2
REPORT ON THE
causes, which shows that the year 1900 was more unhealthy than its predecessor.
The figures for several years past are, it would seem, also so uncertain as to
make fair deductions from them very doubtful. It may, perhaps, be asked
whether the normal annual rate of increase of population is not now sufficiently
known in large Indian cities, as to make it possible to calculate hygienic
statistics for such increase for each year after a census, in the same way as is
done in the case of London and other great British cities, in accordance with
the formula which are adopted by the Registrar-General. The unusual rainfall
in September, by water-logging the soil and by polluting the sources of water
-supply, rendered people more obnoxious to cholera, bowel disorders, fevers, and
chills towards the end of the year. Plague also prevailed with great virulence
and claimed a larger number of deaths, viz., 8,354 against 2,332 in 1899. I
append—as the statement was thought to be useful in my last report—a
summary of the meteorology of Bengal for 1900, in which particulars relating
to the health of Calcutta are shown.
Lieutenant Colonel E. Bovill, Civil Surgeon of Howrah, in considering the
causes of the increased mortality of that town in 1899 and 1900,—it having
risen from 44.56 per mille in the former year to 60.50 per mille in the latter,
whereas it was never higher than 25.95 between 1889 and 1894, and not more
than from 33 to 42 per thousand between 1895 and 1898—attributes it in part
to improved registration, and also to the great increase in the death-rate from
fevers, bowel-complaints, and deaths from all causes. The increase is, doubtless,
not as large as it has been held to be, as no allowance has been made for increase
of population, which the provisional census totals show to have been as much as
from 116,606 in 1891 to 157,847 in 1901, or 41,241. Lieutenant Colonel Bovill's
contention is, however, supported by the large increase of fever cases treated in
various institutions ; as, for example, from the Howrah Town Police, from 102 in
1897 to 236 in 1900, and in the Civil Engineering College at Sibpur, from 992
in 1897 to 1,991 in 1900. He is doubtful whether it is fair to ascribe the increased
fever rate to water-logging produced by the filtered water-supply. The inunda--
tions in September 1900 account, it would appear, for a great increased
mortality and sickness at the end of 1900. General opinion points to much greater
prevalence of fever for two or three years past than formerly. Lieutenant
-Colonel Bovill is not able to assign causes for increase of excessive mortality under
the other heads mentioned, and does not attribute any great excess to concealed
cases of plague. The water-supply of the town is good, but the drainage is very
defective, and the formation of extensive excavations and embankments, in
connection with railway extensions, is an evil, which, he thinks, might be
remedied by filling up ail depressions of the kind with ashes, which he under--
stands are available in large quantities for the purpose.
The Health Officer of Calcutta, Dr. Neild Cook, reports through the Chair-
man of the Municipality, Mr. Greer, c.s., that the mortality of 1900 was 36,728
against an average of 24,444 in the previous five years. Plague accounts for
8,354 deaths, or 7,849 more than the average, and the Special Officer on plague
duty is of opinion that it is responsible, in reality, for more than that number.
Cholera gave 844 above the average. Widespread epidemics of this disease
do not occur now that filtered water has been supplied, and Dr. Cook regards the
disease as one which might be almost entirely prevented, except as regards
imported cases, which usually occur in persons coming from a place of pilgrimage,
who contaminate the tanks. He thinks the mortality might be controlled by
filling up such tanks and wells, so that the people must get their water from the
stand pipes. My belief is that the new water-supply of many large towns in
India often suffers in repute because the old surface wells and tanks are not
closed when it is brought into use; also, where an unfiltered supply exists, side
by side with the more pure water, as it does in most parts of Calcutta, the
former is often used for drinking and cooking instead of the latter, whereas it
should be employed only for bathing and similar use. My experience is based
on inspection of large towns in the North-Western Provinces and elsewhere.
Dr. Cook also refers to the well-known increase of periodic prevalence of small--
pox. The year 1900 was a bad one, and he notices how easily preventable the
disease is, and how difficult it has been to enforce vaccination in Calcutta. He
has adopted measures for improving it. Deaths from fevers the Health Officer
believes to have been really higher than usual, and not lower, as represented,
and he remarks that this opinion is shared in by the Medical Officers of the
public institutions and by educated Native public opinion. He believes that the