NationalLibraryOfScotland/medical-history-of-british-india huggingface dataset:
54
76. The total cholera deaths in the district during 1870 was 7,611, and the
proportion of mortality to a thousand of population in each registration circle is
shown below:—
Streevulliputtur ...
Satur
...
...
Municipal Town, Tuti.
corin ... ...
Ottapidaram ...
Tenkarai ... ...
Nangunnerry ...
M. T., Tinnevelly ...
M. T., Palarncottah...
Tinnevelly Talook...
Ambasamoodrum ...
Tenkasi ... ...
Sankaranayanarcovil
January.
...
0.006
...
0.008
...
0.01
...
...
0.0l
...
...
...
February
...
0.04
...
0.008
0.05
...
...
0. 07
0.1
...
0.01
0.006
March
0.01
0.06
0.1
0.03
0·9
...
0·6
...
0.1
0.01
0.09
0.01
April.
0.1
0·1
0.1
0.1
0.5
0·2
4.3
1.5
0·8
0·5
0·5
0.08
May.
0·2
0·6
1.1
0.4
2·2
2·2
2·2
0.5
1.1
2·1
0·4
0·1
June
0.1
0·5
1·9
0·7
l·8
3·8
0·3
0.1
1.7
1·5
0·3
0·1
July.
0.05
0·2
2·6
0·5
l·6
2.03
0·7
0·3
0·8
0·5
1.1
0·1
August
0.01
0.1
...
0.1
1.1
0.9
0·2
...
0.09
0·1
1.03
0·1
September.
0.01
0.4
0·1
0.1
0·3
1·06
...
0.07
0.04
0.02
0.1
0·1
October.
...
0.1
...
...
0.07
0.5
0.04
...
0.01
0.03
0.05
0.01
November.
...
...
...
0.008
0.009
0·1
0.04
0.8
0.02
0.01
...
0.02
December.
0.01
0.1
...
0.06
0.1
0·9
0·2
l·7
0·6
0·7
0·9
0.09
Total.
0.7
2·9
6·07
2·4
8·8
11·9
8·9
5·3
5.7
5.7
4·8
0·9
The next table, compiled on the general plan of those preceding, exhibits
the number of villages, and the populations affected. It will be noticed that
there was a great difference in the intensity of the disease in various parts of
the country. Speaking generally, the northern talooks of the district
suffered
the least, while the districts on the sea-board and the southern talooks, especi-
ally such of them as were
flooded
after the cyclone in 1869, suffered in an
unusual degree.
Table showing particulars of Citolera Deaths in each Municipal Town and Talook of the Tinnevelly District, during each month of the year 1870.
Tinnevelly.
Population.
Total No. of
Villages in
each Circle.
Months.
!
January
February ...
March
April
May
June
July
August
September ...
October
November ...
December ...
Total...
Streevulliput-
tur Talook,
N. of Dis-
trict.
154,719
499
No. of Villages affected.
2
5
8
9
2
3
1
3
-
Population of affected villages.
5,183
6,632
23,760
39,955
16,636
14,764
...
6,859
—
Cholera Deaths.
3
21
34
30
8
3
3
3
105
SaturTalook,
N. of
District-
145,016
310
No. of Villages affected.
1
5
6
11
24
28
18
11
23
7
10
-
Population of affected villages.
373
9,931
16,764
28,869
40,596
38,070
30,899
26,533
41,789
10,220
25,801
Cholera Deaths.
1
6
10
22
97
79
30
26
67
15
24
377
Tuticorin Mu-
nicipal Town,
S. E. of Talook.
9,544
Population.
954
Cholera Deaths.
...
1
1
11
19
25
1
58
Ottapidaram
Talook,
E, of District.
237,093
225
No. of Villages affected.
2
2
6
15
37
57
43
17
17
2
10
-
Population of affected villages.
3,934
2,896
4,139
16,256
30,173
59,266
48,364
15,608
26,406
1,703
10,466
Cholera Deaths.
