3^21c;

.

j

THE INDIAN MEDICAL GAZETTE.

REPORT OF THE COMMISSION

APPOINTED TO

INTO THE CAUSES OF THE EPIDEMIC FEVER IN NUDDEA.

ENQUIRE

In the Resolution of the ioth November, 1SS1, in the and the Medical Municipal Department, His Honor Lieutenant-Governor, in noticing that the presence in Nuddea of a malarious feyer, in a severe epidemic form, two seasons in succession seemed to point to some local cause distinct from climatic influence, appointed us as a Commission to visit the and

to examine carefully their sanitary condiof their unhealthiness. We were further directed to inspect, as far as possible, all the roads constructed during the past 15 years, and to ascertain whether there was any truth in the statement so often made of the inadequacy of the water-way provided in such roads ; to enquire into obstruction of drainage by the silting up of old channels and creeks ; to give special attention to the supply of drinking-water, and endeavour to induce the people, where the water-supply is now deficient, to clean old tanks and excavate new ones and place them under the charge of the village punchayets, in order they may be kept clear for water-supply ; to impress upon the more intelligent villagers the necessity of purifying water and show how simply and cheaply an efficient filter can be constructed ; to call upon the zemindars to assist in opening and draining channels and excavating tanks ; and to impress upon the people the precaution of sleeping on raised platforms or machans. The sum of Rs. 50,000 was likewise placed at our dis2. posal to meet the cost of making such improvements as we might consider urgently necessary. Tour?In pursuance of the above orders, we remained 3 on tour in the Nuddea district from the beginning of December, 1881 to the middle of March, 1882, when the lateness of the season compelled us to return to Kishnaghur without having been able to visit either Beerbhoom or Jessore. 4. During our tour we visited and examined some four hundred villages, traversed the roads made within the last 15 years and many of earlier construction, inspected numerous embankments, and followed the courses of several old rivers. The route taken by us whilst making our investigations and enquiries will be found marked on a map appended to this worst

villages,

tion and the

cause

report. [Not printed.] 5. Topography.?The district cf Nuddea is a vast alluvial plain intersected by six large rivers, numerous smaller channels,

and by a labyrinth-like network of forsaken riverbeds and old rivers in every stage of decay and effacement. It is dotted with lagoons and marshes, and studded with numerous towns and villages, which are frequently hidden in clumps of bamboos The lands are closely cultivated. As in and clusters of trees. all deltoid formations, the fall of the country is away from the rivers, but the regularity of the slope is broken up by the tangle of rivers and river-beds which cross and recross one another and obstruct the natural lines of surface drainage. 6. History of the fever.?It is in this district that a severe malarious fever has prevailed for the past two years. The reports of Dr. Sutherland and others have shown the history of epidemic fevers in Bengal in former years, and our inquiries have brought nothing new to light. It is quite clear that fever his long been present in Nuddea, and in villages such as Oola, Ichapore, Srinugger and Jaharpore, it is never dormant for any length of time. 7. The present outbreak was first noticed in the middle of In

iSSo,

1880,

when the cieatns irom iever

in mis

district

from 1,927 ir July to 3,759 in August, culminating in November with a mortality of 12,822. The tracts chiefly affected during the period ot greatest fever mortality in that year (?. e., the six months, August 1880 to January r88i) were the sub-divisions of Bongong, the Sudder and Meherpore. In Chooadanga the more easterly portions alone were affected, the condition of the western thanas being In this sub-division, according to Baboo Judoo Nath normal. Bose, sub-divisional officer, the fever was traced to the village of Hurinakunda, in the Jhenidah sub-division of Jessore, where From this place it was transit prevailed virulently in 1879. ferred in 1880 westwards to Jaharpore and Paikparx and other villages situated on the banks of the Bhatahi, a stream formerly connected with the Kumar, but now a closed water-course. The fever did not, in 1880, travel further than Kulcherra, a village about two miles north-east of Chooadanga town. Since then the disease has spread over the whole sub-division. 8. The worst thana, however, in 1880 was Gaighatta, in the south of Bongong, where the recorded fever death-rate for rose

[December, 1883.

the half-year from August 1880 to January 1881 was 41,25per mille. The few neighbouring villages of the 24-Pergunnahs, such as Janapole, Pairigatchi, &c., are said to have been equally affected. The thanas of Honskhalli, in the centre of the district, and Teyhutta, on the north-west, come next, giving respectively fever death-rates of 39*07 aud 3675. 9. Generally speaking, in the season of 1880 fever prevailed line drawn across the over a tract of country situated on a district from south-east to north-west. The sub-divisions of Ranaghat (with the exception of portions of Jaguli) on the south and Kooshtea on the north escaped this visitation. The total number of deachs from fever for the calendar 10. year of 1880 was 54,420; but as this epidemic did not break out till Tuly, for the purposes of comparison it may be better to consider the months from August to January as showing the incidence of fever, in which case the mortality may be put at 51,783 for those six months. In 1881 the virulence of the fever appears to have spread 11. northwards and westwards, subsiding very In x88r. considerably in the southern sub-divisions, where in thana Bongong the highest death-rate was 28*54, while in Ranaghat it did not rise above 19*19. This subsidence of fever in the south of the district was not preceded or accompanied by any local alterations or improvements. 12. Kooshtea sub-division, as a whole, again escaped ; the highest recorded death-rates being 19'81 from Bhaluka in 1880 It must not, however, be and 18*46 for Daulutpore in 1881. supposed that there was no fever. Our enquiries showed that some isolated villages or groups of villages, such as Duhakhola and Durgapore, suffered severely.. In the rest of the district, that is, in the Sudder (except 13. Nuddea outpost) Meherpore, and Chooadanga, the fever was much more severe than in the previous yearf Chooadanga itself showing a fever death-rate of 59*62 per 1,000 for six months (to January 1882) ; while in Kaligunge the rate rose from I^8o to 65*2 in 1881. It should be noted, too, the 28*89 villages in Cutwa of Burdwan and Burwa of Moorshedabad directly adjacent to Kaligunge thana also suffered very severely towards the close of this year. 14. The total number of deaths from fever for the calendar year 1881 was 73,196, an increase of 18,776 over the previous year ; but as a fact the fever at its height was hardly more severe) as the six months, from August 1881 to January 1882, show a return of 52,145 deaths as against 51,783 for the corresponding the of before. year period The disease affected the young and old with special 15. The death-rate for children under one year was 139*21 severity. the calendar year of 1881. It falls to 24*84 per mille during " 20 and under 30 years," and again rises to 83*25 in the period above sixty years. 16. Unfortunately the mortuary registration has been so very irregular and imperfect that the above figures give only approximate results, our enquiries showing that the mortality was

actually greater. Rainfall.?The

rainfall of the district, as taken in eight different places, was examined as far back as records were available ; but the results varied of fever. so considerably even between neighbouring places that it is not safe to attempt any deduction. Speaking generally for the whole district in 1880, when the fever broke out more rain fell than usual, but on the other hand the greatest fever mortality is recorded where the rainfall was rather scanty. 18. In 1881 the trainfall was generally short and the fever was again most virulent in those tracts where the fall was more deficient. The Natives in places especially west of the Jellinghi referred the fever to this deficiency.

17.

