At Amara, paratyphoid A was commonest in the troops coming down from the Front. It was not a very grave disorder, but sometimes, particularly when complicated by other factors, it was fatal. It must be remembered that many patients reached us as emaciated skeletons, in the last stage of exhaustion. Special wards were set aside for typhoid cases. Dysentery was also increasing, and wards were reserved for these cases. It was mainly what is called bacillary dysentery, for which Epsom salts is one of the best remedies. All typhoid cases, as soon as convalescent, were sent to India. That was because they often carry the germs in the intestinal tract a long time after recovery and therefore may become a source of infection. They spent on an average three months in India before returning for service. There was no place in Mesopotamia where convalescent patients could be sent with a reasonable prospect of gaining full health. About twenty miles beyond Aligarbi lie the Pashtikhu hills and there in those high altitudes a big military sanatorium might have been established. This would have saved endless transport difficulties, if a light railway had been constructed. But no doubt the military situation rendered the carrying out of such an idea impracticable. Heat-stroke in Amara was common enough, but it did not seem so fatal as at Basra. This, perhaps, was due to the air, which was drier and fresher. The supply of ice was also more adequate.
We had some unlucky spells. It is a curious thing that luck seems to enter into the matter of death rates. I mean that sometimes for two or three days at a time cases seemed to go wrong and die, on the slightest provocation. At other times, when the luck changed, the most hopeless cases would clear up. It was the same way in the operating theatre. It is the same way with everything, whether it be card playing, or business, or war, or love, or thinking, or sport. There are phases in which something seems to overshadow the scene. The direction of the current changes. For a time everything seems to go wrong. The machinery behind life, that is always helping you on, stops and reverses. And there is another aspect of the same thing which doctors sometimes see in a remarkable way. It is the occurrence of similar kinds of cases at the same time. For part of it there is the scientific explanation of infection by germs.