2
2
7
39
113
185
136
36
32
2
16
570
Tenkarai
Talook,
S. E. of
District.
218,245
1,040
No. of Villages affected.
6
32
27
49
52
54
35
14
10
2
10
-
Population of affected villages.
13,549
105,208
63,249
132,666
135,496
134,206
65,399
38,609
20,031
6,551
52,161
Cholera Deaths.
12
201
118
483
406
356
243
72
16
o
28
1937
'Nangunnerry
Talook,
S. of District.
159,051
763
No. of Villages affected.
3
••
14
52
79
60
35
35
26
12
33
-
Population of affected villages.
19,286
...
...
16,604
72,664
106,032
49,465
66,373
61,241
32,153
22,631
37,722
Cholera Deaths.
3
...
33
359
617
323
149
170
92
21
140
1907
Tinnevelly
Municipal
West of
Talook.
21,553
Population
21.553
Cholera Deaths.
14
94
48
8
17
5
5
]
1
5
193
Palamcottah
Municipal
Town, Centre
of Talook.
13,315
Population.
13.315
Cholera Deaths.
20
7
5
• ••
1
11
24
71
S
No. of Villages affected.
2
3
9
38
40
66
37
11
3
5
2
26
•
Tinnevelly
Talook,
of District.
148,253
476
Population of affected villages.
1,545
6,838
18,494
54,352
75,188
72,579
57,358
13,419
3,902
3,957
1,870
79 536
Cholera Deaths.
2
22
17
126
169
261
119
14
7
5
2
100
844
Ambasamoo-
dram Talook,
S. W. of
District,
149,323
402
No. of Villages affected.
...
2
24
50
41
18
12
4
4
1
22
Population of affected villages.
...
3,752
65,784
118,180
97,086
53,047
36,347
14,689
17,213
1,104
76,050
Cholera Deaths.
2
85
325
238
76
15
4
2
112
864
Tenkasi Talook,
W. of District.
109,685
230
No. of Villages affected.
2
1
12
16
15
19
17
9
4
19
-
Population of affected villages.
3,427
1,368
26,359
15,357
31,340
46,539
46,795
14,622
3,468
...
41,233
Cholera Deaths.
2
1
65
58
39
124
113
21
6
...
107
531
Sankaranaya-
nar Covil
Talook, N. W.
of District.
158,222
270
No. of Villages affected.
1
2
3
8
7
8
5
8
1
3
7
-
Population of affected villages.
7,067
4,073
15,101
23,598
26,964
33,015
9,543
21,226
10,938
7,342
23.947
Cholera Deat
1
2
13
22
27
27
, 22
20
2
4
14
154
Ci
69
epidemic. The districts of the north-west of India do not breed cholera, and
yet when the seeds of the disease are periodically introduced into those districts,
cholera flourishes with a vigour unknown within the true endemic region of
Lower Bengal.
Past epidemic inva-
sions of Ceylon.
82. While this report was passing through the Press, I received from the
Principal Medical Officer of Ceylon the following letter and
statement regarding the years of greatest prevalence of
cholera in the Island since 1859. It will be observed that the 1859 invasion did
not reach Ceylon until 1860, and that the 1863 invasion reached the I sland, as
it did the Western Coast of India, in 1864. The 1869 invasion did not get to
Ceylon until May 1870.
From the Principal Civil Medical Officer, Colombo, to the Sanitary Commissioner,
Madras, dated Colombo, 16th February 1871.
In reply to your letter of the 14th December, requesting me to furnish you
with any data in my office showing the monthly prevalence of cholera in the
Island of Ceylon from the year 1859 to the end of 1870, I regret to have the
honour to state that the forms of Cholera Registers adopted in this department
are so voluminous that, without an additional staff of clerks which are not at my
disposal, I am unable to afford you the information in a monthly form.
I have, however, drawn up a form of return which I trust may, to a certain
extent, answer the object you have in view.
This return gives the number of cases and deaths reported in each province
of the Island from 1859 to 1870 inclusive, together with the date and locality of
the first and last case occurring in each year in every province.
