NationalLibraryOfScotland/medical-history-of-british-india huggingface dataset:
ix
STATEMENT No. VII.
SHOWING THE ALLEGED CAUSES OF INSANITY AMONG THE LUNATICS IN THE PUNJAB LUNATIC ASYLUM, LAHORE, DURING THE YEAR 1910—concluded.
1
1
Remaining on 31st December ... ...
Admitted
Criminal ... ...
Non-criminal ... ...
TOTAL TREATED ...
Discharged
Recovered ... ...
Improved ... ...
Not Improved ... ...
Died ... ... ... ... ...
Otherwise ... ... ... ... ...
Remaming on 31st December
...
...
15
16
17
18
19
20
21
22
23
24
PHYSICAL CAUSES—concluded.
Excessive
sexual inter-
course.
Males.
41
...
...
...
...
...
...
...
...
...
...
Females.
42
...
...
...
...
...
...
...
...
...
...
Total.
43
...
...
...
...
...
...
...
...
...
...
Here-
dilary
Males.
44
13
1
6
20
5
...
...
2
...
13
Females.
45
3
...
...
3
...
...
...
1
...
2
Total.
46
16
1
6
23
5
...
...
3
...
15
Mastur-
bastion.
Males.
47
4
...
1
5
...
...
...
...
...
5
Females.
48
...
...
...
...
...
...
...
...
...
...
Total.
49
4
...
1
5
...
...
...
...
...
5
On account of
never having
menstruation.
Males.
50
...
...
...
...
...
...
...
...
...
...
Females.
51
...
...
...
...
...
...
...
...
...
...
Total.
52
...
...
...
...
...
...
...
...
...
...
Injury to
brain.
Males.
53
...
...
...
...
...
...
...
...
...
...
Females.
54
...
...
...
...
...
...
...
...
...
...
Total.
55
...
...
...
...
...
...
...
...
...
...
Syphilis.
Males.
56
2
...
1
3
...
...
...
...
...
3
Females.
57
2
...
...
2
...
...
...
...
...
2
Total.
58
4
...
1
5
...
...
...
...
...
5
Neurotic.
Males.
59
4
...
...
4
...
...
...
...
...
4
Females.
60
...
...
...
...
...
...
...
...
...
...
Total.
61
4
...
...
4
...
...
...
...
...
4
Exces-
sive
heat.
Males
62
...
...
...
...
...
...
...
...
...
...
Females.
63
...
...
...
...
...
...
...
...
...
...
Total.
64
...
...
...
...
...
...
...
...
...
...
Starva-
tion.
Males.
65
1
...
1
2
...
...
...
2
...
...
Females.
66
1
...
...
1
...
...
...
...
...
1
Total.
67
2
...
1
3
...
...
...
2
...
1
Total
Physical.
Males.
68
249
9
65
323
39
2
...
34
1
247
Females.
69
42
...
8
50
5
...
...
2
3
40
Total.
70
291
9
73
373
44
2
...
36
4
287
25
26
27
MORAL CAUSES.
Grief.
Males.
71
16
...
1
17
...
...
...
2
...
15
Females.
72
15
...
1
16
7
...
...
...
...
9
Total.
73
31
...
2
33
7
...
...
2
...
24
Other
Causes.
Males.
74
14
...
3
17
2
...
...
3
...
12
Females.
75
6
...
...
6
...
...
...
1
...
5
Total.
76
20
...
3
23
2
...
...
4
...
17
Total
Moral.
Males.
77
30
...
4
34
2
...
...
5
...
27
Females.
78
21
...
1
22
7
...
...
1
...
14
Total.
79
51
...
5
56
9
...
...
6
...
41
28
29
30
TOTAL.
Total
Known.
Males.
80
279
9
69
357
41
2
...
39
1
274
Females.
81
63
...
9
72
12
...
...
3
3
54
Total.
82
342
9
78
429
53
2
...
42
4
328
Total
Unknown.
