NationalLibraryOfScotland/medical-history-of-british-india huggingface dataset:
No. 7462-GENERAL.'
FROM
THE HON'BLE COLONEL R. C. MACWATT,
C.I.E., M.B., F.R.O.S., I.M.S.,
Inspector-General of Civil Hospitals, Punjab,
To
THE-HON'BLE MR. O. F. LUMSDEN, I.C.S.,
Financial Secretary to Government, Punjab.
Dated Lahore, the 29th November 1918.
SIR,
I HAVE the honour to forward, herewith, the annual report of the Chief
Malaria Medical Officer, Punjab, for 1917.
2. The monsoon reached the Punjab on the 2nd June much in ad-
vance of the normal time ; rainfall was excessive throughout the Province, and
continued up to the last week of October. The total rainfall for the year was
1693 " above the normal. The result was, as in other parts of India, and in
years of excessive and late rainfall, a universal and virulent epidemic of mala-
ria, most marked in the West and South-West districts of the Punjab and in
Gurgaon, where flooding of the country occurred.
3. Although the rainfall in Amritsar City was less in 1917 than in
1914 and 1916 the number of mosquitoes in 1917 was much greater, and the
prevalence of malaria much more marked.
4. It would appear that the number of deaths from " fevers " has pro-
gressively increased during the past four years in certain districts coincidently
with the introduction of canal irrigation.
5. The increase of Infant Mortality is attributable in part to malaria,
but also in no small measure to inanition from the stoppage of secretion of
milk in malaria-stricken mothers, and from contamination of cows' milk which,
in such cases, had to be substituted for the natural supply.
6. The response by Civil Surgeons to the request for special reports on
the increased incidence of malaria in their districts has been disappointing ;
their attention is again being drawn to the matter.
7. The results of quininisation of school children has not been convinc-
ing ; possibly due to the half-hearted way in which it is said to have been
carried out. The subject is still controversial ; and experiments on a large
scale are being conducted in the Army in India, which, it is hoped, may help
in settling the question of prophylaxis of malaria.
8. The delay in the submission of the report is regretted. It reached
this Office on the 19th November from the Press. The initial delay occurred
in the Chief Malaria Medical Officer's Office and there was further delay in
having the maps and charts zincographed at Roorkee.
I have the honour to be,
SIR,
Yours most obedient Servant,
R. C. MACWATT, COL., I.M.S.,
Inspector-General of Civil Hospitals, Punjab.
61 IGCH—357—2.1.19—SGPP-Lahore..
No. 268 MX
OFFICE OF THE CHIEF MALARIA MEDICAL OFFICER,
PUNJAB.
To
THE INSPEOTOR-GENERAL OF CIVIL HOSPITALS,
PUNJAB.
Dated Lahore, the 20th August 1918.
HAS the honour to forward herewith the Annual Report of Malaria in
the Punjab during the year 1917, together with an account of the work of the
Punjab Malaria Bureau.
H. HENDLEY, M.D., COL., I.M.S.,
Chief Malaria Medical Officer, Punjab«
89 IGCH—357—26-10.18—SPPIlLahore,
REPORT ON MALARIA IN THE PUNJAB DURING THE
YEAR 1917.
I.—INTRODUCTION.
THE death-rate from Malaria in the Punjab is always a large one, but
from time to time it reaches a very high figure, as in the year 1908 and in
the year under review. There were 697,058 fever deaths in the year 1908,
out of a total number of 1,020,125. In 1917 the number of fever deaths was
510,812 and the total number 733, 109.
2. Though all the deaths reported as from fevers were not necessarily
due to malaria, it is probable that these figures represent more truly the
immensity of the mortality caused directly or indirectly by this infection than
for instance to those referable to plague,
3. The indirect effect of malaria on the mortality rate is probably
more to be feared than the direct. It would be difficult to give any idea of
its malign influence on the causation of deaths in infancy and on those due
ostensibly to respiratory diseases. It certainly has a serious effect on the
birth-rate and on the expectation of life, while it is the greatest of all the causes
for disability and inefficiency in the adult.
