Published at the Surveyor General's Office, Calcutta, July 1869 H. A. D. Lawrence, Lilhogr4ij)her (&sAqxk dpiotyr a in flt^ §jfnpl jjrsi(tym^ A REPORT ON THE CHOLERA OF 1866-68, AND ITS RELATIONS TO THE CHOLEEA OF PREVIOUS EPIDEMICS, B\ JAMES L. BRYDEN, M.D., Surgeon, Bengal Army, STATISTICAL OFFICES ATTACHED TO THE SANITAET COMMISSIONER WITH THE GOVEBNMENT OF INDIA. 4)rintm fii> oraer of @oDertttnettt. CALCUTTA: OFFICE OF SUPERINTENDENT OF GOVERNMENT PRINTING, 1869. fit**, Me- $.7«<7 ntt.Z CONTENTS GENERAL INTRODUCTION. The circumstances under which the report was written.. ._ ... ... ... ... 1 The basis of the study of the history of cholera as an epidemic ... ... ... ... 2 Obstacles to the successful study of cholera... ... ... • • • ¦ • ¦ ... 3 The materials employed and the types of the population represented ... ... ... 4 Necessity for systematic investigation on a statistical basis ... ... ... ... 5 SECTION I. THE NATURAL HISTOKY OF THE EPIDEMIC AND ITS SUCCESSIVE REPRODUCTIONS. INTRODUCTORY. The principles upon which the systematic arrangement of the report has been carried out Necessity for the adoption of accurate definitions; definition of the terms, the epidemic, the reproduction, and the outbreak ... ... ... ... ... --• 10 Importance of the study of parallels, and also of natural alliances ... ... ... ... 11 General arrangement of the subjects of the first Section ... ... ... ... 12 CHAPTER I. THE CHOLERA OF EVERY YEAE HAS A GEOGRAPHY WHICH IS DEFINITE, AND CAN BE DEMONSTRATED. ¦ Definition of the two primary divisions of the epidemic area ... ... ... ... 14 Geography of the cholera of the epidemic area of 1854 and 1855 ... ... ... 16 General indications of distribution in the interval preceding the epidemic of 1856 ... ... 17 Geography of the cholera of the epidemic area in 1856 ... ... ... ... 1S Comparative and absolute exemption of portions of the area lying within the extreme range of the invading cholera of the Northern Provinces ... ... ... ... 19 Geography of the cholera of the epidemic area in 1857 ... ... ... ... 20 Geography of the cholera of the epidemic area in 1858 ... ... ... ... ... 21 Phenomenon of the exemption of the eastern division of the epidemic area, the War Province of 1858 ... 21 Geography of the cholera of the epidemic area in 1859 ... ... ... ... 22 Geography of the cholera of the epidemic area in 1860 ... ... ... ... 23 Precise limit of the western invasion of the epidemic of 1860 in the North-Western Provinces ... 23 Geography of the cholera of the epidemic area in 1861 ... ... ... ... 24 Areas of comparative and absolute exemption in the Northern Provinces, the same as those of 1856 ... 25 Area of geographical limitation in the extreme south-west ... ... ... ... 26 Geography of the cholera of the epidemic area in 1862 ... ... ... ... 26 Parallels in the geography of the cholera of 1862 and 1857-58 ... ... ... ... 26 Minimum of 1862, parallel with that of 1858, in the eastern division of the epidemic area ... 27 Geography of the cholera of the epidemic area in 1863 ... ... ... ... 27 Invading eastern epidemic of 1863, its area and western limit ... ... ... ... 27 The geography of the cholera of the epidemic area in 1864. Its importance and significance ... 28 Geography of the cholera of the epidemic area in 1865 ... ... ... ... 29 Geography of the cholera of the epidemic area in 1866 ... ... ... ...... 29 The geography of the cholera of October and November 1866, parallel with that of the same months Geography of the cholera of the epidemic area in 1867 ... ... ... ... 31 Exempted area of 1867, and the limitation of the epidemic area in the south and west ... ... 81 Geography of the cholera of the epidemic area in 1868 ... ... ... ... 31 Re-occupation between March and May 1868 of the exempted area of 1867 ... ••• ¦•• 32 CHAPTER 11. THE CHOLERA OF ANY YEAR OR PERIOD IS NOT A MANIFESTATION CONTINUOUS THROUGHOUT EACH MONTH OF THE YEAR OR PERIOD; IT IS EXHIBITED IN A SUCCESSION OF MANIFESTATIONS ALTERNATING WITH SEASONS OF DORMANCY. THE FACTS OF THE ALTERNATIONS OF DOEMANCY AND BEVITALISATION GENERALLY CONSIDEEED. Illustrations typical for different tracts of the endemic and epidemic areas ... ... ... 33 Seasons normal for districts of the endemic area scarcely elevated above the sea level ... ... 35 Seasons normal for the margins of the endemic basin ... ... ... ... 35 Seasons normal for the Gangetic Valley and eastern division of the epidemic area ... ... 30 Seasons normal for Nagpore and the districts which form the southern epidemic highway , ... 37 Seasons normal for the provinces of Northern India ... ... ... ••• ... 39 2 Page CHAPTER 111. BESIDES HAVING A DISTBIBUTION IN SPACE, THAT IS, A GEOGRAPHY, EPIDEMIC CHOLERA HAS A DISTRIBUTION IN TIME. A CHOLERA WHICH CAN BE RECOGNISED AS NEW AND INVADING REAPPEARS THROUGHOUT A SUCCESSION OF YEARS; THE PERIOD PROM ITS FIRST INVASION TO ITS FINAL DISAPPEARANCE IS THE DURATION OF AN EPIDEMIC OF CHOLERA. Distribution in time of the epidemic of 1855-58 ... ... ... ... ... 40 Distribution in time of the invading cholera of 1855 in the eastern division of the epidemic area ... 40 Distribution in time of the epidemic of 1855 which invaded the western division of the epidemic area in May 1856 ... ... ... ... ... ... ... 41 Cholera of the Central Provinces, 1856-58 ... ... ... ... ... 41 Summary showing the duration in years and the distribution in each year of the epidemic of 1855-58 42 Distribution in time of the epidemic of 1859-62 ... ... ... ... ... 42 Duration of the epidemic in the different provinces illustrated ... ... ... ... 43 Summary showing the duration in years and the distribution in each year of the epidemic of 1859-62 44 Distribution in time of the epidemic of 1863-66 ... ... ... ... ... 44 Duration of the epidemic in the different provinces illustrated ... ... ... ... 45 Summary showing the duration in years and the distribution in each year of the epidemic of 1863-66 47 Distribution in time of the invading epidemic of 1866 ... ... ... ... 47 Epidemics, extending over years, may run a course perfectly parallel; but the body of an epidemic may be diverted from the north to become a great cholera in the south, or from the south to become a great cholera in the north ... ... ... ... ... 48 CHAPTER IV, THE NECESSITY FOR THE RECOGNITION OF THE TRUTH THAT EVERY EPIDEMIC IS A REPETITION OF EPIDEMICS WHICH HAVE PRECEDED IT, AND THAT THE PARALLELS BETWEEN DIFFERENT EPIDEMICS ARE AS FIXED AND STABLE AS IS THE RECURRENCE OF THE PHENOMENA OF THE METEOROLOGY OF AN INVADED AREA. The special aspects of the cholera of the eastern and western divisions of the epidemic area in each epidemic contrasted ... ... ... ... ... ... ... 49 Appearance of cholera in relation to meteorological phenomena generally considered ... ... 50 CHAPTER V. THE PHENOMENA ATTENDING THE INVASION OF AN UNOCCUPIED AREA. Comparative liability to cholera of different portions of the epidemic area ... ... ?, 52 Tracts of comparative exemption in the epidemic area—Northern Punjab, Mooltan District, Jullundur Doab; certain tracts of Central India; tract lying immediately to the west of the line limiting eastern invasion ... ... ... ... ... ... ... 52-53 Comparative exemption of hill stations ... ... ... ... ... 55 Liability of hill stations to suffer in secondary invasion _ ... ... ,„ •. 55 Decay in strength of the cholera miasm in years of minimum in connexion with the disappearance of cholera from provinces ... ... ... ... ... ... 56 Area of perennial existence, the area of endemic cholera ... ... ... ._ gg Natural History of Cholera in the endemic area ... ... ... ... ... 60 Province of endemic cholera defined; its characteristics ... ... ... ... 61 Characteristics of the Upper and Lower Provinces contrasted ... ... ... ... 62 The definition of the term —a Natural Province; and the sub-division of the Presidency in relation to this definition ... ... ... ... ... ... ... 62 Grounds for the sub-division of the Presidency for statistical purposes ... ... ... 63 The importance of invading agencies in determining the standard of health in Upper India ... 64 Provinces defined by influences derived from the south-west monsoon ... ... ... 65 The natural provinces of Upper India are meteorological provinces ... ... ... 66 The provinces east and west of 80° as distinguished statistically ... 1 ... ... 67 Characteristics in natural provinces of epidemic and non-epidemic years ... ... ... 68 Characteristics in the Punjab of epidemic and non-epidemic years ... ... ... 69 Sub-division of the area of the Presidency by provinces ... ... ... _ 70 Importance of the spring rains both in relation to primary and secondary invasion in the different epidemic provinces ... ... ... ... ... ... mi 71 Generalisation from statistical data that the cholera provinces are natural and meteorological provinces... 71 Meteorology affecting the province of the south-western monsoon proper (Arnott) ... ?. 71 The effect of the north-east monsoon as displayed in the Madras Presidency ... ... ..] 72 The provincial distribution of epidemic malaria ... ... ... ## _ 72 Epidemic of the malaria miasm confined to the eastern division of the epidemic area. Malaria of October 1859 ... ... ... ... ... ... ... 74 Epidemic of the malaria miasm confined to the western division of the epidemic area. Malaria The meteorological phenomena attending the invasion of natural provinces by cholera ... ... 76 Illustrations of the meteorology attending the invasion of cholera ... ... ... 77 The meteorology attending the invasion of the Gangetic Provinces in the east ... ... 77 Meteorology attending invasion of the Central Provinces ... ... ... ti| 79 Meteorology attending the invasion of the Northern Provinces ... ... ... ._, 79 Meteorology in 1860 of the famine tract of 1861, an area exempted from the invasion of the cholera Parallel of the exemption of the Meerut District in 1850 ... ... ... 80 Meteorology of non-invaded tracts beyond monsoon influences ... ... ... "t" t 81 The meteorology attending invasion at the north-western limit of the western division of the epidemic area. Epidemic of 1856. Epidemic of 1861 ... ... ... 81-82 Countries beyond monsoon influence in which invading cholera terminates. The North-Western Desert. Trans-Indus Districts. Mooltan District ... ... ... ... §t< 82-83 The distribution of epidemic cholera a provincial, not a local, phenomenon ... ... ... 83 Secondary manifestations are also subordinate to a definite meteorology ... ... ... 83 The meteorology attending revitalisation in an already invaded area is to be carefully considered apart from that attending invasion ... ... ?, ... 3 Illustration of revitalisation in the year following invasion in the eastern province ... ... 84 Rain-fall of an epidemic and a non-epidemic year in the eastern division ... ... ... 85 A year of excessive rain-fall is not necessarily a cholera year as shown by the exemption of the Central Provinces in 1867 ... ... .... ... ••¦ ... 86 Contrast between the aspect of the plains of Berar and Khandeish and the plateau of Central India, essential to be recognised ... ... . ... ... ... ... 86 The meteorology attending the occupation of the southern epidemic highway ... ... 86 General deduction from the facts of the seasons and circumstances of invasion ... ... 86 May epidemic distribution take place while the cholera miasm is in a state of dormancy ? ... ... 87 The aura of an epidemic ... ... ... • ••. . ••• ••¦ •¦• 87 General deductions regarding the relation of epidemic cholera to humidity ... ... ... 88 The essentials for epidemic manifestation ... ... ... ••• ••• ... 87 The effects of aerial influences recognised by previous observers ... ... ... ... 88 Baly's unknown cause of the fluctuations of epidemic manifestation ... ... ... 89 Presence of cholera in different months demonstrative of the effects of aerial influences ... ... 89 The vehicle of moisture in districts beyond the primary range of monsoon agencies ... ... 90 The rate at which cholera travels is to be calculated only in relation to provincial manifestation ... 90 Parallel occurrences result from the subordination of cholera to a definite meteorology ... ... 90 Importance to the meteorological observer of the recognition of natural provinces ... ... 91 The limits of natural provinces are not transgressed by epidemic cholera, and the provincial limitation of epidemic cholera negatives the theory that its primary distribution is due to human agency ... 91 CHAPTER VI. CHE PHENOMENA OF REPRODUCTION IN EACH YEAK OP AN EPIDEMIC, AND THE DURATION OP THE EPIDEMIC IN YEARS. Summary of generalisations regarding the reproduction ... ... ... ... 93 Duration of epidemics. Normal duration of cholera in the epidemic area ... ... ... 93 Re-invasion before the decay of the cholera of the preceding epidemic as obscuring the phenomenon of disappearance ... ... ••• ••• •¦• ••; ... 94 Epidemic history. The value of indices as illustrative of the general facts of unrecorded epidemics ... 94 Study as a type of the epidemic of 1817-20 ... ... ... ... ... 95 General history of epidemic cholera between 1820 and 1855 ... ... ... ... 98 Indices derived from the history of the epidemics of 1826-29 and 1830-33 ... ... ... 99 Cholera of 1833-34 in Northern India ... .. ... ... ... ... 101 Cholera of 1833-34 in the Central Provinces and Western India ... ... ... ... 102 The cholera of 1836-39 in the endemic area and eastern division ... ... ... ... 103 The invading cholera of 1837 on the southern epidemic highway .. ... ... ... 104 Cholera of Northern India of 1837-38 ... ... ... ... ... 105 Cholera of the province of the south-west monsoon proper of 1839 ... ... ... 106 Choleroid fever and Malwa sweating sickness of 1839 ... ... ... ... 107 Indices of the duration and distribution of the epidemic of 1840-44 ... ... ... 108 Position in epidemic history of the frontier cholera of 1844 and 1845 ... ... ... 109 Persia a portion of a cholera province of Hindostan ... ... ... ... ... 109 History of primary invasion in the epidemic of 1841-44 ... ... ... ... 110 The provincial distribution of the cholera of 1846 associated with the great Kurrachee outbreak ... 11l Indices of a new invasion from the East in 1844 and 1845 ... ... ... ... 113 Great Indian cholera of 1845 ... ... ... ... ... ... ... 113 Place of the cholera of 1845-46 among European epidemics ... ... ... ... 113 Conclusions regarding the cholera of Northern India of 1845-46 ... ... ... 114 Epidemic of 1849-52. Phenomena of the invasion of 1850 in Agra and Rajpootana ... ... 116 The cholera of 1849-50 on the southern epidemic highway ... ... ... ... 117 Cholera of 1851-52 in Northern India ... ... ... ... ... ... 118 Gangetic cholera of 1853; its aura and subsequent manifestation ... ... ... ... 115 The cholera of the epidemics of 1850 and 1854 beyond the limits of Hindostan ... ... 118 Interval preceding the epidemic of 1856 in Northern India ... ... ... ... 118 The re-occupation of the southern epidemic highway in 1860 ... ... ... ... 118 The epidemic of 1863-65 in Upper India and on the southern highway ... ... ... 119 The starting point of the cholera of Europe of 1865-66 ... ... ... ... 120 Conclusion regarding the parallels afforded by the epidemics of the past fifty years ... ... 121 The direction in which the exit of epidemic cholei-a from Hindostan occurs, and the phenomena that ought to be studied on the occasion of an invading cholera reaching a foreign country . . , 122 CHAPTER VII. THE CHOLERA OF THE EPIDEMIC AREA OF 1866-69. Minimum of manifestation preceding the invasion of the new epidemic of 1866 ... ... 123 The epidemic of 1866 in its endemic home previous to its appearance in the epidemic area . . . 124 Advance from out of the endemic area towards the north and north-west, with the monsoon of 1866 ... 125 Effects of the meteorology of 1866 in retarding and accelerating the movement of the epidemic . . . 125 The geography of fevers in October 1866, illustrating the effects of a meteorology favourable to the epidemic advance of cholera in the same month ... ... ... ... 126 First indications of advance into the western division of the epidemic area of the new invading cholera of 1866 ... ... ... ... ... ... ... 127 Meteorology attending the appearance of the invading cholera of Agra and Rajpootana of October and November ... ... ... ... ... ... ... i2g Geography of the dormant cholera of the cold season of 1866-67 and the anticipations regarding its distribution after revitalisation ... ... ... ... ... ... 129 The revitalisation of the cholera of the Behar Provinces, and epidemic advance from the east into Oude in March and April 1867, and into Cawnpore and the districts south of the Jumna in May ... ... ... ... ... ... ... ... 130 Spring revitalisation in the states of Rajpootana affected in the end of 1866 ... ... ... 130 The minimum of prevalence towards the southern margin of the area affected in 1867, and the (geographical continuity of this with the exempted area of the year ... ?, ... 130 4 Eevitalisation and invasion within the radius alleged to have become affected in consequence of the spread of cholera by Hurdwar pilgrims ... ... ... ... ... 131 Breeding grounds of the cholera distributed in the invasion of November 1866 ... ... 132 Two phases of the May cholera of 1867, — decay and disappearance in the eastern districts of the western division, and growth and epidemic spread in the western districts. The significance of the phenomenon ... ... ... ... ... ¦•• ••• 132 Parallel history of May 1862 explanatory of the geographical distribution of the May cholera of 1867 ... ' .. ... ... - ... .» - 133 Epidemic malaria of 1867 in the tracts which chiefly suffered from the cholera epidemic of May ... 135 Epidemic malaria of the Punjab of 1867 ... ... — ... ••• ••• 136 Meteorology of the season of epidemic advance from south-east to north-west from the Jumna to The actual date at which the Punjab was invaded in 1867, and the method in which the date of invasion is to be determined ... ... ... ••• ... ••• ••¦ 137 General conclusion regarding the cholera of the Punjab of May 1867, alleged to have been introduced into the province and spread by Hurdwar pilgrims ... ... ... ... 140 Exempted area of 1867 ... ... ... >•• •¦• ••• •¦• 14^ Definition of the northern margin of the exempted tract, and the occupation of the districts lying immediately within the area of invasion, in May 1867 •• ... ... ... 141 Phenomena attending the invasion of these districts ... ... ... ... ••• 142 Monsoon reproduction of the cholera of 1867 ; its range and intensity ... ... ... 142 Monsoon cholera of Kajpootana; of Nepaul; of Oude, Shahjehanpore and Bareilly ... ... 142 Comparative intensity of the epidemic of 1867 in different tracts of the eastern division of the epidemic Evidence of the invasion of the Punjab from south-east to north-west, and of the removal of the material of the epidemic out of the districts of the south-east ... ... ... 144 General conclusions regarding the epidemic relations of the cholera of Northern India of 1867 . . . 145 Cholera of the epidemic area of 1868-69 ... ... ... ... ... ... 146 Cholera of the spring of 1868 epidemic within the endemic province ... ... ... 146 Cholera of the spring of 1868 on the margins of the endemic basin ... ... ... 147 Invading cholera of the epidemic area of the spring of 1868, and its probable alliances ... ... 147 Geography of the cholera of the North-Western Provinces and the Punjab in 1868 ... ... 148 Characteristics of 1868, a non-epidemic year in the Punjab ... ... ... ... 150 Characteristics of the year 1868 on the northern epidemic highway ... ... ... 151 History and results of the invasion of the Central Provinces in 1868 ... ... .• • 153 The invasion of the Madras Presidency in 1868 ... ... ... ••• ••• 154 Illustration of invasion and revitalisation on the southern epidemic highway .. ... ... 155 The invasion of Bombay, Nimar, and Mai wa in the end of 1868 ... ... ... ... 156 Postscript. — The cholera of Chota Nagpore of 1868, connecting on the cholera of the Central Provinces with the epidemic cholera of the endemic area ... ... ... 15t SECTION 11. THE NATUEAL HISTORY OF THE OUTBREAK. EPIDEMIC CHOLERA IN ITS RELATIONS TO COMMUNITIES. INTRODUCTORY. THE RELATIONS IN WHICH THE NATURAL HISTORY OF THE OUTBREAK IS TO BE STUDIED, AND THE GENERAL ARRANGEMENT OF THE SUBJECTS OF THE SECOND SECTION 16] CHAPTER I. THE PHENOMENA COMMON TO ALL OUTBREAKS OVER A PROVINCIAL AREA. Causes determining special aspects and parallel phenomena in the outbreaks of a provincial area . . . 164 Intensity of local manifestation owing to geographical repression ... ... ... ... 164 Aerial waves indicated by the dates of provincial outbreaks ... ... ... ... 165 Outbreaks indicative of aerial progress. Method in which a natural area is occupied ... ... 165 Phenomenon of disappearance subsequent to invasion in a provincial area, as illustrated by the outbreaks of 1856, and the parallel in the outbreaks of the invasion of 1861 ... ... 165 In relation to a special meteorology, to geographical site, or to comparative elevation, the outbreaks of an area may be represented, some in substance, some in shadow ... ... ... 165 The outbreak in subordination to the meteorology of a province ... ... ... ... 166 Localisation of cholera as determining the aspect of the outbreak ... ... ... 167 The outbreaks of a province viewed as controlled by one agency common to all ... ... 168 The cholera wave. The significance of the phenomenon ... ... ... ... 166 Outbreaks of provincial areas illustrative of the natural aspects of a cholera invading or revitalised in relation to the contained population ... ... ... ... ... 169 The local persistence of cholera throughout the life-period of the reproduction illustrated ... ... 174 CHAPTER 11. METHODS AND COURSE OF INFECTION, THE DURATION OF OUTBREAKS, AND THE CIRCUMSTANCES WHICH TEND TO PROLONG OR TO CUT SHORT THE OUTBREAK. The outbreak in any locality appears at the date normal for that locality. No circumstances which are merely contingent can determine the occurrence in time of the outbreaks of an epidemic . . . 175 The primary exit of the cholera of invasion from within the endemic province has no relation to lines of human communication ... ... ... ... ... ... 175 Forerunners in advance of the actual invasion, often give warning of the threatened outbreak ... 176 Conditions affecting the type and duration of the outbreak ... ... ... ... 176 The outbreaks of a special locality in different epidemics are sometimes parallel ... ... 177 Outbreaks of communities. The types of minimum and maximum duration ... ... 178 5 Page, The minimum of duration shown by troops on the march ... ... .. ?. 178 Type of the outbreak after infection of a Keghnent as a body. A. On the march. B. In the station ... ... ... ... ... ... ... ... 180 Aspect of an outbreak on boardship parallel with that of the infection of the Peshawur Cantonment in May 1867. Ship Renown, August, 1865 ... .. ... ... 182 [lustration of persistence after infection on a known date ... ... ... ... 180 .spect due to retention of bodies within the area of infection. Apparent prolongation of the outbreak throughout the vital period of the reproduction ... ... ... ... \%\ 'he normal type of the outbreak as deduced from examples which are clearly typical, and the conditions under which the manifestation of the normal type occurs ... ... .., 181 'rolongation of manifestation due to the attachment of cholera to a locality illustrated ... • ... 183 Tie outbreak in cantonments and jails ?, ... ... ... ... ... 185 ?acies of the outbreak m Bengal Proper among European and Native Troops ... ?, 185 of the outbreak in the jails of Bengal Proper ... ... ... ... ... 186 i'acies of the outbreaks in the jails of Behar in the provincial invasion of July 1866 ... ... 189 Tacies of the outbreak among the jail population of Upper India ... ... ... 190 ltered aspect of the outbreak among Native Troops shown during boat voyages ... ,„ 192 )uration of the outbreaks of the European Army in 1867 ... ... ... ?, 194 uration of the outbreaks of the European Army, 1856-66 ... ... ... ... 195 eneral conclusions regarding the normal type of the outbreak and its duration, and the causes of aberrations from the normal type ... ... ... ... ... ... 199 le deaths in the neighbourhood of the Broad Street Pump. The significance of this outbreak ? . 199 of the outbreak in the case of disease spread by contagion throughout a community . . . 200 le method of affection in the case of bodies struck by cholera ; cases of the Kurrachee camp in 1846, the 42nd Highlanders, and the Secundra orphans ... ... ... ... 200 le outbreak at Hurdwar viewed in relation to. the typical outbreak ... ... ... 202 vocalisation of cholera as affecting the duration and aspects of outbreaks ... ... ... 203 ustrations of what is meant by infection of a locality ... ... ... ... 204 le attack of attendants on the sick in relation to affection of localities ... ... ... 205 ospital infection sometimes indicative of infection of a locality and nothing more. The facts do not bear out the theory of infection from man toman ... ... ... ... 204 gnificance of the high ratio of attack among orderlies employed in the hospitals of European Regiments during an outbreak ... ... ... ... ... ... 205 nfection of locality in relation to the movement of troops. Cawnpore, 1863 and 1864 ... ... 207 le spread of cholera from one man to another is neither the whole truth regarding propagation, nor yet the primary truth ... ... ... ... ... ... 207 Uases illustrating the good effects that frequently follow movement into camp... ... ... 207 le recurrence of cholera in the same locality in every succeeding epidemic illustrated from the experience of Cawnpore between 1826 and 1868 ... ... ... ... 208 ecurrence and persistence of cholera in the jails of the endemic province ... ... ... 211 'eculiar phase of the manifestation of the cholera miasm sometimes seen in jails, indicative, apparently, of the local growth of cholera at an unfavourable season. Patna, October 1859. Tirhoot Jail, Mackinnou. Lucknow Jail, October 1863 ... ... ... ... 211 illustration of affection of locality and affection of attendants. Kohat, 1858 ... ... 212 CHAPTER 111. r CIRCUMSTANCES WHICH INTENSIFY OR DIMINISH THE RATIO OF ATTACKS DURING THE OUTBREAK. THE DIRECTION IN WHICH THE STUDY OF THE NATURAL HISTORY OF THE EPIDEMIC AND THE OUTBREAK POINTS IN TRYING TO DETERMINE THE PRINCIPLES ON WHICH THE OUTBREAK SHOULD BE MET. It is not alone the strength of the miasm or its accumulation in a locality that determines the intensity of the outbreak .. ... ( ... ... _ ... ... ... 213 Suggestions apt to divert the mind from the points of essential importance in connexion with the study of how the outbreak is to he met _ ... ... • ... ... ... 213 The abortion of the effects of the miasm in the individual ... ... ... ... ... 213 Good effects of a system of prophylaxis ... ... ... ... ... ... 214 The occasional good effects of quarantine in preventing the development of the outbreak ... ... 214 Measures adopted from the consideration of the contagious nature of cholera ... ... ... 214 Measures deduced from the theory of the poisonous character of the emanations from those already affected ... ... _ .» ... ... ... ... ... 214 Theory of the infection of communities through the emanations from those already affected by cholera... 215 Management of individuals affected by cholera. Dr. Murray's Eeport on the treatment of cholera ... 216 Estimate of the value of disinfectants ... ... ... ... ... ... 217 THE GENERAL PRINCIPLES WHICH SHOULD BE ACCEPTED AS FUNDAMENTAL IN TRYING TO DETERMINE THE VALUE OF PRACTICAL SUGGESTIONS. Methods of meeting the outbreak suggested by different theoretical considerations ... ?, 217 Exemption will not be attained by dealing with cholera as with smallpox or typhus ... ... 217 Or as a miasm sown in our cantonments through emanations from infected individuals ... ... 217 The natural alliances of the miasm of cholera being with the miasm of malaria, the direction of the general measures should in either case be the same ... ... ... ... 218 Causes aggravating the ratio of attack by causing the derangement of the balance between health and disease ... ... ... ... ... ... ... 218 fiatio of attack in the outbreaks of the European and Native Armies contrasted ... ... 219 Belts of vegetation protective against the miasms of cholera and malaria ... ... ... 224 Local elevation protective against epidemic cholera ... ... ... .. ... 225 The air stratum containing the cholera and malaria miasm is the same ... ... ... 226 The manifestation of the effects of the miasms of malaria and cholera is developed parallel with the supply of moisture afforded ... ... ... ... ... ... 226 The effect of the sub-division and of the massing of bodies in determining the facies of the outbreak and the ratio of attack ... ... ... ... ... ... 227 Influence on the outbreak of stagnation of the atmosphere .. ... •• ... 228 The ratio of attack during the outbreak in relation to the race of the body or community affected. TheGoorkha ... ... ... ... ... ... ... 228 The causes determining the ratio of attack in the case of the British Soldier ?, ?, ?, 230 6 t loss of balance due to the same causes which originate climatic diseases ... ... ... 2M> powerful influence of the poison of alcohol 1 in preventing the elimination of the cholera miasm ... 231 stratum of the effects of mental depression ... ... ... ... ... 232 doctrine of contagion inadequate to explain the facts of the outbreak ... ... ... 232 apparent increase in virulence of the cholera of recent epidemics ... ... ... 233 CHAPTER IV. DEPENDENCIES OF OUTBREAKS rFAR THE NATURAL AND PRIMARY ASPECT OP THE EPIDEMIC, THE REPRODUCTION, AND THE OUTBREAK IS AFFECTED BY THE SECONDARY MANIFESTATIONS OF CHOLERA. The value in a system of secondary truths ... ... ... ... ... 236 The comparative value of statistical data and of observation and experiment in support of a theory or as the basis of a system ... ... ... ... ... ... 236 The building up of a system from the results of observation contrasted with the structure having a natural basis ... ... ... ... ... ... ... 237 The relative value of primary and secondary truths as estimated in India. Recorded evidence regarding the secondary manifestations of cholera ... ... ... ... ... 237 It is a fact that a tainted stream of human beings may pass off cholera ... ... 238 The mixing up of an infected with an uninfected body is not necessarily followed by the appearance of cholera in the uninfected body. Eesults in the General Hospital of Calcutta ... ... 238 Pilgrim cholera. The phenomena in relation to the epidemic. The necessity for carefully trying to avoid erroneous deductions ... ?, ... ... ... 239 The cholera of Juggurnath manifested in relation to season, over and above any results due to the assembly of pilgrims ... ... ... ... ... ... ... 239 The introduction of the epidemic cholera of 1860 into Upper Assam. Effects of human intercourse ... 240 The possibility of the spread of cholera as a parasitic affection. Spread in fomites ... ... 241 The conclusions of Baly and the Constantinople Conference contrasted ... ... ... 242 Indian authorities on the nature of the cholera miasm ... ... .. ?, 243 CONCLUSION. Recapitulation of the fundamental propositions of this Report ... ... ... ... 241 SECTION I. 1. — Deaths from cholera in the European Army of the Bengal Presidency during 1854 ... 15 2. — Deaths from cholera in the European Army of the Bengal Presidency during 1855 ... 15 S. — Deaths from cholera in the Native Army of the Bengal Presidency during 1854 ... ... 16 4. — Deaths from cholera in the Native Army of the Bengal Presidency during 1855 ... ... lfi s.— Cholera deaths of the European Army of the War Provinces of 1858 ... ... ... sj] 6.— Typical examples showing the seasons of appearance and dormancy normal for different portions of the endemic and epidemic areas. The cholera of the jail population is taken as the index. I.— Backergunge. A jail of the endemic province in the Sunderhuns, on the diluvium, and scarcely elevated above sea level ... ... ... ... ... 35 2. — Midnapore. A jail of the laterite on the margin of the endemic cholera field, little elevated above sea level (compare tables, pages 59 and 239) ... ... ... 35 3.— Bhaugulpore. A jail of the valley of the Ganges, probably within the endemic area, 154 feet above sea level ... ... ... ... ... ... 3H 4. — Patna and Decgah, 185 feet above sea level, also typical for the valley of the Ganges ... 'Mi 5. — Allahabad, typical for the eastern division of the epidemic area ... ... 30 6. — Nagpore and the other jails of the Central Provinces, typical for the southern epidemic highway ... ... ... ... ... ... ... 37 7.— Jubbulpore. Illustrative of the cholera of the same situation modified by elevation ... 38 8. — Central jails of the North-West, typical for the western division of the epidemic area ... 38 7.— Distribution of epidemics in time. 1. — Cholera admissions of the jails of the eastern division of the epidemic area in the epidemic of 1855-58 ... ... ... ... ... ... 41 2. — Deaths from cholera in the European Army cantoned in the western division of the epidemic area during the three-year period 1856-58 ... ... ... 41 3.— Cholera admissions of the jails of the eastern division of the epidemic area in the epidemic of 1859-61 ... ... ... ... ... ... 42 4. — Admissions from cholera in the European Army cantoned in the eastern division of the epidemic area during the three years of the epidemic of 1859-61 ... ... 42 5.— -Admissions from cholera in the Native Army cantoned in the eastern division of the epidemic area during the three years of the epidemic of 1859-61 ... ... 43 6. — Cholera admissions in the European Army occupying the western division of the epidemic area in the epidemic of 1860-62 ... ... ... ... 43 7.— Admissions from cholera in the jails of Agra, Eohilcund, Meerut, and the Punjab during the three years of the epidemic of 1860-62 ... ... ... ... 43 B.— Cholera admissions of the jails of the eastern division of the epidemic area in the epidemic of 1863-65 ... ... ... ... ... ... 44 9. — Cholera admissions of the European Army in the eastern division of the epidemic area, 1863-65 ... ... ... ... ... ... ... 45 10. — Cholera deaths of the western division of the epidemic area in the epidemic of 1864-66. European Troops; Native Troops; Jail Population ... ... ... It; 11. — Jail population of the Central Provinces. Cholera admissions in the epidemic of 1863-66 ... ... ... ... ... ... ... 46 8. — Deaths of the general population of the North-Western Provinces in the invading offshoot of 1865, showing the tract of maximum south of the Jumna and the gradual tailing oft' towards the north-west ... ... ... ... ... ... 45 9. — Diagram to show that the maximum of any epidemic may fall upon the northern or upon the southern epidemic highway, in place of covering equally the entire Presidency from east to west. The epidemic of 1863-65 was confined in its intensity to the southern epidemic belt, and that of 1866-67 never entered the southern highway at all; the epidemics of 1856-58 and 1860-62 occupied both the southern and the northern routes ... ... 48 10. — Aspects of the cholera of epidemic periods in relation to the season of prevalence in the different provinces of the epidemic area. 1. — Contrast of the aspect of the cholera of the jail population in the eastern and western divisions ; the admissions of the eastern taken from the period 1859-65, and those of the western division from the years between 1860 and 1867 ... ... 49 2. — Aspect in the European Army of the eastern division, contrasted with that in the European Army of the western division ; period 1859 to 1866-67 ... ... 50 11. — Tables to illustrate the comparative exemption from cholera of the tract lying between eastern and western influences, on the margins of the two natural provinces. 1. — Jails of the tract. Cholera deaths during the thirty years, 1839-68 ... ... 54 2.— Station of Bareilly. European Regiments, 1859 to 1868 ... ... ... 54 12. — Natural history of cholera in the endemic area. 1. — Months of prevalence in that portion of the endemic tract for which the experience of Calcutta is typical ... ... ... ... ... ... 58 2. — Cholera of South- Western Bengal ; of Midnapore, Cuttack, and Pooree ... ... 59 3.— Contrast of the cholera of the endemic area in non-epidemic and epidemic years. (1), jails and Bhootan Field Force, 1865 ; and (2), jails in 1866, indicative of invasion on and beyond the margins of the endemic basin ... ... ... ... 59 13. — Relation to season of the cholera of the districts lying east of the Bhurmpooter and on the North-Eastern Frontier. I.— Cholera admissions of the jail at Sylhet, 1854-67 ... ... ... ... 60 2. — Cholera deaths of thejails of Assam, — thirty years between 1839 and 1868 ... 00 3.-— Seasons of prevalence of cholera in Lower Assam. Monthly admissions between 1856 and 1867 in the jails of Gowalparah and Gowhatty ... ... ... 61 14. — Indications of the character of the diseases which prevail in the region in which cholera is endemic. The death rates of the jails of the Lower Provinces and of Northern India contrasted ?, ?, ... ... ... ?, ... 62 8 Pack, 15. Diagram to illustrate the relation of k the area of the Bengal Presidency to the south-west monsoon, and influences derived from it. Explanatory note appended ... ... 65 16. Altitude of different stations of the plains, from the watershed between the Jumna and the Sutledge to Patna on the Ganges ... ... ... ... ... 66 17. — Contrast of the effects of the influences prevailing in the easternand western divisions in the same years. I.— Experience of the European Army of the two provinces in 1859, 1860, 1861, and 1862... 67 2. — Cholera ratios of 1863, 1864, 1865, and 1866 of 1 the two provinces contrasted ... 67 18. — Experience of 1860 in the western division of the epidemic area. The ratios for fevers and bowel complaints in the European Army contrasted in the stations included within and lying beyond the point reached by the monsoon in 1860 ... ... ... 68 19.— The stations of the eastern division in epidemic and non-epidemic years. The ratios for European Troops for 1862 contrasted with those for the same stations and for the province 20. — The stations of Central India in epidemic and non-epidemic years — Jhansi, Agra, Morar, 1860-66... ... ... ... ... ... ... ... 69 21. — The gradual diminution of the death ratio towards the North-West in non-epidemic years ; illustrated by the ratios for 1859, 1860, and 1866 ... ... ... ... 69 22. — The fever admissions of the European Army of the western division in each month of the same three years ; to show the characteristic of the distribution by months of the fevers of years of similar constitution ... ... ... ... ... ... 69 23. — Death rates for stations beyond monsoon influences in non-epidemic years — Ferozepore, Mooltan, Peshawur, in 1859, 1860, and 1866 ... ... ... ... 70 24. — Provincial distribution of epidemic malaria. The eastern epidemic of malaria of October 1859 ... 74 25. — Distinction between the cholera of the spring and monsoon evident even in the Cawnpore District, Experience of European Regiments of 1859, 1860, and 1861 showing the clear separation of the cholera of the two seasons ... ... ... ... ... 78 26. — Eain-fall of an average year in the eastern and western half of the Doab ... ... 80 27. — Rain-fall of 1860, a year of minimum, over the same areas ... ... ... 81 28. — Spring rains of the Punjab in epidemic and non-epidemic years. Rains of May 1866 contrasted with the rains of May 186/ ... ... ... ... ... ... 82 29. — Tailing off of the monsopn from Delhi to the Indus in epidemic and non-epidemic years. Rain-fall of 1865, 1866, and 1867 ... ... ... ... ... 83 30. — Rain-fall of other stations of the Punjab in the same years. Hill stations; stations lying towards the hills ; and stations on the Frontier ... ... ... ... 83 31. — Monsoon rains of the east in epidemic and non-epidemic years. Rain-fall of the stations of Oude in 1863 (an epidemic year), and in 1864 (a non-epidemic year) ... ... ... 85 32. — The prevalence of cholera among European Troops in the first six months of the year (January to June) contrasted in the eastern and western divisions of the epidemic area ... ... 89 Choleka of diffebent Epidemics. 33.— Cholera of the European and Native Armies of Madras, 1831-38, showing two epidemic periods and an interval of exemption from 1834 to 1836 ... ... ... ... 1C 34. — Cholera invading the western division of the epidemic area in 1838. A. Statistics of Jails. B. Of European Troops. C. Of Native Troops ... .. ... ... 10 35.— Cholera of the south-western province of 1839. Statistics of the Native Eegiments of the Nusseerabad Circle ... ... ... ... ... ? 107 36. — Table showing the evidence of the occupation of the northern epidemic highway and of the invasion of Northern India in 1843 ... ... ... ... ... 108 37. — The great cholera of the east of 1842, from which the cholera of Northern India of 1843 and 1844 originated ... ... ... .. ... ... H 38. — The invasion of 1841-42 on the southern highway ... ... ... ... 11 39. — Cholera deaths of Bombay Island, 1848-65, showing the date of arrival from the east of the different epidemics included within these years ... ... ... ... 11 40. — The cholera of 1849 invading from the east and on the southern highway before the appearance of the northern cholera of 1850-52 ... ... ... ... ... 11 41. — The cholera of 1853 in the Gangetic Provinces, showing the aura of the spring, followed by the great manifestation of the monsoon ... ... ... ... ... n 42. — The same invading cholera on the southern highway ; the cholera of Khandeish, Nimar, and Malwa of 1854 ... ... ... ... ... ... ... n 43. — Indices of the invasion of July 1866 in the Gangetic Valley. European Troops ... ... 12; 44.— Geographical distribution of the deaths of the general population of the North- Western Provinces in 1866 ... ... ... ... ... ... ... 12-45 — The cholera of 1866 in the endemic province, in South-Western Bengal, as shown among the jail population ... ... ... ... ... ... ... 12 46. — The invasion of July 1866 from the south-east into the Behar Provinces. Jail admissions, July to December 1866 ... ... ... ... ... ... 12 47.— The geography of fevers during the monsoon of 1866, showing that the cholera area and the fever area was the same, and the areas of exemption also the same ... ... ... 12 48.— Fever admissions of the jails of the Punjab of August and September 18G7, possibly an extension of the fever epidemic of the east of 1866 ; the table shows also the geographical distribution of these fevers in the Punjab ... ... ... ... .„ 13 49.— The April cholera of 1867. Table to show the tailing off of the cholera along routes diverging from Hurdwar, proving this cholera of April to have been chiefly, if not altogether, confined to the pilgrims ... ... ... ... ... ... >m 13 50.— Cholera of the general population^ of the eastern division in 1867 ; showing its geograph}',' and the varying degree of severity in tracts geographically continuous ... ... 14 51.— Cholera admissions of European Troops in the station of Meerut. A statement to show the indices of April and May followed by the full manifestation during the monsoon months ... 14 52.— Statement to show the removal of the cholera of the districts lying in the south-east of the Punjab into those lying towards the north-west ; the first half shows the rapid decline in the districts of the south-east after the departure of the cholera for the north in May 1867 ; and the second half the augmentation from May to August in the districts into which the invading cholera was transferred ... ... ... ... ... 14 53.— Cholera deaths of the general population of the North-Western Provinces of 1868 geographically arranged ?. ?, ?, 1M ?, t 14 9 Page 54. Cholera deaths of the general population of the Punjab in 1868, showing the gradual dying away and disappearance of cholera from south-east to north-west ... ... ... 141 55, Rains of the spring and monsoon of the Punjab of 1868 ... ... ... 15 56. The fever admissions of the European Army of the Punjab in each month of 1868, showing the characteristic aspect of a non-epidemic year ; in continuation of table at page 69 ... 15 57_ — Death rates of Ferozepore, Mooltan, and Peshawur in 1868 ;in continuation of table at page 70 15 58. — Cholera deaths of the Central Provinces in 1868; in illustration of the fact of invasion, and of the geography of the invading cholera ... ... ... ... 15J 59, — Illustration of invasion of the southern epidemic highway in 1868 ; showing the facts of invasion, the death of the invading cholera, and revitalisation in the spring of 1869 ... 15 60.— Rain-fall of the Central Provinces of 1868 ... ... ••• ... ... 15 61. — Statement to show the invasion of Bombay in October 1868 ... ... ... 15 SECTION 11. 62. — Outbreaks indicative of the aerial progress of cholera. The western province in 1856 ... 165 63. — Provincial disappearance of cholera in relation to meteorological phenomena. Spring cholera of the East of 1860 ... ... ... ... ... ... ... 166 64. — The cholera wave and its significance. Illustrated from the epidemics of the western area of 1860 and 1862 ... ... ... ... ... ... § ... 167 65. — A series of parallel statements to illustrate the succession of outbreaks and the duration of the reproduction. 1. — European Army of the western area in 1856 ... ... ... ... 1( 2. — European Army of the western area in 1860 ... ... ... ... 17 3. — European Army of the western area in 1861 ... ... ... ... 1! 4. — European Army of the western area in 1862 ... ... ... ... 17 66. — Cantonment of Morar. A statement showing the persistence of cholera in this cantonment throughout the monsoon reproduction in different epidemics ... ... ... 17-07 — Statements illustrating the minimum in time during which an infected body may carry cholera. 1. — European Kegiments on the march ... ... ... ... ... 17 2. — Native Regiments on the march ... ... ... ... ... 17 68. — Lorimer's table showing the result for twenty Native Regiments of the Madras Army attacked on the line of march ... ... ... ... ... ... l! 69.— The type of the outbreak after infection on a known day. On the march, 66th Goorkhas (two Wings) ; in cantonments, 42nd Highlanders, 1867. Modification of the aspect of the outbreak due to various conditions ... ... ... ... ... 1 70. — Cholera of the camp before Delhi and the Lucknow Garrison. A statement to illustrate the local persistence of cholera throughout the life-period of the reproduction ... ... 1 71. — Further examples of the stational outbreak protracted throughout the life-period of the reproduction ... ... ... ... ... ... ... ... 18 72. — Aspect of the outbreak in Lower Bengal. fa).— Among European Troops ... ... ... ... ll (b). — Among Native Troops ... ... ... ... ... 1^ (c). — Among the Jail Population ... ... ... ... 18 73. — Statement to show the results of an invasion on a known date upon the jails of a province. Jails of the Behar Provinces, July 1866 ... ... ... ... 18* 74. — Aspect of the outbreak in the jails of the epidemic area ... ... ... ... 1J 75. — Altered aspect of the outbreak among Native Troops shown during boat voyages ... ... 1$ 76. — Aspect of the outbreaks of the European Army within the cholera area of 1867 ... ... 15 77.— Outbreaks of the European Army, 1856 to 1866 ... ... ... ... 19 78. — Facies of the outbreak in the case of disease spread by contagion throughout a community. Relapsing typhus of the jails of Upper India ... ... ... ... 200 79. — Localisation of cholera as affecting the duration of outbreaks. Her Majesty's 70th Regiment, Cawnpore, 1853 ; 93rd Highlanders, Peshawur, 1862 ... ... ... ... 203 Recurrence of the cholera of successive epidemics in the same locality. Cawnpore as a cantonment, 1826-68 ... ... ... ... ... ... ... 208 80. — Recurrence and persistence of cholera in jails of the endemic area. Alipore and Hooghly Jails, 1859-68 ... ... ... ... ... ... ... 211 81. — The outbreak in the European and Native Armies contrasted. Statement showing the outbreaks of Regiments of the Native Army which have lost while in cantonments above ten men on the occasion of an outbreak of cholera ... ... ... ... ... 220 82. — The Native Army in a provincial invasion, Meerut, 1856 ... ... ... ... 229 83. — Comparative Statement of the loss of the European and Native Regiments cantoned in the same station, 1845-67 ... ... ... ... ... ... 221 84.— The effect of local elevation and free ventilation. Fort William. 1862-68 ... ... 225 85, — Statement to show the contrary, and danger of community of infection. Central jails of the North- Western Provinces, 1856-65 ... ... ... ... ... 228 86. — Loss of different races in the Armies in the epidemic area of 1861 ... ... ... 229 87. — Climatic diseases in the European and Native Armies contrasted, 1864-68 ... ... 231 88.— The apparent increase in virulence of the cholera of recent epidemics. European Army of Bengal. Died out of each 100 treated for cholera in each year between 1827 and 1868 ... 234 89. — Cholera admissions of the Pilgrim Hospital at Pooree in each month of the twenty-five years from 1842 to 1866. A statement to show that the cholera of Juggurnath is manifested strictly in relation to season ... ... ... ... ... ... 239 Appendix I.— Tables showing the admissions and deaths from cholera in the European and Native Armies during the twenty -eight years from 1826 to 1853 Appendix II. — Table showing the number of deaths from cholera in each jail of the Bengal Presidency in each year from 1833 to 1868 ... ... ... xxx Appendix lll.— Tables showing the admissions and deaths from cholera in the European and Native Armies and among the jail population of the Bengal Presidency during the fifteen years from 1854 to 1868 ... ... ... xxxvi At page 240, while quoting 1 the remarks of Mr. White, of Debrooghur, regarding the presumed fact, that in August 1860 coolie immigrants, landed from the Steamer Adjal, introduced the cholera of the year into Upper Assam, I stated, that I was under the impression that Mr. White had never again observed the same phenomenon of communicability. The epidemic of 1868-69 having covered Eastern Bengal and Assam to the North-East Frontier, the Commissioner of Assam lately instituted an inquiry as to whether immigrants might have been the means of introducing this cholera into the districts of his province, and the I suits, embodied in his report dated 15th July, have been published by the Government Bengal. It is, I think, evident that the cholera of Assam of 1869 was a cholera ritalised throughout the province, and not primarily distributed. As early as June 68, the cholera of this epidemic showed itself in Upper Assam, at the very time that it 3ame epidemic in Burmah, at Tongoo and Mandelay, where the same cholera, manifested er reproduction, is at present (September 1869) raging. The spring cholera of the east, of 69, epidemic between January and April, showed itself universally from Akyab to Debroour, and it is this spring cholera to which the report of the Commissioner of Assam has erence. As far as lam able to judge, this cholera was not introduced into Assam in 1869, b was redeveloped within the province from the cholera of invasion epidemic between June I August 1868. In his reply to the queries of the Commissioner, Mr. White makes cifically the statement to which I casually alluded, in the following terms :—: — I" During the time (nearly eleven years) I have been here, I have only once known an tance in which the introduction of cholera could be attributed to the influx of imported orers from Bengal, and that was so far back as July 1860, when the Government Steamer f'ai arrived here with a large number of immigrants who suffered from cholera on the passage, I many were ill from that disease. On arrival they all went to the Maijan Tea Factory, 1 from thence the outbreak which followed soon after could be distinctly traced. The epide-3 was, however, at the time coming up the valley from Bengal, having raged for some time ore at Gowalparah and Gowhatty, and it is a question whether these laborers did more than elerate its outbreak here by a few weeks. " Owing to this introduction of the disease by immigrants, I for some time afterwards, and long before the Legislation of 1865, inspected the steamers on arrival and prevented the landing of passengers suffering from cholera. In 1864, when the tea speculation was at its height, the number of laborers who arrived, amounting to upwards of 600 a month, was so great and nearly every steamer having cholera on board, it was found impracticable and it would have been inhuman, to prohibit their landing. I then observed that, although patients were removed actually suffering from cholera to the various factories in the neighbourhood, it was never communicated to the old coolies. So complete was this immunity from contagion that in 1866 and 1867, when acting as Debarkation Officer, I never once prohibited the removal of cholera patients from the steamer to the several tea gardens to which they were consigned. As I incurred no little responsibility in doing so, I followed up and watched the results attentively, and I never heard of an instance of any of the old laborers on the garden to which the cholera patients were taken being seized ; at times some of the new party of coolies who disembarked in health would be attacked on arrival at the garden, but never any of the coolies who had been previously there. t" Being much interested in the matter, I from time to time in former years enquired from Medical Officers of the Assam and Jorehaut Companies, the two other principal centres of igration, and their experience was similar to mine, that cholera was never propagated by l arrivals to either Cinnamara or Nazirah. There have been epidemics at both those js, but they could not be traced to introduction by recently arrived coolies." At page 65, after the sentence ending " which are never reached in primary invasion/-' add — except when monsoon influences pass the usual limits. STATISTICAL REPORT ON THE CHOLERA OF THE BENGAL PRESIDENCY OF 1866-68 CONSIDERED IN ITS BELATIONS TO THE EPIDEMICS OF PREVIOUS YEARS. INTRODUCTION. DURING the sitting of the international sanitary conference at Constantinople in 1865, 1 was asked by the Sanitary Commissioner for Bengal to give my attention to the subjects on which the conference desired information, with the view that the results might be made available during the deliberations of this body. As the conference was already constituted, and as the questions proposed were being deliberated upon before the request was made to me, I had no hope of contributing material so systematised as to be useful as a guide, or likely to affect the results of deliberations based upon information received at an earlier period. I preferred carefully to study the whole question of the relations of cholera in connection with the occurrences of the past fifteen years, with the object of determining whether the recurrence of identical phenomena and the repetition of the same lessons year after year, might not become to us the indices of principles on which to frame generalisations as landmarks in the study of the cholera of this Presidency. The wide range of the subjects included, necessitated the study of cholera in all its relations ; of the phenomena of geographical distribution ; of duration in time ; of the methods of dissemination ; of the influence of climatic conditions ; in short, of cholera taken as an object of Natural History. The publication of the proceedings of the international conference, and the promulgation of the doctrine of the multiplication of the cholera miasm in the human economy and the constant diffusion of cholera as an epidemic by human intercourse, gave confidence to those observers in this country who, until very lately, suggested rather than maintained as a truth the transmission of epidemic cholera by human agency. The great outbreak among the pilgrims at Hurdwar in April 1867, and the subsequent diffusion of cholera over Northern India, alleged to have been consequent on the Hurdwar outbreak, has given an impetus to this doctrine towards an extreme from which the recoil of opinion in an opposite direction is unlikely to occur for years to come, unless the facts be shown in their true aspect and their actual significance be made clear. The Inspector General of the Medical Department has directed me to review the occurrences of 1867, in order to elucidate the relations of the cholera of Hurdwar to that of Upper India generally, and the extent to which the cholera of 1867 was indebted to the pilgrims for its geographical spread in that year. By request of His Excellency the Commander-in-Chief, the Government of India has forwarded to me documents showing that the results of moving into camp during the prevalence of epidemic cholera, with the view to the mitigation of an outbreak impending, or which has actually commenced, have been in many cases unsatisfactory, and in some disastrous, — in one case cholera continuing its ravages, and in another, diseases due to exposure causing a heavy loss, which possibly need not have been incurred. His Excellency wishes that the facts ma)- be put on record, and that the grounds may be clearly stated on which troops are ordered into camp in cholera seasons by the Medical and Sanitary Authorities. It will be convenient to sub-divide this Report somewhat in the following manner, in relation to the questions to be specially treated : — In the first section, the cholera of this Presidency will be studied in relation to its geography, and to the conditions which affect its growth, its distribution, and its decay ; and in the second, the phenomena of the affection of communities will be illustrated. The results of these studies will be applied to the elucidation of the phenomena of the cholera of the latest Epidemic. The opportunity has been afforded to me of placing on record in a systematic form, more particularly the occurrences of the fifteen years 1854-68; and I have linked on the experiences of previous years, as far as it has been possible to collect these, in order that I might take as the basis for the conclusions of this paper the widest range of statistical facts. I shall have v [Introduction. 2 THE BASIS FROM WHICH THE SUBJECT IS TO BE STUDIED. occasion to refer to the history of tha epidemics of India from 1817 onwards, as illustrative of the behaviour of the cholera of recent years. The history of these epidemics is far from complete, and were it not for the indisputable evidence which, even in the condition in which I am enabled to present them, the statistical data afford of truths which are parallel to and explanatory of the facts of our times, it might have been as well to have confined the illustration of the subject to the experiences of the later period. I The period which I have specially chosen, affords for study the experiences of four different trading epidemics. It has long" been known in a general way that cholera has not a perenil existence in Upper India; but the fact has not been appreciated at its proper lue, that the conditions affecting the vitality of cholera as an epidemic, are not more rorable in Northern India than they are beyond the boundaries of Hindostan. If this itement be true, and if on the occasion of every epidemic invading Northern India, the enomena are offered for our comprehension of their significance, at intervals short in nparison to those at which cholera as an epidemic is presented for the study of European servers, it is obvious that the recognition of this as a truth is of primary importance. I The general princijile upon which I propose to systematise this Report, is one which has n recognised as true, more or less, by all writers who, for any considerable period, have had opportunity of watching the course and sequence of epidemics of cholera. It is this, that ry epidemic whioh recurs is a repetition more or less precise of epidemics which have ceded it. As far as I am aware, we have had as yet no elaboration illustrative of this teral statement taken from the cholera of the Bengal Presidency, No attempt has been le so to systematise the epidemics of the past, that when the epidemics of the future come yard, the phenomena shall be viewed according to what may be termed their natural or nor- I aspects. The impressions of observers have not been based on misconception, and ecept the conclusion as the very groundwork of the study of the cholera of India. I The tendency of late years has been to study cholera more immediately in its relation man, and to subordinate facts as they occur, as far as possible, to the theory of the bribution of epidemic cholera by human intercourse, and of its multiplication in the human nomy. No observer in this country has ever held exclusively the doctrine so much in our at present, and were we now to accept it as satisfactory and explanatory of the ire series of observed facts, it cannot be doubted that the progress of the study of lera on a true because on a natural basis, would be indefinitely retarded. The present is opportune occasion for re-opening this question on a basis of statistical facts. A bias has n given to the direction of sanitary measures by the doctrines promulgated; but pever excellent the recommendations may be in themselves, no permanent or adequate d can come of them if they are directed against secondary objects and not at the root of the evil. I Again, an impulse has been given by the events of 1867, to the theory that the institution quarantine is likely to be followed by the exclusion of epidemic cholera from the cities 1 districts of Upper India ; and to those who seek to apply practical measures to the cutting >rt or to the mitigation of an epidemic, the prospect held out is an inviting one. "Whatever may the advantages of quarantine as a secondary measure, it is not going too far to assert, that ure experience will never elevate quarantine into a position of primary importance as pre- Ltive of the spread of cholera, and that the hopes of those who now imagine that an epidemicinvading cholera must necessarily be cut short provided a sufficiently strict system of irantine be carried out, are certain to be disappointed. A clear comprehension of the natural characteristics of the cholera of Bengal, which may give direction to the measures by which its influence is to be met, is demanded as a national necessity. As the case stands at present, the fact cannot be concealed, that, in the past ten years, one-third of the mortality of the British Army of this Presidency has been caused by epidemic cholera; for, during the years from 1859 to 1867, out of a total mortality of 12,134, the deaths from cholera were 3,460, or 28"51 per cent, of the total. I Reckoning the general mortality of 1859 and 1860 as exceptional, and as influenced for worse by the character of the material of which the Army was composed and by exposure L 857 and 1858, the anticipation for the future is, that the mortality from cholera is not sly to be less than one-third of the total, unless some remedy more applicable to the 3 than those at present employed be discovered. Those who would point to the diminished rtality of the years from 1863 to 1866, as indicative of the efficacy of movement ) camp as a remedy against invading cholera, have not given due weight to the fact, t, as far as regards the military stations most liable to the attack of invading lera, the years from 1863 to 1866 constituted virtually, if not theoretically, a true ;rval of exemption between the epidemic of 1860-62 and that of 1866-67. And on the ision of the reinvasion of 1867, the results of movement into camp disappointed the anticiions which the proposers of the measure had formed, so far as to demand from the highest itary Authority, an explanation of why it is that so little success has attended a step n which so much good was looked for. The tendency to give undue weight to facts that are of secondary importance only, and to elevate them into the position of primary truths, has done much to retard the prosecution of the study of cholera on a healthy basis. A proposition that is true in itself may be of a significance very much more limited than those who hold it recognise. Some observers, knowing that they have a basis of facts to reason from, are very apt to maintain that those who would put a limitation on the truths which they advance, deny these truths altogether ; and they are inclined to hold the principles of other observers to be untrue, when the facts of their doctrines hold a position which is incompatible with the structure of a system as they have built it up. I would not have it supposed that the difficulties of the case are met by admitting 1 that the truth lies between two extremes. All truths which are clearly appreciable as such, must take their place in a system if the system aspires to be complete. From a basis a structure can be built up ; without a basis it cannot. No number of secondary truths can ever of themselves complete a system if the fundamental truths be wanting. The truths advanced regarding cholera of late years, are, I believe, secondary only ; and, therefore, I cannot receive them as the foundation of a system, however important a place they may occupy in the superstructure. I observe, that at home, weight is laid on the excellent tendencies of these doctrines as giving direction to sanitary proceedings, and that those who oppose them are saddled with the responsibility of opposing what is good in its tendencies. In the absence of fixed principles sanitary proposals are but provisional. The general principles of sanitation the scientific investigator will not sacrifice ; while the ultimate aspiration is, that from his labours, practical measures shall receive their direction, and be generally accepted because of their being in accord- ance with scientific truth. I would have it recognised that the doctrines which I have here urged are fundamentally ibher exclusive nor new. They are a development of the institutes which the best observers hat home and in this country have agreed upon. It has fallen to me to exhibit one aspect haps more powerfully than the aspect which springs out of a limited conception of the ural history of cholera, and I know that it will be contended, that I maintain this to be the aspect of cholera to the exclusion of the other most in favour at present. I urge that the reception of exclusive doctrines must prevent the whole truth from being recognised. But one of the two doctrines is fundamental, and must be recognised as suck. He who holds as his radical assertion, that cholera is essentially dependent for its growth and spread on its relations to man, and declines to entertain the doctrine of aerial transmission and reproduction in the soil, cuts himself off from what I believe to be the primary fact which must be received, before any adequate idea of the natural history of cholera can be taken in. Holding fast to this as a primary truth, we pursue it, and we carry on the study naturally up to the point at which we are led to enquire into the relations of cholera to the human race. Those who say dogmatically, that cholera is an object which has no relations except to man, and that, therefore, cholera must be transmitted from man to man and must be multiplied in the human economy, and that the materies so multiplied must be the means of infecting others, cut themselves off from what I believe to be the true basis of all enquiry. Those who do not, are prepared for an investigation of these questions, and are not driven into a corner in which they must take their stand or surrender their opinions. Step by step they are led on to recognise that it is an object and not a conception that is being studied, a thing as appreciable as if it had bulk or colour to make its presence evident to the senses, a thing with the attributes of a vitalised organism and with recognisable alliances, and, therefore, behaving in all respects like other vitalised and actually appreciable objects. Recognising this individuality, and knowing as & primary fact, that the cholera germ is earth-born and aerially conveyed, they are not prohibited from pushing enquiries into the behaviour of this object, when man, to whose system this object acts as a deadly poison, is concerned. When the conveyance of cholera from man to man, or from place to place by fomites, is proved, the fact is admitted ; and the collection of evidence corroborative of such occurrences is an essential, although a secondary, portion of a complete investigation into the natural history of the cholera miasm. When it is said, that a cholerastricken stream of pilgrims passes off cholera to travellers or others who meet it, the fact is not disputed, because it is known to be indisputable. When it is asserted, that cholera is multiplied in the economy and that the dejections are the medium by which the object when multiplied leaves the economy, and that a body of cholera patients is a focus of cholera, while the facts of 50 years' experience in our largest cholera hospitals, recorded by the best observers, negative the belief that, as the rule, those already suffering transmit cholera to those around, the door is left open for further enquiry, from a conviction, that multiplication in the economy may be a fact, although not of the practical significance which those who hold the exclusive .doctrine are compelled to attach to it. If the elevation of little truths to the position of great truths is mischievous, much more is the acceptance of a fallacy detrimental to progress in the right direction. It often happens that loose assertions pass current for accepted truths. The true relations of epidemic cholera to meteorological agencies are obscured by accepting in a general way statements which are incorrect, such as that cholera prevails during the blowing of the hot dry winds as well as with an atmosphere saturated with moisture, or with the extreme of cold as with the extreme of heat. So, too, we find the reporters of the International Conference taking for granted as a fact, that epidemic cholera in India may advance against the prevailing winds, and supporting their conclusions by what they allege to be a fact, but what, in reality, is a fallacious statement. The eradication of such fallacies, which have passed current for truths because uncontradicted by the production of the actual facts, will certainly occur pari passu with the production of the facts. Various circumstances have combined to retard our knowledge of the laws regulating etnic cholera. I have above referred to narrowness of view as one of these conditions, tudy of cholera from an adequate, well connected, and thoroughly authenticated aggregate 3 of statistical data, can alone lead to accurate generalization, and to a due appreciation of the weight of a fact, or series of facts, in a systematic enquiry. The local view has the one spect which it presents to the local observer, and from this he is apt to generalise. We have, or example, been told of the affection of Oude as a province, in 1863, by an infected pilgrim ;ream, and told of the affection of the Central Provinces from the pilgrim shrines of the ocality in 1860 and 1864-65. To the local observer these appear as epidemics of which le is the centre. The investigator on a wider basis, recognises the cholera of 1 860 as a great >idemic covering India from the frontiers of China to the mouth of the Nerbudda, the epidemic 1863 as universal throughout the Gangetic provinces from the Bhurmpooter to Bundelcund, id the epidemic of 1864-65 as a great cholera spreading from the Bay of Bengal the shores of the Atlantic. So, too, the affection of communities is a subject which an be advantageously studied only on a wide basis of observed and registered facts. The loose assertion so frequently repeated, that the adoption of certain measures was immediately followed by the disappearance of cholera, is made too often from a misconception of the part which cholera plays in the affection of bodies of men, and when the same means are subsequently applied by those who credit the statements made, the result is disappointment. I would not have it supposed that in this paper I have woven the deductions from the facts of the period into a system which is perfect. Such opinions as I have recorded, have len arrived at after many previous misconceptions, and no one can be more aware of the it than I am, that every year and every epidemic teaches something new, and throws a different a clearer light on the conceptions derived from former experiences. I have tried to pose the facts and figures in such a shape that it is open to every one to draw his conclusions m them, and these may be corroborative of my views, or they may not. I have tried to r e shape to the study, and I have little doubt that some at least of the inferences which I have de, will be found available in the future when the laws of the cholera of India shall have sn framed into a system. tAs regards the data from which the deductions are made. The field of observation 3nds from the Assam Frontier in the north-east, to the valley of the Nerbudda and Western lwa in the south-west ; and from Pooree and Cuttack in the south-east, to the Northstern Frontier. The population of which the statistics are here employed, exceeds 160,000 y under European medical supervision, and is representative of three distinct types. The opean Army furnishes the results for between 40,000 and 50,000 men, women, and children ted within this area ; the Native Army numbers 60,000 men ; and the Jail population the Presidency varies from 50,000 to 55,000. I For the correctness and completeness of the figured statements lam responsible. They r e been drawn by my own hand, from the monthly and weekly returns furnished at the time t the events occurred, and in no case are they drawn from second-hand or from annual sources information. These afford a true index of the presence of cholera, whether endemic or lemic ; and the indications which they give are confirmed by such general statements relative the cholera of localities as I have been able to gather from the official sources at my disposal, rom the general death registration which has been carried out for some years back in Upper IThe experience of one type can never contradict that of another ; and whatever statistics of general population it has been in my power to collect, have been illustrative of and have er contradicted, the indices given by the types. The value of the statistics employed be best judged of from the sequel; but I think it right to ask that no preliminary objee. be taken to the data which I shall employ. IThe area included within the limits of the Presidency, wide as it is, is not too extensive the study of the geography of epidemic cholera. Indeed it is too limited, seeing that the ndaries of natural areas are curtailed by political divisions, and that the most essential connectlinks are thus cut. Still, within the limits of the Bengal Presidency there are several areas eh are truly natural provinces, and which are complete in themselves when the cholera of igal is studied in its geographical relations. I do not say that a more extended series of observations might not have been advantageous to a more accurate study. I have employed the whole data which are in my hands, and I am not conscious of having made use of them to forward, beyond what is legitimate, any view of my own. I would willingly have deferred to place on record my opinions, in order that further data might be accumulated ; but the facts of the past have been demanded, and, therefore, I have set them down in order here. I Whatever conclusions I have come to, have not been built up upon theories of my own eh I have brought to the study of cholera, Like others, I may have brought my impressions ved from authentic records or from personal experience; but the study on a statistical 8 has produced its own results, and has led me, step by step, through many phases of error and [conception, to shape the result in the form in which I now publish it as representing opinion which I hold provisionally, and liable to correction from future experiences. I find it most instructive to review the different aspects which the subject has presented, under the limitation of facts and with short experiences. The retrospect shows that to have started in the study with a plan ready sketched out, would have been of little use. It became evident at a very early stage, that it was from an aggregate of statistical facts and from those facts alone, that the subject would fall systematically into order. And these data I therefore propose to give as an essential introduction to the conclusions to be based upon them. 4 Clntroduction I The author of the report on the cholera of 1861 in Northern India, has well observed, t much of the mystery that hangs over the Natural History of Cholera is owing not to the iculties of the study so much as to the neglect of the systematic study of cholera in India, d yet, as he states, the natural facilities for such a study are very great ; cholera is never ent, and all meteorological phenomena occur with a regularity and intensity unknown in the iperate regions of higher latitudes. He adds (para. 338 of report), — "This is a branch of uiry in which literally nothing has been accomplished, nor indeed can we find that any ous attempt has hitherto been made in India even to point out its importance, and almost our scientific knowledge is derived from European observation. It would be difficult to I a better example of the vast practical interest of those statistics of science the collection vhich in India has hardly up to the present time been commenced." And yet again he fees, — " When we consider the regularity with which the same phenomena constantly recur, the excellence of the opportunities which exist for their observation, we cannot doubt that ; in the power of science to solve many problems regarding them, which nothing but our berate neglect and ignorance have suffered to remain in mystery." I In consequence of the want of scientific information regarding the behaviour of cholera this country, the demand for a special investigation into the generation and development of lera in India, was made during the sitting of the Constantinople conference by the internalal commission, but the proposal was objected to by the British delegates. It was therefore )lved "to invite the attention of the respective Governments of the countries believed to :he birth places of cholera, to the utility of undertaking or continuing strict local enquiries n the generation and propagation of the disease." — (Report, Indian Ed., page 293). A report containing the substance of the following paper was forwarded to the Sanitary Commission in July 1865, and in 1866, I had an opportunity of explaining and illustrating the general propositions to a conference of Medical Officers convened by Dr. Murray, Inspector General for the Upper Provinces. These papers have been re- written, and the statistical data have been brought down to the present date. 5 SECTION I THE NATURAL HISTORY OF THE EPIDEMIC AND ITS SUCCESSIVE REPRODUCTIONS. IN THIS SECTION THE AFFECTION OF THE HUMAN ECONOMY BY THE DISEASE CALLED CHOLERA, IS EEGAEDED AS THE INDEX MEEELY OF THE PBESENCE IN A CEETAIN SITUATION OF AN OBJECT WHICH HAS AN INDIVIDUALITY OF ITS OWN, AND WHICH, BECAUSE OF THIS INDIVIDUALITY, GIVES ORIGIN TO THE EPIDEMIC MANIFESTATIONS OVER AN AREA. OF THESE MANIFESTATIONS CEETAIN ABE DUE TO WHAT THE OBJECT IS IN ITSELF, OTHERS TO THE CONTROL OF ITS PEOPAGATION AND DIFFUSION BY NATURAL AGENCIES. SECTION I INTRODUCTORY. THE METHOD IN WHICH THE NATURAL HISTORY OP CHOLERA IS TO BE STUDIED, AND THE GENERAL ARRANGEMENT OF THE MATTER OF THE FIRST SECTION. The natural sub-divisions of this section are two : the first should treat of the phenomena manifested by cholera which are due to its own individuality ; the second, of those which are due to its subordination to external agencies. Taking 1 the affection of human beings as the index, the first thing which I propose to show is, that in any year and in every year, the cholera of the Bengal Presidency has a geography which can be demonstrated ; that the affection of certain areas only in certain years is a fact ; and that this affection is subordinate to what cholera is in itself, and in its relations to natural agencies. In the sequel these areas will be defined, and they will be proved to be natural areas or provinces. The reasons why they are so will be studied in detail. Over and above its subordination to natural agencies which retard or accelerate the manifestation of cholera, it will be shown that the phenomena of the vitalisation and decay of cholera are manifested in subordination to what cholera is in itself. This is the unknown something of which authors speak, which to us, in this country, is made clear from the strict and absolute laws regulating the revitalisation, decay, and death of cholera, which also fall to be studied in this section. The observation of these laws enables us to define almost to a day when a latent cholera shall reappear, or when a cholera which is in epidemic vigour shall come to its termination, as we can foretell when a tree shall put forth its bud, or when the leaf shall fall. KThe accurate study of the same phenomena necessitates the employment of a nomenclature eh is rigorous ; we are called on to apply precise terms to certain phenomena, and to call the c phenomena, wherever manifested, by the same terms throughout. I A clear comprehension of these preliminaries will enable us to speak of cholera as having itural history of its own, and to apply to it terms which are comprehensible when employed this understanding ; and the general idea may be received, that the cholera of each year may c a habitat, as regards which we have to tell how and why cholera came to take up its abode b. I The fundamental proposition of this section is very simple. It is this, that in Upper a cholera has not a permanent habitation ; that, at intervals of years, the cholera of the inces of Upper India is renewed by invasion from without ; and that in certain areas of the r er Provinces cholera has a permanent and perennial abode. Hence the primary geographisub-division of the area of the Bengal Presidency is into two — the area of endemic cholera, the area of epidemic cholera. (The second proposition is, that the invasion of the epidemic area is not dependent on ingencies, but is governed by laws which are natural and capable of definition. When it been proved that the geographical sub-division of the epidemic or invaded area is a fact as ;es to invading cholera, I propose to show that the same areas are related not to epidemic era only, but to the natural agencies which influence the health of communities for good or evil ; that the part which cholera is called upon to play is forced upon it ; and that it no locomotion in itself, and has no capability for the selection of a habitat beyond that }h is assigned to it by natural and meteorological agencies alone. I But invasion is, necessarily, secondary to l'eproduction. Previous to manifestation the talisation of cholera as an object is a primary necessity. The first study of cholera as an ict is that of its periods of dormancy and revitalisation. The periodical recurrence of the c series of phenomena is an universal fact in whatever situation cholera is met with, whether em the endemic or in the epidemic area. The reproduction of cholera is a vital phenomenon ; ision is of meteorological significance merely, and the two ideas should never be mixed up. reproduction and decay of the object producing the disease cholera, whether in the endemic or tded area, is as truly a phenomenon of season as is the phase of vegetation of each month cries of months. It is regulated in the time of its occurrence, that is, its appearance is aerated or retarded, by the speciality of geographical site, and by the meteorology connected 1 and natural to this geographical site. But controlled as cholera is by meteorological agencies, it must never be forgotten that reproduction and decay are vital phenomena always and essentially, and that they occur becmise cholera is a vitalised object, and not because of the prevalence of certain meteorological phenomena. I have said that the natural tendency of the cholera which invades Upper India is to decay and death. But not the less is the vital phenomenon of dormancy and renewal displayed during the period for which it continues in epidemic vigour, that is, in life. Revitalisation in different portions of the epidemic area is retarded for weeks or months in comparison with the dates prevalent within the endemic area ; and the extent of the retardation is regulated in v ition to the physical aspect of the occupied situation, or to the meteorology natural to the yince of the epidemic area occupied by the cholera which has made its invasion. In the epidemic i the repression of a cholera normally due to re-appear because of having made its invasion, phenomenon which is often apt to be powerfully exhibited. Nor is this to be wondered at, ag- that the cholera is on a foreign soil, and prone to decay under the operation of agencies 3rse to its vitality. But the fact of recurrence is as true here as it is in the case of the era of the endemic area, and is truly indicative of the renewal of vitality or of the cessaof a period of dormant existence. I Having studied these preliminary questions we find ourselves in a position to define accuily what is meant in speaking of an epidemic of cholera within the epidemic area. The defU xm is as follows : An epidemic is a new emanation of the cholera miasm from within endemic area, invading from the margin of the epidemic area lying in contiguity to the fines of the endemic area, and covering within a certain limit in time, one, or more, or all, ording to circumstances, of the natural provinces of the epidemic area, and generally, tainly as the rule, occupying anew provinces which have become vacant by the death of the lera of the epidemic, the predecessor of the epidemic now in progress of invasion ; destined live out the life-period normal to it in the epidemic province, unless exceptional meteoroloil conditions shall repress or kill it before the date of its normal demise ; and certain to ome revitalised in the occupied area in such situations as foster the germ and preserve it c through its period of dormancy, in each year of its epidemic existence, From the study of a succession of epidemics the normal duration of the life of the invading cholera of Upper India may be reckoned ; and from strict parallels in different epidemics, the limitation of the invading cholera to certain areas, the season of invasion, the phenomena accompanying it, and the dates of reyitalisation normal for a province already occupied. The Epidemic extends over years. It has a true limit in time. The history of the epidemic embraces the behaviour of an invading cholera from the day of its invasion to the day of its decay, within the entire geographical area occupied either in the first or in the succeeding years of its epidemic life. In virtue of what cholera is as an object of Natural History, the epidemic is made up of a certain number of different and successive renewals, reproductions, or revitalisations occurring in each year of the lifetime of the epidemic. I The tj'pical Reproduction shows the natural behaviour throughout its period of revitalisa-. i of a cholera revitalised over an area on a certain date ; its lifetime is included between dates of its appearance and decay. Whether in the endemic area or in a natural province the epidemic area, the cholera miasm is revitalised for a certain number of tveeks or months only i time. This revitalisation is the equivalent in Natural History of the renewal of vegetation i certain geographical situation at certain seasons, and with a certain climatology. Besides oming apparent by the affection of communities, it is during the continuance of a Repro:tion that cholera is manifested to us under the aspect of a moving or progressing epidemic. I The Outbreak is a local manifestation of cholera. The study of the Outbreak is the history jholera in relation to a community, and not to a geographical area. The Outbreak has a limit in le as definite as is that of a Reproduction or of an Epidemic. Since the Outbreaks of a procial area taken collectively, are the manifestation of a Reproduction, it follows, that no Outak can survive beyond the date of the natural decay of the Reproduction of which it is a t. Any community within an invaded area is, in theoiy, liable to attack at any time during persistence of the Reproduction. Every Outbreak has its place in a Reproduction and in Epidemic. I Every Outbreak consists of an aggregate of individual cases of cholera, and, therefore, each, these cases has a place in a Reproduction and in an Epidejnic of air-conveyed and soil-generd cholera. I Over and above what is compi*ehended in this classification, there is yet another group of ;s which occur during an epidemic period, and then only, but which has not its origin pri-i ¦ily from an air-conveyed cholera. This group is made up of cases of cholera transmitted n those who have been subjected to the choleraic influence, or from fomites impregnated h the virus of cholera. The instances of the dissemination of cholera by such agency may be lprised in a group termed " Dependencies of outbreaks." But this is to be observed, that le the aggregate of a certain number of Outbreaks of soil-born cholera constitutes a Reproduci, which again has its place in an Epidemic, there is no evidence to show, that, in this country, ¦ aggregate of cases of cholera derived secondarily from true Outbreaks through human agency, ever, by the combination, produced the phenomenon distinctive of a Reproduction, that is, a vincial manifestation of cholera ; and, consequently, it never can have given rise to an Epidemic. this distinction be true, then this group has a place of its own, and we are not called n to study it as necessarily connected with the Outbreak, the Reproduction or the Epidemic. One of the most important chapters of this section is that which takes cognizance of the parallels afforded by different epidemics — parallels not occurring as mere coincidences by a chance combination of events, but inculcating the truth and forcing us to the belief, that it is, in subordination to natural agencies alone that the same phenomena of relation to space and to season occur with recurring epidemics. It is in these parallels that the history of the past may be read by the light of the history of the cholera of the present time; and it is the recorded parallels which, when a system shall have been established, will be employed for the anticipation of the occurrences of an epidemic years before they actually happen. This is not a mere fancy. Its truth will be shown not only when we compare one with another the 10 NECESSITY FOR THK ADOPTION OF ACCURATE DEFINITIONS. I demies of these fifteen years, but when we go back to review the records of the cholera of the ,y years that are past. The study of these parallels follows that of the geography and of ! statistical facts of the cholera of the period, and it takes its place naturally after the compleq of the study of the Epidemic, and of the statistics of the epidemics of Upper India of recent its, since it falls to be shown in what respects these epidemics have resembled each other and in at they have differed. Generally speaking, the grand parallels of any epidemic are clear ; but letimes, the minor details are complex and difficult to refer back to similar events in the past. ;en the parallels are perfect ; occasionally, we are disposed to regard them as incomplete. And we cannot but feel, that the complexity lies in our want of comprehension, and the incomseness in our inability to grasp as a body the facts which every epidemic affords. This we must overlook, that the manifestation of parallels is under the control of natural agencies, and that disparities of these in the course of different epidemic periods, must have due weight in mating the completeness or incompleteness of parallel facts. Much advantage also will be gained by giving, in this Section, due consideration to the alliances of the object cholera with other morbific agents which react upon the human economy, and which have an equal value with cholera when regarded from a natural history point of view. The miasm of influenza, malaria, and cholera is in each case a distinct individuality; it is immutable, and it has the value in a system, of a thing which has been created. Typhus and small-pox have the same value, but with these the miasm of cholera has nothing in common. On the other hand, much of the natural history of malaria and influenza has a parallel in the history of cholera ; and the behaviour of the one throws light frequently upon what is less clear in the operation of the allied miasm. In the case of epidemic malaria, of which I shall have to speak hereafter, the individuality of the epidemic influence is sufficiently well marked to render the presence of the miasm unmistakeable, and to bring into prominence its relations to seasou and locality. Much of this individuality is lost when the miasm is in a state of decadence ; and, indeed, so far is this the case, that some have not hesitated to assert, that there is no specific miasm engaged in the production of what we know by the term malarious fever. The impress which cholera leaves on the human economy leaves no doubt as to the presence of the existent something which we have to recognise, and it is seldom that we can fail to trace its connexions, geographical and meteorological. t Where the alliance is natural, consistency is maintained throughout when comparison is le ; in cases where there is no natural alliance, in place of finding the objects compared wn together by a common bond of union, the contrast becomes the wider in proportion as natural history of each is properly appreciated. The laws of Typhus are, in India, diameiri'y opposite to those of cholera, and no observer, with a knowledge of the laws to which the • agents are subordinate, would ever place them together for the purpose of searching for latural alliance. The following quotation from Copland* having reference to influenza, might almost have been penned with reference to cholera as it is to be described in this section, substituting the one term for the other throughout. Copland writes, — " That influenza neither originated in nor was diffused by contagion, direct or mediate, seems satisfactorily proved by the nature of the disorder, and by the phenomena and circumstances connected with its appearance and spread. No facts have been adduced of a contagious property, according to the meaning I have attached to the term, having belonged to it, whilst numerous circumstances, showing that it was devoid of such property, have been observed by all who were practically acquainted with it. The almost simultaneous outbreak of the epidemic in distant countries, the rapidity with which if traversed immense spaces, the fact of its often pursuing, in its spread, a different course from that of human intercourse, the great numbers attacked at the same time when it appeared in a district or town, and the frequent suddenness of the seizure, showed that it proceeded chiefly from a very generally diffused change in the atmosphere that modified or infected the system in a determinate manner ; that this malady depended principally upon atmospheric influence, these and other considerations fully prove; but that in some instances, other agents or causes concurred with, or aided this, the principal cause, may be admitted. These other concurring or aiding causes seem to have been the ordinary exciting causes of catarrh, and infection proceeding directly from those laboring under the malady. It was often observed that communication with those already attacked appeared to favor the development of the complaint in the healthy; for when an individual came with the disease from a distance, the inhabitants of the house in which he arrived were usually the first attacked. But it must be conceded, that this infection was a very subordinate cause to that upon which the epidemic principally depended, and that it was merely a concurrent and contingent circumstance in the diffusion of the complaint." ¦ The general scheme of this Section is contained in the following arrangement, and it is ewhat in this order that the subject is taken up in the sequel : — SECTION I.— THE NATURAL HISTORY OF CHOLERA. »- Section A. — General Enquiry into the Phenomena of Epidemic Cholera. Chapter I. — The cholera of each year has a geography which is definite and can be demonstrated. * Dictionary, page 434, Art. Influeuza. 11 Chapter II. — The cholera of any year or period has not a manifestation continuous throughout each month of the year or period ; it is exhibited in a succes- sion of manifestations alternating with seasons of dormancy. Chapter 111. — Besides having a distribution in space, that is, a geography, epidemic cholera has a distribution in time. A cholera of the epidemic area which can be recognised as new and invading, re-appears throughout a succession of years ; the period from its first invasion to its final disappearance is the duration of an epidemic of cholera. Chapter IV. — Every epidemic is a repetition of epidemics which have preceded it, and the parallels between different epidemics are as fixed and stable as is the recur- rence of the phenomena of the meteorology of an invaded area. Sub-Section B. — Special Enquiry into the Relations of Cholera, and into the Circumstances UNDER WHICH THE PHENOMENA DISTINCTIVE OF CHOLERA ARE MANIFESTED. Chapter V. — The phenomena of the invasion of an unoccupied area. Separate propositions to be considered in this chapter. (a). — Certain areas enjoy comparative exemption from cholera in every year; in others it is endemic and perennial. Certain areas are occupied by cholera in each year, while others are free from its presence. The area of the Bengal Presidency may be mapped out into two primary divisions, the areas respectively of endemic and epidemic cholera ; the epidemic area is essentially an invaded area. (b) . — The invaded area has a direct relation to cholera already existing beyond its boundary line ; when the boundary is overstepped, an endemic cholera becomes epidemic and invading. Cholera, however, may become truly epidemic within its endemic area without the transgression of the endemic limits, but in this case invasion of the epidemic area is imminent within a limited period. (c). — When cholera invades an unoccupied area, the source of invasion and its direction are exhibited to us ; the geographical limit to which an invading' cholera extends is also made evident. (d). — If the great epidemic area of this Presidency (within which cholera has no perennial existence) be invaded at more points than one, if the direction of invasion in each case be capable of recognition as the same on the occurrence of each fresh invasion, and if the geographical limits of the invading cholera be fixed and definite, then the epidemic area becomes sub-divided into as many epidemic provinces as there are separate points and directions of invasion. (c ). — If each of these provinces be clearly capable of definition by the consistency of its characteristics in evciy year, the index being the general prevalence or non-prevalence throughout it of sickness and mortality, and of certain special diseases ; if the separate divisions of the great epidemic area have necessarily no characteristics in common in any year (excluding altogether the question whether cholera be absent or present) ; if the history of each province repeats itself constantly and with precision after a succession of years, so that we can at once recognize the parallels — then, the cholera provinces are the natural divisions of the area of the Bengal Presidency ; and they are natural not for cholera alone, but in relation to all influences, the general prevalence of which, determines the standard of health among the population. Q*). — The geographical distribution of an invading cholera is purely a phenomenon of meteorological significance. Epidemic cholera is never in any case spread over a definite geographical area by human intercourse alone ; nor can human agency cause the boundaries of a natural province which has been occupied by cholera to be transgressed, so that a cholera epidemic from suck a source shall appear in the province immediately adjoining, and become generally diffused among its inhabitants. (g). — Cholera has no locomotive power in itself, and the geographical distribution of an advancing epidemic is essentially dependent upon the existence of a vehicle. A cholera which has no vehicle afforded to it is anchored, and is shown in localised outbreaks only. A cholera of a dry and hot season, when such a cholera is found, is a reproduced and not invading cholera. In connexion with the phenomena of reproduction to be presently alluded to, and the conditions which retard or accelerate it, the epidemic distribution of cholera is effected in the different regions of Hindostan, at the seasons when this vehicle is afforded ; epidemic advance occurring in one region in March and April, in a second subsequent to the 20th June, and in a third in October, November, and December. The vehicle required is in all cases, and wherever epidemic advance is in progress, a humid atmosphere. (h). — The prevailing wind is the agency which directs the course of an advancing epidemic and determines its limitation in geographical distribution. The assertion that cholera may advance against a prevailing wind is contrary to fact, 12 GENERAL ARRANGEMENT OP f HE SUBJECTS OP THE FIRST SECTION. and the phenomena brought forward in support of it are, generally speaking, those of a cholera reproduced over various, and possibly widely separated, portions of the same natural province, months or years subsequent to the original invasion ; or they may be related to the cholera of two natural and distinct provinces, each invaded from a separate source and in a different direction, in which cholera may be in existence at the same time. Chapter VI. — The phenomena of reproduction in each year of an epidemic, and the duration of the epidemic in years. I This chapter should treat of the aspect of a reproduced cholera, as distinguished from holera in actual course of distribution, and of the behaviour of an invading cholera after an a has been covered, under the following heads :—: — (a). — Since it has been shown that the epidemic area of this Presidency, or any of the provinces of the area, may become free from a cholera which has made an invasion, it follows, that an invading cholera has a definite life-period, to be reckoned from the date at which it leaves its endemic province, at the termination of which it dies ; and the geographical area covered by it is free from cholera, provided a new invading epidemic has not made its way into it, and introduced within it a new source of reproduction. (bj. — Reproduction is distinctly a provincial manifestation. But a cholera which has invaded an epidemic province is not necessarily reproduced over the whole area of the province ; many portions of such an area are entirely unsuited for its reproduction, while others which are well adapted to its requirements, afford the breeding grounds whence it emanates when renewed, in the vigour of epidemic manifestation. Besides being renewed in these localities, a cholera in its second or third year after invasion is liable to come forward in many special situations which have afforded to it the opportunity for localisation ; that is to say, such localities retain cholera and foster it, while its life is extinguished in others less favorable to its existence. (<¦¦). — The reproduction of cholera in each year is essentially a vital phenomenon proper to the miasm of cholera as an object of Natural History. The phenomenon is manifested wherever cholera is met with, whether in its endemic or epidemic provinces. It is the equivalent of the budding of a tree or the flowering of a plant. The date of reproduction is regulated by the normal conditions of the geographical position in which cholera finds itself; for example, the very same repi'oduction which occurs in one locality on the 20th February is delayed in another to the 20th April, and yet the two are one and the same phenomenon. The duration of each of these reproductions is the duration of a provincial epidemic outburst, and when the period for which it has come forward is at an end, the cholera is again dormant until its normal period of revival comes round. Hence no combination of conditions can prolong the vitality of cholera in any general manifestation be} r ond a definite time ; and no cholera can be artificially propagated so as to prolong beyond this normal period such a general manifestation. (il). — -Cholera has special seasons of reproduction in every year. Euch of these is distinct, and it can be absolutely demonstrated; but the date of each reproduction must be studied in connexion with the special locality of its occurrence, and statistics in the mass render obscure what is beautifully evident on analysis. — — — _ __ „ _ _ — __ __ ,. _ — ._ _. — _ _ j (c). — Cholera may become an invading epidemic in any of these reproductions, and does become so provided a vehicle be afforded to it at the same time. By determining the date of these reproductions normal for any locality, we can predict at what dates a cholera which has made its invasion shall naturally re-appear. (/). — In each year of the period which constitutes the life-time of an invading Epidemic, the natural revivals of the miasm are to be looked forward to ; and at the very end of this period the cholera may be as deadly in its character as at the beginning of its epidemic life. A cholera which then disappears is actually dead, and without a history of reinvasion no cholera can again appear within the same province of the epidemic area. I In studying the subordination of epidemic cholera to meteorological agencies, I have been npelled to notice and illustrate the facts of provincial revitalisation as well as the phenomena ich accompany primary distribution. Hence, I have been obliged to treat, in anticipation, many subjects which would properly have appeared in this chapter. I shall, therefore, only briefly sum up the conclusions under these heads deduced from the illustrations already given, and then endeavour to show how far the epidemic history of the past 50 years is a consistent history, and how far the facts and phenomena coincide with those of the period more especially under review. K shall conclude the Section by placing the aspects of the facts of the epidemic of 1866-68 light in which they appear to me when viewed in relation to the occurrences of previous 13 CHAPTER I. THE CHOLERA OP EVERY YEAR HAS A GEOGRAPHY WHICH IS DEFINITE, AND CAN BE DEMONSTRATED. The Natural History of the Cholera of Bengal Proper and of Eastern Bengal and Assam I shall consider in another place. Here, I propose to show that the history of the cholera of the epidemic area of this Presidency is capable of being strung into a continuous narrative extending from one year to another. In the succeeding chapters I shall speak of this cholera as invading, as reproduced, and as dying out ; the present is designed to indicate the simple tact of the presence or absence of cholera over the areas occupied by the types under observation throughout a series of years. I shall, therefore, merely reproduce here the cholera tables o each year for each of the types,* and call attention shortly to the indications afforded by these tables, and supplement the facts indicated by such explanatory or corroborative statements as may enable the reader clearly to comprehend the statistical data upon which the narrative is >ased. It is expedient to go back to an interval between two known epidemic periods, to a year Definition of the term, " the inter- or years in which over certain districts of Upper India vai between two epidemics." cholera has ceased to manifest its existence. It can be readily conceived how in a field so wide and of which the natural aspects are so varied, the phenomenon of extinction occurs in certain provinces of the epidemic area, anc n others is represented only by decline to a minimum of manifestation ; how epidemic lines lefining the boundaries of natural areas are, as a rule, shaded lines and not abrupt definitions nd how even the districts lying between the endemic area proper and the provinces recognisec s epidemic, may be a neutral ground, one observer insisting that these constitute truly a portion f the endemic area, while another, with an equally accurate knowledge of the facts of the case, wlds that they are not entitled to be so regarded. Some are in the habit of saying, that it is 'cry doubtful whether any city or district of Upper India is ever free entirely from cholera. Whether this be a fact or not, and it certainly is not asserted to be so on statistical data, )erennial persistence is not a fact in the Natural History of the cholera of the Upper 'rovinces. This history leaves no door open for the assumption, that the germ pre-exists n these provinces, and that epidemic manifestation is a mere phase in the life of this existing holera developed under certain conditions, known or unknown. Shaded our lines may >c, but the shape which they give to the areas which they limit is scarcely on this ccount the less definite ; it may be that in many cases local causes specially foster cholera, but o collection of such cases can alter the facies of a cholera epidemic as regards its relations ¦> time or to space. iThe use of the term, " the interval between two epidemics/ may in one province of the idemic area imply that the cholera of invasion has declined to a minimum, and in another, at the cholera of invasion has become extinct ; in either case, it implies that the province enjoying a respite which is to be broken after a certain period by the irruption from without an invading cholera. I have chosen as convenient, the interval between the epidemics of 1849-53 and 1856-58, ;ind I commence the narrative by describing the geographical relations of cholera in this Presidency previous to the invasion of 1856. In speaking of the epidemic area of the Bengal Presidency, I shall frequently have occasion Definition of the two Primary Divi- to use the terms Eastern and Western Divisions as applied to ons of the Epidemic Area. two portions of the area. When I may do so, it will be unerstood that it is of the epidemic area of our North- Western Provinces only that I speak, and fiat the Central Provinces are not included, nor yet the province in the extreme south and vest, which I shall speak of afterwards as the province of the south-west monsoon proper, n the Eastern Division are included the Gangetic Provinces from Behar westwards, Oude, the astern half of the Jumno-Gangetic Doab, and Bundelcund ; and in the Western, Rohilcund, Vteerut, Agra, Central India properly so called, and the Punjab. The line of 80° East jongitude will very nearly define the demarcation of these two divisions. Cholera of 1854 and 1855. For several years previous to the annexation of Oude the bulk of the European Army- was massed in the Western Divi- Eitkopean Army, 1854. sion ; in the Eastern, the British Burmah and Pegu ... 2,426 Eastern Division. Army was represented by a single I Bengal Proper Dinapore 878 Battery at Cawnpore, and a Benares ... ... 77 second at Benares, by the Invalid °rt William 921 Cawnpore ... JT7 Battalion occupying Chunar Fort, Chinsurat. ... ... 788 1.032 and a Battery and Regiment at the eastern extremity of the divi- 1,904 sion cantoned at Dinapore. The * These tables are placed in the Appendix. GEOGRAPHY OP THE CHOLERA OP THE EPIDEMIC AREA IN 1854 AND 1855. 15 Chap. 1.3 European Aemy, Western Division, AcTa 977 Mferut 2,159 Umballa LJSJ Dugshaie •• • ¦• • al9 Subatboo ... " 'l l,OlB Kussowlie ... ... J Wuzeorabad ... ... 948 Jullundur ... ... 987 Sealkote ... ... 1.1 12 1854, — (continued.) Western Division, Govindghur Meean Meer Ferozepore Mooltan Rawul Pindee Peshawur distribution of the European (continued.) Army in 1854 is shown in the 74 margin. Out of a strength of ... 1,429 oi nnn o ac\(\ ™ Q r. ™».o ™ aa^A na -*|^ 21,000, 2,400 men were on service 92 in Burmah and Pegu, 1,900 were 956 cantoned in Bengal Proper, 1,050 2,331 m c Eastern Division, and 15,700 in the Western Division of the Upper Provinces. Army of Bengal ... 21,074 It is obvious that no account can be taken of so small a body as representative of the population of the eastern division. The experience of subsequent years, however, teaches, that from the presence or absence of cholera among a body of 16,000 European soldiers having the distribution in the western division here indicated, a very fair idea may be formed of the prevalence of cholera in, or of its absence from, the various districts of the area. From January 1854 to June 1856, not one fatal case of cholera occurred among the European Troops occupying the western division of the epidemic area. Forty-eight deaths from cholera, in all, occurred in the European Army of the Presidency in 1854. The distribution of these deaths is shown in the following statement : — Deaths from Cholera in the European Army of the Bengal Presidency during 1854. Place op Death. £¦ « • -g % £ § •= illtii#ifii § I Burmah and Pegu ... 5 11 ... 1 5 5 ... 27 On the Ganges ... ... ... 3 3 Calcutta ... ... 4 , 2 G Pum-Dum ... ... 1 1 Chinsurah ... ••• 2 14 1 8 Benares ... ... ••¦ 1 1 Total 7 16 5 1 ... 1 ... 1 6 6 5 48 The two fatal cases returned as cholera from Peshawur and Meerut, are exceptional to the distribution which I have stated to hold good in these years. I find the following explanations given regarding these two cases. The Medical Officer in charge writing of the case at Peshawur says :* — " This man died from ebrietas, on the day after his admission, in collapse resembling that of cholera." The Superintending Surgeon of Meerut with reference to the case in his division writes thus, in his general report for the year :—": — " There has not been a single case of any epidemic disease, either in the form of cholera or of any other, in Meerut, or in any station of the circle." Whatever cholera, therefore, may have existed in Upper India in 1854, was limited to the eastern division, as far as its presence is illustrated by the European Soldier as a type. The Cholera History of the British Army in 1855 is a repetition of that of 1854. Sixtyfour deaths occurred with the following distribution :—: — Deaths from Cholera in the European Army of the Bengal Presidency during 1855. Place op Death. f, £¦ . £ . £ S I2¦§a.-6, I § | I I i .111111 I I I I I I I Burmah and Pegu ... ... ... 3 6 ... 3 1 13 On the Ganges ... ... ... 1 4 16 Calcutta 13 4 8 4 1 21 Dum-Dum ... ... ... 1 4 5 Chinsurah ... ... ... ... 4 1 ... 3 8 Berhampore ... ... ... 2 2 Dinapore ... ... ... 6 6 Dugshaie ... ... ... 1 1 Nowshera ... ... ... 1 ... 1 Peshawur ... ... •¦• 1 ... 1 Total ... 9 9 4 12 11 ... 3 5 2 1 6 2 64 The case at Nowshera occurred among a party of convalescents removed from the Peshawur Valley on account of fever. It has long been known that the cases of fatal collapse occurring * Report of Ist Troop, 2nd Brigade Bengal Artillery, for 1854. in the course of Peshawur fevei 1 , have been, in nearly every year, a blemish to our record of cholera. I may have occasion to make allusion to this circumstance in showing" the distribution of cholera in years before 1854 and 1855, and I have on this account placed here the remarks which these two cases have called forth from the Officers who had charge of them, which distinctly state that such cases are not to be accepted as cases of cholera, because they are returned under the head of cholera. Lin the report of H. M.'s 24th Regiment for 1855, with reference to one of these cases, geon Gamble writes :—: — I" A remarkable feature occasionally results from the peculiar poison producing this interttent fever, namely, that symptoms occur so truly simulating cholera that it were hardly jorrect to name the disease by that most formidable nomenclature. The cold clammy •face, the peculiar up-turned eye, cramps, suppression of urine, purging and vomiting, th a feeble circulation (becoming less and less distinct till it fails to be perceptible), ! all present. Quinine to cinchonization acts as a charm. " The details of another of ;se cases are thus given by the report of Her Majesty's Bth Regiment for 1855 :—: — man was admitted on the 23rd November, suffering from an attack of fever and ague rather a severe character. He had had several relapses of the disease. On the evening the 24th, he was suddenly seized with all the symptoms of true Asiatic cholera, collapse, lips, ids and feet blue, suppression of urine, and cold breath. All means employed failed to relieve i, and he died at 2 o'clock on the morning of the 25th. It is a curious fact connected ih the peculiar nature of the Peshawur fever, that it often attacks patients with the sympas already related, particularly those who have had frequent relapses of the disease, and to erson not prepared for it, death would be set down as caused of an attack of cholera. Other patients were attacked in the same way, but their cases yielded to treatment/ I can find no explanation regarding the case returned as cholera from Dugshaie. It is not alluded to in the annual report of the Regiment. It matters little whether these be regarded as true cholera or not. But from the observa- Xl in later years, of cases apparently isolated, I think it worth noting here that cases of lera holding a true place in an epidemic, have been attributed to the exaggeration of the lptoms of malarious poisoning in the debilitated constitution. I shall not illustrate further what I have said regarding the form of choleroid disease apt to "M f • is>>4. P reya il a t Peshawur. I call attention merely to the fact that and 1855. ° *" c my '" while in 1854 and 1855, the rest of the Punjab affords no case of fatal cholera, in each of these years three cases are found jur records among the Native garrison of Peshawur.* The explanation given in the case the European Soldier holds good in the case of the Native Troops cantoned in this station. The strength and distribution of the Native Army in 1854 is noted in the margin. In Native Army, 1854. the western division of the epidemic fil Proper ... ... ... ... 7,965 area, a force of 92,000 men was cantonrn Bengal and Assam ... 3,895 e d ; in the eastern, a force of 22,500 ; etic Provinces from Futtehghur eastward ... 22,448 . ? <•. ? , , ? ¦ n t> cund, Meerut, and Agra ... ... 20,221 m tne districts under the influence ot al India ... ... ... ... 13,627 endemic cholera, 12,000 men were loealb ••• ••• - - 57 > 939 ted. This Army lost 90 men from ToTAL 126,0a5t cholera in 1854. Deaths from Cholera in the Native Army of the Bengal Presidency during 1854. Place or Death. g 1 A . . | S J "g | j ifiSji^fflfli On the march ... .„ ... 6 ... 2 g Calcutta ... ... ... 2 11 ... ... i ... 5 Barrackpore ... ... ... ... 3 ... | 1 1 2 j 3 10 Out-post of Debrooghur ... ... ... 1 Bhaugulpore ... ... ... ... _, j Dinapore ... ... ... ... '" ... 5 6 3 ... 1 ... ... ... ... ... 15 Benares ... ... ... .. 1 4 22 .'" ?, 27 Peshawur ... ... ... 1 j "j _ 3 Total 2 9 11 16 30 5 5 1 1 1 U 8 * The strength of the native portion of the garrison of Peshawur was upwards of 8,000. f The strength here given is that of July 1854. It dous not iuelude the men abwnt cm ftirlough. 16 I With the exception of the cases at Peshawur above alluded to, one fatal case of choleni y is recorded among* the 78,000 men stationed in the Punjab, and in the Meerut, Rohilcund, i Agra Districts. It is not worth while to enquire whether this single case was, or was not, •enuine case of cholera. The statistical fact shown is, that as far as the Native Army was index, in these districts of the western area cholera was either extinct or at an absolute limum of prevalence. Gwalior and Rajpootana show no case of cholera ; but the seven ,ths of Bhopal, Malwa, and Nimar in the extreme south-west, are the indication of the presence true epidemic cholera which made its invasion in the end of June. Of this and its relations, hall speak in a subsequent chapter. The presence of cholera is indicated by this type in every station of the Gangetic Provinces from Cawnpore eastwards, in March, April, and May. Deaths from Cholera in the Native Army of the Bengal Presidency during 1855. ._ I i Place of Death. £• §* ¦ *s "° »>' •= ¦§ On the inarch ... ... ... ... 17 4 ... 9 30 Stations of Bengal Proper ... 6 6 3 4 2 3 1 2 27 Dorundah ... ... ... ... 1 ... I 1 Hazareebaugh . . . ... ... 4 1 | 5 Camps in the Sonthal Districts ... ... 2 15 ... 3 j 3 1 24 Bhaugulpore ... ... ... I 4 l 5 Dinapore ... ... ... 3 10 1 I 14 Benares ... ... ... 13 1 j 5 Lucknow ... ... ... j 1 1 ... 2 Seetapore ... ... ... ... ... 2 ... | 2 Allahabad ... ... ... 1 1 ... j 2 Cawnpore ... ... ... 2 4 1 7 In boats on the Ganges near Cawnpore ... 40 ... j 140 Mynpoorie ... ... ... 1 ... | j j 1 Moradabad ... ... ... ... ... 1 ... | l Peshawur ... ... ... 1 1 ... ] 3 Total ... ... 17 6 8191711|620 47 J 9 10 6 176 Again, as in the ease of the European Army, the experience of 1854 is repeated in 1855 ; in the extreme south-west, however, evidence of the presence of cholera is no longer furnished in the returns from Malvva or Bhopal. In the Western Division of the epidemic area, a death of Moradabad in August and a second at Hansi in December may be regarded as the forerunners of the epidemic of 1856. I believe both of these to have been cases of true epidemic cholera, the indications of an epidemic in progress from the east represented to us in the above table by the deaths of Hazareebaugh and the Sonthal districts, and of Dinapore and Benares of the earlier months ; by the deaths of Oude, Allahabad, and Cawnporc of August and September; and by the loss in September on the Ganges below Cawnpore of 40 men of the Bth Native Infantry. t The jail population gives for 1854* and 1855 a history entirely consistent with that of the ...,..,. ? . Native and European Armies. Out of a prison population eral distribution of cholera among ? „, ?A A . ? r , v • • j? £• j. i i era in 1854 and 1855 0 * 25,000 in the western division, iour ratal cases are shown in 1854. In 1855, a single fatal case only appears over the same area; it occurred at Jhansi in December, and it was a true forerunner of the epidemic of the year following. The epidemic of the extreme south-west, of 1854, is shown in the affection of the jails of Hoshungabad, Nimar, and Neemuch. IThe jails of the eastern division of the epidemic area were generally affected in both years. Table of 1855 in particular, shows cholera to have been universally distributed between ireebaugh and Cawnpore. 1 The details of the admissions from cholera during 1854 and 1855, among Native Troops Prisoners, form the first tables in the Appendix containing the returns of the past fifteen Summary op the History of the Years 1854 and 1855. In 1854, the limitation of the cholera of the epidemic area was to two distinct provinces ; the one, that portion of the Presidency lying east of Cawn- Eeral indication of distribution afforded pore the other, that lying to the west and south-west of cholera of the three types in the 7i r< v -j • mi •j. j" •<- *- "+ n il preceding the epidemic of 1856. the Gwahor territories. The intermediate territories, Central India, Agra, Meerut, Rohilcund, and the Punjab to smotest station, were free from cholera.* No portion of the cholera of the south-west * Nagpore was not included in the Bengal Presidency in 1854. The Nagpore force, as is shown in the Madras Returns, out of a strength of 3,400, lost only one man from cholera in 1854, and no death occurred in 1855. The jails of Nagpore also appear to have been free from cholera in 1855. In some of the Jail Reports for 1856 I find it stated, that unti] that year cholera had been absent from the districts for (bur years, 17 GEOGRAPHY OF THE CHOLERA OF THE EPIDEMIC AREA IN 1856. [Section I. 18 entered the Gwalior territories while epidemic in Bhopal and Malwa ; and the cholera of the east showed no disposition to establish itself in the intermediate area. I find no history which would lead to the inference that the cholera of the east was an invading cholera ; the facies of this cholera causes me to regard it as a reproduction of the cholera of 1853, a very severe epidemic in the districts bordering on the Ganges. The year 1855, repeating the history of 1854, exhibits the western division of the epidemic area free from cholera from Nagpore in the south-east, to the Peshawur Frontier in the north-west. The provinces intervening, namely, Central India, Agra, Meerut, Rohilcund, and the Punjab, were entirely free from cholera. But the facies of the cholera of the eastern division of the epidemic area underwent a change in 1855. It was no longer shown in local outbreaks, but was an epidemic in motion from Hazareebaugh in the east to Jhansi in the west, truly epidemic in the Doab from Cawnpore to Allahabad and in the Gangetic Provinces to the east. Three cases I have indicated in the western division as probably true outrunners of this moving cholera of the east ; one at Moradabad in August, a second at Hansi in December, and the third, also in December, at Jhansi. It is in the report from Jhansi for 1855,* that I find the most westerly indication of the presence of cholera epidemic from the east ; it is stated that during the months August, September, and October cholera was very prevalent and very fatal in Jhansi. In the district immediately to the east, the report is precisely the same. The report from Nowgong states, that although the city of Nowgong nearly escaped, cholera was very prevalent and fatal during the months August, September, and October in all the large cities and populous villages of Bundelcund. The report from the Futtehpore and Cawnpore Districts lying to the north between the Jumna and Ganges is the same.f I The appearance of cholera on the plateau of Hazareebaugh and its subsequent presence roughout Bundelcund, has in every epidemic from 1817 downwards, implied, that all the ervening country has been swept by an advancing epidemic. The rising of cholera far in 3 east over the hills which enclose the endemic cholera basin, gives a sure warning that after long interval the entire geographical area which I have called the eastern division of } epidemic area, will be covered by an invading cholera, This province is to us the area of 1 ep identic cholera of the year 1855; the area extending from the south-east of the Presidency the extreme north-west, and lying to the south and west of the Eastern Division of the Epidemic ea, is to us the exempted area of 1855, Cholera of 1856. The quiescence of the moving cholera of 1855 during the early months of 1856, is marked by the absence in the European Army during the X a C th?ArmL 1856 ° f thC EaK>Pean aUd first . five month^ of . the year > of fatal cholera > in ap- portion of the epidemic area. There was little in 1855 to ticate the enormous volume of the cholera which in its reproduction and reinforcement was constitute the great cholera of 1856 ; and up nearly to the end of May, no one unacquainted h the part which cholera invading from the east is destined to play in the epidemic area, Id have foretold, that within two months the exempted area of 1855 from Nagpore to the him, was to be covered universally, and desolated by the advancing epidemic. I As in 1854 and 1855, so in 1856, the European Army was very inadequately represented in i eastern division. One Regiment was added to the strength in consequence of the annexaa of Oude, and the 52nd Regiment was sent to occupy Lucknow. On the 20th June cholera acked this Regiment, and carried off 46 men out of 66 seizures. In the table for the tive Army, however, the presence of cholera as an epidemic throughout the eastern division April is clearly shown, and as early as March in the extreme east, in the camps in the athal country. In April, the 1 9th Native Infantry marching down the Grand Trunk Road t cholera on two separate occasions at an interval of ten days, and lost 30 men out of 3 who were attacked ; and in the same month, the 34th Native Infantry proceeding in boats m Cawnpore to Allahabad fell in with cholera at the place where the Bth Native Infantry re attacked in the end of August in 1855, and lost 30 men out of 70 seizures. The ruckpore District suffered heavily at the same time, and early in May the valley of Nepaul 3 invaded. In the south, early in March, the Nagpore territories, which for four years had n free from cholera, were reinvaded. Up to the 20th May, cholera had not as an epidemic occupied any portion of the western division of the epidemic area. In the Native Army, a single death is recorded at Moradabad, Delhi, Wuzeerabad, and Kangra in April, and at Meerut in May. I think there is reason to conclude, that these cases were the outrunners of the advancing epidemic. The invasion of the.western division was effected not through the Doab from east to west, but through the districts lying south of the Jumna. The report of the Civil Authorities from Shahjehanpore, the most easterly of the districts which I have grouped as the province of Meerut and Rohilcund, states :—": — " The district has been singularly free from the cholera epidemic which has raged throughout the North-Western Provinces. Individual cases have occurred in * Report on the Civil establishments at ,Ih;m, . for 1855, by Surgeon Boyes. + Oude was not annexed until 1856. Hud the statistics of this province been available, the cholera history of the year would have been the same, namely, that of an invading cholera. GEOGRAPHY OP THE CHOLERA OF THE EPIDEMIC AREA IN 1856. Chap. I.] 19 all parts of the district, but on the edge of the Terai alone, did any sufficient number of cases come to notice to warrant special attention."* It was in May that the western division of the epidemic area was entered. Cholera was reckoned to have become epidemic in the Agra District from the 21st May. The Allyghur and Agra Districts were invaded simultaneously; but in May and June, this cholera made no progress beyond these limits, and was confined to the Agra, Muttra, and Allyghur Districts. It was not until July that this cholera began to move northwards, north-westwards, and westwards. In the movement northwards, it was on the 15th July that Meerut was attacked. In Bolundshuhur the Death Register dates from the 23rd July ; in Moradabad from 20th July ; and inßudaon from 24th July. In Bareilly, some cases occurred in the end of June simultaneously with the epidemic appearance of cholera in Oude ; but the Civil Authorities date the true outbreak between the 15th and 29th July (Official Report, p. 51). In the first week of August the moving epidemic reached Mozuffernuggur, Seharunpore, and Deyrah ; and Bijnore became affected on the 14th. The movement to the north-west was simultaneous with the movement to the north. The limit of invasion of the year in this direction was reached exactly in the time occupied in the progress northward of the same cholera from the Agra District to the Himalayas ; for it was on the 7th August that Meean Meer was struck, and this station, or Gooj ran walla, forty miles beyond it, is reckoned as the limit of the invasion of 1856. The movement to the extreme west of the western division of the epidemic area of the Presidency occupied exactly the same time as the movements to the north and north-west. The report from Ajmere dates the appearance of the cholera from the beginning of August (p. 56) ; and it was on the 12th that the jail was attacked. Meantime, Bhurtpore, Jeypore, and Gwalior had been covered ; and the Bth August I find to be the day on which the Superintending Surgeon of the Gwalior Circle (Dr. K. Kirk) communicated to the Medical Board that the cholera which had shown itself some weeks previously had begun to prevail as an epidemic in his district. How much further to the west than Ajmere the cholera of August extended we need not here enquire. Beyond the desert, we find it at Mooltan before the end of the month. This seems to have been the cholera which reached Persia on 17th September; for Persia appears generally to be invaded in the same year in which cholera as an epidemic enters our North - Western Provinces. This was the case also in 1860 and 1867. Very little explanation of the tables for 1856 is required after what has been said above. The table for the European Army, shows, in the western division, the June epidemic of Ag»ra carried forward in July and August towards the north and north-west, and at an end in the first week of October. The table for Native Army shows the same thing, and in this type the extreme range of the invading cholera of August in the north-west is pointed out. Jhelum was the last station touched in the advance. The Jail Table shows the jails of Umballa and of Dhurmsalla in the hills, still suffering in Secondary appearance of the invad- the en & °f October. At the same time cholera reappeared cholera of 1856 in the Punjab in in the Battery at Mooltan ; and on the very first day on which )ber and November. if, rlpspmirlpr] fmm Knssnwlip +,n flip nlnins. Hpr M.iipstv's it descended from Kussowlie to the plains, Her Majesty's 32nd Regiment marched into the epidemic, losing 44 out of 66 men attacked. On the same day, the 31st October, the 2nd Sikh Regiment, being under orders to march from Dhurmsalla to Hazara, was removed from Dhurmsalla from the fear that it might be attacked by the prevailing cholera; but the precaution proved unavailing, and for eighteen days the Regiment carried cholera with it on the march and lost 32 men out of 55 who were attacked. Beyond the Jheluin and on the east of the Indus, cholera also showed itself in October, and the 3rd Sikh Regiment on its march from Hazara to Dera Ismail Khan, met it in the Rawulpindee District. This was the end of the epidemic of the year in the western division of the epidemic area. I have described the invasion from the south-eastern extremity of this division as proceeding 1, . ? . , ? in the two directions, to the north and to the north-west ; the mparative and absolute exemption „ „ . . .. . ' , , TT ' irtions of the area lying within nrst striking the hills at Deyrah, the second having the staextreme range of the invading tion of Jhelum as its limit. In the fork between these lie ira of the Punjab. tne Julhmdur and Sirhind Districts. These enjoyed a corns immunity during the epidemic advance of July and August, although intersected by great highway of communication with the affected districts in the east, south, and west, the beginning of September, Umballa was threatened, but it was not until October that iffered, and the Jullundur Doab escaped altogether for the year. The Regiments in the : beyond Sirhind, at Kussowlie, Dugshaie, and Subathoo, escaped also. Sealcote and zeerabad were out of the range of the cholera of July and August 1856. Dr. Graham irts concerning Sealcote : — " To the best of my knowledge, not a single case occurred at For the epidemic cholera of the eastern division of the epidemic area, the Jail Table for 1856 gives an accurate history. In the east and south- tdications of epidemic distribution eagt t h e existence of the epidemic is indicated in March in ded by the jail Table of the year. Hazareebaughj j ub bulpore, and Nagpore, and in nearly every in the valley of the Ganges in March and April. The jails in the east, Monghyr, Bhaug>re, and Purneah, suffered extremely. In many of these jails cholera reappeared in July. Lultaneously with the appearance of cholera in the Agra District and in the western * The outbreak in the jail is exceptional to this st'tement. GEOGRAPHY OF THJS CHOLERA OF THE EPIDEMIC AREA IN 1856 AND 1857. [Section I. 20 division of the epidemic area, the jails of Shahjehanpore, Futtehghur, Banda, Humeerpore, Oraie, Jubbulpore, Seonee, and Chandah suffered. The tendency to revival of the cholera of the year as an epidemic in November is shown in the jails of the Behar Provinces. The |3t of the epidemic revival of November is better illustrated, however, in the table for c Native Army, which shows the enormous losses of the Native Regiments passing down c Ganges in boats in November and December. In the western division, besides the jail tbreaks at Umballa and Dhurmsalla above alluded to, the jail at Bareilly gives 11 admissions November after a clear interval of three months. tin the western division, in the epidemic advance of July, the jails of Etah, Mynpoorie, daon, Bareilly, Moradabad, Meerut, Delhi, and Muttra were attacked. In August, the jails Dumoh, Mozuffernuggur, Ajmere, Bijnore, Deyrah, Almorah, and Dhurmsalla suffered ; in )tember, those of Saugor, Ferozepore, Umritsur, Jhelum, and Googaira ; and in October, those Rohtuck, Kurnaul, and Umballa. In October the jail at Dhurmsalla was re-attacked. Iln the progress of the figures from the left hand to the right in these tables the vement of the epidemic from east to west and from south-east to north-west is beautifully acted. t Twenty-one days sufficed to cover universally the area indicated as that actually invaded 1856, from Ajmere in the west to Bareilly in the east, and from the Agra and Allyghur tricts in the south-east to the Lahore District in the north-west. Except in the ilities indicated, this cholera was almost extinct before the end of September. In these weeks, it is computed that at the very lowest estimate, 50,000 persons were carried off the North- Western Provinces. For the Punjab no estimate has been made of the loss sed by this invasion. Cholera of 1857. 1 have not drawn up a table for the cholera of the Native Army for 1857. From May this army was disorganised, and the returns are too incomplete to render the reduction of their contents into Cholera of 1857. ler satisfactory. To illustrate the cholera of the European Army, I have constructed •eath Table only, taking the details from the Nominal Roll of Deaths. In this respect s incomplete, that the loss of several of the Regiments which suffered most severely n cholera with Havelock's Force at Cawnpore and in Oude, is omitted; for the 64th 78th Regiments being on the strength of the Bombay Presidency, and the Madras liliers on the strength of the Madras Presidency, furnished no returns to Bengal. The results wn for the Cawnpore District mil therefore indicate to us simply the fact that in the ance on Cawnpore in July and August this force suffered extremely.* After May 1857, il Authority was in abeyance throughout Northern India between Benares and the Punjab, [ little progress had been made towards its reconstruction by the end of the year ; and it > not until after the Rohilcund campaign of the hot season of 1858, that the district sof the North-West were fully reoccupied. It will be understood, therefore, that for the i half of 1857 the jail population of these provinces is not represented unless in exceptional I The area of the geographical distribution of the cholera of 1857 was precisely that of s invading cholera of 1856 ; the cholera of 1857 was a cholera revived over the r aded area of 1856. Cholera still persisted in 1857, in the south and west, in Nagpore, the vallies of the Nerbudda and Taptee, and in the Saugor and Jubbulpore Districts ; in ! North- West Provinces, from Agra in the south, and Bareilly in the east, to the Lahore strict in the west; and in the eastern division it continued virulent from Cawnpore, Banda, i Nagode in the west, to the eastern limit of the epidemic area, and occupied the Gangetic ovinces from Chota Nagpore to the Himalayas. In the province of Oude it was indicated us by the loss in the Residency of Lucknow, where the 32nd Regiment alone lost 45 men ring the months of the seige. Whatever amount of locomotion the cholera of 1857 possessed, was displayed within the limits of the area invaded in 1856 ; and the history of reinvasion by newly invading cholera is wanting. During the months from November 1856 to March 1857, the invading cholera of the westn division disappeared ; it was dormant. The only exception to this statement is the fact, that some of the Terai districts immediately below the mountains, a few cases continued to appear December and January. On the 13th March, the Head Quarters of the 66th Goorkhas marchg towards Almorah, encamped at Kaladoongee at the base of the hills, and the detached Wing ntered the Terai 70 miles to the east on its way to Lohooghat ; both Wings were simultaneusly attacked by cholera, and 56 men died out of 114 seizures. At the same time the irmoor Battalion stationed at Deyrah at the foot of the Mussoorie Hills suffered. This as the reawaking into epidemic life of the cholera of 1856. But the plains of Upper India id not afford to it the conditions necessary for epidemic manifestation in these months ; and it as not until the end of April that it showed itself, and until May, that the presence of the newed cholera was general. In April, the pilgrims returning from Hurdwar suffered, and .wo European soldiers died at Roorkee, and two at Subathoo. In May, the 9th Lancers i the cantonments of Umballa were attacked ; the Bengal Fusiliers and Her Majesty's 75th escending from Dugshaie and Kussowlie on their way to Delhi, marched into the cholera on * The detail* hay« b**u furnished since this was written, and are added iv a foot note to the table for 1557. Chap. I.] GEOGRAPHY OF THE CHOLERA OF THE EPIDEMIC AREA IN 1857 AND 1858. 21 the day on which they left their hill station, as had occurred to H. M.'s 32nd Regiment on the .'3lst October 1856 ; and many Regiments coming from the Punjab, Native and European, got cholera before they reached Umballa. Subathoo and Dugshaie were attacked before the end of May, and the Nusseeree Battalion of Goorkhas marching from Simla to Seharunpore carried cholera from the 24th May to 3rd June, the day in which it reached its destination. In March, cholera appeared in the jail at Umritsur, giving intimation of its reappearance as far to the west as was the limit of the primary invasion. The Jail Table for the Punjab indicates an interval between the cholera of May and August 1857 by the absence of any admission; in August and September, the general presence of cholera is shown by its appearance in the jails of Thanesur, Umballa, Jullundur, Hoshyearpore, Dhurmsalla, and Umritsur. There was no admission in October. KThis was the cholera from which the army of Delhi suffered so much. From the comlcement of the seige until the 4th October it persisted, with but one interval, from the h July to the 27th August; and even during this interval, several fatal cases occurred. Agra and Meerut suffered much less ; seven men of the Meerut garrison died, and five died at Agra. I Cholera was universally renewed also over the Central Provinces. The battery at Saugor 3 three men, and 20 cases appeared in the jail at Saugor between May and August. 3 jails of Nursingpore, Jubbulpore, Seonee, and Nagpore in the Central Provinces suffered ween April and September. The column which formed the nucleus of the Central India Force 1858, met the same cholera in July while marching through Khandeish on the way to Mhow. II find no record of cholera beyond the Jhelum or in the districts beyond the Indus. No press towards the north-west of the Punjab was made in 1857 ; nor have I any information epidemic advance before May 1858, when the Rawulpindee and Huzara Districts were sred by an invading cholera. II have already shown that the eastern division of the epidemic area was still covered by era in 1857 ; and what I have said above of the western division, is sufficient to demonstrate fact of the presence of cholera from Nagpore and the valley of the Nerbudda in the south, he Himalayas in the north. By the first week of October, this cholera, speaking in general is, was dead or dormant. Cholera of 1858. In the statistics of 1858 the geography of the cholera of Upper India is exhibited in a new phase. Cholera has nearly disappeared from the eastern division Cholera of 1858. of the epidemic area and from Central India, while it is still Bvn in epidemic force in the western division. Meerut and Rohilcund are not free from era ; and from Delhi and Umballa westward to the frontier, many severe outbreaks mark the tence of the epidemic cholera derived from the invasion of July and August 1856. LOver the eastern division, cholera had declined to a minimum. In the Native Army leraoflßsß. Phenomenon of taken as a type, the phenomenon of disappearance is total; Becay of the iiivadiug cholera of that is to say, out of a force of upwards of 30,000 employed ¦56 in the eastern division of throughout these districts in 1858, and exposed in the field to the epidemic area. every vicissitude of season, not a single death from cholera was reported. Out of a jail population of 8,000 distributed between Patna and Futtehghur, three deaths only were attributed to cholera, one in the jail at Ghazeepore, a second in the jail at Mirzapore, and a third in the jail at Allahabad. The Death Table for the European Army occupying the eastern division, the war province of 1858, shows the number of deaths given below :—: — Cuolera Deaths of the European Army of the War Provinces of 1858. Place of Death. Strength. >• §" -g c -2 M IlJfii^rllJJi Dinapore ... ... „ 877 Shahabad ... ... „ 1,692 2 3 "5 Ghazeepore ... „ 435 3 3 Benares ... ... „ 557 2 3 ... 2 ? 7 Goruckpore and Oude ... „ 17,024 2 11] ... 1 6 Allahabad and Cawnpore „ 4,788 3 ... 4 1 ... 1 ... 1 ... 1 ... ,„ 11 Total for the War Provinces of 1858 25,373 3 ... 4 5 8 1 2 5 1 2 ... 1 32 The cholera deaths of British soldiers returned at Benares and Allahabad in 1858, must not be regarded as showing that cholera was present in these stations at the time. These stations are situated at the termination of the lower section of the Trunk Road leading out of Bengal Proper, and while marching on this lower section, troops are in every year liable to the attack of cholera, and they carry the cholera with them to the terminal stations. Another source of fallacy is, that, in former times, the Monthly Return prepared by Superintending Surgeons did not always clearly exhibit the fact, even in the Death Roll, of cholera having GEOGRAPHY OF THE CHOLERA OF THE EPIDEMIC AREA IN 1858 AND 1859. [Section L 22 occurred on the march and not subsequent to it ; and detachments which had marched during the month were frequently returned with the station occupied at the end of the month opposite to their statement of sickness and mortality. It is certain that some of the fatal cases of the terminal depots at Benares and Allahabad were due to cholera acquired on the Grand Trunk Road above Raneegunge, from which cholera is seldom absent. It will be observed that this loss was confined almost entirely to the stations on the Ganges. In the Army of Oude, traversing" every part of the province and even its Terai districts, six deaths only occurred. The contrast with 1857 is very striking, when, within the same area, the Field Forces were decimated by cholera. The Army of Central India of 1858 was not on the strength of the Bengal Presidency ; it is, however, a well-known fact that this force had no loss from cholera. Over the western division of the epidemic area, the experience of all the three types shows Cholera of the western division well cholera still existed throughout the northern provinces the epidemic area in 1858. of Upper India. The Meerut, Delhi, and Umballa Districts still retained cholera in 1858. In May 1858, as in May 1857, lolera appeared at Umballa and Dugshaie, and simultaneously as an invading epidemic in the ¦awulpinclee and Hazara Districts. In this year, troops marching beyond the Jhelum got lolera in May. In July and August, this cholera was, as in the same months of 1856 and 1857, n full vigour in the Punjab. In July, Abbottabad and Murree were attacked by the invading lolera of May ; in August, a severe outbreak occurred in the Delhi Jail, and another among le troops at Jullundur ; and, in September, a Field Force proceeding from Lahore towards era Ismael Khan became affected in the second march after leaving Lahore, and the jail at oshyearpore was attacked in the same month. Up to the end of October, nothing more was leard of cholera in the Punjab, until suddenly it appeared, for the first time for many years, the Peshawur Valley, and the valley of Kohat was invaded within a few days. It was on the th August 1856 that Meean Meer was struck; it was on the 26th October 1858 that this same lolera entered the vallies of Peshawur and Kohat. The same cholera which within 21 days vered the entire epidemic area of 1856 and extended far beyond Hindostan to the west, cupied two years and nearly three months in finding its way over little more than 100 miles country intervening between the Jhelum and the Frontier. This cholera of Peshawur of the end of October and November 1858, was a deadly cholera. No European Soldier Avho was attacked survived; the Native Troops lost 12 men out of 15 attacked ; and the prisoners, 4 out of 6. At Kohat, the Native Regiments lost 18 out of 39 men attacked. I Nowhere within the western division of the epidemic area did this cholera of 1856-58 . . „ , ? revive in 1859. The cholera so deadly up to November .rmination of the epidemic of 1866-68. wfl? revita lised ;n; n 1859j an d from Nagpore to bul, India was free from the epidemic invading in 1856. Choleka op 1859. § While cholera Avas at a minimum in the eastern division of the epidemic area in 1858, ? ? , ... , . and while 32 deaths in all occurred among the armies in (.'occupation ot the eastern division by ? n ¦,-• .-, vu> j. • J.i j invading cholera of 1859. the field, the case was very dinerent in the endemic province, Few parties of soldiers passing through Calcutta on their way to the Upper Provinces, or preparatory to embarkation for England, escaped ; and before the end of the year, 373 deaths had occurred in Bengal Proper. This cholera of 1858 was epidemic within the endemic area. In 1859 also, it was evident that here, in the endemic province, cholera was in motion as an epidemic, when on the same night in August, the Barrackpore and Dum-Dum cantonments were struck, and 100 men were carried off within ten days. I described the cholera of the early months of 1855 as a cholera in motion from Hazareebaugh in the east to Bundelcund and Jhansi in the west, and I defined its epidemic area to be, geographically, exactly what I have termed the eastern division of the epidemic area; over the western division of the epidemic area I showed that cholera had no existence in 1855. KThe cholera of 1855 was not palpably a cholera invading an unoccupied tract of ntry; but in 1858, the same tract was free from cholera altogether in certain portions, and hin the others cholera was at the minimum of decline. The epidemic area of the cholera of 1859 was the epidemic area of the cholera of 1855 ; the exempted area of 1859 was the exempted area of 1855. Cholera epidemic from the east, covered the eastern division from Hazareebaugh to Bundelcund, leaving intact the districts to the west, and no cholera was, in 1859, reproduced within the western cholera area of 1858; that is to say, the western area from the extreme south-east to the extreme north-west had no cholera in 1859. The geography, therefore, is definite, and the map of 1855 may stand for the distribution of the cholera of 1859. I In the tables, the distribution of 1859 is shown with great precision. Among the "opean Troops the enormous losses in all stations from Banda and Cawnpore eastwards, trast with the absolute exemption of every station to the west. In the Native Army the ribution is perfectly parallel ; exemption over the western area was complete with the excepl of a single case in December, a forerunner probably of the epidemic of 1860, similar to the i to which I drew attention in the table for 1855. Among the entire jail population of lilcund, Meerut, Agra, Central India, and the Punjab, a single fatal case is recorded ; this GEOGRAPHY OP THE CHOLERA OF THE EPIDEMIC AREA IN 1859 AND 1860. 23 Chap. I.] was returned by a Native Doctor in charge of the small jail at Kurnaul, and I do not regard this instance as exceptional to the generalisation which I have made. The western limit of the invading cholera of 1859 is indicated in the reports from the districts lying south of the Jumna. I have spoken of the eastern cholera of 1855, brimming* over the edge of the endemic basin on to the plateau of Hazareebaugh, as sending a warning to the highlands of Bundelcund of the approach of the epidemic ; the warning and the sequel were both demonstrated in 1859 as in 1855. I The European Regiments of the Banda District suffered in 1859 as is shown in the table the year. This indication is the most westerly which we have for the year of the sence of cholera, and here it was distinctly an invading epidemic. It is important observe the date of the outbreak with reference to the date of the appearance of previous subsequent epidemics. The Civil Surgeon of Banda writes : "It was on the 7th May 9 that I was informed by the Magistrate that cholera was prevailing in his district. * * the 16th May cholera appeared in the town of Banda." This cholera was immediately :ed on to the great eastern cholera of Cawnpore, Allahabad, and Nagode, and the Gangetic vinces to the east. The line of 80° east longitude will define with sufficient accuracy the tern limit of the cholera of 1859 in the Northern Provinces. lAs far as our records inform us, cholera did not invade Nagpore or any station of the tral Provinces in 1859. Certainly as an epidemic, cholera did not visibly cover these dnces before March 1860 in succession to the invasion of March 1856. Cholera of 1860. Ilf the cholera of the Eastern Division of the epidemic area has followed the parallel of invading cholera of 1856, it will be found invading to the westward, in the extreme south March ; and in May, it will be found universal between the Vindhya Mountains and the ma and still invading to the westward. The epidemic cholera of this year has a special and most instructive geography. I In the south the invasion did occur. The Nagpore territories and the valley of the Nerbudda re covered universally by cholera invading from the east in March 1860 ; but the cholera May of Agra and Central India was but a warning of the coming invasion. The actual ance of the epidemic occurred in the end of June, and early in July it became evident that sholera wave had swept across Central India from east to west. In August, cholera was versal in the western division of the epidemic area from Jhansi in the east to Goonah and sfur in the west. This cholera is shown in the table for European Troops by great loss in ry station of the area which was occupied, the chief being Agra, Muttra, Jhansi, and rar ; and in the Jail Table by the dreadful outbreak in the Agra Jail, in which upwards 800 prisoners were attacked. The table for the Native Army shows the same limitation ;his cholera with great accuracy. tin the eastern division of the epidemic area the cholera of 1859 was renewed in great ur throughout Bundelcund, the Cawnpore and Allahabad Districts, in every station of Oude, universally in the Gangetic Provinces ; a single glance at the tables for the European Army jails will show this. It was from this universal cholera that Nagpore was covered in eh. Its limit in the west was the Shahjehanpore District. Thus, I have shown an enormous and vital body of cholera occupying the east of the epidemic area, and a second body of invading cholera, equally powerful and universal, pressing from the south upon the north-western portion of the western division ; Bareilly, Meerut, Allyghur, and Delhi threatened on the east and threatened from the south, by one of the greatest cholera epidemics on record. And this was the result. No cholera invaded these districts, and they proved a barrier which neither the cholera of the east nor the cholera of the south, could break through ; and to the North-West Frontier, the Punjab was as free from cholera in 1860 as in 1859. I A single death among European Troops is noted at Bareilly. Proceeding from east to this is the last recorded death of the eastern area ; and even this carries us too far to the , for the man actually contracted the cholera from which he died, while escorting a party of ers' wives from Cawnpore, who were also attacked on the road. The case is thus alluded i the report of the 42nd Highlanders for 1859 : "On the 15th March, the women nenced to arrive from Calcutta. They had suffered from cholera on the way, and one an died a few days after arrival more from fatigue simulating cholera than anything else ; a Sergeant who came up with the women was attacked with cholera on the 17th and the same day. There was not another case in the station afterwards." It is a coincidence hy of being noted, that in 1859 the last European Soldier died of the cholera invading the east, at the same station. Muttra was the last station reached in the invasion from the south in 1860, if we except the case of a prisoner who died in the Goorgaon Jail in Becise limit of the western invasion August, while cholera was epidemic in the Muttra District ; lvnP^L 18GOin the N ° rth ' this case was undoubtedly an indication of a threatened cholera. I am inclined to consider the only three fatal cases of cholera returned in the Punjab among European Troops, as true indices of the aborted invasion. The following is the history attached to these cases. From this history, some would say that they were not cases of genuine cholera ; others, that they were the outrunners of the cholera of 1861 : — 24 GEOGRAPHY OF THE CHOLERA OF THE EPIDEMIC AREA IN 1860 AND 1861. [S6CtiOH !