Males.
83
234
15
57
306
33
4
...
41
8
220
Females.
84
60
3
19
82
9
...
...
6
...
67
Total.
85
294
18
76
388
42
4
...
47
8
287
Grand
Total.
Males.
86
513
24
126
663
74
6
...
80
9
494
Females.
87
123
3
28
154
21
...
...
9
3
121
Total.
88
636
27
154
817
95
6
...
89
12
615
x
STATEMENT No. VIII.
SHOWING THE CASH ACCOUNT OF THE PUNJAB LUNATIC ASYLUM, LAHORE, FOR THE YEAR 1910 AND TWO PREVIOUS YEARS.
YEAR.
1
1908
...
...
...
...
...
1909
...
...
...
...
...
1910
...
...
...
...
...
RECEIPTS.
Received
from Treasury.
2
Rs.
89,248
93,839
85,582
A.
5
7
8
P.
5
4
2
Received from paying patients.
3
Rs.
4,947
5,110
6,769
A.
10
7
11
P.
8
7
10
Value
of stores received from
the Manufacturing Depart-
ment, less cost of raw
material.
4
Rs.
3,748
4,379
4,028
A.
14
4
1
P.
10
4
6
Book receipts, i.e., the total of
expenditure entered in co-
lumns 19, 20 and 21.
5
Rs.
34,076
8,515
4,748
A.
9
13
6
P.
1
9
8
Miscellaneous receipts.
6
Rs.
1,041
2,249
2,078
A.
9
1
13
P.
11
0
11
Total.
7
Rs.
1,33,063
1,14,094
1,03,207
A.
1
2
10
P.
11
0
1
CHARGES.
Establishment.
Establishment, proper.
8
Rs.
15,676
16,467
16,249
A.
8
1
12
P.
4
9
6
Superintendence.
9
Rs.
17,914
18,143
14,367
A.
8
4
1
P.
0
0
9
Diet.
10
Rs.
43,832
46,473
44,403
A.
9
12
0
P.
2
0
8
Clothing and bedding.
11
Rs.
8,113
7,846
5,669
A.
6
6
1
P.
8
4
7
Bazar medicines.
12
Rs.
152
329
231
A.
5
1
4
P.
8
7
2
YEAR.
1
1908 ... ... ... ... ...
1909 ... ... ... ... ...
1910 ... ... ... ... ...
CHARGES—concluded.
Contingencies.
Contingencies, pro-
per.
13
Rs.
6,391
8,004
7,879
A.
10
6
1
P.
6
11
6
Repairs and mainten-
ance.
14
Rs.
781
493
283
A.
10
12
0
P.
11
1
6
Rates and taxes.
15
Rs.
134
460
528
A.
9
15
3
P.
0
0
0
Remitted to Treasury on
account of paying pati-
ents, &c.
16
Rs.
5,989
7,359
8,848
A.
4
8
9
P.
7
7
9
Miscellaneous items.
17
Rs. A. P.
...
...
...
Total of columns 8.17.
18
Rs.
98,986
1,05,578
98,459
A.
8
4
3
P.
10
3
5
Book Charges.
Charges on account
of work done by
the Public Works
Department.
19
Rs.
33,138
7,377
3,757
A.
0
0
0
P.
0
0
0
Cost of printed forms
and stationery.
20
Rs.
74
127
97
A.
6
2
0
P.
11
8
1
Cost of
English
stores, medicines,
etc.
21
Rs.
864
1,011
894
A.
2
11
6
P.
2
1
7
Total of columns 18.21.
22
Rs.
1,33,063
1,14,094
1,03,207
A.
1
2
10
P.
11
0
1
REMARKS.
23
xi
STATEMENT No. IX.
SHOWING THE SANCTIONED ESTABLISHMENT OF THE PUNJAB LUNATIC ASYLUM, LAHORE, AS
IT STOOD ON THE 31ST DECEMBER 1910.
1
Establishment.
