NationalLibraryOfScotland/medical-history-of-british-india huggingface dataset:
5
Fever mortality for Punjab districts
compared.
The distribution of the fever mortality rate in all the 28 districts of
the Punjab is given in Table 1 of Appendix B.
It also gives the comparative figure for the last
year, and the mean ratio per 1,000 of population
for the previous five years.
Districts with highest mortality.
A scrutinv of this table shows that the highest fever mortality-rate
was recorded in the districts of Mianwali with
3282 per mille, Gujranwala 30·87, Muzaffar-
garh 29·79, Multan 22·59, Kangra 22·40, Dera Grhazi Khan 2·99, Rawalpindi
21·18, Attock 20·99, Sialkot 20·89, and Hissar 20·06. A reference to the last
year's fever mortality figures shows, that the mortality-rates in these districts
was 20·10, 16·89, 20·34, 17·31, 17·41, 16·19, 17·98, 18·13, 12·97, and 14·85
respectively. All these districts had a much higher rate this year than their
quinquennial average.
Districts with lowest fever mortality.
The districts with the lowest fever mortality-rate por mille were Simla
9·23, Gurgaon 12·94, Rohtak 14·27, and Lyallpur
14·90. These rates were, with the exception of
that tor Gurgaon, where it was slightly below, higher than the quinquennial
average.
Districts where fever figures keep high.
Prom a comparison of the fever figures with the previous quinquennium
(vide Table 1 of Appendix B) it will be noticed
that the fever death-rate has been persistently
high in the districts shown in the table below:—
TABLE II.
Showing the districts with persistent high fever Mortality.
No.
1
2
3
4
5'
6
7
8
9
10
Name of the district.
Karual ...
Kangra ...
Hoshiarpur
Gujranwala
Rawalpindi
...
Attock ...
..,
...
...
' ...
Mianwali
Multan ...
,..
...
...
...
Yuzaffargarh
Dera Ghazi Khan
RATIO OF FEVER DEATHS PER
MILLE OF POPULATION.
1915.
15·14
17·41
16·93
16 89
17·95
18·13
20·10
17·31
20·34
16·19
1916.
16·79
22·40
19·66
30·87
21·18
20·99
32·82
22·59
29·79
21·99
Mean ratio for
previous 5
years.
19·43
17·39
18·19
17·44
19·04
18·76
19·82
17·00
21·14
16·47
Fever mortality in the largest towns of
the Punjab.
In the three largest towns of the Punjab the fever death-rates of
21·13, 15·78, and 13·57 were recorded in Lahore,
Multan, and Amritsar, respectively : the figures
for the last years in these towns are shown in the following table :—
TABLE III.
To show the fever death-rate of the three largest towns of the Punjab from 1909 to 1916
compared with 1908 figures.
No.
1
2
3
Name of the town.
Lahore
Amritsar
Multan
1909.
22·56
25·32
23·04
1910.
19·11
14·52
18·41
1911.
15·75
1300
15·16
1912
12·12
13·84
13·12
1913.
21·27
19·00
15·41
1914.
18·48
19·68
1931
1915.
18·59
15·59
15·38
1916.
21·13
13·57
15·78
1908.
33·69
68·16
23·80
6
Towns with high fever figures.
In the smaller towns a fever death-rate as 5441 was recorded
in Begowal 48·82 in Karor, 44·34 in Kila Didar
Sins;h, 36·01 in Bhakkar, 28·01 in Miani, 27·17
in Khangarh, 25·45 in Leiah, 25·40 in Pind Dadan Khan, 25·39 in Gujranwala,
25·31 in Wazirabad, 24·16 in Ramnagar, and 24·00 in Sodhara.
Towns with low fever figures.
Towns affected to a markedly less extent, as shown by the fever mor-
tality, were Rewari with 0·69, Gojra with ,2·03,
Sargodha 3·05, Shahabad 6·\ill\4, Dharmkot 6·32,
Tarn Taran 6·57, Mitranwali 6·91, Hafizabad 6·97 and Akalgarh 7·10. The
Provincial fever death-rate of 19·44 was exceeded in 14 districts and 26
towns.