Probable

causes

19. In considering how far the natural surface drainage of Obstruction of Nuddea is affected by roaas, embankments, &c.t drainage by in- and what works should be undertaken for the adequacy of improvement of water-channels, it will be conin water-way venient to divide Nuddea into five sections, roads and by silting up of old namely, (i) between the Bhagiruttee and Jeland channels linghi rivers ; (2) north of the upper Matacreeks, &c. bhanga and the Kumar rivers ; (3) between the Jellinghi and Matabhanga rivers; (4) the tract enclosed by the Kumar, the lower Matabhanga (down to Kissengunge), and the Ichamati rivers ; and (5) between the Ichamati, the lower Matabhanga (below Kissengunge), and the Hooghly. Each of these sections is separated from the adjacent ones by broad.rivers, and consequently it is obvious that any local obstructions to drainage in one can have no possible.effect on the othersi

Dumber,

20.

In the first tract

Section

I

REPORT ON THE EPIDEMIC FEVER IN NUDDEA.

1883.]

road.

Un

by bridges

found ample water-wsy on every the water-way was provided and on others (famine roads of 1874)

we

some

gaps left wherever necessary. There are no permanent embankments of any consequence. 21. It is deserving of particular notice that this tract of country which has been visited by the fever epidemic with special severity is absolutely free from artificial obstruction as far as we could ascertain. Some of the people in the neighbourhood of Goteparah were anxious to have an attempt made to open an old bed of the Bhagiruttee, known as the Goorgooriah khal, near that place, and also to open the khals from the Jellinghi at Beerpore to Mooragacha. The outlay would be great and the success of the schemes very doubtful, and in the case of the latter project the benefit would be slight even if the work were successful. In regard to the second tract, which, as already noticed, 22. Section II, has, comparatively speaking, almost entirely subKooshtea escaped the fever, the only roads that in any division. way impede drainage are the Poradaha and Damookdia State Railway and the road from Durgapore to the Halsha railway station. The principal obstruction in the former is the closing of the Burral khal on the second mile of the line, regarding which loud complaints were made to us, and apparently with reason. The want of water-way on the latter road is slight, and we understood that the matter was already receiving the attention of the Road Cess Committee. An old road from Naopara (near Mirpore railway station) to the Kooshtea-Dadupore road had evidently at one time been a serious obstruction to drainage ; but the bridges on it were carried away years ago by the floods, and the gaps left (seven in number) have been widened by successive floods until there is ample passage for the water. 23. The only embankments are those which enclose an eggshaped basin near Alumdanga. They were constructed many years ago, and are necessary to protect the crops on the low lands, the rain-water being let out by cuts at the close of each

by

rainy season.

fever has prevailed more or less the past two years, and the mortality has been great. This tract is peculiarly liable to flood from both the Jellinghi and Matabhanga rivers. It was formerly traversed by two important water-courses, the Bhyrub river and the Unjonah khal, which flowed from north-west to south-east, and both of which connected the Jellinghi with the Matabhanga : they are now dead streams. 25. Roads.?As regards the roads in this section, theMeherpore and Chooadanga road requires considerable additional flood-way, though in ordinary seasons it probably passes the On the road from Narainpore to water without obstruction. Ramnugger a sluice is much required at Fullia, in thana Koremthe Jellinghi river at will. This, pore, to admit water from however, is a work that might be carried out under the EmbankThe roads from Kissengunge ment Act by the local authorities. to Kishnaghur and from Bagoolah to Kishnaghur are provided with sufficient waterway to pass all local drainage ; but in high inundations when the Bhagiruttee embankments above Moorthe Jellinghi becomes gorged, the local shedabad breach, embankments give way, and an enormous volume of water is poured across country and intercepted by these roads. Probably would be either to effecthe best way to deal with this tually strengthen the Bhagiruttee embarkments, or to lower two roads and thus allow the floods to the level of the above At present, on the occasion of excepsweep over them. enclosed between these roads and the tional floods, the country Matabhanga river and Eastern Bengal Railway is waterlogged for several weeks. 26. There are embankments in this tract on the left bank of the Jellinghi on the Julkur Pultah Doho khal, Embankments. and on the right bank of the Upper and Lower Matabhanga. The first are slight in character and have been long in existence ; they do little or no harm, and when the Bhagiruttee embankments give way, retard the flood sufficiently long to enable the ryots to prepare for its effects. They would probably be mostly useless and be allowed to fall into decay if the Bhagiruttee embankments made secure. were The embankments on the Julkur Pultah Doho khal are under Government, and are known as the Kooly khal embankments, and are absolutely necessary to be retained. 24.

In the third

Section III.

during

section,

difficulty

27. The only equires notice is

embankment on the Upper Matabhanga that the Akubpore bund, which is situated at

353

Akubpore, near Bamoondee, and was constructed 10 or 12 years previous to which temporary bunds were put up by the indigo factors and removed after the indigo crop was cut. So long as temporary embankments only existed, which were annually allowed to give way, the country inland received each rains a fresh supply of good water ; but since this has been stopped the water in most parts of the thana has become excessively bad and unfit for even bathing, much less drinking purposes. We had careful enquiries made, and found that out of 149 villages 61 desired the removal of the bund, 27 wished It would probably it to be retained, and 61 were indifferent. ago,

lead to difficulties if the bund were at once removed, and we would therefore recommend that, as it is close to where the bank of the Matabhanga is rapidly cutting away, it should be allowed to remain until it is cut through by the advancing river, when its re-erection should be prevented, unless those interested are prepared to provide the funds for erecting the new embankment, and for adequately sluicing it uuder competent professional advice. The embankments on the right bank of the Lower 28. Matabhanga extend from below Chooadanga to above Kacheekhatta, and, with the exception of the Kacheekhatta bund, which is a Government work, were made by Mr. Skrine, when Assistant Magistrate at Chooadanga. The Government bund is only about two miles in length, and is required to protect very low lands ; in former times indigo-planters put up temporary bunds where Mr. Skrine's bunds now run, and the crops were temporarily protected and secured ; whilst the bund bursting afterwards admitted of the land receiving a rich deposit from the silt brought in with the flood waters, and the water-supply This has now been entirely of the people being renewed. changed; afinekhal near Kudompore has been closed, and many other small channels, while the inland water-supply has deteriorated in quality. The embankment burst in 1879 in a few places, and let in fresh water, and the breaches have not been repaired ; the river is now approaching the embankment at many points, and will eventually cut through it in several places. These bunds should not be allowed to be re-erected, unless they are sufficiently sluiced under the advice of a competent engineer. It is only right that we should mention that the people are greatly in favour of retaining the bunds, preferring the security of their crops to what they cons'der the doubtful advantage to their health. The most important works which it is desirable to 29. undertake in this tract in order that the people Rivers and khals. may get fairly good drinking water are the

opening anil improvement ot the iShyruu river and the Unjonah khal, both of which are now closed at their entrances, and for a considerable distance down. We are quite alive to the difficulty of resuscitating a 30. dead river, but there is a peculiar feature in the case of the Bhyrub which renders success not very improbable. We refer to the (Moorshedabad) Bhyrub having through changes in the parent stream now become the main J el liny hi, and to the water being in consequence backed up in the upper reaches of the Tellinghi from which the Nuddea-Bhyrub takes off. We therefore propose to attempt to make a channel for the water which enters the Upper Jellinghi by a cut from that river to the Bhyrub, about two miles in length and 150 feet in breadth at top. This new cut would shorten the Bhyrub by several miles, as will be seen from the map at the end of this report ; [not printed] and it already has a good outfall at the Matabhanga end. The cost would be about one lakh of rupees, of which perhaps one-sixth This would admit fresh could be raised by local subscription. water through a thickly-populated and extensive tract where it is much required. The entrance of the cut would be liable periodically to silt up, and would very probably require to be occasionally cleared out, but how often, and at what cost, we If the work were successful, it have no data to determine. would also open out a large rice-producing country to boat

traffic.