Superintendent
...
...
...
...
...
...
...
Deputy Superintendent ... ... ... ... ... ... ...
Assistant Deputy Superintendent ... ... ... ... ...
Head
Clerk
...
...
...
...
...
...
...
Muharrir
...
...
...
...
...
...
...
Head Attendant
...
...
...
...
...
...
...
Deputy Head Attendant ... ... ... ... ... ... ...
1st Class Attendants
...
...
...
...
...
...
...
2nd Class Attendants ... ... ... ... ... ... ...
3rd Class Attendants
...
...
...
...
...
...
...
Matron
...
...
...
...
...
...
...
Assistant Matrons
...
...
...
...
...
...
...
Sub-Assistant Surgeon ... ... ... ... ... ... ...
Dhobi
...
...
...
...
...
...
...
Tailor
...
...
...
...
...
...
...
weaver
...
...
...
...
...
...
...
Chaprasi
...
...
...
...
...
...
...
Probationers
...
...
...
...
...
...
...
Attendants
...
...
...
...
...
...
...
Cook
...
...
...
...
...
...
...
Sweepers
...
...
...
...
...
...
...
2
Number.
1
1
1
1
1
1
1
4
12
45
1
3
1
1
1
1
1
6
6
1
18
3
Monthly wages.
Rs.
1,150
160
115
44
20
25
20
62
168
506
60
120
45
9
9
10
8
54
51
12
110
A.
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
P.
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
Daily average number of males ... ... ...
„
„
„
females ... ... ...
Proportion of
Jamadars to males ... ... ...
Jamadarins to females ... ... ...
Male keepers to males ... ... ...
Female keepers to females
...
...
508.26
123.63
254.13
123.63
8.20
30.91
xii
STATEMENT No. X.
SHOWING RECEIPTS AND EXPENDITURE ON ACCOUNT OF MANUFACTURES IN THE PUNJAB LUNATIC ASYLUM, LAHORE, DURING THE YEAR 1910 AND
TWO PREVIOUS YEARS.
1
YEAR.
1
1906 ...
1909 ...
1910 ...
2
MEAN POPULATION.
Males.
2
508.17
508.32
506.26
Females.
3
124.17
124.53
123.63
Total.
4
627.34
632.85
631.39
3
4
5
6
7
8
CREDITS.
Cash paid into Treasury for
articles sold.
5
Rs.
1,041
2,249
2,078
A.
9
1
13
P.
11
0
11
Value of manufactured goods
made
over to Asylum for Asy-
lum purposes.
6
Rs.
7,939
9,213
8,732
A.
13
3
2
P.
1
1
1
Value of raw material in store
at the and of the year.
7
Rs.
237
674
1,289
A.
3
9
3
P.
4
0
3
Value of manufactured goods
in store at the end of the year.
8
Rs. A. P.
...
...
...
Value of plant and machinery
in store at the and of the
year.
9
Rs.
617
650
653
A.
8
0
0
P.
0
0
0
Total credits.
10
Rs.
9,836
12,786
12,753
A.
2
13
3
P.
4
1
3
9
10
11
12
13
14
15
DEBITS.
Value of manufactured goods
in store on 1st January.
11
Rs. A. P.
...
...
...
Value of raw material in store
on 1st January.
12
Rs.
797
237
674
A.
10
3
9
P.
2
4
0
Value of plant and machinery
in store on 1st January.
13
Rs.
610
617
650
A.
12
8
0
P.
0
0
0
Raw material purchased.
14
Rs.
4,055
4,713
4,580
A.
4
2
11
P.
6
4
9
Contingencies of manufacture.
15
Rs.
135
150
123
A.
9
4
4
P.
9
9
10
All other charges.
16
...
...
...
Total debits.
17
Rs.
5,599
5,718
6,028
A.
4
2
9
P.
5
5
7
16
17
RESULTS.
Excess of credits or profits.
18
Rs.