Towns where fever figures usually keep
A study of Table II of Appendix B shows, that the fever mor-
tality continued to remain high in the previous
five years in the following towns, though the
Province as a whole was relatively malaria free :—Karnal, Jagadhri, Burya,
Dasuya, Tanda Urmur, Mukerian, Una, Bahon, Kamalia, Dinanagar, Sodhara,
Bhera, Pind Dadan Khan, Pindigheb, Kalabagh, Shujabad, Muzaffargarh,
Khangarh, Alipur, Leiah, Karor, Dajal, Rajanpur, and Kot Mithan.
A study of the last six years' fever figures would appear to show that
this list includes most of the towns where endemic malaria exists.
Distribution of fever figures in the
Punjab.
On Chart III of Appendix A it will be seen, that the fall in the fever
curve, which had started at the end of December
1915 continued to the close of March 1916,
being made more conspicuous by the drop in April. There was a slight
but distinct rise in May, which—commonly noticed since the introduction
of plague into the Province—was probably due to plague deaths incorrectly
recorded under the head of "Fever". After May there was a steady fall
which continued throughout the months of June and July. This was
followed by a rise in August reaching its maximum in November. The out-
standing feature of the chart is a very distinct increase in the fever mortality
figures during the months of September, October, and November, and its con-
tinuance to the end of the year.
Description of maps.
Map I given in Appendix C gives the comparative figures of the fever
death-rate per mille for 1915 and 1916 for the
districts of the Punjab.
Map II is appended in the Appendix C to show the epidemic figures for
the whole of the Punjab. The epidemic figure for the districts is given in red
and the towns in blue. It is intended to show the variations in the prevalence
of malaria and its intensity in different tracts.
Maps III and IV are appended in the same Appendix 0 to show spleen-
rates of different places (in which there are dispensaries) taken before and
after the fever seasons in the months of June and November respectively.
Endemic and hyper-endemic centres
in the Punjab.
The tables below emphasize the fact, that in most of the towns which
were found in the previous year to be endemic or
hyper-endemic in the terms of relative intensity
from the point of view of malaria, the spleen-rate remained high.
7
TABLE IV.
Showing highly-epidemic areas with spleen-index approximately between 25 and
50 per cent.
No.
1
2
3
4
5
6
7
S
10
11
12
13
14
15
16
17
18
19
20
21
22
23
District.
Town.
AMBALA DIVISION.
Hissar
...
...
••• "
Rohtak
...
•••
•••
Gurgaon ...
...
...
Karnal
...
...
1. Fatehabad
2.
Sirsa ...
1. Gohana
...
...
l. Ballabgarh
2. Punahana
3. Sohna...
4
Faridabad
...
1. Kaithal
2. Guhla
JULLUNDUR DIVISION.
Kangra ...
...
Hoshiarpur
Jullundur ...
...
Ferozepur...
•••
1.
Dharamsala
...
2. Dera Gopipur
3. Hamirpur
4. Nurpur
...
...
5.
Jawalanuikhi ...
1. Gagret
...
...
2. Shamchurasi
...
...
1. Phillaur
...
...
1. Fazilka
...
...
LAHORE DIVISION.
Lahore
Amritsar ...
.••
•••
Gurdaspur...
...
Sialkot
Gujranwala
1.
Shahdara
...
...
2. Khudian
1. Attari
1. Pathankot
...
...
2. Dunera
...
...
1. Phuklian
...
...
1. Akalgarh
...
RAWALPINDI DIVISION.
Gujrat
...
...
...
Shahpur...
...
...
Jhelum ...
.••
•••
Mianwali ...
...
•••
1. Kotla...
1.
Bhera
...
...
2. Nurpur
1. Kalar Kahar
1. Mianwali
2. Bhakkar
MULTAN DIVISION.
Montgomery
Lyallpnr...
Jhang
Multan
Muzaffargarh
...
Dera Ghazi Khan
1. Boyleganj
...
...
2. Jaranwala
...
...
1. Atharanhasari
...
...
2. Bhawana
...
...
1.
Khanewal
...
2. Jalalpur
3. Kabirwala
1.
Kot Adu
2. Sinawan
...
...
3.
Rangpur
...
...
1. Mithankot
Spleen-rate in
1914.