A project for deepening the Unjonah khal, and placing 31. inlet sluice at the Kishnaghur end, and a regulatiag sluice at the Matabhanga outlet, at an estimated cost of one lakh of rupees, has already been prepared by the Irrigation Branch of the Public Works Department, and is now under the consideraIt provides for letting about six feet of tion of Government. water into the khal during ordinary high floods, say for about one month each year, and would doubtless be a very great improvement. It is evident, however, that the project has principally been prepared with a view to the surface drainage of the town of Kishnaghur, and although it would also give an

354

THE INDIAN MEDICAL GAZETTE.

better water to th". villages along the banks of the khal, we do not think that the scheme goes far enojgh, and would suggest that the cut should be three feet deeper, and be 20 feet instead of 10 feet in width at bottom at the Kishnaghur end. If this the villages along the khal would get a greatly were done, improved \Vater-supply, and the khal could he much more effectually flushed out. The cost of the work would probably be raised by these pioposals from a lakh to a lakh and-a-half of rupees. 32. We also think that it would probably be desirable to connect the Kalinga khal with the Jellinghi, by a cut near Chupra, sluiced at its head, and we would suggest that a qualified officer should be sent to ascertain the probable cost ; and the extent to which those interested are prepared to subscribe. 33. The advisability of deepening and sluicing the Sarasatti khal and its branches, and thereby enabling the water to be run rapidly off io or 12 square miles of low land in the cold weather, was pressed onus by those interested. At present the khal is bunded in the rains to prevent the river water entering, and the bund cut in October to let the rain water out from the Chuchookhala bhil. The question appears to be one of an agricultural rather than a sanitary nature; what is aimed of the water being run off as at chiefly being to admit quickly as possible to get in the rubee crops The scheme might be carried out at the cost of those benefiting by the work. 34. Roads.?In the fourth tract, which is literally seamed with old river beds, fever was particularly Section IV. severe in 1881. Here we saw the only road during the whole of our investigation on which the provision of waterway had been systematically neglected ; this was a very which crosses old road between Karagola and Ramnuggur, several beds of dead streams and rivers, with very insufficient waterway, and in some cases with no opening at all. We found the sub-overseer closing the breaches m de by the water last year in its endeavours to escape, instead of leaving ample provision for waterway. This road should receive the urgent attention of the Road Cess Committee. We consider that a few culverts and small bridges would be desirable on the following roads:?Chooadanga to Sindureah and Kalapole, Kissengunge to Kotechandpore, Moheshpore to Chowgacha, Haghda to (Jarapotta, and Garapotta to Bongong. There was, however, no serious obstruction to drainage on the above roads, and in fact the last three are barely raised above the level of the country. 35. Embankments.?The principal embankments in this tract are on the left bank of the Matabhanga from near Chooadanga to Moonsheegunge, and on the right bank of the Kumar from Kesabpore through Oosmanpore, Hurdui, and Kumaree to near Alumdanga : all these appear to have been either constructed On the Matabhanga they are low or repaired by Mr. Skrine. and fast wearing down lower, and in parts will soon disappear Their reconstruction should not be in the advancing river. allowed unless they are properly sluiced, and the people would the water-supply probably be better without them altogether, as To ascertain this, would be improved and the lands fertilized. however, with certainty would require a closer enquiry than we the to matter. to small cuts Several have been were able give made in the Kumar embankments to let out the rain-water them : behind these of cuts are course reclosed. which lodges A few small sluices are required at such places. Near Alumdanga which breaches have been two left If these are unclosed. there embankments are again repaired the work should be carried out under professional supervision, and sluices be provided to allow of water being let in or out. 36. We consider professional advice necessary in most cases of construction and renewal of river embankments, in o'der that the effect of a proposed work in stopping the natural escape of the spill across country and thereby raising the floodlevel of the river below, and confining the floods to a few main arteries, may be fully considered before a work is undertaken. The Matabhanga and Kumar embankments, constructed by Mr. Skiine, tend to raise the flood-level below them and to concentrate the flood discharge crossing the Eastern bengal Railway on to a few large bridges, instead of allowing it to escape by Profesthe whole of the flood openings provided on that line. sional advice is also required to determine the number and sluices of to admit an requisite adequate supply of description water to a tract of country enclosed by an embankment?an important consideration which has in most cases been overlooked. 37. There is a bund at Jeebunnuggur 011 the Uhyrub, which is sometimes cut to obtain water, the result of which is that ?

[December, 1SS3.

sub-division are said reason the bund should be sluiced, and should not be allowed to be cut. 38. Rivers and k/ials.?In this tract we have a number of once were dead streams which large rivers ; these are the lihatahi, the Cobailuck or Bhyrub, the Nobogunga, and the Mysore-Chitra, and the advantage which would accrue to numbers of villages in both Nuddea and Jessore if these w ere le-operied has been impressed upon us in several quarters, and we fully admit this ; we are, however, of opinion that the idea " on recent Mr. J. Fergusson in his paper is impracticable. changes in the delta of the Ganges," read before the Geological Society of London,' has shown how the chang( See Volu me es in. these dead rivers occur, and ^\liy they XIX of the Quarleave their old beds and take new courses, and terly Journal of the the course of nature in Geological he aptly remarks that Society, 1863.) this matter can be no more interfered with than beat once 111 a pendulum 39 inches in length can be made to two seconds of itself. It can be forced to do so for a time, by of the pressure is removed, theapplication machinery; but directly So it is with these it will rapidly return to its normal beat. rivers ; it is their office to raise the delta by the deposition of silt, and each river flows in a given course until it has completed its work, when it either changes its direction or dies, and a new river Is opened out elsewhere. The application of various expedients may retard the operation of natural laws for a time, but eventually nature will effect her end. The rivers above alluded to are already dead ; to resuscitate them is practically impossible. The cause of the change above referred to is this : A river runs in a given course, gradually elevating its bed and the country near it to or above the level of the rest of the adjacent delta, until one of two things happens, namely, either the river overflows into a lower tract of country, and commences to raise the new tract, or, if that part of the delta is practically levelled up and completed, the river is gradually choked by its own sediment and dies, and a new river is opened where the land is lower out in some other part of the delta, and requires raising. The above rivers have followed this the delta in and western Jessore has Nuddea latter course ; been raised and practically completed, and by the gradual deposition of silt, the line of drainage, which (Sec Westland's was fromerly from north-west to south-east, is Jessore ) now from north-east to south. In other words, the work that had to be performed by the Bhyrub, the Cobaduck, the Nobogunga, and the Mysore-Chitra, has been completed, and the rivers have died. In their place the little Elankhali khal has opened out into the great Madhumati, and the Gorai has enlarged ; and, to use Mr. Westland's words, the formative energy has been carried at one bound from the west of the Jessore district to the east of it. It has been argued that the Eastern Bengal Railway 39. was originally constructed with "absurdly inadequate" waterway, and that this has had a good deal to do with the deterioration of these rivers ; but we do not concur in this opinion, for they were all dead many years before that line was made: The belief probably arose as follows : In 1S71 the Bhagirut'nee embankments burst for the first time since 1856, and an enormous volume of water was suddenly poured across the country in consequence, and thrown against the railway ; and the waterway on that line, which had hitherto been ample to pass all flood-water that crossed it, was quite inadequate to pass this unexpected additional amount, and the line was breached in several places. Additional water-way has since been provided to guard against a re-occurrence of a similar accident. We see no reason for a moment to suppose that, had the railway not existed, any of the old rivers would have again opened out, or that matters would have been different from what they now 200

or

be

to

300

more

villages in the Bongong or less submerged ; for this

*

are.

