Volume 1

A system of medicine / edited by J. Russell Reynolds.

Date:
1866-1879
Catalogue details

Licence: Public Domain Mark

Credit: A system of medicine / edited by J. Russell Reynolds. Source: Wellcome Collection.

    186/976 (page 166)
    the epidemics. The greater mortality in the collapse stage may be seen in the results of the Indian epidemic of 1861, in which we find that ol 927 deaths, 717, or 77'4 per cent, died in the collapse stage. An opinion prevails that Cholera is becoming more fatal to European troops in India than it was formerly. Dr. Ewart’s tables seem to show, that though the disease is less frequent than it used to be, the ratio of deaths to cases has largely increased. Thus, in Bengal, for eighteen years, from 1818 to 1835 inclusive, the per centage of admis- sions to strength was 3-25, and the deaths to admissions 26-36, or 263 deaths per 1,000 attacks; while for the eighteen years from 1836 to 1853-54 inclusive, the admissions to strength were 2'62, and the deaths to admissions 39-75, or 397 deaths in 1,000 attacks ; showing an average increase of mortality to attacks of above 13 per cent, or at the rate of 134 per 1,000 above the rate of the first series of eighteen years. In Madras, from 1829 to 1838, the deaths were 271 per 1,000 cases, and from 1842 to 1851-52, 502 per 1,000 ; or an increase of 231 deaths per 1,000 cases. The increase has taken place through all the presidencies, but in Madras it seems to have been the greatest. It is to be hoped that this increase is not permanent, and that the averages may again descend. In another of Dr. Ewart’s tables, the time is divided into quinquennial periods, and it appears that although, in the main, there has been a rise in the mortality within the last and in the later quinquennial periods, there were considerable fluctuations in the earlier terms, descending as much as 10 or 12 per-cent, in Bengal and Bombay, and then ascending. In Madras the fluctua- tions have not been felt, but the increase has been maintained during four quinquennial periods. It is possible that a great deal of the apparent difference has arisen from a different method of recording cases. Of late years those cases only in which the presence of the disease was decided, have been entered under the head of Cholera, and cases which would formerly have been classed under this, are now placed in the columns for diarrhoea. On turning to Dr. Ewart’s Table 29, it will be found that there is an increase of cases of diarrhoea in all the presidencies. The returns are not exactly for the same years as those for Cholera, but include them. Thus, in Bengal the returns from 1812 to 1832 give 11-55 ; and 1833 to 1853-54, 1215 per cent, admissions, to strength ; in Bombay, 1803-4 to 1827-28, 6'85 per cent.; and 1828-29 to 1852-53,12 97 per cent.; and in Madras, from 1829 to 1838, 7'8 per cent.; and 1842 to 1851, 10-3 per cent. It will be seen that in Bombay and Madras, in which the rise in mortality of Cholera is apparently the highest, the increase of per centage of admissious of diarrhoea is also the largest of the three presidencies. It is probable,