4
by the registered mortality in places in which kála-azár was prevalent in that year.
From the statistics it appeared that kála-azár was most prevalent in May, June and
April, and that February and January were the months of minimum prevalence.
Only 10.07 per cent. of the deaths occurred in May, the month of maximum prevalence,
and as many as 7.33 per cent. of the deaths occurred in February, in which month fewest
deaths were registered. The months of maximum mortality from fevers, other than
kála-azár, were June, May and July, and fewest deaths were registered in April,
September and October ; 12.44 per cent. of the deaths occurred in June, in which the
largest number oí deaths were registered, and 7.17 per cent. in each of the months of
April, September and October, the months of minimum prevalence. He notes that in
the Nowgong district kála-azár was not most prevalent in terai lands, but in the villages
on both sides of the Rullung river, and he also notes that the sanitary condition of that
district, including drainage and water-supply, was certainly not worse now than it was
before kála-azár made its appearance.
10. In the second portion of Section VI, Dr. Rogers has very clearly indicated the
distribution of the disease, especially in the Νowgong and Darrang districts, noting that
the disease has generally travelled along the principal lines of traffic. There are, how-
ever, exceptions to this rule, as may be seen in the case of Silghát and the villages beside
it. Silghát is situated on the bank of the Brahmaputra, is 32 miles from Nowgong, and
is in daily communication with it, and yet the disease is only beginning to appear in Silghát,
though it was prevalent in the town of Nowgong in 1891. I agree with the summary
of the broad facts relating to the spread of the disease given in pages 145 and 146,
except that the seasonal distribution of malarial fevers and kála-azár in 1896 was not
the same. In that year the mortality from kála-azár was comparatively high in the
months of minimum mortality from malarial fevers.
11. The communicability of kála-azár is discussed in Section VII. The facts given
in this section are very interesting, and Dr. Rogers walked hundreds of miles, in a very
difficult country, in places in which the disease had recently broken out, in order to find
out the circumstances under which the disease had appeared in individual villages. The
facts ascertained by him tended to prove, what was already held by many medical
officers who had considerable experience of the disease, that kála-azár appears to be
frequently conveyed from one village to another by human intercourse. That communi-
cation is frequently not readily effected is shown by portions of villages remaining un-
affected for months after other portions of them have been severely affected, when all
intercourse between the affected and non-affected portions of villages could not have been
prevented. Silghát, on the bank of the Brahmaputra, is at present only slightly affected,
though Nowgong and Puranigudam, with which it is in daily direct intercourse, were
severely affected in 1891.
12. In the beginning of Section VIII, on. the origin of kála-azár, Dr. Rogers states
that he is of opinion that kála-azár could not have appeared in epidemic form in the
Gáro Hills before 1875, as up to that year the revenue had always been collected in
full. He, however, states that the greater part of the country was not taken over till
1871-72, so that the revenue registers could give little information regarding the state
of matters in the district as a whole previous to 1871. That the disease had committed
great ravages in portions of the Gáro Hills previous to 1875 is shown from what the
Sanitary Commissioner states in an appendix to the Sanitary Report for 1882, that as far
back as 1869 the attention of administrative officers had been directed to kála-azár, which
had decimated, and, in some instances, almost depopulated, numerous villages in the
district. Dr. Rogers gives no proof that the outbreak which was prevalent in 1875 was
different to what was observed in 1869. Further on, in this section Dr. Rogers attempts
to prove that the outbreak of Kála-azár in the Gáro Hills, which appears, from informa-
tion given by Colonel Maxwell as quoted in page 169 of the report, to have been very
fatal in one portion of the Gáro Hills soon after 1872, if not in that year, and to have been
so prevalent in 1875 as to cause a deficiency of revenue in that year, was produced by
malarial fever spreading by contagion from Rangpur to the Gáro Hills district. Malarial
fevers were very prevalent in Rangpur during the years 1872-77. From the extracts
from the sanitary reports of this district, it appears that in 1873 and 1874 the fever in
that district was of the character usually seen in severe outbreaks of malarial fever,
the majority of the population (in 1874, 80 per cent. of them; having been prostrated by
the disease. This is very different to the incidence of kála-azár as seen in Nowgong
and Mangaldai, where the inhabitants of many villages remained in a normal state of
health long after the disease was very prevalent in neighbouring villages. In 1875,
the fever mortality in Rangpur was about the same as it was in 1874, but the
remittent type of the disease seems to have been more prevalent than it was in the
previous year. The fever mortality in that district was very high in 1876 and 1877,
and began to fall in 1878. No one seems to have questioned that this prolonged