from the Mauritius, where it had undoubtedly been contracted. During the period of hostilities there was an increase both in admissions and deaths from that cause. Although the net admissions (after eliminating wounds and injuries and fevers) are less in the later period (1878-80) than in the earlier (1870-77), as shown in the preceding table, yet the death-rate is higher. This is almost entirely due to diseases of the digestive system, mostly dysentery and diarrhoea. These were more common formerly than they are now in ordinary years; in many cases, especially in the small frontier stations, they were clearly owing to bad water.

Ophthalmia has prevailed rather largely, especially in some years; there is a good deal of dust in many parts of the colony, and it has been attributed to this; the disease is probably the specific ophthalmia (gray granulations), and is propagated by contagion. Whether it had its origin in any catarrhal condition produced by the wind and dust, and then became contagious, is one of those moot points which cannot yet be answered.

The Cape has always been noted for the numerous cases of muscular rheumatism. Articular rheumatism is not particularly common. There is also much cardiac disease. The prevalence of this affection has been attributed to the exposure and rapid marches in hill districts during the Kaffir In 1863 there was, however, less rheumatism than usual.

wars.

Taking the years 1859-66 as expressing tolerably fairly the effect, per se, of the station, we find that the whole colony gave 18.3 admissions and 1.90 death per 1,000 of strength from diseases of the circulatory organs. In 1869-77 the admissions were 13.5 and the deaths 1.47; in 1878-80 they were 20.3 and 1.25 respectively.

1

Dr. Lawson has contributed a valuable paper on this subject. He finds the death-rate from diseases of the organs of circulation (mean of seven years, 1859-65) at 1.91 per 1,000 of strength. at any other foreign station, as will be seen from the Lawson.

This is higher than table copied by Dr.

This table shows an extreme diversity, hardly to be reconciled with differences of climate or duties. In the years 1869-74 the death-rate was 1.68, and was exceeded by that of the Mauritius, 2.29, and that of Madras, 1.99. In 1875 the rate at the Cape was only 1.45, while Ceylon showed 3.87, Bermuda 2.63, and Madras 2.05; Mauritius returning no death. In the eight years (1870-77) the rate at the Cape was 1.62; and in the years 1878-80 it was 1.25.

Scurvy formerly prevailed much at the Cape, particularly in the Kaffir wars, and may have had something to do with the prevalence of dysentery.

1 Army Medical Report, vol. v., p. 338.

The average

Venereal diseases have of late years been very common. admissions from "enthetic" diseases in 1859-66 were 248.5, and in 1867 they were 438.3 per 1,000 of strength in the whole colony. In Cape Town alone, where facilities for promiscuous intercourse are greater, they were even more numerous. Much diminution has taken place in recent years. In the ten years, 1871-80, the ratio for syphilis, both primary and secondary, was only 102, and for gonorrhoea 80.

1

The Cape has always been considered a kind of sanitarium for India. Its coolness and the rapid movement of the air, the brightness and clearness of the atmosphere, and the freedom from malaria, probably cause its salubrity. It has been supposed that it might be well to send troops to the Cape for two or three years before sending them on to India. This plan has never been perfectly tried; but in the case of regiments sent on hurriedly to India on emergency, it has been said that the men did not bear the Indian climate well. Probably they were placed under unfavorable conditions, and the question is still uncertain.

As a convalescent place for troops who have been quartered in a malarious district it is excellent."

SECTION VI.

MAURITIUS.

Garrison, about 300 to 500 men. Civil population (in 1879), 359,988. Mauritius in the eastern has been often compared with Jamaica in the western seas. The geographical position as respects the equator is not very dissimilar; the mean annual temperature (80° Fahr.) is almost the same; the fluctuations and undulations are more considerable, but still are not excessive; the humidity of air is nearly the same, or perhaps a little less; the rainfall (66 to 76 inches) is almost the same; and the physical formation is really not very dissimilar. Yet, with all these points of similarity in climatic conditions, the diseases are very different.

Malarious fever was formerly not nearly so frequent as in Jamaica, and true yellow fever is quite unknown; Mauritius, therefore, has never shown those epochs of great mortality which the West Indies have had. Hepatic diseases, on the other hand, which are so uncommon in the West Indies, are very common in the Mauritius. For example, in 1859 there were 47 cases of acute and chronic hepatitis in 1,254 men, while in Jamaica there was one case out of 807 men. In 1860 there were 31 admissions from acute hepatitis out of 1,886 men; in Jamaica there was not a single case. In 1862 there were 12 cases of acute, 11 of chronic hepatitis, and 72 cases of hepatic congestion, out of 2,049 men; in Jamaica, in the same year, there was only 1 case of acute hepatitis out of 702 men. This has always been marked; is it owing to an error in diagnosis or to differences in diet? It can scarcely be attributed to any difference in climate. In 1863 the difference was less marked, but was still evident. In later years, however, there has been considerable diminution: in 1872 there were only 4 cases of hepatitis, and in 1873 only 2. Since that year no detailed statistics have been published, but it is mentioned incidentally that there were 3 cases in 1880, out of a strength of 353.