4,236
7,068
6,724
A.
13
10
9
P.
11
8
8
Excess of debits or loss.
19
...
...
...
18
REMARKS.
20
Average number of lunatics employed on manufactures—
1908.
1909.
1910.
138.40
136.40
124.44
Males
...
10.00
6.21
10.35
Females ...
148.40
142.61
134.79
Total ...
No. 19.
( NEW SERIES .)
IP/QB, 10
SCIENTIFIC MEMOIRS
BY
OFFICERS OF THE MEDICAL AND SANITARY DEPARTMENTS
OF THE
GOVERNMENT OF INDIA.
ON KALA AZAR, MALARIA AND MALARIAL CACHEXIA.
BY
CAPTAIN S. P. JAMES, M.B., I.M.S.
ISSUED UNDER THE AUTHORITY OF THE GOVERNMENT OF INDIA
BY THE SANITARY COMMISSIONER WITH THE GOVERNMENT
OF INDIA, SIMLA.
CALCUTTA:
OFFICE OF THE SUPERINTENDENT OF GOVERNMENT PRINTING, INDIA.
1905.
Price Re. one Annas four or 1s. 11d .
No. 19.
(NEW SERIES. )
SCIENTIFIC MEMOIRS
BY
OFFICERS OF THE MEDICAL AND SANITARY DEPARTMENTS
OF THE
GOVERNMENT OF INDIA.
ON KALA AZAR, MALARIA AND MALARIAL CACHEXIA.
BY
CAPTAIN S. P. JAMES, M.B., I.M.S.
ISSUED UNDER THE AUTHORITY OF THE GOVERNMENT OF INDIA
BY THE SANITARY COMMISSIONER WITH THE GOVERNMENT
OF INDIA, SIMLA.
CALCUTTA:
OFFICE OF THE SUPERINTENDENT OF GOVERNMENT PRINTING, INDIA.
1905.
Agents for the Sale of Books published by the Superintendent of Government
Printing, India, Calcutta.
IN ENGLAND.
ERNEST LEROUX, 28, Rue Bonaparte, Paris.
H. S. KING & Co., 65, Cornhill, & 9, Pall Mall,
London.
MARTINUS NIJHOFF, The Hague, Holland.
E. A. ARNOLD, 41 & 43, Maddox Street, Bond
Street, London, W.
IN INDIA.
THACKER, SPINK & CO., Calcutta and Simla.
CONSTABLE & CO., 16, James Street, Hay Market,
London, W.
NEWMAN & CO., Calcutta.
S. K. LAHIRI & CO., Calcutta.
P. S. KING & SON, 2 & 4, Great Smith Street,
Westminster, London, S.W.
R. CAMBRAY & CO., Calcutta.
HIGGINBOTHAM & CO., Madras.
KEGAN PAUL, TRENCH, TRÜBNER & CO., Charing
Cross Road, London, W.C.
V. KALYANARAMA IYER & CO., Madras.
G. A. NATESAN & CO., Madras.
BERNARD QUARITCH, 15, Piccadilly, London, W.
THACKER & CO., LD., Bombay.
B. H. BLACKWELL, 50 & 51, Broad Street, Oxford. A. J. COMBRIDGE & CO., Bombay.
DEIGHTON BELL & CO., Cambridge.
D. B. TARAPOREVALA, SONS & CO., Bombay.
RADHABAI ATMARAM SAGOON, Bombay.
ON THE CONTINENT.
N. B. MATHUR, Superintendent, Nazair Kanun
Hind Press, Allahabad.
R. FRIEDLÄNDER & SOHN, 11, Carlstrasse, Berlin,
N.W.
RAI SAHIB M. GULAB SINGH & SONS, Mufid-i-Am
Press, Lahore.
OTTO HARRASSOWITZ, Leipzig.
Superintendent, American Baptist Mission Press
Rangoon.
KARL W. HIERSEMANN, Leipzig.