500
32·4
52·9
56·2
21·5
29·0
29·6
32·7
28·5
37·6
40·7
492
20·4
77·7
28·5
60·3
32·3
42·5
39·9
40·0
23·3
45·0
33·3
53·2
32·4
23·9
25·2
22·8
36·0
21·4
24·7
...
61·2
30·5
24·0
50·0
27·2
35·5
50·4
75·8
94·04
59·6
Spleen-rate in
1916.
25·8
22·8
37·8
25·0
49·2
23·0
27·2
20·6
29·3
20·9
36·1
36·4
44·4
40·8
20·4
68·2
63·4
26·7
48·8
24·0
17·7
52·2
58·3
26·8
34·04
48·2
26·7
37·8
43·7
37·7
57·2
85·0
3·0
52·5
33·8
36·8
35·6
19·1
19·5
33·3
46·9
41·5
8
TABLE V.
Showing hyper-endemic areas with spleen-index above 50 per cent.
No.
1
2
3
4
5
6
7
District.
Karnal
Hoshiarpur
Ferozpur ...
...
...
Gurdaspur...
...
•••
Gujranwala
Shahpur ...
...
...
Montgomery
...
1.
i,
1
1.
1.
1.
2.
1.
1.
1,
Town.
Pehawa
Thanesar
Miani...
Jalalabad
,.,
Narot
...
Eminabad
Butala
Girot ...
...
Montgomery
Boyleganj
...
Spleen-rate in
1914.
}
65.0
71·4
84·2
66·6
54·1
97·1
54·5
53·4
48·0
Spleen-rate in
1916.
20·9
58·9
45·4
82·1
69·3
86·6
39·7
98·2
85·0
Conclusion.
It will be seen that, though the spleen-rate is liable to fluctuations,
it tends to keep high, and where this is the case
over a number of years, it may be confidently
concluded that malaria is endemic, and that it may pass into an epidemic
condition under suitable climatic and other conditions.
Relation of canal irrigation with fever
in Montgemery and Mianwali.
Montgomery.
A special reference to Mianwali and Montgomery seems called for in
this connection, The spleen-rate has consider-
ably increased in both places since the opening
of the canal at the end of 1913. The parasite-
rate was also determined in Montgomery in
September 1913, i.e., before, and in February 1916, i.e., 2 1/4 years after, the
canal was opened. A glance at the table below will show as measured by
these two methods, the extent to which malaria increased in Montgomery on
the introduction of canal water : —
TABLE VI.
Showing the spleen-rate and malaria index before and after the introduction of the canal in
Montgomery town.
1913.
4·16
SPLEEN-RATE.
1916.
85·0
1913.
2·72
PARASITE-RATE.
1916.
27·27
This result is confirmed by the statement given below in table form
showing the fever cases treated at the Civil Hospital and Jail Dispensary,
Montgomery, from 1908 to 1916 :—
TABLE VII.
Name of Dispensary.
Civil Hospital, Montgomery...
Jail Dispensary, Montgomery
1908.
6,640
148
1909.
3,784
207
1910.
2,G51
145
NUMBER
1911.
1,408
268
OF CASES TREATED.
1912.
1,708
130
1913.
2,889
63
1914.
6,797
57
1915.
3,612
898
1916.
5,569
1,224
It will be observed, that the number was highest in the Civil Hospital
in 1914, the first year of the introduction of canal water, and that in 1916 it
9
was nearly as high. If anything the jail figures are still more striking. A
distributary passes through the jail and from the running water in this, larvae
were caught which bred out into a carrier species — culicifacies. Specimens
of the same species were caught in the jail dairy.
The presence of the dairy in the same compound as the jail seems to, be
undesirable. The canal water breeds out the carrier anopheles which ordinarily
feed on the dairy cattle, but if they happen to bite a carrier of malaria in the
vicinity, they have the dairy for protection and for feeding, while the parasites
are undergoing development in their bodies. This also accounts for the increased
amount of malaria in the jail, and that in spite of the prophylactic issue of
quinine.
Mianwah.
As for Mianwali, the canal irrigates the Civil Station, the Jail and Police
Lines. The town, supplied by well water, as will
be observed from the, following table, has not
suffered nearly as badly as the Civil Station altnough tne number oí rever
cases has increased very markedly since 1913, the year before the opening of
the canal :—
TABLE VIII.
