Medical News PLAGUE IN THE CUMBUM VALLEY Fumigating
villages
To eradicate endemic plague in the Cumbum valley, Madras, 19 villages and hamlets around Cumbum town have been fumigated with cyanogas. The enquiry is being conducted by the Research Health Officer, Madras, under the auspices of the Indian Research Fund Association. Fumigation of the villages every quarter consistently for a few years is recommended. Over 200,000 rat holes and 6,000 cracks in walls in 25,000 houses were fumigated. As many as 6,000 Rattus rattus, 300 bandicoots, 9,000 house mice, 100 musk rats and 20 snakes were picked up dead or dying during these operations. Rodents examined in the laboratory numbered about 12,000, 42 proving positive to
plague.
About 100 carcasses from various villages were examined and over 50 were positive. Using bone marrow material for culture and animal inoculation, it has been possible to diagnose infection in some specimens 102 hours after death. _
fs
The problem of killing rats and fleas in thatch roo^ specially studied. The usual type of mud in the Cumbum valley can in no sense be render? gas-tight, but, for killing rats and fleas, it is if the doors and windows are tightly closed, all 611111 (1 openings packed with wet mud and any gap betwee wall and roof stuffed with gunny rolls. When the S is pumped in and it diffuses through the thatch, all ra and fleas therein are immediately killed. was
ho11^ enou?jj
Rat densities reduced Rat flea surveys of selected villages immediate > before and after fumigation of rat holes have that while rat densities were reduced by 40 to 80 P cent, the flea indices showed no marked differen possibly due to concentration of other wild fleas on
sh?^'
surviving rats. r3 Fumigation of rat nests in air-tight c^alBtfat ??* fleas. and of thoroughly destroys eggs imagines nests recovered from fumigated rat holes have be observed to yield adult fleas after sufficient incubati showing thereby that the eggs have not been affecte ,
>
Dec.
MEDICAL NEWS
19391
Cyanogas fumigation
was
adopted
as
a
routine
measure of disinfestation in the control of grain tramc, etc., from plague affected villages. The traffic is largely in bullock carts and to a small extent in motor lorries and all varieties of local produce and personal effects are encountered. Fumigation is done under oiled tarpaulins over prepared ground -on the roadside, with a shed for protection against weather. A hut like the usual type of huts in Cumbum valley has been constructed, introducing certain devices to
eliminate
rat
PEPTIC
ULCER STUDIES IN SOUTHERN INDIA
harbourages.
Peptic ulcer is sixty times more common in south India than in the north and is found more in men than in women in the ratio of 95 to 5. This information has been yielded by researches conducted_ under the auspices of the Indian Research Fund Association. The highest incidence in south India is in the centre
and north of Travancore. The diet of these districts is niarked by deficiency in protein and in vitamins A and B. Test meal examinations carried out on normals in south India, the Deccan and in north India, have shown that the south Indian stomach is commonly affected by chronic gastritis and duodenitis and possibly for this reason the acidity though high is not excessive. A large proportion of those who complain of dyspeptic symptoms have no actual ulcer but a condition of irritable duodenum which may go on to ulcer
formation. The enquiry
has not established any valid reason of ulcer incidence amongst men and ^'ornen in south India is 95 to 5, though certain suggestions have been made. It has been noted in a small series of barium meal examinations on normal Travancorean women that the stomach lacked tone and motility when compared to the male stomach. Lack of protein and of vitamins A and B in the south Indian diet appears to be the direct cause of the nigh incidence of peptic ulcer and the addition of milk and milk products, cereal grains and green vegetables t? the diet would protect the stomach from the nerve regeneration and inflammatory change which precede
why the ratio
Ulcer.
