Chapter III.] EPIDEMIC FEVERS OF INDIA AND THEIR RELATION TO JAIL MORTALITY.
grew more prominent, and became soft and soon assumed a spongy hæmorrhagic appearance.
The mouth and tongue got pallid, and the breath emitted a heavy sickening odour. Now the
pulse increased in frequency steadily throughout the day; irritative fever set in; and torment
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ing pains were developed in the muscles or in the tendons of the extremities, seldom in more
than one member, unless when the cases were of considerable aggravation. These sites got
tumified, exceedingly tense and non-elastic, and having the skin over them of a colour un
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naturally dark. They were more or less diffused, sometimes occupying the whole circumference
and extent of the limb, which would have a shining polished appearance. Sometimes they
would only embrace a portion of the extremity such as the calf, and then the color was
generally darker. Vibices occasionally came out in other places, without either pain or swelling.
In this state the patient's flesh and strength wasted rapidly. The teeth embedded in the flabby
gums felt loose and were unfit for the purpose of mastication, and a horrid fœtor now proceeded
from the mouth. Despondency took entire possession of the mind; there was no sleep from
intense suffering, and no appetite. At this period every symptom underwent rapid advance,
and the unfortunate subject sank eventually, and more immediately under dropsical effusion."
On this state of matters followed the epidemic malarious fever of 1834, and in the spring
of 1836 relapsing typhus was epidemic over Rohilcund,* and the
Pali plague in Rajpootana. Throughout 1837, there is a long
record of typhus over all the same area. Rankin tells us that,
while the reported plague prevailed in the west, common inter
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mittents and remittents existed in the intermediate space; and an infectious yellow fever
devastated our villages and jails in Upper India. Appendix 8 of the Report proves that the
same yellow fever existed in Rajpootana. Dr Irvine's letter states, that at Jodhpore, where
thousands have died from the present epidemic of yellow fever, in very few or none of the
cases buboes were observed; hence the malady was said not to be the plague, and to have no con
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nection with the Pali disease.
The great famine of 1837-38 came in the midst of this epidemic. We know that it did not
introduce the typhus, since the fevers had already been epidemic for two seasons. The accounts
of this famine are voluminous; and I have already quoted details regarding it in another
r e p o r t .
This fever, known as the Moradabad fever, was not confined to Moradabad in 1836.
find the Superintending Surgeon of Agra, writing on 10th
June, reporting that a hundred natives are dying daily in Agra
and about fifty daily in Muttra from fever, although the troops
at both stations are perfectly healthy. From the date of this communication, there is almost
the certainty that this was a typhus.
In the Annual Report of the Agra Circle for 1836 the fever is thus alluded to
—
"Much fever, attended with jaundice and delirium, prevailed, and was very fatal generally
in the district of Bolundshuhur, where the working prisoners were employed, but they do not
seem to have suffered anything like so much as the poor villagers, few of whom escaped. Some
villages were almost left desolate by the ravages of this fever. On the setting of the rains, the
evil became less general."
The Report for 1836 for Meerut, also mentions that this fever reached its climax in May
and June.
The Superintending Surgeon at Meerut writes: "A very fatal epidemic, attended by
contagion, prevails at Moradabad, the symptoms very nearly resembling those of the yellow
fever of the West Indies, and some nearly approximate to those of the plague of the Levant.
Numbers of prisoners have fallen under its attacks, and many villages between Bareilly and
Moradabad and to the southward, have been depopulated. In Rampore and in the City of Mo
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radabad its ravages were fearful. Generally speaking, May and June have been particularly
sickly all over this part of the country, and few places have escaped from remittent fever of
varied severity. The sickness has been pinch felt by the villages between Bareilly and Morada
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bad, and melancholy results have followed in the cities of Delhi, Meerut, Moradabad, and
Rampore. To the northward of that line, it has not committed any marked ravages, although
to the southward it has been experienced in several places more or less intensely."
All the districts west of Delhi suffered from relapsing typhus in 1837. Ranken's report
and its Appendices contain full particulars both as to the extent of its prevalence and the clinical
characteristics of the contagious fevers which appeared at this time over Northern India. To
this report I must refer for the details.
187
Epidemic malaria and typhus in
various forms, and famine following
on the scurvy. Typhus general over
Northern and Western India.
Details illustrating the character
of the fever of 1836 and 1837 in
Upper India.
Typhus of the Agra jail of the
spring and hot months of 1838.
I find that in the spring of 1838 a typhus was introduced
into the Agra jail, commencing its attack in the healthiest
month of the year.
The Agra Jail necessarily received a famine population at this time, and with these people
was probably introduced the originating germ of this deadly fever. The remarks made
month by month by the Civil Surgeon record the progress of the fever in his jail:
Remarks for April 1838.—" A very fatal distemper has appeared—a peculiar form of fever
that, without manifesting any very violent external symptoms, attacks the head at a compara
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tively early stage, and has in repeated instances lately carried off the patients within a few
hours of their admission into hospital. It is not easy to ascertain the exact duration of the
disease at the time of admission, as no information can be obtained from the patients themselves,
* Mahamurree was particularly fatal in Kumaon in 1835, so that it is probable that typhus existed in the plains
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before 1836; for we know that bubo fever in the Himalayas is almost invariably associated with the presence of contagi
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ous fevers in the districts below.