Showing the number of cases treated in the Civil Hospital, Mianwali, and in the Civil Station
Dispensaries from 1908 to 1916.
Name of Dispensaries in
Mianwali.
Civil Hospital (City)
Police Dispensary
Jail Dispensary
1908
9,186
685
364
1909.
5,752
653
336
NUMBER OF
1910.
2,923
484
317
1911.
1,986
233
139
CASES
1912.
2,265'
386
174
TREATED.
1913.
4,765
366
205
1914.
6,304
919
187
1915.
3,904
649
266
1916.
4,762
787
397
The following table will also clear the fact pointed out before :—
TABLE IX.
Showing comparison of spleen-rate and parasite-rate between Mianiwali Town and Civil Station.
Town.
Mianwali Town
...
...
Civil Station
RESULT OF A VISIT IN APRIL 1916.
»
Number of children
examined.
98
22
Number of children
with spleen.
19
10
Spleen-rate.
19·3
45·4
Parasite-rate.
5·1
36·3
A table is given below to show a very distinct increase of fever inci-
dence all over the Punjab :—
TABLE X.
Showing tîte number of fever cases which attended the different dispensaries in the different
districts of the Punjab from 1908-1916.
District.
Hissar
,.,
Karnal ... 5
Town.
Sirsa
City Dispensary
Thanesar ...
1908.
...
...
...
1909.
...
...
1910.
...
...
1911.
1,817
1,229
1912.
2,568
2,312
1913.
2,642
2,012
1914.
2,413
1,427
1915.
1982
2,248
1,031
1916.
1,572
2,794
2,448
REMARKS.
Ghaggar Canal.
Western Jumna
Canal.
Sarusti
and
numerous
other tanks.
11
IV.-EPIDEMIC MALARIA.
Increased incidence of malaria.
There cannot be said to have been an epidemic of malaria in the year
under review, although the incidence of fever
was high, and the number of autumnal fever
deaths was more than double that of the previous autumn. The prevalence was
fairly universal except for the districts of the Ambala Division, where the rain-
fall was somewhat deficient in intensity ; it was more marked in the western
or south-western districts of Mianwali, Muzaffargarh, and Dera G-hazi Khan,
and in some isolated places and rural areas, of which a number were newly irri-
gated. To discover the amount of intensity in certain towns, and rural circles
the following factors are made use of :—
1. Epidemic figures for different towns and rural circles of the Pro-
vince.
2. Comparison of spleen census figures before, and after the fever
season of 1916.
3. Comparison of hospital returns for the previous quinquennium.
Epidemic figure.
For working out tine epidemic figure in the present year, the fever deaths
for the montn of November were taken tor the
numerator, and the average monthly fever
mortality for the months of February, March, and April for the denominator,.
This change was necessary, as. the fever mortality exhibited its greatest virulence
in November. In very many places this year the epidemia figure was above 1,
showing that (1) there has been a marked increase in fever incidence, (2) the-
number of fever deaths exceeded the normal in the months of greatest intensity,,
and (3) the autumnal recrudescence was markedly conspicuous. The epidemic
figure 5 or about it is taken to indicate increased incidence on normal autumnal
recrudescence.
The towns and rural areas,, where the epidemic figure was about 5 or
exceeded this number, are given below:—
TABLE XI.
Showing towns and rural circles with epidemic figure about 5 or above it.
District.
Simla.
...
...
Kangra
...
Hoshiarpur ...
Gurdaspur ....
r
Sialkoit
...
...
Town..
Kot Khai
...
...
Dharmsala ... ...
Mukerian ... ...
Pathankot ... ...
Daska
...
...
Jamke ... ...
Sambrial
....
...
Sahowala
...
Begowala ... ...
Mitranwali. ... ...
Bhopalwala ... ...
Epidemic figure.
7.0
5.0
6.0
6.0
12.0
6.0
1'2'3
18.0
24.6
5.3.
10.0
Hill torrents.
Near bank of Beas.
Chaki Nalla.
Raya Branch of Upper Chenab
Canal
Upper Chenab Canal Aik Nalla
12
District,
r
Gujranwala
...
Gujrat
...