II.—GBNERAL CONSIDERATIONS.
4. The total number of deaths from fever was 510,812 against 376,003
in 1916 and 284,784 in 1915 giving a death-rate respectively of 26.42,
19.44 and 14.72.
5. The number of autumnal fever deaths for the year 1917 was 190,235,
while for the years 3915 and 1916 it was 45,685 and 92.936, giving a mor-
tality rate of 9.83, 2.36 and 4.80, respectively.
6. There were 91,505 more deaths in 1917 than in any one of the last
17 years excepting in the great epidemic of 1908.
7. The total number of deaths from "Fevers " was 510,812, while
from all causes this amounted to 733,109, the corresponding death-rates being
26.42 and 37.91, respectively ; thus " Fevers " were responsible for more
than 5/7th of the total deaths in the Province.
Table No. I
Showing the fever Mortality and autumnal ratios per mille for the Punjab for the
last 17 years.
19
Annual.
25.26
19
Annual.
20.40
01
Autumnal.
7.17
09
Autumnal.
4.25
19
Annual.
23.54
19
Annual.
17.10
02
Autumnal.
4.62
10
Autumnal.
3.21
19
Annual.
25.33
19
Annual.
15.33
03
Autumnal.
6.72
11
Autumnal.
2.18
19
Annual.
18.82
19
Annual.
14.22
04
Autumnal.
3.49
12
Autumnal.
2.67
19
Annual.
18.40
19
Annual.
17.15
05
Autumnal.
3.03
13
Autumnal.
3.79
19
Annual.
20.28
19
Annual.
17.87
06
Autumnal.
5.49
14
Autumnal.
3.64
Annual.
20.16
19
Annual.
14.73
19
15
Autumnal.
2.36
07
Autumnal.
3.99
19
Annual.
19.44
Annual.
34.66
16
Autumnal.
4.80
19
19
Annual.
26.42
08
Autumnal.
15.28
17
Autumnal.
9.83
Chart.
Showing Monthly Rainfall, Epidemic Figure and Annual Fever Mortality of Amritsar town
for the years 1908, 1914, 1916 and 1917.
NO.3138-5.-356
26. In this chart it is noticeable that while the rainfall in 1914 and
1916 was much in excess of that of 1917, the town of Amritsar only experienc-
ed an epidemic in the latter year. On the other hand, the fever death-rate of
Multan city was 30.46 per mille, which was much higher than even that in the
epidemic year of 1908 when il was 23.80, while the rainfall in the year under
review in Multan city amounted to 1983" against 6'25" in 1916 and 9.53"
in 1908. In the previous 20 years (since records have become available) Multan
had never had such a heavy rainfall ; in the year 1897 it is true it had reached
12.55" but in that year the death-rate from fever was only 14.49.
From the history of these two towns it would seem quite certain that
though a heavy rainfall is essential to the production of an epidemic of malaria-
it is not the only factor as it may not necessarily be followed by one.
27. Map I appended to Appendix 0, gives the annual fever mortality
rate fer mille for the 28 districts of the province for the years 1916 and
1917 with a view to singling out those in which the fever death-rate, having
remained constantly high for some years, may be held to contain endemic
centres.
Maps II and III are given in Appendix 0 to show the spleen census of
different places (where there are dispensaries) preceding and following the
fever season, i.e., at the end of the June and November respectively. From this
chart some idea should be obtained as to the places which were visited by the
epidemic and those that escaped it.
28. The tables below show the names of the places at which the spleen
rate remained high after a succession of mild malarial years have been classed'
as endemic or hyper endemic centres in the terms of relative intensity of
malaria :—
Table IV.
Showing highly endemic areas with spleen index approximately between 25 and 50 per cent.