• " One fatal case of doubtful cholera occurred in a man t Cases returned from stations beyond wno j^ keen suffering- from an indolent ulcer of the leg ; he KeJoSwthHighlande^ MeeanMeer. sank yei 7 ra P idl y> and must have been the subject of an attack of cholera or of a very virulent attack of malarious fever." " One death occurred from cholera. The first symptoms were purging-, vomiting-, and Report, sth European Cavalry, Meean cramps followed by prostration. He died suddenly on the Meer. seventh day, when he seemed to be improving-." I am authorised by the officer who had charge of the case to state that the diagnosis was doubtful. b TT „ The third case was possibly not a case of cholera. The S're JeBty>S24thßegiment ' man > a Sergeant of very habits, died in collapse after a fever of seven days' standing. To illustrate the geography of the cholera of 1860, not a special map, but the famine The exempted area of 1860 in ma P of 1861 might have been employed. The exempted Meerut and Rohilcund, the famine cholera area of 1860 was the famine tract of 1861, almost to tract of 1860-61, q tnilp ¦ fhp nroa mfir wliioVi rVhnWn ™ Q c a™^™^ ,'„ 1 B«ft a mile; the area over which cholera was epidemic in 1860, escaped famine in 1861. The significance of this fact will be discussed in a future chapter. tin the last three months of 1860 cholera was dead as an epidemic. Indications of vitality c, however, shown in some cases ; thus, in December, the camp of the Lieutenant Governor, W. Provinces, marched into a vitalised cholera between Bhurtpore and Agra, a locality oh had been affected in the invasion of August. I Scinde had been un visited by cholera for years, but, in September 1860, both Upper and >wer Scinde were invaded. This cholera was the same which entered the Nerbudda Valley in arch, and which covered Central India in August. During the cold season of 1860-61, is invading cholera of September died out in Scinde also.* Cholera of 1861. Reference to the tables for 1861 shows, that it was not until the end of June that the cholera dormant from September 1860 began to move upon the area uninvaded in the primary advance; no fatal case of cholera occurred in the first five months of 1861 even in any part of the invaded area of 1860, in any of our types. I make the reservation that this cholera did not show itself as an epidemic in motion. The facies of a cholera in motion is totally different from that of a cholera merely revitalised ; and this facies was wanting in the cholera of 1861 before the end of June and the first week of July. To one accustomed to recognise it, the distinction has this significance; — that the cholera of 1860 might, in May and June 1861, have been very general over the area of the previous year among the general population (as, in fact, it was), and yet neither our cantonments nor jails would be affected; the exempted area of 1860 would not be encroached on by one mile; and the most extensive gatherings of human beings, although composed of men drawn from the districts of the infected area, would remain free from cholera provided the gathering took place within the exempted area of the year preceding. I say this with reference to the cholera of the western division of the epidemic area only ; for in the eastern division, the cholera of the first half of the year has, speaking generally, an aspect different from that of the western division of the same months. From the experience of recent years, lam in the habit of dating the reappearance of the reproduced cholera of the western division from the 20th April, making at the same time, allowance for its reappearance in Terai districts, weeks or even months earlier, as we found the cholera of 1856 revitalised on the 13th March 1857 all along the base of the hills; and admitting the possibility, under peculiar and abnormal conditions, of the appearance of cholera in the open districts as early as the 15th March, a circumstance of which we have had no experience in our times, but which actually did occur in 1838, when the Muttra District suffered severely. The most northerly indication which we had of the advance of the cholei'a of 1860 was into the Goorgaon District.! In the end of May 1861 cholera lates of revitalisation and invasion re-appeared in the south of the Goorgaon District fp 61) • \B!ht2Lyr£Zt\ 8 !ht2Lyr£Zt: e{eV t0 tUe cholera became P^valent in the western parts of the Muttra District in the end of May (p. 105) ; cholera was general jughout the principality of Bhurtpore in the months of April and May| (p. 144) • cholera le its appearance in the Ulwar Territory early in May last (p. 144) ; in the north-west ;he Allyghur District cholera appeared at Atrolee on 23rd May (p. 74) ; cholera appears lave been prevalent in the Agra District early in June (p. 108). The above are the statements 3n from Strachey's Report, which show the reawaking into life, although not into a vitality bined with the power of locomotion, of the cholera of 1860. It will be observed, that in se statements there is not a single indication of the presence of cholera east of the Jumna i the exception of the cholera of Atrolee ; it was in another phase of existence that the ided area of 1861 was covered. In Northern Scinde, the cholera of September 1860 was talised in April 1861, at a date as early as the same cholera in the States west of the ma. * Grierson's Report on the Scinde cholera of 1861, quoted by Straehey, (p. 143). ¦ t It was in the Jail at Goorgaon that the last and most northerly indication of epidemic advance in 1860 shown. X In the Bhurtpore District cholera first broke out in the village of Kvthvvara in the end of April d> 147} • ;„ the table (p. 150), the 26th April is the day noted. ' ' • Chap. L] GEOGRAPHY OF THE CHOLERA OP THE EPIDEMIC AREA IN 1861. 25 It was early in July 1861, that the cholera of 1860 began to move to the north, north-west, and west, over the exempted area of 1860. " Cholera was widely spread through the states of Rajpootana in July/ * * "It reached Gwalior in the middle of that month." * * "At Nusseerabad the disease appeared towards the end of July." * * " The first undoubted case of cholera occurred at Meean Meer on the 31st July." * * "On the 17th July cholera broke out in the poor-house established in the Cantonments of Umballa for the relief of sufferers from the famine which prevailed." "On the 31st July it appeared in the city of Umballa." * * " On the 17th July the town of Thanesur was attacked." * * "From the sth July onwards the epidemic continued to prevail in the city and suburbs of Delhi ; up to the 10th fiftean deaths occurred." * * " Cholera appeared in the city of Meerut on the Bth July." * * "At Grhazeeabad cholera first appeared on the Bth July." * * " Cholera is said to have appeared at Shamlee, the largest town of the Mozuffernuggur District, about the 22nd July." * * « The first case of cholera at Seharunpore is said to have occurred on the 10th July." * * "At Roorkee cholera first appeared in the poor-house on the 23rd July." * * " A fatal case of cholera occurred among the work-people employed in the Mohun Pass, in making a carriage road to connect Seharunpore with the Dehra Doon, on the Ist April j* there were no more cases until the 26th July, when the disease broke out epidemically." * * " Cholera attacked the town of Bijnour on the 25th July." * * " Cholera is said to have first appeared in the Sumbhul Subdivision of the Moradabad District early in July." * * " Cholera is said to have first appeared at Bareilly on the sth July." "Early in July, when the rain had well set in, cholera reappeared in Bhurtpore" (p. 144). * * "In the city of Jeypore cholera appeared about the 2nd of July." * * " Cholera broke out at Ajmere on the 6th July." * * "In Nusseerabad the first cases occurred on the 27th July." * * "In the Deolee District cholera arrived early in July." * * "In Kotah it commenced in July." •* * "In Shalra Putun it prevailed as extensively as at Kotah and during the same months." * * E These extracts from Strachey's Report give very clear indication of the area occupied in ; and the area occupied on or before the 31st July, was the limit, in this Presidency, of the Ling cholera of 186 1.f The areas which suffered least were those lying to the south and east of the western Istinctive character of the cholera division of the epidemic area. The Cholera Commission note eastern and western divisions of tice incidentally this separation of the cholera of the eastern ipidemic area in 1861. division from that of the western division of the epidemic ? "It will be observed," they write, " that we have traced no connection between cholera in ihabad and Cawnpore with that which occurred in the districts further to the north," 192) . "In the district of Bareilly the epidemic seems to have been widely diffused, but to have been nowhere virulent." * * "In Budaon the disease appears to have been common, but to have been nowhere very fatal." * * "It is stated that the disease did not assume an epidemic form in any part of the Shahjehanpore District." * * " There is no information regarding the total mortality of the Etah District, but the disease was apparently not very fetal." * * " Although the disease was heard of in many parts of the district, it was nowhere at all virulent; cholera can indeed hardly be considered to have prevailed epidemically in the Myhpoorie District." * * " The number of deaths is not known ; but although the disease appears to have been very common in many parts of the Etawah District, it was apparently not very fatal." The following is the report from the adjacent districts lying to the south of the Jumna as given by Deputy Inspector Rind of the Saugor Circle :—": — " The districts of Banda and Nagode were slightly visited. The towns visited were widely apart, and it did not seem to visit any intermediate place. It may be considered to have stopped at Kirwee, as the few cases which occurred at Banda may, I think, be viewed as of a sporadic nature." The line of country to which these extracts have reference, was a belt of minimum separating the cholera of the east from that prevailing in force from Meerut to Cabul ; for although the north of the Punjab entirely escaped invasion in 1861, cholera had passed, on a more southerly parallel, through Bikaneer and Bhawulpore into Cabul, giving us the only evidence of its passage by attacking the outposts beyond the Indus. The exempted area of 1856 was the exempted area of 1861. " Cholera did not spread epidemically through any of the districts of the Punjab north of Lahore" (Strachey's Report, p. 4). The fork between the cholera invading to the north and the cholera invading to the north- Areas of comparative and absolute west > was also exempted, as in 1856. "The country lying exemption in the Punjab, the same as between the Beas and the Sutlej 1 ' called the Jullundur Doab, those of 1856. finioved mvnerallv the same immnnitv (n A4,\ " * * "ThaAla enjoyed generally the same immunity (p. 44) ." ** " The dis- trict of Loodianah, which lies immediately to the south of the Sutlej and due east from Perozepore, appears also to have entirely escaped the attack of cholera. It prevailed, however, epidemically at Umballa, the district adjoining Loodianah on the south ; and this may be considered to be the northern limit of the tract in which the late epidemic assumed a virulent form." This sentence has reference to the limb invading from south to north. The Ferozepore District was left out in Probably a true forerunner of the invading cholera of July. t Compare the Tables showing the invasions of 1856 and 1861, and the history of the limitation of the cholera of 1856, as given at p. 20. 26 GEOGRAPHY OF THE CHOLERA OF THE EPIDEMIC AREA IN 1861 AND 1862. [Section I. the first invasion, and was not entered until September, when a secondary wave passed over the covered area, exactly as we traced it sweeping over the Umballa Cantonments on the 4th September in 1856. This struck Umritsur on the 2nd, and Ferozepore on the 3rd September ; and the outbreak among" the prisoners employed at Lahore in arranging- the cholera camps for the European Troops, occurred on the 4th, a coincidence to be noted in estimating- the value of the deduction that the gang acquired this cholera while engaged on these duties on 27th and 30th August (p. 35 ).* Sealkote and Kangra also escaped as in 1856. The fact plainly taught is, that the invaded area of 1861 was the same as that of 1856, and that the districts exempted, or comparatively exempted, were the same in both epidemics ; and that the original invading wave reached the limits of the area of the year within three weeks after it began to move, when the power of locomotion had been superadded to its The cholera of the eastern division of the epidemic area holds a secondary place in the cholera history of 1861. It was a cholera of the third year Bliolera of the eastern division of the having made its invasion in 1859. It was still vital throughomic area in 1861. , j, _,• f • , • ,-. - f FnttftWhnr to TteW. nrmfiar- out all districts in the east from Futtehghur to Behar, appear- ing at its usual seasons, but with none of the characteristics of a fresh or invading cholera. The south-western limit of the invaded area of the year was absolutely denned, at a limit which, as I shall have occasion to show, is in every year and trea of geographical limitation in j n every epidemic, true and natural. I quote from Strachey extreme south-west. , ?-< .1.. T , ,/, , -, . , ? t\ /r „„„,„_ rp :±_ A (p. 147) :—"lt: — "It did not spread into the Meywar Territory, at least into that portion of it between Nusseerabad and Neemuch. Neemuch was quite exempted from cholera during the year" — (p. « 48) — " Cholera does not seem to have prevailed to any extent along the high road between Ajmere and Palee. The small cantonment of Erinpoorah on the direct traffic track, had not a single case, nor could Dr. Eddowes hear of any village having suffered on the Marwar border." Cholera of 1862. We are to look for the same geography in the cholera of 1862 as in the cholera of 1858, since the statistics of both years represent an epidemic cholera tarallels in the geography of the j n fa f our th year in the eastern division of the epidemic era of 1862 with that of 1857-58. • • ft ,i • j ,1 ti? ±1. 11 1 area, and in its third year m the western. If the parallel ds good, the eastern division will be found the exempted area of the year, while from serut and Rohilcund westwards to the frontier, the cholera of 1860 and 1861 will still be nd in epidemic vigour, although destined to die in October or November and to leave the stern division free from cholera. I Let it be remembered, that the cholera of 1860, the year of invasion, did not enter Rohilad, Meerut, or the Punjab; consequently, although 1862 was the third year of the cholera, 11 it was only the second in the invasion of these provinces. Let this be kept in mind, and the phenomena of the year 1862 be read as parallel with the phenomena of the two years 57 and 1858, and the parallel will be found perfect for the area invaded in 1861. The history of 1857 showed cholera revived along the base of the hills early in the year; cholera among the returning Hurdwar pilgrims, in the •cantonments of Umballa, Subathoo, Dugshaie, and in the districts west of Delhi, in May ; and general in the rainy season from Meerut and Agra to Umritsur. tThe history of 1858 showed cholera still present in Meerut and Delhi; cholera at Umballa [ Dugshaie in May, and invading the Rawulpindee District and Hazara in the same month ; rerful outbreaks at Hoshyearpore, Jullundur, Abbottabad, and Murree during the monsoon son; and the invasion of the Peshawur and Kohat Vallies in October, folio wed. by extinction the invading cholera of 1856. I The cholera of 1862 played in one year the part played by the corresponding cholera of 37-58 in those two years. The repulsion of the cholera of 1860 from the famine tract, brought )ut a true loss of a year to the invading cholera, as far as the Punjab, Meerut, and Rohilcund re concerned, and the invading epidemic of 1860-62 actually died out within a week the time occupied by the parallel epidemic of 1856-58. The epidemic of 1856 having entered ! western portion of the epidemic area, began to move in the first week of July 1856, and was id in the first week of November 1858; the epidemic of 1860 having entered the western tion of the epidemic area, began to move in the first week of July 1861, and was dead in the t week of November 1862. Thus both survived for exactly the same time within the area invasion, that is, for two years and four months. tThe facts of 1862 were as follows : — The appearance of cholera among the returning Hurdwar ¦rims, and in all the districts west of the Jumna from Delhi northwards to Umballa, in May ; he Dhurmsalla District cholera occurred even in April, and at the same time it was raging Cashmere; and, just as the cholera of 1860 reappeared in April 1861 in Scinde simultaney with its appearance in the Bhurtpore State, so in 1862, before the end of April, cholera appeared in the Bunnoo District, leaving untouched the country intervening between the lum and the Indus exempted from invasion in 1857, although covered in May 1858. In the * The difficulty in connexion with the conclusion is already admitted, that out of the same gang, 20 men remained Jay and night in attendance on the sick, and not one of those who had been thus employed, suffered, when the rest of thf gang was attacked. Chap. IJ GEOGRAPHY OF THE CHOLERA OF THE EPIDEMIC AREA IN 18(52 AND 1863. 27 monsoon season, cholera was universal from Gwalior, Jhansi, Agra, and Meerut to Peshawur, the Doab between the Jhelum and the Indus being- an exempted area as in the earlier months ; at this time the Sealkote District, untouched in 1861, suffered with the Lahore and Umritsur Districts. The cholera which had appeared on the frontier in April, entered the valley of Peshawur in June, and persistently maintained its ground for the four months following, appearing in a succession of outbreaks with clear intervals between ; on the 3rd of November this cholera of Peshawur died, and the epidemic of 1860-62 was at an end. Turning to the eastern division of the epidemic area to enquire for the parallel of 1858, there is no difficulty in recognising the fact of the decline fuSTta fheSemSion of of cholera to a mmi ™ « this province. Out of an army OI XoOOi Hi 111" UdotClU UIVIDIUU UI tile S*-|nr'/-w\*rt a j*lCll"l* ¦ n s-+ ? -—. * pnidemic area. ot 13,500 British Soldiers occupying the Gangetic Provinces, c y /~v__j_ /-i . -n j_i 3 i t i i i -i -. ? Oude, Cawnpore, Bundelcund, and Jubbulpore, only one death Ii cholera occurred in 1862, The man who died was a recruit, seized while on board a r steamer proceeding from Mirzapore to Allahabad ; he died in the General Hospital at the ir station. It is also worthy of notice, that on the day after leaving Mirzapore, on the 10th f 1862, a severe outbreak commenced in the 25th Native Infantry on board the river mer, in which fifteen men died. There was evidently in this locality, a body of cholera lised, while generally over the eastern area cholera was extinct or devitalised. Among Native Troops of the eastern division a single fatal case only is found, and this man also at Allahabad. For the jail population of Benares, Oude, Cawnpore, and the Central irinces a total of seven deaths is shown, occurring in six different jails. The minimum of ifestation of 1858 was remarkable and striking, but the parallel fact of 1862 is a phenoon probably rarely witnessed to the extent shown in this year. I In comparing the two epidemics of 1856 and 1860 in their third year, in the western sion, there is one difference only which strikes the observer, namely, the extreme severity of cholera of 1862 in Jhansi, Agra, and Gwalior, as compared with that of 1858 in the same ricts. I think that the lesson which this teaches is the same taught by the cholera of lawur of this year, that a cholera having once invaded an area, may be in as perfect vitality lie end as at the beginning of its career ; and I shall have occasion to show, that it is not at teeessary that the year of invasion should be the year of the maximum of manifestation. Cholera op 1863. B If the parallel of 1863 with the years 1855 and 1859, holds, we shall find 1863 a year of era invading from the east in the early months, covering anew the exempted eastern »ion of the epidemic area of 1862, and leaving untouched the western division. The minimum of the western area in 1863 is thus shown : Excluding the Agra District, two deaths only are recorded in Rohilcund, Meerut, Central Minimum of the western division j^a^ n«rl +V.« Pnm'nK o™™™ I?.™.*™™ T«nn O ™ Q o* TT^Kollo India, and the Punjab among European Troops, one at Umballa, the other at Itawulpindee ; of these two, the latter is a doubt- of the epidemic area in 1863. ful case which occurred in the person of a phthisical patient who had been in hospital for many months. The Native Army shows one death in the Hazara District, and two in the Frontier Force. The jail population shows no fatal case of cholera. ¦ I have excluded the Agra District. There can be no doubt whatever, that this district touched by an epidemic cholera in 1863. On the 20th May, in the very week on which cholera became epidemic in 1856, and in several former epidemics, cholera appeared in the jail ; again in July and August both jail and cantonments suffered, and, simultaneously, two mild cases appeared in the Muttra Cantonment, and the fatal case at Umballa among the European Troops, already mentioned. One case occurred also in the jail at Etawah and another at Allyghur. This Agra cholera of 1863 had a peculiar phase. Dr. Murray who has described it, says : — " The disease appeared to be confined to Agra and the vicinity, and did not spread over the country like a wave, as on previous occasions." To my idea this was typically an epidemic and invading, and not a reproduced cholera. It was a true out-runner, indicative of the existence of the body of an epidemic in progress from the east. Although we cannot trace the geographical continuity, a glance at the tables, especially the Jail Table, shows its coincidence with the great cholera of the year, epidemic and invading both in the east and in the south, universally reoccupying for the third time in these fifteen years, the eastern division of the epidemic area. We cannot connect on this cholera of Agra with that of the east through the Doab, for the Futtehpore District and Western Oude was the limit of the eastern cholera. Nor can we trace it continuously as in 1855-56 and 1859-60, through the districts south of the Jumna. The report is the same from all : — " No epidemic has occurred at or near the Station." Nowgong. "No epidemic." Humeerpore. " There was no epidemic during the year." Oraie. " Not a single case of cholera has occurred during the year." — Jhansi. But this exempted tract was the limit set to a great cholera invading from the east and occupying the entire eastern area from the Bhurmpooter west- Invading eastern epidemic of 1863, wards . fOl.f 01 . i n t h e first six months of the year, cholera preits area and western limit, ? , ' ? . ? ? -» T j tv ±• ± l • vailed as an epidemic all over the Nagode District, lying immediately to the east of those above noted as exempted. From the plateau of Hazareebaugh to the extreme western limit of Oude, this cholera was universal throughout 1863, over the exempted area of 1862. The report for Behar states that not a single village of any considerable size escaped, From Benares, Jounpore, and Goruckpore the report is the same ; throughout Oude to the extreme northern and western limits, cholera prevailed ; for it is clear from the tables that although the districts south of the Jumna escaped, Allahabad, Cawnpore, and Futtehghur in the Doab, suffered. In June and July, we find the districts in the east and north-east of the Central Provinces immediately joined on to our eastern cholera province, affected, cholera appearing in the jails of Jubbulpore, Mundla, Seonee, Bandara, and Raepore. Thus, over the area which in 1862, showed cholera extinct, or at an absolute minimum, an universal sheet of cholera was spread, from Nagpore to the Himalayas, in 1863 ; while over the epidemic tract of 1862, the western division of the epidemic area, from Shahjehanpore and Bareilly to the North- West Frontier, cholera was dead. Cholera of 1864. The cholera of this year is very interesting in its geography. The cholera which touched Agra in 1863 was not revived in 1864; the western division Elera of 1864. Minimum of the o f c epidemic area was not encroached on by the invading n division, and the absence or i i /» io n o -j.i c j.-l j. j_i t j.t_ -v )n cholera of 1863 either from the east or south; and through- out the area no cholera existed, or else the indications len of its existence were the most trifling. Each of our three types furnishes but one fatal case, .eh may or may not have been a case of true cholera. On the 19th April, a prisoner 1 in the Umballa Jail. Of this man Mr. Bateson writes : — " There were no cramps, re was universal warmth of surface, nor were the eyes sunken, although, in other jects, the symptoms of cholera were complete."" A Sergeant of the 90th Regiment at Meean er, was struck down in May with choleraic symptoms on returning from an entertainment, and 1. The third case, which occurred in a Native Detachment, has no history attached to it. It is 10 moment to decide as to these cases being genuine or not ; lam inclined to believe that both he cases noticed were due to the cholera miasm. Mr. Dallas, the Superintendent of Jails the Punjab, has attempted to trace for me the presence of cholera along the base of the hills, districts where it would have been most likely to survive ; but two police stations of the ugra District alone note cholera as existing for a time in 1864. Over the eastern division of the epidemic area, the invading cholera of 1863 was univer- L sally revitalised in 1864, as is well shown in the tables for neralrevitalisation Over the eastern -p, llrnr< p nn Trr>rmc nnrl fnv Pvi"cnn*»rs Tf i'a n rnnaf. vPTnnrl™V.lp European Troops and for Prisoners. It is a most remarkable division of the epidemic area. coincidence, that the most westerly death of an European Soldier, should in this year, as in 1859 and 1860, have occurred at Bareilly. But the chief interest of the epidemic cholera of 1864, lies in the fact, that while this eastern cholera was forbidden to intrude into the western I^ST^orten!? 16 invaded area division of the epidemic area, it spread itself from east to west veiy 1 throughout Nagpore, throughout the valley of the Nerbudda, above the Vindhya, through Saugor, Bhopal, and Guzerat to the Western Coast, between rch and May. The Bhopal Territory was reached on the 3rd May, and for months before, the ;ricts lying to the south of the Vindhya had been ravaged. This cholera left all to the north the districts mentioned, untouched. Central India Proper was as truly an exempted tract in 14 as was Agra, Meerut, and the Punjab. By all precedent, this cholera was due to appear in north-west of India in 1864 ; I have noticed the tract south of the Jumna, barring its pro-3S from the east in 1863, and now, in 1864, the barrier was still unbroken, and the sheet of lera was spread from east to west, from sea to sea, on a lower parallel, leaving Agra, alior, Rajpootana, Bikaneer, Cabul, and Persia, to share immunity with Rohilcund, Meerut, [ the Punjab. Choleka of 1865. In the third year of the epidemic life of the cholera of 1863, an offshoot was directed towards the north-west of India. Before this invasion occur- fivasion of the western division of red c h o i era had covered the eastern epidemic tract from the epidemic area of May 1865. „. ' , A t _ mA , A ¦ \ fifl , «,„_ Himalayas to Nagpore, and had, in 1864, stretched thence Istward to the sea. With this great body of cholera thus curved round the Northern Provinces, 1 crossing the pathway by which the northern provinces of India are entered, and lying ectly in the way of the influences which bear cholera onwards, it was impossible that Agra, falior, Meerut, and the Punjab should escape invasion in 1865. The fact that invasion 1 occurred, was made evident to me by the occurrence of a few cases between the 15th 1 30th May, which showed that in these weeks, the area of the year had been occupied a cholera which had struck even the peaks upon which our hill stations are perched, prisoner died of true cholera in the jail at Hissar (May 16th); an Artilleryman was struck jvn at Meerut (12th May) ; a man of the Governor General's Body Guard, at Deyrah, was ;acked (in the last week of May) , and a man of the small European Detachment at Phillour [ay 19th); at Dugshaie, a soldier of the 101 st got cholera (26th May); and a fatal case purred at Kussowlie (sth June) . These cases were indicative of the presence of a body of cholera epidemic in the Banda, Jhansi, Gwalior, Etawah, and Agra Districts, clearly enough shown in our records. It is the cholera of July and August of our tables. This cholera did not reach Lahore in its advance towards the north-west, but was stopped in the Ferozepore District, where its presence is recorded in the Mortuary Returns for the Punjab for 1865; the limb directed 28 northwards, seems to have reached the Kangra District on 15 th July, if the Police Reports are to be credited. The last .which we hear of this cholera in 1865, is as prevailing in the city of Meerut in October and November. This was a cholera invading in the third year of its epidemic life, and it was destined to die in the fourth year of its epidemic existence ; the occupation of a new soil tended in no way to the rejuvenescence of this cholera. In the tables of our types, cholera had no existence in 1866 over this invaded tract of 1865 ; the cholera of November and December 1866, has a history totally unconnected with that of this cholera of 1865. I This inevitable offshoot, was but the shadow of what might, under other conditions, have been an epidemic of 1864 and 1865 in the north-west, as .olera of the Central Provinces, gre^ if not greater than any which ever preceded it. This was its character in its diversion to the south, the most idful cholera on record in these provinces, universal from Nagpore westwards to the The same cholera of May 1865, was simultaneously cutting off the Mhow Artillery achment below the Simrole Ghat in Khandeish, was striking our stations of the Simla [s and the mountains of Abyssinia, and was decimating the pilgrims of Western bia. It was in epidemic life as early as March, to the east. In April, the valley of the budda was swept down to the sea ; Nursingpore, Hoshungabad, Nimar, Guzerat, beyond, Kattywar and Lower Scinde (where our invalids of the season from the jab, were attacked before they went on board ship), were all included in the area of cholera in the early months of 1865. This great cholera is happily represented in our ms for European Troops, only by a loss of eighteen men at Saugor, and six at Jubbulpore. tin the eastern division of the epidemic area of our Presidency, this great cholera is esented to us simply under the aspect of a third year cholera, that is, as general throughout division, but shown only in localised outbreaks, some of which were severe. Ciioleiia of 1866. » Taking our parallel from 1858 and 1862, the cholera of the year 1866 was due to be at a imum of prevalence ; nearly extinct over the eastern division, and at an end as an emic, in the western division of the epidemic area, since 1866 was the fourth year from fresh invasion of 1863. In the western division of the epidemic area, the cholera of 1863, invading in May 1865, never revived, if the absolute disappearance of fatal cholera from our cantonments and jails in 1866 be taken as the index Exempted area of 1866, Ihe presence or absence of cholera. Up to November 1866, not a single fatal case of cholera recorded in the western division of the epidemic area, except that of a single prisoner of Agra Jail, who died in August, a case the true forerunner of the ej>idemic of the end of the . In the eastern division, one case only of fatal cholera was recorded among the entire jail ilation of the area, and that a doubtful one. But the statistics of the stations of European ]>s situated on the Ganges, put the fact in a different light. It is quite true that over ly the whole area the cholera of 1863 was extinct; but it was equally true, that in July, aura of a fresh invasion swept up the valley of the Ganges and across Bundelcund ts most westerly limits.* From this, our stations on the Ganges, and these alone, ;red ; four European Soldiers died at Allahabad, and one at Futtehghur. 1 Turning to the Jail Table for 1866, we see at once the body of the epidemic, of which this was the aura, coming up from the east, and As invading cholera of July and .^ abgolute limitation in geographical space; a line C ±000. j , _ . drawn from north to south, from Katmandoo in the Nepaul By to Pooree on the coast of the Bay of Bengal, mil define the western limit of this ncing cholera. It was universal throughout Cuttack, Midnapore, Chyebassa, Hazareebaugh, ir, Shahabad, and Tirhoot, up to the foot of the Himalayas, before August 1866. This is now the fourth time since 1855, that we have traced cholera rising in the east from the sea level, appearing on the hills which close in the endemic aiea, and covering as in a mist the plateau of Hazareebaugh, and Chota Nagpore, with an offshoot up the valley of the Ganges simultaneous with the advance of the body of the epidemic into the Behar Provinces. We do not require to take a parallel from our own times to define the relation of this cholera, or the probable history of its career. This distribution and limit of July and August 1866 was precisely parallel with that of July and August 1817, as Jameson describes it. The parallel is wonderfully perfect. Jameson writes :—": — " The only spots on the eastern side of the Ganges beyond the precincts of Bengal (Proper), attacked by the epidemic in the autumn of 1817, were Mozufferpore and Chupra, the principal stations of the Tirhoot and Sarun Districts, and the cantonment of Ghazeepore. The districts south of the Ganges were simultaneously attacked. Cholera broke out in the city of Patna on the 11th of July, and spread to Dinapore and the adjacent villages in August, and in the same month it became epidemic in Bhaugulpore and Monghyr." (Report, pp. 5 and 6). * This visited the Futtehpore Jail and District as mentioned in a note to the Death Tahle for the jails of the Presidency for 1866. 29 The next stage in the advance of this cholera of July and August 1817, afford* the parallel of the geographical distribution of the end of The advance of October and Nov- October and the beginning of November 1866; and I make ember, parallel with that of the same th tation now in order that th geography of the cholera months in 1817. „ * ? ' . , • ¦ J « J „, « ? of these months may not be conceived of as a distribution isolated or abnormal j I shall have occasion to call attention to the same phenomenon of Ivance in intervening epidemics also. Jameson continues (Report, p. ]1): "Aiid now the idemic began to show one of the most striking peculiarities which characterised its march, no longer pushed its influence without distinction or apparent choice in all directions and -oughout each track coming in its way. It began to affect particular lines, and to fix elf in particular divisions of country ; wholly restricting itself for the time to the irse of those lines and divisions. Instead of shooting up from Mozufferpore, Chupra, and lazeepore through the contiguous districts of Goruckpore and Jounpore to the provinces Oude and Rohileund, it wholly left that part of the country, and for many months ifined itself to the tracts lying west of the Ganges and Jumna. Thus, from the beginning November, when it quitted Mozufferpore, until the end of March (1818), when it broke j in Allahabad, it does not appear that any one spot of the immense tract stretching to the t of these rivers from the northern point of Seharunpore to the southern boundary of Tirhoot s visited by the disease. It will be afterwards seen that, in the following year, a new 3am of the pestilential virus, issuing in various directions, made a great part of this loccupied) tract suffer for its previous immunity." I" Although the epidemic would seem to have beset Zillah Mirzapore and to have slightly >eared in the camps at Oonchara and Mongawa near the northern extremity of Rewah, it did great mischief, until, in the end of the first week of November, it reached the centre division the grand army then encamped under the personal command of the Marquis of Hastings ,r the banks of the Sinde in Bundelcund." I Then follows the account of the great outbreak of 7th November 1817. This was the ponse of Rewah and Bundelcund to the invading cholera of July and August, brimming sr the hills shutting in the endemic basin. It is certain that the sources of information at neson's disposal regarding the extension of this cholera further to the west, were limited, it was at the time an enemy's country. But in 1866, the case was different, and the iect of the parallel cholera was that of an invading cholera of a known provincial distributi; of a cholera invading from the east, which had entered the western division of the demic province from the south, before the eastern division of the epidemic area had been ered by the same cholera. This was the cholera which appeared at the Durbar at Agra in the t week of November 1866. I An epidemic cholera invading at an unseasonable time is, as a rule, a weak body of ilera ; at least, observers generally would reckon it to be so. To me, however, it has not this nificance. In my estimation, it is the vehicle for manifestation that is wanting or limited, and ; the amount of the miasm that is deficient. The most powerful body of cholera is almost ocuous if the agency to which it owes its mobility is withdrawn. Hence, the few outbreaks in ich cholera showed itself in the western division of the epidemic area in November and cember, were significant to me, not of the invasion of a weak body of cholera, but of an invasion m a body of eastern cholera, of which the strength was not to be estimated by the immediate sets. This I represented at the time, and the same idea was incorporated ' in the following ;er to the Sanitary Commissioner, dated 25th February 1867, which also defines the igraphy of this cholera of the close of 186<3, except that the western extension was ater than is here stated ; for the invasion extended in these months far to the west into jpootana, where it re-appeared as an epidemic in April and August 1867. KThis letter has reference to what I have described as the liwb invading to the north, in 1 the asions of 1856 and 1861 ; it was written in anticipation of the geography of the epidemic of >7. I wrote :—: — I" I think it right to suggest to you the chance of an outbreak of cholera at Hurdwar and jr the adjoining districts in April and May. The invading cholera of November was, I nk, spread over the whole area of Rohileund, &c, even up to the hills; and if this was the c, we are bound to expect its re-appearance from all parallel history. The cholera of the years ¦S3, 1852, 1857, and 1862 teaches the same lesson throughout, that a cholera of this distribua will re-appear in April. To me, the cholera of November and December 1866 is indicated five deaths of the 36th Native Infantry at Ghazeeabad, and one in the Bth Native Infantry Moradabad; a sepoy of the 3rd Goorkhas died on 17th December while on detachment at mpore ; and another man of the Sappers was attacked while returning to Roorkee from his me in the Futteala District. Dr. Walker also-. notices two fatal eases in the Roorkee Bazar on l and 23rd December; and we know generally, the fact of the appearance of cholera in Delhi 1 the neighbourhood at the same time." " I do not know the strength of the body of cholera so distributed; but I dread universality of spread as much as the strength of special outbreaks, for we never know what the main body may be of which these trifling indications are the mere index. * * I shall show you upon what my apprehensions are founded." "This cholera has no immediate epidemic connexion with the cholera of the east of July and August 1866, which we may expect (in 1867) to occupy the eastern division of the epidemic area, that is, up to the line of 80° east longitude/ 30 GEOGRAPHY OF THE CHOLERA OF THE EPIDEMIC AREA 1X1866. Chap. L] GEOGRAPHY OF THE CHOLERA OF THE EPIDEMIC AREA IN 1867 AND 1868. 31 The few cases which occurred in the jails of Nagpore are to be regarded as the remains of the cholera of 1864-65, the equivalent of a cholera of the fourth year in the eastern division of the epidemic area. I make this statement from a retrospect of the events of 1867. It could not have been anticipated that the diversion of the great eastern cholera of 1866 to the north-west, should have utterly cut off the materies required for invasion on this parallel from east to west. But such was the case, and in 1867, while cholera was universal from Gwalior to Persia, not a single case is recorded over the epidemic area of 1864-65, and the Central Provinces were absolutely free from cholera.* Cholera of 1867. tl have above accurately described the geography of the cholera dormant in the interval besn the invasion of 1866 and the manifestation of 1867. According to what I have stated, we Id find the history of 1855, 1859, and 1863 repeated over the eastern division of the emic area> and the history of 1857-58 and 1862 reproduced over the western division of epidemic area. To the general observer, the phenomena of distribution will be parallel i those of 1857, showing cholera universal from Behar to the Punjab. And this is what did occur. Cholera was universal in the east up to Northern and X Western Oude> and in the Shahjehanpore District ; the olera of 1867 m the eastern northern and western Hmits of the eastern division were the blackest spots upon the Cholera Map of 1867. This eastern Ilera I reckon to have been the great cholera of Northern and Western Oude and of lhjehanpore and Bareilly. As early as March, as in 1818, Allahabad was attacked, and lera was reported in the Banda and Cawnpore Districts in May. But it is evident from history of the year, that it was upon Oude and the districts north of the Ganges generally, t the force of the eastern invasion fell. This was the cholera indicated in the last paragraph ny letter. In April, cholera was universal in the east over the area of invasion of July 1866, from Hazareebaugh to the foot of the hills; and in May 1867, as in 1856 and 1860, the valley of Nepaul was invaded by the epidemic. Speaking from the experience of 1857 and 1862, I had fixed the 20th April as the date at which a cholera distributed within the western division of B olera of 1867 in the western the epidemic area was due to revive.f It was on the 12th, On. i 1 j 1 l -I 1 • i in i T-r j. J'i. ? ..1 that cholera showed itself at Hurdwar, and it was general Img the pilgrims within four or five days after this date. The dates and distribution of the [era of 1862 correspond with sufficient accuracy; in short, the tables for 1862 and 1867 are, learly as possible, reproductions one of the other, as far as concerns distribution within the tern division. There is this difference only, that the cholera of May 1867 descended into the hawur Valley in place of appearing a few miles further to the south. At Bunnoo on the itier, cholera appeared on 20th April in 1862, the Peshawur Valley remained untouched until f, and the Rawulpindee District was passed over altogether. In 1867, the Rawulpindee trict was covered in May, as in 1858, and the Peshawur Valley immediately beyond was 3red simultaneous^, although it remained absolutely free from cholera under the parallel umstances in 1858, until the 26th October, when it was entered from another direction. The history of this cholera I shall have occasion to consider at length in a subsequent chapter; here, I indicate merely the fact, that Nagpore and ¦pmpted area of 18(57, and the the Contra! Provinces were free from cholera in 1867, that the ition of the epidemic area in the eas t ern division of the epidemic area was covered by a freshly and west. • ¦%• v. l l 4.1, ¦*- 4-T-. 'U 1 f 4-V.^. Ai ;„;«« invading cholera, and that the cholera of the western division was a second-year cholera reproduced in April and in May from the invading cholera of November 1866 over the districts covered in November 1866, and during the year extended from Deolee in the south-west — the south-western limit being precisely that of the cholera of 1861 to the Rohilcund Terai in the north-east, and advanced westward as an invading epidemic to beyond the Peshawur Frontier, to Cabul and to Persia. Cholera of 1868. ¦ The cholera of 1868 possesses two chief points of interest, its geography in the south, its repression over the northern provinces. In March, the invasion of the east of the Jubbulpore District was reported ; and in May, I June, and July, there was a severe outbreak among the .-invasion between March and May European Troops at Jubbulpore, the only severe outbreak of iof the exempted area of 1867. ? r . ?' • i • /» .1 t» • j r t the year m the epidemic area of the Presidency. In June, Jail Table shows cholera in the jails of Mundla and Seonee ; and in July, there was cholera the jails of Nagpore and Nursingpore. On 21st August, a fatal case occurred in the ¦opean Regiment at Saugor, marking the invasion of this district. By this time, all the districts to the south had been covered ; for, even as early as the 14th August, cases had appeared in the Bengal Cavalry Regiments stationed at Malligaum in the Bombay Presidency, and cholera was reported to be prevailing in the neighbourhood at the same time. It was in * A few cases of cholera was reported from Mundla, the district of the Central Provinces lying furthest to the north-east ; this district suffers in common with our eastern epidemic province. f Letter to the Sanitary Commissioner for Bengal, 28th July 1865. Ie week ending the 15th October that this cholera entered the city of Bombay, and Poonah was attacked simultaneously. In December, the attack of Native Begiments marching- in Khaneish and Malwa, gave evidence that these territories had been re-occupied. While this report is >eing printed (March 1869,) the same cholera has appeared in the Mhow Cantonment; and in onsequence of its re-appearance in Khandeish, the movement of troops between Bombay nd Central India has been put a stop to. Thus, in these months, there was a distinct invasion ong the track which I have elsewhere described as the southern epidemic highway, and le entire exempted area of 1867 was covered anew. And while this body of cholera was oving westward in October 1868, another offshoot was moving to the south; and the Madras 'residency, which had enjoyed a respite for two years, following the death of the epidemic of 864-65, was re-invaded. In the beginning of 1869, this cholera was prevailing epidemically Hyderabad ; and the marching of llegiments was prevented by the prevalence of cholera ong the routes. In the Northern Provinces, the marked feature of the year was the inability of cholera k anywhere to localise itself in virulence. As a third year enomenon of repression in the c h o l e ra both in the eastern and western divisions of the iern Provinces. -i • •- • *li j.i _± _ j c ii t epidemic area, it is possible that even, under favorable condi- |>ns, the manifestation of the cholera of 1868 in Upper India might have been in no great wer. With the conditions afforded by the climatology of 1868, manifestation was powerfully pressed, and it was only when the general character of the season was temporarily altered, that attempt at re-appearance over a very wide area was made, in August and September. This very well illustrated in the tables for the European and Native Armies. I do not think that the invading cholera of the south, of Madras and Bombay, is, like the material of the epidemic of 1863-65, a cholera immediately emanating from the endemic area, and destined to increase in power in 1869 and 1870. It appears to me but a portion of our Bengal Epidemic of 1866-67; and, if this be the case, I do not look for great power of manifestation, even in a tract so congenial as that invaded in 1868. A new invasion is, however, to be watched for ; and should the fact of the occurrence become apparent in 1869, its possible connexion with this invading cholera in the south must not be overlooked. 32 CHAPTER II. THE CHOLERA OF ANY YEAR OR PERIOD IS NOT A MANIFESTATION CONTINUOUS THROUGHOUT EACH MONTH OF THE YEAR OR PERIOD; IT IS EXHIBITED IN A SUCCESSION OF MANIFESTATIONS ALTERNATING WITH SEASONS OF DORMANCY. This chapter is designed to show the facts of the alternations of manifestation and dormancy of cholera whether in its endemic or in its epidemic area, but not the causes of these phenomena. tl have carefully defined the term "an epidemic" as applied to the invading 1 cholera of the i beyond the limits of endemic cholera. An epidemic is due to the presence of a body of lera; the materies is the same, existent for a period of years, destined to die in the end, having a definite part to play during its life-period. At one time, this body of cholera is lifestly existent within the area invaded, but at another, it gives no sign of its existence, know, however, that it exists, and we can anticipate the fact of its reappearance ; therefore, speak of cholera under these opposite conditions as dormant and as revitalised. I We are apt to associate the motion of cholera with its vitality ; but vitality is not essenly associated with power of locomotion, although a cholera in motion necessarily gives a lifestation of vitality far beyond that afforded by an anchored cholera; it may be the ;, that a dormant as well as a vitalised cholera, may undergo epidemic distribution. What have to note here is, not the absence of motion leading to the phenomenon of the repression :he manifestation of a vitalised cholera, but a dormancy beyond the control of any contint circumstances ; and we have to study a vitality which has no essential relation to the ticies which may control the extent of its manifestation. It is true that invasion and vital manifestation appeal to our senses at one and the same time; but vitalisation is not the cause of invasion. Cholera does not become an invading epidemic in virtue of its having lecome revitalised. I Many of the facts of the alternations in the disappearance and reappearance of cholera, are rely concealed in the massing together of statistical data relating to cholera ; and the lect to reduce to the locality and date of its occurrence every case of cholera afforded by our 3S, has been the chief cause of the absence of generalisation from the experience of each year. II have had occasion in speaking of the history and geography of these recent years, to call ntion to the fact of the almost total disappearance of cholera in Upper India, in every year, l the first week of October up to the 20th April. I have, howevei", had occasion to allude aany occurrences exceptional to this statement. I have noticed cholera in the Umballa riot as late as November 1856; cholera along the base of the hills below Nynee Tal in eh 1857 ; cholera epidemic at Peshawur in October and November 1858 ; cholera epidemic 'eshawur up to the first week of November in 1862; cholera prevailing in the city of rut in October and November 1865 ; cholera distributed as an epidemic over Meerut Rohilcund in November 1866 ; and cholera again in the frontier in October 1867. Such exceptions, due to speciality of conditions and speciality of locality, are of no weight in opposition to the generalisation, that in these provinces cholera does not show a vital existence from the end of September up to the last ten days of April ; in my estimation, the occurrence of these cases is only significant of the truth, that with the conditions afforded, it was normal and proper that the manifestation should occur. It is one of the advantages of studying cholera in so vast a field as that which this Presidency presents, that the contrast of the natural and normal aspects which cholera offers in different and widely separated portions of the field, enables us to view these contrasts as harmonies in a system, which, indeed, would be no system at all, if it did not recognise cholera under these aspects, as modified and adapted to the physical aspect of the locality of their occurrence. The dweller in Eastern Bengal observes cholera prevalent around him during the very same time that it is extinct in the northern provinces ; and he dates his epidemic season from the beginning of October to the May of the year following. Were the population under observation, in parallel circumstances in the two provinces, and were their statistics taken in the mass, the cholera of the Presidency would be shown to be nearly as prevalent in one month as in another. And yet how incorrect would be the generalised statement. As so stated, the generalisation would be no more a scientific truth than is the popularly accepted error, that neither the snows of Russia nor the hot winds of India are inimical to the development and progress of cholera. Putting aside as irrelevant to the question at issue, any consideration of the seasons of invasion of the epidemic area, and viewing cholera simply as reproduced within an invaded area, or within an area in which it is endemic, the circumstances attending the reappearance of cholera wherever it be manifested, prove the manifestation to be an assertion of its vitality by the object the cholera miasm ; and not the less do the facts of its decline and decay prove, that it is a vitalised object which is sinking into dormancy. I speak of the cholera of reproductions, which I have explained to be, in the epidemic province, the revitalisations of the cholera of an epidemic for a certain number of months in each year, and exhibited to us in the outbreaks within a provincial area. I wish to show here what are in the different provinces of this Presidency, the normal periods between the reproductions of cholera ; that is, the periods for which in each year we X t entitled to expect that a cholera which we know to be present, shall cease to manifest its tence. II have above given the caution against regarding the motion of cholera and the vitalof cholera as one and the same thing. I have been in the habit of regarding the reductions of cholera in each year in this Presidency as three : the first, persistent from >ut the middle of February to May; the second, manifested from about the 20th June to end of September; and the third, beginning at the end of October and lasting until sember. In so doing, it is possible that I may not have paid sufficient attention to the i-ning which I have, given. It is possible that I may have elevated into the position of arate reproductions, manifestations which denote simply the fact that mobility has at these sons been communicated to a cholera vital throughout the interval. Thus, those living in Gangetic Provinces beyond Bengal Proper, know, that cholera may be looked for in March I April, and again in July and August, and that not unfrequently, a third visitation will ur in November. There are some who would say, that of these three manifestations each , separate revitalisation ; while others would prefer to regard them merely as indicative of impulse given, at these seasons, by the prevailing conditions, to the manifestation of :i cholera miasm persistent in life from March to November. The difficulty is the greater, since the estimation of both may be correct. The analogy of cholera life is with that of vegetable existence ; and as the plant, vital throughout, shows its flowers, or puts forth its new leaves ut intervals, under the influences of season, so may this cholera become vigorous in itself as well endowed with mobility, when those influences under which revitalisation occurs and motion is communicated, which we have reason to believe to be the same in both cases, predominate. This reservation being made, and the causes for which I make it being clearly understood, I shall divide the cholera of the year into three : the cholera of the spring, the cholera of the rains, and the cholera of the cold season. The cholera of the spring is the cholera manifested between February and April ; the cholera of the rains, is the cholera in evident existence from the 20th June to the end of September ; and the cholera of the cold season, is the cholera of the end of October and of November, December, and January. Each of these three manifestations has a history and geography peculiar to it. The homologue of each will, under all circumstances, be found in the various epidemic divisions of the Presidency : thus, a spring cholera will be found in the Punjab or in Nagpore as well as in Lower Bengal or in Assam ; a cholera of the rains will be found in the endemic province and the countries bordering on it, as well as throughout the monsoon area of Upper India; and a cholera of the cold season will be found in Rohilcund and the adjoining Terai, as well as in the districts east of the Bay of Bengal. But the very fact of the predominance of the cholera of any one of these manifestations in any area of our Presidency, is sufficient of itself to call for the recognition of this as a natural area, distinct in its relation to natural influences from the other geographical areas in which at the same season, the aspect of cholera is different. §In the tract which I have called the western division of the epidemic area, a cholera of ion is vitalised in certain localities about the 20th April, and generally, in the first fifteen of May ; thus, it has an existence of barely two months before the commencement of the manifestation coincident with the setting in of the monsoon influences, and during these two months, the conditions necessary for mobility are afforded only exceptionally ; thus, we found • spring cholera anchored in the western division for the six weeks preceding the invasion of first week of July in 1856 and 1861. In the eastern division of the epidemic area, including Jubbulpore and Nagpore in the south, the spring cholera is a great cholera ; with conditions which are not abnormal, this cholera may be revitalised and may be a moving epidemic as early as March, and when we meet it epidemic in April, we recognise it as the cholera due in April in any year. Within the endemic area, this is the predominating cholera of the year, due to appear on any day after the middle of February, persistent up to May, and at the close of that month disappearing as an epidemic. I The cholera of the monsoon season is as wide in its distribution as is the range of the asoon. This is specially the cholera of the epidemic area, waking into life within a fortnight or 3e weeks after the rains have set in, and mobile over the entire area of Upper India within the its of monsoon influence. It is equally a cholera of the eastern and western divisions of epidemic area ; and its limit in time is the same in both areas, although in the western ision, the oittbreaks of September are liable to be more severe and numerous than those of same month in the eastern division. It is a mistake to suppose that this cholera is unknown the endemic area. If absent as an epidemic from its centre, it is abundant around its rgins, and great invasions from such a source may occur, as, for example, the cholera of m-Dum and Barrackpore of August 1859, which was a cholera invading apparently from the th-west of the endemic province. i Recalling the history of the cholera of October and November of the epidemic area, two occasions only, have we found this cholera displayed under the aspect of a moving lemic, namely, in 1858, on the frontier, and in the invasion of the western division of 1860 ; 3n marched in upon, its presence has on several occasions been shown, as in the case of r Majesty's 32nd Regiment at Kalka on 31st October 1856, of the escort of the Lieute- Lt Governor, N. W. Provinces, between Bhurtpore and Agra in December 1860, and the Goorkha Company of the 9th Native Infantry between Fyzabad and Lucknow in comber ISG3. It i$ not until the shaded line separating the endemic from the epidenrio 34 province of cholera is reached that this cholera asserts its importance. From Patna to Chittao-ong and the Assam Frontier, this cholera of the closing months of the year, is, in every district, vital, and may become in any district a great epidemic cholera. This cholera is due in the endemic province as soon as the diluvial tracts submerged during the rains, reappear. In Calcutta it appears after the 15th October. As typical for the provinces in which they are situated, I have tabulated the admissions from cholera for the twelve years ending 1867, in certain jails which are liable to attack. These statements show the comparative predominance of the cholera of the spring, the rains, and the cold season. In these typical jails, the facts are the same as I have, in the previous paragraph, stated them to be when applied to provinces. The following are typical examples showing* the predominance of cholera at definite seasons relative to locality ; the numbers represent the admissions from cholera in each month of the twelve years 185G-G7 :—: — j , Backergunge — A Jail of the endemic province in the Sunderbuns, on the diluvium, and scarcely elevated above the sea level. Year. £ £ •§ v £ J "" ° Deaths. § § "S a • o ¦ P § ¦§ § § —§ S 1856 ... ... j 2 f the mousoon season, of July, August, and September, is tmrepresented. ii. — Midnaporc — A Jail of the Laterile, on the margin of the endemic cholera field, little elevated above sea, level. i .2"S •. s 2 Viuu. iT 1 J to' 1 J f •§ a . Deaths. II l£ P3 ; * -2 I ? § «'i -' Deaths. 1111111-S I I I I I gll 1856 ... 4 38 I 1 16 ... 60 38 1857 1 ... 4 4 16 15 7 10 1 58 26 1858 63 3 2 ... 2 70 40 1859 ... 39 1 7 36 9 92 39 1860 ... 38 29 67 80 1863 ... '.'. 13 26 39 In 1864 ... , ... 5 24 12 15 1 ... 67 10 1866 ... ... ... ... 3 9 1 '.'.'. 1 32 46 16 1867 ... 3 1 10 14 5 The cholera of Bhaugulpore is very intimately related in season to that of Midnapore. The spring- cholera reappears every year in March or April ; but May is not altogether a month of exemption. The cholera of the rains shows itself towards the end of June; this cholera, however, is not extinct in July, as at Midnapore, but is a great cholera in August and even in September. As in 1856, cholera may become epidemic in October and November; it is not an abnormal circumstance that cholera should occur here at this season. 4. — Paina and Deegah — A Jail on the great kunkur clay, ISSfeet above sea level, and also typical for the valley of the Ganges ; water close to the surface, and the fields irrigated from shallow wells. Yeab. I | 4 !_ _ . § i 5 § f -I*' Deaths. 4 & I % al§|-l fl I I g'gg 1856 ... 1 8 16 1 1112 ... 3t 5 1857 ... ... 1 ... 2 ... 5 5 4 43 21 ... 1 ... 82 31 1859 .'." !.. Z. '.'.'. '.'.'. '.'.'. "i '.'.'. "i is 25 2 47 "*25 1860 ... 2 1 12 21 1 1 ... ... 88 14 1861 ... 2 31 33 14 1863 ... ... 23 .'.'. 2 ... 81 18 '.'.'. ... j 74 20 1865 ... ... '.'.'. '.'.'. 1 54 ... ... ... ... 5 1 8 I ... 69 | 29 1866 ... ... 15 4 4 ... 13 81 8 125 46 1867 ... 13 1 3 37 7 21 ... 82 51 In this typical example, the balance is very evenly held between the cholera of the springand the cholera of the monsoon. The minimum of May marks the termination of spring 1 cholera; the minimum of June, the commencement of monsoon cholc. . While the spring cholera is thoroughly illustrated, the monsoon choleiva of July, August, and September, is quite as well marked as in the northern provinces of India. The tendency to the reappearance of cholera in the end of October and in the beginning of November is shown in six years out of the twelve. The cholera of these districts has distinctly two associations — the one to endemic cholera, the other, to the cholera of the epidemic area. 5. — Allahabad — A Jail typical for the cholera of the eastern division of the epidemic area. .. _* a j 4 f fe 1 1 Total EAR - Slid 7 ... 24 3 27 14 In all the examples hitherto given, from sea - level upwards, the cholera of March has been powerfully developed. In the Allahabad Jail, one serious outbreak only is noted in these twelve years, but this must be accepted as indicating what is a fact, that in any year, under favouring influences, cholera may come forward here in March. Viewed as a type however, the cholera of April and May of this jail takes the place of the cholera of March and April of the districts further to the east ; the minimum of Patna of May, is a maximum in the spring cholera of Allahabad ; and here, a monthly record does not suffice to draw the line of distinction between the spring cholera and that of the rains, which has been clearly drawn in every jail to the east ; the interval is obliterated, and the cholera which analogy teaches us to regard as of two distinct periods, is apparently one continuous manifestation from April to September. In many years, and in every year in fact if the area for which this jail is typical be viewed throughout its extent, the cholera of the districts represented is without difficulty separable into its two normal manifestations ; and the more readily so, because in the eastern division of the epidemic area, the cholera of the spring is frequently a moving and not an anchored cholera, as it is, as the rule, in the western division. 6. — Nagpore — A Jail of the plains of the Central Provinces, 935 feet above sea level, in the extreme south of the Presidency. Year >> & • -^ . J jj Total rtlja. "KSo'g'a Admissions of Deaths. illliiilll 1 I eachyear eachyear-1856 ... 24 6 13 ... 2 2 47 18 1857 ... No records. 1859 ... None. None. 1860 ... * * ... * * 44+ 15 1862 ... ... ... ... ... Z. '.'.'. ... "{ "i '.'.'. Z. '.'.'. Z 2 Z. 1863 ... .. ,-. 1 ... 4 14 1 ... 20 8 1864 ... ... 24 3 1 28 2 1865 ... ... 7 13 1 2 68 11 102 54 1866 ... 7 7 7 1867 ... None. None. The other Jails of the Nagpore territories, 1860 to 1867. | I I I I I I I I I I I jift | I 1860 7 14 49 1 2 73 36 1861... 4 4 8 7 1862 28 1 29 11 1863 9 41 50 20 1864 1 12 6 43 62 31 1865 2 6 42 9 59 6 1 1 126 70 1866 61 21 2 84 48 It is in March of any year that the appearance of the cholera of the Nagpore territories is due ; the cholera of the rains is also a cholera of earlier occurrence by a few weeks than in the districts of Northern India, showing little tendency to ran into September. Whether or not there be a clear interval between the cholera of the spring and of the monsoon depends upon contingent conditions ; the interval was distinctly shown in 1860, when the spring cholera disappeared after the 15th May, and was succeeded in the end of June by the monsoon cholera. The following statements taken from the reports of the jails for the year, prove this disappearance and the fact of the occurrence of a true interval, in 1860 :— Nagpore. — Cholera occurred between Ist March and 25th July. "No cases were admitted in May. Handhara. — " No case occurred after the 15th May ; two months later it prevailed in the town." Chatlda. — sth to 17th May. " Cholera prevailed in the city some months later." Haepore. — " The first admission Avas on 22nd March ; the last admission on the 18th August." Considering their distance from the sea, the plains of Nagpore have a very trifling elevation,* and it is evident that their geographical situation exposes them to the same influences which in the east of our Presidency determine the early appearance of the cholera of any year. The relation of this locality to cholera, is, in truth, the same as that of our districts bordering * Hingenghat is 610 feet, and Nagpore 935 feet above the sea. f From the Annual Report of this jail I find that the cases of 1860 occurred in March and April and in June ami July; the monthly details are wanting in the jail records for 1860 and 1861. 37 on the endemic area, typically shown in the cholera of the Midnapore Jail, or of the jails low down in the valley of the Ganges. There is no more important fact in the Natural History of the Cholera of the Presidency than this, and I shall frequently have occasion in the sequel to inculcate its significance. 77 # — Jubbulpore, 1386 feet above sea level, 160 miles north of Nagpore. Ybab - a S a . j . 1 § .2 § S 5 3 g I I I I I i I I I I I i f* |_ 1856 1 51 49 101 61 1857^ 6 36 1 3 18 3 67 44 1858 ... ... 1 1 None. 1859 None. None. 1860... ... ... None. None. 1862 ... ... None. None. 1863 29 29 8 1864 ... None. None. 1867 ... •¦• None. None. The Jubbulpore District is apt to come under the influence of spring cholera in any year. The facts from the districts lying to the south, south-east, and east of Jubbulpore show the predominance of the cholera of the spring months more powerfully ; but a cholera of April and May is as normal for Jubbulpore as for these territories. As is the case further to the south and east, the monsoon cholera has the tendency to appear in June and July rather than in August and September. The cholera of October and November is not an usual manifestation in the Jubbulpore or Saugor District ; exceptionally however, it is met with. On the plains of Nagpore on the contrary, Regiments marching may meet a vitalised cholera in any month of the cold season after it has been distributed as an epidemic. 8. — Central Jails of the north-west, typical for the western division of the epidemic area. p ** Yeah. Cbwibai. Jaiis. fc 1 & . -J % 6 % £ M% ™ s g 3 a £ g f I I 1• I I 1* » 1856 ... Agra 3f 442 132 2 ... 579 234 1856 ... Meerut 72 75 ... . 1 ... 148 90 1856 ... Bareilly 1 1 ... 131 ... 11 ... 144 65 1856 ... Lahore 1 302 181 484 244 1860 ... Agra 809 7 816 175 1860 ... Bareilly 2* 3* ... 5 l 1861 ... Agra ... 2 171 20 ... '„, \ 193 67 1861 ... Bareilly 11 1 ... 12 5 1861 ... Meerut ... 3 32 635 670 335 1861 ... Lahore ... 1 1 1862 ... Agra 123 ... ... ... '" 23 12 1862 ... Lahore 1 81 12 94 41 1863 ... Agra 7f ... 49 58 114 45 1865 ... Agra 1 13 18 32 20 1865 ... Bareilly ... l 1 j 1866 ... Agra ... 1 1 1867 ... Agra 1 "\ [ 1 1 3 ... 2 5 11 444 602 2,034 202 1 14 ... 3,318 1,887 Passing from south-east to north-west over the space intervening between Jubbulpore and Agra, an area is reached in which the statistics of cholera present a contrast radically distinct from those of the cholera of the east or of the south of the Bengal Presidency. From Agra to Lahore it is the monsoon cholera which predominates ; and the representation given above is no exaggeration of the fact. It is quite true that cholera may be vital and epidemic in May or in November within this area, but it is during the continuance of the monsoon, from its commencement to its termination, that epidemic manifestation occurs in its intensity. May cholera takes the place of the cholera of March and April of the south and east. It was 11 cholera of May which we have traced in epidemic vigour at Agra in 1856; in May 1857, prevailing over the Umballa District; in May 1858, epidemic in Rawulpindee and * These cases belong to a cholera of the eastern division of the epidemic area; Bareilly was the last station" to the west reached by the eastern invasion of 1860. f Cholera of Invading Epidemics. » 38 ALTERNATIONS OP DORMANCY AND REVITALISATION. Hazara ; in May 1861, in the territories west of the Jumna covered in 1860; in May 1862, epidemic from Hurdwar to the Frontier; on 20th May 1863, striking 1 the prisoners of the Agra Jail; in May 1865, sparsely epidemic over Meerut and the east of the Punjab ; and in Ma y 1867, epidemic over the same area that was covered by the cholera of May 1862. I se " examples teach clearly, that the early cholera is not unrepresented, but that it is, his situation, repressed from manifesting its existence for a certain period, by the conditions eh it finds in this western division of the epidemic area. Six admissions are shown at eilly in March and April in the table showing the cholera of the Central Jails. The silly District is under eastern as well as under western influences ; the five admissions of 1860 j the most westerly representative of the great cholera of the eastern division of that year, should be cut out of this table as having no association with the cholera of the other years stations. The November cholera of this area is marked by a slight attempt at renewal in jails of Agra, Meerut, and Bareilly in November 1856, after the great epidemic of the isoon season had passed ; this is the same manifestation which I have traced in the same Lth, epidemic at the base of the hills beyond Umballa and below Dhurmsalla. I These cases are typical ; that is, they truly and accurately represent the experience of the ulation generally of the districts for which they have been here produced, and what they h holds good, not for these twelve years only, but for all time. I might have deferred ging these forward until I came to treat of the causes which bring about the disparities vn in these illustrations. But it is essential, even for the general consideration of the le subject of the laws of cholera, to pave the way so as to prevent any misunderstanding erms, when it becomes necessary to employ the terms " dormancy" and " reappearance/ peaking of the materies of an epidemic. These illustrations will be associated in the mind i the aspect of cholera in this Presidency, not as a thing casually occurring or dependent ts appearance or decay on any mere contingent circumstance, but as bursting forth as the bursts forth and decaying as the leaf decays, in subordination to the conditions offered le geographical situation which it occupies. It will be understood, that, although, in these illustrations, the statistics of invading and reproduced cholera are mixed up, the combination is immaterial ; invasion and reproduction are popularly regarded as synonymous terms, and the period of the occurrence is very much the same in both cases. I It is the recurrence of absolutely identical parallels which proves the truth, that the era re-awaking within the epidemic area, is a revitalisation of the very cholera distributed ths or even years before, and not a fresh invasion succeeding the cholera of the previous emic. From what has here been said, the conclusion may be drawn, that wherever, ughout this Presidency, cholera is met with, its manifestation is intermittent, the periods of rrence and disappearance being the same, within certain laws and limits, in each year, that these differ for almost every province according to its geographical situation ; that disparities are necessities, not contingencies, and are shaded off harmoniously wherever istency requires that the line of distinction shall cease to be abrupt. (These remarks have reference to the cholera of provinces. It is an universal truth, cholera has no power of continuous manifestation throughout the year in any province, no answer to say, that in Calcutta or in Dacca cholera may be met with in every month of rear, and in every year ; or that in some portion or other of the endemic tract, cholera is ys prevailing. Scientifically speaking, the intervals are as truly observed in Bengal >er as in the northern provinces, and it is as unreasonable to expect an utter cessation lolera throughout its perennial habitat, as it is to expect a total disappearance of its tation because of the necessity for its renewal with the revolving seasons. CHAPTER III. BESIDES HAVING A DISTRIBUTION IN SPACE, THAT IS, A GEOGRAPHY, EPIDEMIC CHOLERA HAS A DISTRIBUTION IN TIME. A CHOLERA WHICH CAN BE RECOGNISED AS NEW AND INVADING REAPPEARS THROUGHOUT A SUCCESSION OF YEARS; THE PERIOD FROM ITS FIRST INVASION TO ITS FINAL DISAPPEARANCE IS THE DURATION OF AN EPIDEMIC OF CHOLERA. »In order to render intelligible the geography of the cholera of recent years, and to st in the general comprehension of the tables illustrating the first chapter, I have been ged in some measure to anticipate the contents of the present chapter. II have described as a new and invading cholera, the eastern cholera of 1855, of 1859, of 33, and of 1866. I have described this cholera as in motion from the east towards the west, 1 1 have followed out the geography of the four epidemics of which this new cholera formed ! materies. From the history of these four epidemics from their beginning to their end, I til try to show what an epidemic is, and what is, in this Presidency, the normal duration time of a cholera emanating from the endemic source, or, in other words, for how many years i materies of an epidemic shall retain its vitality in the epidemic area. It would be premature here to detail the history of the various emanations of cholera from within the endemic basin, which, since 1817, have covered Northern India or the Central Provinces ; it will suffice to state generally, the fact, that during these fifty years, a fresh cholera has issued forth every fifth or sixth year, and has been marked by phenomena of distribution, both in time and in space, corresponding with the phenomena of the past fifteen years. It is our misfortune, that each of these emanations has not been systematically watched, and the facts placed on record ; and at the present day, it is difficult, if not impossible, to piece together the fragmentary data, whether statistical or documentary, in such a shape as to make it evident that the behaviour of these old epidemics was the same as that of the more recent. But there are parallels and landmarks which can be tangibly grasped, of such a character that we know, that what lies between the gaps has existed, although now forgotten and unrecorded. It must not be overlooked that some of these gaps were unavoidable, since the territories under British dominion did not in those days form the unbroken sheet which they do in our times. I hope before concluding this paper to put on record something in regard to each of the epidemics which have made their invasion between 1817 and 1855, which may be recognised as illustrative of and as illustrated by, the events of the past fifteen years. I After the illustrations and explanations of the previous chapter, the term reproduction revitalisation, may now be employed without its meaning being misunderstood; when I ak of an epidemic, for example, that of 1855-58, it is of one and the same body of cholera, 1 1 shall speak, having an interrupted manifestation, being manifest for a certain number of iths in each year, and dormant during the remaining months. Distribution in time op the epidemic of 1855-58. iThe minimum of manifestation throughout the Gangetic Valley and in the eastern division of the epidemic area so striking in 1858, 1862, and 1866 !£^V£iJ& ll Bfi preceding the epidemics of the years following, was .not so of the epidemic area. strongly marked in 1854. Throughout the Gangetie Provinces, the year 1853 was noted for the virulence of its cholera, and this cholera was very generally reproduced in the spring of 1854. Still, the disparity between the year of invasion and the year preceding it was sufficiently marked. The mortality of the jails' of these provinces stands thus for the last six months of 1854, and it contrasts broadly with the results in the same jails in the year of invasion :—: — Jails of the Eastern Division— July to December 1851. "S g « "g -I 3 P H) o O & _ "a < oi O fc O Deaths from cholera in the jails of the Dinapore Circle ... ¦¦• 4 1 2 6 6 I Deaths from cholera iv the jails of the Benares Circle ... Deaths from cholera in the jails of the Cawnpore Circle ... ... 2 During the last six months of 1854, out of a jail population of 16,750, in the Gangetie Provinces, twenty-two deaths only occurred, and with two exceptions, these were confined to the most easterly circle of jails ; of the twelve deaths of October and November, eleven occurred at . . Cholera Admissions of the Jails of the eastern division of the epidemic area in the Epidemic of 1855-58. £i.41 i I i i iYBA». Strength. 1| d J j | !¦§!§¦< * 4 £ H •£¦ S ?? £ < to <§{§«£ 3 ... 14,914 1 1 20 25 21 102 93 276 102 42 19 3 705 295 16,007 ... 8 68 249 93 93 51 25 25 10 24 4 650 298 8,092* 2 3 14 25 55 56 228 167 51 16 3 ... 620 26 from t.lie mrmf.Vi nf i-fe the duration of this invading epidemic, from the month of its invasion to the month of its extinction. It has been shown that cholera was unrepresented within this area in 1854 and 1855, and up to the 20th May 1856, when it was entered from the south-east through the Agra District. Taking the statistics of the European Army cantoned within the area for the year of invasion and the two following- years, the figures stand thus : — Deaths from Cholera in the European Army cantoned in the western division of the epidemic area during the three-year period 1856-58. Year. t 1 ! 4 j . a 1 § I g Total Deaths. 1 I I I I I I I I f_J_ J__i 1856 ... 15,105 76 24 370 84 4 44 ... 602 1857 ... 15,193t ... U ... 4 68 79 137 86 127 20 522 1858 ... 14,486 1 ... 4 1 32 26 23 5 3 ... 95 This is an accurate picture of the duration of the epidemic of 1856-58 in the western division — vigorous from the day of its invasion to the day of its death, with the normal periods of dormancy intervening, amounting to five months in each year ; taking the province as a whole, ending in each year in the first week of October, and reproduced in the first week of May ; and dying out at the close of the third year after invasion. The areas within this province occupied and the areas exempted in each year have been sketched, and the dates of invasion and x -— - x j decay have been noted in a previous chapter. The year 1856 is well remembered throughout the Nagpore territories as a year of invading cholera. The statistical facts are shown in the Jail Table for Cholera of the Central Th "j^^g fo r 1857 are deficient, but it is well known that I'i'ovinces, 1856-58. , , J ? , ? . _ x ? . n • tnr-n cholera prevailed throughout Nagpore in this year as well as m 1856, that it was general throughout the vnllies of the Nerbudda and Taptee, and that it * Cawnpore Circle wanting. f Strength of April 1857- j A man proceeding by bullock train, who got cholera between Uuiballa and Jullundur, 41 DISTRIBUTION IN TIME OF THE INVADING EPIDEMICS OF 1855 AND 1859. [Section I. 42 prevailed even north of the Vindhya Range. The weak European Battery shut up in Saugor during 1857, lost three men from this cholera. There are no data to inform us whether cholera did or did not prevail in the Central Provinces in 1858. I have already said that our troops in the field in Central India did not suffer from cholera in 1858. The Central Provinces and Central India, however, are two different tracts of country, and must not be mistaken the one for the other ; and the more so, because they have a contrasted meteorology and a widely contrasted relation to epidemic cholera. The Central Provinces, Central India, Rohilcund, Meerut, and the Punjab enjoyed, in common, immunity from cholera during 1859. Summary for the Epidemic of 1855-58 LI 855. — The year of invasion from the east. The invading cholera confined entirely to the tern division of the epidemic area. 1856. — The year following the invasion of the eastern area. Cholera in the spring reproduction, covering the Central Provinces, and entering the Agra District from the east ; during the monsoon season, universal over the area covered in 1855, and by the invading spring cholera of 1856, and advancing as an invading epidemic from the south-east to north-west, from the districts covered in spring as far to the north-west as the Jhelum and no further ; but with an extension to the west undefined by the limits of our Presidency. 1857. — The third year of an invading cholera in the eastern division of the epidemic area ; the second year in the western division of the epidemic area. Cholera universally in epidemic vigour both in the spring and monsoon reproductions over the entire area covered in 1855 and 1856. This cholera made no further advance towards the north-west into the districts remaining uninvaded in 1856. 1858. — The fourth year of an invading cholera in the eastern division of the epidemic area ; the third year in the western division. Cholera extinct or at a minimum throughout the eastern division of the epidemic area ; dead over many portions of the western division, but wherever the local conditions in any degree favour vitality, in vigorous manifestation up to the close of the year. 1859. — The fourth year after the invasion of the western division of the epidemic area. Cholera extinct throughout the western division. Distribution in time of the Epidemic of 1859-62. The epidemic of 1 859-62 is included between the years of minimum in the eastern division 1858 and 1862, and between the years of minimum in the th e E e P pfdemic of 1856 58 succecdmg western division, 1859 and 1863 ;it "was thus, as in the case of the epidemic of 1855-58, an epidemic dead in the fourth year following invasion, both in the eastern and western division of the epidemic area. Among the jail population in the eastern division of the epidemic area, this epidemic is ivyn-esented to us by the following admissions :—: — Ezra Admissions of the Jails of the eastern division of the epidemic area in the Epidemic of 1859-61. Yeab. Btbbnoth. I g 4 a ? «j ± t 1 I I § i o llll|l# I I I 1 1 1 a 10.303* ... j 1 7 i 111 82 33 56 61 26 19 41 8 445 227 11,649 2 | ... 58 j 158 105 46 | 185 158 48 7 2 1 720 330 ... 13,448 1 ! ... 5 | 09 108 45 127 53 25 2 10 ... 445 180 Excluding, as in 1858, the jails of Bhaug-ulpore and Monghyr, which in 1862 gave ty-five deaths, the total mortality among the jail population of the eastern area amounted in to eleven ; of these the Patna Jail gave three, the jail at Seetapore two (returned as cholera lit Kosa), and the remaining six cases were distributed through six different jails. The extreme ility of this cholera of 1862 is marked by the fact of these eleven deaths being the result of ;y-nine admissions. Subsequent to the events of 1857 and 1858, a large proportion of the European Army was massed in the eastern division of the epidemic area, and the statistics of this body are exactly corroborative of the experience of the jail population. Admissions from Cholera in the European Army cantoned in the eastern division of the epidemic area during the three years of the Epidemic of 1859-61. Yeah. Strength. g g ¦§ _• .« . 5 8 •»§§>* I I I I 111 | I J I i__j |_ 1859 25,2=>5 3 2 10 59 193 47 71 195 37 13 5 5 640 338 1860 17,368 ... 16 109 25? 25 31 21 38 22 6 9 . 532 299 1861 14,625 1 ... 1 5 13 15 39 52 6 2 -2 1 137 atf * Excluding the jails of Oudc, of which many were opened only in 1859; in Severn] of these cholera was prcseut Out of a force of equal strength, in 1862, a single death represented the fatal cholera of the year — a, man landed, at Allahabad, moribund, from a river steamer. In the Native Army the epidemic of these years was similarly represented, although, as usual, by a very much smaller ratio. The admissions of each month were as follows :—: — Eissions from Cholera in the Native Army cantoned hi the eastern division of the epidemic area during the three years of the Epidemic of 1859-61. v ._• Tear. Sthength. >. £ -S C ¦& x, illt|i#lfllii § 27,369 ... 1 ... 2 10 28 20 115 24 ... 1 5 206 80 17,467 1 10 68 97 41 52 7 10 2 2 1 ... 291 141 9,771 2 9 19 16 11 9 4 5 1 ?. 76 29 The minimum of 1862 was represented by a single fatal case; this, also, occurred at labad. This is the only fatal case noted in twelve admissions from different stations le area. I The spring cholera of 1860 covered the Central Provinces, from Nimar in the west to ?pore in the east, as early as March, and Saugor and Bhopal, above the Vindhya Mountains, 'ered immediately after the first fall of rain on sth June. At the usual season of its valence, in the districts south of the Jumna suffering in common with the eastern division, lera raged ; but it was not until the monsoon months that Jhansi, Agx*a, and Gwalior ered; and beyond these districts, the cholera of 1860 made no progress whatever towards north-west. Nevertheless, this limited cholera was typical for a cholera which might have its distribution as far as Lahore in 1860, a point which it did not attain until the isoon season of 1861. tThe European Army of these provinces, in the epidemic of 1860 and the two years eding the invasion, gave the following admissions : — Cholera Admissions in the European drmy occupying the western division of the epidemic area in the Epidemic of 1860-62. Tiu. BuunroiH. | \ | | j- 1 | 9islli9 i slIiI i S > lfllls s 1860 ... ... 20,897 ... 11 3 2 4 26 283 72 5 2 1 400 194 1861 ... ... 26,728 ... 1 1 2 1 4 359 943 142 3 2 ... 1,458 946 1862 ... ... 27,588 4 6 3 131 304 103 69 5 1 626 381 The deaths in Her Majesty's 93rd lleg'iment in the Peshawur District, in the first week of November 1862, brought to a close the epidemic of 1859-60. In October 1863, there was a case returned as cholera at Rawulpind.ee; to this I have already referred as a doubtful case, occurring- in a phthisical patient many months in hospital. Io not reckon the only outbreak within this area in 1863, that of Agra, as exceptional to the ippearance of cholera within this area. I regard it as a true offshoot of the great lera in progress at the time from the east, which was at the time covering the unoccupied tern division of the epidemic area and the north of the Central Provinces. There is no son that a' cholera when first moving as an advancing epidemic, should not reach as far to west as to Agra; Jhansi was affected in 1855, and the offshoot of the new cholera of 16 crossed from east to west even into Rajpootana. As I have already noticed, this Agru lera of 1863 was most normal in the dates of its appearance, first striking the jail almost the very day from which the invasion of 1856 is reckoned, namely, the 20th May, and in coming back again with the monsoon on 7th July. I The jails of the western division of the epidemic area (excluding those of the Central vinces) gave the following admissions during the years following the invasion of August 0 :— Admissions from Cholera in the Jails nf Agra, Rohilcund, Meerut, and the Punjab during the three years of the Epidemic of 1860-62. Year. Strength. S§ < id>tfri,&ll|| Totai. I>i*». __ __ . • — , 1860 ... 17,645 4 1 810 8 823 177 1861 20,504 1 18 258 713 63 2 1,055 495 186-2 18,888 1 3 16 39 199 17 24 299 122 43 Chap. Ill] DISTRIBUTION IN TIME OF THE INVADING EPIDEMICS OF 1859 AND 1863. [SeCtlOH I- 44 As we found the cholera of 1855-56 disappearing- in the Peshawur and Kohat Districts in October 1858, so do we find, now, the last representative of the cholera of 1859-60 in the jails of Kohat and Peshawur in October 1862. Throughout Rohilcund, Meerut, and the Punjab no fatal case of cholera was recorded in any jail in 1863, and but one admission; apparently exceptional to the fact of the disappearance of the cholera of this area, was the cholera of Agra of 1 863 above alluded to as a freshly invading cholera. Summary for the Epidemic of 1859-62 11859. — The year of invasion from the east. The invading cholera confined entirely to eastern division of the epidemic area. 11860. — The year following the invasion of the eastern area. Cholera in the springproduction, reappearing over the eastern area generally, and covering the Central Provinces invasion; during the monsoon season, universal over the area covered in 1859, and the invading spring cholera of 1860, and advancing as an invading epidemic from the st, from the districts south of the Jumna as far to the north-west as to Muttra and lurtpore, and no further, covering at the same time the Jhansi, Agra, and Gwalior rritories, and advancing even into Scinde and Persia. 11861. — The third year of an invading cholera in the eastern division of the epidemic a; the second year in the western division. Cholera universally in vigour both in the -ing and monsoon reproductions in the area covered in 1859 and 1860. Advancing as invading epidemic in the western division from south-east to north-west, stopping short the Lahore District in the north-west, although covering at the same time Bikaneer, awulpore, and Cabul. 1862. — The fourth year of an invading cholera in the eastern division of the epidernie area; the third year on the western division. Cholera extinct or at a minimum throughout the eastern division, but in vigorous manifestation up to the close of the year in Aery many portions of the western division. tl 863. — The fourth year after the invasion of the western division of the epidemic i. Cholera extinct throughout the western division, if we regard the cholera of Agra an invading cholera, as I judge that this as well as the cholera simultaneously invadingnorth and east of the Central Provinces, ought to be regarded. Distribution in time of the Epidemic of 1863-66. I The reinvasion after the minimum of 1862 (which we found to be represented in the i by a total of eleven deaths) had a distribution among the jail population of the Gangetie vinces as under :—: — lolera Admissions of the Jails of the eastern division of the epidemic area in the Epidemic of 1863-65. y,*B. STBB* 6 TH. | I J | I Jj I 1 j 111 111 % I | 1 1• 1 1 a 1863 ... 17,197 1 3 294 42 82 57 439 137 35 46 48 4 1,188 498 1864 ... 17,688 ... 6 16 127 70 165 16 53 2 1 1 1 458 148 1805 ... 18,601 ... 1 1 104 3 2 40 31 48 27 18 ... 275 IJ4 I In noting the disappearance of cholera in the fourth year after invasion, that is, in 1866 are compelled to recognise the invasion following that of 1863; for with the monsoon of y 1866, the south-western portion of Bengal Proper, Chota Nagpore, and the Behar ?vinces were covered from the Bay of Bengal to the Himalayas with the material of a new 1 great epidemic. It is, therefore, in the provinces lying to the west of Behar alone, that the limum exists. And the Jail Table of 1866, as printed, showed but a single death of a prisoner in the jails of the Gangetie Districts, Oude, and Cawnpore, who died in August at Futtehghur. a note to the Death Table of the year, however, a severe outbreak is referred to as occurring August in the lock-up at Futtehpore, in which twelve prisoners died. This and the cases which urred in the European Regiment at Allahabad at the same time, were linked on with the ading cholera of July 1866, and this offshoot was noticed in other stations of the ages, for example, in Buxar and Mirzapore. I have no hesitation in stating, that these es were not reproductions of the epidemic cholera of 1863-66; for, besides ' the history ached to them, the history of the same cholera later in the year, proves, that if this was not actual body of the cholera invading Agra and Rajpootana in October, it was a portion of same, and the immediate precursor of it. Cholera admissions of the European Army in the eastern division of the epidemic area, 1863-65. ==¦ ( ~ - - Ybab. Stbewgth. £" I" • *.-•§«-' -2 Total. Died. g jjj ¦§ — • ¦ <& • p J> * 1 | § ¦§ Jj =• j? i 3 s 1 j I | o 1863 ... 12,855 4 ... 2 14 3 1 79 55 9 8 175 136 1864 ... 11,753 2 2 2 3 9 6 66 2 92 71 1865 ... 11,254 4 27 2 3 ... 19 13 ... 1 2 71 57 With the exception of the eight cases and four deaths at Allahabad which I have mentioned above, there was in 1866, as in 1862, but one death of an European soldier west of the Behar Provinces, between Dinapore and the Peshawur Frontier ; he died at Futtehghur at the time that the only case representative of cholera among the jail population appeared. It is interesting in Inexion with the history of the invading- cholera of 1866, to note a single death in the -a Jail in August (the only representative of cholera in the western division, in the isoon months) ; this I believe to have been a true outrunner, from the east, of the cholera eh appeared in the end of October. Taking the parallels of 1856 and 1860, the cholera of 1863 was due to reappear by revitalisation, or by reinforcement, or by both, in the Central Provinces in March 1864 ; and the reappearance did occur. Taking the same parallels, the western division of the epidemic area was liable to be entered in May, and to be covered by the monsoon cholera of 1864. But here we are at fault. Neither in the types under observation, nor yet from any record, can it be shown that epidemic advance into this area did occur. We may take the case of the prisoner in the Umballa Jail in April, and that of the Sergeant at Meean Meer in May, to represent a cholera invading in the spring of 1864; I prefer, however, to say, that the cholera due to have appeared in the western division, was lost to us for this year, and appeared only when its appearance was inevitable in 1865, and even then in limited volume and curtailed in geographical distribution. The invading cholera of 1865, did not, like the cholera of 1856 and 1861, reach the Lahore District, but was abruptly cut short in the Ferozepore District, which was the north-west limit of this small but true epidemic, which, as a scientific fact, covered the entire western epidemic area as far to the east as Meerut, and to the south as Gwalior. This advance was well represented among the general population, and it is very clearly demonstrated in our types. If the Mortuary Returns of the Punjab are to be believed, this cholera was attended with a loss of 3,000 lives in the Ferozepore District. In 1866, as in 1858 and 1862, this cholera of the Ferozepore District seems to have been carried on to the Rawulpindee District and to the Frontier. Had our types been taken as demonstrative of the fact of the absence or presence of an epidemic, we should utterly have failed to trace this weak body of cholera in its third year after invasion, but with the assistance of the Mortuary Statistics to bridge over the difficulty, the parallel of 1864-66 stands substantially the same with 1856-58 and 1860-62, although the power of the body of the cholera invading in 1865 (the second year) is in no way to be compared with that of the invasion of 1861 (also a second year cholera). The body of the cholera from which this offshoot occurred, did not advance epidemically even into the Agra District. But immediately to the south, it was a dreadful epidemic, which cut off 36,000 people in Etawah, Jhansi, Jaloun, Humeerpore, and Banda. I The following table shows the geography of the epidemic of 1865, which in May made sporadic invasion into the western division of the epidemic area. It was in the districts h of the Jumna, and geographically connected on to the Central Provinces, which suffered eavily, that this cholera of the North- Western Provinces was concentrated : — Deaths of the general population of the North-Western Provinces in the cholera of 1865, which was derived from the invading cholera of 1863, and was confined as a virulent epidemic to the districts lying south of the Jumna. I Districts South of the Jumna. Western Division of Epidemic Area. (Tract of maximum). Agra ... ... ... 308 da ... ... ... 2,748 Muttra ... ... ... 92 Humeerpore ... ... ... 8,829 Etah ... ... ... 247 Jaloun ... ... ... 10,190 Allyghur ... ... ... 151 Jhansi ... ... ... 9,948 Bolundshuhur ... ... ... 200 Etawah ... ... 3,513 Mynpoorie ... ... ... 581* t748 Moradabad ... ... ... 965* Meerut ... ... ... 854* Mozuffernug'g'ur ... ... ... 107 Seharunpore ... ... ... 344 Bijnore... ... ... ... 99 Deyrah Dhoon ... ... ... 1 Terai ... ... ... ... 45 * Geographically connected on with the tract of maximum. 45 The deaths of the second column indicate the presence of the cholera which sent its offshoot into Meerut, Rohilcund, and the Punjab between the 15th and 31st May. It was extinct in 1866. Cholera Deaths of the western division of the epidemic area in the Epidemic of 1864-66. European Troops. I . j Year. £ f • 4 II ti 1 I J !JII I i^ 1 I'J l ! f J 1865 ... ... ... 1-2831 I ... 16 I ' Native Troops. Yeab - fr I a i 1 *' 1 I j § g-gj >,« >. I, •-S P P ! I Jail Population. Year. £ g tf i ti 1 ij p-3t(?=«l)j^i>-sHs<)ar3Ofcsifi I But there must have been a reason why this epidemic of 1864-66 of the western division of the epidemic area proved an aborted epidemic. The eastern invading cholera of 1863 was very far from being a weak body of cholera ; although, to judge from its effects on the European Army, it was very much weaker than that of 1855 and 1859. The fact seems to be, that in place of its volume having been divided between two invasions, each of a different geography, as in 1856 and 1860, when the spring cholera became a great cholera over Nagpore, and the monsoon cholera a great cholera over our northern provinces, the cholera of 1863 was swept clear out of the highway leading to our North- Western Provin- I, and was thrown as a body over the Central Provinces, in which it provided the materies of epidemic greater than those of 1856 and 1860; the epidemic of the northern portion of the demic area being at the same time reduced to the shadow which became the invading cholera May 1865 shown in the preceding table. All that need be said of this cholera is, that reproduced or reinforced in the spring of 1864-65, s Central Provinces from sea to sea were covered by it, and from this great sheet of cholera, occupying the southern epidemic highway, emanated the cholera of Arabia, Eastern Africa, and Europe. This cholera was still represented in 1866, as reference to the Jail Table will show : — Jail population of the Central Provinces — Cholera Admissions in the Epidemic 1863-66. fiiSfifiiiJi § s 1863... ... 33 93 I 1 6 22 1 .. ]56 59 1864... ... 25 15 18 50 18 !23 3 3 155 63 1865... ... 9 36 51 22 129 17 2 1 .. ... 267 143 186 ?-~ ••• ••¦ None. None. • Marking the invasion from the east of the new epidemic, 1806-68. 46 The year 1867 was the fourth year after the invasion of the Central Provinces, and was marked by the universal disappearance of cholera throughout the area covered in 1863 and 1864; in fact, throughout the Central Provinces, from east to west, there is no record of cholera from any district. As I have explained, the cholera of Mundla was no exception, since this was a portion of the great cholera of 1867, universal in the eastern and western divisions of the epidemic area to the north. Summary for the Epidemic of 1863-66. 1863. — The year of invasion from the east. Cholera confined to the eastern division of the epidemic area, the Agra District being the western limit of the invasion. The stations of the north and east of the Central Provinces were invaded in June. 1864. — The year following the invasion of the eastern area. Cholera general in the same area, both in the spring and monsoon reproductions ; revitalised and probably reinforced in spring in the Central Provinces, but making no advance into the northern provinces of the western division. 1865. — The third year of invasion in the east. Cholera still general, both in the spring and monsoon reproductions. Universally reproduced also over the Central Provinces. Advancing by invasion of the western division of the epidemic area towards the north-west as far as into the Ferozepore District, but in epidemic vigour only in the tract south of the Jumna. 1866. — The fourth year of an invading cholera in the eastern division of the epidemic area. Cholera at a minimum or extinct west of the Behar Provinces. In the Central Provinces, cholera in the third year following invasion, still existing. In the northern provinces of India, still existing, but at a minimum. 1867. — The fourth year of an invading cholera in the Central Provinces ; cholera extinct. A fourth year in the northern provinces ; cholera would have had here also no existence but for the reinvasion by the new epidemic, that of 1866. Distribution in time of the Invading Epidemic of 1866. II have in a previous chapter, noticed the parallel between the invasions of 1817 and 6. In considering the distribution of this cholera in time, I believe that we should not have ¦d had we regarded the invasion of 1866, although limited in its geographical distribution, as -esentative of a first year's cholera, such as that of 1855, 1859, or i 863. Had the parallel 1 good, then over the eastern division of the epidemic area, the years of persistence of this lera would have been — 1866, 1867, and 1868, with 1869 as a year of minimum, eorresding in character with the years 1854, 1858, 1862, and 1866, minus the invading lera of that year. I But it must never be forgotten that all epidemic history is subordinated to the operai of natural agencies, and any anticipations formed have been disturbed by the exceptional racter of the meteorology of the year 1868, in relation to which the phenomenon of repression been generally manifested. For reasons which I shall state afterwards, I do not think t there were grounds to anticipate, in 1868, from the cholera of 1866-67, a revival of very at epidemic strength in the northern provinces of India. Still, repression and unnaturally id decay consequent upon the prevalence of conditions prejudicial to continued vitality, uced the death-rate of the year for the general population, to a minimum much lower n was to be anticipated, having regard to parallel epidemic history. Whether cholera can sibly survive in Northern India through such a year as 1868, the expei'ience of 1869 will w. But at the same time, reinvasion from the belt of cholera stretched across the Central •vinces in 1868 is possible, and should be watched for. tl look upon the cholera invading the Central Provinces and Madras and Bombay in 1868 third year cholera, a true offshoot of our invading cholera of 1866-67, and it will be resting to watch the progress and duration of the epidemic in relation to this theory. The mencement of a new epidemic may also now be looked for at any time, and there is little ice of its appearance being delayed beyond 1870. The parallel of the invasion of the Central Provinces in the year following the invasion of the Gangetic Provinces from the east, was utterly wanting in 1867, and it occurred only in the spring of 1 868. As far as we can judge, the conditions for invasion from the east were favorable in the spring of 1867 ; but one essential condition was wanting, namely, the pabulum of an epidemic. The explanation seems to be, that, as in 1863 the body of eastern cholera was withdrawn from our North-Western Provinces to become the great epidemic of Central India of 1864-05, so in October 1866, the cholera which would in March 1867, following the parallels of 1817, 1821, 1856, and 1860 and other years of invasion, have become the invading cholera of Nagpore, was bodily removed, and entei'ed the epidemic highway leading to the north-west of India in place of remaining where it was, and seeking in the next spring the epidemic highway through Central India. The part played in 1866-67, was precisely the converse of that played in 1863-64, and had the role of these two epidemics not been so played, and had the cholera of the north and south been equitably adjusted, the four epidemics of our period would have been precisely parallel one with the other. The materies of an epidemic is a plaything in the hand of the influences which direct its distribution, and its future depends upon the meteorological 47 conditions of the geographical area from which it has its starting point. The experience of these years shows — first, that two epidemics, extending over years, may run a course perfectly parallel next, that the cholera, the body of an epidemic, may be diverted from the north to become a great cholera in the south ; or, thirdly, that the body of the epidemic may be diverted from the south, to become a great cholera in the north. In a diagram, the case is thus displayed :—: — A typical epidemic appearing both in the Central Provinces and in Northern India, such as that of 1856 or 1860, is represented by the perfect parallelogram; while such an epidemic as that of 1863-65 is shown by the half only. In this case the epidemic predominated in the south ; but a second epidemic, as was the case with that of 1866-67, may predo minate in the north without appearing at all in the south, or only typically and not substantially. The track which cholera pursues beyond Hindostan is also regulated by the agencies conflicting at the fountain head ; either the southern or the northern cholera is the base of an epidemic emigrating from Hindostan. When the materies of an epidemic is distributed thick throughout the epidemic highway in the Central Provinces, the western extension is through (riizerat, Kurrachee, Southern Persia, and Arabia to the Mediterranean ; when through Bundelcund, Agra, Ajmere, Bikaneer, and Cabul, it is towards Northern Persia and the shores of the Caspian that the ejridemic travels. Perfect though these parallels be, we shall be as often wrong as right in our anticipations regarding the career of epidemics, until the records shall have been very much extended, and shall have been accurately studied with reference to the significance of the phenomena and their relations to the agencies by which they are regulated. In a succeeding chapter, the general principles taught by the history of the epidemics of this period, will be shown to be confirmed by previous epidemic history, as far as we now can draw inferences from data which have passed without special record, or which have been looked at in the light of some special theory when recorders have attempted to make use of them for purposes of generalisation. 48 CHAPTER IV rRY EPIDEMIC IS A REPETITION OP EPIDEMICS WHICH HAVE PRECEDED IT, AND THE PARALLELS BETWEEN DIFFERENT EPIDEMICS ARE AS FIXED AND STABLE AS IS THE RECURRENCE OF THE PHENOMENA OF THE METEOROLOGY OF AN INVADED AREA. I In the first chapter, the distribution in space of the epidemic cholera of the past fifteen year s i shown ; in the third, the distribution in time of the epidemics of the period was considered ; [ in the second, the intervals between the various manifestations occurring 1 during each epidemic, ural for the different geographical situations of an invading 1 cholera, were suggested. For the lprehension of their natural history, it is essential to conceive ofthe epidemics of this Presidency cv these different aspects ; as having a distinct geography and a distinct limit in time, with ;ain periods of dormancy recurring throughout epidemic existence, differing for different ations, but natural for these situations. tit has been shown, that after sub-dividing the epidemic area into provinces, the geographidistribution of one epidemic is repeated with more or less precision in every recurring emic, the parallel being, in many cases, absolutely identical, and in others less perfect, ough the typical fact of its occurrence is quite apparent. It has been shown, that the rvals between the manifestations of epidemic existence are for the same locality, the same ich year; and that the recurrence of the manifestations of each year during the occupation n invaded area, are to be looked forward to at seasons which are natural, but which vary i geographical situation. I have exhibited the space which I have mapped out as the eastern division of the epidemic I. . , ... ? „ area, as free from cholera, or as having cholera at a minimum, he special aspects of the cholera of . ' N nD ro id on i -\onr> it i_ i .v. eastern and western divisions of m 1854, 1858, 1862, and 1866 ; and 1 have shown the same epidemic area in each epidemic area to be the limit of invasion in 1855, 1859, and 1863, raSted. urlimi in +lia rKcfvinfa +r> +lio nroot />Vir»lov«l lind nn PYiatdTlOU when in the districts to the west cholera had no existence, lin 1867, when cholera from a different base had invaded the districts beyond. I have ed the cholera of this area as having a behaviour of its own, peculiar to it and consistent mghout, and an aspect which cuts it off from the cholera of any other territorial disution. Its intervals of dormancy also, are different from those of other portions of the area. tThe following tables will illustrate the special aspect of the cholera of the eastern division lation to season, and its contrast with the aspect of the cholera of the western division Le epidemic area. The figures fall as they do, not by chance, but because the cholera of of these provinces has a natural aspect which is proper to it : — JAIL POPULATION OF THE EASTERN DIVISION OF THE EPIDEMIC AIIEA, 1859-65. Cholera Admissions of each month for the period. Years. sA O j ¦§ jj ¦§ £ . 1859-65 ... 5 30 438 | 653 390 321 629 522 151 100 83 12 3,334 Admitted in each month per cent, of the total admissions. 3859-65 ... -15 '90 13"14 19"59 11-69 j 9-63 18-87 15"65 453 300 249 '36 100-00 JAIL POPULATION Ol 1 THE WESTERN DIVISION OF THE EPIDEMIC AllEA,* 1860-67. Cholera Admissions of each month for the period. ?•""" \ s f i J . . i I | I i i '1111111 I I I I § I 1860-67 ... 17 43 55 379 1,842 97 27 2 ... 2,462 Admitted in each month per cent, of the total admissions. 1860-67 ... ... "69 1-75 2-23 15-40 74"82 3-93 1-10 -08 ... 100-00 * Excluding the Central Provinces. o EUROPEAN ARMY OF THE EASTERN DIVISION OF THE EPIDEMIC AREA, 1859-67. Cholera Deaths of each month of the period. Ybam. i; IT ti 1 £ 1 I 4 lllt|il'l|l|| | 1859-67 ... 4 4 59 219 131 64 127 278 110 18 8 1 1,023 Died in each month per cent, of the total deaths. 1859-67 ... -39 -39 5-77 2141 12-81 6-26 1240 2MB 1075 176 78 -10 100-00 EUROPEAN ARMY OF THE WESTERN DIVISION OF THE EPIDEMIC AREA, 1859-66. Cholera Deaths of each month of the period. I|l I i ¦2 5 tf * fi H d & s 1859-66 ... ......... 1 8 5 339 1,007 257 61 10 ... 1,688 Died in each month per cent, of the total deaths. ... -06 -47 -30 20-08 59-66 15-22 3-62 -59 ... 100-00 tl have already explained, that the cholera of the western area will reappear after the 20th oil, and with the means of epidemic diffusion, will be shown as a moving epidemic ; and that nee the cholera of May of any year following invasion, may show itself in the west as a great olera, as it did in 1857, 1862, and 1867. But the truth is not the less plain, that the repreltation of the cholera of April and May, must in the east, be of a very different weight in 9 general estimate, when we find 481 deaths from cholera in the European Army recorded in i first six months, against 14, recorded in the districts lying immediately to the west during } same time. The contrasts of areas enable us to determine the parallels proper to each which illustrate le behaviour of the contained or invading cholera. The parallels are as fixed as is the recurnce of the phenomena of the meteorology of any area ; and this is true both as regards re>roduced and newly invading cholera. If the phenomena be those of invasion, it holds true, that ley are coincident in time with the spread of natural agencies over the same area; if of production, then, manifestation is precisely regulated in relation to the geography and the lysical aspect of the region occupied. The contrasted statements above given, simply express le fact, that the physical aspects of the two provinces are different. I shall show that the fluences invading them are propagated from different bases; and this difference in the irection of their invasion cuts them off one from the other so completely as to prove the fact lat they are under two meteorological systems which are distinct. A contained cholera may in the eastern division reappear in any year in March ; a confined cholera in the western division, will not reappear provincially before the 20th April. In le eastern, the reproduced cholera of March and. April will, in all probability, be a moving lolera; in the western, the chances are against its finding the means of locomotion, though it may find them. Invasion of the eastern area occurs with either the spring or the monsoon cholera, and as often with the one as with the other ; the invasion of the western area May 1865, teaches that invasion of the western division may occur with the spring reprouction, but we know that this is exceptional, and that it is in the monsoon season that invasion ormally or, at least, most frequently, occurs. tJ S * ± J 7 Invasion in May is quite normal as far to the west and north as to Agra. In the second chapter, I have indicated what is for each portion of the Presidency le normal season of invasion or reproduction. Cholera at sea-level and in the region of >erennial moisture and early heat, is reproduced in February of every year. In the ast and south, in the endemic basin, or on its margins, or in tracts of a similar spect, the cholera of March is a great cholera ; this in any year may be found in vigour nd mobility from one sea to the other, across the plains of Nagpore, from the mouth : the Nerbudda to the Bay of Bengal, and low down in the valley of the Ganges. In the racts lying along the foot of the hills, I showed cholera to be general after the 13th of larch in 1857 ; and in 1867, as early as the 20th February, cholera was reproduced in 50 ITerai below Nynee Tal. The cholera of April and May, is a great cholera in the emic province, and is the great cholera of our eastern province shown in the Tables given ye ; it is apt to be as powerful as is the monsoon cholera over the Gangetic Provinces, Oude, vnpore, Bundelcund, Jubbulpore, and the Central Provinces ; and it is as normal to Malwa [ Guzerat in the west as it is to the Behar Provinces in the east. The eastern districts dermg 1 upon the western division, such as Cawnpore, Banda, or Humeerpore, get this cholera May, and very seldom earlier in the year ; May is the month of reproduction or invasion mal for these districts. In the western division, reproduction begins late in April ; it is not era! until] the first fortnight in May, and except in seasons such as 1862 or 1867, the miasm able to be fixed, and therefore but little apparent until the monsoon appears. I The same dates are maintained when invasion is in progress : — March for the extreme th; March for the extreme east, except in certain seasons of special meteorology, en the whole of the eastern division may be covered in this month ; April for the valley the Ganges and the western parts of Central India, such as Bhopal and Malwa ; May for tvnpore and the districts south of the Jumna, and for Saugor. In the western division the epidemic area, the 15th May is the earliest date at which invasion has been recognised our time, namely, in 1856, 1863, and 1865 ; generally it occurs with the monsoon reduction. The cholera of May 1867 was a secondary invasion proceeding from within area already occupied; the invading cholera of Rawulpindee, Hazara, and Peshawur Vlay 1867, was strictly homologous with the May invasions of 1856, 1863, or 1865. I Following the track of the monsoon which affects the western epidemic division of our sidency, in a line from Juggernauth to Lahore, the dates of reproduction or invasion extend l the 20th June to the 7th August, becoming later gradually as progress is made towards the ts reached by the monsoon influences in the north-west ; for one province the end of June July is normal ; in another, the cholera of July predominates ; in a third, that of August, ere the monsoon ends, there the epidemic of the year ends : in 1856 and 1861, it was at ore; in 1865, in the Perozepore District. The limit of the monsoon is marked geographir by the north-western desert, which is, on every occasion, the limit in the north-west of olera invading with the monsoon from the south-east. Since the reproduction and invasion of cholera takes place in coincidence with the conditions of a locality and the presence of normally invading agencies, it follows, that where for the time, conditions other than those normal for the season are found, the phenomena of reproduction or invasion must be repressed or accelerated in relation to these existing conditions. This is a necessary consequence if what has been alleged above be true, that whatever variations there may be, are due to natural causes and not to contingencies. In certain years, our eastern division of the epidemic area becomes in the months before the setting in of the monsoon identical as regards its meteorology with the western area, and the hot westerly winds prevail over the east from Cawnpore to Dinapore for weeks at a time. In such a season, eastern influences are in abeyance for the time, and the reproduction of the cholera existing withir, the area is repressed in proportion to the predominance of the westerly influences. In a season of the maximum of the prevalence of western influences, the eastern area will show the same dates for reproduction and invasion that are normal for the western division ; and when eastern influences prevail for the season at a maximum, coincidently with the presence or invasion of cholera, early and abundant manifestation is to be looked for. Invasion in progress may even be brought to an abrupt stand-still, when the influences which govern it fail, as happened in 1860, when the failure of the monsoon over the famine area of 1861, was attended by the repulse of cholera invading from the east and south. I These introductory observations will suffice to indicate, in a general way, what cholera is ;self, and how it comports itself in its various relations. What has been stated shows, that tever phenomena occur, occur primarily in subordination to what cholera is as an individur; ; that its secondary manifestations are played in direct relation to surroimding influences ; it has a mobile as well as a sessile existence; and that the phenomena attending ility must be studied apart from those of vitality. The generalisations of these chapters now form the basis of a more detailed examination, illustrated by the facts of the period. 51 CHAPTER V. THE PHENOMENA OF THE INVASION OF AN UNOCCUPIED AREA. Proposition A. — Certain areas enjoy comparative exemption from cholera in every year; IN OTHERS IT IS ENDEMIC AND PERENNIAL. Certain areas are occupied by cholera in each year, while others are free from its PRESENCE. The area of the Bengal Presidency may be mapped out into two primary divisions, the AREAS RESPECTIVELY OF ENDEMIC AND EPIDEMIC CHOLERA; THE EPIDEMIC AREA IS ESSEN- TIALLY AN INVADED AREA. Repression or acceleration is a phenomenon of season subsidiary to the presence of the material of an epidemic. It is not true as some wonl( Comparative liability to cholera of gu ™ e st, that the repression of a constantly existing cholera fterent portions of the epidemic area. , & Vi ; • i- i 1 • 1 • by the operation ot meteorological agencies and the acce eration of its manifestation by others, are sufficient to account for the phenomena of the )idemic appearance of cholera in one year and its disappearance in others over Uppe ndia. Repression at a certain season is not followed by extinction, but the manifestation tept back for the time, comes forward as soon as the repressing agencies are substituted fo ihers favorable to the manifestation of epidemic existence. Reproduction is normally pressed over the western division of the epidemic area in each year up to the 20th April nd for two months and a half later the movement of the revitalised cholera is repressed, bu ; is not scientifically true to say, that this area is an area of comparative exemption because ' its liability to cholera being confined within so small a number of months in the year n the eastern division as well, the most violent and moving cholera may be repressed in it reer and hindered from manifestation, as in 1860, when throughout the Gangetic 'rovinces and Oude, the epidemic was brought to a stand between the 16th and 21st April , an example of the converse, as when, in June 1864, the cessation of westerly influence as followed at once by the appearance of cholera over the area. I These manifestations are secondary only. Whether cholera may be repressed or acceleratei its appearance has nothing to do with the question of the comparative exemption from cholera certain areas of this Presidency. The eastern division of the epidemic area may show cholera ;al throughout from March to September, while the western shows, as the rule, epidemic life ly from July to September ; but this is a question of degree, and stands apart from the sential consideration, which is, the relative liability of either tract to epidemic invasion. II true at the same time, that the capabilities for retaining and localising epidemic cholera any area, may be accurately gauged by the acceleration of its revitalisation in any year. In sketching the geography of epidemic cholera, I have demonstrated, that throughoul le entire epidemic area from north to south and from east to west, cholera may disappear as i disappears beyond the boundaries of Hindostan, and, I repeat, that no suggestion as to le possibility of repression, can account for the phenomena, which are distinctly those oi xtinction from the death of the material of each epidemic. I have showed, that up to the ay of the invasion of 1856 — March in Nagpore, May in Agra, and August in the Punjab — the Central Provinces, Central India, Agra, Rohilcund, Meerut, and the Punjab were free rom cholera for the two years previous ; how over the same extent of country, cholera was cad in 1859 and 1860 up to the invasions of 1860 and 1861; and how, a third time, i 1 isappeared during 1863 and 1864 from Rohilcund, Meerut, and the Punjab; and how but or the invasion of 1866, cholera would have been lost again in 1867, as it was actually lost the Central Provinces. I have showed also, how in the eastern division, that is, in the langetic Provinces, Oude, Cawnpore, and Bundelcund, cholera was lost or at a minimum in le fourth year following each invasion, in 1858, 1862, and 1866. These are the exemptions of certain years. It is very important to enquire whether there are any portions of the epidemic area that are perennially exempted, or which enjoy a marked immunity on the occasion of invasion, or in years subsequent to invasion. This question is not to be answered by figured statements only, but from a comprehensive grasp of the histories of epidemics. This question can be studied only in connexion with and under the law, that the range of epidemic cholera is rigidly limited to areas of natural influences. The invasion of the western area from the south-east terminated in 1856 and 1861 in the Lahore District, and that of 1865 in the Ferozepore District, while all the districts to the north and north-west remained Northern Punjab. uninvaded. On no occasion in the history of invading cholera with which lam acquainted, has the high Punjab ever been reached, although forerunners may have been thrown out as warnings of its existence in the east and south; when the Frontier was attacked in 1858, 1862, or 1867, it was by a cholera secondarily invading, reproduced from the cholera of 1856, 1860, and 1866, spread over the east and south of the Punjab in the years before. The primary invasion extends only up to the limits of monsoon influences from the south-east ; it is with the spring rains and the easterly winds of May that the districts beyond the Jhelum and Indus lying beyond the monsoon influence from the south-east, of July and August, are entered ; examples are, the invasion of the Rawulpindee District in May 1858, of the Bunnoo District on 20th April 1862, and of the Rawulpindee and Peshawur Districts in May 1867. When invasion of such an area has occurred, attack may take place at any time subsequent to the occupation, because invasion is a phenomenon of provincial and not of local significance ; thus, the Peshawur Valley was entered in July 1862 and in the end of October 1858, as well as with the advancing epidemic of May 1867. The geographical situation of the high Punjab does not place it beyond the reach of epidemic influence, but it limits that influence in time. Out of the four years of the persistence of the epidemic of 1855-58, Peshawur suffered for twelve days only, while the stations of the eastern area were liable to attack at any time throughout the four years; in the epidemic of 1859-62, Peshawur suffered for four months only. What is true of the Northern Punjab holds good generally for the south of the province also. Mooltan and other stations lying to the west of the desert, are touched by the monsoon on rare occasions only, Mooltan District. and are not reached but as the exception, in the first year of an invading epidemic. In such a year as 1856, when the weather was so unseasonable that it might have been said that in the western division the monsoon lasted from the end of May up to October, Mooltan was reached at the same time with Lahore, and also Googaira lying half way between. Mooltan Iy be reached also by the May cholera of these provinces, as in 1867 ; but there can be doubt that this region is the one probably least liable to cholera of any included within the lemic area of this Presidency. Districts lying but a little to the south of Mooltan, are situaon the second epidemic highway by which cholera crosses from the east of our Presidency ) countries beyond the limits of Hindostan,* which leads through Bundelcund, Agra, Gwalior, nere, Bikaneer, Bhawulpore, and Rajanpore, and these enjoy no such immunity as the oltan and the districts lying immediately to the north and west. This immunity seems to be i to the fact, that this tract lies in the fork between the monsoon influences proceeding from ; to west, and those proceeding from south-east to north-west in the western epidemic area, !ch by their divergence leave the interval a desert. I have shown how a similar portion of the western epidemic area is generally exempted in primary invasion, lying between the range of the influences proceeding from south-east to north-west and those invading Jullundur Doab. iectly to the north, namely, the Jullundur Doab, and adjacent districts ; this area is not expted from secondary invasion, as the events of 1857 and 1858 and 1867 prove. In connexion ;h this exemption, I have referred to Umballa and the districts adjoining, as remaining iffected in the great epidemic of 1856 up to the 4th September, when all the districts to the t and west had been occupied a month earlier. There is another tract which would, I believe, show consistently a minimum of liability „ , . , er, , , T ? to invasion had we the statistics of a population to demon- Certain tracts of Central India. , , ? » , ? . . ? , . ff , ? „_, . strate the fact ; this is the country lying to the south of Jhansi II Gwalior in the neighbourhood of Seepree and Goonah. This is, I think, scarcely reached influences from the south-west, and it is at the same time out of the direct track of eastern uences. This much is certain, that it lies between two natural provinces ; it is not a track ass which cholera can reach Gwalior from Indore, nor Indore from Gwalior. It is the tract jountry lying immediately to the south of the line limiting influences proceeding directly n the east to the west on the northern route ; it was, for example, an exempted tract in 17, when to the north, from Gwalior to Peshawur, the cholera of the year was universal. We c no experience, however, to show what actually is the state of the case as regards this i. Perhaps the most important tract of minimum in the epidemic area is that separating eastern influences from those having the south-east for their Iract lying immediately to the west k ase- This is the tract which I have traced from Mr. Strahe line limiting eastern invasion. i , .« « ,i i i » ¦,(,„, . „„ T . •? 6 chey s narrative of the cholera of 1861, at page 26 . It lies nediately west of the western limit of the invasions from the east of 1855, 1859, and 1863. I ard this as a tract as distinctly neutral as it is possible for any tract separating two epidemic vinces to be. We have no record of cholera crossing it from east to west or from west to east. •m the earliest times the record is consistent. Jameson shows how, in 1818, eastern cholera s repelled from its margins, finding its western limit in the Shahjehanpore District. I Jameson writes : — " When cholera had reached Cawnpore in the following spring, it showed larked aversion to Bareilly and the other tracts east of the Ganges/ Again, after speaking the epidemic at Bithoor and its neighbourhood, Jameson adds : — " But cholera appeared le disposed to extend far on that direction — Bareilly, Moradabad, and almost every other to in the same line enjoyed their wonted health. The town and district of Shahjehanpore, rever, formed a remarkable exception to the general healthiness of the province of Again, we find Jameson indicating to us this exempted tract between the eastern and western invasion of 1818: — " On the Jumna, the epidemic spared Culpee and almost every intermediate village between it and Etawah." Etawah was reached in May 1818 as Agra was reached in May 1856 and May 1863. * I have alluded to the route through Nagpore and the Central Provinces as the southern epidemic highway. 53 In the records of later epidemics, for example in that of 1826, we find the Superintending Surgeon of Meerut describing the ravages of cholera west of the Jumna while Meerut is still unaffected ; and we find Mackinnon asking, how it is that those who say that cholera I Still Ulliaild; ugu , •*"«. .. v, ...... -..—. ~~— aJ --- „ ivels by human intercourse from Agra to Delhi, never venture to allege the same ot cholera as its passing from Agra to Cawnpore. This was the eastern limit of our western cholera of 58 and 1862 and of 1861, as it was the western limit of the cholera of 1855, 1859, 1860, Id 1863. Exemption must be used as a comparative term in speaking of this tract. It is exempted compared with the Banda, Humeerpore, or Oraie Districts lying to the south ; as compared with estern and Northern Oude and Cawnpore, lying to the east; and as compared with the Meerut d Agra Districts lying to the west of it. A great eastern cholera will march up to this limit, did the Shahjehanpore cholera of 1818 or 1867; a great cholera from the south will not leave uninvaded. But taken altogether, this is a tract of wonderful exemption, as the statistics its jails show : — Thirty Yeaes— lB39-68. Deaths from Cholera in the Jails undernoted. TEAE'. BotTTNDSHUHTIB. AIMOHCB. ETAH. MyITPOOBIE. ETAWAH. 1839 ... 3 No record. 2 1840 ... 1 None. 1843 ... ... ... - 1 1844 ... ... ... 1 1856 ... ... 14 1861 "3 !" '.'.'. ... ... 1863 '.'.'. "i '.'.' '.'.'. '.'.'. 1865 ... '.'.'. ... ... 1 1867 '.'.'. "i "i '.'.'. It would be wrong to infer that in epidemic seasons cholera is absent from these districts ; it is a minimum of manifestation and not the absence of cholera that is to be anticipated. Even, at long intervals, a maximum may be found if the circumstances prove suitable. Thus, all these districts suffered extremely in the year before this table commences, 1838, when Bolundshuhur Jail lost forty-nine prisoners, Allyghur thirty-six, Etawah eighty-four, and Mynpoorie twelve. In a minor degree this applies also to the Bareilly District. Since the occupation of Bareilly by European Troops in 1858 the cholera record has been singularly favorable, as the statement annexed proves : — European Troops, Station Bareilly, 1859-68. Teas. Strength. Admissions. Deaths. 1859 ... ... ... ... 823 1 1 1860 ... ... ... ... 1,008 1 1* 1861 ... ... ... .., 1,188 5 5 1864 ... ... '." '..'. 881 'l' "V 1865 ... ... ... ... 853-3 2 1867 ..'. '.'.'. '.'.'. '.','. 805 '"3" '"2" An imported case. 54 These are, as far as I know them, the only portions of the plains of the epidemic area that can claim comparative exemption from cholera in primary or secondary invasion. We shoul( not be justified in saying that any square mile of the area can lay claim to absolute ex emption. The districts above referred to, have their liability to cholera diminished, because they lie upon the borders of epidemic provinces, or beyond primary invasion. The significance o their comparative exemption is this, not that these districts are deficient in the local conditions necessary for the retention of a passing epidemic, but that the material of an epidemic is excludec from them owing to the failure of the vehicle which is necessary for its conveyance into any area . which is to be invaded. The dissemination of epidemic cholera is as wide and as diffuse and as universal as is the spread of air-borne influences ; the repression in space of advancing cholera is exactly limited by the failure of the same influences ; and no secondary agency can carry an advancing epidemic beyond the lines which are those geographically defined by natural agencies. The comparative exemption from cholera of our hill stations is due more to elevation ? , ?„ ?. than to situation. Several are apt to suffer to a trifline- Comparative exemption of hill stations. , , , . ? ?, ,£ ?,. .. S extent, and in the case of these, the statistics of imported ises are so mixed up with those said to have been acquired on the spot, that the actual facts local liability to cholera are difficult to arrive at. When Darjeeling is said to have )lera in its bazars, it is raging in the Terai below, and the coolie population are found dying along the road leading from the plains to the hills. During our period of observation no ropean Soldier has died from cholera at this station,* and I believe that there is every ground hope for exemption in the future. The valley of Nepaul has a population extremely susceptible to the attack of cholera. This valley is entered oft every occasion of eastern invasion in the second year, and its ravages extend over months. The conditions afforded to it are such as favor its spread among the Nepaulese as if it were a contagious pestilence. KAt Nynee Tal, one admission was reported in 1862 ; this is the only case of these years, nee Tal will always, I believe, enjoy immunity from cholera in connexion with its geogracal situation in the tract of minimum between eastern and western influences. No case of cholera has occurred in the Landour Depot during this period. I The Simla group of stations cannot lay claim to the same extent of immunity; still, isidering their situation, their statistics must be reckoned as very favorable. In the great asion of 1845, both Kussowlie and Subathoo suffered severely, in common with every station the western area then occupied (see the Table for the year 1845) . Kussowlie lost thirty-eight n out of 137 attacked, and Subathoo forty -two out of 133 attacks. This fact must, however, taken to denote the possibility rather than the probability of attack in so heavy a ratio, f I In the next great outbreak, that of 1852, when Umballa lost seventy-three men, there was a single death in Kussowlie, Subathoo, or Dugshaie, although each station gave several admiss, showing that cholera had passed over them while Umballa was suffering. In the succeeding ision, that of 1856, not a single death occurred at these hill stations out of a strength of 2,150, on the very day on which the 32nd Regiment descended from Kussowlie, the 31st October 6, the great outbreak commenced, in which the Regiment, although moving daily, had fortydeaths. In the invasion following, that of 1861, when Umballa had fifty- three deaths, as in two previous invasions, not a man was affected at the three hill stations. In the little invasion klay 1865, which I have described as covering Meerut and Rohilcund almost universally, ough sparsely, two menj and a woman were struck at Kussowlie, and at the same time, a iof the 101 st Regiment on the opposite hill, at Dugshaie. In the invasion of November 6, there was no cholera at these stations. In the invasions of 1852, 1856, and 1861 elevation c saved these stations, for they lay in the direct track of the invading cholera. I But this group of stations is very liable to attack with the spring cholera of the year following invasion. The cholera of May 1857 threatened d^invaSon 8^ 0118 t0 "^ ** them at t he time when the g arrisons were withdrawn to join 1 ' the Delhi Force. Already in April two men had died at athoo ; the Nusseeree Battalion marching through Subathoo three weeks later, was believed aye there acquired the cholera which the men carried on with them to Seharunpore, as it was ng at the time in the bazars. The small depot of the Ist Fusiliers at Dugshaie lost twelve in May and June, and had the Regiment not been withdrawn before, it would in all •ability have suffered heavily. In May 1858, cholera again appeared in Dugshaie. owing the invasion of 1861, none of these stations were attacked by the widely and rously revitalised cholera of 1862. In the epidemic of 1867, Kussowlie escaped with igle admission, and Dugshaie had none ; but cholera clung to the Regiment of Subathoo t April to September. In an affected locality elevation is one of the first safeguards * The case of April 1866 was an imported case, developed subsequent to arrival, in a man of the battery which was attacked while marching from the Bhootan Territory to Darjeeling. »I am unacquainted with the circumstances attending the outbreak at Kussowlie in 1845. So heavy a ratio of is contrary to the experience of all subsequent epidemics, and it may be significant of something beyond the fact of the affection of the station of Kussowlie, % Both cases were fatal. 55 against attack, but from a valley once occupied cholera has great difficulty in making its exit. Whether it be the Nepaul Valley, the great valley of the Simla hills, or the valley of Peshawur, the history is the same. Dr. Munro tells us how in the Peshawur Valley between July and October 1862 his Regiment was on four different occasions subjected to attack ; and so again in 1867, the cholera is described as turning round and round for weeks, unable to effect its escape. Subathoo, it is true, is a station of low elevation (4,000 feet), but it will probably be found the best policy when the adjoining valley is invaded, not to remove the Regiment even from this hill top to a lower situation where it may fall into a persistent cholera. The warnings of October 1856, and of May 1857, when the Fusiliers and 75th Regiment suffered so severely, teach, that on these occasions, descent from a hil top implied immersion in a cholera-containing stratum. The valley of Cashmere suffers almost as much as that of Nepaul. It suffered in 1858, 1862, and 1867, the years of secondary invasion in the Punjab. tMurree and Abbottabad suffer in common with the district lying between the Jhelum and Indus; they were affected in 1858 and 1867 when the Doab was covered, and remained [fected in the epidemic of 1857 and 1862 when this tract remained unaffected. An elevation of so many feet above sea level is not from the mere fact, protective against* cholera. Abruptness of ascent combined with elevation, will probably be found to be the requisite for exemption. Where there is a funnel directing cholera in a definite direction into the interior of the hills invasion will certainly occur. Stations, such as Kussowlie or Mussoorie, having an abrupt ascent from the plains, are far less likely to suffer severely than those to which the ascent is gradual ; a plateau, such as that of Hazareebaugh, is as liable to be swept by cholera as are the plains above which it is elevated by 2,000 feet. Iln connexion with the disappearance of cholera from provinces,* the decay in strength of „ , cholera in years of minimum, is a very remarkable phenomecay m strength of the cholera t i i- -.l a i, i • l. ij.i. i, i. am years of minimum. non - 1 believe it to be general m such years, although at the very same time the cholera of the year may be evident in a virulent form in certain special situations of any province. When in 1862 cholera was at its lowest degree of manifestation in the eastern province, the 25th Native Infantry suffered severely on the Ganges; and yet I recall the fact from my own experience, that in this year cholera patients did not die, and other observers in the same province made the same remark. The significance of the fact I was not acquainted with at the time of its occurrence. Dr. Walker, late Secretary to the Sanitary Commission, informs me, that for years preceding the epidemic of 1856, the cases which seemed to be cases of true cholera in the great jail at Agra, which was under his charge, did not prove fatal ; and that the treatment employed when tried in the invading cholera of 1856 was of no avail. In 1858, in the six months from January to June, the Grand Army of Oude lost only one man out of eighteen admissions attributed to cholera. In the western area in 1859, after the disappearance of the cholera of 1856, the Cholera Table for European Troops shows twenty -two admissions, in thirteen stations, without a single fatal result ; and the table for the jail population, an equal number of admissions with one death, and that in a doubtful case. In such cases we are apt to seek an explanation in error of diagnosis. I do not think that we are justified in doing so; for the character of the symptoms and the date of the occurrence of such cases, point to the effects of a true choleraic influence on the constitution. It is necessary that there should be no misunderstanding when the term " endemic" is Ij-ea of perennial existence, the area applied to the cholera of a certain area. Some have one conendemic cholera. Definition of the ception of the meaning of the term ; others, another. Some n" Endemic." wnnlrl onv +T>a+ wl. OTa olmlora ia mflt with in pwnr ircar tlumi would say that where cholera is met with in every year, there lis endemic ; others would limit endemic cholera to the geographical area within which it is every occasion generated prior to invasion of the epidemic area. Some, speaking loosely, ; ready to assert that cholera is never absent from any of the great cities of India, and xt it may therefore be considered to be endemic in these ; others, with more reason, can int to the experience of cities, such as Patna, and say that cholera must be endemic in jh a locality, inasmuch as in the memory of the present generation, cholera has never in y year been absent. I think it better to connect the fact of invasion with the cholera of jhysical area of defined characteristics, and not to accept the mere fact of the constant of cholera for a certain distance beyond the defined margins as necessarily constibing the occupied tract a portion of the endemic province. The line is, in truth, a shaded c, especially towards the north, where the Ganges enters this province. Speaking as a ysician, it is perfectly correct to say that cholera is endemic in the Behar Provinces; making as an epidemiologist, it is more correct to say, that the Behar Provinces lie on the ided tract beyond and out of the endemic limits. The statement, that cholera may be found in any year in the cities of Northern India, is not based on statistical facts. lam inclined to think, that the minimum reached in many years in the northern provinces of this Presidency is absolute ; and it is beyond dispute, that from such a minimum as a focus, cholera never becomes revitalised to form an evident epidemic, when the life period of an invading cholera is accomplished. In the cities of the eastern area, however, which lies in immediate proximity to the confines of the endemic region, cholera will be found in 56 every year. I can point to no year since 1855, in which it can be with truth affirmed, that cholera has disappeared from the eastern division of the epidemic area. The minimum of 1858, 1862, and 1866 was still a minimum, and in April, July, and November cases of cholera, if carefully searched for, would probably have been found in every station of the valley of the Ganges, from Cawnpore or Futtehghur downwards to Dinapore. To say that cholera is endemic in this province because cholera will be found to exist in eveiy year, is not correct j it persists because of being reinforced by fresh invasion from behind— a fact prominently brought out by the evident decay of such years as the three above mentioned, followed by the renewal from a fresh body of cholera. In the cities of the western area, such as Meerut, Agra, or Lahore, I believe that cholera does actually disappear, although the repeated epidemics which have swept through this area of late years, prevent the fact from being made so evident as it would otherwise be. This persistence, however, is also due to reinforcement, and not to the fact that in such localities a cholera which has located itself, remains perennially as a consequence of its having found a suitable habitat. The epidemic area I have denned as including the portions of the Nagpore territories which furnish returns to Bengal, Central India, the Punjab, the North- Western Provinces, and Oude, and I have included also the Behar Provinces and Chota Nagpore. I do not think that we are entitled to infer that cholera is endemic east of Allahabad in the Gangetic Districts, using the term in the sense in which I have above denned it. In the Behar Provinces, invasion is always distinctly marked, coming either from the east or south, I they participate in the comparative immunity of years of minimum. The same, however, is of the cholera of the endemic area also ; for this, too, has its years of minimum and of true emic prevalence within its own limits. Intensity and persistence both denote in Behar approach le endemic area, so much so that the Behar Provinces with Chota Nagpore might almost have i made a distinct province intermediate between the eastern epidemic province and the endemic proper. A glance at the table showing the prevalence of cholera in the jails for thirty-six s past (vide appendix) , shows how wonderfully persistent is this cholera of Behar. I have consid it better, however, to take the line of the Rajmehal hills as the western boundary line of the ;mic area, and I have made it to include Monghyr, Bhaugulpore, and Purneah. Here cholera be looked for in every year in April and July, and very often in November also. To the south, era is expected at Hazareebaugh every year in April ; and the adjoining stations of Bengal )er on the laterite elevations bounding the diluvial deposits, are constantly subject to the c invasion when the winds pass over the breeding grounds at the seasons of revitalisation. The breeding grounds of the endemic region in the extreme south-east of this Presidency and the phenomena of invasion, are well described by Dr. Bensley, of Midnapore, in his very interesting paper replying to the questions submitted by the French Government in anticipation of the Conference at Constantinople. From this report I abstract the following, which relates to the diluvial district at sea-level, lying west of the Hooghly, and bounded on the west by laterite elevations, the terminations of the trap systems of Central India : — " The conclusion that one naturally arrives at is, that low marshy lands intersected by estuaries and by numerous streamlets, all under tidal influence, favor the preservation of the cholera poison. We find cholera endemic on the eastern sea-bordering country known as Higeelee, and this. tract of land appears to be oftener invaded by epidemics than any other part. But it is not .alone a favorable soil that is essential to the rise and progress of an epidemic. Were this the only thing required, we should have it for ever ravaging those parts; whereas, although occasional cases occur throughout the year, yet epidemic visitations arise after greater or less intervals of time. Confining my experience to the Midnapore District, we have had epidemics in March and April, in June and July, and in November, December, and January. To my mind, a something beyond the cholera germ is necessary for an epidemic. A seed possessing fertility will germinate at times under circumstances which are considered unfavorable to germination; but with air and a due supply of water, it springs up quickly and healthily. The cholera germs lie hidden in the ground. Occasionally they are extricated in sufficient quantity to develop a few cases of cholera; but when the atmospheric condition, which is air and water to the cholera seed, presents itself, their vitality is roused into full play. I confine my remarks to Higeelee, that part of the Midnapore District where cholera has its nursery. This atmospheric condition (shall we call it a cholera vapour?) progresses through the air, and it is attracted to, and is resuscitated by, swampy lands and localities that revel in sanitary defects. We have sufficient grounds, I think, for ascribing much of the advance of an epidemic to currents of wind. It has been stated that cholera has progressed in the face of a wind, but I should be disposed to receive statements of this sort with caution, especially in those instances when cholera passes over a large tract of uninhabited country to attack the dwellers at the opposite end, or when cholera passes from one country to another over a large expanse of water. The epidemic that visited this district in February 1866 commenced in the Higeelee tract, which I have already designated the nursery of cholera, and progressed steadily in a north and westerly direction, tacked up by a favorable wind.* The severest visitation we had, was in November 1864, soon ¦* It was this body of cholera which became the invading cholera of 1866, covering Behar in August, and the districts ie west in Cctpber and November; and which in its icvitnlisation became the epidemic of 1867 of Northern India, 57 lier the great cyclone of 4th October, when a storm wave rolled over the tract of country lying the west of the mouth of the Hooghly and over some of the northern parts of the Higeelee mitry. Cholera swept through the country like wildfire, and the houseless and starving labitants were carried off in countless numbers before relief could reach them. The condin of this tract of country was never one of great healthiness ; but it will require years and 3 absence of epidemic visitations, to bring back this district to what it was. The symptoms re very violent and the cholera the most rapid that I have ever witnessed or read, of, but > range of the epidemic was not wide. Starting on the western shores of the mouth of i Hooghly, it spread in a north-westerly direction, attacking Tumlook, and it stopped at a lage twenty-four miles east of Midnapore, where it appears to have exhausted itself. In a southerly direction it invaded the sea borders of the Higeelee District as far as Contai." I know no better account of the behaviour of cholera in its endemic region than the above, extracted from Dr. Bensley's paper. He clearly appreciates the natural history of cholera, and the three requisites for epidemic manifestation, the vitalisation, the medium of diffusion, nnd the directing agency ; and he gives us with accuracy, the dates of the budding forth of the cholera germ in the endemic area — February, March, and April, June, and October and November. I Dr. Bensley also well expresses the fact, that nothing in the geological speciality of any ¦ality, nor yet its elevation, exempt it from the attack of an air-borne endemic cholera. i instances his experience of Raepore in the south, in the Central Provinces, a station of the ;erite, which is subject to frequent and violent invasions of cholera ; and we know the same to be ie of Sooree, of Raneegunge, and of Hazareebaugh with an elevation of nearly 2,000 feet. He ites :—": — " Cholera is not met with in the town of Midnapore as an ever-existing evil. This may owing to the advantage which the station has in being sixty or seventy feet above the level of ! surrounding country, and its situation on the eastern extremity of the great laterite range ich runs through a portion of the Central Provinces and Chota Nagpore. I think, as far frequency is concerned, that there is truth in the idea that cholera is neither so frequent nor violent in the laterite country as in the alluvial. In the Higeelee District, which is mostly iivialj cholera is ever-existing, while in Midnapore it is not endemic ; but as far as regards entity, I think that cholera, when it does occur, is quite as severe at Midnapore as at ICuttack and Pooree also are within this south-eastern endemic area, and the dates of roduction in each year are the same as in Midnapore. In February and March, when cholera ades towards the Central Provinces, it is the Juggurnauth pilgrims who are blamed as ning the vehicle of diffusion ; it is in the end of June, that great outbreaks frequently occur at. j-gurnauth ; and in 1867, it Avas in November that a great outbreak was reported. Mr. Stewart, a special report on the cholera of Juggurnauth, writes : — " To state that Pooree is at ¦ time free from cholera would be risking the truth. The same may be said of Cuttack ; lera is seldom absent. Epidemics alone attract notice. Past experience shows that the end of hot season and beginning of the rains is the most usual time for outbreaks/'* The first of rain has been noticed to be the signal for the immediate appearance of an outburst. Thi> rerend Mr. Buckley writes :—": — " One reason, doubtless, of the great mortality is the time when principal festival is held, late in June or early in July. There is, however, a great differe between one year and another as to the prevalence of cholera. I have been at festivals triiuc utJLWctui une year ituu. auutiiei a.a iv tiic picvzuciiuc vi vuuiciii. x nave uceu itu lesuiviuh where the mortality, as far as I could observe, has been very slight ; but when a heavy fall of" rain occurs either at Pooree or on the return journey, disease and death may be confidently Stalement showing the months of Prevalence of Cholera in the Endemic Tract for which Calcutta is typical. GeneraMPopulation. Cholera deaths of the General Admissions orNative Troops. Months. Cholera deaths of Calcutta-26 1880 * 8 ' Calcutta, Barrackpore, and years (Maepherson). icrougnam;. j Dum . l)um _ 1 o years— lB6B-67. January ... 