May 1898.]
DISEASES AMONG GOORKHAS: DUNCAN.
?ritjimil
(Jloinimmicafioiis.
notes on some
prevalent
of the
DISEASES AMONGST GOORKHAS. By Surg.-Maj. Andrew Duncan, m.d., b.s. (Lond.), f.u.c s.
(Eng.),
2nd Batt2nd Goorkha
Goorkha
and
On August 28th, 1897, the battalion left Dehra Dun on field service. For the remainder of the year, in the portion of the regiment on field service, there was but one case of conjunctivitis in it, affecting a married man. In the depot there occurred five cases, four of which were in the married men.
enquiry I found there was a general conof opinion that Goorkhas were peculiarly to prone phthisis. I therefore wrote to SurgeonCaptain Armstrong, the Residency Surgeon at On
sensus
Rifles.
-UURING iny service as medical officer with the 2-2 Goorkha Rides, my attention has been fixed 011 the fact that the men of the regiment sufieiec the men of t ie to inordinately, as compared previous regiments of other nationalities I hat liad experience of, from certain diseases, lliese were ophthalmia, phthisis, measles and mumps. after Shortly joining my regiment, I was struck with the comparatively large number ol cases of ophthalmia and phthisis met with. And during the three years that I have been in charge of the regiment, the admissions for these two diseases have progressively increased as shown by the following tables:?
Admission for Phthisis
i61
Conjunctivitis Rifle Regiment,
who has informed me that the Goorkha in his opinion, is by 110 means prone to phthisis, in fact, rather the reverse, whilst ophthalmia also is not more prevalent in Nepaul than in the plains. From information obtained from the different medical officers of the other Goorkha Regiments for 189G, the various admissions for these two diseases were the following :
Nepaul,
race,
?
Admissions for Ophthalmia and Phthisis amongst Goorkha
Regiments for
Phthisis.
I
Phthisis.
Ophthalmia,
in the 2 2 Battalion.
Married.
Year.
1896.
Married. Single,
Single
Conjunctivitis. 1-1
1895
Nil
10
41
1896 189/ up to 2S
Aug.
|
Having occasion
2-1
I
12
62
who
was
to visit the wife of one of the
suffering
inspection respectively. This inspection resulted in the following facts : I found the bachelor huts to be large and airy. The entrance to them had no doors; there were large windows opposite
bachelor lines
the another fully two feet square, whilst men cooked their food not in their huts, but in separate buildings away from them. The huts o the married men, on the contrary, were of far ess legular shape, were closed by doors, and the windows were not opposite one another, were much smaller, and were generally closed by articles of clothing, blanket, &c. The cooking also was carried on inside these huts. I next determined the incidence of these two diseases on the married and single men respectively. During the past three years it has been as follows:? one
Incidence
of Phthisis and Ophthalmia among the Married Men and Bachelors of the 2-2 Goorkha Rifles respectively.
Year.
Phthisis.
1895 1 b?6 1897 up to 28th Aug. ...
...
Married. Single, 5 8 9
cases
Not obtained.
tributed.
from phthisis in the married lines, I was at once struck with the bad ventilation of the hut in question, and shortly after made a close of the married and
riflemen,
Eleven
pretty evenly dis-
1 XU 3
|
Year.
j
I
1895 ! 1896 | 1897 pto | 28th Aug. ...
...
I
Ophthalmia.
1-2 2-2 1-3 2-3 1-4 2-4 1-5 2-5 9th 42ud
69 68 13 3 29 23 10 1 1
14 7 8 1 20 12 25 3 5
Not obtained.
1
8 Nil Nil Nil 1 5 1
5 0 1 3 6 14 2 Nil 2
Not obtained
43rd 44th Guides Co. of Goorkhas Total (exclusive of 2nd Goorkha Ilifle Regi-
101
93
18
33
ment.)
It will be seen from the above table that no other Goorkha regiment has been affected with conjunctivitis to a like degree with the 2nd Goorkha Rifle Regiment. The only fact bearing on the question I could gather was obtained from the 1-3 Goorkha Rifle Regiment. Here there were 21 cases of conjunctivitis admitted. Now the hutting arrangements of the 1-3 Goorkha Rifle Regiment consist of (a) four airy double-storied barracks for a certain number of bachelors, (b) the remainder of the latter, and all the married men live in a series of lines closely aggregated under the brow of a hill. The cooking is also carried out here. Now 20 of these 21 cases came from the latter barracks, only one from the double-storied airy lines.
162
INDIAN
MEDICAL GAZETTE.
with regard to the 'phthisis in the it will be seen that for the three years 1895-1897, the incidence of the cases has been?
Next,
regiment,
22 cases in the married 4 cases in the bachelor
far as facts are
as
lines, lines, the second battalion is concerned. Like present in the first battalion, thus? 20 cases in the married lines, 10 cases in the bachelor lines,
the general environment of the men is similar in the two battalions. The history of the Guards in London is peculiarly apposite with regard to the above facts. Formerly, though the men on enlistment were of superior physique to the rest of the army, yet phthisis amongst them was excessive. Their barracks were insanitary and ill-ventilated. Since this has been remedied, the excessive rate of phthisis has disappeared. The fact that immediately the battalion left its station, ophthalmia practically disappeared points to the fons et origo mali. The chief factor lies in the ill-ventilated condition of the married lines, and in this, the fact that the men cook in their huts is chiefly responsible. With doors and windows closed, the whole tenement What wonder then becomes filled with smoke. that ophthalmia is increasingly prevalent. The Officer Commanding the Battalion on my representing the facts tried to alleviate the condition of affairs by ordering a Non-Commissioned Officer to ?0 round the married lines to see that the windows were not artificially closed. This has had, however, no effect on the disease. With the return of the regiment from field service, it is to be feared these diseases will again become rife. With regard to mumps and measles, Goorkhas are certainly prone to these diseases, but they occur almost exclusively in my experirecruits recently joined from ence amongst
Nepaul. Finally, a few words may be said with regard to fevers occurring in Goorkhas. Shortly after
over charge, I was at once struck with the inveterate character of the fever in many The cases may be divided under two cases. heads: In the first class, we meet with cases of an irregular type occurring daily for a month or six weeks. Repeated examination of the lunws shows not the slightest physical sign. Suddenly there appears at one apex a few subcrepitant rhonchi and the case rapidly goes down hill as Hence in all obstinate one of rapid phthisis. cases of fever, the rule should be to examine the lungs periodically even where the first examinations have shewn nothing abnormal. In the second class occur those cases of malarial fever which in Goorkhas have, as far as my experience has shewn, proved to be peculiarly resistant to the usual anti-malarial remedies. In of the races of India have I experinone enced such difficulty in overcoming the fever. A number of drugs have been tried, and, as the
taking
[May
1898.
result of my investigations two methods of treatment are only of' value. Cases in which for three or four weeks the men have been taking 30 grains of quinine by the mouth dail}7, have yielded at once on the administration of 20 grains by the rectum. Lately I have tried kreat with a large amount of success?" Siouneea," a patent drug sold by Messrs. Smith, Stanistreet & Co., of Calcutta, though of use in ordinary malaria, is not of the slightest effect in these cases. The same may be said of the nuch-vaunted Chonthea," a drug largely advertized, but which on analysis is shewn to be only quinine and sulphate of potash. Should the patient not be relieved by kreat or the rectal administration of quinine, sick leave is the only course left. "