Another point that has been urged is that Government 40. has been apathetic in the past, and that small amounts judiciously expended on the Nobogunga, Hliyrub, and other rivers, would have prevented their closing. We do not concur with this for the reasons already given, but consider that any money spent would have beer, simply thrown away, and that the rivers were choked by natural laws which must have prevailed in the end, although undoubtedly, in the case of the Bhyrub-Cobaduck, its final extinction was hastened by the construction of a cut-off near Ramnuggur on the Matabhanga. about 60 years ago. We would also notice that two attempts were actually made to keep the Bhyrub-Cobaduck open, one at its off-take from the Matabhanga, the other where the Bhyrub and Cobaduck bifurcate. The works were carried out

December,

1883.]

REPORT ON THE EPIDEMIC FEVER IN NUDDEA.

under the direction of Mr. John May, who had been specially brought out from England to manage the Nuddea rivers, and both attempts resulted in complete failure. In regard to the Nobogunga, the practicability of re-opening it was fully enquired into in the years 1876 anil 1877, and Govern(No. 746C. of of ment in the Public Works the 15th Department decided August, 1878.) that the enquiry conclusively showed that it would he "unadvisable to undertake the re-opening of the river either for navigation or even for irrigation purposes." 41. On the general question of re-opening the whole of these rivers we would remark that the Upper Matabhanga does not even now bring down sufficient water to prevent the If such is the case with a stream Kumar from deteriorating. still living, how hopeless must it be to expect that the Matabhanga would, in addition, keep open a number of dead rivers like the Nobogunga, Bhyrub, &c., even should artificial connections be effected. It has {also been urged by Mr. Skrine and others that 42. the construction of the Eastern Bengal Railway has caused saturation of the sub-soil in Eastern Nuddea and Jessore. A glance at the map will show that this is impossible ; the railway runs parallel and close to ihe general course of the river Matabhanga, whilst the fall of the country trends away from that If the water-way were inadequate river to the south-eastward. the effect would be to divert the flood-water into the river Hooghly, and thus keep those tracts drier, and so prevent any general water-logging. As a fact, observations in December of water-level in wells, showed it to be from 15 to 24 feet from the general soil surface level in the west and north-west of the district. This also was about the observed depth at which water flowed out from scarped banks of rivers, proving that there was no water-logging of the surface soil, or even of the soil generally, down to the depth of at least 15 feet. In the south and south-east of the district the subsoil water-level is somewhat higher. In fact, as Dr. Sutherland observed in 1868, " ihe district is becoming more and more arid, tanks and other reservoirs of water dry up even before the hot season, tanks full to overflowing in the rains rapidly dry up?facts which prove that there has been of late no increase or excess of moisture in the soil." The very jungle, contrary to the assertions of some natives we met, as Dr. Lidderdale points out, is of a kind that prefers a dry to a damp habitat. In the villages themselves no doubt water-logging does occur, and L)r. See Sanitary Coates has clearly pointed out the cause of this Commissioner for in the following words* ;?" About the drainage Rengal'sNo. 726S of the 23rd of the ordinary Bengali village. It is dug out of of S e pt ember the common rice-field level of the country. Holes 1S79,to the Secre- are left owing to the mud floors and walls of tary to Governhuts having been taken from them ; tanks are ment, Financial I )e(Sanitary/ dug also, and when the road has been worn partment, part- below mean level, it is repaired with earth taken graphs 17 and 18. from excavations made alongside, which leave hollows and ditches of irregular width and depth, rarely connected wirh each other so as to form one continuous drain. Now these tanks, cesspits, hollows, and ditches are the drainage reservoirs of the village, and as their deepest parts are below the levels of the fields around, they cannot he thoroughly drained away." Near Damarhuda there is an old loop of the Mata43. bhanga, which runs past Jovrampore and rejoins the river near This loop or bend was a main the village of Roghonatlipore. The Damarhuda end of this old bed stream many years ago. has silted up for about half a mile, and the lower end is closed by a b ml, to keep out the floods and enable the land to be cultivated. The result is that the water in this loop is not renewed from year to year, and so has become unwholesome. The people have presented a petition asking that a sluice gate may be erected at Roghonatlipore, so that water may be let in or out as desired. This would, no doubt, be a great improvement : but as the outlet has been closed by a bund made by the ryots themselves for their own advantage, this is a work which we think should be undertaken at the cost of those who benefit by the bund. In the fifth tract, the eastern half which >s similar in 44. character to Section (IV), suffered most severely from fever in )8So, but less in lool ; whilst in the western Section (V). half, which is generally higher than the rest of

Nuddea, the fever has not been very severe in either year. The only road on which we found insufficient water-way was The obstruction to the road between Chogdah and Bongong. drainage was not excessive, but some culverts were undoubtedly required, and these we arranged to have constructed at once.

355

This was the only work, the project for which was sufficiently advanced before we left Nuddea to admit of our sanctioning the expenditure of money on it with safety. There are no embankments in this tract. 45. Applications were made for the opening of the Jaboona river, which formerly left the Hooghly near Kancharapara, and after a tortuous course of about 30 miles fell into the Ichamati, An examination made by the Irrigation near Goala ferry. Branch of the Public Works Department in 1875 showed that the bed of this khal was about 10 feet above low-water level in the Hooghly, and after this enquiry, the idea of attempting to open it was abandoned. The Jaboona was undoubtedly once a larger rivet, but, like the other dead rivers referred to above, it has fulfilled the purpose of its existence, and is gradually disappearing. Any attempt to open it would involve the outlay of a very considerable sum, and would, there seems every probability, end in failure. 46. As may be gathered from what has been said above, the general result of our investigations shows, that there is very little obstruction to local drainage caused by the roads and railways in the district of Nuddea, and that such obstructions as do exist, are not of serious importance, except on the rare occurFurther we have found that rence of unusually severe "floods on most roads where drainage was obstructed in times past, bridges and culverts have been gradually provided, or breaches have been made to allow the floods to pass, whilst roads recently made have generally adequate water-way, so that there is now absolutely less obstruction to drainage than at any preIn the tract between vious time within the last 20 or 30 years. the Ichamati and the lower Matabhanga and Hooghly, in which the fever was severe in 1880, the slight obstructions on the Bongong road were the only ones we found in the entire tract, whilst in the tract between the Bhagiruthee and Jellinghi. which suffered most severely in 1881, we were unable to find any obstruction at all. These facts, we submit, speak for themselves and conclusively negative the theory that local obstructions to drainage on roads and railways have been an imporWe would further urge tant factor in causing the epidemic. that in an extensive district like Nuddea covering nearly 3,500 square miles and traversed by several large rivers, it would be impossible for a few local obstructions to cause such ood seems to be dying Bongong observes : ?" The old class of men who used to dig tanks, sometimes for the benefit of the public, but chiefly for the good of their own souls, are gone. They have been succeeded by a generation who lack their faith, but are ignorant of the sanitary code of modern civilization. The consequence is that most of the old tanks are in ruins and overgrown with noxious vegetation, and the number of new ones is very small." The people seem, as a rule, to look to the zemindars for the excavation of tanks, and if this is their duty, they do not perform it. In fact during our tour we saw only one new tank being dug.

THE INDIAN MEDICAL GAZETTE.

