2
REPORT ON THE
-
Sanitary Commissioner to examine the houses in which it occurred. I also saw
some cases at the Medical College Hospital. The appearance of the disease
caused much alarm in the minds of the people who fled from the city in large
numbers both before and after Calcutta was officially declared as infected
with plague on the 30th April. As the disease has since formed the subject of
enquiry by Special Commission, before whom I gave my evidence in Decem-
- b e r 1 8 9 8 , f u r t h e r r e m a r k s o n t h e s u b j e c t d o n o t s e e m t o b e n e c e s s a r y i n t h i s
report. It is perhaps sufficient to say that every precaution was taken to
prevent its spread in the town in accordance with the plague rules in force
in 1898, and that arrangements for the reception of plague patients were made
in the Medical College, Presidency General, Campbell, Mayo, Chandney,
Howrah and Sambhu Nath Pandit Hospitals.
4. Referring to the increase in the death-rate in the years 1895, 1896 and
1897 in Calcutta and Howrah, as compared with the previous years, His Honor
the Lieutenant-Governor desired, in paragraph 2 of Government Resolution
recorded upon my report for last year, that I should closely watch the present
course of mortality both in Calcutta and Howrah and promptly communicate to
Government any unusual feature that might attract my notice. In accordance
with these orders, I scrutinised the periodical mortuary returns of both the
towns, and whenever the mortality during any period was found to be greater
than that of the corresponding period of the previous year, I called for an
explanation from the Medical Officers concerned as to the cause of these
variations. The mortality during the year under report in Calcutta and
Howrah did not present any unusual feature requiring special reference to
Government.
5. The causes of increased mortality in past years in Calcutta are probably
of a complex nature, into which it is unnecessary to go here, but the Sanitary
Commissioner is of opinion that the higher death-rates in past years of Howrah
have been due to some extent to an imperfect water-supply. I doubt much
whether this is the only or, indeed, the prime cause, but am not prepared at
present to make further suggestions on the subject. Owing to the want of mete-
- orological and climatic data, which are not at present available, to the non-sub-
mission to this office of monthly returns of sick and to the absence of a more
scientific and minute classification of diseases, it is difficult to form conclusions on
such an important subject. It has been alleged that the enormous increase of
population in certain parts of Calcutta must of necessity greatly add to the mor-
tality, but this is not alone sufficient, as the following note from the report of the
Peabody Trust for London for the year 1898 shows. This Trust provides houses
for artizans and the labouring poor of London usually in lofty blocks of build-
ings. In 1898 there were 11,367 rooms besides bath-rooms. The mean population
during the year was 19,562, showing a density of 714 people to the acre,
or nearly twelve times that of London. Yet the birth-rate for the year was
33 . 1 per 1,000, or 3 .6 above that of all London for the same period. The
death-rate, including deaths of 54 persons removed to hospitals, was 14.7 per
1,000, or 4 . 0 below the average of London, while the infant mortality was
114 .4 in each 1,000 births, or 52 .8 below that of London. Overcrowding alone
is therefore not the cause of great mortality, because the risks attending it are
greatly diminished by careful sanitation which unfortunately is not easily
applied in what are known as the bastis in Calcutta.
Happily, in 1898 the cholera death-rate was lower in both places than it has
been for the 11-year period. Fevers gave less than two-thirds of the mortality
of 1897 in Calcutta and fell considerably in Howrah; but under the heading
" Other causes" there was a large rise in both towns. This points to some
common cause which has not been defined and which clearly indicates that our
diagnosis for registration purposes is very crude and inefficient. It is only when
the statistics which will hereafter be furnished ward by ward are available, that
an answer can be hazarded to the query what this cause was ? I do not think it
could have been due to plague to any appreciable extent, either in Howrah or
Calcutta, as some persons have suggested.
6. Hitherto the returns of the Medical Board of the town of Calcutta,
which furnish very important information regarding the health of the town,
have not been furnished to the Inspector-General of Civil Hospitals, Bengal.
Those returns are now, under the orders of Government, regularly submitted
to my office. I examine, them and refer to the President any matter which
requires explanation.