List of Numbers of Scientific Memoirs by Officers of the Medical and Sanitary
Departments of the Government of India (New Series) published previous
to the present issue.
No. 1. Standardisation of Calmette's anti-venomous serum with pure cobra venom : the
deterioration of this serum through keeping in India, by Captain G. Lamb,
I.M.S., and Wm. Hanna, Esq., M.B. Price As. 3 or 4d.
No. 2. Malaria in India, by Captain S. P. James, I.M.S. Price Rs. 1-8 or 2 s. 3d.
No. 3. Some observations on the poison of Russell's Viper (Daboia Russellii), by Captain
G. Lamb, I.M.S., and Wm. Hanna, Esq., M.B. Price As. 5 or 6d.
No. 4. On the action of the venoms of the Cobra and of the Daboia on the red blood cor-
puscles and on the blood plasma, by Captain G. Lamb, I.M.S.Price As. 8
or 9d.
No. 5. Specificity of anti-venomous sera, by Captain G. Lamb, I.M.S. Price As. 3 or 4d.
No. 6. First report on the anti-malarial operations in Mian Mir, 1901-03, by Captain
S. P. James, I.M.S. Price As. 12 or 1s. 2d.
No. 7. Some observations on the poison of the Banded Krait (Bungarus Fasciatus), by
Captain G. Lamb, I.M.S. Price As. 8 or 9d.
No. 8. A preliminary report on a parasite found in patients suffering from enlargement of
the spleen in India, by Lieutenant S. R. Christophers, I.M.S. Price Rs. 1-8
or 2s. 3d.
No. 9. Second report on the anti-malarial operations at Mian Mir, 1901-03, by Lieutenant
S. R. Christophers, I.M.S. Price As. 10 or 1s.
No. 10. Specificity of anti-venomous sera (second communication), by Captain G. Lamb,
I.M.S. Price As. 8 or 9d.
No. 11. On a parasite found in persons suffering from enlargement of the spleen in India—
Second Report, by Lieutenant S. R. Christophers, I.M.S. Price Rs. 2 or 3s.
No. 12. On the Morphology, Teratology and Diclinism of the flowers of Cannabis, by
Major D. Prain, I.M.S. Price As. 14 or 1s. 4d.
No. 13. Oriental or Delhi Sore, by Captain S. P. James, I.M.S. Price As. 10 or 1s.
No. 14. On a parasite found in the white corpuscles of the blood of dogs, by Captain S. P.
James, I.M.S. Price As. 10 or 1s.
No. 15. On a parasite found in persons suffering from enlargement of the spleen in India—
Third Report, by Lieutenant S. R. Christophers, I.M.S. Price As. 10 or 1s.
No. 16. The specificity of anti-venomous sera with special reference to a serum prepared
with the venom of the Daboia Russellii, by Captain G. Lamb, I.M.S. Price
As. 6 or 7 d.
No. 17. Snake-venoms in relation to Hæmolysis, by Captain G. Lamb, I.M.S. Price As. 6
or 7d.
No. 18. Hæmogregarina Gerbilli, by Lieutenant S. R. Christophers, M. B., I.M.S. Price
As. 10 or 1s.
Published by and on sale at the office of the Superintendent of Government Printing, India, Calcutta. Copies
are also available from all Agents for the sale of Government publications.
ON KALA AZAR, MALARIA AND MALARIAL CACHEXIA.
I
T HE disease long known to natives of Assam by the name kala azar has been
studied by medical men in India so frequently, and has occasioned so much
controversy in the medical journals, that one cannot but feel some diffidence in
adding, however slightly, to its already voluminous literature. For this reason
I propose to present the facts I have observed regarding the disease as briefly as
possible.
I shall deal first with the following important problem :
Is kala azar a form of malarial fever ?
I have attempted to solve this problem by employing a mode of investigation
which, being based upon the following considerations, is essentially different from
those adopted by previous workers.
