Chapter III.]
EPIDEMIC FEVERS OF INDIA AND THEIR RELATION TO JAIL MORTALITY.
183
edly be the case, the local source of the malaria in the East may be looked for. I can only
indicate generally the fact that the malaria miasm has an abode in the same region from which
we recognise that the cholera miasm issues, as we know by the manifestations which have deso-
lated so many tracts of Lower Bengal in the past ten years. I believe that every epidemic
invading Northern and Western India previously affects the Gangetic provinces or Chota
Nagpore. In 1808, as in 1866, the epidemic is found crossing the Hazareebaugh plateau;
the Calcutta fever of 1833 precedes the epidemic of 1834 in Western and Upper India; the
Gangetic valley, as far east as Patna, is occupied by the epidemic of 1816; the fever of 1844
affects the Europeans at Ghazeepore as well as in Scinde and the Punjab; the fever of 1859,
repressed out of Northern India by the famine meteorology until 1861, had its base in Raj-
mehal, Rajshahye, and Purneah; the great malaria of Agra and Northern India of 1856 was
preceded by the epidemic year 1855 in the East; the 80th Regiment was decimated by yellow
malarious fever at Dinapore in 1849, and the 1st Fusiliers at Lahore, by the advance of the
same epidemic in 1850. The sequence I hold to be natural, and not fortuitous.
Localisation of epidemic malaria
in Upper India. The subject illus-
trated.
The localities which malaria prefers are the same chosen by cholera. Naturally dry
stations, such as Meean Meer or Nusseerabad, are stricken by
malaria and by cholera as a moving epidemic. They suffer for
a certain number of days or weeks from both epidemics, and
into this short period much suffering may be compressed, although no true localisation has taken place.
But many districts of Northern India invite both malaria and cholera to settle, and afford
to both the opportunity of renewing their manifestations for months afterwards.
The localisation of malaria is a point of very great interest. Moist tracts of Upper India
have of late years retained the miasm as effectually as similar tracts within the endemic area
in Lower Bengal. For the past ten years, these fevers have run a parallel course with those of
Lower Bengal. They have formed the subject of many memoirs addressed to Government,
called for in consequence of the deadly results which they have caused in the tract affected in
the different years. Even before the mutiny, we had a notable example of the localisation of
the epidemic fever of 1856. It settled in a portion of the Allyghur district, which was
covered also by the great cholera of 1856. It died with the setting in of the cold season, after
having in a few months cut off 34,000 persons. The bad fevers of Bolundshuhur, Allyghur
or Mozuffernuggur are identical with those of Burdwan, Hooghly, or Nuddea; they appear, run
their course and die out, and continue absent for a long series of years, and no one can say that
the local conditions are different from what they were when the invasion took place. The
entire disappearance of the terrible fever of Lower Bengal, last manifested as the Burdwan
fever, is a case in point.
The following are extracts from Mr. Cutcliffe's report to the Government of the North-
Western Provinces on the fever of 1866-67, localised in the Saharunpore and Mozuffernuggur
districts:—
"Though the disease prevailed in many parts both of the Saharunpore and Mozuffer-
nuggur districts, it was neither universally distributed throughout those districts, nor was it
equally severe in those parts which were affected by it. Its ravages were chiefly marked along
certain watercourses and low swampy valleys.
"The fever commenced in all the affected places at nearly the same time, namely, in July
or August, and ended generally about December.
"The evidence seems to me to be conclusive, that the character of the fever which I have
been directed to trace and study, was malarious fever.
"It was most often intermittent, of which the most frequent type was the quotidian,
though cases of the tertian type were not uncommon. Sometimes the fever was remittent,
when it was always most severe, and was frequently attended by enlarged spleen and by
hepatic affections, manifested by jaundice and sometimes leading to dropsy; and occasionally
cases ending in general anasarca (dropsy of the whole body) were described. Diarrhœa, in
some of the towns, was spoken of as not a very uncommon complication of the graver remit-
tents, and when it came on it usually destroyed life. Where patients did not die from remit-
tent fever, the disease usually became intermittent before it ceased, the most common type
being the quotidian, and, at a later period of convalescence, not unfrequently tertian.
"In some of the towns rheumatic affections were much complained of as attending the
later stages of the fever."
I make this last quotation chiefly to disprove the suggestion which has lately been made,
that the same fever is an enteric fever. There are no grounds for entertaining such a sugges-
tion, whether as applicable to the endemic of Bengal, or to the localised epidemic of the North-
Western Provinces.
Localised malaria is not allied in
its nature to enteric fever.
A detachment of Her Majesty's 85th Regiment, marching from Futtehghur to Meerut in
November 1874, became affected by the fever, evidently while
passing through the infected tract of 1874. The fever con-
tinued to show itself for weeks afterwards. Nineteen men
were attacked in a severe form, and several died. The fever was confined to the detachment,
and did not affect the rest of the regiment after the detachment joined. The Surgeon attri-
buted. the fever to the use of an impure well near Koorja, one of the towns which suffered
most in 1874. That the poisoning took place in this neighbourhood is certain. But that it
was due to the use of bad water, can only be guessed at; and that it was an enteric fever is
disputed by nearly all who saw the cases. The Surgeon admits that the age and length of
service of the men affected were exceptional, and contrary to what has been recorded regarding