STATISTICS OF THE JAIL POPULATION OF BENGAL FROM 1859 TO 1876.
[Section III.
180
cholera. Its manifestations are, however, less definitely marked; and hence the difficulty of
appreciating the natural history of the malaria miasm, as read in its manifestations, is far greater
than in the ease of cholera, since the fact of the presence of cholera can never be misapprehended.
Many of the most deadly epidemics of India have been caused by fevers purely mala
-rious. When the deadly remittent type of this fever is general
over an area, the inexperienced constantly ask, whether so viru
-lent a fever is not being propagated from man to man; and
inferences entirely at variance with facts are deduced from a mistaken view of the nature
of the prevailing fever.
Another very common misapprehension is, that, for example in a jail community, the
ordinary fevers of August and September degenerate into a typhus in the end of the year. In
several eases I have noted the true history as very different. As a rule, these jails have been
infected by typhus in April and May, when the typhus season was coming to an end; the
germ of contagion was lost sight of from June to October, although all this time continuing
to infect the community, and ensuring a deadly outbreak lasting from November till June of
the year following.
The extreme importance of apprehending correctly the natural history of fevers in general,
and of yellow fevers in particular, cannot be too strongly urged.
Copland insists on the same thing in the very comprehensive
sentence which follows:
—
"The manner in which very different diseases have been confounded the one with the
other, by those espousing the non-infectious nature of yellow-fever, whether from ignorance or
unfairness, has led to the most serious consequences to the community, has misled the inex
- p e r i e n c e d , m y s t i f i e d t h e s u b j e c t s i n d i s p u t e , f u r n i s h e d g r o u n d s f o r a s p e c i a l p l e a d i n g s o r t o f
argumentation, and endangered the safety of fleets and armies and even of kingdoms." *
Epidemic Malaria.— The Succession of Epidemics from 1807 onwards.
What is meant when we speak of an epidemic of malarious fever, I have many times tried.
to explain, and I shall here again illustrate the subject.
Taking a typical station or district, say in Northern India,
which experience tells us will localise malaria if epidemic, the
records of a very long series of years will point out certain
seasons, separated by clear intervals, which are indices of the universal prevalence of malarious
fevers, not in the district specially, but over the entire provincial area defined by subjection to
the same meteorological influences.
The history of the Saharunpore district in Northern India in its relation to malaria epide
-mics is typical. The local enquirer ascertains, that in the past
seventy years certain years are recorded or traditionally remem
-bered as years distinguished from all others as fever years; and
these are the years recognised in all other districts of the same
natural area as the fever years of the present century. As in
the case of cholera, not one but many natural provinces may be covered simultaneously, or in
succession, by the same epidemic.
Dr. Garden, who was for many years Civil Surgeon of Saharunpore, in endeavouring to
estimate the effects of canal irrigation on the development of fever, has brought together
from the records of his district the general facts extending over a period of fifty years, and has
supplemented these by enquiries among the inhabitants, who, as I have said, recognise seasons
as epidemic, and know that in their constitution such seasons differ essentially from what is
normal for the locality.
Such an aggregate of facts was exactly what was required to show that a single locality may
be typical for a natural province in relation to epidemic malaria. The natural provinces of
malaria and cholera being the same, and the laws of distribution homologous, a typical station
or a typical district, as in the case of cholera, will show that the local phenomenon is but a
fraction of a universally spread and geographically limited whole; and what is noted as an
epidemic of malarious fever in Saharunpore is but an index of the spread of the same fever over
many or over all the epidemic provinces of the Continent of India.
It was the localisation of epidemic malaria in 1869 that caused Dr. Garden to turn his
attention to the enquiry. He writes: "Feeling that the terribly fatal outbreak of 1868—70 must
be in some way exceptional, I have searched all available records for information, in the belief
that to read the epidemic aright, the history of the past must be studied." His conclusion is,
that the study furnishes proof that at certain periods violent epidemics have occurred, which,
implanted on the ordinary endemic fever, have proved most fatal, though at the same time they
formed but portions of wide-spread outbreaks, extending over more or less of the whole penin
- s u l a , a n d p a s s i n g e v e n b e y o n d i t s b o u n d s .
Dr. Garden quotes my account of the geographical area covered by the fevers of 1850 and
1859, as given in the original cholera report, and be states that ever since he witnessed the great
fever of the end of 1859, when he was Civil Surgeon of the Ghazeepore district, the impression
left on his mind has been the same as that conveyed to me by the occurrences of these few weeks.
In the present century up to 1850, Dr. Garden finds in the Saharunpore district records
of the following epidemic years: 1809, 1817, 1829, 1834, 1843—45, and 1850.
*Dict. Epidemics, p. 779.
Primarily, malarious epidemic
fever is not contagious, and mistakes
may arise by assuming the contrary.
Importance of distinguishing
the difirent varieties of yellow
fevers.
Epidemic malaria has a history,
general and local. A single locality
may be taken as typical for a great
-natural province.
The Saharunpore district as typi-
-cal, taking the epidemics from 1810
onwards. The epidemics from 1810,
general as well as provincial mani
-festations.