PASTEUR INSTITUTE OF INDIA, KASAULI Eor nearly forty 3'ears the name Kasauli has been with dog-bite and rabies. The Pasteur Insti^ssociatedIndia has had a reputation second to none on ?f tj!ne scientific side of rabies work, and judged by the "mber of persons treated with Kasauli anti-rabic accme, it can claim to have been the largest institu-
of its kind in the world. As this institute closed as far as anti-rabic work is concerned on September, 1939, a short account of its history is some general interest. ?I asteur, in his fifty-ninth year and with a lifetime pioneer scientific work to his credit, took up the Jeet of hydrophobia in Paris 1880. After in Xnaustive laboratory investigations he employed his ethod of anti-rabic treatment on his first human case dog-bite in 1885. In the following year he was able 0 report the treatment of 2,490 bite cases with only f!eaths from hydrophobia. "his work attracted attention all over the world. p reviously, scientific knowledge of rabies had been i?n-existent. The particularly unpleasant human lsease with its hundred-per-cent mortality could be f viCed only with the feeling of complete helplessness. v ?wj it appeared that a considerable proportion of Urnan deaths from hydrophobia could be prevented. April, lfiA public meeting was held in Lahore on an22nd institute when it was resolved to establish ,? ' the Punjab on the same lines as the Pasteur Instite in Paris. A committee was formed to implement
tion
J doors
gjjth
^
,
759
this resolution and the Government of India promised to give the services of a medical officer. Actually the services of Major David Semple, r.a.m.c., were not made available until 1900. A bungalow in Kasauli known as Manor House was found suitable for the purpose and the Pasteur Institute of India was formally opened there for the treatment of dog-bite and similar cases on 9th August, 1900. It was the earliest Pasteur Institute in the British Empire. The original functions of the institute included the study, diagnosis and teaching of bacteriology and the investigation of tropical diseases. These functions were transferred with the opening of the Central Research Institute, Kasauli, in 1905 and the establishment of a bacteriological institute in Lahore in 1914, the routine bacteriological and pathological work for the Punjab being finally taken over by the Medical College, Lahore, in 1918. In the first year 321 persons received anti-rabic treatment in Kasauli and the numbers increased year by year, being over 1,000 in 1905, over 5,000 in 1915 and over S,000 in 1925. Meantime there had been a demand for anti-rabic treatment to be made available in other parts of India to avoid the long and expensive journey to Kasauli. Thus, Pasteur Institutes were opened at Coonoor in 1907, Rangoon in 1915, Shillong in 1917 and Patna in 1929 and anti-rabic work was started at the Haffkine Institute, Bombay, in 1922 and at the School of Tropical Medicine and Hygiene, Calcutta, in 1924. Originally the dried cord method of Pasteur was in Then the dilution method of use from 1900 to 1907. Hoyges of Budapest, using a live vaccine} was employed for some years, and in 1912 the carbolized vaccine of Semple was introduced. As a result of laudatory reports from Europe regarding certain vaccines of other types it became necessary about 1925 to carry out very large scale investigations of different vaccines on comparative lines. By 1933 the investigations were complete and the method of treatment selected as a result of these studies was Semple's carbolized vaccine but of a greater strength and dosage than Semple had employed, and using the original Pasteur Paris virus in preference to certain Indian viruses which had been tried. Another important development was the decentralization of treatment. Formerly, all cases requiring anti-rabic treatment had to attend a Pasteur Institute. It was found, however, that Semple's vaccine when properly bulbed could be transported to, and stored in, Accordingly the distant places without detriment. Railway Centre, Allahabad, was opened in 1924 as the first out-centre for anti-rabic treatment and centres in Lahore and Rawalpindi were opened a year later. The checked for some process of decentralization was then years in view of the critical experimental work referred to above. By 1932 about 300 persons were attending the institute daily for treatment, of whom over 200 could be accommodated in the various quarters for different social groups, which had been acquired or constructed near the institute from time to time. After 1932 the decentralization proceeded rapidly and was complete by 1938 when nearly 200 centres were being supplied with Kasauli vaccine. With this decentralization the number of persons treated with Kasauli vaccine rose enormously and reached over 22,000 fully treated in 1938. The total treated from 1900 to 1938 was
276,912.
A suggestion was put forward in 1937 that the routine work of manufacturing and issuing anti-rabic vaccine could now be carried out by the Central Research Institute, Kasauli, along with the large-scale manufacture of other biological products. Suitable arrangements having been made between the Government of India on the one hand and the Pasteur Association of India on the other, this transfer of work has now been affected. The scientific work on rabies carried out in Kasauli was of very great importance and will be particularly associated with the names of Semple, Lamb, Harvey, McKendrick, Acton, Cunningham and Shortt although _
760
THE INDIAN MEDICAL GAZETTE
other workers have played their parts. In many connection with the important International Conference
[Dec.,
Rabies hold in Paris in 1927 it was stated experience dominated the Conference on
1939 '
Indian
villages
To eradicate endemic plague in the Cumbum valley, Madras, 19 villages and hamlets around Cumbum town have been fumigated with cyanogas. The enquiry is being conducted by the Research Health Officer, Madras, under the auspices of the Indian Research Fund Association. Fumigation of the villages every quarter consistently for a few years is recommended. Over 200,000 rat holes and 6,000 cracks in walls in 25,000 houses were fumigated. As many as 6,000 Rattus rattus, 300 bandicoots, 9,000 house mice, 100 musk rats and 20 snakes were picked up dead or dying during these operations. Rodents examined in the laboratory numbered about 12,000, 42 proving positive to
plague.
