236 THE INDIAN MEDICAL GAZETTE. [April,, 1930.

Correspondence. NOTES ON ULCUS TROPICUM IN THE JHARTA

COALFIEDS IN 1922.

To the Editor, "The Ixdian Medical Gazette."

Sir,?Noting in your comment on Dr. Doshi's letter in the January 1930 issue of the Gazette that you had found the infection among the grass cutters of the Cavalry Regiments in the U. P. in 1909?11. I was

struck by your finding as compared with mine in the

few notes I made upon the disease in late October 1922. The statistics are from four fairly large collieries

which were then under my charge, and, although they differ somewhat in compilation, they curiously all make reference to the grass in the notes. The description of the ulcer and the treatment thereof have been omitted, they tally exactly with present day observations, with perhaps some difference in technique of treatment, but, it was then largely a matter of opinion and experiment as to the way in which the period of inefficiency of the sufferer could be shortened; all however are agreed in the main.

Kits I ore Colliery (the Raneegunge Coal Association Ltd.).

Year. No. of Cases. Date of Appearance. Date of Total Disappearance. 1919 .. .. ?? 120 7th June 6th December. 1920 .. .. ?? 10^ 27th June 30th November. 1921 .. .. ? ? 46 3rd September 26th December. 1922 .. .. ?? 44 22nd July Up to the 31st October and

still continuing. Note 1.?Site of ulcer nearly always on the anterior

aspect of the leg below the knee joint, most often on the ankle and dorsum of foot. May he single or mul- tiple. Attacks mostly confined to adult males, less common in females, and rare in children. Two cases however were noted on the arm during these years. Note 2.?Occurrence generally from the beginning of

the rainy season or certainly when the grass becomes long and "spear grass" abundant. Found in Punjabi coolies, Beldars, and Bilaspuri miners.

ATotc 3.?Treatment if taken in hand early generally lasted from 12?18 days. If much erosion had taken place and there was much oedema present, treatment was considerably lengthened.

Jamadoba Colliery {Messrs. Tata Iron and Steel Co.). Year. No. of Cases. Date of Appearance. Date of Total Disappearance.

1919 .. .. .. 109 July November! 1920 .. .. .. 169 juiy December. 1921 .. .. .. 9S June December. 1922 .. .. ?? 41 July Up to October 31st and then

still occurring. Note 1.?Site of ulcer always below the knee and mostly

found adjacent to the ankle joint and 011 the dorsum of the foot. There was at times much oedema below the ulcer level.

Note 2.?The figures for 1919-1920 should not be recorded as being all tropical ulcers, 'but undoubtedly the majority of them were so owing to the seasonal

occurrence. The percentage of persons afflicted was

much higher in tiie case o f adult males. In 1920 only 2 children were affected and none in the other yearS under question. Note 3.?From the records, it would appear that the

disease reaches its height concomitant with the height and ripeness of the grass, and, that Beldars and others who work on the surface are more often affected.

Si'/ua Colliery (Messrs. Tata Iron & Steel Co.) ^ear. lotal.

Appearance of Date of total disappearance. 1st ulcer.

1919 ?? 146 (including 4 females and 1 child) July December 1920 .. 82 (including 6 females and 4 children) June (late) January 1921 1921 52 (including 9 females and 2 children) July December 1922 .. 112 (including 6 females and 2 children) June (late) Up to October and still continuing.

Note 1.?The disease was noted on no other part of the body except the leg below the knee.

Note 2.?The disease is generally found in the months where the grass is highest and rankest, and has bee" most commonly found amongst the male earth cutters.

Malkcra Choitidih Colliery (Messrs. Tata Iron & Steel Co.)

Year. Number of ulcers. Appearance. Disappearance. Length of period ,nir.

-- , r i - i-ii inefficiency.

919 .. 75 (females 5, ch dren nil) July January 1920 12 to 16 days. 1920 .. 55 (females 4. children nil) july December 10 to 16 days. 1921 .. 80 (females o, children 1) August December 10 to 15 days. 1922 .. 91 (females children 2) July . October 21st and 10 to 15 days.

still continuing.

Note 1.?The ulcer is generally found on the lower one-third of the leg, more often on the anterior than on the posterior aspect. Mostly confined to the ankle and dorsum of the foot. May "be single or multiple.

Note 2.?The percentage of affliction is found to be strikingly higher in adult males than in females, children being rarely afflicted. The age incidence varies from 20 to 45, and it is noted to be rare among elderly people. Note 3.?Mostly seen amongst the poorer classes, but

also found amongst the Punjabi coolies, Bilaspuri miners.

and surface coolies. A single instance in 1921 occurred in a Balm's family. Note 4.?It may be of some interest to note that tnc

ulcers are more prevalent at the end of the rainy season when the grass is long and in the seed-bearing stage. You will thus note how strikingly the grass is blafrte

throughout. The rough notes were compiled by assistants, who were not in communication with eaC

other and were " boiled down" for my report t0.

the Managing Agents, They all appear to have associate this element as a possible factor in the causation of t'1

April, 1930.] CORRESPONDENCE. 237

ulcer, and, curiously enough, after a quiescent period the ulcers reappeared in great numbers in 1929, con-

comitant with a heavy monsoon and a consequent luxurious crop of grass!?Yours, etc.,

Frank t. simpson, Chief Medical Officer,

Messrs. Kilburn & Co.'s Collieries.

Ku STORE, P. O. Kusundu, E. I. Ry.,

Manbiium District, .illtli January, 1WU.