You will observe that the Northern and Central provinces are the most
obnoxious to cholera, and these two provinces are chiefly affected by importa-
tions from India.
It is, however, in the Northern Province alone that cholera is in the habit
of locating itself, and the history of every outbreak, I believe without exception,
points to India as its origin, the infection having, in every instance, been
imported direct.
The climate of the Northern Province assimilates to that of Southern India.
Its people are all Tamils, and resemble the inhabitants of Southern India in their
habits, customs, and constitutional peculiarities, and they are in constant and
close communication with them.
A cholera epidemic seldom prevails in the south of India without establish-
ing itself in the peninsula of Jaffna and at Mannar, and from thence it is
conveyed along the central road, the tract of the immigrant coolies into the
Central Province.
The whole of the localities indicated in this return in the Northern and
Central Provinces are liable to infection by gangs of coolies passing into the
interior from the coast of India. As compared with the returns from India the
total number of cases occurring in the remaining provinces of Ceylon is very
small.
70
The disease has occasionally occurred spontaneously towards the south of
the Island, but it can scarcely be said to have become epidemic excepting in the
Northern Province, and seldom exhibits any tendency to diffuse itself much
beyond the locality of its first appearance.
The Northern Province is at all times favourable to the rapid spread of the
disease, and in uncertain periods of time, it assumes a malignity which seriously
affects the population.
In the years 1866 and 1867 more than 20,000 cases occurred, which led to a
Commission being appointed by the Government to inquire into its causes, and a
long report was the result, a copy of which I will endeavour to have forwarded
to you.
It will afford me much pleasure if I can offer you any further information
on the subject.
72
EXTENSION OF CHOLERA TO TRAVANCORE.
83. I have already alluded to the circumstance that the cholera epidemic
passed into Travancore, and that its progress in this direction was arrested by the
mountain "barrier existing between Tinnevelly and Travancore—a barrier rising
in some parts to 4,000 or 5,000 feet in height, the higher plateaus consisting of
dense forests, some portions of which are not only uninhabited, but, to this day,
have never been explored.
It bears strongly on the question of the movement of cholera, that a barrier
of this nature should cut off cholera completely from an adjoining district, and
that invasion should occur only in places where the barrier is weak (i. e., by a
mountainous pass, or highway for human intercourse) or altogether wanting, as
at the extreme south of the district where the coast lines of Travancore and
Tinnevelly are continuous. I have received no detailed account of the general
Report of Physician
to the Maharajah of
Travancore.
progress of cholera in Travancore, though such has been
promised by the Physician to His Highness the Maharajah of
Travancore, who meanwhile has favoured me with the following
" conclusions " from the facts before him :—
" 1st.—The disease invaded Travancore from Tinnevelly through the Aram-
booli Pass, and by the plain to the south of the end of the ghaut line, and lying
between it and the sea."
" 2nd.—It spread following the streams of human intercourse." [With
reference to this I may remark that it pursued generally a northward course
up the Western Coast. It only reached the latitude of Cannanore in any force
about the end of January 1871.]
"3rd.—In almost every case occurring in Trevandrum, the origin of the
disease was traced to contact or approach either to infected persons, or persons
who had been in contact with, or in the neighbourhood of, persons suffering from
the disease.
" 4th.—It was in no way affected by the aerial currents, by the weight of
the column of air, nor (in Trevandrum) by the occurrence of heavy rain."
" 5th.—The presence of abundant organic matter intensified the disease
greatly."
CHOLERA IN MALABAR.
84. By the end of the year cholera had advanced through the Travancore
and Cochin States, and had become prevalent on the banks of the Ponnany river,
and had extended up the coast so far north as Cannanore. In some few villages
the epidemic caused considerable mortality, but it was not very fatal to the
general population. The Palghaut Talook lying under the mountains of the
Western Ghauts suffered more than any other part of the district and here the
disease became active early in the year. A report from the Collector of Malabar
on an outbreak in a fishing village near Quilandy is appended. The question as
Fish diet & Cholera. to the influence of a fish diet in the production of a choleraic
type of diarrhoea, and the connexion between the mortality of
fish on the coast and the ordinary coast cholera, is here opened up, but the
facts are still under investigation, and I shall defer commenting upon them until
another opportunity.
