‘Military report on south-west Persia, including the provinces of Khúzistán (Arabistan), Luristán and part of Fars.’ [‎47r] (98/470)

05
9
motives, tlie whole, or nearly so, of the Residency An office of the East India Company and, later, of the British Raj, established in the provinces and regions considered part of, or under the influence of, British India. staff happened to be removed
from town. Hardly any particulars of value were, under these circumstance?,
recorded. The medicines, or whatever treatment was deemed advisable, was
administered to each patient on examination, and no memoranda of cases kept;
so that I have not been, until very recently, in a position to speak with any
degree of confidence on the nature and probable causes of the diseases most
prevalent in the place, or the relative frequency of their occurrence.
The only affection always prevalent in Bushire is fever of the intermittent
type, which stands far ahead of other diseases in the
Intermittent fever. number of admissions on our sick list, and there is no
period of the year when this is not the case.
During the months of April and May of the year under consideration a
malignant malarious fever* raged both in town and
M.ilanous fe\er. country with grave fatality. It assumed the bilious
remittent type, but the remissions were so slight that without careful observ
ation the disease might be mistaken for ardent continued fever. The symp
toms were so severe as to prevent the sufferers from coming to the dispensary,
death frequently following four days from the commencement of the attack.
In the worst cases the symptoms were increased by the appearance of a
pinkish rash all over the body, accompanied generally by congestion of the
lungs, cough, and intense muscular pain. As regards treatment, attention to
the bowels, calming the nervous excitement by administering the sedatives
most indicated by the symptoms, and the copious exhibition of quinine was
the plan found most serviceable.
The chief sequelae of this disease were hepatitis and perihepatitis; but
these affections were seldom serious, convalescence with a keen appetite follow
ing rapidly on the subsidence of the high temperature.
Whether this malignant fever was due to the presence of a concentrated
form of malarial poison in the atmosphere at the time, or to the less resistance
offered to the operation of the ordinary proportion of this virus by tbe reduc
ed and prostrate bodily condition of the people from starvation, consequent on
the existence of famine in the land for the two previous years, it would be
difficult to decide. Possibly, and indeed probably, it was the result of a
combination of both circumstances. For the then over-crowded and more
than ordinarily dirty condition of the town, caused by the flocking in of the
famishing inhabitants of the surrounding country, would certainly intensify
the virulence of any contamination afloat in the atmosphere. Moreover, the
fever was most prevalent and fatal among the weak and emaciated, while the
strong and well-to-do either escaped altogether or suffered slightly when
attacked.
The ordinary intermittent fever of Bushire is never serious, though a few
paroxysms coming on year after year, with every little
change in the temperature, and almost every time the
wind is southerly, have the effect of inducing a pathological condition of the
liver and spleen ; enlargement of the latter being rather common among the
inhabitants, not excepting those who are of tender years.
A peculiarity of the Bushire intermittent fever is the great amount of
discomfort often experienced by those who suffer from it while an actual
* The malarial poison is of a cumulative nature. Fresh arrivals at Bushire escape fever during
their first year’s residence. Once it is accumulated in the system, the proximate causes of an
attack of fever are—(1) exposure to draughts, wet chills, differences of temperature; (2) unsuitable
clothing; (3) breathing a noxious effluvia.
Intermittent fever.