No.
1
2
3
4
5
6
7
District.
Hissar ...
Gurgaon
Karnal
...
Kangra
...
r
Hoshiarpur
...
Jullundur
...
Ferozepore
...
Towns.
AMBALA DIVISI
1. Sirsa
1. Punahana
1. Pehowa ...
2. Thanear ,..
3. Guhla
4. Munak ...
JUILUNDUR DlVI
1. Nurpur ...
2. Jawalamukhi
3. Dera Gopipur
4. Hamirpur
1. Tanda
2. Mukerian
3. Hariana ...
4. Bharwain...
...
5. Miani
...
1. Phillaur ...
1. Fazilka ...
Spleen-rate
in
1914.
ON.
32.4
21.5
65.0
59.0
28.5
42.8
SION.
20.4
77.7
40.7
49.2
25.1
41.01
26.5
21.7 (June
84.2
32.3
26.7
Spleen.rate
in
1917.
422
66.6
29.1
27.6
33.3
30.7
29.5
40.4
33.3
22.0
35.0
46.08
25.4
1917) 35.5
20.0
24.6
20.0
REMARKS.
Escaped epidemic.
Dispensary opened in
1917.
Ko.
8
9
10
11
12
13
14
15
16
17
18
19
20
2
2
District.
r
Lahore
...
L
Amritsar
...
r
Gurdaspur
L
Sialkot
Gujrauwala
...
Gujrat
...
7
Towns.
Spleen-rate
in
1914.
LAHORE DIVISION.
1. Khudian ...
2. Shahdara ...
3. Ali Razabad
1. Tarn Taran
2. Atari
1. Pathankot
2. Dunera ...
3. Sujanpur ....
4. Kot Naina
...
5. Madhopur
...
6. Dinanagar
1. Phuklian
1. Sangla
2. Akalgarh ...
40.0
36.9
20.0
49.3
43.4
45.0
23'3
24.7
49.3
66.0
20.0
53.2
37.3
32.4
RAWALPINDI DIVISION.
1. Mong
2. Kadirabad
3. Kunjah ...
1. Nurpur ...
Shahpur
..
2. Shahpur ...
3. Sillanwali
Rawalpindi
..
1. Kahuta ...
Attook
1. Fatehjang
1. Mianwaii...
2. Bhakkar
MULTAN DlVIS
1.
Montgomery
Montgomery
Jhang
) Multan
Muzaffargarh
Dera Ghazi Khan
2.
Boylesganj
3. Pakpatfcan
4. Gugera
1. Atharanhazari
2. Shorkot ...
..
3. Kot Isa Shah
4. Bhowana...
5. Shah Jewna
1. Lodhran
2. Talamba ...
3. Jalalpur.
1. Khangarh
2. Sitpur
3. Leiah
4 Kahror ...
1. Mithankot
2. Taunsa ...
25.6
25.0
23.7
22.8
27.7
36.7 (June
37.9
355
21.4
24.7
ION.
44.9
48.0
29.05
20.0
30.5
23.8
38.8
24.0
62.2
23 7
27.9
47.7
44.7
20.0
22.5
35.1
59.6
36.2
Spleen-rate
in
1917.
30.2
84.7
68.8
29.0
30.3
26.9
87.5
27.8
81.3
36.3
26.6
29.5
48.4
72.2
34.2
58.6
46.3
56.1
70.-1
1917) 37.5
39.7
37.6
22 7
661
90.0
100.0
47.0
44.7
243
29.6
32.06
33.3
43.7
100.0
38.6
74.7
67.3
57.6
29.8
91.66
42.6
48.5
REMARKS.
Dispensary opened in
1916.
8
Table V.
Showing hyper endemic areas with splenic index above 50 per cent.
Wo.
1
2
3
4
4
6
7
8
9
10
District.
Hissar
Ambala
Ferozepore
Gurdaspur
Gnjranwala
...