356

51. The embankment of the rivers for protection from floods has also had a bad effect by preventing the tanks being annually replenished by a good supply of river water. 52.

The other usual

causes

of the deterioration of tank water

everywhere at work, such as admission of village drainage, bathing, washing of clothes, general defcecation on the banks, planting trees and bamboos round them, the leaves of which falling into the water quickly rot, whilst their branches prevent the access of light and air, useful in the oxidation of animal and vegetable matter. 53. We have done what we could to induce the people to clean their tanks, to use filters, and to adopt other precautions, were

but with scant success. The influence that an itinerant commission such as ours can exercise over the ignorant villagers is but as a rule, are fully alive to the want of good slight, though they, tanks, and in many instances are ready to make the necessary at their own ultimate expense. improvements Inability to raise the money stands in their way. Some labourers might be ready to assist by giving a few days'gratuitous labour as their quota, but it must be borne in mind that the bulk of the villagers do not understand earth-cutting, and would have to pay their subscription for the hire of labour in money or kind. But they have no capital ; their only chance to obtain it is on loan, with the condition of repayment by easy instalments at small interest. As the zemindars in many instances are unable, and still more frequently are unwilling, to advance the money, though ready enough to stand security for its repayment by the villagers interested, we recommended the Collector to apply to Government for permission to make advances, to private persons or commutes for the purpose of digging new or restoring old tanks. We are not aware what action has been taken in the matter.

54. A condition of the loan should be that those tanks be made the property of the village community under the control of the punchayets, and should not belong to the zemindars, who might let them out for fishing, &c., to the detriment of the water-supply. The puncnayets being residents have an equal and immediate interest with the people in preserving the purity of the water, which an absentee landlord has not. In all cases where loans are made, the Collector should look to the position of the tanks proposed to be dug, and have those intended for drinking purposes placed outside the villages. Constant care will have to be taken to see that the banks towards the village are kept in good repair to prevent the entrance of village drainage, and that no trees or jungle are allowed to be planted or grown on the banks. In every village (and in every large parah if possible) one tank should be set apart for drinking alone, and no bathing or washing of pots should be permitted in it. These are obvious precautions, but we repeat them, found that are having they constantly disregarded.

55.

carefully

56. Dead rivers. A very large, perhaps the largest* Casting of corp- part of the water-supply of the district is ses. from dead rivers, and nothing can be worse than their condition. Corpses are freely thrown into them as long as there is sufficient water to cover the dead body. In many parts of the district no pretence of cremation was observed, and burning their dead among ihe lower classes of Hindus is evidently not now the custom. Near Meherpore, on the Bhyrub, just above the municipality, where a fishing weir had created a pool, a peculiar oily scum, very evidently of animal origin, was plentiful, clearly betokening that many corpses had been thrown there, while all along the course of this Near Akunstream there was further evidence of the practice. daberia the lake that is now the source of the Cobaduck was for this favourite of the immersion manifestly spot corpses, for dozens of turtles came swimming to where we happened to stop to converse with the villagers, evidently mistaking our gathering for a funeral party, and so expecting to obtain a meal. 57. Nothing can be more horrible or more dangerous than this practice of throwing the bodies of the dead?many perhaps victims of contagious disease?into the drinking water-supply of the survivors. At all costs it should be prevented. The extracts appended from communications received from Bahoo Shama Charan Chatterjea and other inhabitants of Dvirgapur show that the more intelligent natives are fully alive to the clanger, but the mass of the people are utterly careless and thoughtless. At a place called Bara Salooah the villagers took credit to themselves for throwing their dead into the Mysore stream below their village, but only smiled when it was pointed out

[December, 1883.

that this stream, a mile lower down, flowed past Kaloopole, and supplied its inhabitants with water. 58. The custom has long existed, but in this time of sickness it has enormously inexcessive mortality and creased, probably owing to the survivors being unfitted by ill-health or prevented by poverty from obtaining The scarcity of fuel is no doubt, the great sufficient fuel. obstacle to proper cremation ; forests and jungles have long since disappeared, and the sole supply available is derived from the village lands. The amount belonging to each village is insufficient in ordinary years, and therefore cannot possibly meet the demand of periods of sickness. The difficulty is further complicated in some places by private rights in existing burning ghats, which add greatly to the cost of cremation. Altogether the question is so involved that we confess that after careful thought we are unable to suggest any really satisfactory solution.* The current in these dead rivers is very sluggish, and the surface of the water is frequently covered by Fishing weirs acquatic plants chiefly patina, a floating weed and bunds for found everywhere in Nuddea. These plants cultivation. would ordinarily exercise a cleansing action on the water if allowed to float away with the current when their work is done. But unfortunately, besides natural, there are many artificial obstructions. Everywhere we have met with large fishing weirs, built from bank to bank, with perhaps a small opening at either side to allow boats to pass. These weirs are permanent during the greater part of the year, and are so contrived as to stop all but the very smallest fish. Their mischievous action is obvious ; not only is the slow progress of the current retarded and scour prevented, but all matter floating on or suspended in the water is stopped, collects near, and, for some way above these weirs, rots and falls to the bottom. The water is rendered foul by such decomposition, and the channel A of the stream is permanently injured. shallow is formed by these deposits, the bed of the river silts up year by year, until a a running stream is transformed into a stagnant marsh. The Unjonah khal, whose foul condition is alleged to 60. have caused so much fever near the town of Kishnaghur, is a notable example. These traps still exist there, and until they are removed altogether, or their number very considerably reduced, there can be no hope of improvement.

59.

61. The Ichamati and other streams in Bongong near the sub-divisional head-quarters are gradually being injured by simiIn 1878 the sub-divisional officer, being alive lar contrivances. to the impending danger, ordered their wholesale removal : but his decision was upset in High Court, the obstructions were allowed to remain and even increase; and notwithstanding the remarks made in paragraph 3 of the Government Resolution of the 17th May, 1881, nothing has since been done to stop the practice. The district officer seems to have considered the order of the High Court as establishing the indefeasible right of the "julkur" holder to erect fixed engines, but in our opinion the order of the sub-divisional officer was quashed 011 account of irregularities of procedure, and not on the merits of the question. As we consider these obstructions most deleterious, and likely to cause much damage to the future water-supply from these ri\ers (to say nothing of the impediments they offer to free navigation), we beg to append a copy of the High Court's order, [not printed] with a recommendation that the question should, if possible, be

re-opened.

Another most objectionable custom of a similar nature in the introduction of large collections of grees Kamors." boughs and branches known as Ivamors into the water (particularly of bhils and baors) for the purpose ot attracting and sheltering fish, at a time, too, when the water is subsiding. Many complaints were made against this mcde of fishing, and with reason. The wnter of the Bhatahi, on whose banks for several miles there are situated large villages, has been completely spoilt in its upper reaches : these green boughs not only rot but cause increased growth of water-weeds and propagate worms of various kinds?all fatal to the purity of the water. Of late, particularly in the Bongong sub-division, the immersion of " Kamors" has been greatly on the increase, probably owing If the to the failure of the sub-divisional officer's test case. supply of good and pure water is to be maintained, fishermen 62.

"

Note?Dr. Lidderdale desires to record that in his opinion land suitable for the creation of fuel reserves is plentiful in Rajshahye, near Godagari, on the Ganges, in the Bhurind country, already partly under jungle, and that it might be just possible to utilize this for the production of a cheaper fuel supply to those parts of Nuddea connected by water carriage with the Ganges.

December,

t883.]

must be made to return to innocuous means.

