188

STATISTICS OF THE JAIL POPULATION OF BENGAL FROM 1859 TO 1876.

[Section III.

owing to the cerebral complication having come on. Few in whom the cerebral affection has
once appeared have ultimately recovered."

       Remarks for May 1838. —"Unprecedented as was the jail mortality in the preceding month,
that of the present month greatly exceeds it. In spite of the utmost vigilance, and every
possible attention on the part of the civil authorities, the disease prevails now throughout the
whole jail. Many of these fever cases have survived only a few hours. Out of 64 fatal
cases, more than the half have been thus lost within the three first days of their admission,
and one died in the jail before he could even be brought into the hospital.

       "The constitution of the inmates of the jail seems to be much below the average. Many
cases of diarrhœa, even when the relaxation of the bowels was moderate, sank and died in a few
days, without apparently an attempt on the part of the constitution to rally or to resist the
tendency to death.

       Remarks for June 1838. —"Fever has been the source of 33 of the casualties, and in five of
these the fatal issue took place within forty-eight hours. Two men died before reaching the
hospital; and in almost all, the cerebral complication was established before admission. This
arises from the insidious nature of the disease, which often shows no symptoms sufficiently
urgent to be noticed by the attendants till the result has actually occurred. When the cases
have been received early, the termination of the primary affection has generally been favorable,
though in some cases the patients have been ultimately carried off by bowel complaints or
pectoral disease. Dysenteric disease and fever continue the chief causes of mortality. Forty-
eight deaths have occurred from dysentery and diarrhoea of all periods of duration, from six weeks
to two days. In many of these cases, the disease, though rapidly fatal, exhibited nothing in
the general symptoms to excite alarm, till the patient suddenly sank exhausted.

       Remarks for July 1838.—The mortality from the same causes as before, still continues
excessive, the casualties being 66. Dysenteric disease continues unabated; 49 prisoners have
been carried off by it.

       Remarks for August 1838.—During the present month, the mortality cannot be said to
have either increased or abated. From fever the mortality happily continues to subside, the casu-
alties being only 15. The disease has assumed more of an intermittent character than
during the months of the hot weather, when the continued or remittent form prevailed.
The mortality from bowel complaints still continues unabated, and 50 prisoners have died during
the month.

       The remarks for August indicate the dying out of the fever at the usual season of its
decay.

Epidemic malaria, relapsing fever
and famine, 1859-66.

       As most of my illustrations will be taken from the history of the epidemic period, 1859-66,
I shall enter more at length into the characteristics of the two
fevers which came forward over Upper India in these years—
the malarious fever of 1859-60, and the contagious fever which
for six years subsequently held its ground.

The epidemic of malaria in the
valley of the Ganges, of October
1859. Behar Provinces.

       Reports on this epidemic malaria of October and November 1859 were called for by the
Inspector General of the Medical Department from the medical
officers serving in the Gangetic districts affected. Reports were
furnished by the Civil Surgeons of Patna, Behar, Shahabad, and
Buxar. A notice of these will be found in the "Indian Annals"
for 1860. There is no difference of opinion exhibited in these reports; the writers give the
same history, and almost in the same words.

       The writer in the "Indian Annals," to whom they were handed over for analysis, has grasped
the leading feature which distinguished this fever, namely, that it was an invading epidemic.
He writes:—"There is, in the first place, a very strong analogy, not to say similarity, between
the occurrence of this outbreak and the sudden spread of other endemic diseases through and
beyond regions in which they always exist in some degree. Secondly, it resembles the sudden
invasion by ague of considerable districts, both urban and rural, of Europe, in which diseases of
this class are by no means generally prevalent. And, thirdly, internal evidence in the patho-
logical features of the fever leads to the same conclusion."

       The character of the fever itself is thus noticed,—"Its operation on the system and in the
production of pathological changes, was precisely that of the ordinary fevers of the country, in
all the instances recorded in these papers. Fatal cases in the hands of English medical officers
were extremely few, and this brings us to the point, which, in the absence of all other specific
characters, We must regard as the chief peculiarity of this epidemic; it is, that, while simple
treatment proved so perfectly and uniformly efficacious that the fact is remarked upon in all
the reports, the disease unresisted was extraordinarily fatal."

Eastern Bengal.

       The epidemic commenced earlier in Eastern Bengal than in the Gangetic districts in-
vaded in October. The Civil Surgeon of Rajshahye, writing
in the beginning of 1860, appends the following to his Jail
Report for 1859:—"The whole district of Rajshahye has during the last five months been very
unhealthy. Not one village has escaped the scourge of fever and dysentery, and there is cer-
tainly no family in which one or two deaths have not occurred. It is said that so frightful a
visitation has not been known for many years."

Ghazeepore, Benares, and Mirzapore.

       The Civil Surgeons of the eastern districts of the North-Western Provinces, of Ghazeepore,
Benares and Mirzapore, also recognised clearly the true nature
of this epidemic fever in their districts, and the date of the