Shahpur
...
Jhelum
...
Lyallpur
...
Multan
...
Muzaffargarh
...
1.
1.
1.
1.
2.
1.
1.
2.
1.
1.
2.
1.
2.
3.
4.
Towns.
Fatehabad
Sadhaura
Jalalabad
Narot
Spleen-rate
in
1914.
AMBALA DIVISION.
...
500
52.0
JULLUNDUR DIVISION.
...
66.6
LAHORE DIVISION.
...
Kila Didar Singh
Eminabad
Girot
54.05
76.9 (1916)
79.1
RAWALPINDI DIVISION.
...
Kallar Kahar
...
Choa Saidan Shah
Jaranwala
Kabirwala
Khanewal
MUJLTAN
Muzaffargarh
Rangpur
Kot Adu
Sinanwan
...
53.4
87.5
70.0
DIVISION.
63.9
50.0
50.0
67.0
94.04
66.0
75.8
Spleen-rate
in
1917.
53.6
67.9
89.6
60.4
79.5
68.3
1000
60.0
70.5
63.2
73.6
71.4
57.-6
88.5
93.0
86.1
REMARKS.
From these tables it will appear that the spleen-rate is liable to fluc-
tuation and that in spite of the malaria incidence being so high this year some
places show a lower spleen-rate figure. Factors that have some bearing on
these results are (1) the eastern half of the province escaped the epidemic and
(2) the introduction of quininisation as a prophylactic into schools.
£9. A high spleen-rate extending over a series of years presupposes
endemic centres, and as they in turn are likely to be the seats of epidemics
when other conditions are favourable it is necessary to keep them under close
observation.
30. The spleen-rate has been steadily on the increase in Montgomery,
and the parasite-rate has increased in both it and Mianwali since canal water
was introduced. The following table has been introduced to show this and also
the marked difference between the conditions existing in the civil station of
Mianwali and the town to which irrigation has not been extended.
Table VI.
Showing the spleen-rate and endemic index preceding the introduction of canal in Montgomery
town, Mianwali Station and after it.
No.
1
2
3
Towns.
1913
Montgomery
...
4.16
Mianwali
...
21.4
Mianwali C. S.
SPLEEN-RATE.
1916
85.0
37.7
45.4
1917
90.0
22.72
50.0
PARASITE-BATE.
1913
2.72
9.61
1916
2727
5.1
36.3
1917
60 per cent in jail and
70 per cent in schools.
l8.63
32.14
31. The results of an examination made of the children in the vil-
lages and the civil station on the New Namal Canal as well as those of Mian-
wali Town and Kundian which are not so irrigated, are given below to show
that in the former places (1) the spleen-rate in children is markedly higher,
(2) the infection index is fairly high and (3) the spleen-rate and parasite-rate
in the children on quinine parade have not been appreciably affected.
Table VII.
Showing the results of an examination of children in the villages and civil station on the
New Namal Canal as well as Mianwali town and Kundian.
No.
1
2
3
4
5
6
7
Locality.
Mianwali Police Lines ...
Wanda Fazil Shah
Aba Khel
Surabwala
Musakhel Town
Musakhel School
Mianwali Town
Kundian
Number
of
children ex-
amined.
33
16
30
30
40
12
66
20
Number
of
children with
spleen.
14
12
21
24
28
3
15
Spleen-rate.
50.00
75.00
70.00
80.00
7000
25.00
22.72
55.00
Parasite-rate.
32.14
19.00
20.00
13.33
48.00
18.75
13.63
15.00
Anopheline Fauna.
N. M. Rossi, M. Culicifacies..
C. Pulcherims, M. Listoni.
N. M. Rossi, M. Culicifacies.
Ditto.
Ditto.
C. Pulcherima, M. Listoni.
N. M. Rossi, M. Culicifaciea.
Ditto.
32. A further statement giving number of deaths has been prepared to
show the effect of canal irrigation on the people in this area since it was intro-
duced 4 years ago.
