M.99
All cases with one exception have been of a mild type. They belong, as previously noted, to the coolie class and it is doubtful if the degree of their opium addiction is in itself a serious matter. What does seem of more importance is that the majority suffer from some physical ailment which has been the cause of the taking of opium in the first place. The average amount of money spent by our cases on opium has been fifty cents a day.
One case of relapse (fourth time) of heroin addiction was treated and did well in hospital. He was fit on discharge.
Continued observations on the gastric function of addicts show the deleterious effects of the habit.
Treatment has been on former lines namely, complete and immediate withdrawal of opium followed by Modinos auto-serotherapy.
I am still of opinion that the effect of this method of treatment is mainly psychological. I have not experienced the wonderful results reported by some other observers. Then again those of our addicts whose physical ailments are relieved by ordinary medical treatment have no need of further opium and hence the former habit is easily dropped. One case relapsed and was re-admitted but in this instance patient suffered from symptoms due to a duodenal ulcer.
Avitaminoses: Beri-beri is still very prevalent and mostly of the polyneuritic type.
Duodenal ulcer: The incidence appears to be higher and in most cases the diagnosis has been confirmed by radiological examination.
Dyspepsia: The incidence is very high and etiology is varied.
Cirrhosis of liver: Comparatively prevalent-accompanied by ascites and in most cases by splenomegaly the clinical picture of Banti's syndrome and the etiology uncertain. See note under "Special Investigations".
Chronic parenchymatous nephritis: Incidence remains high but the etiology remains obscure.
Anaemia-hypochromic: Extremely prevalent as a concomitant of other diseases.
Syphilitic cardio-vascular disease: Aortitis resulting in well-defined signs and symptoms of aortic incompetence remains moderately prevalent.