to throw much light upon the matter, and the conclusion is obvious that the disease must have been in the past and must be now quite un- common.
Records do not help us much even as regards its prevalence in the rest of India, for though cases are reported from Northern India, in none apparently has the diagnosis been confirmed by a reliable bacteriological examination. The only references I can find point to the compara- tive rarity of diphtheria in Northern India also, unless it happens that officers do not consider such cases worth reporting.
For instance in the Indiav Medical Gazette:
August 1880. — Greene says that he saw several cases of diphtheria in November 1879 in Serampur.
August 1884. — Norman Chevers states that diphtheria was rather common in and out of Calcutta in his time.
February 1891. — Bose relates the histories of 11 cases in Calcutta Roy asserts that it is met with in hill stiitions and the N.-W. P. at the end of the rains and beginning of tlie cold season.
Macleod gives it as his experience that diph- theria is not common in Calcutta.
April 1894. — O'Brien mentions a case in Calcutta.
April 1895. — Crombie describes a case in Calcutta in a person who had just arrived from Bombay. Antitoxin, recovery, no bacteriologi- cal examination.
June 1895. — Hansom mentions a case at Poona. Antitoxin, recovery, no bacteriological examination.
July 1901. — Basu records a case at Bankipore. Antitoxin, recovery, no bacteriological examina- tion.
In the annual report of the Sanitary Commis- sioner with the Government of India diphtheria finds a place in the statistics, but no mention is made of diagnosis or of locality or source of infection.
 | A table should appear at this position in the text. See Help:Table for formatting instructions. |
Although Major Semple, R.A.M.C., had such things as specimens of malarial blood and tuber- culous sputum sent to him to Kasauli for examin- ation, in his report for 1902 diphtheria is not mentioned. It would certainly be worth while if
all who have come across indubitable diphtheria in India would report the localities where it occurred, especially stating if the diagnosis has been confirmed bacteriologically. Until the pre- valence of a disease is known adequate means to combat it cannot be 4evised, and if a man is told before he comes out that such and such n disease is unknown in India, he not unnaturally hesitates to diagnose it. To be forewarned is to be forearmed as regards both diagnosis and the provision of remedies.
REPORT ON A SMALL OUTBREAK OF CHOLERA IN 10th D. C. O. LANCERS (HODSON'S HORSE) IN JUNE 1903
By E. A. C. Matthews, M.B, B.C
Captain, I. M. S.,
First case. — The first case occurred in a Sikh aged 32. When first admitted there was a history of having passed two loose motions followed by some collapse.
On admission he was collapsed, and haggard, but there was no vomiting nor purging; no cramps and no suppression of urine. He was isolated on suspicion, but it was only just before he die<l that he had any cramps, and passed two typical rice-water stools ; death occurring five houra after admission.
Subsequent ca^es.— Ten other cases occurred between June 13th and June 20th, and were dis- tributed all over the lines, three only recovering. The last case was interesting, in that he was the mess dufiadar, and had not been to the lines for some days. He had a very severe attack, but was a sturdy man and made a good recovery.
Source of ivfection . — Samples of water from all the wells in the lines were at once forwarded t^ Kasauli for examination, with the result that vibrios were found in the water from the quarter guard well, but the others were free.
This well is on the main road, which is greatly used by coolies and others coming from the surrounding districts, in which cholera had been prevalent for some days; and there is every probability that the well was infected by a lotah or similar vessel used b}' one of these people.
Bearing of cases on this source of infection. — Infection from this well is the only way in which the wide distribution of the cases could be accounted for, as cases occurred in every squadron and amongst ihe followers, each having their own well for oidinary purposes, while the quarter guard well was resorted to by men on guard and after leaving the parade ground.
The mess duffadar had not been drinking from this well, but it transpired that he ha4
