?5
excessive mortality in Rangpur was due to ordinary malarial fever of a severe type, and
was ascribed to scantiness of rain and excessive heat, which intensified and concentrated
the marsh poison. As the mortality from kála-azár in the Gáro Hills was sufficiently
great t? produce a reduction of revenue in 1875, the disease was probably prevalent in
1874, and, from what Colonel Maxwell says, was possibly very fatal in certain places in
1872. 1 cannot, therefore, see how this outbreak of a type of fever, the symptoms of
which are so characteristic that, when several cases occur in a village, the ordinary
native at once recognizes them as kála-azár and as quite different to ordinary malarial
fever, could have been caused by persons crossing the Brahmaputra from Rangpur to
the Gáro Hills, suffering from a fever which, up to 1874 at any rate, was ordinary
malarial fever, and which appears never to have been considered by medical officers
in Bengal to have differed in any respect from severe outbreaks of ordinary malarial
fever.
13. In pages 182 to 192 of the report, Dr. Rogers gives the resemblances between
Burdwan fever and kála-azár. The distribution of the two diseases seems to have been
in many respects similar, but the character of Burdwan fever appears to have been very
different from that of kála-azár. Many cases of Burdwan fever suffered from severe head
symptoms, which are not seen in kála-azár and death in those cases often occurred
after an illness of from three to ten days. Kála-azár is essentially a chronic disease,
and death rarely occurs under a period of two months.
14. In Section IX, while discussing the communicability of malarial fever, Dr.
Rogers quotes as an analogous case the outbreak of fever in the Mauritius in 1865.
It is certainly the case that a very severe outbreak of what was generally believed to be
malarial fever occurred in Mauritius in that year, and that some poeple were of opinion
that the disease was introduced by coolies from India.
In order to show that there is nothing inherently improbable in the view that the
poison of malarial fever may become so intensified as to become communicable, he brings
forward the fact that pathogenic bacteria can be artificially intensified, and he notes
that some persons are of opinion that pneumonia, and perhaps the plague, may have two
types, a contagious and non-contagious one. These diseases are believed to depend on
the presence of vegetable micro-organisms, and, therefore, it is scarcely logical to draw
any analogy between them and malarial fever, which is supposed to be caused by an
animal micro-organism.
15. In Section X, Dr. Rogers makes certain recommendations, which, if carried out,
he believes, would put a stop to kála-azár in affected places, and would prevent the
disease spreading to places in which it has not appeared up to date. The recommenda
tions are the following:
(a) In affected tracts of country, he recommends that the people of affected villages
should be encouraged to remove their houses from affected to new sites, which
need not be more than 200 yards from the old ones, during the cold weather
months, when the disease is at a minimum. To encourage them to do this, he
recommends that they should be obliged to pay rent for only one site for the
year during which the change is made. As the sites of villages, which have
been in existence for some time, are usually in a very insanitary condition, this
recommendation might, when practicable, be carried out. Too much should
not, however, be expected from the change, as Dr. Rogers has shown that
kála-azár frequently breaks out in previously-unaffected villages when single
cases of kála-azár take up their residence in them, and the inhabitants of affect-
ed villages, when they make the change, must take their sick along with them.
Though the mortality from kála-azár is at a minimum during the cold-weather
months, the death-rate even then is very little below the average of the year.
In 1896, 23.21 per cent. of the kála-azár deaths occurred during the months
of December, January and February.
(b) He recommends that means should be taken to prevent the entry into tracts,
not affected with the disease, of persons suffering from the kála-azár, and with
a view to giving effect to this proposal, he suggests that the provision of the
lately-passed Epidemic Diseases Act, which renders this action possible, should
be put in force. It is certainly the case that kála-azár has usually been
checked when it reaches a broad belt of uninhabited country, and there have
been many examples of outbreaks of the disease in villages soon after the
arrival in them of persons suffering from kála-azár, but as, in order to be