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in October. The disease was not confined to any particular locality, but was
often found to be present in widely separated villages.
Bhagalpur.—In this district the endemic cholera often assumes the
epidemic form. March to August is the period of greatest prevalence ; Septem-
ber and October are months of subsidence, and January and February and
November and December are months of marked immunity from the disease.
In 1876 cholera was spread over the whole district, but, on the whole, the
visitation was not severe. A large number of cases in the town of Bhagalpur
occurred among children.
Parma.—The periods of immunity, increase, and subsidence of cholera
in this district resemble those observed in Bhagalpur. The disease was not
severe in 1876, though every circle was affected, and there were smart and
fatal outbreaks in some of them. In this year the rainfall, 64·85 inches, was
above the average, 62·54 inches, of several previous years. In 1873 the rainfall
was only 33 inches, and the disease prevailed epidemically.
Sonthal.—The periods of cholera prevalence, subsidence, and immunity
in this district are same as in the other districts of Eastern Bihar, except that
there is exacerbation of the disease in November and December. In 1876
cholera first appeared in February among the pilgrims assembled in the town
of Deogarh for the Shibrath festival, and rapidly spread to the neighbouring
villages where it continued until May, March being the month of greatest
prevalence. In the Godda sub-division cholera commenced in March and
lasted till August ; in April, May, and June the disease spread over the whole
sub-division, and these were the months of greatest suffering. During the
rains the disease subsided greatly, but it reappeared after their cessation, and
was very severe in November. " Village after village was attacked, but the
affected villages were at a great distance from one another."
Kattak.—Cholera prevailed with greatest severity throughout the year
1876, but May, June, and July were the months of greatest suffering. There
was scanty rainfall and drought here in this year. " It is worthy of notice that
though so many thousands of pilgrims pass through Kattak year by year
carrying cholera with them, the European residents have never suffered from
it. The Madras Regiment, too, almost invariably escapes." * * *
Puri.—A very severe and wide spread epidemic outbreak of cholera occur-
red in this district in 1876. It commenced in January and lasted until
August. In March, June, and July, the last mentioned month particularly, it
was most virulent and fatal in character. In January the disease was present
both in the district and in the town. In many places far from the pilgrim
routes the disease prevailed virulently: " notably among them are Gop, where
it was severe, and the Karnalla and neighbouring villages in parganah,
Chowkisbad bordering on the Chilka lake, in the Puri circle, where it was
most virulent this year, while in the previous one there was hardly any present
in this locality. There was no communication between these villages and the
nearest pilgrim route. "With regard to the prevalence of the disease among the
pilgrims themselves, the usual oft-repeated causes were in operation, principally
fatigue and exposure during the long journeys that they undertake, errors of
diet, coarse, uncooked food, polluted water, damp earth, night chills along the
road, &c. On arrival at Puri the people are densely crowded, sleep outside,
eat bad food, drink foul water, and their defoecations pollute the soil. During
the festival they are in a high state of religious excitement, and this is followed
by utter mental depression, and they are also subjected to much exposure, as
the festival takes place in the beginning of the rains (June) when the pilgrims
have to walk about in the wet, and lie on the damp ground. It is noted that
the record relating to the mortality among pilgrims could not be completed
this year, but the ascertained number of pilgrims who died in the Puri circle
was 508, of whom 274 succumbed to cholera, and the rest to the other diseases,
principally bowel-complaints. Of this number again 204 were victims to
cholera during the months of June and July when the car festival took place.
A high temperature with maximum rainfall is mentioned as the great
concomitant of the severe prevalence of the disease this year as compared with
the preceding year. The temperature during the first seven months of 1876
was much higher than it was during the corresponding period of 1875 while
the rainfall was much less, the mean temperature for this period in the former