All observers agree that kala azar is a very severe and, in the great majority
of cases, fatal, disease. If it be a form of malarial fever, it must therefore be a very
severe and fatal form such as would occur only in intensely malarious places.
It follows that if we find kala azar to be prevalent in places where there is very
little malaria, and especially if it is prevalent in a place where malarial fever is not
present, we may conclude that kala azar is not a form of malarial fever.
The following are the results of some of my investigations in this connection :
—
1. GAUHATI IN THE DISTRICT OF KAMRUP IN ASSAM.—My investigation
was carried out with regard to the inhabitants of the town of Gauhati and with
regard to the inhabitants of a small village (Ulloobari) about two miles distant
from the town.
Prevalence of kala azar in Gauhati town. —There can be no doubt that
kala azar is prevalent in this town. On the first and second mornings after my
arrival I attended at the local dispensary and found five cases of the disease
among out-patients who were residents of the town, and four among
residents of Ulloobari village. On every subsequent visit to the dispensary I was
able to find at least one case among the out-patients, and I came to regard the
town dispensary as one of the most favourable places in Assam for studying
kala azar. The prevalence of the disease could have been ascertained more
accurately by a house-to-house inspection, but it may be taken for granted that
the number of kala azar patients seen at the dispensary represented only a
small proportion of the total number of sufferers resident in the town ; and even if
we suppose that only one new patient suffering from the disease attended at the
dispensary each week (an estimate I believe to be far below the true number),
there is ample justification for the statement that kala azar is prevalent in the town.
B
2
Prevalence of malaria in Gauhati town. —Although kala azar was so
common among the out-patients attending at the dispensary that one or more
cases could be obtained at every visit, I found to my surprise—for reading
previous reports had given me the impression that Assam is intensely
malarious—that cases of malarial fever were quite rare. I examined the peri--
pheral blood of a large number of out-patients, but found malaria parasites in only
two during my stay in Gauhati. Both patients were suffering from mild
Quartan fever. From the rarity with which malaria parasites were found in
slides obtained from patients attending at the dispensary, 1 soon gained the
impression that, in spite of the prevalence of kala azar, malarial fever was by no
means common in Gauhati. In order to ascertain whether this impression was
correct or not, I examined and took slides of finger-blood from 35 young native
children living in the centre of the town. Only one of these children had an
enlarged spleen and in only two were malaria parasites found. The spleen-rate
of the children was therefore 2.8 per cent., and the parasite-rate per cent. ( i.e., the
malarial endemic index) was 5.7.
Conclusion.—A disease known to the natives by the name kala azar is
prevalent in Gauhati town. Malarial fever is rare, and such cases as occur are
not severe.
2. ULLOOBARI VILLAGE, ABOUT 2 MILES FROM GAUHATI TOWN.—The
prevalence of kala azar in this village was estimated by a house-to-house
inspection of the inhabitants with the following result:—
House-number.
Number of people living
in the house.
Number of cases of kala
azar among these
people.
Number of deaths from
kala azar within the
last year.
1
12
0
0
2
2
I
0
3
10
2
0
4
9
0
0
5
4
I
0
6
4
0 0
7
3
0
0
8
16
3
1
9
5
1
1
10
0
4
1
1 1
6
0
0
12
4
1
1
13
5
0
0
14
7
2
1
15
5
I
0
16
3
x
1
17
10
2
I
13
5
I
o
19
4
I
0
20
3
0
0
20
123
21*
7
*This number includes only cases which, being in an advanced stage, could be diagnosed as kala azar
without prolonged examination. It was obvious that a large proportion of the sufferers had but a short time
more to live. The true number of kala azar patients (including all early cases) would be considerably
greater than the number given here.
3
The sick-rate from kala azar in this village at the time of examination
was therefore17 per cent. of the population examined, and the death-rate for
the previous year was 5.6 per cent.
Prevalence of malaria in Ulloobari village .—This was estimated by an
examination of children, with the following result :—
Number of children under
10 years of age
examined.