7,150 11 13 February ... 9,346 40 33 JUarch ... 14,710 93 70 April ... 19,382 75 64 May ... 13,335 96 83 June ... 6,325 78 43 July ... 3,979 27t 28 August ... 3,440 33J 26 September ... 3,935 20 24 October ... 6,211 33 29 November ... 8,323 33 34 December ... 8,159 8 25 * The equivalent of the July cholera of the epidemic area, t Seventeen of these cases occurred in the one year, 1866. X Twenty-four of these cases occurred iv the three years, 1866-68. 58 These statements show that from Calcutta cholera is never absent. They show that in every year cholera is ready for revival in the end of February, that it remains vitalised until June, i[ that it reasserts its presence as an epidemic towards the end of October. The distinction of i periods included between February and July cannot be made from such data as those given, would it be suspected, had we not the indications of the epidemic area as a clue. The difficulty rht readily be met by admitting that this period is the spring and summer of endemic lera, and that it persists in vitality throughout, with an interval of decline only, and not of The statistics of the jails of the districts lying west of the Hooghly for 1860, seem to me to show beautifully the seasons of reproduction normal for all parts of the endemic area. The entire submergence of the breeding grounds lying near the sea level as soon as the monsoon fairly sets in, hinders general manifestation in June and July, which therefore takes place only around the margins of the basin. Jails of Pooree, Midnapore, and Cuttack in 1860, an example typical for the Endemic Province and its margins. Jam-. Feb. Mabch. Apbil. Mat. June. July. Atjgcst. Sept. Oct. Nov. Dec. JAIL. oaSSaooSflSog OOooOOOOOOO^ .2 ja .3 .a .3 a .2 .3 .2 Ja .2 is .2 j= .2 .c .3 S .2 ¦£ -2 js .3 J3 l^j-sina-ss-sals^ §"sa-ssl|||-g t^ Q3'X3 «T3 GJTJ «r-J (DO aS^ > |" j \ (j 1 | YEAR. I'il&ii.ll.lli TOTAI " 18(50 4 4 48 ... 4 ... 12 23 92 1864 "... ... | "... ".'.. 3 4 !!! 11 5 "i 1 '." '", 26 ]Bfio 1 '20 ... 2 23 1866 6 2 3 1 ... 1 1 14 Total... 21 6 23 35 60 4 I 18 27 15 35 6 18 | 268 This table tells of the relation in season of this cholera to that of Bhaugulpore or of Patna, on the opposite margin of the endemic basin. The minimum of June is indicated, which is a very constant interval also in the valley of the Ganges between the April and July cholera. The cholera of the spring and of the monsoon is well marked here ; for this region liesses sufficient elevation to subject it to the cholera of the monsoon season. But it he cholera of the spring and the October cholera which predominate, and cholera is not ormal even in December and January in this land of perennial moisture. Cholera is not endemic beyond the hills on the eastern bank of the Bhurmpooter, although it is probable that even Upper Assam occupies a relative position nearly resembling- that of the Behar Provinces, a country not antagonistic to the vitality of invading- cholera, but in which the supply of cholera requires to be kept up by reinforcement from behind to ensure its constant presence. This tract of country lying to the east of the Bhurmpooter and invaded from west to oast, enjoys the same years of minimum as the tracts of Upper India, invaded from east to The region of endemic cholera of this presidency, is the basin having the hill L country east of the Bhurmpooter for its eastern margin, and province of Endemic cholera the Ra j melial and Cuttack hills for its western margin. Its northern limit is the Terai of the Himalayas from Lower lam on the east, to the Terai of the Purneah District on the west; and its southern limit is sea border of the Bay of Bengal, from Pooree in the west to beyond the mouth of the irmpooter in the east. It has two natural outlets — the valley of the Ganges, including the 1 country between the Rajmehal Hills and the Himalayas, and the valley of the Bhurmber between the Cossyah Hills and the Eastern Himalayas. These are natural outlets ards the west and north-east, but an endemic cholera vitalised for epidemic invasion, may a over at any part of the margin of this basin. The epidemic invading towards the east, etrates the valleys of the tributary streams, and overtops the highest hills of the eastern >-es. The Rajmehal and Cuttack Hills form no barrier to a cholera invading towards the This province possesses a climatology which is peculiar to it, and a population whose physical characteristics appear to have become adapted to its climatology, and whose diseases take on their special aspect Its characteristics. in relation to it. The whole region is under influences from seaward ; it is a region of perennial moisture, from the drainage of its own bounding hills, and as the outlet of the enormous bodies of water forming the Ganges and Bhurmpooter, which carry off the floods of India from the watershed between the Jumna and from the Sutlej eastwards, and from much of Central India also, from the northern and southern slopes of the Himalayas, and from the hill countries between Assam and the valley of the Irrawaddy. It receives, too, the full strength of the monsoon ; its rain-fall is double when contrasted with that of any other province of this Presidency, and at high elevations the rain-falls, as of Cherra and Darjeeling, are almost incredibly large. tThe ground moisture is always within a few feet or inches from the surface, and it requires the waters of inundation derived from the striking of the monsoon on the hills, to vast tracts of it under water, which continue submerged in every year until the cessation c monsoon and the falling of the rivers, permit them to rise; it is with the inundation ese tracts that cholera disappears, and it is with their reappearance that cholera reappears the diluvial soil and districts adjacent immediately invaded from it. It is a region 61 ? which possesses a vegetation of its own ; the cocoanut palm may be taken as typical, for it i ;o the region of endemic cholera in this Presidency that this tree is confined. The fact o ,s perennial moisture is shown by the circumstance, that ferns flourish within it, while the; ecay and disappear immediately after leaving its western margins. The fern will be founc 1 the Ganges in the walls of the fort at Monghyr, but it is never seen in the walls o le forts of Buxar and Chunar. If looked for in these situations, it will be found lining the side of wells, and further to the west it disappears altogether. The aspect of the population ters with the aspect of the country. It is a rice-feeding population, because rice is the atural product of the inundated diluvium. With the variation in the aspect and habits of the >opulation liability to disease increases, and the combined conditions cause the diseases due to naemia to come forward as characteristic. When placed under conditions necessarily in me measure prejudicial to health, prisoners succumb to the diseases induced by anaemia in a far reater proportion than in any other province of our Presidency ; the normal liability to death is double what it is in Meerut or Rohilcund, and three times what it is in the Punjab. Death rates for the diseases undernoted in the Jails of Bengal Proper, of liohilcund and Meerut, and of the Punjab — a contrasted statement. DIED ANNUALLY PER 1,000 OF STBENGIH ON THE AVERAGE OF THE SEVEN YEARS, 1859-65. DISEASEB. __ Bennl Proper. I Meerut c ™£ Rohil - Punjab. Cholera ... ... ... ... ••• 18-27 11-63 2-<>3 Dysentery and Diarrhoea ... ... ... 42-17 1429 8-99 A nsemia and Atrophy... ... ... ... 3-38 3-19f Mlf Dropsies ... ... -. ... •¦¦ 353 "41 -27 Phthisis pulmonalis ... ... ... ... 491 152 -55 Pneumonia* ... .. ... ... 366 2-45 165 All other causes, excluding Jail Typhu3 ... ... 3189 13-95 1 1 -88 All causes, excluding Jail Typhus ... ... ... 89 - 54 47 - 44 2648 Mackinnon contrasts the characteristics of the Lower and Upper Provinces in the following .. „ ?. „ , sentences :—": — " The winds blowing- up the Bay of Bena-al and Characteristics of the Upper and ?. -^iiT t» ¦ ° r , f, T, ," v Lower Provinces contrasted. prevailing fti the Lower Provinces are saturated considerably with moisture; rain falls there in great abundance, about seventy inches in the year; the soil is alluvial, low lying, and greatly intersected with various receptacles for Iter, and covered with verdure ; the vegetation is rank and luxuriant, and the rays of the 1 being vertical strike with great intensity on the earth, but the heat is modified by the Ler circumstances mentioned. Far to the north-west all is found the reverse of this. The ids are dry and parching ; the fall of rain is scanty and less regular (scarce twenty inches fall the banks of the Sutlej) ; the soil is less alluvial, and more dry and mineral in character ; 1 the rays of the sun fall more at an angle, but this is counterbalanced by the scanty fetation in the hot months and distance from the sea." This slight sketch, studied in connexion with the facts detailed in the first and second chapters, will suffice to show what are the general relations of the cholera of this Presidency to the different tracts which make up its area. Liability to attack and exemption from cholera, have been traced to distinct relations to climate, season, and meteorological agencies, and the one important conclusion is, that no phenomenon in the Natural History of Cholera is due to chance or contingency, any more than is the budding or flowering of the vegetation of any tract of country. tl have not the materials to enable me to connect on the natural history of the cholera of dras and Bombay with that of Bengal. It can, however, readily be predicted, that taking the tions of this cholera to elevation above sea level, monsoon agencies, and geographical situa., the manifestations in season will be the same as they are in different tracts of the Bengal t DEFINITION OF THE TERM A NATURAL PROVINCE; AND THE SUB-DIVISION OF THE PRESIDENCY IN RELATION TO THIS DEFINITION. Propositions B. to E. B. — The epidemic area is essentially an invaded area. The invaded area has a direct relation to cholera already existing beyond its boundary line ; when the boundary * Generally asthenic. t Generally a sequela of typhus in the jails of Northern India. 62 is overstepped, an endemic cholera becomes epidemic and invading. Cholera, however, may become truly epidemic within its endemic area without the transgression of the endemic limits, but in this case invasion of the epidemic area is imminent within a limited period. C. — When cholera invades an unoccupied area, the source of invasion and its direction are exhibited to us ; the geographical limit to which an invading cholera extends is also made evident. D. — If the great epidemic area of this Presidency (within which cholera has no peren- nial existence) be invaded at more points than one, and if the direction of invasion in each case be capable of being recognised as the same on the occurrence of each fresh invasion, and if its geographical limits be fixed and definite, then the epidemic area becomes sub-divided into as many epidemic provinces as there are separate points and directions of invasion. E. — If each of these provinces be clearly capable of definition by the consistency of its characteristics in every year, the index being the general prevalence or nonprevalence throughout it of sickness and mortality, and of the prevalence of special diseases which are in a great measure subordinate to meteorological agencies ; if the separate divisions of the great epidemic area have necessarily no characteristics in common in any year (excluding altogether the question whether cholera be absent or present) ; if the history of each province repeats itself constantly, and with precision, after a succession of years, so that we can at once recognise the parallel, then the cholera provinces are the natural divisions of the area of the Bengal Presidency; natural not for cholera alone, but in relation to all influences the general prevalence of which determines the standard of health among the population. I have often been asked on what grounds I have sub -divided the area of this Prcsi. . ? ?. . . ». , dency while massing in one statement the statistics of a Grounds for the suh-uivision ot the -in-, i • 1 tj_ i i 1 • l i i Presidency for statistical purposes. definite geographical space. It has been objected, that the different areas are not those included each under one Medical Inspectorship, and that they are not political provinces. I allude to the statistics of areas, such as Bengal Proper, Behar Benares Oude and Cawnpore, Meerut and Rohilcund, and the Punjab. When first I undertook to study the natural history of disease in relation to season and locality, I was led from want of an existing standard, to map out the provinces which promised to give results special and uniform when taken as a whole, according to an ideal plan, drawn partly from my own experience and partly from the writing of authors on the diseases of Upper India. That my first conceptions were in some degree erroneous or short of the truth, cannot be imputed to me as a fault. The arrangement was provisional, and the details were carefully preserved for rearrangement in accordance with the experience of a period of years. It may have been noticed, that the division of the eastern from the western province was first made in the printed statements for 1864, and that it was continued in subsequent years, in relation to my later views. For the sake of comparison, I have rearranged the statistics of the five years 1859-63, and the tables superseding those already printed for the provinces implicated, will be published in an appendix to the tabular statements for the decennial period 1860-69. But it is necessary to give the explanation, that I have to some extent consulted convenience, and also, that I have not felt myself bound to adhere to limits that seemed natural when further sub -division promised inappreciable results. Had the vital statistics of an entire population been at my disposal the case would have been different ; for it is obvious that a population cannot be adequately represented by a few hundred prisoners, or by a single European Regiment confined to one station of the area. Community of suffering or exemption is frequently also a question of degree ; and we could not with justice, include the country between Jubbulpore in the south-east and Ferozepore or Lahore in the north-west, and say, that in this we have a natural province under one great system. It would be true ; but at the same time, the question of the amount of influence exercised by monsoon agencies in the different portions of the natural area requires to be taken into account. The rain-fall of the south-east is very much greater than that of the districts north and west of Delhi, as we shall have occasion to show further on; and striking contrasts also are of frequent occurrence in different parts, when this area is viewed as a whole. The stoppage of the monsoon of 1860, and the results consequent upon the limitation of its distribution, affords an example of the sub-division for the year of this natural area into two portions, each with characteristics radically con- Because monsoon influences may in certain years fail to affect such stations as lie usually within their reach, and because the limits of the natural province become for the year circumscribed, we cannot on this account alter the geographical limit adopted as the standard in a statistical system. Such cases are only to be met by consulting the details for stations, which are carefully given ; and when, for example, the Punjab is affected to an extraordinary degree, and in consequence the fever ratio of Peshawur runs up to a maximum so high as greatly to affect the general ratio for the province, the general statement should always be read with the details for stations as gauide. 63 I Considering the materials which lam required to employ, the general arrangement gives use, not unsatisfactory results. Taking the Jail Tables for reference, the following modificais might, perhaps, with greater regard to precision be adopted :—: — (1). In the south-east, Raepore, Mundla, and Jubbulpore might take their place with stations of Chota Nagpore, which are entirely under influences from the east ; the stations Nagpore, although liable to be affected from the east, are under western influences also. . Jhausi and Ajmere suffer in common with Agra, and should be added to the vince in which it is included. (3). Shahjehanpore is retained in the same province more as ortion of Bareilly than as a district suffering in common with those further to the west; it is lerally affected from the east, (4). The distinction between the North- Western Provinces I the Punjab is unnatural ; the climatology of the Punjab is a direct continuation of all uences felt west of 80°, and vice vend. The western area should thus naturally include but • provinces — the one, subject to climatic influences from the south-west, although affected, certain seasons, also from the east ; the other, affected from the south-east only. I In the east, from the Behar Provinces westward to 80°, is a great and natural province ; s requires no modification when regarded simply as a province. But it is quite in reason at we should hesitate to include such a climate as that of Behar and Chota Nagpore with i climate of Oude and the eastern half of the Doab. The meteorology of such years as 1817, 59, and 1866 seems, moreover, to indicate, that this area has a very natural limit of its n, due not to its physical geography, but to its natural meteorology. This sub-division uld include Jubbulpore, Mundla, Raepore, Sumbulpore, Chyebassa, Ranchee, Hazareelgh, and the Behar Provinces Proper lying west of the llajmehal Hills, namely, Gya, bna, and Shahabad south of the Ganges, and Chupra, Tirhoot, and Chumparun north the Ganges. The natural western limit north of the Ganges would be the western limit the Behar Districts ; but in the south it would be much more indefinite, as the limit extended to the west in proportion to the distance to which it is found to the south. lih an arrangement would leave remaining in the east, only the great basin, the region endemic cholera, which has been shown to be a true and natural province ; for with the r opportunities of observation which we possess, the separation of Assam, Cachar, Sylhet, 1 Chittagong from this tract would be productive of no more accurate result in our general KAVhether I shall in future frame the statistics of this Presidency according to this amended i, is a point requiring very careful consideration. I think it right in the meantime, to show defects that at present exist, and which are capable of remedy when the statistics of the eral population become available for tabulation. Those who know what the climate of Upper India is when monsoon influences are withdrawn, and when solar influences are no longer in sufficient strength The importance of Invading Agencies to j n( j uce disease, can best appreciate what is the truth, !u Upil-flmlia" 16 StaUdal ' d th . at Evading agencies are those which determine the character of the year as regards health, throughout the area of this Presidency which I have called in speaking of cholera, the epidemic area. In speaking of the invasion of cholera, I shall have occasion to show what are the meteorological characteristics of epidemic and non-epidemic years ; here I note the fact only, that the epidemic area is naturally to be mapped out according to the direction of invasion, and the limits reached by invasion from a known base. It is by the extension of influences during the monsoon season, that these areas are defined in this system ; but it is essential to keep in view, that there are natural provinces of spring influences as well as of monsoon influences, and that these are of equal importance in estimating the phenomena of epidemic cholera. The spring winds and spring rains have their natural cholera areas as well as the winds and rains of July and August ; hence arises the necessity for studying epidemic advance under either system, and it is from neglect to do so, that the utterly erroneous deduction has been made and insisted on, that the advance of cholera may occur in directions opposite to those in which natural agencies invade. In this study there is nothing complex, provided the distinction be not overlooked between an invading and a reproduced cholera. The error has been committed and the distinction has not been made ; and it is needless to say, that it is unprofitable to attempt to draw parallels relating to cholera when the circumstances are different, or to try to trace the fact of invasion in a year when no invasion has occurred, under the idea that there has been freshly distributed cholera, while, in truth, the manifestation has been that of a cholera revitalised within an already invaded area. These erroneous deductions have been placed on record and received as the record of facts, while they are in reality but the theory of the writers. Those who know best how to observe, can best appreciate how rigid are the laws which direct and limit the advance of epidemic cholera. I If from the effects of monsoon agencies, I have been able to define the limits which are mally reached in every year by influences from a certain base, it follows, that the area ered from the limit reached, backward to the base from which invasion occurs, is a province Ler one aspect as regards its invading meteorology, which, as I have said, determines in per India the aspect under which the province is shown for good or for evil in any year. ¦ What have represented themselves to me as the monsoon systems which define natural vinces are shown in the following diagram : — 64 Diagram to illustrate the relation of the area of the Bengal Presidency to the South- West Monsoon, and influences derived from it. I,— The province of tlie south-west monsoon proper. • 2,— The province lying to the east of the Bay of Bengal, also invaded from south-west to north-east. 3 .—The province immediately under influences from the Bay of Bengal, invaded from the east and south-east, comprising the ovince of endemic cholera and the eastern division of the epidemic area. '"" 4.— The western division of the epidemic area, before reaching which influences proceeding directly from the east up the valley I t ] ie Ganges and across Oude, fail. It is entered from the south-east through the districts lying south of the Jumna. / a ). — The tract which I have described in various epidemics, for example, those of 1856 and 1861, as occupied in the northern tension o f influences which have entered the western division of the epidemic area. (h).— The tract occupied in the north-western extension. ( c \\ — The tract occupied in the western extension. s.— The province lying beyond primary monsoon influences, comprising the north-western desert and the Trans- Indus territories, which are never reached in primary invasion. au ' n h ' ¦^¦^^^^™"— ¦ Q H a D Lawrence, Lithographer. Lithographei at the Surveyor General's Office. Calcutta, September law. Explanation. — The diagram represents the aspect of the Bengal Presidency during the prevalence of the south-west monsoon only, or during the months from June to September. The provinces of the spring are entirely different ; thus, for example, influences derived from eastern sources may spread between March and May from east to west across the tract which, in June and July, becomes the province of the south-west monsoon proper, and is entered from the south-west and invaded from south-west to north-east. The portion of province No. 1, lying in the Bengal Presidency, is the tract which I have described as the southern epidemic highway ; the westerly extension (c) in province No. 4, is the tract which I regard as the northern epidemic highway. Nagpore and Saugor are index stations when the southern tract is occupied ; Ajmere, Bikaneer, and Bhawulpore are index stations on the northern highway. The occupation of Agra and Gwalior from the east clearly denotes invasion of province No. 4. Jhansi is generally associated with Agra and Gwalior, but not necessarily so j in the geography of the epidemic of 1866-67, Jhansi lay to the south of the occupied area, while Gwalior was included within it. Jhansi or Agra may be reached in primary invasion from the east without the general occupation of the western province as a province ; this was the case in 1855 and 1863. Bareilly and Shahjehanpore are, provincially considered, frontier stations, invaded frequently by influences epidemic within province No. 4, but quite as often by influences prevailing to the east of 80°. In the North-West, Sealcote and Rawulpindee lie beyond primary invading influences, while Ferozepore, Lahore, and even Jhelum are included in the monsoon area. 65 ihap. V.] All of these are provinces under one monsoon from the south-west, but two natural provinces only of the epidemic area have this as a monsoon of which the influences progress from the south-west to the north-east. From the Bombay Coast as a base., the province of Nag-pore and Central India up to a definite line, have monsoon invasion proceeding 1 from south-west to north-east ; and from the north of the Bay of Bengal (where the obstruction offered by the continent to the advance of south-western influences is no longer felt), invasion again occurs over Eastern Bengal and Assam from south-west to north-east. Beyond a certain line limiting the extension of monsoon influences from the Bombay Coast (that is to say, proceeding from south-west to north-east), the influences operating in the continent of Hindostan being more powerful than those advancing from the south-western coast, a second line of monsoon influence is determined, crossing that of the influences from the south-west. To the north of the line limiting south-western influences, the Bay of Bengal is the base of departure, and from Pooree to Lahore it is from the south-east that, monsoon agencies set in, in every district. The limit in the north-west is a natural limit; the monsoon dies here, and the rain-fall diminishes inch by inch until its failure causes the great north-western desert, as a natural result. In orfr North- Western Provinces, it is to the west of 80° E. Longitude that this prevalence of monsoon agencies proceeding directly from south-east to north-west is felt ; the districts of this area are invaded through Jhansi, Gwalior, and Agra, and through the tract lying south of the Jumna. The Gangetic Provinces, Oude, and the eastern half of the Doab receive the monsoon from the north of the Bay of Bengal as a base. In the south, there is no line distinguishing the point of departure from that of the agencies setting out for the western division of the epidemic area, but at the north of the Bay monsoon directed agencies turn as on a pivot, and progress up the valley of the Ganges from east to west ; and the influences thus setting out, attain as their western limit, Western Oude, Shahjehanpore, Futtehghur, and the Jaloim District, and the area covered constitutes a province which is true and natural. From its physical geography and special attributes, the province of endemic cholera is a natural province, considered apart altogether from invading agencies; it stands naturally constituted. It admits of no sub-division. It is a basin within the hills which form its margins, with features which are special to it. But the case is very different in the provinces of Upper The different stations of the plains of Upper India, whether east or west of the epidemic line of 80°, are all under one general aspect. The watershed between the Jumna and Sutlci is little over 1,000 feet above sea level. The fall is gradual, to 185 feet at Patna, thus, — ;tie over i,uuu ieet aoove sea level, me ian is gradual, to 100 ieet at ratna, thus, — Umballa ...1,026 Meerut ... 859 Lucknow ... 535 Kurnaul ... 912 Bareilly ... 693 Allahabad ... 310 Delhi ... 827 Futtehg-hur ... 635 Benares ... 252 Agra ... 657 Cawnpore ... 408 Patna ... 185 This is no diluvial basin, but the tract of the great kunkur clay, which is dense, imper iter, and water-containing- only in its interstratified sand beds ; not a mere local deposit mation filling 1 the basin between the hills of Central India and the Sub-Himalayan mi I Agra ... 657 | Cawnpore ... 408 j Patna ... 185 This is no diluvial basin, but the tract of the great kunkur clay, which is dense, impervious vater, and water-containing only in its interstratified sand beds ; not a mere local deposit, but >rmation filling the basin between the hills of Central India and the Sub-Himalayan ranges. every one of the above-named stations is on the same footing, and except, perhaps, the Behar Provinces, the influences arising from the nature of the soil and the approach water to or its recession from the surface, are the same throughout. I say this advisedly, for the facts indicate to me not so much localised conditions, although these have, of course an importance apart from any other considerations, as the general meteorological aspects of any year as powerful in determining the ratios of disease for natural provinces. There is, therefore, nothing in the physical features of the Gangetic Provinces nor yet in the geology of the area to indicate, that there is in Upper India a line of separation of two natural provinces ; the index is afforded solely by the facts of invading meteorology. Statistically, we are Kipelled to take the same absolute limit for every year, but it can be we'll understood, that were at liberty slightly to modify the geography of each year in relation to its precise characteristics, results would be even more striking than those here to be shown. II take the statistics of the years from 1859 onwards, to illustrate the fact, that the inmces prevailing in each year in the wes.t of the Doab are different both in kind and degree, n those prevailing in the east. It may be as well to explain, that the rain-fall of the west of Doab in 1859 and 1860 was exceptionally small, and that, in consequence, the western divil became the famine area of 1861. Forewarning of the famine was given by the comparative ure of the monsoon from the south-east. Baird Smith states the case thus :* — " The famine 1837-38 was in fact the crisis of five or six years of great climatic irregularity. Such irreguty seems to be indeed a characteristic preliminary sign of a complete suspension of the usual l-fall, and I trace it more or less distinctly through the series of the greater droughts. Simiy, 1858, 1859, and 1860 gave cause to fear from their very abnormal character, that a like nax might be impending in 1861. It was at any rate expedient to give serious attention to *rave a possibility, and to take such precautionary measures against its effects as might be .dent and practicable. The Government of India came to this conclusion, and I confidently ieve, that the early anticipation of its being possible that a great calamity might have to * Report, p. 18. 66 be provided against, contributed very materially to the prompt and decisive action by which it was met when the time of need came." The contrast in the ratios for the European Troops in the east and west is as under. The material was essentially the same in either case, namely, the new army of 1857-58 :—: — European Troops, 1859. An epidemic year in the east, in Dinapore, Benares, Ourle, and Gawnpore. A non-epidemic year in the west, in Rohilcund, Meerut, and Agra. * In the East. In the West. Died per 1,000 from all causes ... 61-95 35-09 Cholera ... ... 14-15 -25 f Fevers ... ... ... 9-27 3-84 Dysentery and Diarrhoea ... 19-33 6-79 Hepatitis ... ... 6*53 4-22 All other causes ... ... 12-67 9-99 European Troops, 1860. An epidemic year in the east, in Dinapore, Benares, Oude, and Caumpore. A non-epidemic year in the tvest, in Meerut and Rohilcund. In the East. In the West. Died per 1,000 from all causes ... 48-35 22-70 Cholera ... ... 21-58 ... \ Fevers ... ... 6-21 3-91 Dysentery and Diarrhoea ... 7*lo 3#763 # 76 Hepatitis ... ... 3-97 4-36 -All other causes ... ... 1049 10-67 European Troops, 1861. The case teas about to become reversed. The year 1861, was an epidemic year in the west, with a rain-fall much above the average, but a healthy year in the east. In the East. In the West. Died per 1,000 from all causes ... 2502 46-92 Cholera ... ... 5-66 21-52 Fevers ... ... 3-11 597 Dysentery and Diarrhoea ... 4-22 6-93 Hepatitis .., ... 2-87 2-77 All other causes ... ... 9-16 9-73 European Troops, 1862. hi this year, the minimum of epidemic influence was reached in the east; in the west, the invadUu/ influences were not those of an epidemic year, although the invading cholera of 1861 was universally reproduced. In the East, In the West. Died per 1,000 from all causes ... 1467 23-37 Cholera ... ... '08 514 Fevers ... ... 2-95 3-23 Dysentery and Diarrhoea ... 2*70 3*83 Hepatitis ... ... 3-12 3v82 All other causes ...'. ... 582 i'oo The cholera ratios for the four years following 1 , are as under : — In the East. In Rohilcund and Meerut. Died per 1,000 of the average strength 1863 11-66 NiL 1 1864 6-77 '16 V s 1865 5-55 '' s II 1866 2-89 Nil. * Agra is thrown in here in 1859, because this was the only station occupied south of Meerut. Troops had not in 1559, settled down into cantonments in the south and west. ?,111 n +,,™iw 1«» inoindad hi t The equivalent of two deaths, one at Shnhjehanpore, the other at Bareillyj both should naturalh bf included m the loss of the eastern area, leaving the cholera ratio for the west nil. „ hrtnntr t., t None of twenty-nine cholera deaths, which give the ratio of 4-36 shown in the printed able for 1860 belong j to the natural province; Twenty-four of these deaths occurred at Muttra which was struck by f on the *3uU - east in common with Agra, Jhansi, and Morar. The five deaths of March and April, belong to the eastern cnoleru of Bareilly and Shahjehanpore, § A case at Bareilly ; under eastern influences. || The result of the* slight epidemic of 1865, invading from the south-cast. 67 It seems to me very evident, that with an equalised meteorology, these two provinces will Ie almost identical results ; but it is not less clear, that, in almost every year, the influences and resulting 1 ratios are widely different. i Within the tract which became the famine area of 1861, we find in 1860, the maximum of alth, while beyond its eastern boundary, all ratios are in excess of the average. Knowing 3 history of the cholera of the south-east of 1860 with its limitation by the southern undary of the famine tract of 1861, we naturally look for the same phenomenon in stations ith of the epidemic line at which the monsoon failed, namely, a maximum rate for cholera, 1 also for fevers and bowel complaints, with a minimum rate for fever and bowel complaints stations north of the line, coincident with the absence of cholera. The figures are as under :— >¦ European Troops, 1860. I mission-rates per cent, of Strength for the Admission-rates per cent, of Strength for Cholera Area of 1860. Stations beyond monsoon influence in IS6O. Fevers. Diarrhoea. Fevers. Diarrhea. msi 203-26 23-16 Bareilly 17*46 8-73 rar 139-95 27-91 Moradabad ... 20-95 6-05 ra 76-50 18-42 Meerut 39-66 9-24 ttra 89-93 14-25 Umballa 2796 10-09 Jullundur ... 24-39 5-02 Ferozepore ... 26-70 5-16 II know no fact more strikingly illustrative of the effects of the absence of monsoon in¦nce in the famine tract in 1860 than this, that not one European Soldier out of a force of 00, died of dysentery or diarrhoea in this year at Meerut. The Kegimental Medical Officers •ibuted this to the more extensive employment of ipecacuanha in the treatment of dysentery ; ne it appeals, chiefly, as a climatic phenomenon, a modification of type in relation to the abce of influences which are powerful to induce such diseases. The anticipation of a permanent umum in the death-rate for dysentery was not realised, and we find twelve deaths at Meerut in il attributed to dysentery and diarrhoea. In the report of the Meerut Artillery Division for iO, Dr. Mactier alludes to the climatology of the year as follows :—": — " The past season has proved of the most remarkable on record in consequence of the almost entire failure of the odic rains. The total fall during the year has been eight and half inches. The first fall took ;e on 17th July, a mere shower ; and in August only five inches fell. It is a common remark ban unseasonable year is a sickly one. Such, however, has certainly not been our experience Meerut during 1860. Few stations could have been more healthy, and in very few, I imagine, the rate of mortality be found so small." II shall take a final illustration from the medical history of the eastern province, to show all stations of a natural area suffer in common. It must not, however, be concluded from absence of cholera shown in the latter half of this table, that cholera is necessarily absent non -epidemic year, or that an unhealthy year must be characterised also as a cholera year. European Troops. Stations of the Eastern .Division of the Epidemic Area in 1860 and 1862. A contrasted statement. 1860, — an Epidemic Yeah. 1862, — a Non-epidemic Yeah. I , Number of deaths. Number of deaths. Stations. Strength. 8 _ Strength. § I ! I I I I J I I Q o fa ft O OfejC Dinapore ... i 887 46*22 8 11 5 665 1527 ! Nil i ... 2 Benares ... I M 47 73-94 !33 21 13 1,142 \ 13 14 ... 5 I 2 Ulahabad 2,460 i 46-34 27 20 26 1,107 18-97 ... 2 5 ('awnpore 1.228 I 54-55 24 8 17 1.259 14-30 ... 1 6 Gondah '.'.'. i 965 : 24-87 18 ] 3 787 5-08 | ... ; ... 1 Fyzabad 1,054 ; 33-21 | 20 2 6 i 1,254 568 ' Roy Bareilly I 876 21-69 1 1 2 587 3-41 ... Lucknow ... I 2,216 31-14 22 , 8 7 2,093 15 29 ... 1 8 Seetapore 1,018 18-66 8 2 5 606 8-25 ; ... 1 ¦ The contrasted admission-rates of the stations of Central India below noted, in epidemic non-epidemic years, show very well the rise above the normal average in epidemic years. 68 P European Troops. Admitted per cent, of the average strength. Epidemic teaks. Non-epidemic yeabs. Ybahs. g l«j Yeabs. „¦ l d ill i i I i 51860 ... 35454 20326 43-91 5"49 1863 ... 179*24 54-85 17-25 1861 ... 308-35 181-22 26-00 -00 1864 ... 155-68 3469 933 1862 ... 339-92 21339 26-92 663 1865 ... 19655 8995 -15 f 1860 ... 277-79 139-95 3721 13-60 1863 ... 17995 61-75 12-08 Morar ... ] 1861 ... 287-43 148-73 26-50 1899 1864 ... 170-03 61-08 9-71 (. 1862 ... 222-33 124-43 22-36 6-29 1865 ... 171-39 4260 1-08 {1860 ... 217-85 76-50* 22-13 9-29 1863 ... 176-32 66-99 31-93+ 2-87 1861 ... 367-94 217-62 40-66 934 1864 ... 16844 7066 1352 1862 ... 249-18 145-10 13-36 5-72 1865 ... 183-34 57-54 14-61 '.'.'. It will be observed, that I attach to the terms epidemic influence and epidemic agency a meaning which is definite, and that I do not employ them with reference to a thing which is unappreciable. Absence of epidemic influence, I use as implying the non-prevalence of such meteorological conditions as in any province determine the rise above the average of the local manifestation of disease, and which afford the least amount of vehicle for the importation of evil influences from without. An epidemic year affords, if not a large rain-fall with a full geographical distribution, at least an average one ; and often there will be found the phenomenon of a moist atmosphere at an unusual season, for some of the worst of the epidemics of this Presidency have had their rise and distribution after the cessation of the monsoon rains. To my idea, an atmosphere of moisture supplies every requisite for the spread of epidemic cholera or epidemic malaria, without the superaddition of a something 1 which is mysterious. I fear to digress too far from the subject immediately in hand by further illustration of the (ibutes of natural provinces and of the characteristics of epidemic and non-epidemic years. ,nnot, however, pass the subject without a single paragraph regarding the relations of the ions of the higher Punjab to influences from the south-east. I have said that influences prelinating in Agra and Meerut are continued into the Punjab up to the monsoon limit. In such •s, therefore, as 1859, 1860, or 1866, the death ratio runs down towards the north-west, thus : — European Troops. Died per 1,000. Yeah Eastern Pro- Meerut and p nn : flh * EABI vince. Rohilcund. Punjab. 1859 ... ... — ¦•• ..• — 61-95 25-09 2018 1860 — •¦• •¦• • •- ... 44-99 2270 1420 1866 ... ... — .» — ... 22-54 1530 14-41 In such years, the usually unhealthy stations of the north-west, such as Mooltan and Peshawur, show a maximum of health scarcely attained elsewhere in the Presidency, a fact which is often obscured in an annual ratio, inasmuch as the very conditions producing 1 a nonepidemic season, are apt to redevelop the phenomena of fever in constitutions rendered susceptible ¦fever by suffering in the year previous, and to raise the death-rate by the undue prolongation the season in which heat apoplexy prevails. Iln a non-epidemic season in the Punjab, the fever rate of September and October exhibits predominance ; on the contrary, these months are marked by the steady decline of fevers, le the reverse is the case in epidemic years. European Troops, Punjab. Fever Admissions of 1859, 1860, and 1866, characteristic of the distribution, in months in a non-epidemic year. >, S SB S3 Yeab. I I ji j ¦ 4 ' \ I £ I I si 1859 293 265 373 1,260 1,744 1,825 1,299 964 607 711 679 316 10,336 1860 " 190 183 231 767 1,051 859 854 957 793 680 435 279 7,279 I860..! ... 325 224 208 | 290 1,071 832 994 708 652 649 448 427 6,828 Three years... 808 672 812 2,317 3,866 3,516 3,147 2,629 2,052 2,040 1,562 1,022 24,443 * Scarcely an epidemic year, although a cholera year ; there was not half of the usual rain-fall, and the limiting line of epidemic influence was in the Agra District. Kf Diarrhoea coincident with the cholera outbreak. T 69 The above statement beautifully illustrates the maximum of the hot months, May, June, and July, and the decline of fever in the malarious months, August, September, and October, owing- to the absence of the humid fever-bringing wind below described. In such years, if undisturbed by heat apoplexy, the death-ratios of the stations bordering on or beyond the limits of the north-west monsoon are wonderfully small. European Troops. Died per 1,000, in the non-epidemic years 1859, 1860, and 1866. ¦= 1859. 1860. 1866. STATION. All Causes. Apoplexy. ! All Causes. Apoplexy. All Causes. Apoplexy. Ferozepore ... ... ... 14-02 3"80 921 ... 7-02 Mooltan . ... ... " 194-2 971 2631 1077 3"63 Peshawur ... ... ... 15-15 2-05 ! 1-208 ... l»*02 -52 ! Deducting Apoplexy. Deducting Apoplexy. Deducting Apoplexy. , Perozepore ... ... ... 10-22 9-21 7 02 Mooltau .. ... — 9-71 1554 3 - 63 Peshawur ... ... ... 1250 1208 1-2-50 The following extract from Mr. Verchere's Eeport for 1861, on Kohat, a station which may be grouped with the above, shows, that he recognises well what I have described as epidemic influence. I think it right to explain, that Ido not unreservedly adopt his views on the non-specific character of the malaria poison, while fully coinciding with him in the belief that the phenomena which he here describes are due to general and non-specific influences ; to the |)stion of the diffusion and characteristics of epidemic malaria, I* shall return in considering the ;ural distribution by provinces of miasmata related in character to cholera. Mr. Verchere ites : — " From the middle of July to the middle of October a few puffs of the southern nsoon blow with a south-east direction. This wind is very trying, being a feeble, humid, and rm wind, and it is exceedingly enervating. With this wind comes the endemic fever of the umn. Not that the southern monsoon brings the fever malaria with it ; for I have before previous reports expressed my opinion, that ' malaria' is a mere word and expresses nothing, th the monsoon comes the fever. A different state of the atmosphere, and especially a very erent state of electric tension, are induced by the warm and humid wind, and the effect on the vous system is the fever." I From its proximity to the mountains on the frontier, the rain-fall of Kohat is greater than ,t of stations of. the plains lying in the track of the monsoon, and heavy rain can frequently seen falling on the mountains, while no fall takes place in the adjacent stations of the plains. I It is important to note, that the limitation of cholera to the monsoon area may hold even fears of reproduction subsequent to invasion, and that the special climatology of the Translus territory may cause the appearance of cholera here, while the intervening districts to the ¦j from the cholera limit of the previous year, remain apparently unaffected. Thus the lera of 1862 universal in the east of the Punjab, appeared also epidemically along the Trans[us Frontier from April to November, while the Doab between the Jhelum and Indus reined unaffected. The exemption of this Doab in 1862 has been attributed to the effects of quarantine established at Jhelum and Attock ; but to my mind the explanation is unsatisiory, because I find the parallel phenomenon in the parallel year 1857, when no precautions •c taken and when no quarantine was established. The meteorology affecting the epidemic area of the extreme south-west of the Presidency, is very shortly and neatly summed up by Dr. Arnott of Bombay. In treating of the Kurrachee cholera of 1846 he writes : — " What was wanting for the appearance of this cholera may have been supplied about the beginning of June, when the weather begins to partake of the peculiarities of the south-west monsoon, which sets in along the coast of Malabar, the Concan, and Guzerat about the end of May, or the commencement of June. Although the annual fall of rain at Kurrachee and throughout Scinde does not probably average four inches, yet the winds then blow steadily from the south and south-west and are loaded with moisture. Clouds accompany the winds, and sweep over the southern coast of Scinde ; whilst, most likely, those electrical changes which usher in the monsoon elsewhere, are also more or less felt. Previous to the appearance of the clouds the sun is powerful, and when the winds lull the weather is hot and sultry. Such a state of the atmosphere when epidemic influence prevails, is favorable to the appearance and propagation of disease, and may have called into active operation the choleraic influence then prevailing." following are, as I appreciate them, the provinces naturally traced on the area of our idency : — Ist. — Assam and the districts lying east of the Bhurmpooter, invaded from the south- west. 70 [Section I. Ind. — The province of endemic cholera having the geography which I have described. 3rd. — The eastern division of the great epidemic area, comprising all districts east of 80° East Longitude, invaded from the east. Uh, — The western division of the epidemic area, invaded from the south of the Jumna from east to west, and from south-east to north-west, including all districts 1 • 4- „!• OA° 1 j_ T il _i? J_l_ T\ . lying west of 80° and east and south of the Desert. hth. — The districts lying west of the desert north of Mooltan, including the Punjab north of the Jhelum, beyond primary monsoon influences, and, therefore, an area secondarily invaded. Qth. — The province of the south-west monsoon proper, invaded from the south-west in the monsoon season, of which the north-western limit is represented in our Presidency by a curved line, commencing a little to the south of Ajmere and Deolee in the south-west and extending to Nagpore and Raepore in the east, but not reaching to the Coromandel Coast which escapes this monsoon. Throughout Northern India spring rains to the extent of several inches are due from the Io ix. o__ t it ¦ in east, and these are of extreme importance, as it is coincident! y mportance of the Spring Rains both . ' , . . ? X . ' / elation to primary and secondary Wl th their occurrence that epidemic influences spread second - isiou in the different epidemic pro- arily, as the rule. It is to these, rather than to the monsoon 3es< rains, thn.t fhf» Jiorinnltiirist trusts in tho nrnvmnn lvino* l-ipvm-.fi rains, that the agriculturist trusts in the province lying beyond I reach of the monsoon. Over the eastern division of the epidemic area, the east winds, ich always bring moisture, very frequently prevail in the early months, and the degree of ir prevalence and the amount of the moisture which they bring with them, determine the racter of the season; for in proportion to the prevalence of the east winds, the hot and normal westerly winds are withdrawn. This is also a distinguishing feature cutting oft' eastern from the western division. BSo it is over the south. In Saugor, Jubbulpore, and Nagpore all moist winds and rains from the east in the early months, and so constantly and powerfully do they prevail, that area of their prevalence is a spring province with features peculiar to it. I Hence, if Nagpore, Jubbulpore, and Saugor are entered by influences from the east having ir origin in our Presidency, it is not in the monsoon season, when the winds and rains are ling from the west that we look for evidence of invasion, but in the spring months, from irch to May when east winds and moisture are in progress from east to west or from northtto south-west; and it is in March 1818, March 1821, March 1856, March 1860, and irch 1868, that we find invasion to occur. I have shown, as regards the eastern division of : epidemic area, that it is as frequently with the rains of the spring as with the rains of the nsoon, that this province is covered. And I have also shown, that in the western division, it 3 with the spring- rains of May, in 1858, 1862, 1865, and 1867, that the secondary advance invading cholera occurred; and how it was after long continued and abnormal east winds of ly, that the great invading cholera of 1856 came upon Agra. If the advance of cholera be limited by monsoon agencies, the geographical limits of the cholera of the monsoon season must be found as well denned Ileneralisation from statistical data and as antagonistic as there are provinces under different t the cholera provinces are natural S y S t ems having different bases of departure for the influences i meteorological provinces. • T i i invading them. And no demonstration can be more beautifully perfect than that bearing out such a theory. I The eastern province was universally covered in 1855, 1859, and 1863, when cholera had existence in the western division; it was an exempted area in 1858 and 1862, while cholera 1 persisted in the western. tit was from the south-east that the western division was entered in 1856, 1860, and 1860, on every occasion, invading cholera has had its limit of primary invasion in the northt, at a point coinciding with the termination of monsoon influences from the south-east. extreme north of the Punjab has never been reached in primary invasion. The cholera of the northern provinces of 1861 and 1867 had its limit in the south precisely at the line cutting off south-western influences having their origin from the western coast, and the cholera of 1854, 1864, and 1865, a cholera under the south-western system, had its northern termination at identically the same line. Of the cholera of Assam I have already spoken as having its invasion in the line of the south-west monsoon, and of its invasion and progress being coincident with that of a second limb of the same cholera invading and progressing in the opposite direction, that is, from east to west, up the valley of the Ganges. I The dweller in every province knows whence the cholera comes that affects the population ; 3 dweller at Lahore knows that the cholera comes from south-east, and that he has every ance of attack when cholera is in motion west of the Jumna ; the dweller in Saugor or lopal looks for his cholera of the monsoon season from the south or south-west, dreading it len he hears that it is epidemic in the vallies of the Nerbudda or Taptee ; the dweller c:: 3 Ganges knows that the easterly winds of April and July will surely bring cholera th them; and when cholera is epidemic in Lower Assam, the dweller in Upper Assam knows it advance is imminent, and is apt to see, in cases of cholera imported from lower down B Bhurmpooter, not the warning only of invasion, but the actual focus of the cholera which advancing' upon him as an air-borne epidemic. 71 IBut it will be asked, are there no well authenticated examples opposed to this wide neralisation ? I know of only two instances in which it has been persistently held, that cholera advanced against monsoon agencies. It has been stated that cholera crossed the continent from Calcutta to Bombay in the teeth of the monsoon in 1818 ; and again, that cholera marched down from Central Asia to Peshawur, to Lahore, and to Meerut between 1843 and 1845. The assertions are plausible only to those who do not know the facts upon which they are founded, or to those who cannot recognise the fallacy of the reasoning upon the phenomena which actually did show themselves. To these cases I shall subsequently refer at length. We lose sight too much of the effects of the north-east monsoon when our observation is confined to the Bengal Presidency. I have explained how in The effect of the north-east monsoon th Benffa i p res idency the manifestation of cholera in relation rlianlnvprl in f-.linMnilr.is Presidency. __ o _ . * -... as displayed in the Madras Presidency. . .. *? , ' . •% • 1L -, ¦ ,-, . 1 J t| to climatology coincides in the extreme east and in the extreme south, and I therefore suppose that there should be in the north of the Madras Presidency a great cholera of the end of the year corresponding to our cholera of Dacca, Chittagong, or Assam ; and if this be a cholera invading from the south-west of Bengal Proper as a base, this portion of our Presidency must be the commencement of a natural province extending into Madras and Bombay, of which we lose sight entirely in the system above sketched. The Madras report of the epidemic of 1818 thus describes the meteorology of the northern provinces of the Madras Presidency, and I have reproduced this description as being of extreme interest in epidemiology, and essential for the correct comprehension of the part which cholera plays on the southern epidemic highway. "The north-east monsoon commences generally in October, and is attended with dry weather over all the Peninsula, excepting on that narrow stripe of coast forming its eastern side, which is washed by the Bay of Bengal, and commonly known as the Coromandel Coast. On this stripe, the north-east monsoon brings the periodical rains, which commence sooner or later in October, terminating sooner or later in December. From this last period till towards the end of February, the north-east wind, or monsoon, now a dry wind, continues to prevail, and the weather remains cool, and in many places cold. The north-east wind then ceases, and from this period till towards the end of May the winds are irregular, and the heats are intense all over. In the Bay of Bengal and on either of its shores, the winds at this time are chiefly from the south, and are remarkable for their humidity, heat, and relaxing effects. About the middle or end of May the south-west monsoon commences, and is attended with the periodical rains in all parts of the Peninsula, excepting the Coromandel Coast, which then suffers great heat and drought ; these rains cease in August or September, when the climate becomes generally sultry and variable until the north-east monsoon sets in again. Thus there are two great and most important distinctions of climate. The Coromandel Coast has its rainy along with its cool season, and its hot season may be said to be always dry. All the rest of India has the rainy season along with the heats of June, July, August, and September, Avhen the sun is to the northward of the Equator. These rains, indeed, in some degree, temper the excessive heat, but their intervals are often distinguished by an intense force of the solar rays and by dead calms, and that whole period is subject to all the effects of heat and moisture combined, acting on the soil and vegetation. The Nagpore and Hydrabad States and all others to the west and south are subjected to the rains from the south-west monsoon. The Northern Division* experiences the rains of the north-east monsoon, but this tract feels also the occasional influence of the south-west rains." " The north-east monsoon not unfrequently carries its rains far to the westward of the limits assigned, and, in like manner, the south-west monsoon refreshes the eastern parts with occasional heavy showers. In some of the more elevated tracts, though the sun be vertical, the air is cold during the rains, especially where the wind blows fresh ; but in lower situations, and where the soil is inundated, the air is often extremely hot and oppressive, and is surcharged with moisture." " The flat open plains of Nagpore seem to approach in character to the alluvial districts of the Ganges ; for at the very base of the Peninsula, and at a distance of 400 miles from either the eastern or western sea, they attain only an elevation of 800 or 900 feet. Hingunghaut, situated 50 miles south of Nagpore, is only 700 feet above the level of the sea."t " The general appearance of the countries above and below the ghautsj is considerably different ; the former are distinguished by a dry soil, intersected by streams of running water, having but few tanks, and the general cultivation being that of dry grain ; the latter are more open and flat, sandy, watered chiefly by tanks, and affording great fields for rice cultivation." The provincial distribution op epidemic malaria. I shall now illustrate the truth, that the invasion of malarious fever, when exhibited in an epidemic form, has a relation to season and geography parallel with that of the cholera invasion. The miasm which is known by the name of the malaria poison has not to the same degree the individuality which distinguishes the cholera miasm. Some have doubted whether there be a something specific producing what is called malarious fever and allied diseases, because climatic changes alone and without the superaddition of a specific poison, operating in relation to human material of a certain predisposition, produce effects which to the local observer are suggestive of the presence of a specific miasm where no miasm exists. The natural recoil has been to the opposite extreme. When it has been appreciated, by * Of the Madras Presidency. t See p. 39. j In the Central Provinces. 72 competent observers, that the prevalence of a fever of purely climatic significance has been unjustly attributed to the localisation of a specific miasm by insanitary conditions, the tendency is to deny altogether that a specific miasm exists, the effect of which is to produce fever. The natural history of epidemic malaria is yet to be studied ; and the study will be more difficult than that of cholera by so much as the individuality of the miasm of malaria is inferior to that of the cholera miasm. It is through its history traced as that of an epidemic, that we shall come in time to know its normal behaviour in this Presidency. I can do little more than state the broad facts which have been brought under my observation, which liow to me this miasm as a something having tangible effects, as having a history capable f being written, and as the materies of periodic epidemics having a definite geographical istribution. My remarks are little more than suggestive, and I offer them chiefly that hey may give direction to the observation of the facts relating to epidemic malaria in the uture. What I have to say here is, however, sufficient to show, that the epidemic history of lie one miasm is strikingly allied to and illustrative of that of the other. The effects of epidemic malaria are very different from those which result in Upper India rom the malaria which is supposed to have a local and perennial existence. In its worst form, i is the yellow remittent — the jungle fever, a type of fever which in Upper India is no more ndemic than is the cholera miasm. It is wrong to use the term type without the explanation lat the same miasm which in one situation or at one elevation produces yellow remittent ever, followed possibly by the typhoid state, in another situation or at a higher elevation, lows its effects as a pure intermittent. The yellow relapsing fever caused by a typhus poison, nd communicated from man to man, has been mistaken for this yellow fever ; and an epidelic even of this malarious fever has been erroneously associated with one of yellow typhus, iut the natural history of these two yellow fevers is diametrically opposite, in their relation to eason, and to the circumstances of the populations affected. When the characteristics of each lave been clearly laid down, no mistake need occur as to their identity. It is no unnecessary part of the study of cholera to place here on record the details of these sidemics of malarious fever. As air-borne or geographically distributed epidemics, they have ot hitherto been properly recognised. In the future they will certainly recur, and the details may then be studied with a knowledge of what it is that they belong to and whence they spring, nd then the truth of the parallels between the air-borne cholera and air-borne malaria poisons, vhich now we can do little more than guess at, will come to be recognised, and the want of riking individuality in the malaria poison will be compensated for by the more accurate appreation of the significance of its phenomena. Although not necessarily coincident, it not unfrequently happens, that epidemics of the cholera and malaria miasms become developed parallel with each other, or at trifling intervals ; as examples, we have the epidemics of 1850, and 1856, and 1860, in the western division, and those of 1859 and 1866 in the eastern division of the epidemic area. In speaking of the meteorology attending the cholera epidemic of 1866-67, I shall have occasion to trace the geography of the malaria of the first of these years, and to show its statistics. Here, I shall define the geography of two epidemics only of previous years, each of a different provincial distribution and confined to the limits of the provinces which are natural for epidemic cholera. The first, that of October 1859, was confined to the eastern division of the epidemic area; the second, that of 1850, was distinctly a malaria of the western division of the epidemic area. Both were universal over the areas covered ; they were as universally distributed in fact, as is an epidemic of cholera over its natural province. It is no more true to say of either of these malarious epidemics, that it was due to local malaria called into epidemic vigour by a special meteorology, than it is to say the same thing of lolera. To any one who has had experience of such a malaria, the fact is evident, that it is an airnveyed miasm which has covered the area ; aggravated and localised it may be by conditions >eculiar to certain situations, but a miasm invading, which had previously no existence, and hich is destined to die. The epidemic of October 1859 remained in intensity for three onths, and scarcely a single individual living within the sphere of its operation escaped ; and the eaths of districts were reckoned by the thousand. So deadly and unusual was this visitation, lat it has actually been regarded as an epidemic typhus ; but beyond the fact that in many ses the symptoms of the fever were so severe as to approach in character to those of typhus, le epidemic had no characteristic to associate it with a visitation due to the typhus poison. ; was a malaria in its purest and most intense form, varying according to circumstances from le true intermittent to deadly yellow remittent; and all its alliances were with the cholera miasm. I No visitation of such intensity had been known for sixty years previously. Happily the er was under the influence of quinine, and hence comparatively few of the European Soldiers d. In two fatal cases which came under my own observation, the aspect was exactly that typhus. These occurred in a detachment of Her Majesty's 6th Regiment, which occupied aporary barracks on the ground level ; and all, both officers and men, suffered from the fever the remittent form; in the detachment of the Naval Brigade, 100 strong, occupying irters in the fort of Buxar, a mile distant, elevated about 40 feet above the level of the nges, every case without exception was intermittent, although the fever was equally universal . ere was no difference of opinion among the Medical Officers who had experience of this demic; indeed, nearly all of them suffered in common with the general population. . Sutherland, of Patna, writes :—": — " Never was the superiority of European medical treatnt more obviously and decidedly exemplified than in the treatment of this disease, which 73 swept off hundreds of the population and in some places left none to till the ground." It was the general subject of remark, that the jail population of the area was almost entirely exempted from 1 this fever/ apparently in consequence of being shut up every evening at sunset. Elt rained daily from the Ist to the 6th October, and the wind blew steadily from the t the whole time. As soon as the rains ceased the fever commenced. Its geography is very accurately denned. It was universal from Hazareebaugh to Cawnpore ; it was not felt at Futtehghur, Seetapore, Shahjehanpore, nor Bareilly. In the Purneah District in the east, it raged with great malignancy. The table which follows shows the fever at Hazareebaugh and universal in the valley of the Ganges, where it was localised, and reached its maximum in November :—: — Distribution of the epidemic malarious fever of October 1859. European Army of the Eastern Division of the Epidemic Area. Fbtee Admissions. Admitted per _ _, , cent, of Strength Vvxmnm Stations. Strength. ;„ otnlior nml kemahks. September. October. November. m^J^fb er^ nd Hazareebaugh ... ... 430 21 119 89 48-37 "1 The invading Dinapore ... ... ... 1,053 41 128 286 38"90 malaria of Ooto- Shahabad .. 242 16 40 95 65*78 ber localised in Sasseram " '.'.'. '.'.'. 266 10 100 177 104-53 }-the valley of the Ghazeepore ... ... 802 IS 204 297 62 # 47 I Ganges, and at its Benares . ... 1,006 101 143 276 41*65 | maximum in Nov- Sultanpore'" ... .. 708 42 152 153 4021 J ember. Roy Bareilly ... ... 99^ 75 141 123 2645 "") Little tendency Fyzabad ... ... ... 1,632 102 161 130 17*83 fto localisation, Allahabad... ... ... 1,800 289 387 273 36-67 C marked by decline Cawnpore .. ... ... 1.513 89 248 79 21-19 Jin November. Futtehghur ... .. 887 49 44 76 13-53 ") Lucknow ... ... 3,716 -269 299 149 9*36 Altogether be- Sf ca P°. re 946 60 38 17 581 ' dfc epidemic bhahjehanpore ... ... 650 8 li 3 ' 308 I influence Moradabad ... ... 419 8 9 3 2-86 | mUuence - Bareilly ... ... ... 9-20 27 9 8 I*Bs J Dr. Rice, then of Saugor, described an epidemic fever as prevalent in his district in the hot and monsoon months of 1859, and in this he thought that he recognised a typhus. Now, we know from abundant experience of late years, that typhus dies in May as surely as smallpox becomes extinct, and, therefore, I have long regarded with suspicion the conclusion arrived at in this instance. A parallel epidemic, that of 1866, had a distribution as far south as Jubbulpore, and I find the Surgeon of Her Majesty's 23rd Regiment, in describing the fever, incidentally stating, that Dr. Rice had in this case also been inclined to regard the disease as a Ihus. It would appear rather, that the fever of 1859 in the south, of Raepore, Dumoh, Saugor, . Bhopal, was geographically continuous with that of the Gangetic Valley and Chota Nagpore, . a portion of the same epidemic, having a distribution parallel with that of the cholera of same provinces. It is at least important that in following out the geography of epidemics malaria in the future, the distribution of this southern fever of 1859 should not be The malaria epidemic of 1850 was confined to the western division. In the following extracts, the exempted area is clearly defined as that separating Edemic of the malaria miasm con- the eastern from the western division of the epidemic area. to the western division of the mr. I.i o • j. v a c t\t j- 'i- ix. j. m. Nic areil Thus the Superintending Surgeon oi Meerut writes, that it was felt in all but the eastern part of his division ; and that Shahjehanpore seemed to be free from any epidemic ; and that the atmospherical influence was felt in a diminished degree over Bareilly and Meerut. From this eastern limit to Goojrat and Lahore in the west, was one unbroken sheet of malaria ; the natural province being exactly the same as in the case of the cholera miasm. The reports of the year for Shahjehanpore, Banda, Humeerpore, and Oraie, which I have examined, make no mention of the unusual prevalence of fever in 1850; the epidemic covered exactly the area of such a cholera as that of 1856 or 1861. The great fever of 1829 had a similar area ; but this I need not notice here. The extracts which follow, show the range and character of the fever of 1850. My inference with regard to it is, not that any unusual meteorology developed in situ the germs of pre-existing malaria, but that as the cholera miasm is disseminated by aerial influences over the same area, so was this fever of 1850, a miasm distributed with the monsoon. No such universality and strength of revitalisation is ever likely to occur with a mere fortuitous combination of meteorological conditions, and we know that in the case of cholera, epidemic appearance in this area is not due to any such combination. The following is an extract from Dr. Renny's Annual Report of Meerut for 1850 :—: — t" Fever prevailed extensively over a great portion of the Meerut Division at the close of ! rainy season of 1850, and was felt, more or less, in all but the eastern part. It assumed much of an epidemic appearance that the description of it comes most aptly under this tion of the present report. This epidemic seemed to depend on atmospherical influence, 74 and was extensively prevalent over the North- Western Provinces and Punjab ; Ferozepore being 1 , as far as is known, the only exception of a large station being exempted. In the Meerut Circle the same powerful atmospherical influence was observable in the Saharunpore and Delhi Districts, and the intervening country running along the Jumna ; that is to say, the same districts that are in all years subject to malarious mischief, were, under the epidemic impulse, much more unhealthy than usual. This is to be seen in the returns of the Saharunpore and Delhi Jails in the months of September and October 1850 ; the mortality caused thereby is however recorded chiefly in the months of November and December, because the destructive nature of the fever was marked by the frequent relapses it gave rise to. Meerut mot show much indication of the epidemic, and the jails on the north side of the Ganges, nore, Moradabad, and Bareilly, are reported healthy during the year ; yet the same atmosjrical influence, in a diminished degree, over these places, was observed in the Military spitals at Meerut and Bareilly in the increased admissions of fevers. In the eastern quarter, ihjehanpore seemed to be free from any epidemic, and Almorah is reported as being more than imonly healthy." tThe following extract from the report of the Saharunpore District shows the true rious character of this fever of 1850, and its identity with the fever of the eastern diviof 1859, described in the previous paragraph :—: — I" So general was the epidemic in its seizures, and so frequently fatal in its effects, that from ¦ return of deaths sent to the Magistrate, it appears that one in fifteen of the inhabitants of ! city have been carried off; amongst the European residents of the station, only five escaped aiess by going to the hills before they were attacked. In several, it assumed the remittent m ; one case ended fatally, and several others were in danger from head symptoms. One case, eared, would end in typhus ; all these cases of remittent fever have recovered completely, ; those who suffered from the less alarming form of intermittent fever are still, with but r exceptions, troubled with enlargement of the spleen, and are constantly laid up with attacks intermittent fever up to this date. There appears to have been a peculiar property in the lemic of the past year to induce enlargement of the spleen. I caused all the patients who sented themselves for treatment at the dispensary on or about the Ist December, to be mined for spleen ; and twenty-two out of fifty-three were found to have the organ enlarged ; ilst out of above 300 prisoners in the jail, only eight were found at the same period to c splenic enlargement. The disease appears to be the ordinary epidemic of the rainy son, more than usually virulent." I The two extracts which follow, show the western limit of the epidemic and its extreme ilence even at this limit ; this is a phenomenon parallel with the great intensity of the lera of Meean Meer, the last station reached in years of invasion. IGoojrat District, 1850. — "The great epidemic of fever which raged so universally in Punjab at the latter part of the past year, also visited this station, with a mortality ceding all belief. In one of the neighbouring towns, among a population supposed to L O,OOO souls, the deaths counted in one month were 556. Not one in ten escaped, and nearly iird of the number attacked fell victims. It commenced at the latter part of August, preed with the utmost violence through the two entire months of September and October, ined slowly in November, and disappeared by the middle of December. The high and the antageous position of the jail enabled it to withstand the disease for a considerable time, in the end its inroads were mild and slight compared to the fatal violence with which it id among the population around. Our jail was in this respect so completely defended, that as a subject of remark, that not a single dead body was brought from the prison, while he city scarcely a house escaped." BThis phenomenon of the exemption of the prisoners, is the same which we observed in the em epidemic of 1859, and attributed to the fact of the shutting up of the prisoners from ospheric influences prevailing after nightfall. I Lahore District, 1850. — "An epidemic fever prevailed in the district from the comcement of August to the middle of November. It attacked all classes of individuals lout exception, and assumed all types and forms. The intermittent was the most obstinate least dangerous form, and the quotidian was its usual type. All its stages were very well ked. Some patients became delirious during the hot fit, and in the interval, they enjoyed lerably good health for the first three or four days, after which period they generally became ciated and were confined to their beds. Enlargements of the spleen and dropsy have been usual consequences of protracted agues, and these cases often proved fatal when neglected." 1" Among the acute symptoms, are to be enumerated, a white-furred yellow or brown tongue, a yellow skin and conjunctiva, showing that this fever was in many cases what is called a us remittent. " The fever of 1850 does not seem to have prevailed beyond the Jhelum, and the European ¦estem limit of the Hegiment at Eawulpindee enjoyed excellent health. Ferozepore and Sirsa of 1850. in the south were beyond its limits. In the reports of the year we read :—: — in the south were beyond its limits. In the reports of the year we read :—: — " Sirsa in the desert has been extremely healthy, even more so than Sirsa. last year." "No epidemic has prevailed during the year ; the prisoners appear to be as healthy as the inhabitants of Ferozepore. The sickness and mortality have not Ferozepore. been greater than usual, and the fevers have been slight." Passing to the east of this limit the epidemic is at once met with. 75 " Fever was of the intermittent type, and the disease prevailed as an epidemic in and around Loodianah, as well as over all the upper provinces Loodianah. of India/ " From the middle of October to the end of November, fevers pre- Khytul and Thanessur. fo & frightful extmt all oyer thig part of the country .» v Hissar suffered from the general sickness ; 200 deaths were recorded Hissar. in the town from diarrhoea following fever. There was a much larger amount of sickness from fever than there has been for many years." EOnce more I would say, that these epidemics of malaria have an importance in connection ith the study of the Natural History of disease in India which cannot be over-estimated ; and trust, that when parallel epidemics occur in the future, the aspect here shown, namely that of an tually invading miasm having a basis of departure, a limitation in space, and universality of stribution over the area affected, will not be overlooked. tl shall return to the subject of epidemic malaria in speaking of the conditions favoring c epidemic advance of the cholera of 1866-67. The Meteorological Phenomena attending the Invasion op Natural Provinces by Cholera. Propositions F, G, and H. G. — Cholera has no locomotive power in itself, and the geographical distribution of an advancing epidemic is essentially dependent upon the existence of a vehicle. A cholera which has no vehicle afforded to it is anchored, and is shown in localised outbreaks only. A cholera of a dry arid hot season, wherever manifested, is a reproduced and not a primarily invading cholera. In connexion with the phenomena of reproduction and the conditions which retard or accelerate it, the epidemic distribution of cholera is effected, in the different regions of Hindostan, at the seasons when this vehicle is afforded. The vehicle required is in all cases, and wherever epidemic advance is in progress, a humid atmosphere. II. — The prevailing wind is the agency which directs the course of an advancing epidemic, and determines its limitation in geographical distribution ; the assertion that cholera may advance against a prevailing^ wind is contrary to fact, and the phenomena brought forward in support of it are, generally speaking, those of a cholera of reproduction, appearing over various and possibly widely separated portions of the same natural province, months or years subsequent to the original invasion, or they may be related even to the cholera of two natural and distinct provinces, each invaded from a separate base, and in a different direction, in which cholera may be in existence at the same time. tThe following paragraphs treat of invasion in relation to the atmospheric conditions preling during epidemic advance at different seasons and in different localities ; the seasons which advance occurs have already been sufficiently indicated. The region of endemic cholera is a region of perennial moisture, of moisture which is both air-conveyed and universally and permanently lodged on the surface or immediately beneath it. Here it is that in the dry months cholera is extricated, as soon as the breeding grounds appear above water in October, and it is here that it appears epidemic, when, in February and March, and April and May, the spring and summer of this region, the permanent moisture causes vegetation to sprout forth in luxuriant life. In early spring, the south-eastern breezes carry this cholera over the brim of the endemic basin ; their steady continuance gives promise of an early season, and but too frequently of a cholera season also. These are the moist winds of the eastern division of the epidemic area, which are met and opposed by the dry or hot and healthy winds of the west and north. In the south, in the Central Provinces, the influence of these northern and western winds is tempered ; and in proportion as their influence is diminished, the wider does the range of eastern influences extend across the continent on what I have designated an epidemic highway. A great portion of this tract is, in fact, in the spring months, assimilated in character to the region of endemic cholera. The general fall of the first rains of the monsoon over Upper India is followed by the submersion of the cholera breeding grounds of the endemic region, and by the comparative extinction of cholera ; while in the Upper Provinces the miasm is roused into epidemic life, and becomes a moving epidemic, ready for the invasion of every province lying within the influence of the monsoon of July, August, and September. Wherever cholera is met with in Upper India in October or November as an evident epidemic, there must coexist a meteorology special to the locality, or generally diffused as an abnormal occurrence, in connexion with which the presence of cholera is manifested, and which causes the locality or the province, to approximate in character for the time being, to that of the lower provinces in the same months, or of that portion of the epidemic area in the extreme east, apt to be affected in the same months. If this generalisation be correct, the conclusion is inevitable, that cholera, wherever met with, is entirely dependent on an atmosphere of moisture for epidemic invasion or progress. tl have already had occasion to show, that delay or acceleration, both of invasion and of roduction subsequent to invasion, is regulated almost to a day by the meteorology of any (graphical situation — that cholera almost never reappears in the west before 20th April; that cholera of the 20th February in the east, or of the 12th May in the west, is one and the same ; [ that the cholera of the Terai below Nynee Tal of February 1867, is, in homology, the same i and the Calcutta cholera of February, and with the cholera of the Delhi District of May. 76 THE METEOROLOGY ATTENDING THE INVASION OF EPIDEMIC CHOLERA. Chap. V.] METEOROLOGY ATTENDING THE INVASION OF THE GANGETIC PROVINCES. 77 Again, I have shown, how, although revitalised over an area including many thousands of miles, it is on rare occasions only and with exceptional aerial phenomena, that a cholera of May an d June in the western division of the epidemic area is endowed with the capability of invadina> any station ; and that the mortality of July, August, and September was one hundred times as^great as that of the months of April, May, and June, in the nine years from 1858 to 1866. I have shown, that this was due not to want of vitality, for the dormant cholera of 1861, for example, revived in almost every part of the province in the end of April and in the first week of May, and yet, no station affected in 1861 became reaffected in 1862 before the monsoon set in. I shall here illustrate the phenomena of invasion and of reproduction subsequent to Illustrations of meteorology attend- invasion, in relation to the prevailing meteorology, ing invasion. Jameson writes of the cholera of 1817* as follows — " From knowing that during the existence of former pestilences the diffusion of the virus could be frequently traced to the motion of peculiar currents of air, it was natural to look for an explanation of this extraordinary regularity of progression in the prevailing course of the winds during that period. Accordingly upon reference to various reports of the rise of the disorder in different parts of the country, it was discovered that in a vast majority of instances the wind was blowing from the east or south-east quarter at the time of 'its breaking out. This may be stated to have been almost without exception the case in Bengal." * * " The same prevalence of easterly and southerly winds attended its progress through Tirhoot, Sarun, Behar, and Shahabad." * * "In the camp of the centre division of the Army (in Bundelcund) the wind which from the 21st of the preceding month had blown strongly from the west, suddenly changed round to the east quarter on the 7th November, and there are grounds for believing that from that day the disease raged in camp. With the Left Division (Jubbulpore, Nagpore, and Nerbudda Field Force) the wind ranged from east to south from the Ist to the 14th April. The epidemic was with them on the 9th, and abated as the winds came round to the west." "In Jeypore, Agra, and other stations of Central India, the winds were easterly during the prevalence of the disease." * * * " The apparent exceptions were not numerous, and when placed in contrast with the innumerable instances bearing towards the opposite point, are not of such magnitude as to overturn the general deduction which we now venture to draw ; that the appearance of the epidemic in a particular place was usually accompanied or preceded by an easterly wind, and that there was apparently some connection between the dissemination of the pestilential virus, and the prevalence of currents from that quarter. Of the nature of that connection we cannot speak certainly, nor can we tell whether those currents acting as a vehicle of the poisonous matter carried it along with them from one infected spot to another previously healthy, or acted merely from their superior moisture in the light of a strong exciting cause, eliciting the disorder in places where the virus had previously existed, although it were not yet brought into action." I Jameson goes on to say, that the facts of the distribution of cholera in the west of the ddency, will leave the reader almost satisfied, that there at least the virus must have been ised and propelled by the winds, but that the distribution was not so readily to be distinhed in Lower Bengal, which we now recognise as the endemic seat of cholera, in consequence holera having become generally diffused and the whole air impregnated. He adds :—": — " In ier India the air being less corrupt, required for the production of the epidemic an admixture itiated currents which were borne along by the winds. In this view of the case, the agency of wind, setting aside the effect of its dampness, must be held to have been purely mechanical." § Writing in 1820, Jameson, recognising the retention of cholera by low and damp ,tions, says :—": — " In the low and stagnating climate of Bengal cholera having once gained nd has tarried for years ; in the pure and elastic atmosphere of the Upper Provinces it slowly received and quickly lost." The effects of easterly winds in the early months, in spreading cholera over the eastern portion of the Presidency has constantly been recognized. Indeed, any Be meteorology attending the in- one w^o j^ ]| v^ on fa e Ganges knows well, that cholera may uof the Gangetic Provinces in the , .. . , ?„ , . j ° ? r -j i_i -• be anticipated it east winds continue for any considerable time, and bring rain with them in March and April. Mackinnon, speaking of Cawnpore in 1845, writes: — "The hot seasonf was remarkable for repeated falls of rain during the latter part of March, in April, and in May while cholera raged very violently." ¦ I quote again the following passage :—": — " The hot winds of the Upper Provinces extend some seasons over the whole of Behar ; but in other years the south-east monsoon appears to set in earlier and stronger, and east winds will prevail for the whole of the hot season ; the west wind is dry and parching; the east, damp and relaxing. Frequent falls of rain in the hot weather, especially with much easterly wind, observation has led me to think, are followed by disease, especially in the Upper Provinces, where they are least common." Again, in 1848, Mackinnon, writing from Cawnpore, remarks : — " This station has for two years been perfectly exempt from cholera during the hot months, and no rain fell. This year I foretold its appearance when we had falls of rain and very changeable weather during these months." (p. 297). In describing the great outbreak of 1848 in the Ist Fusiliers at Cawnpore, Dr. Bruce writes :—": — " In May easterly winds had prevailed from the Bth to the 22nd of the month, and between the 14th and 23rd there had been several very heavy falls of rain : on the ,23rd the hot * Pages 97 to 101. f That is, the mouths of April, May, and June before the setting in of the monsoon. westerly wind began again to blow, and continued during the remainder of the month, drying up rapidly the moisture that had fallen : the appearance of cholera was clearly to be ascribed to the above cause. The men had been healthy up to the time the rain fell ; but before the end of the month thirty-one cases had been brought to hospital. Almost simultaneously, the epidemic made its appearance among the native inhabitants and the native regiments at the station." tThe following is quoted from the report of the Deputy Inspector, Cawnpore Circle, f-arding the character of the hot season of 1859 in Allahabad and Cawnpore :—": — " There was ;hing remarkable in the season beyond a longer continuance of easterly winds than usual, was remarked by all the Medical Officers that the disease appeared to ebb and flow as the id was westerly or easterly. Cholera invariably increased with the return of the east wind." c regular rains commenced very early, on the 6th June. tWe must, however, be prepared to meet statements the very reverse. In the case of the rible outbreak in Her Majesty's 70th Regiment at Cawnpore in May, June, and July 1853, which 183 men were lost, we read:* — "The predisposing cause of the cholera must be isidered as due chiefly to atmospheric causes, on account of its having visited several other tions on the Ganges equally with Cawnpore, and from its existing only with a west and ith-west wind, and dying away completely with an easterly wind."f I The meteorology of the two months preceding this outbreak I find recorded thus : — April, lain on the whole of the 13th. Rain and thunder on 14th, 22nd, and 23rd. The remainder of ; month cloudy." May. " Rain and thunder on 27th ; rain on 11th, 12th, and 13th. Remainder the month cloudy by day and sultry by night." Such a meteorology exactly agrees with my iception of an epidemic season in the eastern province. Observers say that such a season is iracterised by the absence of the hot dry and healthy west winds ; I prefer to say, that it is iracterised by cloudy weather with occasional rain and the continuous presence of damp and ixing east winds at the season when the hot winds are due. The fact was, that the regiment Fered in both the first and second reproductions of the year, in May and in July. It was uck on the 20th May, and this cholera continued to the 11th of June. A very few cases urred subsequent to this ; but after the last of these, there was a clear break of three weeks m the 27th June to 19th July, when the epidemic recommenced. Exactly the same phenonon occurred at Cawnpore in 1859. I quote from the report of Her Majesty's 80th Regiment this year : — " Cholera made its appearance in the regiment on the sth of May, and continued prevail up to the 25th of the month ; it then ceased, and did not recur until the sth of August." These are in fact, instances of what all dwellers on the Ganges so readily recognise as the two clearly separated cholera outbreaks of April and Illustrations of the fact of the oc- July, the first of which in Cawnpore is generally retarded currence of cholera in the Gangetic ii n t 0 May. The first reproduction or invasion occurs with the Provinces at two different seasons, in • , n,i • j.i_ at. j *j.l ix. l cix the spring and with the monsoon. moisture of the spring months; the second with that of the monsoon, subsequent to the middle of July. I have placed here four examples to show this distinction between the spring and monsoon cholera in this situation. They are typical for this portion of the epidemic area, and occur with the meteorology indicated. Itbreaks typical in season for the Allahabad chid Cawnpore Districts, showing the distinction between spring and monsoon cholera. Bath op Admission ov Fatal Cases of Choleka. Her Majesty's 80th Regiment, Her Majesty's 54th Regiment, Her Majesty's 51th Regiment, Her Majesty's 90th Regiment, Cawnpore, 1859. Cawnpore, 1861. Cawnpore, 1860. Allahabad, 1861. May 5 1 May 25 1 March 25 1 May 19 2 7 1 „ 28 1 April 16 1 „ 26 2 11 1 „ 30 2 „ 23 1 June 4 ... 1 12 1 June 1 2 „ 24 1 * * * 23 4 „ 10 1 * * * July 21 1 25 2 „ 11 2 August 12 1 „ 24 2 15 1 „ 14 1 „ 25 . 1 * * * * * * ?22 1 „ 28 1 August 5 ... ... 1 July 16 1 ? 23 1 „ 29 '" 1 » « 1 „ 29 1 ? 24 1 „ 30 ..'. ' 2 „ 12 1 „ 30 1 „ 26 2 „ 31 . "" 1 » 13 1 August 1 1 „ 27 1 August 1 1 „ 14 1 ?2 1 „ 28 1 „ 2 ... 1 » 15 1 „ 3 2 „ 29 1 3 .... 1 „ 20 1 „ 6 1 * * * ,5 1 „ 22 2 „ 10 1 „ 23 1 „ 12 1 „ 25 1 „ 13 1 „ 26 1 „ 14 1 .. 27 1 „ 28 1 * The Surgeon in charge at the time of the outbreak died of heat apoplexy, induced hy over-fatigue, and it is evident that the Medical Officer who wrote this report was not acquainted with the facts. The meteorology was the reverse of what is stated. It was on the 23rd May that the outbreak commenced, and for six weeks previous the Cawnpore District had been under influences from the east. This cholera of 1853 was a cholera of a perfectly normal provincial distribution, absolutely confined to and universal over the eastern province. This cholera swept tiie Ganges Valley, striking Dinapore on the 6th May and Cawnpore on the 23rd. t Report of H. M.'s 70th Regiment for 1853. 78 Chap. VJ METEOROLOGY ATTENDING THE INVASION OF THE CENTRAL AND NORTHERN PROVINCES, 79 Another parallel example showing the distinction between the May and monsoon cholera in this geographical situation, is thus described in the report of Her Majesty's 97th Regiment, stationed at Banda in 1859 :—": — " Towards the end of May, cholera which had been committing great ravages at Allahabad and in the intermediate districts, made its appearance at Banda. During the first week of June, the disease became exceedingly virulent and deadly amongst the Natives, and although at this time only five cases occurred among the men of the regiment, they all proved fatal." " The periodical rains set in earlier than usual, and cholera for a time entirely disappeared. The immunity, however, did not last long. The monsoon had not fairly commenced. The rains entirely disappeared towards the end of June, and for a period of three weeks the weather ao-ain became intensely hot. Cholera reappeared in the regiment on the 10th July and continued until the 23rd." KThe prevalence of east wind was noted in every station of Oude previous to the outbreak c spring of 1860; it is noted that the weather was foggy and sultry with occasional falls in. Dr. Hilson, with reference to the cholera of Gonda in March 1860, writes thus : — I" One of the meteorological conditions which is known to favour the development and Lsmission of the cause of cholera is a moist state of the atmosphere, and it is worthy of note ; the advent of the disease in Gonda and the surrounding country, was immediately pre)d, or at any rate accompanied, by a heavy fall of rain with thunder and lightning. Locality to exercise little influence on the extension or virulence of the epidemic. No village ped, whether it was situated on high ground or low ground. I was unable to find one village 3h had not been attacked, while in some the population had been literally decimated. This era finally disappeared from the district on 17th April." 1/ X A « -*- In the south and south-east where the climatology closely approaches to that of the The meteorology attending the in" re g ion of endemic cholera, cholera may be distributed in vasion of the Nagpore territories in seasons which for such a locality have an exceptionally small spring. Significance of the phenomena rainfall. This is a geographical continuation, in fact, of the observed in this situation. a o « nmmn « i™ fV. Q nnc , a r>f nn^am, 1 /, nl^l-™ ™™«Nr phenomenon observed in the case of endemic cholera, namely, lirevalence in the hottest and driest season, from March to May ; and the explanation of is, that in such a situation, moisture is perennial, and there is no equivalent of the conms under which, in Northern India, a moving epidemic is brought to a standstill or to an mely end. In the report of the Haepore District for 1860, it is stated, that for the Ah of April, the thermometer stood 10° above the average, and that the tanks and sin the station dried considerably more than in previous years. I have noted previously , that throughout the Nagpore Circle the cholera of March and April disappeared throughout month of May, and was renewed only with the monsoon, by which it was conveyed as far to north-west as Agra. But the cholera of Nagpore of this year was not distributed, as the re report would suggest, in April, but immediately after the revitalisation of 20th February, and the meteorological report of Nagpore mentions that in February rain fell on Ist, 7th, 14th, 19th, and 23rd, while the weather was cloudy and sultry. Cholera broke out in Nagpore city on Ist March. Again at Chanda, at the same time, the early and abundant blossoming of the mango trees was held as indicative of a cholera season. The Medical Officer says :—": — " I would here note a curious belief which prevails among the Natives respecting the appearance or absence of cholera after the close of the cold season. They are able to foretell its coming by the abundant flowering of the mango trees, a phenomenon which they maintain to be always the harbinger of the disease. This statement has been verified in my experience in 1856 and in the present year. In this year, the mango harvest has been abundant, and in the intervening period between 1856 and 1860, when we enjoyed exemption from cholera, the harvest was almost a total failure." KThe meteorological phenomena attending the invasion of this portion of India I have ed to in many parts of this paper in connexion with my description of it as an epidemic way, and in describing the invading epidemics of Nagpore and Saugor, and the method hich cholera is carried from the east to the west of India. Following invading cholera towards the north-west, we find Dr. Murray describing the atmospheric conditions prevailing at Agra in the months x x w w The meteorology attending the in- previous to the coming of the great cholera of 20th May 1856, Siiif %L7?SI£ ri £?£ X thu f ="" V™°g April and May the atmosphere was hazy monsoon season. with easterly winds, and with little ot the usual hot westerly wind. The regular rainy season commenced with a heavy lof rain on the 30th May. The quantity that fell during the season was 3785 inches t inches more than the average fall at Agra for the year. During the month of June, the elt oppressively hot, close, and damp." Dr. Crozier evidently reckons the setting in of the regular rains from a different date, but his testimony entirely confirms that of Dr. Murray. He writes* :—: — " The hot westerly breezes of the months of May and June were entirely absent, a deprivation much felt, as the tatties would not work and were rendered useless. Easterly winds, however, prevailed to a great extent, and many ascribe the unhealthiness of the season to their occurrence." " The regular rainy season did not set in until a later period than usual, but when the rain did fall, it continued almost unremittingly for a whole month. It lasted also fbr a longer time, and advanced somewhat into the cold weather." * Report, 3rd European Regiment, for 1856. The cholera of 1860 did not reach Agra with the spring rains, but in the regular monsoon season. I have above noted how in Nagpore and the extreme south-east, the spring rains failec in April and May, and therefore no material was left for the formation of rain clouds in the north-west, and cholera having no vehicle, remained where it was in spring until the setting in of the monsoon rains. Dr. Murray describes the season, and the stoppage of the advance of cholera in the north-west with the failure of the monsoon, thus :—: — " The season has been irregular. There was scarcely any rain during the cold weather. fiere was a heavy shower on the 9th or 10th of June, after which the hot winds returned; d the rains did not appear until the 18th July, and there was little rain after the 20th August the country north of Agra.*" I "Cholera reached Gwalior on 22nd July, some days after the first fall of rain. It appeared Agra in the beginning of August, and a few days later at Muttra, beyond which it has not ended to the north." Dr. W. Walker notices the phenomena immediately attending the appearance of this cholera at Agra in the following sentence :—": — " During the prevalence, or more correctly at the first onset of the disease, the atmosphere remained for days clouded and murky to a degree ; not much rain fell, but a thick drizzling mist continued during the greater part of a day." I The meteorology of the exempted cholera area of 1859 and 1860, within which our • ,o™ * XT. j. • European Soldiers enjoyed so high a standard of health, is eteorology in 1860 of the famine , ¥, , . ? » ¦.-, ° * ,?. T ? , , ,X r ;of 1861, an exempted cholera area, described in the following quotation. In the eastern half of the Doab, included in the eastern division of the epidemic Ea, which suffered so severely from cholera both in 1859 and 1860, Colonel Baird Smith sribes the harvests as magnificent. The failure of the crops within the famine tract he ribes to the following causes. He writes :—: — I" It is well known that 1858, 1859, and 1860 were very dry and unfavorable. The nature the drought was in each case the same. An almost entire failure of the rains required for c autumn crop, and the consequent destruction of that crop, was followed by a total failure the spring rains, so that no land could be cultivated but with the aid of artificial irrigation, hen no autumn rains fall after August, it matters very little, as far as agriculture is conrned, what the previous falls may have been, and as it was the case that both in 1837-38 and 60-61, not a shower fell from September till March within the bad parts of either famine ict, the conclusion that the physical intensity of the drought was practically the same in th is a safe and reasonable one, and the broad fact of this identity makes the absence of tailed registers in the earlier period a matter of no serious practical importance." tThe commencement of the movement of the cholera of 1860 on the exempted tract of it year in the end of May 1861, was coincident with the reappearance of the normal rains, his report to the Punjab Government, Dr. D. B. Smith, then Civil Surgeon of Delhi, ntions, that the first heavy fall of rain at Delhi in 1861, occurred on the 31st May; and was on the 11th June, that the first case of cholera was noticed at Delhi. As I have ted, the cholera of 1860 had been generally revitalised in the districts immediately to the th and south-west of Delhi for six weeks previous to the date of this invasion. The cholera which was universal between the Jumna and Nagpore in 1850, and which Parallel of the exemption of the ecam^ the cholera of 1851 > and 1852 of Meerut and the Punjab, was excluded, as in 1860, from these provinces by an Meerut District in 1850. adverse meteorology. I find in the report of the 18th Royal h, stationed at Meerut in 1850, the following: — >" The weather was exceedingly backward and unseasonable, the hot winds blowing fiercely til the end of July without the temporary alleviation incident on the storms usual at that riod of the year. Even when the rains set in they were scanty, and the hot winds prevailed a greater or less extent up to the end of September." The table which follows, shows very well the distinction, even in ordinary years, between the meteorology of the eastern and western half of the Doab. It is compiled from the data given in the Famine Map of 1861. Rains of (he Boob, (Baird Smith). BAIN-FALL OF AN AVERAGE YEAB. Eastebn Hall. Western Half. Districts. Spring Rains. Autumn Rains. Districts. Spring Rains. Autumn Bains. Allahabad ... ... 623 3640 Mynpoorie ... ... 306 21-60 Cawnpore ... ?. 2 - 41 2172f AUyghur ... ... ? 2093 Shabjehanpore ... 590 24-96 Muttra ... ... 1-83 1645 Bareilly ... ... 521 3273 Agra ... ... 170 1788 Moradabad ... ... 631 2379 Bolundsbuhur ... 4"08 1683 Humeerpore ... 2"82 2800 Meerut ... ... 467 17-30 Etawah ... ... 267 2599 Mozuffernuggur ... 956 24-82f Seharunpore ... 14 - 21 3300f j Bijnore ... ... 842 3274f * Vide Mactier's Eeport for Meerut regarding the rains of 1860, page 68. t This average is understated. For 1866-67 a fair average year, the rain-fall was 28"6 Q. j Rain-fall increased by proximity to the hills. METEOROLOGY ATTENDING THE INVASION OP THE NORTHERN PROVINCES. 1860, A YEAR OF MINIMUM BAIN-FAIL. Eastern Half. Western Half. Districts. Spring Bains. Autumn Rama. Districts. Spring Bains. Autumn Rain*. Allahabad ... ... '90 3290 Mynpoorie ... ... -90 11 08 rwnnm-p 1 -GO i Erroneously Al'lyghur ... ... 1-20 14-20 Cawnpoie ... ... iw £ | Muttm __ _ nm Shahjehanpore ... 300 2721 I Agra ... ... -40 955 Bareilly ... ... '90 1870 Bolundshuhur ... 72 8"13 Moradabad ... ... "90 22"81 Meerut ... ... l'4O fi-60 Humeerpore ... 230 20 - 00 I Mozuffernuggur ... I'OO 8 - 97* Etawah ... ... -00 2722 | Seharunpore ... 2"21 11-55* I find that in the west as well as in the north, monsoon influences and cholera were Extension to the west of the exempt- hoi } in 1860. Ajmere which usually suffers along Ed area of 1860. with Agra, was not reached in 1860. The report of the year states :—": — " The rains set in a month later than usual, and were ¦¦ scanty • about three inches only fell in July. We had two showers in August, and also a it shower on 27th September. Altogether, we had not above six inches of rain during whole year." But Ajmere may be reached with the very same eastern influences under which Agra is attacked in May. The meteorology of this part of India is thus described by Irvine : — "If the hot winds commence early in April and blow steadily, with only one or two heavy Meteorology of Ajmere and the J^* k *fe tl } e r raixiS may be confidently expected about neighbourhood in relation to invasion. the lUth or 15th ot June, and will set in heavily and continue at intervals till early in October, at which time there will be an lidant supply of water all over the country, and a very cold season will follow till the middle December, about which time, if one or two heavy showers fall, and then the clouds disperse, cold season will be diminished greatly in temperature, and prolonged in duration, the crops be splendid, and again a regular hot wind will succeed. "On the other hand, if a considerable period of cloudy weather occurs in December, with light partial showers, the cold season will be much cut short and become less healthy ; the clouds will clear up, and after an interval of fifteen or twenty days again appear and light showers fall ; the season will be altogether hotter, and the crops will be inferior. In March, April, and May clouds will continue to gather, and in May generally heavy rain toill fall; the hot wind will not blow freely. The season will be oppressive comparatively ; the rains will not set in till the end of June, or early in July, will be light, and end about the middle of September. The following cold season will probably again be of shorter duration than usual, and hotter."f This is another illustration of the results of the antagonism of eastern and western influences. At the opposite margin of the western province of invasion, the influences from the southeast, which bring cholera with them, remain the same. At Agra, in 1856, the rainfall was reckoned by Dr. Murray, at 37*85 inches. Dr. Paton „,, , . .... states that at Meean Meer, the limit of the invasion of the The meteorology attending invasion , . „ / „ ... . , , , at the north-western limit of the monsoon cholera of 18a6, the fall was 38-62, although the western division of the epidemic area, climate of Meean Meer is naturally dry. The prevailing Epidemic of 1856. winds here also were from the east and south-east. He gives the following history of the condition of the air at the onset and during the prevalence of the great outbaeak :—: — " The weather in July, especially its latter half, was hot, sultry, and oppressive, reminding one of that still, heavy state of the atmosphere observed before an earthquake. What wind there was during the day came faintly, generally speaking, from the east and south-east, but about 9 p. M. it usually came steadily from the latter direction. Lightning was also observed low down in the horizon in the same direction, and not unfrequently in the east and north, for many days before the rains actually commenced. The average of the thermometer in the air for the latter half of the month of July was 95° at 4 p.m., and at 10 p.m. 79 s . Heavy rain fell on the 7th, 25th, and 26th, and the total fall for the whole month, indeed I may say for the three days, was 8 inches and 39 cents. " During the month of August the rains were, for Meean Meer, abundant, measuring for that period 14 inches 30 cents, the south-east wind almost invariably prevailing. The average of the thermometer in the air at 4 p. m. was 96°, and at 10 p. m. 85°. The atmosphere had frequently that heavy, leaden, dull appearance which gives a sickly hue to both mind and matter • the very clouds seemed fixed and immovable. On the 7th of this month, cholera attacked the Europeans of the Artillery. " For the first fifteen days of September, only 2 inches 40 cents of rain fell ; the wind, too, which had been also constantly south-east, began to change towards the latter half of the month to the south, south-west, and west, and the weather immediately cleared up, and the epidemic subsided and gradually disappeared at the same time." * ltainfall increased by proximity to the hills. f Topography of Ajmere, Irvine. 1811, page 67. The cholera of 1860 did not reach Agra with the spring rains, but in the regular monsoon season. I have above noted how in Nagpore and the extreme south-east, the spring rains failed in April and May, and therefore no material was left for the formation of rain clouds in the north-west, and cholera having no vehicle, remained where it was in spring until the setting in of the monsoon rains. Dr. Murray describes the season, and the stoppage of the advance of cholera in the north-west with the failure of the monsoon, thus :—: — " The season has been irregular. There was scarcely any rain during the cold weather. There was a heavy shower on the 9th or 10th of June, after which the hot winds returned; and the rains did not appear until the 18th July, and there was little rain after the 20th August in the country north of Agra.*" "Cholera reached Gwalior on 22nd July, some days after the first fall of rain. It appeared at Agra in the beginning of August, and a few days later at Muttra, beyond which it has not extended to the north." Dr. W. Walker notices the phenomena immediately attending the appearance of this cholera at Agra in the following sentence :—": — " During the prevalence, or more correctly at the first onset of the disease, the atmosphere remained for days clouded and murky to a degree ; not much rain fell, but a thick drizzling mist continued during the greater part of a day." The meteorology of the exempted cholera area of 1859 and 1860, within which our . ,_.„,_ „, , . . European Soldiers enjoyed so high a standard of health, is Meteorology in 1860 of the famine , £ j « . ¦, » « " % ,?• T j.t_ x i ie r tract of 1861, an exempted cholera area, described in the following quotation. In the eastern half of the Doab, included in the eastern division of the epidemic area, which suffered so severely from cholera both in 1859 and 1860, Colonel Baird Smith describes the harvests as magnificent. The failure of the crops within the famine tract he ascribes to the following causes. He writes :—: — "It is well known that 1858, 1859, and 1860 were very dry and unfavorable. The nature of the drought was in each case the same. An almost entire failure of the rains required for the autumn crop, and the consequent destruction of that crop, was followed by a total failure of the spring rains, so that no land could be cultivated but with the aid of artificial irrigation. When no autumn rains fall after August, it matters very "little, as far as agriculture is concerned, what the previous falls may have been, and as it was the case that both in 1837-38 and 1860-61, not a shower fell from September till March within the bad parts of either famine tract, the conclusion that the physical intensity of the drought was practically the same in both is a safe and reasonable one, and the broad fact of this identity makes the absence of detailed registers in the earlier period a matter of no serious practical importance." The commencement of the movement of the cholera of 1860 on the exempted tract of that year in the end of May 1861, was coincident with the reappearance of the normal rains. In his report to the Punjab Government, Dr. D. B. Smith, then Civil Surgeon of Delhi, mentions, that the first heavy fall of rain at Delhi in 1861, occurred on the 31st May; and it was on the 11th June, that the first case of cholera was noticed at Delhi. As I have stated, the cholera of 1860 had been generally revitalised in the districts immediately to the south and south-west of Delhi for six weeks previous to the date of this invasion. The cholera which was universal between the Jumna and Nagpore in 1850, and which Parallel of the exemption of the ecam^ the cholera of 1851 and 1352 of Meerut and the Meerut District in 1850. runjab, was excluded, as m 1860, from these provinces by an adverse meteorology. I find in the report of the 18th Royal Irish, stationed at Meerut in 1850, the following: — " The weather was exceedingly backward and unseasonable, the hot winds blowing fiercely until the end of July without the temporary alleviation incident on the storms usual at that period of the year. Even when the rains set in they were scanty, and the hot winds prevailed to a greater or less extent up to the end of September." The table which follows, shows very well the distinction, even in ordinary years, between the meteorology of the eastern and western half of the Doab. It is compiled from the data given in the Famine Map of 1861. Rains of the Doab, (Baied Smith). EAIN-FALL OF AN AVERAGE TEAE. Eastbkst Hall. Western Ham. Districts. Spring Bains. Autumn Rains. Districts. Spring Eains. Autumn Bains. Allahabad ... ... 6-23 3640 Mynpoorie ... ... 3-06 21-60 Cawnpore ... ?. 241 21'72f Ailyghur ... ... ? 2093 Shahjehanpore ... 5"90 2496 Muttra ... ... 1«83 1645 Bareilly ... ... 5*21 3273 Agra ... ... 1-70 1788 Movadabad ... ... 6-31 2379 Bolundshuhur ... 4-08 16-83 Humeerpore ... 2"82 28-00 Meerut ... ... 4-67 17-30 Etawah ... ... 2 - 67 20 - 99 Mozuffernuggur ... 956 24-82f Seharunpore ... 14-21 33'00f Bijnore ... ... 8 - 42 32"74f * Vide Maetier's Report for Meerut regarding the rains of 1860, page 68. 80 METEOROLOGY ATTENDING THE INVASION OB 1 THE NORTHERN PROVINCES. 1860, A TEAE OP MINIMUM BAIN-FALL. Eastbbn Half. Wkstebn Half. Districts. Spring Rains. Autumn Rains. Districts. Spring Eains. Autumn Rains. Allahabad ... ... '90 32-90 Mynpoorie ... ... -90 11-08 fawnoore 1-60 ( Erroneously Allyghur ... ... 1-20 14-20 Cawnpoie ... ... lou £ Muttra n Shahjehanpore ... 300 27 - 21 Agra ... ... '40 955 Bareilly ... ... -90 18-70 Bolundshuhur ... -72 8-13 Moradabad ... ... -90 22-81 Meerut ... ... 1-40 6-60 Humeerpore ... 230 20-00 Mozuffernuggur ... 1-00 8-97* Etawah ... ... "00 2722 Seharunpore ... 2 - 21 11-55* I find that in the west as well as in the north, monsoon influences and cholera were Extension to the west of the exempt- b °J} 1 f Sent in 1 ? 60 ' , A J n ? er % /^ hic^, USuall y suffers along edarea of 1860. with Agra, was not reached in 1860. The report of the year states : — ¦" The rains set in a month later than usual, and were very scanty ; about three inches only fell in July. We had two showers in August, and also a slight shower on 27th September. Altogether, we had not above six inches of rain during' the whole year." But Ajmere may be reached with the very same eastern influences under which Agra is attacked in May. The meteorology of this part of India is thus described by Irvine : — "If the hot winds commence early in April and blow steadily, with only one or two heavy Meteorology of Ajmere and the S( l ualls in Ma Y> the rains ma 7 be confidently expected about neighbourhood in relation to invasion. the 10th or 15th of June, and will set in heavily and continue at intervals till early in October, at which time there will be an abundant supply of water all over the country, and a very cold season will follow till the middle of December, about which time, if one or two heavy showers fall, and then the clouds disperse, the cold season will be diminished greatly in temperature, and prolonged in duration, the crops will be splendid, and again a regular hot wind will succeed. " On the other hand, if a considerable period of cloudy weather occurs in December, with light partial showers, the cold season will be much cut short and become less healthy ; the clouds will clear up, and after an interval of fifteen or twenty days again appear and light showers fall ; the season will be altogether hotter, and the crops will be inferior. In March, April, and May clouds will continue to gather, and in May generally heavy rain loill fall; the hot wind will not blow freely. The season will be oppressive comparatively ; the rains will not set in till the end of June, or early in July, will be light, and end about the middle of September. The following cold season will probably again be of shorter duration than usual, ana hotter."f This is another illustration of the results of the antagonism of eastern and western influences. At the opposite margin of the western province of invasion, the influences from the southeast, which bring cholera with them, remain the same. At Agra, in 1856, the rainfall was reckoned by Dr. Murray, at 37"85 inches. Dr. Paton „, , .... states that at Meean Meer, the limit of the invasion of the The meteorology attending invasion , . „ o ' „.. . , . , at the north-western limit of the monsoon cholera ot 1806, the fall was 38" 62, although the western division of the epidemic area, climate of Meean Meer is naturally dry. The prevailing Epidemic of 1856. winds here also were from the east and south-east. He gives the following history of the condition of the air at the onset and during the prevalence of the great outbaeak :—: — (" The weather in July, especially its latter half, was hot, sultry, and oppressive, reminding of that still, heavy state of the atmosphere observed before an earthquake. What wind 3 was during the day came faintly, generally speaking, from the east and south-east, but it 9 p. m. it usually came steadily from the latter direction. Lightning was also observed down in the horizon in the same direction, and not unfrequently in the east and north, for many days before the rains actually commenced. The average of the thermometer in the air for the latter half of the month of July was 95° at 4 p.m., and at 10 p.m. 79 c . Heavy rain fell on the 7th, 25th, and 26th, and the total fall for the whole month, indeed I may say for the three days, was 8 inches and 39 cents. " During the month of August the rains were, for Meean Meer, abundant, measuring for that period 14 inches 30 cents, the south-east wind almost invariably prevailing. The average of the thermometer in the air at 4 p. m. was 96°, and at 10 p. m. 85°. The atmosphere had frequently that heavy, leaden, dull appearance which gives a sickly hue to both mind and matter ; the very clouds seemed fixed, and immovable. On the 7th of this month, cholera attacked the Europeans of the Artillery. " For the first fifteen days of September, only 2 inches 40 cents of rain fell ; the wind, too, which had been also constantly south-east, began to change towards the latter half of the month to the south, south-west, and west, and the weather immediately cleared up, and the epidemic subsided and gradually disappeared at the same time." * liainfall increased by proximity to the hills. f Topography of Ajmere, Irvine. 1841, page 67. 81 He adds :—": — " Cholera I believe firmly to be a poisoned and altered state of the atmosphere carried steadily in one direction ; this atmosphere appears to have travelled almost in a direct line from south-east to north-west." The author of the Cholera Report of 1861 admits the fact that east winds and rains in the North- West usually accompany the appearance of cholera ; that cholera has been chiefly prevalent during seasons when Epidemic of 1861. t amount of rain has been greater than usual, as in 1845, 1852, 1856, and 1861 ; and that terly winds in Northern India are favorable to the diffusion of cholera. He says :—": — " Easterly ids always prevail during the periodical rains of Northern India ; when the rains are especially ,vy, the wind will be especially constant ; if, as we believe to be undoubtedly the case, seasons heavy rain are favorable to the diffusion of cholera, it necessarily follows that seasons of ilera will ordinarily be seasons when easterly winds are especially prevalent." He speaks c of invading not of reproduced cholera. His conclusion, which is the same as that of all er observers, is thus stated (para. 348) :—: — " Cholera has not its origin in atmospheric causes. The facts have an entirely different bearing. They show that while the relation to atmospheric conditions is evidently real, the original causes of cholera are perfectly distinct, and that the poison, whatever it may be, has a separate existence which certain conditions of climate may aggravate or repress." The nature of the country in which the monsoon comes to its end, and in which invading I Countries beyond monsoon influence cholera stops, I find well described in the following, from a which invading cholera terminates, report on the topography of Upper Scinde by Mr. Sutherland, i North- Western Desert. JJ e writes : k" The influence of the periodical rains is lost soon after entering the territories of Bhawul n. Bhawulpore, Beekaneer, Jessulmeer, and Upper Scinde have none. When rain does it is uncertain both in time and quantity, and more likely to occur at the cold season at any other." I" After leaving Ferozepore, the nature of the country for the first five marches differs in no terial degree from that in its immediate neighbourhood. Here commences the Bhawule country, and six marches beyond, the sandy plains of the Beekaneer desert are found to )roach the great road. The whole country up to this point is covered with jungle, consisting acacia trees, which affords admirable grazing for camels, which advantage, as well as the ure of the ground, renders this country well adapted for the rearing and keeping in health t most useful animal. Immediately on leaving the Seikh states, the influence which the ximity of the Beekaneer desert exerts on the Bhawulpore country is apparent ; the very ect of the soil, without enquiry, tells the observer that rain is there unknown."* On the frontier beyond the monsoon, although the rainfall is larger, it is not necessarily coincident with the rains of the east, and the advance of cholera at this season is utterly cut off from the Trans-Indus Trans-Indus Districts. stations. We read :: — tf At Kohat there is no fixed period of rain. It is pretty equally distributed over the year, and the average fall is only 12 inches." Again, — " At Bunnoo the seasons may be divided into two, the hot and cold. The hot lasts from Ist May to 15th October; the cold from 15th October to Ist May. The falls of rain do not preserve any regularity, sometimes occurring in spring, sometimes in autumn, but, generally speaking, at uncertain intervals during the cold .season. Heavy falls rarely occur in autumn, but when they do, sickness is greatly increased." Rainfall of the Punjab in epidemic The table below shows the spring rains of the Punjab and non -epidemic years. contrasted in an epidemic and non-epidemic year : — Spring rains of an epidemic and non-epidemic year in the Punjab. Stations. May 1866. May 1867. Goorgaon ... ... ... -0 £-3 Mooltan ... ... ... -7 ]_.g Umballa ... ... ... -0 -9 Jullundur ... ... ... -0 7*2 Sealkote ... ... ... 4-2 62 Dhurmsalla ... ... .. -5 130 In an epidemic year (not necessarily a cholera year), the rainfall of Meean Meer may be ;is high as that of Agra. * Observations on the route from the N. W. Provinces to Scinde, 1844, p. 29. 82 THE DISTRIBUTION OF EPIDEMIC CHOLERA A PROVINCIAL PHENOMENON. Chap. V.] SECONDARY MANIFESTATIONS ALSO SUBORDINATE TO METEOROLOGY. 83 But in a non-epidemic year the falling off of the monsoon towards the North- West is beautifully shown The figures for 1866, for the months from May to September, when Mooltan and Peshawur were among the healthiest stations of Bengal, were as shown in the following table : — Tailing of of the monsoon in the North-West indicated by the gradual diminution of the rainfall. Stations. 1865, 1866, 1867 an average year. a non-epidemic year. an epidemic year. — — - _ g elhi . - ••• - .» 24-3 32-3 326 Kuraaul ••• - -. ... 209 15-0 277 JlBBarJ 188ar 16-8 10-2 19-5 Kohtuok .. ... ... ... 13 . 7 n . 8 o , ?j™ - •• 15-6 13-7 13-9 $ $ '" -' "' 60 4ln*.oi^ Provinces, regarding the simultaneous appearance of choleraic influence throughout the eastern province in the week from Bth to 15th June 1864. This affords also an instance, additional to the many which I have already quoted, of the true provincial distinction between east and west in the North- Western Provinces. It shows how this powerful cholera, which had advanced up to the margin of the eastern province as fains to Banda and Humeerpore, was unable to travel in the course of the Jumna, even to Calpee or to Etawah."* The few cases exceptionally noticed at Muttra belonged probably to the cholera which became the cholera of the Ferozepore District in 1865. The cholera which Dr. Walker describes, I regard as the reproduction of the invading epidemic of 1863, which covered the exempted area of 1862 in the months between April and July. Its distribution is an absolute parallel with that of the eastern cholera of 1860 following the invasion of 1859. Dr. Walker writes :—": — " I have taken advantage of my position (as Inspector of Jails) to ascertain how far the choleraic influence in the atmosphere was felt among the population of the North- Western Provinces during the week 7th to 15th June, when cholera so heavily visited the jail of Allahabad." * For the parallel fact in 1818, see quotation from Jameson, p. 58. • Dr. Walker finds no case in the Dehra, Seharunpore, Meerut, Bolundshuhur, Allyghur, ted area Bijnour, Moradabad, Bareilly, Budaon, Shahjehanpore, Futtehghur, Etah, Exemp e< Mynpoorie, Etawah, Agra, Jhansie, Lullutpore, and Ajmere Districts. Some cases are said to have occurred in a village of the Mozuffernuggur District, and seven cases are reported from Muttra; and he adds, "strange to say, at Bareilly, a man of the 107 th was attacked on 18th June."* In the Humeerpore District cholera prevailed extensively. In the Banda District the ied area disease was very prevalent, and also in the south of the Mirzapore District Although prevalent in the Allahabad District, its intensity was not so great as might have been expected from the sharpness of the attack in the jail. In Benares the disease was prevalent, but not to a marked extent. In the district of Azimghur the population suffered considerably. In the Goruckpore District also the disease was generally prevalent The Civil Surgeon of Oraie states that reports of the appearance of cholera in some parts of the district had been made to him. Dr. Walker concludes :—": — " The" choleraic influence was confined to a continuous tract of country. The Humeerpore, Banda, Allahabad, Mirzapore, Benares, Azimghur, and Goruckpore Districts suffered most. The sudden appearance of the disease put it out of the question that the affection moved with slow tread along human highways. Simultaneously, at Goruckpore, Allahabad, and Banda, on the Bth of June, the affection showed itself, indicating beyond a question that it had its origin in wide spread atmospherical conditions/ Had Oude been under Dr. Walker's jurisdiction, he would have found this cholera general throughout this province at the same time. The phenomenon above described was a redistribution within the provincial limits, of a vitalised cholera of May, by a generally prevailing atmospheric condition favorable for epidemic manifestation. The usual difficulty occurs in determining what this actually was. Dr. Walker says that he has not succeeded in tracing any extraordinary condition that would justify him in recording it as a concomitant of this cholera. He adds, — "Dr. Hooper remarked at Allahabad that during the five days — Bth to 13th June — the wind veered about several times in the twenty-four hours, and from the 18th, the wind began to blow steadily from the east." The conclusion I feel inclined to draw is, that the epidemic manifestation of this invading cholera of 1863, revitalised in May 1864, was repressed so long as the hot west winds blew steadily; but that as soon as eastern influences commenced to dominate on Bth June, the conditions became those suited for general manifestation, and that this was distinctly confined to the natural province within which revitalisation occurred. In the chapter treating of aerial influences as affecting the attack of communities by epidemic cholera, I have given a precise illustration of the converse of this case, occurring in the same area ; namely, of the sudden cessation of the cholera of April 1860 from the opposite combination of meteorological conditions. The small number of outbreaks of cholera over the east in 1864, and the fact that with a single . „ „ . ... , exception (Her Majesty's 36th at Lucknow), these were attended Rain-fall of an epidemic and a non- ?, c . ?,• ivj j • ntn t i»im. ±. j_i • i epidemic year in the Eastern Division, with trifling mortality, was due in all probability to the special character of the season. The rains were a month behind the usual time in setting in, and by the middle of September they had ceased. The rain-fall was in some stations but 12 inches ; and the result was, the maximum of health in acclimatised troops, and the maximum of sickness in the non-acclimatised, true typhoid fevers with ulceration of Peyer's glands taking the place of paroxysmal fevers. The cholera distributed in 1863 did not show itself in epidemic force, as it would have done in a year of a different constitution ; and even the outbreak at Lucknow commenced after the medical officers were congratulating themselves in the termination of the cholera season without any general manifestation. The smallness of the mortality in the European Regiments at Allahabad and Cawnpore, and in Her Majesty's 107 th at Lucknow, may, in a great measure, be attributed to the character of the season. Monsoon rains of Oude, 1863 and 1864. 1863, AS EPIDEMIC VEAB. 1864, A TEAS OF EEPUESSED CHOLERA. Months. Lucknow. Fyzabad. Lucknow. Boy Bareilly. Baraitcb. Gonda. Seetapore. May ... ••• 1-4 in. "7 in. j 7 in. 20 in. 91 in. 1-9 in. 23 in. June ... ••• 10-6 „ 107 „ I -5 „ 30 „ 7 „ 2 „ -Q „ July ... ... 263 „ 15-1 „ 69 „ IB „ 6-5 „ 76 „ 9-4 „ August ... ... 22-4 „ 16-8 „ 39 „ 3"8 „ 3'l „ 56 „ 37 „ September ... ... 13"3 „ 18-5 „ 27 ? 2"0 „ 2-9 „ 39 „ 2*6 „ Total ... 739 in. 61-8 in. 14-7 in. 126 in. 223 in. 191 in. 180 in. * The third occasion on which during these fifteen years the last European soldier died from cholera, at Bareilly, reckoning our stations from east to west. The two previous occasions were in 1859 and 1860. 85 [Section I. THE ESSENTIALS FOR EPIDEMIC MANIFESTATION. 86 1865 and 1866 were also in Oude non-epidemic years, with a rain-fall below the average; ;ind in 1867, when cholera again covered Oude to its furthest limits, the rain-fall was far in excess of the average. Dr. Cannon, in his report on the cholera of Lucknow of 1867, gives the rain-fall of the five years in inches as under : — 1863. 1864. 1865. 1866. 1867. 61-4 200 ' 273 252 661 Such a fact might very readily tend to the suggestion of the theory, that a certain amount A year of excessive rain-f ill is not of rain occurrin g at a certain season, causes the springing up j\ y cell Ul uaLUooI Vc I *llU"J.tlil IB LHJU ? . . . 1 j_ i " j 1 " 1 * * I*l necessarily a cholera year, as shown by of the cholera germs latent in the epidemic provinces, while the exemption of the Central Provinces these are not evolved by the minor degree of humidity, and in 1867. fVmf n.n pnirlpmin of r'linlpra. mpu.ne rrmvplv flip mn.nifpst.n.tinTi that an epidemic of cholera means merely the manifestation 1 local cholera in relation to a certain meteorology; or again, that the extreme humidity essarily provides a vehicle for the importation of the cholera miasm from without. I The provincial distribution of cholera in 1867 disproves both suggestions. In Nagpore 1 Central India, the rain-fall was the heaviest that had occurred for years, and yet ; a case of cholera occurred from Raepore in the east to Erinpoorah in the west. Even far to the north as Jhansi and Etawah, no cholera occurred along with the excessive Q-fall of 1867, although the limiting line of the epidemic of the year was but a few les distant. The report from Jhansi is, — "No epidemic has occurred during the year. September, October, and November, however, there was much fever, due, apparently, to the lessive rain-fall of the year, which exceeded the average by at least a third." From Etawah, s Civil Surgeon writes :—": — " We have been, I may say, quite free from cholera and other demic diseases." From Jubbulpore, Dr. Rice writes :—": — " Rain fell in each of the first five nths of the year, and this tended much to temper the heat in April and May. The rains set with their usual regularity on the 7th of June, and from that day till the day of cessation— ! 19th September— it rained on seventy-three out of the 104 days. The total rain-fall has ;n unusually heavy ; it has been the greatest but one, of the last eighteen years, during which ecord has been kept/ In the report from Nagpore, it is stated :—": — " The rain-fall far seeded the average, amounting to 5918 inches/ Bandhara gives a rain-fall of 57"9 inches, cry one of these districts reports that no epidemic has shown itself throughout the year. It requires to be taken into account, in considering the invasion of Central India lying „ . ... ? n,i above the Vindhya, and vet in the southern epidemic hijHi- Contrast between the aspect ot the ? J .' \ , . . - l ? . ° plains of Berar and Khandeish and the wa y across the continent, that the physical aspect of the counplateau of Central India, essential to try is very different from that of the rest of the epidemic be recognised. tract with which it is associated. The districts through which this tract runs in the south are known receptacles of epidemic cholera. The plains of Berar or of Khandeish (a jungly swamp between the Sathpoora and Chandore Hills), or the valley of the Nerbudda, afford facilities for the crossing of cholera from sea to sea, which are not afforded by the plateau of nearly 2,000 feet of elevation. The climatology is in all respects different ; and hence it is, that cholera passes far to the west in the epidemic tract south of the Vindhya before Saugor or Bhopal is reached ; that Guzerat and Western Malwti often suffer earlier than Saugor or Bhopal, and that invasion is generally delayed until May, while in the east, south, and west, cholera is frequently epidemic in March. For this part of India, May seems to be naturally the month of the appearance of cholera, as it is for the Cawnpore and Banda Districts. No parallel can be drawn for this plateau and that of Hazareebaugh, which is of a similar elevation. The geographical situation and its proximity to the base of eastern influences, determine for Hazareebaugh an aspect totally distinct. the meteorology attending the oecu- . The following quotations very well illustrate the condion of the southern epidemic high- tions under which a body of cholera, whether dormant or invading, becomes epidemic over these provinces. vading, becomes epidemic over these provinces. weather by which the epidemic of 1864-65 was ushered in in Nagpore in the early nths of 1864, I find from the Nagpore registers to be of this character :—: — "April. — Stormy on the nights of 11th and 13th, with thunder and lightning jon former date. Slight rain on 3rd, 12th, 18th, and 19th. Cloudy on 6th and 7th; weather hot and sultry during the day. " May. — More or less rain fell on twenty-five days, and on eight of these it was accompanied by violent storms of wind, lightning, and thunder. In the day, atmosphere close and sultry." I On the 2nd May, the Civil Surgeon writes, reporting that cholera is prevailing throughout c whole of Nimar. On the 4th May, cholera appeared in many parts of the Bhopal territory, d between the 12th and 15th May, cholera was distributed over the Saugor District. It was the 11th July that the monsoon cholera of the year made its appearance at Saugor.* It was th a humid atmosphere that this cholera of Saugor of May was introduced, the result of the r enty-five days of a moist atmosphere to the south. Dr. Rice writes :—": — " Rain fell here in May sufficient quantity to take the great dryness out of the air, and until the rains set in' on the h July, the atmosphere was hazy and the sun a good deal obscured." All of these examples illustrate what I believe to be an universal truth, that it is with an General deduction from the facts of atmosphere essentially humid that epidemic cholera is distrithe seasons and circumstances of inva- buted. It would serve no purpose, and it would be only to go Blon - nvprtlip shttip crrminrl no-uin fn elirmr f.Viof fVinco r>V»aa™7£iT.o *.rlw. over the same ground again, to show, that those observers who * Compare table at p. 78, showing Cawnpore cholera of May and July. have not comprehended the phenomena of distribution over definite areas, the share which moisture and the prevailing winds have in distributing- epidemic cholera, and the phenomena of vital reproduction subsequent to invasion, have had no basis for their assertions. Let me say merely, that the term radiation, so frequently used in speaking of the epidemic spread of cholera, is a wrong term, inasmuch as it is not the fact that cholera does radiate from any focus. I make this generalisation subject to reservation, in anticipation of the study of the period during which a moving body, affected on a known day, may carry cholera from the point of affection as a centre. To distribution in such a case the term radiation is applicable, but the aerial diffusion of epidemic cholera is from one point to another, in the direction of the progress of natural agencies, and solely in subordination to the fact of these agencies being provided. Cholera has no motion due to its inherent vitality. This is an inference from negative facts rather than from positive data ; that is to say, it is to be inferred from the fact that cholera is not found to move without a vehicle, and without the influence of a directing agent, that the vehicle and the directing agency are essential to its epidemic progress. For epidemic manifestation to be obvious to us, it is necessary that it should take place coin- cidently with the vitalisation of cholera, and therefore at the May epidemic distribution take place seasons w h en cholera naturally revives. But I see nothing imwhile the cholera miasm is in a state , ,- . ¦ , j> . , ? p t of dormancy? probable in the suggestion, that cholera may be distributed in its dormant state as well as in its vital condition. Ido not make the remark for the purpose of making this possibility the explanation of phenomena of distribution which I cannot explain, for I believe the facts of our period to require no such assistance. I observe, that in England weight has been laid upon the aerial spread of a minor form of choleraic influence some months before invasion occurs, as premonitory of a coming invasion ; and my own observation of the forerunners of a cholera approaching, although several hundred miles in the rear, leads me to conclude that a diffuse choleraic influence is not un frequently spread abroad without its diffusion being suspected. I allude to such cases as those occurring in 1861, when far ahead of the moving cholera, a patient in hospital in the Huzara Hills or at Kohat is fatally struck with cholera, evidently from a far-flying offshoot from the cholera-bearing atmosphere in the east of the epidemic province. The presence of an aborted as well as of a diffuse cholera, may possibly be shown by an epidemic diarrhoea. Dr. Rice describes a diarrhoea for which he could not account, as epidemic in the Saugor District in the cold season of 1863, and this may have been the precursor, and premonitory of the invading epidemic of May 1864. That there is such a thing as the aura of an epidemic, a manifestation of the presence of cholera in an innocuous shape, the index and precursor of a great and fatal cholera following', such instances as the following seem to show :—: — The aura of an epidemic. In March and April 1853, fifteen jails of the eastern division of the epidemic area, affected by the spring cholera of the year, gave seventy-eight admissions and only six deaths ; as soon as the monsoon of the year set in, this cholera became a deadly epidemic, in which upwards of 300 prisoners died in the jails of the same province. In 1855 the most westerly district affected from the, east by the cholera the precursor of the great invasion of 1856, was Cawnpore. In this jail, in August and September, seventytwo cases of cholera occurred with only three deaths. Dr. Tresidder asserts that this was a true choleraic affection. In 1863 the most westerly jail affected in the invasion from the east was Etah; in July, twenty-eight 'out of 200 prisoners were seized with cholera, but all recovered. This^is what seems to have occurred in the Saugor District towards the close of 1863, probably in connexion with the onward movement— the succeeding epidemic leap — of the cholera which invaded Jubbulpore, Mundla, and Seonee in June, which appears to have reached Bombay in December 1863. The essentials for manifest epidemic progress are three — (1) , the presence of the cholera miasm ; (2^, the humid atmosphere, which is in every case its vehicle ; The essentials for epidemic mamfes- an( j prevailing wind to give direction and limitation tation. J.,. J.l ' Unmirl otmncnlu™ to this humid atmosphere. I hold as a scientific truth, that with these three conditions cholera shall be distributed universally over a natural area, those portions of the natural area only being exempted in which these conditions are not fulfilled. I have shown what localisation means when applied to epidemic malaria, and it will be understood, that the degree of liability of any portion of an area will vary with the varying degrees of the facilities afforded or the obstacles offered to advance or localisation. But when we know that a province is invaded, then cholera has not necessarily any limit but that of the boundaries of the natural area, and the facts of distribution within this province give a positive proof that the dissemination is as wide and as general as are the invading meteorological influences. It is no more true that epidemic cholera moves along highways of communication than it is that it radiates from a focus. To take as a single example, the Grand Trunk Road of our Presidency. I have shown, that cholera is never conveyed along it from the eastern half of the Doab to the western, or in the contrary direction ; that when the western half of the epidemic area is invaded, Lahore is reached from the south-east as soon as Umballa, or even, as in 1856, a month before Umballa is affected; and that cholera had no power in 1856 or 1861, to pass beyond the Jhelum on its way towards Peshawur and Cabul. Some have endeavoured to advance 87 THE EFFECTS OF AERIAL INFLUENCES RECOGNISED BY PREVIOUS OBSERVERS. [Section I. 88 the hypothesis, that because it will generally be found that the first cases of cholera which occur come from an affected district, the fact is sufficient proof of the introduction of foci of onta°"ion. It has no such significance ; it must follow almost as a matter of course, that the rst cases occurring 1 in any province shall be imported cases. When, as in 1856 or 1861, lidemic cholera continued chained down in the Agra District and in the districts south and est of the Jumna from May to July, it cannot be imagined that six weeks elapsed without ome passenger on the great highways carrying cholera with him in the latent stage into the [eerut District or the Punjab. Ido not know that such cases did occur ; but it suffices to me ;o know, that within three weeks from the date of the epidemic commencing to move with the tting in of the monsoon, the entire province was covered and its population destroyed by tens ' thousands ; and I infer, that the same distribution would have occurred had there been no luman being existing within the invaded area. I have no hesitation in stating it to be a law, that in this Presidency, epidemic cholera General deductions regarding the is never distributed with a dry atmosphere, and that, therefore, lation of epidemic cholera to huini- cholera moves only at those seasons in which the atmosphere ty- -^ is humid, whether the direction of invasion be from east to est, from south-east to north-west, or from south-west to north-east ; that the retention of lolera in any tract, in any year, is proportioned in time to the natural degree of humidity hieh it possesses (in subordination to the vital existence of cholera as an object) ; and that pression of a cholera which we know to exist, also occurs in a degree proportionate to the )revalence of influences which determine a dry atmosphere. Jameson drew the very same conclusion as the result of his researches, although from failing to recognise the sub-division of the epidemic area into natural provinces, he was puzzled by what appeared to him Jameson's generalisation. ;o be exceptions to the generalisation. He recognises the effects of the moist easterly winds ; )ut, forgetting that over the eastern division of the epidemic area, these winds brought the lolera of the spring of 1818, he concludes, that it was during the dry months of the hot eather that cholera prevailed here, while the moisture of the monsoon carried on the same lolera across the Doab into Meerut and Rohilcund. This was in fact part merely of the lenomenon which did not escape his notice, namely, the abhorrence of the cholera of the )ring for the Bareilly District ; the truth being, that the spring cholera was confined to the rea of spring influences from the east. His general deduction fp. 100 of his report) has >een already quoted in the introduction to this chapter. the following sentence Jameson expresses what I conclude to be the truth, that the ncy of the winds directs and limits the invasion of cholera :— t" In Upper India the air, being less corrupt than that of the Lower Provinces, which were questionably the primary seat and seminary of the disease, required for the production the epidemic an admixture of the more vitiated currents which were borne along by the ads. In this view of the case, the agency of the wind, setting aside the effect of its npness, must be held to have been purely mechanical."* Throughout Mackinnon's treatise we find him constantly recurring to his experience of the e % ffects of east winds in the dry season as influencing epidemic disease. His experience is of the Gangetic Provinces and Mackinnon's generalisations. Cawnpore. He thus characterises an epidemic season : — " Frequent falls of rain in the hot weather, especially with much easterly wind, observation has led me to think are followed by disease in the Upper Provinces. "f tHe indicates very clearly the three seasons of the prevalence of cholera ; the third is cvi- Ltly noted from his long experience of the Behar Provinces, where cholera may be found in r year in November, as in 1856 and 1857. "Cholera is most prevalent (in the spring nths) in years when the weather is unseasonable by frequent and cooling showers followed intense heat (indicating east wind) . In the rains, again, I have seen it when there has n a long interval without good soaking falls. A third period when I have occasionally, but re rarely, seen outbreaks, is after the rains are over, and when the cool nights and heavy vs denote the approach of the cold season." He suggests the geographical and aerial diffusion of epidemic cholera, taking as his example the converse of the phenomenon which fixed Jameson's attention, namely, the inability of cholera to pass in the Doab from west to east ; Jameson noting its inability to pass from east to Mackinnon recognises the truth thus :—: — I "There will be some to say that to Delhi (in 1856) cholera has been conveyed from Agra human intercourse, and no doubt the believers in this manner of diffusion will find what y consider proof in the undoubted fact that travellers arrive daily at Delhi from Agra. But ihey do at Cawnpore and other places lying east of Agra. Then why does not the disease rel as commonly in that direction also ? " J All writers on the cholera of this Presidency have been similarly impressed with the essen- tial connexion between aerial influences and the phenomena of cholera. Strachey writes :—": — " Observers in the North- Strachey's remarks. Western Provinces and Punjab noting the similarity, we might almost say identity, of the * Report p. 101. t Already quoted at p. 77. X Indian Annals, 1856, p. 133. curves representing cholera, the tension of vapour, and rain-fall through a vast extent of country, might easily be led to the conclusion that the disease was necessarily dependent upon these special atmospheric conditions. Such a conclusion would have been evidently based not upon knowledge of the facts, but upon ignorance." The meaning of this is simply, that over and above the prevalence of all meteorological conditions, the presence of the cholera miasm is an essential to the prevalence of cholera, and that the possible allegation of the perennial presence of cholera, and its manifestation or repression merely in relation to prevailing meteorology, is untenable. KBut, again, I repeat, that the manifest epidemic existence of cholera in any locality is subinate to the vitality which cholera possesses as an organised object, and the phenomena due meteorological agencies must be studied, keeping this clearly before the mind. This was lently present to Baly when he wrote the following sentences :—: — " No known influence effecting alterations in the purity or impurity of the air will explain „ , „ the occasional rapid subsidence of the epidemic while the ex- HoK'^ST.SS.^. """' ternal temperature is high; and it is therefore necessary to admit the agency of an unknown cause capable of producing Kn more remarkable variations in the intensity of the epidemic than those caused by fluctions of temperature. " And, again, — " The cessation of the epidemic cannot be referred to any known external agency."* No illustration can be more striking than that afforded by the distribution of cholera in Kresence of cholera in different months in relation to the prevailing meteorology. An excepths demonstrative of the effects of tional meteorology will bring with it results which affect the il influences. oi m of an illustration, such as the following, whinh is mpnnf, aim of an illustration, such as the following, which is meant thow how, in the first six months of the year, the divisions of the Presidency under eastern western influences are respectively affected by cholera whether invading or reproduced ; it be observed that the statement is for the nine years included between 1857 and 1867, in both vhich years the mortality was heavy in the western division in these same months. Not ng sight of this, the case, as I put it, stands thus : — With a larger strength, in the area under western influences, no cholera death occurred in the European Army in these nine years in January, February, or March ; one man died in April, eight in May, and five in June — in all fourteen men, in the first six months of these nine years. In the division under eastern influences, with a smaller strength, 1,556 admissions occurred during the same six months of these nine years. European Troops in Lower Bengal, Behar, Benares, Oude, and the Eastern portion of the Doab. Cholera Admissions of each yeae in the fiksi six months. Months January to June. j f i Torn,. 1858. 1859. 1860. 1861. 1862. 1863. 1864. 1865. 1866. .January ... ... 13 8 ... 6 2 4 ... 5 3 41 February ... ... 47 4 57 4 2 15 11 122 March ... ... 59 28 158 22 7 3 15 4 7 303 April ... ... 91 66 271 27 10 17 22 28 2 534 May ... ... 34 202 52 23 7 3 4 15 2 342 June ... ... 89 53 47 18 1 1 2 3 ... 214 Total for si:: months ... 333 361 585 100 29 29 48 56 15 1,556 Some have sought to prove, that the prevalence of cholera bears no specific relation to the moisture of the atmosphere, because it prevails and is epidemically spread with very different degrees of saturation. As I have shown from the phenomena of diffusion over the eastern area in the spring, it is the absence of the dry heat of the west winds that makes an epidemic season ; and a few inches of rain in May will determine an almost universal distribution of cholera I: Rohilcund, Meerut, and the Punjab, as in 1862, 1865, and 1867. In the height of the lsooii season, cholera dies out nowhere ; and that its manifestation as an air-borne epidemic in endemic area, is, as the rule, repressed, is unquestionably due to the fact of the submergence he entire breeding grounds, as soon as Lower Bengal receives the floods of the monsoon, s in Calcutta, as in the valley of the Ganges, when the rivers are at their lowest, and n in March and April the south-east breezes steadily prevail, that cholera comes as an airle epidemic. But it is a mistake to suppose, that an air-borne cholera is never distributed lin the endemic area during the monsoon; for the facts of 1859 (when Barraekpore and Dumq were heavily struck in August) show the contrary. Before the floods have taken place, extrication of cholera with the first rains is always a likely event ; and this is the great June era of the margins of the endemic basin, the representative in this situation of the monsoon era. I have already noted the statement of the Rev. Mr. Buckley, that when a heavy of rain occurs, either at Pooree or on the return journey from Juggurnath, disease and h may be confidently expected among the pilgrims. XI need not further insist, that cholera moves with monsoon influences, and that a cholera ored by a dry atmosphere takes on locomotion as soon as the vehicle for its conveyance is * Kcport of the College of Physicians, pp. 43 ami it). 