The following table will show the particulars of cholera mortality in each
talook of Malabar :—.
Return showing the Monthly Cholera Mortality in each Talook of the Malabar District, during 1870.
—
Population ...
Total No. of
Villages in each
Circle.
Months.
January
February
March
April
May
June
July
August
September ...
October
November ...
December ...
Total
Cannanore
Municipal
Town.
6,011
_____
Population.
6,011
Cholera Deaths.
11
11
Cherical
Talook, N. of
District.
214,612
317
No. of Villages affected.
3
2
6
-
Population of affected villages.
8,765
...
9,065
36,262
Cholera Deaths.
3
...
5
16
24
Tellicher-
ry Munici
pal Town
W. of Ta-
look.
17,726
Population.
17,726
•
Cholera Deaths.
-
Kottyam
Talook,N. of
District,
122,789
248
No. of Villages affected.
1
1
1
-
Population of affected villages.
2,249
2,249
5,603
—
Cholera Deaths.
1
1
1
3
Wynaad
Talook, N.E.
of District.
56,603
83
No. of Villages affected.
1
1
-
Population of affected villages.
6,183
2,452
...
...
—
Cholera Deaths.
1
2
••
3
Kurumbra-
nad Talook,
Centre of
District.
203,549
411
No. of Villages affected.
1
...
1
9
2
-
Population of affected villages.
2,464
...
...
6,309
41,946
8,781
—
Cholera Deaths.
••
1
32
10
44
Calicut
Municipal
Town,
Centre of
Talook.
36,602
Population.
1
36,602
•—•
Cholera Deaths.
...
...
...
...
»
-
Calicut
Talook,
Centre of
District.
123,798
234
No. of Villages affected.
••
••
1
2
1
Population of affected villages.
...
...
5,188
9,191
...
...
3,453
—
Cholera Deaths.
•.
1
2
...
»
1
4
Ernaad
Talook,
Centre of
District.
240,675
350
No. of Villages affected.
1
2
3
2
6
1
3
3
2
3
-
Population of affected villages.
6,612
10,375
10,939
9,552
27,628
7,448
17.581
18,768
10,921
13,515
— 50
Cholera Deaths.
3
2
5
2
7
4
6
5
3
13
Valawanad
Talook,S. E,
of District.
246,752
564
No. of Villages affected.
1
1
3
2
2
2
2
5
6
6
5
Population of affected villages.
3,828
6,335
15,205
7,089
...
11,564
7,934
9,096
16,926
21,588
22,234
18,662
—
Cholera Deaths.
1
3
3
12
8
5
3
12
23
14
95
Palghaut
Municipal
Town, S.E
of Talook.
27,533
Population.
1
27,533
Cholera Deaths.
1
1
16
28
21
31
16
7
121
Palghaut
Talook, S. E.
of District.
251,770
233
No. of Villages affected.
1
7
13
12
33
16
8
7
6
7
13
•
Population of affected villages.
7,985
36,912
67,679
48,622
1,43,470
85,427
97,565
37,616
25,219
37,755
66,343
1
!
Cholera Deaths.
1
21
23
57
151
91
62
18
27
17
85
553
Ponnany
Talook, S. of
District.
310,131
586
No. of Villages affected.
2
1
1
2
1
1
L0
291
15
12
13
17
-
Population of affected villages.
10,047
6,210
6,210
8,860
...
4,973
41,421
1,12,939
65,252
43,812
59,219
78,421
1
Cholera Deaths.
3
3
4
2
1
27
116
48
57
57
261
579
Cochin
Municipal
Town, S. of
Talook.
9,940
Population.
Cholera Deaths.
9,940
3
1
4
Cochin
Talook, S. of
District.
1,183
2
No. of Villages affected.
•
1
-
Population of affected villages.
...