Spleen rate per
cent.
Malarial parasite-rate per cent.
(endemic index).
Varieties of parasites found.
4 0
32.5
12.5
Three cases of Simple
Tertian infection ; two
cases of Quartan infection.
Conclusion.—Out of a total of 123 people examined, at least 21 were suffer-
ing from a deadly disease known as kala azar.T h e v i l l a g e i n w h i c h t h i s d i s e a s e
occurred was so slightly malarious that only about 12 per cent. of the young
children were infected with malaria parasites.
3. TEZPUR IN THE DISTRICT OF DARRANG IN ASSAM.—It was seldom
possible to walk through this town without meeting several persons suffering from
kala azar , and in a later part of this report I shall give particulars of a number
of cases studied at the local dispensary. By far the greater number of patients-
attending at this institution on account of fever and enlargement of the spleen
were suffering, not from malaria, but from kala azar, the former disease being so
uncommon that often several days elapsed without a single characteristic
case being seen. During one of my walks through the town I was able
to examine and take slides of finger blood from 15 young children living
in the neighbourhood of houses occupied by persons suffering from kala
azar. No one of the children had an enlarged spleen, and in no slide were
malaria parasites found. Experience in other parts of India has taught us
that, if this neighbourhood had been at all malarious, it would have been
impossible to examine the blood of 15 young native children without finding
malaria parasites in at least two or three, and we are forced to conclude that,
as in other instances, kala azar existed here in a place which was only very
slightly, if at all, malarious.
4. KOHBARI VILLAGE NEAR TEZPUR.—This small isolated village, situated
on a bank of the river Brahmaputra near Tezpur, afforded an even better
example of a place where kala azar existed in the absence of malarial fever
B 2
4
The Civil Surgeon of Tezpur informed me that the village had always held the
reputation of being heavily infected with kala azar, and during a walk through
it I saw several cases in an advanced stage. With the assistance of the Civil
Surgeon I was able to examine and obtain slides of finger blood from 25 young
children. The results of this investigation were as follows :—
Number of children
examined.
Number with
enlarged spleens.
Spleen-rate
per cent .
Number with malarial
parasites in their blood.
Parasite-rate per cent.
(endemic index.)
25
6
24
0
0
One of the six children with enlarged spleens was suffering from kala azar ,
and it is very probable that the remaining five were ill from the same disease :
at any rate, very careful examination of the slides of peripheral blood showed
that the malarial endemic index of the village was nil, and in the light afforded
by this method of investigation, Kohbari village must be regarded as an example
of a place where kala azar exists in the complete absence of malarial
fever.
The places cited above were not selected ; they were among the first I visited
in Assam, and it was therefore established very early in my investigations not only
that kala azar often exists in places which are only very slightly—and sometimes
not at all—malarious, but that the opinion of previous workers that Assam as a
whole is intensely malarious needs to be modified considerably. Indeed, it
was not until I reached the tea-gardens of Salonah, near Nowgong, that I came
to a place which, as regards the prevalence of malaria, was at all comparable to
those part of the Darjeeling Duars that were examined in 1901.
An investigation carried out upon the native inhabitants of villages situated
in the tea-gardens just referred to afforded an opportunity of comparing the
amount of kala azar in a place only slightly malarious and in a place
intensely so. The village of Ulloobari, already referred to, will serve as an example
of a slightly malarious place and the village of Old Salonah, on the Salonah tea
estate near Nowgong, as an example of an intensely malarious one. I have
already shown that in Ulloobari at least 17 per cent. of the inhabitants were
suffering from kala azar, and that the malarial endemic index of the village
was 12.5. Previous to my arrival at Salonah, Dr, Dodds Price had satisfied
himself, by very careful examinations of all the inhabitants, that no case of
kala azar existed in Old Salonah village. With his assistance I examined 25
young children resident in the village with the object of finding out the
prevalence of malaria. The results were as follows :—