REPORT ON MALARIA IN THE PUNJAB DURING
THE YEAR 1913.
I.—Introduction.
IT has not up to the present been the practice to submit any formal
report in regard to the annual incidence of malaria in the Punjab, nor has it
been considered necessary to summarise the work of the Punjab Malaria Bureau.
It is thought, however, that a periodical review dealing with these matters
will serve a useful purpose, and it is therefore proposed to submit for the informa-
tion of Government an annual report solely devoted to the subject of malaria.
Some of the reasons which suggest the expediency of adopting this course
may be mentioned. In the first place there is no disease in the Punjab, not
excluding plague, to compare with malaria in point of prevalence and impor-
tance. It affects all races and every social grade, and the classes as well as the
masses pay an annual tribute to its ravages. It is one of the chief causes of
infantile mortality in this Province, and its influence on the birth rate is only
less marked than on the death rate. It is therefore no exaggeration to state
that malaria is the dominant factor in the pathology of the Punjab.
Secondly, a short annual review of .the situation in regard to malaria
will form a permanent record of the course of events.
Again, in view of the fact that a special department, although of a small
and temporary nature, has been created in this Province for the stud;/ of malaria
and for the preparation of schemes for its amelioration it seems expedient that
it should render some account of its stewardship.
Finally, the submission of an annual report offers an opportunity of in-
dicating the aims and objects of the department and of recording any progress
that may have been made in the systematic study of the disease and in the eluci-
dation of measures necessary for its control.
II.—General considerations.
In submitting the first of these reports it will be expedient to refer briefly
to some of the main features in regard to the incidence of the disease in the past.
Confining attention solely to the period since 1867, when vital statistics
first became available, it must suffice to state that malaria has prevailed with
a varying degree of severity throughout every district of the Province during
the forty-seven years that have elapsed since 1867,
During the major portion of this period the disease has been attended
with an average annual mortality of about 350,000, but in certain years, notably
in 1878, 1879, 1890, 1892, 1900 and 1908 the fever mortality has been greatly
in excess of this ; in 1908, for example, the malaria mortality for the months
of October and November alone reached the enormous figure of 300,000. The
annual mortality from malaria is shown in Chart I of Appendix A, which also
exhibits the relationship of the " fever " mortality to the total mortality from
all causes.
The two chief points which the chart emphasises are the relatively high
proportion the fever mortality bears to the total mortality and the marked
osculations to which the " fever " mortality in the Punjab is subject.
The latter point, however, is best brought out in Chart II wherein the annual
fever mortality during the months of October and November for the above
period is depicted. As it is proposed to bring these charts up-to-date and in-
clude them each year in these reports it will be expedient here to consider the
value attaching ta the figures on which they are based.
The recording of vital statistics in India, it is well known, leaves much to
be desired in point of accuracy. It is generally believed that the total mortality
returns are for the most part approximately accurate, but this view has not,