89 PARALLELS DEVELOPED FROM SUBORDINATION TO AERIAL INFLUENCES. [Section I. 90 Testimony to the necessity of a moist vehicle beyond the range of direct monsoon influences The vehicle of moisture in di B trict s is not wanting. Jn the year 1862, when cholera attacked the beyond the primary range of monsoon 9ord .Regiment in the reshawur valley on tour separate occaagencies. sions, between July and October, Dr. Munro writes, — "In July and August the weather was hot and oppressive with occasional heavy showers of rain, and the irst and second outbreaks took place after the rain." And again, before the great outbreak of )ctober, — " Rain fell on the sth, and on that day and on the following the air was cold and amp, and the hills were enveloped in a dense fog." Dr. John Brown has stated it as his pinion that Nepaul was invaded in 1856 from the plains by a succession of dense fogs acting as a vehicle to the cholera miasm ; these he describes as clinging to the mountain sides. tThe Dhurmsalla cholera of April and May 1862, is described as having been ushered in by a olent storm of rain, thunder, and lightning, and a dense yellow fog that was as dark as night. Granting that a vehicle of moisture acted on by steadily prevailing winds is the agency which distributes cholera over a provincial area, the phenomena attending distribution may be of two kinds, — the cholera may be viewed as showered down over a province, or as moving with a broad front steadily in the course of the prevailing influences ; in either case, the distribution will be equal to the area covered by these influences. This is my conception of the covering of a natural area by an air-borne cholera. I believe the eastern division to be frequently covered by cholera in a single week, just as we found that it was overspread with epidemic malaria in the Est week of October in 1859. I have called attention to the remarkable cholera of the fortnight m 15th to 30th May 1865, striking the country west of Delhi, Meerut, the Umballa District, yrah, Kussowlie, and Dugshaie, with a rain-fall of 3 inches.* In speaking of the cholera of 1867, I shall have occasion to describe the distribution of the cholera of May, from the Jumna to the frontier, as occupying probably not more than eight days. Even in the case of invading cholera, it is quite impossible to say with precision how long Rate at which cholera travels to be such a cholera occupied in its progress from one place to another, calculated only in relation to provin- We find the Agra cholera of May 1856 and 1861, appearing cial manifestation. at Lahore on the 6th and 7th August in the same years : it is at Lahore on the 6th and 7th August in the same years ; it is useless, however, to draw a straight line through Agra and Lahore, to measure it off" in miles, and dividing by the number of days, to say, that cholera has advanced towards the north-west at the fte of so many miles a day. A more approximate estimate would be made by calculating ¦ogress in such a year from the date at which the monsoon influences set in, and cholera began sibly to move. But even this estimate would be subject to many corrections. In 1856, the lolera of May was followed by a clear interval before invasion commenced. The dates of vasion in 1856 are given by Dr. Murray as under : — 3rd and 4th weeks of May ... ... Agra. Ist week of June ... ... Muttra. 3rd week of June ... ... Bhurtpore, Allyghur. Here there is an interval of a month preceding the monsoon advance. 3rd week of July Ist week of August 2nd week of August 3rd week of August Ist week of September Delhi, Bareilly, Dholepore. Meerut, Deyrah, Lahore. Gwalior, Nynee Tal, Seharunpore. Ferozepore. Umballa. In the endemic area, and in a very large portion of the eastern division of the epidemic area, it is often found impossible to note any sequence of attack such as that here noted, from the universality and suddenness of the general affection of the province, whether by invadinoor revitalised cholera. In all cases, epidemic cholera advances in a series of rapid strides, alternated with intervals in which no apparent progress is manifest ; moving, as it does, in obedience to meteorological fancies and to these alone, the natural barrier cannot be overstepped, and the epidemic may rer in one week the same geographical area as in a year, provided the conditions for mediate diffusion be at hand — the vehicle and the directing agency. The very fact of the extreme subordination of epidemic cholera to meteorological influences _ _ . .. . . has, I believe, created many of the difficulties which havp Parallel occurrences result from sub- i , , ¦, ? , j /• ji i r> t , ? . . ' uu nave ordination to a definite meteorology. obstructed the study of the laws of distribution and reproduc- tion. When the beautiful parallels of such epidemics as those 11855-58 and 1859-62 are brought to notice, those who have not made the phenomena >ir special study are apt to demand, that all parallels shall be as perfect and as obvious to their elligence as those upon which the generalisations have been based ; and when these parallels are perfectly represented, they are apt to conclude that the generalisation is wrong and unworthy their further consideration. They forget, that parallels are but so many manifestations ectly subordinate to natural agencies, and that these too must be taken into account as well the mere fact of the visible presence or absence of cholera. And they will find, that what ims to them a contradiction, will in itself prove a parallel as valuable in the future as that * The meteorology during the epidemic invasion of May 1865 is thus noticed in the Weekly Returns of the Kussowlie Dep&t : — I May 12th. — " During the last week we have had a great change in the weather, preceded by heavy falls of rain " May 2lst. — " Owing to the unsettled state of the weather, white clothing has been discontinued." June Qth. — " We have had a considerable increase in the sick list, consisting chiefly of fever and rheumatism d c unfavorable condition of the weather. A case of spasmodic cholera has occurred and has proved fatal " ' Chap. V.] SIGNIFICANCE OP THE FACT OF PROVINCIAL LIMITATION. 91 liich they have lost. Had the cholera history of this Presidency been, simple and without nplication, the arrangement of the exact data at our disposal, would, during the past fifty irs, have led to the recognition of some substantial truths ; it is when facts which he cannot oncile, meet him, that the observer loses faith in himself, and nothing but steadily to keep view as a truth and as a fundamental principle, that every manifestation is subordinate to jncies which are natural, and whose operation is therefore unalterable, will carry him over ¦ difficulty and into the smooth harmony which really lies beyond. I The reproduction of the cholera distributed over Northern India, is a truth which some are billing to accept, because it is not on every occasion so obvious as they would like to see it. ey forget that a provincial re-manifestation must take place with a certain meteorology, and hout it, may never occur at all ; or that it may be repressed for an indefinite period. Let the i essential for epidemic manifestation be carefully sought for, and it will be found, that en cholera does not re-appear when it is due to re-appear, this essential is wanting, namely, vehicle of moisture. We are not to expect an epidemic diffusion of a revitalised cholera ile the hot west winds blow; and failure of the monsoon may, as in 1860, 1864, and 1868, ermine a minimum of cholera, where a rain-fall twice or three times as great, would have been snded with the general movement and the obvious epidemic presence of cholera within the ered provinces. I The vehicle for the cholera of May is not wanting in the west; it was found in 1862, in 5, and in 1867, and on each occasion carried cholera with it. The spring rains in the western sion of the epidemic area represent the moist east winds which distribute cholera over, or waken cholera in, the eastern division in March, April, and May. I have already said, that cholera is due to appear about the same time that it appears normally in Banda or Tipore ; that is as a May cholera. But the record is not wanting of the epidemic presence of era in the western area at an earlier period ; for I find that, in reporting the prevalence holera at Muttra in 1838, the Superintending Surgeon says, that although he writes in il, the weather entirely resembles that of the rains. This illustration proves how true it liat an exceptional meteorology alone is wanting to determine exceptions to the period of nal manifestation. In speaking of the cholera history of 1867, 1 shall have occasion to speak of the meteorology attending the invading cholera in the eastern and western divisions ; and in the section on the affection of communities, I shall have to illustrate the fact, that many of the phenomena which occur during the course of a reproduction and even of an outbreak, are due to the aerial transmission of a moving cholera. I need not, therefore, enter into further explanations in the present chapter. 1 After viewing these great questions as I have done in relation to so vast an area as that of ,ortance to the meteorological ob- the . Bengal Presidency, and illustrating them by the facts of the recognition of Natural which I hold to be universally true for the area and for each ices. of its nrnvinceß. it cannot bf> exTWcteri that T slimilrl sunn 10. of its provinces, it cannot be expected that I should supple- ft the generalisations by the details of stational meteorology. All local meteorology is rdinate to that which is provincial, and details for any locality are only so many items ributed to a general result. It is better, in studying epidemiology on a large scale, and country where the annual repetitions of the phenomena are so perfect, to grasp the result to view details in the light which it affords. I Holding that the aim of the meteorological reporter is frustrated when he is compelled to with meteorological systems of which he sees only the terminations, I would recommend the stations of observation be redistributed, so that each reporter may have a system under otice which possesses both a base and a limiting line, that he may trace natural influences their commencement to their normal termination. Proposition F. The provincial limitation of epidemic cholera negatives the theory that ITS PRIMARY DISTRIBUTION IS DUE TO HUMAN AGENCY A sequel to what has been advanced in the two previous chapters is the proposition which follows : — Jp. — The geographical distribution of an invading cholera is purely a phenomenon- of meteorological significance. Therefore, epidemic cholera is never in any case spread over a definite geographical area by human intercourse alone ; nor can human agency cause the boundaries of a natural province, which has been occupied by cholera, to be transgressed, so that a cholera epidemic from this source shall appear in the province immediately adjoining, and become generally diffused among its inhabitants. The positive aspect of this question does not fall to be treated in this section. I shall not here attempt to show that cholera has not been spread over a definite area by human intercourse in cases in which epidemic distribution has been attributed to such a vehicle. The negative aspect of the case is this, that the universal experience of these fifteen years has demonstrated, that human intercourse cannot carry cholera as an epidemic over the boundary line of any area which is, for the time, a natural province ; be it a province of spring cholera, or of monsoon cholera. This is a proposition of fundamental importance, in considering the share which human intercourse has in the propagation of cholera geographically. I do not require to explain, that I am not referring to the question of individuals carrying cholera with them from an [Section I. 92 SIGNIFICANCE OF THE FACT OF PROVINCIAL LIMITATION. affected into an unaffected area, or denying 1 the possibility of cholera so imported being secon darily passed off to other individuals by those who have imported this cholera ; but I leav such cases at a point where others take them up and found their theory upon the alleged fact in connexion with them. It is alleged that these are the foci whence springs the epidemic whic follows at an interval of weeks or months ; for invasion is always imminent when the heralds o its approach have made their appearance. The history of these fifteen years gives no encourage ment to the theory of epidemic spread from such human centres. It teaches clearly, tha cholera carried beyond the bounds of a natural province by human agency, is dead as an epidemic agent. The areas of exemption which I have noted in every year, have been truly exemptec areas, and the most virulent epidemics have been repelled from their margins, although human intercourse, both by river and high road, has been uninterrupted. Whether invasion has beei threatened from the east, south, or west, the result has been in every case the same. To repea the illustrations would be only to rewrite the whole history of cholei'a as an epidemic, as I have already stated it ; and to argue against these facts, it is necessary to deny that the natura provinces are such as I have described them to be. I The highways by which epidemic cholera travels are, in this country, aerial highways, and routes of human communication. If the doctrine of the aerial distribution of cholera be 3 at all, I insist that it is proper that the fact be made the starting point in all enquiries iting to the geography of any epidemic. The fact is, no doubt, perfectly true, that the lera of 1865 first appeared in the ports of the Mediterranean holding communication with xandria, and that the Hurdwar pilgrims of 1867 were, in very many cases, the first victims he different districts to which the cholera-stricken crowd returned ; but that the geographical ision of the epidemic of 1865 or of 1867 was influenced as to its direction or limit by these mdary manifestations, I do not admit. CHAPTER VI. THE PHENOMENA OF REPRODUCTION IN EACH YEAR OF AN EPIDEMIC, AND THE DURATION OF THE EPIDEMIC IN YEARS. The previous chapter related to the mechanical phenomena of transmission and diffusion by winds and a moist atmosphere ; the present would have been the proper place to treat of the vital phenomena manifested within an invaded area subsequent to invasion ; but of these I have been compelled to speak throughout in noticing the reappearances of cholera at certain dates which are normal for definite localities. I have placed the conclusions thus: — 1(1) . It is not to be denied that a dormant but vital cholera does reappear within the province over which it has been disseminated ; and so entirely the'Reprodu^tilmr ISa IOnS regar " * s ne phenomenon of reappearance under the control of the normal meteorology of any district, that, according to the geographical situation of an invading cholera, the date of its reappearance may be anticipated. That, in short, the phenomenon of reawaking into life at a certain date is as true for cholera as it is for vegetation. (2) . That the obvious seasons of reproduction are three — The first, coincident in its appearance with the disappearance of the monsoon floods, extending into November and December, confined as an epidemic to regions of perennial moisture, and hence nearly unrepresented on the plains of Northern India, when the dry west winds of the cold season blow;, a great cholera of the true endemic region, and liable to appear in any locality allied to it in character, as for example, in the low lying districts of Western India. The second, the spring cholera, which reappears, according to locality, between the 20th February and the first week of May, the further to the east and south, the earlier being the date of reappearance ; a cholera not due to appear in the western division of the epidemic area as an epidemic before the last week of April or the first week of May, since the normal meteorological conditions retard earlier manifestation. The third, the cholera of the monsoon, appearing about the 20th June and dead in the last week of September, universal within the range of monsoon limits, but at a minimum where the region of perennial moisture has, in a great measure, become for the time submerged. While some might urge that the monsoon cholera is but the summer manifestation of the spring cholera with vigorous locomotion imparted to it, it is at least convenient to recognise, that, viewed as mere manifestations, the two appearances are distinct phenomena. To observers in the western division, the spring cholera of February, March, and of the first half of April has no existence ; and seeing that their cholera persists from the first week of May into the monsoon season, they naturally generalise from their observations, which are true only for their own portion of the epidemic area. 1(3) . That subordinate to repression by an exceptional meteorology, these reproductions are at the date normal for revitalization in whatever province the invading cholera finds II wish it to be noted, that this remark has reference to a provincial and not to a local lera. For it is certainly true, as the rule, that locally studied, cholera is not reproduced in sequence of the fact of its having been locally manifested even to the most virulent degree ; ile it is no less certainly true that a provincial distribution of cholera is followed by vincial revitalization. The conclusion from this statement is, that the breeding grounds in ich the vitality of a dormant cholera are retained, are local tracts within the province, and t from these epidemic cholera emanates, when in a second or third year of epidemic life it is I playing its part as an earth-born and air-conveyed miasm. Duration of Epidemics. II have said that in any province an epidemic is made up of the reproductions of a certain period, and that observation leads me to conclude that the mal duration of cholera in the epidemic extends over a series of years, reckoning from the date of invasion to the date of final disappearance. The statistical facts of the past fifteen years are before us. It is upon these facts alone that I form any generalisation. I have no theory that, in the fourth year after the invasion of a province, the invading cholera shall have died out, or shall have become reduced to a minimum, unless reinforced by invasion from an endemic source. I state simply as a truth, that the epidemic which we know to have made its exit from the endemic province in 1855, and which entered the western division of the epidemic area on the 20th May 1856, died finally in the first week of November 1858; that the fresh epidemic of 1859, which entered the western division of the epidemic area with the monsoon of 1860, also died in the first week of November 1862 ; and that the new cholera of 1863, which became in March 1864 the great invading epidemic of Nagpore and the south of our Presidency, was dead before the beginning of 1867. Were the same parallels to hold true, then the invading cholera of 1866 (the fourth 2a invasion of the fifteen-year period) should have had its existence prolonged up to 1869. Up to the date at which I write,* the cholera of 1868 has been repressed in a wonderful manner, coincidently, I believe, with the entire failure of the monsoon over Upper India, and the continued prevalence, as in 1860, of hot westerly winds ; and subsequent events and the history of epidemic cholera in thespvingof 1869, have shown, that I was in error in suggesting that the cholera which was in 1868 in vitality and epidemic vigour on the southern epidemic highway, and which invaded Nagpore in April 1868, struck Bombay in October, and in December was epidemic from Bombay to Malwa, was possibly derived from the materies of the epidemic of x§66.t It will, 1 think, be found, that the duration in time, normal for an epidemic invading Upper India, is four years. The epidemic of 1817, invading from the south of the Jumna in May 1818, survived until 1820, with a continuous history of reproduction in each year up to the date of extinction ; this was a four-year epidemic, a parallel to the epidemics of 1856-58 and 1860-62. The probability is, that if we could trace them with accuracy, very many of the intervening epidemics would be found to have the same range in time. And this must not be forgotten, that it is not necessarily the year of invasion that is the visible year of maximum. Distribution in "force may occur under conditions so unfavorable that the presence of the invading cholera may scarcely call for remark at the time ; the invasion of the western division of the epidemic area of November 1866, was an example of this. The maximum of manifestation of the cholera of 1855-58 was in 1856; the maximum of the epidemic of 1859-62 was in 1861 ; the maximum of the epidemic of 1863-66 was in 1864 and 1865 in the province of chief distribution ; and the maximum of the epidemic of 1866-68 was in 1867. The great Umballa cholera of September 1852, occurred in the third year of the manifestation of the invading epidemic of 1850. In the absence of very precise and complete data, I prefer to adhere to the events of recent years. It is not unlikely that difficulty may arise in J%S^«2££L* ° bSCUre even the current events in the future as in the past, for it is probable, that in very favorable cholera seasons, during the life-period of an epidemic, the cholera of one natural province may be reinforced through the legitimate channel from another province, and the phenomenon of reinvasion exhibited, while the cholera invading on the separate occasions, is truly only a portion of the materies of one epidemic. Another circumstance which I regard as also likely to occasion obscurity in studying the regularity of the succession of epidemics is, that invading cholera may be thrown oif from I'erent areas of the endemic field, and that hence intercurrent invasions may show themselves, [ the phenomenon of an invasion occurring regularly every fourth or fifth year may be cured by the mixing of separately invading epidemics. The great Gangetic cholera of i 3, lost to us in the North-West, was, I think, an epidemic of the class to which I refer ; Id its course be traced, I believe it would be found to be the origin of the invading epidemic of Western India of 1854, which I have traced invading from the south-west as far as to the north-western limit of the province of the south-west monsoon proper, and which struck Bombay Island in October 1853. It is upon the tracts which I have called epidemic highways, lying the one to the south of the north-western desert, the other, to the south of the Vindhya, that I should regard it as most easy to trace the recurrence of invasion, as being less liable to the vicissitudes of monsoon agencies than the regions in which these influences terminate. The monsoon of 1860 reached exactly to the Jumna, and this fact constituted the districts lying to the south *to the north, for the season, two truly distinct natural provinces — the southerly marked by presence of cholera, the northerly by its absence. From the southerly, the cholera of 1860 advanced westwards into Scinde in the same season. And this is only one illustration out of many, which shows, that it is not through the Punjab that influences travelling to the Bt proceed as the rule, but along the northern highway ; and hence I should trust to tracing k invasion from India not through the Punjab so much as through Scinde and Kajpootana. It is remarkable how from a few disjointed facts, apparently relating to events having no „,,„.,. , natural sequence, the history of an invading epidemic of The value of indices towards com- t. i • xi i j. j. i_ i j_ii ,i pleting epidemic history. cholera in the last century can be shown to have been the same as in the present day. In 17S1, cholera was epidemic over the entire south-east of the Presidency, and is said to have cut off 700 men of a force marching towards the East Coast in March of that year. That it was widely extended we know from the quotation which follows. It is from a letter from the Government of India to the Board of Directors concerning the unfortunate event, dated 27th April 1781 : — "The disease has not been confined to the country near Ganjam. It afterwards kiid its way to Calcutta, and after affecting the inhabitants so as to occasion a great rtality during the period of a fortnight, it is now generally abated, and is pursuing its course to the northward." * Written in September 1868- + In writing of the history of this cholera of IS6S in the chapter which follows, I have not adopted the opinion expressed in a previous chapter of this report, namely, that the cholera of the Central Provinces of 1868 was derived from the materies of the epidemic of 18(56-67. I have tried to show, that there is reason to fear that this is n cholera of a new emanation, appearing on the southern highway, because repelled by the meteorology of 1868 94 The next we hear of it is in April of 1783, decimating the pilgrims at Hurdwar. It is easy to fill up the blank although the facts are unrecorded. Upper India was covered in 1782, and the western province was invaded in the monsoon or the cold season by the cholera which was revitalized in April of the year following. I The epidemic of 1817-20 may be taken as the type of all epidemics, and its stages of Epidemic of 1817-20. invasion and the dates of the successive movements, as typical for the experience of the past fifty years. I have rearranged ow, according to my reading of the sequence of the occurrences, the events of these years far as recorded by Jameson, and this will serve as a tabular index in endeavouring to link the history of the successive epidemics which have appeared between 1817 and our time. fc it be remembered that all advance is per saltum, and that all the phenomena of progress ange themselves accordingly. The beautifully detailed facts of Jameson's narrative are not iable of being perverted. They stand with the stamp of truth upon them, and its impress endered every day clearer as experience widens and facts accumulate. I have indicated in the margin the position which the facts comprised in the quotations seem to me to occupy in the history of this Epidemic. The references are to the pages of the only edition ever published of this valuable report. I "The disease was perhaps more common in the first six months of 1817 than in former ... . ? . . years. In May and June it would seem to have occurred in an iversal cholera of the endemic "* i j • _± r-vr n i ming affected, the disease had begun to prevail epidemically in the distant provinces of ar and Dacca. On the 23rd August we find it raging at Chittagong; at the same moment Lajshahye ; and not a week afterwards in the high and distant tracts of Bhaugulpore and lghyr. * * * It is distinctly stated to have broken out in the city of Patna on the 11th r ¦#¦*•# Tj ie on \y sp O ts on the eastern side of the Ganges beyond the precincts of Bengal 3ked by the epidemic in the autumn of 1817 were Mozufferpore and Chui>rah and the tonment of Ghazeepore."* 1" The disease, now strictly epidemical, extended from the most easterly parts of Pumea, ntation of the monsoon cholera of Dmagepore and Sylhet to the extreme borders of Balasore the first step of epidemic progress, ana Luttaek; and reached trom the mouths oi the Ganges nearly as high as its junction with the Jumna." (p. 8) . The Mirzapore and Bundelcund cholera of November is described in the pages from 12 to 19, and ends with the outbreak of 7th November K shoot of Novemher into the dis- i n the army of the Marquis of Hastings. " A few cases of t^&SSfJSSk cholera did certainly appear at Lucknow in December and lof 1817-18. J anuary, but these were probably merely sporadic and an exception to the general rule, that from the beginning of November until the end of March 1818, when cholera broke out in Allahabad, no spot of the immense tract stretching to the east of the Ganges and Jumna from the northern point of Scharunpore to the southern boundary of Tirhoot was visited by the disease. The cholera, instead of shooting up from Mozufferpore, Chupra, and Ghazeepore through the contiguous districts to the provinces of Oude and Kohilcund, wholly left that part of the country, and for many months confined itself to the tracts lying west of the Ganges and Jumna/ (p. 11). In the spring of 1818, cholera became universal throughout the eastern division of the epidemic area. " Cholera visited the city of Lucknow Revitalization and epidemic advance with great violence in April and May, when it was Flailing epidemically in the neighbouring countryi ay# (p. 12). " It broke out suddenly in the town and district of Allahabad in the end of March, and prevailed for several months with great malignancy, sweeping off nearly 10,000 of the inhabitants. The troops were not affected until the middle of July,f although holding daily and unrestrained intercourse with the people of the town. The epidemic entered Cawnpore on the Bth April, and remained in full force during fifteen or twenty days" (p. 25). In Bundelcund, " cholera reached Banda in the end of March. There and in the dependent district it is reported to have destroyed 10,000 of the inhabitants." In the Jubbulpore District, " the troops under Major- General Marshall, during their march from Saugor to Mundla, fell in with the disease on the * South of the Ganges, Buxar was attacked on 17th September, f In the monsoon revitalization. 95 9th April at Jubbulpore, and suffered severely from it during- the remainder of the month. Before the arrival of this force cholera had been raging in Jubbulpore for several weeks" This affords proof of the advance of this revitalized cholera, with a front of at least 300 miles, from north to south, within the ten days preceding the last mentioned outbreak. Within a month, the entire epidemic belt across the continent was occupied. (P. 19) . "It is quite certain that, after appearing in this quarter (Bundelcund) in November 1817, the epidemic now took a decidedly south-westerly direc- chd£S liB1 i8w rVed Kne ° f thG SpriDg tion ' and after being propagated along the beds of the principal rivers and great roads* to almost every town and village of iundelcund and Saugor, was successively communicated to the provinces of Berar, Malwa, and thandeish, and finally to almost every portion of the Decean. * * * It reached Banda in le end of March (1818) . *** We now find it proceeding in a westerly direction to Lohargaon, latta and Saugor, in which neighbourhood it remained with great virulence from the beginning f April till the middle of May. ** * From Saugor the virus diverged in two directions — one tream took a southerly course to Nagpore, the other went south-west through Bhelsa and ihopal to Oujein* ** * It was at Oujein on the 9th May, and at Mehidpore on the 12th." 'hence Jameson continues to trace the southerly stream through Jubbulpore and the plains of fagpore towards Bombay. Looking back now, we do not associate the Jubbulpore cholera of 9th April 1818 with the Vfarch cholera of Banda, and we do not see it as a sequence, because cholera appeared in Bundelund in March, Jubbulpore in April, and in Saugor in May, that the cholera of Bundelcund )ecame the cholera of Saugor. The facts are precisely the same as in modern times, but we race the cholera moving in the spring from east to west, and not from north-east to southwest. The appearance of the curve is, no doubt, often a true phenomenon ; but it is due to the act of the climatology of the extreme south, differing very widely from that of Central India 'roper. In Western Malwa, we find that Mhow was reached on the 4th May, Oujein on the 9th May, and Mehidpore on the 12th (p. 20). These stations »The Spring Cholera of 1818 reached \[ e w ithin 200 miles of the western coast, and are the last b southern and extreme south-western , ,• n t> -j i.* 1 j v. *.' lits of the Bengal Presidency. stations of our Presidency which are under observation. the end of May, Berar was covered, and the Hoshungabad District, in the valley of the Nerbudda, had been occupied some weeks previously. This carries us up to the limits of our Presidency. What is chiefly to be noted, is, the enormous area covered in these six weeks, extending from the Himalayas to Guzerat, and stretching, as well, uninterruptedly from the north to the south of the Presidency. The facts of this spring advance of the cholera of 1818 effectually push aside the constantly reiterated error that the advance from east to west was in the teeth of the monsoon. The epidemic leap occurred nearly two months before the setting in of the monsoon, and the same cholera when revitalised or reinvigorated in the monsoon season, was mistaken for a cholera of invasion. Jameson, speaking of the meteorology of May 1818, says, that from the Bth to the 27th the winds were hot and westerly. It may be inferred that previous to the Bth, they were from the opposite direction ; and speaking of the re-attack at Oujein on 22nd March 1819, he says (p. 136) that the appearance of sickness was here preceded by exactly the same atmospherical phenomena as in almost every part of India, namely, easterly winds, very hot days, and great variations of temperature between day and night. tFrom Oude eastward, the Ganges Valley had also been filled with revitalised cholera . ? . , ? _ , _ (p. 32) : — "Cholera reappeared in May, and spread with itaiization in the Gangetic Pro- < 1 lxr v. i j* j. •j. vnr i_ j. w * je. in the Spring of 1818. extreme virulence over the whole district of Tirhoot. * * "Jounpore, Sultanpore, Goruckpore, Oude, Fyzabad, and Lucknow were successively attacked in April and May. In the end of April, the inhabitants of Goruckpore suffered so greatly that they quitted the city and sought for safety in the adjoining villages and groves." While cholera was thus epidemic from Bundelcund to Western Malwa, there was no ex- tension of cholera from Oude, Cawnpore, and Banda into Agra, Eestern limit in the Doab of the Meerut, or Eohilcund, lying immediately to the west. It was 2 cholera of 1818, the same as i , • tvt i t-i.l i i j / an\ -m i of recent epidemics. ate m May wnen Etawah was reached (p. 26). Etawah, Futtehghur, and Muttra seem, in the first week of June, to Ive first felt the influence of the monsoon cholera which was destined to invade the western rision of the epidemic area in the first week of July. tin three different places Jameson notices this disinclination of the spring cholera of 1818 cross the Doab (p. 91) :—": — " In Upper India did it not in Benares, Bundeleund, Oude, and the ithern districts of the Doab rage virulently, whilst it appeared not in Delhi, nor in Meerut, nor Jeypore, and the tracts in their vicinity until the rains had set in and the air was loaded with listure." Again, (p. 25) :—: — "On the Bth April cholera attacked the city of Cawnpore, the ntonments, the Civil Station of Bithoor, and the adjoining villages, and remained in full cc during fifteen or twenty days. But it appeared little disposed to spread far in that * This must be regarded as a statement only, not as a fact; this is the theory of the writer. 96 direction : Bareilly, Moradabad, and almost every other town in the same line enjoying 1 their wonted health." And yet again (p. 97) ; — "When the cholera reached Cawnpore in the following spring, it showed a marked aversion for Bareilly and the other tracts east of the Ganges/ I While, as in 1856 and 1863, Agra and Muttra were invaded in advance of the true monr -.c-,0 •i. .i soon ca V> tne date °f g" ener al advance was to a week the same rXwJrTthf^dL 1 ?^ in 1818 as in 1856 or 1861. « On the 11th July cholera entered the town of (Joel. We next find the disease on the h. at Delhi. Meerut and the Cantonments attached to it suffered under it from the [i July to the 20th of August." The force collecting at Hansi for service in the Bikaneer and :a countries got cholera in the first week of August, and although marching daily, falling k upon Hissar, carried cholera up to the 12th; 250 men were attacked. A detach- Lt of the same force which passed through Delhi on the 29th July, was attacked on the 31st 29) ; — " Several places intermediate between Delhi and Hansi, and between Delhi and maul, particularly Paniput, were affected previously to Hansi being brought within the ;ilential influence." Jameson adds, that the epidemic in this direction appears to have been ted by the Sutledge. This was the limit to which authentic information extended ; but it is to be inferred that this was the actual limit in the North- West. tWith the advance from the Agra District towards the north-west, the cholera of the isoon of 1818 invaded also westwards into Rajpootana. " Cholera reached Jeypore in the jr end of August; the whole mortality, however, scarcely exceeded a thousand men. the 12th September it began to abate in the city." The Rajpootana Field Force encamped ity-five miles south-west of Jeypore, 4,200 strong, had among the fighting men, 292 cases 122 deaths, between the 14th and 28th September (p. 31). Kin the east, simultaneously with the Allahabad outbreak, appeared that of the Shahjehanpore District of July, in which 5,000 of the inhabitants onsoon cholera of 1818 of the &re r rt dt h di d dth t out break of Nepaul n-n division of the epidemic area. f > nQlo / qo\ j i.-i \n- Kwas also with the monsoon of 1818 (p. 33), and while the c cholera was prevailing in the Gangetic Provinces. I" In Noacolly and the tracts near the mouth of the Ganges it began in February and terminated in June 1818." Note the months as precisely the miSaL ° f Ch ° lera 1818 same as those of the e P idemics of modern times. «In Tipperah it returned in March 1818. In Sylhet, after reg in October 1817, and being for several months dormant, it returned in the end of March, subsisted until the setting in of the rains ; but about the middle of October it suddenly sased all over the district to as great a degree and with greater fatality than on its first arance. It again withdrew in the end of the year." The third reproduction was in this typically displayed. t/ J. t/ J. t/ Writing on the 31st December 1819, Jameson says (p. 299). — "There seemed grounds for hoping that the dreadful mortality was on the decrease, and that we should soon be wholly released from a pestilence Persistence throughout 1819. Ich had ravaged India during a period of more than two years and had spread, dismay . destruction into every portion of its provinces. But the six months that have since elapsed c unhappily disappointed these expectations. During no part of the time can the country said to have been wholly free from the disorder; and at several distinct periods and in ant quarters it has again shown itself in such an appalling and widely epidemical form :o leave no doubt that the distemperature of the air in which it originated yet subsists and ver ready to be brought into action by external agents." Jameson (p. 156) mentions February 1818 and April 1819 as " the two most marked 1819. Sprino- cholera of Lower periods of the aggravation of the epidemic" in Lower Bengal. Bengal. " The rains did not regularly set in for many weeks after their customary time ; and as the K_. . . „., hot winds continued to blow without interruption during June olora of the eastern division ot the iti j j. r a j.i lir x> i.i. mio area in its third year, 1819, and July and part of August, the whole face of the country Io great virulence, probably owing was entirely parched up. The epidemical disposition of the ie exceptional character of the sea- a j r k ad certainly abated ; since from Cawnpore downwards the Parallels 1861 and 1868. AS^JUm „„« JL~~U. 1 ' »ffi,™~A U«™, «««™;i^ ™^?nlLr disorder can scarcely be affirmed to have prevailed generally subsequently to the conclusion of the period included in this report ; for, although a few cases now and then appeared at Dinapore, Chunar, and places in their vicinity, the aggregate amount of these was very inconsiderable, and. only went to show how greatly the sickness was on the decrease." p. 305. " The epidemic made its second appearance at Agra on Cholera of Agra of the last ten days th 2 7th of May, was very destructive during the first week of May, parallel of 1856 and 1863. „ T , /',. ? J , ,_ , ?° Jot * ot June, and wholly withdrew on the 15th. " Sporadic cases had been frequent among the Europeans, especially the drunkards, at lay cholera of Meerut, the forerun- Meerut for several months ; but it was not until August that of the cholera of August. the disease incurred in an epidemical shape." „. ? „ , (P. 301). " The disease next appeared in the Rajpootana a] pootana Field Force and Nussee- „ v . „ ' , , . v , ..,. 11 , Q ,, T )} y r QfM . d affected along with Agra, not Force; it first showed itself mildly on the Bth June. (p. dO4). i Malwa. Cholera appeared in Nusseerabad on 12th June." 2 b 97 STUDY AS A TYPE OF THE EPIDEMIC OP 1817-20. X In the spring 1 of the present year the epidemic raged extensively in Nagpore and Malwa, and largely affected the Nerbudda Field Force and the detach- Reproduced spring cholera of Nag- men t s serving in the vicinity of Neemuch in April and May. pore, Saugor, aud Malwa. q£ reached g augor D i vis i on of the Army." (P. 304) . "In July some corps of the Nerbudda Force suffered considerably. * * * From this month the disease ceased to be epidemic equally Monsoon cholera of same province. in the Nerbudda, Saugor, and Rajpootana Divisions." The great Meerut outbreak began on Bth August (pp. 309 to 318). (P. 318) : "Nearly at the same time when it broke out in Meerut the epidemic Monsoon cholera of western division displayed itself in Kumaon, at Bareilly, and at Moradabad of the e pi dem 1C area of 1819. tQ Kumaul to weg £ It vigited A l morah on the 10th August. * * The disorder showed itself at Kurnaul on the 10th August, and wholly disappeared in September. * * * From Kurnaul the disease spread in the direction of Loodianah, but as in the former year died away before reaching that station." The direction of this cholera was probably towards Ferozepore and Lahore, leaving, as usual, the Jullundur Doab and its vicinity unoccupied. •At the very close of the reproduction, on the 2nd October, Deyrah Dhoon was entered : " Although it remained only three days in the valley it worked fearful desolation during its stay." It is stated that the Sirmoor Goorkha Battalion lost seventy-four men, and seventy-three women and children. The last authentic information we have of the cholera of 1817-20 is regarding the May cholera of 1820. Jameson's narrative ends with December , J^f^f iSf ° f 182 °' paraUel ° f 1819 > an d we know only in a general way that 1820 was 1857, 1862, and 1867. -, , * . i . . . ° jit a year recognised by tradition as a great cholera year in the extreme north of India. In the records of the Medical Department we find mention made of the outbreak of Hurdwar, and among the escort on duty at Hurdwar, of the cholera of Kurnaul City and Cantonment (sth to 28th May), and of the Goorkhas at Subathoo (3rd May 1820). This was, no doubt, a cholera answering with great precision to our cholera of 1858 and 1862, marking the winding up of the epidemics of 1855 and 1859 ; in both years aggravated and universal in the area affected, and dead in the year following. I need not repeat that I maintain the parallel of the epidemics of 1855-58 and 1859-62 with that of the epidemic of 1817-20 to be perfect, and those Conclusion that the identity of the f 1863 and 1866 t mak between them a geography and epidemic of 1817-20 with the epidemics ? , . ? ? . ,J^ , -i j- i. H F a history also identical, although necessarily distributed over of recent times is perfect. the life period of two epidemics. The general identity of the events of the intervening epidemics may in most cases be satisfactorily read, allowing due weight for the prepond, ? iSS 08 JSS 5 betW6ea th ° Se erance to the south > or to the north and north-west, of different epidemics not having the general or double distribution of the universal and typical epidemic. We must not expect now, however, to go back and read with perfect accuracy a history in which accurate statistical data are wanting ; and the difficulty is the greater since the written record is a mere casual notice of local experience. The wonder is to how great an extent these isolated narratives fall in and take their place, and prove to be the indices of general facts from which we can generalize on the homologies of epidemics which have almost been forgotten. It is from the want of the record of facts that the chief difficulty arises in trying to elucidate the history of successive epidemics. Had the history of each been written even in a cursory manner, we could now have placed the facts in position, as we have done those of this perfect record of the events of 1817-20. As matters stand, we are compelled to grasp the outlines only, and we are fortunate in having even these to fall back upon. From 1826 onwards, the statistical data have been kept in such a form and so perfectly, that I have been able to construct the tables which follow ;* and these are most valuable, not only as connecting into a chain the cholera history of 1826-68, but also as showing the aspects of cholera in relation to the soldier in former years in contrast to those of modern times. I have tried to trace the periodicity of the recurring epidemics, and the chain can, I think, Unrecorded Epidemic of 1821-23. be constructed from the different links which I have been able to bring together. There is one epidemic missing, between the epidemic of 1817-20 and that which commenced in 1826. That this was typically represented is certain, but of its history in Upper India nothing can now be traced. The statistical tables of the Madras Army do not assist in making its history clearer. Many will say, that the cholera of 1821, which followed the route of the Persian Gulf into Syria and Asia Minor, leaving Egypt untouched, was the cholera of 1817-19. I do not think so. The reinvasion of Nagpore by a cholera of great power in 1821 ( Corbyn on Cholera, p. p. 90 to 93), indicates to me a fresh epidemic on the southern highway, and in the far off cholera of 1823 of Laodicea and Antioch and the shores of the Mediterranean, . I see the termination of the epidemic journey on this highway, begun in 1821 ; while in the cholera of the same year progressing through Upper Scinde into Persia and the provinces of the Caspian, I see the termination of the northern limb of the same epidemic. * These appear as an Appendix. 98 [Section I. I read the sequence of the different epidemics between 1826 and the present time, as Bows:— 1. 1826-29.— 2. 1830-33.— 3. 1836-39.— 4 and 5. 1841-46.— 6 and 7. 1.9-54. — 8. 1856-58.— 9. 1859-62.— 10. 1863-66.— 11. 1866-68.— 12. 1868-69. Clear intervals are provincial ; exemption extends to certain of the natural areas only in any ear. A new epidemic is constantly following 1 up that which is dying 1 out, appearing 1 often almost >efore its predecessor has departed. Sometimes the exempted area is very wide, and the interval ong ; at others, the interval may be so short as to induce some to believe that the new cholera s a revitalisation of the old, and not the cholera of a new invasion. One of the most perfect ntervals was the period 1834-35-36, in Madras and Bombay, during- which only one cholera eath was recorded in the Nagpore and Hyderabad Forces, and among- the Madras troops cupying the Ceded Districts. In the European Army of the Madras Presidency, 4,600 ;rong, there were but four deaths in these three years ;* and in the same years in the European rmy of Bombay, only three deaths.f I All of these epidemics have at one stage or another of their lifetime broken through the indaries of Hindostan. The epidemic of 1829, invading Persia and Russia through the ions of the Caspian, was the offspring of our cholera of Northern India of 1827-28; the ilera of Mecca, Egypt, and Southern Europe of 1831-33 was, as I reckon it, the extension of Indian Epidemic, not of 1826, but of 1830-31 ; the great cholera of Southern Europe, rthern Africa, and Central America, of 1837-38, was, I believe, the produce of our epidemic of same years ; our epidemic of Western India of 1846 was followed up by the European lera of 1848-49 ; and that of the province of the south-west monsoon proper of 1854, by cholera of Arabia, of the Danubian Provinces, and of Europe generally of the same year. 3 cholera of 1856 died apparently in the end of 1858, after showing itself all along the shores of the Red Sea, in the very month in which it died on our north-west frontier ; and, finally, I have shown how our epidemic of 1864 was distributed over Arabia, Eastern Africa, and Europe, f;n before it had the opportunity of throwing itself into the Meerut District or into the East the Punjab. I It is very difficult to know with what epidemic to associate the Gibraltar cholera of 1860 ; i association can scarcely be with the cholera of Eastern Africa of 1858; and yet, it is little tsistent with modern ideas of epidemic spread, to find a cholera which swept the southern demic highway of India in March, striking the west of the Mediterranean on 14th August the same year. I incline, however, to the latter alternative. I call attention to the invasion of 1826 as an exact counterpart of that of 1866. The districts south and west of the Jumna, as in November 1866, were invaded in the same month of 1826 ; and the history of 1. Epidemic of 1826-28. the year following shows me, that, as in 1866, the epidemic extension in the western division had been carried as far as to the hills, and much beyond the apparent limits of invasion. The advance of November was from a great body of cholera thrown into the eastern division of the epidemic area between April and August. The history of this great cholera of the Gangetic Provinces is recorded by the Superintending Surgeons of this province, of Dinapore, Benares, and Cawnpore.J The invasion of the spring and monsoon of 1826 was confined to the eastern division of the epidemic area. As in May 1819, 1856, and 1863 cholera reappeared at Agra in May 1827. It was repro- iduced, as in May 1867, over Rajpootana. On the sth May olcm of the Western Division of t h e same cholera struck Nusseerabad and was dead on the go J . "L. J. 4-Vin A 4-a ~\ XV A nmnnn* fVi 4- 23rd ; between these dates 157 cases occurred among the troops j il at Beaur, six men of the Mhairwarrah Battalion were attacked. I look upon the following nark made by the Superintending Surgeon of Meerut as of value in showing the parallel \\ 1867. In describing the outbreak of the monsoon of 1827, he adds : — " The Board is aware it cholera morbus had prevailed epidemically in this district from so far back as May last." In Ihi and the districts to the west, it reappeared even earlier than at Meerut ; for I find the same perintending Surgeon, writing in May, reporting the outbreak in these countries, while, as he tes, Meerut yet remained free from cholera. This May cholera prevailed also in the lower hill tions, at Nahun and Subathoo ; and also at Deyrah and Hurdwar. This is the centre point of the epidemic. We require nothing more to tell us that we have substantially grasped, the epidemic history of these two years. The revitalisations of the monsoon of 1827 and the history of 1828, are secondary to the facts of invasion in 1826 and renewal in the spring of 1827. As far as we can gather, the body of this epidemic was diverted out of the southern epidemic highway. If this was the case, the history of 1867 exactly repeats the history of 1827, when cholera was dead throughout the Central Provinces and Central India, apparently as a consequence of the diversion of November 1866, and universal in the same area to the north of the exempted tract. The weakness of the southern offshoot was probably compensated for by the strength of the northern limb, and hence, as in 1867, resulted its ability to pass as an invading cholera into Cabul and Persia. This weak body of cholera in the south could have * Nineteen, including King's Troops, f Thirteen, including King's Troops. The quotations from the Proceedings of the Medical Board have been extracted by Mr. C. Macnamara, and printed ie Indian Medical Gazette for September 1868 and following months ; therefore, 1 shall not reproduce them here. 99 afforded no starting base for the cholera of Scinde and Arabia of 1831 ; and, therefore, we look to the succeeding 1 epidemic for evidence in this situation of power and substance sufficient for the materies of the cholera of a wide epidemic career. Taking the statistics of the Madras Troops stationed in the northern divisions, and of the Madras Armies generally, as the index of the presence or 2. Epidemic of 1830-33. absence of epidemic cholera, we have evidence of an epidemic interposed between those of 1827-28 and 1837, thus :— • Deaths from Cholera in the Armies of the Madras Presidency 1830-36. v A Madras Army of the « v Native Army of European Army of Yeab - Ceded Districts. Nagpore ioree. Madras as a Body. Madras as a Body. 1830 1 None. 125 45 1831 23 14 271 91 1832 48 16 332 223 1833 103 32 580 233 1834 None. None. 57 14 1835 None. 12 2 1836 None. None. 11 3 In the "Madras Topography," I find the following remarks on this epidemic of the northern division (p. 88) :—: — "Cholera appeared in an epidemic form in 1830, 1831, 1832, and 1833. In April and May 1830, while the Left Wing of the Ist Madras European Regiment was marching from Kamptee to Masulipatam, twenty men were buried out of forty attacked j in August 1831, in the same Wing, while stationed at Masulipatam, 40 cases of cholera occurred with six deaths. Again, in November 1832, Her Majesty's 46th Regiment, while marching from Secundrabad to Kulipatam, lost fifteen men out of thirty-four attacked ; and lastly, as has already been iled in a former part of this report, Her Majesty's 62nd Regiment suffered severely from era in 1833 on its march to Masulipatam from Bangalore."* I find the fact of this invasion in the south confirmed on referring to the epidemic history of the cholera of 1831 in our Presidency. The Surgeon of Ramghur, in describing the great cholera which came down over the Hazareebaugh plateau upon his district in the spring of 1831, calls attention to the remarkable circumstance that his district should have had no cholera in 1830, while the country immediately adjoining it to the south was nearly depopulated. He writes : — " 1830 passed over without a single case, though the district of Palamow, a short distance to the south-west, was reported to have been nearly depopulated by it." In 1831, it was on the 10th April that the epidemic invasion occurred. Fifty-eight prisoners died in the Sherghotty Jail, besides 11 out of a gang of 100 prisoners detached to a sub -divisional jail. ff The mortality/" he adds, " among the inhabitants here and in the neighbourhood has been infinitely greater than on any former occasion ; in a village, seven miles from this, about 350 deaths are reported; three of the runners employed in carrying the mails have died, and most of those remaining have had the disease; from the ghats to the Soane every dak post has been visited, and has lost part of its establishment." These are precisely the terms in which the Civil Surgeon of Behar writes in describing the invasion of 1863, preceding the epidemic of 1864-65 on the Central Provinces. lln forwarding this report the Superintending Surgeon of Dinapore writes : — " Cholera within several of the districts of this circle committed deplorable havoc amongst the ye population." In a later report, dated 18th June, he says :—": — " Cholera prevailed on both ks of the Ganges between Monghyr and Patna in the month of April, and to a still iter degree in the Purneah District. Amongst the troops at Dinapore it first appeared in Barracks of Her Majesty's 13th Toot on the 6th Mayt and disappeared on the 25th, and it ined its ravages almost exclusively to that regiment . Sixty-four cases occurred, out of which, ng to the early and efficacious measures adopted on the first symptoms appearing, only nine ;hs resulted." Again he reports to the Medical Board, that in June the cholera prevailed epidemically mgst the native inhabitants of Tirhoot, Bhaugulpore, and other districts of his circle. Simultaneously, cholera was prevailing all over the south and south-west of the Presidency on the southern epidemic highway. We read in various reports that during June cholera was epidemic throughout the valley of the Nerbudda. At Hoshungabad out of seven sepoys attacked not one survived ; but the disease is stated to have been of a milder type among the general population. On the 9th June, the Superintending Surgeon of Neemuch reports the appearance of cholera at Mhow and in Nimar ; and the report for July shows that the whole south-western * This Regiment had 118 admissions. t It was on the 6th May 1853 that Her Majesty's 29th Regiment was struck at Dinapore by a cholera wave which I believe to have been the same that struck the Danubiim Provinces in July 1854, 100 province had been occupied, as Neemuch and Bhopawur both had suffered. There were fifty-five cases among the European Artillery at Mhow* " with the melancholy result of nine deaths." We find cholera still prevailing over this province in August and September. It was in June 1831 that the shores of the Persian Gulf suffered, and that cholera became universal over Turkey and the Danubian Provinces. Are we to connect on the May cholera of Mecca and the August cholera of Egypt of 1831 with the Indian epidemic of 1826-29 or with that of 1830-33 ? Was the May cholera of Arabia one and the same with the cholera of Archangel of the same month ? I think not. That the cholera of 1829 became the cholera of Northern Europe is not doubtful, but the cholera of Southern Europe of 1831 I regard as a fresh invasion, and a cholera of a different provincial distribution; an example of what I have drawn attention to as a fresh body of cholera opening its career before that of the previous epidemic has wholly withdrawn. That this was the case is, I think, proved by the history of all succeeding European epidemics. That the outbreak of Mecca should have occurred in May, a month before we have a definite history of the occupation of the southern epidemic tract in India, must not be accepted as a final argument against this conclusion. I know nothing of the history of this cholera in Western India in April 1831. It does not, however, follow that there was not, as in 1864, a great cholera spread over Guzerat, Cutch, and Scinde, in that month; and, in fact, the actual invasion of Arabia may have occurred, as in 1864, towards the close of 1830.f T. his cholera which we trace continuously from the Bay of Bengal to the Persian Gulf, I take to be the parent of the Mediterranean cholera of 1831, invading between July and September, and covering Greece and Corfu towards the end of the year. I It was in the revitalisation of the spring of 1832 that France, England, and Ireland fered, the dates of invasion being, in Paris^ March 24th, in London, February 10th, and in blin, March 22nd. With all its halts by the way, the Indian cholera of 1831 seems to have en but one year to reach the shores of the Atlantic ; and in July and August it was prevalent and wide in North America, the first case, in New York occurring on the 24th June, w Orleans was reached in November. Thus, the Indian cholera of 1830 appears to have ended from the Ganges to the Mississippi in less than two years. It probably was nearly inct in 1833. Wood writes, — " In North America and in the greater part of Europe it disieared entirely in somewhat more than two years from its first visitation."! t There is a great tendency in recent times to deny to cholera extreme rapidity of epidemic ance or dissemination ; and yet some of the minor facts of this very epidemic are as striking any that have ever been produced. Thus this cholera was universal over Lower Egypt tim five days after its appearance at Cairo; and in five days the great cholera of Paris was ;ad over four-fifths of the city. We have now to trace the progress of this epidemic in Northern India. As far as I can ? . ?__„„.. TT T,. ascertain, the cholera of 1831 was, like the cholera of 1863, a Epidemic of 1833-34 in Upper India. ? - j i i r v« i. i> i jtt t ¦?'. diverted cholera of which no portion reached Upper India in 1831 or 1832, and it is not until 1833 that I find it in Upper India, south of the Jumna, while still in epidemic vigour on the southern highway; this epidemic of 1833 appears to have been a parallel with the epidemic of 1865, of which I have so often spoken as first entering the western division of the epidemic area in the third year after its original exit from the endemic I As cholera appeared at Cawnpore in 1864 and 1865, so we find it in 1833 with the setting in he monsoon. On 9th July it broke out, and a second great outbreak followed on Bth August ; at this time it was committing great ravages at Allahabad and in the surrounding districts. 1 16 th Lancers lost forty men, and the 44th Regiment twenty-five men, seven women, and en children. No prisoners seem to have been lost at Cawnpore in this outbreak ; for I find death recorded out of a strength of 780. All the other jails of the east, however, give cation of the epidemic. Allahabad gives five deaths, Futtehpore seven, and Shahjehanpore ; and, south of the Jumna, the Banda Jail shows thirteen deaths || and the Humeerpore Jail ¦ deaths among the prison population. Allyghur gives three deaths out of a strength of \7 , and this is the furthest limit to the west of which the statistics of the prison population of north-west give evidence. But there was probably a reason for the failure of the type to id an adequate index of the extent of the spread of cholera in this year ; and cholera may c been widely spread, although repressed. I find the following in the annual report of Her Majesty's 31st Regiment of Foot, stationed at Kurnaul during the year 1833 :—: — " The last hot season was the most extraordinary that lias been observed in this country for a great many years, inasmuch as the hot winds continued nearly two months longer than usual, and the quantity of rain that fell late in the season was trifling in the extreme compared to former years. The baneful effect of this was felt to an intense degree, as the * Out of a strength of 196. In the monsoon cholera of August, there were eight admissions and one death in the same body. f "An official report by the British Consul at Jeddah stated that cholera existed in many places in the interior of Yemen towards the end of the year 1864." Report Constantinople Conference, p. 356. % Practice of Medicine, Vol. I, p. 715. § Balfour notes from Sir R. Temple's Punjab Report of 1854 the following, as years remembered in that province, as having been characterised by epidemic invasions of cholera, namely, 1803, 1820, 1827, 1833, and 1845 ; in these years cholera appears to have pervailed universally in the Punjab. || The representative of a great cholera among the population ; compare table showing the enormous mortality in the same districts in 1865, the parallel year, p. 48. 101 [ Section' I. CHOLERA OF 1833-34 IN THE CENTRAL PROVINCES AND WESTERN INDIA. 102 lEFevent crops were thereby nearly destroyed, and the price of grain exceeded anything in the jmory of any person living. This was succeeded by starvation among the lower order of tives, particularly in those districts bordering on the desert, where hundreds are reported to ye died of want, others to have sold their children, while some are stated to have devoured eir own offspring. Thirteen cases of cholera have been admitted in the hospital of Her ajesty's 31st Regiment, of which two proved fatal. These were generally very severe cases, i almost all were incorrigible drunkards." In the note placed below, 1833 is noted as a great cholera year in the Punjab. In 1834, cholera was renewed generally over the west ; for we find cholera deaths in the Jai Table 0f,1834 noted at Banda, Humeerpore, Mynpoorie, Agra, Delhi, Goorgaon, and Bolundshuhur a tract from which cholera disappears in 1835. This cholera seems to have been more severely felt at Muttra than elsewhere. The Superintending Surgeon writes :—: — " About the middle o July cholera made its appearance in the city of Muttra and carried off great numbers ; at one time twenty and thirty were reported to have died daily." ** * " From the 14th to the 22nc August it prevailed among the Europeans of the Artillery, and eight of the worst cases terminated fatally" INot a single cholera death is found among the prisoners of the Central Provinces during year 1835. Scarcely any jail, however, escaped in the two previous years, although no suffered severely." Cholera Deaths of the Prison Population of the Central Provinces, 1833 and 1834. 1833. 1834. Jubbulpore ... ... 1 4 Nursingpore ... ... 3 Hoshungabad ... ... 2 Mundlaisir ... ... ... 4 Baitool ... ... 1 Seonee ... ... 5 ... Saugor ... ... ... 6 These figures are truly representative of cholera in the Nerbudda Valley and Saugor District in these years. In the report of the Superintending Surgeon for 1833 we read: — " Cholera raged epidemically at Hoshungabad after having appeared some time previously in the neighbouring villages. Of fifty-one cases treated forty-one recovered, and seventy or eighty deaths were returned by the Kotwal of people who had not undergone treatment." He adds, " South of Hoshungabad the village inhabitants avoid communicating with each other when the disease is present ; and few attended the late fair at Hoshungabad for fear of contracting the disease by association with those who had come from diseased towns." I In the spring of 1834 cholera was extensively reproduced all through these provinces. The perintending Surgeon of Saugor writes, dating 9th June :—": — " Eleven fatal cases occurred ong the troops during the month of May from cholera. The disease during this period has ;n raging throughout this high table land with greater severity than it has been known to do many years past; and not less than two hundred have died in and around the town Saugor. The Medical Officer of Seonee states, that one thousand have died of it at imdla on the banks of the Nerbudda. In the neighbourhood of Bhilsa, reports state that s roads have been nearly impassable from the putridity of the numerous bodies. Some of the iths have been very sudden, as only two or three hours elapsed from the first attack when the ith took place. The whole country is in such dreadful state of aridity that it is impossible any n-sh miasma can be produced." I should doubt the correctness of an observation made in is report, that che winds were steadily from the north-west; we know the history of the ,'asion of the Saugor District in May in many succeeding epidemics, and it is opposed to the ttement here made. The report from the adjoining Circle of the same month, tells us, that 3 winds were from the west or south-west. §The following is an extract of a letter from the Superintending Surgeon, Neemuch vision, dated 14th June 1834 :—: — I" Throughout the month of May cholera prevailed extensively over the country and ised great mortality. At Neemuch the wind blew strongly from the west or south-west, I from the 12th it became humid, as if rain had fallen in the vicinity. On the sth ly five persons were seized with the disease and died in the bazar of the 3rd Local Horse, i the 21st, the day following the Mohurrum, it attacked about sixty people in the dder Bazar of this station ; the Mussulman population chiefly suffered, perhaps from the 'vious exposure to the weather during the Mohurrum. On the 23rd, some severe cases >urred at Neemuch in the men of the 2nd Cavalry on the right of the lines, and those the Foot Artillery on the left, whilst the 51st and 61st Regiments occupying the intermediate es were unmolested by it. About that date it attacked also the grass-cutters of the 2nd Cavalry Barowh, fifteen miles distant ; three were brought into hospital and recovered ; medical assistance a sent to the others ; of fifteen who had been attacked four died. Up to the Ist of June twelve >oys of regular corps have been admitted into hospital, of whom six died. Of the inhabitants the Sudder and Regimental Bazars with other camp followers, the number of deaths from s disease amounts to seventy-two. Since the Ist instant none have occurred ; only two or ¦cc very mild cases were brought to hospital ten days ago, and now I indulge the hope it the disease has left this cantonment. I regret to notice that some cases of cholera have irred at Mhow, five having been among the European Artillery, up to the 3rd instant." The facts of this period as here placed, afford a history of a distinct epidemic, with a o-eographical distribution and a limit in time consistent with the history of typical epidemics. These facts carry us back not to the epidemic of 1826-29, but to another and succeeding invasion. This epidemic commenced its invasion into the east of the Madras Presidency in 1830, and was extinct, or nearly extinct, after 1833 ; and I regard the great cholera of Northern and Central India of 1833 and 1834 to have been the same which I have shown as an invading cholera in the spring of 1831, descending into the plains of Behar from the high lands closing in the endemic basin. Some would see more in these two years of cholera in Western India (1833 and 1834) than merely the winding up of the epidemic of 1831, and might consider the strength of the body of this cholera proof of its being a new and fresh material. It is, as I estimate it, perfectly true that the cholera covering in 1833 the districts south of the Jumna and simultaneously occupying the Saugor District and the Nerbudda Valley, was a newly invading cholera, but I see no actual necessity for coming to the conclusion that it was a cholera freshly emanating from within the endemic area, or other than the materies which first appeared in 1831. I have remarked in the beginning of this chapter, that any year of the lifetime of an epidemic may be its year of maximum manifestation, and that the aspects of an epidemic must be looked at in relation to its provincial localisation and the circumstances attending the occupation of provinces. While this aspect of this cholera of Western India of 1833 and 1834, and thefact of the appearance in 1835 among the Mecca pilgrims of a cholera which we must reckon to have been an offshoot from this same western cholera, would suggest that the cholera of these years was a new epidemic following up the epidemic of 1831, we cannot but recall the parallel fact of the persistence on the same tract of the cholera of 1863, through 1864, and 1865, up to 1866. At the same time, the possibility of the connection between this cholera and the epidemic of 1837 of Europe and Central America, which I have spoken of in connection with the Indian epidemic of 1837-38, must not be overlooked. Graves tells us that between 1838 and 1847 cholera disappeared from Europe. There is no difficulty in recognising the fact that the epidemics of the Mediterranean and the cholera general throughout Europe and Central America of the years previous to 1838, was cone 3. Epidemic of 1836-39. I ted with the cholera epidemic in India ; the difficulty lies in establishing the different linksthe connexion. I have now to speak of a new epidemic, that of 1836-39; and while it is icult to believe that the cholera which we find filling the Ganges Valley in 1836, and fully played only in the beginning of 1837, was the same cholera which covered the continent Europe in the autumn of 1837, and Northern Africa in September and October, and ich at the same time devastated -Central America,* and appeared in England and Ireland,t 1 we are forced to conclude, either that the cholera of Western India of 1833 and 1834 3 thrown in epidemic strength into Europe, and, in contradiction of all parallel history, intained its vigour throughout successive revitalisations up to 1838, or that the new cholera India of ] 836-38 supplemented this cholera in Europe before it finally died out ; and that is the cholera of two separate invading epidemics became blended, as I assume to have urred also in the case of the European invasions of 1829 and 1831. The Indian cholera of 1537-38 has a very plain history. Early in the spring of 1837 it is found in the lower section of the Grand Trunk Road ; next brimming over the Hazareebaugh plateau ; then universal in the Ganges Valley and over the entire eastern epidemic province. The next stage finds it, as in 1860, attacking Agra in September; and we trace its usual career in the western division of the epidemic area in 1838, precisely as in every other epidemic. I The first we hear of the invading cholera of 1837 is in the extreme east. A party of titeers for the European Regiment at Hazareebaugh lost three men and a woman on the road ; it is mentioned that at the time cholera raged in the villages on the Calcutta Road een Bancoorah and Hazareebaugh. This detachment left Fort William on 20th February. lOn the 26th March cholera appeared at Hazareebaugh. From the 26th March to the April twenty-nine soldiers and twenty-six women and children were attacked ; twenty-three :ie former and eleven of the latter died. From the 9th of April to the ] sth, there were only admissions among the men and two among the women and children, with one death in the er and one death in the latter. I The outbreak at Dinapore immediately follows. The Superintending Surgeon reports :—-ot a case had been admitted at the station during the period of its prevalence at Hazareebaugh, ire the 14th of the month, when it broke out among the European Soldiers at Dinapore." fatal cases were admitted after the 23rd; but between the 14th and 23rd forty-five tissions occurred, with eight deaths. tThe annual reports of the Superintending Surgeons of the two remaining circles of the m epidemic province also notice the prevalence of this cholera as an epidemic, as follows :— * " At no time has the destruction of the human race heen greater in a given time by cholera than at present, in those countries through which this modern pestilence is travelling. In Central America the destruction of life has been melancholy in the extreme, and whole districts are represented to have been depopulated. An impression that the rivers were poisoned seems to be universally diffused, which has led to several barbarous outbreaks against the Government hardly less fearful than the cholera itself." — Boston Medical Journal, quoted in Indian Journal of Ist May 1838. ¦f Algiers, 14th October; " Dreadnought," Bth to 28th October; Marylebone, in same weeks; Liinehouse, 26th ber ; Ireland, November. 103 THE EPIDEMIC OF 1836-39 IN THE ENDEMIC AREA AND EASTERN DIVISION. "At Benares three per cent, of the Artillery died from cholera. Cholera broke out in the -Invalid Garrison at Chunar early in March and carried off in the course of that month and -the following 1 , 11 men, being six per cent, of the whole strength. In July cholera broke out at Cawnpore, and prevailed to an alarming' extent during- that and the succeeding month ; of the ten deaths which occurred in the Artillery, seven were from cholera morbus." But this cholera had made its appearance in the Valley of the Ganges in 1836, and the fact that we can trace it in 1837 into the most northerly station occupied, shows this to have been the second year of the epidemic, invading the western division probably in November 1836, as in the same months in 1826 and 1866. The* following is a report from Kurnaul: — " Cholera likewise appeared at this station in August, and prevailed during that and the three following months. Three per cent, of the mortality is attributed to that disease." The appearance of cholera at Kurnaul in 1837 shows, that the whole western province was affected. The affection was, however, probably little felt at the time in consequence of the peculiar meteorology of the year. The famine tract of 1837 was, in fact, like the famine tract of 1860, an area comparatively exempted, while to the south and east cholera was universally in full epidemic* vigour. Baird Smith, writing of the famine of 1860, says :—": — " As regards the comparative intensity of the drought (of 1837-38 and 1860-61), I think it may with confidence be taken as virtually the same. * * As it was the case that both in 1837-38 and 1860-61, not a shower fell from September until March within the bad parts of the famine tract, the conclusion that the physical intensity of the drought was practically the same in both is a safe and reasonable one." This parallel very beautifully corroborates what I have written regarding repression of manifestation due to the failure of monsoon agencies. The epidemic of 1837 seems to have come upon Agra quite at the close of the monsoon, as in 1860, having been delayed by the peculiar meteorology of the year. The battery at Agra was attacked on 24th September, and simultaneously the jail and general population. The Superintending Surgeon writes :—": — " Many of the famishing poor who have resorted to Agra for relief, as well as some of the distressed inhabitants of the city, have fallen victims to the disease ; but still I am happy to conclude that cholera is not very prevalent, and as the wind hate set in again from the west, I am in hopes that it will soon disappear altogether." As in November 1826 and 1866, cholera reappeared at Agra in November 1837,* and also in Rajpootana. Thus we read :—": — " At Kotah between the 12th and 31st October, 400 people are reported to have died in the town. A range of from twenty to thirty deaths daily at Kotah and its immediate vicinity, continued up to the 14th November 1837/' In accordance with parallel history, this cholera was due to reappear on 20th April in 1838. While covering Agra and Rajpootana, the cholera of 1837 made its way all down the Nerbudda Valley and over the plateau above the Vindhya, and every station further south on the epidemic highway suffered. The general facts of this invasion are contained in the following extract from the report of the Superintending Surgeon, Saugor Division, for the year 1837 :—: — " Cholera reached the station of Saugor on the 9th of July 1837, having first made its appearance at Rewah and Jubbulpore,f on its transit from Mirzapore on the banks of the Ganges. "At first it was confined to the town of Saugor. Out of an approximate estimate of the population put at 30,000 inhabitants, 1,632 cases of cholera occurred between 9th of July and 9th August, of whom 945 died. In the neighbouring villages 126 deaths occurred. Accounts have been received of its appearance at Dumoh and other neighbouring towns, and it is known to have committed great ravages at Hutta. So far back as two months ago, cholera has been at Jubbulpore, Nursingpore, and Hoshungabad. It has also made an extraordinary mortality among the cattle/ "In the month of July twenty-three cases occurred among the Native Troops at the station of Saugor ; of these only three died. The disease increased somewhat in the following month ; seven died during that period, and only one European of the Artillery Company/ "At Nursingpore, distant about 110 miles to the eastward of Hoshungabad, and fifty-five miles to the westward of Jubbulpore, not less than 2,645 fatal cases of cholera occurred, in that locality, and in about 150 villages surrounding the town. At Seonee 137, and at Jubbulpore 153 died from cholera/ Here, too, the monsoon rains were very deficient, and the weather is described as cloudy and threatening only, while rain should have been falling. The first fall was but small, and was followed at irregular periods of from seven to ten days by partial showers, so slight in their effects that after a month the soil was not found to be penetrated for more than five or six inches. The total rain-fall of the year was twenty-five inches in place of forty-six ; I have noticed that the comparative deficiency of the rain-fall in 1860 and 1868 did not prevent the spread of the cholera of these years along the same tract. A non-epidemic season has on the southern highway features very different from a nonepidemic season in our North-Western Provinces. The spread of cholera in the hot season * Two cases, one fatal, occurred in the Battery of Artillery at Muttra in November 1836 ; these were, I think, indicative of the original invasion of this epidemic into the Western Division. t The date given for the Jubbulpore District is 20th May ; it was ou the 23rd May 1868 that the Jubbulpore Cantonment became affected. X Already quoted at p. 84. • , 104 I a limited rain-fall is exactly what takes place in the endemic area ; and it is the absence te normal south-west monsoon and the substitution of eastern influences for it that mines the phenomena of a year such as 1837. When the Superintending Surgeon of •or or Dinapore writes that the season is one of the hottest he has known, the statement b to mislead any one unacquainted with the meteorology of these districts, into the belief the long continued prevalence of the hot, dry, and westerly wind is implied, whereas it j very contrary. It is the continuance of moist and relaxing east winds that brings a hot, jssive, and unhealthy season. This is in fact an extension of what is natural for the, nic area. It is precisely what we observe in regard to the cholera of Calcutta, for pie ; it is the hot season of Lower Bengal (April to June), which develops the maximum olera. But it is not heat alone, but heat with moisture, that causes the cholera to prevail. It was owing to this deficiency of the rain-fall in the south that Agra escaped until September, as in 1860, and that Meerut, Rohilcund, and the Punjab remained comparatively untouched in 1837. Cholera of 1838. There was a true interval between the cholera of September 1837 and March 1838. The Superintending Surgeon of Agra writes : — " We escaped the disease altogether in the cold season." I have said that the cholera distributed over the western division was due to reappear, with a normal meteorology, about the 20th April in 1838. But on 29th March 1838, the Superintending Surgeon writes to inform the Medical Board that cholera has reappeared among troops, prisoners, and the general population at Agra. But the following sentence explains the cause of the early reappearance. Speaking of the cholera which had broken out among the troops at Muttra, he writes (20th April) : — " The seasons appear to be out of joint, and we have now occasional rain with a warmth and mugginess of the atmosphere like that felt in the beginning of the rains." From the 20th April to the 11th of May, sixty-seven prisoners died at Etawah, and the epidemic raged in the town. In Banda, as usual, cholera reappeared in May, and the sepoys of the Native Regiment lost seventeen men from cholera, through being compelled to go into camp in consequence of their lines having been burnt. The Superintending Surgeon of Cawnpore writes :—": — " The weather has deviated considerably from its usual state at this season of the year ; there is an easterly wind and a murky sky/* On the 14th May cholera reappeared at Hoshungabad. It was not until the rains set in that the cholera of 1838 became universal over the North- West. In the return for July twenty-three cases of cholera and ten deaths appear among the European Troops at Meerut. In the movement of the cholera of July all the country up to the hills was covered. From the report of the Superintending Surgeon for July we learn that cholera prevailed greatly in the town at the time when it attacked the European cantonment ; and that cholera had appeared also at Seharunpore and Deyrah,* and that many had fallen victims to it. In August, while cholera was still prevailing at Meerut, it was committing great ravages in the Mozuffernuggur District (Report, 18th August). Kurnaul was affected at the same time, and within a month the whole western area appears to have been covered. In the Report of the 13th Light Infantry stationed at Kurnaul in 1838, we read :— " Cholera of a most malignant and fetal character prevailed for a period of more than six weeks, between the middle of July and the end of August. The disease first appeared in the station at the latter end of June, and committed great havoc until the middle of August." In the 13th Regiment forty -nine men were attacked, of whom nineteen died ; and of twenty-seven children attacked twenty-one died. The statistics of the invasion of the western division are as under : — A. — Jails. Ibx Quabtbb, 2nd Quaetbb, 3bd Quabibb, 4th Qcabteb, Januaey to Mabch. Apbiii to Junb. July to Septembeb. Octobeb to Decejibeb. JAILS. Admitted. Died. Admitted. Died. Admitted. Died. Admitted. Died. Banda ... 9 J Humeerpore ... ••• * f Etawah 230 M(c) ... fSur%) ::: '" w m 32 62 4 1 *£»& £ I 2 v , r i ::: S&r :.: ::: 1 1 «* 15 ... » Delhi ... 3 \ - .» 19 1( > ter ::: ::: ::: ::: j 10 J "i ::: TTiasar ••¦ ••• ••• y " ¦* ••• ••• ••¦ Sirsa^> ». ••• £S? ::: ~ = - "« -¦ 5 Moradabaa ... 1 ... 8 2 1 Bijnore ... - ••• - ° 1 Mozuffernuggur ... ••¦ l -•• t. ... x * Cholera commenced on 4tb July. Forty -four deaths occurred in the Goorkha lines, besides thirteen cases which were admitted into hospital. fa) Thus in original return. £bi For this jail there is no return, but it is stated that forty -one prisoners died from cholera. (c) The mortality among the famine stricken inhabitants at the same time was reckoned at 150 a day. 105 B. — European Troops. Jaw. Feb. Mabch. Apbil. Mat. Juwb. Juit. August. Sept. Oct. Not. Dec. STATION. . § § | | § I | I I § | I 1 1 js' 1 £ llilllllllll 1 I •* I I I 1 I Affra 4 2 2 13 2 2 1 Meerut 2 1 20 9 10 4 2 1 Landour ... ... 1 2 ... 3 2 Knrnaul 1 1 30 14 49 17 3 1 2 1 1 1 At Cawnpofe in the reproduced cholera of 1838, the European Troops, 1840 strong, lost 43 out of 152 attacked. C. — Native Troops. Jan. Feb. Maech. Apeil. Mat. June. Jult. August. Sept. Oct. Nov. Dec. STATION. | I | | I | | I I | I _ | 1I1|II1I!I!I ! I I I 1 1 1 I J I 1 I T Epidemic. £¦ Epidemic. 1838 ... ... 52J 480J This cholera thrown into the province of the south-west monsoon, was fostered, and when so little redeveloped in the North- Western Provinces in 1839, became a powerful body of invading 106 cholera occupying- the south-western natural province from Nusseerabad and Jodhpore southwards and westwards. Among the Native Troops I find the invasion thus represented : — Nusseebabad Circle, 1839. Admissions and Deaths from Cholera. May. June. July. August. Septesibeb. Octobeb. Novembeh. Decembeb. STATION. j _ | | | | | | | |_ I I _l_ I J |__| l__l |_ I I | 1 | 1 Bhopawur ... 393 9 1 3 Ncenmuh ... 5,309 3 ... 8 6 6 2 19 9 22 ... 30 17 Nusseerabad ... , S? % . fe Si <3 g ,d . . "SgS'g'g ll}|i# I f 1 I I Aitnere ... ... ... * * Muttra ... ... ... 1 1 "9 ?| Agra ... .. ... 1 1 2 60 3 ... 2 ... Etawah ... ... ... ... ... ' Allyghur ... ... ... 2 2 19 "5 ... "i "i Bolundshuhur ... ... 2 1.. 1 Budaon ... ... ... 2 11 „', ]" Meernt ... ... ... Moradabad ... ... 1 1 '3 "' Mozuffernuggur ... ... .^ ' Seharnnpore ... ... ,' \", '' Bijnore ... ... ... ' 1 '? ' " t [ \ '" Deyrah. ... ... ... 1 '" '" Hissar ... ... ... "j " "' * Teu pases and five deaths ia this jail in these mouths. 108 In the May cholera of Rajpootana, epidemic with the spring rains of 1843, I see the body ?...., ... of the cholera of Central Asia so destructive in 1844, the same which ** » all^ed descended upon Peshawur in November 1844, and which was revitalised on the frontier in April 1845. ; me follow out the parallel of 1860-62 in illustration, to show how little necessity there is the assumption that this cholera must have descended from Central Asia upon the Punjab and Rohilcund. In September 1860, the cholera of a new epidemic re-entered Scinde which had enjoyed almost complete immunity from cholera since the epidemic of 1853.* I quote from Strachey's Eeport (p. 143), the parallel in this province of the April and May cholera of 1843 :—-" In April 1861, cholera again appeared, and soon spread with great violence through the province. During April and May the mortality was very large. In June the disease became much less prevalent, but it did not disappear until a month or two later." Immediately afterwards we find this cholera in Cabul, before a single case of cholera had appeared in the north of the Punjab K4) :—": — " Cholera did not spread epidemically through any of the districts of the Punjab north Lahore. It was, however, virulent at Cabul in October/ In November 1860 the same lera entered Persia. But it was not until April 1862 that the cholera of 1860 appeared on Peshawur Frontier. I The same occurred in the previous epidemic ; it was not until November 1858 that the cholera 1856 crossed from the Jhelum to beyond the Indus, although the same cholera had raged in rsia in the year before. lAs the cholera of 1860, when revitalised in 1861 invaded Cabul in the same year, and not appear at Peshawur until 1862, so did the cholera of 1843, when revitalised in 1844, ide Cabul, and it appeared at Peshawur only in the last months of 1844, and again in the ng of 1845. We trace the frontier cholera of 1858 through Huzara in May and in July, until it descends the Peshawur Valley in November; we note the coincident appearance in April 1862 of the c cholera on the frontier that we traced general over the east of the Punjab. But we do not a moment think of seeking beyond the mountains the source of the cholera of the high jab of these years, since we know it to be in the countries lying to the east and to south of the newly invaded tract. I Persia is but a province of Hindostan as regards the invasion of an epidemic cholera. The Scinde cholera of 1860 entered Persia in the beginning of ?of a mndo° s r tin n a° b Pr °" November (Report, Constantinople Conference, p. 319), and the same cholera did not move upon Meerut or the Punjab until the t week of July in the year following, an illustration of the truth that epidemic cholera has no )motion due to human agency. Again, we read, that there have been no epidemics in Persia from 51 to 1865 ; and the reason is, that the epidemic of 1863-64 moved along the southern highway ough Nagpore, Lower Scinde, Arabia, and Egypt, leaving the northern highway unoccupied. 3 epidemic of Northern India of 1867 reached Teheran on 28th August in the same year. ¦sia suffered greatly in our epidemic of 1856-57, and it died out apparently in the month of final disappearance throughout our Presidency, namely, November 1858 ; and to this succeeded September cholera of 1860, our great September cholera of Agra, Jhansi, and Morar of the le year. tl go back to the epidemic of 1843, to show the connection of the Rajpootana invasion l the cholera of the east and south. The July outbreak of Agra was a great cholera, all the adjoining districts were covered. The figures which I have given from the Jail urns show that this cholera was lightly spread even as high as Umballa, but they serve also how, how trifling was the cholera of 1843 in this extension. The force of the wave evidently ed south of the Punjab. The returns of 1844 show only fourteen deaths in the jails of same provinces, and these I regard as indicating the termination of the epidemic. I The great cholera of Agra of 1843 was distinctly traced as the successor of that "of 1837; we are told that for many years Agra had been exempted from any epidemic visitation. In report of the 39th Regiment, it is stated that the hot winds blew with less intensity and constancy in their direction, and that the rainy season was protracted, and the fall above average. In this Regiment the first case occurred on Bth August and the last on 22nd tember. The Surgeon remarks, however, that for upwards of a month before the Regiment affected, the disease had been raging with fearful malignity in the city and in the hbouring villages. I have said that the fact of the appearance of the cholera of 1843 over the western area in 1 April and May, induces me to believe that the invasion must Cholera of 1842 in the west. haye oceurre a in 1842p j find in the Meywar Bheel Corps deaths in 1842, in the Mhairwarra Battalion one, and altogether thirteen deaths among the )s of the Nusseerabad Circle (see table of 1842). These cases are to me perfect evidence le fact of invasion having occurred. Again, among Native Troops, the Nusseeree Battalion übathoo gives one death, and the Sirmoor Battalion at Deyrah also one death. I find also death at Meerut, Delhi, AUyghur, Bareilly, and Ferozepore, and this is the total for the * Grierson's Report quoted by Stracliej. r 109 western province. The European Regiments at Kurnaul lost eight men between June and September. In the east, every station suffered in 1842. Among the Native Troops, Banda shows m. i eioAv «, OD «>=+ thirteen deaths; Cawnpore eight, in five different corps; Cholera of 1842 m the east. T . „ ahii-io •»«-• • t» „- Lucknow five; Allahabad five; Mirzapore six; iienares thirty-five ; and Dinapore forty-five. From March until July, the report of the Superintending 1 Surgeon of Dinapore is one deplorable record of cholera and its malignancy, as the following- table shows : — Admissions and Deaths from Cholera, Dinapore Circle, March to July 1842. 1842. Native Troops. European Troops. Prisoners. March Admitted 14, died 5 Admitted 63, died 11 April ... ... ... ... Admitted 16, died 8 Admitted 10, died 3 Admitted 120, died 38 May ... "... ... ... Admitted? died 4 Admitted 2, died 0 Admitted 245, died 86 June ... ... ... ... Admitted 20, died 16 Admitted 5, died 4 Admitted ? died 44 July ... ... ... ... Admitted 6, died 3 Admitted 7, died 6 Admitted 140, died s7 Following- this cholera up the valley of the Ganges, we find that the Chunar Garrison had thirty cases, of which twenty-one were fatal, between 4th April and 7th May. During the monsoon reproduction, the Superintending Surgeon writes from Cawnpore, that between the Ist and 13th August, thirty-nine European soldiers had died, besides women and children ; and writing again on 2nd September, he reports twenty-seven deaths out of forty-five admissions. In the south, from May to September, this same cholera prevailed. In May, cholera is re- Ch 1 f 1842 " th th ported from Jubbulpore, Hoshungabad, and Baitool, and in June, from Jubbulpore and Seonee. In July, cholera again appeared at Saugor ; ninety-two cases and forty-one deaths were reported among the inhabitants. In August and in the beginning of September, the troops at Saugor were attacked ; the Battery (European) lost five men, the Native Regiments eight men, and the jail ten prisoners. But this cholera, both in the east and south, was a second-year cholera. It was in 1841 that the actual exit of the epidemic occurred, and finding, as I do, the minimum or extinction of this cholera in the south and west of our Presidency in 1844, I can without hesitation refer the epidemic of 1845 and 1846, dead in 1848, to a fresh source, and not to the endemic cholera of 1840 or to the invading cholera of 1841. The invasion of 1841 was well marked. Terrible boat outbreaks among the Native Regi- ments moving on the Ganges between Dacca and Dinapore occurred in March. The 32nd Native Infantry was struck on Cholera of 1841. the 3rd March, and at the time the Medical Officer wrote, between 150 and 170 men of the fleet had died. The 15th Native Infantry had forty-three deaths in the end of March and the beginning of April, on the river near Rampore Beauleah. Next, as usual, we find the cholera brimming over the Hazareebaugh plateau. Her Majesty's 62nd Regiment had nine admissions and three deaths after 19th March. Dinapore Cantonment is next attacked ; t March and April, the 21st Fusiliers had twenty-three cases and ten deaths, and in May, enty-nine cases and twenty-one deaths. Up to June, cholera was general both in jails and cantonments. Cases are noted up to June in Hazareebaugh ; and at the same time cholera disappeared in the 21st Regiment. In the Tirhoot Jail alone, there were in April ninety -five admissions and fifty-one deaths ; and in May, eighty-nine admissions and forty-nine deaths. No jail of the Ganges Valley escaped in 1841. From Cawnpore eastwards, every jail had cholera, although in no great severity ; the weight of the epidemic fell further to the east. From Behar south as far as the Bay of Bengal the country was covered by a sheet of cholera, as is indicated in the Jail Tables. Hazareebaugh Jail gave seven deaths, and Ranchee Jail six; at Chyebassa, the detachment of the Ramghur Battalion lost eight men between the sth and 21st June ; and the jails of Cuttack, Balasore, and Pooree give respectively sixty-two, twenty-four, and twenty- three fatal cases among their prisoners. t Simultaneously, occurs the march along the southern highway, through Jubbulpore and i , , 0 ,, xi. a. Saugor, and through the Nagpore Province to Madras and olera of 1841 oa the southern x> i ? „ ° ,OKA, OK A ,•¦ . n ,i-mic highway .Bombay. At baugor, as at Agra, the succession of this epidemic to that of 1837 is distinctly recognized. The Super- intending Surgeon writes : — " At the close of the month of June the epidemic cholera invaded the Saugor District. The total of cases treated during the month of July did not exceed 402, of which 289 were cured and 102 died. * * * The epidemic of the present year has thus been particularly mild as compared with that of 1837, in which so many as sixty-eight died in one day in the town of Saugor alone, and in the single month of July 812. * * * Cholera is said to be declining at Jubbulpore since the close of the last month." It is not until 1844 that this cholera entirely disappears, taking the jail population as the index. 110 The same phenomenon of repression of the monsoon, that is, the abnormal prevalence of Iterly over south-westerly influences, to which I have called attention in speaking of the vious epidemic of Saugor of 1837, was seen in 1841. The Superintending Surgeon writes : — 'he season of hot weather was much protracted. The clouds collected but slowly, and the ater part of the month of June was cloudy, threatening, and very close ; but the fall of rain, !ch is usually rather abundant from the 12th June to the end of July, did not, up to the 21st y, give more than 8| inches, and up to the close of July less than one-third of the amount of rain due in an ordinary season fell." tin the Native Army of Madras the interval between the epidemics of 1837-38 and 1845-46 us marked; in 1847, cholera had disappeared from nearly. every station of the Presidency, in our provinces, it was not until 1842 and 1843 that the cholera invading in 1841 was bited in power. Cholera Deaths of the Native Army of Madras, 1839 to 1847. 1839. 1840. 1841. 1842. 1843. 1844. 1845. 1846. 1847. Strength ... ... 06,514 71,188 72,232 74,618 73,763 73,577 74,861 74,682 Died ... ... 249 122 241 741 903 521* 708 1,208 78 t _____ > i i i Interval. Invasion. Decline. Re-invasion. Decline. It seems to have been in the marching season of 1844-45 that Madras was re-invaded by the fresh cholera, which I regard as the parent of the cholera of 1845-46. The great calamities on the march roused the Madras Government to an enquiry, of which the results were thrown together by Lorimer. Of twenty- three marches undertaken in 1844, twelve only were completed without the appearance of cholera, and the deaths of four corps alone made up an aggregate I £90. In the spring of 1845 we find the same recurring. During 1845 and 1846 Madras ered nearly as much as our North-West Provinces and Western Division of the Army; 708 oys were lost in 1845, and 1,208 in 1846. The cholera of Madras and of our Presidency one and the same cholera; the cholera of 1844-45 was our cholera of these years, and our it cholera of 1846 was geographically added on to that of the Madras and Bombay Presicies. In 1847, cholera was dead as an epidemic in Madras ; dead in the province of the th-west monsoon proper ; dead in our North- West Provinces and in the Punjab ; a sufficient cation that the cholera, wherever we may have met with it, was the cholera of the same a In April and May 1846, we find, as in all other years following epidemic invasion, cholera re-appearing at Umballa ; there were, however, only fourteen terval succeeding the cholera of fiye deathg amQng the Europeans> Tne Native por . tion of the Punjab Field Force suffered at the same time, between March and June. The European Regiments at Ferozepore also lost a few men ; one man died in May, and five in August and September. Cholera still appears in the Jail Returns of this province, although evidently nearly at its end. The European Army of the North- Western Provinces gives but a single death ; and the troops in the stations of the Ganges Valley three. Among the Native Troops of the same provinces, 37,500 strong, seven deaths only were recorded. Mackinnon, writing from Cawnpore regarding the outbreak of September 1847, says : — " During the two past years I do not think there was a case of cholera even among the Natives, until the disease appeared a few days ago/ (Op. cit., p. 81). This statement clearly defines the interval between the epidemics of 1845 and of 1847. REven in Central India cholera was little felt in 1846. I find the Superintending Surgeon augor congratulating himself on the fact that the terrible cholera of Malwa and Guzerat had scarcely reached so far to the east. The jails of his circle show six deaths only during the year, three at Saugor, and three at Hoshungabad, which suffered greatly in the provincial invasion. In the extreme north of the south-western province, cholera coming up from the south-west _ . . , . „ , appeared on 15th June, after ravaging all the country to the *StZ?on%ll7ot%% south in April and May. This extension seems to have coin- cided to a day with the invasion of Scinde ; it was on the ELg of the 14th June that Kurrachee was struck, and Nusseerabad became affected on the The extension, reaching as far to the north-west as Ajmere, was due to the peculiar rology of the year which I have noticed further on. The provincial range of this cholera of 1846 is beautifully defined. Every Regiment marching westward from the east came within its influence as soon as a certain line was passed ; and within the provincial limit cholera was absolutely universal and extended westward to the sea. »In connexion with the origin of the great Kurrachee outbreak, I have placed here extracts Regimental Reports, which show the bounds and extent of the choleraic influence of April * Of these 290 occurred in four Regiments on the inarch. 111 and May, and carry up its history and geography until the occurrence of the Kurrachee outbreak of June. 4t/t Company, Ist Battalion Artillery. — " During the march from Saugor to Mhow, between the 20th March and 14th April, the men continued healthy and escaped cholera, which was then raging in the country and broke out very severely in the 58th Native Infantry which travelled over the same route only ten days later/ lOtk Light Cavalry. — "The Eegiment was at Nowgong in Bundelcund until the 28th April, when it marched for Mhow ; with the exception of cholera which occurred in camp duringthe march to Mhow, little sickness has occurred. Thirty -nine cases of cholera were treated, between the 27th May and the 9th June, of which twelve died. On the latter day the disease suddenly disappeared. Some days before cholera appeared, I had been told at various places that cholera had raged to a great extent, and had carried off many of the inhabitants ten days or a fortnight before we marched through." 58t/i Native Infantry. — "On 19th March, the Regiment commenced its march from Jubbulpore to Mhow. The Regiment continued very healthy until it arrived within one march of Indore when it was attacked with cholera. Cholera commenced on 21st April and continued to rage for sixteen daysr* The village at which it was picked up had lost many of its inhabitants, but this information was not given until afterwards. Cholera had not appeared at Mhow to any extent for five years previously. This was told me by Dr. Arnott, who, with about 200 men of his Regiment, fell victims to this dreadful malady a few days after leaving Mhow."* There were fifty-two cases and twenty-two deaths in the 58th. 74„! .• Ji T»_._: __• • * i "HI tember 1848, the cholera invading Prussia in August, Eng- land in October of the same year, and New Orleans in December, and to reckon it as the parent of the cholera surviving up to the end of 1849. My impression is different. Notwithstanding the violence of this invasion, I consider that the cholera of the epidemic of 1844-41) died, and did not prolong its epidemic existence except in its extension below indicated, and in the Caspian Provinces ; and lam inclined to believe that it was another body of cholera which two years later passed into Egypt. The history of cholera in Persia confirms this view. There is said to have been a clear interval of thirteen years previous to the invasion of 1815 ; and this cholera was dead in 1846, and Persia was free again from cholera until a fresh invasion occurred in 1848. I This cholera of 1846 was prevailing in Persia while the same cholera was raging at Kurra; and at Aden we find it even earlier, as usual, in the month of May, after a violent and ual fall of rain.* The next epidemic advance occurred in October 1846, when this cholera reached Aleppo and Damascus ; and in January 1847, the Mecca pilgrims suffered, probably from the same cholera still retained in Arabia. tAs the cholera of 1829 became unquestionably the Eussian cholera of the years following, here can be as little doubt that our cholera of 1845-46 found for itself a habitat far more able than any offered to it in India, and prolonged its existence until Northern Europe was sred. As with the epidemic of 1831, the difficulty lies in bridging over the interval between y 1846 and July 1848, the dates of its appearance in Arabia and in Egypt, and in determinwhether the Egyptian cholera of 1848 was a new invasion from India derived from the iding cholera of 1847 noticed in the previous page, or an invasion from the north. It is >c noted that it was in July of 1831 and 1848 that Egypt was entered. This western cholera of 1846 was but the extension of a cholera invading in 1845. I_, , T] . ? „ ,0,1=; This cholera of 1845 was a great cholera as well in the south Great Indian cholera of 1845. ? .-, D -n • j T i j. 1 i • as in the north of our Presidency. It was a great cholera in aipore and Bundelcund, as well as in Meerut and the Punjab. In 1844, Cawnpore did not ir. No cholera death took place out of a strength of 3,300 European Troops. Oudh also ?ars to have had no cholera in 1844. In the report of the King's Hospital for 1844, I find statement : — " We have not seen nor heard of a single case of cholera since the year 1843." i exemption of Oude and Cawnpore I consider to mark distinctly the interval between the emics of 1841-44 and 1844-46. To the east, however, the cholera which I reckon to have 1 the cholera of the new invasion, was abundant in 1844. The Regiment at Allahabad had cases and thirty deaths, and the Regiment at Grhazeepore seventy-one cases and lty-seven deaths. Cholera appears to have been epidemic in Chota Nagpore also, as 109 hs are returned among the prisoners of the Ranchee Jail.f tThe spring of 1845 was peculiarly favorable for the extension westward of cholera, kinnon particularly remarks upon the meteorology of the early months of 1845 as favorfor bringing up from the east the great cholera of May and June upon Cawnpore. He writes cit., p. 80) :—": — " The hot season of 1845 was remarkable for repeated falls of rain during the latter part of March and in April and May." It was in March and April that cholera began to appear at Cawnpore and over the east generally. The Native Regiments at Benares had twenty-one cases and fourteen deaths in March, and those of Dinapore twenty-two cases and nine deaths in the same month and in April. At Cawnpore there were in March and April thirteen cases and three deaths, and cholera appeared at the same time at Lucknow. What is remarkable is, that Agra should have had cholera in March and April. Of the fact I believe there can be no doubt, for I find a death in the European Battery as well. Among the Native Troops I find sixteen cases and five deaths. And what, it will be asked, is the value of this, if it be a fact. I have said before that I reckon the importance of a cholera by the evidence of its epidemic spread rather than by local indications of malignancy. We know that the cholera of Cawnpore of June, in which sixty-eight European Soldiers were lost, was this same cholera, and I think it very probable that the cholera which swept over Agra in these early months was the very same body which when revitalised in the end of June, became the cholera covering the provincial area from Meerut to the Indus. That a wide spread body of cholera had been disseminated I have no doubt, and the forerunners of which I have elsewhere spoken as of so much importance to be watched and noted, were not wanting. At Meerut a single death in May gives intimation of the great monsoon outbreak of September, in which ninety-one men were lost. In reporting on the Meerut cholera of 1861, Dr. Wilkie traces these indications, noting that Private * Sutherland's Report on the European Cholera of 1848, p. 4. f It is possible that there may be some error in connexion with this ; in the Jail Return these 109 deaths are entered, but I can find 110 record of the circumstances under which they occurred. 113 Jones, Her Majesty's 29th Regiment, died on 27th May 1845, and Private Lockwood, of the ltlth Regiment, on 19th July, in anticipation of the outbreak. At the very same date in May, I find the Superintending Surgeon of the Saugor Division reporting the death from cholera of the Adjutant of the Bundelcund Legion at Jhansie on 22nd May. The very lightness oi the visitation of Agra is, to my mind, a proof of the fact of its occurrence ; had it occurred as usual about the 20th May in place of in March and April, we know what the result would have been. Scarcely a trace of cholera would have reached the Punjab or Meerut before the first week of July, but in the intervening six weeks cholera would have seated itself in the Agra District, and would have raged with a virulence equal to that of 1856 of the same six weeks. The passing on of this spring cholera without localisation, was followed by the ordinary results, namely, sparse distribution of cholera in May, and powerful revitalisation coincident with the setting in of the rains. The phase of distribution at the two seasons is different. The distribution of the spring in the western division, as for example that of May 1865, is not traceable, except when carefully and statistically surveyed ; but it is true nevertheless, as is evinced by the fact that it is provincially reproduced when the moist vehicle is given to it with the setting in of the monsoon. The ojher phase, that of the monsoon, as of 1856 and 1861, shows epidemic advance in the same vehicle which would revitalise a spring distributed cholera. In either case the province is covered as a province, and we do not say that cholera has travelled here or has travelled there within the province, because we know that to say so is to make use of an expression which is essentially incorrect. When, in 1867, for example, we find cholera at Mooltan in May and at Meerut in September, we know both to be one and the same cholera, but we do not say that cholera travelled from Mooltan to Meerut. And yet this is exactly what has been done with regard to the cholera of 1845; and the cholera of Sukkur and Ferozepore is asserted to have marched against the monsoon until it reached successively Umballa and Meerut. The fact of cholera having in November 1866 passed over Agra almost as an aura, and occiipied the province over which it was so powerfully redeveloped in the spring and monsoon of 1867, and of Agra 'aving been nearly exempted in 1867, when every station and district to the north and north-west was covered, is quite an illustration in point. It is this limitation in distribution, due to the absence of influences which carry on an invading cholera, which I have spoken of as an ideal wall against which cholera is thrown, and behind which it falls thick in consequence of repression in space ; when the wall is absent the chances of localisation are comparatively small, for the miasm becomes diffusely spread in place of being precipitated in tWhy did cholera appear first at Sukkur before appearing in Rohilcund and the east of the njab ? Note, that it was on the 15th June in 1845 that this Scinde cholera broke out, and it it was on the evening of the 14th June in 1846 that the Scinde cholera of Kurrachee de its outburst, and the reason becomes apparent. It was because this station lay within ! province of the south-west monsoon proper, under monsoon influences which do not reach to ) Punjab stations ; it was, as usual, in the first week of July, and under monsoon influences m the east, that the general provincial manifestation in Meerut, Rohilcund, and the Punjab yan to show itself. I This is the explanation which I give of this great cholera, and I believe it to be the correct c, namely, that the history of this period comprehends the facts of two distinct epidemics — c one, invading in 1841 and dead in 1844, having its maximum in the epidemic area in 1843 ; c other, commencing its invasion in 1844 and dying out in 1847, known generally as the eat cholera of the years 1845 and 1846. Granting that the explanation is incorrect, the bernative does not lie in accepting as a fact the march of this cholera from Cabul to Meerut ; ) one holding generalisations founded on the history of cholera as an epidemic in India can tbscribe to such a theory, and generalisations based on the assumption of this as a fact must ' necessity be valueless. The alternative lies in conceiving the invading cholera of 1843 to bye been repressed from powerful manifestation during 1844, and to have revived in force with c altered meteorology of 1845; to have been, in fact, a powerful third year cholera, such as c history of our time shows 1858 and 1862 to have been in the same province; and as Uowing the Agra epidemic of 1843, as the cholera of these years followed the Agra cholera 1856 and 1860. It is also right that I should remark that there is a great want of stematised informrvi ion regarding the medical history of these years, and beyond the mere atistical data no explanations are given in the returns. The period between the death of the epidemic of 1846 and the appearance of the 6 and 7 Cholera of IP 'B-54 great epidemic of 1856 had also apparently two epidemics included within it. I The end of the epidemic period was in 1854, when the province of the south-west monsoon oper was co\ Invading epidemic of 1856-57. 1857 459 165 306 363 249 302 157 86 32 31 18 13 2,181 J 1858 19 9 8 15 11 9 5 8 11 6 7 7 115 1 859 9 10 9 7 69 843 329 170 41 85 131 282 1,985 Invading epidemic of 1859. 1860 289 332 396 321 163 107 89 128 51 47 29 9 1,961 1861 15 18 5 4 12 18 13 10 11 34 35 466 641 1^62 625 240 339 260 367 218 117 95 161 272 201 269 3,161 1883 189 60 89 161 153 161 412 240 178 181 176 319 2,309 ¦> > Invading epidemic of 1863-64. 186* 622 401 302 680 837 395 371 351 232 88 137 431 4,847 J 1865 363 640 522 356 624 206 116 62 31 32 22 13 2,887 This table shows that only once in these eighteen years has invading cholera struck Bombay in the monsoon season. It is in the spring months, or after the close of the monsoon, that our epidemics from the east appear, and it is possible that the invasion of 1849 may have been no exception. The fact of the constant sequence of these epidemics to invasions from the east forbids us to attribute their appearance to the local growth under favoring conditions of a cholera endemic in Bombay. Such increase and decrease does occur, but only as a phenomenon secondary to that of invasion. The invading epidemic of May and June 1854, like that of May 1846, is illustrative of „, , „,, . „,, ? the distribution of a cholera confined within the limits of the Cholera or the province or the south- ? . - XT ?, ? ? . west monsoon proper of 1854 south -western province. JN either at the time of invasion nor afterwards did this cholera pass into the Gwalior territories in its advance from the south-west. While Bhopal, Western Malwa, Nimar, and other districts bordering on the Nerbudda were covered within a few weeks, no advance was made beyond the epidemic line towards the north-west. To illustrate this, I show here the distribution of the 10,000 men composing the corps of Central India in June 1854, geographically divided, noting the stations affected and those which remained unaffected in this advance : — Native Corps of Central India, June 1854. Stations unaffected. j Stations affected. Gwalior, strength ... ... 3,570 Boorhanpore, strength ... ... 238 Augur ... , 983 Mundlaisir 527 Seepree 901 Bhopal 1,050 Goonah 100 Sirdarpore 383 Lullutpore 670 Mehidpore 1,568 The Cholera Table for the jail population for the same year shows that Neemuch Jail suffered in common with the jails of Mundlaisir and Hoshungabad. IThe universality of this cholera is what is chiefly worthy of notice, and also its connexion t • c 1D » c i.v. n *• with the cholera of the preceding year. I think that there can lemic of 1853 or the Uangetic , iij.i'j.i^j.j.-ljj.'lj pii r-n i iceg be no doubt of the fact, that a great body of cholera followed up the cholera of 1848-49 in 1853. In May, it swept up the valley of the Ganges, and struck Cawnpore on the 20th. This invasion initiated the terrible cholera of the 70th ltegiment, of June, July, and August, in which 183 men were lost; but in May the premonitory cholera lasted four days only and cut off only four men. The same cholera had attacked the 29th Regiment at Dinapore on 6th May ; but here also this May outbreak was of secondary importance to the monsoon manifestation of this cholera wave. Few bodies of cholera have given greater evidence of universality and power than this Gangetic cholera of July and August 1853. I find it noted, that in Chunar twenty to 115 thirty deaths occurred daily ; and it is supposed that 1,000 persons died out of a population of 12,000. The invasion and revitalisation of July is beautifully shown in the statistics of the jail population. What is well worthy of notice is, the apparent aura of March and April, universally displayed without the occurrence of almost a single death, and the deadly revitalisation of July, which did not spare a single jail between Hazareebaugh and Cawnpore. Admissions and Deaths from Cholera in each month of 1853. ¦ ===- Jail Stations. ff § A . % % % % liIItI i i I I I I . _ Ranchee ... ? ... 3-0 1-0 Hazareebaugh ... 1-1 2-0 28-13 0-1 Monghyr 1-0 2-0 ... 10-1 1-0 1-0 Bhaugulpore 2-0 1-0 8-2 20-13 ... 52-19 1-2 Purneab. 3-0 3-1 1-0 ... ... 1-1 Gyah 1-0 5-1 2-0 1-0 3-1 47-16 18-11 2-3 Patna 5-1 2-0 5-3 ... 1-0 3-0 1-0 Deegah 2-1 6-0 4-1 6-2 5-1 131-42 4-5 4-3 6-5 Arrah 2-0 8-0 ... 2-1 84-24 Chumparun ' ... 2-0 10-2 18-14 2-0 0-1 3-0 Mozufferpore 1-0 4-0 1-0 6-1 26-6 12-1 0-1 Chuprah 2-0 3-0 10-2 10-1 73-24 27-13 Ghazeepore 1-0 6-0 4-0 ... 2-0 18-2 1-1 Benares 2-0 1-0 38-13 2-1 4-5 1-0 Mirzapore 1-0 ... 2-2 ... 2-0 1-0 2-1 Azimghur ... ... 2-0 3-1 3-1 2-1 Jounpore 1-0 ... 1-1 6-2 22-9 Goruckpore 2-0 2-0 0-0 18-10 46-19 1-3 2-1 2-1 1-0 Allahabad 3-1 2-0 3-0 33-13 2-0 1-0 ".Futtehpore ... ... ... ... ... ... 5-1 Cawnpore 5-0 1-0 16-3 2-0 1-0 ... 1-0 Tuttehgliur Banda ... 3-0 ... ... Oraie Humeerpore ... ... ... ... ... ... 1-0 ... ... ... ... Etawab. Saugor ... ... ... ... ... ... ... ... ... 1-1 1-0 Dumoh ... ... ... ... 2-1 Nursingpore ... ... ... ... ... ... ... 1-1 Hoshungabad Baitool Seonee Jubbulpore ... ... 1-0 No sooner is the monsoon at an end than we find this same cholera on its journey on the southern highway. The cases of Dumoh and Nursingpore of September give evidence of the passing on towards Bombay of the cholera which reached the city of Bombay in October. Thus in one year we connect on the cholera of Bombay with the endemic cholera of Bengal.* It was this cholera which in the spring of 1854 became the cholera of Malwa, of which I have indicated the epidemic spread, just as at present, while this paper is passing through the press, the invading Bombay cholera of October 1868 has shown itself epidemically throughout the same province. Nothing of this epidemic is found in the western division of the epidemic area of our Presidency either in 1853 or in 1854. It was powerfully reproduced in the Gangetic Provinces in 1854, but the invading materies was lost, diverted as in the case of the epidemic of 1863-65, to constitute the very body of the cholera which we trace going to the south and west, and which we shall further trace as the European cholera of 1854-55. We have now to look to the epidemic which immediately preceded this. This cholera invaded Bombay apparently in the end of August 1849, and became in the same year an epidemic of minor intensity in Epidemic of 1849-52. Madras. This epidemic I regard as the cholera of the invasion of 1 848, from which the Ist Fusiliers suffered so severely at Cawnpore. On the 12th May 1849 (the identical day on which the cholera of 1866 reappeared in 1867), a great outbreak commenced in the Banda Jail, in which forty-two prisoners were lost. Next, this cholera appears universal on the southern highway in * The invading October cholera of Bombay of 1868 I have traced commencing its march early in 1868, through Mundla, Seonee, and Jubbulpore, halting until the end of the monsoon, and then resuming its course westward and reaching Bombay on 15th October. 116 Chap- Vl.] THE CHOLERA OF 1850 ON THE SOUTHERN EPIDEMIC HIGHWAY. 117 June and July, ready for the next epidemic leap, in which Bombay was reached. The fact and date of invasion is thus shown in the case of the jail population of these provinces :—: — Admissions and Deaths of the Jails of Gawnpore and Sangor, 1849. & Si ** ** Stations. f"> fe . -° v -° Ja I I 4 d • d • 1 l^sa lIIIII# = §• I = s Allahabad 31-7 60-19 13-10 5-1 1-0 Futtehpore ... ... ... ... ... Mt | Cawnpore 1-0 ... 6-2 8-4 5-4 Futtehghur ... 12th to 31st Banda 23-12 63-26 4-2 1-1 1-1 Humeerpore ... 1-0 1-0 ... 1-0 Jubbulpore ... 1-0 26-13 30-16 Saiigor ... 7-4 16-11 2-2 Nursingpore ... ... ... 53-38 ... ... Mundlaisir ... ... ... ... ... ... 1-1 Another reason that induces me to consider this a cholera reproduced from the invasion of 1848 is, that 1849 in the valley of the Ganges below Allahabad, was a year in which very little cholera appeared. In fact, of the whole of the jails of Benares and Behar, Bhaugulpore and Tirhoot alone suffered, and scarcely a single death is reported out of the remaining- sixteen jails. In 1850 this cholera is found in full epidemic force in the south. But on the northern epidemic route this was but a feeble although a distinctly c idemiTroute 185 ° On epidemic cholera. The cholera of 1849 was, in fact, as in epi emic rou e. 1837 and 1860, repressed from the northern provinces during 10. In the report of the year from the Meerut Division we read : — "No particular epidemics reported in any of the civil districts of the Meerut Circle." As in 1860 ( mark the parallel ), rgaon is the last station at which cholera invading 1 from the east or south-east is met with. Jail Return of 1850 gives seven cases and two deaths. Next it is found at Muttra : — ¦ lolera made its appearance at Muttra about the middle of August, but was confined eipally to the city and sudder bazaar ; in both places the mortality was considerable, disease began to decline in October and disappeared entirely in November." Dr. Murray, in his report on the Agra epidemic of 1851, states that cholera was very general towards the end of the hot season of 1850 in Gwalior, and that it extended during the rains as far as to the banks of the Chumbul. At the same time, this cholera appears as far west as Ajmere, our index station, on the same route. In the jail twelve cases and four deaths occurred. In the report it is stated that these occurred in September towards the close of the monsoon. This cholera hung about the Agra District also up to the close of the year. The Death Rolls of the Agra Jail show a death on each of the following days, — 2nd, 4th, and 30th October, 13th November, and 9th and llth December. Dr. Murray says that the cold season of 1850-51 was cloudy and wet, with very little truly cold weather. But this, although a true and typically marked invasion, was not a great cholera in the North- West ; and the meteorology of the year, as in 1837 and 1860, was sufficient to account for the phenomenon of limitation in geographical distribution and of repression in intensity of manifestation. Writing from Meerut, the Surgeon of H. M/s 18th Regiment states in his Annual Report : — " The year was exceedingly unseasonable. The hot winds blew fiercely until the end of July without the temporary alleviation incident on the storms usual at that period of the year ; and even when the rains set in they were scanty, the hot winds prevailing to a greater or less extent up to the end of September." On the southern epidemic route the cholera of 1850 was powerfully revived. The following quotations from jail reports illustrate this :—: — 1850, Baiiool. — "Throughout almost the whole of the hot and rainy seasons cholera prevailed in the district ; it did not, however, attack the Cholera of 1850 on the southern j a y un^l J u } y w h en seven eases occurred." epidemic route. J J Seonee. — " The jail mortality has been principally occasioned by cholera, by which twenty-two men were attacked. The cholera has not appeared, lam given to understand, in this district for five or six years, till it in this last year devastated the villages in the surrounding country. It seemed to appear at the same time in all parts of the district, and subsided as suddenly without any particular progress." Jubhulpore. — " Cholera first appeared on the 7th June in the gang of prisoners at work at Moorwarrah, fifty-seven miles east of Jubbulpore. Thirty-two cases and seventeen deaths occurred. In June two cases occurred in the jail hospital, and in July seven. In August it raged with the greatest violence." Thirty cases and twenty deaths occurred in the Jubbulpore Jail. In the same year this cholera covered the west of India ; it is found invading Malwa, and as far west as Surat, Baroda, Deesa, and Kurrachee. It reappeared here again in 1851, 1852, and 1853. The following paragraph from a report by the Civil Surgeon of Nimar, dated Ist September 851, shows the provincial distribution in the south-west with the monsoon of that year. He writes :—": — " Cholera first broke out in the southern part of the province bordering on Khandeish, where is situated the large city of Boorhanpore. Then it continued extending in the direction f the Nerbudda, and spreading forth east and west. It has not concentrated its virulence within a limit. Villages in the interior as well as those on each bank of the river have been qually attacked ; nor has the Vindhya range proved a barrier to the progress of the disease, s the cantoniqpeat of Mhow and the city of Indore have not escaped." This is the parent of the cholera of Persia and Europe of 1851-54. It was in July 1851 that cholera began to spread along the Persian Gulf, and within K Cholera of these epidemics beyond tnree mon ths the whole of the south of Persia was occupied, c limits of Hmdostan. mi • ii t> : t-_i ~r toki _j icko t>,,4- „,„„;¦», This was the Persian cholera of 1851 and 1852. But again, tolera appeared in the very month in which I have shown Bombay to have become reaffected our Gangetic cholera of the same year, namely, October 1853. In the report of the Constantinople Conference we read (Indian edition, p. 318) : — "On the 19th October 1853, the Inspector announced that cholera had reached Bassorah, imported vid Mohammerah. The troops of the Shah ravaged by cholera spread themselves, and disseminated the disease throughout Persia.* On the 18th November it passed from Persia vid Bassorah to Bagdad." This, our Gangetic cholera of 1853, is, as I reckon it, the cholera which appeared in the Black Sea on 16th July 1854, and on the 21st July at Varna. I The cholera of 1851, derived from our epidemic of Northern India of 1850, had appeared Warsaw in July 1852, and in St. Petersburg in October. Mr. Grainger' s report gives the •eer in Eastern Europe, up to September 1852, of this cholera, regarding it, and with truth, the same which in the summer of 1853 made its appearance in England. I regard the imean cholera of 1854-55 as a cholera different from this, and belonging to the epidemic ;ceeding that of Northern Europe of 1852-53. This was the great cholera of Arabia, which lgrave mentions as traditionally remembered, and the same from which Persia became affected October 1853. In May 1851, as on the occasion of all former and subsequent epidemics, we find the cholera of 1850 revitalized west of Agra and south of the Bholera of 1851-52 in Northern j umna . j) V Murray notices its prevalence at Banda, Hattras, •*• __J All 1 T>— J. li. J. J.:i .J.l~_ «i" ICCI and Allyghur. But it was not until the monsoon of 1851 that this same cholera entered Meerut, Rohilcund, and the Punjab. It was on the 25th July that the great cholera of the Agra Jail appeared, in which 254 prisoners were attacked, of whom seventy-three died. In August, Lahore is reported to be suffering from fever and cholera, the deaths being estimated at from forty to fifty a day, and in the end of the year we find it raging in the Terai. The Sub-Assistant Surgeon, who was deputed to Kaladoongee to look after those attacked, reports that between 25th December and 21st January he treated 128 cases, of which seventy-one were fatal. This was followed, as usual, in April and May of the year following, 1852, by a general outbreak over Kumaon, when Deyrah and Almorah also suffered ; and the last we hear of the epidemic is the great outbreak of sth September 1852 at Umballa, in which seventy-three European soldiers were carried off out of 147 affected by the cholera. At the same time the Goorkha Regiment at Deyrah suffered severely. But in no other station of Meerut or the Punjab except in Umballa and Deyrah was this cholera of 1850-52 felt ; individual cases of cholera only appear in the returns. I believe that the strength of the epidemic in these provinces was broken by the repression of 1850. For four years after 1852, Northern India remained free from cholera, until the invasion of the epidemic of 1856. This, probably the greatest of all our I^S-^^^T" Indian epidemics, owed its greatness perhaps to its geographical eof 1856 in Northern India. . 1 ? ,, ' . ,¦ ° . ? r .r,. r , ,i ,i repression. Although a true invading epidemic in the south, limb was weak m comparison to that invading to the north, and it was not until •S that it reached Aden. In October 1858, and for some months afterwards, cholera mitted great ravages amongst the population on both shores of the Red Sea.f It prevailed lie same month in the Persian Gulf. In 1857, this cholera was general from Jubbulpore iombay, as well as throughout our North-Western Provinces. The following extracts from Annual Stational Reports relate to the new epidemic of 1860, traversing the southern epidemic route :—: — IRaepore. — " Epidemic cholera visited the station after a lapse of four years. The first Cholera of the early months of admission of this station was on the 22nd March, a sepoy who 1860. Invasion on the southern epi- was on guard ; the next a prisoner. After this, cholera spread demic route. o^mnH-aT^^clUr k^l, ±\,~ +™ m nn J ™?;™™± n *A +?r Q r,+ ,r +,> simultaneously both in the town and regiment, and twenty to * This is the theory of the writer. t Report on the Army of India, Station Aden, Vol. 11, p. 851. 118 Chap- Vl.] THE CHOLERA OP 1863-65 IN UPPER INDIA AND ON THE SOUTHERN HIGHWAY. 119 thirty died daily, while it was at its worst in April and May. The last admission was in the city hospital on the 18th August. The disease appears to have travelled to us from Nag-pore, as it occurred there some time previous." Chanda. — The date of the appearance of cholera at this station is not given. v Cholera tt r ailed in the jail from sth to 17th May, when the disease was committing great ravages in city. It continued to prevail in the city for months after its disappearance from the iail." INagjiore. — " Cholera prevailed epidemically first in the city, and afterwards, it attacked the ners. The first case was admitted on the Ist March, and the last on the 35th July, but no were admitted in May." Chindwarra. — " On the 28th February I saw the first case of cholera." IHoshungabad. — " Epidemic cholera made its appearance in the district in March, but only cases occurred in the jail." BNursingpore. — " The Nursingpore Jail was exempted from any epidemic during the year, cholera was rife in the district during April, May, and June." IBaitool. — " The district of Baitool is said to have suffered severely from cholera during months of May, June, and July." Nimar. — "Cholera made its appearance in the month of March (6th March) . After this month there were only two cases of cholera in the jail, although it still existed in the dis- Above the Yindhja — Sehore. — " Cholera prevailed in Sehore, although the prisoners enjoyed complete immunity from the disease. It commenced about the 15th June and continued until September. Cholera is stated to appear here generally about the end of March or in April ; the Vecent attack was therefore at an unusual season." »Saiigor. — " Cholera made its appearance among the people soon after the first fall of rain, i the 6th to the 9th June, and lasted during the monsoon, gradually disappearing towards end of August." tMundla. — " Cholera appeared in the city of Mundla in May last, and continued until the of July." If this district was crossed by epidemic cholera in 1859, when our eastern emic province was covered, our returne give no clue to the invasion. It may have occurred srtheless, for it is remarkable to note the great outbreak in Bombay city coincident with the sion of the Gangetic Provinces. tThis was the cholera that reached Persia in the beginning of November, which is thus ed in the report of the Constantinople Conference (p. 313) :—": — " Towards the terminaof the year 1860 cholera came into the country with the Persian troops returning Turkistan, and in its rapid march it invaded Turkey." I need not trace again this epidemic in the successive stages of its career up to its death in November 186.2. I have already shown that this epidemic and its predecessor of 1856-58, were strictly moulded upon the type of the cholera of 1817-20, and were strictly parallel one with the other. The epidemic of 1863-65 claims greater attention, as having illustrated to us in our time the method and course of invasion from the Bay of Bengal to Eastern Africa. 10. Epidemic of 1863-65. IWe can trace it back to the week of its exit from the endemic province. The Jail le for 1863 tells the whole story of invasion with absolute precision. It shows cholera rming up the Ganges Valley in the east, and covering the Behar Provinces, in which we told not a village of any note escaped. It is in March that invasion commences ; the spring era struck Agra on 20th May, and the entire eastern province was covered within those iths. Next mark the revitalisation of July, and the east of our Presidency covered by an •mous body of cholera, universal from Agra to Hazareebaugh, not sparing one station of the iral province. Oude also is occupied throughout. Agra was the station furthest to the west 3h was touched ; not a case of cholera is seen in Rohilcund, Meerut, or the Punjab in 1863. I The commencement of the epidemic journey to Africa and Europe also appears in this ;. It took place along the southern epidemic highway. Mark ¦ carefully the geography he jails affected in June in the Central Provinces, and it will be seen that those alone were ted which are apt to come within the influence of our monsoon from the Bay of Bengal, — >ore, Bandhara, Seonee, Jubbulpore, and Mundla, the cluster of five jails occupying the east north-east of the Nagpore Province and immediately adjoining to Chota Nagpore and endemic province.* It was in September, October, and November that the Nagjwre Jail red, and this cholera marched onwards to the west after waiting for the conclusion of the soon. This I regard as the cholera which reached the city of Bombay in December 1863, which cut off upwards of 3,000 persons between this month and May following. (The history of the same cholera revitalised in 1864 is also perfectly marked. Powerful universal over the area in the east invaded in 1863, it was at the same time as powerfully ;ssed by the meteorology of this non-epidemic season, the character of which I have ihed in the previous chapter. Cholera struggled to attack the Europeans in Lucknow, npore, Allahabad, and Benares, and happily succeeded to but a small extent ; and it obtained iting in six jails only of the province. Its epidemic advance in 1864 was not promoted by V* This was a true invasion, for not a case of cholera appears iv these jails until the common outburst with the )on, which sets in earlier in the south, and which is the equivalent of the same meteorology which revitalised iv the great body of cholera spread between Nagpore aud Oude. THE STARTING POINT OF THE CHOLERA OF EUROPE OF 18G5-66. [Section I 120 a mile, for cholera was dead, as in 1868, over the western division of the epidemic area in our Presidency. Throughout the Punjab, Western Rohilcund, Meerut, Agra, and Central India, to a clear bounding limit of the natural cholera province of the south-west monsoon proper, cholera had no existence in 1864, unless the three cases below referred to be regarded as true forerunners of the cholera invading in May 1865.* Before tracing the cholera of 1864 and 1865 in the south, I shall finish what I have to say of the cholera of 1865 in the North- Western Provinces. In the eastern area the fact of the continued prevalence of the cholera is clear enough from the figures shown in the tables of the year. Finding the persistence of cholera in the south-east also, I feared that the western division f the epidemic area would not escape invasion in 1865. In anticipation of this, I addressed lie Sanitary Commissioner, not knowing at the time that what I anticipated had actually ccurred, and that the persistence of the cholera in the south-east in 1865, had been followed »y the invasion of the Northern Provinces. Speaking of the cholera of the early months of 865, I wrote : — " Cholera has reappeared also in the jail of Nagpore (where it has been present from MaKch to June), in Chanda, Belaspore, Bandhara, and Seonee. Jubbulpore Jail las also been threatened, and to-day the death of a woman of Her Majesty's 91st is reported, am inclined to regard the fact of the appearance of cholera in so many jails with f reat suspicion, for I have held, and feel inclined to hold, that, under the circumstances, we may ook for its progress north and west. Happily this is a cholera in its third year of invasion, nd, should we suffer, next year should see the end of the invasion, unless it be supplemented lew. There is another circumstance favourable to us, viz., that however powerful the )idemic may be when pursuing a normal progress to the west, as this cholera has done and is oing, the offshoot which may have come into the highway leading to our Presidency may be mt a feeble one, and may possibly be dissipated before reaching so far on its journey northward. _owever, I give you my impressions and Ido not hesitate to do so ; and I make my assertions ithout insisting upon their truth dogmatically." The anticipations contained in this letter were precisely realised. Between the 12th May and the end of the month a sparse body of cholera was thrown over the western area, even into the hills, striking Kussowlie, Dugshaie, and Deyrah. Writing of these sparse cases, I addressed the Sanitary Commissioner thus :—": — " In regard to the renewal of cholera subsequent to invasion, I have stated that I consider universality of distribution rather than the strength of individual Itbreaks a criterion of the seriousness of an invading cholera. But the cases VIV I wrote about sterday seem of so thoroughly sporadic a nature that I doubt the power of the cholera which s already invaded to do much mischief; at the same time if cases do occur shortly, in which i cannot trace distinct continuity with the cholera of the Agra and Morar Districts now in Jgress, we shall at least recognise their origin, and regard their occurrence as no mystery." c more powerful body of the same invasion came only as far north as to Etawah, ansi, Agra, and Morar, where it became the cholera of June, July, and August 1865. This ilera was, as I reckoned it would be, dead in 1866. This May cholera of 1865, for the first time since the exit of the epidemic from within 3 endemic area invading our Northern Provinces, was the very cholera which was at the ne time cutting off the Mhow Artillery Detachment below the Simrole Ghat in Khandeish i the pilgrims at Mecca, and which was ravaging the highlands of Abyssinia. I have traced it beginning its journey on the southern epidemic highway in June a 3 ; the journey was continued in the following stages :—: — The revitalisation in the spring of 1864 showed the epidemic belt covered with cholera m sea to sea. The Bombay Gazette, in its overland summary of the 28th March 1864, states :—: — " The provinces of Central and Western India are suffering from the effects of an outbreak of cholera almost as deadly and widespread as that which, three years ago, ravaged Hindostan. Letters from most parts of the Bombay Presidency and adjacent territories give sickening accounts of the desolation which this fearful pestilence has made in the land. In Berar and Khandeish the people are dying by the hundreds every day. From Surat we hear hardly less sad a tale ; and although Bombay itself is still comparatively free from cholera, the districts of the Southern Concan have been stricken as heavily as Guzerat." mi . „ _ v tThe monsoon manifestation of this cholera was worse than that of the spring ; and re the end of the year this same cholera was prevailing in Arabia. We know the exact limits of this cholera of 1864 ; it was the curved line which bounds cholera province of the south-west. As I have shown, we had not a trace of this cholera Northern India in 1864. The limit was reached about twenty miles north and east of Saugor, and this limit was not overstepped by human intercourse. And from this point westward to the sea and southward to Berar and Khandeish no spot escaped ; Nursingpore, Nimar, Saugor to the west, Bhopal, Malwa, and Guzerat, suffered equally. In our printed returns three deaths, attributed to cholera, are shown over this area in 1864. A prisoner died in linballa Jail with symptoms much resembling those of cholera; a Sergeant of au European Regiment died at Meean Meer in collapse after attending an entertainment ; and a death of a sepoy is noted at Uinritsur in December, an unusual month for the occurrence of cholera in the Punjab. It may be doubted whether any of these three cases was a This universally distributed cholera was ready for reproduction in the spring of 1865, in the more favourable localities in February, March, and April, and in the later localities in April and May; and it came forward throughout the entire area covered in 1864 as an epidemic within the area. It became the cholera of the early months of 1865 of Kattywar, Scinde, Arabia, I Eastern Africa. In Guzerat, in the beginning 1 of 1865, it was exceedingly virulent; in ich so much so that the Courts were closed for the time. Colonel Keatinge writes to me l Kattywar in June 1865 : — " There is much cholera in the south-east of the province, •c was a fearful outbreak at the close of a great concourse of pilgrims at the Paleetana Hill le cold weather, and it has lingered ever since." Our invalids and time-expired men i the Punjab who went down the Indus, met this cholera as soon as they arrived at rachee in the early months of 1865. It was by this cholera that in May 1865, the Mhow llery Detachment was cut off in Khandeish. In the introduction to the " Deaths of ras" for 1864, it is mentioned, that in these months of 1865 the high road leading from pore to the terminus of the Bombay Railway had been literally a valley of death. The following are extracts from this report : — t" During the past year (1864) and the present (1865), two fearful epidemics have taken 1 origin from the same spot.* The troops in Nagpore have suffered on both occasions, ana, highroad between the terminus of the Railway and Nagpore has been literally a valley of l for months together. Officers, their families, and Native travellers innumerable have l victims in attempting to pass it." »" In another direction, cholera has passed down the valleys of the rivers leading into the avery. It attacked the coolies employed in the works in connexion with that river, so that whole camp became for a time demoralised. At one station the deaths had numbered 828, many coolies had deserted and returned to their homes." That this was truly a reproduced cholera is shown by the account which Dr. Thompson, of Bhopal, gives of its reappearance in the spring of 1865. As in our Northern Provinces, the date of the first reproduction here of a cholera which has made its invasion in the previous year, is about the 20th April. It is quite evident that, throughout the Bhopal territories, this cholera was generally reproduced at this date because it was lying latent from the cholera of L 864, and came forward when the climatic conditions suited its revival. He writes : — "The disease did not seem, as in former outbreaks, to pursue a particular direction, or to be confined to towns situated near the high road. In former outbreaks, occurring during the past ten years, the disease has always pursued the same course. It has been heard of in Khandeish and Nimar, gradually travelling along from Boorhanpore, Burwai, and Simrole to Indore ; it then shows itself at Sehore, and pursues its course in an easterly direction. f But this year only two cases entered the station from that direction, and they came in August after the disease had been prevailing for months in Sehore/' He adds, that the Natives all agree that the cholera of 1865 was the most severe and the longest continued ever known. BThe Native Regiments of the Central India Force attached to this Presidency, lost v-nine men. This force is distributed in many out-posts, and very few escaped a visitaof cholera in 1865. All of these facts are shown in the tables for these years; they give c indication of the distribution of this great southern epidemic. We are told .that Persia preserved herself in 1865 against this cholera by closing her chief ports against arrivals from the Arabian Coast. Had the cholera of 1863-64 occupied the northern in place of the southern highway, we know how futile any measures of quarantine would have proved. It is probable that the body of the cholera of 1864-65 passed altogether to the south of Persia, as it reached very far to the south on the east coast of Africa. ¦ There was no escape for Persia in 1867-68 when our northern provinces suffered. By 28th August 1867 our Indian cholera of May was raging in Teheran. % In the next chapter I shall show the relations of the epidemic of 1866-68 (No. 11). The one feature of this epidemic is the exemption of the southern epidemic highway in 1867, apparently consequent on the transfer in October 1866 into Northern India of the cholera which would normally have commenced to enter it in March 1867, and its re-occupation in the spring of 1868, by a body of cholera which reached Bombay in October after the close of the monsoon, and in November and December has given evidence of having extended into Khandeish and Malwa. Even in this rapid sketch, touching merely the more readily tangible features of so many different epidemics, the grand truths parallel throughout these fifty years force themselves into notice. Sometimes they are easily read ; sometimes the parallels are read with difficulty ; but that the harmony is perfect is not to be doubted. It is our misinterpretation or ignorance of the facts which alone introduces discord. The laws of control and repression are but part of the harmony ; and when we cannot follow out what we imagine to be the natural course of events, we may be sure that there is a good reason for what is obscure to us. That the present method of investigating the means and routes by which Europe is invaded from India is erroneous, we, studying cholera in India as an air-conveyed miasm, cannot but * The temple of Mahadeo. This is a theory of the writer. t Covering the natural province from the south and south-west. * The Bombay Gazette states, that cholera of the most virulent type, is reported to have broken out at Teheran In three days 150 deaths took place, and the cases averaged 80 per diem. This intelligence came in a telegram via Bagdad, dated from Teheran, August 28th. 2 H 121 POINTS IN THE NATURAL HISTORY OF THE EPIDEMIC REQUIRING TO BE INV tSTIOATtD. LooCtlOu 1 122 conclude. The different routes — through Central Africa, through Arabia and Egypt, through Syria and Asia Minor, and through the provinces of Russia, seem each to be specially selected by different epidemics, and as long as the theory is held to, as conveying the whole truth, that cholera is continuously spread to Europe by transmission from man to man, so long will the o-rand and fundamental laws of diffusion and control be overlooked and unappreciated, and disappointment result when epidemics advance unchecked and unmitigated. Since the progress of the cholera of Hindostan is now carefully watched and recorded, lere need be no difficulty in tracing to their base of departure the epidemics which shall in uture years leave this country. We shall watch for them on both the northern and southern lighways, and especially at their gates of exit ; and we shall note the age of the cholera at its ate of departure, in order to ascertain whether the delay of a year or of two years, determines the earlier death of the epidemic invading beyond Hindostan. To those watching for le arrival of the invading cholera in countries foreign to it, I would recommend that less itention be paid to the observation of isolated cases thrown forward in anticipation ' the coming cholera; or, at least, that the occurrence of these shall not be allowed to ivert the observer from the true object of his research, — the actual date of the coming of the r-conveyed epidemic which is to be studied, the meteorology attending its advent, the terval between successive epidemic leaps, and the natural phenomena of dormancy and vitalisation normal for natural provinces which, although less marked than with us, no doubt xist as well in the West as in the East. It is evident that on every occasion of renewed epidemic exit from the endemic area the invasion of countries beyond India is to be looked for. If it does not occur, this is the exception and not the rule. The causes which extend the distribution of cholera in space extend it, apparently, in time also. For I think it is certain that once the epidemic barrier caused by the African, Arabian, and Syrian deserts is passed, Eastern Europe affords facilities for the extensive revitalisation of cholera quite as great as those of the provinces of Upper India. A definite record is required, to show with what meteorology and at what seasons, Eastern Africa, Arabia, and Persia are covered ; the dates normal for invasion, as fixed by the parallels of different epidemics ; and the limits of distribution, especially whether the meteorology attending invasion is capable of carrying and does carry the miasm over the desert tracts into the well watered countries of Eastern and Southern Europe. I cannot conceive that a cholera, such as that of 1866-68, destined to die in 1869 in Upper India, should, from the mere fact of its exit from Hindostan on the southern epidemic highway, renew its vitality in countries beyond. The opportunity was lost to it, when, in October 1866, it was turned aside from the southern into the northern epidemic highway. This northern limb has played its part in Cabul in 1867, and in Persia in 1867 and 1868, and if this epidemic is to reach Europe at all it must be through Northern Persia. The body of this cholera covered in its exit the whole of the Behar Provinces in the first week of July 1866; it was in the week ending the 15th October 1868 that cholera struck Bombay on the occasion of its reentering and reoccupying the province of the south-western monsoon proper. If this invading cholera belonged to the epidemic emanation of 1866, then two years and four months were occupied in crossing from the brim of our endemic basin to the western coast ; and I can scarcely think, favourable although the track traversed in 1868 by this cholera certainly is, not only for the passage, but also for the propagation of the cholera miasm, that its vitality shall be so renewed and its volume increased, as to adapt it to become the pabulum of an epidemic invading Arabia and Egypt. It is possible that it may be heard of, like the cholera of 1858, the fourth -year cholera of the epidemic of 1855, as a cholera confined to, and ending in, Southern Arabia and Eastern Africa.* very fact of the constant mixing up one with the other of the different epidemics India and Europe shows how rapidly the succeeding epidemic follows up its predecessor rond as well as in Hindostan ; but I think there will in future be no insuperable difficulty fixing the base whence a body of invading cholera originating in India has departed. >* After a review of further facts observed since this was written, I now recognise that the cholera reoccupying southern epidemic belt, which reached Bombay in October, was not a portion of the epidemic invading in 186G, the cholera of a fresh emanation from the endemic area in the spring of 1868. CHAPTER VII. THE CHOLERA OP THE EPIDEMIC AREA OP 1866-69. It was evident that with the monsoon of 1866, a new invading epidemic, in succession ¦hat of 1863, had made its exit from the endemic area and was threatening to cover the lemic area in the east. LThe year 1866 was the fourth year following 1863 ; and, therefore, in accordance with the inrnm of manifestation preceding parallels of 1858-59 and 1862-63, a minimum or the extinc- Invasion of the new epidemic of tion of cholera over Upper India was to be anticipated. Putting aside the part played by the newly invading cholera ;he year, this minimum was thus represented in our types in 1866 : — A. Prisoners. — A daily average of 13,529 prisoners in the jails of Benares, Oude, and Cawnpore gave during the year five admissions and one death. A daily average of 9,695 prisoners in the jails of Central India,* Agra, Meerut, and Rohilcund gave two admissions and one death. A daily average of 10,697 prisoners in the jails of the Punjab gave no admissions and no deaths. A daily average of 33,921 prisoners in the Upper Provinces gave seven admissions and two deaths from cholera during 1866. B. Native Army. — There was a local outbreak at Benares in April and May, in which five men died out of eight admitted ; and one man died at Lucknow in June, whose death was attributed to cholera. With these exceptions, the Army of Upper India had no admission nor death from cholera, until the end of October, when it became affected by the new epidemic. C. European Army. — The stations of the Ganges were slightly affected in the monsoon advance of the epidemic. It is perfectly well known that an offshoot of the advancing cholera was thrown over the valley of the Ganges simultaneously with its advance over the Hazareebaugh plateau and the entire occupation of the Behar Provinces. The effects of this offshoot were thus represented among the European Troops : — Cholera admissions of the European Army of the Eastern Division 1866. ¦«—. f , & I | | AdZEiL. SSL Hazareebaugh ... 806 5 12 2 19 13 Benares ... ... 645 3 6 ... 1 10 6 Azimghur ... ... 146 ... ... ... ... ... ••¦ ... ••• Seetapore ... ••• h^>% ... ... ... ... ... ••• ... ... ••< Futtehghur ... 235 1 1 1 Cawnpore ... ••• 813 ... ... ... ... ... ... ... ... ••• ••• Allahabad ... ... 1.020 3 4 1 8 4 There can be no doubt that it was the same invading wave which struck Hazareebaugh, Benares, and Allahabad in July. The Chunar Invalid Garrison was affected at the very same time, and the Civil Surgeons of Buxar and Mirzapore also recognised the advance of this cholera from the east. Into the western division of the epidemic area this cholera did not penetrate before November; and among the European Troops throughout Rohilcund, Meerut, Agra, Central India, and the Punjab no admission from cholera took place up to November out of a daily average strength of 22,403. * Not the Central Provinces. The jails of Nagpore suffered slightly from a cholera which was probably the remains of the great epidemic of 1864-65. B. General Population. — The cholera deaths of the North-Western Provinces were returned as 75,338 in 1865 ; in 1866, the total is 8,167, thus distributed : — Districts South of the Jumna, Eastern Division of the Epidemic Area. Western Division of the Epidemic Area. (Area of minimum). Ghazeepore ... ...1,144* Banda ... ... 