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516 INDIAN HEALTH STATISTICS. No. I. E,i,’g7bteentib A2igbqtal Report of the S’anitarr Commissioner ivitlt the Governmeot of India, 1881. lTlitls Appendices and Returns. THE results for the European army in India in 1881, as shown in the Report of the Sanitary Commissioner, just published, are very favourable, the sickness and mortality having been lower than in any of the three preceding years. The average strength of the European troops during the year was 58,728 ; the admissions into hospital were in the ratio of 1604, the deaths from all causes 16’86, the in- validing 38 ’4, and the constantly non-effective from sickness 69"7 per 1000 of the strength. Compared with the average of the decennial period 1870-79, the admissions and mean daily sick were higher, but the deaths were 21 and the invalided 4 per 1000 lower in 1881. The relative health of the troops in each of the three Presidencies and in Southern Afghanistan is shown in the following abstract :- This shows Madras to have been in all respects more healthy than either Bengal or Bombay. The deaths and invaliding in it were very slightly higher than in 1880, but were much below the average. The admissions into hospital in Bengal were above the average of the preceding ten years, but the mortality and invaliding were each four per 1000 under that average. In Bombay the admissions, invaliding, and mean sick were above, but the mortality below, the average. The force employed in Southern Afghanistan was composed of troops partly from Bengal and partly from Bombay. While it furnished a low ratio of admissions the deaths and mean daily sick were high, a result probably of previous field service, the chief causes being enteric fever, dysentery, pneumonia, and pleurisy. The diseases from which the troops in Madras enjoyed an exemption, compared with those in the other two Presidencies, were malarial fevers and diseases of the respiratory system, but the admissions from dysentery and hepatitis were considerably higher in it, though without causing any excess in the mortality. Cholera in Bengal and enteric fever in Madras and Bombay were the chief causes of the higher death-rates. The class of diseases which gave rise to the greatest amount of sickness in all the Presidencies was fevers, the admissions per 1000 of strength having been in Bombay 845, Bengal 770, and Madras 280. The most prevalent form was the inter- mittent. Enteric fever caused 6’3 admissions and 2’62 deaths per 1000 in Bengal, 4’2 and 2’83 in Bombay, and ’9 and ’58 in Madras. In the force employed in Southern Afghanistan the admissions were as high as 19’7, and the deaths 10 ’62 per 1000. In Bengal, though the disease was very widely distributed, the stations at which its prevalence was marked were Lucknow, Rawul Pindi, Bareilly, Meean Meer, Dum-Dum, and Khanikhet. The influence of age on mortality by enteric fever is shown by the deaths among men under twent,y-five having been in the proportion of 4’56 per 1000 of the strength at that age, 1’57 from twenty- five to twenty-nine, and 0’79 from thirty to thirty-four. These results may possibly have been to some extent influ- enced also by the periods of residence of the men in India; for the returns show the deaths to have been distributed in regard to this as foltows :-Two years and under 4’55 per 1000, third to sixth year ’07, seventh to tenth 0’56, tenth and upwards 0’40. April, May, and June are the months in which the disease is most prevalent in Bengal. Dengue, which had entirely ceased in the European army since 1876, I’ re-appeared as an epidemic in Bengal in February, and con- tinued till the end of the year, It seems to have been confined to Lucknow and Cawnpore ; at the former 89, and at the latter 24, cases were admitted. Next to fevers in point of frequency as regards mortality comes cholera, the deaths by which in 1881 were in the pro. portion of 2 ’33 per 1000 of the strength. In Bengal they amounted to 3’23, in Madras to 1’’73, and in Bombay to ’30. In Bengal it prevailed as an epidemic at Lucknow from August to November, at Meean Meer from June to August, and at Fort Lahore in July and August. At Lucknow 21 cases occurred in a force of 2441 men, at Meean Meer 78 in these three months in a force of 1011, and at Fort Lahore 14 in a strength of 116 men. The diseases which, next to fevers, were the cause of the greatest amount of sickness were venereal, by which the admissions into hospital were 276 in Bengal, 258 in Madras, and 261 in Bombay per 1000, or an average of upwards of one-fourth of the strength in the course of the year. The returns show a considerable increase of primary syphilis in Bengal, but a decrease in Madras and Bombay. Apoplexy caused 12 deaths in a force of 1011 men at Meean Meer, but no information is given of the circumstances under which so great a mortality occurred. The ratio of deaths by it throughout the Presidencv was 1’75 per 1000. A table is given in the report to show the unfavourable influence of the climate upon newly arrived corps as corn’ pared with those which have been longer in the country. As regards mortality, it shows a death-rate among the former of 23’64, against 16’86 in the latter. Unfortunately the figures upon which this calculation has been made are not stated, and an analysis of the tables appended to the report does not bear out these results. It show3 the average strength, during 1881, of the corps which arrived in India from September, 1880, to April, 1881, to have been 6489, and the deaths 107, being in the proportion of 16’49 per 1000, or a fraction under the average. It is worthy of note that if this mortality be divided according to arms of the service the proportion in the artillery, 1316 strong, is as high as 27’35 per 1000; while in the line it is only 11’95, although in the latter is included the 61st Regiment, which was on field service in Southern Afghanistan. This marked dif- ference may have been in some degree due to the distribution of the troops, for the artillery were almost entirely quartered in Bengal, while two-thirds of the line were in Madras and Bombay. The death-rate among the recently arrived corps was in Bengal 19’17, in Madras and Bombay 14’36, and in the 61st in Afghanistan 34-48 per 1000. The experience of the army in India affords important evidence of the value of vaccination and revaccination. Although small-pox is widely prevalent in India, only fifteen cases and one death occurred during the year among the troops. The influence of age on mortality from all causes among the troops is shown in the following table of deaths per 1000’ of the strength at the several periods of life :- The number serving under twenty was only 1255, and was, therefore, too small to justify any positive deductions. The influence of length of residence in India upon the deaths- per 1000 from all causes was as follows :- There appears to be a reduction in the third period as com- pared with the two preceding, but it is difficult to estimate how much of this is due to the great amount of invaliding which takes place in the second period. The mortality of the officers in India during the )ear amounted to 18 85 per 1000, or two per 1000 higher than among the men, but this includes deaths among officers on leave. The death-rate among the officers of the British force was 20’10, and of the Indian army 17 ’48 per 1000 of the strength. The mortality among the soldiers’ wives was in the ratio of 25 ’93 per 1000, the chief causes of death being childbirth, and ahortion, and cholera. Among the children it amounted to 60’17 per 1000, convulsions and diarrhoea being the two most fatal diseases. THE salary of Mr. Buncombe, Medical Officer of the Bow Union Infirmary, has been increased from C300 to JE350 per annum.