1,183
—
Cholera Deaths.
2
2
Zemindaries
3,868
No. of Villages affected.
-
1
Population of affected village
2,215
-
Cholera Deaths.
7
-
73
79
may give any explanation they please of the fact, but, in a narrative of events,
I have only to put down the facts to the best of my ability. In my introductory
remarks, and in the cholera report for 1869, I have shown that the cholera
advance from Hyderabad was in a southerly direction, and that the districts to
the eastward escaped absolutely. I say absolutely, because although three deaths
were entered as cholera in the Kistna District in 1869, these two densely popu-
lated districts had no epidemic, nor hardly a single case of cholera in them from
the end of March 1868 to the end of March 1870. In the Grodavery District, in
fact, not a single death during this period was put down to cholera, and the few
deaths that did occur were confined to the Kistna District. In districts which
have been so completely exempted, it is of the greatest importance, therefore,
that the earlier cases of a new invasion should be accurately recorded. Fortu-
nately, as regards the Godavery District, the facts of the outbreak have been most
carefully ascertained.
Details of the mode
of introduction of cho-
lera into the Godavery
District.
88. The first cholera death occurred on the 28th March in a small out-of-the-
way village, on the right bank of the Godavery, in the Talook
of Ernagudium. The village, Woongatla, is not mentioned in
the ordnance map, but is situated two miles south-west of
Chagalla. The village is not upon any high road, nor is it frequented by
strangers. The only fact recorded, in regard to its sanitary condition at the time
of out-break, is that an offensive cesspool connected with a distillery existed there.
Cholera Deaths in the Northern Districts, 1870.
—
Population.
January ...
February ...
March
April
May
June
July
August ...
September
October ...
November
December
Total
Godavery.
1,427,472
72
365
3,011
5,231
3,504
668
235
186
33
13,305
Kistna.
1,296,652
...
12
6
70
566
1,110
209
62
8
2,043
Vizagapatam.
1,505,045
9
5
11
10
72
78
51
...
21
2
259
The Godavery Dis-
trict a new centre of
cholera diffusion.
Actual facts opposed
to theories of monsoon
winds carrying cholera.
89. This table distinctly proves that the Godavery District was a centre, for
the time being, of epidemic cholera, and that the districts to the
north and south of it were secondarily affected. (The eighteen
deaths in the Kistna District in March and April occurred in
one of the upland talooks a long distance away from the Godavery centre, and
may be left out of account in tracing the epidemic distribution.) The epidemic
became very prevalent in the Godavery District in the month of June, though it
did not prevail in the Kistna District to any extent until July. Accordingly, to
the theory that the south-west monsoon winds carry the
disease, the Vizagapatam District should have suffered more
than the Kistna District to the south : but, as a matter
of fact, owing to the geographical position of the districts, the south-west
monsoon winds could not have carried cholera from the Godavery into
81
theory of transmission must surely have some little difficulty in explaining why
this village should have been affected in preference to the remaining 3,388
villages in the district. But assuming that the fomes of cholera may be
carried about in the clothing of travellers, how easy is it to fill up the blanks in
the picture ! .
92. Here we have two families making a long land journey ; during
the latter part of which they pass through cholera infested districts, and
one or more of the party become affected with the disease. Those who know
how the natives of India travel, can easily picture to themselves the bundles
of dirty clothes accumulating on the way, and the small probability of
any of the clothing being washed before they got to their destination. The
news of the arrival of two families from a famous place of pilgrimage would
very soon spread in a small village, and it is easy to imagine that their
old friends and acquaintances would lose no time in waiting upon them to hear
an account of what had befallen them on their travels. The dirty clothes and
accumulated filth of the journey would also probably,for the first time, be disturbed
on arrival at their village home. In this way, it may be surmised, the villagers
of an unaffected locality were brought into contact with the materies morbi ; and
the new field for development being favourable, cholera began at once to burst
into activity.
Proneness of districts
which have had a long
exemption to suffer
from cholera.
