6
effectual, the provision would have to be in force for a considerable time, and
as even medical men can with difficulty recognise single cases of the disease,
I am very doubtful whether the provision of the Epidemic Diseases Act referred
to should be put in force for this purpose. The inhabitants of non-affected
villages might, however, be encouraged to prevent people, believed to be
suffering from the disease, visiting their villages.
(c) Appendix II attached to this report is a note on the spread of kla-azr and
how it may be checked. Dr. Rogers recommends that this note should be
translated into the languages of the inhabitants of the Upper Assam Valley,
and distributed gratis to the heads of villages in both the affected and
threatened tracts of country. I strongly recommend that this suggestion be
given effect to.
16. I agree with Dr. Rogers that the heading of anchylostomiasis should be
omitted from the return of deaths. Deaths from kla-azr should, however, be given in
a separate column from "Fevers." I also agree with him that heading "Beri-beri of
Ceylon" should be omitted, but deaths from anmia should be returned as a sub-head
under "All other causes."
17. Towards the end of this section, Dr. Rogers gives the measures which, in his
opinion, should be taken on affected tea gardens in order to put a stop to outbreaks
of the disease. The measures are, in my opinion, very suitable, and I recommend that
they be given effect to.
18. Surgeon-Captain Rogers was engaged for upwards of twelve months in investi-
gating the cause, spread, treatment, and prevention of kla-azr, and the result of his
work is given in the accompanying full report on the disease. He showed great
enthusiasm in the investigation of the subject, sparing no trouble in determining the
actual state of matters for himself, often walking 20 to 30 miles a day in very difficult
and unhealthy tracts of country, in order to examine the sick in affected villages and to
find out, if possible, on the spot how different villages became affected. During his
investigation he was able to prove that kla-azr was quite distinct from anchylostomiasis,
thus confirming the opinion held on this subject by almost all medical officers in Assam.
He also showed that kla-azr was very closely allied to malarial fever, but, by not
making a systematic bacteriological investigation into the pathology of the disease, giving
diagrams of the results obtained, he failed to prove whether kla-azr was, or was not,
identical with malarial fever. He also, in my opinion, failed to prove that kla-azr was
carried by human intercourse from Rangpur to Assam, and that it arose from an
intensification of the ordinary malarial fever of that district. The measures which he
has recommended for cutting short the disease in affected villages and for preventing
its spread into tracts which have up to date been free from the disease, are to the point,
and, when practicable, they should, in my opinion, be carried out. Surgeon-Captain
Rogers is, in my opinion, entitled to much credit for the enthusiastic and painstaking
manner in which he has carried out this important investigation, and for the able and
interesting report which he has submitted.
A. S. P. O. (Genl.) No. 212-100-3-8-97.