...
r
Shahpur ,,,
...
1
Mianwali
...
...
r
Montgomery
...
Lyallpur
...
...
Muzaffargarh
...
!
Dera Ghazi Khan
...
Town.
District figure ,.,
...
Wazirabad
...
...
Eminabab
...
...
Kiladidaraingh
...
...
Ramnagar
... ...
Gujranwala rural ...
...
Kamoke rural
...
...
Kiladidarsingh rural ...
...
Wazirabad rural
...
...
Akalgarh rural
...
...
Pindibhattian rural
...
Vanike rural
...
...
Kunjah ...
...
...
Gujrat rural
...
...
Shahpur
...
...
Miani ... ... ...
Khushab
... ...
Miani rural ... ...
Kalabagh
... ...
Montgomery rural .,.
...
Okara rural
...
...
Ranala khurd rural ...
...
Baraghar rural
...
...
Leiah ...
...
...
Karor ...
.,,
Karor rural
... ...
Khanewal rural ... ...
Kala rural
...
...
Vahoa rural
...
...
Draman rural
...
...
Batil rural
...
...
Epidemic figure.
5.1
8.0
5.0
17.0
6.9
5.0
5.0
10.9
7.7
8.8
6.7
11.0
8.6
4.9
19.7
5.7
7.0
5.0
6.0
5.0
5.0
7.3
6.3
5.7
7.3
67
6.7
5.3
5.0
6.0
5.6
REMARKS.
Palkhu Nalla.
Upcountry water.
Lower Chenab Canal.
Upper Chenab Canal Branch.
Palkhu Nalla flooded.
Lower Chenab Canal.
Upper Jhelum Canal, Bhimbe r
Nalla taken in,
Jhelum River.
Ditto.
Ditto,
Indus River.
Lower Bari Doab Canal.
Ditto.
Ditto.
If the figure 4 is taken up to which the autumnal increase in fever
mortality may be considered as normal, the list swells very markedly and in-
cludes many places and rural circles in the districts of Sialkot, Gujranwala,
Gujrat, Jhelum, Mianwali, Montgomery, Multan, Muzaffargarh, and Dera
Ghazi Khan.
Study of spleen-census maps of 1916.
Prom a comparative study of spleen-census Maps III and IV for 1916
appended in Appendix G, it appears that the
places where the intensity of malaria was most
marked was in the vicinity of rivers or newly constructed canals.
13
Spleen-census of November 1916 com-
pared with that of June 1916.
The table given below, which, shows a rise to about double or more in the
autumnal spleen-rate of 1916 over that of June»
indicates the relative virulence of the disease :—
TABLE XII.
District.
r
Hissar
...
Gurgaon
...
Karnal
...
Simla
Hoshiarpur
...
Ludhiana
Ferozepore
...
(
Lahore
...
Gurdaspur
...
!
[
Sialkot ...
r
Gujranwala
...
r
Gujrat
...
Shahpur
...
Town.
Fatehabad ...
Namaund ...
Sirsa ...
Faridabad ...
Sohna ...
Karnal ...
Munak ...
Kot Khai ...
Anandpur ...
Hajipur ...
Ludhiana
Jalalabad
Fazilka ...
Ali Razabad ...
Shahdara ...
Pathankot ...
Narot ...
Madhopur ...
Kot Naina ...
Sujanpur ...
Kalanaur ...
Fatehgarh ...
Zafarwal ...
Akalgarh
...
Sangla
Wazirabad ...
Hafizabad ...
Eminabad ...
Pindibhattian ...
Ramnagar ...
Sheikhupura ...
Butala ...
Kunjah ...
Kadirabad ...
Dinga ...
Sargodha ...
Miani ...
Spleen-
census in
June 1916.
14.2
15.3
106
12.2
0.7
3.7
18.1
0.0
1.9
3.8
0.0
56.6
Not taken
12.2
11.2
18.3
45.9
21.4
Not taken
10.2
3.7
3.2
14.1
75
33
5.1
0.8
45.2
10.1
2.7
4.9
48.3
14.7
8.8
371
6.1
2.3
Spleen-census
in Novem-
ber 1916.