About 100 carcasses from various villages were examined and over 50 were positive. Using bone marrow material for culture and animal inoculation, it has been possible to diagnose infection in some specimens 102 hours after death. _
fs
The problem of killing rats and fleas in thatch roo^ specially studied. The usual type of mud in the Cumbum valley can in no sense be render? gas-tight, but, for killing rats and fleas, it is if the doors and windows are tightly closed, all 611111 (1 openings packed with wet mud and any gap betwee wall and roof stuffed with gunny rolls. When the S is pumped in and it diffuses through the thatch, all ra and fleas therein are immediately killed. was
ho11^ enou?jj
Rat densities reduced Rat flea surveys of selected villages immediate > before and after fumigation of rat holes have that while rat densities were reduced by 40 to 80 P cent, the flea indices showed no marked differen possibly due to concentration of other wild fleas on
sh?^'
surviving rats. r3 Fumigation of rat nests in air-tight c^alBtfat ??* fleas. and of thoroughly destroys eggs imagines nests recovered from fumigated rat holes have be observed to yield adult fleas after sufficient incubati showing thereby that the eggs have not been affecte ,
>
Dec.
MEDICAL NEWS
19391
Cyanogas fumigation
was
adopted
as
a
routine
measure of disinfestation in the control of grain tramc, etc., from plague affected villages. The traffic is largely in bullock carts and to a small extent in motor lorries and all varieties of local produce and personal effects are encountered. Fumigation is done under oiled tarpaulins over prepared ground -on the roadside, with a shed for protection against weather. A hut like the usual type of huts in Cumbum valley has been constructed, introducing certain devices to
eliminate
rat
PEPTIC
ULCER STUDIES IN SOUTHERN INDIA
harbourages.
Peptic ulcer is sixty times more common in south India than in the north and is found more in men than in women in the ratio of 95 to 5. This information has been yielded by researches conducted_ under the auspices of the Indian Research Fund Association. The highest incidence in south India is in the centre
and north of Travancore. The diet of these districts is niarked by deficiency in protein and in vitamins A and B. Test meal examinations carried out on normals in south India, the Deccan and in north India, have shown that the south Indian stomach is commonly affected by chronic gastritis and duodenitis and possibly for this reason the acidity though high is not excessive. A large proportion of those who complain of dyspeptic symptoms have no actual ulcer but a condition of irritable duodenum which may go on to ulcer
formation. The enquiry
has not established any valid reason of ulcer incidence amongst men and ^'ornen in south India is 95 to 5, though certain suggestions have been made. It has been noted in a small series of barium meal examinations on normal Travancorean women that the stomach lacked tone and motility when compared to the male stomach. Lack of protein and of vitamins A and B in the south Indian diet appears to be the direct cause of the nigh incidence of peptic ulcer and the addition of milk and milk products, cereal grains and green vegetables t? the diet would protect the stomach from the nerve regeneration and inflammatory change which precede
why the ratio
Ulcer.