58 Agra ... ... ... 105 Benares ... ... 1,534* Humeerpore ... ... 3 Muttra ... ... 82 Azimghur ... ... 342 Jaloun ... ... 66 Mynpoorie ... ... 116 Jounpore ... ... 289 Jhansi ... ... 1 Etawah ... ... 62 Bustee and Goruckpore ... 344 Lullutpore ... ... 23 Etah ... ... ... 86 Shahjehanpore ... 133 Budaon ... ... 127 Bareilly ... ... 369 This minimum followed the very Allyghur ... ... 74 Mirzapore ... ... 661* great epidemic over these districts Bolundshuhur ... ... 144 Allahabad ... ... 325 of 1865, in which 35,968 deaths Moradabad ... ... 252 Futtehpore ... ... 189 were recorded. Meerut ... ... 719 Cawnpore ... ... 235 Mozuffernuggur ... ... 191 Futtehghur ... ... 247 Seharunpore ... ... 126 Bijnore ... ... 87 Dehra Dhoon . . . None. Terai... ... ... 33 This total of the deaths of the North-Western Provinces includes the deaths of the Gangetic Stations due to the fresh invasion of the year. From these statements it is obvious that the epidemic of 1863 was extinct, or nearly so, throughout Upper India. The field was clear over which the progress of a new epidemic was to be watched; and when the cholera of the monsoon of 1866 had in its advance covered Behar and all districts from the Himalayas to the Bay of Bengal, it was a certainty that Upper India could not escape invasion. It is not difficult to trace back this epidemic to its home in the endemic area. Before its exit, its presence as an epidemic within endemic limits was liieI iie epidemic of 1866 in its endemic exhibited in the most exaggerated form. The population c previous to its appearance in the affected was that of famine-stricken Orissa and Chota Nagpore ; and in these districts, for months before epidemic advance Lmenced, every district between Chyebassa and Pooree had been ravaged. In our dispenes alone in South- Western Bengal 2,080 cases of cholera were treated; and this affords ere indication of the fact of the prevalence of cholera as an epidemic. The Police Report a Balasore for March states :—": — " Cholera is doing its work in a terrific way. Were it not for frightful havoc made by cholera, the sufferings from starvation would have been greatly eased, since many have been carried off by cholera instead of being left to combat with t and hunger." f As early as February 1866, the prevalence of cholera and the debilitated state of the inhabitants of Pooree led to the anticipation, that as the season advanced, the epidemic would show itself in an aggravated form ; and on the 21st February, we find the Lieutenant Governor of Bengal calling for a special report on the subject. Even in January, the Collector of Cuttack reported cholera to be unusually prevalent. The view taken by the Commissioners of the relation of this epidemic to the population affected, is not, in my opinion, altogether correct. They write (p. 24 of Famine Report) :—": — " We believe we are correct in saying, that even where there is no epidemic cholera very generally spread, it has constantly happened that the faminestricken have been carried off by that disease or by something presenting similar appearances. *** In the early part of the famine, it was undoubtedly difficult to distinguish between the two causes of death, cholera and starvation, which in fact we find in the early reports to be generally coupled together. The truth we take to be simply this, that the ordinary outbursts of cholera were aggravated and extended by want and bad food. ** * Cholera constantly accompanied want. We have it first in the districts of Southern Pooree, where excessive want first appeared ; then about Pooree itself; and later, in the eastern portions of Cuttack. At Balasore also it appeared at the same time as starvation. It depended very much on the idiosyncrasy of the narrator whether the mortality was ascribed to cholera, or to want, or to both. * * * The presence of cholera seems at any rate to have had a material effect in rendering less palpable the whole effect of want in the early stage of the famine, and it was certainly to a great degree the result of want." What the Commissioners describe is, as I estimate it, increase in the manifestation of cholera in proportion to the susceptibility of the people to succumb to disease. The progress of events showed, however, that the estimate formed of the value of the prevailing cholera, which recognised it only as an aggravation, by the conditions existing in 1865-66, of the cholera which prevails in Orissa in the early part of almost every year, was inadequate. This was, in short, not the cholera of an average annual reproduction, and the aggravation in manifestation was due to the presence of the material of a periodic epidemic — of a cholera destined for epidemic life beyond endemic limits. * The stations reached by the fresh invasion of August 1866. t Report of the famine in Bengal and Orissa, Vol. I, p. 73. 124 The epidemic prevalence of cholera in the south-western districts of Bengal Proper was indicated by the admissions and deaths of the jail population, as follows : Statement showing the epidemic prevalence of cholera in South-Western Bengal in 1866 among the Jail population. +3 &A fc* .a • Jaii Station-. I 1I 1 § i -? j • 1 ! ! H S Total „.. _. . fllJlJriflifll Ad "i"ted. Total Dled - Midnapove . . . ... 814 ... 21 6 I'd 2 42 9-^ Balasore ... ... 56i 22 23 1 33 3 5 2 ... 89 37 Cuttaok ... ... 856 8 6 3 66 36 42 31 4 3 17 216 113 Pooree ... ... 394 14 ... 3 3 1 1 2 2 26 12 These districts suffered twice; first, from the spring reproduction in February and March, and, again, in the monsoon reproduction in June and July. Dr. Bensley, of Midnapore, in the report already quoted, recognises these two distinct outbreaks (See p. 57). The minimum of May is also evident in the above statement. suffered in common with the famine districts of South-Western Bengal, district was covered in March, and cholera continued throughout the year. It was in the monsoon reproduction that the epidemic invasion of this body of cholera . , „ „,, , . was made apparent. In the iails lying north of the Chyebassa Advance from out of the endemic tv - • , v r •, ¦, ,1 T t- i n • i J n area towards the north and north-west, -^strict, between it and the Himalayas, the evidence of adwith the monsoon of 1866. vance was thus shown :—: — Jail Population of the Behar Provinces. Cholera Admissions, June to December 1866. Jail Station. Juno. July. August. September. October. November. December. Hazareebaugh ... ... 130 22 1 Patna and Deegak ... 13 81 8 ! ..... Arrah 1 29 36 ... 7 15 Chuinparun ... ... ... 17 2 Mozufferpore ... ... ... 72 ... Within a month, the Behar Provinces were covered by this invasion, and the districts between the sea and the Himalayas were universally occupied. In a provincial distribution of epidemic cholera manifested throughout the whole duration of a reproduction, I have said that it is useless to look for direct geographical sequence in the several outbreaks. In the above circle of- jails the dates of outbreak were as follows : Chuprah, 24th June ; Gyah, 30th June; Hazareebaugh, 9th July j Mozufferpore, 10th July; Arrah, 19th July; Deegah, 20th July; Chumparun, 6th August. It was not until the 29th July that the cholera of Hazareebaugh appeared in the Regiment stationed there. tl have already quoted from the report of 1817, the passages which prove that this was sely the limit of the monsoon cholera of that year as regards general distribution, and in that year, as in 1866, an offshoot was at the same time thrown to the westward up the f of the Ganges, which affected Ghazeepore, Buxar, and the Mirzapore District (See p. 29) . Had 1866 been a year of average or excessive rain-fall, it is probable that in the monsoon of 1866 the entire eastern division of the epidemic area would Effects of the meteorology of 1866 h ave b een covered. It is evident from the following state- S^fcS&SS^" 1 ments, that epidemic influence tailed off in this eastern pro- vince in a very remarkable manner in this year; and in con- nection with the distribution of the cholera of October and November, it is of great interest to note the area over which in these months epidemic influence prevailed, in distinction to that over which it was at an end. The circumstance which I have stated to be the best test of an epidemic or non-epidemic season is the steady decline of fevers from July to the close of the year, or their rise through the monsoon months to a maximum in September and October ; a sudden rise in October (as in October 1859), is probably indicative of something more than the normal average of an epidemic year. Such a rise took place in October 1866, and coincidently with it, cholera was epidemically distributed over a great portion of the tract in which the increase occurred. The meteorological phenomena preceding the great cholera of Bundelcund of November 1817 appear to have very closely resembled those preceding the cholera of the districts south and west of the Jumna of November 1866 : Jameson writes : — v In the middle provinces there was nothing very peculiar in the progress of the rains ; but in the districts of Cawnpore and Bundelcund and generally throughout Upper India the rains were observed to be remarkably scanty. Of October the first eight days had been cloudy, with easterly wind and occasional falls of rain." 125 The scanty rain-fall of the monsoon accounts for the geographical limitation of cholera in the eastern division of the epidemic area in 1817. I have shown the effect of eight days of rain in these very same first eight days of October, to have been the epidemic distribution of the great fever of 1859 (p. 74). In 1866, the tailing off of fevers from east to west during the monsoon season with the diminution of the rain-fall, was thus shown, in the case of the European Troops, in the eastern province : — The admissions per cent, of strength were in Hazareebaugh, 48*39 ; in Dinapore, 38-68; in Benares, 32-71; in Lucknow, 19-81; in Fyzabad, 19*00; in Rae Bareilly, 11-22; and in Seetapore, 10*25. The truly non-epidemic character of the monsoon season of 1866 in Oude and Rohileuncl is shown in the following" statement. In the stations noted, there was no cholera at the time when the wave which I have referred to, affected Benares, Allahabad, and Futtehpore :—: — Oude, Meeeut, and Rohilcund. Fever Admissions, European Troops, June to December 1866. Station-. Strength. -g 1 » f •= ToBAt. a i? **> ¦§. -2 > S 0 S Q « O Qj 1-5 >s which in the former w(jre rapid j y dying . out month> Gangetic Valley, Bundelcund, and Central India. Fever Admissions, European Troops, June to December 1866. Station Strength. § 1 Total. >-» i-s < oa o £ a Dinapore ... ... ... ... 920 17 12 16 10 63 79 22 219 Benares ... ... ... ... 550 12 15 15 12 42 29 29 154 Allahabad ... ... ... 1,020 10 25 41 81 194 83 28 462 Nagode 203 1 4 11 31 61 25 3 136 Nowgong ... ... ... 100 17 7 6 8 15 26 17 96 .Thansi ... ... ... ... 520 41 55 71 91 83 30 12 383 Morar ... ... ... ... 1,000 45 42 37 57 52 89 77 399 Saugor 560 13 23 79 101 113 122 75 526 Jubbulpore ... ... ... 660 20 35 73 202 337 231 128 1,026 Agra ... ... ... ... 1,000 44 31 29 38 44 41 40 267 Total ... 6,623 220 249 378 631 1,004 755 431 3,668 N. B. — Native Troops show similar ratios. The inference which I wish to draw is, that the meteorology which determined this distribution of fever, provided the vehicle for the conveyance of the October Reproduction of E great cholera of the spring and monsoon, from the eastern into the western division of epidemic area; and in the usual channel, not across the Doab, but through the districts th of the Jumna. I In continuation of the remarks which I have made on the distribution of the miasm „,„,,„ ... of malarious fever as an epidemic, it is interesting- to be Character or the fever of the east and o i,i« 4-~ i, ni» /,, ?,', » „_, ,b w ue rth-east, of October 1866. able to show as a parallel fact, that this fever of October 1866 was not a mere climatic fever or a fever of trifling significance it a provincially distributed epidemic of the widest range. In the east and south where it as most virulent, it was a malarious fever of the worst type. The Regiment at Jubbulpore Pt ten men from it ; and the symptoms were so aggravated that some medical officers lo saw the fever were of opinion that it might be a typhus. 126 I find it thus described by the Surgeon of the 105 th Regiment, who met with it at Dinapore in a somewhat milder form, although still as a very severe fever : 1051 A Regiment, Binapore, 1866. — "In October, November, and December there was a regular epidemic of fever. It appeared to attack old and young soldiers indiscriminately, neither sparing the acclimatised nor the fresh arrival ; no preference was shown for locality, and the numbers Im each Company were nearly similar. The symptoms were in all cases alike, namely, great iscular pain, entire loss of appetite, constipation, tongue dry, hard, and covered with a brown nost black sordes, face flushed, temporal arteries throbbing, conjunctiva injected, pulse full I hard, in nearly all cases vomiting of bile, and great thirst. The type of the fever was henic, and differed from the ordinary remittent fever, inasmuch as that there was no marked •iod of remission. Remission was followed by convalescence. Some of the worst cases lasted ;hout remission for three and four days and nights. The symptoms were similar to those in igle fevers, and were doubtless caused by malaria arising from the alluvial soil. No steps >rt of evacuating the station could have promised any good results." I This fever has an interest in relation to other stations also. Hazareebaugh suffered from s epidemic fever as well as from .cholera in 1866 ; and I regard it as essential that the demic aspect of this fever shoulft be kept in view in estimating the character of Hazareeigh as a station and the Hazareebaugh District as a locality. The proposal for the abanrnient of Hazareebaugh as a military cantonment in consequence of the experience of Her ijesty's 27th Regiment in 1866, on the plea of the liability of the station to fever and cholera, s considered in this light ; and while the liability to cholera in every epidemic, and alst in every year, was admitted, the statistical facts clearly proved, that no endemic source malaria existed of sufficient importance to justify the abandonment of Hazareebaugh on h a plea, and that there was nothing to warrant the suggestion that a better site could be >cted within the same area. IChota Nagpore suffered very severely at the same time with Jubbulpore, Hazareebaugh, Dinapore. The specific fever by which the 79th Regiment was prostrated, acquired on the march from Rawulpindee to Roorkee and Delhi, was probably an offshoot of this same epidemic; and the endemic of Mozuffernuggur which became so aggravated in 1867, may have acquired its character from having been supplemented by this epidemic miasm. rThis fever I shall notice again in speaking of the geographical localisation of the cholera 1867 in the western division of the epidemic area. I To return to the circumstances attending the appearance of the eastern cholera the western division. Agra had been free from cholera since 1863. As far as the presence cholera is exhibited in our types, no case of cholera had occurred in this district during 54 or 1865. In August 1866, however, a single fatal case of cholera appeared in the Agra 1, and the significance which I attach to this case as a true forerunner of the epidemic, depends the fact that it appeared while the offshoot of which I have spoken was affecting the tions of the Ganges and the Futtehpore District. This I believe to have been one of those es which give warning of the advance of an epidemic upon a definite tract, and which Tht not to be overlooked or passed over as sporadic cases of cholera. When I say that the western division of the epidemic area was free from cholera, it is necessary to exclude the province of the south-west Khe monsoon cholera of the Cen- monsoon, in which cholera was not extinct in 1866. The Provinces, of 1866, was not a rema i ns o f t i ie great epidemic of 1864-65 still existed, and ion of the new and invading epi- , , „ ° ? 1 , , _ .-, . ucu > •""* ie of 1866-67. cholera was found all through the Central Provinces from east [ to west. Of the jails Raepore alone suffered severely, but c ' ' the marginal statement shows that the presence of cholera was > re "4 2 general. The absolute disappearance of cholera over this prola™ ... 5 2 vince in 1867 is sufficient to prove that this was the cholera of ore ... 7 2 the termination of the previous epidemic and not the cholera 3ha '" i 1 °f a fi' esn invasion. As far to the west as Erinpoorah cholera ilpore ... 2 2 was still present. Erinpoorah was for the first time since the formation of the cantonment in 1836, attacked in 1866.* era prevailed also at Palee, in Jodhpore, in September.f Cholera is reported to have ared at Tonk also towards the close of the rains in 1866. I trace no connection, however, between this monsoon cholera of the south-western province and that which I have to describe as the parent of Krst indications of advance into the cholera of the North- Western Provinces and Punjab of western division of the epidemic 1g67 The western limit of this cholera was much further of the new invading cholera ot ow , ~ , , ? , . to the east ; and it was on the 27th October that attention was first called to the fact of its prevalence. On this day I camp of the Agent of the Governor General for Rajpootana which had left Mount Aboo at the middle of September, had reached the Bhurtpore state, on its way to join the •bar camp of the Governor General at Agra. On this day the Political Agent of Bhurtpore ted the camp, and gave information that cholera was present in and around Bhurtpore. (sequent enquiry showed, that in the village of Halena where the camp then was, several cases had already occurred. On the night of the 28th two cases occurred in camp which proved * Report by Mr. Eddowes. f Report by Dr. Lownds. 127 THE INVADING EPIDEMIC OF 1866-67. [Section I 128 rapidly fatal. The establishments and escort were separated, and both parties suffered subsequently; the establishments had fourteen cases between the 4th and 12th November, the escort forty cases between the sth and 9th. The cholera of the escort was believed to have been acquired at the camping ground at Baroda. Dr. Lownds writes : — " We were told on the 2nd that cholera had been present at Baroda some little time before ; I heard on good authorty that it was present about the 26th October at Biana ; and it has since been reported to me as having been present at Futtehpore Sikree about a fortnight before the camp came." * * c Subsequent to the arrival of our camp at Agra, we heard that cholera commenced in Jey>ore early in November, and only ceased about the Bth December/ It was evident towards he end of October that cholera had covered the districts along the northern epidemic lighway far to the west of Agra. Dr. Lownds concludes thus :—": — " I propose further enquiries about the existence of cholera in detached places, and though but little precision may be xpected in the replies, still some trace of the scourge may be elicited, and it will be at least nteresting to watch for its reappearance, should such take place in the ensuing hot season t November is not a season normal for a widespread provincial manifestation of invading Lolera in these districts. Even the great outbreak on tne Sind river in November 1817, d not occur as a portion of a powerful epidemic among the general population. This was, iwever, a true parallel for the November cholera of 1866 ; and a similar one we found in ovember 1826 preceding the epidemic of May 1827, when a slightly marked invasion occurred ? ecting the troops in the stations on the right bank of the Jumna at Agra, Muttra, and Delhi. When in connection with the appearance of the invading epidemic of the east of July id August, my opinion was asked as to whether the extension of this cholera was likely :o affect the troops ordered to assemble at Agra in the end of October, I was ignorant this parallel of 1826, and I was inclined to believe that it was unlikely that the parallel of ovember 1817 would hold good, and my reply was, that taking the parallels 1855-56 and 859-60, invasion of the western area was not to be anticipated before 1867, and that there as nothing to show that invasion into the western division was imminent. The event showed lat the parallels of 1817 and 1826 held good, and although the invasion was marked by no olent outbursts, it became evident that before the end of November cholera had been generally istributed over the unoccupied western area, although its manifestation was repressed by its istribution at an abnormal season. Jin the encampments of the native chiefs and in the city of Agra, sixty-four deaths from )lera were reported between the 11th and 26th November; the European Troops assembled the Durbar lost twelve men ; and nineteen men of the Native Regiments died at Agra and the march after the Durbar was broken up. 1 About the same time cases of cholera were noticed in all districts lying to the north Agra — in Delhi, Mecrut, Moradabad, Rampore, Roorkee, and Umballa. This universality distribution led me to infer, that an extension of a powerful body of cholera into the stern area had occurred, and that in accordance with parallel history its revitalisation from state of dormancy was to be anticipated about the 20th April. The month of October 1866 was almost rainless. Rain fell pretty generally on the 11th and 12th, but the fall was trifling. It is remarkable, however, Keteorology attending the appear- that without any conception of its bearings, Dr. Murray *&£T7h^&& Thomson should in his report of the meteorology of the ber. xMorth- Western Provinces lor 1807, have drawn attention to the fact as remarkable that, although, at Agra, October was I almost rainless month, '08 of an inch only having been registered, yet that in this nth the highest mean humidity of the five years 1863-67, was found. I have before 1, that the epidemic distribution of cholera is not necessarily coincident with rain-fall, and that umid atmosphere is a sufficient vehicle. It was, I believe, with this humid atmosphere of tober that the spread of this cholera occurred, the same atmosphere which I have showed Lsing the general provincial rise of the fever rate in the east and south-east in the same nth. I have above quoted Jameson, who says that in October 1817 the first eight days the month were cloudy, with easterly winds and occasional falls of rain. (Reviewing the spread of cholera in 1866, the anticipation to be formed in regard to its ppearance in 1867, in conformity with the parallels of previous epidemics was, that eastern division of the epidemic area should be covered either in the spring reproduction in that of the rains, or in both, and that the western division of the area should be upied, as in 1857 and 1862, by a cholera of a like distribution. Recognising this, I addressed Secretary to the Sanitary Commissioner in February 1867 in the letter already quoted at I In one respect only did the parallel vary, namely, in this, that there was no invasion of gpore as in the spring of 1818, 1856, 1860 or 1864. It would appear that some essential was ntingin 1867; the material itself had been diverted into our North- Western Provinces, ! vehicle was wanting, or the directing agency was not forthcoming. The fostering conditions re not absent, for the Central Provinces had a steady rain-fall far above the average, which uld have given epidemic vigour to any body of cholera once introduced within the boundary c of the influences of the south-west monsoon. »As I have already remarked (see p. 48 and diagram), the epidemic history of 1867 presents eographical contrast directly opposite to that of 1864 ; and it takes the combined geography of the two years to make up an epidemic such as that of 1856 or 1860. While the violence ot the epidemic of 1864 was expended on the Central Provinces and Western India, the provinces of Northern India received only the shadow of the epidemic; the cholera of 1867, utterly leaving the Central Provinces, concentrated its force on the provinces of Upper India. This distribution, and the possibility of diversion, must in the future be carefully watched by any one who may undertake to define the geography of epidemic cholera in our Presidency. The case stood thus then in the beginning of 1867 : The east of the eastern division of the epidemic area, that is to say, the Behar Provinces and Eieography of the dormant cholera Chota Nagpore, had been covered, and the stations of the S^n.'^^^SSltSr ™ lle y of ¦> •¦, had passed over this tract. It is a remarkable coincidence, and one which shows how rigidly true are the parallels of epidemic cholera in our Presidency, that it is in the very same tract and in the very same villages that the earliest indication of revitalisation is found in 1852, 1857, and 1867 ; namely, in the Terai districts lying west of 80° east longitude, and west of where the Gogra comes through the outer Himalaya.* In the beginning of the year, cholera had shown itself here :it Ramnuggur, Kaladoongee, Huldwanee, and Birmdeo ;f and anxiety was felt lest this cholera should be communicated to the camp of Jung Bahadur, who was advancing up to the Nepaul Frontier from the east with a camp of 5,000 men, coming to marry his daughter to the Rajah of Kasheepore, whose territories lay in the affected tract of country. As soon as the camp reached Birmdeo cholera made its appearance, and the homeward march was commenced as soon as the fact was evident. The camp carried cholera in its retreat for eleven days, and 600 men are stated to have died. Jung Bahadur's camp had skirted the Terai from Segowlee on the march westward, and not a trace of cholera was met with before its advance up to the affected tract, which corresponds exactly to the eastern limit of our western division of the epidemic area, it was at Birmdeo in March 1857, that cholera appeared in the one Wing of the 66th Goorkhas and among their camp followers, and at Kaladoongee, seventy miles to the west, that the Head Quarter Wing was simultaneously attacked. On the 18th February 1867, it was still reported that cholera was prevailing along the foot of the hills below Nynee Tal. II trace no connection between this cholera of the Terai west of 80° and that of Northern de which showed itself in the first week of April. The reproduction followed by epidemic ranee from the east was due in March and April, and it is with this that I connect on the ilera of Oude of the end of March and the beginning of April ; this is the cholera to ich the last paragraph of my letter (p. 30) had reference. The revival of the cholera the east is proved by the following notices extracted from the Sanitary Reports of the s for the months of March and April : — Hazareebaugh, April. — " Several cases of cholera have occurred outside the jail.''' Monghyr, April. — Cholera is described as epidemic in the district. Purneah. — The jail gave 65 admissions and 43 deaths from cholera in April and May. Gi/ah, April. — Cholera is represented to be epidemic in Behar. Patna, April. — Cholera epidemic — fourteen cases and seven deaths in the jail. Ghazeepore. — Cholera is noticed as prevalent in the city in April. Benares. — Much cholera in the city in April. Mirzapore, April. — " Cholera has shown itself in the town and district." the jails of the Behar Provinces, except those of Chumparun and Deegah, furnished of cholera in March and April. ¦ The epidemic advance of this revived body of cholera appears to have taken place about 20th March. On the 22nd March, a sudden outbreak occurred in the Allahabad Jail, in X McClelland describes this locality thus : " The malaria of the place is such that this pass (Birmdeo) is only ble from November to March. Vegetation is so dense and of such rapid growth that it would be very difficult there is so little traffic, to preserve an open communication." Topography of Bengal, p. 2. t Keport from the Conservator of Forests ia Oude to the Secretary, Chief Commissioner, dated 9th February 1851. 129 which twenty-seven prisoners were attacked, with a mortality of fourteen. On the 23rd, the Civil Surgeon of Benares reports the outbreak of cholera in^the city. On the 27th, cholera was first reported in the Central Jail at Lucknow, and simultaneously in the Lunatic Asylum ; and on the 29th March, the appearance of cholera in several towns to the north-west of Lucknow was announced. I We saw how the advance of 1866 was from south to north, until it was stopped by the hills. The great body of this cholera appears in its I, 3£St2fJtU?2li£ advance westward to have duy to the Terai districts east into Oude in March and April, and at the foot of the hills, and to have been but little Cawnpore and the districts south of the diverted towards the south. This is of importance in ma in May. connection with the distribution of the monsoon cholera the eastern province in 1867, and it must not be lost sight of. In March cholera was orted prevalent all along the Terai skirting the northern districts of Goruckpore, Gondah, raitch, and Luckeempore.* In the first week of April, this cholera broke out at a native • in the Toolseepore District, and in this district and in that of Bulrampore adjoining, 1,474 ths were reported. On the 27th April, the cantonment of Fyzabad was invaded; and by 3 time Northern Oude was universally affected. In the Seetapore District the appearance of lera also dates from the last week of April. 1 Going back to the east, we find that it was on the 20th April that the invasion of Nepaul irred, introducing the cholera which eventually burst forth in the second week of June into epidemic which destroyed between 2,500 and 3,000 of the inhabitants of the valley. I The cholera which appeared in the last week of March at Allahabad was, as I have said, bably an invading cholera. The first week of May is the date of appearance normal for the ib west of Allahabad, for Cawnpore and for Banda. The Commissioner of the Allahabad r ision has traced the cholera of 1867 in the May appearance with great care.f Its appeare was first noticed at Lucheeghur, a village on the Ganges a few miles below Allahabad. ;ween the 3rd and 16th May it had extended over the Allahabad District south of the Jumna, [ had entered the Banda District ; at Kirwee it appeared on the 12th May. Cawnpore was eatened at the same time, and three cases occurred among the troops. The Civil Surgeon Cawnpore writes :—": — " Cholera is prevailing in the city, and many deaths have occurred ; deaths in proportion to the attacks have, however, been few." I The line by which the main body of the epidemic travelled, the Commissioner of Allahabad siders to have been south of the Jumna, through Lucheeghur, Arail, Bara, and Khyragurh ) the Banda District, leaving the Doab comparatively uninvaded. "Not a single case/ he tes, "can be traced to pilgrims returning from Hurdwar. As I believe to be universally the 3, the disease first appeared in the east. It came from the east and moved west." I This is the consistent history of the spring cholera of the eastern province. It became Lemic from Behar to Banda between the 20th March and 12th May; and it was universally lifested over this area, in the Behar Provinces, in the valley of the Ganges, and in the ib, dying away at Cawnpore. It was a great cholera south of the Jumna ; a powerful iding cholera in Nepaul ; a great epidemic all along the Terai from Segowlie to Northern le ; and it had a general distribution over Oude, but was concentrated chiefly in its northern riots. This cholera had in truth a geographical distribution of its own as far extended as possible, when the northern and western limits of the eastern area are considered. This a cholera of a geography corresponding in every detail with that of any other epidemic of crn origin. This was the distribution which I predicted in August 1866, basing my Lcipations upon the facts of the distribution of the invading epidemic in that month. c the jail table of 1866 in Appendix). When we come to study the history of the spring reproduction of the cholera of 1866 in the Ipring revitalisation in the states of western division of the epidemic area, we find it complicated pootana affected in the end of 1866. by a question with which I believe it to have no immediate minimum of prevalence towards concern— that of the degree to which the geography of the southern margin of the area aftect- , ¦¦ «,, {~ , • a jixi j ? in 1867, and the geographical cholera ot the year may have been influenced by the spread of ;inuity of this with the exempted cholera from pilgrims attacked at Hurdwar on the 12th lof the year. April. What we have in reality to study is, how far the >graphy of the reproduced cholera of 1867 corresponds to that of other years following the asion of the area, such as 1857-58 and 1862. I In the south of the western division, in the states of Rajpootana affected in November >6, as in 1861 following the invasion of 1860, we look for the reappearance of the cholera anpated by Dr. Lownds, in April. And we find it. Dr. Harvey, of Bhurtpore, states that ilera first showed itself on 6th April, and that in the beginning of May it was prevalent every pergunnah; and Dr. Burr, of Jeypore, reports that it reappeared on the 15th April, the Agra District, although cholera was present both in the spring and rains, its valence was not remarkable ; the chief incident brought to notice in the spring cholera > the attack in which the orphans at Secundra suffered, when thirteen died out of forty-six icked. Agra and Gwalior clearly shared to a great extent the absolute exemption which country lying to the south enjoyed ; for in the Jhansi and Lullutpore Districts not a 3 of cholera was reported in 1867, and these districts are continuous with the exempted 3t of the year in the Central Provinces. * Report on the cholera of Oude by Inspector General Innes, Her Majesty's Service, Oude Gazette, April 4th, 1868 f Report to Government, dated July 13th, 1867. 130 Chap. VIL] THE INVADING EPIDEMIC OF 1866-67. 131 Few cases occurred in Gwalior, although cholera persisted from 22nd May to 15th September. The first European soldier was struck down on 31st May, the day after the sudden attack of the Seeundra orphans. In the Muttra District cholera appeared at the same time. In the report for the week ending 15th May mention is made of the occurrence of a few cases of cholera; on 31st it is reported that cholera still exists in the district ; and in June the occurrence of a few cases at Mahabun is noticed. In considering the reproduction of the spring cholera of 1867 within the radius which may possibly have been affected by the infected streams of levitalisation and invasion within Hurdwar pilgrims, it will be more satisfactory to study the f^sgiiTsnsii i^ l « vents ° f iB6 i in c °™ eetion with °f 1867, 2ra by Hurdwar pilgrims. seeing that the significance attached to the two parallel occurrences by the same observers has been so very differently estimated in the two years. I The universal testimony borne by the Medical Officers in charge of the districts included in i radius is to this effect : — w The cholera was introduced by Hurdwar pilgrims, and there was no lera in the district before the arrival of these pilgrims ; therefore, I conclude that its introduc - i and subsequent spread was due to this source." Nothing can be more plausible than such argument ; and the more so that it rests on what is a fact, that the Hurdwar pilgrims were first to carry cholera into nearly all of these districts. They introduced this cholera at a date prior to that at which it was due naturally to appear. When I fixed the 20th April as the probable date of reappearance, I meant that this was the date upon which the first appearance was due ; the general appearance of cholera I have stated to occur nearly at the date normal for Banda and Cawnpore in the eastern province. The Commissioner of Allahabad fixes the date for 1867 between the 3rd and 16th May; it was on the 11th or 12th that the Banda District became affected. In 1857 it was on the 15th and 16th May that the Fusiliers and 75th began to suffer, as soon as they descended from Kussowlie and Dugshaie into the plains. Scriven gives the date May 12th, 1862, for the general affection of the villages of Rohtuk and Hissar, and May 17th for the villages of the Kurnaul District.* That cholera should have broken out at Hurdwar on 12th April is no exception to the truth that the general diffusion of this provincial cholera was not due for a month later ; and the sequel will show that the actual rise of cholera among the population generally, did not occur before the date at which it was due in accordance with the parallel history of previous epidemics. The Hurdwar gathering occupies the valley of the Ganges for a space of nine mile 3 in the course of the river, with an extension right and left of from two to six miles. The distance of this vast encampment from where the Ganges issues from the Himalayas is but thirteen miles. Hurdwar itself is situated in a gorge of the Sewalik Range, which runs parallel with the Himalayas. The country intervening is a Dhoon, which Dr. Cutcliffe describes as occupied by dense uncleared tree -forests, with heavy brush- wood and rank grass, with large and deep swamps at intervals, and so teeming with malaria that even the natives can reside in it with impunity only from December to the commencement of the rainy season. The winds of this tract Dr. Cutcliffe thus describes : — t" Through this funnel-like gorge of the Sewaliks leading from the swampy and malarious Terai, in which Hurdwar lies, the cold wind locally known as the Dadoo blows from the snowy regions down to the heated plains below. It blows at night, and its direction is steadily from north-east to south-west. In April it commenced to blow about 9P. si., and it ceased at about 10 a. m. By day the current of air is chiefly upwards towards the hills." The meteorology of the days immediately preceding the outbreak he gives in the following sentences: — " The 11th April was a cloudy close day with the usual wind blowing upwards to the hills. In the afternoon a heavy storm of thunder and very vivid lightning coming from the west broke over Hurdwar, when two men were killed and four others severely burnt by the electric fluid. Heavy rain fell and continued all night. The 12th was the great day for bathing, and the pilgrims, who had been wet for twelve hours, began before the dawn of day to stream off in thousands to the sacred ghdt. The rain still continued to fall, though now' only lightly; nor did it cease until the evening, when, just before sunset, the clouds broke and the sun for a short time came out. * * A vast number It have waited in a state of fatigue for twenty-four hours till the sun came out ere they d have got any dry clothes on their bodies. On the following day, April 13th, eight cases holera were sent to hospital." We have the same evidence that cholera had passed over Roorkee into the Terai beyond Hurdwar in the last months of 1866 that we have of its having swept over Moradabad' and Rampore into the Terai west of the Gogra at the same time. Everything required for epidemic manifestation among a population assembled at Hurdwar was present. The cholera had been introduced into a breeding ground well adapted for revitalisation, and known from past Srience to be a certain breeding field. The vehicle of moisture and the wind to bring it a on the assembled mass were opportunely provided, and previous fatigue and exposure rendered the body of pilgrims eminently fitted for the reception of the miasm ; and when it did come, the assemblage succumbed to cholera as a body, just as it would have been prostrated * Report to Punjab Government on the cholera of 1862, dated Ist June 1863. f Cutcliffe's Report. as a body by the malaria poison had it spent the same number of days in the same locality at the season when malarious influences are there predominant. I When the topography and the meteorology of this locality is considered, we are prepared to ecognise the reappearance of its cholera a month in advance of that of the plain districts, as normal occurrence ; and antecedent history warns us not to mix up and confuse together the liolera due to appear over Northern India in May with that which radiated in the stream of ilgrims setting- out from Hurdwar on 13th April. A clear understanding on this subject is of ital importance to the correct comprehension of the epidemic history of the year. If we leave le argument taken up by every Medical Officer and in every report to Government unanswered, t will be handed down as an indisputable fact, that the sequence of events and their significance was such as has been stated, and an obstacle will be thrown in the way of the study of cholera as an epidemic which twenty years of further experience may do little to remove. What is required to be proved is, that the outbreak at Hurdwar, great as it was, was but one outbreak of a reproduction which was certain to have occurred, the geography of which would have been identically the same had no gathering at Hurdwar taken place ; and which would have given warning of reappearance about the 20th April, and would have been generally in manifest vitality before the 15th May over the whole area alleged to have been infected by Hurdwar pilgrims in 1867. In the face of parallel epidemic history, the fact that cholera came into the districts of Shahjehanpore, Bareilly, Budaon, Meerut, Moradabad, Bijnore, Seharunpore, Mozuffernuggur, Delhi, Rohtuk, Kurnaul, Umballa, Loodianah, and Jullundur, first with the pilgrims of Hurdwar, has not the weight that the individual observers have sought to attach to it. In the east, we have found a consistent history for 1867, in which pilgrimage plays no part. And once before I have shown how, on occasions when the pilgrim theory was introduced to prove that such streams polluted certain localities, the local narrator urged his views in ignorance of the fact that what to his observation seemed of so much importance, was but a trifling item in the grand generalisation that cholera was universal from the Bhurmpooter to Bundelcund (1863), from Assam to Guzerat (1860), and from the shores of the Bay of Bengal to those of the Atlantic (1864-65). The antagonistic facts have not yet been satisfactorily explained, why, when the cholera of , r , »,, , r , , „ Hurdwar was at an end among the pilgrims who passed Two phases of the May cholera of , , J# . » r a r 1867,— decay and disappearance iv the through the districts to the east and south of Hurdwar, it eastern districts of the western division ceased among the general population until the setting in of and growth and [epidemic spread iv the the monsoon an( [ wny to t he west and SOUtll-west this western districts. Ihe significance of , , • j•• • f • , i •. i the phenomenon. cholera acquired its epidemic strength only when it was almost at an end among the pilgrims. In the Bareilly District up to the 27th May when the cholera ceased, there had been only .sixty -three fatal cases of cholera, including the pilgrims from Hurdwar. In Budaon up to the 1 lth May, fourteen deaths only had been reported, including pilgrims. In the Shahjehanpove District only three cases of cholera were reported among the population, and nine deaths among pilgrims up to the 30th April ; and nothing more is noticed until the 20th May, when cholera was introduced evidently from the east. The deaths of Shahjehanpore for May amounted to seventy-two ;of June to forty-one ; and of July to fifty-three, after which the monsoon cholera dreadfully ravaged this district. After the 11th May no case was reported from the Moradabad District. In Bolundshuhur thirty-nine deaths of pilgrims and of residents were reported in April, and sixty-nine in all in May. In the Allyghur District we find fourteen deaths in April, 109 in May (seventy-nine being in the towns Khyr and Hattras), and twenty-nine in June confined to two villages. So, too, in Meerut; from April up to the 15th June forty-four deaths in all were reported in Pergunnah Meerut, and nineteen only in the city. This is one phase of the spring cholera of 1867 of the western division of the epidemic area, shown over the districts of the North-Western Provinces lying J££&Cm£ tfXtoS 2 the ? st °f the Jumna and south of the Tend. .We pass to the westward, to the districts lying between the Hindun River, 1866. I the Doab Canal, and the Jumna, and instantly the phase is anged. In the single town of Chuprolee we find 445 deaths; in Barote 1,187 deaths; Benowlie 109 deaths; in Baghput sixty-nine deaths; and in Khikrah sixty-six deaths. It along this tract lying between Meerut and the Jumna that we find the northward progress the great cholera of 1861 traced; in other words, it was in this tract that the advancing idemic was most conspicuously manifested. The Superintending Surgeon of the Meerut ivision, in his report on the cholera of 1861, traces the advance as usual from the south and t from the east. He writes :— " That the epidemic should have pursued this course by rich it travelled from south to north, is attributed to the low and undrained lands lying in c hollow. The locality is invariably subject to malaria, and has on previous occasions been *ited by severe epidemics." This is the most easterly indication of a virulent and localised olera among the population apart from what degree of prevalence may have been due to the insmission of cholera from Hurdwar as a centre. This tract is continued north along the Jumna, through the Mozuffernuggur District, th exactly the same characteristics. And here the facts are the same as in the south. hile in the Mozuffernuggur Tehseel, out of 134 deaths up to the 30th April, 119 were among grims, m the Shamlee Tehseel of the same district lying along the Jumna, during the same 132 Kod out of 290 deaths ninety-seven only were deaths of pilgrims. The mortality of May of Mozuffernuggur District appears to have been almost entirely confined to the towns and iges of this tract. I Turning to the north of Hurdwar, we find the same thing, namely, the spread of cholera, in tiexion with the topographical peculiarity of the situation, in the towns bordering on the Terai, lying in the tract connecting the Terai above Hurdwar with that in which cholera appeared yin the year. The towns of Bijnore in which cholera continued to prevail throughout May ie in this tract, Nujeebabad, Nuggena, Burrapoorah, Afzulghur, and Shercote. The erintendent of the Terai Pergunnahs reports, that out of 130 deaths from cholera in the ith of April not more than ten were pilgrims from Hurdwar ; cholera appeared in fact in ie parts before and simultaneously with the appearance of cholera of Hurdwar. To the bof Hurdwar in the Dehra Dhoon the same tendency to persistence is noted. The report sth May is :—": — " The disease which before existed in a sporadic form has assumed a more j developed character, and the number of cases is greater." It is unfortunate that for the North- Western Provinces we have no record of the cholera of 1862, as it is to this cholera that we look for Parallel History of May 1862, ex- t h e explanation of many of the events of 1867. We know fid? th<^May%Qra P of C iB67! tnbU " the S eneral fact that Hurdwar pilgrims did die on their way home ; that cholera prevailed at Deyrah from the 20th April onwards ; and that in May Kumaon and Ghurwal were affected. The history of the cholera of 1862 west of the Jumna is well known, and the parallel history of the cholera of 1862 and 1867 from the Jumna westward, calls for special attention. For the occurrences of 1867 the one explanation has been, that cholera was introduced by pilgrims, and that its spread and propagation were due to intercourse with those affected; in 1857-58 and in 1862, the introduction and spread were not thus explained. llt is useless to study the cholera of 1867 assuming as a groundwork the theory, that subsequent propagation took place from these Hurdwar pilgrims. The history of this reak is the history of any other typical outbreak as I have defined it in the second section of report ; we have the facts of absolute freedom from cholera up to a certain date, preva-3 for a certain number of days, and inevitable disappearance at the end of a normal period revalence. Whatever is superadded to this, comes within the scope of theory, not of fact, it is here that parallels drawn from the Natural History of cholera come in to supplement and to supply whatever else is wanting to gixe consistency to the history of the smic. I The Government of the Punjab has caused a report to be drawn up to show the progress holera among the pilgrims returning from Hurdwar to that province, and in this report the •wing generalisations are founded on the history of this May cholera of 1867 : 1. That era is conveyed, in the first instance, by human agency alone. 2. That cholera can be con;d and disseminated by persons not themselves suffering from it. 3. That the history of present epidemic confirms the opinion that the transmission of the disease by the atmosphere c is limited to a very short distance from the focus of emission. 4. That quarantine, if itively established and maintained long enough, appears to be the only and best protection or disposal against the dissemination of cholera. In the Punjab, as in the North- Western Provinces, there was no cholera before the stream of pilgrims from the east entered the province. But the fact, in my opinion, goes for nothing when we recall the parallels of 1857 and 1862, which show that the 11th May was the day on which general revitalisation was due. It follows almost as a matter of course, that no cholera could have appeared in 1867 except by importation, prior to that date; and hence it followed, that v/hen between the 16th and 3.oth April the stream had spread over the province and twenty-two districts had reported the invasion, the first case of cholera occurred in every instance in a Hurdwar itilirrim. No conclusion is more natural than that this importation constituted the invading cholera of 1867. But in my estimation this was not the case. I reckon that the invasion of 1867 took place between the 10th and 20th May, the dates on which cholera appeared epidemically in the districts west of Delhi and on the frontier, and in which it was epidemic over the Banda District, and in every pergunnah of Bhurtpore. This was precisely the date, at which Rawulpindee and Huzara were invaded in 1858, and on which cholera reappeared in May 1862 west of Delhi, while it was at the same time an invading cholera beyond the Indus. It has never been alleged that the advance of the cholera of 1856 beyond the Jhelum in May 1858 was due to human intercourse ; and those who saw the reappearance of cholera in Rohtuk and Sirsa in May 1862 had no difficulty in distinguishing it as a revitalisation of the epidemic cholera of 1861, and the opinions of these observers, Scriven, in his report to the Punjab Government upon the cholera of 1862, thoroughly endorses. »The aspect in which the question is viewed in this section, is not whether Hurdwar pilgrims •duced the cholera of 1867 into the Punjab, or whether they did not; but, apart from any possibility, I shall try to show here that invasion was due, independent of human agency 'ether, at the very time that it did take place. I have traced to the influence of locality growth of the cholera of May along the Terai tracts and in the districts lying on the na and immediately to the east of this river, while in Meerut and Rohilcund generally it was dying out or at an end. I have now to trace the growth of this cholera in the districts west of the Jumna through May, to sketch the topography of these districts, and show their meteorology during the weeks in which cholera was spread from the Jumna to Peshawur. 133 Speaking- of the famine of 1861 as affecting the districts west of the Jumna, Baird Smith wr ftes : " The richly irrigated district of Paniput and the northern sub-division of the Delhi District have virtually escaped all injury, by reason, — firstly, of their being traversed by the "Western Jumna Canal j next, of the continued drought having relieved them from the broad areas of swamp by which they are ordinarily infested, and having turned these useless lands into productive fields ; and last, of the low damp valley lands bordering the Jumna having been also dried so as to become culturable, and to give an abundant produce. These resources over by far the largest part of the area indicated have guaranteed wealth and abundance." Speaking of the country south and west of Delhi, Bullubghur and Goorgaon, which suffered to an extreme degree in the famine of 1861, he writes :—": — " A considerable portion of the area is of bleak and barren rocks or deep ravines ; the drainage is under indifferent control, and the rivers sometimes run as wild as those of the Pontine marshes or the Tuscan Maremma," Mr. Adam Taylor describes the part of the Rohtuk District chiefly affected by cholera in 1862, thus : — " A branch of Ferozeshah's Canal runs through the northern part of the district, terminating a short distance from Eohtuk itself. The country through which it passes is extensively irrigated to the distance of sometimes two miles from its banks. The effect produced "on the land is very marked ; the vegetation is rank and luxurious ; and the air is charged with moisture, and it certainly contains malaria owing to the patches of swampy jungle formed by the oozing or overflowing of the water. It will be seen from the statistics that the cholera raged most" violently in the Gohana Pergunnah, and that of the seventeen villages named, fourteen were on the canal, the other three losing but fourteen cases among them. This fatality must have been owing to the poisonous effects of the exhalations from the swamps or from the malaria engendered by the drying up of the irrigated soil." I believe that the cholera of November 1866 found a location in the low lands lying on and west of the Jumna; and from the parallel of 1862, it was about the 12th May that its reappearance from its state of dormancy was due. Writing of the cholera of 1862, Mr. Taylor says :—«: — « lam of opinion that the cholera poison, the cause of the cholera in this district in 1861, never really left, but that it was rendered dormant by some condition of the atmosphere during the cold weather from November to May, and was restored to activity and virulence by the heat of April." Again he writes :—: — " I think the suddenness (almost explosive) of its outbreak over so large an extent of country, embracing not only 11-ohtuk, but also Hissar and Sirsa, precludes the idea of its having' travelled. In no instance was I able to trace the origin of the disease to the fact of its having been brought in by travellers. Generally some inhabitant, apparently not more exposed than his neighbours, was struck down, the first, but not originating victim of the pest ; and although the villagers deserting their homes fleeing from the cholera, would die by the road or at the places where they sought refuge, in no case were they accused of bringing destruction on their asylum." Mr. Taylor, who was Civil Surgeon of the Delhi District in 1867, makes his statement of the parallel events in very different terms : — " I am of opinion," he writes, " that the disease was entirely the result of infection by the pilgrims. * * Cholera had certainly appeared in the Delhi District in November 1866 after the Agra Durbar, but if it had been dormant during the cold weather, it would have appeared earlier than the 19th April." As shown above, revitalisation was not due before the 11th or 12th May, the day on which it reappeared in these same districts in 1862. It was on the occasion of the spread of the great epidemic of malaria over Upper India in 1813, the epidemic of malaria which preceded that of 1850 which I have elsewhere described, that the attention of Government was drawn to the fact, that certain localities seemed to have suffered excessively, and some were not slow to assert that this localisation of the general epidemic was due solely to canal irrigation. In 1845, Mr. Dempster, an officer of high repute, was ordered to report on this localised disease, and the answers which he gave to the questions proposed for investigation, prove, that independent of any effects which the canals may have, the whole of the districts lying east and west of the Jumna are eminently adapted for the propagation of miasmatic disease. His investigations extended over these very districts, in which I have shown that the May cholera of 1867 took its rise, while utterly dying out in all districts lying to the east. The general conclusion which Dempster came to was, that in the rains of the year 1843 there was a general epidemic influence in operation, widely diffused over the North-Western Provinces ; that while the canal districts were severely affected, in situations neither irrigated by canals nor within reach of such influence, as at Kythul, in the vicinity of the Nujufghur Jheels, and in the low lying lands of the Jumna, fever prevailed to an extent and with an intensity as great as in the worst of the canal villages ; and that the influence was a true malarious influence inducing typical malarious fever, such as I have described it prevalent over the same parts in 1850. Dempster writes : — " The season of the year at which the disease appeared, its symptoms, progress, and consequences, mark it to have been everywhere of the same type, viz., the endemic (remittent and intermitte nt) of the rainy season, but everywhere, and especially in naturally malarious localities, greatly aggravated by the constitution or peculiarity of the season." The following answer is import ant in relation to the natural topography of the districts inspected :—: — '•'By far the greater part of the evils we have observed have not been the necessary and unavoidable results of canal irrigation. In all situations where mischief was prominently marked, the natural drainage of the country had been checked or interfered with, stiff' or retentive soils saturated with water, and natural disadvantages of site enhanced by excess of moisture." The districts visited wore those west and north of Delhi, and those immediately to 134 [Section! Chap. VII] THE INVADING EPIDEMIC OF 1866-67. 135 ie east of the Jumna. "The Shamlee Perg-unnah of Mozuffernuggur," Mr. Dempster writes, had for years been notorious for its extreme unhealthiness ; and as this obviously depended in great measure on other causes besides canal irrigation, we agreed to exclude the results from ur returns. (See page 13Z)." He continues :—"ln: — "In point of fact we have just then entered pon an extensive unhealthy tract. A few miles further on and the whole aspect of the canal nd country was suddenly and entirely changed." ** * " The swampy belt of reeds and ligh grass was here met with for the first time. Jheels and marsh swarming with aquatic owls are seen on either side, and the villages are often surrounded with shallow stagnant pools, 'he soil, too, undergoes a decided change, being no longer light and friable, but generally stiff and clayey." ** * " The effect on the health of the inhabitants has been the same in kind and nearly in degree as in the objectionable portions of the Delhi canals, that is to say, in the worst villages, about 70 per cent, of the inhabitants suffer from decided spleen enlargement." On the right bank of the Jumna and to the westward, the conditions are also at certain seasons and in certain years unfavourable to the population, which is apt to suffer from spleen enlargement. The districts inspected by Dempster were Kurnaul, Hissar, Rohtuk, and Delhi. He states it as a remarkable feature of the lands bordering on the right bank of the Jumna that the drainage flows from, instead of towards, that river, and that the fall is towards the south-west, amounting to a foot or a foot and half in the mile. It was this fact which was taken advantage of by the Mussulman Government of Delhi in the construction of the Western Jumna Canal which was re-opened under British rule. This water collects in jheels, as exemplified on a large scale in the Nujufghur District, and to a less degree in many other localities. Goorgaon was not included in Dempster's inspection ; I have quoted Colonel Baird Smith's statement, that its waters run wild as those of the Pontine marshes or the Tuscan Maremma. The parallel of 1867 is as follows : — On the 12th December, we find the Lieutenant Governor of the North- Western Provinces appointing a Epidemic malaria of 1867 in the B p e cial officer to investigate the topography of these very tracts which chiefly sullered from the j* , -, ¦ ? ,v j j. • ± n -,¦ cholera epidemic of May. tracts and instructing him to proceed at once into the districts, " with the view more especially of tracing and studying the character of the fever which is said to be endemic in some of the districts, but which has apparently been more than usually virulent and fatal during the past season/'* The result of Mr. Cutcliffe's enquiry showed, that it was a true epidemic malaria which had affected the population of these tracts, varying locally in malignity according to the degree in which sanitary advantages were provided or were deficient. The special intensity of the fever of the year is assumed to have been due to the aggravation of an endemic malaria by local causes alone, or by these aided by a meteorology such as that of 1867, characterised by a rainfall above the average. It is natural that I should be inclined to associate the aggravation of malaria in these tracts of the western division in 1867 with its provincial manifestations in the south and east in 1866, in Chota Nagpore, Jubbulpore, and Behar, and that I should suggest, that in this fever of the banks of the Jumna, we have an instance of the epidemic distribution of an air-borne malarious miasm , exactly corresponding to that of the cholera miasm which was manifested over Chota Nagpore and Behar in 1866, and in these same tracts on the Jumna in 1867. As to the nature of the epidemic fever, no doubt can be suggested. The descriptions are identically the same with those given by the observers in the same districts in 1850, corresponding even to the detail of the comparative exemption of the jail population. The following are extracts from Mr. Cutcliffe's report to the Government of the North- Western Provinces :— " I have already described the fever-stricken tracts, and have shown that, though the disease prevailed in many parts both of the Seharunpore and Mozuffernuggur Districts, it was neither universally distributed throughout those districts, nor was it equally severe in those ¦ts which were affected by it. I have shown that its ravages were chiefly marked along :ain water-courses and low swampy vallies. I" Up and down the eastern Jumna Canal fever prevailed, and the native doctor proved me that his cases were malarious fever. I have mentioned in my notes that the free popuon suffered generally from fever, while the prisoners of the jail escaped. E" The description of this fever given by the inhabitants of the towns which I visited may ummed up as follows : the fever commenced in all the affected places at nearly the same ;, namely, in July or August, and ended generally about December. 8" The evidence contained in the notes seems to me to be conclusive that the character of fever which I have been directed to trace and study was malarious fever. "It was most often intermittent, of which the most frequent type was the quotidian, though cases of the tertian type were not uncommon. Sometimes the fever was remittent, when it was always most severe, and was frequently attended by enlarged spleen and by hepatic affections manifested by jaundice, and sometimes leading to dropsy ; and occasionally cases ending in general anasarca (dropsy of the whole body) were described. Diarrhoea, in some of the towns, was spoken of as not a very uncommon complication of the graver remittents., and when it came on it usually destroyed life. Where patients did not die from * Instructions to Mr, Cutcliffe appointed special Sanitary Officer for the Mocrut Division. 1-ttE INVADING EPIDEMIC OF 1866-67. [Section I. 136 tmittent fever, the disease usually became intermittent before it ceased, the most common type ing the quotidian, and, at a later period of convalescence, not unfrequently tertian. " In some of the towns rheumatic affections were much complained of as attending 1 the later stages of the fever." This last peculiarity recalls the fever of the 79th Highlanders, which the Regiment _¦... ? - .. —. . . acquired on the march in the Puniab in the cold season of Epidemic malaria of the Punjab of -,q% gar/q ar/ ta *¦ i j • j. £ ±1. -i 186 7 J 1866-67. It was certainly derived from the same epidemic In a note to the Regimental Tables of 1867, I have enumer- ated as sequelae of the fever in the 79th, fourteen casualties by death and invaliding from phthisis, fifty-four admissions from orchitis, and 230 admissions from rheumatic affections. Nine deaths occurred immediately from the fever. It is well worth while to note, that but one section of the Regiment escaped this fever, namely, the women and children ; that the only exception was the family of the Canteen Sergeant, who daily accompanied him when he went in advance of the Regiment to have coffee ready for the men on reaching the halting ground. The other families never moved until the sun was up, and they escaped ; the Regiment as a body succumbed to the malaria of the early morning.* The statement which follows shows the effects of what I imagine to be the same epidemic of malaria on the jail population. It is interesting to note exemption beyond the line limiting monsoon influences in the north-west, and even in those included portions of the geographical area which I have shown usually to escape in the primary invasion of cholera. Fever Admissions of the jails of the Punjab of August and September 1867. A Statement to shoiv the provincial distribution of a fever which may have been connected with the fevers of the districts bordering on the Jumna, and with the fever of the south-east of the Presidency of 1866. Jails appbctbd. Jails not beached. August. September. August. September, Delhi... ?. ... ... 32 122 Mooltan ... ... ... 13 14 Rhotuk ... ... ... 3 32 Montgomery ... 2 Sirsa ... ... ... ... 4 13 Shahpore ... ... 1 Umballa ... ... ... 18 58 Ferozepore ... ... ... 6 8 Loodianah ... ... ... 10 59 Jullundurf ... ... 7 5 Jhelum ... ... ... 10 29 Goojranwalla ... ... ... 13 24 Goordaspore ... ... ... 20 79 Dhurmsalla ... ... ... 8 23 Sealkote ... ... ... 7 17 Lahore Female ... ... ... 13 66 Lahore ... ... ... 135 656 Umritsur ... ... ... 55 172 Total of the above ... 328 1,350 It is certain, that with a meteorology of a definite character, cholera is due to spread Meteorology of the season of epide- TL^ {v °™ wuth-eaat to north-west in the month mie advance from south-east to north- , •*, SUDse quent to its i'evitahsation. Speaking 1 of the mie advance from south-east to north- -"lay subsequent to its i'evitalisation. Speaking of the west from the Jumna to Peshawur. meteorology attending the spread of the May cholera of 1862 , r.u w i. •a 11 1 . n A the . Sir f District, Mr. Minas writes:—" During the prevalence of the hot west wind all moisture is absorbed and the season is salubrious. But when the wind veers to south or south-east, when the thermometer ranges high, when there is slight malariaVlffi" tee Thl^J ** ?*?. feve ? of the lst Fusil^> which suffered at Lahore in the epidemic of Sered far more hiav^ S tM^SX in Sad Gu^T >*t F* T^l *t T"*" ia ing from the effects of themiasm. Scrlven tells us that fttf 8 ? '°? t W-H °PP ortuuit y for recovert The Jullundur Doab, as usual, was not affected. listure consequent on rain falling in very small quantity at a time, under such circumstances appearance of cholera may be predicted. What has been stated, clearly exhibits the fact, t the disease in a great measure spreads in the direction of the wind from south-east to th-west. From the 4th May the direction of the wind changed to south-east. The mings were cool and agreeable, imparting the sensation that there had been rain somewhere ;he neighbourhood. During the night of the sth rain fell, and this tended materially to 1 the atmosphere. Intelligence was received of the first appearance of cholera on the May, in Eundhawa, seven miles south-east of Sirsa. On the 15th, it appeared in the city Sirsa and then it spread in every direction, not following the routes of traffic only, but igularly visiting villages at a distance from them." I Mr. Minas, now in charge of the Hissar District, thus describes the weather prevailing \.pril and May 1867 :—"ln: — "In the month of April the weather was very uncertain ; clouds heredj rain fell h\ drops; a heavy shower fell on 20th, accompanied with a severe storm, rms occurred at times during the month." May. — " There has been constant rain and conled sand storms. The total rain-fall was G # 9 inches. From the 20th, the heat became ressive, and these vicissitudes caused fevers to rage violently." The Reporter for the Punjab, liis review of the meteorology of April, says :—: — "It is to be noted with respect to the spread cholera, which began to appear during the latter part of this month, that the direction the wind throughout the province generally was not unfavourable to the onward course of the disease northward; nor was the air deficient in moisture, the presence of which not ;} few maintain to be very favourable to the development of cholera." The meteorology of the month of May is very important. The Reporter writes : — " Up to the 6th of this month the wind blew principally from a westerly direction. It changed on this date to the Muitli-east, and a fall of rain ensued in many places within a wide area.* Up to the 10th in tact, rain was very general throughout the whole province. From the 11th to the 13th, the barometer, after a slight rise, fell again, and another general rain-fall followed. From the 14th to the 18th the barometer again rose gradually, with a varying wind, but from the latter date it fell steadily to the minimum for the month, which was registered on the 26th. Rain again fell in various parts of the province on the 28th, 29tb, and 30th. * * * Fevers and cholera prevailed in many parts of the Punjab during this month, and the considerable amount of moisture in the air, was by no means against the development and spread of either of these diseases." The rain continued even into June. " From the 7th to the 14th, rain fell in many places throughout the province, though to small amount. The wind up to the 6th blew from a westerly or north-westerly direction, but afterwards changed mostly to east and south-east. During the rain-fall from 22nd to 28th, southerly and easterly winds prevailed." In all narratives which have been written on the May cholera of the Punjab of 1867, the attempt has been made so universally to connect on the Bo actual date at which the Punjab presence of cholera with the arrival of Hurdwar pilgrims, and 6^ ta d*sCS2:Stli to associate its spread among the general population to mined. infection from the contaminated stream, that it is almost impossible, with the data at our command, to say at what date invasion actually did take place. The idea of any method of introduction by other than human agency seems to have entered into the calculation of bvit very few. The palpable fact that the pilgrims were the first to bring the cholera from the east has been accepted as the whole truth, and the attempt has been made to show not only that pilgrims brought in the disease, but that each individual affected proved a focus of contagion. That the endeavour to show that, in nearly all districts from Umballa to Peshawur, a pilgrim was the first to suffer has been successful, is not to be denied ; and that not a few who came in contact with the infected pilgrims, and possibly even with pilgrims apparently uninfected, cannot be questioned, because the alleged facts may be taken as incontestably true. It is when the conclusions from the two series of facts taken together are used as an incontrovertible argument for the full efficiency of human agency to introduce and propagate epidemic cholera, to the disparagement of the theory which maintains the aerial and provincial transmission of epidemic cholera, that it becomes essential to assert, that here as elsewhere secondary truths have been elevated into the position of primary truths, and that the minor has been taken for the major and indeed the entire truth. lln theory, men acknowledge readily enough the existence of a soil -generated cholera, but ciation is so strong that few in reasoning on the theory can forbear to think of cholera >ss in connexion with the index of its presence, namely, affection of the human being ; and r constantly overlook that no theory which does not recognise the reproduction of cholera as tal phenomenon can possibly affect to deal with the facts of epidemic history. The fact is r simple of comprehension to any one acquainted with the history of epidemic cholera in ia, that no combination of conditions (which is not natural) will expedite by three weeks the talisation or epidemic advance of cholera. We might as well look for the continuance by :ingencies, up to the end of October, of the cholera due to die out on the 25th September. ¦ It is certain that it was not until May that the districts of the Punjab generally began suffer. The cholera of April was almost entirely Hurdwar cholera, the cholera of one itbreak.f This is evident from the tailing off of the mortality from the affected centre. The Mooltan, Dera Ismael Khan, Bunnoo, Shahpore, Rawulpindee, Huzara, Sealkote. t The question of the normal duration of the Outbreak falls to be considered in the Second Section 137 maximum of mortality among 1 the pilgrims took place in the Umballa District, and to the south and west the mortality diminished thus in the different districts :—: — Statement to show that the cholera of the Punjab of April 1867 was chiefly Hurdwar cholera. Umballa and Kurnal Districts, Deaths of April 1,067^ Rohtuk . ... ... ... 206 Goorgaon ... ... ... 47 Siraa ... ... ... ... 32 Loodianah ... ... ... 4> )> „ „ 13th to 31st May 84 1> 10 „ „ Ist to 13th June. » 115 „ „ 20th April to 13th June. M Note again, that it was on the 6th that the wind began to blow from the south-east ; and that rain fell during nearly a week over almost every district of the Punjab. It was on the evening of the 10th that the severe, though short-continued, attack at Mooltau commenced, supposed to have been connected with a funeral gathering of a rich man's wife who died on the 6th May after her return from Hurdwar. Dr. Deßenzy, speaking of the locality chiefly affected, says :—": — " The streets were unpaved and undrained, and they happened at the time to be very sloppy from a fall of six-tenths of an inch of rain that had fallen oh the Bth May." The next general fall of rain was from the 11th to 13th, and this reached the high Punjab. The Deputy Quarter Master General at Peshawur writes :—": — " A week before the outbreak of the epidemic (on 20th May), there had been a violent storm of rain and great floods as a consequence." The outbreak at the Sohan River, five miles from Rawulpindee, began on the very same day as the outbreak at Peshawur, and Rawulpindee became affected on the 25th and 26th. Subsequent to the outbreak at Peshawur, "it was ascertained that cases of cholera had occurred amongst some workmen at the Sohan Bridge near Rawulpindee, and that a case or two had appeared at Hurreepore in Huzara on the Same day in which the epidemic showed itself at Peshawur. A woman also belonging to the 42nd Highlanders en route to the family camp at Murree was seized at Tret."* A large village of the Rawulpindee District had become affected in the second week of May, and the origin of its cholera was, as usual, attributed to pilgrims. The meteorology with which cholera was introduced into the Rawulpindee District is thus alluded to by Surgeon F. F. Allen : — " The atmosphere was dense, loaded with dust, and so hazy as to obscure the view of the hills, only about twelve miles distant from the station. During this period the wind came chiefly from the east and south-east. I attribute the comparative mildness of the epidemic at Rawulpindee principally to the purer condition of the atmosphere as compared with Peshawur, which is situated in a low cup-shaped valley surrounded by hills, which materially interfere with the circulation of air, while Pindee is situated on a high ridge sloping on either side to the Jhelum and the Indus, and hence is exposed to every wind, and possesses good natural drainage." That the vehicle, the directing agency, and the materies of the epidemic were all present, and in a position to spread cholera from the Jumna to Peshawur between the 6th and 20th May, has been clearly shown from the above quotations ; and I know of nothing else necessary for a provincial dissemination and manifestation of cholera. I am not prepared to say why it was that the cholera of 1856, one of the greatest epidemics ever known, declined to cross the Jhelum in 1857, and until May 1858. The disturbed state of the country has caused a deficiency in our records for the period, and we can only conjecture that the vehicle was wanting. The reproduction in the east of the Natural Province was as true as in 1867. Several soldiers had died at * Scriven gives the 30th April as the day of the infection of Teree, and Hungoo May 21st, 1862 ; I quote from the repoit of the Inspector General of the Peshawur Division. f Note the parallel forty-eight years before. I quote from the Superintending' Surgeon's Report for the month of May 1820. " Cholera appeared in the town of Kurnaul on the sth May, and continued till the 28th. On the 11th May the epidemic first appeared in the cantonment." t Report of the Assistant Quarter Master General, Peshawur Division. Roorkee and Subathoo even in April ; Dugshaie was invaded in May ; and in the Umballa District (including Loodianah, Umballa, and Kurnaul) , sixty-two European soldiers were lost in this May cholera of 1857, while moving towards Delhi, and from subsequent report we know also that this cholera was virulent at the same time in the districts to the west of Delhi. We have the same circumstantial account in regard to Kangra and Sealkote and the erritories of the Maharajah of Cashmere, how that cholera was spread through these districts n May 1867 by those who had gone to Hurdwar. In Kangra the epidemic began jparently in the first week of May ; the police and jail were attacked on the sth and 6th. A bot note of Mr. Scriven's report (p. 5) gives the parallel in 1862 : — "Since this report was ritten, I have learnt that a number of cases of cholera occurred in the Kangra District, some ' them as early as April 26th ; but I have not been able to trace any connection between lese and the epidemic treated of in the text." Mr. Scriven means to imply that this cholera ccurred as early as that of the frontier, and that of the districts west of" the Jumna, and o he fails to trace the effect of human intercourse in causing the different epidemic manifesta;ions and the geographical continuity of cholera throughout the Punjab. I In Cashmere upwards of 6,000 people are said to have died in 1867. The introduction of ie cholera was attributed to the troops of the Maharajah, who accompanied him to Hurdwar. tiolera existed for three months in the city of Jummoo, and a daily average of sixty died when c cholera first broke out. Jummoo is but twenty-four miles from Sealkote, and a rigid quarantine as established and kept up by a double line of sentries. The Deputy Commissioner writes : — So rigidly was this cordon kept up that I believe not a soul passed from the Jummoo territory to this district except by the Zufferwal road, and then under passes from myself." The mtonment Magistrate of Sealkote states that the precautions taken were successful, and he of ojtinion that had these measures not been taken, the results would have been most distrous. This opinion it is as well that we should qualify by the parallel experience of 1862, in almost every instance the Civil Authorities have subscribed to the theory of the introduc>n of this cholera by pilgrims, and, in consequence, to the efficiency of quarantine as a prevent-3 measure. The then Deputy Commissioner (Mr. Macnabb) writes : — " In May and June 862) cholera raged with such violence in Jummoo that the Maharajah delayed his departure for ishmere till it abated; while Sealkote and other neighbouring towns and villages xoere filled th people flying from, the danger, they do not seem to have brought the disease with them, as ly one isolated case of cholera occurred in the district. A good month elapsed after the dying t of the cholera in Jummoo, when about the end of July, the season of the periodical rains, c disease, brought from a totally different direction, became epidemic." It is very significant remark that the very same tracts localised cholera in the Sealkote District in 1862 and 1867. iska and Pusroor hold the first place in Mr. Macnabb 's enumeration ;* and in 1867, these o Tehsils gave 334 deaths out of a total of 381 for the whole Sealkote District. il think it is clear from all this that the parallel of May 1862 for the Punjab holds most . . . mm. remarkably, whether we take it in the east, the west, or the •oncral conclusion regarding the ? .. , ¦, . '? , ' „ Lllu lera of the Punjab of May 1867, north. Coincidence has no place in my estimation of this jed to have been introduced into parallel. As I read it, the outbreak of Hurdwar, while province and spread by Hurdwar affecting- primarily those there assembled and secondarily those brought into contact with them, had no connexion atever with the geography of this May cholera of 1867 ; and I believe that the phical distribution would not have been different had no Hurdwar gathering taken place. I have shown how in the first week of April the cholera of November 1866 began to revive in the Bhurtpore State; the date given for Jeypore is the 15th. We know nothing definite regarding the cholera of Bikaneer. We know the fact that in the marching season of 1866-67 the route of the camp of the Governor General's Agent was diverted from Bikaneer in consequence of the prevalence of this cholera, and in May 1867 we read in the narratives of the districts to the east of Bikaneer that the villages lying towards Bikaneer suffered more than others. The statement made in the report from the Rajpootana States, that cholera was not epidemic in 1867 in Bikaneer, cannot therefore be regarded as correct for the whole of the Bikaneer territory. I have said that the exempted area of 1867 was the province of the south-west monsoon proper. The report from the Administration of the Central Provinces states, that no case of t_ , , c ,o^ cholera occurred among the prisoners or troops. ' The Civil Sur- Exempted area of 1867. ptt t. i. ? t> -\ l at • -r. v^ivn oiugeons of Hoshungabad, Baitool, JN ursmgpore, Raepore, Nimar mcc, Dumoh, and Nagpore, all report that the year was singularly free from epidemics, and' ,t cholera in particular was almost entirely unknown." I have mentioned that in the Central >vinces its prevalence was confined to some villages of the Mundla District, the cholera of ich is always an eastern cholera associated with that of Chota Nagpore. f I Following the northern line of the exempted area, the definition is found sharp and mistakable. The cholera extending over months in the Banda District passed off no shoot into the Jhansi District immediately adjoining. Lullutpore to the south continued solutely free from cholera during the year. Scriven's Keport, p. 27. Ii Since this was written, another example of this same association lias occurred. In the exit of the current Btnio from the endemic area iv 1868, the cholera of Chota Nagpore and Muudla appeared as portion of the same iion. 140 Saugor reports :—": — " This year was at Saugor a remarkably healthy one among European as well as among Native troops ; and there was not a single case of cholera throughout it." Nowgong reports : — " No epidemic visited Nowgong last year. The Natives in the cantonment and the adjacent villages were remarkably healthy. Cholera here is hardly known." Bhopal reports :—": — " There has not been a single case of cholera." Augur. — " There has not en to my knowledge a case of cholera anywhere in the vicinity during the year." The same the report up to Erinpoorah, the most westerly of our stations, which was also absolutely free from cholera in 1867. The Madras Presidency shared in this immunity, and the European Army lost during j 867 but seven men from cholera. The explanation which I have given is, that 1867 was the fourth year following the invasion of June 1863, and that since this cholera was not supplemented, its decay in 1867 was certain ; these provinces were reinvaded in 1868 by cholera commencing its invasion in the Jubbulpore and Mundla Districts in April. It was not deficiency of moisture which prevented the re-development of cholera in this great province, for the rain-fall was sixty inches, seasonably distributed, which is above the average for these provinces. Skirting the north of the exempted tract, Gwalior, lying immediately to the north of ?. a ... „,, ? . Jhansi, reported invasion in May, the first case occurriner Definition of the northern margin ' , x , . . nn •/ ¦> wvumug of the Exempted Tract, and the occu- among the population on the 22nd imd among the Europeans pation of the districts lying imnie- on 31st. As already noted, it was on the 30th May that 3lf cl lB67 thiU the RP6H ° f iuvusi(m> iv the orphans at Agra, the adjoining district,, were attacked. ay ' The report of cholera from the state of Tonk lying we.st of Gwalior is of the same date, the 30th May. This cholera, showing itself ao widely for the first time between the 20th and 31st May, I connect on not immediately with that of November 1866, nor with its reproduction as it occurred in Bhurtpore and Jeypore in April, but with the Banda cholera of the 12th May, reckoning this a fresh reinforcement from the east, showing itself on the very same date as iii'lBlB, 1856, or 1863, a cholera which would have provided the material for the invasion of the western division of the epidemic area of 1867, had its arrival not been anticipated in November 1866. We have no evidence to show that this body of cholera following up the invasion of the end of 1866 was of great power. All along the line of demarcation between the exempted and occupied area of 1867, a minimum of intensity was shown, and this it is essential to keep in view in estimating the success alleged to have been attained in opposing this invasion; Gwalior, for example, was in 1856 or 1860 central/?/ situated in the affected area of these years; in 1867 it occupied the very margin of the cholera tract. I Precisely as in the epidemic of 1861, Deolee was the last station of our Presidency ;oted; in this district was the extreme south-western limit of the cholera of 1867. This tion lies close on the borders of and indeed within the province of the south-west monsoon. Erinpoorah, our last cantonment to the south-west beyond Deolee, the wind blows for ten nths of the year from the south-west ; this station has no association with the cholera of Presidency, being entirely within the south-western province. The history of the progress cholera from the east into this district is thus described by Surgeon Major J. D. Crawford :—: — >eolee is situated in latitude 25° 50' north, and longitude 75° 30' east, at a point where Jeypore, Boondee, Oodeypore, and Ajmere territories meet. It is about ninety-five miles .ant south and by west from the city of Jeypore ; thirty-six miles south-west from the city Tonk ; and about sixty miles south-east from the cantonment of Nusseerabad." " A strong wind from the south-west prevails generally, and the climate is healthy." I" In the month of May 1867, reports reached us that cholera was prevalent in the irtpore and Jeypore territories. A guard of five men of the llegiment left Deolee on the i May to escort regimental stores from the Jeypore road. On arrival at Tonk they were rmed that cholera had broken out, and in consequence pitched outside the town. As they ;eeded into the Jeypore District, they heard that the disease was very prevalent in many he villages, and avoided entering them. As they were returning to Deolee, it was also r alent along the line of road. A few days after this I heard that cholera had made its iarance at Punwar, a village four miles distant from Deolee, and on the 20th June the case occurred in the station." X" Before the outbreak the weather had been from the 14th June close, hazy, and oppreswith an easterly tvi?id, when there was any. A camp follower was attacked on the 20th cholera, but recovered." Even in this remote corner of the epidemic area, with a knowledge of the fact of the general prevalence of cholera within less than 100 miles persisting up to the 15th of December in 1866, we find the observers not unwilling to adopt the theory that possibly Hurd war pilgrims may have been the means of bringing cholera upon these districts. Dr. Murray, of Ajmere, is in fact the only officer in those parts who states simply that he can trace no connection between the advent of pilgrims and the breaking out of the cholera. Dr. Burr, of Jeypore — a state in which the cholera of 1866 ceased in December — expresses his opinion, that the disease was " communicated by pilgrims from Hurdwar." Dr. Crawford, of Deolee, says :—": — " I have not been able to connect the outbreak of the disease here with the arrival of pilgrims from Hurdwar, but I believe they must have readied this part of the 141 c country about a month before cholera made its appearance." His theory is, that as the stream of pilgrims became small, the disease died out from amongst the pilgrims, but progressed by slower steps from village to village till it reached Deolee. Dr. DeFabeck, of Deolee, thinks that there can be no doubt that this epidemic owes its origin +o the transmission of the disease from Hurdwar ; " but," he adds, " while this conviction forces itself strongly upon us, I must admit that the small amount of evidence which I have been able to collect is very inconclusive." Dr. Menzies, of Grwalior, thinks that we have direct evidence of a connecting link, although a weak one, between Gwalior and the Hurdwar Fair, in the fact that a Sirdar of the Maharajah did go to Hurdwar ; and that although there is no evidence of importation of cholera, this link of connection ought not to be lost sight of. This is exactly the same kind of evidence that we find adduced from the most easterly divisions of the epidemic tract alleged to have been infected by pilgrims, for example, in Shahjehanpore and Budaon. As soon as we pass from west to east into the eastern cholera province, the authorities deny any influence to pilgrim importation. But wherever there has been the shadow of a possibility that cholera may have propagated after its introduction by pilgrims, the introduction and propagation have been insisted on as facts, whereas if my estimate of the sequence of events be correct, whatever amount of truth may have been embraced in the allegations has been used to support a theory which is fundamentally erroneous. District authorities have been invited to take up this aspect of the question, and they have not been slow to generalise from their own limited basis of observation ; and there is probably not a native medical subordinate; in the Punjab who is not impressed with the conviction that at the present time he knows the whole truth regarding the propagation of epidemic cholera, a problem the solution of which has been the aspiration of the most able observers from the past fifty years. Much of what has been alleged regarding infection from pilgrims is no doubt true ; much is as undoubtedly false or exaggerated, or the evidence has been strained so as to give an untrue colouring to the facts.* If the supposed influence of Hurdwar be struck out altogether, and I maintain that it ought to be struck out in studying the Natural History of this epidemic, the opinions so universally expressed are as universally fallacious as they are unanimous. They end in nothing, and a new theory is required to suit the altered circumstances. The one most likely to be formed, namely, that the epidemic travelled along the highways of communication would be as untrue as that abandoned. The theory is no more true — taken as theory and as representing the whole truth — than is the deduction from it, that quarantine is the universal panacea for epidemic cholera. That quarantine prevented the appearance of cholera in certain stations in May 1867, is probably true; and should similar circumstances recur in future, it is not doubtful that it will be the duty of the authorities to act as they acted in this year. But this it is necessary to add, that the true spread of the epidemic will not be limited by the application of these measures, and disappointment must not arise when this is found to be the case. The monsoon cholera of 1867 of the epidemic area had its range from Nepaul to Persia. The 18th of June is reckoned as the day on which cholera began AdemTl^S fZg! Sd generally to affect the population of the Nepaul Valley ; intelligence intensity. from Teheran, dated August 28th, states that within three days, 150 deaths had occurred, and that on the average eighty cases of K;ra were occurring daily. The prevalence of this cholera in Cabul was included between 19th July and first week of September; it is stated that 8,000 persons died up to the August. I Dr. Wright reports :—": — " From the 20th April to the middle of May a few cases occurred nsoou cholera of Nepaul. a * Katmandoo. Towards the end of May rumours arose that cholera m a severe form was raging at Gorkha, sixty miles to the westward of the valley of Katmandoo. I heard no more of it until the second week in June, when it was reported that cases were occurring daily in Katmandoo and Patun, two miles distant. From the 18th June the epidemic fairly broke out, and continued to rage till the end I" In the months of July and August, when the cholera was at the worst, the weather was arkably pleasant. There were showers and breezes daily, but nothing approaching to a iy downfall of rain or a strong wind. The greatest fall in one day in June was I*2 Les, and in July I*s inches. There were eighteen rainy days in June, twenty-four in July, twenty-five in August." I* In the Bareilly District the police reported between the 18th April and 27th May 1867, when the spring !ra ceased, 552 eases with sixty-three deaths ; and in the Budaon District, 151 cases with fourteen deaths. The ment of deaths is probably nearly correct, but the gross exaggeration of the number of cases alleged to have been ivered is conspicuous. Budaon was actually iuvaded from the east, along with Shahjehanpore, in the monsoon iduction ; but upon the fact of the occurrence of these f'ourteeu pilgrim deaths of April and May, the Medical Officer le district constructs his theory thus :—: — " The disease first appeared (at Budaon) with the Hurdwar pilgrims, in April 1867. For nearly two months the se was scarcely felt, and then all of a sudden it broke out, assuming a virulent form, and caused dreadful havoc among population. It appears to be very evident, that the cholera poison lay dormant for the period for want of some instance favourable for its growth, and that when this was supplied either by the .changes of the atmosphere, or ;s of the people (probably the former), the poison became fully developed, gained strength, and spread in different tious." 142 Chap. VII.] THE INVADING EPIDEMIC OP 1866-67. 143 In the extreme south-west of the affected area in our Presidency, the first case of cholera „ nh^ipvn «f R nimn fonp occurred at Deolee on 20th June, and the epidemic was included Monsoon choleia of Rajpootana. y^^ date an(J g lgfc j. Dr. J. Murray, of Ajmere, writes :—": — " Reports reached Ajmere of the prevalence of cholera in various parts of Marwar for more than a month before it made its appearance in Ajmere. * The first case occurred here on the 20th June. I made every enquiry with the view of tracing the first cases to stray pilgrims, but failed to do so. In the city, cholera lingered until the 30th September." * * " I observed on several occasions after a heavy fall of rain that there were a greater number of attacks. This was particularly noticeable after a fall of 3*l inches during the night of 17th August. The detachment of Europeans in the fort was attacked on 20th." {Here we find to a day the rejuvenescence or revitalisation of cholera with the setting in the monsoon at the two extremes of the epidemic area of 1867 — at Nepaul, in the north-east 1 at Ajmere and Deolee in the south-west. Between these points, and indeed between bul and the Behar Provinces, renewed manifestation was nearly universal in July, August, 1 September. The monsoon cholera of Gwalior dates from the 10th July, with a fresh 'asion or wave on 12th August. The 28th July was the day of the outbreak of the insoon cholera among the European Troops at Allahabad. lln Dr. Cannon's Report we read : — " In the city of Lueknow there were eighty. _ . „, , nine cases and forty-two deaths in June :in July, the Police onsoon cholera of Chicle, Shahie- • • acig x. i j ±i. j. r oen ii ,„,,„ nn(l Rqi . P :iiv J returns give 406 cholera deaths out of 859 cases recorded. ioie, ana c.uuiiy. o I Up to the 23rd August, when cholera as an epidemic ceased the city, there were 1,455 cases, of which 781 were fatal." I" On the 23rd August, after nine days without rain, there was not a single fatal case rted. The maximum mortality of any day was on 3rd August, when ninety-two fatal 3 were reported." Iln the last week of July, the cholera reached Khyrabad, and by the 10th August, all the aars of Seetapore had become affected. Sundeela lost 220 inhabitants in an attack which imenced on 23rd July, and died out on 14th August. Khyrabad lies exactly half way between Lueknow and Shahjehanpore. It was unquestionably from the east that the terrible monsoon cholera of Shahjehanpore came, although, as in the case of the Budaon District, it is insisted that the introduction of cholera by Hurdwar pilgrims must have been the origin of the catastrophe, since between the 24th and 30th April nine pilgrims died in two villages of the Shahjehanpore District. In May, June, and July only 166 deaths occurred in this wide district. I have elsewhere stated distinctly that Shahjehanpore is a portion of the eastern division of the epidemic area, instancing the events of 1818, 1859, and 1860 in proof of the fact. Notwithstanding his adoption of the pilgrim theory, we find the Magistrate writing :—": — " The east wind prevailed, as is usual, throughout the epidemic with only a few days' intermission. Whenever any other wind prevailed for a day, the mortality returns were lighter."f From a total of fifty-five deaths in July, the mortality rose in August to 1,147 ; in September 1,738 died; in October 729, in November 290, and in December 130. Along with this occurred the great Bareilly cholera of 1867, which seems to have reached its maximum in September and October, in which months 3,127 deaths were reported. Etah eomts next, lying south and west of Shahjehanpore. In this district there were a few cases of cholera at the end of May when Cawnpore was affected. It was on the 6th August that the alarm was given that cholera had entered the district. This is a district bordering on epidemic limits, and little liable to visitations of cholera. The maximum of the epidemic in this district was in September, when 231 deaths occurred. It is mentioned that while the epidemic was raging in the town, the sky was cloudy and east wind was blowing; on 20th September, when cholera began to decline, we read that cholera had decreased since the setting in of the westerly wind. While cholera was attaining its maximum in the Bareilly District in October, the same cholera was violent in Budaon adjoining; the deaths rose from forty-one in September to 413 in October; in December only fourteen deaths were returned. appears to have been the cholera tract affected from the east in the monsoon of 186 7 .J great force of eastern cholera was concentrated on Oude, Shahjehanpore, and Bareilly ; ihern Oude suffered in the spring invasion, Western Oude, Shahjehanpore, and Bareilly in monsoon revitalisation. »The districts of the Doab suffered little. Futtehgurh gave only 611 deaths for the year, npore gave 287 deaths in September ; eighty-nine in October ; eight in November ; and four December. Futtehgurh had had only sixty-four cholera deaths in September and October ; Allahabad eighty-six. In relation to the geography of the cholera of 1867, the eastern division of the epidemic area may be divided into two tracts, one south of the Jumna, fmparatlve intensity of the epide. second lying between the Jumna and the hills. The of 1867 in different tracts or the , ? • i_ i_ j- »j j • ±. ix. • i i.- j_i_ m division of the epidemic area. lat t er may again be sub-divided into three, in relation to the degree of intensity of prevalence. I* This statement is of importance, as opposed to that of the report furnished from the states of Rajpootana, in which alleged that cholera appeared neither in Marwar nor in Bikaneer. The statement appears to have been in both nces incorrect. f This statement evidently requires qualification or explanation. % It was to this cholera due in 1867 that I ('ailed attention in September 1866, when the limit of the invading cholera of 1866 in the east was apparent; it is also the cholera referred to in my letter of February 1867. Cholera Deaths of the General Population in 1867 — Eastern Division. The districts are geographically continuous, and are arranged from east to west. A. South of thb Jumna. Showing the djin^ out of the epidemi from East to West and South-West Bauda ... ... 2,634 Huraeerpore ... ... 223 ljullutpore ... •¦• None. B southern margin was conterlnous with the exempted tract of c year. B. Between the Jumna and the Hills 1. Tract of Maximum. 2, Tract of Medium. Goruckporc and Bustee 9,221 tihazecporc ... ... 1,880 Gonda and Daraitch ... 5,896 ; Azimghur ... ... 872 Kheree ... ... 4,764 | Fyzabad ... ... 2,339 Shah,j ehanpore ... 7,781 | Luvkuow ... ... 2,468 Bareflly ... ... 7,821 Cawnpore ... ... 1,816 Budaon ... ... 796 Seetapore ... ... 683 Etah ... .. 1,402 Futtehjjhur ... ... 611 Tract of Minimum. Benares ... ...' 502 Joußpore Sultanporc Pertabglmr ... ... it Mirzapore ... ... 305 Allahabad ... ... 192 Futtehpore ... ... 712* Had we not the events of every year from 1858 to 1866 to tell us that there is a true line of distinction between eastern and western cholera, we might without hesitation have added on to the cholera tract including Oude Shahjehanpore and Bareilly, the Moradabad Meerut and Illyghur Districts, which suffered heavily in the monsoon of 1867. In such a year, as in 1856 d 1857, the most careful recorder could not draw the epidemic line. And, therefore, while I ate it as a fact that on every occasion where the history of an epidemic has led us to expect this line has been found, I am willing to admit the possibility of the geographical continuity ove referred to, provided always that a continuity of meteorological phenomena can be own. East winds and rain sweeping the Gangetic Provinces we know to extend to Etah and Shahjehanpore, but it is not my experience that these same winds reach further to the west. But, as I have already said, abnormal intensity and continuance may in any year push back a true epidemic barrier. I do not think, however, that there is any occasion to have xecourse to this explanation in regard to the monsoon cholera west of 80° in 1867. I have shown that any cholera which may appear in these districts in May is to be regarded as the shadow of what is to come in July, August, and September, and I have stated that this |3iiomenon is so constant as to have been recognised by the residents of these parts. In our tistics of European Troops the fact is thus represented in the years in which Meerut and hilcund were affected, namely, 1856-57-58-61-62 and 1867. What is shown for Meerut is c for the whole of the Meerut and Rohilcund Districts :—: — Cholera Admissions of European Troops — Meerut, 1856-67. ¦ i I v~& £ si i YEAR. a I 4 rf .c; . f § J § £ A iilljrl^filJi § 1856 ... ... 6 73 | ... 7!) 1857 ... ... lf| 6f 7 1858 ... ... ... 3 1 : 4 1861 ... ... 1 1 ... 88 27 ... 1 ])8 J862 ... ... 1 ... 1 24 26 j 52 1867 ... ... 1G 106 I . .. 123 Total 3 ] 1 121 144 112 2 | 383 This statement clearly shows that whether it be in the case of an invading or of a reproduced cholera, epidemic manifestation is not due in May, but is delayed until after the setting in of the rains. The tables for the Punjab seem to show us that the very revitalised material which is re- I Evidence of the invasion of the P ro(lu f d iv *** south-east of the Punjab is carried onwards jab from south-east to north-west, in^° the north-west, and that by its transference the district of the removal of the material of out of which it is transferred becomes comparatively free from sofieit. ° Ut ° f thC diStriCtS ° f cllolera > J ust as th ? endemic area seems relieved after invading cholera has made its exit, and has begun its progress through epidemic area. The continuity of the wave over the frontier into Cabul and Persia afso icates that no epidemic wall intervened to oppose the progress of the material. This b probably contributed to cause the weakness of the Punjab cholera of 1868; for had the iemie barrier existed, the invading cholera would have fallen thick behind it, as in 1856 I 1861, ready to manifest its presence at the close of the normal period of dormancy, all the districts little affected by the monsoon, and in which the spring rains prevail, we do find in the monsoon months of 1867 the extensive reinvigoration of cholera which is met with ;her to the east and south-east. Universality rather than vigour is the characteristic of the rjab cholera of July, August, and September 1867 ; and the decline of the cholera of Septem, which is invariably a month of maximum when the invasion has occurred with the monsoon, n 1856 and 1861, was unusually rapid. * Some sub-divisions of FutU-hporu sufl'ered while Banda was buing invaded t Denths. 144 Tract continuous from the Jumna to the Indus, S. E. to N. W. AREA OP DECREASE FROM MAY. ARKA OP AUGMENTATION PROM MAY. Area of Spring Cholera. Area of Monsoon Choleea. Districts. . a % § Districts. . g S P a 2? to ¦£, fe a B & * W *» n «q da « ?» n <; £ Sirsa ... ... 423 435 152 21 5 Hissar ... ... 1,870 683 104 6 ... Umritsur ... 257 601 941 1,143 400 Kohtuk... ... 524 25-2 63 Lahore ... 1-20 421 1,031 3«8 124 Goorgaon ... 1,068 1,435 330 40 35 Goojrauwalla ... 60 50 616 673 270 Delbi ... ... 931 338 50 5 4 Gooji-at ... 9 14 ... 82 248 Kurnaul ... 743 341 12,5 93 51 Sealcote ... 2 52 146 132 -.'5B Umballa ... 1,044 358 152 46 58 I Jhelum ... 4 80 152 303 19« Hoshiarpore .. 484 57 29 35 61 I Shahpore 2 17 231 189 Loodianah ... 352 236 253 112 68 I Rawulpindee ... 57 360 ... 956 200 Kangra... ... 675 459 213 78 127 I Huzara ... 3 96 254 7^5 515 Goordaspore ... 60 9 25 31 61 Total ... 8,174 4,603 ],496 467 470 Total ... 537 1,676 3,157 4.603 2,402 This table I consider to show the transfer of the cholera of the south-east of the Punjab into the tract immediately continuous on the north and west, a transfer effected most probably with the spring rains in the second or third week of May, when the seed was sown, which came forward only as the monsoon reached the different districts. It is scarcely necessary to remark that the pilgrim theory explains nothing in regard to the geography of the cholera of the year, and where such explanation is attempted it fails at every point. We have some difficulty in comparing this Punjab cholera of 1867 with that of any other trnov -lnaarvm/Vh ao nn iraor r\f Anr na^irtrl V»oc« o-nr\-r\l-i/}/1 on ovo/if -rfcafallol T^lt/i «l»r\lai»o rti* Ir, inasmuch as no year of our period has supplied an exact parallel. The cholera of vember 1866 had as much a limit in the western division of the epidemic area as the Behar lera of July had in the eastern. Consequently we have not to deal with the reproduction such a cholera as that of 1856 which had covered the Punjab up to the Jhelum, or that of il, which had a like distribution. We had to look for invasion of the north of the Punjab from east and south-east in spring over a country actually unoccupied, and we had in addition to k. for the monsoon manifestation of the same cholera within the whole provincial area, ise two distinct phenomena are what is shown in the above table ; and, therefore, it was t there was no limitation in space of the Punjab cholera of 1867, no stoppage either by Jhelum or Indus, as in previous invasions. I It is clear that this May cholera did not come out of the Agra, Allyghur, or Meerut tricts unless the tracts of these districts lying along the Jumna may have furnished jontingent. The May cholera began on and west of the Jumna, and with no small innings. Nothing but a knowledge of the fact that these disti'icts were the breeding unds of the cholera of 1862 could have induced me to regard them as the breeding unds of the cholera of 1867. In relation to meteorology, the distribution of 1867 means, that between the rains of the spring and of the monsoon every part of the Punjab Province was covered, and that the same phenomena and distribution occurred in a single year which we generally find included in two, the invasion occurring in the rains of the one year, the reproduction and further extension in the spring of the year following invasion. I The Bunnoo District was reinvaded in October, the first case occurring in the city on the About the 20th it began to abate, but as late as the 15th November, this cholera coned to prevail in the villages of the Bunnoo District. This was a cholera parallel with the lawur and Kohat cholera of October 1858, and with the last outbreak of the Peshawur ey of 1862, which died in the first week of November. Thus the history of the year stands complete in its parallels, and every occurrence presents itself in an aspect consistent with past history, in meteoro- General conclusions regarding the logy, in season, and in geography. The estimate which 1 StTelnlndxS 1°867! he *"*""' have made no doubt be called in . q ue . stion > and the sequence of the events as I have described it will no doubt ¦disputed. And yet I cannot but regard the basis of my estimate as a sound one ; and jed I know of no other from which I could have tried to show the significance and the rela. of the phenomena which actually occurred. Experience of the past entitles us to sketch what would in all probability have been the cholera history of the year had the phenomena of 1866 been different. While the Behar invasion of August 1866 was in progress, I showed that the material of this epidemic was due as a great cholera over the eastern division of the epidemic area in the springand monsoon seasons of 1867, and was due to invade the western division through the 145 districts south of the Jumna, commencing 1 western invasion about the 20th May, if following parallel history. At this time it was no part of my calculation that the parallel of 1817 and 1826 should be repeated, and that the October cholera of the far east should at this season cover the country between Chota Nagpore and Rajpootana. Had the programme of 1855 and 1859 been followed, and had the meteorology of 1867 over the western area been normal, the sequel would have been as follows : The cholera which invaded Banda on 12th May would have been a body of great intensity, and not, as we actually found it, shorn of its strength. With easterly winds this cholera would have commenced to affect Agra as usual about the 20th May, but no progress would have been made before the first week of July, when with the vehicle afforded by the monsoon, Gwalior, Rajpootana, and Northern Scinde in the west, Meerut, Rohilcund, and possibly Umballa in the north, and all districts lying between the Jhelum and Agra would have been affected, the Jullundur Doab and the Sealcote District remaining most probably unaffected ; this distribution would have been completed by the first week of August, and between the 25th •September and the first week of October the invading cholera would have been dormant all over the area, unless, perhaps, in some few places where local conditions might have caused vitality to reappear for a few weeks in the end of October and beginning of November. This cholera distributed in the monsoon of 1867 would have begun to reappear from its dormancy on 20th April 1868 ; and about the 12th May would have been epidemic west of the Jumna, over Umballa and Kangra and the lower hill stations, Rawulpindee and Huzara, and also beyond the Indus on some part of the frontier. In short, the history of the western cholera of 1866-67 in place of being comprehended in the three revitalisations of November 1866, May 1867, and July 1867 would have been extended over a further period of a year ; for what was effected in May 1867 could not possibly have been effected before May 1868 had the invasion of the Agra District from the east been delayed until the end of May 1867. We have seen how little hold, even in 1867, this May cholera had of the Agra District, and eastern cholera could not have crossed this tract at such a season in such a shape as to be capable of forming the body of an epidemic suited tor invasion further to the north and west, as we know from the history of the May cholera of 1856 and 1861.* What actually happened was, that the great south-eastern body of the cholera of 1 866 was diverted in October 1866 into the tract west of 80° east longitude, trifling as was the indication of the fact, taking the affection of the population as an index. Had I not noted universality of distribution to be a better gauge of the importance of a threatened epidemic than the severity of single outbreaks, especially when occurring at an abnormal season, the fact of general invasion might in the instance of this epidemic have escaped notice altogether, and the true clue to the epidemic history of 1867 would in this case have been lost. The fact of the October advance of 1866 enormously diminished the power of the invading cholera of May 1867, which followed in its track, and indeed it seems to have swept away entirely the material which, if present, would have been available for the invasion of Nagpore in March 1867. I believe that the course of the monsoon cholera of 1866 directly from south to north had also much to do with this diversion, and I see in the great cholera of Northern Oude and Goruckpore the compensation for the immunity of the Central Provinces. Cholera op the epidemic area of 1868-69. It seems to me, writing at the present time, April 1869, that the anticipations in regard to the epidemic which is to succeed that of 1866, should take the following direction :—: — Cholera is now widely epidemic in Eastern Bengal; and when we review the facts of 1868, we cannot doubt that in the spring of this year also cholera was widely diffused as a moving epidemic within the endemic area, In the cholera seasons of 1868 the prevalence of cholera was far above the average in very many districts of Bengal Proper. The facts regarding cholera in the endemic province forbid us to conclude that even the indices given by our types were mere evidences of the local reproduction of cholera. In the last days of March 1868, the first wave of the year seems to have swept over a fholera of the spring of 1868, epi- large and continuous tract of the endemic area, and the effects ie within the Endemic Province. o f this seem to have ceased about the 17th of April. The following are the indices of this cholera wave shown in the Returns of 1868 :—: — il.— Three men of the 2-60 th Regiment were patients in the General Hospital at Calcutta the upper ward. The first was admitted on the 20th March, suffering from simple hEemorrds j the second _ had been in hospital for two months, suffering from indolent bubo ; and third was admitted on the Bth April on account of dysentery. These three men were attacked 1 died, the first on 27th March, the second on 30th March, and the third on 16th April, ere was no cholera in Fort William at the time, nor was there any other admission in the Gfiment before December. 2. — The 2nd Native Infantry, stationed at Alipore, a mile in the rear of the General Hospital, had ten cases of cholera, of which five were fatal, between the 31st March and 10th April. * In inaking this broad statement, it is right that I should qualify it with reference to my observations regarding the cholera of the spring of 1845, which I have described as passing over Agra in March and April, and as having had its tull provincial distribution during the spring reproduction. 146 [Section I. Chap. VII- ] THE PROBABLE RELATIONS OF ENDEMIC AND EPIDEMIC CHOLERA IN 1868. 147 3. — The Chinsurah Depot (European) was attacked on the 7th April, and the last case occurred on the 16th ; four men were lost in this outbreak. 4. — The following is from the report of the jail at Burdwan for 1868 : " A slight epidemic of cholera attacked the prisoners in April. On the 15th, five women were taken ill ; on the 16th, another woman; and on the 17th, three more. None of the cases, however, proved fatal." In the same days, the general population around the jail were suffering. 15. — In the Raj shahye jail two great outbreaks occurred in the spring of 1868. The first fimenced on 29th March and terminated on the 17th April; the second, which commenced jr a clear interval of nine days, was included between the 26th April and 13th May. '. French is inclined to believe that the infection of his jail occurred through pilgrims, ause the appearance of cholera in the jail and district was coincident with the infection of '¦rims ; and yet he recognises the difficulties of the case. He writes :* — " I have not the ;htest doubt but that the cholera brought by the pilgrims from Nattore, either through the or in some way or other, infected the jail. There was, however, no communication at all ween the pilgrims and the prisoners, and I have shown that the cholera appeared on the same among the prisoners in two distinct and separate parts of the jail, namely, in the quaran-3 ward and in the main jail. These men had no communication whatever with any one side the jail walls." The question of the poisoning of a tank in proximity to the jail by lera-infected pilgrims, is brought forward as affording a possible clue to the infection of the ;oners ; but from the dates, taken in connection with the four instances quoted, this seems to c been an infection from one common source of the district population, pilgrims, and oners. t About the 20th of May, a second wave appears to have passed over a large portion of vev Bengal. With this Chinsurah and Berhampore became affected on the 20th and 22nd, in the Backergunge jail an outbreak commenced on the 18th. A third outbreak occurred he Chinsurah Depot between the 20th and 22nd June in which five men died; and the hampore detachment was attacked a second time on 25th July. ISuch indications show the wide spread of cholera truly epidemic in this situation. On the higher lying districts bounding the endemic basin, epiolera of the spring of 1868, on d { c h o i era appears to have been very persistent. For largms of the endemic basin. . yL , r t> v V tt t? • J • example, in the report for Beerbhoom we read :—": — " Epidemic (era of a malignant character prevailed in many parts of the district throughout the ,ter part of the year." The report for Hazareebaugh states that cholera f>revailed from il to August. il have on many occasions alluded to the significance of a cholera epidemic on the ;eau of Hazareebaugh; and if we are to reckon this cholera of 1868 a true epidemic mation immediately added on to the cholera epidemic within the endemic basin, I fear that have no right to disregard the warning which similar emanations have given of epidemic ance beyond the boundaries of the endemic province. In previous chapters of this report, written in 1868, I have mentioned, that it was my impression that the cholera re-occupying the southern epidemic trading cholera of the Epidemic highway (the exempted area of 1867), between March and , and its probable silliances. Cholera -~° / v , ,r, r ? „ , ¦. ' , o ,-> v Lota Nagpore of 1868. December, was but a portion ot the matenes of the invading epidemic of 1866 repressed from invasion during 1867, and sringthe Central Provinces with the favouring spring influences of 1868. Further reflection, the most recent experience of the cholera of 1869, inclines me now to view the occurrence i different light, and to regard the cholera of the Central Provinces repressed out of Upper ia by the meteorology of 1868, as the body of a new epidemic commencing its career the epidemic area. K Throughout the Behar Provinces and the valley of the Ganges, and beyond, over Northern , generally, in 1868, the characteristics of a non-epidemic year were universally displayed; and hence probably it was that Bundlecund and the districts intervening gave no great manifestation of cholera in response to the appearance in the east, and that the southern epidemic highway was selected by the invading cholera of the year in preference to the northern. We recall the invasion from the east of the epidemic of 1863, and the gate by which raced it entering to become the great cholera of the Central Provinces of 1864 and 1865. is the circle of jails of the north-east of the Central Provinces that afforded the indication of entrance— Mundla, Jubbulpore, and Seonee. The infection of these same districts early in 1868, added to the indications of the bursting forth of cholera from within the endemic area, leads me to believe, that in the phenomena we cannot but recognise the succession of a new invasion to that of 1863, and one not due to any portion of the cholera of 1866 and 1867. And in addition, we find the connecting link joining on the cholera of Jubbulpore and Mundla with that of Hazareebaugh and Beerbhoom, in the great cholera of Chota Nagpore of 1868, regarding which I hope to append a few details in a postscript to this chapter. The line of repression and of extinction in the north is very beautifully defined in the mortality record of the general population. I append the table showing the mortality from cholera in the North- Western Provinces, which I have arranged geographically. • Report published in the Calcutta Gazette of 1868, page 748. Cholera Deaths of the North- Western Provinces, 1868. (Estimated population, 29,588,653,). fe 53 ?; bL b *t < B «-" *k i m, B § J . 1 i .o a H Total fob D.STBXCTS. | | tiJlliill IHETEAE IHETEAEagg a £ £ •« $ O fc (3 fihawnore «1 33 123 166 145 383 245 378 327 241 87 36 2,215 SnarPß 20 30 169 171 228 444 140 78 70 33 35 15 1,433 Miramore 27 17 601 342 675 434 123 19 29 4 16 3 2,290 aSw ' 48 27 23 55 188 102 258 248 264 219 46 76 1.554 TninSoe '." '.'..5 7' 41 169 195 111 120 3:36 77 35 6 2 IJO4 OnruKre' ¦•¦ 102 12 8 370 463 675 1,040 869 331 96 29 ... 3,995 Bultee "' 73 16 27 29 129 87 125 68 9 1 564 Allahabad'" " 24 7 12 56 119 55 204 58 28 9 14 a 6 622 Futtehpore !'.! ... 40 3 4 2 9 20 4 1 2 ... 1 -2 88 Barida ... 1 3 2 2 . ... ... 8 Hunieerpore 1 11 Z Z. '.'.[ "s 1 11 CaSl?... .'.'.' '.'.'. Z "i "ll "'b " 4 '"n "l 0 '"& 's "s "a "i '"qi Futtehpore 7 11 13 6 23 8 7 13 11 ... 2 1 102 Etah 34484483)6575 61 Mvnpoorie" 3 8 4 16 2 21 9 2 j 5 5 3 2 80 Etawah 1 ... 4 ... 2 1 3 ... 1 l 2 AiWiur 9 14 5 8 6 4 11 11 16 12 7 3 106 Bolundshuhur 3 4 2 12 19 9 • 22 33 8 1 6 102* Muttra 4 3 6 10 13 14 50 ]0 1 5 6 4 3 128 Afrra '.'.'. .. 18 5 10 12 12 6 8 5 7 4 ... 78 M eerut ' 8 8 9 12 13 40 33 18 153 7 8 9 318 Moradabad 13 12 10 10 20 20 7 5 10 12 8 JO 137 Budabn . 1 12 12 8 9 10 11 15 11 8 13 3 104 Bareilly '.'.'. 28 18 46 88 62 41 28 56 27 88 40 9 531 Shahjehanpore 5 8 ... 1' 1 2 5 5 6 8 2 . 43 Terai Pergunnahs 1 2 ... ... .• ... ... ... 3 Kumaoii ••• ••¦ •¦¦ ••• * ••¦ ••• ••• 2 Ghurwal H 6 ... 2 1 20 Biinour ..... 1 1 2 2 8 4 5 3 3 5 4 38 Seharunpore . ... 5 16 9 24 21 11 16 8 4 9? 12 138 Mozuffernuggur ... 21 11 49 7 :^2 36 34 17 10 4 8 9 228 North-Western Provinces 516 290 1,202 1,593 2,381 2,565 2,507 2,260 1,438 828 361 251 16,192 We have not yet a tabulated record for the Gang-etic Districts extending 1 over a period sufficient to show the normal average number of deaths in relation to comparative exemption, to the meteorology of any year, and to the age of epidemics, which would enable us to estimate whether or not the numbers shown in the above table indicate a prevalence of cholera mud) above what is normal for these and localities of a similar character ; nor can we say with certainty from merely looking at the table, that the indication is here afforded of the invasion of a new epidemic. Allahabad and the seven districts lying- to the east clearly form an area which is cut off from that lying to the west by the disparity of the ratio of prevalence ; this area stands associated with the cholera of the east. It is evident that as soon as we pass to the westward a tract of minimum is reached, which is continuous geographically with a great General Population. tract o f absolute exemption lying south of the Cholera deaths of the year. Jumna. The districts noted in the margin Districts. Deaths. Districts. Deaths, form the western division of the eastern Futtehpore 88 Jaloun ... 11 province of the epidemic area, and constitute Cawnpore ... ... 67 Jhansi ... ) «. the tract in which influences immediately Futtehghur ... 102 Lullutpore... ] on ' f rom the east die out. If the cholera of Shahjebanpore ... 43 H~pore ... 5 an( j the east was an invading Etawah ... ... 12 cholera, then it is evident that the western boundary of the eastern province, which normally is very nearly the line of 80°, was pushed much to the east in consequence of the predominance of western influences and the absence of influences which the monsoon would tve brought with it had it reached so far. The cholera area of 1868 in this situation plainly jresents the natural province in the east, whether we regard it as formed by local invading agencies, or by both. (With the exception of the districts of Bareilly, Meerut, and Mozuffernuggur, which ye, respectively, 531, 318, and 228 deaths from cholera, the indications of prevalence afforded the statistics of the general population are trifling, and they show how little the cholera so diffusely spread in 1866 and 1867 continued to affect the northern provinces. * There is an evident error in the return from Bolundshuhur of July. 148 The cholera which passed the frontier and affected Cabul and Persia in 1867 still survived in the Caspian Provinces of Persia. On the 25th August 1868, the Medical Officer reports to Her Majesty's Minister at Teheran that cholera had reappeared. He writes :— " After the cessation of the epidemic in this neighbourhood last autumn, it seems to have moved on towards the Caspian Provinces, where it continued during the winter months, assuming a milder or rather the sporadic form. rt In the spring it gradually spread over the towns and villages on the road to Khorasan, and according to the latest accounts received from Meshed, the epidemic broke out in that town last month with great virulence." He dates the arrival of cholera in Teheran from the 7th August, and considers its appearance to be consequent on the arrival of a caravan of pilgrims from Meshed, which reached Teheran on the sth of the same month. As in Upper India, this cholera died in the end of September. After the Ist October only thirteen deaths were attributed to cholera. Between the 7th August and 11th October, 468 deaths were caused by this cholera in Teheran. The dying away of the cholera of the North- West in the course of the dying monsoon is beautifully shown in the preceding table and in that which follows, which gives the cholera deaths of the Punjab for 1868, geographically arranged. Except in the districts lying along the base of the hills, the indications of prevalence are the most trifling, and the tract beyond primary monsoon influences is exhibited as an area of utter exemption. The Agra District gave but seventy-eight deaths in 1868, and the Muttra District 128 ; and immediately on entering the Punjab from the south-east, the numbers diminish in a still more wonderful decree. This table affords an illustration of what is meant in speaking of the minimum reached in Upper India ; and I believe that in many years the deaths fall even much below what is now represented :—: — Cholera Deaths of the Punjab, 1868. (Estimated population, 17,586,232). IS 5J £ >, & _J -2 v ,Q JSI Districts. Sg-s. . § 5 JS 6 2 JllltJfflfll Goorgaon ... 2 4 7 5 112 1 Delhi ... ... ••¦ J 1 ... 2 1 8 1 ... & .« Rhotuk ... ... -. • » .» 1 ». -. ». ¦•• 1 ¦•• Hissar 1 • •¦¦ ... ... ... 2 1 c; rr = a ... ?. 11l ... 1 1 Kurnaul .'.'. ... ... ... 2 3 3 2 ... 3 2 6 5 1 ... 1 Umballa ... Z ... ... 6 1 5 4 7 5 3 1 ... 3 JuUundur "'. '" '.". '¦'¦' "* "; "l ¦•• "> "} "l '¦'¦'¦ ••'¦ •" '* "2" 2 Loodianah ... ... — * ••• l ••¦ * ... ... . If/yahiirnnrp ... ... ... 5 1 1 ... 6 2 1 ... 1 ... iSET • ::: - 3 6 i 2 3 5 5 3i 4 65 8 4 Goordaspore ... ••¦ ••¦ 8 4 4 3 ... ... ... ... ... c ra | Pl ifp ... ... ... 1 ... 4 2 1 2 2 Imriteur ::: 5 3 i 8 2 s v , ? v « 5 j ... Goojrat 2 . 3 4 3 5 1 5 2 5 2 o Goojranwalla... ... ... ... 8 1 1 1 8 4 5 5 1 ... 1 ... r alinvo ... ... 1 2 1 1 ... 1 4 1 ... krTepore Z ... 2 2 12 112 ... 1 1 Montgomery ... ••• ••¦ • * ¦•• ' ' Mooltan ... ••• ••• ¦ Mozufferghur ... ••• ' Dera (ihazee Khan ... ¦•• • Dera Isinael Khan ..". ••• Jhung ... ... •¦¦ ¦•¦ ••• ••¦ •¦ Shahpore ... ... .... ••• 2 1 - ••• ••¦ f ••• ; ¦•• Jhelum ... ... ••• 9 I ' 2 •¦• Huzara 1 1 ... 2 2 ... 3 1 ... Rawul Pindee ... ••• ¦¦• •• " ••• Peshawur 3 2 2 13 3 2 1 2 Kohat ... ... - ] Bunnoo ... •• ••• * Cholera deaths of the Punjab ... 48 26 31 44 71 64 43 41 37 85 '24 17 I am not of opinion that this minimum was due solely to the natural decay of the invading cholera of 1866 and 1867, although the fact that the cholera of 1867 was diffusely spread far beyond the frontier might have caused the inference to be made, that revitalisation in epidemic vigour was scarcely to be expected, since there was not, as in the invasions of the Punjab of 1856 and 1861, a boundary line behind which cholera was precipitated and survived because of its precipitation. It is certain that the meteorology of the year in this situation had much # No return. 2p 149 CHARACTERISTICS OP 1868, A NON-EPIDEMIC YEAR IN THE PUNJAB. L. vu v*i x* 150 to do with the repression of manifestation, and determined a ratio of prevalence very much smaller than would have resulted with a normal or excessive rain-fall. The following* table shows the meteorology with which the northern cholera was associated in 1868. Except in the stations which enjoy a higher rain-fall in consequence of their proximity to the hills, the minimum was universal : — Rain-fall in inches of the Punjab, 1868, a non-epidemic year. _. Sprinsr rains, Ist April to Monsoon rains, 15th June Districts. * s 14th } une- " t o 4th October. ... ... ... ... ... 1.5 17-4 * Ferozepore ... ... ... ... •¦• 2'l 99 Mozufferghur ... ... ... ... ... "7 "1 Dera Ghazee Khan ... ... ... ... I' 4 1"3 Dera Ismael Khan ... ... ... ... 3*l I*7 Umballa ... . . ... ... ... 9'l 6-8 .Jullundur ... ... ... 1-4 98 Loodianah ... ... ... ... ... IB 126 Hoshiarpore ... ?, ... ... ... I*s 172 Kangra ... ... ... ... ... 6-6 26-6 Goordaspore ... ... ... ... ... 5-3 285 Sealcote ... ... ... ... ... 6-8 284 Umritsur .. ... ... ... ... 4-3 9*o Lahore ... ... ... ... ... 3*5 57 Goojranwallah ... ... ... ... ... 3*4 151 Goojrat ... ... ... ... ... 62 16-6 Jhelum ... ... ... ... ... I*9 110 Eawul Pindee ... ... ... ... ... 55 )2'7 Abbottabad ... ... ... ... ... 9-1 129 Peshawar ... ... ... ... ... 4'o I*s Bunnoo ... ... ... ... ... 5"4 35 Dhurmsalla ... ... ... ... ... 17-0 65-4 Simla ... ... . . . ... 19-2 37-4 Dalhousie ... ... ... ... ... 118 31-2 In continuation of tables at pages 69 and 70, 1 note here the statistics of the province for 1868, to show the consistency of these with the figures of former years of a similar character. The maximum of sickness was attained not in the malarious months, reaching its culminating point in October and November, but in the hot months preceding the usual date of the setting in of the rains ; there is no rise of the sick-rate in the autumn months, in which malarious influences normally prevail, and from September, there is a steady decline to the minimum of European Army of the Punjab, 1868. Average Strength, 12,576. i||||i-s'ill|| i-s fag-s! S h n en o fc a Fever Admissions ... 364 192 250 367 934 1,357 723 795 763 693 694 605 Daily sick-rate per cent, of strength ... ... 419 404 395 3-93 4-52 5-51 5-10 511 5-16 4-85 4-20 8*72 The death-rate for the European Army was 15*50 per 1,000; but of this rate 5*50 was due to heat apoplexy and heat fevers, which, in a year constituted like 1868, I have shown to contribute in excess of the normal mean. I The three stations which I employed as indices, and of which I gave the death rates for 9, 1860, and 1866, gave in 1868 a ratio entirely consistent with the rates of these years, i page 70). * 14" 1 inches of this total fell between 21st and 25th July; 4 inches only fell after this date. European Troops, 1868. Died per 1,000 of Strength. FSKOZEFOBE. MOOLTAN. PBSHAWCB. Strength 817 Strength 774 Strength 1,676 All causes ... ... 979 All causes ... ... 14-21 All causes ... 1488 Heat apoplexy ... 2-45 Heat apoplexy ... 517 Heat apoplexy ... 1-20 Deducting heat apoplexy 7*34 Deducting heat apoplexy 9#049 # 04 Deducting heat apoplexy 1312 The characteristic which I noticed; as distinguishing the heat fevers of a non- Eer Majesty's 9%nd Regiment. epidemic year among British soldiers was Age ... 15 Died ... 1 exhibited in the case ot every Regiment in its first year „ ... 18 1 in India, and many of the young lads succumbed to » ••• | this typhoid fever, which, as usual, was in every case "] 21 " ... 2 attended with the affection of Peyer's glands. The 92nd " ... 23 ," ... i Regiment lost eleven young men, whose ages are noted in » •¦• 2 £ » ••• 1 the margin, and the 85th and l-6th Regiments also suffered " " " "¦ from the same fever.* The death-rate for the jail population sank to a minimum never yet attained in our experience — 12*39 per 1,000, the equivalent of 137 deaths out of an average daily strength of 11,056 prisoners. No death from cholera occurred in the Punjab among troops or prisoners. Over the northern epidemic highway also, a tract which gets its rain and its cholera in common with the north-western extension as far as the desert, monsoon influences utterly failed in 1868. On the 10th September, the Editor of the Delhi Gazette writes as follows regarding the state of Rajpootana :—: — " Advices from Rajpootana, especially towards the south of that district, give melancholy accounts of the condition of the country from want of rain. While the northern parts of Guzerat have been flooded and devastated by a hurricane, a few miles further north the face ot" nature is brown and withered, as in the hot weather. The downpour of rain appears to have extended as far north as the military cantonment of Deesa, while further up the country all effects of the monsoon gradually disappear, until in Marwar, British Mhairwarrah, and Ajmere, there is scarcely the trace of a passing shower. In the first locality mentioned, houses and even villages have been washed away, crops destroyed, and men and cattle drowned. In the latter districts crops are dead, cattle are dying, and the inhabitants leaving their homes in search of water. In Marwar, on the verge of the desert, the rain-fall is generally very scanty, and a slight diminution of the usual amount is sufficient to create dire distress. In some parts of this unhappy country, it is stated that not one drop has yet fallen. The magicians have conjured, the rain-makers have been sent for far and wide, and offerings have covered the numerous shrines. These and many other contrivances have been resorted to, but the time has passed on, and the rain so ardently desired has not fallen. As yet perhaps some few of the crops might be partly saved by a timely downfall; but a longer period elapsing without rain, nothing can save the country north of Deesa, almost up to Agra, from famine. " In accordance with all that has been written regarding the circumstances attending the occupation of the northern highway, it is certain that, even had the material of an epidemic offered itself at the gate of entrance to this tract, it must, for want of a vehicle, have located itself, waiting for the opportunity of epidemic advance denied to it by the meteorology of 1868. I have, in various epidemics, taken Ajmere as the index station, in estimating the fact of the occupation of the northern highway. The indication of a cholera in this situation is not one likely to mislead. And as I write (April 1869), the fact of the appearance of cholera has been reported. A correspondent of the Delhi Gazette, writing from Nusseerabad on the 12th April, says :—": — " I have just heard that cholera of a virulent type broke out in Ajmere on Wednesday last, when four cases occurred with three deaths. On Friday there were six deaths, all natives. I have no later information about the spread of the disease. No Europeans had been attacked, but yesterday morning the Company of the Royals, stationed in the fort, was marched out and quartered in the residency bungalow at some distance from the town." The occurrence of cholera in Ajmere might be considered by some only as caused by a northern extension of the cholera of Malwa of November and December; but I attach to it a significance beyond this. I think it not improbable that an offshoot of southern or southeastern cholera was directed into this route in December, which is now becoming manifest. I have noticed the occurrence in December 1855, of a single fatal case in the Jhansi Jail as the outrunner of the epidemic of 1856 ; and exactly a parallel case occurred in the 103 rd Regiment at Morar on the 27th December last. To this I called special attention at the time, as possibly giving forewarning of a cholera in motion ; and I was struck by its occurrence all the more forcibly from finding at this most unusual season, a fatal case in the sth Lancers at Lucknow, which occurred on the very same day. I looked at the latter case also in connection with the attack of the 4th Native Infantry at Allahabad in the end of * The 85th Regiment lost eleven young men, aud vine of the recruits for Beugal Regimeuts left for the hot seasou at the Kurrachee Depot died from the same fever. 151 CHOLERA OF THE CENTRAL PROVINCES OF 1868. [Section I, 152 November and in the first days of December. A glance at the table for European Troops shows a wide-spread choleraic influence, of no strength, occurring in the month of August.* The present aspect of the cholera of our Presidency leads us back to enquire, whether or not this cholera of August 1868, like the monsoon cholera of 1865, epidemic over the same area and geographically added on to the cholera of the Central Provinces, was the aura of the same cholera which was universally epidemic to the south at the time ; and whether the cholera of Agra, Morar, and Meerut, which occurred in all of these stations in the seven days between the 14th and 21st August, was not one and the same cholera I which Saugor affords us the index. The first case proved fatal at Saugor on the 21st ugust; the Meerut case became affected on the 20th; and the case at Morar during c week ending 21st August. We know that the case at Saugor was truly and unmiskably a portion of the invading wave in the south ; and taking our parallel from the olera of 1865, we shall not, I think, be wrong in regarding the cases occurring simulneously further to the north as a part of the same moving cholera. tThat this cholera of the south was again in motion in the last three months of the year, invasion of Bombay and the occupation of Khandeish and Malwa distinctly points out ; the meteorology accompanying this movement determined over the area in these months a ial manifestation of disease in the form of fever and dysentery. I In connexion with the case which occurred at Gwalior on the 27th December, and the isibility of its being an index of a moving cholera and of invasion, the following case, although tiding apparently isolated, has for us a special interest. The Medical Officer of Bhopal, ing from Sehore on 7th January 1869, mentions, that, on the 20th December, a single case of c cholera had occurred in the city, which he had seen, and from which the boy had )vered. It is on the 20th April that revitalisation of such a cholera is to be looked for the western area ; and, as I write, a telegram from the General Commanding at Morar, ed the 20th April, announces that three cases have occurred between the 3rd and 19th, [ that an outbreak is anticipated. I It is to be hoped that these warnings may be the prelude in the western division only to the asion of a cholera of the strength of that of 1865; which, however, we must not forget, was a [j of enormous power in every district south of the Jumna (seep. 45) ; and while the character the cholera of 1868, as shown on the southern highway, would not indicate great epidemic mgth, we must not overlook the unfavourable meteorology with which it occurred, the well )wn character of the tract occupied, and the possibility of reinforcement from behind. II have shown how, in various epidemics occurring in the fifty years that are past, seasons 3tly characterised in Northern India like that of 1868, afforded, in the Central Provinces, opportunity for cholera of passing from sea to sea; and I have shown this to be the : even when the seasons in the Central Provinces were described as hot and deficient in L-fall. The explanation which I have given is, that in the Central Provinces there is no l condition of dryness as prevails during the blowing of the hot winds over Northern ia ; that dryness is a comparative term, and that in this geographical situation, dryness ms what it means in the endemic province — the normal climatology which exists between rch and June, with which the cholera miasm flourishes in its greatest vigour. And I c remarked, that the vehicle for the westward extension of cholera on this southern high¦ is more readily available in such seasons, since the normal monsoon from the western 3t is in abeyance, and since, therefore, eastern influences are predominant. I The meteorology of this non-epidemic year in the south, and the results in regard to ase, are well stated in the following extract from the medical history of the 12th Native mtry for 1868. Mr. Caird writes : — "The experience of 1868 would give a very favourable i of the climate of Jubbulpore; for the prolonged hot season before the rains, which c a month later than usual, was by no means beyond endurance, and the nights especially c not stifling as in many parts of India. The climate presented a marked contrast to the fierce tof the North- West Provinces at the same time of the year. A fall of rain lasting for a ith was followed by dry weather again, which has continued uninterruptedly till the sent. This has been a season of health as well as of comfort, rarely experienced in the >t favoured parts of India. Instead of a deluge of rain in August and September, only first part of the former month had any rain-fall, and in the latter the heat was very ¦able ; and in the commencement of October the weather became perceptibly cooler, and he middle of the month the cold season had set in. There being no swamps to dry up no fierce heat in the day, the autumn was devoid of the usual malarious diseases, and :e was scarcely more fever than is usual in May and June." I The limiting line of the monsoon and of the cholera of 1868, was not like the line of 1860, bly found as far to the north-west as Agra, although it may have been indicated in iow. As I have shown, there was no cholera south of the Jumna, and no cholera in n&i or Lullutpore. But this was the northern limit; for as soon as we pass south :his line the tract invaded during 1868 is entered, the same tract which was the exempted i of 1867. The history of the invasion has been very clearly traced ; and from the time of its entrance in the extreme north-east in April, until the occupation of Malwa in December No case out of tl.e four which occurred at Morar, Agra, and Meerut, was fatal. there is no difficulty in recognising that it is an invading cholera of which the career is being followed out. I As is shown in the Jail Table for 1863, it is through the Mundla, Jubbulpore, and >nee Districts that cholera is found entering the Central Provinces. The forewarning this cholera had been given as early as March, and the first outbreak that attracted cial notice began on the 15 th April among a gang of coolies employed on the Nagpore din the Seonee District, fifty- five miles from Jubbulpore. It was on the 15th May that lera was reported to have entered Jubbulpore, and the European Regiment became affected the 23rd of May. I have repeatedly called attention to invasion from the east as occurring many epidemics in this week, especially into the Agra District, the gate by which the lera threatening to invade the northern provinces, enters; it is therefore no coincidence t, in the same week, with the meteorology of 1868, this cholera should have appeared in districts to the south and east. The police reported the appearance of cholera in the Mundla District in the same week, and on the Ist of June the first inhabitant of the town was attacked. As is usual for this situation, the vitality of this invading cholera ended in August. The Civil Surgeon writes :—: — "No death from cholera has occurred in the district since the 17th September; in fact, the disease died out in August, and it was only the old cases that were dropping off that were reported in the Mortuary Returns for September.'-' We find the valley of the Nerbudda occupied in June, and in August cholera is reported to be prevailing in Khandeish, at the same time that its presence was noticed in the Saugor District above the Vindhya. This would seem to have been the limit reached with the monsoon ; for it was not until October that the body of the epidemic reached Bombay, and it was subsequent to this date that Western Malwa was occupied. As I have shown above, it was not until the 20th of December that the first case of cholera, an index case, appeared in the Bhopal The table which follows shows the results of the invasion of the Central Provinces, and the dates at which this invasion began and terminated :—: — Cholera Deaths of the Central Provinces, 1868. Number of deaths feom Cholbe.v in bach Month. ~\~7, Z £ ~~£ 7 Total 8 Districts. t « S *j ¦§ c ¦§ .a Deaths of 1 g E " -4 . d . s I £ I s the Yeah. > c-c'*''Ss'o^'Sf"S.-c -c '*''S5'o^'Sf"S.-2 :> " • f Nagpore ... ... ... 4 3 92 120 50 14 8 291 S Bhundara ... ... 55 86 ; 1 ... ¦ ... 142 2reak a further insight into the natural history of the object cholera may be anticipated, he meteorological and geographical aspects of the epidemic and the reproduction have I From the very beginning; of this section, it is necessary to keep before the mind the two-fold .aspect of the out: tirst, the aspect due to the simple fact of the affection of a certain body, such as the prisoners of a jail or the men egiment struck upon a known day ; and second, the aspect shown in relation to the population of a province. Under rst, the persistence is for a period of days, but it is capable of being prolonged, and in many cases is actually pro-1, up to the limit in time of the reproduction ; under the second, the general disappearance throughout the natural L'curs only with the devitalisation of the cholera miasm on the close of the period of the reproduction. 2 s [Section II JG2 GENERAL ARRANGEMENT OF THE SUBJECTS OF THE SECOND SECTION. taught us the part which cholera plays over provinces and in relation to season, the aspect of cholera when viewed locally and as localised by special conditions, and studied in the method of its infection of and decay in communities, should teach us what to expect, and what to iivoid, and how the cholera of the outbreak is to be met. The subjects to be treated of in this section, I shall consider in the following- order :—: — Chapter I. — The phenomena common to all outbreaks over a provincial area. Chapter II. — Methods and course of infection, the duration of outbreaks, and the circumstances which tend to prolong or to cut short the outbreak. Chapter 111. — The circumstances which intensify or diminish the ratio of attacks during the outbreak. The direction in which the study of the natural history of the epidemic and the outbreak points in trying to determine the principles on which the outbreak should be met. Chapter IV. — Dependencies of outbreaks. How far the natural and primary aspect of the epidemic, the reproduction, and the outbreak is affected by the secondary manifestations of cholera. CHAPTER I. THE PHENOMENA COMMON TO ALL OUTBREAKS OVER A PROVINCIAL AREA. The commencement of every outbreak of the epidemic area occurs subsequent to the invasion tthe epidemic or to the revitalisation of the reproduction; outbreaks are at an end with decay of the epidemic, and with the dormancy of the reproduction. Outbreaks which c been termed casual or sporadic have their true place in a system, as well as those occurring conspicuously in connexion with others. These truths are readily acknowledged in a general way in this country, where the absolute |)ordination of the cholera of a province to the climatology of the months and to the phenona of invasion, is manifested without variation year after year. When an epidemic has ranced with the monsoon, and when outbreak after outbreak has shown that a whole proce is in a conflagration, every observer can state positively that this cholera came with the nsoon, and that no cholera already existed in a state of dormancy ready to awake when the natic conditions were afforded ; and he can readily prove by the geography of its advance, t the invading cholera did not advance along lines of communication. And yet, as a rule, sooner have these admissions been made, than they seem to be forgotten, and we find the break treated of as something distinct from the invasion, and as a thing secondary to oan intercourse, which these same observers properly ignore as the originating cause of the invading cholera. This carelessness in expression must be carefully avoided in treating of the outbreak. In thinking of the miasm causing true malarious fever, no observer ever confuses in his mind the two things, the effect of the poison and the effect of human intercourse in spreading the fever. He accepts it as true that one generally prevailing cause, the presence of the miasm in an atmospheric medium, has sufficed to light up and to maintain for a certain time the specific fever over the provincial area. He does not say that this fever has radiated from a centre, or that it has travelled along highways of communication, for he knows that such is not the case. He tries to show that where local causes have been in operation to determine graver or minor degrees of prevalence there the general influence has affected the resident community with greater or less severity ; in short, that the miasm has had a geography and a local prevalence which were not determined by the presence or absence of the human being. The very first and fundamental proposition in speaking of the cholera outbreak is, that the locality of its occurrence and its severity are determined by causes which have not necessarily any connection with human intercourse. It is the powerful individuality of the cholera miasm which clearly cuts it off from all other miasmata, and denies to us the opportunity of ascribing the effects produced to any other cause than the presence of the cholera poison. From the observation of this powerful individuality has sprung the theory that cholera must be something over and above a malarious miasm, and that it is or may become a poison with alliances to typhus or smallpox ; and the extreme view cuts it off altogether from the group of malarious poisons, and associates it entirely with poisons multiplied in the system, and passed on from man to man in virtue of being so I It is from the events of the outbreak, to the neglect of the phenomena of the epidemic and he reproduction, that the natural history of epidemic cholera has hitherto been studied ; and je has arisen the difficulty of equally apportioning the whole truth, which is, that epidemic era has secondary manifestations due to its individuality over and above those which it bits as an epidemic agent in subordination to the meteorological agencies which limit and control it. Baly has carefully discussed the different theories advanced, and his conclusion shows the difficulty he felt in determining how much was due to primary and how much to secondary causes. It is as follows :—": — " That theory alone is supported by a large amount of evidence which regards the cause of cholera as a matter increasing by some process in impure or damp air, and assumes that, although, of course, diffused with the air, it is also distributed and diffused by means of human intercourse. This theory explains much that would otherwise seem capricious in the course of cholera. It is not implied, however, that it is adopted to the exclusion of all others. For the possibility that cholera is occasionally communicated as a virus produced in and emanating from the sick has already been admitted ; and other questions relative to the means by which the cause of the disease is disseminated, and its introduction into this human body effected, have been left open for further inquiry."* It is impossible to get over these difficulties unless by drawing the distinction definitely between the truths which are primary and those which are secondary — the primary being those relating to cholera as earthgenerated and air-conveyed, and affecting a population through infection of the atmosphere and soil ; the secondary, those due to cholera considered as an individuality, as portable, as capable of attachment to and of multiplication in fomites, and, possibly, as capable of propagation in a community subsequent to increase in the primes via of individuals who have been subjected to choleraic influence. It is not a little remarkable that the nearer in our Presidency we approach to the endemic area, the less is the importance attached by observers to the secondary manifestations of cholera. The primary manifestations of cholera alone have been regarded by those who have had. the widest opportunities of studying cholera as a disease in its endemic province. The most careful and skilled physicians have succeeded each other in the charge of * Report of Royal College of Physicians, p. 224, the great cholera hospitals of Calcutta for fifty years back, and not one of them has yet been able to make up his mind to the belief that cholera is a thing communicable to those Eund the suffering patients. The possibility that the establishment of quarantine might vent the introduction of cholera into the jails of Lower Bengal is one which never was suited, simply because of the universal belief in the primary truths regarding cholera, to the exclusion of all other considerations. The writers on the cholera of India before 1857 never dreamt of taking as their basis the view that the extension of epidemics was due t human intercourse. On the contrary, their facts went to show that cholera was not s diffused ; and where individual cases of alleged transmission have been put upon record, it i evident that the recorder reasoned from the narrowest data, and did not comprehend the plac which his facts actually did occupy in the history of the general epidemic. The reverse of a this has of late years been advanced as true, namely, that cholera is a disease and of all dis Eses the most subtilely contagious ; that its growth takes place in the human system ; that th c method of its propagation is by the human race; that the cholera patient spread olera all around him; that the disease cholera has phases in which none of the usua inptoms are developed, and, as a sequence, that an individual who may never have sufferec im cholera at all in a palpable shape may infect a whole community. I This diversity of opinion shows the want of fixed principles to guide our conceptions of c role of cholera, and inculcates the necessity for endeavouring to estimate at their true value the different causes which may give to the outbreak its origin and aspect. Causes determining Special Aspects and Parallel Phenomena in the Outbreaks of a Provincial Area. By trying to read the significance of the aspects of the outbreaks of a few epidemics we shall learn some general lessons o as to the part which the outbreak plays in the reproduction ; and invasion I shall reckon as a reproduction, since this is truly the value it holds in a system. I believe that the intensity of the outbreaks of defined portions of provinces is often due to the limitation or cutting short of an advancing epidemic. Occasional aspect of the outbreaks Hence we find the phenomenon of great power exhibited of a province due to compression. .. * ? , * . , ° . 