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greatest, and when the south-west and north-east winds blow strongly;
and that it appears in an exceptionally severe form after an early subsidence
of inundation. During 1873 the rain floods at their highest were lower than
they had been for years, and cholera appeared at an earlier date after the
rains than usual.
Bakirganj.-Cholera, which is endemic here, assumed an epidemic
form in 1873, and visited most parts of the district, particularly during the
hot-weather and during December and January, the two coldest months.
Patna.-Epidemic cholera of a severe type appeared in several parts
of this district in 1873. Except in the city of Patna, where the disease
lingered longer than elsewhere, the time of prevalence was during the hot
months, from March to September inclusive. * * * At Behar the disease
broke out with great virulence immediately after the subsidence of the
inundation of the town, which was caused by a heavy fall of rain, the severity
of the attack being most marked in those parts of the city which lie at the
lowest level, and were, therefore, most affected by the floods.
Gya.-Cholera was present in this district during the greater part of
the year, and to it in a secondary degree is due the high mortality. During
the rains the disease was more or less epidemic throughout the district-no part
of it escaped. In August it was at its highest. It was reported to have
broken out simultaneously in different parts of the district, and in places remo-
ved from the ordinary lines of traffic.
Shahabad.-Cholera, epidemic in character, prevailed during the year
in every sub-division in this district. It appeared in serious form in April;
became diffused in various parts of the district in May; increased consider-
ably in incidence towards the middle of June, particularly in the vicinity of
Arrah; and attained its maximum in July. The outbreak lasted up to
November, and the mortality that attended it was considerably in excess of
that of the preceding year. * * * Notwithstanding all the precautions that
were taken to exclude the disease from the jail by enforcing strict attention
to cleanliness, isolation, careful examination of food, allowing extra salt, and
keeping prisoners under surveillance, so as to send any to hospital the moment
they appeared unwell, cholera entered the prison on the 25th June, and
continued in it until the 5th July. It attacked 56 prisoners, of whom 18 died.
Every step was taken to stamp out the disease. The sick were isolated; their
dejecta and excreta were promptly removed to a distance from the jail;
sulphur fires were burnt in the wards and in the jail hospital; and immediate
attention was afforded to those who were attacked. Alarm caused many
prisoners to conceal their illness, thus greatly diminishing the chances of
recovery. At last it was deemed expedient to remove the prisoners from the
jail; and on the 4th July they were taken to the large building north of the
police lines and Buxar road. This step put an end to the outbreak in a very
striking manner, as only two prisoners (the last of the cases) were attacked
the next day, the 5th; and one of them was found on enquiry to have had the
disease before he left the jail. All the sanitary arrangements of the jail were
in good order; there was no overcrowding worth the name. This outbreak
cannot, therefore, be assigned to any other cause than the very unhealthy and
unseasonable weather of June and July. As illustrative of the non-conta-
gious character of cholera, it may be mentioned that the four prisoners who
were employed as sick attendants, and had worked night and day throughout
the entere outbreak, were not affected by the disease; and that of 16
others, who were similarly employed for short periods, only one was attacked.
Two methods of treatment of the sick were adopted in the jail during this
outbreak, with a striking difference in results. The first 19 cases were treated
with a mixture of sulphuric, acetic, and carbolic acids repeated every half
hour, or at longer intervals, according to the circumstances of each case. The
patients were allowed to drink moderate quantities of water acidulated with
sulphuric acid, and they had then sago or arrowroot with small quantities of
milk as nourishment during convalesence. Mustard-plasters to the epigas-
tric region, and dry friction to the limbs and chest were also employed in some
cases. In a few cases, where the disease was only just commencing, hyper-
chlorodyne was tried, but without good effect. When the urgent symptoms
were abating, a mixture of nitre, nitric ether, and tincture of cautharides