REPORT ON THE EPIDEMIC FEVER IN NUDDEA.

legitimate fishing

with nets and other

63. In the shallower and shallowing portions of streams, the work of deterioration is similarly hastened by the construction of earthen bunds for cultivation and fishing purposes. 64.

The

Steeping

Jute, &c.

steeping of jute, hemp, bamboos, &c., is constantly practised, and is very objectionable. Some ot the smaller bhils are thus completely ruined. In Durgapore, near Kishengunge, where

there had been an extremely heavy tever mortality, the only insanitary conditions which were specially observed were a very large accumulation of cow-dung in the goalpara,* and jute-steeping in the water holes in the village and in a bhil to the westward, from which the people ot one parah draw water, though most of the villagers took water from the Matabhanga.

Springs and well*.?The water in the dead rivers after rainy season is entirely supplied by percolation from the country through which they pass, and in the beds of some rivers the water was found forcing itself upwards in strong bubbling springs, bringing with it fine sand. Small wells dug in s-uch situations would give good and pure supplies, but the people seem never to have availed themselves of these, as they said the holes filled up again so quickly. They should be encouraged to use them more freely. 66. Other svells are common throughout Nuddea, but the It is chiefly water is never drunk if any other can be obtained. used for cleansing cooking pots and other household purposes. The people dislike it very much, saying that it disagrees with them, and has an [unpleasant taste. Considering that the wells soil of the village, sometimes within a few are sunk in the foul 65.

the

feet of graves, it is not wonderful that the water should be bad. There is a cess-pool, and in larger places a well privy, often in the immediate vicinity, from which percolation must take place directly into the well. Many wells are not dug sufficiently deep, and dry up in the hot season, when the people are reduced to great straits for water. 67. Baors.?There are also a few fine baors or lakes apparently parts of old river beds (chiefly in the eastern half of the district) and numerous bhils ; water from the smaller ones is of bad quality, yet it is universally used. General insanitary condition of villages.?We have dwelt 68. at some length on this subject of the water-supply in Nuddea, as But besides many of its conditions are peculiar to that district. the deficiency and impurity of the drinking water, we found still prevalent in the villages themselves every insanitary defect that former observers had noted?defects that are more or less common throughout Bengal. The bad condition of the land on which villages are built is brought about by the mode of construction of houses and the habits of the people. 69. In a country with a heavy annual rainfall and subject to well raised. Earth is used for this inundation, houses must be " bhita" thrown up, and on top of purpose and a homestead or of a mud. with This necessitates is built this the house plinth the digging of an adjacent hole, often very deep and always undrained. One homestead having been formed in the manner above given, another and another is added without arrangement of any kind generally crowded together until the whole village is honeycombed with such holes. These receive every sort of household refuse, and nearly all the year round contain water of the foulest description. The water in them is often so well retained that in Asowri, for example, we found from actual levels that in March it was only about six feet below the general surface of the village. 70. The roads are mere tracks, passing irregularly among the houses, and are often six or eight feet below the level of the foundations, so that they serve'as drains, and remain wet and muddy long after the rainy season has passed. To obtain earth to raise or repair them more holes or disconnected ditches are dug which hold water, and are much used for steeping bamboos and jute. 71. Tanks of various sizes and depths are scattered about the village. As the people go to draw water and bathe, parts of the protecting banks wear away to such an extent that the drainage from the roads passes through them into the tanks. In this way these (reservoirs become shallow and foul in a very few years. In some of the better arranged villages there is a tank to each parah, placed just outside the village, but not sufficiently removed to ensure purity or freedom from village drainage when the banks are

breached.

?

?

I *

Goalpara is the part of a village where cowherds live.

357

72. Well or surface privies are erected in many a homestead without a thought or a care as to how they are ever to be cleaned ; while from want of latrines or particular localities set apart for the deposit of household and other filth and refuse, the roads and open grounds, especially the edges of tanks, are fouled with the grosser forms of pollution. In the village of Alikdeah, near Chooadanga, we found it almost impossible to get down to the water in one of the tanks, its banks both outside and inside were so covered with filth ; yet the water of this tank The mortality in this village was enormous. was being drunk. 73. Cattle-dung.?Cattle-dung is, as a rule, never removed outside the village. A little is used in the cultivation of sugarcane and tobacco, and some for fuel, but not sufficient to make in difference the cleanliness of the village. any appreciable Cow-houses are generally placed with their backs to the and out of little windows the cow-dung is thrown by hand. A heap is thus formed, gradually getting larger and larger, till it where into the it is over into road, dust by the ground spilis hoofs of cattle and washed away by the rains into tanks and holes. It is again dug out of the holes, and even used in restoring or building walls. A house was found in a village in Gangni thana which had actually been built on an old cow-dung heap, a section of the foundation clearly displaying its nature.

road"

Diminished fertility of the soil in NudJea.?There is a of opinion among Europeans and natives that, except in the lower lands used for the rice crop (arnun dhan) reaped in is a distinct decrease in the the cold weather, there of fertility the soil of Nuddea. Considering that no land except that used tobacco'is and ever for sugar-cane manured, and that the Ganges floods which are so fertilizing are shut out by the embankment of the rivers, it is not to be wondered.that gradually the soil should become partially exhausted. Yet tons of the finest manure in the shape of cow-dung are available in every village, but this supply, which, if utilized by the cultivators, would restore the fertility to their lands, is not only wasted, but allowed to degenerate into a positive insanitary evil. interment.?In the Mahomedan quarters 75. Infra-village of the villages the dead are constantly buried on Fever See the very borders of the tanks, and under even Commission ReHere and there the doorsteps of the houses. port of. 1864. cemeteries are to be found, but even in those places where they exist they are not exclusively resorted to. Graves may be seen scattered abou. in every direction, and these graves are seldom made sufficiently deep to ensure the people against poisonous exhalations from the interred bodies. In fact the bodies lie so near the surface that sometimes as is well known they are disinterred by jackals and dogs. 76. In many villages, particularly those surrounded by low lands, it is difficult to find outside their precincts any wasteland sufficiently above water in the rainy season to admit of corpses being buried to the necessary depth without the graves partially filling with water, hence the burial-grounds are often situated in the very heart of the village itself. 77. Shade. Shade is necessary to health and comfort in tropical climates ; it is therefore to be expected that trees would be freely grown in villages, more particularly those that yield fruit. Their growth should be encouraged, as they assist in purifying and taking moisture from the soil; but the people, from a desire for privacy, permit undergrowth to spring up and flourish all round their houses to such an extent that the ventilation of the village is greatly obstructed and foul air detained. They themselves often complained of the number of bamboo clumps grown, and considered them noxious. A thick matted covering of low jungle shielding the earth from the purifying influences of sun and air is injurious, and keeps the village site damp almost throughout the year, whilst the sheltered places thereby afforded for easement add to the bad effects. 78. Overcrowding.?In the villages of Nuddea human beings and animals live in the closest proximity, and overcrowding at nights is general in the huts. Five or six persons often sleep huddled together for warmth on the floor in a hut so small that there is no room for a proper machan. As these huts, being built of mud, are almost devoid of'ventilation, and are closed at nights, the air before morning must becomc much vitiated and must add to the provocatives of fever. Clothing of the people.?The people seem, as a rule, to be 79. badly supplied with clothing. This conduces not only to acute inflammatory attacks, but is very favourable to fever. 80. Diet.?The diet of the lower classes is of inferior quality. Rice with a small supply of poor watery vegetables or dhall and Fish is scarce in many places. a little salt is their daily fare.

74.

consensus

THE INDIAN MEDICAL GAZETTE.