1 , . over a very limited area, to be due, apparently, to the settle- ient within a limited space of a body of cholera sufficient to cover many times the extent of the ea actually occupied. The cessation of the chief outbreaks manifested in connection with is great limited cholera is not with the end of the reproduction, but with the setting in of aerial agencies adapted to act as a vehicle, and which actually carry off the material and distribute it elsewhere, leaving the infected area comparatively free. The following case seems to illustrate this phase :—: — In 1856, the western division of the epidemic area began to be infected on 20th May, and the death of the cholera which invaded the area took Lessons to be deduced from the as- p i ace generally throughout the province in the third week of Kof Outbreaks in the invading epi- hi \ t> j. • n a tv j. •j. jit,•i t,• , n , ie of 1856. September. But m the Agra District, the district first invaded, the termination of outbreaks seems to have taken place as soon as the body of the cholera began to move to the west and north-west. Cholera was found after this date, as it will be found typically in every case after provincial distribution up to the end of the reproduction, but the outbreaks brought prominently to our notice died between the 7th and 9th July. In the jail the outbreak commenced in strength on 7th June, and terminated on 9th July ; in the 3rd Europeans the commencement was on 1 Oth June, and the termination on 9th July j and in the Artillery the commencement was on 23rd June, and the end of the outbreak on 7th July. In regard to this cholera of the Agra i strict, I have said that between the 20th May and the first week of July the vehicle [uired for epidemic advance was wanting; and I consider that from the 20th May to the first ek of July, the whole body of the cholera which furnished the great epidemic of Meerut and i Punjab of July, August, and September, was lodged in the Agra District, and to the ith and east of it.* I believe it to be true from what I have noted, that when any circumstance checks epidemic advance short of the natural limits, the whole material is precipitated, and the result is enormous strength locally manifested, either at the time or in the revitalisation. On many liasions the natural limit of a province will act as an opposing barrier. If the propellingxer from behind be strong and the resistance by the opposing influences be sufficient to svent overstepping of the natural limits, compression and concentration is the result. Hence iccasioned the frequent severity of the cholera invading from the east, of the Cawnpore strict, of Shahjehanpore, and of Western and Northern Oude ; it is driven towards the :ural barrier by eastern influences, and when it can get no further, it becomes localised in cc along the line of the natural limit, and here it is often found much more severe ' than the countries over which it has merely passed. So also is the case with the great invading stern cholera. This seems to be the reason why Meean Meer has been so constantly and so adfully visited. It is the last station reached from the south-east by invading cholera ; it i, as it were, under the wall against which the advancing cholera strikes and terminates ; it i in the space within which compression and precipitation occurs, because the vehicle fails 1 further advance is prohibited on all occasions of invasion with the monsoon. I regard the malayas as a barrier so situated that the renewal of cholera in strength after invasion ng the base is certain to take place at the proper season, independent of the physical A parallel case, showing the behaviour of the May cholera of 18G7 west of the Jumna, is tabulated at page 145. 164 aspects of the country, which are also calculated to foster the miasm.* The natural barrier being formed by the famine tract in 1860 was the cause, as I imagine, of the extreme severity I the cholera of that year and of 1861 ; the cholera of 1860 which ought to have had the eep of the entire province was concentrated into the area bounded by Jhansi, Morar, Agra, 1 Muttra, and was ready in renewed vigour for invasion with the monsoon of 1861. So with ! cholera of May 1856. The entire body of cholera destined for the invasion of Meerut, hilcund, and the Punjab with the monsoon, was from the last week of May to the first week July, packed into the small space within which the cholera of May and June was manifested, 1 this seems to have determined the duration of the individual outbreaks ; they seem in fact have lasted until the incubus of the cholera was removed by the advancing monsoon, and ,i\ the epidemic was thrown upon new tracts. I have said that this was about the 7th or 9th of July; and as soon as this Outbreaks indicative of nerial pro- cholera ceased, Meerut and Rohilcund, hitherto free from gress. Method in which a natural cholera, were entered. area is occupied. The invading epidemic struck the jail at Delhi on July 3rd, and disappeared on 7th August. Cholera appeared in the jail at Bareilly on July 11th, and disappeared on 4th August. Cholera appeared in the jail at Meerut on July 18th, and disappeared on 9th August. Cholera appeared in the jail at Budaon on July 24th, and disapjieared on 7th August. Cholera appeared in the jail at Moradabad on July 31st, and disappeared on 10th Augt. tAt the date at which the first burst of this invasion was ceasing in the east of the province, extreme limit reached in 1856 was becoming affected. The cantonment of Meean Meer struck on the evening of the 6th August. The Artillery became affected on 7th August ; Majesty's 81st Regiment on 14th; the 26th Native Infantry on 16th August; the Bth x\rj and 49th Native Infantry on 25th; and the 16th Native Infantry on 27th. I Her Majesty's 70th Regiment at Ferozepore had its first fatal case on the very same as the Artillery at Meean Meer, the 7th August. During all this time the Jullundur Doab the Umballa District remained unaffected by the invading epidemic. This gives us an insight into what is meant by invasion or the occupation of a district by invading cholera. Invasion is clearly regulated, and there is nothing like caprice shown in the occupation of a province. Waves or stages there are or may be, as I shall show presently, but the phenomenon is that of a determinate purpose carried out until what is destined is accomplished. I In the area covered all outbreaks do not occur synchronously with the invasion. At time from the date of invasion up to the date of the death of the reproduction outbreaks to be expected within the occupied area ; thus, while the jails of Meerut and Rohilcund erally were affected in the primary advance of July 1856, the jail of Mozuffernuggur was not sted before the 19th August. The termination of the reproduction or invasion is, as I have often before said, truly a natural phenomenon. In the jail at Mozuffernuggur the last lienomenon of disappearance sub- case occurred on the 14th September, almost simultaneously ¦ut to invasion in a provincial area, •,-, ji j- c±l 1 ~l™.n 4.1, « t «kn«/, Tr.^l ustrated by the outbreaks of 1856: with the disappearance of the cholera of the Lahore Jail, which terminated on 16th September. Among the .Native jps of the Meerut Division the last case occurred on 19th September in Meerut, and on September in Bareilly, although these stations were first struck early in July. In the l Regiment at Ferozepore the last cholera case occurred on 22nd September, in the illery on 17th September, and among the Native Troops on 18th September. The last in Her . Majesty's 81st Regiment at Meean Meer was on 23rd September; among ive Troops between the 14th and 21st (Bth Cavalry, 21st; 16th Native Infantry, lith; cc Battalion, 14th; 26th Native Infantry, 16th). This shows what is meant by the end he reproduction. It is the date up to which outbreaks can occur in consequence of the ence of vitalized cholera over the area. A cholera thus decaying in September over the ;ern epidemic area reappears with the spring rains of May, when these are present; and n they are not, with the monsoon rains of July and August in the year following. BThe history of the same area in 1861 repents that of 1856. There is no moving along „. . ? ? , -.. . ways of communication in the spread of this cholera. The illel m the outbreaks of the m- , • 7 . , . • i t • i it j.t.i.l *. o f iB6i. track traversed is an aerial highway, leading the cholera to the same terminus in each epidemic with but one day of difference (the evening of the 6th of August 1856 and the 7th August 1861 at Meean Meer, the last station reached), and winding up on the very same day, the 28th September. The outbreak of Morar terminates on the 27th; cholera dies at the opposite extremity of the natural area at Meean Meer on the day following. ¦ The aggregate of such outbreaks makes, up the reproduction. In one portion of the pro. , , vincial area the manifestation may be substantial, while in to seS^eSriS^o^S mother it may be represented by a mere shadow. Thus the elevation, the outbreaks of an area series of outbreaks at Umballa in September 1852, from the may be represented, some in substance, s{ n onwart ls to the end of the month, in which 147 European some in shadow. iv_ ? i i _ ,j.^,i „+ "E I™^™™™1 ™^™™™ lv, r a soldiers were attacked, were represented at Ferozepore by a * At the present date, July 1869, cholera is prevailing in the interior of the hills, in the districts of the Himalayas >vhieh rise above the valley of the Sutledge; here the cholera which passed as an aura over the Simla Hills in the first week of June appears to have found a locality for settlement and concentration. 165 single case, which is thus noticed by the Surgeon of Her Majesty's 87th Regiment : <( A man was admitted on the 6th September with symptoms of developed cholera, which came on after taking a purgative of compound jalap for a feverish attack. The symptoms were severe, but the man recovered. About the same time two or three premonitory cases occurred in the Regiment and a few natives died in the station." Two cases occurred at Meean Meer in the European Regiment at the same time, which the Medical Officer returned as cholera j but these, he says, may have been cases of the choleroid form of intermittent fever.* Each of the hill stations adjoining to Umballa returned cases of choleraic affection while the cholera was prevailing at Umballa, but no fatal cases occurred. tin the case of Ferozepore and Meean Meer, the stations lay probably out of the line the choleraic influence ; for I have shown that the Umballa District and the Jullundur Doab ! not necessarily visited in the same advance of cholera in which Meerut on the one hand or rozepore and Meean Meer on the other suffer, but seem often to be swept by a secondary ye later in the season. It is more than a coincidence that in the succeeding epidemic, it was the 4th September 1856 that the invading cholera first appeared at Umballa. I The minor manifestation of choleraic influence at the high elevation exhibits the effects of ight in preventing the localisation of the miasm ; these stations were affected by a diffused, d not by a concentrated miasm. f I In the first section, I have in various places spoken of the aura preceding by some months c manifest invasion of the substance of the epidemic, and of the adaptation of different tbreaks in relation to the phenomenon. Thus, I have shown how during invasion from the st in March and April 1853, the jails of the Gangetic Provinces were universally affected a Cholera which was powerless to destroy ; how in the invasion of 1855 seventy- two prisoners of 3 jail at Cawnpore, the last station affected in the west, were stricken down by the choleraic luence with the result that three only died ; and how the same phenomenon was repeated at ah, the last station affected during the epidemic advance of 1863, when twenty-four prisoners 'cumbed with the symptoms of cholera without a single death following. In the last ipter of the first section, I have mentioned the diarrhoea of the Chyebassa jail of January 68 as due probably to the passing out from the endemic area of the body of the cholera itined to become a few months afterwards the great cholera of Chota Nagpore, with whicli ! cholera of 1868 of the Central Provinces was geographically continuous. IThe appearance of the outbreak depends on the coincidence of the presence of the cholera miasm, its vehicle, and the agency which directs its progress • metSSgfof^proS; 88 * 1011 t0 and the commencement and termination of the reproduction are subordinate to what cholera is as a vital object. The cessation of outbreaks may at any time during the life period of the reproduction be due to meteorological causes, and notably to the failure of the vehicle. I have shown how over the eastern area the prevalence of west wind was sufficient to retard the reappearance of the cholera of 1863 up to the first week of June in 1864 (See page 84). The case which follows illustrates the contrary; namely, that the setting in of steady west winds was sufficient to cut shor,t the numerous outbreaks in which the great cholera of the spring of 1860 showed itself over the eastern area. This great cholera was ushered in by east winds and rain. (See page 79). In the Bhaugulpore Jail cholera died out on 13th April. In the Monghyr Jail cholera died out on 17th April. In the Purneah Jail cholera died out on 15th April. In Her Majesty's 37th Regiment at Ghazeepore cholera died out on 17th April. In Her Majesty's 34th Regiment at Fyzabad cholera died out on 16th April. In Her Majesty's 20th Regiment at Gondah cholera died out on 16th April. In the 3rd Troop, Ist Brigade Horse Artillery at Gondah, cholera died out on 16th April In Her Majesty's 82nd Regiment at Shahjehanpore cholera died out on 15th April. In Her Majesty's 13th Regiment at Goruckpore cholera died out on 17th April. In the Ist Company, Ist Battalion Artillery at Nagode, cholera died out on 23rd April In Her Majesty's 54th Regiment at Cawnpore cholera died out on 24th April. In Her Majesty's 70th Regiment at Allahabad cholera died out on 13th April. T__ J_l_ _ Alt Tl T» ¦ itTl 1 n I*l . ~ . . - .- *• In the 4th European Regiment at Lucknow cholera died out on 24th April. The following is an illustration, taken from the history of 1867, of a series of local out- IPhe cholera wave. The significance J^f attributed to the influence of successive cholera waves, the phenomenon. ln e first case of cholera occurred at Deolee on 20th June, and the appearance of the first wave was coincident with tin rain of the 23rd. Surgeon-Major Crawford writes :—: — I" On the evening of the 23rd June a storm with rain passed over the station causing leasant change. On the 3rd July and mornjng of the 4th rain fell heavily, and by this 1* "Of cholera three cases appear upon the return. Although the symptoms were most marked— the collapse, th( clammy perspiration, the cramps in the extremities, and violent vomiting and purging— it was thought they were the collapse of severe intermittent : in a few hours the patients slept, and the acute symptoms disap- peared." Report of H. M.'s 96i/t Regiment for 1852. t In the previous page I have mentioned the fact of the aura of an invading cholera having passed over Simla in June 1869; from this children were almost the only sufferers, and the same special liability to succumb in the case of children was noticed in the invasion of 1867. Dr. Cuningham writes :— " The total number of cases among European residents was sixteen, of which six were fatal. It is a curious fact that they were nearly all children." The adult eonstitutiou had on both occasions the strength to resist the effects of the diffused miasm. 166 time it was evident that cholera was epidemic throughout the station. On the 3rd there was a sudden increase in the number of cases in the station, and amongst the natives attached to the Harrowtie Agency there were eleven admissions on this day and nine on the 4th. On the sth sixteen cases were admitted. From this date cases continued to occur; but except among the 2nd Cavalry there were no cases from the 14th to the 18th, and on the' 19th there was no admission into any hospital. Rain fell on the 19th; and on the 20th the third Kve of the epidemic occurred, with five fresh cases among the troops ; on the 21st ten cases re admitted." iThe phenomenon which has often been noticed, that the cholera invading an area seems come in a succession of waves, admits of three explanations. We can conceive, (1), that sh wave may represent a new body of invading cholera ; or (2), that the reappearance may be eto the sprouting of the cholera seed sown during the invasion of the primary wave ; or am (3), that the renewal of the vehicle may be the cause of manifest reinvigoration. Each tl all of these should be kept in view in trying to determine the aspect of the outbreaks of a Dvince. The invading cholera of the western provinces of July and August 1860 is a very satisfactory ease in which to note the phenomena displayed by the The phenomena common to the whole outbreaks of the reproduction. The area invaded was absolinvaded area shown in each of the , -, „ „ i_ i t v .li • • ir uwl local manifestations in the western in- utely free from cholera before the invasion ; Morar was struck on July 22nd; Jhansi on August 2nd; Agra on August 10th; ration of 1860. and Muttra on August 15th. The vitality of this reproduction ceased at Morar on 16th September; at Agra on 17th September; and at Muttra on 24th September. In three stations out of the four a distinct break occurred as follows :—: — In Her Majesty's 71st Regiment at Morar cholera ceased between 27th August and 6th September. In the 3rd Battalion Rifle Brigade at Agra cholera ceased between the 31st August and 3rd September. In the 2nd European Cavalry at Muttra cholera ceased between 30th August and sth September. In the 3rd Troop, 3rd Brigade Artillery at Muttra, cholera ceased for altogether on 25th August. In Her Majesty's 89th Regiment at Jhansi cholera ceased for altogether on 18th August. The effects of the first cholera wave were evidently over in the end of August. The renewal in these three cases out of the five, I believe to have been due to the revival of a precipitated cholera ; the same cholera, in fact, which as an air-conveyed miasm struck* the stations in its aerial progress. I have shown how this cholera fell thick behind this its limitingline of 1860 — the famine tract line of 1861 — for want of its vehicle, and how on its revival eight months afterwards, the same materies appeared as the great epidemic cholera of 1861. The renewal from September 6th to 16th at Morar, from September 3rd to 17th at Agra, and from September sth to 24th at Muttra, is to me an evidence of the subsidence over these districts of the air-conveyed epidemic of July and August. It is from such an illustration as this that I shall try to explain what I understand by infection of a locality, by a body being struck by cholera, and by a cholera which has been precipitated budding forth after a certain number of days after precipitation. Here the stations were struck on July 22nd, August 2nd, August 10th, and August 15th, and as a consequence the bodies struck carried cholera during a certain period of days. But the original affection of these bodies I believe to have been in no way connected with the reappearance of the September cholera. The cholera-conveying wave had dropped its vitalised cholera as it passed on, and it was this same earth-sown cholera that came forward three weeks later. The conditions for manifestation were not wanting ; this cholera had at least a fortnight of vitality left, and the moist and stagnant air of the termination of the scanty rains sufficed to rouse it into manifest epidemic life for these fourteen days. I This is one explanation which I give of the affection of a cantonment for longer than primary period during which a given body once struck carries its cholera. It is constantly case that what are called successive waves affect the same station in the course of one and same reproduction. What are called localising conditions (or, in other words, the facilities fded to an earth-sown cholera for revival after precipitation) tended to perpetuate cholera in camp before Delhi in 1857 up to the middle of September, and retained up to the same i the Meean Meer cholera of 1856 and 1861. The table which concludes this chapter is a striking illustration of the attachment of epidemic cholera to a locality for the entire od during which in any year the reproduction continues vital. Kit is a mistake to shut our eyes to the fact, that in the rains little is needed for localisation, oist grassy plain is probably as efficient for the purpose as is a foul and stagnant marsh. ink it is a great mistake to insist too strongly that conditions which in themselves are nuisances alone predispose to the localisation of cholera. I believe that an air-conveyed cholera selects the purest of all vehicles, and this we should not overlook. We do not give to the latrines of our cantonments the credit for the diffusion of an air-conveyed malaria ; elevation above ground level and dryness around our cantonments are what we regard as the means of protection most efficient against the moisture-loving malaria poison. I have strongly insisted, that it is not the open and arid plain that is selected as breeding ground, and that it is not in such situations that we find a dormant cholera revive 167 LOCALISATION OF CHOLERA AS DETERMINING THE ASPECT OF THE OUTBREAK. but that it is along low river banks, along the course of canals, in extensive jheel countries, and in moist situations along the base of the hills, that the cholera of invasion delights to propagate itself. I have shown also how rare an event it is for any station of the western area to be struck, and for the phenomena which characterise the outbreak to occur before the setting in of the rains. As an exception, in 1867, we had the example of an air-conveyed cholera falling thick into the Peshawur Valley on 19th May. Here the meteorological agency which Ejught up the cholera was of a temporary character. If this cholera fell thick it was short cd. Ten days saw its termination in the 42nd Highlanders, and it survived but a month all. The dry ness of May and June was not favourable to the localisation of this cholera, 1 probably whatever amount was precipitated was scorched up beyond recovery before the urrence of moisture in July afforded to it the chance of revitalisation. In the Bunnoo strict the same cholera survived until October. In speaking of localisation the phenomenon does not present itself to my mind as necessarily limited to a cantonment or its neighbourhood. Localisation may imply the sowing of the seed over many hundreds of miles — seed which shall spring up and manifest its existence as an air-borne cholera, as an apparent second wave traversing the provincial area under the same conditions and in the same direction as the first or invading wave. I The revitalisation in situ during the vitality of the same reproduction of a cholera tributed over an invaded area, is very much the same thing in homology as the revitalisation lich occurs provincially after the normal period of dormancy : after lying dormant for six >nths vitality returns to the cholera seed sown over a province ; in invasion it is usually a al cholera that is precipitated, and this seems to be readapted for fresh manifestation within brtnight after it is sown. It can be readily understood that many spots and special localities far more favorable than others for preventing the decay of the distributed miasm and for imoting its propagation, and are, in short, adapted to bring about localisation, and conse-3nt intensity of manifestation, even during the course of the current reproduction. I The succession of what seem to be waves is a very remarkable phenomenon. Sometimes : interval is well marked, as in the cases above quoted ; at other times a minimum only and not actual break indicates the fact of the second or third wave flowing over the province ore the recession of the wave that went before. In the invasion of 1856, the death rolls the two European Regiments at Ferozepore and Meean Meer, which had become affected by invading cholera, the one on the 7th and the other on the 15th August, show a sudden ; in mortality on the 22nd ; at Ferozepore, the deaths rose from two on the 21st to eight the 22nd, and at Meean Meer from two on the 21st to thirteen on the 22nd. In both 3s a second period of minimum was reached between the 30th August and 2nd September ; from the 2nd and 3rd of September the mortality recommenced, and continued steady after day up to the 22nd in the one case and up to the 23rd in the other. The attack of Umballa cantonment on 4th September was coincident with the appearance of the second ra at Ferozepore and Meean Meer. II shall close these illustrations with an illustration which is a perfect parallel with the ease 1860, namely, that of the stations of the western epidemic province in 1862. The effects of the first wave of the monsoon reproduction of 1862 — the revitalised cholera of 1861 in the western province — ceased at Morar on 19th BLcnomenon of the succession of j u i y at Jhansi on 23rd July, and at Meerut on 22nd July s shown m the western cholera of , J fr, ii T tt -iwo\ rm. 1 i. i -v i j.-(see Table IV, p. 17o) . This cholera became a second time appa- rent after an interval of thirteen days at Morar, of eight at Itnsi , and of three at Meerut. The second wave probably affected Meerut about the 25th July ; 29th July Gwalior was attacked; on 30th Jhansi; on 31st Morar; and on August 2nd ra, and the effects of this wave terminated in an absolute break in all five cases :—: — From 18th August to Ist September cholera ceased in Her Majesty's 13th Regiment at Morar. On 14th August cholera ceased for the year in Her Majesty's 52nd Regiment at Jhansi. On 12th August the cholera of the Head Quarters Her Majesty's 35th Regiment at Agra ceased. On 14th August the cholera of the Wing of Her Majesty's 52nd Regiment at Gwalior ceased. On 11th August the cholera of Her Majesty's 104 th Regiment at Meerut ceased. iTo this list remain to be added the cases of Her Majesty's 19th Regiment at Meean Meer, hich cholera ceased from the 14th to 25th August ; and of Her Majesty's 93rd Regiment eshawur, in which cholera ceased from the 12th August to 9th September. (But this general subsidence of cholera over this vast province between 11th and 18th •ust was but a break after all. At Morar Her Majesty's 13th carried cholera for the 1 time in 1862 from Ist to 20th September; the 19th Regiment at Meean Meer carried era from 25th August to 11th September; in the 93rd Highlanders, the third attack of I ceased on 16th September;* and by this final wave of the monsoon reproduction of 1862 Slst Regiment at Umritsur was struck on 29th August and carried cholera up to the sth * Report by Dr. Munro, Army Blue Book for 1862, p. 413. 168 Ilf the grand parallels of years and epidemics which I have sought to establish in the first ;tion of the report be wonderful, not less astonishing are the parallels of details such as I ye shown in these paragraphs. The interpretation which I have made of them may be •ong, but this at least is certain, that the occurrences are subordinate to no laws but such are natural, and that the affection of a cantonment or of a province takes place in obedience such laws and occurs by no casual invasion attributable to minor or secondary agencies. The detailed statistics of what I have indicated generally in these paragraphs follow :—: — I The western area as a natural choleba province in the epidemics of 1856, 1860, 1861, D 1862. A SERIES OF PARALLEL STATEMENTS TO ILLUSTRATE THE SUCCESSION OF OUTBREAKS, THE DURATION OF THE REPRODUCTION, AND THE LIABILITY TO CHOLERA THROUGHOUT THE PERIOD OF ITS DURATION. I. — European Army of the Western Division, 1856.* Deaths out of the admissions of bach bay of the bbpboduction. DATE OF ADMISSION. Meerut, 3rd Vorn7pnnr ~ Ferozepore, Mppan Mppr Meean Meer, Meean Meer, | lSni Company, 3rd f nfh Xi ' 6th Battalion 8?*? Helf 4th Battalion 2nd Brigade jUmballa, all flli Xl " Battalion Ben- ? Oth Re gl - Bengal Artil . 81st Regi- Bengal Artil- Bengal Horse ! Corps. fles - gal Artillery. ment lery. ment> Tery. Artillery. ", 12 ;;; \ z "\ z "' 9 6 z " 14 Z. "l Z. 3 .'" Z. 9 5 15 ... 1 1 1 1 2 11 5 16 ... 10 ... 3 11 3 17 1 9 2 2 4 „ 18 ... 4 2 2 5 19 ... 6 ... 2 8 3 20 .. 2 3 3 13 21 ... ::: ::: 23231 22 ... 1 ... 8 5 13 1 1 23 ... .".. ... 5 7 6 11 24 ... .... 6 2 6 1 25 ... 3 ... 9 2 26 ... 3 5 3 27 ... 3 5 8 28 ... ... 2 10 3 September 1 ... ... ... 1 1 1 * After the epidemic movement of the cholera of the Agra District towards the North- West. 169 II. — European Army of the Western Division,. 1860. Deaths out of thk admissions of each day of the bepboductiok. DATE OP ADMISSION. Gwalior. 11th Muttra, 3rd Muttra, 2nd Re»i Morar, 71st Brigade, 6 Bat- Jhansi, 89th Agj-a, 3rd Bat- TrOOP; 3rd Bri . ment BeneaF Regiment. tery, Royal Artil- Keginient. „ . on , Kme gade Horse European lery. ' Brigade. Artillery. Cavalry. July 22 ... 1 23 ... 1 24 ... ... 1 25 26 ... 3 27 ... 1 28 ... ... 1 ... ... * ... 29 30 ... 2 31 ... 2 August 1 ... 2 2 2 ... 2 3 1 ." I 8 ;." .'.'; i i ;;; ;.".' '.'.'. 9 ... 7 ... 1 io ... ii ... i i 111 ... 2 ... 1 18 '.'.'. 1 '.'.'. "i 2 3 21 Z 1 "l Z i 3 29 ::: !" ::: ::: ;;; ::: ;;: 30 ... ... ... ... 4 ... 1 31 ... ... ... ... 5 September ] ... ?. " 3 z. '.'.'. '.'.'. '.'.'. "i ::: ;;; 4 ... ... 7 5 ... ... 1 ... 5 ... 1 6 ... 1 1 ... 2 7 ... ..." 3 8 ... 2 ... ... i 9 ... 2 ... ... 3 10 ii i ... ... i ... Z 12 1 111. — European Army of the Western Division, 1861. Deaths out of the admissions of each dat of the bbpeoduction. DATE OF ADMISSION. Agra, Delhi, ? , ... Meerut, Morar, Umballa, TT .„. „ Umritsur, Ferozepore, 42nd B Regi- 82nd Regi- Meerut , Bt h Mth R ? 27 th Regi- 89th Regi- - UU ™ ba " a ' Meam 94th Regi- 4th Goorment. ment. Hussars. ment ment> ment 7thHussars. Meer. ment khag o "a „ o ... ... & ... ... ... >•• v 24 '4 1 ... 2 ... ... 25 2 6 ... 1 3 26 2 3 2 2 27 1 3 1 1 2 ... ',', 30 1 1 2 .'.'. 6 "3 '.'.'. August 1 1 1 "2 3 2 » 7 3 3 8 "i "', "i "2 2 3..'. 2 " 10 '." - "i "¦ ... 4 i !'.! 8 11 1 ... 3 3 3 ... 5 12 ... ... 2 8 2 ... 3 13 ... ... ... 1 3 1 ... 4 14 ... 1 16 3 ... 26 15 ... ... 1 2 ... ... 43 16 ... 1 2 5 2 ... 38 17 ... ... 13 1 ... 30 ." 20 |" ..', "' '.'.'. 9 ... 3 45 " 25 ..'. '". '.'.'. ... 3 '..'. 50 September 1 ... ... ... ... .. ... ... 17 Table continued on following page. * Admissions of all corps with women and children. — Strachey. 171 OUTBREAKS OF THE MONSOON CHOLERA OF 1861 IN THE WESTERN DIVISION. OL TBKrjAiYS V 172 ¦ Wl.-^European Army of the Western Division, 1861, — continued. Deaths out of the admissions of each day of thb befboduction. datp of September 12 ... •¦• 1 ••• ••• 1 J ¦[ 13 ... ... ••• ••¦ ••¦ •¦• ¦•• ifi ii( tit ... ... ¦«¦ ... 18 ... ¦•• ••¦ ••• ••• ¦¦' "¦ '" „ 19 ... ... •¦¦ ••• 2i 91 ... ... ... ••• •¦• „ ill ... ... ¦•¦ ••• g 23 „ 25 IV. — European Army of the Western Division, 1862. Deaths out of the admissions of each bay of the bepboduction. DATE OF ADMISSION. rwaW WW Thunai fi9nH x^ » < iaxm. Meean Meer, Umritsur, Morar, 13th Ql^S t '^ g J Reriment A »^ 35t f h Meerut 104 th x^Regi. 1 Detachment Regiment. 52^ gl ' Headquarters. Ee g lmcnt Regiment. meat . 8 B lst Regiment. ',', 30 "' "i ... "i 1 31 ... 1 1 1 .» 3 ',', 3 "', "2261 9 ?', "41561 ?10 2 1 ... 6 1 11 ... 1 1 2 1 1 IV. — European Army of the Western Division, 1862, — continued. DBATHB OUT OF THB ADMISSIONS O» BACH DAT OF THB BEPRODBCTIOIf — — — ; . DATE OF ADMISSION. Morar,l3th Wing Jhansi, 52nd Agra 35th Meerut 104 th Meean Meer, Umritsur, Ee gimen t. »«**' He^ r , rB Re Uent. "ggl%* I™** sSSSSSL ugust 23 2 1 24 ;;; ::; ;;; ;;; 2 25 • ... i - 7 26 ... ... - I £ ••• i ::: v ::: :: '9 ;;; ::: : ;. .¦•• j ¦» 30 o ; >» " ... •-¦ ... ... ... ... 6 2 September 1 i 2 2 ... ... ... ..! ;;; 2 2 3 ... 1 ... ... ... ... 3 i ... ... ... ... 3 1 6 ... ... ... ._ 3 7 ... 2 ... ... ... ... 1 ... 9 '.'.'. "a '.'.'. '.'.'. '.'.'. '.'.'. "i 10 v ... 1 ... ... ... '.'.'. 1 12 ... 1 13 ::: ;;; 14 15 ... 2 16 17 ... : is ... ... ... ... ... ... .:. 19 20 :;; 1 ... .. ... .:: ;;; ;;; » 22 .'" '.. ... ... ... .[[ "1 '[[ Without a clear comprehension of the truth that the outbreak has two distinct associations — that in the one case it takes its character from its relations to the epidemic cholera of the reproduction, and in the other from the fact that affection of the community has taken place — the natural history of the outbreak cannot be viewed aright. The two types of the outbreak resulting from these associations are, in my estimation, entirely distinct one from the other. In the next chapters I shall try to show the type of the outbreak in a community affected on a known day, and to illustrate the influence of the conditions which may lead to its aggravation or prolongation. The table which follows illustrates the truth, that what we know to be the case for the province may hold good for a single locality of the province and for the community which it contains, and that localisation may give an aspect to the outbreak of persistent endurance throughout the entire life-period of the reproduction, which is not acquired from any peculiarity in the material affected, nor yet from conditions other than those due to the geographical site and physical aspect of the affected locality. The same locality is not always similarly affected in each epidemic visitation ; invasion must be viewed in relation to the conditions which render persistence possible. For example, the 93rd Highlanders at Peshawur suffered in four distinctly repeated outbreaks between July and November 1862 ; but when the valley was entered in October 1858, the persistence of the invading cholera was limited to a fortnight, and the cholera of May 1867 survived for little more than a month. This is an illustration from a locality lying beyond the monsoon limits. But the experience of 1862 seems to me to indicate, that if the Peshawur Valley were transferred to within the monsoon area, the history of that year might be repeated in each succeeding invasion ; that is to say, cholera might persist from the day of invasion uninterruptedly up to the date of the death of the reproduction, as an immediate consequence of the natural features of the cantonment and the adjacent country. I do not say that the cholera will necessarily continue in force throughout in such a locality. It may or it may not ; but whether in shadow or substance the typical representation is the same. We have, unfortunately, a cantonment the experience of which illustrates what I wish to show, that, once infected, the normal duration of the outbreak is to be reckoned by months 173 174 LOCAL PERSISTENCE OP CHOLERA THROUGHOUT THE REPRODUCTION ILLUSTRATED. [Section 11. tnot by days. The experience of Morar in five years is shown in the statement below ; it rs the coming of the cholera with the monsoon in July, its persistence throughout August, its death with the decay of the reproduction in September in every one of these years, experience of Her Majesty's 71st, 13th, and 27th Regiments is typical for what I wish to irate; the experience of 1865 and 1867 is the same in shadow. Cantonment of Morar. Statement demonstrating the persistence of Cholera in this Cantonment throughout the monsoon reproduction in different epidemics. Deaths out of the admissions of each da? of the bepeoduction. 1860, 1861, 1862, 1865, 1867, H. M.'s 71st Eegiment, H. M.'s 27th Regiment, H. M.'s 13th Regiment, Morar and Gwalior, all Morar and Gwalior, all Morar. Morar. Morar. Corps. Corps. July 22, 1 July 25, 3 July 10, 1 July 23, 1 July 10, 1 23, 1 „ 27, 2 „ 12, 2 August 9 1,, 13, 1 26, 3 „ 28, 3 „ 13, 1 „ 12, 1 August 12, 1 27, 1 „ 29, 7 „ 16, 1 „ 14, 1 „ 14, 1 30, 2 „ 30, 6 „ 18, 3 „ 17, 2 „ 16, 1 31, 2 „ 31, 4 „ 19, 3 „ 18, 1 „ 17, 1 August 1, 2 August 1, 3 f t t 19, 1 „ 23, 1 2, 2 2, 8 „ 30, 1 „ 22, 1 „ 24, 1 3, 1 3, 6 „ 31, 1 September 18, 1 „ 25, 1 4, 4 „ 4, 10 August 3, 2 „ 28, 2 5, 2 5, 4 „ 9, 4 „ 29, 1 6, 3 6, 3 „ 10, 2 September 4, 1 9, 7 7, 3 „ 11, 1 „ 11, 1 10, 11 „ 8, 2 „ 18, 1 li, a M 9, 5 t t t 13, 3 „ 10, 4 September 1, 1 14, 1 „ 11, 3 3, 1 15, 1 „ 12, 8 5, 1 16, 4 „ 13, 3 7, 2 17, 2 „ 14, 6 9, 3 18, 1 „ 15, 2 ? 11, 1 20, 1 „ 16, 5 „ 12, 1 21, 1 „ 17, 3 „ 15, 2 23, 1 „ 18, 5 „ 20, 1 27, 1 „ 19, 5 t t t 20, 9 September 6, 1 „ 21, 3 8, 2 „ 25, 3 9, 2 „ 27, 1 11, 1 „ 28, 3 15, 1 „ 29, 1 16, 2 „ 30, .1 September 2, 1 4, 1 5, 1 7, 1 8, 3 9, 1 10, 1 12, 1 14, 1 15, 1 26, 1 27, 1 CHAPTER II. rTHODS AND COURSE OP INFECTION, THE DURATION OP OUTBREAKS, AND THE CIRCUMSTANCES WHICH TEND TO PROLONG OR TO CUT SHORT THE OUTBREAK. [The anticipation in regard to any outbreak must be based upon parallel history, which s accepted as a fundamental doctrine the truth that every local manifestation of cholera thin the epidemic area occurs as a portion of an epidemic and in subordination to the meteorology the natural province within which the locality is situated. The affirmation that the outjak is a mere contingency, receives no support from any fact in the history of the past fifteen ars. Every outbreak has ranged itself under a reproduction, and every reproduction has len into its place in the epidemic. I The outbreak must be anticipated as a portion of the epidemic. We have as yet no clear . . . ... indices based upon statistical data, to give us warning of The outbreak in any locality appears n.i«. i« •• 0,1 -j • ? ° ? , . ° the date normal for that locality. * he approaching exit of the epidemic from the endemic prov) circumstances which are merely ince. The warning may, however, be found probably in every itingent can determine the occur- instance, in a manifestation regarded as merely an unusual ice .in time of the outbreaks of an preva i ence o f the endemic cholera. The years noted in former aemic. j, + 1, 1 ' r* i t-4- n. • v ±. i times as great cholera years in Calcutta are those immediately leceding the years of the epidemic prevalence of cholera in Upper India. So in our times, bile cholera was dead in the war provinces in 1858, no sooner were regiments and detachments ansferred to Lower Bengal than they were attacked by cholera, and 273 men were thus lost ; Dking back we now recognise that this cholera of 1858 was the same body which formed the vading cholera of 1859-60 and 1861. So, again, the great prevalence of cholera over the mine districts in 1866 was regarded as due to the casual aggravation of the endemic miasm r the circumstances of the population, while it was in reality due to the presence of the great dy of cholera which moved out to form the invading epidemic of 1866-67. It was owing to the want of systematic information regarding the progress of epidemic cholera within the endemic area that I failed to recognise The primary exit of the cholera of i n the cholera of the Central Provinces of 1868 an epidemic invasion from within the endemic n -in. i_ j.i • i • 1 , province has no relation to lines of of a new evasion, although the epidemic character of the cholera prevalent within the endemic bounds warned me that the exit of a new epidemic was imminent. The human communication. trospect of the history of epidemic advance in 1868 has, however, taught us much regarding le primary exit of invading cholera. The universal prevalence of epidemic cholera in the estern districts of Bengal Proper, north of a certain line, in the early months of 1868, as followed by the sudden appearance of epidemic cholera universally spread between the argins of the endemic province and the Jubbulpore and Mundla Districts. The sudden )rojection of this offshoot across a tract five hundred miles in width, implied the occupation >y aerial invasion of a provincial area ; this was the first leap in the history of the newly nvading epidemic. The nature of the tract thus occupied demonstrates to us at once that mman intercourse could have had no share in the transmission of the cholera of this geographical area. I have said that cholera viewed as a natural object, will play out its part n a country in which no human being is found. This invading cholera of 1868 was carried from the inhabited tracts in the east into the inhabited tracts in the west of this area of five hundred miles, across a vast extent of country almost void of population and entirely unprovided with the usual channels of communication. The distribution was geographically defined. There was no extension to the southward from the territories covered by this offshoot. The great Chuteesghur Division of the Central Provinces, one of the worst cholera tracts of India and which has again been ravaged within the last two months^ remained absolutely free in the invasion, only eight cholera deaths having been registered throughout the division in 1868. Next, we have been taught that the occupation of the southern epidemic highway takes place not progressively from district to district, but in a succession of leaps ; and that although there may have been three distinct stages of progress, Hyderabad, Bombay, and Malwa may be covered before the end of the year by a cholera leaving its endemic home in the spring. I The history of this invasion I have been compelled to write from a retrospect of the mts of 1868. It affords a standard which will be available in after years when cholera demic within its endemic province, is being watched in anticipation of the probability of ranee upon the epidemic area. Every effort should be used in future to follow out ;h accuracy the details of primary invasion. The general facts have been sufficiently dent from the history even of the earliest epidemics. What I have written in detail for 1868, the same thing to which I have so repeatedly called attention, namely, the overflowing of lemic cholera upon the highlands of Hazareebaugh and Chota Nagpore and its descent upon the ins of Behar and upon the districts lying to the west and south-west. We know that s not always the one tract which is selected, and, therefore, we must be prepared to shape our imate of the probabilities according to more than the one standard ; the causes of the ergence of this invading cholera in different directions will be found in the varying teorology of different years and seasons. I do not believe that for the eastern division of the epidemic area our parallels will ever tell us the exact date at which the appearance of cholera is to be expected in any station. We can suggest generally as the probable months April and July, or May and August. More than this we cannot say, knowing that even in March with early rains general invasion or revitalisation may occur, while with steady hot winds a body of cholera equally powerful may be repressed from manifesting its effects up to June or until the monsoon sets in. In ie extreme east of the province we know that the danger is to be looked for much arlier. No troops should be moving on the lower section of the Grand Trunk Road after ie middle of February ; in a year of fresh invasion it seems almost an impossibility for roops to make these marches in March and April without encountering cholera, and ie experiment should not be tried. In the same locality the November reproduction in n epidemic year is quite as severe, and movement between the middle of December and ie middle of February will ensure only a minimum of risk and not exemption. The jreat mortality of the Native Regiments on the river in November 1856 shows, that water highway in the east is as deadly as the road, when cholera is abroad as an epidemic. s regards the districts of the extreme west of the province, Banda, Humeerpore, Jaloun, and we shall not err in reckoning May as the month in which the outbreaks of an ndemic cholera are likely to begin. I need not recapitulate the dates which I regard as normal for the cholera of the western province. I have traced them in the previous chapter and in describing the various epidemics and reproductions, and when I have drawn the parallels almost to a day, the objection most likely to be raised is, that the parallels are too severely correct to be true. In my opinion, however, these dates will hold good for all time to come, and if we fail to detect the parallel in the history of one invasion or reproduction we shall find it in that of another, and the reason of the failure of the parallel will also be found if carefully looked for. In anticipation of the outbreak in any special locality, besides studying the general history of the geography and date of previous invasions, I Forerunners in advance of the actual we should not fail when invasion is in progress to look for rasion, often give warning of the the aura and the outrunners of the coming cholera. In reatened outbreak. ? • t 1 "j ix. i bl. the western province I have said that we may often nd them, for example, at Meerut in April and May, when invasion is imminent in July or August; the cases in May 1860 at Meean Meer I regard to have been distinctly premonitory E" the cholera which did not come before August of the year following ; and I have instanced cases ceurring at Huzara and Kohat during the progress of the cholera of 1861, as the herald n the one case of the cholera of the May following, and in the other, the representative of cholera which never actually invaded the district. In the east, I should expect to find lese premonitory cases thrown forward in the November reproduction in anticipation of nvasion in March following ;* occurring at any other season they would be overlooked, from the act that cases occur in every year in a province in which the extinction of cholera is very are. Small invasions the aggregate of such premonitory cases, are not to be disregarded, nee we never know what may be behind them ; they may be the entire representative of an ndemic (as in the invasion of the western division of May 1865), or they may be but the dvanced guards of a coming cholera. It is very important to have a clear comprehension of the truth, that infection of a locality I and infection of a community is not the same thing. Infec- G e^ lco » s i der ation S to be looked to ti fth commun i t y i s not necessarily an indication of a estimating the causes determining . .. , . . *.» , , ii" 7 i •/?j_ i j i duration and aspect of the outbreak, locality having become infected ; a body may be infected and nothing may occur subsequently to show that this same lolera has found a local habitat. But again, the cholera of a camp or cantonment may by s persistence, and by the appearance of the features peculiar to a localised cholera, prove ie fact, that the locality is an infected locality within which human life is in peril so ong as the reproduction remains in vitality. The normal duration of the outbreak is only obe determined after taking into account such prolongations as are due to the localisation : cholera. The minimum period of persistence may readily be calculated from instances infection on a known day in bodies of men moving through a country remaining compaatively or absolutely uninfected ; and the maximum may be illustrated from instances in which movement has been impossible or has been deemed unadvisable. These data will at least ford the groundwork for an enquiry into the causes which shorten or lengthen out an utbreak or a series of outbreaks. There is another point which cannot be too carefully studied, namely, the facies of individual outbreaks. Some would tell us that the outbreak is typically represented in a diagram )y the spindle shape ; that it progresses from small beginnings, rises by stages to a maximum, nd then declines. This may be true on some occasions of the outbreaks of a reproduction when viewed in the aggregate ;it may be true even of certain individual outbreaks ; but it cerainly is not the case that the typical outbreak exhibits this form. The wonder is, that so few ltbreaks should put on this shape, when we reflect, that it is only in a certain number of cases hat attack occurs with the onset of invasion, and that at any time from first to last a body within the affected area may suffer. What are apt to be taken for the cases introducing the utbreak are the sporadic cases which are constantly liable to occur in every community, when, or example, a large cantonment is affected in the course of an invasion; these are not fn l ' nvas * on °f which we have a clear record this was the case. Jameson, speaking regarding the cholera oi Oude of 1818, mentions that a few cases of cholera did certainly appear at Lucknow in December and Jan- Uar i y> f m he rem wks that these were probably merely sporadic, and an exception to the general rule, that until the euU ot March 1818, no spot of the immense tract stretching from Seharuupore to Tirhoot was visited by the disease. i or quotation, see p. 98. 176 necessarily part and parcel of the outbreak which follows, although they are an indication that the choleraic atmosphere is present. To distinguish between these cases and the commencement of an actual outbreak is of great importance when movement into camp is contemplated, but I know of no method of making the distinction. These premonitory cases should not generally be included in studying the aspect of the outbreak. O mi I__l_*i;i.__ _1? 1 31-1.1 i n 1 • t • ,i n ? The probability of various distinct outbreaks occurring during the course of the same visitation of cholera must not be overlooked. It seems as if on some occasions the cholera of the reproduction adhered to a body affected from the first day to the last. At one time we find scarcely a day of the period without its fatal cases, while at another the blanks are so distributed as clearly to show that the occurrence is merely a casual breach in the continuous outbreak ; in a third case, however, the date of different reattacks is perfectly defined. Such persistence is not found in the case of moving bodies ; and therefore its occurrence is fairly attributable to conditions of locality or to conditions affecting the body because of its being stationary. The Regiments at Morar in 1860, 1861, and 1862 carried cholera throughout, from the day of invasion to the day of devitalisation — the 71st from July 22nd to September 16th, losing sixty-nine men; the 27th from July 25th to September 27th, losing 148 men; and the 13th Regiment from July 10th to September 20th, losing thirty-six men. (See Table, p. 174 ). The affection of the Peshawur Valley in 1862 is also a case in point. The cholera was localised in the valley and not in the barracks of the 93rd Regiment, and this Regiment was visited on four separate occasions during the persistence of the vitality of this cholera. Dr. Munro recognised the distinctness of these several outbreaks. He writes :—": — " There were four separate or distinct outbreaks of cholera in the Regiment. The first commenced on 7th July and terminated on the 17th ; the second commenced on 26th July and terminated on 10th August; the third commenced on 9th September and terminated on the 16th; the fourth commenced on 12th October and terminated on 3rd November." The Surgeon of Her Majesty's 77th, writing during the prevalence of the cholera of June 1867, says : — "Peshawur seems to me the most unfavourable station I have been at for an epidemic of cholera to occur in. It seems impossible to get rid of it. It is going round and round as in a basin, and the only way, in my opinion, to get clear of it is by a good start off from the place. The importance of the presence of European Troops in the station renders this most necessary measure impossible, and, therefore, when cholera makes its appearance at Peshawur the gravest consequences may be looked for." The 42nd marched out of the valley, and finally parted with its cholera in ten days after its first infection ; the 77th remained, and suffered from 21st May to 25th June. Sometimes it has happened that a Regiment has been unfortunate enough to suffer from cholera under several conditions in the same year. In 1857, Her Majesty's 84th Regiment was attacked on three different occasions : in cantonments at Chinsurah, cholera continued from 2nd to 16th April ; while marching on the Grand Trunk Road above Sherghotty, from 10th to 21st June; and again when in the field with Havelock's Force, from July 23rd to September 15th, while broken up into numerous detachments. These outbreaks presented different phases, each requiring to be regarded in a special light. The outbreak is not represented under the same aspect in all bodies of men subjected to the same choleraic influence — I mean bodies of the same con- lie outbreaks of a special locality stitution, for the disparity of affection in different classes and ifferent epidemics are sometimes raceg a separate consideration. What shows itself as a great outbreak in one body, may in another y in the immediate neighbourhood, be represented by premonitory cases only, without any jreak. It is very curious that such cases should sometimes occur in parallels. The followinstance taken from the history of the Meerut cantonment strangely repeats itself after an rval of forty-eight years. The 14th Regiment was attacked on the Bth August 1819; 221 became affected, out of whom forty-one died, and so universal was the cholera that the idea got abroad that it had become a contagious disease. After Meevut outbreak of 1819,— Jameson. commenting on the facts, Jameson goes on to say :—": — " These causes do not explain why the Horse Brigade on the right, and 18th Dragoons on the left, should have scarcely suffered, and the whole of the Native jps have entirely escaped, although the latter were from their modes of life doubtless much )sed to the damps of the night and to the heat and sun by day, nor why the sudder bazaar, most crowded and filthy of all the bazaars, should have enjoyed entire immunity/ The parallel of 1867 is as follows :—: — L"From the 15th August to the 25th September the Buffs lost one Officer, 105 men, .v, ! fiflfi* rin v ,, om 12 women, and 20 children, in all 138. There were five cases t outbreak of 1867,— Cumngliam. ? -i n i a +'11™**,. » in all among the men of the Royal Artillery." " The 19th Hussars remained free from the scourge up to the Bth September, when a man under treatment in hospital for contusion was seized and died, and on the 20th September a woman was also carried off. It was not considered necessary to move the Regiment from barracks, no further symptom of cholera having appeared. The Native Troops preserved perfect immunity throughout. The native population was scarcely touched by this second epidemic, nor were the native followers of the European Regiments, only two of whom In a minor epidemic, that of 1838, I find in the report of the Superintending Surgeon of the Meerut Division a third parallel : — " Towards the end of July cholera appeared amongst the Europeans at Meerut. The 3rd Buffs suffered the most, but some of the Lancers and 177 178 THE MINIMUM OF DURATION SHOWN BY TROO"PS ON THE MARCH. [Section 11. Artillery also fell victims to the disease. It prevailed greatly in the town. Some cases occurred in the sudder bazaar, but the sepoys and the regimental bazaars escaped almost entirely/ I Such an example as this might seem to give countenance to the view that the predion of cholera for a special locality is a very constant phenomenon ; and no doubt it is so.* 5, however, is to be remarked, that localisation during the course of an invading cholera i not of consequence imply revitalisation upon the same spot, a doctrine which has been h insisted on. The phenomenon of the reappearance in a certain locality of a cholera on king from a state of dormancy is not uncommon, but the exceptions far preponderate ; and whole aspect of a cholera which reappears in a year following invasion is opposed to the ma, that revitalisation is local in distinction to its being provincial. All outbreaks in the nd or third seasons of an invading cholera are secondaiy to provincial manifestation, and circumstances attending such outbreaks will in nearly every case point to the operation of neral and not of a local influence. X Lastly, the effect of special conditions in lengthening out or shortening the duration of the break remains to be considered ; of confinement within walls, as in the case of prisoners ; of ; finement to cantonments in the case of European and Native Troops ; of marching ; of it voyages ; and of change of locality subsequent to infection. IFrom the effects in different cases, having at the same time due regard to the nature of cholera miasm, the measures for the prevention or alleviation of the outbreak should be led ; and I shall try to show in the conclusion of the enquiry in what direction the results his study point. Outbreaks of communities. The types of minimum and maximum duration, European Regiments on the March, — a Statement illustrating the minimum, in time during 'which an infected body may carry cholera.^ Fatal cases odt op the admissions ov bach day of the outbreak. sililiiill i I I 1 I I I 1 I 1 Her Majesty's 32nd Regiment on the day after leaving Kussowlie, October 31st, 1856 ... 1 6 2 5 2 ... ' Her Majesty's 32nd Regiment reattacked near Thanesur, November 7th, 1856 1 1 s 9 ... 1 1 1 1 ... 1 ... ••• 1 Ist Fusiliers, between Kalka and Umballa, May 16th, 1857 3 3 2 1 2 11 ' ... 1 ... ... Her Majesty's 76th Regiment, between Kalka and Umballa, May 15th, 1857 2 C i 1 ... 4 2 3 5 5 ... ••• I Her Majesty's 9th Lancers, Umballa and Trunk Road, May 16th, 1857 2 2 12 3 ] 1 2 ... l ... Her Majesty's 84th Regiment, Grand Trunk Road, between Raneegunge and Benares, June 10th, 1857 ... ... ... 6 1 ... i 1 l ! 1 ... ... Her Majesty's 42nd Regiment, Grand Trunk I Road, between Raneegunge and Benares, i November 26th, 1857 ... ... 1 2 1 1 ... 1 1 3 ... ... ••• Her Majesty's 19th Regiment, Grand Trunk Road, between Raneegunge and Benares, November 26th, 1857 ... ... 2 2 1 i 1 Her Majesty's 37th Regiment, Grand Trunk Road, between Raneegunge and Benares, Her Majesty's 38th Regiment, Grand Trunk Road, between Raneegunge and Benares, July 29th, 1557 ... ... ... l j j } gl j j j x Her Majesty's 90th Regiment, on River Steamer above Dinapore, August 19th, Field Force proceeding from Lahore towards Dera Ismail Khan, Camp Kamokee, September 23rd, 1868 ... ... ... 9 I .1 i. l! i | ... I Her Majesty's 35th Regiment, Grand Trunk Road, above Raneegunge, February 7th, Her Majesty's 92nd Regiment, on board Steamer in Sunderbuns, March 26th, Total ... 35 3J 27 |28 j 9 7 6 9 11 |~T ~6 10 j~*6 3L. » 1 ... ... T * With reference to the note regarding the cholera of Scotland of 1439, at page 108, it is remarkable to find the very same town selected four hundred years later. No locality has suffered more than Dumfries in the epidemics of the present century. years" il that of Ver Maiest'i 'wth BPriSJ^rf""? "i a^ ilab \ c }'°\ tabulation. The only other case of importance that has occurred of late S Hazareebauirh in March 1 and Ann nscT Jv. 7i! detachments were successively attacked while marching between Raneegunge be sWn separately The term^ation of k P n fl^ I ?re S T" ln a COmmOU roU ' anrevailing at Thanesur when the 32nd Regiment passed near it on 7th November, and by lis time the cholera which had struck the men on the very day on which they came down le hill from Kussowlie was considered to be at an end; and the original outbreak had eased for eight days in the 19th Native Infantry when the reattack commenced in the locality in which cholera so constantly occurs, namely, the lower section of the Grand Trunk Road. I have little doubt that the two tables given above, show what is the typical fact, lat a Regiment moving, without incurring reattack, parts with virulent cholera before the welfth day. I regard such a body as in the same position as a community over which n air-conveyed cholera has passed.* We picture to ourselves the body occupying a certain ncamping ground upon which a cholera-bearing stratum of air has settled ; towards morning later, according to circumstances, cholera begins to show itself, and from this date we reckon lat the outbreak has commenced. The march is resumed. But now the Regiment is an fected body, although the district daily traversed may be absolutely free from a cholera apable of manifesting its presence ; and the experience above tabulated teaches, that the imediate disappearance of the outbreak is not to be reckoned on, and that the cholera will continue rulent for a definite period of days, not from increase of the virus among the affected body, >ut from the coming forward in each individual of the virus implanted on the known date. One of the instances tabulated is singularly instructive. It is that of the 66th Goorkha Type of the outbreak after in- Regiment, of which both Wings were simultaneously struck when fection of a Regiment as a body, seventy miles apart, while marching from the plains to the A. On the march. Tiill sfai.inns nf Almnrnh nnrl T.nhnnoOmf in Mnrr.li lSfi7 TV.£> hill stations of Almorah and Lohooghat in March 1857. The Head Quarters encamped in the Terai below Nynee Tal on the 13th March, in a region filled, as in 1867, with the cholera revitalised from the previous year — the great invading cholera of the monsoon of 1856. On the morning of the 14th, the Regiment marched up the hill and encamped beside the Nynee Tal, and here the first man was struck down. The history of the infection is perfect, for cholera is unknown at Nynee Tal. I The tents were struck the same evening, and the Regiment continued its march. The first fatal case admitted was on the 16th; on the 17th hSbQuaS^ S ™h 7611.7 611. *!"> fatal cases occurred ; and on the 18th and 19th the ithsoutof the admissions of each virulence of the poison imbibed on the night of the 13th day' was in full operation, when nineteen fatal cases came forward March 16th 1 March 18th 10 out of a total of twe nty-three. The last fatal case was on March 22nd l the 22nd, but we have no record to show whether or not I a few mild cases terminated the outbreak.f Sixty admissions all occurred in this Wing out of a strength of 611. I* See Note, page 199. t A traveller who has passed through this Terai in a season when malarious fever is known to prevail is considered c to attack up to the eleventh day. Here is the parallel. The other Wing, 361 strong, reached Birmdeo a week after ; and 66TH GOORKHAS, 1857. Strength of Wing 361. Deaths out of the admissions of each day. March 21st 1 March 24th 18 22nd 2 „ 25th 8 23rd 2 „ 26th 1 March 27th 1 m this evil Terai (see note page 129) the men were affected The Wing moved daily and reached Lohooghat on the 23rd March. The first fatal case showed itself on the 21st, on the 22nd and 23rd four cases which proved fatal were admitted ; the great mortality was on the 24th and 25 th, when twenty-six out of a total of thirty-three fatal cases were admitted ; and from among the admissions of the two following days the 26th and 27th, the two last fatal cases occurred. In a! iere were forty-three admissions and thirty-three deaths out of this Wing. These two cases rroborating each other, come up to my ideal of the type, and exhibit the results of a single ¦ection of which we can tell the date ; for almost to an hour we can tell when these Wings ere infected. Sometimes the stational outbreak affords a facies which conforms very much to this type, and Type of the outbreak after in- I cannot but regard this typical aspect of the outbreak as the ;ion of a Regiment as a body. B. ultimate aspiration to be hoped for in the event of the extreme the Station. o f infection having occurred. To allege that the effects of the asm shall be suddenly aborted or prevented from displaying themselves, by movement )sequent to infection or by other means, is to hold out illusory hopes which are warranted ither by theory nor experience. The most satisfactory result as regards the duration of the tbreak attended the removal of the 42nd Eegiment to Cheerat in 1867, and yet out of a 142 nd Highlandebs, 1867. olera Deaths. Cholera Deaths. ay 20th 7 May 25tb 5 „ 21st 4 „ 26th 7 „ 22nd 1 „ 27th 2 „ 23rd 21 „ 28th 1 „ 24th 18 „ 29th 1 strength of 765, 129 men were attacked and sixty-seven died within twelve days. This is an outbreak singularly resembling that of the Goorkhas in 1857, and I conclude that movement effected all that could possibly have been hoped for in both cases. The descent of the miasm on the 19th May determined the immediate victims of the 20th, 21st, and 22nd. The effects showed themselves generally on the 23rd and 24th, and in minor degree on the 25th and 26th ; and the subsequent ry is that of a few dropping cases coming forward for four days afterwards. The aspect of the outbreak in Her Majesty's 77th and in the Artillery, which did Aspect due to retention of bodies bin the area of infection. Aplarent prolongation of the out>reak throughout the vital period ;he reproduction. EUROPEAN TROOPS AT PESHAWUR, 1867. EXCLUDING 42ND EEGIMBNT). iates of admissions Dates of admissions of fatal cases. of fatal cases. May 20th 1 June 12th 5 „ 21st 2 „ 13th 5 „ 22nd 3 „ 14th 1 „ 23rd 1 „ 15th 9 „ 24th 4 „ 16th 3 „ 25th 4 „ 17th 2 „ 26th 5 „ 18th 2 „ 27th 2 „ 19th 3 „ 28th 1 „ 20th 1 „ 29th 2 „ 21st 1 „ 30th 1 „ 22nd 3f „ 31st 2 „ 23rd 1 une Ist 0 „ 24th 1 „ 2nd 1 „ 25th 1 „ 3rd 2 „ 26th 0 „ 4th 3 „ 27th 0 „ sth 1 „ 28th 1 „ 6th 3 „ 29th 0 „ 7th 1 „ 30th 0 „ Bth 7 July Ist 0 „ 9th 1 „ 2nd 0 „ 10th 5 „ 3rd 0 „ 11th 4 „ 4th 1 not quit the valley, had no alliance whatever to that of the 42nd.* In the case of the other troops the phenomena were those of the effects of a cholera localised and unable to escape from within the retaining walls, and dying- on the spot. The general indications are, however, much the same in both cases. From the 26th May we note in both cases the decline of the invading cholera of the 19th and 20th. Cholera is not absent in the interval between the 26th May and 7th June, but the abeyance of virulence is evident, and I see in the outbreaks between the Bth and 20th June the sprouting of the seed sown on the 19th May, a source of infection which the 42nd escaped altogether by change of locality to an elevation above the cholera level. Such an example as that of Peshawur in 1867, is not to be held up as a type of the stational outbreak. It is as exceptional as is the case of Morar before tabulated, and has its alliance rather in the Peshawur outbreak of 18624 Before I speak of the aspect of the outbreak normal for a Cantonment or a Jail, I shall instance as parallel with the case of the Morar Cantonment that of the camp before Delhi in 1857 and of the 32nd in the Lucknow Garrison in the same year and at the same season, where the necessity of holding fixed positions extended the outbreak for the entire period of the reproduction. In the case of the Goorkhas, the hour in which the Regiment left the Terai was that of its removal above choleraic influence, and in the ease of the 42nd a single march placed it beyond the reach of the miasm. Both were still affected bodies ; but there was no miasm of locality to reinfect them, and a period of ten days saw their cholera at an end. The 77th was an infected Er, and so also were the Regiments before Delhi and the Garrison of Lucknow ; but because 3 bodies were retained within an infected focus, the duration of their cholera is reckoned by ths and not by days. * I shall allude afterwards to the circumstances determining the ratio of attack in the 42nd Regiment. t These cases seem to have appeared on the 19th and 20th. tX With the death of the spring cholera, the invading cholera of May, the miasm disappeared from the Peshawur iy. The invading miasm became devitalised after the termination of the spring reproduction on 20th June, and did reappear during the course of the epidemic, although the same cholera was roused again into epidemic vigour in all istricts of the province lying under primary monsoon influence. This phenomenon is attributable to the normal enforced decay of spring cholera, and to the fact that in 1867, as in 1856 and 1861, Peshawar lay beyond the of the aerial influences of the monsoon months which determine the limits of fresh invasion in July, August, and smber. 181 CONDITIONS UNDER WHICH THK MANIFESTATION OF THE NORMAL TYPE OCCURS. [Section 11, 182 The case of the Renown given by Dr. Sutherland in his Report on Gibraltar, seems to Case parallel with that of the me an instance of the seed sown on a known date, spring. infection of the Peshawur Canton- ing into vigour after a period of latency. By a coincidence, the ment. Ship Renown, August 1865, days of the months correspond with those of the Peshawur utbreak, and the parallel can be the more easily read. The Renown was infected apparently 1 the day on which she left Gibraltar, on 19th August 1865. Dr. Sutherland's Report states • Cholera appeared in the town of Gibraltar on 19th August. On the 21st the Head Quarters Wing of the 19th Regiment went on board the Renown; and the next day, the 22nd, the lird day after cholera was in the town, the fatal case of cholera referred to in the text took ace. The transport was hauled out into the bay and kept for thirty hours, and no subquent case having occurred she proceeded on her voyage. On the sth September, a fortnight 'ter the fatal case at Gibraltar, cholera broke out on board the Renown and lasted for fourteen ays, till the 19th. It was fatal to the ship's surgeon, nine men, one woman, and several lildren. It is worthy of remark that the period of outbreak on board corresponded to the >eriod of maximum intensity of the epidemic in Gibraltar, although the Renown was at the ime far on her voyage to the Cape. The Left Wing which took its departure on the very ay cholera broke out in the town escaped. The Head Quarters Wing, which left four days ter, suffered" (p. 8). This case appears to me to be a rare and important one. It is a pure illustration of a lolera outbreak of normal duration (fourteen days), with the miasm having a dormancy be,ween the 19th August and sth September. Compare the Peshawur outbreak. It is a certain ruth that Peshawur was struck on 19th May; it is equally a fact that Gibraltar was struck n the 19th August. I regard it as distinctly proved that there was a reappearance of cholera the Peshawur Valley in the first week of June, and this I attributed at the time to the oming forward into life of the seed sown on 19th May. Here on the sth September is le same coming forward, although the vessel had been a fortnight at sea, after exactly the same umber of days. This coming forward of the latent cholera was the origin of the fourteenay (sth to 19th September) outbreak, of which the parallel is the . Peshawur cholera occurring >etween the sth and 19th June, after which date cholera was sporadic only (see marginal ;atement on previous page) ; and it coincided with the period of maximum intensity in the Gibraltar Garrison. It may be suggested that this cholera was latent in the individuals ttacked, or that the vessel sailed into a cholera-bearing stratum of air a fortnight after leaving xibraltar. Neither possibility has any degree of probability attached to it. The germ was vidently brought on board with the Wing. The clothes of the Regiment may have been nfected while being washed in anticipation of the voyage, or the regimental baggage may have jeen infected while lying exposed before being taken on board. In what shape the miasm as introduced must be a mere matter of conjecture, but it is clear that there was the nfection of the men or their property ; and the test that infection of attendants implies affection ? locality, to which I shall have occasion to allude afterwards, holds, for we find that the urgeon of the ship also died. I consider this case to be typical for nearly all outbreaks early originating on board ships, and we are fortunate in being able to illustrate it by such a >arallel as the infection of the Peshawur Valley in 1867. The following is an example of the minimum duration of an outbreak due to the fact of le cholera miasm having been taken on board in some form, probably in a dormant state, ince both the crew and the troops suffered, and since the duration of the outbreak was limited o eleven days, the inference is that the poisoning took place within a very short period, nd from a cholera emanating from some special part of the ship or portion of its cargo. )r. Tulloch, of Her Majesty's Service, makes the following communication in his answer to )r. Murray's circular regarding the origin and treatment of cholera :—: — "On the 21st May 1859, I embarked at Calcutta on the Ship Gertrude, in medical harge of a party of wounded and other invalid soldiers for England. Cholera was then universally prevalent in Calcutta, and in several troop ships that had sailed earlier in the season, he disease broke out when they were in the river — a circumstance which caused serious apprehension for our safety at this advanced season, and, I may add, led to our using every available sanitary precaution. Having reached the equator without any signs of cholera, we ongratulated ourselves on what we believed to be our escape. But it was not so ; for on the sth of June, when in the 4th degree of south latitude, and 24 days from all communication with the shore, hundreds of miles from land, the weather hot and steamy, but not unusual for hat latitude, a soldier, invalided for ophthalmia (then convalescent from dysentery contracted on )oard), was seized in the morning and died next day. On the same morning, the Chief Officer of the ship, perhaps the strongest and healthiest man on board, was seized and died in three and lalf hours. In the afternoon, a soldier's child, a boy six years of age, was attacked and died on he following morning. On the 20th, a soldier recovering from dysentery, was attacked and died on the 21st; and on the 25th, a strong healthy sailor was seized and died next day." 183 Chap. lIJ PROLONGATION OF MANIFESTATION DUE TO ATTACHMENT TO LOCALITY. Camp before Delhi, and the Lucknow Garrison, 1857. J, Statement to illustrate Ike persistence of cholera throtighout the life-period of the Reproduction. A Died out of the admissions of each day dukino the siegi:. Date of Adintakm. "3 -g iiiititts* IiIiII 1 ! I I I A gH •< £ tH OS 1H S3 t» 00 1Q «0 1^ *" » !? 2 '"i" 1 ;;.'.¦;; "i '.'.'. '..'. '.'. ..'. '.'.'. ... .'" 1 ;; II 2 .:.¦;;; "r ;.." "i ''.'. ... '.'.! '"' .'" '.'.'. ""i ¦; I? 3 r .;;¦" "" ... z i 'i '" •'• ••• '"i" 28 5 2 2 1 2 29 5 1 1 ... 1 2 c c "i" '.;!!!! »! iii ... ¦•• '¦'¦ i •••' j 3 8 5 .'"•'' '.'.''¦' - •¦'• '¦¦ ••• •• 2 •'• 3 2 io 16 z'". zz "2 z. z "i ""i 7 5 !";;; » is J .::::: "t ::: ::: "a 1 ::: *i 2 ? 17 5 "i" !!!"! i a i 18 6 13 11 19 3 2 ... 1 I! 2« 6 1 ..12. ... 21 4 1 2 ... 1 ;; 22 7 1 1 ... 3 ... 2 r, S 3 ;;;;;; "\" "i z. z. j i" Continued on following page. [Section 11. 184 PROLONGATION OF MANIFESTATION DUE TO ATTACHMENT TO LOCALITY. . Deaths during the Sieges of Delhi and Lucknow, — continued. Died out of thb admissions op bach day dubibg the siege. Date of Admission. "S | g S -g "g 5 § and the date of disappearance in each is as follows :—September 11th, 16th, 18th, 20th and 27th ; and we may, therefore, oughly estimate the duration of the outbreak as two months. I have shown the date of appearnce at Meean Meer to be generally nearly a month later, and yet the termination falls exactly as in the case of Morar, being in the six cases below tabulated (including Ferozepore, 1856,) eptember Bth, 15th, 16th, 22nd, 28th, and Ist October. The phenomenon is precisely the ame illustrated in the case of Morar, namely, local infection up to the natural decay of lie reproduction. I have added the case of Her Majesty's 46th Regiment at Cawnpore in 863, to show that even in the eastern division the very same persistence may occur • the 16th carried cholera typically from the 17th July to 26th September. further examples of the stat'ional outbreak protracted throughout the life-period of the reproduction — Ferozepore, Meean Meer, Lahore, Cawnpore. 1856, 1856, , . *? 6 '.' 1862, 1856 186' 1863 H. M.'s 70th Regt., H. M.'s 81st Regt., Al |" £» sl °™. H. M.'s 19th Re&t., Admissions, Lahore Deaths, Lahore H.M.'sJrfltnßegt., Ferozepore. Meean Meer. Meean Meer. Meean Meer. Jail. Jail. Cawnpore. August 7, 1 August 15, 2 August 6, 1 August 14, 1 August 20, 1 August 2 2 July 17 1 „ Vi > 1 .» 1«. 3 „ 8, 2 „ 25, 7 „ 21, 1 ? 8 "2* „ 13i a » 17, 2 „ 9, 5 „ 2(5, G „ 22, 8 7* " " 'V 1 I*. 3 .. 18, 2 „ 10, 8 „ 37, 12 „ 23, l " B | £ " 3V t „ 1 5 . ! » 19 . 2 „ 11, 5 „ 28, 5 „ 21, H y, j 31 ' 1 lt} . 10 ¦- 20, 3 „ 12, 3 „ 29, 8 „ 25, l 0l 0 , m .[. August 1 1 „ 17, 9 ¦, 21, 2 „ 13, 4 „ 30, 3 „ 20, 15 II •> g 1 ? l**f 4 .» 22, 13 14, i! 6 „ 31, 6 „ 27, 28 „ 12' 1 " i 19. 6 „ 23, 6 „ 15, 43 ! Sept. 1, 2 „ 28, 35 „ 13* 2 ', 5* 1 20, 2 „ U, 0 16, 33 „ 2, 2 „ 29, Jo ? 15 1 0 1 21, 2 „ 25, 9 17, 30 „ 3, 3 „ 30, 38 „ 16* 1 „ 7, 1 22 . 8 .. 26, 3 „ 18, 41 „ 4, 3 „ 31, 57 „ 1« 3 | ? 15, 1 ? 23, 5 „ 27, 8 1!) 28 „ 5, 1 Sept. 1, 47 „ 1!) 3 ! „ 25, £ 21, 6 „ 28, 10 20, 45 „ G, 3 „ 2, 29 „ 20, 3 I „ 31, 1 „ 25, 3 „ 29, 4 „ 21, 80 „ 7, 1 „ 3, 33 „ 2> 1 Sept. 12, 1 20, 3 „ 31, 1 „ 22, 61 „ 9, 1 „ 4, 23 „ 23 3 „ 13 1 27, 3 Sept. 1, 1 23, 58 „ 10, 1 „ 5, 4 „ 2S, 2 „ 14, I „ 30, 2 „ 2, 1 21, 45 ? 11, 1 „ G, 8 „ 31, 1 „ 26, 1 31. 1 3, 9 " 25, 50 * • • „ 7, 4 Sept. 2, 2 Sept. 1, 1 „ 4, 5 „ 2(», 53 „ 22, 1 „ 8, 4 „ 4, 1 „ 2 » 2 „ 5, 2 „ 27, 42 „ 2G, 2 „ 9, 1 „ 5, 1 4, 3 „ 6, 5 ' 2S, 41 October 1, I „ 10, 2 „ 8, 1 „ 5>5 > 2 „ 7, 5 „ 20, 43 „ 11, 1 " 7*, 3 " 9', 4 " 3l', 18 " l 5! 1 8, 1 „ 11, 4 sept. 1, 17 ? If, 0 .. 15.' 1 ',', 18*, 1 " 4. 10 ,',' 23,' 1 ", 8, 3 '.'» !->' } 15, 3 The one grand and incontrovertible fact apparent from all this is, that while the outbreak may be prolonged up to the period of the natural decay of the reproduction, it cannot be prolonged beyond it. This is a primary truth of the same value as that which I have previously determined, that epidemic cholera cannot be introduced into and propagated within a natural province in which it is not due at the time. Ido not discuss here the question how it comes about, that while in the endemic province or on the march, the tenth day sees the end of the outbreak, the normal duration in stations of the epidemic area is often six times as long. Igo on meantime to show what is the aspect of the outbreak in different localities, viewed apart from any circumstances which may possibly affect its facies. The outbreak in cantonments and jails. Between the extremes determined by immediate removal from the sphere of the influence Ihe miasm, and by local persistence throughout the reproduction, fall the great majority 11 outbreaks. I would not have it supposed that the fact of remaining in the same position iequent to infection on a known day necessarily determines the lengthening out of the >reak. I think, however, that we are warranted in dreading that such may be the case ay station of the epidemic area. This I say as the result of experience. It is a very dus fact that among European Troops the minimum of the duration of cholera outbreaks Id be found in the endemic province. The following table includes all the regular outks which I have been able to collect, and I reckon them to be typical for the duration of the outbreak in Lower Bengal. Sometimes the effect of the air-borne miasm is even more transient, as in the ease of all outbreaks in Fort William that have occurred since 1860, and in the three remarkable attacks of the Chinsurah Depot in 1868. In the latter fourteen men were lost — four in the first outbreak, between April 7th and 16th; five in the second, between May 20th and 22nd ;f an d nve * n the third, on June 20th and 21st. The outbreak in Lower Bengal. European Troops — Bate of the Admissions of Fatal Cases, Fort William, Fort William, Chinsurah, Barrackpore, Barraekporo, Dum-Dum, Dum-Dum, Dum-Dnm, 53rd Regiment, 37th Regiment, 81th Regiment, 67th Regiment, Recruit Dcp6t, Artillery Depot, Depot H. M.'s 3rd Bufts, 1856. 1857. 1857. 1359. 1359. 1859. Troops, 1559. 1859. Died. Died. Died. Died. Died. Died . Died. Died. August 30 2 June 17 G April 2 1 Aug. 8 2 Aug. 3 2 Aug. 9 1 Aug. 10 -1 Aug. 10 ;( 31 6 „ IS 1 „ 3 6 „ 9 3 „ G 1 „ 10 10 „ 11 1 „ 11 1 Sept 16 19 7 „ 4 2 „ 10 3 ?8 1 „ 11 6 „ 14 2 ]3 1 ?2 2 „ 20 1 „ 5 2 12 1 „ 11 2 „ 12 10 „ IS 1 „ Hi 1 a i „ 21 i „ « i „ ii i „ is 2 „ 13 is * • 4 3 , 23 2 „ 7 1 „ 15 3 • „ 14 7 27 1 5 3 „ 84 1 ? 8 1 „ 27 2 „ 17 1 li 3 ?9 1 „ 29 1 „ 10 1 "WI * * 13 I " 21 1 „ 10 I „ -5 2 * Including women and children. f On the very same d.iy the detachment of the 25th Regiment was struck at Berlnnipore, and two men died oa 22nd and 23rd. 2 z 185 These examples show the outbreak in its purest type, unaffected from beginning- to end by any adventitious circumstances ; for, as far as I know, every one of these outbreaks was treated throughout in the barracks in which it commenced. These are probably examples of infection at a certain hour from an air-borne cholera from which no localisation of the miasm occurred, as pure as those in which the Goorkhas were affected in March 1857 from sleeping for the night in the cholera-bearing atmosphere of the Terai. The type is the very same as that of the outbreak of the 42nd, struck on the 19th May 1867, as truly as Dura-Dum was struck on the 9th August in 1859. !The affection of Native Troops in Lower Bengal shows rather the fact that at any time uring the prevalence of epidemic cholera, men are liable to be picked off, than anything 1 jming up to my idea of an outbreak. The cases are generally attributed to the effects of ight guards in different parts of Calcutta, especially those close to the bank of the river, le Mint guard, and the guard of the Bank of Bengal. In the epidemic of 1866 the distribution ' the deaths of the Native Regiments was as under : — roradic character of the manifestation of epidemic cholera in the Native Regiments of Bengal Proper. Deaths during the prevalence of epidemic cholera in the spring of 1866.* Alipobe, 1866, Alipoee, 1866, Fani William, 1866, Fohi William, 1866, 2eth N. I. 36th N. I. 17th N. I. 34th N. I. April 7, 1 February 14, 1 May 12, 1 January 20, 1 „ 12, 2 March 1, 1 „ 15, 1 „ 22, 1 „ 14, 2 8, 1 June 13, 1 „ 31, 1 „ 25, 1 I „ 23, 1 July 2, 1 February 14, 1 May 1, 1 „ 27, 1 3, 1 March 27. 1 „ 2, 1 „ 30, 1 „ 29, 1 „ 29. 2 „ 6, 1 April 2, 1 August 28, 1 „ 30, 1 May 27, 1 April 4, 1 June 19, 1 „ 12, I Here there is no tendency shown to accumulation ; almost every case seems to stand isolated. tWith reference to the table which follows, I must premise that I have been compelled to , . ? T., make selections and occasionally to exclude instances in which Ispect of the Outbreak in the Jails ,-, • •i • f j* j. j • w m Lower Bengal. " c provincial miection was represented m outline. To com- pensate for this, while showing the facies of sixty-seven Itbreaks occurring in the jails of Lower Bengal between 1859 and 1867, I have taken the tire mortality of the jails of the Behar Provinces in the invasion of 1866, and exhibited day by day up to the end of the reproduction ; the mortality of 1860 of the same province old have been accurately represented only by a similar arrangement. I Making allowance for this, we cannot help observing- how singularly the facies of the total allied to what we have found true in the case of Regiments on the march and among the iropean Troops in the endemic province. Of the total mortality, 58 per cent, is included within 3 first seven days from the commencement of the outbreak ; 90 per cent, within the first fourm days ; and 10 percent, only occurred after the fourteenth day, and this last ratio would have en still further diminished could the cases of re-infection have been separated. In this aggregate ere is no spindle shape, no swell in the centre, to point to propagation from man to man. ad it must not be lost sight of, that one and all of these outbreaks were treated from st to last within the prison walls, and that the outbreak therefore died naturally, thout the abbreviation which might otherwise have been attributable to change of locality. I* This was the manifestation in Calcutta and the neighbourhood, of the epidemic invading the Behar Provinces July 1866, and Northern India in 1867. 186 Statements to illustrate the duration of the ontlreaJc among Prisoners. i 1. — Outbreaks of the Jail Population of Bengal Puopeu and the Behau Provinces, 1859-67. Ncmbbb or Deaths out of the Admissi n: of each bay of the ouibbeak. T , „ Day of commencement of the .1 ~ ~~~ 2Z¦ II Z~l Z3•••¦'¦'• '• '• 2 " JAIL - outbreak. >, & §¦ & &&£.'>-&S'S'&S'&&S'&s'&&S'§ > l?^S'tS' Burdwan ... June 16, 1859 ... 1 ... 3 1 2 2 5 2 ... 1 | Rajshahye ... May 12, \ 1 ... 1 1 ... 21211." ' '" '" '" Backergunge ... November 18, „ ... \ 3 1 1 2 I 3 1 4 ... 2 1 i 1 .. .'.'. '" Monghyr ... July 13, .. ;1 1 I ... 11 ... 1 i ... 2 1 ... " Bhaugulpore ... May 8 1 ... 1 2 4 4 3 2 13 1 .. Ditto ... August 14, „ ... 1 1 3 2 11 2 1 „ '.' '" Purneah ... May 25, „ ... 3 ... 2 ... 2 1 ... 1 11 1 ... l 2 . ' Patna ... October 29, 1 1 ... 1 ! ... 3 3 1 ... 1 1 \\ ... Dinagepore ... May 23, 1860 ... i 1 ... 1 1 | 1 1 3 1 ... 1 Mymensingh ... March 24, ? ... 1 ... ... 1 12 I 1 ] 2 1 ... ... ] ... "3 Gowalparah ... May 4, „ ... 3 3 I 1 6 1 8 2 3 ... 1 ... 1 ... 1 ... 1 Gowhatty ... September2l, „ ... 1 ... 2 4 ... 1 1 1 ... 1 Ditto ... October 6, „ ... 1 2 ... 1 1 ... ... ... 1 ".[ '" '" Midnapore ... March 20, „ ... 1 1 4 ... 2 2 ... 1 ... ... i Ditto ... June 16, „ ... 1 19 16 3 5 4 2 ... 2 2 1 ... 2 1 1 ... Hazareebaugh ... May 4, „ ... 1 1 ... 2 2 3 4 ... 1 4 I ... 3 2 4 2 Monghyr ... April 6, „ ... 2 2 ... 1 4 2 1 1 ... 1 Bhaugulpore ... March 11, „ ... 1 ... ... 1 1 ... 1 2 1 1 2 1113 ... 1 2 .. 2 "i "2 Purneah ... „ 31, „ ... 1 1 1 ... 1112... 5112 2 Gyah ... August 2, „ ... 3 4 ... 3 3 1 1 ... 2 1 1 I 2 1 1 1 3 " Patna ... July 23, „ ... 1 1 ... 1 11l I 1 ... 1 ... 1 Arrah ... „ 13, „ ... 3 ... 4 6 10 1 6 4 1 1 3 1 ... 2 ... 1 2 Mozufferpore ... September 11, „ .. 1 3 12 1 ... 1 1 ... 1 Sooree ... May 17, 1861 ... 8 5 ... 1 1 1 Mjmensingh ... „ 25, „ ... 2 ... 2 1 ... 1 ... 1 1 1 Ditto October 27, „ ... 1 ... 4 3 3 2 2 ... 1 ... 1 ... " [[[ '." Bhaugulpore ... April 5, „ 1 2 2 3 2 2 11 Patna ... July 3, „ .. 1 1 6 2 1 1 1 1 ... ... Deegah ... April 7, „ ... 1 2 1 ... 1 1 1 1 ... Mozufferpore ... May 2, ? . 1 1 ... 1 1 2 * ... 1 Monghyr ... April 13, 1862 ... 116 2 112 ••• ... Bhaugulpore ... „ 4, „ 1 2 13 1 ... 1 ... 1 ... 1 ¦•• " "' Hooghly ... October 31, 1863 1 3 4 ... 1 2 3 ... 2 1 1 ... 1 ... Backergunge ... March 18, „ ... i ... 1 ... 2 ... 1 ... 3 2 1 3 1 1 ¦•• ... 1 ... 1 ... '"m" m Carried over ... 53 48 47 51 63 62 50 30 21 40 18 18 15 13 5 8 6 3 10 6 4 1 4 5 3 ... ~~ 187 I.— Outbreaks of the Jail Population of Bengal Proper and the Behar Provinces, 1859-G7. Numbkb of Deaths out of the Admissions of bach day of the Outbreak. j^jk Day of commencement of the ~~ "; — _____ $ I i M i gggggggg gg|ig|gg|||gggg Brought forward ... 53 48 47 51 63 62 50 30 21 40 18 18 15 13 5 8 6 3 10 6 A. i ? X o Backergunge ... November 28, 18*33 ... 2 ... 3 1 2 ... 2 1 ... 2 ... 3 2 1 I 1 ? 4 ? ? HazareebaugU ?, August 16, „ ... 1 ... 1 ••• 1 2 ] l i "V '" "i '" 1 Monghyr ... March 17, „ ... 13 4 1 ... 2 5 ... 3 ' li'" "i Ditto ... July 4, „ ... I 1 ... 2 2 ... 5 "i "{ Bhaugulpore ... March 25, „ ... 1 115 11 ... Purneah ... „ 7, „ ... 9 1 10 11 13 7 10 2 11 2 \ "i "• %ah ... July 28, „ ... 1 ... 1 ... 1 1 ... 1 : \ Patna ... March 12, „ ... 1 1 ...... 11 111 3 -Ditto ... July 24, „ ... 1 1 1 ... 1 j 2 1 3 "\ '[', ..] Mozufferpore ... May 4, „ ... 1 3 ... ... 1 ... 1 3 1 1 " "" "3 "' I "\ Chupra ... July 6, „ ... 1 1 ... ... 1 ,[ 1 "\ '" Jessore ... April 3, 1864 ... 1 1 13 3 3 1 3 ... 4 ... l "{ "' Bancoorah ... March 5, „ ... 1 I ... 2 I 3 1 { llajiuahal ... May 19, „ ... 12223 3 1 '" ? "" ' Dinagepore ... April 12, „ ... 1 5 1 3 1 | 3 2 "2 2 3 "i "i "2 1 1 "" Kajsbahye ... February 18, „ ... 1 ... 1 ..11 V "' I Ditto ... March 22, „.1 4 2 112 '.'. \ '..'. '" "" i"i Sumbulpore ... April 16, „ ... 1 ... 1 ... 4 3 13 ! 3 "« 8 "4 "3 "i "i '" Bhaugulpore ... June 8, „ ... I ... I 1 .. 11l Patna ... April 3, „ ... 1 ".' 1"| 1 2 '*' "l "*i Bancoorah ... March 23, 18G5 ... !11 1 1 111.. "i "" I Gowhatty ... April 3, „ ... !11331 "i .. ' " Cachar ... October 17, „ ... 1 2 11 3 "4 2 "i "i '" "i I Purneah ... April 10, „ ... 4 1 j 2 1 7 1 1 2 2 '" " atna , - » 8, » .. 1 - 2 ... 13 2 "3 2 "2 Z "i 1 •" "2 Deegah ... „ 18, „ ... 2 11 2 I '"" Ohupra (a) ... July 19, „ ... 3 ... 1 ... 4 1 3 '" "\ '" ".' '" Ohupra^ ... October 6, „ ... 111"i "j '" 1 .'[ '{ '" Cachar ... April 9, 1867 ... 1 4 3 2 1 "" 'j Monghyr ... July 15, „ ... 1 1 ... ;" 4"]\! "1 " X Purneah ... April 30, „ ... 1 2 2 5 5 8 6 ... 3 1 3 1 4 " De stth5 tth ••• August 25, „ ... 1 ... 1 ... 1 1 I ... 2 2 5 4 3 2 "2 "2 Patna ... October 26, „ ... 1 ... 11l 132 2 11 Total of the above OUTBREAKS ... 101 72 82 96 120 100 9<> 03 60 69 47 52 46 ~38~ ~JgT "l8~"l5~ l2~"ir~14"|~4~ ~ ~6~ ~6~ ~4 ~\~ 188 THE OUTBREAK IN THE JAILS OF BENGAL PROPER AND BEHAR. 11. ChaP« lIJ FACIES 0F THE OUTBREAKS IN THE JAILS OP BEHAR IN THE INVASION OF JULY 1866. 189 Jails of the Behar Provinces — Cholera Deaths in the Invading Cholera of July 1866. Deaths of each Day. H B™- G ™- BE " M °™- *«"• *»««¦ *"""¦* CHCPBA. ""^ C -«- Datb. , Strength Strength Strength Strength Strength Strength Strength Strength Strength Strength GS9. 649. 341. 468. 571. 60S. 492. 499. 457. 286. ;; I? "i •¦¦•¦ 2 :::::: :::::: :::::: :::::: :::::: \ ::: ", 26 3 '""i ZZ '.'.'.'.'.'. ;;;•¦. } i " 21 '.'.'. '.'.'.'.'.'. ""i s ;;;;;; i 2 g 1 Total ... 79 10 13 6 13 24 21 17 17 15 * This jaU had an additional outbreak between 14th October and 18th November, in which nine prisoners died. This table showing the cholera deaths of the jails of Behar during- the invasion of JuL 1866, teaches that we are not to dogmatise that the outbreak is ; a thing extending overi certain number of days. It shows us the play of the epidemic over this area from the las week of June to the first week of September. In theory, any one of these jails might have suffered in repeated invasions for the whole of this period. The typical outbreak is representet >robably in the case of Patna, Bhaugulpore, Mozufferpore, and Chumparun. But the other examples give evidence of something over and above the effects of a choleraic influence once applied. In Arrah we find the influence present from the 19th July to 18th Novem>er; in Gyah, from the end of June to the middle of August fatal cases continued to crop up throughout at intervals of about ten days ; in Hazareebaugh, we see on the 22nd July evidence of a great and sudden increase followed by decay on the 12th day after. Whether this was founded on the cholera invading between the 9th and 14th, or whether it was a fresh invaion, we cannot say. Those who believe in the growth of cholera in communities would point o this as an example, and would instance the death of the medical officer as a proof of the ommunicability of this cholera, while others would see only the typical outbreak — intense in he first few days of attack, tailing off gradually, and dying at the date on which the typical outbreak dies. This much may be fairly inferred, that with the universal presence of epidemic cholera over a province we are not entitled to overlook the extreme probability of the repetition of outbreaks and of the lengthening out of outbreaks due to this cause only. The same remarks apply to the cholera of the epidemic area. Calling to mind individual examples, the impression left on the mind is, that the outbreak in the jails of Upper India has a different aspect, and is of much longer duration than the outbreak of the Lower Provinces. And yet when tabulated, the results are not very different. The following table shows fifty-seven outbreaks in Upper India with a mortality of 1,164. Of this mortality 54 per cent, occurred during the first seven days, 85 per cent, during the first fourteen days, and 15 per cent, subsequent to the 14th day. Against the generalisation deduced from this table, the experience of the great jails of the Upper Provinces may be adduced. The aspect of the outbreak in these would seem to give countenance to the views of those who have held that the prolongation of the outbreak may be related to the numerical strength of the body aggregated under the same conditions. To this question I shall return in speaking of the circumstances determining the intensity of the outbreak. The proposition involved as it is generally put is certainly not true, namely, that towns retain cholera longer than villages and country districts. The provincial reproduction is at an end in the great cities of an affected area quite as soon as among the rural population. This is a perfectly well known fact in Upper India, and the history of the cholera of any epidemic bears out the statement. 190 11.— Outbreaks of the Jails of the Epidemic Area.— Jail Population of Upper India, 1858-67. i NUMBEB Of DEATHS OUT OF 188 ADMISSIONS OF BACH DAT OF THE OUTBREAK. t.tt Da ? of commencement . . . . . . • 2? & 2? ;? & £ &• 5? !? £ g? i^ 1 5? £ £ 5? 1 £• >¦ £ 1 & 1 & jAn " of the outbreak. ££-&&§ > §>&S?j?.§.§'§.3'§'a.o'o-o'3-a,§.§.3.§'§'§'§'3'a'o Delhi ... ... August 12, 1858 ... 1 113 3 1 ... 1 1 Hoshiarpore ... September 14, 5 1 » • ("May 18,1859 ... 1 1 ... 1 1 ... 4 1 1 Allahabad < *' une '» » *•* I ' ® " ••¦ * * V Benares ... ... „ 17,1860 ... 1 .". 1 2 1 1 3123 12 ... 1 4 1 i i Goruckpore... ... May 18, „ ... 1 ... ... 1 ... 1 1 2 ... ... ... ... ... ... ••• ••¦ ••• ••• ... ... ••• ... ... ... ... ... ••• • Mundlaisir ... ... March 6, „ ... 1 ... 3 1 1 1 ••• 1 ... ••• ••• •¦• ••• ••• ¦•• •• ••• •• Agra ... ... August 9, „ ... 2 3 8 16 25 27 14 14 2 8 15 10 7 4 5 1 2 6 2 1 2 1 1 Mirzapore ... ... July 3,1861 ... 1 2 1 1 1 1 1 1 .. 1 Luclmow „. ... September 1, „ ... 1 2 2 1 1 2 ... 3 1 1 ... ~ Futtehghur ... July 23, „ ... 1 1 3 •• .. - Allahabad ... ... May 13, „ ... 2 1 1 ... 1 ... 1 2 ... 4 1 7 ... 1 ••• - ... 1 1 •• - Asra ... ... July 6 "... 3 1 7 9 3 3 3 6 2 1 1 2 2 1 1 1 2 ... 1 1 3 3 2 4 2 ... Delhi ... ... „ 1, 2 5 3 4 1 2 ... 1 Bohtuck ... ... August 17, „ ... 1 ... 1 ... 1 ... 1 1 ... 1 1 1 1 8 ... 2 2 2 ... 1 Umballa ... ... September 7 1 ... 3 ... 1 4 3 3 1 1 1 ••• Aimere ... ... July 21,1862 ... 2 1 1 1 1 1 Agra ... ... August 11, „ ... 3 1 1 3 3 1 ¦• ••• • ¦•• - ••• - ilhore ... ... „ 7, "... 2 2 1 4. 2 1 2 1 1 ... 3 3 3 ... 1 3 2 1 ... 2 ... 11 ... Sealkote ... ... „ 13, „ ... 2 ... 1 1 ... 1 1 1 ... 1 1 * Goojranwalla ... „ 20, „ ... 1 ... 3 3 4 1 1 Peshawur ... ... July 6, „ ... 2 1 1 2 1 ... 1 ... 1 Ditto ... ... October 17 1 1 ... 2 5 1 1 2 1 Benares ... ... June 15,1863 ... I ... 2 1 1 2 ... 3 1 2 ... ... ... ... Ditto ... ... July 8, „ ... 1 2 ... 2 2 ... 2 3 1 3 3 3 2 1 ... 1 ... - 2 ... 1 1 ... 1 Goruckpore ... „ 17, „ ... 3 5 6 2 5 3 1 3 1 1 •» 1 1 1 1 1 1 ... 1 1 2 2 Fyzabad ... ... August 3, 1 1 ... 1 1 1 Baeßareilly... ... ? 6, „ ... 1 ... 11l 1 Lueknow July 15, „ ... 2 1 8 5 9 17 10 8 11 8 5 6 3 5 1 3 3 ... . . ... ... Ditto ... ... October 31, „ ... 1 1 1 2 ... 1 12 1 2 ... 1 ... 2 1111111 Mundla ... ... June 11, „ ... 1 ... 2 2 1 Jubbulpore ... ... July 15, „ ... 1 4 1 2 — ••¦ •• ... ••• •• •• Seonee ... ... June 20, 1 ... 1 ... 1 1 2 112 •• - 1 ... 1 1 1 Agra ... ... July 12, 1 4 3 2 ... 3 1 1 } ... 1 ... 3 2 1 2 3 1 Benares ... ... August 4,1864 ... 1 6 1 2 1 ... 1 3 2 2 ... 1 1 ... 1 1 Goruckpore ... June 13, 1 1 1 1 1 2 ... 2 Ditto ... ... July 22, „ ... 1 1 1 3 Fyzabad ... ... April 18, 1 5 7 3 2 Sultanpore ... ... May 23, „ ... 6 1 1 4 1 2 1 1 1 Allahabad ... ... June 8, „ ... 4 16 3 1 4 ... 1 ¦• Nagpore ... ... March 13, „ ... 1 1 2 2 1 1 Seetapore ... ... September 1, 1865 ... 1 ... 1 ... 1 1 2 1 ... 1 1 2 Nagpore ... ... April 9, „ ... 1 ... 1 ~ 1 1 — 1 Ditto ... ... July 8, „ ... 2 1 2 1 11l ... 2 1 Ditto ... ... „ 25, ? ... 1 8 4 6 3 1 ... 3 1 Eaepore ... ... April 27, „ ... 13 12623.. 211 1 1 Bandhara ... ... June 29, „ ... 3 ... 2 ... 2 2 1 2 2 2 1 4 1 1 2 Hoshungabad ... April 13, „ ... 2 1 1 1 ... 1 Agra ... ... July 25, 3 2 1 ... 1 2 11 114 1 ... 2 Allahabad ... ... March 21, 1867 ... 1 2 2 1 ... 14 2 3 1 Seetapore ... ... August 15, „ ... 1 12 1112 2 1 1 Shahjehanpore ... „ 6, „ ... 1 2 1 1 1 Lahore Female Jail ... July 10, „ ... 2 2 ... 1 1 * 1 .• Peshawur ... ... May 24, „ ... 1 1 1 1 1 Total oe the abovb octbbeakb ... ~91 93 86 84 94~~ 85 69 76 48 50 52 61 33 30 26 23 19 13 13 5 14 9 32 10 6 7 2 4 3 1 191 ALTERED ASPECT OF THE OUTBREAK AMONG NATIVE TROOPS SHOWN DURING BOAT VOYAGES. [Section II 192 Native Troops in Boats on the River. Fatal cases out of the admissions of bach bat of thb outbbbak. Native Regiments tubing j . m Boat Voyages. £££;y*££&&J'| > .t|'| > |'|'l > l'l'l'| > '§tt loth N. 1,, Ganges en route 2!& tehgh "' jßnU '? 1 1 ... 1 1 1 2 ... 1 1 ... 3 1 2 1 ... 68th N. 1 ., Ganges en route to BareiUy, March 20, 1855 ... ... 1 1 1 ... 1 1 3 A Bth N. 1., Ganges, below Cawnpore, August 31 > 2 2 . 3 2 3 g 6 4 4 2 3 1 2 1 1 ... 43rd N. 1., on Matabanga, January 10, 1856 ... 1 1 1 ... 1 1 3 1 1 1 ... 1 11 7 1 34th N. 1., Ganges below , . , Cawnpore, April 4, 1856 2 116 6 2 6 3 1111 ... 34th N. 1., on voyage to Baxrackpore, October 29, x 2 1 2 4 3 7 3 2 ... 4 ... 4 . x 78rd N. 1., Ganges below Dinapore, November 8, x 2 8 3 ... x 3 2 2 12 12 4 ... 1 32nd N. 1., Ganges below Dmapore, November 28, , , 2 M , M 10 ,„ „ „ , , , , x 1 70th N. 1., on the Ganges, December 5, 1856 ... 1 2 ... 1 13 1 25th N. 1., river steamer l b | 6 °2 W Mir T re ' 2 ... 1 3 2 2 2 2 ... 1 \ Wing, 7th Native Infantry in ooats between Dacca and Cachar, January 3, 1868 ... ... 3 2 1 4 2 ... 2 1 1 1 The aspect of the outbreak of cholera on board boats, deduced from the experience of former years when it was the custom to move Regiments by water, differs materially from that which the outbreak of Regiments on the march presents. Its aspect is much more that of the cholera of the Central Jails of the epidemic area. The typical duration is from twelve to sixteen days, and where this is exceeded, there will generally, I think, be found the probability of a second infection. The typical aspect is not that of cholera with a period of maximum during the first five days, as in the case of the cholera of the march, although this aspect may be exhibited, as in the last of the examples above tabulated. It seems rather as if the cholera naturally inclined to die out, was fostered, and appeared in power between the sth and 12th day, and as powerfully at the end as at the beginning of these eight days. It looks, in short, as if the cholera poison had been repressed from coming forward, and the inference may be made that it would never have come forward at all but for the speciality of the conditions, namely, the crowding up within a limited space. I believe that the aspect tthe outbreak shown in this table is the same which is so often exhibited in the great s of Upper India, and that it is determined by the confinement of the men to the its. Of this there can be no doubt, that the cholera miasm determines cholera in an nitely higher ratio when the amount of space furnished is limited ; crowding up a body men when the cholera miasm is abroad diminishes the chance of preventing the explosion in portion to the extent of overcrowding. tl am not inclined to attach much weight to the cases of the 73rd and 32nd Native Infan¦ shown in the above table, as indicating the simulated cumulativeness of the cholera poison, ese Regiments were passing through a tract ravaged by cholera at the time, in every mile of ich they might have received fresh infection ; and much of their mortality occurred after ving the boats. Regiments marching along the banks of the Ganges between Bhaugulpore 1 Dinapore parallel with their course suffered equally. I The case of the 43rd is very remarkable for the sudden blaze which occurred after the jiment reached Barrackpore, while lying at the river bank immediately before disembarking, L when the original outbreak was apparently concluded. Twenty fatal cases occurred hin four days. The aspect is very much that of re-infection cut short by immediate withwal from the boats. The type of the outbreak on board boats is evidently that shown in the cases of the Bth, 34th, and 25th Native Infantry. The case of the 25th Native Infantry occurred at a time when there was no epidemic cholera abroad, The infection took place near Mirzapore on a known day, and the cholera continued up to the 12th day during the voyage down stream. tl may here remark that the distance to which an infected body is removed makes no ference in the duration of the outbreak. When the Chinsurah Depot suffers, the men removed mit may be admitted into the hospital at Allahabad. The following is a case in point :— tin Dr. Beatson's Report for 1864 we read : — "The cholera admission of November was ecruit, who scarcely had time to settle himself in camp after arrival from Chinsurah before was attacked. The detachment to which he belonged had been sent away from that depot consequence of the appearance of cholera amongst the men, and after they reached Allahal, while they were under canvas, three cases more occurred amongst them. *' A newly landed Regiment gets cholera while encamped in Calcutta, and carries cholera into the Benares cantonment (Her Majesty's 58th Regiment, 1865) ; a Native Regiment on the march (39th Native Infantry, 1863), is affected between Allahabad and Benares, and continues to suffer after reaching Calcutta. In these cases the removal was by railway. The tabulation of 105 outbreaks among European Troops with a total of 2,127 deaths gives the following result : — 50 per cent, of the total mortality occurred within the first seven days ; 80 per cent, within the first fourteen days ; and 20 per cent, between the 14th and 28th day of outbreak. KThe chief outbreaks of 1867, arranged after the method adopted in the tables for the vious years, appear in the following form. Several of the cases tabulated have been broken in relation to the normal type of the outbreak, and to the probability of reattack having urred.* »* The breaking up of the Regiment affected into different parties of which all the casualties appear in a common adds much to the difficulty of accurately tabulating the duration of the outbreak. In this statement 1 have taken corps simply as one affected body. 193 NUMBBB OP FATAL CASKS OUT OP THB ADMISSIONS OP BACH DAY, Regiment and Station. Date of outbreak. Premonitory cases. . '. Umballa, 94th Begiment May sth April 22nd, 1 ; 26th, 1 ; May 2nd 1 2 ... 2 3 4 2 1 Peshawar, 42nd Eegiment 20th 6 4 1 18 23 6 7 3 ... 1 ... ... ... ... ... ... "'„ ... ... I I '. " 77th - 21st ... ... 2 1 2 2 1 3 1 1 1 ... 1 ' ," 2 ... '" (2) June 3rd ... ... 4 1 1 3 1 5 1 3 1 2 1 1 2 2 1 1 ... 1 1 ... 1 „ F. Brigade, E. Battery, Artillery ... ... ... „ 13th May 26th, 1 ... ... 15 2.11 ! » r - » F. » >, ... ... ... May 20th ... ...21.2. 1 * »• *• •»• ••¦ » » » » » w (2) ... ?, ... June 19th ?, ... 1 2 1. „ XIX Brigade, E. Battery, Artillery ... ... ... May 25th ... ... 2 111 » » » » < 2 ) — - ••• June 10th ... .... 1 3 1 2 1 2 1 „ XXII Brigade, 4th Battery, Artillery ... ... ... May 25th ... ! i » >» » » (2) ... ... ... June Bth ... ... 3 Subathoo, 90th Eegiment July 28th April 28th, 1 ; June 6th, 1 ; 13th, 1 1 ... 1 1 " " •" - ••• ••¦ - August 9th ... ... 2 1 2 1 ... 1 4 2 Mcean Meer, 106 th Eegiment ?. ... ... ... May 27th 2 1 " " ™' •" ••• ••¦ ••• ¦¦• June Bth ... ... ... ... ... 1 3 ... 1 1 (3) » 3° th .» ... 3 3 3 3 ... 1 ... 1 ... 8 2 3 3 2 1 ... " » < 4) •" •¦• •• .» - July 22nd ... ... 14 12 2 2 Jullundur, 82nd Eegimeut September sth ... ... 1 ! 2 4 1. Ferozepore, XIX Brigade, A. Battery, Artillery ... ... ... jj u ] y 4th j x „ l-sth Eegiment June 27th ... ... ill 1 11. Shahjehanpore, 36th Eegiment, Wing August 13th ... August Bth, 1 ... ... ill 3 ... 2 4 I 1 2 ... I 1 1 ! Moradabad, 36th „ „ July 24th ... ... ! , j ' ~ Meerut, l-3rd „ August 17th !"'"2 "j ... , '"' ~ ... .~ '" '" '"' ... 1 " 3fd " (2) » 27th •¦• ... 2 4 1 1 4 8 9 10 7 9 6 5 4 3 3 5 4 6 3 1 1 1 1 Allahabad, 107 th „ sth JlUy 28thj x _i_!_ J_ -3 . _3_ .1 1 . TOTAt •" - ... 44 36 19 42 45 34 30 22 18 20 14 11 ~T ~~T To" ~~77~T ~3 1 T~~T 194 II Outbreaks of the European Army, 1856 to 1866. \ T4u; fatal cases only have been selected in drawing up these Tables illustrating the Duration of the Outbreak, not because they are supposed to give results more accurate than those which the detail of the \ admissions would have afforded, but because the data from which such information might have been drawn do not exist. The figures are taken from the death rolls of Regiments ; and as the form ' in use since 1860 does not specify the actual date of the admission of fatal cases, this has been deduced from the columns showing the day of death and the duration of the disease in days . The numerous examples which show modification of, or recession from, the type, must be viewed as having been changed as regards their aspect by the conditions causing the difference in aspect studied in the text, and more especially in relation to the fact of the presistence of the vitality of the cholera of the reproduction over the affected area. Number of fatal cases out of the admissions of each day. REGIMENT AND STATION. Date of commencement of the outbreak. ¦£>! •si • X - c >>£>;>; ££b££ ti £ >; £*>££>,>,£ Fort William, 53rd Eegiment August 30th, 1856 0)... 2 6 6 2 13 3 3 '" Lucknow, 52nd Regiment ... June 21st, „ ... 1 2 3 1 1 2 3 3 5 2 2 ... 2 ... 1 5 2 1 I ... ... 2 1 Agra, 3rd Europeans ... „ 10th, „ ... 1 2 1 ... 1 1 1 4 1 2 2 2 3 4 5 4 6 8 11 7 1 6 ... 5 1 2 1 ... „ 2nd Company, 6th Battalion Artillery ... „ 23rd, „ ... 3 2 12 111 1 Meerut, l-60th Rifles ... August Ist, „ (2)( 2 ) ... 2 2 3 1 1 1 1 4 5 1 3 2 ... 1 1 1 „ ¦ 3rd Company, 3rd Battalion Artillery ... July 28th, „ (3)( 3 ) ... 1 ... 1 ... 1 1 1 1 ... 1 ; Ferozepore, 70th Regiment... August 12th, „ (4)( 4 ) ... 1 2 3 1 10 9 4 6 2 2 8 5 6 3 3 3 2 1 1 2 ... 3 2 1 3 1 „ 6th Battalion Artillery ... ... „ 15th, „ ?. 1 ... 2 2 ... 3 3 5 7 2 ... 5 5 2 2 1 ... , 1 ... 1 Meean Meer, 81st Regiment „ 15th, „ 2322232 13 66938 10 4... 1119525514... 4 ? 4th Battalion Artillery ... ... „ Bth, „ ... 1 1 3 7 9 9 9 11 11 4 5 8 1 3 1 1 1 2 , 3 ... 2 1 ... Meean Meer, 2nd Brigade Horse Artillery ... „ 7th, „ (7)( 7 ) ... 3 5 4 2 6 6 5 5 5 3 3 3 1 1 1( 6 ) Fort "William, 37th Regiment June 17th, 1857 ... 6 1 7 1 4 ... 2 1 Chinsurah, 84th Regiment ... April 2nd, „ ... 1 6 2 2 1 1 1 1 1 1 2 Umritsur, Wing H. M.'s 24th Regiment ... ... August 20th, „ ... 2 1 8 2 4 3 ... 4 Umhalla, 9th Lancers ... May 16th, „ ... U 2 1 2 3 112 ... 1 Dugshaie Depot, Ist Fusiliers „ 23rd, „ ... 2 ... 1 1 2 2 3 Jullundur, 87th Regiment ... August 26th, 1858 ... 6 5 3 ... '.'.'. 1 ... 1 1 1 2 2 Murree Depot ... ... JJ u l y 12th, „ ... 1 2 6 4 4 4 1 ... 2 2 ... 1 1 1 ... Peshawur (all Corps) ... October 26th, „ ... 1 ... 1 2 1 1 1 Fort William, (Recruits) ... April 16th, „ ... 1 1 2 4 ... 4 2 1 1 t,, 77th Regiment June 28th, „ ... 4 2 3 2 ... 2 4 6 3 4 1 .' n 77th „ July 26th, „ ... 5 ... 1 1 2 ... 1 1 1 1 1 ... 1 Carried over ... 49 43 62 38 49 55 44 70 51 32 34 32 29 29 21 17 16 13 16 20 12 12 8 15 4 7 7 6 1. No case occurred after the 10th day. 5. A concluding case on 28th September. 2. A premonitory case on 16th June. 6. A case occurred on October 15th in this Brigade. 3. A premonitory case on 10th July. 7. A premonitory case on Bth June, i. A premonitory case on 7th August. 195 Number op patai, cases out of the admissions of each day . I EEGIMENT AND STATION. Date °1 commencement of the outbreak. . >!,>,>,> : .:AsAw;Ae^tA:A:4 ! * i sAsAtA>»i > '»>i Brought forward ... 49 43 62 38 49 55 44 70 51 32 34 32 29 29 21 17 16 13 16 20 12 12 8 15 4 7 7 6 Calcutta, 2-60 th Rifles ... June Bth, 1858 ... 2 2 1 7 1 Dum-Dum, Bengal Artillery August 9th, 1859 ... 1 10 6 12 15 7 1 .... 1 112 - Depot, Her M.'s Troops ... „ 10th, „ ... 4 1 2 1 ] 1 3rd Buffs ... „ 10th, „ ... 3 1 ... 1 1 Barrackpore, 67th Regiment „ Bth, „ ... 2 3 3 ... 1 ... 1 3 Recruit Depot ... „ sth, 2 1 ... 1 2 ... 2 1 ... 1 Depot of discharged men ... „ 13th, „ ... 1 2 ... 1 ... 116 4 2 3 4 4 Benares, discharged men ... „ 17th, „ 4 3 ... 4 Cawnpore, Ist Cavalry . July 30th, „ ... 1 3 2 1 ... 113 1 1 1 1 1 ... r> *™™ onn. i? • * 5 May sth, „ ... 1 ... 1 1 1 4 ... 2 Cawnpore, 80th Regiment... | Au^ ust sfch ; " _x 1 1111 1 ... 2 1 ... 11 1 1 Allahabad, 60th Rifles ... May 16th, „ ... 3 2 3 3 3 2 ... 1 1 ( April 19th, „ ... 1 11l ... 1 ... 1 Allahabad, sth Fusiliers ... -5 May 6th, „ ... 1 2 ... 2 3 2 1 2 ... 2 3 11 1 2 1 ... 1 ... (11) (3) (1) i August 10th, „ ... 2 12 1 3 3 1 1 ... 3 1 1 1 1 Lucknow, 23rd Regiment ... „ 9th, „ ... 1 3 ... 2 3 ... 12 2 1 1 Allahabad, 4th Europeans ... April 19th, „ ... 6 3 3 ... 1 2 ... 1 ... • 1 1 1 2 5 1 ... 2 Ghazeepore, 77th Regiment Ist, 1860 ... 1 2 3 3 ... 2 3 2 1 11l 37th Regiment ... March 29th, „ ... 4 1 2 8 2 9 1 2 3 2 2 1 2 1 ... 1 2 1 1 1 Fyzabad, 34th Regiment ... April 6th, „ ... 6 4 1 ... 2 ... 1 ... 2 12 Gondah, 20th Regiment ... March 25th, „ ... 1 ... 1 2 1 1 ... 1 1 1 ... 1 1 2 - „ 3rd Troop, Ist Brigade Artillery ... „ 23rd, „ ... 1 1 1 ... 1 ... 1 1 Nagode, Ist Company, Ist I Battalion Artillery ... April sth, „ ... 1 ... 1 ... 1 1 1 ... 2 2 3 Allahabad, 70th Regiment ... March 25th, „ ... 2 ... 1 ... 1 1 2 1 1 1 Goruckpore, 13th Regiment... April 6th, „ ... 1 1 1 1 1 Chunar, Invalid Battalion ... March 6th, „ ... 3 1 1 1 Cawnpore, 54th Regiment ... August 12th, „ ... 1 ... 1 1 1 ... 1 ... 12 1 1 Jhansi, 89th Regiment 2nd, „ ... 1 1 2 11113 1 1 ... ( July 22nd, „ ... 11 3 1 2 2 2 2 14 2 3 Morar, 71st Regiment ... < August 9th, „ ... 7 11 2 ... 3 1 1 4 2 1 ... 1 1 ... 1 1 ... i Sept. 6th, „ .. 1 ... 2 2 ... 1 1 2 ' 196 6UTBREAKS OF THE EUROPEAN ARMY, 1856 TO 1866. Agra, XI Brigade, 8 Battery 7 . * km. 1 1 ; 1 Agra, XI Brigade, 8 Battery Royal Artillery ... Sept. 2nd, „ ... 1 1 Muttra, 2nd B. Cavalry ...{W 841^- » - \ 1 ;; 3 »• l - 1 - 1 - ••• 1 '••• ¦•¦••• Z '•'¦' "' '¦'¦'¦ ''¦'¦ Z. Z Z Z ? 3rd Troop, 3i-d Brigade Horse Artillery ... August 17th, „ ... 3 3 1 ... 3 1 1 fl-Bth ... Feb. 16th, „ ... 2 ••¦ 2 2 11l "" ... — Fort William < 37th ... May 19th, „ ?. 1 13 3 ... 1 ... 1 '". ••• '" (.l-sth ... „ 18th, „ ... 1 ... 3 1 ' "¦ "i — ¦" ¦" •• Gwalior, XI Brigade, 5 Bat- \ July 24th, „ ... 1 1 2 3 12 ... 1 '.'.! '" '" "i ••• * tery Eoyal Artillery ... J Sept. sth, „ ... 1 1 1 ... ... .. "" '" Allahabad, 90th Regiment ... July 21st, 1861 ... 1 2 1 112 1111 1 CawnDore 54th f Ma y 25th ' » - 1 1 '" 2 - 2 'l *2 .'" '¦'¦'¦ Z. "l '.'.'. '.". ... Cawnpore, &4tn „ ... | Juiy g^ 1 1 ... 112 1 1 111 Futtehghur, Wing 42nd Re- giment... ... August 4th, „ ... 1 2 2 1 2 11 ... 1 Bth Hussars ... „ 13th, „ Q) ... 1 2 1 1 1 1 1 ... 1 2 14 2 2 2 1 1 1 '" "i '" Agra, 42nd Regiment ... July 14th, „ (2)( 2 ) ... 1 ... 12 1 3... 42215215111 1 "l Delhi, 82nd „ ... „ 4th, „ ... 1 1 ... 1 ... 2 ... 1 1 ... 4 3 ... 2 3 2 2 2 2 ... 1 6 3 3 1 "i "v Umballa, 89th Regiment ... „ 30th, ?...3 12 3 9 2 3 3 13 2 13 2 1 1 "l 1 1 I 4I 4 „ 7th Hussars ... August2oth, „ ... 3 1 1 1 Umritsur, 94th Detachment Sept. 3rd, „ ... 1 ...... 46 1 2 ... 7342 2 1 4 ... 11 "] ... "' ..'. ' ."{ Meean Meer, (all Corps) ... August 7th, „ (s)( s ) „ 19th Regiment „ 25th, 1862 ... 7 6 12 5 8 3 6 2 2 3 3 1 3 'l ... 1 'l "i 6 Z Z Z. Z. Z Z Umritsur, Detachment 81st Regiment ... ... „ 29th, „ ... 1 1 2 1 2 ... 1 1 ' July 9th, „ ... 1 3 1 ... 1 1 ... 1 ... 1 ... "m" m ]][ Z. Z '" Z Peshawur, 93rd Regiment...] 2g2 g - ;¦; } •» ;;; I ;;¦ } - ¦¦ - ••• •'" - 2 ... Z ' Z Z I October 12th, „ ... 2 1 2 ... 2 ... 1 2 ... 787 8 4 3 4 4 2 Z "i "3 T July 10th, „ ... 1 ... 2 1 1 ... 3 3 Morar, 13th Regiment ... < „ 30th, „ ... 1 1 2 421 ... ... , 1 . Z ( Sept. Ist, „ ... 1 ... 1 ... 1 ... 2 ... 3 ... 11 ... Z. 2 ... ... ... ... 1 Z '" ". Jhansi, 52nd Regiment ... July 30th, „ ... 4 1 ... 1 6 1 1 1 ... 1 5 ... 2 3 1 1 ... Z. ... Z. Z. ... Z. ... Z. ... Carried over ... 164 129 133 114 142 118 96 115 116 89 98 65 58 70 59 53 38 41 45 31 26 31 20 23 7 11 11 « 1. Four deaths on 6th, Bth, and 9th. 5. See separate statement, page 185. 12. Three premonitory cases on June 21st, 28th, and July 2nd. 6. Pour cases on 22nd and 26th September and Ist October. 3. Four deaths subsequent to this date ou sth, 10th, 14th, and 16th August. 7. Admissions ended on 16th. 4. One death subsequent to this date on 4th September. 8, Suspicion of reattack on 20th October. 197 Outbreak* of the European Army, 1856 to 1866,-continued. Number of fatal cases out of the admissions of bach day. REGIMENT AND STATION. Date "{SST' ° f $££*£££**££££££££££££$££££££ Brought forward ... 164 129 133 114 142 118 96 115 116 89 98 65 58 70 59 53 38 41 45 31 26 31 20 23 7 11 11 8 . o _., _ . f August 2nd, 1862 ... 4 1 ... 4 2 3 4 6 6 ... 2 Agra, 35th Regiment ... J * _x 2 ... 23 2 ... 22 1 ... 1 Gwalior, 52nd Wing ... July 29th, „ ... 1 ... 1 ... 1 2 4 ... 2 1 1 1 1 1 1 ... 1 1 Meerut, 104 th Regiment ... „ 25th, „ (>) 1 1 1 1 ... 1 3 ... 2 1 11111 ! ... xi «vui. tj • f March 31st » !863 ... 1 ... 221.. 2 1 1 1 ... Benares, 20th Regiment [ July 13thj 11112 2 11 1 1 ... 1 ... i ... t i in^t^T. • i. f » 9th, „ .- 1 1 2 ... 2 1 ... 1 1 I ... Lucknow, 107 th Regiment £ A ugustl2th, „ ... 1 1 ... 1 1 ... Agra, l-23rd Regiment ... July 30th, „ ... 1 ... 1 1 ... 2 ... 1 1 1 1 1 „ XXII. F. Royal Artillery „ 26th, „ ... 1 1 ... 2 ... 2 1 Lucknow, 36th Regiment ... Sept. 15th, 1864.., 1 3 2 2 2 ... 4 3 .. 3 2 4 1 1 1 Allahahad, 77th Regiment ... „ 14th, ?...1211121 Fyzabad, 1-llth Regiment... April 22nd, 1865... 2 4 1111 1 Lucknow, 46th Regiment ... Sept. sth, „ ... 1 ... 1 1 1 ... •» 1 Saugor, 97th Regiment ... August 7th, „ ... 1 ... 1 ... 1 ... 1 1 ... 3 ... 1 2 1 Hazareebaugh, 27th Regiment July 29th, 1866... 1 1 1 1 1 ... 2 ... 1 Total ... 184 143 147 |131 155 '138 119 130 132 102 107 72 62 73 65 56 43 43 48 31 27 34 20 ' 23 7 11 11 8 iiiii I i 1 ; __L ! 1, Four premonitory cases between 15th and 22nd. 198 I shall say nothing here regarding the outbreak among Native Troops in cantonments, but I leave this point for consideration when the relative mortality The duration of the outbreak among o f European and Native Troops in cantonments comes to be itive Troops m cantonments to be • j tm. m xn jj j ? , isidered in the following chapter. examined. It will suffice meantime to say that, as in every other case, the limit of the general outbreak is the date of the decay of the reproduction, and that the outbreak in the case of Native Troons is represented in outline only, and is seldom filled in in substance. Thus, then, it appears that the outbreak may have three special aspects each significant General ccmclusions regarding the of a different phase '.-first, the outbreak may be typical, cornnormal type of the outbreak and its prised withm ten days irom the date ot poisoning ; second, it duration, and the causes of aberrations may be supplemented by conditions of locality, so that it may from the normal type. endure from the date of attack up to the death of the reproduction ; and in the third aspect, while the type presented is evidently that normal for the minimum, the affection of the body is maintained to about the 16th or 17th day. I The last is the aspect of nearly all stational and jail outbreaks. I consider that this iue to the fact that these localities are not affected merely by the primary afflatus of the air lveyed miasm. As in the case of a locust flight, for days after the flight has passed over a ality, the individuals dropped from the main body are abundantly scattered over the tract versed ; and if the material of the locust flight constituted a miasm, the duration of its effects uld be measured by the time during which these individuals remained visible. In the case of cholera, when the source of infection has been removed, we do not, as some would have us believe, at once get rid of its effects ; I reckon Deaths in the neighbourhood of the that for a week afterwards the cholera latent in the individual Broad Street Pump constitution is due to come forward. Judged by the standard 1854 August ... 31 31 which I have proposed, the celebrated outbreak attributed to „ September ... l 131 the Broad Street Pump seems to me a pure case of the typical 3 58 outbreak. We cannot suppose that the water was poisoned for " ," ... 452 a single day, and that all who drank of it on this day and these » » — 5 26 persons only, were affected ; the facies of this local outbreak " 7 22 * s precisely that which we know to result from the afflatus of "t" t '', *.* 8 14 the cholera miasm of a certain day — the nine-day poisoning dating from a known hour.* Here is observed the maximum tng the past five days, the tailing off, and death on the ninth day, the Bth August, on which alleged that the pump handle was removed and that cholera as a consequence ceased. . the cholera in question been due to the use of this water, the facies of the outbreak would have been such as it was, and the removal of the source of infection on the Bth would have been followed by the cessation of cholera until the 17th or 18th. (Compare the case Le Goorkhas in 1857 (p. 180), and that of the 42nd in 1867, (p. 181). We have been lately told that the cholera germ is the most insidious of all poisons, and that a single case of cholera may poison a nation. Nay more, that a single case of diarrhoea, undistinguishable from the simple and non-specific diarrhoea, may be the focus from which fatal cholera may radiate, multiplying as it goes until a kingdom has been ravaged. And this is held to represent the whole truth. The aspect under which I have represented the cholera of India is very different. I have as yet described it as no insidious miasm creeping along from man to man, from village to village, or from province to province, or as a thing to be watched for and isolated, and to be limited in its diffusion by quarantine restrictions. I have written the history of the cholera miasm as that of a thing individualised and appreciable, due at a certain date in a certain situation, budding forth from the soil because it has been sown there, revitalised in relation to what it is as a thing organised, and advancing, when invading, with a front as wide stretching as is the breadth of the natural province which is being covered. I have described the persistence between two definite dates as due, not to any meteorological reason, and certainly not to any contingency secondary to human infection ; but as a leaf, or a flower, or an insect has a temporary existence absolutely defined and yet manifested in obedience to a known meteorology, so has the vitalised cholera its life period which no combination of conditions (however powerful these may be) can prolong. iThe following table will illustrate what is meant in speaking of the insidious spread of a bific agency in a community. I place it here that it may be viewed in contrast with the facts he paragraph which succeeds, in which the explosive character of the outburst of cholera is cted ; the spindle-shape of the typhus outbreak is contrasted with the cone-shape of the era outbreak. * It will, I think, be found to be the case, that the same shape of the outbreak may be impressed on the stationary population of a locality by a cholera in motion as is impressed upon a moving body which on a known day marches into a cholera-containing area. In the first week of June 1869, we had the evidence of the movement of cholera over an enormous tract of Upper India; this wave struck Deolee on the 2nd June, and the impress is thus shown in the case of the population as represented by the mortality in the Charitable Disponsary i — Ist 2nd ' 3rd 4th sth 6th Ith Bth 9th 5 5 5 2 12 1 This statement Bhould be compared with the other illustrations which I have given of the typical outbreak, in order that its significance may be understood. 199 Fades of the outbreak in the case of diseases spread by contagion throughout a community. Relapsing Typhus of the Jails of Upper India.* Number or Dbaths from Relapsing Ttphus. JAIL * outbreak. Strength. Firgt Second Third Fourth Fifth month after month after month after month after month after invasion. invasion. invasion. invasion. invasion Asra ... ... 1860 1,890 9 42 93 40 18 Agra ... ... 1864 1,993 15 39 76 134 43 Meerut ... ... 1860 2,096 8 14 35 92 59 Allahabad ... ... 1860 1,595 5 11 37 44 10 Loodianah ... ... 1861 ... 4 29 37 18 1 Futtehehur ... ... 1864 404 7 9 22 11 3 Umritsur ... ... 1864 554 8 13 35 18 11 When it has occurred that powerful outbursts have taken place suddenly and without the occurrence of premonitory cases, it has been alleged that all The phenomenon of a body of men £ ne phenomena might have been produced by the infection of being "struck Ly cholera" has been of ktrf Qr th pollution of the water supply from a human late years too much overlooked. r . rr j , « "<*" J source. In the case of bodies marching, as in that of the Grand Army of 1817, it is useless to suggest the possibility of infection from human emanations in explanation of what occurred ; and it is equally purposeless to enquire whether it were possible for the five latrines of the five different barracks of the Peshawur cantonment to have become simultaneously poisoned from unknown sources on the evening of the 19th May 1867. With every desire to trace in the poisoning of the water supply a fruitful source of cholera, believing, as I do, that in all truly epidemic cholera a vehicle of moisture is the means of conveying to the human economy the air-borne miasm, I cannot regard this alleged source of infection as of the value which some would attach to it, even when my opinion is qualified by the consideration, that the poisoning is much more likely to be due to an aerial cholera than to cholera emanating from the miasm after multiplication within the human system. Indeed, wide and constant as are our opportunities in this country for following up to their origin in such a source the everrecurring outbreaks, there is still up to the present time no recorded evidence which proves that the water supply has been the means of introducing cholera into our jails or cantonments. I do not say that impregnation of water does not occur, or that water thus impregnated may ft in certain instances have been the cause of special outbreaks ; I state simply that lam in session of no tangible facts bearing on the question, such as I would gladly have inserted this place. Modern writers do not seem to have appreciated rightly what is meant when the phrase " struck by cholera" is used, whether applied to a province or to a body of men. In the case of a body struck by cholera, the commencement of the outbreak dates from a given hour, and it is not individuals who are affected, but the entire body. The great outbreak of November 1817 was dead on the 22nd, the 14th day after its commencement ; it was on the lbth, 17th, and 1 8th June, the 3rd, 4th, and sth days of the outbreak, that the great mortality took place in the Kurrachee camp. On the 7th November 1817 the Grand Army is struck, and hundreds fall before evening; the Kurrachee camp is struck on the evening of the 14th June 1846 and 175 men come into hospital on the 15th from many different corps; Dum-Dum is struck on the evening of the 9th August 1859, and seventeen fatal cases are admitted from the different corps on the 10th. In such cases the mortality is generally compressed into a small number of days : thus at Dum-Dum, in the Recruit Depot, of fifty-five deaths, six only occurred after the 6th day (the 14th August, the body having been struck on the evening of the 9th) ; it was on the 4th and sth days (12th and 13th) that the great mortality occurred, when twenty-five men died. Peshawur was struck on the evening of the 19th May 1867; five fatal cases were admitted in Her Majesty's 42nd on the 20th, and it was on the 4th and sth days (23rd and 24th) that the great mortality occurred, when forty-one fatal cases were admitted. In none of these instances was prolongation coincident with universality of infection ; the single outbreak in which thousands of lives are lost, is not prolonged beyond the day up to which the typical outbreak continues in a community which may lose but ten individuals. I have selected a few cases in order that I may bring prominently forward the truth that there is such a phenomenon as that implied by the phrase " struck by cholera." The general fact is expressed statistically in all the figures and ratios of the preceding tables, but the constant obscuring of the fact by the antagonism of the phenomena of affection of bodies and affection of localities, leads the mind away from the contemplation of the type towards which we ought constantly to be turning for guidance, and therefore the truths supplied by the type cannot be too impressively brought forward. Corbyn gives the following narrative of the commencement of the great outbreak of November 1817. He writes: — "I was the first person to observe it on Bth November. * The duration of the outbreak of Typhus in a community is reckoned not by days, as in the case of the cholera outbreak, but by months ; in the instances tabulated, the cessation of the outbreak occurred at the season when the meteorological conditions determine in every year the disappearance of the effects of the Typhus poison. During such outbreaks very few of the attendants on the sick escape infection. 200 few dooly bearers were brought to me ; and having never seen the disease before, I thought ie men were in a state of inebriation, for the symptoms seemed to indicate as much. But soon iscovering my mistake I reported the circumstance, and was immediately directed to proceed o the encamping ground of the preceding day. The officer commanding the rear guard laving arrived, and reported that on the whole line of march multitudes were dead and ying, I proceeded escorted by a strong guard of cavalry. Whole families who, in the course ¦ the morning in perfect health had accompanied their Eegiments, before proceeding many iles, were attacked by the disease, and I found them lying dead by the side of tanks and ullahs. On the following day, being the second of its appearance in our camp, the disease burst forth with indescribable violence in every direction/'* Jameson continues the narrative : — " Unsubjeeted to the laws of contact, this cholera outstepped the most fatal diseases hitherto known in the destructive rapidity of its progress. Previously to the 14th it had overspread every part of the camp, sparing neither sex nor age in the undistinguishing virulence of its attack. The old and the young, the European and the Native, fighting men and camp followers, equally sunk in a few hours under its o-rasp. The mortality latterly became so great that there was neither time nor hands to carry off the bodies, which were thrown into the neighbouring ravines, or hastily committed to the earth on the spot in which they had expired. I" Hundreds dropt during each subsequent day's advance,f and covered the roads with dead 1 dying; the ground of encampment and line of march presented the appearance of a d of battle, and of the track of an army retreating under every circumstance of discomfiture 1 distress. In this fatal week 764 fighting men fell victims to the disorder, and of the camp owers it was estimated that about 8,000 were cut off. The disorder ceased to be epidemic the 22nd or 23rd ;J a few instances of mild attack were seen afterwards, but after the i December not a case occurred." tThe following is another example taken from the cholera history of the year 1818. It is ) from Jameson's report : — " In May, the Nagpore Subsidiary Force, encamped nine miles th of Nagpore, was suddenly attacked. Many loitering for water in the neighbouring rivulets •c brought in expiring, and some dead. Of between seventy and eighty patients brought to vital on the first day more than ten were found dead or in the act of expiring in the doolies." I The following is another description of a body struck by cholera ; it is the history of the et in the great Kurrachee outbreak of 1846. It is related by Dr. Arnott who was present, ive the narrative as published in the Bombay Medical Journal for 1855 :—: — " Between 5 and 6 p. m., during Divine Service on 14th June 1846, the wind veered round n south-west to north-east, and although there was scarcely any breeze, it was raw, chilly, and deasant to the feelings, and a thick lurid cloud, apparently of dust, hung low and almost stagt over the camp. Some people observed, or fancied they observed, at the same time an offensive beating and putrid odour, and that a sudden nausea was produced ; but these I did not remark, s atmosphere had for about half an hour the appearance that often precedes a storm, but it lually cleared away, and by 7 o'clock it was clear and again fine. It is certainly possible b the epidemic cholera virus had no previous existence, but was generated and diffused by the iliar state of the atmosphere on the evening of the 14th of June, although I am inclined to eve that the origin of its sudden fatal and fearful intensity, so immediately manifested, was to that agency of which the meteorological disturbance was a sign or effect." The sequel that, on the night of the 14th, thirteen different corps were at once affected. This cholera dead by the 11th of July, but its virulence was confined to the first days of the outbreak. Dr. Arnott continues the narrative thus :—": — " On the 14th of June, the admissions into the different hospitals were numerous, and they increased rapidly during the night. On the 15th, 175 men were admitted and seventy-five died. On the 16th, 277 were admitted and 186 died. Next day there were only 245 admissions and 116 deaths, and on the following day, the .idmissions were 117 and the deaths sixty-five. In the 60th Rifles, the 86th Regiment, the Bombay Fusiliers, and the 12th Native Infantry, the disease broke out simultaneously; on the 15th June, fifty-one men were admitted from Her Majesty's 86th Regiment, and twenty-eight from each of the others."§ II take a fourth example from the cholera history of 1867. In the last letter written by Maclntyre, Deputy Inspector General at Peshawur, before he succumbed to cholera, he ;e S : "I was at Peshawur until half past 12 on the night of the 19th May, and up to this j all was quiet. There was no cholera reported in my division within 130 miles, and the ps were healthy. I was anxious about Rawulpindee, for the disease was in the district, and ift in order to look after this station. I had scarcely refreshed myself with a short sleep n I received a telegram from the General, saying that cholera had appeared at Peshawur. erefore returned on the following morning, and found that about five hours after I left on night of the 19th, the Horse Artillery and 42nd Highlanders had been attacked." The wing report from the Surgeon, Her Majesty's 42nd Highlanders, for the week ending 24th May clearly indicates the fact of the Regiment having been struck by the cholera wave : — " Up to the morning of the 20th May, the health of the Regiment was inconceivably good, fifteen men * Corbyn on cholera, p. 6. f The camp was broken up on the 13th. t Its decline is dated from the 17th November, the ninth day. Jameson says : — " The disease sensibly declined trom the 17th, and wholly withdrew towards the latter part of the month." tile J.YDII, nUU YillUliy nUlHinin lU».uua mi, mun/i jji.iu «i unc muumi, § For the epidemic relations of this Kuvrachee cholera, see the cholera history of 1846, p. 115. 201 THE OUTBREAK AT HURDWAR VIEWED IN RELATION TO THE TYPICAL OUTBREAK. [Section 11. 202 nly being" under treatment, and of these all were either chronic or incurable cases, or else mile nd trifling- ones. The weather has been unusually cool, and on the evening* of Sunday, th 9th, a very heavy and long continued dust-storm blew into the station from the south-east nd this, I think, may have brought up the cholera. During morning visit on the 20th, twe ases of cholera were brought into hospital, and in the course of the day, four others wer dmitted.* The cholera was in its most virulent form, and there were no premonitor rmptoms. Up to the 23rd, the number of cases increased daily ; on this day thirty-six case were admitted. On the 24th (the last day included in the weekly return), the admissions fell t ;wenty-four." The report for the week ending May 31st shows that the maximum was reache< n the 23rd, the sth day after invasion, and that even the character of the cholera was alterec report says : " Cholera has shown, not only as regards the numbers attacked, a tendency to ecline, but also those attacked have not complained of the intense and painful spasms present n all the first cases." Thirty-five cases were admitted in this week. By the end of May, the lolera of the 19th was dead. The following is the report of 7th June :—": — " There has been no ase of cholera since the 31st May ; all cases remaining are progressing favourably/ I quote, finally, a remarkable case which occurred ten days after the Peshawur outbreak at le opposite extremity of the province, that of the female orphans at Secundra, who were struck on )th May 1867. Dr. Playfair thus records the occurrence : — " Secundra is five miles from Agra on le Muttra road, not far from the tomb of the Emperor Akbar. Here, in numerous buildings, are ocated many orphans of both sexes ; on the 29th May, there were 169 male orphans and 168 female rphans. On that date all were in apparently perfect health. On the evening of the 29th May, le girls were out for their usual walk, and when returning and already within the compound of le orphanage, a sudden shower of rain fell. The younger girls were close to their dwelling and caped, but the elder girls having to go about a hundred yards further got more or less wet. I" Next morning about half past 4 o'clock one of the elder girls was found lying moribund ¦ 7 /-> ,i 7 c i n 7 m the court attached to the, sleeping verandah. She died in oical Outbreak— Secundra Orphans, . , , ,„ ~ . i -.r oftll . . 1867. an hour and a half. On the same day, May 30th, sixteen y 30 ... 16 admissions, cases were admitted, and on the 31st, fifteen, and between the 3 1 ¦•¦ x | " Ist and 6th of June, fifteen cases more; in all forty-six. Of 2 '" 3 " the elder girls, forty were attacked ; of the small children six. 3 ... 4 ,',' The first twenty-eight cases were among the elder girls who 4 ••• 3 » had been exposed to the rain ; the first small girl was seized at noon on 31st May. The boys were immediately removed I the large verandah round the base of Akbar's tomb ; while the girls were placed in a ruined mb, half a mile distant. Not one boy was attacked. But the smaller children were also oved out to the old tomb among the elder girls, and this I believe to have been a mistake. ut I did not know that the big and small girls always lived apart, and I did not at the ne clearly understand the circumstances under which apparently the epidemic commenced, ad I kept the small girls separate, they might have remained as free from the disease the boys did. I" Thirty-six persons were exposed day and night in attending to the sick, and in addition cc mehtranees. Not one caught the disease, although several of the girls, tired with tching, were found asleep on the beds of the patients." I The orphans were removed on the morning of the 30th May. Cholera died out on the l June, the ninth day from the attack of the 29th, after forty-six children had been seized. This c is an exact counterpart to that attributed to the impure water of the Broad Street Pump. IFrom the narratives which have been written of the outbreak at Hurdwar on the The duration of the Hurdwar Out- 12 . th , April 1867 the impression which is apt to be left upon the sak of April 1867. mmd is, that the iacies ot this cholera was different to that of the typical outbreak. But it is only when the facts are |3wed with the preconceived theory, that the pilgrim cholera was the epidemic cholera of the ar, that the aspect of the outbreak is pictured in this light. To any one investigating the 3ts statistically they come out in their true light, and prove that the typical outbreak is not bject to modification by the circumstance that the number attacked is large or small, le dying out of the Hurdwar cholera to the east and south, coincident with its increase the west and south-west of Hurdwar, is considered an inexplicable phenomenon. It is easy explanation when the theory with which it is viewed in connection is set aside. Taking urdwar as the , centre, the known spot upon which it is universally admitted that the semblage was poisoned on the 12th April, the pilgrims died in those districts only which were ached in the daily march before a given date. The great bulk of the mortality occurred the districts not immediately round Hurdwar, but such as were reached in the first few days' arch. Bijnour, the north of Moradabad, the Jumna ferries of the Meerut District, ozuffernuggur, Seharunpore, Kurnaul, Umballa, and Loodianah give the great bulk of the urdwar mortality, while the pilgrim mortality of the Bareilly, Shahjehanpore, Budaon, Southn Moradabad, and. Allyghur Districts for April, was so trifling as scarcely to deserve mention, le same remark applies to the districts west of the Jumna. The figures shown at ge 137 distinctly prove the dying away of the Hurdwar cholera before the end of April in c districts of the Punjab as well as in the districts lying east of Hurdwar. The pilgrim Drtality was great, but it was far short of what the promoters of the pilgrim theory have * Five different barracks in the cantonment were simultaneously affected on 20th May. Chap- IL] LOCALISATION OF CHOLERA AS AFFECTING THE DURATION OF OUTBREAKS. 203 alleged. That the epidemic cholera of the Punjab of May 1867 was the same cholera, (bited after its propagation, is the theory which suits the belief in the constant spread of era by human intercourse. I see the termination of the Hurdwar outbreak — viewed as an ireak — at a date as early as that of the great outbreaks detailed in the previous para>hs; and I trace no connection between the May cholera of the Punjab and the return of dwar pilgrims. I speak of the grand fact, not of the secondary question, whether ny case the propagation of cholera in individual cases was due to the returning pilgrims. But it is not on every occasion that bodies are so struck by cholera. If all bodies were struck, the probability is, that cholera would, in the great majority of cases, die between the sth and 9th day. But a cholera lasting from fourteen to twenty-one days comes up in a community affected like the seed sown in a field, all due to appear before a certain date if its vitality remains, and bursting forth day by day without intermission, until all that is destined to spring has sprung into life. This is the more general facies of the cholera outbreak. A body affected while moving is beyond doubt in the condition most favourable for getting rid of cholera infection at the earliest date. No one will venture to assert that it is safe to trust to the possibility of a stationary body parting with its cholera on or before the 9th day, when the outbreak, viewed in relation to the type, ought to be at an end. Most observers can from their experience of cantonments recall cases of the typical outbreak ; but when we place against these the experience of cantonments such as Morar or Meean Meer, which habitually maintain the invading cholera up to the conclusion of the reproduction, few would assert that the stational outbreak ought to be allowed to have its sway unchecked. And it is upon a knowledge, on the one hand, that removal from an infected spot will almost to a certainty be followed by the cessation of cholera within the 9th day, and possibly much sooner, and a dread, on the other, that the conditions of the locality may lengthen out the life of the miasm up to the end of the reproduction, that removal in every case, as the rule, is advocated. Before speaking of movement into camp, let me place here the case of the 70th Regiment, which suffered at Cawnpore in 1853 — a case to show how terrible may be the calamity when local infection is not recognised and made the ground for the removal of the infected body. Compare this marginal statement with the Peshawur outbreak of 1867. It commenced 70* Begiment, Galore, 1853. on ve 7 sam * <%> the 20th May, and was at an end (as resibewgth 9ii, admissions 261, died 183. gards fatal cases) on the 24th. We know that this outbreak ¦n ,-, n .i was due to a wave of enormous strength which swept up Deaths. Deaths. „ , „ . . ° r . i the valley ot the (ranges at this time, as before noticed. May 20 ... 1 July 26 ... 7 I find the statement made that Chunar lost 1,000 out of 12,000 " 24 f " 28 inhabitants, and Dinapore and Benares were ravaged at the same # #'" # " 29... 8 time, the 29th Regiment losing twenty-three men at the former June 4 ... 5 „ 30... 8 station. » s"'? . " ?\'\ G The four deaths of May represent the primary attack. The „ 6 ...1 August 1 ...13 ? , A S, y 1 r ,, J , i . 7# 6 ° 2 ... 4 outbreak commencing on 4th June was apparently the springing ),' 8 ... 4 ',', 3 ... 8 up of the seed sown. This is exactly what took place at » 9 ... 2 „ 4... 5 Peshawur in the first week of June 1867, and the termination " jg "¦ j " 6¦" y was the same to a day. Here the last case was on 27th June ; "t" t 19 ..[ 2 " 7 !..n at Peshawur (with the exception of a case on 4th July) » 26 ... 2 „ 8 ... 8 the last case occurred on 28th June 1867. There was no #2#2 # " # " in " q doubt some localising cause which helped to revitalise the cho- Julyl9 ...2 ',', lli." 1 lera of 20th May. The local cause to which I attributed the „ 21 ... 2 „ 14... l second Peshawur outbreak was the physical aspect of the Peshawur „ 23 ... 4 „ 16 ... 1 Valley ; here it was attributed to the emanations from a cess„ 24 ... 8 „ 17 ... 1 i mv _j i? j/l 25 ...13 „ 24 ... 1 pool. The report ot the year says :—: — — — ' ( When the disease made its second appearance on 4th June Totai^jlB3 was chiefly confined to one barrack, and about twenty yards from the south-west corner of this barrack a cesspool ' ' When the disease made its second appearance on 4th June tbeen recently opened, and the effluvia from this were thrown immediately through the ack in question. The first case occurred in the corner nearest to the nuisance." The localising cause was in abeyance only, and when the monsoon set in the cholera reed with renewed vigour.* The report goes on to say : — "On 19th July the epidemic returned with increased severity, and on the 25th a Wing removed to the Artillery Barracks, three miles distant. The Wing continued to suffer notstanding the change of quarters ; and on the 4th and sth August both Wings marched out intonments and encamped at Roomah, six miles from the Artillery Barracks." And the it is thus stated : — ucu . 4th to the 11th the epidemic continued to rage (cutting off forty-five men), " From the and then suddenly ceased. The Regiment returned to cantonments on 20th September free of the disease." I" Some benefit would seem to have been derived from going into camp, for the disease tinued rife in the cantonment bazaars long after it had entirely ceased in camp." In this case the Regiment parted with its cholera on the seventh day after moving, and the fact of losing forty-five men after leaving barracks in this instance must not, as some would • Compare Table, p. 78 ; and see remarks, p. 215. conclude, be accepted as a proof of the inutility of the measure ; it indicates only the more strongly how great was the necessity for movement, and intimates that had the movement taken place on 19th July, the terrible mortality that followed might have been in a great measure avoided. It will be observed that the facies of the outbreak from the 4th onwards Fis precisely that of the type, which proves that the source of infection was parted from on the y on which the Regiment moved out of cantonments. The localisation which lengthens out the outbreak is not the localisation of cholera in lervaiesvmrI ervaiesvmrd Highlands, Pcs ha*ur,m2. the economy and its spread from one man to another by personal communication, nor is it to avoid such a con- July l Sept. 10, 3 tingency that Regiments go into camp. In the great " 13' i * * • majority of cases there is no prolongation of the outbreak '/, 15, 1 October 12, 2 beyond the 16th or 17th day, and such cases as those of Morar » Jg> j- " g an( l Meean Meer and of Peshawur in 1862, (see marginal " 20' 1 " 16,' 2 statement), are exceptional to the general rule; and, as * * * „ 18, 1 I have shown, they are in a great measure due to local » 26 > 1 " f peculiarity in the station, and are very generally manifested August 1, 1 " 22,' 4 coincidently with provincial phenomena. It is true that „ 2, 1 „ 25, 3 the typical stational or jail outbreak, has an extension » 3, 1 . „ 26, 4 o f seven (Jayg over the typical outbreak of the march or " 12 ' j " 28^ 2 na^ ue a s i n g"le afflatus of the cholera miasm. But in * *' * " 31,' 1 both cases the termination is brought about by the fact Sept. 9, 1 Nov. 2, 3 o f a certain number of days having elapsed since the outbreak commenced ; and this being the case, we are forbidden. in either to look to multiplication in the infected body as the cause of prolongation beyond the typical minimum of duration. Sometimes we can almost tangibly grasp the fact of the infection of special localities, and when we can do so the fact is almost certainly confirmed to us by the phenomenon that the attendants on cholera patients are liable to be attacked. When this shows itself, the conclusion is hurriedly drawn that the sick are spreading the disease ; the fact being, that it is the locality and not the patient which affords the miasm which strikes down the attendants. The most zealous supporters of the doctrine of contagion admit and dwell on the truth, that it is in rare instances that even in the most deadly outbreaks the attendants on the sick suffer, and they hold the fact to be inexplicable ; and fifty years' experience of the great Calcutta cholera hospitals has led a succession of the most careful observers to deny that infection from cholera patients ever takes place at all. The paper by Dr. McClelland on the causes localising cholera in the cantonment of Meerut in 1861 deserves to be reproduced here at length.* He traces in the epidemics of 1845, 1856, and 1861 cholera in the same bungalows and along the same lines, reappearing in each epidemic because of the conditions of these localities, and for no other reason. The soil is retentive of water ; during the prevalence of the epidemic the open drains are overcharged and the compounds are flooded, and. almost immediately those occupying the bungalows become affected. I quote the concluding paragraph only : — " The line of drainage divides the sandy surface of the Native lines from the clayey soil of the European lines. On the side of the Native lines, although occupied by bazaars and officers' bungalows, no case of cholera occurred. Dr. Wilkie considers this part of the station less liable to cholera than the European lines, and this may be considered to be entirely due to the protection it derives from the dry layer of- sandy soil which overlies the clay. It has been observed at Meerut that those parts where this dry sandy soil is wanting and the surface is composed of a bare sterile clay have suffered most severely in the late as they always have done in every preceding epidemic." There is no reason why the hospital building should escape when the barracks surrounding it are infected. In the epidemic of 1861, the hospital of lya^yaSof'SbSS Her Majesty's 35th Regiment at Meerut became infected and nothing more. The facts do not eight days before a case of cholera appeared m the Regiment, bear out the theory of infection from i u i simtdtaneously with its appearance in the adjoining barracks man to man. /» .j ia o/Z TT,,oa nv <, . anA nr>f ™+i,vr.^ V.,,4- „!„„ .Uw. of the Bth Hussars ; and not only patients, but also the lidents in the hospital and attendants, became affected. One theory alleged that these men 3ame affected from their communication with those already affected, or with something lanating from them ; the other, that the hospital suffered in common with the neighbouring valry Barracks, and that therefore both patients and attendants were as liable to attack as they had never left their own barracks. The alleged contrasted ratio of attack in barrack 1 hospital is very apt to be erroneous ; and in any case the disparity becomes much less iking when the cholera cases admitted in the undeveloped stage are excluded from the culation. lam led to regard the statement in regard to the alleged disparity as the more : to be fallacious if it be the case that the normal incubation of cholera may in many cases longer than is generally supposed. The case in point Dr. McClelland attributed to a faulty latrine situated in proximity to one corner of the hospital and joined on to it by a covered way, which, in his opinion, conducted the choleraic influence into the hospital from without. He pointed out. that it was this * Strachey's Report, pp. 97 to 99. 204 corner of the hospital ward that was infected, and not the hospital generally ; and, consequently, that the case for infection from man to man could not hold good. I state this as his view communicated to me. In the report of the cholera of 1861, the case is stated thus :—: — " The first man in the Regiment attached with cholera was a patient in hospital under treatment for syphilis. He was seized early on the 11th July. He was immediately removed to a separate ward, and in about an hour afterwards the man in the next bed, who was also under treatment for syphilis, was attacked. After this there were no more cases (in connection with this Regiment) until the 15th July, when a man was seized with cholera in the hospital where he was in attendance on his sick wife and children, (who, I infer, were not cholera patients). On the 17th July there were two more cases in the hospital. One was a man, who was employed as clerk, and who lived in the hospital enclosure. The other was a patient suffering from syphilis, who occupied a bed next to the beds of the two men who had previously been attacked in the same room. The first case was admitted from the barracks on the \§th July" From this date the accurate distinction between cases commencing in hospital and cases Commencing in barracks ceases ; but cases pointing to the fact of local infection continued to occur in hospital as late even as the 15th August. The hospital for women suffered as well as the hospital for men. Three out of five cases treated originated in the female hospital. The first sufferer was a patient, the second, the hospital matron, the third, the wife of the hospital sergeant. I suppose that the infection of this hospital enclosure must have occurred at the time when the lines of the Bth Hussars were affected (on Bth July) ; and that the Cavalry barracks and the hospital of the 35th had something in common which separated them from community with the regimental barracks of Her Majesty's 35th. The infection may have been that of a latrine as conjectured, or it may not ; but some localising cause certainly did exist, a something peculiar to this spot, which retained in vitality the air-sown cholera which first reached Meerut on the 24th June and revived on the Bth July to show itself generally diffused and in epidemic life. This hospital cholera could not have been in existence before this date, for no cholera had appeared at Meerut after the death of the epidemic of 1856-58, that is to say, for three years I The parallel fact from the cholera history of 1819 is as follows :—": — " It was the opinion of Surgeon of the Corps (Her Majesty's 14th Regiment stationed at Meerut) that the disease become contagious. This opinion was grounded upon his observing that the apothecary of corps, the hospital serjeant and the apprentice were successively attacked, and that several were taken ill while nursing their dying comrades." I would not have it supposed, however, that all examples of apparent transmission of cholera from man to man are examples of infection of localities ; but if we mistake the significance of such cases as that of the hospital of the 35th, we are apt to theorise in a direction away from the truth. The fact of infection of locality warns us that it is unsafe where such a condition exists to continue to occupy the infected locality for any purpose ; and, certainly, an infected hospital should not be maintained for the treatment of cholera patients. Such instances as the above are the cases which those who hold the transmission of cholera from man to man point to as conclusive of infection from something from within an infected person or from the excreta. To my mind the tendency of the evidence is very different. Much weight has been attached to this case of the hospital of Her Majesty's 35th Regiment ; and the parallel has been transferred to the case of the hospitals of Morar and Meean Meer in the same year, to show that the fact was of general and not of local significance. I have said, that, in my opinion, the ratios adduced are much more apt to be wrong than right. The excess to the discredit of the hospitals occurs from various causes. In the cantonments of Upper India hospitals and barracks mean the same thing ; and the hospital is as liable to attack as the barracks, for it is unreasonable to expect that on the same plain one special building should be exempt from attack because it is a hospital. Add to the men thus seized (not because they are patients in hospital, but because they are men living in the hospital barrack), the patients who are admitted from barracks with undeveloped cholera, which has an incubation of days and which may exhibit its effects by the existence of premonitory diarrhoea or in some other manner, or may never cause any premonitory symptoms whatever ; add, moreover, the cases contracted in barracks which come forward among the numerous orderlies whom until lately it was customary to tell off for attendance on their sick comrades, and it follows that the ratio for regimental hospitals, putting aside the possibility of contagion altogether, must normally be very much greater than for the barracks — the ratio ought probably to be three times as high. An uninfected body of men introduced among the most numerous collection of cholera patients does not necessarily become affected with cholera in our great hospitals of Calcutta ; and I think there are good grounds for hesitating to adopt without reservation the theory that cholera hospitals are in Upper India a powerful means of propagating the cholera of the outbreak. But this reservation I would earnestly make, that the truth is not to be set aside that when a body, such as a Regiment, is suffering as a body, many Significance of the high ratio of secondary causes will develop the latent miasm, and no cause trLs g of°tSLr^anS ™>™ p™-*% than daiiv *«** w *\ the scenes ° f a during an outbreak. cholera hospital in a great epidemic. Malarious poisoning does not necessarily end in malarious fever ; poisoning with L cholera miasm does not necessarily end in cholera in any of its phases. But as shock, 3b 205 ILLUSTRATION OF THE NECESSITY FOR MOVING AWAY FROM AN INFECTED LOCALITY. [Section 11. 