2
4. Chief diseases.—The paragraphs in the report which deal with the
history of the chief diseases are mainly statistical and do not enter into any
discussion as to the causes of the variations when compared with previous
years. The Governor in Council realizes the difficulty of determining
the causes which influence the healthiness or unhealthiness of a particular
locality, particularly so when registration is far from perfect, but it should
not, he considers, have been impossible to give some indication as to the
cause of the large increase in the mortality, especially that from fever and
cholera.
Plague in this Presidency is confined almost entirely to Calcutta and its
suburbs, and 1,905 of the 1,995 deaths from this cause occurred in this
locality. Cholera was prevalent in every district except Darjeeling, and the
mortality was considerably in excess of that of 1912. No explanation of the
increase is furnished in the report, but there is little doubt that it was largely
due to the deficient monsoon of 1911, and to the want of rainfall in the early
part of 1912, which resulted in the water-supply becoming scanty and contam-
inated. The disinfection of wells with permanganate of potash was carried
out in several districts with successful results. There is however no scope
for any great improvement from such a measure, as tanks, not wells, form the
main source of the water-supply of Bengal. There was a slight increase in
the mortality from small-pox, but the number of deaths from this disease
was less than half of the average of the preceding five years. The highest
mortality was recorded in Mymensingh, Dacca and Tippera; these dis-
tricts were responsible for 92 per cent. of the deaths amongst children.
Dysentery and diarrhœa are more fatal in towns than in rural areas.
The mortality in 1912 was slightly above the average. Among divisions
Burdwan, and among districts Howrah, return the highest death rate.
5. Fever.—Fever continues to maintain its position as the disease most
responsible for the mortality of the province, and His Excellency in Council
regrets to find that, despite the measures taken to prevent the spread of
malaria, there was a rise in the mortality from this disease during the year.
Of deaths in the province as many as 959,193 are attributable to fever.
Malda, Dinajpur and Jalpaiguri have the worst record, but while Dinajpur
and Jalpaiguri do not show any great variation from the average of the
previous five years, the mortality in the Malda district has reached the
high figure of 35.83 per mille against a previous average of 25. Reference
was made in the report of the Sanitary Commissioner of Eastern Bengal
and Assam for 1911 to the severe epidemic which was responsible for the
increase in the mortality of the year in Malda, and it was stated that special
arrangements had been made for the distribution of quinine through the
District Boards and for facilities for the sale of " treatments." The present
report makes no reference to the result of these measures, but the increase
in mortality in 1912 would seem to indicate that they have proved of little
avail. This district alone accounts for one-sixth of the increase in the
number of deaths from fever in the Presidency. In the town of Malda
itself the death rate from fever rose from 29.33 to 41.60. These facts
demand further investigation, and the Sanitary Commissioner will be requested
to make a full enquiry to ascertain, as far as possible, the causes which have
led to this marked unhealthiness of the district, and to determine what
measures, if any, should be undertaken to effect a remedy. The Governor
in Council is also disappointed to find that despite the employment of Sub-
Assistant Surgeons in the distribution of quinine in the districts of Nadia
and Murshidabad there has been no diminution in fever mortality, but the
reverse. The various anti-malarial measures that have been undertaken
throughout the province have so far been unproductive of any real permanent
advantage, and in many places they have been discontinued. The clearance
of jungle and tanks and the destruction of mosquitos have not proved
successful measures, and a more extended use of quinine seems, on present
knowledge, the only method by which it is possible to reduce the rate of
mortality and the risk of infection. An experiment on a fairly large scale to
determine the effect of the wholesale clearance of jungle on general health
in the villages is about to be undertaken. Major Fry and Dr. Bentley
continued their malaria investigations, the former principally in the malarious