25.8
42.3
22.8
38.4
23.0
13.7
31.2
60.2
14.7
12.0
18.18
82.1
26.7
30.2
46.8
52.2
69.3
56.0
49.3
33.05
35.0
20.5
43.9
34.04
10.9
51.5
23.3
86.6
30.03
48.9
20.0
93.7
38.2
44.2
99.3
62.03
20.5
REMARKS.
Ghaggar Canal.
In vicinity of Jumna River and fed
by Western Jumna Canal.
Sutlej River.
On bank of Beas River.
Bank of Beas and Sutlej.
Ravi River.
Ditto.
Chaki Nalla.
Ravi River.
Ravi River, Upper Bari Doab Canal.
Ujh Nalla
Upper Bari Doab Canal.
Dek Nalla.
Upper Bari Doab Canal.
Aik Nalla.
Lower Chenab Canal.
Ditto
Rakh Branch.
Palkbu Nalla.
Upcountry water collected there.
Chenab River.
Lower Chenal Canal.
Upper Jhelum Canal. Bhimber Nalla
taken in.
Chenab River.
Upper Jhelum Canal.
Lower Jhelum Canal.
Jhelum River.
l4
District.
Jhelum ...
•••
r
Rawalpindi
...
Attock ...
...
X
Mianwali
...
r
Jhang ...
...
Multan ...
...
!
Town.
Pind Dadan Khan
Murree ...
...
Kahuta
alagang
Hassanabdal ...
Isakhel ...
...
Kainarmashani
...
Atharanhazarl ...
Shorkot ...
Mailsi ...
...
Lodhran
...
Kahror ... ...
Spleen-census
in June
1916.
9.5
0.9
10.8
5.6
6.6
6.4
10.8
13.1
8.9
15.0
15.6
2.3
Spleen-census
in Novem-
ber 1916
31.06
21.8
32.1
43.07
26.0
26.3
20.0
28.5
52.5
38.0
83.7
23.3
REMARKS.
Jhelum River.
1
Hill torrent runa close by.
A nalla.
Indus River.
Junction of Jhelum and Chenab
Rivers.
Jhelum and Chenab Rivers.
Jasuwah Khurd Branch of Mailsi
Canal.
Lodhran Canal.
Sultanwali Branch of Mailsi Canal.
Hospital returns of fever cases of differ-
ent towns for last six years.
The use of a third factor—the record of fever cases at hospitals and
dispensaries of various towns—is also useful as
showing the degree of severity of malaria and its
prevalence in different towns of the Punjab :—
TABLE XIII.
Showing the number of fever cases which attended the different dispensaries of the
Punjab from 1911 to 1916.
District.
Hissar ... ...
Karnal ...
Hoshiarpur ...
Ferozepore ...
r
! !
Gujranwala
...
Gujrat
...
Jhelum ...
Shahpur ...
Mianwali
...
Multan ...
...
Muzzaffargarh ...
Town.
Sirsa ... ...
City Dispensary ...
Mukerian ...
Fazilka ...
Civil Hospital
City Branch
Female Hospital ...
Police Hospital
Ramnagar
...
Sharakpur ...
Sangla
...
Pindibhattian ...
Kunjah
...
Dinga ...
Civil Hospital
...
Pind Dadan Khan ...
Sargodha
...
Police Hospital ...
Jail Dispensary ...
Massan
...
Kalabagh
...
Kamarmashani ...
Bhakkar
...
Isakhel
...
Khanewal
...
Leiah ...
Karor ...
Khangarh
1911.
1,817
1,094
777
1,497
1,985
508
57
853
769
935
1,066
1,113
687
2,581
1,758
1,360
233
139
509
2,757
950
3,051
2,814
771
1,262
288
2,301
1912.
2,568
1,082
654
1,600
2,766
704
150
779
846
2,511
1,062
1,104
1,113
2,533
1,322
2,194
386
174
964
2,260
898
3,228
3,045
866
1,885
1,259
2,580
1913.
2,642
1,216
1,179
2,474
4,445
942
219
777
1,626
5,277
1,607
1,401
1,194
3,660
4,133
3,525
366
205
1,415
4,348
2,445
4,174
3,989
1,007
2,280
2,358
5,600
1914.
