "
of manifestation, which are
existence of these in Burma among natives. his data
Dr.
Kelly, the Sanitary "Many of the exciting causes of enteric fever exist in the towns and villages of this province, such as filthy and stagnant drains and cess-pits in close proximity to sources of water-supply, and it is only reasonable to Accepting
Commissioner of the
as indisputable, province, observes:
suppose that deaths do occur from it, which are attributed to fever, especially when the marked nature of some of
remittent
important symptoms is considered, and that it has been a jai^, the sanitary condition of which is far superior to anything to be hoped for amongst the general population of towns and villages." The inquiry regarding the existence, its most
found to exist in
extent
and
causation of enteric fever among the native popuinfancy, and we would commend
lation of India is still in its
Dr. Crombie's careful and instructive researches for imitation.
49