35^ 8l.

Many petitions

Petitions.

were

received from

villagers asking

for

assistance towards the excavation of their tanks ; to take in most cases the were

ready

people

loans, as mentioned in paragraph 53. In none consider the excavation of a tank such a work of urgent necessity as to bring it within the category of works on which we should have been justified in spending any portion of the Ks. 50,000 placed at our disposal. Besides the application for the drainage of the Chuchuk82. hola bhil through the Sarsatti khal, already referred to in paragraph 33, similar applications were forwarded to us from villages near Oosmanpore in Baluka thana of Kooshtea and Bairampore in Bongong. But as they were not received until sometime after we had left these sub divisions, we were unable to visit the places in person. Mr. Anderson, the Sub-divisional Officer of Kooshtea, made minute local enquiries into the subject-matter of the first of these petitions, and his conclusions coincide with those which we formed in the matter of the Chuchukhola bhil, that these works are not of great importance from a sanitary point of view, but that the real object of the applicants was to obtain the rich bottom lands for cultivation. The matter is, however, being dealt with by the local civil authorities under Act VI (1J.C.) of 1880. 83. Other subjects on which we have received petitions have been alluded to in the body of our report. 84. In many places we had the opportunity of meeting deputations of the more influential inhabitants, while Action of the two meetings of special importance were held at Commission. Kishnaghur and Chooadanga. At the former the question of opening the Unjonah khal was in particular discussed, while at the latter the want of proper Mahomedan burialgrounds having been pointed out, Munshis Nasimadin, Keyamadin, and other resident jotedars most generously agreed to preInformation and advice was everysent the necessary land. where offered. No opportunity was lost of impressing upon the villagers the advantages of filtering water ; and in order to afford them a practical illustration, Mr. Tayler, the Magistrate, ordered a three-gurrah filter to be put up at every thana, and its use and construction explained to the chowkidars on their weekly visit. We found, indeed, that some villagers were accustomed to purify water by plunging a red-hot iron into it, or even by boiling, and these practices we recommended them to continue ; others, again, used alum ; but usually no precaution whatever is taken. 85. The advantage of sleeping on machans was strongly urged, but their use is not the custom, nor is it likely that the people will improve in this respect. Apart from the fact that the smallness of the huts renders their adoption difficult, the villagers themselves object that in their present want of warm clothing and wrappers, it is more comfortable to sleep on the floor than on machans unprovided with proper bedding. did

we

'

Relief of the fever-stricken was under the control of the Medical Department, and Government, at our Works of urrecommendation, supplemented this by the gent necessity. liberal distribution of cinchona febrifuge to 86.

many native practitioners. 87. As we have shown above, in Summary.

out

opinion

the outbreak

of lever cannot be attributed to local

obstruction,

from want of water-way in roads or railways, nor can it be shown that the silting up of old channels or creeks has been the immediate cause. 88. If it were within the range of practicable expenditure to thoroughly drain away the surface water by a system of arterial drainage laid out by professional agency and supplemented by village drains, good might result ; but disconnected attempts to drain particular localities should be carefully watched, as much injury might be done thereby to adjacent places. 89. With the exception of the Bongong road, mentioned in paragraph 44, we found that there was no work on which there could be immediate expenditure. We further considered that the excavation of tanks had better be left to the village communities themselves, aided by tucavvi loans. Thus a very large balance of the Rs. 50,000 placed at our disposal still remains unallotted. We would recommend that it be laid out on the scheme for opening the Nuddea-Bhyrub, together with any further sum which may be necessary to supplement local

subscriptions.

to

drainage

90. The opening of the Unjonah khal has, we understand, been already provided for. 91. The Kolinga khal scheme, if feasible, might be undertaken by the District Board, supplemented by local subscrip-

tions*

[December,

i!

92. The advantages to follow from the opening of the Nabogunga, Cobaduck, &c., would be undoubtedly so great that if Government does not consider the inquiry of 1876-77 conclusive, we would recommend, notwithstanding our own opinion expressed in paragraph 38, that the matter should be further professionally enquired into. 93. A list of the roads examined by the Commission on which additional water-way is required is appended, with the amount of water-way necessary, so far as the visit of the Commission enabled them to determine. We have dwelt at length on the various insanitary con94. ditions found in the villages, and have no doubt as to their very injurious action upon the general health of the people. How far they have caused or even influenced this outbreak of fev?r is more a matter of medical science than one to be decided by a mixed commission ; but the opinion of the Sanitary Commissioner will be found in Appendix B. In any case, the defects we have pointed out should be remedied. All of them are within the immediate power of the people themselves to remove Under the guidance of Mr. Tayler and his subordinates, a few villagers have tried to improve their condition by clearing jungle, forming buiial-grounds outside the villages, raising subscriptions for the improvement of the roads and drains, and in other ways ; but very much more remains to be done : more power must be given to District Committees, such as is contemplated in the Bengal Government's letter No. 9212, dated 8th April, 1882. We, however, feel that it is sufficient for us to call attention to these sanitary defects, and to leave it to the experience of the Magistrates and Committees to frame such bye-laws concerning them as may meet the peculiarities of their respective charges. Sd. R. Lidderdai.e, m.d., A. W. Paul, ,, T. W. WlCKES, ,, Note

on

the type

of

President,

}

Members.

Fever.

An enquiry into the nature of this fever was undertaken by officers of the Sanitary Department in the season of 1880, and there was no clashing of opinion concerning it. All recognized it as a malarious fever, such as is usual in Bengal during and after the rainy season, but of a very virulent kind. The Civil Surgeon of Nuddea, after two seasons' experience, speaks of it as " an ague intermittent, characterized by relapses, which in the majority of cases terminated in splenic enlargement followed by anaemia, and in prolonged cases splenic dropsy terminating in diarrhoea and death." Extreme emaciation was also often seen among the sufferers, depending upon almost complete loss of the power of digesting food. The fever does not differ from that described by Dr. Elliot, after enquiry in 1863, and accords with descriptions of the disease as seen in Hooghly and Burdwan during the great outbreaks in these districts. It has, however, some very characteristic features, making it as something apart from ordinary marsh malarious fever, viz., its virulence, its incidence in, and absence from neighbouring places, its mode of progression over the face of a country, its extreme tendency to relapse, and its difficulty to treat successfully, except without long periods of medication. Its virulence has been so great as to have led several careful observers, such as Dr. Elliot, Dr. Jackson, and Dr. Sutherland, to believe that it was contagious fever in the same sense as scarlet fever or small-pox is contagious. Noticing how it travelled along lines of communication, taking years at times to progress across a district?how it stuck to houses till, in many instances, nearly every inhabitant had been removed by death?how offensive the smell proceeding from the bodies of the sufferers was,?it is not surprising that this opinion of its contagious nature should have arisen, and be still held by numerous native medical men. One of the oldest and most experienced practitioners in Kishnaghur, Baboo Kali Kumar Lahori, who has seen the fever since its first appearance, believes it to be contagious, and has muchto advance in favour of his opinion. 0 With the light of later pathological observations, the progress in elucidating causes of disease afforded by the germ theory, and especially the cultivation of Anthrax virus of various degrees of virulence by Pasteur, it seems unnecessary to consider the fever as a contagious one. It is obvious that it requires many favouring circumstances, especially those of locality, to originate or reproduce an outbreak, and Dr. Jackson remarks that "it is intensified in old, effete, decaying, rotting places, saturated with

December,1 '1883.]