Table VIII
Statement showing the number of deaths, deaths from fevers, and Infantile
Mortality in
M
and
Nammal Canal Villages.
No.
1
2
3
i
5
6
7
Locality. ,
Mianwali Town ...
Yarn Khel
Vata Khel
Musa Khel
Nammal
Aba Khel
Takanwala Wanda...
Total
deaths.
106
5
131
170
98
11
8
1910.
Fever
deaths.
60
5
105
11l
58
7
7
33. The two
Infantile
mortality.
42
4
64
58
32
5
5
Total
deaths.
149
7
133
156
80
15
l
1911.
Fever
deaths.
90
2
127
135
64
13
10
Infantile
mortality.
58
5
56
61
24
7
5
statements
Total
deaths.
125
data
190
172
69
28
10
1912.
Fever
deaths.
81
not
142
135
58
21
5
Infantile
mortality.
40
av
49
71
18
8
3
below
Total
deaths.
133
ail
185
179
20
16
9
1913.
Fever
deaths.
75
ab
149
154
17
13
8
Infantile
mortality.
46
le.
58
52
2
4
4
Total
deaths.
146
14
231
155
64
24
19
1914
Fever
deaths.
87
11
194
131
50
20
16
Infantile
mortality.
48
4
75
37
16
8
3
Total
deaths.
162
16
198
183
70
23
10
1915.
Fever
deaths.
113
12
175
154
56
19
7
Infantile
mortality.
54
6
2
50
23
6
3
1916.
Total
deaths.
203
98
170
164
70
21
28
are interesting as showing
11
11
Fever
deaths.
138
19
142
143
62
15
22
Infantile
mortality.
60
8
37
51
25
12
5
Total
deaths.
195
23
222
182
65
27
23
1917.
Fever
deaths.
147
23
189
174
56
25
22
the effects
Infantile
mortality.
70
4
77
48
18
13
5
of
irrigation at Mianwali and Montgomery as expressed by the mortality-rate
and the cases of malaria treated in the Civil Dispensaries and Departmental
Hospitals.
Table IX.
Showing fever mortality-rate per mille from 1908 to 1917 in the towns of Mianwali and
Monioomery.
No..
1
2
Town.
Mianwali Town
Montgomery
1908.
35..09
1136
1911.
14.46
5.78
1912.
12.69
7.87
1913.
13.66
7.38
1914.
13.98
13.29
1915.
18.16
14.88
1916.
22.17
16.24
1917.
23.62
15.13
10
Table X.
the number of fever cases treated in Mianwali and Montgomery Hospitals from 1908
to 1917.
No,
1
2
3
4
5
Name of Hospitals.
Civil Hospital, Mianwali (City) ...
Police Dispensary, Mianwali
Jail Dispensary, Mianwali
Civil Hospital, Monigomery
Jail Hospital, Montgomery
1908.
9,186
685
364
6,640
148
1909.
5,752
653
336
3,784
207
NUMBER OF
1910.
2,923
484
317
2,051
145
1911.
1,986
233
139
1.408'
268
FEVER
1912.
2,265
386
174
1,708
130
CASES
1913.
4,765
366
205
2,889
63
TREATED.
1914.
6,304
919
187
6,707
5"
1915.
3,904
649
266
3,612
898
1916.
4,762
787
397
5,569
1,224
1917.
10,362
1,222
536
6,955
1,705
34. In the following table those places in the province are shown at
which the fever death-rate remained constantly high over a number of non-
epidemic years and in the year under review. These may be safely taken as
endemic centres.
Table XI.
Showing the names of towns with consistently high fever mortality-rate during the
non-epidemic years.
No.
1
2
3
4
5
6
, 7
8
9
10
11
12
13
.
14
District
Gurgaon
Ambala
r
Hosbiarpur
...
!
Gurdaspur
Sialkot
r
Gujranwala
..