INDIAN HEALTH STATISTICS. No. I

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516

INDIAN HEALTH STATISTICS.No. I.

E,i,’g7bteentib A2igbqtal Report of the S’anitarr Commissionerivitlt the Governmeot of India, 1881. lTlitls Appendices

and Returns.THE results for the European army in India in 1881, as

shown in the Report of the Sanitary Commissioner, justpublished, are very favourable, the sickness and mortalityhaving been lower than in any of the three preceding years.The average strength of the European troops during theyear was 58,728 ; the admissions into hospital were in theratio of 1604, the deaths from all causes 16’86, the in-

validing 38 ’4, and the constantly non-effective from sickness69"7 per 1000 of the strength. Compared with the averageof the decennial period 1870-79, the admissions and meandaily sick were higher, but the deaths were 21 and theinvalided 4 per 1000 lower in 1881. The relative health ofthe troops in each of the three Presidencies and in SouthernAfghanistan is shown in the following abstract :-

This shows Madras to have been in all respects more healthythan either Bengal or Bombay. The deaths and invalidingin it were very slightly higher than in 1880, but were muchbelow the average. The admissions into hospital in Bengalwere above the average of the preceding ten years, but themortality and invaliding were each four per 1000 under thataverage. In Bombay the admissions, invaliding, and meansick were above, but the mortality below, the average. Theforce employed in Southern Afghanistan was composed oftroops partly from Bengal and partly from Bombay. Whileit furnished a low ratio of admissions the deaths and meandaily sick were high, a result probably of previous fieldservice, the chief causes being enteric fever, dysentery,pneumonia, and pleurisy. The diseases from which thetroops in Madras enjoyed an exemption, compared withthose in the other two Presidencies, were malarial feversand diseases of the respiratory system, but the admissionsfrom dysentery and hepatitis were considerably higher in it,though without causing any excess in the mortality. Cholerain Bengal and enteric fever in Madras and Bombay were thechief causes of the higher death-rates. The class ofdiseases which gave rise to the greatest amount of sicknessin all the Presidencies was fevers, the admissions per1000 of strength having been in Bombay 845, Bengal 770,and Madras 280. The most prevalent form was the inter-mittent. Enteric fever caused 6’3 admissions and 2’62deaths per 1000 in Bengal, 4’2 and 2’83 in Bombay, and ’9and ’58 in Madras. In the force employed in SouthernAfghanistan the admissions were as high as 19’7, and thedeaths 10 ’62 per 1000. In Bengal, though the disease wasvery widely distributed, the stations at which its prevalencewas marked were Lucknow, Rawul Pindi, Bareilly, MeeanMeer, Dum-Dum, and Khanikhet. The influence of age on