206 lental or bodily, may determine a rigor, and its sequence in fever, so, in like manner, will mental bodily shock determine collapse and death in cases where otherwise cholera would never have own itself. The moral is evident, that in grave epidemics very serious consequences are to be prehended from the employment of European orderlies over their sick comrades, and a ratio attack much above the average is in their case to be anticipated.* A single fact embodied in the cholera report of 1861 seems to me to invalidate the con- elusion that the hospitals became the foci of infection. We Eative Soldiers employed as order- read w j tn reff ard to the dreadful cholera of Meean Meer, rtMeean Meer m 1861 were not following *_« On the 23rd August, when the lamentable results of the employment of the European Soldiers as order- lies in the hospitals had become very manifest, it was suggested that the men of the 31st Regjyrnent of Native Infantry might give assistance in these duties. There were about 330 men present when the cholera commenced, and when it became virulent, they furnished nearly all the guards supplied in ordinary times by the European Troops. From the 24th August, thirty men were sent every day to the Infantry Hospitals to assist in attending on the sick. No case of cholera occurred among them. The exemption from attack of the medical establishments in the hospitals was remarkable. There were very few cases of cholera among them, and hardly any of the native menial servants appear to have suffered."f Virtually, we are treating men in the locality in which their cholera originated when we treat them in a regimental hospital in the north-west. When Enfection of locality is constantly an other buildings are vacated the hospital building should mded by the phenomenon of the . ¦¦ • i m • j. • j_i i. m. i • a. il- .l j.i ck of the attendants on the sick. n °t be occupied. To maintain the hospital is to subject the establishments to a risk which we count upon in removing the men from the barracks. The difference between the results in Calcutta and in the North- West does not seem to me really to exist. The patients of the Calcutta hospitals are affected from a cholera which has its home on the river bank or in the filthy bazaars ; they are removed from the sphere of its action, and no one suffers from being brought in contact with them ; the patients of the regimental hospitals up-country are treated virtually in their own barracks in the locality in which they have been struck, and when those surrounding them fall stricken likewise, it is said that the phenomenon is the transmission of cholera from one man to another. So in public buildings in England or elsewhere ; it will be found that attendants suffer only when cholera has actually invaded the building, and while patients seized within the building are being treated within the walls, and that great cholera hospitals spread the contagion of cholera as little as they do in Calcutta. (I make an exception of the conveyance of cholera by fomites, a subject to be studied afterwards) . In attending patients at their own homes whether in this country or in Europe, the danger both to attendants and medical men is great. We know how frequently it occurs in this country that those occupying the same house suffer in common, and it is not less the case in Europe. We cannot tell what condition may have determined an offshoot of an epidemic cholera to one particular spot. It is sufficient to know that if we have good grounds for believing that a patient has become infected from a cholera which has its location in his neighbourhood, there is a risk incurred in attending on him ; and when the risk is increased by the general spread of cholera in a neighbourhood, it is not surprising that medical men should fall, whose valuable lives would be saved were all cholera cases treated in General Hospitals. The risk is much greater in Europe than in India. There are many circumstances M'hich in India tell in favour of the medical officer, and the chief is, I think, that his exposure takes place by day and rarely by night, for it is when the air is weighted with moisture and spread out over a sleeping body that cholera and typhus become diffused. I can recall only five cases in which medical officers have suffered, and not one of a fatal termination, in the typhus epidemic of the past nine years in which upwards of 6,000 prisoners have died, and in which scarcely a single attendant has escaped infection in any one of the great jail outbreaks. In 1817, only three or four medical men were attacked with cholera in this Presidency, while in Russia the deaths of medical men were very numerous. When a jail becomes infected in this country and prisoners are still confined within the walls, the medical officers have occasionally succumbed to the effects of the miasm, as at Agra in 1856 and Hazareebaugh in 1866 ; but it is the rarity of the occurrence and not its frequency that forces itself upon our notice. In Bengal Proper the known fact of the absolute termination of a cholera outbreak in a certain number of days has led to the fact being almost overlooked, that the attendants on the sick of our jails may suffer. * In a letter from Dr. Bruce published by Mackinnon, we find the following :—: — t "Mental depression predisposes is much to the disease as anything I know. So confirmed was lof this fact, that tterly objected to let any soldier ue attended by his comrade in hospital. I always caused his attendant to be :ted from men who knew nothing and cared as little about him. It was a curious fact too, that the disease did not i to attack the attendant till the excitement was over. It always followed after the death and funeral of the person ras anxious about. This predisposing effect of mental depression struck me as long ago as April 1833. Cholera broke out in the Jail Hospital at Bancoorah ; and I found that almost all those attacked and all the fatal cases, ! among some Cole prisoners who had been caught and brought away from their homes during the insurrection in Cole country, and who had been remarked as especially melancholy and dispirited during their confinement." — an Annals, October 1856, p. 141. t Report on the cholera of 1861, p, 27. CflJip. J.-L- J CA° E ILLUSTRATING THE GOOD EFFECTS THAT FREQUENTLY FOLLOW MOVEMENT INTO CAMP. 20 1 Holding, as 1 do, the doctrines which I have stated in the first section to be essentially fundamental truths, I am led to scrutinise the facts of The spread of cholera from one man alleged conta gion from my own part of view, and it may £S£T JSSSS -r yet le be that lam inclined to push my opinions too far towards the primary trnth. opposite extreme from that view which holds up the human being as the propagator and diffuser of cholera. Those who Id exclusively the doctrine of human transmission cannot feel aggrieved that we decline to •scribe to it as inclusive of the whole truth. Every one feels that it would facilitate much the dy of the phenomena of cholera could we hold as a truth and not as a theory the constant or juent presence of the cholera germ in the evacuations, and could we trace to this as a source infection of localities or the poisoning of the water supply. In this country we act upon belief in the transmissibility of cholera in such a manner, and the precautions used against possibility of infection from such a source have been elaborated to the last degree ; and yet 3 a melancholy truth that the liability of our cantonments and regiments to cholera in its •st form is as great now as it has been at any time during the past fifty years, and that the olute mortality is on the increase. I have held up as a warning the case of the 70th Regiment in 1853, showing the effects of cholera localised in the Cawnpore cantonment, and the loss of ¦fection of locality in relation to the 183 men as the result of the neglect of movement. The mjent of troops. Cawnpore, 1863 higtory of 4 g th {n the game can t onmen t in the invasion of 1863, presents a parallel which it will be well to study and to Itrast with the history of the 88th Regiment in the same barracks in the year following. It lear in the case of the 46th that the medical and military officers temporised, probably in er to avoid the movement into camp ; but the urgent necessity for the movement is shown by fact that the cholera survived in the cantonment up to the date of the decay of the vitality the reproduction, since the return to Cawnpore in the first week of September was uediately followed by the renewal of the outbreak, and since two men left behind were icked as late as the 26th of September. This last occurrence finds its exact counterpart in history of the 88th in the outbreak of the year following ; the Orderly Room Sergeant was : into cantonments from the cholera camp on the 17th September, and on the 18th he was icked and died. IThe history of the movement is thus detailed in the weekly returns of Her Majesty's Regiment : — t'y lli/i. — Regiment very healthy ; sanitary conditions good. 17 tk. — General health of the Regiment remarkably good. An increase in the number of cases of diarrhoea ; two severe cases, of which one proved fatal in ten hours with choleraic symptoms. A second case of same kind under treatment this morning. Weather depressing, with heavy ram. 24^. — A fatal case from choleraic diarrhoea died in forty-seven hours. Eleven out of twenty-three admissions have been from diarrhoea. 31 st. — Two isolated cases of cholera in Cavalry and Artillery. Choleraic diarrhcea attended with extreme depression on the increase among the men. Three deaths from this cause. A Wing moves into camp tomorrow morning. Auyust Ith. — Neglected cases of diarrhcea rapidly present choleraic symptoms. Five deaths from cholera, and four cases of diarrhcea fatal during the week. One case of cholera attacked in hospital never rallied. The entire Regiment is under canvas except the families. The reports from camp are very favourable ; barracks are being whitewashed. l^th. — A marked change for the better since moving out. All cases of diarrhcea are discharged ; no admission from cholera or choleraic diarrhcea during the week, nor is the tendency to depression marked in any case of simple diarrhcea. 2lst. — A case of cholera proved rapidly fatal in camp. A second case of choleraic diarrhoea is progressing favourably. Camp changed to Maharaj- pore, and Right Wing encamped near Bhowpore Railway Station. ¦l%th. — Three cases of cholera have occurred, two fatal; one case of choleraic diarrhcea admitted. The cholera cases occurred in the Right Wing; the other in the Left Wing. September Uh. — Health of Left Wing very satisfactory. A fatal case of cholera in Right Wing. The Wing has been ordered into Cawnpore by the Commanding Officer. \\th. — Tendency to choleraic disease still presents itself. Among the men of the Right Wing, three admissions from cholera and one from choleraic disease during the week. 118^. — Two admissions and three deaths in the Wing at Cawnpore. The Wing was again moved into camp on 15th; one slight case since. The camp is six miles distant from Cawnpore on the Oude side of the river. loth. — No admission from choleraic disease. The case remaining progresses favourably. October 2nd. — One man died in Cawnpore from cholera, and another was attacked as soon as he reached camp from Cawnpore. Every man has been moved from the echelon barracks. n 9th. — The one choleraic case remaining will be convalescent in a few days. „ 16t&. — Regiment ordered into Cawnpore on 19th. The outbreak of 1864 was more successfully met, and the facts regarding it may be recorded tmual Report, Her Majesty's 88th as illustrating all that is to be desired or expected from movement for 1864.— Surgeon A. H. me nt into camp :—: — "A man and woman were attacked by cholera on the 19 th I August. I immediately recommended that the men, women, and children, as well as »arty of sixty men who occupied a building in the neighbourhood, should be removed across Ganges to a suitable piece of ground which had been previously selected in case cholera uld appear, and then encamp. My recommendation was promptly acted upon by the nmanding Officer, and the party moved that same evening. On the 22nd of August a d was admitted with cholera from the married quarters ; and on the 25th a man was litted from the barracks. Seeing that the disease was now likely to gain a footing, I )mmended that the Regiment should move out of cantonments at once ; this was promptly )onded to, and next day the Head Quarters and Right Wing marched across the Ganges about seven miles distance from Cawnpore, the Left Wing to Rooma, about six miles n Cawnpore, on the Allahabad road." I" The whole of the sick men, women, and children accompanied the Head Quarters. Bedids were taken for all in order that any possibility of danger from sleeping on damp ground »-ht be obviated. The tents were pitched well apart from each other, drains were made round li leading into larger drains cut in the direction of the natural drainage of the encamping und. Latrines, consisting of a trench three feet deep, covered over with a tent, were structed on each flank. A native attendant was constantly on duty at these pits to cover r with earth the excreta, and the trench was filled up and a fresh one dug every three days, conservancy police was established, and native camp followers and servants were cornled to resort to trenches." " The water supply was good and abundant.'" I" A patient in hospital complained of the premonitory symptoms of cholera after having Cawnpore en route to the camp ; the disease was checked, but he died from exhaustion on 28th." t" The health of the Regiment began soon to imp rove. The men were almost constantly pied, and there was a general buoyancy of feeling amongst them from knowing that they out of Cawnpore, which has an evil reputation for mortality. Their amusements were not sight of. The library, cricket in the cool of the morning and evening, games, feats of lgth and activity, and for the well conducted soldiers, shooting, fully occupied their minds." B" Both Wings remained in camp till the 26th of October, before which time it was not sidered advisable to return to cantonments/ »" The Orderly Room Sergeant was sent into Cawnpore on the 17th September; on the Y&th he was ?d with cholera and died that night. There can be no doubt but that the speedy removal he Regiment from the influence of the disease in cantonments into camp saved it from devastating consequences of an attack of epidemic cholera." I These parallel cases teach the same thing, namely, the probability of the localisation of lera in the Cawnpore cantonment, as in Morar, up to the end of the reproduction, that is, n July to the last week of September, and the danger of keeping bodies of men within the ere of its influence. It cannot be doubted that the tendency to localisation is much stronger some localities than in others ; and that, while in every station of the epidemic area there ;he liability of attack on any day between the invasion or reappearance and the decay of reproduction, few stations are so situated as to maintain throughout an uninterrupted Lifestation such as has been shown in the case of Cawnpore, Morar or Meean Meer, of the ip before Delhi, or of the Lucknow Garrison. The probability of persistence is, however, be determined less by inference than by actual experience ; and we may always infer in icipating the history of future epidemics, that what has once happened is almost certain to :ir again. European Troops, Caionpore, 1826-68 Ncmbbb of Deaths phom Choleba us bach Month. YEAR. A . £ C • * S § J § f. -j a is | * ' 2 * Srt^ 182« ... 1,763 1 I 7 10 ... 2 2 ... 22 1827 ... 1,988 1 1 ... 1 ... 11l ... 6 1828 ... 2,192 1 ... ... 3 15 8 3 1 1 1 33 1830 '", 2%-Bl ... ".', '.'.'. ... ..'. 1 ... "i ,",' 1 '[[ Z 3 1831 ... 2,039 1 1 2 I 208 European Troops, Cawnpore, 1826-68, — continued. Numbbb of Deaths from Choleba. Ik each Month. I I « -a • «J it 111*! 5 £ I (* S O £ >^ i-s O m O fcq QQ 1833 ••'• i' 842 •'" ••• ••• ••• ••' "l "l 63 1 '.!.' ')| loi 183 4 ... 1,885 1 ... 1 3 2 1 8 1835 ... 1,905 ... 1836 ... 2,059 1 1 2 XS37 ... 2,049 .. 3 5 23 1 32 1838 1,890 1 4 4 13 9 6 2 1 1 1 42 1839 ... 1,277 2 ... 3 2 1 8 1841 ... 1^336 ... ... ... ... ... 5 5 3 11 "'.) |" 15 1842 1,583 57 2 2 61 1843 1,966 9 2 7 1 19 1844 ... 2,297 1845 1,944 44 7 4 11 1 1 ... 68 1846 ... 1,487 1848 '.'.' '789 "• '.'.'. '". '.'.'. 7 *7 23 27 3 '.'.'. ','.'. Z 67 1849 ... 786 - ... 31 1 1 33 \ll% '.'.'. ',". \" t ',',', '", '". "i 1 ... '.'.'. '.'.'. Z 2 1853 "v" v ... 4 30 64 97 195 jog- ][ V " HI # '# # I" 111 * 1859 ... 1,372 .'. ... ... 5 25 "2 1 i' 6 3 ... "[ "i 47 1860 1,228 2 6 1 ... ... 14 1 ... 24 1861 ... 1,230 1 2 4 7 6 12 2 ... 1 ... 35 1862 .. 1.259 1863 ... 1,162 ... 1 5 12 5 1 ... ?. 24 1865 !'.! '880 .'. ... .'.'. '." i ... •• 1 1 1866 ... 813 ... ... 1868 ... 722 ... ... ..! ' I place here the Death Table for the Cawnpore cantonment from 1826 up to the present time as illustrative of various points of importance. First of all, it shows the extraordinary fact that a single locality may prove an index station, furnishing a record in which we may accurately read the history of the succession of epidemics throughout a long course of years. Here is shown the invasion of 1828, dead in 1832; the invasion of 1833, dead in 1885 ; the invasion of 1837, dead in 1840 ; the invasion of 1841, dead in 1844 ; the invasion of 1845 ; the invasion of 1848, dead in 1852; the great invasion of 1853, after which troops were withdrawn, so that we lose the indices in 1854 and 1855; the great cholera of 1857 derived from the invasion of 1855-56, dead in 1858; the invasion of 1859, dead in 1862; the invasion of 1863, dead in 1866; and even of the invasion of 1867 the true index is afforded, although the Doab lay in the fork of the progressing cholera and escaped, the epidemic passing to the south of the Jumna and through Northern Oude. : I Next, after the fact of the persistent affection of Cawnpore in every succeeding epidemic, season of manifestation is to be observed. There is no difficulty in associating the cholera !awnpore in season with that of Northern India (See Tables, pages 38 and 50) ; and while we w that Cawnpore lies under eastern influences, the statistics of cholera are of themselves cient to prove the proximity of this station to the limit separating the eastern and western sions of the epidemic area, the line of 80°. The table shows how, before the setting in of isoon influences, the history of all these years has afforded little more than the warnings of cholera so certain to appear when the vehicle of manifestation is afforded ; for the absence :holera in May implies repression, whether it be the advance of the materies that is retarded, whether the materies be present and unable to exhibit its presence for want of a vehicle, en once the vehicle has been afforded, Cawnpore is clearly a favourite habitat, as is shown the continuous manifestation of cholera on the occasion of almost every invasion up to tember. While we might point to the results of the past four years as affording grounds tor estimatthe advantages which have resulted from sanitary improvements and the occupation of hous and lofty barracks, the explanation that attack was not due in X 866, inasmuch as * See Table for J. 857 and note in Appendix. 209 the invading cholera of 1863 was at an end, that in the epidemic of 1867 the Cawnpore District virtually escaped with the neighbouring districts of the Doab, and that the invading cholera of 1868 was repressed by the meteorology of the year into Allahabad and the districts lying to the east, must be admitted in making the calculation ; and, therefore, lam inclined to tk to future experience in estimating the effects for good of what has been done. The account of the cholera of the Saugor Jail of the monsoon season of 1864 is interesting in many particulars — in respect to the measures taken in anticipation of the outbreak, the success of these measures, the evident localisation of the cholera and its persistence, and the fact of the attendants on the sick having suffered. The cholera was raging in the city, and a site for the camp had been fixed on, so that there Ight be no delay in moving in the event of cholera appearing within the jail walls. Dr. Rice writes : — " On the 11th July the first case occurred in the Saugor Jail ; the man. a hospital sweeper, was taken ill at 2 a. m. ; and within stbength^f peison^esl' 350. twelve hours, seven cases had occurred in seven different wards." Cholera Deaths. "On the morning of the 12th every prisoner was out of July July ** | jail on his way to the camp. The site selected was the " * "" # # # narrow ridge of a crescent shaped hill two hundred feet August 5 1 higher than the jail and two and half miles to the south. The » 8 * fall was good, and although the period during which the 22 1 prisoners were upon this hill was the wettest of the whole * * * * season, no water ever lodged and no muddy half dried patches September ... 28 1 existed. There were no villages to windward ; and to the south-23 ¦, west, the direction of the prevailing wind, the country » '" '" j j r • • -P l '11 ___j '.li i stretches away in successive ranges of hills covered with low jungle/ ff On this ground I placed the tents in echelon. On a lower plateau three quarters of a mile distant, I placed my cholera tents in three divisions ; one for suspected cases, a second for convalescents, and the third for those in whom the disease was unmistakeably developed. Communication between the camp and infected localities was prohibited." "In the main camp I abolished a general hospital, distributing the patients throughout the camp. An extra blanket was issued to all ; and food was cooked and served out twice a day. When the weather was dry the prisoners were employed on light labour, — at first in clearing the camp of stones, brushwood, and roots. I then cleared the top of the hill of all jungle ; and trenches were dug for the carrying out of a well regulated system of conservancy. As soon as the camp was made trim and all necessary work done, the prisoners were employed in roadmaking. There were parades morning and evening, and every prisoner suffering in the least was put under observation. The result was, that not only was cholera prevented from spreading, but the opening out and airing of the prisoners seemed to free them from the taint which they had acquired in the jail." "On the 12th no cases occurred. During the night between the 12th and 13th seven cases more occurred, five in the camp, and two amongst the attendants on the cases first attacked. Of the seven, three died who had not been attendants :on the 16th, 18th, and 22nd three attendants were attacked."* " Cholera ceased in the main camp on 13th July, and I considered I was safe in bringing the prisoners back to the jail on the 28th. I, however, took the precaution of bringing them back in detachments of twenty a day and distributing them throughout the entire jail. At the end of eight days some 150 men had thus returned, when, on the sth August, a ease occurred which proved speedily fatal. On the Bth another case appeared, and the occurrence of three cases in rapid succession warned me that I had better take to the tents again. Between the Bth and 12th eleven cases had come forward. For two months a case appeared every third or fourth day, chiefly among the attendants on the sick." Contrasted with the probable results had the prisoners continued to occupy the jail, the effects of removal in this instance must be regarded as very satisfactory. The type of cholera was deadly. In fifteen cases collapse set in within an hour of the first symptom of uneasiness :of these eleven died within eight hours. There was no diarrhoea in thirty-nine out of forty-eight cases ; choleraic symptoms followed in from ten to twenty minutes after the first feeling of discomfort and sinking at the pit of the stomach. I regard this as a typical outbreak, extending over the normal eleven-day period, but reduced to the minimum by the judicious measures adopted, * k Cho?*a*}dmisS!s: and chiefly by the _ opening out and airing of the prisoners July 11 7 immediately after infection. The seventeen admissions appear 12 ... to represent the abortion of an outbreak which under " Jg J less favourable conditions would have been attended with jj \" t |" 17 i a much higher ratio of attack. » «•¦ ... 22 l In the jails of the endemic province recurrence rather I than persistence is the prevailing phenomenon. It is not at all usual for a jail of this area to have three cholera outbreaks in the year each distinct from I* Without any regard to whether those affected may have attended on the sick or not, we have here an evident iple of the typical outbreak, dead on the eleventh day, and cut short and mitigated by the means employed to meet The primary effects of the infection were developed on the 11th and the secondary on the 13th : and under the ; favourable circumstances cases were due up to the date at which they occurred. 210 rCp P 4.; n y. tt LOGCtIOII IX' the other, and so clearly has the duration of each been defined by experience that the medical officers have been content to await the result without moving out the prisoners. From some jails, indeed, it would appear that cholera is never absent. The monthly returns of Alipore or Hooghly Jails rarely fail to show the presence of cholera, which several times in each year is lighted up into an outbreak. In the intervals the phase is often changed, so that some might almost be inclined to deny that the symptoms were due to the true cholera miasm. HOOGHLY JAIL. ALIPORE JAIL. CHOLERA ADMISSIONS OF EACH MONTH. CHOLERA ADMISSIONS OP BACH MONTH. g ~~^ : — r Total "~~ : Total Ybab. g £jj _ I I J £ Died. Strength. . h _ | jj j Died . S S E ° a ,i ,: 5 8 I N y ear - g N d -d -cl^Sa year. 1859 ... 776 * 5 3 4 ... 11 2 ... 33 i ... 54 25 1,766 5 13 5 2 5134 2 ... 113 3 74 30 1860... 672 ... 39 8 18 7 7 8113 53 226 87 1,896 ... 233 30 2 ... 8 3 3 1 82 42 1861... 713 4 32 20 4 1 6 14 12 6 4 103 15 1,759 5 7 6 14 12 3... 1 30 1 11 1862... 688 2 328 36 2 ... 13 19 3 11 7 2 126 19 1,823 8 15 4 5627102 56 la 1563 ... 571 ». 18 7 10 9 9 4 2... 339 ... 101 28 1,817 4 128 6 2 6 0 2 3 10 4 ... 75 13 1864... 451 •¦• 17 2 3 1 4... 1 28 7 1,793 2 4 14 19 7 3 3 3 4 1 6 3 G9 17 1865... 578 2 6 1 ... 1 2 1 2 15 6 1,811 2! 6... 2 1 3 36 13 3 66 25 1866 ... 642 10 ... 2 ... 4 ... 6 19 41 17 1,901 1 0 9 3 5 41 8 2 4 5 2 ... S6 24 1867... 593 ¦¦• 9 ... 1 ... 10 5 2,356 ... 236 8 5 2 16 ... 2 12 4 77 20 1868... 549 ••¦ 4... 2 6 2 2,451 1 5 11 1 5 5 1 ... 1 1 4 2 37 12 We see the same sometimes in the jails higher up the country. The peculiar climatology of October 1859, which I have described as ushering in the malarious epidemic of the Gangetic Provinces, appears to have brought forward at the same time the latent cholera of this epidemic In the Patna Jail the symptoms took a low and deadly type, which it is important that we should not overlook nor undervalue ; and the impression Peculiar phase of the manifestation conveyed to the mind is, that this insidious cholera was ?n? n ti^T revitalised within the very walls of the jail— a jail from which local* growth of choiera^Tan unfavour! cholera has never been absent for thirty years. Dr. Sutherable season. Patna, October 1859. land described this as a congestive cholera, as opposed to the usually concussive character of the onset. He writes :— fllapse does not ensue rapidly, the case is apparently less urgent, reaction takes place to rtain degree, and the prognosis seems hopeful. But the appearance of improvement is tcious ; the tongue is dry, the pulse is slow and feeble, no urine is passed, but there are sral dark, thin, and offensive evacuations, the patient falls into a state approaching to tor, and finally dies comatose with the aspect of a person sinking from a narcotic poison, the third or fourth days of an outbreak, great hopes are entertained that there will be but casualties. But the conclusion is premature. On the fifth and sixth day the patients in to sink, and it is fortunate if the mortality does not exceed one-half." Of the outbreak which commenced on the 28th October 1859 Dr. Sutherland writes :—: — " The facility with which reaction was established led me to hope and expect that the epidemic visitation would not be a fatal one. In this I was grievously disappointed. A degree of stupor almost amounting to coma generally ensued; the motions continued thin, and were eventually coloured red with blood; the pulse remained weak and rapid; and the patient passed into a state of coma. This followed every form of treatment. It was obvious that we had a disease to treat differing in some respects from every epidemic I had Mackinnon noted the very same phase of cholera. He writes, Cop. cit., p. 280) :— "In a report which it was once my duty to forward to the Medical Board descriptive Lof a dreadful visitation of cholera in the jail at Tirhoot, I had uliar outbreak in the Tirhoot Jail, nnnna i nn t- n n r>^n O I*^o+ wao +^ ™ o o v OT ,r w™/!nvfl,l mn AW™. occasion to notice what was to me a very wonderful modification of symptoms." * * * * " After a check had been described by Mackinnon. tto the vomiting and purging, the voice, breathing and warmth of skin became natural, the face had none of the peculiar character of the disease. The patients walked about called for food, saying, they felt well ; on feeling the pulse it was barely perceptible, jme cases, I think, not to be felt at all. In this extraordinary condition some of the men . for more than two days. They all died, if my memory serves me, invariably by coma." In October and November 1863, following the new invasion of that year, the Lucknow Jail had eighty-five admissions and forty-five deaths from ¦ucknow Jail in October and Novem- cholera. Dr. Cannon observes, that it is worthy of remark 1863, after the close of the normal that c h o lera of these months was entirely confined within period of vitality of the invading cholera . . .. _ , , • Ine ¦ t 1 of the year. the prison walls. During the invasion IUS prisoners died between the 15th and 31st of July; there was a complete cessation of cholera up to the 25 th September, and from this date, when cholera ought to have 211 • been at an end, as it was everywhere else, up to the 27 th November scarcely a day passed without the occurrence of a fatal case of cholera. On no day did more than two deaths occur ; between 19th October and 27 th November there were fatal cases on twenty-two days, and but twenty-seven in all. The aspect of this cholera is that of a material kept in abeyance, unable from its diminished vitality to do more than indicate the fact that it is present. I shall conclude what I have to say on the localisation of cholera and its relation to the attack of attendants on the sick, with an illustration taken E'inal illustration of affection of local- f rom the experience of the Native Army. The case is that aim anection of attendants. Konat, .... oin •i. ti> a. i. •i. w j a. vt_ i of the 3rd Punjab Infantry, which suffered at Kohat in October 1858. The narrative is related by Mr. Deane :—: — 1858. On the 24th the first man fell ; another was struck down on the morning 1 of the 25th, hird on the same evening, and a fourth at noon on the 26th, and a fifth on the 27th." I" On the 28th ten men went down (the Regiment had been moved into camp on the 27th). 29th and 30th six men were attacked ; on 31st three. Eight more seizures occurred before disease ceased on 7th November, before which date the camp had been three times shifted/ tt On this occasion a dresser, a cook, and three coolies were attacked while in attendance n cholera patients." But remark the simultaneous infection of the lines. I" Every day brought fresh proof that the atmosphere of the empty lines were charged th the cholera poison, which found victims among the few camp colormen who had been t behind to watch over regimental property. Nor were the men on quarter guard safe ne forty yards in front of the lines, nor yet the tent-pitchers who were under canvas near j quarter guard, till in the end every man was turned out of the foul locality. One day's ay and I believe that the epidemic would have blazed up in the ranks with fearful energy ; it was, ten men were attacked in camp on the first day after removal." When this case is looked at as regards its relation to the type, it loses much of the signi- Typical Otttbbeak, 3ed Punjab j^ character which we might otherwise have felt inclined Infantet. to attach to it. The (xoorkhas were infected on the evening Kohat, October 1858. of the 13th and morning of the 14th May 1857 in the Ny nee Admissions. Tftl rj,^ and J t wag on lgth out b rea k blazed October |4, 1 up . p eshawur was stmck on the 19th May 1867j and ft wag 26, 1 on the 23rd that the conflagration occurred in the 42nd 27, 1 Highlanders (see page 181). In this case the same pheno" !?• . 10 menon of the outburst on the fifth day is seen. It is import" 3o] j 6 ant to note this typical aspect in relation to the facts » 31, 3 regarding the outbreak among Native Regiments in canton- I "be 1 1 to 7 8 ments treated of subsequently, and as exhibiting, in all probability, the results of a single afflatus of the cholera sm, in contradistinction to the effects produced by the cholera which has attached. If to a locality. 212 Loection IL CHAPTER III. THE CIRCUMSTANCES WHICH INTENSIFY OR DIMINISH THE RATIO OF ATTACKS DURING THE OUTBREAK. THE DIRECTION IN WHICH THE STUDY OF THE NATURAL HISTORY OF THE EPIDEMIC AND THE OUTBREAK POINTS IN TRYING TO DETERMINE THE PRINCIPLES ON WHICH THE OUTBREAK SHOULD BE MET. Hitherto I have spoken of the circumstances which prolong or diminish the duration of It is not alone the strength of the * he °^ h^i n ? w J ha ™ to speak of the conditions which miasm or its accumulation in a locality determine intensity or comparative escape during the period that determines the intensity of the of the outbreak with the view of determining the principles outbreak. on wn { cn th e outbreak should be met. Could we so weigh the conflicting views of different theorists as to reduce the facts to a systematic whole appreciably true, we should lay the basis upon which the great question is to be solved — why it is that the British Soldier is struck down, and how his valuable life may be saved. No one has yet answered the question, why it is that the British Soldier alone is selected in the cantonments of Upper India as the victim of epidemic cholera, and why the Native Soldier living in circumstances which are theoretically opposed to all the sanitary conditions supposed to favour the spread and intensity of cholera, either absolutely escapes or exhibits but in shadow what is filled up in substance in the case of the European Regiment, and why localities regarded as enjoying the greatest immunity from cholera are no sooner occupied by European Troops than they acquire the character of plague-stricken spots. It is the British Soldier in himself or in his domestic relations that fixes the ratio of attack ; the special localisation of cholera will not account for the absolute exemption of Native Troops and the decimation of every corps of Europeans in the same station at the same time, which is habitually the rule and not the exception. Mr. Strachey tells us that Meean Meer had not the reputation of being an evil locality for cholera before it became a British cantonment ; he says also :—": — " It is remarkable that not many years ago Grwalior and Morar had the character, apparently well founded, of enjoying an almost complete immunity from the attacks of epidemic cholera." This, however, is not the explanation ; Gwalior has all along been a station lying directly on the route of invading cholera ; it was the want of the pabulum for manifestation alone that prevented it from appearing in its true character. From the following note by Dr. Kirk, I have no difficulty, with subsequent experience, in inferring, that had Morar been occupied in the epidemic of 1856 by European Regiments, the mortality would have been reckoned by the hundred. He writes in August 1856 :—": — " Cholera has been for six or seven weeks in the city of Gwalior. Up to within a few days ago, however, the irruption was comparatively slight, but since then the seizures and deaths have both increased. In the cantonment there was a marked increase at the same time. In four days we have had twentyseven seizures, and about twenty people are ill now in the sudder bazaar. In the Regiments* there have been a number of choleroid cases, and in one Regiment there have been some well marked cases of cholera among the sepoys." I An enormous responsibility is involved in the attempt to solve the problem of the causes :he cholera death rate of the British Soldier, and no theoretical considerations which do not n consistent with the best understood hygienic laws should be allowed to divert our minds ;n we study it. But this we cannot help feeling, that no clear basis of theory has yet been upon which we can boldly urge our practical measures. Even immediate movement, the remedy to which, above all others, we looked for a diminution of the death rate, which very mind appealed as just and proper, has proved in its application below the standard to eh its advocates sought to raise it, and the outbreaks of the Buffs and 42nd Regiment in 1867 } their place among the most deadly on record. The measure which it was hoped would inish the average outbreak both in duration and intensity, has, we cannot doubt, effected in ly cases what was hoped for ; but the truth cannot be hid that in others the intensity during period of the duration of the cholera has been extreme. tin considering the grand problem I would have all minor facts and theories likely to jgestions apt to divert the mind decoy the mind from the essential truth placed on one side ; the points of essential importance for there are many rocks, small in themselves, which have nnexion with the study of how stopped the progress of those trying to pass this difficult itbreak is to be met. , r £ L & j a r strait. One of these is the idea which exists, that the cholera which is coming forward in any individual may be aborted. It has been insisted that by the The abortion of the effects of the employment of remedies to check the preliminary symptoms tmasm in the individual. /» i i ,i , i• , r. t* a ij • l i of cholera the mortality of our European Soldiers has been lessened. There is no reason to question the truth of the statement that a cholera may be cut short in its earliest stage by sedatives or antispasmodics. Some of our most experienced men have satisfied themselves that they have succeeded in cutting short a cholera in this stage. It is right to use such remedies if no better course is available. But the employment of these remedies is not to be mistaken for a combat with an outbreak of epidemic cholera. * Native Regiments of the Uwalior Contingent. 3 G MINOR CONSIDERATIONS APT TO DIVERT THE ATTENTION FROM THOSE MOKE IMPORTANT. [SfiCtioH IL 214 Taking* into account all fallacies that may possibly arise in a statistical enquiry, it is certain that two-thirds of all men. in whom cholera becomes developed die. When it comes to this, the medical mind is apt to ask itself whether nothing 1 has been done to mitigate the calamity ; and it is to be feared that the solace afforded by the suggestion that many cases of cholera may have been aborted by medical means is too often appropriated, and on insufficient grounds,, since we find that in the case of Native Soldiers who reject such measures, the premonitory symptoms of the same period do not pass into cholera. tA second suggestion is, that cholera may be in a great measure averted by a system of prophylaxis. It is said, that as debilitating influences may d effects of a system of prophy- lead to the com [ ng f oma rd in the economy of a cholera which i*j__j" _ i..i.i i j __. _ it __ i • i i -i i a constitution better braced up would certainly have shaken off, so cholera which has infected a body may be prevented from developing by the individuals composing the body being placed in a position to bear up against the poison. This proposition also has a basis of truth. No one who recognises, as I do, the extreme resemblance of the two specifically distinct miasms of malaria and cholera, would hesitate to recommend the use of prophylactic remedies when cholera is threatened. But the general use of prophylactic measures will not, in very many cases, prevent the development of the outbreak, although some, perhaps not a few, lives will be saved by the fact of the individual being carried over the critical point which must be surmounted if he is to escape cholera and death. For lam strongly of opinion that there is in the cholera of any individual a point reached, marked, however, by no particular symptom, at which the disease advances or recedes, just as in the case of malarious poisoning. The individuality of cholera is more pronounced than that of the malaria poison, but I believe that in this alone the phenomena of the two miasmata differ. It is not in every one poisoned by malaria that febrile symptoms come forward, for before the critical point is reached at which rigor and the subsequent stages of fever follow, the scale of the balance has begun to sink backwards. I judge the same to be the case in cholera poisoning ; it is not the case that in every one who imbibes the cholera poison cholera becomes developed.* I am sure that it is wrong to say that in all cases the existence of cholera in the system is marked by premonitory diarrhoea. It may be marked by diarrhoea or it may not, and probably the most deadly form of cholera is that in which no symptoms at all or symptoms attributed to dyspepsia merely, are present. Next, it is advanced that a rigid system of quarantine is an efficient bulwark against Rthe advance of cholera, and that cholera epidemics are to TeXrSoX::£r tmS be met V circumscribing those affected by a sanitary cordon. In all cases in which we have evidence that cholera is being Iried about a province by human intercourse, lives will be saved by this means which would lost through its neglect. Quarantine, however, has never been efficient to prevent the intro:tion of cholera into any country, and to trust to quarantine measures as the root of a system which the epidemic cholera of India shall be met and restricted, is to lean on a broken 1, and to leave our soldiers virtually unprotected. Quarantine should undoubtedly be enforced nany cases as conducive towards a good end ; but if a general line of action be recommended the theory that absolute protection follows strict quarantine, its adoption can end only in ippoiritment. X Another suggestion is, that the outbreak should be treated on the theory that cholera is one of the most subtilely contagious of diseases, and every developed easures adopted from the consider- cage a possible focus of infection to all around. The epidemiorof the conta glO us nature of ii O g ist w iU dread the spread of cholera as a disease as much in the incubative as in the developed stage if it be true that cholera Ims spread. The aspect of outbreaks, however, is strongly opposed to the reception of this t placed in this light. Viewing the question in the light that a body of men may suffer in iequence of aggregation and community, I would not lightly set aside what I conceive to be uth, that the tainted stratum of air over a sleeping mass may be selected by the cholera 3m, as we see only too plainly that it is selected by the typhus poison when an outbreak is g fomented in our jails. This consideration should have no light weight in an estimate of causes which augment the ratio of attack ; but the empirical assertion, that because cholera contagious disease its ravages can be controlled by precautions directed against contagion, i grave error, and not the less so because it has been so universally assented to of late. I A fifth theory holds that cholera outbreaks are to be prevented by the adoption of a perfect system of conservancy and the use of an untainted water supeasures deduced from the theory ply. The dry-earth system lately introduced is beyond Question L P SZ?2E£^ ff^y ff?l to secure the end aimed at; and if I believed to the full the proposition so eagerly put forth of late rs, that cholera is multiplied in the primae viae, and that it is through the discharges b cholera is propagated from man to man, I too should hope to see the deaths of our •opean Army counted not by hundreds, but by tens. But the events of 1867 give no tnise of the fulfilment of any such expectation. * In replying to Dr. Murray's queries, Surgeon Eteson gives his impressions in regard to this subject in the following terms : — " During the occurrence of an epidemic, I believe that every living soul within its influence must be infected • and all experienced medical men are familiar with a premonitory train of symptoms, which assumes greater or less seventyaccording as the individual has in his system that which favours the development of the contagion or otherwise. " Chap» IH-3 THEORY OF THE INFECTION OF COMMUNITIES FROM INFECTED INDIVIDUALS. 215 II have anxiously sought for evidence of the highly poisonous character of cholera evacuains, and I think that I have done so with an unprejudiced mind. I do not go so far as to f that the evidence against the presence of the cholera germ in the evacuations is decisive. 1 the contrary, I think it probable that latrines are occasionally infected and especially spital latrines, as I judge by observing that in a year in which a reproduced cholera is c to appear, it not unfrequently happens that the first affected are men already in hospital bh trifling ailments, which do not prevent them from leaving the wards or from making use the hospital latrines. The following is a case to the point : — Dr. Sutherland, in his report for 60 of the Patna Jail, calls attention to the fact that four men out of seven engaged in breaking old privies which had become saturated with ordure were attacked by cholera; this happened ring a general outbreak in the jail ; but he affirms likewise that the wards to which the old vies were attached had three times as many cholera cases as those in which a better convancy system was in force. Cholera has appeared in this same jail annually for thirty years, lerally twice and frequently three times in each year. I It has been observed that on some occasions, cholera when about to become epidemic a cantonment has appeared first among patients in hospital. The following cases taken from the history of the eastern cholera of 1860 illustrate this statement: — Seetapore, 7th to 18th May 1860. " Out ° f four fata . l .. CaseS ' two we P^ents in hospital with gonorrhoea and syphilis, and one was a convalescent." Gondah. H. M.'s 20th Regiment. " l \ the CaSeS fatal in A F* ( four ) > wer f » hos l\ tal whe * attacked, suffering from trifling ailments (gonorrhoea and primary syphilis) ." „ „ .„ t> ,». •„ " T ne nrs t case occurred in hospital : and three other patients Kae Bareilly. Koyal Artillery. ? <• j ? . L '.., ? , \ were attacked the same evening with diarrhoea, and great depression." Cawnpom H. M.'s 54th Regiment. J' I *. » remarkable that many of these men were seized when in hospital under treatment for other diseases. .. , „, ™ „ , -Ten cases of cholera occurred in September : of these Lucknow. 2nd Dragoon Guards. , ±- j. • i -j. i » nine occurred among patients m hospital. "In the course of the morning of 6th May, three men, Allahabad. Royal Artillery. Kiaiiabad. Koya! Artuiery. patients in hospital for other diseases, were attacked, and ther followed in the afternoon." I From noting that these cases occurred not in a year of invasion but in a year in which lera was revitalised over an occupied area, the inference might be drawn that the cholera le forward in these hospitals in consequence of local poisoning due to the fact of patients ing been treated in them on the occasion of the invasion of 1859. I find it very difficult to mate the significance of these cases. But in bringing them forward, I do not wish the jrence to be drawn that it is the rule for cholera to appear first in hospitals in the r succeeding an invasion, or that cholera necessarily reappears in a place in which cholera ients have been treated. The most deadly outbreak is not frequently succeeded by a )nd in any locality at the date when revitalisation is due, and when cholera does reappear i second year, it is while a general provincial manifestation is occurring ; but he is rise who, after the invasion of a barrack or cantonment, neglects to remove whatever ses may favour the retention of the vitality of the cholera germ, whether inside or outside the barrack walls. I The local reappearance of cholera in July and August after its distribution in spring, which requently occurs (see Tables, pages 78 and 203), suggests the important enquiry, how far the ressed cholera of May may be the very same materies which comes forward in our cantonits of Upper India when the conditions of the monsoon season are calculated to afford to a ilised cholera which has shown itself on invasion as little more than an aura the means of ibiting its presence in power ; and how far there may exist local causes determining whether invading cholera shall die or shall maintain its vitality until the season comes round when means of manifesting its presence and its vitality are afforded. The nature of these localiscauses must be studied in connection with the definition which I have given of the term lisation ; but I think it right prominently to notice the phenomenon in order that those who ird the emanations from cholera patients as a source of the poisoning of a locality may have r attention directed to the fact. t[ observe that a recent reviewer gravely reprehends the tendency of the work of Dr. Macon, as undervaluing the merits of disinfectants and the importance of the total destruction crupulous cleanliness in the removal of every particle of cholera excreta ; and he suggests is typhus dies out by heat and ventilation, so possibly in the hospitals of Calcutta may cholera it by dilution and dissipation, a phenomenon not perceived at home. We are told that one of facts is true of cholera in Lower Bengal, another of cholera in Upper India, and a third of tiolera of Europe. Primary and essential facts are unchangeable ; but aspects alter, and tes are apt wrongly to shape these aspects and to elevate them into a significance to which are not entitled. Conclusions derived from the alleged analogy between the typhus and ra poisons are essentally erroneous, I have had the opportunity of studying most carefully a very large number of typhus outbreaks spread over the last nine years. We can foretell to a week when smallpox and typhus shall die out throughout the length and breadth of Upper India ; and, far from there being any alliance between the poisons of cholera and typhus 216 FURTHER SUGGESTIONS RELATING TO THE MANAGEMENT OF THE OUTBREAK. [Section II- as regards their relations to the influence of the seasons, there is a direct antagonism when the statistics showing the results of the two epidemic agencies are placed side by side. A certain number of weeks of dry heat inevitably cuts short the most deadly and wide spread typhus, and as inevitably chains down cholera. It is only when the vehicle comes forward and after typhus is dead that cholera appears ; the typhus season of Upper India is from the end of October to the beginning of June ; the cholera season from July to the beginning of ctober. The great typhus epidemic of the past nine years has never yet managed to tablish a footing in Bengal Proper, merely because the climatology is inimical. It is arcely necessary to repeat, that the seasons in which the cholera hospitals of Calcutta are owded are those in which every facility seems offered to the propagation of cholera from man o man. The hospitals are filled at a season when cholera is universally in epidemic vitality and hen the air is damp and saturated from surface moisture and from frequent fogs ; and the act of the lower wards of the hospital being on a level with the chief cholera wards seems also alculated to afford every opportunity for the local diffusion of the miasm ; and yet the rrangement has been maintained for these fifty years because no evil results have been >served to follow. The reviewer appears to me to argue as if it were an established act that cholera excreta are the means of propagating cholera, and that Dr. Macpherson ught to have conceded this point. But in this country we do not hold, except as a leory, the transmission of cholera by means of the evacuations, although we recognise the estruction of such materials to be a duty incumbent upon all who are called on to treat cholera. It is a most unusual occurrence for our great cholera hospitals to become infected. The fact of its ever occurring at all has been absolutely denied by all who have had charge during the past fifty years of the great hospitals of Calcutta, general hospitals in which cholera patients are scarcely separated from others, from which cholera is never absent, and which in epidemic seasons are crowded with cases of the most malignant cholera. The infection of a medical officer or of an attendant on the sick or of the sweepers or washermen is a thing unknown. From first to last in these fifty years, this observation has been made by no careless observers, but by men whose position was in itself a guarantee for the highest intelligence. It is useless to suggest that the conservancy system is superior to a regimental system. It is not; on the contrary, greater liberties are used in general hospitals with cholera excreta than would be thought safe in regimental hospitals. Scriven who had the opportunity of observing cholera during some of the worst epidemic years in Calcutta in the General Hospital, confirms the experience of all his predecessors, and writes thus in his report to the Punjab Government on the cholera of 1862: — "I may sum up my own experience in the same way; and I had considerable experience of cholera during six years and a half at the General Hospital in Calcutta. It may be truly said that cholera is never absent from Calcutta, and at the changes of the seasons we used to have numerous cases of the severest kind. They were always treated on the south division of the large lower ward in the body of the building, which was not in any way shut off from the rest. I have often seen this ward full of cholera cases, with the attendants constantly employed among them, yet I never heard of any of them catching the disease, nor do I remember any of the other patients in the ward being infected. This southern part of the ward was so frequently filled with cholera cases that we never thought of taking any special steps to cleanse it otherwise than by ordinary washing, nor do I remember any facts occurring at the hospital that would have led me to think such a step was necessary/ I It must not be concluded that cholera never originates in the hospitals of Calcutta. It 10 very unfrequent occurrence for a patient under treatment for some other disease to be Idenly seized with cholera ; and I know that oftener than once during the past five years eral cases have come forward together in different wards and different buildings of the aeral Hospital. But this is an occurrence to be noted because of its rarity, and no one say with, certainty that it has resulted from poisoning of the hospital, seeing that h an occurrence has always been coincident with the epidemic prevalence of cholera in the I In conclusion, although lam not unwilling to believe that there may be a certain amount truth in the assertion that poisoning of a locality from the evacuations of cholera patients y occur, I cannot assent to the proposition that a community is always poisoned through rines, nor should I make it the basis or theory of action in leaving a cholera-stricken Ltonment ; and, above all, I would not trust to immunity being obtained or to the mortality eh lessened by the most perfect conservancy system. All the measures which I have mciated are means towards a good end, but their inefficiency is terribly evident. To me seems that none of these measures, nor all combined, grasp the one essential necessaiy to be ognised in the application of a remedy. llt is not my place in a paper on the natural history of cholera to enter into the question nagement of individuals affected f the frfta 1^ of a disease of the human economy. So olera. Dr. Murray's Report. lon g as but one-fourth, or, at best, but one-third of our European Soldiers who fall into the collapse of cholera survive, mere mockery to point to what has been done in the way of applying a direct antidote to the disease cholera. I am not prepared to say that all treatment is alike useless. Some methods of treatment are certainly more judicious and perhaps more successful than others. * For continuation of this subject see page 239. In the last chapter of the first section, I have traced the coincidence of the cholera of March 1868 of the regimental department of the General Hospital with the general cholera wave, of which the effects appear to have ceased over a wide area in Lower Bengal on 17th April. Dr. Murray, Inspector General of the Medical Department, has undertaken to tabulate and weigh the recommendations of those medical officers whose experience is wide and whose judgment is to be relied on as to what ought to be done and what ought not to be done during the progress of a case of cholera, and his report is now ready for publication. I Many suggestions have been made on the theory that it is possible to devitalise a virulent cholera. I have called attention to aborted cholera coming- Estimate of the value of disinfect. forward between epidemic visitations; to the western cholera of 1859, in which one died out of thirty-five; to the Oude lolera of the hot months of 1858, in which the mortality was one out of eighteen; and to ie eastern cholera of 1862, in which the mortality was very trifling. These I cited as nstances of natural decay occurring after the close of the normal life period of the epidemic, ie employment of disinfectants is, I suppose, related to a theory of artificial devitalisation. ut the measure is necessarily of very limited application, and when the assertions as regards s alleged efficiency are viewed in connection with the natural facies of the outbreak, the vidence in its favour will be found to be materially weakened. And when I regard the legations as to the results that may possibly follow disinfection, keeping in mind the width ' scope which I have admitted in defining what is included in the term "infection of locality," can form no very high estimate of the practical utility of disinfectants towards lessening ie intensity of the outbreak, even granting that all that has been said in their favour be true. tCan the cholera germ be devitalised in the economy before the setting in of collapse ? The jstion is associated with the possibility of the economy being braced up to resist the tendency succumb until the miasm decays naturally, which occurs within the eight or nine days owing infection, judging from a study of the typical outbreak. This question ought, I ieve, to be studied through the parallel of the malarious poisoning, on the principle that h is an air-conveyed miasm entering the human system through the lungs. As in the i case we know that the system may be artificially placed in a position to resist the manifestai of malaria in fever, so in the other there would seem to be the possibility of the repression the crisis which determines the manifestation of the disease cholera, and beyond which lies lapse and death. The general principles which should be accepted as fundamental in trying to determine THE VALUE OF PRACTICAL SUGGESTIONS. II believe that it is from a just conception of what the epidemic, the reproduction, and the ;break are in all their relations that the sanitary code applicable to the prevention or mitiganof cholera will in time be framed. If it has been found necessary in the preceding chapters efully to distinguish between cholera as a disease and cholera as an epidemic agent, not 3 carefully must the distinction be drawn in judging of the measures adapted to meet the demic and the outbreak. The physician and the epidemiologist see cholera under two aspects ich are very different one from the other, and each is perhaps inclined to depreciate the iect which is least prominently brought before him. But so perseveringly have the advoes for one view of the epidemic relations of cholera urged what they allege must be the ts in regard to cholera as a disease, that the physicians who treat cholera as a disease sink; their individual and aggregate experience, have been inclined to defer to the constantly eated assurances of the epidemiologist, that his study insists that cholera shall be regarded a communicable disease passed on from man to man. I The meaning of this I take to be, that as in the study of cholera as an epidemic, primary I secondary truths have been erroneously arranged one against the other in antagonism, so t harmony has been styled caprice, and the most perfect truths fallacies ; so in the study cholera as a disease the deductions from secondary truths have been exalted to the deprecial of those drawn from primary truths, and indeed to the ignoring of the latter altogether. The study of the outbreak has shown us how in the type and in the vast majority of all recorded cases, primary and not secondary truths influence Ketbods of meeting the outbreak ne f ac i es an( j duration, and how powerful are local condiatio by differenttheoreticalcon - tions in causing those very phases which are represented to be due to infection from a human source. If it be true that Blera is generally or very frequently a disease passed on from one man to another, the inition to be pursued is plain enough ; the same measures that are powerful to prevent the spread of typhus or smallpox are available against cholera Exemption will not he attained by — quarantine to prevent infection, space or ventilation to ortyphuT ithCllOlei ' a With SmallP ° X ensure diffusion of the poison, segregation of those affected, and the destruction of fomites and of everything emanating from the cholera stricken patient. Those, on the contrary, who are slow to believe that cholera is thus propagated successively in a community, and who yet are unable in their minds to dissociate the idea of cholera as an air-borne miasm multiplied in the soil, from that of its being infinitely increased as is the typhus or smallpox germ in the human economy, find in the infection of drains and common latrines from human emanations the nidus of the general infection of a body, and promise that when greater care is taken in preventing the las a miasm sown in our canton- introduction of the germ into these sources of local infection iduX Sh emanations from infected and when a system of dry conservancy is rigidly carried out, cholera shall cease to show itself in violent outbreaks ; and from a 3 h tilief in the danger and universality of local infection, abandonment of the spot in which cholera a once shown itself is the additional remedy which is suggested. Those who are not afraid to knowledge to themselves that, as a portion of the epidemic, the outbreak is too often inevitable, maintain that with change of locality, elevation, efficient The natural alliances of the miasm of drainage, a pure water supply, in short, by the use of all such oholera being with the miasm of mala- ap pii ances as are unquestionably efficient against the poison ria, the direction of the general mqa- X* . . , ,• n ? ¦< J i t, j- ••i_ V sures should in either case be the same, of malaria, the ratio of attack may be much diminished; they believe that, as the rule, the localisation of epidemic ILolera is apt to be proportionate to the existence of conditions favouring the localisation the miasm which causes malarious fever, making, however, a wide reservation for the stinctive character of the two poisons, and for the effects of monsoon influences which along ith their advance create for a time the conditions which determine the localisation of airrne miasmata ; and knowing from experience both of the cholera and malaria poison that a 3ality which has once been affected may, and in all probability will, retain the miasm r a certain number of weeks or months, they see in change to another situation the probability, t the certainty, of a degree of immunity which they could not expect in the place in which fection has actually occurred. Thus with the knowledge that the cantonment of Meean Meer Morar will on the occasion of an epidemic invasion almost certainly retain cholera from the mid-3 or end of July to the last week of September, a Regiment may quit either station after being •uck, with the assurance of throwing off the original cholera on or before the 12th day; thout any guarantee, however, that up to the last week of September it shall not be struck ew if still remaining within the natural province invaded. Those who have felt the influence epidemic malaria can well understand what is meant by such localisation; when the rer of October 1859 settled down for two months in the Gangetic Provinces, every indivial included in the area was aware of the fact that he was throughout the period breathing an nosphere impregnated with the fever poison. I There is no respect in which the cholera miasm is more closely allied to that of malaria n in this, that the reception into the system of either poison is not followed of necessity the diseases cholera or malarious fever. I believe that a susceptibility of the individual or class more to do with the aspects of the outbreak as regards gravity or mildness than has ever been pected. It is not alone the amount of the poison operating which fixes the ratio of attack, do the conditions of life alone determine that one body shall succumb while another ipes. The effects of race and of influences operating over and above the mere presence the cholera miasm will be treated of in the paragraphs which follow ; and all that ere written goes clearly to show, that the causes determining the ratio of attacks in the c with which we are more immediately concerned, namely, the British Soldier, cannot duly estimated if the idea be maintained that the ratio of attack is merely a question of local accumulation of a certain amount of the cholera miasm. In a cholera-tainted atmosphere the highest play of functional activity is required for the maintenance of the balance, and we know that, as the Kuses aggravating the ratio of at- ru l e^ the balance is maintained, and that cholera is not SSSSwrSZ^.* 1 * ™ iversal because of the presence of an universally distributed I nice between health and disease. ? . . .*_;. ? . «,i n i cholera- bearing atmosphere. It is discordant with all theory suppose that all affected by the cholera miasm succumb to cholera, and I believe that the r of the comparative exemption of certain classes, on occasions when the diffusion of cholera miversal, points to the grand principles on which the treatment of outbreaks will in the ure be conducted. Predisposition to succumb may be owing to many causes interfering h due performance of function ; — to the presence of the venereal taint in the system, ;he poisons of malaria or alcohol, to the disturbance in the economy caused by the seasoning er, to the effects of a barrack atmosphere tainted by overcrowding — to any cause, in short, ich by its operation is known to destroy the just balance between health and disease. I "We know that many a man would escape cholera, although thoroughly poisoned, were it not for the operation of immediately exciting causes. I ondary causes immediately excit- j iave noted severa i instances corroborative of the belief he attack of an individual or ? , . , ? , , , , , ? . „ un ity. which exists that when cholera is abroad the use of a simple purgative may determine an attack of deadly cholera ; I low of no case more typical than that already quoted which occurred in Her Majesty's i Regiment at Ferozepore on the same evening on which Umballa was so heavily struck tie first week of September in 1852. Dr. W. Walker very well expresses what I wish to trate, in the following sentence :—": — " Let any medical man cast up in his memory the fatal s of cholera which have occurred in his own practice amongst all classes of patients, and rill have it at once impressed upon him how many fell victims to a temporary lowering of r vital powers. In one case, it was the depression following the use of stimulants to ss that was the exciting cause; in another, the fatigue of a long journey, or of a ting excursion ; in a third, exposure to cold and wet ; in a fourth, confinement and watchby a sick bed ; in a fifth, mental depression from grief or fear of the disease itself ; in a i, (and this perhaps is more frequent than any other cause,) temporary weakness caused light diarrhoea, the result of indiscretion in diet." * * Keplies to Dr. Murray's queries, Appendix 11, p. 7. Chap, ni] THE OUTBREAK IN THE NATIVE AND EUROPEAN ARMIES CONTRASTED. 219 Statistics which profess to show that the temperate are attacked in an equal ratio with the intemperate misrepresent the actual state of matters. Dr. Murray is of opinion that Non-commissioned Officers and others accustomed to hahitual indulgence, who have the opportunity of keeping up the stimulus throughout the outbreak, are not so liable to succumb as the Private, perhaps not habitually given to exceed his allowance, who during the outbreak has the opportunity but once to drink to excess before a check is put upon him. It is in the state of prostration following the excessive indulgence that the attack of cholera is imminent, just as in the case of the orderlies alluded to by Dr. Bruce, who fell into cholera after the death and burial of their comrades ; lowering of nervous power from alcohol in a system which has been exposed to the influence of the cholera miasm implies loss of the ability to tide over the infection, and the result is cholera and death. We know how powerful is the effect of terror in regulating the ratio of attack from heat apoplexy. The disastrous retreat of the detachment of Her Majesty's 35th Regiment on the 22nd April 1858 from Jugdespore into Arrah is a case in point.* Very few men fell before the enemy, and fatigue and exposure might, even in the event of the expedition having been successful, have been the cause of some deaths ; but the actual ratio of attack was due to the influence of terror, and not to the degree of fatigue, exposure or heat to which the men were subjected. So with the cholera outbreak, a certain number of men will, under any circumstances, succumb when the cholera miasm is abroad, and local and domestic causes will influence the ratio of attack ; but we must not fail to recognise in causes affecting the integrity of the nervous system a very powerful means of multiplying the ratio. One of the very earliest cases on record pointed to this as a truth — the case of a woman at Musselburgh, in the first invasion of Scotland, who stood at her door while the funeral of a neighbour who had died of cholera was passing, who went into her house and was immediately seized with fatal cholera. Such cases can only be explained by the analogy between the miasmata of cholera and malaria, both showing the same phenomenon of latency in the system until certain circumstances determine the manifestation of its presence, or until the poison dies or is eliminated without its existence having been in any way indicated. What in the case of the malaria poison is shown as coldness, as rigor, or at the worst as blue collapse which yields to stimulants, is in the case of the cholera miasm represented by collapse and by death in the European Soldier, in from two-thirds to threefourths of all cases in which collapse has supervened. II think that it is quite essential that the varying aspect of the outbreak in different sses should be studied in this light. That it does vary is a sad truth. And indeed, as shall show, taking the European and Native Armies as types, the outbreak of the former s no representative in the latter class. In a single sentence, the object to be aimed at in the management of the outbreaks of the European Army is to endeavour to make Kiitio of attack in the outbreaks of them what they are in the Native Army. That the ratio of European and Native Armies con- attack or the death rate may be reduced in the European ' e( l. Avmv fn ¦Khnf, of f.Vifl Nnfivp Avmv ia flip Tit.mnst, +.Tin.f ie f.r» Vio Army to that of the Native Army is the utmost that is to be hoped for; and all our efforts should be directed towards It attainment of this minimum. That it will ever be attained is too much to hope, for I mot help coming to the conclusion that the influence of race and of personal habits is more verful in determining the invasion of cholera in any body than are the influences of al or even of domestic conditions. In saying this, I do not overlook the fact that on i march, and especially when crowded in country boats, the outbreak in a Native Regiment ss the aspect which it presents in cantonments, and that under such conditions the out>ak of the two classes becomes assimilated (see page 192). But to my mind, the inevitable iclusion from the tabulated experience of twenty-four years is entitled to the value of a r, and this conclusion is, that what we term the outbreak, that is, a general manifestation cholera in a certain body, is in the cantonments of our Presidency among Native Troops aost a thing unknown. I It is a mistake to suppose that Native Regiments in cantonments give no evilce of affection by cholera when the epidemic is abroad. Native Regiments are struck upon day just as the European Regiment is struck during the progress of cholera, and few lies of Native Troops escape on the occasion of an invasion. To take an illustration : rino* the epidemic of 1867, there were in the Punjab forty-seven different Native Regints, generally distributed over the province. The only cantonment which escaped alto;her was that of Dera Ismail Khan, a district which was scarcely touched, only eighty-three tths having been recorded among the population during the period of the prevalence of the demic. Out of the remaining forty-three Regiments only nine escaped infection ; and yet . acoregate mortality of the thirty-four affected bodies was but eighty-four men, an jra^e 5 of 25 for each corps. The only corps which lost above six men was the Ist Sikh "•iment at Kohat, in which, at head quarters and in detachments, fifteen men were KThe table which follows gives all the examples of regimental outbreaks in cantonments of tive Regiments, which it has been possible to collect from the records of the past fifteen rs, in which above ten men have been lost. Some even of these may not represent the * Three Officers and 101 men were lost out of a force which started in the morning with 150 men and five Officers. outbreak in a single body, since although appearing in one death roll various detachments affected during the same month may be included : — Fifteen years, 1854-68. Regiments of the Native Army which have lost while in Cantonments above ten men on the occasion of an outbreak of Cholera. 1854 Benares ... 50th Native Infantry Admissions 34 Deaths 19* 1856 Deyrah ... Sirmoor Goorkhas ... „ 82 „ 23 1856 Meean Meer ... 26th Native Infantry ... „ 40 „ '21 1856 Agra ... 44th Native Infantry ... ? 47 „ 18 1858 Furreedpore ... Kamroop Regiment ... „ 64 ? 36 1858 Abbottabad ... Huzara Goorkhas ... „ 19 „ 11 1858 Kohat ... 3rd Punjab Infantry ... „ 35 „ 16 1859 Cawnpore ... Ist Jezailchee Eegiment ... „ 89 „ 15 1860 Gondah ... 18th Punjab Native Infantry ... „ 16 „ 15 1860 Oraie ... Shahjehanpore Levy „ 20 „ 13 1860 Various Stations of Upper Assam ... Ist Assam Local Infantry ... „ 72 „ 35f 1861 {FeroSpo're } 19th Native Infantry (Goorkhas) « \\ » \\ 1861 Meean Meer ... 15th Cavalry ... „ 32 " 11 1862 Bunnoo ... Ist Sikhs ... „ ... „ 12 1865 Kherwarrah ... Meywar Bheels ... „ 29 „ 16 1867 Kohat ... 3rd Sikhs ... „ 22 „ 15 What this table teaches is very plain, and when it is read in connection with the table which follows, no one can, I think, doubt that it is to the solution of the problem which they offer that we must look if the death rate from cholera in the European Army of India is to be permanently diminished. From the record of fifteen years, sixteen cases alone are capable of being selected, in which either outbreaks or manifestations similar to outbreaks occurred. Of these sixteen eases three only occurred among men representative of the Native Army as constituted before the mutiny of 1857. In the great epidemic of 1856, I find that two Regiments lost, the one eighteen men and the other twenty-one men; and in the epidemic of 1861, one Regiment lost eleven men at Meean Meer. Again, in 1860, we find two Regiments losing the one fifteen and the other thirteen men, but in both cases in temporary cantonments, in which the men were probably living much in the same manner as in the field. Add to these the loss of Frontier Regiments at Kohat and Bunnoo, and the catalogue is complete for all men of the plains — Hindoos, Sikhs, and Mussulmans. Kohat occurs twice in the list; in 1858, when the Regiment lost sixteen men, and again in 1867, when fifteen men died. In 1862, the Ist Sikhs lost ten men at Kohat, but this mortality was included in three outbreaks between the Bth June and 12th October. The persistence of cholera for so long in 1862, and the severity of the cholera of 1858 and 1867, point, I think, to the effects of the same geographical peculiarity which I have alluded to in speaking of the persistence of cholera in the Peshawur Valley, namely, the retention of cholera by the frontier hills and its consequent subsidence in great volume into the adjoining Kohat Valley. Of the eight instances remaining out of the sixteen tabulated, the effect of race is shown as in the case of the European ; four occur in Goorkha Regiments ; two in the mixed races forming the Assam and Kamroop Local Regiments ; one is the case of the Meywar Bheels ; and the last, that of the Jezailchee Regiment, composed of frontier hillmen. The following table shows the results of the great invasion of July 1856 in the Meerut Division ; it illustrates the truth that the outbreak among Native Troops is but the shadow of what it is among Europeans. (For contrast, see table for 1856 in Appendix) :—: — Native Army of the Meerut Division in July, August, and September 1856. Strength 12,340, Loss from the invading cholera of the year. "ffi^tiSSK'BS^S? 1 ' X—K — G^ kha ™ta.ion ( «• July 4th 1 August 14th 1 „ 12th 2 * * * „ 16th 1 „ 18th 7 „ 26th 1 „ 20th 2 „ 27th 1 „ 21st 3 „ 30th 1 „ 22nd 1 31st 1 „ 23rd 3 Aug. 2nd 1 „ 24th 1 „ 4th 1 „ 25th 1 7th 1 „ 26th 1 „ 10th 1 „ 27th 1 „ 21st 1 „ 28th 1 Sept. Ist 1 .. „ 30th 1 The seventeen deaths of the Regular Regiments were spread over the entire period of the vitality of the reproduction, and over nine different corps. It will be observed that in the case of the Kumaon Goorkhas the outbreak has the facies of the type. * A typical outbreak from 17th to 29th May j see note to page 42 of Appendix. + Head-quarters and all out-posts suffered; this, therefore, does not represent a regimental outbreak. The constitution of the Local Assam Regiments is peculiar, from the large proportion of Goorkhas and men of races other than those which go to form the ordinary Native Regiments. 220 Lit must be understood that there are no examples of the converse of what is shown in this statement, viz., that Native Troops in cantonments have suffered severely while European Troops in the same cantonments have escaped with trifling loss.] Number or admissions Pbofoetion eelative to AND DEATHS* KTBJiNGTH. STATION. Year and month of outbreaks. Strength at date of the invasion. — c ss t r gng tni 'le strength. °** °affe < cte < d'. C Treated. Died. Treated, Died. __ , _ _ , . - — , „ J , 1O ._ ( European Troops ... 1,944 145 66 1 in 13 1 in 29 Europeans 74' 58 Europeans 33-95 Europeans 45*52 Cawnpobe... ... June to September 1845 ... -j Native Troops ... 5,451 62 24 1 in 88 1 in 227 Natives... 11-37 Natives... 440 Natives... 38-71 f European Troops .. 2,1)54 143 85 1 in 21 1 in 35 Europeans 48*41 Europeans 2877 Europeans 59*44 Meeeut ... ... August and September 1845 | Native Troops ... 8,274 7 4 1 in 1,182 1 in 2,069 Natives... "85 Natives... -48 Natives... 5714 _, , , im C European Troops . 2,139 385 204 1 in 6 1 in 12 Europeans 157*85 Europeans 83*64 Europeans 52 - 99 TJmballa ... July to September 1840 ¦•• | Native Troops "... 7,358 111 62 1 in 66 1 in 119 Natives... 1509 Natives... 8*43 Natives... 55*86 ( European Troops 948 84 54 1 in 11 1 in 17 Europeans 88 - 61 Europeans 5696 Europeons 6428 Loodianah ... July to September 1845 ... j Native Troops ... 4,466 38 12 1 in 118 1 in 372 Natives... 8-51 Natives... 2"69 Natives... 31*58 f European Troops . 1,130 82 39 1 in 14 1 in 29 Europeans 7257 Europeans 34*51 Europeans 47*56 Feeozepoee ... June and July 1845 ... | Native Troops ... 6,530 54 17 1 in 121 1 in 384 Natives... 8*27 Natives... 2*60 Natives... 31*48 f European Troops 1.986 140 69 1 in 14 1 in 29 Europeans 70 - 49 Europeans 34*74 Europeans 49*29 Umballa ... ... September 1852 ... | Native Troops ... 3,135 15 4 1 in 209 1 in 784 Natives... 4*78 Natives... 127 Natives... 26*67 C European Troops 1,009 280 195 1 in 4 1 in 5 Europeans 27750 Europeans 193*26 Europeans 69*64 Cawnpoee... ... May to August 1853 ... ( Native Troops ... 2,626 57 25 1 in 46 1 in 105 Natives... 21*71 Natives... 952 Natives... 43*86 (besides details). . _ . , „_. ( European Troops .. 1,594 501 271 1 in 3 1 in 6 Europeans 314*30 Europeans 170.01 Europeans 54-09 MeeanMeee ... August and September 1856 | ¦$ a fij c Troops ... 3,024 104 41 1 in 29 1 in 74 Natives... 34*39 Natives... 13*56 Natives... 39*42 C European Troops 1,013 200 134 1 in 5 1 in 8 Europeans 197*43 Europeans 13228 Europeans 67*00 Feeozepoee ... August and September 1856 £ Native Troops ... 2,120 37 17 1 in 58 1 in 125 Natives... 17"45 Natives... B*o2 Natives... 45*95 r European Troops .. 1,600 79 43 1 in 20 1 in 37 Europeans 4938 Europeans 26*87 Europeans 54*43 Meeeut ... ... July and August 18ofa ... | Native Troops ... 2,598 20 10 1 in 130 1 in 260 Natives... 7*70 Natives... 3*85 Natives... 50*00 C European Troops 980 206 98 1 in 5 1 in 10 Europeans 210-20 Europeans 100*00 Europeans 47*57 Agha .¦. ••¦ June and July 1806 ... | Native Troops ... 2,897 91 34 1 in 32 1 in 85 Natives... 31*41 Natives... 11*73 Natives... 37*36 f European Troops ... 905* 66 46 1 in 14 1 in 20 Europeans 72*93 Europeans 50*83 Europeans 69*70 Lucknow ... ... June and July 1806 ••• | Native Troops ... 8,312* 1 1 ... ... Natives Natives Natives C European Troops ... 1,804 50 23 1 in 36 1 in 78 Europeans 2771 Europeans 12*75 Europeans 46*00 Baeeackpoee ... August 1859 ... ... | Native Troops ... 1,312 3 1 1 in 437 1 in 1,312 Natives... 2"28 Natives... 76 Natives... 33*33 C European Troops . 1,623 113 70 1 in 14 1 in 23 Europeans 69"62 Europeans 43*13 Europeans 61*95 Dum-Dum... ... August 1859 ... ... | Native Troops ... 236 ... ... ... ... Natives Natives Natives !«/.« C European Troops... 1,237 113 59 1 in 11 1 in 21 Europeans 91"35 Europeans 4770 Europeans 52*21 Agea ... ... August and September 1860 | Native Troops ... 570 7 5 1 in 81 1 in 114 Natives... 12*28 Natives... 8-77 Natives... 71*43 oo c European Troops... 1,083 155 77 1 in 7 1 in 14 Europeans 143*12 Europeans 71*10 Europeans 49*68 M Moeae ... ... August and September 1860 I Native Troops ... 1,412 10 6 1 in 141 1 in 235 Natives... 7*oB Natives... 425 Natives... 60*00 f Eurowean Troops... 380 50 24 1 in 8 1 in 16 Europeans 131-58 Europeans 63*16 Europeans 48*00 Muttba ... ... August and September 1860 | &^ 0 Troops ... 560 3 1 1 in 187 1 in 560 Natives... 5*36 Natives... 179 Natives... 33*33 ? Ouile Field Force. 221 222 LOSS OP EUBOPEAJT ASTD NATIVE REGIMENTS IN CANTONMENTS CONTRASTED. {Section 11, Comparative Statement oj the Loss of the European and Native Regiments cantoned in the same Station in the Invadino Cholera Emdemic of Into VM « ,w« i NUVBBB OP ADMISSIONS PEOPOETION BELATIYE TO STATION Year and month of out b rea k . Strength at date of the in^ion. EIBEN ° IH - Affected per ?000 of Died per ?000 of Died out of each !00 strength. strength. affected. Treated. Died. Treated. Died. **""' August and Sfp te m ter 1860 J E^PennT,^ 005 32 13 } j" » 1 in 47 Eujppea™ »» W 2149 Europeans 4062 U5 ™"" July and A ng »stlB6l ... j few*" 'I 1 ! J S^ SS-SIS^JS-ii r ame I1 9PP S ••• 795 2 1 lm 397 1 in 795 Natives... 2"52 Natives T26 Natives SO-00 MEEEUT July aM August 1862 ... g^^P-- f% & ¦ } m 40 1 in 64 Europeans 25-23 Lt^ans 16-S Sropelns SS ¦»r v r £ atlve lr^P s ••• 7 2 lm 158 lm 551 Natives... 635 Natives 1-81 Natives 28"57 Hnuirlbß. ... August and September 1862 { gSSrW^ '" 7 « } 12 1 m 22 Europeans 83-54 Europeans 4fiS Euro^ans 54-48 tt r iioops ... 614 11 6 1 m 66 1 in 102 Natives... 1791 Natives 9-77 Natives 54- ( 5 ( > UMEITBIIE Au gg u S ta n d September 1862 { JJ» 3J3 J « J» » 1 in 40 Europeans 49-34 S^s 24-67 E^i SS — August and September 1863 j E^^ "g * « i£ S^s g^ 20 S £^ LUCKNOW July and August 1863 fS? 3 « } !! n '^ 1 p'" 142 Solans 14" 90 Europeans 706 I^opelns 47-87 t hoops ... 1./17 8 2 1 in 215 lin 858 Natives... 466 Natives... 1-17 Natives 25-00 A « EA July and August 1863 ... JfejJSS!*'"' 'S 32 .. T 21 1in351 in 63 Europeans 28"7O Europeans 18-88 Euro's SS < Aative Tioops ... 704 None. None. ... J ... Natives | Natives Natives Chap- Hl.] LOSS 0F EUROPEAN AND NATIVE REGIMENTS IN CANTONMENTS CONTRASTED. 223 I Native Troops ... 1,527 1 1 ... ... Natives... "65 Natives... '65 I Natives ... A rnnmn Antriicflßfi 1 ? $ European Troops ... 9i2 28 18 1 in 34 1 in 52 Europeans 29*72 Europeans 19-11 Europeans 6428 Allahabad ... August i»o/ ... ... | Native Troops ... 552 7 4 1 in 79 1 in 138 Natives... 12-68 Natives... 7*25 Natives- 5714 ut their villages. Altogether Sumbulpore is as thickly wooded as probably any cultivated trict in India, and in this respect it is the very opposite of Raepore." " Now, it is well known that cholera rarely, in most instances never, visits any of the villages of Sumbulpore which are off the main line of communication, and if it does come, it is in the mildest form, and the reason of its ever showing itself in the villages on the main road is, that ( as in the present year) *it is brought by pilgrims returning from Cuttack and Pooree." I" In Belaspore, cholera, when it does break out, is bad enough, but still its visit>ns are not so frequent, nor is it of that very deadly form which it assumes in the plain Raepore, where, in the course of three or four days, it sweeps off sixty and seventy per t. of the inhabitants of a village. Not even in the time of the great plague was there such rful mortality as I have known here." I" The Sumbulpore Road runs through jungle (which about Petora and the Jbnk River somes very dense) for about sixty or sixty-five miles. Now, it is a remarkable fact, but no 3 a fact, that even on the main road, which is traversed by hundreds of travellers, carts, 1 pack bullocks, cholera rarely shows itself in the length of these sixty miles, and if it !S show itself, it is very mild indeed ; but if we take the section of the road from Arung stwards to the Chicholee bungalow, about ninety miles, which traverses a bare treeless in in all its length, we find cholera present every year in its worst form, — the dying 1 the dead lying about the road, and convoys of carts with half their drivers gone." I" One more fact I would state as the result of my investigations, and that is, that in ages which are closed in with those large and magnificent groves we occasionally which stand in a low and probably a swampy situation, surrounded by hills, and eh, owing to the quantity of decayed vegetable matter about, are especially feverish in Member, October, and November, are rarely visited by cholera, and when it does come, re are but few deaths, while villages, which stand on high ground, or on what would considered a fine bracing situation, which, being free from foliage and hills, are thoroughly tilated, appear to suffer most from cholera." I" Why thick foliage round human dwellings should be a preventive or a partial preventive jholera is a matter which I must leave to others to ascertain. Ino longer doubt the fact ; . being convinced, that it is a partial preventive, I avail myself of this opportunity to lay result of my observations before the Chief Commissioner, who, I trust, will be pleased to port my recommendation to grant land revenue-free to agriculturists, who will plant yes in their villages. "f But the necessity for some measure adequate to cope with air-borne or soil-generated causes of disease is recognised in the fact of the general adoption throughout Upper India of lofty double-storied barracks, and it will be fortunate if the same results follow as have followed in the case of Fort William, where cholera has scarcely intruded during the past seven years. Fort William, European Garrison, seven years, 1862-68. 1862. 1863. 1864. 1865. 1866. 1867. 1868. S3 £ g» Jb a> so* Strength ... 880 745 790 789 861 739 858 1 I^3 Jj Admitted ... 7 5 7 0 4 3 2 }¦ § 'f-'S * • Died ... 6+ 4 2 1 2 2 2§ J |2-|| Until the new barracks of Upper India have been tested, it would be premature to conclude that their elevation will raise the occupants above the cholera-containing stratum * This is the theory of the writer ; in 1865 the same cholera was universal from Pooree to Abyssiuia. f Report dated May 23rd, 1865, Central Provinces' Gazette, December 22. j Excluding the deaths after arrival of the Wing of the 92nd attacked in the Sunderbuns. § Besides these, three men were attacked in the General Hospital, a mile distant, under circumstances which showed that the cholera could not have been acquired in the fort. 225 THE AIB STRATUM CONTAINING THE CHOLERA AND MALARIA MIASM IS THE SAME. [Section JJ, 226 of air. And while the results obtained in the case of Fort William are very hopefuj, we must not forget that the cholera season in Upper India is not the cholera season in Lower Bengal. When the maximum of moisture is attained, cholera is generally nearly extinguished ii epidemic in Bengal, while it is in full career from south-east to north-west in the north, broad-fronted cholera of the monsoon is not a ground-seeking and insidious miasm, and we pite entitled to infer that the depth of the air stratum in which it is conveyed will be found me degree proportionate to the width of its lateral extension. In the epidemic of malaria of end of 1859, I found that the elevation of the fort of Buxar (about forty feet) sufficed not •event the attack of malarious fever, but to alter its type. Every ease which occurred lie Naval Brigade occupying the fort (and every man suffered), was a case of purely mittent fever, while in the detachment of Her Majesty's 6th Regiment, occupying horary barracks on the ground level, every case, both in officers and men, assumed remittent type, passing in several cases into continued fever and ending in death ; and ;ype in the Ghazeepore cantonment, thirty miles distant, was the same. That elevation mitigate, if it does not prevent the attack of cholera, is extremely probable ; and no one leny the expediency of providing the degree of elevation which it is designed generally to 1, whatever may be his theory. It is the diminution of the ratio of attack that is aimed he possibility of affording locally such conditions as shall place the soldier beyond the of the ground-seeking miasm altogether, or place him in a stratum of air so diffusely sgnated by the miasm as to be powerless to affect either the individual or the regiment as ly. This seems to have been attained in the case of Fort William, and the European er, though given to frequent the cholera infected bazaars of Calcutta, appears to be now placed as regards liability to attack on a footing with the population of Chowringhee. In the Sanitary Report for 1867, attention was drawn to the fact that the circumstances of our prisoners while they laid them open to the invasion and spread of typhus did much to shield them from malaria and cholera ; the high walls screen the enclosed buildings, and in place of night guards, we have the heavy damp night air shut out from the dormitories of the prisoners. When invasion of our great jails does take place in Northern India, the attack is too often adapted as regards its strength in relation to the very same conditions, and cholera spreads as if contagion were going on from man to man. It is during the night, or in the early morning, that men seem to be infected, and hence night guards should be dispensed with as far as possible, when epidemic cholera is abroad. The effects of night air and damp encamping grounds was remarkably illustrated in the attack on Her Majesty's 79th Regiment, while marching in the end of 1866, from the Punjab towards Delhi and Roorkee. The intermittent was of a most pernicious type, nearly universal, fatal in. itself, and serious in its sequelae. I have called attention to the fact, that the women and children did not suffer, with the exception of a single family, the family of the Canteen Sergeant who preceded the Regiment daily in order to have coffee ready for the men at the end of the march ; the exemption of the families was attributed to the fact of their following the Regiment after daybreak, and of their not arriving until the new encamping ground was thoroughly dried by the sun. What are called good sanitary conditions are not of themselves calculated to ensure our men against cholera. If it be true that cholera is air-borne and conveyed in the purest of all aqueous media, the conditions requisite for human infection are produced at the same time with epidemic advance ; and hence local measures can be only comparatively successful, and are not absolutely calculated to avert the consequences of invasion. I see no occasion to look to impurity of the aqueous medium as of supreme consequence, and the search after special I.tamination, when every foot of grass covered plain may retain the miasm, decoys the id from the simple truth. Let us never lose sight of the plain truth, that the reproduction not be prolonged, and that the outbreak of a body has a normal limit in time which is y exceptionally prolonged. Let the results of our endeavours be read in this light, and shall have less seldom occasion to dispute the assertions, that local measures have proved quate to cope with an invading cholera. We know well that some stations are worse than ers because of their natural disadvantages, but we know also that in the very best, General itation has not availed to prevent cholera.* Had general sanitation been found efficient, the necessity for movement from our canton- ments would never have been recognised. Not but that elevated The manifestation of the effects of situation and good drainage are very powerful in preventing the of localisation of cholera. < Cholera loves to abide in excavations, moisture afforded. and tor any given spot it is m the lowest stratum of air that the cholera miasm is to be found. When air-conveyed, cholera may I* Our stations of exemption owe their exemption to their geographical situation or to their elevation, Rawullee, Campbellpore, Nowshera, and Sealkote are stations very nearly exempted in consequence of their position beyond \axy influences. I cannot affirm that a genuine case of cholera has originated in the Bawulpindee cantonment ur time. No case of cholera has ever been returned from the Campbellpore cantonment since its occupation in B, and the nearest approach to the phenomenon of infection occurred in 1867, when nine men in one barrack were lltaneously affected with febrile symptoms which passed off with violent diarrhoea ; I have very little hesitation in ibuting these symptoms to the cholera miasm which was general throughout the Punjab at the time. Nowshera had no violent outbreak of cholera since its occupation ; it was, however, touched in the three years of secondary sion, 1858, 1862, and 1867, but on each occasion two men only were lost. Sealkote lost ten men in the secondary ision of 1862, and in 1867 some of the women and children were affected, but no man died. Of the comparative nption of the hill stations and of Jullundur and Bareilly, I have spoken in the fifth chapter of the first section. Cbap- 111 J RATIO OF ATTACK PROPORTIONATE TO THE MASSING OR OPENING OUT OF BODIES AFFECTED. 227 Pon a level so far above the earth as to leave no trace of its progress In its advance, and may ike the hills while it leaves the plains untouched j* but whether it be on an elevated plateau, the plains of Upper India, or in the swamps of Lower Bengal, it is the ground level that is to t>e dreaded, because upon it broods the cholera-bearing stratum of air. I have shown the enormous influence of moisture on the affection of a great provincial area. I have stated how in the nine years 1858-66, fourteen deaths only had occurred in the cantonments of the western area in the months from January to June inclusive ; while the deaths of the three months, July, August, and September, were to be reckoned not by units but by thousands. The meaning of this is not to be questioned. Provide cholera with a vehicle of moisture and instantly it appears in epidemic life and endowed with locomotion ; remove the vehicle and cholera is dormant and powerless. So it is with the malaria miasm ; the phenomenon of repression is marked precisely as in the case of the cholera miasm. To the sound and acclimatised constitution no season is more healthy than the months when the hot west winds blow; for then, no country in the world is more free from malaria than are the plains of the north-west of India. Our Native Soldier does not live under sanitary conditions superior to those of the British Soldier. His hut is small and badly ventilated, and it The disparity of ratio between the i§ no t raised above ground level ; his water supply is from European and the Native Soldier is nearegt tank d hig n j v dutieg are mQre Q neither altogether due to domestic . > . ° „ . . . . ' arrangements nor to race distinction. especially during the prevalence ot the outbreak. It is on the domestic differences of the two classes that the theories I warding the disparity are founded. One traces exemption as due to resort to the plain, ributing the cholera of the British Soldier to the use of general latrines ; another to the lividualisation of the chance of infection by the sub-division of the aggregate body into as ,ny separate bodies as there are sub-divisions in the regimental lines. From the experience 1867, it was impossible to tell whether the use of general latrines by Native Regiments 1 any effect in determining the extent of infection ; and it is remarked (Sanitary Report, 128), that, as the rule, in all stations, Native Soldiers are not now allowed to resort to the The sub-division of the Native Regiment as a community into very numerous items, is probably one, although certainly not the sole, cause of the Ihe effect of the sub-division and of smallness of the ratio. The great disasters to Native Regimassing of bodies in determining ment on h and Qn board boatg when magsed ag a racies ot the outbreak and the .. „ ?, , , ? . ? ? ? p ? )of attack. community, forbid us to conclude that the disparity or ratio is solely a race distinction; since they show that, under different conditions, the Regiment, an exempted body in cantonments, may succumb as a body. It may be the infected air stratum of an encamping ground that places the Native Regiment under one common influence ; or the crowding on board boats may cause an artificial stratum of impure air over the occupants, of sufficient power to place those living within it in circumstances unfavorable for throwing off the miasm imbibed. Thus, when a Regiment moving by boats makes a halt below a river bank known to be infected, cholera does not blaze up suddenly (see table, p. 192). The men return on board, and for the whole twelve or thirteen days following there is a steady coming forward of the disease, sometimes in outline, sometimes in substance, according to the varying conditions. This seems to me the type of the outbreak in our European barracks and central jails. Liberal as is the allowance of cubic and superficial space in our European barracks it is not sufficient in the event of an epidemic ; and sub-division cannot be carried to the same extent as in the case of the Native Troops, — an extent sufficient to individualise the chances of attack. This facies of the outbreak calls imperatively for the opening up and ventilation of every infected body, and where barrack accommodation with sufficient elevation cannot be given on a scale extravagant and uncalled for under ordinary circumstances, the alternative seems to be the use of temporary habitations. What is to be aimed at is the removal of the barrack atmosphere or the atmosphere which covers the sleeping body of prisoners within the walls of a great prison, since we fear that what from the fact of infection must come forward in outline may be filled in in substance, and that an outbreak which might have been represented by ten cases during the normal sixteen-day outbreak, may come to be multiplied by ten or twenty during the same period of typical prevalence. Ido not coincide in the views of those who would assert that the phenomena characteristic of these outbreaks are due to contagion ; but except in theory it matters little whether we regard this multiplication of ratio as due to infection from man to man, or not. While believing both causes to be efficient in increasing the ratio of attack, I feel inclined to attribute less to the increase of the miasm in impure and damp air, than to the deterioration of the economy of each individual, with increased liability to succumb from living under such conditions of community. It is as a community that the prisoners of the central jails of the North- Western Provinces suffer on occasion of nearly every invasion. I* I refer to the occurrence of cholera at Kussowlie and Dugshaie in the last week of May in 1865, which was cative of the epidemic presence of cholera in Central India and south of the Jumna. Something very similar, laps identical, has happened in this year (1869) ; the appearance of cholera in the Agra and Morar Districts in the of May was followed by the occurrence of several very suspicious cases at Simla early in June, and now (June 21st) appearance of cholera is reported among the coolies working on the road in the interior of the hills twelve marches beyond. Central Jails of the North-Western Provinces. A Statement to show the danger of community of infection. 1866. 1860. 1861. 1862. 1863. 1868. _ , . CBHTBAt JAIH. .a "g A ¦% 5 "2 4 "S 4 "t 4 "t tc ~£ So £ be a tc£ 6b£ to£ Agra 3 632 582 234 2,080 I 816 | 175 2,688 193 67 2,5-tl 23 I 12 2,409 114 46 1,933 | 32 I 20 Meerut 941 148 90 "1 2,189 670 335 1,312 None ~) Barellly . 2 244 144 65 > No epidemic ... 1,171 12 5 1,768 None. SNo epidemic. Lahore 2^454 484 244 J 2,101 1 ... 2,109 94 I 41 J I would not have my views on this important subject misinterpreted, for I would sacrifice any theory rather than that the belief that cholera is incapable of increase in a community by multiplication in the moist air covering- a body of sleeping- men should be made the excuse for the neglect of practical measures which mig-ht seem to take their direction from such a theoretical basis. There is probably no nidus so favourable for increase as the moist air laden with the exhalations of human beings, and such examples as those above quoted seem to teach that the extent of infection is nearly always proportionate to the number aggregated and to the extent of overcrowding. The phenomenon of infection of a community does not imply that the contagion is from one man to another, except in cases which in this country are exceptional. It is not the aggregation of a certain number of individuals affected with cholera that forms the cholerabearing atmosphere. We have decisive evidence to the contrary in the records of our cholera hospitals. If a cholera-bearing' atmosphere is anywhere locally formed, as within the walls of a great jail, the impregnation is caused by the increase in a suitable nidus of the invading g erm — a nidus derived generally from the massing of individuals, and the artificial creation of a stagnant, moist, and impure atmosphere. But no conclusion can be justly formed regardingthe alleged facts of local infection if what I have formerly urged be not recognised as true, that the air of a locality may be poisonous not from the fact of containing cholera poison, for it may contain none, but only in as far as its impurity interferes with due elimination, and hence causes the coming forward of the symptoms of cholera in cases in which we know that with, better opportunities for the full exercise of vital function the effects of the imbibed miasm would never have become developed at all.* A body with a certain amount of cubic and superficial space might escape, while, with the half, cholera might become general throughout it. The case of the Artillery at Cawnpore in the great cholera of 1853 seems a case in point. While the cholera of the 70th Regiment was in progress the Battery escaped altogether; and when it was considered necessary to take up more room in barracks for the Regiment the Artillery Company was doubled up into half the space previously occupied. Cholera immediately broke out and twelve men died out of a strength of sixty. IThe rarity of cholera in the European quarter of Calcutta, except where special conditions n to have localised cholera, f shows how much the risk of attack is diminished when space ibundantly supplied both in and around the dwellings of Europeans. The following is example of the converse. Surgeon Boyd, 90th Regiment, writing from Subathoo on May 1867, remarks :—": — " The fact has particularly forced itself upon us that the cases which r e hitherto occurred were brought from barracks, old, badly situated, ill ventilated, and ;ady condemned ." IThe deadness of the atmosphere, so often observed in this country during the great outaks of the monsoon season, denotes probably that the constitution of the existing atmosphere ot altered by the substitution of a fresh atmosphere, and no condition can be more favourable the local spread of such a pestilence as cholera among any population than that which is aished by a dead moist atmosphere. IThe following case was related to me by the officer who was the orderly officer of the when the outbreak of 25th August 1862 occurred at Meean Meer. Being new to the ion, in going the rounds during the night, he and his party deviated from the road, and le halting to determine their position, the stillness and deadness of the air was such that perspiration from the horses could be heard dropping on the ground. He made the ark, that it was on such a night as this that the outburst of cholera, which had already in warning of its presence in the station by a death in the 19th Regiment on ]4th August, to be dreaded. On returning to their quarters they were informed of the outbreak, eh within two hours was widely spread through the cantonment. At page 185, the 3t of this outbreak in Her Majesty's 19th Regiment is tabulated. Upwards of fifty t were lost during the period of the typical outbreak; and 38 of these deaths occurred lin the first five days. »* Dr. Wise made the observation that those of his men succumbed most readily to fever whose beds were most vourably placed in regard to the air supply ; he observed that those who breathed during the night the air ;h was most vitiated were the men who were far more liable than others to yield to the effects of the fever poison. t Macpherson. Cholera in its home, 1866, p. 22. The localities noticed have been twice affected since, in the epidemics of 1866 and 1868. 228 Yet again there remains to be considered the effects of race. The distinction is a true one, putting aside any minor considerations regarding domes- The ratio of attack during the out- tic relations. Whether the Goorkha be placed in his native break in relation to the race of the hills, in Lower Bengal, or in Upper India, he suffers from hoAv or community affected, lne r 1 j i xv i> n i •¦• ,-, Goorkha. cholera, and he suffers from smallpox, while the natives around him escape. His economy brings to maturity the miasm or the virus of infection, which is dissipated or wears itself out in the economy of the native of Hindostan. It is in our Goorkha Regiments alone that smallpox appears as an outbreak. Jameson did not trace to its true source the great cholera outbreak of the Sirmoor Goorkhas at Deyrah in 1819, when he attributed it to the fact of the medical officer in charge being seized at the same time. Out of a body of 900 men, the seizures were 113, and the deaths seventy-four ; and in the lines seventy-three women and children were cut off. In the epidemic of 1856, the Kumaon Goorkha Battalion at Deyrah lost twentysix men, and at Deyrah, Ferozepore, and Umritsur, it was the Goorkha Regiments alone which suffered in 1861. * It was a Goorkha Regiment (the 66th) which was struck in the Terai in March 1857, with a loss of fifty-six men ; and in May of the same year, the Nusseeree Goorkha Battalion on the march had sixty-four attacks and twenty-six deaths. It was the Goorkha Company of the 9th Native Infantry which was selected for attack in December 1863 while the Regiment was marching from Fyzabad to Lucknow. It was the Goorkha Police Levies which suffered so much in Lower Bengal after the Police Force was formed; thus in 1859, we find the 3rd Police Battalion losing fifty-six out of seventy-nine men attacked. The fact is, in short, universally true, that the Goorkha constitution localises cholera as it localises smallpox. The Goorkha seems to succumb even when the danger to the population generally has passed. Thus Dr. Buckle, in his report on the outbreak in Huzara in 1858, writes :—": — " As far as concerned the station generally (Abbottabad) the attack of cholera was over before the end of July. Yet cases were constantly occurring in the Goorkha lines, especially on their being re-occupied by parties returning from duty on out-posts." I The questions well deserving of the deepest study are, the circumstances which localise lera in the Goorkha, and how far the European is subject to the same influences. It is no purpose to trace the distinction to peculiarities of lines or latrines, seeing that the ratio of icks is equally excessive on the march. We know that the habits acquired in their ive hills render the Goorkhas far less punctual in their ablutions than the men of Hindostan, that the power of elimination in the Goorkha due to functional activity is not to be compared ;hat of the sepoy of the plains, whose system has acquired it by birth and retains it by y habit. In his food also the Goorkha is not so scrupulously careful as the sepoy of the ;ns. In the case of the Goorkha Company of the 9th Native Infantry, the bad quality of the 1 was particularly remarked on. On this subject Dr. Brown, of the 4th Goorkha Regiment, tes in his report for 1861 : — "Their diet is under no supervision; and, being Hindoos, their 1 must not be inspected by men of another sect ; I hear them say of each other that the lity of their food is very inferior. The Goorkhas prefer fish and vegetables, but when y cannot get fish in the markets they will eat goat's flesh : generally speaking, however, it s the inferior parts of the animal only which they use, and in order to save the expense of vegetables they use but little. Wheat flour is their staple food, to which a little da.l is sometimes added; these, to begin with, are generally of inferior quality, and are made still more unwholesome by careless and imperfect cooking ; they grudge the expense of the wood for the fire, and to save fuel the remains of the evening meal is eaten cold in the morning, and, in the meantime, the metallic flavour from the utensil in which it has been kept through the night, has penetrated the whole of the food." All this, however, is probably secondary to the effect of race considered per se, and I should consider it as of little weight in determining the radical ground of distinction. Besides, from the great care bestowed on the food and water of the British Soldier, we have almost ceased to think of the outbreak in connexion with such possible sources of evil. The loss of the different races in the Epidemic Area of 1861. bi..m«-. Europeans. Goorkhas. Hindostanees. Stations. Strength 11,898. Strength 1,447. Strength 6,172. Deyrah ... ••• ••• ••• »•• 7 ... Ferozepore ... ... ••• ••• I 34 ... MeeanMeer ... ... ... ... 479 ... 16 939 52 32 Died per 1,000 ... 7892 35-94 5-18 EThe same 19th Goorkba Regiment lost sixty men from smallpox in the eighteen months preceding the cholera ik. 229 But looking at the preceding statement, we cannot affirm that the British Soldier . „ is even on a footing* with the Goorkha. I fear we must add J%i^£S£!S*& X *&£ to the physical defects of some of our stations to that community which is apt to multiply the ratio of attack, and to effects of race, the deterioration of the system by climatic influences and by personal habits. It is the loss of the balance that makes the difference between exemption and the attack of cholera, and it is too true that the balance is apt to prepon- ITie loss of balance due to the same ,j era te in many ways against the European Soldier. The h» which originate climatic diseases. European ss o idi e r taken as an individual is not in this country ypically healthy individual as the sepoy in the plains of Upper India certainly is ; nor is the itish Army of India typically healthy as is the Native Army taken as a body. It is the c that the European Soldier suffers from climatic disease from which the Native Soldier does ; suffer at all, because his constitution has been for generations adapting itself to the jumstances of the climate. The acute dysentery, the hepatitis, the pure heat fevers, I the heat apoplexy of the European Army have no counterpart in the Native Army of iper India ; heat apoplexy or acute dysentery, such as we meet with it in the European dier, are almost as rare in the Native Army of Upper India as are the same diseases among population of England. The causes which produce these affections operating through a ies of years on the European Soldier implant upon his constitution a special tendency to Id to miasmatic influences. The very adaptation which undoubtedly occurs, implies t the internal organs have assumed an abnormal excess of function very little in advance which lies disease. I cannot help coming to the conclusion that a very large portion the cholera ratio must be ascribed to the climatic causes inimical to that even balance of ,Ith which is the most powerful preservative against the development of cholera in the When in this Presidency the European Soldier dies of fever, if we exclude certain instances in which the character of the fever has been specifically marked, we recognise the fact that the man dies not from the virulence of the fever poison, but from some collateral condition which in the majority of instances is absolutely personal. The man is old, or of intemperate habits, or is the subject of some cachexy, and his fever takes on the deadly type because his system has not the resiliency requisite for tiding over the crisis. There is no denying the fact that the strongest soldiers may succumb to cholera; but these very same men would under extraordinary exposure succumb to dysentery or to heat influence. I do not think it unfair to conclude that the European Army, and especially its old and its unaeclimatised Regimeats, is not a material well fitted to throw off the cholera miasm, and that the ratio of attack is necessarily high ; while in Upper India the sepoy typically healthy, as a rule in his native province or in a climate corresponding to that of his native province, and at the same time a careiral liver, does not readily succumb to the cholera poison, but throws it off. It is by no fortuitous contingency that the Goorkha is singled out. His social habits may predispose to. cholera, but over and above all this, the same personal condition which causes seventy-five per cent, of all Goorkhas attacked by smallpox to die, and which among these hillmen converts Relapsing Typhus into Bubo Plague, brings him down to a level, in, regard to liability to cholera, with the European who suffers from what are called climatic diseases, diseases due to the non-adaptation of organs and functions to the altered conditions in, which the European finds himself in India. II cannot leave this paragraph without once more inviting earnest. attention to> the truth ich is here asserted. If we are ever to reduce the mortality in the case of the British Soldier r aim must have a definite direction, and I feel convinced that the clear recognition of this ith will place us a step in advance. And there are collateral truths also which become exhibited an aspect of great importance when once we divert our minds into this channel of investigan. Chief among these is the fact that young and newly arrived Regiments are liable to scumb as communities. The case of the Buffs was apparently of this nature. There were in s Regiment 195 young men below twenty-five years of age; of these fifty-three died in 67 in their first year of Indian service. The old soldiers also suffered extremely; of enty-five men, above thirty -five, twelve died in the first year. The cholera came upon this giment in the end of August, when the depression caused by the climate of the previous five inths was at the maximum. I see no reason to doubt that the Artillery and Cavalry at jerut were subjected to the very same degree of infection ; and yet five men only sucnbed out of a strength of 1,040, while 105, men of the Buffs were lost. I The cholera miasm was superadded to the effects of climatic influences, and the Regiment a body had not the strength to bear up against it. Dyspepsia and a sense of nausea became neral ; and as panic naturally followed the rapid progress of the pestilence, the ratio of attack nt on progressively increasing. It ought carefully to be impressed upon Commanding Officers it too much care cannot be taken to prevent fatigue or exposure in a case of this kind. The >vement into camp has a bright and dark aspect ; and the method in which it is carried out will en determine the aspect for good or for evil. The necessity for daily or often repeated movemt is entirely secondary to the conservation of the general health of the men ; and when we ewwhat the outbreak actually is, we can readily judge that the constant movement hither and ther because of the continued appearance of cholera in camp after leaving cantonments is in ! very great majority of cases altogether uncalled for ; . and in bad weather likely to be followed 230 Chap. Hl.] THE EFFECT OF ALCOHOL IN INCREASING THE RATIO OF ATTACKS. 231 Climatic Diseases in the European and Native Armies contrasted ; five years, 1864-68. Average Strength of the European Army 35,590. Average Strength of the Native Army 38,349. NUMBER OF CASES. RATIO PER 1,000 OF STRENGTH. REMITTENT AND „„,„ . RBMITTENT AND CONTINUBD "* AT 3lPO " HEPATITIS. CONTINUED „ „_,,, Fevebs. m«!™ii (Dbaths). Fevers. Heat apoplexy. Hepatitis. YEAR. (Admissions). (Dbaths). (Admissions). (Dbaths). (Dbaths) I ¦__! ?_^ \ | \_ Jill 1864 4,348 747 59 5 119 4 108 20 1-46 -13 2-95 -10 1865 5,945 495 111 6 130 9 160 15 298 '19 349 -28 1866 4,312 633 55 8 95 6 123 17 157 -21 271 -16 1867 3,518 519 83 9 89-9 101 13 2-40 -23 2-57 -23 1868 4,465 417 88 7 108 7 141 10 278 -17 3-42 -17 Five years ... 22,588 2,811 396 35 541 35 127 15 2-23 -18 3-04 SJT I cannot enter into the wide subject of the aspects of disease caused hy disparity of race. I have placed this table here that its contents may be looked at in relation to the table showing the disparity of the cholera ratios for the European and Native Soldier ; and if the parallel be not perfect, inasmuch as non-specific disease is represented, the facts here shown cannot but go far towards habituating the mind to the doctrine which I wish to urge, namely, that the balance of health and disease is so equally poised in the case of the British Soldier that it takes but little to turn the scale. Nor are the habits of the British Soldier those of the Native. The habitual stimulus of alcohol and occasional excess, predisposes the European to the The powerful influence of the poison i nvas i on o f disease, both climatic and epidemic, and thus of alcohol in preventing the eliinina- p ,- • t j A m. ll\ j« i ? tion of the cholera miasin. function is paralysed, too otten at the very time when the highest play is essential to ward off attack. The economy of the Native is, as the rule, unaffected by this cause of deterioration. I have already spoken of this, and of the opinion which Dr. Murray entertains in regard to it ; but it is a truth which cannot be urged too strongly. In determining the ratio of attack such influences tell very powerfully against the British Soldier. Even in the earliest of our great outbreaks, the effects of dissipation were regarded as adding greatly to the power of the cholera miasm. I The outbreaks at Berhampore in 1828 and 1829, in which 430 cases of cholera were ited, appeared after the Kegiments had indulged in great dissipation. I find from a manu/pt report, that it was after the 14th and 47th Regiments had received the gratuity for Ava t the cholera appeared in 1828 and 1829 ; it appeared for the second time in the 14th, after the *iment received the Bhurtpore prize money ; and in the same year in the Buffs, at Boglipore, > after the volunteers from the 59th Regiment had received their prize money. Dr. Cox, among his replies to Dr. Murray's queries, gives the following narrative : — I" There is during cholera epidemics a very general tendency to fly to the brandy bottle for ;e. I was once at a station with an European Cavalry Regiment and a Troop of Horse Artilwhen cholera became epidemic. Both were as nearly as possible similarly circumstanced as rds barracks and hospitals. A panic seized the troop and the men took to excessive king> while the Regiment remained sober. I witnessed man after man of the Artillery ght into, hospital drunk, and death followed within three or four hours. No such cases were ) seen in the Cavalry; and the result was (for the medical treatment was the same in both), of eighteen seizures in the troop seventeen died, whilst out of thirty-two seizures in Regiment there were only twelve deaths." We find the same repeated in 1867. In the first eleven days of the Peshawur outbreak, in the 42nd Highlanders, out of a strength of 674, 124 men were attacked,, while in the 77th Regiment, out of a strength of 857, seventy-four only suffered during the month and three days that the outbreak lasted, and during which time the Regiment was confined to the valley. In explanation, the Major General Commanding the Division writes : — " There is one subject which in concluding this report I think it advisable to bring under the consideration of His Excellency the Commander-in-Chief. At the close of the volunteering from the 42nd to the 92nd Highlanders, a sum of no less than Rs. 6,430 had been, agreeably to the orders received, paid over by the Field Officer superintending the volunteering into the hands of the volunteers, and on the 20th May the outbreak of cholera took place in the Regiment ; and it is possible, nay, according to my long experience as a regimental officer, very probable, that a considerable proportion of so very large a sum of money may have been expended in drink among comrades, and this may have more or less influenced or facilitated the inroad of the disease/ He continues : — "The immunity of the Native Troops appears a subject deserving of very special consideration, as the tabular state-, ment shows, that out of eight Native Regiments only twenty-nine men died, or an average of THE DOCTRINE OF CONTAGION INADEQUATE TO EXPLAIN THE PACTS OP THE OUTBREAK. [Section 11. 232 scarcely four men per Regiment, and this notwithstanding that in consequence of the epidemic and the numerous camps out on the frontier, the duties fell heavier than usual on the Native The following is from the report of the Assistant Quarter Master General Peshawur Division ; it is singularly consistent with all that has been written above :—: — ivi v I have reason to believe that it could be proved that nearly all the soldiers who were acked during the late epidemic at Peshawur were men of indifferent constitution — men who I recently undergone or were then undergoing treatment, men who were known to be in ifferent health, men who were addicted to drink or had been recently drinking heavily, men alysed by fear, or men who had been undergoing unusual fatigue or exposure. If such can proved to be the case, it goes far to confirm a theory which I understand to have been very lerally entertained amongst medical men and others who were close observers during the j epidemic, namely, that cholera is contagious or infectious only to those whose conditions of body are such as to render them prone to the disease.* The steady men in strong health who have no fear of the epidemic are not liable to an attack, however much they may frequent Ilera hospitals or minister to the wants of patients. It is a notorious fact that such men if strong health, steady, and free from fear, are not more susceptible to an attack of cholera n those who keep aloof from such places." The remarks which I have made regarding employment of European orderlies are in accordance with this observation; and I ik the conclusion is warranted that the employment of European Soldiers as orderlies ails a certain and unnecessary waste of life, not from contagion, but from the ressing effects of contact with the sick acting on constitutions already infected by the lera miasm. As I have already said, it is a recognised truth that it is on rare and exceplal occasions only that natives brought in contact with the sick suffer ; and the ratio of ick is never commensurate with the gravity of an outbreak, or the aggregation of cholera cken individuals. Kegarding Meean Meer in 1861 Strachey writes :—: — I" The exemption from attack of the medical establishments in the hospitals was remarke. There were very few cases of cholera among them, and hardly any of the native nial servants appear to have suffered." In the case of the Buffs, which lost 138 individuals 1867, only two of the native followers of the Regiment died. I Dr. Bruce, an excellent observer, adds the following testimony, from his experience at ivnpore in 1848 and 1849. He writes: — "In 1848, I had cholera in the Fusiliers from y till September. During the whole of that time I may say the hospital was never free some cases, and at times it was crowded. The whole establishment may be said to have :d in the wards ; the coolies for hours together never left the beds of the patients, and the fljeal officers did nothing but minister to their wants ; and yet not one man, European or tive, ever showed the least symptom of cholera. I took most particular care to have them stered and looked at, but in that year there was not even a case of bowel complaint among m. I had often not less than 100 men thus exposed. In 1849, the result was exactly the le ; not one man of the hospital establishment was attacked."f I The moral effect produced by the breaking up of hospitals altogether, as far as possible, when an outbreak is imminent, is undoubtedly very great and ustntton of the effects of mental ft powerM auxiliaiy in keeping . down tne J mt{o J of a t tack . and so also is the movement into camp under ordinary circum- stances apart from any other theoretical advantage which it may possess. What is the extent of the actual benefit, and what the ratio determined by mental depression, cannot be shown statistically ; but the omission to recognise it would be very dangerous, as diverting the mind from an aspect which calls for a remedy as powerful as any proposed in the way of antidote. I feel sure, that in very many cases in which calamities have been attributed to severity of choleraic infection, demoralisation and not the strength of the miasm per se fixed the ratio of attack and the mortality in relation to it. In the case of the Buffs it is well known that men sought the last consolations of their religion many days before cholera became developed in the same individuals. The following case occurred atDeolee in the outbreak of 1867 ; it is, however, impossible to say whether fear alone determined the attack of cholera, or whether the dread was the indication of its development : — "Two sepoys lived in same hut. The one died of cholera on 11th July. The second man on going into his hut on 16th July fancied that the dead man was sitting on his bed ; he rushed out in a state of great alarm calling out that Umur Singh's ghost was sitting on his bed and had asked him to smoke. A white cloth was found on the bed. The man was taken ill soon afterwards and died next day." Perhaps I have digressed too far from the simple statistical facts in thus trying to explain r, , , . ? wn y it is that the European Soldier dies. But I regard it General conclusions regarding the „„ n f t • j. o n t» ¦•« n •, 1 1 outbreak. c s as ot extreme importance for the application of a suitable remedy, that not only should the direction in which the ristical data point be clearly indicated, but also that the radical difference between the condition the European and the Native — natural, domestic, and moral — should be weighed in •I read this—" that those only succumb to the generally prevailing influence whose conditions of body are such as render them prone to the disease." t Letter to Mackinnou, Indian Annals, October 1856, p. 140. estimating the causes determining the disparity of the ratio of attack, in order that we may not be led into error in miscalculating the effects of the prophylactic or remedial leasures employed. The fact of disparity stands plain and unmistakeable. Some will apporm differently the effects of different conditions; and my estimate may be in some spects inadequate and in others exaggerated. Under any circumstances the question mands the deepest study that the Sanitary Officer can give it. Before leaving it, I wish remark once more, that the great truth is not to be passed over as a curious statistical fact, t that its teaching is to be weighed, holding that its value is that of a law and true for time to come, and that in the study of this law we have the truest groundwork for the plication of a remedy to what has come to be a great national misfortune. In this shape lam compelled to leave the subject. There are many difficulties which I lave not solved ; and I have been able to give an answer only in general terms to the all-im>ortant question — how the life of the British Soldier in the cantonments of Upper India nay be saved. I have tried to remove the whole question out of the province of conjecture and 1 misrepresentation of facts and their bearings ; and from the facts as they are here systemically placed, it is open to all to endeavour to push on the enquiry to a solution of the >roblem. And to him who shall have demonstrated the sanitary conditions under which the nortality of the British Soldier is capable of being assimilated to that of the Hindostanee will >c due the credit of having saved in the future a fourth of all lives that are now lost on Indian service. I see no indication that the cholera miasm shall in our time fall into a state of decadence. From the great epidemic of 1845, the epidemics of Northern India have shown no tendency to decay; and when the Northern Provinces have escaped comparatively or altogether, I think it is evident that escape has been the result of chance diversions alone, upon which we have no grounds to reckon for prolongation of the interval between the epidemics of the future. Slight epidemics such as those of 1852 and 1865 will often be interposed between great epidemics such as those of 1845, 1856, 1860-61, and 1867, but comparative exemption will even in these cases be found to be but a provincial phenomenon compensated for by intensity in some other province of the epidemic area. We are not weakly to listen to the assertion that the great recurring periodical calamities are not to recur in the future, and that human agency will determine whether or not Northern India is to be ravaged or to escape. The epidemic is not under human control. It is upon the outbreak alone and upon the dependencies from outbreaks, that attention must be fixed when it is proposed to apply practical measures. It is the careful study of what cholera is as a natural object that must direct these measures ; and while studying the relation of cholera to communities, the results of this study will be incomplete and inadequate to the protection of the types brought immediately before us, unless also the conditions of these types are studied in their relations to the miasm. The history of cholera in India tells that there was a time when this miasm was insignificant even in the country of its birth. It is needless to speculate as to whether cholera is a thing capable of being created ; or whether it was created before or after the appearance of man. It is sufficient to know that it has a natural history of its own, and that its place in nature is as fixed as that of any other existing species. That there have been previous to the modern period of fifty years during which in a continual succession of invading epidemics the miasm has displayed vigour and vitality, similar epidemic periods extending back to the remotest antiquity, even the imperfect data which exist enable us to infer. The history of our period shows that cholera which has once made its exit from the c ndemic basin in strength, plays a definite part, and may make the circuit of the globe before it finally decays. When, therefore, history has failed to record invasion, the inference is, that in the endemic soil the germ had for the time gone to decay, or survived in so debilitated a state as to throw off no swarm of sufficient strength to leave its impress on the population of the epidemic area. From what we know of the behaviour of the miasm in the endemic basin in every year, it would probably be found true did the grounds for forming a conclusion exist, that the epochal manifestations of epidemic cholera and the intervals of decadence have been caused by the geological changes connected with the rise and fall of the water level in the great tract between the Cuttack hills and the hills east of the Bhurmpooter. Be this as it may, I fear we must come to the conclusion that at present we are in the midst of an epoch in which not only are the different epidemics of extremely rapid recurrence, but in which each succeeding epidemic surpasses the other in the virulence of its effects on the human constitution. KMr. H. Macpherson has called attention to this same fact, showing that while in the epilic of 1818-21 the loss was 25*92 out of each 100 attacked by cholera, it was about 41*00 per t. in the sixteen years ending with 1854. I The full significance of this truth is apparent from the table which I have placed below. 3 fact is notorious and not to be concealed, that for the past ten years two-thirds of all ropean Soldiers in whom the collapse of cholera has been manifested have died. Speaking lerally, the loss in the ten years preceding was from fifty to sixty per cent. Between 17 and 1840 the loss was in no year over one-third, the maximum being 33*42 in the lemic of 1837. But from 1841 onwards this ratio has always been exceeded ; between U and 1852 the minimum was 38*46 in 1841, and the maximum 48*67 in the epidemic 1845 ; and since 1853 the ratio has never fallen below fifty per cent. It would serve no pose to enquire whether we now treat our patients with less skill than did our ancestors . 233 234 THE APPARENT INCREASE IN VIRULENCE OF THE CHOLERA OF RECENT EPIDEMICS. [Section H, In the estimation of the epidemiologist, the question is elevated very far above any consider, ation of such secondary importance :—: — European Army of Bengal — Died out of each 100 treated for Cholera, 1827-68. 1827 ... ... ... 2813 1846 ... ...^ 1828 ... ... ... 2977 1847 1829 ... ... ... 22-89 1848 1830 ... ... ... 2613 1849 ... ... 5- ... 4074* 1831 ... ... ... 23-50 1850 1532 ... ... ... 21-12 1851 1833 ... ... ... 31-96 1852 1834 ... ?. ... 3231 1853 ... ... ... 61-00 1835 ... ... ... 2604 1854 ... ... ... 5054 1836 ... ... ... 16-17 1855 ... ... ... 5000 1837 ... ... ... 3342 1856 ... ... ... 57"85 1838 ... ... ... 27-70 1857 ... ... 1839 ... ... ... 1850 1858 ... ... ... 5434 1810 ... ... ... 31-25 1859 ... ... ... 5017 1841 .„ ... ... 38-46 1860 ... ... ... 5325 1842 ... ... ... 43-46 1861 ... ... ... 6404 1843 ... ... ... 3977 1862 ... ... ... 6128 1844 ... ... ... 44-81 1863 ... ... ... 75-11 1845 ... ... ... 48-67 1864 ... ... ... 69-59 1865 ... ... ... 72-50 1866 ... ... ... 6000 1867 ... ... ... 60-87 1868 ... ... ... 65-52 * Eight years ending 1853. Macpherson, Indian Annals, 1858, p. 250. CHAPTER IV. DEPENDENCIES OF OUTBREAKS. HOW FAR THE NATURAL AND PRIMARY ASPECT OF THE EPIDEMIC, THE REPRODUCTION, AND THE OUTBREAK IS AFFECTED BY SECONDARY MANIFESTATIONS OF CHOLERA. Many of the facts which would naturally have fallen into this chapter have been inciden- tlly noticed. For reasons which I shall presently give, I do not propose to enter at length to the enquiry included under this head. Had I done so, the arrangement would have taken the form which follows :—: — A. — The effect of human intercourse on the epidemic or reproduction, as regards its duration and its geography. B. — The effect of human intercourse on the outbreak. a. — Duration in relation to virulence. b. — Multiplication in communities. c. — Effects of pilgrimages in multiplying foci. C. — Infection of individuals. a. — By fomites. b. — By attendance on the sick. D. — Infection of localities from infected individuals. Hospitals. }\ Sec2ry. Latrines. Water Supply. II. — Question of the multiplication of the cholera germ in the human economy. F. — The chances in favour of the efficacy of preventive measures based upon the facts of the secondary manifestations exhibited during the epidemic prevalence of cholera. In the preceding chapters, I have tried carefully to distinguish between such truths as I conceive to be of primary importance and such as are secondary. It would be tedious to repeat why it is that I hold the distribution in space and time, that is, the geography and duration of the epidemic and its reproductions, to be uninfluenced by human agency. I have summed up the general conclusion in the assertion, that the statistical data prove distinctly that the duration of the reproduction is not lengthened nor its geography extended, by the gravest affection of the population of a province, and that the distribution in time and space would be the very same if the area affected were uninhabited ; that, in short, the earth-generated and air-borne cholera miasm is a natural object which might play out its part unobserved were it not for the contingency that when it meets the human economy, it acts upon it as a poison. The question of the possibility of the multiplication of cholera in the human economy, the affection of special localities from human emanations, the affection of individuals by fomites or by proximity to the sick, in short, of the secondary propagation of epidemic cholera in communities, stands widely apart from all this ; so widely, that many good observers in India have allowed it no place at all in their calculations, in consequence of the minor facts having been altogether over-shadowed by the great and primary truths. I The evidence upon which the demonstration of the two aspects of epidemic cholera, the mary and the secondary, depends, is of a very different value in either case. The registion of the facts regarding the primary truths affords in its aggregate the basis for the uction of the phenomena to a system, built upon a true because upon a natural and unalter-3 foundation. The minor details of this system may be erroneously read, but the tendency lot to the perpetuation of such error, but to its elimination from future experience, leaving system itself the more complete as the erroneous deductions are one by one removed, s demonstration of the secondary truths or allegations rests on observation or experiment, not upon a something which is absolute ; and, consequently, room is left for fallacious uctions which spring from misdirected or imperfect observation and from an erroneous ception of the significance of what actually occurs. From the latter, however, the attempt has been made to construct a system which aspires to be complete in itself and independent of the truths which I regard as fundamental, in which human agency alone, or human agency assisted and controlled in a secondary manner only by meteorological agencies, is made to play the part of the propagator and distributer of the epidemic cholera of Europe. lam naturally led to conclude that the construction of this system cannot be carried out into a perfect whole ; and that since this is the case, the individual elements of the structure must be wrongly placed. These elements may be good and valuable in themselves, but the effort to put them together may be misdirected. It may be true that cholera is multiplied in the human economy, and that buildings, latrines, and the water-supply may become infected from the miasm thus multiplied, and it may be true that cholera is portable and capable of being transmitted by fomites ; but it is no necessary sequence that cholera is never multiplied unless in the human economy and in localities infected from human emanations, and that cholera is never geographically distributed unless in districts into which it is conveyed by human agency. Very many narratives have been given of observations upon which it is sought to base this system. These tell how cholera appeared in a certain family in a certain town, possibly brought in contact with a recognisable source of [Section 11, 236 THE VALUE IN A SYSTEM OF SECONDARY TBUTHS. cholera infection, and how a certain number of individuals, necessarily or accidentally brought in contact with the first sufferers, were also affected. The invariable conclusion is, that from this time the disease spread, not locally, but universally ; and it is distinctly implied that there was a necessary sequence between the first cases and those surrounding 1 them, and the general infection of the province or kingdom. As I have shown, the progress of cholera is not continuously progressive ; its advance is mapped out by the successive affection of natural provinces, and is made per saltum at definite seasons. At any time in the intervals between the epidemic leaps, importation into the countries beyond the already occupied area by human agency or by fomites, may occur. But we must carefully distinguish between importation and true epidemic advance, seeing that both undoubtedly occur ; and we must not come to the conclusion that there is some subtile influence at work, diffusing the miasm imperceptibly from those already visibly affected by cholera, when we see a trifling local outbreak followed at an interval of weeks or months by the universal infection of the country. This is certainly not the method in which the gap is bridged over when true epidemic advance occurs ; and it is a mistake to call the casual introduction of the forerunners of an epidemic the advance of epidemic cholera. At home, in anticipation of the actual cholera invasion, daily registers should be kept from the date of the occurrence of the premonitory cases or outbreaks, in order to time to a day the arrival of the air-borne epidemic, and to note its Selected habitat. In our natural provinces of Upper India, we can note advance very readily, from knowing the seasons at which it is to be anticipated, and because of the invariable association of the miasm with its vehicle ; and if the definition in space be more accurate and the occupation of the area covered be more complete than at home, it is to be remembered that in this country the limit of the geography of the epidemic advance is precisely at the point to which the special meteorological agencies extend, and that the vehicle is of universal distribution, while at home there is no phenomenon corresponding with' the undeviating regularity of the Indian monsoons to define the position of any air-borne miasm in time and space. I It is suggested as contradictory of the alleged fact of the provincial distribution of cholera aerial influences that, if it be true at all, the distribution of cholera within the provincial i must be universal or nearly so, and that hence every human being within it incurs the :of death from the invading cholera. The case is not unfairly put. In theory this is ctly what does occur. Certain types of the population and certain localities suffer in differproportion, and in some portions of the area even the index of the presence of cholera may vanting ; but the universality of the liability viewed as a scientific truth holds good. Excepls do not make the general proposition less true, that the entire population resident within nvaded natural area, incurs the risk of the attack of cholera on the occasion of an invasion, en an air-borne cholera sweeps over Calcutta, certain conditions peculiar to locality or conned with predisposition in individuals or classes, cause selection among the general population, every resident in Calcutta on such occasions runs a risk of succumbing to cholera ; and it is true in this case of a city is true of the natural areas of Upper India. The dependencies of outbreaks are not to be classed in a systematic arrangement along with the outbreaks of the epidemic; and it remains Bie comparative value of statistical simply to be considered how far observation and experiment have | ed t0 * c «**>«* of facts which demonstrate to us the system. secondary truths regarding the affection of individuals or localities. In contrasting the primary and secondary truths I difficulty lies in duly apportioning to each the true value, and I repeat that it is infinitely •c difficult to weigh the alleged results of observation than those for which we have the est statistical data. So long as attention is confined to the tabulation of statistical facts, •y figure represents a truth which invites us to place it in its position in a system ; when we come to weigh the results of observation, we have to deal no longer with a nony but with a series of antagonisms. And even in experiment, the results are scarcely c satisfactory. So unsatisfactory indeed are they, that they are sustained more by the blished reputation of the experimenters than by general assent to them as scientific hs. It is a safe maxim never to call in question what an observer of acknowledged itation affirms that he has seen or done ; and we have no right to deny his positive facts luse others do not appear to coincide with them. We must not at the same time forget that srved facts are subject to different interpretations. But notwithstanding the difficulties that meet the scientific observer at every turn in the collection and estimation of evidence from observation and experiment, others are less scrupulous in making use of results which he frequently puts forward by way of suggestion only, producing them as facts adapted for the furtherance of theoretical propositions far in advance of those in explanation of which the data have been brought together. And this misuse of evidence has seriously complicated all recent investigations regarding cholera. tWhat those who have sought to build up a system out of the secondary manifestations of cholera allege to be truths may be true or they may not. J^f i? P ° f f a Systei ? fr^ This we cannot P ass over without remark, that when the the results of observation contrasted V m - •<• i i, ,1 in • i ¦, ¦, -i , with the structure having a natural different propositions are placed together and fairly looked at, basis. they will be found leaning one on the other for surmort. they will be found leaning one on the other for support, having evidently been added one by one in each succeeding European epidemic, when it was felt that the prop had been struck out upon which the previous theory reckoned for its stability. The facts of the first European invasion showed that aerial transmission did not account for all the phenomena observed, such as the transmission of cholera by fomites, and the occasional infection of attendants on the sick. Hence there was initiated (a) the doctrine that cholera might be propagated by human intercourse; and as the latest phase of this doctrine we find the confident assertion promulgated as a truth that cholera is always and not occasionally so propagated. To prop up this assertion, it was necessary to make a second assumption or theory. And hence arose the doctrine (b) that cholera is multiplied in the human economy. But this also must have stood alone and unsupported unless it could be shown how and where the multiplication took place. And this led on to the starting of the third theory (c), which asserts that cholera is multiplied in, and is spread around by the intestinal evacuations of those already suffering from the disease. But even this, although urged in the most forcible manner, did not meet all difficulties ; and there arose the demand that it should be supplemented by a fourth theory. In relation to this demand the latest theory (d) alleges that the evacuations of an individual in whom cholera has not become apparent, and never will appear, may be the means of spreading cholera around. While it is very evident that the last of these theories may very readily be made antagonistic to the elimination of scientific truth, and while its general adoption should be resisted until the grounds upon which it rests are well substantiated, in accordance with what I have said regarding the methods and consequences of cholera infection, the doctrine is not one which [ would rashly assert to be destitute of foundation. But I repeat once more, that the truths upon which the theories of this group depend for their construction, even granting that they were true to the full extent asserted, cannot be made the basis of a substantial and complete system which shall supersede every other. I should be going out of my province were I to attempt to fix the relative value of the primary and secondary truths. It probably differs much The relative value of primary and i n different countries and among different races. Secondary secondary truths as estimated in India. , ? , , ° , -i , ,¦. i ? Recorded evidence regarding the se- truths seem most have appealed to the observers ot condary manifestations of cholera. Europe, while the primary truths are those which chiefly force themselves upon our notice in this country. What then do we learn from the accumulation of facts in this country which demonstrate the share which the human being and his surrounding conditions have in the propagation ami distribution of cholera? I If lam asked to what the sum of the recorded facts regarding the dependencies of outbreaks India amounts, I fear I must answer that the collection of these facts is scarcely yet begun. A general conception that cholera may be transmissible from one man to another exists, and the record of cases, which are undoubtedly authentic, gives ground for the belief. We are only too willing and eager to put together any facts which seem to show, that human emanations are one source of the infection of communities ; because we recognise that a thoroughly thenticated collection of such facts would justify the employment of practical measures in a nite direction. Not one of the theories above referred to has taken its origin in this ntry, for they can all be traced to an European source. We are called upon to corroborate se theories from the evidence afforded by the phenomena of the cholera of India. As might have been expected, the facts which have been brought forward in their support by Indian observers have frequently been open to question, and illustrations have often been erroneously idied as a result of local and limited experience. Looked at as standing alone, the great stration of 1867, the Hurdwar outbreak and the spread of cholera over Northern India, r e great encouragement to those who highly estimate the effects of human intercourse in the pagation of cholera. The verdict of the European Conference was, that pilgrim assemblages ¦c foci from which the epidemic cholera spread. The twelfth year had come when the great, hering was due. Measures were taken in anticipation of the probability of the outbreak. 3 outbreak took place as was anticipated. The appearance of cholera over Northern India was a true sequence; for, over the invaded area, the appearance of cholera among pilgrim travellers preceded the district outbreak in almost every instance, and many perfectly authenticated cases of the direct transmission of cholera from pilgrims to inhabitants were put upon record. No link in the chain seemed deficient, and yet the conclusion at which I have arrived is, that the Hurdwar outbreak played but a secondary and altogether unimportant part in the epidemic of 1867 ; and I had formed my anticipations of the same sequence from previous parallel history months before the event occurred. I need not enter into the facts of the secondary distribution of the Hurdwar cholera; they have been carefully detailed in the narrative of the Sanitary Commissioner for every district of Upper India, and in this the opinions of the civil and medical authorities are also given. The facts, generally, may be regarded as authentic, whatever interpretation we may attach to them, unless in cases in which the testimony of native agency is introduced, when, in every instance, the record may be regarded as trimmed according to the theory which the facts of 1867 were supposed to establish. The same tendency is, in a certain measure, clearly traceable in most of the reports of the civil authorities of districts, which have a distinct bias towards the prevailing theory of the hour. In the midst of a mingled and confused mass of evidence, it is very satisfactory to pick out tfible facts, such as the following, given by Dr. Verchere, of Jullundur, which demonstrate truth that the pilgrim stream was tainted by a cholera which it had the power to pass off to c brought into its current. The city of Jullundur escaped altogether, while a certain small on of its population, detached to a distance of two miles, for the purpose of turning aside 237 IT IS A FACT THAT A TAINTED STREAM OF HUMAN BEINGS MAY PASS OFF CHOLERA. [Section 11. 238 the pilgrims or taking care of their wants, suffered. The following cases occurred at the Beyn Chowkey, where the pilgrims were turned off on the road to Jullundur from Phillour :— Dr. Verchere writes :—": — " On 25th April, out of a guard of twenty-one men, two sepoys of the 3th Native Infantry were attacked; and on the 26th, a chuprassee, two bunneahs, and a hospial servant. A third sepoy of the guard had a sharp attack of choleraic diarrhoea. Of these ases one sepoy, the chuprassee, one bunneah, and the hospital servant died." He continues :— All the sepoys were perfectly well before they left the lines. This small detachment alone came to contact with the pilgrims. It appears to me as strong an example as any I have seen or ad of, of the contagion of cholera. The lines of the Regiment are not more than two miles rom the spot where the cholera camp was established, and not a case of cholera or even of bad iarrhcea occurred." {The shortness of the period of incubation is proved by the following case : we have seen c same in the case of Regiments attacked on the very first day after descending from hill itions to the plains :—: — t" A Goorkha sepoy, aged twenty-five, left the lines at sunset on 24th April, and arrived at c camp an hour afterwards. Early in the morning of the 25th he was attacked with diarrhoea ; 10 a. M. he was in deep collapse, and died at 3 p. M. w Such facts have very properly been used as an argument for diverting pilgrim streams from towns. They teach that pilgrim streams are sources of infection ; and the exemption of the towns from which they have been diverted shows the efficacy of the measure. But here must be interposed the equally certain truth, that there is a cholera against which such quarantine is unavailing. He knows but half the truth who, judging from such local experience, concludes that perfect quarantine is invariably effective in keeping out cholera. Applying the same to jails, we find such a case as the following: — During the prevalence the invading cholera of 1863, a party of prisoners coming from the direction of Nagpore, as affected by cholera before reaching the Central Prison at Allahabad. On arrival they ere placed in strict quarantine, and a cook was provided for them from among the resident risoners. This cook was the only man selected from the jail at this time by cholera. The nference is, that he acquired it from the cholera-stricken gang to which he was attached, and lat had others of the resident prisoners been brought into immediate contact with the same en, they might also have suffered. The conclusion is, that when cholera is abroad, quaranine is a proper precautionary measure ; but we must not expect that the prison population is variably to escape because quarantine has been enforced. The narrative is thus given in the report of the Allahabad Jail for 1863 :—: — t" Among the European Troops cholera commenced on 19th April, and in the jail on d May. After this outbreak, the jail continued free from cholera up to the 23rd July, il between this date and sth September thirty-three cases occurred. t" But in the meantime, a party of prisoners from Nagpore marching towards Allahabad, it the epidemic a few days before reaching their destination, and brought it with them o the jail on 7th June. Out of seventy-one, two had died before reaching Allahabad. On 3 day of arrival five were admitted into hospital ; on the Bth seven ; on the 9th seven ; on the th two; and on the 12th four; no other cases occurred until the 23rd, when another of the ne party was attacked.