1 Army Med. Depart. Report, vol. viii., p. 548.

* See effect on the 59th Regiment in the Army Medical Report for 1859, p. 99.

In 1866-67 a very severe epidemic fever prevailed in the Mauritius, which offers many points of interest. As already noted, the Mauritius has till lately been considered to be comparatively free from malaria. All the older writers state this, and it is apparent from all the statistical returns. Deputy Inspector-General Dr. Francis Reid, in a report' in 1867, mentions that he had served ten years in the Mauritius, and had looked over the records of the troops for twenty-four years. He found some records of intermittents, but he traced all these to foreign sources, viz., troops coming from India, China, or Ceylon, and presenting cases of relapses.

For the first time, in the latter months of 1866 and the commencement of 1867, malarious fevers of undoubted local growth appeared on the western side of the island.

2

The causes of this development were traced by Dr. Reid, and also by Surgeon-Major Small and Assistant Surgeon W. H. T. Power, in some very careful Reports. During some years a large amount of forest land had been cleared, and there had been much upturning of the soil; coincidently the rainfall lessened, and the rivers became far less in volume. At the same time, there was a large increase of population; a great defilement of the ground in the neighborhood of villages and towns, so that in various parts of the island there was a constant drainage down of filth of all kinds (vegetable and animal) into a loose soil of slight depth, resting on impermeable rock, which forms a great deal of the western seaboard. In 1866-67 there occurred an unusually hot season, and again a deficient rainfall. This seems to have brought into active operation the conditions which had been gradually increasing in intensity for some years. The development of the malaria was not so much on the regular marshy ground as on the loose contaminated soil already noticed.

That the fever which in 1866-67 became so general was of malarious type, is proved by a large amount of evidence on the spot from both military and civil practitioners, and from the fact that many soldiers returned to England and had at home relapses of decided paroxysmal fevers. Dr. Maclean also stated that he had seldom seen spleens so enlarged as among the invalids from this fever who arrived at Netley.

But in some respects this fever presented characters different from common paroxysmal fevers. There was no very great mortality among the troops, but it was excessively fatal among the inhabitants of Port Louis and many other towns and villages. It also lasted for many months, and was attended in many cases with symptoms not common in ordinary paroxysmal fevers, viz., with yellowness of the skin and with decided relapses, closely resembling in these respects the common relapsing fever. Mixed up with it also was decided typhoid fever. The question whether the great bulk of the epidemic was a purely paroxysmal or malarious fever, with an independent subordinate outbreak of typhoid fever, or whether it was a composite affection like the "typho-malarial fever" of the American war, or was mixed up with the contagious "Indian jail fever" imported by Coolies, is not a matter very easy to decide. The officers best qualified to judge (Drs. Reid, Small, and Power) looked upon it as a

3

1 Letter to the Director-General, February, 1867.

2 Annual Report on the District Prisons Hospitals (in 1867, Mauritius, 1868). On the Malarial Epidemic Fever of the Mauritius, Army Med. Depart. Report, vol. viii., p. 442.

As described by Woodward, Camp Diseases of the United States Armies, by J. J. Woodward, M.D., Philadelphia, 1863, p. 77.

purely malarious disease, and expressed themselves very strongly on this point.1

This much seems certain, that in various parts of the island the loose, porous, shallow soil had been gradually becoming more and more impure with vegetable matters, and in some cases with animal excreta; that there had been a gradual diminution of the subsoil water, and that this reached its maximum in 1866, when the rains failed, and the hot season was prolonged. There coincided, then, an unusual impurity of soil, lowered subsoil water, consequent increased access of air, and heightened temperature. Under these conditions, a usually non-malarious soil gave rise to an epidemic fever, which was characterized (chiefly, at any rate) by the symptoms referred to the action of marsh miasmata, and was curable by quinine. The admissions for paroxysmal fevers alone were, in 1875, 585.5 per 1,000, and in 1869-75 (five years) 722.3 per 1,000 as a mean. In later years the type has been distinctly paroxysmal, the large majority of cases being returned as ague. The mean admissions per 1,000 for six years, 1875–80, were 970, with a maximum of 1,557 in 1879.