PASTEUR INSTITUTE OF INDIA, KASAULI Eor nearly forty 3'ears the name Kasauli has been with dog-bite and rabies. The Pasteur Insti^ssociatedIndia has had a reputation second to none on ?f tj!ne scientific side of rabies work, and judged by the "mber of persons treated with Kasauli anti-rabic accme, it can claim to have been the largest institu-
of its kind in the world. As this institute closed as far as anti-rabic work is concerned on September, 1939, a short account of its history is some general interest. ?I asteur, in his fifty-ninth year and with a lifetime pioneer scientific work to his credit, took up the Jeet of hydrophobia in Paris 1880. After in Xnaustive laboratory investigations he employed his ethod of anti-rabic treatment on his first human case dog-bite in 1885. In the following year he was able 0 report the treatment of 2,490 bite cases with only f!eaths from hydrophobia. "his work attracted attention all over the world. p reviously, scientific knowledge of rabies had been i?n-existent. The particularly unpleasant human lsease with its hundred-per-cent mortality could be f viCed only with the feeling of complete helplessness. v ?wj it appeared that a considerable proportion of Urnan deaths from hydrophobia could be prevented. April, lfiA public meeting was held in Lahore on an22nd institute when it was resolved to establish ,? ' the Punjab on the same lines as the Pasteur Instite in Paris. A committee was formed to implement
tion
J doors
gjjth
^
,
759
this resolution and the Government of India promised to give the services of a medical officer. Actually the services of Major David Semple, r.a.m.c., were not made available until 1900. A bungalow in Kasauli known as Manor House was found suitable for the purpose and the Pasteur Institute of India was formally opened there for the treatment of dog-bite and similar cases on 9th August, 1900. It was the earliest Pasteur Institute in the British Empire. The original functions of the institute included the study, diagnosis and teaching of bacteriology and the investigation of tropical diseases. These functions were transferred with the opening of the Central Research Institute, Kasauli, in 1905 and the establishment of a bacteriological institute in Lahore in 1914, the routine bacteriological and pathological work for the Punjab being finally taken over by the Medical College, Lahore, in 1918. In the first year 321 persons received anti-rabic treatment in Kasauli and the numbers increased year by year, being over 1,000 in 1905, over 5,000 in 1915 and over S,000 in 1925. Meantime there had been a demand for anti-rabic treatment to be made available in other parts of India to avoid the long and expensive journey to Kasauli. Thus, Pasteur Institutes were opened at Coonoor in 1907, Rangoon in 1915, Shillong in 1917 and Patna in 1929 and anti-rabic work was started at the Haffkine Institute, Bombay, in 1922 and at the School of Tropical Medicine and Hygiene, Calcutta, in 1924. Originally the dried cord method of Pasteur was in Then the dilution method of use from 1900 to 1907. Hoyges of Budapest, using a live vaccine} was employed for some years, and in 1912 the carbolized vaccine of Semple was introduced. As a result of laudatory reports from Europe regarding certain vaccines of other types it became necessary about 1925 to carry out very large scale investigations of different vaccines on comparative lines. By 1933 the investigations were complete and the method of treatment selected as a result of these studies was Semple's carbolized vaccine but of a greater strength and dosage than Semple had employed, and using the original Pasteur Paris virus in preference to certain Indian viruses which had been tried. Another important development was the decentralization of treatment. Formerly, all cases requiring anti-rabic treatment had to attend a Pasteur Institute. It was found, however, that Semple's vaccine when properly bulbed could be transported to, and stored in, Accordingly the distant places without detriment. Railway Centre, Allahabad, was opened in 1924 as the first out-centre for anti-rabic treatment and centres in Lahore and Rawalpindi were opened a year later. The checked for some process of decentralization was then years in view of the critical experimental work referred to above. By 1932 about 300 persons were attending the institute daily for treatment, of whom over 200 could be accommodated in the various quarters for different social groups, which had been acquired or constructed near the institute from time to time. After 1932 the decentralization proceeded rapidly and was complete by 1938 when nearly 200 centres were being supplied with Kasauli vaccine. With this decentralization the number of persons treated with Kasauli vaccine rose enormously and reached over 22,000 fully treated in 1938. The total treated from 1900 to 1938 was
276,912.
A suggestion was put forward in 1937 that the routine work of manufacturing and issuing anti-rabic vaccine could now be carried out by the Central Research Institute, Kasauli, along with the large-scale manufacture of other biological products. Suitable arrangements having been made between the Government of India on the one hand and the Pasteur Association of India on the other, this transfer of work has now been affected. The scientific work on rabies carried out in Kasauli was of very great importance and will be particularly associated with the names of Semple, Lamb, Harvey, McKendrick, Acton, Cunningham and Shortt although _
760
THE INDIAN MEDICAL GAZETTE
other workers have played their parts. In many connection with the important International Conference
[Dec.,
Rabies hold in Paris in 1927 it was stated experience dominated the Conference on
1939 '
Indian