Shahpur
Jhelum
Attock
r
Mianwali
...
Montgomery
...
Multan
r
!
Muzaffargarh ...
t
Dera Ghazi Khan
1
Towns.
1. Fariaabad
1. Tagadhri
1. Dasuya
2. Tanda
3. Mukerian
1. Dinanagar
1. Begowala
1. Eminahad
2. Sohdara
3. Kila ' idar Singh
1. Miani
1. Pind
Dadan
Khan.
1. Pindigheb
1. Miauwali
2. Bhakkar
3. Kalabagh
1. Montgomery ..
2. Kainalia
3. Pakpattan
1. Shujabad
1. Muzaffargarh ..
2. Khangarh
3. Alipur
4. Leiah
5. Karor
1. Dajal
2. Rajanpur
3. Mithankot
Provincial Fever Mortality-rate
Average Fever Mortality-rate for towns
1911.
15.77
25.85
18 24
27.76
18.54
7.96
14.57
3.17
12.55
18.32
20.12
14.46
25.98
25.10
5.78
18.70
12.26
20.68
16.01
20.01
48.42
22.02
17.98
15.96
2484
33 99
15.33
16.00
FEVER MORTALITY-RATE PER
MILLE.
1912.
i
26.08
15.69
18.65.
20.10
21.43
22.87
9.23
17.79
4.98
14.26
16.15
18.79
12.69
21.90
22.69
7.87
1772
13.90
15.31
17.72
15.23
18.12
15.78
20.55
15.81
24.03
27.81
14.22
11.95
1913.
37.22
23.66
20.02
22.09
21.92
26.00
24.61
22.93
11.31
19.42
21.06
17.36
13.66
27.10
16..83
7.38
10.39
16.43
21.63
23.79
2568
16.91
18.84
25.98
16.54
18.09
28.20
17.15
15.84
*
1914.
27.64
20.59
28.30
25.09
20.46
26.24
23.89
19 29
12.22
13.92
23.04
21.89
13.98
28.40
21.34
13.29
26.95
22.12
20.84
24.28
34.64
25.97
22.39
25.98
20.75
1593
18.15
17.87
15.64
1915.
11.59
21.17
20.02
20.24
12.66
22.63
15.66
17.73
21.22
10.41
16.33
15.39
20.23
18.16
24.13
19.09
14.58
22.34
18.96
2037
16.99
27 77
2234
14.93
26.33
15.38
16.74
18.93
14.73
13.32
19.16.
15.15
19.26
17.79
12.54
22.89
17.81
54.41
14.66
24.00
44.34
28.01
25.40
2'2.33
22.17
36.01
22.84
16.24
19.55
19.34
18.31
18.94
27.17
22.04
25.45
48.82
23.65
15.66
21.24
19.44
14.87
1917.
21.40
19.10
21.41
36.06
48.22
25.76
49.36
23.89
43.08
40.27
23.72
33.43
20.67
23.62
34.71
2299
15.13
44.19
50.48
50.21
2938
60.91
38.04
25.69
54.52
70.51
95.03
78.41
26.42
21.46
Table XII.
Showing the towns and rural areas with epidemic figure 5 or over it in 1917.
(R. C. = RURAL CIRCLES).
District».
AMBALA. DIVISION.
r
Hissar
...
Rohtak
r
Gargaou
...
JULLUNDUB DIVISION.
Ferozepore
...
1
LAHORE DIVISION.
Lahore
...
t
1
Towns and rural circles.
Hansi
Sirsa
-,
Fatehabad
R. C. Sirsa
R.C. Ellenabad
Jhajjar
Rewari
Palwal
Firozpur-Jhirka
Farrukhnagar
R. C. Rewari
Jatasana
Nub
Taoru
Firoapur-Jhirka
Punahana
District figure
Ferozepore
R. C. Malanwala
...
