9
(c) Health of civil communities.—Cholera.— In the first quarter of the year
the incidence was already high in Bengal, low in central India and absent in
the north and west. From March to July there was a marked rise in cholera
incidence to four times any normal incidence in every province except Ajmere-
Merwara and this extended onwards to the end of the year in southern parts.
The cause was mainly wide dissemination following two largely attended
Hindu festivals, the Kumbh Melas of Hardwar and Brindaban, which lasted
respectively from the 1st February to the end of April and of March. One
million and three hundred thousand persons attended in a single day on the
principal day of each fair.
From these centres infection spread explosively in all directions, extending
from eastern Bengal to Tribal territory on the north-west frontier, where
several of the followers of the Faquir of Ipi succumbed to the disease.
Small pox appears to have had an average incidence throughout the
country except in Northern Command, where there were several local epide-
mics.
Plague.—The downward trend continues and only certain areas of the
Eastern Command appear to have been seriously affected.
Dysentary and Diarrhoea.—The heavy toll of these preventable diseases
continues. The mortality is actually greater year by year than that from
cholera, while the morbidity must run into collosal figures and fully accounts
for the vast reservoir of infection which surrounds our cantonments. The
first two quarters of the year have the smallest incidence.
Respiratory diseases.—The figures for 1938 exceed the decennial average
and the mortality from pulmonary tuberculosis and pneumonia together
account for 65 per cent. of deaths from this group.
Malaria is noted as having been prolonged in certain areas very late
into the autumn. In the civilian population of the Mhow district the incidence
and virulence of malaria was the worst known for 15 years owing to prolonged
and excessive rainfall and malaria was excessive in parts of Eastern and Sou-
thern Commands.
(d) War and movements of troops.—In Waziristan, though there was no
official war, peace was more honoured in the breach than in the observance
and there were unceasing columns moving out on " light scale ", often bivouac-
ing where the fight ended, without mosquito nets and with limited supplies of
fresh foods. Road protection duties were carried through between Kohat
and Bannu in the very hottest season, and yet the health of troops remained
excellent. In Eastern Command small detachments of British and Indian
troops were out for short spells in the autumn.
Infection of troops with malaria and dysentery at Rest camps and on
journeys was particularly noticed on several occasions. Measures have been
called for to prevent recurrence as far as possible.
(e) The effects of adequate modern treatment or preventive medicine. —The
reduction in the admissions for malaria, particularly of relapse cases due to
our effective methods of treatment, the effects of T. A. B. inoculation on the
military incidence of enteric fevers, and the relative absence of military cases
of small pox and cholera in the midst of civilian epidemics all indicate the
efficiency of modern preventive medicine.