2
4. Verification of vital statistics.—Registration of vital statistics is
still defective in Eastern Bengal and in the Burdwan district. Rangpur
shows the high percentage of 13.66 omissions to register deaths.
5. Chief diseases.—The death-rate from cholera fell from 2.10 to 1.74
per mille. It was highest in Noakhali, where the people are partial to
dried fish and drink freely from tanks in which jute has been steeped ;
the population also contains a large element of Muhammadans, whose long
fasts followed by a heavy meal do not conduce to good digestion. A slight
epidemic in the Jalpaiguri Terai swelled the mortality of the Darjeeling
district ; but a plenteous and well-distributed rainfall rendered practically
immune the districts of Jessore and Rajshahi which had suffered heavily
in 1912. Cholera was, as usual, most prevalent in December and April.
This is due to the drying up and consequent pollution of the water-supply.
As soon as the rains commence epidemics cease, the lowest death-rate
being returned in July.
The mortality from small-pox shows a slight increase ; that among
infants, however, declined from 45.14 to 32.22 per mille. Small-pox is
especially prevalent in the Dacca and Chittagong Divisions. where there
is great opposition to vaccination among Muhammadans.
The number of deaths from plague shows a decrease of 1,011, the
disease as usual being confined almost entirely to Calcutta and its suburbs.
The mortality from dysentery and diarrhœa shows a slight increase, but the
relative intensity in districts and divisions is practically unchanged.
There was a small increase in the total number of deaths from fever, the
rates per mille for 1913, 1912 and the average of the five years 1908—12 being
21.30, 21.16 and 20.45, respectively. The mortality from fever in 1913
represents 72 per cent. of the number of deaths from all causes, an increase
of 1 per cent. over 1912. Dinajpur and Jalpaiguri head the list with death.
rates of 30.08 and 29.39 as compared with 34.13 and 32.08 in 1912. In
twelve districts the death-rate exceeded 25 per mille. In the district of
Malda six Additional Sub-Assistant Surgeons were employed for the dis-
tribution of quinine. The result was satisfactory, for the death-rate from
fever fell from 35.83 in 1912 to 28.93 in 1913 ; no reference, however, is
was asked to make into the unhealthiness of this district. In Nadia and
Murshidabad the death-rate continued to increase, though slightly, notwith-
standing the deputation of Sub-Assistant Surgeons to these districts. The
reason for this continued increase cannot be ascribed to any antipathy to
the services of these officers, for it is stated in the report that their work
was generally appreciated. In the Burdwan Division twenty-five Sub-Assist-
ant Surgeons were deputed to the flooded areas to render gratuitous medical
aid. The subsidence of the floods, however, was not marked by any unusual
prevalence of fever ; in Burdwan town, on the contrary, the almost complete
absence of mosquitoes and flies attracted the attention of the Civil Surgeon.
The travelling dispensaries previously established in Dinajpur and Rajshahi
were transferred to Jalpaiguri for work in the Western Duars for a period
of one year. Quinine in " treatment " form is reported to be increasing in
popularity, and its use is being encouraged, as far as possible, by advertise-
ment and by the appointment of quinine vendors. The Provincial Malaria
Committee dealt chiefly with this question of the popularisation of quinine,
but jungle-cutting experiments were also considered. Major Fry, one of the
two Special Deputy Sanitary Commissioners for Malaria Research, was on
leave from March. His reports, containing many important researches, have
since been received. Dr. Bentley drew up two experimental anti-malaria
schemes, which have been approved by the Malaria Committee and
submitted for sanction with the proposal that the grant made for jungle-
clearing be utilized in carrying them out.
6. Vaccination.—The report on vaccination covers the triennial period
1911-12 to 1913-14. The number of operations performed each year
averaged 1,929,425, of which 1,722,101 were primary and 207,324 re-
vaccination cases ; these figures are all slightly higher than those of the
preceding triennium. In Bakarganj there was a very large decrease in
1912-13 ; but it is reported that the figures of the previous years were totally