Report on typhoid or enteric fever in relation to British troops in the Madras command / by C. A. Gordon.

  • Gordon, C. A.
Date:
1878
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Licence: Public Domain Mark

Credit: Report on typhoid or enteric fever in relation to British troops in the Madras command / by C. A. Gordon. Source: Wellcome Collection.

Provider: This material has been provided by London School of Hygiene & Tropical Medicine Library & Archives Service. The original may be consulted at London School of Hygiene & Tropical Medicine Library & Archives Service.

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    Lucknow. Gibraltar. China. it is found superseding the common miasmatic diseases in localities that are under a high state of cultivation ; it cannot there be traced to any specific poison, but only to the influence of high temperature. In 1861 epidemic Malta' typhoid fever at Malta was considered due to bad sewage, overcrowding, defective sanitary arrangements superadded to miasmatic influences. The circumstance of many cases, said to be of typhoid fever, being returned under other heads in army returns in India is explained as due to the intimate alliances that exist between the paroxysmal, the so-called simple continued, and the enteric fevers. In 1864 it was stated, of 24 cases of intermittent fever occurring in the 36th Foot at Lucknow, that at least 10 of them might with equal propriety have been called typhoid. In 1862 Dr. Laycock held to many varieties of fever depending on the evolution of malarial, or fecal, or mixed miasms, any of which could produce continued fevers of a corresponding type. According to Surgeon-General Crawford, A.M.D., the irregular Crimean remittent ■was in some regiments after May 1855, “ a typhoid fever of indefinite duration.” In 1858, during the months of March, April and May, our troops engaged in the siege and occupation of Lucknow were encamped in a low polluted locality close to the river Goomtee ; on that occasion they suffered much from diarrhoea, dysentery, small- pox, and typhoid remittent fever. In the 71st Highland Light Infantry at Gibraltar in 1868, remittent fever, common continued, and the enteric types were not always easy to distinguish. Surgeon Mullachy, E.N., describing cases of enteric fever on the China Station in 1874, alludes to the resemblance often seen between enteric and the low forms of malarial fever on that coast, and is disposed to think that the distinction between these two diseases is somewhat artificial. Dr. Murchison points out that there is an analogy on many points between enteric fever and diseases acknowledged to be malarious. He places the ague-lilce form among varieties of that disease—a form chiefly seen in persons who have been exposed to the malaria of ague, and in whom the two diseases may be supposed to co-exist. The “ Burdwan fever ” is looked upon as having been a malarious typhoid ; so was that in 2-13th Light Infantry at the Mauritius in 1866-77. For these and several other particulars I am indebted to a summary of “ Some undetermined Points in Typhoid Fever ” by Surgeon-Major D. Cullen, A.M.D. Dr. Morehead observes that intermittents may pass into remittents and vice versa ; also that some occupy an intermediate position. He observes that the modifications alluded to occur from the intensity of malaria acting on an ordinary constitution, or a less degree of malaria acting on one asthenic. The Sanitary Commissioner with the Government of India at pages 88, 89, and 224 of his report for 1869 gives a number of particulars illustrative of the well-known fact in India, that epidemics as well as endemics of malarial fever suddenly occur from time to time at particular places. Dr. Baikie described the yellow fever at the mouths of the Niger as typhoid remittent. He adds that there is a seeming connection between remittent fever and dysentery, not very easily to be explained, but still very evident. Dr. C. J. B. Williams asks, what do we find in hot climates ? He replies, Intermittent fevers assume a malignant form ; they become typhoid nearly in their commencement, that is accom- panied by an enormous amount of congestion in the internal organs, and by a palpable change in the condition of the blood in them. From these observations then, the conclusion is evident, that a disease presenting the morbid appearances said to be characteristic of enteric fever may be produced by local endemic influ- ences included under the general term “ malaria.” Niger. Malarial fevers, dysentery, and typhoid fevers. By Twining 19. Allusions to the occurrence of so-called Enteric Fever in India.—Dr. Twining long ago described a fever in Bengal which proved fatal by the occurrence of typhoid symptoms, and in which the small intestines were found ulcerated. He wrote thus—“ In the course of almost every protracted fever which terminates fatally in this country there is a period marked by tremor or subsultus tendinum, rapid and feeble pulse, low delirium, brown sordes on the tongue and teeth usually considered typhoid.” He adds, that this condition most frequently occurs when the early stage of fever has been neglected or imjoro-