Makhoo
Mamdot
Chunian
Patti
R. C. Naulakha
...
Shabdara
...
Chung
Bhai Pheru
., Serai Mughal ...
Chnnian
...
Chhanga Manga...
Kanganpur
Khalra
Barki
8.5
10.6
8.0
8.6
53
6.9
8.3
5.1
12.6
5.1
5.5
12.6
8.6
8.9
12.3
Té
6.5
6.4
8.9
6.1
5.0
6.4
9.0
7.1
5.4
7.0
5.3
10.0
53
6.0
5.7
5.7
5.8
Districts.
r
LAHORE DIVISION—
contd,
Amritsar
...
Gurdaspur
...
r
Sialkot
...
Gujranwala
...
Towns and rural circles.
Amritsar
Majitha
Tarn Taran
R.C. Amritsar
Kathunagal
Ajnala
Lopoki
Gharinda
R.C. Gurdaspur
Kot Naina
Daska
Zaffarwal
Sambrial
Sahowala
Begowala
Badomali
R.C. Sialkot
Chaprar
Sambriàl
Daska
Kila Sobha Singh
Pasrur
Dharmkot
Satrah
Midhoki
District figure
Kila Didar Singh
Akalgarh
Sodhrah
Hafizabad
Sharakpur
R.C. Gujranwala
Kila Didar Singh
Wazirabad
Akalgarh
Hafizabad
Sheikhupura
Khangarh
Epidemic figure.
9.8
8.0
95
7.2
54
5.9
57
6.2
55
53
8.2
7.0
7.0
6.0
73
7.0
50
5.0
5.7
5.7
7.4
57
6.0
5.0
5.0
5.0
6.9
5.4
112
17.9
11.3
8.2
5.2
61
6.3
8.3
5.7
5.6
13
Districts.
LAHORE DIVISION—
contd.
1
Gujranwala—concld.
RAWALPINDI DIVISION.
r
Gujrat
••• i
r
1
i
Shahpur
...
Jhelum
••
Attook
... |
Miamvali
...
MULITAN DIVISION.
r
Montgomery
TOWNS and rural circles.
R. C. Pindi Bhattian ...
Vaneke
Sharakpur
Mangtanwala
Nankana
Naushera
Sukheke
District figure •
Dinga
R.C. Gujrat
Pahranwali
Kadirabad
Shahpur
Sahiwal
Khushab
R.C. Jhawarian
Sahiwal
Bhera
Midh Ranjha
Khushab
Mitha Tiwana ...
Nanshera
Katta Sahgal
Sargodha
Sillanwali
District figure
Pind Dadan Khan
R. C. Lilla
R. C. Makhad
Tanman
Lawa
R.C. Mehbal
Chakrala and Dhak
Kamali a
Pakpattan
R.C. Harapa
Chichawatni
Kamalia
Gugera
Chuchak
Pakpattan
...
|
if
Epidemic
figure.
8.0
5.6
5.6
11.3
5.2
6.5
5.9
5.5
11.8
5.2
6.9
6.9
7.7
9.7
19.2
19.3
10.1
7.0
10.3
12.7
5.8
5.1
165
6.1
5.6
7.0
6.2
9.0
6.4
6.2
5.8
5.1
6.4
9.2
1 8.4
149
8.5
16.2
6.0
8.3
18.21
Districts.
MUITAN DIVISION—
contd.
Montgomery—concld.
r
Lyallpur
...
|
{
1
|
\
Jhang ...
...
1
!
{
r
Multan
!
|
1
Towns and rural circles.
R.C. Tibbi
Kabir
Hujra
Dipalpur
Haveli
Attari
Kanal Khurd
Nur Sha
Kasowal
Katorwala
District figure
Gojra
R. C Gojra
Sayadwala
Toba Tek Singh ...
Chutiana
Bhalak
Kilianwala
Jhang
Maghiana ...