93. In dealing with this part of the subject we must bear in mind that a
locality which has enjoyed exemption from cholera for a
lengthened time, is always in a more favourable condition to
feel the choleraic influence, than a district that has lately been
swept by an epidemic. If cholera had recently prevailed in the village, it is
probable that an importation of the germs might have borne no fruit. There
can be no doubt, I think, that cholera will always prefer an unoccupied locality,
when it has the chance, and there can be no doubt that the whole of the
Godavery and Kistna Districts were, by the simple reason of their unusually
prolonged exemption, ready for occupation in the spring of 1870.
Interval between the
first 'cases and the out-
break.
94. After the three cases at Woongatla on the 28th March,
there were no fresh attacks in the village until the 12th April,
when it broke out with considerable virulence.
The following return shows the daily mortality in the village :—
1870.
Woongatla cholera deaths
Population—1,138
March 28
1 3
!
4 5 3 3 2 3 r
o
6
¿4
1 2 s 1 2 1 2
o
2 2 1 2
©
CO
3
Outbreak confined to
the one village until
19th April.
From the 28th March to the 9th April, the outbreak was confined to the
village of Woongatla. It next appeared in a small hamlet
Grudiwada and then in a village Bramanagugen, about a mile
off, and subsequently spread to the adjacent villages of Mar-
kondapad and Nandigampada.
This distribution will be better seen in the daily register of cholera deaths
for the month of April.
82
Villages.
Population
April
1
„
2
„ 3
„ 4
„ 5
„ 6
„ 7
„ 8
„ 9
„ 10
„ 11
„ 12
„ 13
„ 14
„ 5
„ 16
„ 17
„ 18
„ 19
„ 20
„ 21
„ 22
„ 23
„ 24
„ 25
„ 26
„ 27
„ 28
„ 29
„ 30
Gudiwada.
697
1
Chagalla.
2,106
...
1
• • •
• ••
t • •
• • •
Pangidigudam.
443
1
...
...
...
Vadapalli.
1718
1
...
Woongatla.
1,138
...
...
...
3
4
5
3
3
2
3
5
3
6
1
2
5
1
2
1
Ellore Municipal
Town.
19,910
...
...
...
...
...
• ••
1
Malakapuram.
667
...
...
...
•. •
1
1
1
Bramhanagudem.
910.
...
...
...
...
2
2
1
1
2
4
Pemmaraz Pola-
varam.
375
... '
...
...
...
...
...
...
• • •
• • •
1
1
. • »
...
Vadangi.
1,044
...
...
...
...
...
...
...
...
1
...
...
... ...
...
...
...
Total.
29,008
...
...
...
...
...
...
1
...
3
5
5
5
5
2
3
5
7
6
1
2
6
3
1
3
• • •
4
5
Extension of epide-
mic to Rajahmundry,
Outbreak in Jail three
days after arrival of
infected persons in the
town.
95. The extension of the epidemic to Rajahmundry is
thus described by the Sub-Collector :—
" On the 3rd May, the Hospital Assistant attached to my office was sent to
Woongatla to attend to the people attacked there ; he was seized himself with the
disease on the 8th of the same month, and was brought on a litter to Rajahmundry
in a comatose and dying state. That same night cholera broke out in the district
jail and also in the town. It gradually extended to Juggiampet and other
villages of the Peddapur Talook, and is now (22nd July 1870) prevalent more or
less throughout the whole district."
The statement as to the exact date of the outbreak in the Jail and town is
not quite correct. From a report received from the Civil
Surgeon of the station, it seems that both the Hospital
Assistant and his servant were brought into the town on the
8th of May dying of cholera, and that the prisoners were not attacked until the
evening of the 11th May. The following is the true account :—
" The outbreak, although not quite unexpected, was sudden. The prisoners
to all appearance being in their usual good health when they were locked up on
the night of 11th May 1870. At eight o'clock on that night, a prisoner was
brought to hospital labouring under symptoms of the disease. The second and
third cases occurred at 2 A.M. the following morning * * * Six more men
were attacked the same day. Six others were attacked on the 13th. The