mortality by enteric fever is shown by the deaths amongmen under twent,y-five having been in the proportion of4’56 per 1000 of the strength at that age, 1’57 from twenty-five to twenty-nine, and 0’79 from thirty to thirty-four.These results may possibly have been to some extent influ-enced also by the periods of residence of the men in India;for the returns show the deaths to have been distributed inregard to this as foltows :-Two years and under 4’55 per1000, third to sixth year ’07, seventh to tenth 0’56, tenthand upwards 0’40. April, May, and June are the months inwhich the disease is most prevalent in Bengal. Dengue,which had entirely ceased in the European army since 1876, I’re-appeared as an epidemic in Bengal in February, and con-tinued till the end of the year, It seems to have been

confined to Lucknow and Cawnpore ; at the former 89, andat the latter 24, cases were admitted.Next to fevers in point of frequency as regards mortality

comes cholera, the deaths by which in 1881 were in the pro.portion of 2 ’33 per 1000 of the strength. In Bengal theyamounted to 3’23, in Madras to 1’’73, and in Bombay to ’30.In Bengal it prevailed as an epidemic at Lucknow from

August to November, at Meean Meer from June to

August, and at Fort Lahore in July and August. AtLucknow 21 cases occurred in a force of 2441 men, atMeean Meer 78 in these three months in a force of 1011, andat Fort Lahore 14 in a strength of 116 men. The diseaseswhich, next to fevers, were the cause of the greatest amountof sickness were venereal, by which the admissions intohospital were 276 in Bengal, 258 in Madras, and 261 inBombay per 1000, or an average of upwards of one-fourth ofthe strength in the course of the year. The returns show aconsiderable increase of primary syphilis in Bengal, but adecrease in Madras and Bombay. Apoplexy caused 12deaths in a force of 1011 men at Meean Meer, but noinformation is given of the circumstances under which sogreat a mortality occurred. The ratio of deaths by itthroughout the Presidencv was 1’75 per 1000.A table is given in the report to show the unfavourable

influence of the climate upon newly arrived corps as corn’pared with those which have been longer in the country.As regards mortality, it shows a death-rate among the formerof 23’64, against 16’86 in the latter. Unfortunately thefigures upon which this calculation has been made are notstated, and an analysis of the tables appended to the reportdoes not bear out these results. It show3 the averagestrength, during 1881, of the corps which arrived in Indiafrom September, 1880, to April, 1881, to have been 6489,and the deaths 107, being in the proportion of 16’49 per 1000,or a fraction under the average. It is worthy of note thatif this mortality be divided according to arms of the servicethe proportion in the artillery, 1316 strong, is as high as27’35 per 1000; while in the line it is only 11’95, althoughin the latter is included the 61st Regiment, which was onfield service in Southern Afghanistan. This marked dif-ference may have been in some degree due to the distributionof the troops, for the artillery were almost entirely quarteredin Bengal, while two-thirds of the line were in Madras andBombay. The death-rate among the recently arrived corpswas in Bengal 19’17, in Madras and Bombay 14’36, and inthe 61st in Afghanistan 34-48 per 1000.The experience of the army in India affords important

evidence of the value of vaccination and revaccination.Although small-pox is widely prevalent in India, onlyfifteen cases and one death occurred during the year amongthe troops.The influence of age on mortality from all causes among

the troops is shown in the following table of deaths per 1000’of the strength at the several periods of life :-

The number serving under twenty was only 1255, and was,therefore, too small to justify any positive deductions. Theinfluence of length of residence in India upon the deaths-per 1000 from all causes was as follows :-

There appears to be a reduction in the third period as com-pared with the two preceding, but it is difficult to estimatehow much of this is due to the great amount of invalidingwhich takes place in the second period.The mortality of the officers in India during the )ear

amounted to 18 85 per 1000, or two per 1000 higher thanamong the men, but this includes deaths among officers onleave. The death-rate among the officers of the Britishforce was 20’10, and of the Indian army 17 ’48 per 1000 ofthe strength.The mortality among the soldiers’ wives was in the ratio

of 25 ’93 per 1000, the chief causes of death being childbirth,and ahortion, and cholera. Among the children it amountedto 60’17 per 1000, convulsions and diarrhoea being the twomost fatal diseases.

THE salary of Mr. Buncombe, Medical Officer of theBow Union Infirmary, has been increased from C300 toJE350 per annum.