512
state
The more experience of dysentery I get the more do I abominate what I can only term "fiddle sticking "-jumping treatment from one drug to another every other day and month. There are many diarrhoeas which are classed as dysentery where the amoeba coli is absent but where straining and blood may be present. Foeter is often great and in these cases what might be termed a "high of affairs is present in the bowel. In these cases a dose of castor oil followed by the regular use of some intestinal antiseptic such as salol, naphthol or arsenite of copper generally brings about early improvement. The great difficulty always arises in getting sailors persuaded to remain on milk diet long enough. When the case has been a long standing one the sailor ought to seek shore employment for a time, as relapses are almost sure to follow a resumption of "salt junk" and rum.
I give these views in the full knowledge that treatment of dysentery is generally one of the last things one should dogmatise about.
19. Beri-beri. Twenty cases were admitted during the year and there were no deaths from this disease. Some cases from the China Navigation boat Chingtu led me to investigation on board the ship. It was found that for several voyages, small epidemic of beri-beri had broken out at different periods. New men were generally shipped in Japan, and it was usually on the way down to Australia that new cases cropped up-on that particular voyage two men had died from beri-beri. This simply goes to show that the most careful disinfecting measures should be taken to prevent recurrence of the disease. In the case of the Chingtu an efficient disinfection by carbolic acid was recommended, in addition to afterwards shipping a new crew; and I am informed by Messrs. Butterfield & Swire's representative that the results bave been most favourable. A similar case of infection of a ship by Beri-beri occurred on board the Canadian Pacific boat Abyssinia when I was surgeon on board. The Chinese firemen's fo'c'sle became infected and every trip to Vancouver produced cases of beri-beri, two particular bunks always supplying patients. Disinfection was carried out by corrosive sublimate solution, but even to the last a case occasionally cropped up. The solution of carbolic acid should be strong-1 in 5 or thereabouts-and freely applied; do not mind burting the woodwork. In a case of well marked infection it will always be a good investment for owners to tear out the woodwork, more especially if it is old, and replace it with new material. This is what would have been done on the Abyssinia had I had the experience I have at present, but the good old craft was most effectually disinfected later on, as two years ago she was burned to the water's edge and now reposes at the bottom of the deep in Mid-Atlantic.
Several of the cases were of a subacute type and were much more severe than the usual type of the disease met with in Hongkong. Dr. W. W. MYERS, of Taiwanfoo, saw two such cases when visiting here and he remarked that they were very like those of pernicious malarial attacks he frequently met with in Southern Formosa and which were attended by prominent nervous symptoms. Although these were out of the common for Hongkong I think he was persuaded they were bonâ fide cases of beri-beri.
20. In addition to those operated upon the following fractures were treated :-
Fracture of Femur,
Patella,
Tibia,
Tibia & Fibula,...
..4 (1 dislocated at knee).
..1
.3
.3 (1 compound).
1
Carpus (Compound),
Humerus,
3
Humerus & Ulna,..
1
Humerus & Femur,
.1
Radius,
.8
Radius & Uloa,..
.1
Ulna,...
Carpal & Metacarpals,
Base of Skull,
.2 (1 compound).
.2 (1 compound).
8
Skull,....
..5 (all compound).
Skull (Compound) & Clavicle, ......1
Skull (Compound) & Lower Jaw, .....1
Skull & Femur,
Skull & both Femurs,
Skull & Pelvis,
.1
.1 (1 compound).
Ribs,
Pelvis,
Spinous Processes,
Tarsus,
.1
.4
.1
..1
...........1 (compound).
Of these six died. The patient with the compound fracture of both ankles refused operation and died; one with fractured base of skull died; the fracture of the pelvis patient died from perito- nitis, &c.; the fracture of skull and pelvis case also died; whilst a compound fracture of skull (gun- shot wound) proved fatal to the fifth within a few minutes of admission; the sixth suffered from a bad smash of skull and lower jaw and also succumbed rapidly to his injuries. In the case of fracture
No comments yet.
Private notes are available after approval.