In the Mauritius, as in Jamaica, a "continued fever" is not uncommon; this is now being returned in part as typhoid.' It has occasionally been imported. There are fevers vaguely named "bilious remittent," "Bombay fever," "Coolie fever," etc. The last term denotes the communicable fever so common in the jails in the Bengal Presidency. It prevailed in the jails in the Mauritius in 1863 and 1864, among the Hindoos. The "Bombay fever" is probably typhoid. Dysentery and diarrhoea have largely prevailed, but are now becoming less frequent. In this respect Jamaica now contrasts very favorably with the Mauritius; thus, in 1860, there were altogether 213 admissions per 1,000 of dysentery and diarrhoea, and 6.8 deaths per 1,000; in Jamaica, in the same year, there was not a single admission from dysentery, and only 19 from diarrhoea, among 594 men, and no death. Cholera has prevailed five times-first in 1819;

The two latter gentlemen say, op. cit., p. 453-"It was entirely of malarious origin, and in every form, we might say, perfectly curable by administration of quinine in large doses." These observers entirely deny that it had any contagious properties.

Dr. Reid had no doubt of the frequent occurrence of typhoid for many years. He mentioned an interesting fact, viz., that patients with true enteric fever were also affected with the malarious epidemic fever; this latter was, however, easily curable by quinine, but the typhoid fever, which was also present, was quite unaffected.

not afterward till 1854; then again in 1856, 1859, and 1861. (It appears to have been imported in all these cases.) Formerly there was a large mortality from lung diseases; now, as in Jamaica, this entry is much less, not more than half that of former days. The deaths from phthisis per 1,000 of strength were, in 1860, 0.521; in 1861, 1.03; in 1862, 1.94 (but in this year 11 men were invalided for phthisis); and in 1863, 2; in 1875 no death was recorded. Venereal (enthetic) diseases formerly gave about 110 to 130 admissions per 1,000 of strength, but they are now greatly diminished. Ophthalmia prevails moderately; to nothing like the same

extent as at the Cape.

In 1873 (the last year of detailed statistics) there were 8 admissions for diarrhoea and none for dysentery in Jamaica; in Mauritius there were 29 for diarrhoea and 16 for dysentery and 2 deaths, out of a strength of 441.

SECTION VII

CEYLON.1

Garrison, 800 to 1,000 white troops; and about 100 gun-lascars (black). Population, 2,758,166 (in 1881), including about 5,000 Europeans. The stations for the white troops are chiefly Galle, Colombo, Kandy, and Trincomalee, with a convalescent station at Newera Ellia (6,200 feet above sealevel). The black troops are more scattered, at Badulla, Pultan, Jaffna, etc.

Geology.-A considerable part of the island is composed of granite, gneiss, and hornblende granite rocks; these have become greatly weathered and decomposed, and form masses of a conglomerate called "cabook," which is clayey like the laterite of India, and is used for building. The soil is derived from the débris of the granite; is said to absorb and retain water eagerly. In some parts, as at Kandy, there is crystalline limestone.

Climate. This differs, of course, exceedingly at different elevations. At Colombo, sea-level, the climate is warm, equable, and limited. Mean annual temperature about 81°. Mean temperature - April, 82.70°; January, 78.19°; amplitude of the yearly fluctuation = 4.51. April and May are the hottest months; January and December the coldest. Amount of rain about 74 inches; the greatest amount falls in May with the S.W. monsoon (about 13 to 14 inches); and again in October and November with the N.E. monsoon (about 10 to 12 inches) in each month. Rain, however, falls in every month, the smallest amount being in February and March. The heaviest yearly fall ever noted was 120 inches. The relative humidity is about 80 per cent. of saturation. The S. W. monsoon blows from May to September, and the N.E. monsoon during the remainder of the year, being unsteady and rather diverted from its course (long-shore wind) in February and March. The mean horizontal movement during the year 1872 was 125 miles; in 1870 it was 139 miles, or rather under 6 miles an hour.

At Kandy (72 miles from Colombo, 1,676 feet above sea-level), the mean temperature is less, 3° to 5°; the air is still absolutely humid, though relatively rather dry. At 9.30 A.M. the mean annual dew-point is 70.4°, and at 3.30 P.M. it is 71.54°. This corresponds to 8.11 and 8.42 grains in a cubit foot of air; as the mean temperature at these times is 76.37 and 79.27, the mean annual relative humidity of the air at 9.30 A.M.

1 For a full account, see Sir E. Tennant's Ceylon.