Medicine - Institutions > Army health reports and medical documents > Report of an investigation of the epidemic of malarial fever in Assam, or, kala-azar > Section VI - General course and distribution of the epidemic
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Report on Kála-ázar.
invasion by an epidemic of malarial fever. No part of the
district has escaped, but it has been most severe, and
has spread most rapidly in those parts which are most
thickly peopled, namely, all along the banks of the Kulung
river.
Relation to sanitary
conditions.
Here, again, there has been absolutely no change to account
for the origin or spread of the disease in
any of the affected districts, and what
little change there has been is for the better, yet this
frightful epidemic of fever has spread itself steadily over
the country in a manner that has scarcely a parallel. It
cannot be due to the water-supply, for this again has
improved rather than deteriorated, and I may say that in
the course of my travels I saw nothing that would lend
any support to the hypothesis that the disease is spread by
means of water, but, on the contrary, I found some villages,
or even parts of villages, that had so far escaped the disease,
although other parts of the same village, or neighbouring ones
with the same, or a similar water-supply, had suffered for sever-
al years from the pestilence. It must also be borne in mind
that the disease dies out of villages and districts in the
absence of any change in the local conditions. I had expect-
ed to have found some local difference between affected and
unaffected villages; but in this I was in error, for no
such differences are to be detected, and, as will be shown
in the next section, the mode in which the disease really
spreads is quite independent of any such changes or
differences.
The distribution in
the villages.
This rather belongs to the next section, but it may
be stated here that I have been able to
confirm the facts pointed out by Dr. Giles,
namely, that one part, or certain houses, of a village may
suffer severely from the disease, while other houses in the same
village may entirely escape it for some considerable time,
and that although all are living under precisely the same
conditions.
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