2,413
2,185
1,378
2,689
4,635
1,024
351
1,650
2,719
3,979
1,559
1,155
1008
3,720
4.159
3,167
919
187
1,460
4,050
3,107
3,487
3,890
1,816
2,708
3,727
8,486
1915.
982
2,248
1,119
939
2,063
3,270
792
219
1,075
1,463
2,899
1,065
1,055
1,170
2,657
2,458
2,156
649
266
978
3,627
2,110
2,232
3,162
1,756
1,468
1,842
4,125
1916.
1,572
2,794
4,036
1,902
3,848
4,959
1,224
402
3,361
2,803
4,411
2,842
3,080
2,525
5,032
5,294
3,518
787
397
2,114
5,965
4,438
5,988
7,033
2,028
4,587
4,708
8,465
REMARKS.
15
Map II in Appendix C.
As there were many places where the epidemic figure was 5 or above, it
has been thought advisable to prepare and
append a separate map (Map II in Appendix 0)
showing the distribution and intensity of malaria during the year under review.
Special note on the malaria of Kangra,
District.
The epidemic figure, the spleen-rate, and the hospital returns fail to show
the increase in malaria in the Kangra District,
yet the fever mortality figures are higher than
any year m the decade except in 1908 :—
TABLE XIV.
Name of District
1906.
Total deaths.
190
Ratio per mille.
7.
Total deaths
190
Ratio per mille.
8.
Total deaths.
(M
190
Ratio per mille.
r—1
9.
Total deaths.
19
Ratio per mille.
ID
i-l
10.
191
Total deaths.
ô
ia
Cq
rH
1.
Ratio per mille.
-<?
o>
o>
i—i
191
Total deaths.
o
ea
i—i
2.
Ratio per mille.
o
.t-
\O
. 1—1
191
Total deaths.
i«
CD
i—t
3.
Ratio per mille.
i—t
in
to
191
Total deaths.
eo
co
M
eo
1-4
4.
Ratio per mille.
o»
CO
t-
r—1
191
Total deaths.
->?
m
eo"
rH
5.
Ratio per mille.
t-
i—i
191
Total deaths.
t-
i—i
tĩ
—i
6.
Ratio per mille.
Special note on the malaria of Lyallpur
District.
The table below shows that in the Lyallpur
District malaria is present in a markedly endem-
ic manner :—
TABLE XV.
Showing fever mortality and ratio per mille in the Lyallpur District from
1907 to 1916.
Name of
district.
Lyallpur
190
Total deaths.
9,841
7.
Ratio per mille.
18.85
190
Total deaths.
16,860
8.
Ratio per mille.
32.29
190
Total deaths.
13,387
)9.
Ratio per mille.
25.60
191
Total deaths.
11,330
0.
Ratio per mille.
21.70
191
Total deaths.
10,271
1.
Ratio per mille.
11.97
191
Total deaths.
10,311
2.
Ratio per mille.
12.02
191
Total deaths.
11,649
3.
Ratio per mille.
13.58
191
Total deaths.
13,087
4.
Ratio per mille.
14.71
191
Total deaths.
12,023
5.
Ratio per mille.
13.53
19
Total deaths.
13,248
16.
Ratio per mille.
14.90
But in a rapidly growing population like that of Lyallpur a ratio-rate is very-
misleading and even actual figures are not very dependable.
Changes in the staff.
As two members of the staff applied for, and obtained temporary com-
missions in the I.M.S., the research work of the
laboratory was considerably affected.
Showing the fever mortality figure of Kangra District from 1906 to 1916.
APPENDIX A.
CHART I.
Showing the Total Mortality, "Fever" Mortality and Autumnal Mortality
in the Punjab from 1867—1916.
Red = Total recorded Mortality.
Green = Total "Fever" Mortality.
Yellow = Autumnal Fever Mortality.
APPENDIX A
CHART II.
Showing the Total Mortality, "Fever" Mortality and Autumnal Fever Mortality
in the Punjab from 1867—1916.
Red = Total recorded Mortality per 1,000 of population.
Green = Total "Fever" Mortality per 1,000 of population.
Yellow = Autumnal Fever Mortality per 1,000 of population.
Showing the Monthly Fever Mortality in the Punjab during 1915—1916.
Blue = 1915.
Red = 1916.
APPENDIX B.