REPORT ON THE EPIDEMIC FEVER IN^ NUDDEA.

organic debris, and either in Jessore or

that a fever, originally malarious, acquired Nuddea contagious properties." Further, that in the large crowded towns of western Nuddea, he says Oolah for instance, a still further elaboration of poison and accession of intensity occurred." That this last view is correct seems to agree witfrvfiry high scientific opinion that diseases long known may, with favouring circumstances, appear in much more general and fatal forms. Pasteur has shown this with regard to the disease called Pebnne, among silkworms. The sudden and unaccountable appearance of great flights of insects passing over and devastating countries?the appearance generally of a plant which before was only noticeable by a few specimens?all assist us in reasoning that germs which in ordinary conditions are in normal number, more suitable conditions, spring up but under may, very similar, in unusual numbers and strength. Professor Tyndall writes: "Though epidemic disease requires a special contagion to produce it, surrounding conditions must have a potent influence on its development Looked at, therefore, from the point of view of the germ theory, the exceptional energy which epidemic disease from time to time exhibits is in harmony with the method of nature." His experiments, too, on the sterilization of liquids proved fully that the measures sufficient for complete sterilization in " 1875 were quite inefficient in 1876, in consequence of increased vitality or virulence in the contagia afloat." Following the germ theory, therefore, we may reasonably conclude that the fever which has done such havoc in Nuddea, as in many other districts of Lower Bengal, is nothing but the ordinary fever of the Gangetic delta, whose germs, by specially favouring conditions, have so intensified as to cause a very virulent and fatal disease. "

The history of cholera is a similar one. Originally looked upon as a mild endemic disease, it appeared in 1817 in Jessore in epidemic form of extreme fatality, which has been its characteristic ever since. It has acquired intensity not only in its natural home, but strength to travel all over the world. Dr. Sternberg, when considering the question of the occasional of virulent qualities by micro-organisms, writes :? acquisition " The fact observed by myself, that during the summer months the mud in the gutters of New Orleans possesses an extraordinary degree of virulence, shows that pathogenic varietes of bacteria are not alone bred in the bodies, of living animals. The more I study the subject, the more probable it seems to me that in this direction lies the explanation of many problems, which have puzzled epidemiologists, and that the sanitarians are right in fighting against filth as a prime factor in the production of epidemics, a factor of which the role is easily understood if this view is correct." The germ theory applied to the explanation of malarious fever has numerous objectors. Lately Professors Klebs and Tommasi-Crudeli have announced the discovery of a Bacillus Malarise in the soil of the Agro-Romano and in the blood of M. Laveran, another persons suffering from intermittent fever. investigator, found parasitic organisms, very definite in form, and most remarkable in character, in the blood of patients suffering from malarious poison. Dr. Oldham, however, a writer on Indian fever, has failed to find the Bacillus, and he has inoculated himself and others, and dogs with the blood of fever patients without producing the disease. ' Dr. R,oy records : I have examined about 30 specimens of blood of fever patients in all stages of illness, and I must confess that I have not noticed any of those crescent-shaped bodies of Laveran or Bacillus Malaria of Huxley. Some small spherical-shaped bodies were discovered either clustered together round blood corpuscles, or separate, having a clear centre, and about quarter the size of a blood corpuscle. These belonged to the class of micrococci, but inasmuch as their presence was constant in all specimens of blood of fever and fever-free patients, I am inclined to look upon the admixture as accidental from the air. The microscope used in these experiments had a magnifying power of 500 diameters.' Dr. Sternberg, whose investigations into the etiology of the malarial fevers are published in the annual report of the National Board of Health, United States, 1881, shows reasons for the belief that a fallacy is involved in the celebrated experiments of the Italian observers, still negative evidence is not conclusive that there is no germ which produces malarial fever. We know that matter can be so finely divided as to be quite invisible under the highest powers of the microscope, and Only at present discoverable and demonstrable by the electric beam. We are therefore not entitled to say that there is no germ, because it has

359,

not yet been satisfactorily demonstrated under the miscroscope, or, because intermittent fever exists in both dry and marshy countries, jump to the conclusion that its origin is chill. Reasoning from analogy, and using the germ theory, much is satisfactorily explained. For instance, treating the cause of the fever as an intensified malarious germ, which originated in certain"" highly favourable insanitary conditions, we can understand that, when transmitted from one place to another where the conditions are similar, it will grow and flourish. It requires a Mahomedpore, Srinuggur, or Oolah to bring it to full vigour, in the same sense as overcrowding is favourable to typhus poison, and, once reared, it can be carried from place so place. It accords with the history of the disease that it is removed from village to and if mushroom spawn can be imported from Europe to India, why of this virus disease the be carried not in should the sciil On a bullock's hoof or a cart wheel ? An instanc.e, and a very marked has been Baboo of introduction given by one, Shyama Charan Chatterjea, a medical practitioner residing in Gosain Durgapur, He reports : " During a village on the left bank of the Pangasi. last year before the general outbreak of fever at Durgapur, a few people went to Belgachi to dine with a relative. They came' back and got the fever. Since then the whole village' was violently overtaken with the disease, which gradually assumed an obstinate and fatal type." Special centres of disease, such as Belgachi and Nagarbanka, should be carefully looked after. Any village where the usual factors of disease lie in a dormant state is much likely to catch the infection from a neighbouring place by means of human intercourse. We do not mean -to say that these fevers are strictly communicable from man to man, but that the disease germ from an infected spot acts much like a ferment in an already predisposed neighbouring place. Such These centres of infection are in was the case at Durgapur. fact the fons et origo viali? the hot-beds of fever germs. Following this mode of reasoning, it is easy to explain many of the facts which have been considered stumbling-blocks in its In a memorial from the zemindars, talookdars, way before. and traders of Hooghly and Burdwan, presented in March 1869 to the Lieutenant-Governor of Bengal, they say: " But they have at the same time remarked that many low and jungly the drink which water from stagnant pools people villages in while several villages are not at all affected by the epidemic, and on broad roads and good drinksituated high land, having have been the hot-beds of water tanks, ing epidemic mortality." Again "it (the epidemic) is shown to have been unaccountably in its incidence, seizing fitful and capricious indiscriminately on towns whose sanitary arrangements are the best, and others where sanitation was quite neglected, and entirely overleaping tracts which there was every reason to suppose most liable to its attacks." The explanation is easy if we supposed that all that is required is the introduction of a virulent fever germ, carried by human intercourse chiefly. All villages and towns in Bengal are sodden with animal excrement, no matter whether they are situated on the old alluvion or the new in Burdwan or Bankoora, in Nuddea or in Moorshedabad, or Beerbhoom, and the only element apparently wanting for the creation of an outbreak of this fever in them is the presence of its own special germ. If they are unable to originate this type of the disease, they at any rate possess all the conditions necessary for its pre-

viilage,

valence."

(Signed.)

R; Lidderdale, M.D., Sanitary Commissioner for Bengal.

Inoculability of Leprosy in Animals.?Dr. Otto Damsch has made a number of experiments on the inoculation of leprous material in animals. The results seem to show positively that leprosy can be communicated to animals. Portions of leprous tissue may remain for months in the animal body without the nuclei of the cells or the bacilli contained in them losing their power of absorbing colouring matter and becoming stained not and the bacilli may only remain intact for as much as four to seven months in the bodies of cats or rabbits, but they may His experiments show further that, where actually multiply. the bacilli penetrate, processes occur which are analogous to the leprous processes in man, not only histologically but also in their progressive character and in their tendency to infect neighbouring tissuess. ( Virchozu's Arehiv, vol. 92, April, ?

1883.}

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