Chiniot
R. C. shing
Mochianwali
Massan
Kadirpar
Bhowana
Chiniot
Lalian
Barana
Shorkot
Atharanhazari ...
District figure
Multan
Shujabad
R. C. Multan
Shujabad
Jalalpur
Lodhran
Kahror
Mansi
Mithu
Epidemic
figure.
12.1
19.0
8.0
10.4
12.8
7-S
6.9
7.4
13.0
71
10.6
7.4
54
64
5.8
5.8
5.0
8.4
6.9
6.0
5.0
13.0
8.0
9.3
6.7
10.3
12.3
8.2
8.3
5.4
5.8
7.7
6.0
75
8.1
10.8
11.1
8.0
5.8
8.5
6.4
Districts.
r
MULTAN DIVISION—
continued.
Multan—conold
•••
r
Muzaffargarh
...
Towns and rural circles.
MULÍTAN
R. C. Luddan
Talamba
Sarai Sidhu
Kabirwala
Alpa
Basti Malak
MakhdumRashid...
Pakhi Mian
...
Sahuka
Khanewal
Mian Channu
District figure
Muzaffargarh
Khangarh
Alipur
Karor
R. C. Muzaffargarh ...
Rangpur
Kinjhar
Khangarh
Rohillanwali
Shahr Sultan
Jatoi
Epidemic
figure.
Districts.
DIVISION—conduded.
6.6
12.9
9.0
6.7
14.0
9.8
6.7
12.1
6.6
15.2
5.0
8.2
6.2
9.0
7.3
7.4
5.0
6.0
5.1
7.0
7..3
7.6
11.2
Muzaffargarh—
concted.
r
I
!
Dera Ghazi Khan ...
!
1
Towns and rural circles.
R. C. Alipur
Sitpur
Sinanwan
Chobara
District figure
Jampur
...
Dajal
Rajanpur
Mithankot
R. C. Dera Ghazi Khan
Kot Chatta
Kala
Retra
Jampur
Dajal
Harrand
Fazilpur
Rajanpur
Rojhan
Shahwali
Mithankot
District figure
14.1
10.7
6.0
6.6
58
11.6
191
31.2
18.7
6.1
5.9
5.2
5.9
7.9
11.1
6.4
12.7
17.9
17.4
16.5
9.8
7.2
41. It will appear from this statement that the following districts suf-
fered badly from malaria and were visited by an epidemic during the year
under review :—
Gurgaon, Lahore, Amritsar, Sialkot, Gujranwala, Shahpur, Montgo-
mery, Jhang, Multan, Muzaffargarh, and Dera Ghazi Khan. The towns or
rural circles with exceptionally high epidemic figure were Rajanpur with 31.2,
Jhawarian R. C. (Shahpur) 19.3, Khushab 19.2, Dajal 19.1, Kabirwala R. C
19.0, Mithankot 18.7, Pakpattan R. C. 18.2, Hafizabad 17.9, Rajanpur R.C.
17.9, Rojhan R.C. 17.4, Kamalia 16.9, Katta Sahgal R. C. 16.5, Shahwal:
R. G. 16.5, Harapa R. C. 14.9, Alipur R. 0. 14.1, Alpa R. C. 14.0, Jhang
R. C. 13.0, Kasowal R. C. 13.0, Talamba R. C. 12.9, Khushab R. C. 12.7,
Fazilpur R. G. 12.7, Firozpur-Jhirka l2.6 and Jattusana 12.6. (R. C. =
Rural Circle.)
42. Map IV ÍV appended in the Appendix C. to show the relative in
tensity of malaria as it affected the whole of Province. The epidemic figure
for the districts is shown in red while that of the towns is in blue.
43. (2). Comparison of spleen census figures for 1917.—From
comparative study of the spleen census maps II and III for 1917 appended
Appendix G. it will be seen that the incidence of malaria was most marked ir
the vicinity of rivers, newly constructed canals and inundation canals.