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PART II.

AUTUMNAL EPIDEMIC (FULMINANT) MALARIA.

CHAPTER III.

The Epidemic of 1908.

   The autumn of 1908 in the Punjab was characterised by an epidemic of
extraordinary severity. The effects of this epidemic were first prominently brought
before the public by a sudden disorganisation of the train service due to "fever"
among the employees at the large railway centre, Lahore. With equal suddenness
it made its presence felt throughout the whole Punjab. Where the epidemic was
severely felt almost the entire population seems to have been prostrated by sick-
ness; and the mortality almost invariably rose in such places to a rate of several
hundreds per mille.

   A very peculiar feature of the epidemic was that though it was severely felt
in the rural areas (the returns for the Gurgaon district for example showing
among a population of 687,199 a death rate during October of 267 per mile), it
seemed to reach its greatest intensity in certain of the towns and very severely
affected even the larger cities.

   At Amritsar, a city of 160,000 inhabitants, it is stated that almost the entire
population was prostrated and the ordinary business of the city interrupted. For
many weeks labour for any purpose was unprocurable and even food vendors ceased
to carry on their trade. Thus not only was ordinary food difficult to obtain and
the prices excessive, but, owing to malaria among the cowkeeper class, milk, a
necessity for the very young and the sick, was practically unprocurable even at
the exorbitant rate of 8 to 12 annas per seer.

   In the two months, October and November, during which the epidemic was at
its highest, 307,316 deaths were recorded in the Punjab. In Amritsar the mortality
for many weeks was at the rate of over 200 per mille. In Palwal mortality rose to
420 per mille and in Bhera to 493 per mille. Curiously enough in Delhi, a noto-
riously malarious town, the death rate rose only to 149 per mille. But a closer
examination of the statistics shows that parts of the city were much more
seriously affected than one would judge to be the case from the statistics for the
whole city; in Ward I, for instance, the mortality rose to over 300 per mille.

   In the rural returns the mortality rates were not as a rule so high as those given
for badly affected towns. This might be taken as showing that the mortality was
greater in towns than in rural areas, but a study of returns from individual thanas
and villages modifies this conclusion, many villages and even whole thanas showing
mortality rates during October and November of 300—400 or even 500 per mille

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