180

Report on Kála-ázar.

report (1874). But curiously, after the heavy rains in September,
and especially after the cyclone of the 16th October, the disease
abated."

     In 1875, there was a further increase of the fever-rate in
both Dinajpore and Rungpore, the mortality in the former
district having increased in the selected areas from 20.36 to
24.75, and in the latter from 23.61 to 24.56. From Dinajpore
no report was received from the Civil Surgeon for the third
year in succession, so details as to the type of the prevalent
fever cannot be given here. In Rungpore, however, it is
recorded that—

     "Remittent fevers are common and fatal in this district, but the
principal disease is intermittent fever, which is most prevalent during
and after the rains. Chronic enlargement of the spleen and liver
follows repeated attacks of the disease, and in the cold-weather months
diseases of the lungs and general dropsy supervene."

     This year once more the rainfall was very much below the
average, being only 43.6 in Dinajpore, and in Rungpore was
60.45. It was also very unevenly distributed. It is worthy
of note that the six areas, which are especially mentioned
as having suffered most severely from fever during this
very unhealthy year, are all situated in the east of the
Rungpore district, that is, in the portion which borders
on the Garo Hills terai, from which it is only separated
by the Brahmaputra river, which with its numerous islands
is included in Rungpore, and, as already noted, these river
banks and islands shared in the outbreak. Now this year was
the very one in which it was ascertained by an independent
study of the Assam district reports, before I had any knowledge
of the details of the Rungpore outbreak, to have been that in
which the fatal depopulating epidemic malarial fever first made
its appearance in the south-west corner of the Garo Hills dis-
trict; and, although the fever in this terai country at the foot of
the hills might have been expected to be intensified by the same
seasonal influences, which have been just shown to have affect-
ed that in the Rungpore and Dinajpore districts, yet as a matter
of fact the rainfall in the Garo Hills was not deficient at that