* The only other man attached in jail during the period was a Brahmin '£, who was told off to cook for this party ; he was seized two days after he began his duties." I A cholera-infected body does not necessarily infect a community with which it mingles ; at „, . . „ .- . . ... the same time, it is not justifiable to mix up an infected with an flic mixing up of an infected with . „ , . % m , J „ . . .„ r , „ uninfeeted body is not necessarily unmtected body, lhe crews of ships, it drawn from separate owed by the appearance of cholera sources and shipped immediately before sailing, have been ;he uninfeeted body. observed to share in no community of attack, cholera being ifined to those shipped from a definite quarter. In the case of a mail steamer, which was ected by cholera in 1868, it was observed that those only who slept on board on a certain night die the vessel was moored in the Hooghly were attacked. When the Rajghat Detachment of 3i" Majesty's 54th Regiment was moved to head quarters in 1863, cholera had showed itself a single case only, and the outbreak which followed during the next seven days was confined the men at the Rajghat Detachment. The Detachment of Her Majesty's 92nd Regiment, lich arrived at Fort William by the Sunderbun route on 24th March 1862, had between at date and the 11th April seven fatal cases, while the other Wing remained unaffected. tMr. Reilly, Apothecary to the General Hospital, sends to the Editor of the Englishman ?,»„,, , the following very interesting letter on the subject of hospital he cholera hospitals of Calcutta do • c , • • f j.i_ i r> t , , prove foci of contagion. infection in reply to the remarks of a correspondent who suggests that the hospitals of Calcutta may be foci from which cholera spreads. It is published in the issue of 21st August of this year. IHe writes :—": — " lam very glad to be able to reply at once to some of the remarks made, ich tend to give the idea that cholera finds a centre in the Calcutta General Hospital, and t patients there treated run a considerable risk of contracting that very dangerous disorder. Doubtless men have been seized with cholera after having been admitted with other eases. I have the proof before me in the hospital records, that during the last thirteen irs, there have been eight men who, after being admitted, were so attacked. That is to say, about twenty-four thousand Europeans, eight have been seized with cholera in the General * This seems to have been a nearly typical outbreak. Hospital. But as seven of these were admitted with diarrhoea or bowel complaints, it may be doubted whether these ought not really to be considered as cases of cholera in the first stage, which would, of course, reduce our average to one in twenty-four thousand, among whom eleven hundred cases of cholera are included. " In the General Hospital for many years cholera patients have been admitted into a receiving room, where patients with cholera are alone treated ; they are then moved into what was intended to be set apart as a cholera ward, where they remain till discharged. Unfortunately, from the increasing number of sick, we are unable to give up so much space to one class of patients. Other patients have been treated in that ward with men suffering from cholera ; yet, out of the total of eight cholera admissions above referred to, seven occurred among the patients in the wards of the centre building where cholera was not treated, and only one among the sick who were received into what we call the cholera ward. It is evident that the fears expressed regarding the spread of cholera within the wards of this Institution are quite without foundation, and that the evils anticipated have, up to the present time, had no real existence." The proof of the fact of the introduction of cholera by human intercourse is not always „.,.,, „,, , . convincing even in cases where the evidence seems very clear. Pilgrim cholera. The phenomena in m , ° ? , » n -n •« ? ..— ?. " ? , relation to the epidemic! The neces- The case which follows will illustrate the difficulties which nty for carefully trying to avoid present themselves in dealing with instances of alleged infecerroneous deductions. tion. The Artillery from Benares were encamped for their annual practice at Sultanpore in January 1863 ; and they were attacked coincidently with the passing, through their camp, of a body of pilgrims from the fair at Allahabad. The morning following seven men were attacked, six Natives and one European : the European died, the six Natives recovered. iln this case there is no doubt of the fact of the coincidence of the cholera of the Artillery 1 the pilgrims ; and the application of statistics on a limited scale would almost certainly /c led even an accurate observer to conclude that the coincidence was more than suspicious, c tabulated experience of a series of years would have shown him nothing corresponding this January cholera of 1863, and had he thence concluded that the cholera was localised in the pilgrim stream, few would say that his conclusion was illegitimate. And yet when the statistical record is extended the parallel is not found to be wanting. Looking at the cholera history of 1863, and the two years following, we now know this to have been the first wave of the invasion of the epidemic of 1863-65 coming from the east ; and we recognise as parallel the cholera of December 1817 and December 18G8 preceding the manifestation in power of the spring cholera of 1818 and 1869. At page 59 of the first Section will be found a table drawn up many months since, intended to represent my ideal of the relation to season of the cholera of the margins of the endemic basin; it shows the cholera of the jails of Cuttack, Pooree, and Midnapore in 1860. I find in the Report of the Jails of Bengal for 1868 the following table, and I have placed it here to show how true a long continued series of observations prove the type, as I have represented it, to be :—: — Cholera admissions of the Pilgrim Hospital at Pooree in each month of the 25 years from 1843 to 1866. Yeabs. £ & . « 1 li 1 I I I I ttlfftjl l_ | 1842 ... 36 5 47 1 ... 17 1 6 2 106 1843 ... 7 ... 35 164 25 2 1 234 1844 3 2 200 1 206 1845 ... 1 2 3 1 ... 2 57 2 ... 1 69 1846 ... 2 ... 14 1 ... 72 1 ... 1 3 4 1 99 1847 1 14 ... 1 4 29 1 1 ... 51 1848 ... 1 5 3 3 ... 2 47 ... 61 1849 1 107 4 1 1 114 1850 ... 1 37 11 1 2 5 1 58 1852 "... ... 5 4 ... 1 104 "2 1 ..'. 1 3 3 123 1853 ... 2 2 10 1 1 6 26 2 1 51 1854 6 48 129 18 ... 1 7 1 210 1855 2 1 ... 2 ... 156 3 2 1 167 1857 ... ... 8 43 11 1 66 2 '.'.'. 4 ..." 135 1860 ... i 8 19 1 2 96 4 ... ... 1 ... '.'.'. 132 1861 12 3 ... 3 27 4 ... 1 50 1862 ... 2 5 6 91 20 ... ... 1 3 ... 128 1863 1 ... 1 93 2 2 99 1864 ... 1 3 ... 1 ... 1 12 1 4 ... 23 1865 1 2 2 1 74 13 ... 2 95 1866 ... 1 22 26 1 1 1 ... 52 Total ... 56 127 313 28 15 1,255 538 13 5 15 53 13 2,431 239 SPREAD OF CHOLEKA rKOM L.UUL.I IJtIMIU a V U. IQBCuIOII XI, 240 To the general results here shown, the question as to the numbers of pilgrims assembled in the different months and the influence which they may have had on the diffusion of cholera is logether secondary. One glance at the facies of the table is sufficient to prove this. It is oughout and consistently a beautiful demonstration of the truth of the relationship which vital object cholera bears to the influences of season. Here is seen the sprouting into iility of the spring, the monsoon, and the November cholera. Note that the spring cholera the extreme south-east is the cholera of February and March, not of April, as in the valley the Ganges, nor of May, as in Cawnpore and in the western division of the epidemic area ; I that the monsoon cholera of the extreme south-east is not a cholera of July, August, and )tember, as in Upper India, but of June and July. It is wonderful here to mark the minim separating the spring from the monsoon reproduction ; and such a demonstration is of all more value when we reflect how difficult it is to define the line between the cholera of May [of the monsoon in Northern India. Fifteen admissions in 25 years mark the minimum of y in this pilgrim hospital; while the maximum of the monsoon is indicated by 1,793 nissions in June and July during the same period. I It must never be forgotten that the mere fact of the presence of cholera among pilgrim other assemblages, especially in the epidemic province, is an index that epidemic cholera is road. No pilgrim body will develop or acquire cholera except where cholera exists and is tdy for epidemic spread. Every manifestation that occurs has its place in an epidemic Lich is in progress. When I have spoken of the great pilgrim outbreaks of 1860, 1863, and 67, I have done so merely as of a single outbreak in an epidemic involving half of dia. We cannot be too careful in trying to avoid fallacy of deduction from the observation the facts of pilgrim cholera. It has been recorded' that the cholera of the Allahabad grinds of January, above referred to, was the origin of the universal cholera of Oude of 1863. it we know that this was not the case ; we know this cholera to have been truly a portion the cholera spreading at trie time from Cachar to Bundelcund. I In connection with what I have written regarding the geography of epidemic cholera in 37 and 1868, the absence of cholera from the pilgrim shrines of the Madras and Bombay jsidencies in these years was to be anticipated. I cannot, therefore, but regard as premature conclusion that the sanitary precautions adopted during this period have been the means preventing the outburst of cholera.* It is when cholera is due to appear because of its vincial distribution, that the effects of local sanitary measures in preventing or mitigating outbreak will in the future be tested ; and knowing how detrimental to the true advance sanitation as a science is the holding out of expectations which are not realised when fairly ; to the test, while recognising the propriety of the measures employed and acknowledging benefit likely to be derived from them, we cannot be too cautious in our estimate formed ti the results of a limited and local experience. The following case related by Mr. White, of Debrooghur, is one of those upon which the theory of the introduction of cholera by human agency is founded, cholera "STiSSo ° hitf u^V^tS? ? he correctness of the observation, that the body of individuals Effects of° human intercourse^ m °t ues ti° n spread cholera, seems to be beyond dispute; the deduc- tion, that human agency introduced into Upper Assam the de- vastating cholera of 1860, portion of a great epidemic universal from Bombay to China, is incorrect. This cholera was introduced from Lower Assam into Upper Assam, two months in advance of the true invading epidemic. tThe history of the successive steps of advance in 1860 from south-east to north-west, the Bay of Bengal to Lower Assam, is thus given by Dr. Thomson, Superintendingeon of the Dacca Circle ; it is interesting to observe how, even in so general a state;, the normal dates of appearance from the sea-level upwards are recorded, and also the •rence of the three reproductions, of the spring, the monsoon, and the cold season : — olera first appeared on the 29th February in the Backergunge District, and was rife in the adjacent zillahs of Dacca and Mymensing during the months of March and April. It broke out with great violence at Gowalparah on the 4th May, and terminated on the 19th ; again ifc appeared on the 16th July; and thirdly, on the 9th October." Along with the third appearance in Lower Assam, Upper Assam was invaded. iOut of a population, in the Debrooghur District, of 10,000, 1,250 cases of cholera were rted in October and November. Kit was, however, coincidently with the second appearance of cholera in Lower Assam, in y and August, that the cooly gang, to which the following narrative relates, imported lera into the Debrooghur District : — I On the 18th August, the river Steamer Adjai arrived at Debrooghur, having lost on the sage about a fourth of the cooly immigrants on board from cholera. Several died immediately ir disembarkation, and the survivors were removed to the tea garden in which they were to employed. Mr. White remarks :—: — Ist. — " There was no case of cholera in the province before the arrival of the Adjai." f * Reviewing the Report of the Madras Government regarding the control of pilgrimages in the Madras Presidency, the Army Sanitary Commission remark :—": — " It is most satisfactory to know that an arrest can be put on cholera by these simple and easy measures of prevention, which have moreover the experience of all past epidemics in Europe to sustain them." t I do not attach much value to this statement in as far as it may be regarded as conclusive against the existence ji' cholera in Upper Assam ; it is far more consistent with experience to conclude that many warnings of the approach of the epidemic had by this time been given. I observe that in his monthly jail return for May Mr. White shows two of cholera among the prisoners Kind. — " The first case occurred at the tea garden to which the infected immigrants were oved from the Adjai." B3rd.—" The first case in the military lines occurred in a sepoy on his return home from cooly lines of the same factory." KUh. — " The first case in the civil station occurred in a bazaar merchant who had been to same factory on the day on which he was attacked." tMr. White believes that he witnessed in the epidemic of October and November also, the c phenomenon of communicability. With experience of cholera both in England and erica, he regarded this as something new to him ; and, I believe, that he has not again, ng eight years of further residence in Upper Assam, recognised a repetition of the lomenon. I The inference from this is, not that the cholera miasm has two separate intimate character's under which it is communicable or incapable to be passed off to others from those affected, that there are certain conditions which admit of cholera becoming communicable. And it st not be lost sight of, that so dense was the body of the Assam cholera of October and member, that, according to Mr. White's own statement, more than 12 per cent, of the »le population were attacked. And, besides, the atmosphere was stagnant and impregnated 1 moisture ; for it had rained on one hundred consecutive days before the cholera appeared, history of the Assam cholera of October and November must be read in connexion with \,t I have said regarding affection of locality and the attack of attendants as a consequence. White writes : — " The first convict attacked had been engaged the same day in removing corpses of cholera patients. The second convict seized had been employed as an attendant he cholera hospital for three days previously; he died in three hours. Two attendants dcs, who had waited on the first five attacked in the jail, were next attacked." " Four servants in the military hospital were seized while in actual attendance upon the sick, and also eight sepoys who were acting as supernumerary attendants."* While now, as in all time past, it is denied, that those brought into immediate contact with the soiled or unsoiled bedding and hospital clothing of The possibility of the spread of cno i era pa ti e nts are liable to the attack of cholera, as far at cholera as a parasitic affection. Spread , , X c i.\. r* i t-j.l it in foinites. *- eas * as ne experience of the Calcutta hospitals goes, and I have no statements, figured or written, in the records of the Btary hospitals of Upper India, which are capable of being used as contradictory of this expece, the possibility of the transmission of cholera by means of fomites is not open to question. tThe apparent explanation of this antagonism of facts is, that the miasm has become isitic upon the clothes or persons of those transmitting the cholera, while it is not increased nor passed off from, the excreta. It is the classes whose clothing is offensive to the sense imell who thus transmit cholera. Dr. Stewart, of Pooree, writes :—": — " Pilgrims are a terror he native population, and are avoided by all who see and know them. Natives fully believe ;rims to be sources of infection." He adds, that the villagers can recognise them by the smell. What seems to occur in the case of the unwashed pilgrim, is noticed also in the case of the unwashed Groorkha. The Nepaulese Durbar writes regarding the cholera of 1867 : — "Cholera is a plague sent by God. It spreads by intercourse with pilgrims, and traders. It is a catching disease. It does not spread much in clean places, but it spreads much in unclean places." I The squalor of a famine-stricken population affords opportunity for the growth of such a lera, as the loss of valuable lives in connection with the duties of presiding over famine ;hens in the North- Western Provinces in 1861 showed. There is great difficulty in selecting individual cases of transmission by means of clothing, or other vehicles, f and there is always the danger, that the true explanation may be different from that suggested by the observer who records the circumstance. These remarks apply to such a case as the following : — A pilgrim from Hurdwar was taken ill on 28th April in a village of the Groogaira District, and was immediately carried on by his companions to his village, nineteen miles distant, where he died. On the 30th, cholera broke out in the village in which his attack commenced, and twenty-seven people died. I The theory attached to this narrative is, that the spread of the cholera was due to the fact, i the man was taken ill at the village well, and that his clothes were washed in an adjacent 1. This explanation seems to be shaped in accordance with the home theory, and I do accept it as satisfactory, since I consider that a more careful enquiry into the history of the stion of the district at the time was required to confirm its truth. iHow long cholera may be kept alive in fomites, and spread primarily and secondarily, is an ortant subject for enquiry. The case of the Renown teaches how, at least three weeks after ction, fomites, or, at least, a locally existing cholera, J may give rise to secondary outbreaks, ined to last for a normal period beyond the date of commencement ; and in the case of the trude (see page 182) cholera did not appear until the twenty-fifth day after leaving Calcutta. all this, I regard it as essential, that we should clearly recognise the simulation of gion by localised cholera and the aspect of cholera as a parasitic miasm, whatever import- * It is worth while to note, that in the same building the sick of the detachment of the Naval Brigade (European Sailors) were treated, and that although they Were separated from the natives only by a screen, no ca: c of cholera occurred among this peculiarly susceptible body. + Dr. Verchere thought that he could trace the importation of cholera into Jullundur and neighbouring villages through carts which had been to the Hurdwar fair of 1867. X Emanations from the hold of the ship were believed to have determined the attack in this instance, as the men exposed to such influences chiefly suffered. 241 anee may be attached to it beyond this as a miasm multiplied in, and emanating- from within the human economy. The sum of all experience, and the lesson taught by the facts given in illustration of the secondary truths regarding epidemic cholera, is, that, while In all investigations regarding se- the aggregate of the outbreaks of soil-born cholera invaria ™^7JITIL^ g S: mM baSIS Wy through successive reproductions make up an epidemic^ there is, in the history of the cholera of this Presidency, no evidence to show, that any aggregate of cases of cholera, derived secondarily from true outbreaks through human agency, has ever, by the combination, produced a reproduction or provincial manifestation of cholera, and consequently never can have given rise to an epidemic. Snow wrote as follows :— "If cholera cases were not connected one with another, there would be no reason why the few cases which happen in a village, should not be scattered over as long a period as the thousands which occur in a great metropolis/'* The statistical facts, as I have here recorded them, entirely invalidate the conclusion from the presumption that the cholera of rural districts has a shorter duration than that of cities. They show that the duration in time of the provincial reproduction is identically the same in the case of all classes of the population, and whether the numbers affected be large or small • typically the same, for example, for the sepoy as for the European Soldier, and for the cities of a province as for the villages. Baly also sums up against Snow's view in the following terms : — "The theory, that cholera is propagated and diffused by means of human intercourse, receives no support from the facts relating to variations in the intensity of cholera epidemics, and the eiroumstanees determining those variations. These facts tend, on the contrary, to establish the close resemblance borne by Asiatic cholera to the common summer cholera and diarrhoea of this country, and to «mittent fever, which there are such good grounds for believing to be purely of malarious igin, and not to be in any way communicable." (p. 43) . It seems to me that the modern deviations from the verdict of the College of Physicians , . „ , of London on the cholera of 1848 delivered throua-h Balv's Summary or conclusions. Baly. -r> ± i. t, :_ at. i • j • i i <. J J Jxeport have been in the wrong direction, and that the conclusions of this classical memoir will be held in esteem in all time to come, when the natural history of epidemic cholera shall have been placed on a sounder footing than at present. I have deviated little from the principles of this report. In this country, however, we have to deal with data more appreciable, and with a wider basis of recurring facts ; and this admits of comparisons being made for which the data are wanting in Europe, owing to the short duration of epidemics and the eccentricities manifested during the period of their occurrence. The conclusions are given in summary by Baly nearly as follows, (Beport, p. 216, p. 224) : Ist. — It is not proved that cholera is spread subsequent to its multiplication in the human economy :— "No sufficient reasons have been found for adopting the theory, that the cholera poison is swallowed with the food or drink, is reproduced in the alimentary canal, and being discharged with the secretions of the stomach and intestinal canal, propagates the disease by finding access in the same vehicles to the stomachs of other persons." (p. 222). 2nd. — He assumes the controlling power of atmospheric and hygrometric influences : " This theory — of multiplication in the economy — -has been found especially inconsistent with the great mass of evidence which establishes the influence of the different conditions of the atmosphere * * * ; and that theory alone (of the six theories previously enumerated) s supported by a large amount of evidence which regards the cause of cholera as a matter increasing by some process, whether chemical or organic, in impure or damp air, and assumes that, although, of course, diffused with the air, it is also distributed and diffused by means of human intercourse." (p. 223). tSrd. — He holds that cholera is not contagious in the sense in which we apply the m to the method of operation of other zymotic poisons ; and that the theory of spread by Ltagion is opposed to conclusions drawn from well observed facts which place cholera in a erent category — (p. 221). "These characteristics," he says, "suggest the belief, that the ipagation of the disease cannot be maintained by any matter emanating from the bodies the sick." I4tk. — He attaches to human agency a share in the dissemination of cholera far above at I assign to it. But, be it remarked, Europe has supplied the theory, and yet Baly is npelled to fall back upon India for the data which have been produced in support of it ; and I facts which he quotes are, in my estimate, valueless, since they have been misrepresented in iir bearings, and are incapable of application to the points which they are supposed to prove, many cases what are alleged to be facts are simply erroneous allegations, without any claim the title of scientific or statistical truths, (p. 218). bfJi. — The theory of the provincial distribution of cholera by a controlling aerial agency, is irely in accordance with that of this report, although the full development of the* idea is, * Baly, p. 50, quoting Snow. Chap. IV.] THE CONCLUSIONS OF BALY AND THE CONSTANTINOPLE CONFERENCE CONTRASTED. 243 curbed by the preceding consideration of the spread of cholera by human intercourse and by want of specific data, such as we possess in this country : — I" The facts, however, by no means sanction the belief that cholera is always propagated in is way. On the contrary, it is certain that the extension of the disease over large towns, if t over larger areas, may take place independently of communication between the sick and c healthy* * *. In cases where human agency cannot have been the means of diffusing olera, the agent most likely to have conveyed the poison from one spot to another is the nd." (p. 219). Qth. — Cholera is recognised as a material substance, not of a gaseous nature, the area of the distribution of which is marked by the presence of the object cholera. Its relation to a vehicle of moisture, is also hinted at, and the phenomena of increase and decrease consequent on meteorological changes, inferred. He instances the preference manifested by cholera for low and densely populated districts, especially the tracts of countries about the mouths of rivers, and the ill ventilated parts of towns ; and remarks on its appearance at the commencement of an epidemic as a general rule in places in which impure and damp air will be found earliest and in the greatest abundance- (p. 216). blth. — Baly recognises that, beyond all other conceptions of its relations, epidemic cholera ents certain phenomena which are inexplicable. These are such as are dependent on the butes which I have assigned to cholera in viewing it as an object of natural history :—: — I" But there occur very remarkable variations in the intensity of the epidemic not referable temperature, which show that some unknown conditions of atmosphere, though not the cause cholera, exert a powerful influence over it, either by acting directly on the material cause the disease, or by affecting other matters in the air, which enable it to exist or increase." . 218). 1 Finally, for want of evidence, Baly leaves open the question of poisoning by emanations m the sick, and of methods of dissemination other than those indicated. I The structure of the Constantinople Conference, which professes to stand complete, is a very different edifice from that which Baly constructed as the r™oZ£ce.° nClmiOm ' Consfcanti - result of his study. I have spoken of the propositions leaning one on the other; the conclusions also appear to depend for their stability on the support which they derive from each other. In these the dependencies of outbreaks .are exalted into the place of the epidemic. The conclusions are as follows :—: — »lst. — " No fact has hitherto been brought forward to prove that cholera is spread abroad the atmosphere alone, whatever may be its condition." kind. — " The principle of cholera is regenerated in man, and accompanies him in all his gri nations ; it may thus be spread far and wide, from country to country, by successive nerations, never reproducing itself spontaneously, except in the human frame." tSrd. — " The matter of choleraic dejections is incontestably the principal receptacle of the rbific agent. It follows, therefore, that everything contaminated by such dejections also iomes a receptacle whence the generating principle of cholera is evolved, under the influence of ourable conditions. It also follows, that the choleraic germ very probably has its origin in digestive canal, to the exclusion, perhaps, of every other part of the organism." I Mh. — "Extension of cholera has always taken place in the direction of the human currents rich have set out from a place where it was raging. Cholera has never, in its progress, preferbially taken, as believed by some, a direction from east to west ; but on the contrary, it 3 radiated and radiates in India in every direction, to the south as to the north, to the east to the west, spreading itself everywhere in consequence of the facility and multiplicity the communications. Those who think otherwise have not studied the facts, and reason as the inese would do, who pretend that cholera invariably proceeds from west to east." Istk. — v . The study of facts demonstrates that there is no proportion between the amount cholera imported and the intensity of the epidemic consequent upon it, as a conflagration not proportionate to the spark that gave rise to it. Man tainted with cholera is the ncipal propagating agent of the disease, and a single case of cholera may give rise to an demic." I Indian authorities have never favoured such views as these. Jameson (1819) sums up s :: — v Without going at large into the argument, it may be stated that the total exempi of the medical officers, notwithstanding their being in constant attendance upon the ng, and frequently having to handle the dead, is hardly reconcilable with a belief in iction ; and that the unaccountable rise and speedy diffusion of the disease, its rapid -ease and equally rapid decline, the narrow bounds of its influence amid great and estricted intercourse, its limited duration, and, above all, its sudden and entire cessation, hout a single precaution being taken against its further extension, are facts decidedly racteristic, not of contagion, but of pure epidemical influence." ICorbyn (1832) devotes an entire chapter of his work to illustrations tending to blish the non-contagious nature of cholera. tMackinnon (1848) writes : — << After much thought and reading, I cannot believe that i disease is ever produced by contagion, and by contagion I mean any product of the human fanism capable of exciting disease in another by direct contact, or through the medium the atmosphere * * *. After large experience in this matter, I must express my total belief in the contagious nature of cholera, and I believe this to be the present opinion of [Section 11. 244 IKDIAN AUTHORITIES Otf THE NATURE OF THE CHOLERA ML4.SM. the immense majority of the medical service in India * * *. It has been remarked by Annesley, Irving, Mouat, Corbyn, Jameson and a host of others, that the attendants on the E: have not been observed to suffer from the disease more than others similarly exposed the other influences, and this is entirely accordant with my own experience during nty-one years." Scriven (1863) comes to the same conclusion: — " It is scarcely conceivable if contagion were the usual mode of propagation of such a disease as cholera, whose diffusion is so wide and whose ravages are so extensive, that so many men of large experience in India and elsewhere, should not have had convincing evidence of its power of spreading in this way."* tThe opinions of these observers as thus recorded, serve to show how little importance has \g the past half century been attached to the secondary manifestations of epidemic cholera. The apparent antagonism of the facts regarding cholera is in most cases to be attributed to the want of intelligent appreciation of their significance, and the less the whole truth is grasped, the stranger appears all that is put down to the inexplicable. If there be any truth in what has here been deduced from facts, there is no room for extreme views, especially for such as have most recently been put forth upon authority. While I have tried to hold the balance fairly between those who insist each on the acknowledgment of his own peculiar doctrines as representative of the whole truth, I have made no compromise tending to the undue exaltation of secondary phenomena. I should have liked further to have illustrated the secondary manifestations of cholera due to its individuality, but the illustrations are to be collected in the future. My experience furnishes none beyond those which I have given, and those incorporated in the Cholera Report of the Sanitary Commissioner for 1867. That it has given me greater satisfaction to frame into a system the isolated facts of outbreaks, and to find for these their place in the reproduction and in the epidemic, I will not deny. But it is the substantial value of such cases that I have chiefly looked to, recognising that they were tangibly part of a whole ; and the same feeling of satisfaction is not imparted by the study of the phenomena of any aggregate of the cases which depend on secondary manifestations of the cholera miasm however interesting these may be in themselves. Conclusion. In concluding, I wish to repeat the caution which I gave at the commencement of this paper, that, clear as the laws appear to be, and perfect as the parallels seem, the demonstrations from the history of this period are but a small contribution towards the perfection of a system ; they are given as the commencement of a study to be pursued in a certain direction, which it will take many years of research to elaborate. I would not have it concluded, when on any occasion in the future the parallels may not have fallen exactly as I have described them to occur during the present period, that the deductions from the facts as I have stated them are incorrect. Parallels do not fall except by the intervention of natural agencies, and it is these agencies which are to be studied as well as the part played before us by the object cholera. Ido not insist upon the absolute stability of parallels, but upon the truth, that epidemic cholera shall play its part side by side with natural agencies ; and if at any time it may appear that the order of things is broken, I think we shall do well if we mistrust our judgment and try to read the facts over again, under the conviction that it is far more likely that our data are deficient, or our appreciation of them wrong, than that the subordination of the epidemic cholera to natural laws has been removed. We have found the same truth persistent throughout this enquiry, not that the epidemic had a certain geography, a certain course, and a definite date of appearance in virtue of the fact that it was an invading epidemic; but we have found one and all of the manifestations of epidemics to vary precisely as they ought to have varied, to have been deferred and to have been accelerated, to have been repelled and to have been urged forward, to have left certain areas unoccupied and to have occupied others, under the guidance and control of an unerring agency. It is true that we shall for a long time to come recognise truths regarding cholera as an epidemic during or after the occurrence of the events as often as in anticipation of them ; but the time may come when the anticipation of events will be the rule and failure to anticipate them the exception. The stability of the standard here attempted rests on the truth of the three assertions, that the cholera provinces are the natural provinces of this Presidency, and will remain so in all time to come , that cholera has a distinct existence as an organised object in subordination to which the phenomena of reproduction, dormancy, and final decay occur ; and that the control of vital manifestations and also of epidemic progress is exercised by the meteorological agencies prevailing within geographical areas, which in this Presidency we can clearly recognise and define, but which for countries beyond Hindostan have yet to be framed. It is the special physical geography of Hindostan, the perfection of the regularity with which the seasons come forward year after year, and the normality of the limit of meteorological agencies in every year that causes its surface to become mapped out into natural areas. Limits there are of natural areas within the geographical limits of our Presidency, but its geographical boundaries are not the limits of the spread of aerial influences. The western limit to the province covered when our spring cholera is thrown over Eastern Africa, or the eastern limit of the air-borne cholera progressing beyond our north-eastern frontier, has never yet been defined ; and I have shown that Persia is only a halting stage in the first year of their career for the epidemics of Report on the Punjab cholera of 1862, p. 30. Chap. IV] RECAPITULATION OF THE FUNDAMENTAL PROPOSITIONS OF THIS REPORT. 245 our North-Western Provinces traversing the northern epidemic highway leading- out of the Bengal Presidency towards the west. The history of cholera as an epidemic within the endemic area is yet to be written. The immediate channels through which it emanates require still to be traced with care ; our knowledge is entirely deficient as to whether one breeding area supplies the pabulum for one geographical distribution of invading cholera and another for another, and as to whether exhaustion follows the throwing off an epidemic swarm in those localities from which we have reason to infer that it has issued. That cholera has a distinct provincial history as an epidemic over and above the fact of its reproduction and decay in each year in relation to the endemic area, is certain. I know of no enquiry of greater importance than that which shall teach us whether absolute prevalence over certain divisions of the endemic area is invariably the prelude to epidemic advance beyond the boundary limits, and whether the materies of an epidemic destined for far invasion is accumulated from the year of the throwing off of the one swarm up to the date of the exit of the swarm succeeding. Minor emanations do probably occur during these intervals, and these, no doubt, contribute to the perpetuation, from year to year, of the cholera which I have shown to exist in the shaded tract lying immediately beyond endemic limits. But the entire series of facts treated of in the first section, teaches, that there is held in reserve over and above the cholera of such casual emanations, a body of material sufficient, after the multiplication of a very few years, to constitute the material of the widest spreading epidemic. INDEX A. rrtion of the effects of the cholera miasm in the individual, 213. See Crisis of Cholera, and Strength of the Cholera Miasm. rleration of the appearance of cholera in relation to meteorology, 35, 36, 50, 239 ; in anticipation of the date normal for the province, in 1838, 105 ; in 1867, 129. See Repression. rmatisation, want of", a cause of the increase of the ratio of attack, 230. rvance of cholera. See Occupation of Natural Provinces. rhol, abuse of, a cause of the increase of the ratio of attack, 219, 231. Alliance, natural, of epidemic agents, defined, 11. tas. See Provinces, Natural, Endemic Area, Contrasts of Areas, Exemption of Areas, Famine Areas, &c. rsct of the Outbreak, causes determining the, 163 to 234 — see Table of Contents ; of a moving as distinguished from an anchored cholera, 24. rm, cholera of, in relation to seasons ; invasion of, in successive epidemics, 60, 61 ; phenomena attending invasion of, in 1860, 240. Attack of cholera. See Crisis, causes determining. Aura of the Epidemic. See Strength of the Epidemic. B. Behar Provinces, persistence of cholera in, 57. See Eastern Division of the Epidemic Area. Bengal Proper. See Endemic Province. rding grounds of cholera, selected portions of Natural Provinces, 93 ; nature of, in the Endemic Province, 57 ; in the Northern Provinces of India, 129, 132-136. C. Camp, movement into. Local persistence of the miasm up to the period of its natural decay suggestive of the necessity for, 169, 174, 182-185, 203-208; danger of the massing of individuals suggestive of the necessity for, 227, 228 ; unless fresh infection occurs, the outbreak at the worst becomes typical after movement into camp, 203 ; although limited in duration to nine days, great mortality may occur during this period, 199-202 ; 42nd Highlanders, 181; 70th Regiment, 203; 66th Goorkhas, 180 ; should be looked at in connexion with the duration and type of the cholera of the march, which shows that a moving body is in the best position to part with cholera at the earliest date after infection, 178, 179, 199; an infected body does not at once part with its cholera in consequence of, hence repeated movement is not necessarily called for on account of the cholera continuing to appear, 230 ; illustrations of the results of movement, 207-210. Central Provinces. See Southern Epidemic Highway. Choleroid Fever. See Sweating Sickness. I a Nagpore, cholera of, the connecting link between the cholera of the endemic and epidemic areas, and of the northern and southern epidemic highways, 175 ; occupation of, by invading cholera in 1826, 99; in 1830-31,100; in 1837, 103 ; in 1841, 110 ; in 1844, 113 ; in 1849, record wanting ; in 1853, 116 ; in 1855, 18 ; in 1559, 22 ; in 1863, 27, 119 ; in 1866, 29, 125 ;in 1868, 147, 156. Btic deterioration as influencing the ratio of ttack ; climatic diseases of the European and fative Annies contrasted, 231. Compensation for the weakness of the material of the epidemic in one portion of the epidemic area, by the strength of the miasm in another portion, 48, 143, 145, 165. Compression of air-borne cholera, the epidemic wall, 165. Contagious disease, facies of the outbreak of, in communities, 200. See Infection. Contrasts of natural areas afford the groundwork for estimating the fundamental truths regarding cholera as an epidemic, 50. Crisis of cholera, secondary causes determining the, 205, 213, 218 ; 227-233. D. Decay of the strength of the cholera miasm after the termination of the life-period of the epidemic. See Strength of the Cholera Miasm. Desert, North- Western, its characteristics and meteorology, 82 ; North-Western invasion limited by, 19, 25 ; relation of, to epidemic malaria in 1850, 75. Disappearance of the cholera of the Epidemic. See Interval, and Exemption of Provinces in relation to the age of the Epidemic ; of the Cholera of the Outbreak with the close of the Reproduction, in relation to the vitality of the miasm, 163-174. Disinfectants, estimate of the value of, 217. Dormancy. See Revitalisation. E. Eastern division of the epidemic area defined, 14; a natural province, 64 ; as distinguished statistically, 66-68 ; epidemic malaria in relation to, 73, 126 ; cholera repressed over, in 1864, 84 ; in 1860, 164 ; geography of cholera of, tabulated, in 1866, 124; in 1867, 144; in 1868, 148; influences prevailing within, as contrasted with those of the western division, 51, 71, 79, 88 ; seasons of prevalence of the cholera of, 36 ; aspect of the cholera of, in relation to months, as distinguished from the aspect in the western division, 49, 89 ; years of comparative exemption from cholera in 1858, 21; 1862, 27; 1866, 124; invasion of, in 1817, 29, 95 ;in 1818, 96 ; in 1826, 99 ; in 1831, 100; in 1833, 101; in 1837, 103; in 1841,110; in 1844-45, 113 ; in 1848-49, 117 ; in 1853, 116 ; in 1855, 17 ; in 1859, 22 ; in 1863, 27 ; in 1866, 125 ; in 1868-69, 147 ; meteorology attending the invasion of, 77-79, 125. Elevation, effects of, in preventing the manifestation of the effects of the cholera miasm, 225 ; above the cholera-containing 1 stratum of air, 226 ; in causing diffusion of the miasm ; stations of the Simla Hills, 1852, 165 ; Simla, 1867, 166. Endemic Province, defined ; its characteristics ; natural history of the cholera of, 56-61 ; special character of disease in the, 62; the cholera of invasion within, of 1866, 124 ; of 1868, 146, 156 ; method of exit from within, illustrated, 175 ; want of accurate information regarding, 244. Epidemics, indices of, in last century, 94 ; succession of, between 1817 and 1866, 95-122 ; of 1866-67 and 1868-69, history of, 123-157 ; geography of epidemics during the past 15 years, mapped and explained in Appendix 111. Epidemic, the definition of the term, 10; the normal duration in time of, 93, 40-48 ; laws regulating the geography, the diffusion, and the acceleration phy, Provinces, Natural, Repression. Essentials for epidemic manifestation, 87. rpe, cholera of. See Invasion beyond the limits of Hindostan. rnption of areas during primary invasion, see Trans-Indus Territories ; of limited areas within the range of invasion, 19, 25 ; of limited areas in secondary invasion, 23 ; of hill stations in primary invasion, 55, 166 ; comparative, due to elevation, 52-56, 225 ; years of, in different provinces, due to the age of the epidemic. See maps of Appendix 111, and explanations attached, as under 1855, 1858, 1859. 1860, 1862, 1863, 1864, 1865, 1866, 1867, 1868. ft of invading cholera from within the endemic area in 1866, 125 ; in 1868, 146, 156, 175. F. Facies of outbreaks. See Aspect. rine tract of 1860, cholera repelled from the, 24, 26; meteorology attending the repulsion of cholera from, 68, 80 ; tract of 1868, absence of cholera from the, 151 ; area of 1837, cholera in relation to the, 104. rine-stricken popu'ation, cholera of, in Orissa, in 1866, 124; of 1861, diffusion of cholera by the, 241. r runners of invasion, 176 ; illustrated in the case of the Meerut Cantonment, in 1818, 97 ; in 1845, 113 ; 185G-67, 144. See Aura of the Epidemic. Q. fgetic Provinces. See Eastern Division of the Epidemic Area. r graphical site of stations, as determining a minimum of liability to cholera, 226 ; of certain tracts of the epidemic area, 52-56. [fraphy, the fact that the cholera of every year has a definite, illustrated from the history of the years between 1854 and 1868, 14-32 ; Appendix III ; of cholera, in relation to Natural Provinces and to Meteorology, 52-88 ; see Table of Contents ; of cholera in 1866, 24-128; in 1867, 129-146 ; in 1868, 147-157 ; of cholera in relation to diffusion by human intercourse — see Human Intercourse ; of epidemic malaria, 72-76. H. tnony in Epidemic History. The experience of one type never contradicts that of another, 4 ; of parallels, often lies bej^ond what appears on the surface, 91. I), dry, inimical to the epidemic spread of cholera, 50, 68, 80, 82, 89, 154 ; represses revitalisation, 50, 84; promotes the disappearance of cholera over provincial areas, 166 ; meaning of, in the endemic province, and on the southern epidemic highway where the dry season is constantly associated with cholera, 105. |)itals, cholera of, 204-206, 210, 215,216, 232, 239 ; moral effect of breaking up of, during the outbreak, a means of diminishing the ratio of attacks, 232. See Infection. lian intercourse, distribution of cholera by, negatived by the provincial aspect of cholera shown in every epidemic, 91 ; illustrations of distribution by, 238; distribution by, does not include the whole truth, 3, 207 ; system founded on distribution by, its incompleteness, 235, 243 ; Jameson's opinion on, 243 ; Mackinnon, 88, 243 ; Punjab Commission of 1867, 133 ; indices of coming invasion afforded by, 124 ; review of the Hurdwar Cholera of 18G7 in relation to, 133-141. liidity, the characteristic of eastern influences wherever met with, 62, 72, 77, 78, 82 ; increases gradually in intensity when progress is made from north-west to south-east, from the North- Western Desert to the Bay of Bengal, 50; perennial, the characteristic of the endemic area, 61 ; of southern epidemic highway, determines the early crossing of cholera from east to west, 72-86 ; Jameson's curved line, 96 ; in relation the conveyance of cholera, see Vehicle. I. Index Station, Cawnpore as an, 208 ; stations on the southern and northern epidemic highways :— ¦ Saugor. Ajmere and Nusseerabad. 1818, 96. 1818, 97. 1827, index of exemption. 1827, 99. 1831, 100. 1831, index of exemption. 1834, 102. 1834. See Jail Table. 1837, 104. 1837, 104. 1841, 110. 1843, 108. 1846, 111. 1846, 112. 1849, 117. 1850. See Jail Table. 1856-57, 41. 1856, 20. 1860, 119. 1861, 25. 1864-65, 120. 1864, index of exemption. 1867, index of exemption. 1867, 142. 1868-69, 154-156. 1869, 151. Indices, value of, towards completing Epidemic History, 94. Infection of hospitals, illustrated. Its significance, 204; of hospitals unknown in Calcutta, 206, 215 ; carried by pilgrim streams, and in gangs of prisoners and coolie immigrants, 238 ; introduction of infected bodies not necessarily followed hy, 238 ; of attendants associated with infection of locality, 206, 212 ; of attendants, a rare occurrence, 205, 232. Infection of locality. See Localisation of Cholera. Intensity. See Strength of Cholera Miasm. Interval between epidemics. The term defined, 14 ; illustrated — See above, Index Stations ; an absolute interval often true for certain provinces only of the epidemic area, 94; between the dates of dormancy and revitalisation in different localities. See Revitalisation. Invading agencies. Their importance in determining the health of Upper India, 64. Invasion, of Provinces (see the names of provinces); on the tract of primary exit from the Endemic Province, 175 ; recurrence of, to be watched for on the northern and southern epidemic highways, 94 ; of regions beyond primary monsoon influences, see Trans-Indus Territories ; beyond the limits of Hindostan, 99,124; in 1864-65, 120; in 1860, 99, 119; in 1858, 118; in 1854-55 and in 1851-54, 118 ; in 1846-48, 113 ; in 1844,109 ; in 1837, 103 ; in 1834 (on the southern highway), 102; in 183.1, 101; in 1827-28, 99; in 1821, 98. J. Jails of the Bengal Presidency. Aspect of the outbreak (a) in Bengal Proper, (b) in Upper India, 186-191; outbreaks in the course of a provincial invasion illustrated, 189; outbreaks of Central Jails illustrative of the effects of the massing of individuals, 227 ; comparative exemption of prisoners during the invasion of epidemic malaria in 1859, 74; in 1850 75 ; in 1 867, 135 ; persistence of cholera in certain jails of the endemic area, 211 ; occasional aspect of cholera seen among prisoners, 211 ; cholera deaths between 1833 and 1868, and what these deaths illustrate, Appendix 11. L. Laws regulating the various manifestations of cholera, such as repression and acceleration, geographical distribution, dormancy and revitalisation, the duration of the Epidemic, the occurrence of parallel phenomena, the phenomena accompanying invasion, the aspects of outbreaks over provincial areas, &c, are permanent, inasmuch as they are determined by the behaviour of a vital object which is subordinated to natural influences. Illustrations passim. 2 INDEX 3 Liability to the attack of cholera in European and Native Regiments contrasted, 219-224; of Goorkhas, 228 ; of attendants on the sick, 205, 232 ; secondary causes influencing, 218. Limitation of geographical spread. See Repression. Limits, geographical, of invading cholera, the boundaries of the Natural Provinces of Upper India, 66, 71. Lines of communication are not the cholera highways of India, 88, 90, 92, 175. Ilisation of epidemic cholera, as affecting the duration of outbreaks, 173, 181, 203, 206-210 ; phenomenon of the affection of attendants in connection with, 206, 210. M. Iras Presidency, north-east monsoon as affecting the, 72; cholera of, in 1830-36, 100; in 1839-47, 111 ; invasion of, in 1868, 154 ; exemption of, in common with the Central Provinces, in 1867, 140. Iria, epidemic, defined as a specific miasm, and its provincial distribution demonstrated from Epidemic History, 72-76 ; localisation of, 218 ; of 1866, 125-127; natural alliance of cholera with, 11 ; the effects of cholera and, developed parallel with the supply of moisture, 226 ; the British Soldier in relation to, 224 ; effect of damp encamping grounds in relation to the manifestation of, 136, 226; the crisis in poisoning by cholera and malaria, 214, 217. March, cholera commencing on the, in European Regiments, 178 ; in Native Regiments, 179. Meteorology attending invasion See names of Provinces. Meteorological phenomena, 49-92. See Table of Contents. Moisture. See Vehicle and Humidity. fsoon, province of north-east, defined, 72 ; of south-west, mapped and defined, 65. Monsoon influences, appearance of cholera in geographical areas in subordination to, 34, 38, 51, 64. N. Ive Regiments, nearly exempted from the outbreak in cantonments, 219 ; loss of, in provincial invasion, 220 ; loss of, in cantonments contrasted with the loss of European Regiments, 221-223 ; outbreak in, on the march, 179 ; during boat voyages, 192; aspect of, in the endemic area, 186. »,ul, invasion of, in 1818, 97 ; in 1856, 90 ; in 1860; in 1867, 142; aspect of cholera in, 241. Northern epidemic highway, the invading cholera on, in 1818, 97 ; in 1827, 99 ; in 1833, 101 ; in 1837, 104; in 1842-43, 108,109; in 1850, 117; in 1856, 19; in 1860, 24; in 1866-67, 127, 130 ; in 1869, 157 ; meteorology attending the occupation of, in 1818, 77; in 1867, 141; repulsion of cholera from, in 1868,151 ; the southern limit of, in 1861, 26 ; in 1867, 141. rh-Western Provinces consist of more than one Natural Province ; sub- divided relative to the antagonism of eastern and western influences, 66-68, 88, 96 ; geography of malaria in relation to the same sub-division in 1859, 74 ; in 1866, O. Obstacles to the successful study of cholera, 3. Occupation of Natural Provinces by invading cholera, ¦ method of, illustrated, 19, 25, 138, 153, 165, 175. c. See Eastern Division of the Epidemic Area. break. See Table of Contents, Section 11. P. rllels, importance of the study of, 10 ; result from subordination to a definite meteorology^ 90, 244 ; natural contrasts of the different provincial areas determined by the recurrence of, 50 ; illus- trations of, passim. Persia, a portion of a cholera province of Hindostan as regards invasion, 109 ; invasion of, in 1821, 98 ; in 1828, 99 ; in 1831, 101 ; in 1851-52, 118 ; in 1858, 118; in 1860, 119; in 1867, 142; Cholera of, in 1868, 149 ; cause of exemption in 1865, 123. Peshawur. See Tians-Indus Territories. Pilgrim cholera, a manifestation of a cholera already distributed over the provincial area within which it is exhibited, 4, 239, ; viewed as a parasitic affection, 241 ; of Juggurnath, developed in relation to season, 239; of Hurdwar, of 1867, anticipated from the distribution of the invading cholera of 1866, 30 ; its influence on the spread of Cholera over Northern India in 1867, 137 ; evidence regarding, beyond the radius actually infected, 141 ; viewed in relation to the typical outbreak, 202. Prolongation of the outbreak, causes determining, 173, 181, 185, 203. Propagation of cholera in communities by what emanates from the cholera patient ; multiplication of the miasm in the primae viae, 214 ; observations of Indian authorities upon, 243; of Baly, 242; the system based upon, 243; its want of stability, 237. Prophylactic measures, estimate of the advantage of, 214. Provinces, Natural. The term defined, 62 ; the limits of, in Upper India determined by invading agencies, 64 ; mapped in relation to invading agencies, 65 ; disease in relation to, 67 ; characteristics of the same provinces in different years, and of the different provinces of the epidemic area in the same year, 68-70 ; are provinces determined chiefly by their meteorology, 71 ; of epidemic malaria are the same as those of cholera, 72-76 ; meteorology attending invasion of 76-92 ; boundaries of, are not overstepped by means of human communication, 91. Punjab, invasion of, in 1819, 98 ; in 1827, 99 ; in 1833, 101 ; in 1837-38, 105 ; in 1844-45, 109, 114; in 1852, 118; in 1856-58, 18-21; in 1861-62, 24-27 ; in 1865, 45 ; in 1867, 137 ; characteristics of epidemic and non-epidemic years in the, 69, 150 ; rain-fall of, 82, 150 ; meteorology attending the invasion of the Punjab by cholera, 81, 136 ; invasion of, by epidemic malaria, 74 ; cholera deaths of, in 1867, 144 ; in 1868, 149. Q. Quarantine, the facts of the Natural History of cholera in India are opposed to the alleged efficiency of, in preventing the epidemic distribution of the miasm, 2, 214 ; cholera does not overstep the boundaries of Natural Provinces whether quarantine be enforced or not, 91 ; cases to which quarantine is applicable, 238 ; alleged efficiency of quarantine contradicted by exemption under parallel circumstances when no quarantine existed, 140. R. Race, effects of, in increasing the predisposition to succumb to the cholera miasm, 219-224, 227, 229. Radiation of cholera. The cases to which the term is applicable defined, 87; from Hurdwar as a centre, 137 ; a term used only by the local observer, 4. Rains. See Vehicle of Moisture. Rain-fall, not essential to Epidemic advance,_ 128 ; excessive, is not necessarily accompanied or followed by cholera, 86; in epidemic and nonepidemic years contrasted ; of Oude, 85 ; of the North- Western Provinces, 80; of the Punjab, 82, 150 ; of the Central Provinces, 155. Rajpootana. See Northern Epidemic Highway. Rate at which the cholera miasm travels, how to be calculated, 90 ; illustrations of, in Upper India, 1 19, 25, 139 ; across the southern epidemic high* way, 96, 156, Appendix 74 ; into Persia, 109 ; is not a mere question of radiation, since Arabia and Africa may be reached before Northern India, 29, 120. Recurrence of cholera in the same locality illustrated ; it ia subordinate to the provincial manifestation of revitalised cholera, 177. Removal from one district into another of the material of the epidemic, illustrated, 141, 165. Repression of the manifestation of cholera — revitalisa- Ition controlled in relation to geographical situation and to meteorology, and invasion in relation to the same circumstances, 34-38, 50 ; of cholera in space due to the bounding lines of Natural Provinces — general conclusion, 91 ; due to special meteorology, illustrated, 85, 125, 166. Reproduction, defined as the annual manifestation of the cholera of the epidemic, which appears between the normal periods of dormancy, 10 ; a vital phenomenon, 9 ; equivalent of, in Natural History, 10, 199 ; summary of conclusions regarding, 93. rtalisation from a state of dormancy in Natural Provinces, an universal phenomenon, 9, 13, 93 ; dates normal for different situations, 34-39, 58-61, 89, 208, 239 ; illustrations of, in 1867 and 1868, 130, 155. S. Season, aspects of endemic and epidemic cholera in relation to, 49-92. (See Table of Contents). t)ns, cholera, normal for the different tracts of the Bengal Presidency, due to the varying meteorology of the different provinces, 33-39, 50. [hern epidemic highway. Strength of epidemics, thrown at one time on the Southern at another on the Northern Highway, 48 ; occupation of, in 1818, 96; in 1821, 98; in 1830-34, 100-102 ; in 1837, 104 ; in 1841, 110 ; in 1844-45, 111 ; in 1849 and 1850, 117; in 1853, 115 ; in 1856, 19, 79 ; in 1860, 23, 118 ; in 1863-65, 119-121 in 1868, 153-157 ; connection of the cholera of, with endemic cholera, 156, 175 ; meteorology attending the occupation of, 72 ; in 1818, 96 ; in 1837, 104; in 1860, 79; in 1868, 152, 154 ; in 1864, 86 ; occupation of, occurs per saltum, 154 ; termination of journey in Bombay Presidency, 1848-65, 115. tig cholera, as distinguished from the cholera of the monsoon, 34, 35, 78, 239 ; vehicle of, in the western division, 91. Stagnation of the atmosphere, favourable to the local manifestation of cholera, 228. lagth of the cholera miasm in relation to the age of the epidemic, 56 ; to elevation, 225 ; to the aura of the Epidemic 87, 116, 166, 176, Appendix 74 ; to appearance at an abnormal season, 211 ; not necessarily indicative of accumulation of the miasm in a locality, 213 ; increased in recent epidemics, 233. »uck by cholera." The phenomenon illustrated, 200-202. f.erbun tract. Its annual submersion followed immediately by the universal disappearance of cholera in the districts around, 35-60 ; as influencing the epochal manifestation of cholera, 233. liting sickness (choleroid fever ) of Malwa, in 1839, 107 ; of Agra, in 1856, 107 ; of Peshawur, in 1855, 16 / of Meean Meer in 1852, 166. ¦jm, the construction of a, value of primary and secondary truths in, 235-237 ; comparative value of statistical data and data derived from observation and experiment in, 236 ; Baly, 1848, 242 ; Constantinople Conference, 1865, 243. Systematic arrangement of the matter of the report— of Ist Section, 11 to 13 ; of 2nd Section, 162. T. Terms defined — the Epidemic, the Reproduction, the Outbreak, Dependencies of Outbreaks, 10 ; Interval between two epidemics, 14 ; Endemic Cholera 56 ; a Natural Province, 63 ; Epidemic Malaria 73. Trans-Indus Territories, — affected only in secondary invasion, 52 ; invasion of, in October 1858, 22, 212 ; invasion of, in April, 1862,26; in May 1867,' 137; on same days, in 1862 and 1867, 138; parallel between cholera of November 1844 and April 1845, and the cholera of October 1861 and April 1862, 109 ; localisation of cholera in, 177, 181, 204 ; meteorology attending invasion of, 70, 82, 139. Treatment of cholera as a disease — Dr. Murray's report, 216. Truths regarding cholera, primary and secondary. Primary, essential to a complete structure, 3 ; fundamental, must be recognised at their proper value, 3 ; primary, are those chiefly regarded in the province of endemic cholera, 163; relative value of, as estimated in India, 235-237. Type of the epidemic. — The epidemic of 1817-20 studied as a type, 95-98. Type of the outbreak, 180, 181, 199, 202, 210, 212, 229, Appendix 42. Typhoid of the unacclimatised, 85, 151. Typhus, the miasms of cholera and, contrasted, 215 ; the facies of the outbreak of, in communities, 200. V. Vallies, favourable to the retention of cholera, 56 ; Nerbudda Valley (see Southern Epidemic Highway) ; Peshawur, 177, 204 ; Nepaul, 142 ; Cashmere, 139. Vegetation, belts of, protection against air-borne cholera, 224. Vehicle of moisture essential to the epidemic spread of o'lolera, 88, 89, 105 ; not necessarily attended by cholera in Upper India, nor in the Central Provinces, 86 ; in countries beyond monsoon influences, 70 ; in the spring months, in Northern India, 71, 91; in the hot season in Bengal Proper and on the southern highway, 105. (See Eastern Influences). Virulence, increase of, in recent epidemics, 233. (See Strength of the Cholera Miasm). W. Wave, cholera — Its significance, 167, 168; in the endemic province, in 1868, 146. Western division of the epidemic area. See Northern Epidemic Highway and Punjab. Western influences. See Eastern Influences. Winds, east and west, effects of, contrasted (see Eastern Influences) ; east winds accompanying the epidemic spread of cholera to the west, Jameson, 77 ; Mackinnon, 88 ; in recent epidemics, 79-82 ; mechanical effects of, in diffusing the cholera miasm, Jameson, 88 ; winds of the north-east and south-west monsoon, 65, 72. Y. Years, epidemic and non-epidemic, characteristics of, in Natural Provinces, contrasted, 67-70, 150, 4 APPENDIX I. TABLES SHOWING THE ADMISSIONS AND DEATHS FROM CHOLERA IN THE EUROPEAN AND NATIVE ARMIES DURING THE TWENTY-SEVEN YEARS FROM 1826 TO 1853. 2 CHOLERA OP THE EUROPEAN AND NATIVE ARMIES, 1826-53. [ ApDfinH EUROPE^ ARMY, 1826. NUMBER OFADMISSIONS~AND DEAThJ FROmThOLERaTn EACH 'MONTH. STATIONS. SIKK.OXH. 1 J "™"- Zf!"^!*! . MABCH ' A ™*" *** *"¦• J™. A TOP sx. Sepxbmbbb. Qctobeh. Novbmbsb. Dbcbmbb* Total A D hx S - W j^^-^_^- A d .| Died . Ad .| Died . Ad . t^j^j. Ad , Dled Ad , Died , Aaj^-AT^^r^^r^: BIONySe °™ °S I Presidency Hospital ... ?, ... 7 o 1 is * qq oo < t „ "' Fort William 603 2"' 15?S2SJJ 3 * 9 6 4 * 5 ... 2 2 158 93 Buxar ... ... ... 76 ... » U 5 1 3 1 3 1 44 IS Ghazeepore... ... ... 569 : "* ? ¦• 3 3 Benares ... ... ... 92 x '•' o 1 ... 1 ... 1 7 Allahabad... ... ... i 36i 36 [|\l* | o lg - Cawnpore ... ... 1763 "l I "i ' "-i "V "" Meerut ;;; sgoQB I." | ..! .. * "" | "' " 14 10 1 ... 3 2 3 2 1 45 22 1 - 651 ;;; ; ;;; 2 - 2 ••• i 6 1 n 1 J Mnttra ... ... 12 ® Nusseerabad q,s • Saugor ... ... ... 108 ... | ... .2 Kurnaul ... ?, 5g H BLurtpore Field Force... ... j "i 3 1 1 1 ... ... ... ''[ "' []' '4 "2 ¦'.'. ... '.'. 1 1 Troops on the march ... ... 1 o «« 9 « o - — — — JL^^L^l ? 3 - 2 2 1 1 2 2 78 34 Bengal Pbesidency -.. 10,080 ; 14 2 7 1 2R TO l=;n 7<» t?q ! or c) ~T- Ti ¦ I I I 0 lS0 \ n 179 | 96 M lo "16 68 43 16 J 9 4 13 2 13 5 592 279 NAJTIVE ARMY, 1826. jKfc* \ m*{ 26 1 19 | 2 33^ 749M92? 1 12 8 12 140 37 I Cawnpore „ ... C 5 - 1 1 ! , ' •• ••• i ••• Is if-ut ; ... ;;; \ i ;;; ;;; } } 5 ••• 8| 4 5 2 13 3 52 3 . 2 ... 2 i 1 ": "1 1 46 £i I |^-a „ ... ... j27j 27 - 316 1 3- "2 ;;; 341 11 5 ... 13 492 35 8 Nusseerabad „ ... ... 121 2) 596 ill f ' ? "" "a a 10 | ai^ or 14(: » ¦•• ... 8,976 i ... ;; ;;; ;;; ;;; J-: 4 2 ••• ¦•• ••• liB 'i 1 Kurnaul* „ ... ... 1\16121 3 1 14 4 § | | ' 45 9 3 22 6 47 7 92 34 101 29 62 18 44 9 27 9 11 2 ~15 2 33 ~9 19~"~4~| 475 132~f ¦ Ti CHOLERA OF THE EUROPEAN AND NATIVE ARMIES, 1826-53. Hi EUROPEAN ARMY, 1827. i NUMBER OF ADMISSIONS AND DEATHS FROM CHOLERA IN EACH MONTH. 11 j \ „_...„.,„ _ Jaxuabt. Febeuakt. i Mabch. Apkil. Mat. June. July. August. Skptembeb. Octobeb. Novembeb. December. Total Admis- deaths STATIONS. Strength. sioks of the „„ „" Ad. Died. Ad. Died. Ad. Died. Ad. Died. Ad. Died. Ad. Died. Ad. Died. Ad. Died. Ad. Died. Ad. Died. Ad. Died. Ad. Died. Ybab# Presidency Hospital ... ... ... 1 | ... I ... | ... 7 6 I 149 54 ... 1 4 ... 7 3 3 3 6 4 5 6 8 3 | 190 80 Fort William ... ... 901 2 ... 3 2 2 1 7 2 14 8 2 1 3 1 1 ... 6 2 ... 1 40 18 Dum-Dum ... ... 918 2 ! 2 ! 2 ... 2 ! 1 21 7 7 ... 1 ... 2 1 2 2 39 13 Chinsurah Depot ... ... 378 1 ... 1 2 i 1 75 20 14 4 7 3 8 6 3 1 7 4 118 39 >P Berhampore ... ... 1,738 ! ... ... 3 2 3 ! 2 1 ... 1 2 ... 4 ... 1 .. 3 1 11 ... 29 5 g Dinapore ... ... ... 1,211 1 ... 3 : ... 1 I ... 6 ... 81 4 ... 63 1 ... 1131 5 -a Buxar ... ... ... 81 I ... \ 1 1 1 1 ¦§ Ghazeepore ... ... | 942 2 ... 2 1 1 1 ... 3 ... 3 1 2 ... 2 '.'.'. 1 ... 17 2 2 Benares ... ... ... 87 ' i 1 1 1 ! 2 1 Chunar ... ... ... 258 3 ... 1 ... 2 1 4 ... ." 10 1 *S Allahabad ... ... ... 85 1 ! 1 ... -*s Cawnpore ... ... ... 1,988 2 1 ... 12 j 1 8 ... 6 1 2 ... 4 1 3 1 2 1 4 ... 1 ... 44 6 ¦Meerut ... ... ... 1,892 1 2 ... 7 1 6 2 1 ... 4 2 ... 1 ... 22 5 :| Agra ... ... ... 1,092 11 3 1 2 ... 1 ... 12 4 22 2 11 2 ... 3 ... 1 ... 1 1 I 49 10 & Muttra ... ... ... 103 2 1 2 1 t Nusseerabad ... ... 126 ... 19 4 3 22 4 q Kurnaul ... ... ... j 183 j 1 ... 1 Troops on the march ... ... ... 6 1 ' 7 Bengal Presidency ... 12,095 11 2 12 5 19 3 39 15 309 98 71 11 24 6 35 13 i 27 7 23 10 31 16 24 5 I 625 191 =_| ' I _ NATIVE ARMY, 1827. | j I i i | Presidency Circle ... ... 1,700 1 ... 11 1 6 1 12 ... 7 ... 8 ... 3 ... I 6 ... I 1 ... 4 1 3 ... 6 2 68 5 Barrackpore „ ... 15,203 5 ... 8 ! 2 21 5 29 5 31 12 15 4 9 2 18 1 4 3 13 2 6 2 4 ... 153 38 *j Berhampore „ ... . 2,488 11 2 ... 2 1 11 1 2 . i 3 I 1 11 6 3 4 .. 1 ... 24 8 •* Dinapore „ ... ... 6,594 11 1 ... 2 ... 4 ... 5 2 ! 2 1 3 2 19 9 26 2 63 17 f* Benares „ ... ... 7,434 ; 1 ... 1 ... j 2 11.211 13 22 23 4 _® Allahabad „ ... ... 8,101 ... ... 1 ... 4 4 **3 6 5 1 1 1 1 1 1 18 11 Cawnpore „ ... ... 16,848 3 1 ... 1 6 ... 4 1 4 2 10 3 4 1 6 1 8 5 1 ... 46 15 h I Meerut „ ... ... 16,185 ... J... I 2 1 17 5 37 13 16 4 39 16 11 3 2 ... 2 1 1 ... I 127 43 «g jAgra „ ... ... 12,938 ... ... 1 | 1 5 ... 2 ... 36 14 53 8 23 ... 27 5 12 2 4 ... 1 164 30 Nusseerabad „ ... ... | 11,202 ... ... jI 8 ; .. 124 23 725* 3 3 1 147 29 g Saugor „ ... ... 8,077 ... 1 1 ... 1 1 1 ... 8 ... 15 6 i 2 3 5 1 '.'.'. '..'. 43 12 Kurnaul „ ... . 11.160 I ! : ! I. I ! I 14 3 27 12 12 4 4 1 57 20 S Bengal Presidency . 117,930 \ 9 3 29 5 37 ' 0 i 67 8 238 ! 57 ! 155 39 103 24 123 33 48 ! 18 64 26 47 7 13 3 933 232 fi ' i I I : i Jy • CHOLERA OF THE EUROPEAN AND NATIVE ARMIES, 1826-53. [Appendix! EUROPEAN ARMY, 1828. NUMBER OP ADMISSIONS AND DEATHS FROM CHOLERA IN EACH MONTH. January. February. Maech. April May. Junb. Jitly. August. September. October. November. December. jTotal Admis- i tv_°*" STATIONS. Strength. I sions of the "EA" EAI * n s Year. °^ THE Ad. Died. Ad. Died. Ad. Died. Ad. Died. Ad. Died. Ad. Died. Ad, Died. Ad. Died. Ad. Died. Ad. Died. Ad. Died. Ad. Died. IBAB - Presidency Hospital ... ... ... 1 1 3 3 17 15 25 12 12 7 22 9 7 ... 1 ... 1 7 3 96 50 Fort William ... ... 925 16 7 11 7 4 11 1 ... 26 13 Dum-Dum ... ... 1,085 7 3 2 1 6 3 5 3 2 1 1 11 24 12 Chinsurak Depot ... ... ... 7 3 1 ... 7 3 3 1 18 7 £ Berhampore ... ... 1,692 7 135 31 70 12 6 2 1 ... 219 45 a, Dinapore ... ... ... 1,605 3 34 11 51 10 14 4 17 3 7 1 4 ... 2 ... 132 29 Buxar ... ... ... 75 ... ... -3 Ghazeepore ... ... 968 2 4 1 3 ... 19 5 24 10 11 4 5 2 7 1 3 ... 3 81 23 g Benares ... ... ... 80 1 ... 1 ... 1 3 ... H Chunar ... ... ... 210 J ... «g Allahabad ... ... ... 105 ... ... «j Cawnpore ... ... ... 2,192 4 ... 3 ... 3 1 1 ... 12 3 39 15 30 8 11 3 11 11 2 1 107 33 § Meerut ... ... ... 1,929 I 1 1 ... 2 1 6 3 2 ... 5 1 2 19 5 * Delhi ... ... 1,111 1 1 2 ... & Agra ... ... ... 96 ... ... U ISTusseerabad ... ... 160 1 1 ... p Saugor ?, ... ... 146 Kurnaul ... ... ... 156 1 1 Bengal Presidency ... 12,535 34 8 6 3 170 52 148 42 ; 101 30 88 33 82 25 52 13 24 4 6 1 6 1 12 5 729 217 I J NATIVE ARMY, 1828. Presidency Circle ... ... 2,018 4 1 10 3 6 1 4 3 7 ... 1 ... 1 ... 2 ... 1 ... 1 •- 1 ... 38 8 . Barrackpore „ ... ... 10,273 3 ... 9 1 11 3 25 13 20 9 28 12 12 6 8 ... 4 1 1 ... 3 1 4 ... | 128 46 r-i Berhampore „ ... ... 6,930 2 ... 12 6 5 3 3 ... 3 ... 3 ... 1 1 2 ... 11 5 9 4 I 51 19 g Dinapore „ ... ... 6,478 2 5 1 9 4 9 2 21 11 4 ... 2 1 1 ... 2 1 9 ... 64 20 Benares „ ... ... 7,797 2 ... 4 ... 6 3 1 ... 9 3 9 1 31 7 -_ Allahabad „ ... ?, 7,832 1 ... 1 7 4 5 1 11 1 26 10 12 2 2 1 65 19 £ Cawnpore „ ... ... 16,673 | 1 ... 3 ... 3 1 6 2 5 1 12 4 18 7 4 21 8 1 ... 74 23 Meerut „ ... ... 15,788 3 ... 3 1 12 5 19 11 4 1 1 ... 2 ... 1 11 46 19 *o Agra „ ... ... 10,134 21 2 ... 10 ... 92 2 ... 5 ... 3 ... 3136 4 _ Nusseerabad „ ... ... 11,813 4 2 3 3 1 ... 8 5 | Saugor „ ... ... 7,385 11 2 ... _ Kurnaul „ ... ... 9,275 1 1 1 1 ... 2 ... 2 7(1 2. Bengal Presidency ... 112,396 12 2 11 1 39 7 74 27 78 33 96 38 64 15 76 22 28 5 sill 38 15 / 26 j s j 550 j 171 jj jj Wo. I J ' EUROPEAN ARMY, 1829. NUMBER OF ADMISSIONS AND DEATHS FROM CHOLIiKA IN EACH MONTH. I 111 January February Mabch. I April. May. June. July. August. September. I October. I Novembeb. Decembeb. \ Total Admis- i d e , ths STATIONS. Strength. \ . . j "Tear™ I OF IHE Ad. Died. Ad. Died. Ad. Died. Ad. Died. Ad. Died. Ad. Died. Ad. Died. Ad. Died. Ad. Died. Ad. Died. Ad. j Died. Ad. Died Year. Presidency Hospital • 3 ... 2 ... 4 2 2 1 12 3 17 3 6 1 1 2 9 4 4 ... 11 61 17 ForiSm P :.: ..: 896 3 1 1 ~. 4 1 2 ... 6 3 8 2 7 2 7 3 6 i 2 1 46 14 Dum-Dum 1,037 1 ... 11 4 11l ... 2 1 10 3 Chinsurah Depot 1 - 1 - 5 - 17 6 2 X - 27 6 g Sainjore " Z U* 3 1 1 ... 153 40 49 18 1 ... 2 1 1 210 60 g Dinapore ... ... 1,804 71 17 72 9 34 1 30 4 4 1 4 1 2 ... 6 2 223 35 « GWpore Z 948 1 Z Z Z Z Z Z Z "* 3 2 3 Z Z 1 Z Z Z Z Z Z ... Z Z 13 6 | Benares 130 2 1 2 1 H Chunar ... ¦ • ¦ 230 .. 4 ... • • • • • • "¦© Allahabad ... ... 117 ••• ••• ••¦ ¦ ••• ¦•• ••• ••• •• ••• •¦• • ••• ••• ••• Cawnpore 2,206 1 ... 13 ... 11 ... 6 ... 5 3 5 1 4 . 2 12 ... 1 ... 50 5 | ' Meerut 1,823 2 1 ... 2 1 11 b 2 « Agra ... ... 1,032 1 1 ... 1 - 1 f - & Muttra ... ... 102 1 •• ... j ••• -g Nusseerabad ... ... 171 • • •¦¦ 1 1 • IP Mhow (lOMonths) ... ... 179 1 ¦•• 1 ••• 1 1 4 Saugor ... ... 82 •• ••• ••• •• ¦•• ••¦ ¦•• ••¦ Kurnaul ... ... 293 <^ 1 & 1 Troops on the march ... ... ... *¦ *¦ "• "• '" Bengal Peesidency ... 12,751 8 ~T 4 j ... 247 61 143 28 73 9 78 20 28 9 j 27 7 11 3 j 26 10 14 2 5 2 664 152 NATIVE ARMY, 1829. ' Presidency Circle 2 ... 2 1 2 ... 4 . 3 1 1 ... 1 ... 3 ... 18 2 Barrackpore „ ... ... ... 4 3 1 ... 1 ... 2 ... 1 .. 2 ... 10 2 3 ... 2 ... 1 . 5 ... 2 ... 34 5 g Berhamjore 3 ... 2 ... 34 16 14 4 4 1 3 2 3 . 7 3 4 ... 7 1 1 ... 9 5 91 32 « Benares „ ... ... ... J. ... « f 1 r "" ...... Allahabad „ 1 2 1 ... 1 ... 5 1 1 ... 1 - •¦• •¦• " 1 g fc c » w :; ::: ::: ::: .! . : ::: ::: I ::: I - 1 1 :: i S ::: J ~ ™ "* ::: ? : i ;;* ::: S ! i - SS, ;: ::; ::: ::: ..' ::: ::: ::: • ::: ::: ::: ::: ::: i ::: ::: :::" I ::: "i - i •¦ "» "i "» ::; 10 » | Bengal Peesidency ... ... 15~ 5 4 ... 91 -17 36~ 6 22 6 23 5 32 4 35 6 13 2 18 3 13 2 21 7 322 63 y{ CHOLERA OF THE EUROPEAN AND NATIVE ARMIES, 1826-53. [ Append' EUROPEAN ARMY, 1830. NUMBER OF ADMISSIONS AND DEATHS FROM CHOLERA IN EACH~ MONTH. STATIONS. Sxbbkgth. J " PA "- g »™"- Ma »eh. J^ I_^L_ _J^!l_ _^"- _An^T_ Skptkmbeb. Qctobeb. No.e^T^^m^T |tot A l Admxs- £<£« Ad. Died. Ad. Died. Ad. Died. Ad. Died. Ad. Died. Ad. Died. Ad. Died. Ad. Died. Ad. Died. Ad. Died. Ad. Died. Ad. Died. T™ Presidency Hospital ... ... ... 1 2 ... 2 1 9 5 16 6 5 2 21 10 93 17 a o Port William ... ... 1,068 1 ... 9 1 2 ... 5 6 13 111 i '" \ I 7? I 4 2 85 41 Dum-Dum ... ... 720 7 .. ... ]" '" * " 4 2 14 4 10 2 57 11 Chinsurah ... ... ... 378 ! 1 t. " I" " 8 Berhampore ... ... 1,227 2 ... 511"i"" V '" o""?513 f 20 9 « Dinapore ... ... ... 1,737 1.. 2 ... 51 '" 2'" 1""""}••21 12 3 27 5 « Benares ... ... ... 98 [ '" 2 ¦•• I 5I 5 ••• Ghazeepore ... ... 902 1 ... 6 2 1 ... ... ... ,g Chunar ... ... ... 211 ".'. "\ ... ".'. I X 9 2 | Buxar ... ... ... 68 8 .... ••• ••• Cawnpore ... ... ... 2,031 1 ... 2 ... 3 ... 3 '.'.'. "6 1 "i "4 "i "i "i ••• % Allahabad ... ... ... 145 3 X - 26 3 Meerut ... ... ... 1,940 I 5 1 3 1 1 "i " i'a "9 "q ¦• •" 9, Agra 1,366 17iZ 1 '" 13-28 4 I Saugor ... ... ... 89 4 ••• &, Mhow ... ... ... 193 '.". ...' •¦• ... % Nusseerabad ... ... 90 ••• ••• p Kurnaul ... ... ... 284 [ [[, .[[ "' ]][ "\ ]" Troops on the march ... ... ... Bengal Pbesidenc? ... | 12,547 9 ... 11 1251 30 5~20 6 28^ 8^ 15~ ~ »8 6 ..." 87 18 Sa" 86 ~M V *287^ 75~ NATIVE ARMY, 1830. Presidency Circle ... ... 1,526 11 2 ... 2 ... 4 ... 4 ... 3 ... 4 4 S 2 a 9 o ~, ™ Barrackpore „ 1,446 1 ... 4 ... 2 ... 5 1 3 ... 3 ... 3 1 2 '" I '". J 'l SI ? 1 q« 3 Berhampore „ ... ... 5,865 2 ... 1 4 ... 5 1 2 ... 1 { 4 1 " ? 1 J 5 i J 585 8 6 Dinapore „ ... ... 4,626 3 3 111 ¦ J i 4 ... l ... 3 2 5 4 2 1 30 9 t* Benares „ ... ... 5,176 31 " 41 "" a"i X"' 13 2 2 Cawnpore „ ... ... 13,708 1 2 1 4 "i "i '" "r X 1 12 2 t Allahabad „ ... ... 6,656 I " X f V , V 1 - 15 1 -§ Meerut „ ... ... 12,868 6 2 3 .'.'. 3 1 1 " "a "l 32 "2 2 2 | y 1 *« w t I CHOLERA OP THE EUROPEAN AND NATIVE ARMIES, 1826-53. yjj EUROPEAN ARMY, 1831. NUMBER OF ADMISSIONS AND DEATHS FROM CHOLERA IN EACH MONTH. " UI *\ Januaby. Febbuaby. Maech. Apbil. Mat. June. Jult. August. Septembeb. Octobeb. November. Dbcbmbeb. Total Abmis- tv?*™,. STATIONS. STRENGTH. SIONB OP IHE ÜBATHS Ad. Died. Ad. Died. Ad. Died. Ad. Died Ad. Died. Ad. Died. Ad. Died. Ad. Died. Ad. Died. Ad. Died. Ad. Died. Ad. Died **' Yeak. I Fort William ... ... 843 3 2 1 3 1 4 1 11 1 1 ... 1 1 ... 17 4 Presidency General Hospital ... ... 4 4 2 11 2 2 11 5 4 2 ... 5 3 22 15 ' Dum-Dum ... ... 780 1 ... 1 ... 11 1 ... 1 1 ... 1 2 .. 9 1 i Chinsurah ... ... 1,108 1 ... 2 1 4 4 2 ... 1 10 5 § Berhampore ... ... 790 3 2 4 2 1 ... 1 2 2 11 6 §§ Cherrapoonjee ... ... 37 .. ... Dinapore ... ... 914 ... 67 9 2 11 1 71 10 -g Ghazeepore ... ... 1,013 1 ... 11 16 3 24 12 9 4 1 52 20 ® Benares ... ... ... 126 1 1 1 ... 1 3 1 H Chunar ... ... ... 229 1 1 2 3 1 «g Buxar ... ... ... 58 4 3 43. Cawnpore ... ... 2,039 4 ... 2 ... 11 1 11 1 1 ... 1 ... 1 31 2 g Allahabad ... ... 112 Landour ... ... ... 186 .. §> Meerut ... ... ... 1,889 ... 3 1 3 ... 2 ... 1 ... 1 ... 2 12 1 a Muttra ... ... ... 102 . ... 2 Agra ... ... ... 1,298 11 6 4 3 1 1 ... 11 6 A Saugor ... ... ... 102 1 ... 1 2 Kurnaul ... ... ... 1,302 5 ... 2 ... 7 ... 2 ... 2 ... 2 20 Mhow ... ... ... 196 1 1 55 9 8 1 1 65 11 Nusseerabad ... ... 112 Troops on the march ... ... ... 7 ... 11 ... 5 23 Bengal Presidency ... 13,236 8 4 2 ... 21 5 23 2 120 26 26 4 92 23 26 6 9 2 20 10 10 1 9 3 366 86 NATIVE ARMY, 1831. Presidency Circle ... ... 1,165 2 2 ... 2 ... 3 ... 6 1 4 1 5 1 5 ... 1 ... 5 3 35 6 © Barrackpore „ ... ... 8.159 2 ... 1 1 10 8 7 1 6 2 3 ... 1 ... 1 ... 4 ... 3 ... 2 1 10 5 50 18 £> Berhampore „ ... ... 4,914 3 1 3 ... 5 ... 2 ... 2 1 ... 4 1 ... 21 1 Dinapore „ ... ... 4,160 1 9 3 5 2 8 2 3 ... 6 2 11 4 1 37 11 Benares „ ... ... 4,965 ... 1 .. 1 5 1 4 1 5 3 1 ... 1 18 5 g Cawnpore „ ... ... 11,465 2 ... ... 2 ... 2 ... 4 1 2 ... 3 ... 1 ... 1 ... 1 ... 2 20 | 1 £ Allahabad ... 4,969 3 1 ... 3 ... 2 9 ... c_, Meerut „ ... ... 10,914 3 j 1 ... 1 ... 6 1 4 2 2 1 2 I 18 5 Agra „ ... ... 6,081 1 > .1.1424 2 I 11 4 -g Saugor „ ... ... 6,503 7 *7 1 ... 1 1 10 7 8 Kurnaul „ ... ... 8,715 2 ... 1 ... 2 ... 1 1 2 8 1 g Nusseerabad „ ... ... 14,215 2 1 1 5 3 25 9 5 2 2 ... 2 ... 4 1 46 16 * Bengal Peesidenct ... 86.225 11 2 4 1 23 9 26 2 28 8 34 13 53 15 23 6 22 3 24 3 15 4 20 9 283 75 g * These deaths occurred in out-posts at Hoshungabad. EUROPEAN ARMY, 1832. NUMBER OP Amvnasirngg amt^ tipa^xxo rroiT rnnTrF| , m r|inTHr);Tia ====-— stations. b»»«>. J^!l Z!!!!^i _* abch ;_ _^!I!i_ _^li__ _^^^_ HZ^EZ _^^^^ oAl > Mia - w § Ad. | Died. Ad. | Died Ad. Died Ad. Died. Ad. Died. Ad. Died. Ad. Died. Ad. Died. Ad. Died. Ad. Died. Ad. Died. Ad Died """iS.™ °$*** Fort William ... ... 776 1 4... 21 1 1 71 Presidency General Hospital ... ... 3 2 1112 2 111113 "" 2 - 19 2 Dum-Dum... ... ... 733 1 ... i i 2 1 1 j "' "j ', •; "• 4 1 16 9 Cliinsurah... ... ... 585 1 1 i - l X J f 2 1 14 8 N - Berhampore ... ... 730 ... 1"' ''' '" " g"j 1 3 2 Cherrapoonjee ... ... 36 7 3 15 4 Si Dinapore ... ... ... 1,163 3 ... 4 ... 4 ... 1 ... 11 '" -'" — ••• 'Z Ghazeepore ... .. 966 1 " "-, ' ",' 13 1 Benares ... ... ... 95 1 1 l 2 1 Chunar ... ... ... 194 2 1 1 Buxar ... ... ... 60 [ '" 2 1 o Cawnpore ... ... ... 1,945 1 ... 1 ... 1 ... 4 ... 1 1 1 •¦• ... -g Allahabad ... ... ... 169 1 "' 10 ... g Laiidour ... ... ... 142 1 ... g Meerut ... ... ... 1,711 '""i "" 22 1"T- — * Muttra ... ... ... 107 . "' " 24 1 % Agra ... ... ... 968 1 ... '" | ... ... 5 Saugor ... ... ... 85 ".' ..'. "{ '" 1 Kurnaul ... ... ... 1,178 1 ... 5 ... 312."4 "s 8 2 " 1"""i " 1 Mhow ... ... ... 179 i 1 ... ¦¦ 1 ¦¦¦ 1 ••• 33 3 Nusseerabad ... ... 109 ... 'jj "9 1 Bengal Peesidency ... 11,931 5 2 3 1 . 8 2 19 ... 15 5 12 3 32 4 18 ~~2 16~ ~3 8~"~3 9~~~16 I 161 3T" ' 1 NATIVE ARMY, 1832. Presidency Circle ... ... 1,109 3 ... 1 ... 4 1 3 1 2 ... 1 ... 1 g 1 4 1 4 I 1 l I on * '¦ Cawnpore „ ... ... 10,768 212 1 ... 1 ... 2182 3 1 a ¦*" o"iV 9 1 g Allahabad „ ... 4 615 ..."... 1..""i"i"" i 21 5 eerut " H. 132 i ... 2"a"s i 7 ::: 2 ::: 3 ::: 4:: i ::* 2 ¦ 9 ? I % Agra „ ... ... 6,059 113 12 .£"\" J "' - ,"'2J J ° 01 . » 6,538 i ... i ... 3 ... i ;. .; ;;; 2 \ ;;; J » ? 1 Kumaul „ ... ... 8.023 1 1 6 3 2 q i "i 9 '" " S 1 C eerabad ' 1^261 5 ... 3 ... 3 "1 ... ::: i :;: i 0i 0 :;; n 3 2 ::: ::: :;: . i ;;; 1 .;; | 39 • 4 i Bengal Peesidency ... 82,427 19 6 6 ... 24 5 35 7 32 2 17 ... 20 1 33 ~10 19| 3 111 2 I 19 I 2 1 SO I 14 I 265 I 52// ° 8 CHOLERA OF THE EUROPEAN AND NATIVE ARMIES, 1826-53. • I Ti CHOLERA OF THE EUROPEAN AND NATIVE ARMIES, 1826-53. IX EUROPEAN ARMY, 1833. NUMBER OF ADMISSIONS AND DEATHS FEOM CHOLERA IN EACH MONTH. \\ l\ \ Januaby. Febeuaby. March. April. May. Jems. July. August. Septembeb. Octobeb. Notembeb. Decembeb. Totai, Adhis- t) X . twr STATIONS. SIBENGTH SIONS OF THE "EATHB Ybab ° Ad. Died. Ad. Died. Ad. Died. Ad. Died. Ad. Died. Ad. Died. Ad Died. Ad. Died. Ad. Died. Ad. Died. Ad. Died. Ad. Died. Yeab - Presidency Hospital ... ... 1 4 4 2 1 8 4 11 3 2 2 2 3 ... 1 ... 24 15 Fort William ... ... 685 1 ... 3 2 2 ... 1 ... 2 11 1 1 ... 7 2 1 ... 20 5 Dum-Dum... ... ... 770 42 1 ... 2..32 1 12 3 _ Chinsurah... ... ... 550 5 1 2 1 3 1 3 3 2 12 ... 17 7

A«e Barrackpore „ ... ... 15,253 22 1 ... 5192193 21 "5 2 '.'.'. "i '" "7 "4 "5 "3 13 "i 2'" 87 21 Dinapore „ ... ... 3,560 3 2 1 ... 3 ... 2 ... 2 1 4 1 5 1 ? "" la I « Benares „ ... ... 4,106 2 5 1 5 3 4 ... 1 20 "i I 11 "S Cawnpore „ ... ... 12,768 1 ... 55221027155527462412412 6 "5 "l "g B "» '" 1 194 95 1 eerut » 13,526 11 2 2 6 ... 8 2 11 3 21 8 12 5 11 1 1 11 "3 74 2l2 l H A^ ra " 4,471 1 ... 1 ... 27 94119148 35 11 4 ... 315112 U "" 113 5I t %™Z°\ " - 7>790 151412111 3 2 2 "l 3 "' 21 7 * Je«m^ 12,694 11 1 ... 21 1 ... 9332614141 1 .. 2 2 "" 69 13 « ?™\ '.'_ 6,246 2 1 1 ... 2 ... 1 ... 3 1 5 2 9 5 2 6 3 1 "l 32 13 S Afghanistan Field Force ... 5 3 14 7 2 1 21 11 S Bengal Presidency ... 81,560 14 6 13 6 70 26 98 41 123 45 156 51 49 14 47 15 33 14 25 14 51 j 15 j 4,3 j 9 722 j 256 7/ if 1 I I I ' I I I 1 I I I / // // II " II I T1 CHOLERA OP THE EUROPEAN AND NATIVE ARMIES, 1826-63. XV — _ — , NATIVE ARMY, 1839. NUMBER OF ADMISSIONS AND DEATHS FROM CHOLERA IN EACH MONTH. I I I | _.__-__ Januaey. Febeuaby. Mabce. Apeil. Mat. June. July. August. \ Septembeb. Octobeb. Novbmbeb. Decembbb. Total Ad«b- dEATHBd EATH8 STATIONS. Stbength. sions ob the qv tm Yeaß. Yum Ad. Died. Ad. Died. Ad. Died. Ad. Died. Ad. Died. Ad. Died. Ad. Died. Ad. Died. Ad. Died. Ad. Died. Ad. Died. Ad. Died. IEAB- Presidency Hospital ... ... I 1 2 11 1 ... 5 ... 10 1 Fort William ... ... 667 I 1 ... 3 1 ... 11 1 ... 2 1 9 2 Dum-Dum ... ... 632 11 11 2 1 4 3 Chinsurah ... ... ... 414 8 3 8 3 Hazareebaugh ... ... 704 1 ... 1 2 4 ... V 3V 3 Dinapore ... ... ... 748 1 , .. 2 1 1 ... 2 ... 11 1 8 2 *} Ghazeepore ... ... 671 2 4 1 2 ... 7 ... 22 ... 3 ... 5 ... 3 1 11 2 1 51 4 -a Benares ... ... ... 90 1 1 ... -g Chunar ... ... ... 230 1 1 1 ... 2 1 Buxar ... ... ... 24 1 1 Cawnpore ... ... ... 1,277 1 ... 1 ... 3 ... 9 ... 5 2 5 ... 9 3 4 2 3 1 1 41 8 o Landour Depot ... ... 159 1 1 .¦¦ -g Meerut ... ... ... 1,437 ... 1 4 ... 1 ... 4 1 1 ... 11 1 8 Muttra ... ... ... 104 1 1 1 ... 2 1 ft Agra ... ... ... 277 ... •¦• £ Saugor ... ... ... 99 ... ... f> Mliow ... ... ... 109 ... 1 ... 5 2 1 ... I 7 2 p Nusseerabad ... ... 105 ... 1 1 I 1 1 Kurnaul ... ... ... 829 ... 1 ... 1 ... 2 1 17 7 21 8 Loodianah and Ferozepore ... 213 ... >•> Troops on the march ... ... ... 3 , 3 Afghanistan Field Force ... 1,820 i 1 1 ... 5 ... 3 ... 3 ... 1 ... 1 15 Bengal Presidency ... 10,609 5 ... 2 1 15 2 9 1 31 4 39 3 22 3 25 6 29 11 8 4 6 2 9 ... 200 37 EUROPEAN ARMY, 1839. •__ Presidency Circle ... ... 1,142 2 . 1 1 1 4 2 1 ... 1 ¦•• 2 2 13 4 § Barrackpore „ ... ... 17,209 5 ... 1 ... 27 4 15 7 33 15 22 '*8 10 2 # 9 "3 20 8 33 10 28 12 13 6 216 75 g Dinapore „ ... ... 4,560 2 1 2 ... 7 9 3 7 4 3 ... 2 2 1 1 2 2 i 65 Id Benares „ ... ... 5,160 4 ... 2 2 3 3 2 ... 4 2 11 3 3 5 3 11 1 ¦•¦ 26 15 £ Cawnpore „ ... ... 13,684 11 3 1 5 ... 6 1 6 2 5 ... 8 2 8 3 1 4 5 3 1 1 49 18 Meerut „ ... ... 13,418 1 ... 73 3 ... 4 ... 5 ... 1 ... 1 ... 4 ¦¦ ¦¦• •¦¦ - f 6 . J £ Agra „ ... ... 3,677 12 1 ... 11 1 ... 3-• * ••• in i Saugor „ ... ... 6,846 1 ... 1 ... 11 2 ... 1 ... 1 ... 1 ... 1 ... 1 ¦•• ••• ¦•• ••¦ ••• ,J° ?* "g Neemuch „ ... ... 11,558 3 3 ... 12 3 21 10 37 10, 33 13 25 1 194 71 4 2 1 ... 333 110 g Kurnaul „ ... ... 9,963 11 1 ... 2 1 ... 12 6 1 ... 1J» n g Afghanistan Field Force ... 7,601 1 1 70 39 5 ... 1 77 40 5, Bengal Presidency ... 94,818 16 3 3 ... 46 9 43 10 59 22 68 23 70 21 128 58 79 23 238 89 43 18 21 11 814 287 g x j{ CHOLERA OP THE EUROPEAN AND NATIVE ARMIES, 1826-53. [ Appe^ I __^ _ i — — — — — ¦ EUROPEAN ARMY, 1840. NUMBER OF ADMISSIONS AND DEATHS FROM CHOLERA IN EACH MONTH. ===== „ Jakuaby. Febeuaby. Mabch. Apeil. Mat. June. July. August. September. Octobeb. Notembeb. Decembee. Total Admis- Total stations. otbeitgth. , — . _ _ _ sions of the deaths Ad. Died. Ad. Died. Ad. Died. Ad. Died. Ad. Died. Ad. Died. Ad. Died. Ad. Died. Ad. Died. Ad. Died. Ad. Died. Ad. Died. YEA *' Ybab - Fort William ... ... 733 1 1 7 1 1 1 6 3 1 ... 5 2 4 2 4 2 2 1 3 3 1 1 2 37 17 Presidency Hospital ... ... ... 5 . 6 6 4 2 4 2 2 ... 4 1 2 ... 3 ... 5 ... 12 7 3 "... 50 18 Dum-Dum ... ... 712 1 3 1 ... 2 ... 1 8 CHnsurah ... ... 571 1 •¦¦ 3 1 6 2 4 3 " ... 14 "g £ Berhampore ... ... ... 11 1 1 S Hazareebaugh ... ... 895 1 ... 7 2 1 49* 17 go 19 Dinapore ... ... ... 741 3 ... 1 ... 3 ... 4 ... 3 2 10 2 2 1 1 ...' 11 28 6 * Ghazeepore ... ... 691 3 ... 7 4 5 4 8 1 12 5 6 1 10 5 9 7 .. 60 27 2 Benares ... ... ... 85 4 2 2 1 -. 6 3 H Chunar ... ... ... 228 1 1 2 4 *S Buxar ... ... ... 27 Cawnpore ... ... ... 1,271 1 ... 1 ... 1 ... 1 ... 6 ... 7 ... 3 ... 2 ... 2 ... 1 "2 '.'.'. 27 Landour Depot ... ... 205 £ Meerut ... ... ... 1,670 1 1 ... 1 1 ... 1 )" "" "g %, Muttra ... ... ... 105 t3 Agra ... ... ... 981 1 1 ... 1 ... 2 1 1 ... 1 ... "3 \" '{q "{ -JJ Saugor ... ... .., 89 2 ... 1 ... 4 3 7 3 Mhow ... ... ... 104 1 2 ... 3 1 1 ' ".".". "„ 7 1 Nusseerabad ... ... 101 Kui-naul ... ... ... 1,118 1 2 1 1 ... ... ... "4 "{ Loodianah and Ferozepore ... 202 Afghanistan Field Force ... 1,022 2 1 1 "] "." "3 "j Troops on the march ... ... ... 2 5 1 7 1 Bengal Presidency ... 11,551 10 1 26 8 19 7 33 13 26 4 36 10 29 6 32 12 30 11 13 3 69 29 13 1 336 105~~" • Cholera appeared while the Regiment was moving from Fort William to Hazareebaugh. NATIVE ARMY, 1840. Presidency Circle ... ~ 1.251 ... | ... 3221 7 3 3 ... 21 2 ... 3 ... 1 ... 2111 26 9 Barrackpore „ ... ... 14,137 53 21 16 8 18 5 12 4 93 17 7 44 73 61 10 2 53 111 44 « Dinapore „ ... ... 4,673 1 ... 3 ... 3 1 8 3 2 ... 1 ... 18 7 7 3 6 3 8 1 1 1 58 19 £ Benares „ ... ... 7,563 2 5 1 5 3 6 3 3 2 1 1 1 ... 2 1 1 ... 1 27 11 °° Cawnpore „ ... ... 16,147 2 2 3 ... 9 1 2 1 8 3 6 2 2 ... 1 ... 5 2 2 40 t Meerut „ ... ... 14,882 6 2 3 ... 3 1 4 1 5 ... 1 1 "i 23 5 ! Agra „ ... ... 4,272 1 ... 2 2 4 ... 3 2 1 2 | 13 4 £ Saugor „ ... ... 5,508 . Neemuch „ ... ... 8,741 121 1 3 ... 31' "" 110 "i Sirhind „ ... ... 12,318 1 1 5 ... 4 1 4 ... 1 ... 11 1 ... 1 ... 18 3 "3 Afghanistan Field Force ... 6,713 1 1 ... 1 1 ... 4 s Troops on the march ... .. ... ... I ... // — Bengal Presidency ... 96,205 11 6 1O 3 50 16 46 14 48 I 16 20 9 25 9 36 | 11 [ 29 1O 15 I 4 / 23 ) 4 I 8 \ 6 \\ 330 /' 108 II & Jj - Ti CHOLERA OF THE EUROPEAN AND NATIVE ARMIES, 1826-53. XVU NUMBER OP ADMISSIONS AND DEATHS FROM CHOLERA IN EACH MONTH. I ' Jaituaby. Febbuaby. Mabch. Apbil. May. June. July. August. Septembeb. I Octobeb. Novembeb. Deceubeb. Total Ad- tyritith STATIONS. Stbbtoth. I missions op »* AT * S \ THE YEAB lll « Ad. Died. Ad. Died. Ad. Died. Ad. Died. Ad. Died. Ad. Died. Ad. Died. Ad. Died. Ad. Died. Ad. Died. Ad. Died. Ad. j Died. Ybab - Fort William ... ... 692 2 ... 9 2 15 3 37 14 6 4 69 23 Presidency Hospital ... ... ... 2 1 10 7 7 5 5 2 4 3 4 4 1 ... 3 1 13 4 2 1 7 ... 58 28 Dum-Dum ... ... ... 718 1 1 3 2 ... 11 2 1 1 ... 10 3 «5 Chinsurah ... ... ... 248 1 ... 17 8 7 2 25 10 g Berhampore ... ... 109 1 1 ... 1 3 Hazareebaugh ... ... 792 9 3 1 ... 3 ... 1 ... 10 6 4 3 28 12 Dinapore ... ... ... 922 3 1 7 1 19 9 29 21 1 ... 1 1 ... 1 ... 3 65 32 Ghazeepore ... ... 878 1 1 1 ... 47 20 47 13 12 8 7 7 8 4 1 124 53 £ Benares ... ... ... 95 11 1 1 «h Chunar ... ... ... 439 Buxar ... ... ... 18 ... 11 11 2 2 "S Cawnpore ... ... ... 1,336 1 1 ... 17 5 49 5 11 3 2 1 11 82 15 8 LandourDep6t ... ... 179 ... ... & Meerut ... ... ... 1,758 1 1 ... 1 ... 11 1 ... 1 ... 11 1 8 2^ Muttra ... ... ... 91 1 1 2 ... .2 Agra ... ... ... 1,138 11l 1 31° Saugor ... ... ... 74 9 6 5 3 ... 1 11 ... 15 11 Nusseerabad ... ... 107 Kurnaul ... ... ... 2,080 2 1 7 1 10 1 Loodianah ... ... ... 11l 1 ... 11 2 1 Ferozepore ... ... ... 89 Afghanistan Field Force ... 1,460 Bengal Pbesidency ... 13,334 7 2 4 i 3 38 13 65 25 ! 130 59 80 25 89 32 39 19 9 3 27 12 11 2 I 8 ... 507 195 NATIVE ARMY, 1841. Presidency Circle ... ... 1,229 1 1 2 2 3 ... 1 7 3 Barrackpore „ ... ... 7,346 10 7 3 ... 8 3 2 1 2 ... 2 ... 8 6 59 23 41 20 135 63 Dacca „ ... ... 6,105 1 ... 3 2 2 1 3 2 39 18 16 6 5 1 2 1 2 2 ... 1 ... 76 31 § Dinapore „ ... ... 6,123 I 43 29* 26 14* 45 34 6 1 17 12 26 14 2 1 3 2 11 6 3 1 ... 176 111 § Benares ... 5,679 2 3 3 11 5 4 6 2 5 2 1 ... 2 25 12 Cawnpore „ ... ... 16,438 1 1 3 ... 1 ... 13 6 33 9 12 4 1 1 6 1 9 4 2 1 81 27 -§ Meerut „ ... ... 15,519 112 ... 14 3 17 4 16 1 6 ... 4 ... 2 ... 2 64 9 g Agra „ ... ... 3,821 6 1 2 ... 4 1 12 2 H Saugor „ ... ... 4,356 1 ... 12 7 11 1 15 8 =g Neemuch „ ... ... 7,731 111 113 ... 2 ... 1 9 2 j Sirhind „ ... ... 14,195 12 5 16 6 10 1 8 1 12 4 5 3 3 1 11 67 22 Afghanistan Field Force ... 10,495 2 ... 2 1 4 2 8 3 fe Troops on the march ... ... ••• 3 Bengal Pbesidency ... 99,037 3 2 49 31 31 16 80 52 84 31 93 37 111 37 47 15 24 8 27 9 81 31 45 21 675 290 ? These Deaths from Cholera occurred in the 15th Regiment Native Infantry, while in progress to Dinapore by water, on the river near Rampore Beauleah. xv ji£ CHOLERA OF THE EUROPEAN AND NATIVE ARMIES, 1826-53. [ Appendix I g EUROPEAN ARMY, 1842. NUMBER OF ADMISSIONS AND DEATHS FEOM CHOLERA IN EACH MONTH. Januaby. Febbuaby. Mabch. Apbil. Mat. Junb. July. August. Septembeb. Octobeb. Novembbb. Decembbb. Total Admis- Dbaths STATIONS. Stbbhgih. _ . . sioot of the or TH , Ad. Died. Ad. Died. Ad. Died. Ad. Died Ad. Died. Ad. Died. Ad. Died. Ad. Died. Ad. Died. Ad. Died. Ad. Died. Ad. Died. XBAB " ncy General Hospital ... ... 6 1 23 16 12 6 22 13 6 2 11 3 1 1 13 7 14 5 11 4 112 56 ilHam .. ... 954 2 1 13 6 15 5 66 32 5 5 1 2 1 3 1 8 6 3 2 118 59 Dum-Dum... ... ... 927 1 1 10 2 7 1 6 ... 5 ... 5 34 4 Chinsurah ... ... ... 911 5 ... 29 11 13 2 59 29 28 12 113 ... 1 139 55 ? Berhampore ... ... 530 27 7 6 33 7 9 Dinapore ... ... ... 938 I 1 13 3 2 ... 5 4 7 6 3 3 5 3 2 ... 38 19 *g Ghazeepore ... ... 206 I 1 1 1 1 % Benares ... ... ... 82 ... ... ... £ Chunar ... ... ... 436 27 18 3 3 1 1 2 ... 33 22 £ Buxar ... ... ... 24 Cawnpore ... ... ... 1,583 2 ... 104 57 2 2 18 2 126 61 -g Landour ... ... ... 168 ... ... 8 Meerut ... ... ... 1,726 ' 1 ... 1 ... S3 Muttra ... ... ... 102 ... ... * Agra ... ... ... 943 ... ... 1 Kurnaul ... ... ... 1,362 2 1 6 ... 11 5 2 2 1 22 8 ft Loodianah and Ferozepore ... 191 I Afghanistan Field Force ... 3,115 3 ... 3 ... 3 1 12 1 1 ... 1 23 2 Saugor ... ... ... 76 5 4 3 1 8 5 Nusseerabad ... ... 96 Bengal Pbesidency ... 14,370 13 2 68 35 50 15 224 103 59 22 16 7 38 10 125 66 14 9 17 8 27 14 37 8 688 299 NATIVE ARMY, 1842. Presidency Circle ... ... 1,142 111 54 10 6 2 1 1 1 2 2 I 21 15 rf Barrackpore „ «... ... 6,639 31 17 15 6 5 ... 30 14 34 16 5 1 3 ... 2 1 4 1 3 1 6 2 3 ... 141 59 « Dacca „ ... ... 6,300 1 ... 1 ... 2 ... 2 ... 91 5 ... 22 2 ... 11 6 8 4 43 13 3 Dinapore „ ... ... 5,280 1 ... 1 1 14 5 16 8 14 4 21 16 5 3 3 2 3 3 2 1 1 ... 81 43 * Benares „ ... ... 7,346 2 2 1 ... 36 18 9 2 5 5 2 1 3 3 58 31 -g Cawnpore „ ... ... 19,886 6 1 7 2 8 1 13 3 29 13 46 17 12 8 3 1 124 46 8 Meerut „ ... ... 16,328 4 1 1 ... 1 ... 2 ... 1 2 ... 11 1 ... 13 2 H Agra „ ... ... 4178 I 3 1 11 4 2^ Saugor „ ... ... 4,478 I 7 5 13 7 3 1 2 1 3 ... 28 14 ¦£ Nusseerabad ... 7,724 1 ' 5 ... 8 5 4 2 8 2 4 4 3 ... 1 34 13 § Kumaul „ ... ... 12,853 4 ... 7 1 ... 5 3 3 ... 5 2 25 5 g Afghanistan Field Force ... 9,822 1 10 3 9 3 16 5 5 ... 1 1 ... 43 11 & Bengal Prbsidbncy ... 101,976 35 18 24 13 35 7 116 49 77 29 71 32 73 29 92 39 40 18 11 I 3 I 22 I 11 1 19 I 6 615 j 254 J g? // I IT CHOLERA OP THE EUROPEAN AND NATIVE ARMIES, 1826-53. Xix EUROPEAN ARMY, 1843- NUMBER OP ADMISSIONS AND DEATHS FROM CHOLERA IN EACH MONTH. \ U * Jahtaby. Februaet. Makch. Apbil. May. June. Jumt. August. Septembeb. October. November. Decembbr. Total Asms- «,„.. STATIONS. Stbength. sioms of ihb of the Ad. Died. Ad. Died. Ad. Died. Ad. Died. Ad. Died. Ad. Died. Ad. Died. Ad. Died. Ad. Died. Ad. Died. Ad. Died. Ad. Died. YsAE - Presidency Hospital ... ... ... 6 4 9 3 2 1 11 2 2 1 1 ... 2 1 24 12 Fort William ... ... 1,014 1 10 9 7 3 4 2 1 11 24 15 Dum-Dum ... ... 532 1 ... 12 3 4 1 2 1 1 13 4 1 1 34 10 Dinapore ... ... ... 895 3 1 1 7 6 3 2 2 ... 1 ... 1 ... 18 9 . Buxar ... ... ... •>«» ••• ••• *~ Ghazeepore... ... ... 940 5 5 4 3 30 19 ... 2 2 41 29 g§ Benares ... ... ... 135 ... ... r3 Chunar ... ... ... 394 2 ... 1 ... 1 ... 2 ... 3 1 1 10 1 | Cawnpore ... ... ... 1,966 2 1 ... 4 ... 3 ... 10 9 14 2 11 7 1 1 46 19 g Allahabad ... ... ... 837 17 8 5 2 22 10 H Landour ... ... ... 134 1 1 ... o Meerut ... ... ... 2,796 1 2 3 ... -g ¦ Muttra ... ... ... 108 13 3 1 ... 11 15 4 § Agra ... ... ... 1,195 1 142 48 11 7 154 55 g Saugor ... ... ... 76 3 3 ... <* Nusseerabad ... ... 68 3 1 3 1^ Kurnaul ... ... ... 1,026 2 2 1 ... 11 4 2 2 12 3 | p Umballa ... ... ... 856 1 1 3 1 5 1 3 1 2 ... 11 1 ... 16 5 Kussowlic, 9 months ... ... 989 1 1 Subathoo, 9 months ... ... 816 2 ... 1 ... 3 2 8 Loodianah ... ... ... 11l 1 ... 1 Troops on the march ... ... ... 3 2 3 2 Bengal Presidency ... 14,921 14 4 14 3 26 17 26 9 65 31 21 14 37 13 180 63 17 9 14 4 18 5 7 3 439 175 NATIVE ARMY, 1843- Presidency Circle ... ... 945 1 4 1 11 2 ... 1 ... 4 1 1 14 3 1^ Barrackpore „ ... ... 8,711 1 ... 3 1 24 6 12 1 13 2 12 4 2 ... 10 7 2 1 79 22 \ Dinapore „ ... ... 5,898 .... 2 2 2 1 11 2 1 12 8 2 ... 1 ... 2 1 4 2 I 28 16 g Benares „ ... ... 7,512 1 ... 2 1 1 . .115 2 10 4 h Cawnpore „ ... ... 16,824 2 2 7 3 2 ... 7 3 10 6 7 4 19 7 17 5 5 2 5 2 2 ... 83 34 «g . Meerut ... 14,786 3 2 ... <> 1 ... 1 5 ... 3 1 - 14 2 I Agra „ ... ... 5,148 T 1 \\ m 39 19 1 ... 1 42 19 gg Saugor „ ... ... 10,939 1 ... 11 2 ... 1 1 1 • 6 2 " Nusseerabad „ ... ... 8,819 11 2 ... 17 11 7 1 7 4 4 1 6 3 14 ... 3 61 21 g, Kurnaul „ ... ... 15,182 3 2 2 ... 1 . 2 2 2 ..2 1 13 4 Bengal Presidency ... 94,764* 6 4 16 8 32 j 8 24 5 51 23 33 12 42 19 72 25 17 5 28 5 19 10 10 3 350 127 ? Dacca Circle wanting. EUROPEAN ARMY, 1844. NUMBER OF ADMISSIONS AND DEATHS FROM CHOLERA IN EACH MONTH. | STATIONS. Stbewgth. jAinTABY - Fbbupaby. Ma.bch. Apbii.. Mat. Jtob - Jp^t. August. September. Octobee. November. | Decembee. TotaiAdmis- £™£ a Ad. Died. Ad. Died. Ad. Died. Ad. Died. Ad. Died. Ad. Died. Ad. I Died. Ad. 1 Died Ad. Died. Ad. Died. Ad. Died. Ad. Died. YEAB ' "ybab? Presidency Hospital ... ... ... 2 1 17 13 31*18 16 12 6 2 7 5 2 1 4 2 8 I 2 4 3 97 *q Fort William ... ... 506 1 1 4 ... 11 2 2 2 5 3 15 ? Dum-Dum... ... ... 851 312211410412 3 2 '" '" ' 40 Chinsurah ... ... ... 439 6 3 8 3 5 3 ... ... 2 2 1 ... o; it a "o « t> Q Dinapore ... ... ... 904 I 2 1 1 ... 2 1 1 1 ... . "i "{ | 2o2 o 3 ¦ Ghazeepore ... ... 661 I 2 ... 2 ... 50 24 17 3 ... '" '" [" 7l 272 7 5 - Benares ... ... ... 125 ... ... . Chunar ... ... ... 408 2 1 1 1 ... l i "; "2 jj Buxar ... ... ... 23 1 .. ... 1 1 Cawnpore ... ... ... 2,297 4 ... 1 ... 1 1 ... " " 7- H Allahabad ... ... ... 908 2 2 ... ... 2 2 21 9 36 17 (51 30 *° Landour Depot ... ... 149 11 o -*• Meerut ... ... ... 2,304 1 2 1 ... ..... . a Muttra ... ... ... 102 ' Z Agra ... ... ... 1,089 2 ... ... '" " " " "g •" & Saugor ... ... ... 85 'g Nusseerabad ... ... 92 TJmballa ... ... ... 1,356 2 .'.'. ... . "i Kussowlie ... ... ... 978 1 ... 1 '". Sill 5 "a Subathoo ... ... ... 870 2 ... 2 1 ... "' fi Loodianab.... ... ... 750 1 2 ... ... '" '" '" 3 Ferozepore ... ... 373 5 2 2 ... 7 "m Sukkur ... ... ... 889 1 ... ... ..'. ... ... [][ "." [[[ [[ '[ '" [ Troops on the march ... ... ... 1 ... 2 1 g |l Bengal Presidency ... 16,161 7327186025422084363312943211 42 19 7 3 40 20 12 6^ 395~| 177 NATIVE ARMY, 1844. Presidency Circle ... ... 1,038 4 2 2 ... 5 2 3 2 ... 1 1 18 4 Barrackpore „ ... ... 7,271 1 ... 4 3 9 4 19 7 8 1 5 1 4 i 1 *2 '" "{ 54 17 S Dacca „ ... ... 6,743 7 ... 10 8 9 4 25 11 6 4 4 1 5 1 8 1 2 1 1 1 "i 79 32 w Dinapore „ ... ... 6,313 5 1 5 ... 5 ... 9 4 4 1 1 1 6 4 3 1 1 1 7 "3 1 "i I 47 17 % Benares „ ... ... 6,303 1 13 3 3 1 4 ... 3 ... 1 1 1 11 29 5 * Cawnpore „ ... ... 16.539 2 ... 3 ... 10 3 2 ... 11 1 ... 6 3 . 24 7 Meerut „ ... ... 17,382 2 1 6 1 1 ... 2 2 5 '.'. 1 1 17 5 Z Agra „ ... ... 6,856 3 1 2 ... 4 ... 2 11 1 ° Saugor „ ... ... 11,031 4 1 1 "i \[\ [[ 5 • 2 "S Neenmch „ ... ... 7,603 I Sirhind „ ... ... 18,804 1 ... 4 2 1 ... 2 3 3 ... 3 ... *2 "i "i '.'.'. "i "i "'. ..'. 18 "7 g kBEKGAL Peesidency ... 105,883 14 1 20 13 45 12 71 26 38 11 32 8 16 3 21 5 17 8 12 3 11 I 5 I 5 I 2 302 // 97 // 5 // 1,. T] CHOLERA OF THE EUROPEAN AND NATIVE ARMIES, 1826-53. xx j B — EUROPEAN A X, M V , l™^^^^^^^^^^^^^^^^^^^^^^^^^^"^*^*^"^"^" I NUMBER OF ADMISSIONS AND DEATHS FROM CHOLERA IN EACH MONTH. i i \\ Januaby. Febbuaby. Mabch. Apbil. Mat. June. July. August. Septembbb. Ociobbb. Novembeb. Decbmbeb. Total Admis-| jjbJths I Ad. Died. Ad. Died. Ad. Died. Ad. Died. Ad. Died Ad. Died. Ad. Died. Ad. Died. Ad. Died. Ad. Died. Ad. Died. Ad. Died. ' Ybab - Presidency Hospital ... ... 125 13 8 1 1 23 12 17 11 8 6 6 4 8 4 4 4 2 82 50 Fort William ... ... 457 4 4 10 4 13 5 2 1 29 14 ! Dum-Dum ... ... 346 1 1 ... 1 8 4 13 6 23 11 Chinsurah ... ... ... 471 1 ... 5 3 2 ... 9 8 3 2 11 3 1 1 25 15 ' Dinapore... ... ... 1,107 18 10 12 9 3 1 5 4 2 40 24 Benares ... ... ... 140 1 1 Chunar ... ... ... 356 11 8 2 3 ... 1 ... 3 3 1 ... 1 ... 11 19 7 Cawnpore ... ... ... 1,944 5 ... 4 ... ... ... 100 44 15 7 8 4 22 11 11 11 156 68 & Allahabad ... ... ... 248 ... 2 2 9 6 1 12 8 Muttra ... ... ... 93 1 3 1 4 1 ! Agra ... ... ... 1,063 4 1 6 1 11 1 ... 4 1 16 4 'S Meerut ... ... ... 2,954 2 ... 2 1 2 1 29 9 114 76 4 3 2 2 155 92 S Landour ... *. ... 141 ... ... iL '. Umballa ... ... ... 2,439 ... ... 1 ... 1 ... 3 ... 3 ... 2 1 123 57 227 130 35 17 2 ... 1 398 I 205 g Kussowlie ... ... ... 1,045 1 ... 1 ... 2 ... 120 34 12 4 1 137 '. 38 ! Subathoo ... ... ... 817 ... ... ... 2 2 1 108 38 21 3 133 42 1 Loodianah ... ... ... 948 ... 3 1 2 ... 2 1 11 10 57 39 16 5 91 56 Ferozepore ... ... ... 1,130 2 .. 36 19 46 20 2 ... 14 6 1 101 45 iSukkur ... ... ... 851 3 1 18 9 7 7 28 ** ; Troops on the march ... ... 1 ... 33 20 4 2 5 5 . 43 27 I Troops on river ... ... 3 2 4 1 11 9 1 j 19 12 Bengal Pbesidency ... 16,675 18 12 11 6 80 39 97 48 45 20 172 82 231 117 566 263 243 :124 26 11 23 14 1512 736 • • nTrnTTTJA fiF TTTP ETIROPEAN AND NATIVE ARMIES. 1826-53. L At)T>Pti/1' I ¦ ' ' " ~~ ' —» . I INAIIV-Cj iiiliVll, 104:J, Nbmbeb oh Admissions *bom Choieba in bach Month. ¦ Totah Ad- Total Strength of ; " missions Deaths STATIONS THK Abmy of thb of the in Julx. Jan Fob Mar April . May . j un c. July. Aug. Sept. Oct. Nov. Dec. Yeab. Yeab. 1,007 | 1 1 3 5 3 3 1 1 1 3 ... 1 23 10 Barrackpore 3,747 ... 812 16 4 6 4 3 110 4 1 69 16 Dum-Dum 812 6 5 2 1 ... 1 ... 1 16 Berhampore ... ... 841 ... 1 1 Dacca ... ... 9G4 ... 1 1 13 2 Cheerapoonjee ... 720 1 Sylhet ... ' ... 960 2 1 ... 1 4 1 Cachar ... ... 289 ... 1 1 Gowhatty ... ... 574 12 11 1 6 1 Jeypore (Assam) ... 1,104 1 1 * Chittagong ... ... 248 3 ••• 3 Segowlie ... ... 781 I ... 2 1 Dinapore ' 2,362 j 12 10 7247 12 8 2 4 1 87 27 Dorundah ... ... 751 Chyebassa ... ... 225 ... Bhaugulpore... ... 474 1 2 1 ••• 4 1 Benares ... ... 1,695 ... 1 21 2 4 7 1 1 37 20 Ghazeepore ... ... 212 I 1 1 •¦• 2 1 Mirzapore ... ... 372 2 1 3 2 Azimghur ... ... 186 ... 1 1 ... 1 3 Jounpore ... ... 470 1 ¦*¦ Goruckpore ... ... 807 1 ••• 1 2 Allahabad ... ... 2,326 114 4 11 12 4 Cawnpore ... ... 5,451 j ... 1310233 19 6 4 3 81 30 Lucknow ... . 3.285 I 10 2 2 6 10 ... 2 32 6 £ Snltanpore ... ... 941 | 1 1 1 1 4 I 5 Seetapore ... ... 940 ••• '" | Futtehghur ... ... 1,442 ••¦ * ¦•¦ X •" £ Shahjehanpore ... 1,048 1 l •" Mynpoorie ... ... 1,027 1 4 — 5 •" 1 Etawah ... ... 998 8 4 7 1 ° Agra ... ... 4,805 5 11 4 1 1 22 5 ft Muttra ... ... 1,208 ••¦ ¦" g Allyghur ... ... 1,159 1 1 1 3 X Meerut ... 8,274 1 ... 6 6 2 1 4 1 6 1 3 ... 31 10 Dei M... ::; 3,55s ... 1 ... 3 1 1 2154 is 10 Moradabad ... ... 1,051 2 ... 4 3 ... 9 2 Bareilly ... ... 2,972 2 1 1 •¦• 4 Deyrah ... ... 1,049 - 1 1 14 5 ... 12 10 Aknorah ... ... 679 1 1 ... 2 Hawulbagh ... ... 319 Luhooghat ... ... 591 • ••• Petoraghur ... ... 469 1 ••• 1 1 Hansi ... ... 1,065 2 8 8 18 3 Kythul ... ... 488 1 4 5 2 Umballa ... ... 7,358 ... 2 ... 12 1 2 779 25 4 1 ... 133 71 Jutog, Simla ... ... 1,113 1 4 ... 5 2 Loodianah ... ... 4,466 ... 1 2 3 ... 2 3 30 5 2 1 ... 49 16 Ferozepore ... ... 6,530 1 ... 4 3 ... 25 29 9 ... 1 ... 1 73 21 Sukkur ... ... 1,773 1 21 22 10 Shikarpore ... ... 454 E march ... ... 23 3 732 ... 47 2o ar... ... 1 1 1 Peesidenct ... 86,440 62198 96 49|140 93 159 77 61 64 14 868 310 I y T"| CHOLERA OF THE EUROPEAN AND NATiyE ARMIES, 1826-53. XXiU EUROPEAN ARMY, 1846. NUMBER OP ADMISSIONS AND DEATHS FROM CHOLERA IN EACH MONTH. 1 j Januaby. Febbuabtt. March. Apbili. Mat. June. July. August. September. Octobeb. November. December., Total Ad- t^ STATIONS. Sibength. missions op ~j™ "*f THE YBAB. °l ™ Ad. Died. Ad. Died. Ad. Died. Ad. Died. Ad. Died Ad. Died. Ad. Died. Ad. Died. Ad. Died. Ad. Died. Ad. Died. Ad. Died. iear. Presidency Hospital ... ... 113 11 2 2 13 7 14 7 14 4 24 14 6 1 1 ... 17 5 5 4 2 ... 99 45 Fort William ... ... 467 11 7 7 5 4 14 8 4 1 31 21 Dum-Dum ... ... 649 1 ... 1 1 2 2 8 7 2 ... 7 3 1 22 13 • Chinsurah Depot ... ... 160 4 2 4 1 25 10 33 13 X Dinapore ... ... 712 1 ... 2 2 1 ... 5 1 Ghazeepore ... ... 122 4 ... 4 j ... 'g Benares ... ... 130 1 1 1 j 1 -g Chunar ... ... 309 1 ... 1 2 j ... 8 Cawnpore ... ... 1,487 2 ... ... 2 ! Allahabad ... ... 490 2 1 1 1 3 2 => Landour Depot ... ... 275 ... ... -g Meerut ... ... 2,108 1 2 1 ... ... 3 1 g Agra ... ... 1,127 ... .. & Saugor and Mhow ... ... 155 ... ... * Nusseerabad ... ... 80 | 23 11* 23 11 t Umballa ... ... 2,521 2 ... 5 3 2 1 4 1 1 14 5 P Kussowlie ... ... 793 Subathoo ... ... 1,418 „ 2 2 Loodianah and Jullundur ... 1,216 1 3 ... 2 6 Ferozepore ... ... 1,023 1 ... 4 ... 11 1 ... 2 ... 9 4 2 1 1 21 6 Lahore ... ... 1,121 1 ... 2 2 5 Troops on the inarch ... ... 1 5f 4 7J 4 2§ 2 15 10 Bengal Presidency ... 16,476 3 2 4 3 28 ! 16 39 22 47 20 42 20 44 15 16 6 9 3 45 16 6 ! 4 8 1 2 291 129 ? Between 26th July and 9th August. t Artillery Drafts proceeding to Cawnpore. t Her Majesty's 16th Lancers while coming to the Presidency, on the river. § Her Majesty's 03th Regiment proceeding- to Dinapore, oa the river. NATIVE ARMY, 1846. Presidency Circle ... ... 937 .... 2 ... 4 2 4 2 8 2 2 1 1 ... 1 ... 1 ... 1 . 1 ... 25 7 Barrackpore „ ... ... 6,631 3 1 2 ... 3 2 27 9 14 3 47 12 2 ... 3 2 1 ... 3 ... 3 1 5 ... 113 30 "? Dacca „ ... ... 5,282 1 2 1 7 2 8 2 3 1 1 1 7 1 1 1 2 1 10 5 6 2 48 17 S Dinapore „ ... ... 6,277 4 ... 2 ... 3 1 7 ... 8 ... 38 10 8 2 5 ... 3 ... 3 ... 2 1 .. ... 83 14 *% Benares „ ... ... 6,302 2 1 3 ... "g Cawnpore „ ... ... 12,626 ... 3 ... 5 1 2 ... 3 1 5 ... 2 ... 11 11 11 23 5 J5 Meerut „ ... ... 13,958 1 ... 2 1 1 4 1 Agra „ ... ... 3,582 11 1 ... 1 ... 2 1 6 1© Saugor „ ... ... 3,433 7 1 12 4 25 9 12 3 7 ... 2 ... 1 ... 11 67 18 -g Neemuch „ ... ... 9,832 I - ... 194* 79* g Sirhind „ ... ... 5,972 11 2 2 1 11 1 6 4 Jj Punjab Field Force ... ... 35,721 | 6 4 10 5 20 ... 16 1 4 ... 2 ... 3 ... 2 ... 2 ... 5 3 70 13 £ Bengal Pbesidenct ... 110,553 9 2 10 2 22 10 71 22 73 11 136 35 35 6 27 3 14 2 14 3 20 9 17 5 642 189 p Xx iy CHOLERA OF THE EUROPEAN AND NATIVE AEMIES, 1826-53. [Appendix EUROPEAN ARMY, 1847. (I NUMBER OP ADMISSIONS AND DEATHS FROM CHOLERA IN EACH MONTH. o — January. Febbuaby. Mabch. April. Mat. June. July. August. Septehbeb. October. Noyembeb. December, l Totai Admis- r!l OTAII STATIONS. bTBESGTH. . sions or the i ' EATH s Ad. Died. Ad. Died. Ad. Died. Ad. Died. Ad. Died. Ad. Died Ad. Died Ad. Died. Ad. Died. Ad. Died. Ad. Died. Ad. Died. ' Yeab. i Presidency Hospital ... ... 167 7 5 1 1 5 4 15 7 3 2 2 2 33 21 Fort William ... ... 557 5 2 5 i 2 Dum-Dum ... ... 370 4 2 4 2 co Cbinsurah ... ... ... 66 .. i ...

4 2 1 1 5 3 Loodianah, Hoshiarpore, and Jullim- ft dur ... ... ... 673 1 ... 1 Labore ... ... ... 1,226 | Troops on tbe march ... ... ... 1 1 ... 2 Bengal Peesidency ... 15,609 j 11 7 3 1 10 6 33 10 112 41 16 3 15 4 10 7 12 6 1 ... 5 3 4 ... 232 88 NATIVE ARMY, 1847. ! Presidency Circle ... ... 965 3 2 1 2 1 2 ... 2 11 2 • Barrackpore „ ... ... 6,318 2 ... 2 1 10 5 9 1 26 15 2 ... 2 ... 3 15 5 9 5 .... 80 32 S Dacca „ ... ... 4,869 3 ... 2 3 7 3 20 7 49 20 15 3 3 2 1 2 I ... 11 3 107 38 § Pinapore „ ... ... 5,596 10 4 23 7 4 ... 8 2 18 4 14 5 3 ... 10 5 2 .. 92 27 -n Benares „ ... ... 4,804 3 ... 12 7 10 1 2 ... 2 1 1 1 ... 1 ... 32 9 % Cawnpore „ ... ... 10,452 3 2 6 1 5 ... 4 ... 3 ... 2 ... 2 2 3 ... 6 2 1 ... 35 7 Meerut „ ... ... 13,487 3 ... 4 ... 2 ... 3 ... 1 1 14 S Agra „ ... ... 3,471 1 ... 1 1 3 Saugor „ ... ... 3,469 1 ... 1 2 ... 1 1 ... 1 ... 1 1 8 1 -4 Neemuch „ ... ... 10,014 1 1 ... 2 ... 1 5 Sirhind „ ... ... 8,902 1 1 1 ... 3 ... 1 ... 2 1 5 2 3 1 11 3 20 "(j n Punjab Field Force ... ... 31,078 11 2 1 1 4 2 & Bengal Peesidenct ... 103,425 9 1 5 5 27 11 64 21 124 44 31 3 28 3 34 7 23 9 27 6 31 13 8 1 411 124 HO I] CHOLERA OF THE EUROPEAN AND NATIVE ARMIES, 1826-53. XX y EUROPEAN ARMY, 1848. NUMBER OF ADMISSIONS AND DEATHS FROM CHOLERA IN EACH MONTH. STATIONS. Sibbsgth. I J-"^b*- Febbuaby. Mabch. Apbil. May. Jdjte. July. August. Septembeb. Octobbb. [ n ovembbb. Dbcbmbbb. j ToTix AbmiB . I | ' —~l SIONS OF IHB OF THE Ad. I Died. Ad. Died. Ad. Died. Ad. Died. Ad. Died. Ad. Died. Ad. Died. Ad. Died, Ad. Died. Ad. Died. Ad. Died. Ad. Died. Teas. Yeab. FortWMiam " ... ... 758 1 ... 4322 11 1 ... 1122 12 9 Presidency Hospital ... ... ... 1 2 1 3 Dum-Dum ... ... 713 1 ... \[[ "' .. '[ "3 ""{'""{ '" ' [[[ '[] "" "3 "' 110 Darjeeling... ... ... 96 2 2 S Dinapore ... ... ... 1,063 1 ... 13 3 9 i l ... i 1 26 "4 g Benares ... ... ... 159 1 1 ... „, .... 1 1 — Chunar ... ... ... 338 11 31 ! ' ... .42 -2 iCawnpore ... ... ... 789 j 1 ... 2 ... 31 7 28 7 49 23 63 27 7 3 181 67 I Allahabad ... ... ... 182 I £ j Landour Depot ... ... 143 1 1 1 "j Saugor, Mhow and Nusseerabad ... 239 1 . . 1 ° .UmbaUa ... ... ... 1,881 j "2 '.'.'. "4 1 ... '.'.'. "3 '.'.'. '.'.'. '.'.'. 2 '.'.'. '.'.'. '.'.'. ... ... ... ... 1 ... 12 "l g, ¦ Kussowhe ... ... ... 1,129 ! . Loodianah ... ... ... 179 1 1 " Jullundur ... ... ... 1,173 2 5 15 10 29 15 <£ Dina^re . Z Z 1,028 Z Z ... ¦ 1 ••• 2 ... 3 2 1 5 3 12 5 f BenaL ... Z ... 161 11 2 1 1 ... ... 4 2 3 Ghazeepore ... ... 385 5 3 2 1 ... 3 1 10 ? 3 Chunar . ... ... 304 1 ... 1 1 2 1 Is Cawnuore 786 - 80 31 2 1 11 83 33 £ Meerut 487 • ••• ... ... ¦ ••¦ 4 1 4 1 | Agra ... ... ... 498 ... 2 ••• 2 1 1 1 5 2 g Uraballa ... ... ... 1,505 3 ... 4 3 ... 2 ... 2 ... 1 15 ... Subathoo ... ... ... 46 | • ¦« 1 I 1 •- -2 Loodianab. ... ... ... 263 ... 1 ¦ \ - M Jullundur ... ... ... 1,390 I 2 1 ... ... 3 Ferozepore... ... ... 355 •• •• ••• •• 1 ••• ••• •¦• ••• Lahore ... ... ... 2,867 1 3 1 . ... 3 1 ... * * 1 ... 9 | 1 IWuzeerabad ... ... 2,306 1 } - 2 ... . ... . . 4 i ... Eawulpindee 882 1 ¦•¦ ••¦ - 1 - 1 •¦ } ... - - 2 ... 3 ... 1 1 10 1 Peshawar ... ... ... 1,191 3 1 2 11 1 ... 1 2 ... 10 2 Punjab Field Force ... ... ... 1 . ••• ••¦ ••• J•• Troops on the march ... .. ... »»••- ¦« - _^ Z__Z !T ——__- — — — AjPBOXiMATg_SrBggGTH_ ... 17,467 ~ "1 5 S 2 1 2lj_B__B2 19 18 10 95 35 1 60 28 113 60 52 32 26 13 10 5 I 490 215 • Returns wanting. NATIVE ARMY, 1849. Presidency Circle 1063 ****** 1 * * * 2 * * * * * * * * * * * * * 3^ * BarracSe 5800 !* 4 *3******************* 8 * g™ Pc" - •" 3560 1124139 18 3 5 ... 62315 1 8 2 1 ... 4376 25 g Dinapore '/, Z Z 5,319 I 1 ... Z. ... 2 ... 44 14 19 5 2 ... 30 6 8 1 4 ... 4 . 5 1 14 12g | 31 Benares 5 405 I 1 •¦¦ o ... 11 1 7 1 "9 Swnpore "„ Z Z U974 9 1 3 1 29 13 30 14 74 19 12 7 3 2 2 1 5 1 1.37 59 Meerut „ 13,657 I 1 . 8 ... 3 1 2 1 2 ... . ... 1 1 1 . . ... 18 3 Agra 3,980 » - ¦¦¦ ~ •» | ••• ••• - * 1 *¦ ¦•• ¦•• ¦•• «g baugor ? ... ? o,mJ4f ••• •*• •¦¦ •¦¦ * •• 1 Bengal Peesidency ...I 111,541 |l 21~| 4 V~Z. 2~~5^_99_33 84 26 68 24 124 32 | 37 | 11 I 22 [ 6 1 26 | 6 15 2 7 7 I 531 156 / I • The average of the three monthß, January to March was 20.660; from April, the Army of the Punjnb was broken up. No. I] CHOLERA OP THE EUROPEAN AND NATIVE ARMIES, 1826-63. 27 NATIVE ARMY, 1850. Number of Admissions into Hospital in each Month. __.__-„ Strength 'TotaiAd- Tofai, STATIONS. or I MissmNS Deaths op 3™3 ™- Jan. Feb. Mar. Apl. May. June. July. Aug. Sept. Oct. Nov. Dec. "yeTr! YsYb. Stations of Presidency Circle ... ¦> „ Barrackpore Circle ... J * „ Dacca Circle ... 3,558 2 1 ... 6 1 2 ... 1 l 2 2 is 6 „ Dinapore Circle ... 4,514 ******##*##* # # „ Benares Circle ... 8,456 ******####*# # # „ Cawnpore Circle ... 11,940 ******#*##** # # Aemt op the Westeen Division of the Epidemic Aeea.* II Nimar ... ... ... 412 Sirdarpore ... ... 380 ... 1 1 Mehidpore ... ... 1,580 8 19 3 30 g Erinpoorah ... ... 1,230 5 5 i Kherwarrah ... ... 1,009 1 1 jl Ajmere ... ... 918 1 3 4 2 Beaur ... .. 650 Muttra ... ... 515 3 1 1 ... 5 Agra ... ... 3,325 1 ... 1 ... 2 1 ... 2 ... 7 1 Allyghur ... ... 960 1 1 ... 2 1 I Shahjehanpore .. ... 992 iti ... pareiUy ... ... 2,667 1 1 2 2 Almorah ... ... 953 Moradabad ... ... 900 Meerut ... ... 2,456 Delhi ... ... 3,075 Deyrah .. ... 1,320 12 1 , ... 4 1 Umballa ... ... 3,472 1 1 2 1 Hoshiarpore ... ... 3,747 1 1 Lahore ... ... 5,132 1 ... 15 11 9 1 Phillour ... ... 1,091 1 1 Wuzeerabad .. ... 3,427 2 1 3 ET^'-m ... ... 2,439 1 1 Ipindee ... ... 2,377 3 3 1 ¦Stations of the Punjab ... 33,858 None. None. Bengal Pbesidency ... 114,515 1 ... 1 19 29 10 2 10 4 1 4 ... 81 20 I Monthly Returns for the Circles of the Eastern Division, with the exception of those of the Dacca Circle, are too imperfect to admit of their being tabulated. I DEATH TABLE FOR THE EUROPEAN ARMY OF THE PRESIDENCY, 1850. STRENGTH 21,063. Cholbea Deaths or the Aemy in each Month. Total 11 PLACE OP DEATH. Da « ° F Jan. Feb. Mar. Apl. May. June. July. Aug. Sep;. Oct. Nov. Dec. Yeab. Calcutta ... 12 111 6 Dinapore ... * 2 3 Cawnpore ... 15 2 8 Umballa ... 1 1 Jullundur ... ••• ••• ••• ¦*¦ *¦ Wuzeerabad ... ••• ••• ••• ••• ¦*¦ ¦•• ••¦ ¦•¦ 1 1 ... 3 Peshawur ... 2 1 1 1 ... 5 On the Ganges 12 1 4 Bengal Peesidency ...***. 3 8 7 2 1 1 3 4 3 32 CHOLERA OF THE EUROPEAN AND NATIVE ARMIES, 1826-53. NATIVE AEMY, 1851. Nukbkr of Admissions into Hospital in kach Month. Total Ad- Total Sthhw o™ (in I ~~ "" MISSIONS DbaTHSOfI STATIONS. J ULy OP TUB . THB Jan. Feb. Mar. April. May. June. July. Aug. Sept. Oct. Nov. Dec. Ybab. Yeab. Stations of Lower Bengal ... 5,955 4 1 ... 9 7 13 5 2 ... 3 7 3 54 19 „ of Eastern Bengal and Assam ... ... 3,897 1 1 ... 2 2 6 „ of Dinapore Circle ... 5,656 ... 1 * 7 10 * 8 2 2 30 8 Ghazeepore ... ... 229 ••• ••• ••• •¦¦ 1 ••• ] ••• Benares 2,968 1 2 ... 1 2 4 2 1 1 14 6 Chunar ... ... 299 2 13 13 10 2 Mirzapore ... ... 643 2 * 1 Goruckpore ... ••• 944 1 l l Azimghur ... ¦•• 231 •¦ ••• ••• ••• Jounpore ... ••• 194 ... 1 ••¦ •¦¦ ••• j- * Sultanpore ... ... 940 • ... 1 ... 1 ••• ¦•¦ J ] Lucknow ... ... 2,910 j 1 1 5 ... 6 7 2 22 1 Seetapore ... ... 942 ... 1 ... 1 ... ... ... ... Allahabad ... 2,105 1 1 14 1 8 2 clwn^orf ::. ... iill ... 11114 4 4 618 1 2 ... 7 I C 8 21 Futtehghur ... ... 1,064 ; ... •• ••• •¦• ••• Banda ... ... ,918 3 ... 7 1 11 4 Nowgong ... ... 1,057 1 J 1 Jhansi ... .» 861 I 1 1 Erinpoorah ... ... 1,232 j ••• Kherwarrah ... ••• 1,031 ••• Beaur ... ... 666 ••• Muttra ... ... 508 ... 1 - ••• 1 Agra ... ... 3,118 •• 1 1 1 Mynpoorie ... ... 579 ••• ¦• ¦•• Allyghur ... ... 972 ... 1 1 1 » Etawah ... ... 529 | 1 1 | Shahjehanpore ... ... 1,041 I ••• j Bareilly ... ... 2,575 Almorah ... ... 1,015 Moradabad ... ... 900 •¦ ••• ••¦ ... Meerut ... ... 2,257 I 2 ••• 2 2 Deyrah ... ... 638 •• Delhi ... ... 3,043 ... 2 2 1 ... 5 Umballa ... ... 4,073 2 4 11 8 Loodianah ... ... 4,040 ¦•• 3 2 5 2 Jullundur ... ... 3,429 I 1 ... 1 1 3 Ferozepore ... .. 3.249 I 1 3 »¦ ••• 4 Lahore ... ... 5,677 ... 1 1 2 1 1 ... 1 1 ... 8 1 Jhelum ... 2,113 1 J Rawulpindee ... ... 2,225 •• 1 Peshawar ... ... 6,649 1 ... 2 1 ... 2 6 4 Kohat ... ... 2,387 2 2 2 Other Stations of the Punjab ... 26,313 i ... None. None. On board boats on Bhurmpooter ... 1" lb 16 Bengal Pbbsidkkcy ... 114,816 10 7 18 52 40 31 41 47 8 6 11 30 301 101 i ' * Monthly Return wanting. DEATH TABLE FOR THE EUROPEAN ARMY OF THE PRESIDENCY, 1851. STKENGTH 20,710. Cholera Deaths of the Arm? in sach Month. Total PLACE OF DEATH. DB j™ 88 ° F Jan. Feb. Mar. April. May. June. July. Aug. Sept. Oct. Nov. Dec. Yeae. Calcutta ... 6 3 1 » 10 20 Dum-Dum ... ... ... ... ... ... •¦• ••• •¦¦ ••• ... ¦•• 2 ... 2 Dinapore ... 8 2 ... 1 2 12 20 Benares ... ... ... ... 3 ... ... ... ... ... ... ... ••• •• 3 Cawnpore ... ... ... ... ... ¦•• ... ... ... 5 2 .. ••¦ ... 7 Agra ... ... ... •¦• • ... ••• ... ... t> a ... ... ... o Meerut ... ... ... ... ... ... ... ••¦ ... ••¦ ••¦ ••• 1 ••• 1 Wuzeerabad ... ... ... ... ... ... ... ... ... ••• 1 ¦•• ¦•• ... 1 Rawulpindee... ... ... ... ... ... ••• ... ••• 1 ... ••• ¦•¦ ¦¦• 1 | Peshawur ... ... ... .. ... ... ... ... 2 ... ... ... 1 ¦•• 3 On inarch in the Punjab ... ... ... 1 ... ... ... ... ... ... ... ••¦ ••• 1 Bengal Peesidency 3 6 6 4 2 14 12 5 1 4 10 67 I' ' ' CHOLERA OF THE EUROPEAN AND NATIVE ARMIES, 1826-53. NATIVE ARMY, 1852. Numbbe op Admissions into Hospital in each Monte. 1 Total Ad- Total STATIONS. Stbkngth of missions iDbathsof V- * ¦*. v ? > , OP THB TUB Jan. Feb. Mar. Apl. May. June. July. Aug. Sept. Oct. Nov. Dec. | Ykab. Yeab. I Calcutta... ... ... 1,253 3 2 2 ... 4 2 3 2 ... 2 20 ' 6 Dum-Dum ... ... 24:3 1 ... 1 2 I I Barrackpore ... ... 3,313 2 7 68 1 2 2 1 106 9 1 199 101 I Berhampore ... ... 648 ... 7 ... 2 1 2> 3 4 42 28 I Midnapore ... ... 294 1 ... 1 Stations of Eastern Bengal ... 2,368 2 3 1 10 16 10 „ of Assam ... ... 2,305 1 ... 9 2 5 5 3 5 4 7 4i 9 of Dinapore Circle ... 5,173 ... 2 * * 3 5 1 1 12 3 of Benares Circle ... 10,503 ... 1 2 27 3 3 1 3 I 40 4f „ of Cawnpore Circle ... 9,662 2 3 4 -2 2 2 1 ... 1 1 18 1 Western Division. Erinpoorah ... ... 1,038 Kherwarrah ... ••• 1,031 ... Beaur ... ... ... 666 , ..i Jhansi ... ... ... 854 ... 1 1 2 I 2 Muttra ... ... ... 472 1 ... 1 Agra ... ... ... 2,040 1 ... 1 1 Allyghur ... ... 972 1 1 - 2 Shahjehanpore ... ... 1,024 Bareilly ... ... ... 2,691 1 1 ... 2 Almorah... ... ... 812 1 1 ... 1 1 4 1 Moradabad ... ... 900 4 ... 1 5 3 | Meerut ... ... ... 3,571 ... 1 1 4 3 9 ... I Delhi ... ... ... 1,931 112 2 1 ... 1 1 9 Deyrah ... ... ... 564 il 16 1 58 33J Hansi ... ... ... 735 I - 1 1 Umballa... ... ... 3,971 ! 1 1 1 ... 2 13 13 2 33 15 Jutog ... ... ... 774 i , 1 1 Phillour... ... ... 1.067 1.. 1 ... 1 ¦ 2 Loodianah ... ... 1,588 ... 2 ... 1 1 1 5 1 Jullundur ... ... 3,406 1 Noorpore ... ... 547 I 1 ¦•• Kangra ... ... ... 1,225 | ... ... ... 1 ••¦ ... ••• ••• - 1 Umritsur ... ... 1,135 I 1 1 ••¦ 1 ¦•• ... ¦ 5 1 Lahore ... ... ... 6,829 1 1 ••• 1 1 4 2 Ferozepore ... ... 3,984 1 3 1 ... ... 5 Mooltan... ... ... 2,467 1 11l ... 1 ... 5 4 Eawulpindee ... ... 2,740 ¦¦ ... 1 ••• ... 1 ... Peshawur ... ... 7,563 1 3 1 ... ... 3 ... 8 2 Zohat 1,964 ... 11.8 5 3 Bharookote ... ... 900 1 1 2 ... 4 ... ... 8 ... Other Stations of the Punjab ... 21,448 »¦ »• »•__». " - None - None - Bengal Presidency ... 116,671 21520 58 107 15 67 50 29 154 26 27 570 230 I * Monthly Return wanting, t All in the Station of Benares. t Goorkhas. DEATH TABLE FOR THE EUROPEAN ARMY OF THE PRESIDENCY, 1852. STRENGTH 20,865. Cholera Deaths op thb Abmy in each Month. Total — Deaths of PLACE OF DEATH. the Jan. Feb. March. April. May. June. July. Aug. Sept. Oct. Nov. Dec. Yeab. Burmah* ..." ... 1 » » 8 1 - * 10 ._ *.' _JL 2L Calcutta '1 " 8 1 .j ... M ... 20 Chinsurah ... ••• ••• ¦•• ••¦ *" "A j 3 Dinapore ... ••• "2 "' ... 2 Benares ... • "• ": '" |_ 3 Chunar ... ...... ...... "i "i '.'.'.','.', 2 Cawnpore ... ¦•• ••• ••• ••• '•• ' ' Kussowlief ... Subathoof ... ''' '" "' "; \,\ Dugshaief ... "j "^ qJ "5 "' ['[ 73 Umballa Ferozeporef ••¦ ••• ••• ••• "* \ '•'•'• ._ \ Meean Meer... "j m "' "[ \ Rawulpindee... ... ••• ••¦ ".' "j "j 1 3 Peshawur ... •¦• X "j "' "3 j "."' n On the Ganges " _ _ j; _ 2 On march ... ••• ••¦ "' *" I i 1 12 4" 1 3 6 72 9 13 1 123 Bengal Presidency 1 ••• l * x ~^g CC a gg h mm o CC f n lhe°Be r U e s n fnbr O ded h o e nfo'r 1 tw O o f chgle» Stagg^ich occurred simultaneou.ly with the outbreak at Umballa, but no deaths. || NATIVE AKMY, 1853. Numbee oe Admissions into Hospital in each Month. Total Ad- Total Strength missions Deaths of' stations. of op thb the Jcl " T - Jan. Feb. Mar. Apl. May. June. July. Aug. Sept Oct. Nov. Dec. Yeah. Yeab. Odette 1,236 2 2 9 2 5 12. 23 13 SS^S. :¦¦ ::: »'S« "? "j »'"» « "• ¦•¦ "» "« "j ¦- f Berhampore 875 1 5 2 ... 4 3 . 15 10 Midnapore ... ... 860 2 ... 3 ... . 3 ... ... . J 1 10 4 Stations of Eastern Bengal ... 2,275 8 1 1 17 2 ... 1 7 4 36 10 , of Assam ... ... 2,903 9 4 7 22 23 7 3 1 2 1 2 ... 81 27 Dinapore ... ... 2,134 5 5 16 3 16 * ... * 45 9 Other Stations of the Dinapore Circle ... ... 2,146 1 ... 1 ... 3 * 1 * ... 1 7 2 Goruckpore ... ... 888 * 4 4 4 tee? ::: ::: »™ ::: ::: "¦ "4 "j £; "¦ ::: "i ;::.;:: 42 is Chunar 293 ¦¦ ... 8 1 J ... 0 4 Mirzapore ... ... 579 13 5 ... • 1 ... 1 11 1 Allahabad ... ... 2,076 M 8 1 20 7 Cawnpore 2,626 ... 13 15 6 3 35 2 ... 74 31 Futtehghur ... ... 877 1 1 .... 2 2 Banda ... ... i 731 ••• J J Nowgong ... ... 1,080 1 •• 1 ... Lucknow 3,412 4 2 ... 1 * 8 1 16 3 Seetapore ... ... 942 „. ... 1 1 ••• Shahjehanpore ... ... 963 5 5 2 Other Stations of the East ... 1,402 None. None. Stations of Agra and Central India ... ... 9,359 • None - N °ne. Bareilly ... 1,591 1 1 Almorah ... ... 830 ... Moradabad ... ••• 1,088 1 1 Meerut ... ... 4,194 1 1 Delhi • 8,126 2 12 111 ... 8 2 Deyrah ... •¦• 755 • ••• ... ITmballa ... ••• 2,160 3 ... 3 6 1 Phillour ... -. 572 1 •¦ ... Hoshiarpore ... ... 1,666 •• 1 ... 1 1 Kangra ... ... 1,811 »• } ¦•• Jullundur ... ••• 3,486 ... 1 1 MeeanMeer ... ... 6,926 ... 2 Eerozepore ... ... 2,233 1 1 ... ••• ••• Mooltan ... ... 3,464 1 •-¦ 1 1 Sealcote ... ... 2,814 , 1 1 1 3 Jhelum ... ... 2,481 112 4 Huzara ... ... 1,374 4 7 1 12 1 Bawulpindeo ... ... 2,850 | 1 11l ... 4 Peshawur ... - 6,765 1 2 1 11 6 Kohat ... ... - 2,331 ... 1 1 2 1 Other Stations of the Punjab ... 14,968 -None. None. Bengal Peesidency ... 113,278 22 20 63 70 109 51 63 89 9 10 20 8 534 180 * Monthly Return wanting. DEATH TABLE FOR THE EUROPEAN ARMY OF THE PEESIDENCY, 1853. S H Cholkea Deaths ov the Abmy in each Month. h Total WM Deaths ofJ PLACE OF DEATH. § ° g the mh S Jan. Feb. Mar. Apl. May. June. July. Aug. opt. Oct. Nov. Dee. Ybab. Burraah 3 5 67 ... 2 1 1 1 1 81 Calcutta 16 4 1 1 ... 13 Dum-Dum ?. ... ... ... 2 JJinapore ... 993 10 8 7 25 Benares ... 78 ... ... ... ... ... ••• 3 1 ... ... ... ... * Chunar ... 182 1 10 ... H Cawnpore ... 981 4 30 64 97 ... 195 Meerut ... ... ... ... ... ... ... ... ... 1 ••• ••• ... ... * MeeanMeer 1 ... ... Peshawur ... ... ... ... ... ... ... ... ••• 3 '2 On the Ganges 12 3 Bengal Presidency 21,505 1 6 6 2 14 39 84 99 ... 3 4 2 260 APPENDIX II. TABLE SHOWING THE NUMBER OF DEATHS FROM CHOLERA IN EACH JAIL OF THE BENGAL PRESIDENCY, IN EACH YEAR FROM 1833 TO 1868. 9 NUMBER OP DEATHS FROM CHOLERA IN EACH JAIL OF THE BENGAL PRESIDENCY, 1833-68. The Returns for the Punjab, Nagpore, and Oude commence from the period at ivhich these States were annexed to the British Territory ; from the independent Native States no Jail Returns are received. Many Jails have been opened for the first time in recent years, and others have been abolished ; an asterisk marks the years for which there are no returns. I ' i , 111 ii i ' JAIL STATIONS. 1833. 1834. 1835. 1836. 1837. 1838. 1839. 1810. 1841. 1842. ] 1843. 1844. 1845. 1846. 1847. 1848. 1849. 1850.1 1851. 1852. 1853. 854. 1855. 1856. 1857. 1858. 1859. 1860. 1861. 1862. 1863. 1864. 1865. 1866. 1867.' 1868. j Bengal Peopeb and Eastern Bengal— Alipore ... ... 34 18 8 6 9 17 ... 12 12 27 ... 17 10 ... 5 4 2 19 21 8 6 7 24 60 30 42 11 13 13 17 25 24 20 12 Baraset ... 1 3 2 1 ... 1 1 2 10 1 1 ... 1 ... j 3 Jessore ... ... 15 15 1 4 2 3 1 4 50 19 10 28 6 11 1 4 17 7 ... 3 19 ... 16 17 2 22 j 2 1 Kishnaghur ... ... 6 ... 2 ... 1 1 5 8 6 3 4 1 2 1 2 11 3 j 1 2 Moorshedabad ... ... 18 14 5 12 11 15 5 20 27 15 12 9 17 5 4 6 17 1 3 2 9 1 ... 75 11l ... j 2 Howrah ?,**##*##*#####**#**# 2 * 1 11711 Hooghly ','.'. ... 8 5 2 9 3 5 4 12 12 7 6 12 34 36 12 6 12 5 8 38 29 27 15 12 12 35 16 87 15 19 28 7 6 17 5 2 Burdwan ... ... 11 53 80 29 10 18 5 14 2 11 16 2 12 4 1 2 ... 30 19 ... 10 3 5 13 25 3 3 5 ... 4 ... 6 Bancoorab. ... ... 9 ... 7 1 ... 5 1 ... 14 2 3 ... 11 1 ... 17 2 1 17 ... 2 1 3 11 2 16 8 3 ... 2 Purulea ... ...**#********,., 46 2 29 ... 57 23 ... 54 31 1 ... 12 9 ... 1 7 1 ... EaneeoTinee ... ####*######*•#**#*###*••#*# 1 ... 8 Sooree° ..' '.'.'. 2 3 20 3 12 ... 10 14 4 ... 29 2 .. 2 20 2 2 ... 9 5 4 1 17 ... 1 1 1 Eajmehal and Pakour _***####**### *######*#*#####*391 14 4624 Deoghur ... "'#**•#*###*.*##*#*•*##**•*•**••,., 11... 13 1... Malda ... ... 3 3 1 2 10 2 6 8 1 9 4 2 14 1 ... 1 1 10 10 ... 3 ... 2 1 1 1 ... 3 Dinagepore ... ... 79 4 2 ... 10 4 50 40 14 1 17 ... 18 5 13 16 4 7 1 19 3 3 31 25 5 2 4 17 1 ... 1 37 2 1 1 1 Rajshahye ... ... 34 8 30 6 28 45 1 1 40 2 9 6 17 ... 6 ... 2 18 2 15 33 ... 48 3 57 28 15 4 3 5 ... 18 ... 1 2 37 Eungpore ... 7 ... 2 3 6 33 1 1 3 3 2 2 4 22 1 1 ... 2 9 2 1 1 ... 3 Bograb. ... ...******** 4 1 ... 1 6 ... 3 5 1 ... 4 13 1 2 112 8 Mymensing ... ... 15 11 ... 5 ... 20 17 2 21 4 10 ... 3 1 ... 2 4 8 ... 1 11 8 18 27 ... 11 Pubna ... ...***** 3 1 2 7 1 3 5 3 2 3 1 10 1 ... 4 3 ... 6 3 1 ... 10 3 7 ... 1 Furreedpore ... ... 1 17 8 2 6 6 4 14 1 2 2 9 2 2 13 11 1 Backergunge ... ... 31 31 7 15 11 23 16 31 49 12 19 10 22 2 5 10 4 9 13 33 35 7 19 11 2 9 22 12 8 8 51 17 1 5 5 19 Noacolly ... ... 3 * ... 62397 11 19 ... 1 ... 2213 2 2 Chittagong ... ... 12 1 10 4 34 1 12 17 36 32 9 25 1 2 12 2 ... 32 ... 1 ... 2 1 1 4 ... 2 1 ... 4 Tipperah ... ... 4 ... 3 3 1 6 7 2 5 5 10 11 4 9 ... 45 ... 5 9 8 1 ... 1 1 1 1 Dacca ... ... 18 8 2 4 1 9 4 8 10 1 11 1 23 3 ... 3 4 3 ... 10 16 3 5 6 9 6 2 1 1 ... 5 ... 5 Sylhet ... ... 12 33 ... 3 1 1 73 3 8 9 ... 17 67 ... 1 2 20 46 3 4 ... 9 ... 24 1 1 1 27 7 ... 3 4 Cherrapoonjee ... *##*##*#* i 2 ... 1 8 7 Cachar ?. i%> ################ 2 1 4 6 6 5 7 24 6 16 2 Stations South and West of the Hooghly — Midnapore ... ... 31 15 29 57 26 49 4 14 3 1 9 5 3 3 3 3 38 1 11 ... 11 ... 2 1 68 43 ... 93 5 4 ... 23 1 ... Balasore ... ... 4 12 ... 11 4 4 ... 1 24 1 1 ... 1 7 ... 4 ... 3 ... 1 5 1 2 3 ... 2 1 1 ... 2 37 1 ... Cuttack ... ... 20 4 ... 12 99 11 1 34 62 9 5 1 1 ... 5 2 10 9 4 4 ... 13 3 ... 113 1 1 Pooree ... ... 11 22 ... 8 11 3 23 7 2 1 1 ... 1 ... 3 1 1 2 ... 1 3 12 Assam — Gowalparab ... 11 1 2 7 9 1 ... 9 1 3 28 6 1 2 ... 11 4 12 ... 8 43 6 5 2 2 ... 3 1 ... Gowhatty ... 66 1 2 1 49 22 17 1 3 28 4 ... 10 10 1 22 8 4 10 ... 1 20 ... 4 12 2, 11 I 1 — Seebsaugor ... , ?*******#* ....... 54 2 , ... 3J- ••¦ ••• Nowgong ... ...*** 1 ... 7 1 3 20 1 14 ... 6 5 3 5 ... .„ 32 _—— ti•• m -.« _,--- dtv 'A T PT?VQT^T I TW*\ r Ift *^*^- GS CHOLERA DEATHS IN THE JAILS OF THE BENGAL PRESIDENCY, 1833-68. Chota-Nagpoke and Behab ] I 1 I 1 PfiOVINCES — Chyebassa ... ... ****** 1 ********* 1 67 ... 3 ... 8 - 84 Kanchee ... ...******** 6 7 5 109 5 5 6 4 1 3 5 33 12 9 1 ... 1 Hazareebaugh ... ...*** 1 24 1 ... 1 7 5 ... 5 1 1 14 15 ... 13 10 4 4 ... 30 2 ... 15 ... ... 76 Gyah ... ... 93 2 4 2 4 8 7 17 18 54 11 I 15 22 17 17 6 ... 7 5 ... 30 2 22 7 ... 37 4 1 9 1 ... 12 Patna ... ... 2 25 1 2 * 7 6 18 22 29 35 32 63 6 22 5 27 1 4 3 20 ... 25 14 14 3 19 8 14 18 25 6 Dee<*ah ... ... *******************... 60 7 * * 11 * * * 13 ... 1 ... 15 28 26 4 Arrah ... ... 3 2 ... 4 8 5 10 10 14 43 7 ... 18 ... 31 12 15 21 25 ... 42 4 48 3 ... 10 3 ... 32 3 ... Cb-umparun ... ...*•***** 6 ... 13 1 1 3 32 4 ... 15 ... 3 1 16 ... 1 3 ... 14 ... 1 Mozufferpore ... ... 4 1 ... 4 8 7 7 5 133 85 ... 54 48 1 27 36 33 ... 3 ... 8 38 4 13 6 ... 5 20 10 ... 16 1 1 17 6 1 Chupra ... ... 1 4 1 14 32 15 2 9 9 20 ... 4 6 ... 3 2 40 4 1 ... 16 ... 11 26 7 ... 13 1 24 19 1 ... Monghyr ... ... 9 4 ... 2 8 2 3 31 16 23 23 5 27 ... 2 14 33 4 1 15 11 54 3 ... 18 19 8 14 39 ... 6 6 8 ... Bhaugulpore ... ... 13 3 8 2 40 ... 6 4 16 20 18 29 29 3 11 5 26 4 53 ... 36 47 119 42 26 40 39 30 14 11 10 10 1 16 5 1 Purneab ... ... 23 1 18 ... * 2 20 16 3 1 27 ... 43 3 4 36 2 68 2 22 1 50 ... 1 60 20 81 ... 23 1 43 ... Darjeeling ... **************** ! ]_ 2 2 Benabes, Oude, Cawnpoee and BtTNDELCUND — Ghazeepore ... ... 12 2 5 8 7 3 4 2 8 1 3 4 ... 2 2 4 6 3 ... 4 1 5 1 2 3 Benares ... ... 2 2 4 17 8 3 6 4 5 4 ... 9 4 7 6 ... 5 ... ... 19 2 54 7 58 ... 3 19 ... 1 44 26 1 1 Mirzapore ... 9 ... 1 12 5 9 11 9 11 ... 3 8 1 3 1 1 3 4 6 ... 5 1 1 7 11 ... 4 1 1 Azimghur ... ... 2 ... 1 ... 6 7 1 ... 3 1 1 2 ... 1 ... 1 ... 3 5 2 3 1 1 ... 1 2 1 1 Jounpore ... ... 7 2 5 3 2 14 12 ... 2 4 1 9 9 1 4 10 ... 12 ... 1 2 3 5 Goruckpore ... ... 3 ... 1 ... 25 1 4 2 1 2 ... 2 1 ... 6 2 1 ... 5 ... 34 2 54 ... 1 7 44 19 2 ... 5 £ Gondah ... ... "1 f ... 1 Baraitch ... ... 3 11 1 ... Fyzabad ... ... ... 3 9 19 1 Sultanpore ... ... ... 2 1 18 1 Rae Bareilly ... ... 6 ... 1 Pertabghur ... ... ¦ •{ Hurdui ... ¦•¦ Luckimpore ... ... Lucknow ... ... 7 4 20 ... 153 1 ... Seetapore ... ... 2 2 1 11 ... 13 ... Oonao ... ••• J [_ 3 1 Bareilly ... 4 10 ... 7 ... 17 2 1 1 1 ... 12 65 * 1 5 1 Shahiehanpore ... ... 10 2 17 3 1 ... 1 1 2 ... 28 29 * 6 ... Etah ... ?.************ ************ .. 1 ... Oraie (Jaloun) ... ...************..****_ * "' "' \ Humeerpore ... ... 4321 1 1 '" ... 1 * Banda ... ... 13 5 1 ... 54 2 ... 12 1 ... 1612 1 ... 42 11 ' 99 3 Futtehgbur ... ... 1 5 1 21 1 ... ... 1 1 ... 2 36 * 22 ... 3 1 Cawnpore ... 7 3 ... 863 11 ... 2 2 ... 4104 13 3 ... * ... 1 Futtehpore ... ... ? 1 12 2 8 1 * * * * 1 * 5 * * Allahabad ... ... 5 ... 1 ... 1 16 5 9 14 16 ... 3 67 1 2 11 38 ... 14 4 33 19 * 1 49 8 26 1 5 28 2 ... 14 2 Nagode ... ••• ******************* "*****7... 1... 2 1 H Centeal Peovinces— ®' Sumbulpore ... ... ******************* 3 ... 17 1 9 2 1 1 46 Belaspore ... ") f • * • 3 1 Baepore ... > \ ... 2 * 10 7 11 11 23 40 44 Bandhara ... ) \ I ... 1 * 11 9 ... 26 2 ... ... * ' * L *^pp6llCilX Centbai, Provinces —continued — Chanda ... Nagpore ... | f ... 9 * 15 ... 5 S 9 Wurdah ... ). ... 18 * . ... 15 "' o%_° * ... ... Sironcha ... f J * * * "; & 8 9 54 2 ... 2 Chindwarra ?, **# '" •• Seonee ...... 5..1211 * * * •• ££ ' I * * 8 -. 1 :: - 4 "8 i ! ! ••; i ! 8 » « - 3 - «j « ::: ::: ,9, 9 i ,. s J :; •-, ::: ? Jnansi ?, ****#####*** ******* #1O ... Sehore ... '"******** I ************* 1"" * 1 Rajpootana, Agea, Meeexjt and Ai mere - 2 4 15 i . Beaur ... • x ° 1 4 12 1 q n Muttra ... * 19 "j - 2 - ••• L - 3 XJX J iJolundshuhur ... 6 2 1 49 * '" "\ V '.V Budaon ... ?#### "# # • •• ••¦ 1 * ..' '» "¦ x x -• Seharunpore ... 6 "j "J - x * 1 4 1 1 10 * ;;; - Bynour ... 1 .. 1 l "' 6 2 1 1 16 Almorah ... , mm [][ \" "[ L 10 ~ x 1 30 ... i ... ". ] J Mozuffernuggur ... ... k "\ ;•¦ 9 1 "i c ? Punjab- "' d 35 Goorgaon ?, 1 fi , swBar5 w8ar ::: 3 ::: ::: i- i - ••; 22 * ... ;;; 242 4 :¦:¦: ::: Pamput and Kurnaul ... 11l if 11* "' " 1 ul • ¦#**** •* •* •¦* I \ - •• * * * • 4 * i i ;;; ;;; Thanessur ... ...******#*** 7- l * ... " toubatnoo ?, ... a \ c Umballa ... " •" 5 ••• Loodianah |" "* "* "* -- 7 2 • .'•".' 27 S"l181 V "' Jullundur ... t j 1 | ° — " l - 1 ¦•¦ Ferozecore V."7 S*;**;* * * * # * * ... j ... 1 I ... I ... ] 1 ••• 2 I ... \ ... 1 ... I ... \ ... I 1 i ... \\ \ i & 1 ::: ;: i E E E .5 " E E E E s E E :::::: Sl-!S 1 -! tit? i t a ********* Lahore Female Jail... ••• Hoshiarpore ... I I in 1 l^ kote - j * ¦•* ••* ¦• ¦* •* •* 10 ::: - * ::: Goordaspore ... * ••¦ • Goojranwallah ... * * 1S 4 - Goojrat ... Shahpore ... Jhelum ... )¦ •! * * ¦ Googaira and Montgomery * Dera-Ghazee-Khan * j * '" Dera-Ismael-Khan * * "¦ I Kohat ... ***** Bunnoo ... * * I X ,' ! V o* ' Eawulpindee ... * ¦• ••• £ ••• ••• ¦•• ¦« j: 'l "A "1 "± "A % "1 Hurreepore ... ********... 2 ********** Peshawur ... J L * 4 l 23 5 '" I * Sohan Bridge Gang. The importance and value of this Table depends on the fact, that every individual outbreak or case occurring in the Epidemic Area is an index of the geographical distribution of an invading cholera. In looking at these deaths in their by Fovmces ; i the succession of the different invading epidemics is in almost everj case perfectly denned ; and so true is this, that Chapter VI of the first Section may be regarded as a commentary on the facts of invasion as here exhibited. The results even for individual jails in the provincial group prove what I have in various places of this report illustrated, namely, that the epidemic history of a long series of years may be accurately read in the records of a single locality. I 35 CHOLERA DEATHS IN THE JAILS OF THE BENGAL PRESIDENCY, 1833-68. APPENDIX III. TABLES SHOWING THE ADMISSIONS AND DEATHS FROM CHOLERA IN THE EUROPEAN AND NATIVE ARMIES AND AMONG THE JAIL POPULATION OF THE BENGAL PRESIDENCY, DURING THE FIFTEEN YEARS FROM 1854 TO 1868. 11 U 15 49 50 5 ! § 117 128 131 133 144 137 146 149 150 151 154 157 159 TABLE OF CONTENTS. CHOLERA TABLE FOR THE NATIVE ARMY OF THE BENGAL PRESIDENCY FOR 1854 THE JAIL POPULATION OF THE BENGAL PRESIDENCY FOR CHOLERA TABLE FOR 1854 EPIDEMIC OF 1855-58, The Distbibution in Time, and the Geogbaphy of the Epidemic CHOLERA OF 1855.— Map and Explanations Choleba of the Native Abmy Choleea of the Jail Population- CHOLERA OF 1856 — Map and Explanations Choleba of the Eubopean Abmy Choleba of the Native Aemy Choleba of the Jail Population CHOLERA OF 1857.— Map and Explanations Choleba of the Eubopean Abmy Choleba of the Jail Population CHOLERA OF 1858— Map and Explanations Choleba of the Eueopean Aemy Choleea of the Native Aemy Choleea of the Jail Population EPIDEMIC OF 1859-62, ¦The Disteibution in Time, and the Geogbaphy of the Epidemic CHOLERA OF 1859.— Map and Explanations Choleba of the Eueopean Aemy Choleba of the Native Aemy Choleea of the Jail Population CHOLERA OF 1860. — Map and Explanations Choleea of the Eueopean Abmy Choleba of the Native Aemy Choleea of the Jail Population CHOLERA OF 1861.— Map and Explanations Choleea of the Eueopean Aemy Choleea of the Native Aemy Choleba of the Jail Population CHOLERA OF 1862.— Map and Explanations Choleba of the Eubopean Aemy Choleea of the Native Aemy Choleea of the Jail Population EPIDEMIC OF 1863-66, ¦The Distbibution in Time, and the Geogbaphy of the Epidemic CHOLERA OF 1863.— Map and Explanations Choleea of the Eueopean Aemy Choleba of the Native Aemy Choleea of the Jail Population CHOLERA OF 1864— Map and Explanations Choleba of the Eueopean Aemy Choleea of the Native Abmy Choleba of the Jail Population CHOLERA OF 1865.— Map and Explanations Choleea of the Eubopean Aemy Choleba of the Native Aemy Choleea of the Jail Population CHOLERA OF 1866.— Map and Explanations Choleea of the Eueopean Aemy Choleba of the Native Aemy Choleba of the Jail Population •The Distbibution in Time, and the Geogeaphy of the Epidemic CHOLERA OF 1867.— Map and Explanations EPIDEMIC OF 1866-68 Choleea of the Eueopean Aemy Choleea of the Native Aemy Choleba of the Jail Population CHOLERA OF 1868.— Map and Explanations * Choleea of the Eubopean Abmy Choleea of the Native Aemy Choleba of the Jail Population INTERVAL PRECEDING THE EPIDEMIC OP 1855-58. CHOLERA OF 1854. General indications of distribution afforded by the Tables of 1854. Except in the valley of the Nerbudda and in Western Malwa, the cholera of 1 854 had nowhere the aspect of an invading epidemic. The invasion was limited to the province of the south-west monsoon proper. It is illustrated both on the case of the Native Army and of the Jail Population. Among the Native Troops in the western division of the epidemic area, out of a strength of upwards of 85,000, four deaths only were attributed to cholera in 1854; and in three of these cases, which occurred at Peshawur, the diagnosis may be considered as doubtful. The devitalised condition of the cholera occupying the western division is shown by the fact that the four deaths recorded occurred out of a total of 56 admissions ; I have noted the same phenomenon in the cholera of the same area of 1859, following the death of the epidemic of 1856-58. In the valley of the Ganges, and throughout the eastern division, the spring cholera of April and May was generally revitalised, but the monsoon cholera is scarcely represented in either of the types. The Death Table for the European Army has been placed in the body of the Report, at page 15. The strength for the areas occupied by cholera in 1854 is too small to be representative, and therefore the Admission Table has been omitted in the Appendix. 18 Appendix No. 11l ] ?• CHOLERA OP THE EUROPEAN AND NATIVE ARMIES AND JAILS, 1854-68. [Appendix CHOLERA OF THE NATIVE ARMY OF 1854 Those Stations only are noted at which cases of Cholera were returned during the Year. IfsTMirwHO. Number of Admissions fbom Choleba in bach Mouth. om _£££ Circles of STATIONS " j " " op the op the mncb Jan. Feb. Mar. April. May. June. July. Aug. Sept. Oct. Nov. Dee. Yeab. Ybab. fob July. - "~ "Ift ft Regiments marching 14 ... 4 Pbesidency and Baeeackf |Swilliam .. 29 1 ... jl J •¦• 11 1 \ ™ 5 * qfi , J Sumbulpore ... j 3 x 79657 ' 965 \ Dum-Dum ... ... I • \ ••• • ••• q "L ± \k Banackpore j 1 2 4 ... 5 2 1 ... 5 2 3 7 32 L Berhampore ... *- "• * Dacea — 4 2 Dacca ... ••• 1 2 1 •• ¦•• ••• „ 4,857 1 Chittagong '..'. 2 ... 1 1 ••• . * Gowhatty ... l ••• ¦¦¦ ¦, Outposts of Debvooghur ¦»• DINAPOEE — j {Chyebassa ... ¦•• ••• ••• ••• '"' 19 "| K-ugulpore 1 111 I"i - 2 3 39 15 Dmapore .. y iv i» 1 J- Benaees — 2 1 f gST ::: ::: 1 ::: "i 1 J ::. "1 "1 ::: ::: :" : ¦ H w«] S™."™ ::: ::: ::: ..' ::: ::: 1 - "•' "i "i "i ~": Lucknow ... 1 1 2 [_ Seetapore ... 1 ! Cawnpoee— <7 q Allahabad .. 1 2 8 . ... 1 ••• 7 Cawnpore ... ?. 2 ... 1 3 6 4 4 20 Mynpoorie ... 1 ¦• Nowgong ... .., 1 1 l GWALIOE— 2 " Bhooranpore ... ... t ••• "j Mundlaisir ... 1 _ „ | 10,280 \ Sehore ... - 1 J 2 ... ... 6 « j Sirdarpore I J 9 "' 9 Mehidpore ... 4 3 2 W 7,652 Agra 2 ... 3 7 [12 1 Meeeut — 2 19^09 i Almorah ... ... 1 ... 1 •• ••• „ 1^,302 1 Demi §ti 2 ... 2S V SIEHIND — g Umballa ii! !!! .' j J •" I n(!O(! J Jutog ... 1 9,686 pMllour ... ... 1 Loodianah ... 1 . |^ Jullundur ... 3 ... ... 1 4 Lahoee — . t Mppan Mepr 1 ... 1 1 1 4 14,91 d Umritsur ... ... 1 3 1 5 Sealkote — 1 ' fSealkote ... ... 1 1 1 I Jhclum ... ... 1 •¦• ••• :[ Mooltan ... 1 ¦•• l Peshawub — C Bmmoo ... ... 1 ••• 1 lanl . ) Kohat ... 1 1 ••• % 18 > 015 j Eavvulpindee 2 1 8 (. Peshawur ... 1 2 4 11 ... 1 ... 10 3 I 126,711 Abmt of the Pbesidency ... 10 23 33 41 91 28 32 12 11 715 14 317 90 * The cholera of the 50th Native Infantry, which chiefly suffered in this outbreak, had the aspect which I have described as typical for a body affected on a known date. The 19 deathß of this Eeginicnt were from the admissions of the days noted as under, May 15th, 1; 17th, 1; 18th, 6; 20th, 4; 26th, 2; 27th, 2; 2Sth, 2 ; 29th, 1. t Stations of the extreme south-west only affected, namely, those of Nimar, Malwa, and Bhopal— See the parallel in the case of the Jail Population. JJO. Hl] CHOLERA OP THE EUROPEAN AND NATIVE ARMIES AND JAILS, 1854-68 vli'ii* CHOLERA OF THE JAIL POPULATION OF 1854. Avbbage Cholera Admissions op bach Month. Total I . I _ Stbunpttt Ahmio Admitted Total t . TATT, STATIONS OTBENGTH __ ADMIS- , Drattti Uikl) peb JAILi SIAUUfIS. DURIIfa SIONB ' „ DEATHS J 000 0 F thuYeab. Jan. Feb. Mar. April. May. June. July. Aug. Sept. Oct. Nov. Dec. «£*" StbeiUh. Yelb* Strength. Alipore ... 1,287 1 12 ... 2 ... 1 1 1 2 ... 1 2 23 I 8 Baraset ... 259 ... ... 3 3 x Jessore ... 686 ... >ti 2 ... 1 4 1 2 ... 10 Kisbnaghur ... 449 ... ... Moorshedabad ... 472 2 ... 2 1 ... 5 "{ Howrah ... 224 ... Hoogbly ... 494 ... ... 5 58 ... .. 12 75 ['.', 27 Burdwan ... 384 2 2 Bancoorah ... 308 ... . 1 1 "" "j Purulea ... 186 ... Sooree ... 337 ... l ... ?, 1 Malda ... 99 ... ... 1 1 "' "{ Dinagepore ... 677 ... ... ... 1 1 1 3 3 Rampore Bauleah ... 700 ... ... 4 4 ... ;§i ''[ Eungpore ... 549 I ... Mi 1 1 Bograh _ ... 105 ... 1 1 ... 2 , ,',', Mymensing ... 386 ... ... | Pubna ... 289 ... 1 1 2 I ... ... ..,. Furreedpore ... 431 Backergunge ... 584 3 2 6 ... 1 ... 1 13 ... 7 Noacolly ... 217 .. ... Chittagong ... 312 1 1 ... 1 Tipperah ... 450 ... Dacca ... 806 , Sylliet ... 474 2 11 3 1 17 ... 9 Clierrapoonjee ... 64 Cachar ... 27 | Gowalparah ... 141 1 1 ... ... ... ' Gowhatty ... 161 1 ... ... I Seebsaugor ... 115 ... 1 1 ... 1 Nowgong ... 102 ... ... ... .. ... I Tezpore ... 137 ... ... ... ... I Debrooghur ... 62 ... ... ... ..; ... Midnapore ... 596 3 1 4 Balasore ... 163 ... ... ... ... ... Cuttack ... 237 1 ... 3 4 Pooree ... 88 ... 116 8 ... 1 Sumbulpore ... 101 4 4 17 25 ... 17 Cbyebassa ... 430 ... Kancb.ee ... 220 ... 1 1 ... 1 1 4 ... 2 Hazareebaugb .. 839 1 1 2 Mongbyr ... 888 1 5 26 ... 4 3 ... 1 ... 40 ... 15 Bhaugulpore ... 430 I 1 1 ... 1 12 50 1 1 ... 10 9 ... 86 ... 47 Purneah ... 421 ... ... 14 17 2 2 35 ... 22 Darjeeling ... 46 Total ... 16,423 9 26 23 71. 45 104 34 10 8 17 12 15 374 222 165 1005 Gyah ... 608 I 2 1 1 ... 1 5 ... 2 Patna ... 659 I 1 2 3 1 1 1 I 9 I ... ! 3 I ... | Deegah ... 316 I 1 2 5 3 7 5 1 23 I ... I 7 Arrab ... 608 1 1 Mozufferpore ... 469 1 87 ... 1 89 ... 38 ... j Cbumparun ... 278 1 2 1 4 ... I Chupra ... 567 ... 2 2 1 9 1 1 ljj ¦¦• 4 | Gbazeepore ... 773 1 1 1 ••• ¦•• Benares ... 1,234 3 5 1 9 ••• 2 Mirzapore ... 752 1 ... 5 ... 6 ... 4 ... , Azimgbur ... 1,249 1 1 7 9 ••• 5 Jounpore ... 811 1 ¦" '" ?•" 1 Goruckpore ... 1,225 1 2 2 0 ... ... ... Jails of Oude* No returns No returns Etab ... 420 Humeerpore ... 236 Oraie ... 322 •• Futtebgbur ... 882 1 j: •" | Banda ... 548 1 ••• 1 _* - "' Cawnpore ... 876 ... 1 141 26 69 ... 13 Futtehpore ... 425 "' ••• ••: Allahabad ... 874 2 6 ... 1 9 ... *¦ - j Total ... 14,132 ~7~rU"lTl27~sB~irHi 1 2 261 1-85 82 s'Bo * Oude was not annexed until 1856; the Jail Returns for this Province were furnished from 1859 after the conclusion of the war. CHOLERA OF THE EUROPEAN AND NATIVE ARMIES AND JAILS, 1854-68. f CHOLERA OF THE JAIL POPULATION OP 1854— continued. Avebage Admissions fbom Choleba in each Month. Admis- Admlttbd Total Dikd STHENGtH __ 8I0 » B o", CE^ BOFB 0F £ A ™ imJ the Year. Jan. Feb. Mar. April. May. June. July. Aug. Sept. Oct. Nov. Dec. Y ™£ # Strength. Yeab. "*«» th. * 1,461 320 507 1 1 '.'.'. 203 '.'.'. '.'.'. ... ... ..'. ... 615 21 ... i 5 ... J 225 17t 17 •¦• 6 125 t 18 18 ... 5 Total ... 3,736 1 17 6 33 57 -V 52 26 696 Ajmere 200 Beaur 128 ... ' Muttra 71 : Agra 3,521 5 12 8 ... 1 Etawah _ 327 1 2 3 ... 1 Mynpoorie 468 Allyghur 362 Bolundshuhur ... 310 ••• ••• "* ••• | Shahjehanpore ... 831 ••• ••¦ ••• ••• I Bareilly 2,063 Budaon 442 Seharunpore ... 388 Bijnour ... ... 337 ••• •¦• ••• Deyrah ... ... 54 Alinorah ... ... 118 ••• ••• Mozuffernuggur ... 260 Moradabad ... 643 Meerut ... 521 -¦_ ••• -_ Total ... 11,044 6 3 2 ... 11 I '10 2 -18 Delhi ... ... 593 I ••• Goorgaon ... 266 ••• Ehotuck ... 274 Hissar.., ... 202 Sirsa ... ... 237 Kurnaul ... 133 Thunesur ... 274 Umballa ... 638 Simla ... ... 52 •• Hoshiarpore ... 201 Loodianah ... 548 1 .. 1 ->- 1 Jullundur ... 353 Ferozepore ... 360 ••• ••• Umritsur ... 837 Lahore... ... 2,506 Sealkote ... 451 Dhurmsala ... 209 Goordaspore ... 241 Goojranwalla ... 444 Goojrat ... 337 * Shahpore ... 331 I ... • j Jhehun ... 264 Googaira ... 268 Mooltan ... 830 i Mozufl'erghur ... 349 Jhung... ... 299 | ... I Leia ... ... 440 ... Dera-Ghazee-Khan... 331 [ Dera-Ismail-Khan ... 226 ••• ••• I Kohat ... ... 105 j Bunnoo ... 114 | 1 1 ... 1' Hurreepore ... 97 Eawulpindee ... 712 ' Peshawur ... 494 Total ... 14,016 1 1 2 -02 2 -14 Jails of the Presidency ... 59,351 |13 33 42 85 167 179 79 49 12 17 12 17 I 705 I 1-19 277 I 4-67 * No returns for the jails of Xapfpove were received before 1855. t At the same time two fatal cases occurred in the outgangs of the Nimar District. I EPIDEMIC OF 1855-58. First Year, 1855. — Cholera epidemic from the east, occupying and confined to the eastern division of the epidemic area. Second Year, 1856. — Cholera universally reproduced over the area invaded in 1855 ; in the south, invading the Nagpore territories in March ; occupying the districts lying south of the Jumna in May; covering the western division of the epidemic area, and attaining the epidemic limit of the year in July and the first week of August, reaching Ajmere on 26th July and Meean Meer on 7th August. Third Year, 1857. — Cholera universally reproduced over and confined to the areas covered in 1855 and 1856. Fourth and last Year, 1858. — Cholera extinct or at a minimum throughout the eastern division of the epidemic area and in Central India : generally revitalised in B/ohilcund and the Punjab within the cholera area of 1856 and 1857 ; and between May and November, occupying the exempted area of 1856 and 1857 in the north of the Punjab. EPIDEMIC OF 1855-58. CHOLERA OF 1855. GENERAL INDICATIONS OP DISTRIBUTION AFFORDED BY THE TABLES OF 1855. See Map of 1855. Cholera epidemic from the east, occupied and was confined to the eastern division of the epidemic area. Within the eastern division, the epidemic area of 1855, the strength of British Troops was too small to be representative. The Death Table of the year has been included in the body of the Report, at page 15. In the Native Army, taken as a type, the exemption of the western division is shown by the occurrence of two fatal cases only (excluding three doubtful cases returned from Peshawur), out of a strength of 80,000. The fatal case at Moradabad in August, and at Hansi in December, may be regarded as true fore-runners of the invasion of 1856. From Cawnpore eastward to the margin of the endemic area, the invading cholera of 1855 was universal; this is thoroughly illustrated in the Tables for the Native Army and for the Jail Population. The Table for the Jail Population exhibits the western division entirely free from cholera with the exception of a single fatal case which occurred at Jhansi. Jhansi was the western limit reached by the cholera of 1855 invading south of the Jumna ; this case, therefore, affords a true indication of the extent of epidemic spread to the west in 1855. NATIVE ARMY IN THE EPIDEMIC OF 1855-58. CHOLERA OF 1855. Those Stations only are noted at which cases of Cholera were returned during the Year. I Stsbwoth of Numbeb of Admissions from Cholera in bach Month. Total I Total 'SS. STATIONS. AB oo M FIF IS II S h° E NS o™ »o" B J-dlx. Jan. Feb. Mar. April. May. June. July. Aug. Sept. Oct. Nov. Dee. Yeab. I Yeab. Kegiments marching in Bengal Proper and in the Eastern Division ... ... 27 8 5 21 ... 61 | 30 Pbesidency and Baebackf Fort* William ... ... 1 2 1 1 2 1 1 ... 1 2 12 4 Midnapore ... ... 4 2 ... 2 2 1 11 3 7,619-! Cuttack ... ... 2 ... 6 5 1 1 ... 15 7 Barrackpore ... ... 3 4 5 111 ... 3 ... 1 19 10 l_ Berhampore ... ... 8 ••• 8 3 f Dacca"" ... ••• I ... 1 4 2 ... 3 ... 2 12 6 1 Sylhet ... ... I 2 ... ... ... 1 ... 3 4,434-i Chittagong ... ... 1 1 ] Gowalparah ... ... 1 L Gowhatty ... ... 1 1 j DINAPOEE — {Dorundah ... ... ' 1 1 ... * Hazareebaugh ... ... ... 5 1 «- 5 Camps in the Sonthal Districts 3 41 ... 10 6 2 62, 24 tßhaugulpore ... ... ... 1 1 ... 31 7 4 17 5 Dinapore ... ... ... 6 50 3 59 14 r Benares ... ... 2 2 4 6 5 10,158^ fXanpore '.'.'. '." I"\ '.'.'. ... '.'.'. ".'. .1 '.'.'. "l '¦'¦'¦ '.'.'. '¦'¦'¦ "l J Lucknow ... ... ... ... ... ..,1224 ... 9 2 Cawnpoee— „ i f Allahabad ... ... ... 1 1 1 3 1 ... 1 ... « * Cawnpore ... - ... 2 ... 1 7 7 1 1 ... JJ 7 I On Ganges near Cawnpore* ... 6 /9 ... oo 4W 8,987^ Mynpoorie ... ••• 1 i Baitda ... -. 1 - 1 - { 7,788 Agra ... ¦•• ... 2 2 ... 1 5 Meeeut — 3 1 ioaaoC Moradabad ... ••• ... A q 13 '°° 3 1 Deyrah 1 - 2 ... | SIEHIND — , i j i 9,853 Hansi ... ••• ... "" „ „ „ '" None None 17,017 Sealkote ... •¦• ... None None 13,161 Lahoee ... Peshawub — 1 3t 3t 18,486 Peshawur .... l l 115,383 Aemt o F the Peesidenct ... 31 10 29 42 67 32 21 67 95 23 22 14 453 176 j * Bth Native Infantry in boats, attacked on the day after leaving Cawnpore. t Probably choleroid fever, ' \ CHOLERA OF THE EUROPEAN AND NATIVE ARMIES AND JAILS, 1854-68. 1 JAIL POPULATION IN THE EPIDEMIC OP 1855-58. CHOLERA OF 1855. Cholera Epidemic from the East, limited to the Eastern Division of the Epidemic Area. Average Number of Admissions into Hospital in bach Month. Total Strength , Admis- Admitted d „„ sions pee cent. ' total , zil * JAIL- STATIONS. p BI soners during of j Deaths. af', of duhing Jan. Feb. Mar. April. May. June. July. Aug. Sept. Oct. Nov. Dec. the Stbength. i ngth. the Year. Year. Alipore ... 1,279 ... 1 1 ... 1 1 1 2 1 ... 2 ... 10 ... 6 Baraset ... 203 1 1 2 ... 1 Jessore ... 572 1 46 1 48 | ... | 16 Kishnaghur ... 428 ... 1 1 1 1 4|4 | ••• I 1 Moorshedabad ... 418 4 1 ... 2 1 ... 1 9 - 4 Howrah ... 192 •• - -¦ Hooghly ... 422 10 ... ... 3 2 4 1 2 ... ... 22 ... 15 Burdwan ... 422 1 19 20 ... 10 Bancoorah ... 264 ... ... 11 20 31 ... 17 Purulea ... 190 ... 3 3 Sooree ... 364 1 ... 1 ... 1 12 1 16 ... 9 Malda ... 83 1 3 1 ... 6 ... 2 Dinagepore ... 795 46 2 48 ... 31 Rampore Bauleah ... 662 1 7 28 1 10 1 37 ... 85 ... 48 Rungpore ... 437 Bograh ... 72 Mymensing ... 420 1 1 .. 1 3 Pubna ... 323 3 2 1 ... 6 ... 2 Furreedpove ... 275 1 2 ... Backergunge ... 544 17 1 7 ... 2 16 5 48 ... 19 Noacolly ... 254 Chittagong ... 257 1 1 Tipperab. ... 220 I I ••• Dacca ... 796 4 4 1 1 ... 2 ... 2 1 1 I 16 ... 10 Sylhet ... 529 2 1 3 Cherrapoonjee ... 40 Cachar ... 37 ••• ¦•• ••• ¦•• ••• Gowalparab ... 185 Gowhatty ... 182 ... 1 1 Seebsaugor ... 112 Nowgong ... 109 Tezpore ... 175 Debroogbur ... 61 ! Midnapore ... 598 2 . 2 ... 2 Balasore ... 126 ... 1 1 1 3 ... 2 Cuttack ... 242 I ••• Pooree ... 93 ... 1 1 2 ... 1 Sumbulpore ... 126 1 1 Chyebassa ... 113 , Eancbee ... 182 ¦•• Hazareebaugb. ... 913 ' 21 1 1 23 ... I 13 Monghyr ... 870 2 13 3 1 3 1 2 3 ... 2 30 ... I 11 Bbaugulpore ... 520 ! 12 1 ... 1 107 45 32 10 ... 199 ... 119 Purneah ... 444 I ... 1 1 2 ... 1 Darjeeling ... 38 | Total ... 15,587 j1749237893 35 23 121 52 62 82 11 646 414 341 21-88 'Gyah ... 630 i Patna ... 595 ... 1 11 2 3 3 3 3 ... 1 2 ... 29 lArrab ... 537 1 4 2 45 45 12 6 1 2 ... 118 ... 42 i Chumparun ... 269 4 ... 4 ... 3 i Mozufferpore ... f4BB ... 12 1 2 1 ... 7 ... 4 ... | Chupra ... 520 1 1 2 1 ... 1 Gbazeepore ... 872 (21) I ... (4)* Benares . 1,316 6 23 8 57 19 1 114 ... 54 Mirzapore ... 716 I 1 ... 4 2 4 8 6 3 3 1 32 ... 6 Azimghur .. 1,648 I (9) ... (2)*| Jounpore ... 882 (4) ... (1) * Goruckpore ... 1,181 Allahabad ... 1.384 ... 26 38 64 ... 33 Futtehpore ... 417 I 4 5 9t ... 5 Cawnpore ... 674 ... j 50 22 72 ... 3 Etah ... 420 ... j i Humeerpore ... 157 ... •» Oraie ... 186 ... j 1 Futtebghur ... 970 ... , Banda' ... 584 ' Total 14,446 1| 1I 17 91780 88 167 55 6 9 1 485 336 158 10-94 i J • A true epidemic in October and November, t The monthly details for the jails cannot be procured. 1 t Stated to have been cases of genuine choleraic disease ; compare Etah jail on the occasion of epidemic advance from the east in July 1863. [ Appendix flo. Ill] CHOLERA OP THE EUROPEAN AND NATIVE ARMIES AND JAILS, 1854-GB. 51 CHOLERA OF THE JAIL POPULATION OF 1855 —continued. Average Number of Admissions into Hospital ir EAcn Month. Total Strength .—. — | Admis- Admitted - JAIL STATIONS. ° P W *V ! stolfS percent. Total 7™,™ sowers ! during op I Deaths Ia > during Jan. Fob. Mar. April. May. June. July. Aug. Sept. Oct. Nov. Dec. j the Strength I oibength. the Year. Year. Eaipore ... 150 Chanda ... 96 Nagpore ... No record Jubbulporo ... 1,608 Dumoh ... 265 Saugor ... 527 ... ... ... Nursingpore ... 348 Lullutporo ... 134 I Jhansi ... 119 1 1 ... 1 Seonee ... 223 Baitool ... 176 ... ... ... ... Bhopawur ... 184 Hoshungabad ... 249 Mundlaisir ... 190 Total ... 4,269 1 1 -02 | 1 -22 Ajmere ... 205 | Beaur ... 128 i ... i ] Agra ... 3,062 ... Etawah _ ... 184 Mynpoorie ... 335 j ••¦ ... ••• ••• Allyghur ... 152 Bolundsbubur ... 241 I ' Sliahiehanpore ... 813 ... i Bareilly ... 2,303 Budaon ... 179 - I Seharunpore ... 402 Bijnore ... 366 Deyrah ... 32 Almorah ... 133 Mozuffernuggur ... 263 Moradabad ... 595 j ••• Meerut ... 570 Muttra ... <34 ••¦ | Total ... 10,570 | ••• I Dellu ... 505 ." Goorgaon ... 251 Rhotuk ... 230 Hissar ... 188 | ¦•• I Sirsa ... 160 I •¦• I Thanesur ... 206 Paniput ... 135 I ••• Umballa ... 596 I Hoshiarpore ... 266 Loodianah ... 253 Jullundur ... 345 1 - 1 Fei'ozepore ... 439 Umritsur ... 799 Lahore ... 2,495 I ••• I •" Sealkote ... 462 | ••• ••• | •" | Dhurmsala ... 162 Goordaspore ... 290 Goojranwallab ... 567 Goqjrat ••• 390 Shahpore ... 236 '"#" # Jbelum ... 278 W - '- Googaira ... 371 Mooltan ... 832 Mozufferghur ... 406 Leia ... 530 Jhung ... 506 Dera-Ghazee-Khan... 385 Dera-Ismail-Khan ... 268 Kohat ... iBi ••• ;; ;;; Bunnoo ••• 85 ¦ Rawnlpindee ... 703 Huzara ... HI Peshawur ... 446 | '__ _____ '-—\\ Total ... 14,077 _L _1_ _11_ — — — - — — 1 Bengal Pbesidency lis^T ~18~ 10~ lw ~87~ ITo" IIT Hi' 2B9* 107 68 91 13 1,134 I*9B 500 | 8-48 ? The monthly details for this Jail cannot be procured. " " 14 11l EPIDEMIC OF 1855-58. CHOLERA OF 1856. GENERAL INDICATIONS OF DISTRIBUTION AFFORDED BY THE TABLES OF 1856. See Map of 1856. Cholera universally reproduced over the area invaded in 1855 : in the south, invading the Nagpore territories in March ; occupying the districts lying south of the Jumna in May : covering the western division of the epidemic area, and attaining the epidemic limit of the year in July and the first week of August, reaching Ajmere on 36th July, and Meean Meer on 7th August. The history of the invasion of the Western Division is accurately depicted in the statistics of the European Army, the invasion is seen to commence in the south-east in June, when the Agra District showed the presence of the epidemic ; next is seen the advance of July and August, and the persistence of this cholera up to the first week of October. The absolute exemption of all stations lying to the north-west beyond the limits of the epidemic influence of the year is also to be noted. The Table for the Native Army shows the Jhelum to have been the north-western limit reached in the invasion. The occupied areas and the exempted areas are the same shown in the case of the European Army. The universality of the epidemic of 1856 is well illustrated in the cholera statistics of the Native Army. The great loss in boat voyages on the Ganges is an indication of the extreme severity of the cholera prevailing all along the banks of the river; and throughout the entire Eastern Division the cholera of 1856 existed in equal intensity. The Table for the Jail Population gives also a perfect picture of the invasion of the year, and is thoroughly illustrative of the history of the invading cholera from March to October. This history is capable of being read in the second page from left to right, where it begins at Nagpore in March, and ends at Dhurmsalla in the Punjab in November. NO. Hl] CHOLERA. OP THE EUROPEAN AND NATIVE ARMIES AND JAILS, 1854-68. lv EUROPEAN ARMY IN THE EPIDEMIC OF 1855-58. i ADMISSIONS AND DEATHS FROM CHOLERA IN EACH MONTH. SlE op GTH STATIONS Januaby. Febbuaby. Mabch. Apbil. Max. June. July. August. Septembeb. Octobeb. |Novembeb. Decembeb. Admis- pebcent. vxAXKaor D l 000*0*/ Ad. Died. Ad. Died. Ad. Died. Ad. Died. Ad. Died. Ad. Died. Ad. Died. Ad. Died. Ad. Died. Ad. Died. Ad. Died. Ad. Died. IHt lliAB - OISsa6IH OISsa6IH-1,646 Burmah and Pegu ... 1 1 1 ... 1 Troops on the march ... 2 1 1 1 3 ... 2 On hoard Eiver Steamers 1111 3 3 5 ... 5 543 Calcutta ... ... ... 1 ! ... 8510 6 4 3 ... "9 "4 34 23 '" . ... ... 66 ... 41 678 Dum-Dum ... ... ... 1 116 6 4 4 ... 11 I ... 12 I Chinsurah Depot ... , [[ .. 1 l 1 ... 1 918 Dinapore... ... ... | ... ." ... [[' '" ... '" \[ 6 3 '.'. ... ... I 6 ... I 3 73 Benares ... ... ... ... ... 905 Lucknow ... ... i 352431 22 . '.'.'. ' 166 ... 46 479 Cawnpore ... ... . 6 2 6 ... 2 Newly Invaded area of the Year— C 9 Saugor ... ... ... I I i j .. ... ... I i«?n Agra - - - ¦ - ••• i6 '° 76 45 21 "1 i ?. ::: ::: ::: ;;; ;;; 206 ... 98 1,610 Meerut ... ... .. j j ... 6 3 73 40 I 79 ... 43 | 31 Roorkee ... ... ... .................... ' 807 Umballa .. ... ... | ... ..'. ... j ... .'.[ ... \ ... '..[ ... ." "" m \ "' [[[ ..[ ''[ "(j "i ... \" m "[ "'' 6 ... 4 „on the march near ... '• i ... ... " .. ... ... .. 64 44f 64 ... 44 1,054 Jullundur ... I ... ... ... j 1,025 Ferozepore ... ... ... ..'. ..'. ... [.'. '. ... ... ".'. ['.[ '". '". 165 107 35 24 ... ... ... ... ... ¦ i 200 I ... I 131 80 Mooltan ... ... 3 j 5 2 ••• 8 ... 3 73 Umritsur ... \. ... 8 5 11 9 ... 6 996* Wuzeerabad ... I . . ... ... ... 918* Rawulpindee ... ... " 2,590* Peshawur ... ... ... Hill Stations and Hili Depots — 419 Dugshaie ... ... I 834 Subathoo... ... ... " ... < ... ¦¦¦ 84 Darjeeling Depot ... ... . ..'. ... ... ... ... .'. .. ' ... '". *" "' ... ... 64 Landour Dep6t ... ... ... 108 Murree Dep6t ... ... ."' "" "" '" .[. '" ... ... ... ..'. '" ..] ..'. [[. "' "' "' [[[ .'" ... ..[ ... 20,500 Bengal Presidency ... 3 2 8 5 12 8 11 10 5 5 195 100 88 48 686 374 154 110 8 5 68 48 ! 1,238 6-04 715 34-88 * Stations lying to the north and north-west beyond the epidemic influence of the year ; the Jullundur Doab was also an exempted area. The exemption of the hill stations and depots is also to be noted, t H. M.'s 32nd Regiment was struck on the 31st October, the day on which the Regiment descended into the plains from Kussowlie, its station for the year. CHOLEBA OF THE EUROPEAN AND NATIVE ARMIES AND JAILS, 1854-68. NATIVE ARMY IN TEE EPIDEMIC OF 1855-58. CHOLERA OF 1856. Number of Admissions fbom Choleba in each Month. Total | Totai, ~ Admissions Deaths Strength of STATIONS. of thb of the II JctT 1856. Jan Feb _ Mar _ ApU May> June> Ju , y> Aug . Se p t . Oct. Nov. Dec. Yeab. | Yeab. J! Bengal Proper and Assam— ' 1,725 Calcutta - ... ... 2 11 6 5 2 3 ... 2 3 ... i d& , 14 751 Midnapore ... ... i 2 • * i iNone iNone-876 Cuttack ... ... , 1 - 1 •• j - ••• - g f 198 Dum-Dum ... ... 8 1.. ] X ~L * '" 959 5 l A 3,038 Barrackpore ... 4 5 ... 5 . ... 1 - ' ... ... £& \ v_ np I I -j-. . ii (Jilt • Al uIR . | Dorundah ... ••• ' " 2 f-iooJ Hazareebaugh ... ... I 1 1 ••• '" ¦•¦ '" '" ono n Bhaugulpore ... 2 o 6 ••¦ ••• ' ' * q Dinapore ... 1 1 1 "' 4 - "' i ? I Segowlie ... ... 12 2 ... ... j 5 j 3,173 Benares ... ... 11 5 ... 4 1 - •¦• f£ " 173 Chunar ... ... ... 5 5 2 ... •¦• ••• - *J £ 233 Azimghur ... ... 1 — ¦•• g jj Qne ( 831 Goruckpore ... ... 1 ••• '" * AT l xr^ „' 232 Jounpore ... •" ! None - N ° ne ' 10,443 \ Oade Field Force... ... ] 1 1Q 2Q 5 ... 1 1 ... 4 ... j 48 14 C Lucknow ... ) . ¦, -j 634 Mirzapore ... ... | •¦• ¦•'• l \ ,i i 2,025 Allahabad ... ... I 12 4 3 2 ••• ••• ... J* ° I 4,560 Cawnpore ... 2 511 3 9 7 1 1 dy J' 1,137 Futtehghur - j None g Noa \ 1,107 Nowg^ng '.'.'. '.'.'. '.'.'. '.'.'. '.'.'. '.'.'. '"¦ '.'.'. '.. 1 "2" 2 I o 90 Oraie ... 1 2 1 3 ... ••• ••• I \ 1,085 Jhansi ... ... j 3 .... •* a Central India, Agra, Meerut, and kohilcund — # j Aimere* ... ••• „,'. "^J 3,560 G-waliorf ... 21 ... ••• Jit f\\ 2,897 Agra ... ... 11l 38 53 ... 94 ** 1,360 Hansi ... 1 1 2 ... 4 2 3,012 Delhi ... ... 1 1 4 ... ... J J Allyghur ... 1 12 2 ... ° 2,598 Meerut ... 1 ... 9 8 3 21 11 963 Moradabad ... 1 3 8 " w 1,033 Shahiehanpore ... 2 ... - f None 2,616 Bareilly ... ... I 1 6 ... 1 8 4 837 Almorah ... - ... None V 2° ne ne-587 Eoorkee ... ... 1 ••• QLQ L " N °"q+ 755 Deyrah ... 32 82$ 23J Punjab — , ,T, T 2,985 Umballa ... ... ! 1 ••• AT X *J° n °" 762 Jutog ... •¦• None V sone'5 one ' 731 PhiUour ... 1 } gone-2,247g one one-2,247 Jullundur ... ... | 1 AT 1 £ one< 1,223 Hoshiarpore ... ... ! gone. None. 295 Loodianah ... ... ' ••• S° ne ' gone. 448 Goordaspore ... ... ¦ g one - gone-430g one one-430 Noorpore ... None. , None. 1,874 Sealkote ... ¦¦• Noue - None V 357 Wuzeerabad ... 1 1 509 Kangra .. ... 1 .1 \ * 910 On march from Dhurmsala§ 55 ¦•• 6°6 ° I d f 2,017 Umritsur ... 1 ¦•• 2 3 , 1 Carried over ... ~6 8 ~67~~88~~8T 61 112 79 19 17 68 5 601 253 * Records wanting. Cholera appeared at Ajmere on 26th July. ? _ . „ T1 IQKa • f^. i. f ..j t The Records of the Office of the Superintending Surgeon of the Gwalior Circle were destroyed in 1857. The Monthly Return for July 1856 is the latest available for reference. t Kumaon Goorkha Battalion. § Cholera prevailed at Dhurmsalla when the Regiment (2nd Sikhs) marched. l| CHOLERA OF THE EUROPEAN AND NATIVE ARMIES AND JAILS, 1854-68. CHOLERA OF THE NATIVE ARMY OF ISbQ —continued. Nombbe of Admissions feom Choleba ik each Month. — | Total Total Stebkoth of STATIONS. Admissions Deaths JULY loot). QP rpjjjj Qp XHK Jan. Feb. Mar. April. May. June. July. Aug. Sept. Oct. Nov. Dec. Yeae. Yeab. Brought forward ... 6 8578881 61 112 79 19 17 68 5 ' 601 253 3,024 Meean Meer ... 1 .. 51 53 1 105 42 1,459 Jhelum ... 2 9 ... 1 ... 12 8 2,120 Ferozepore ... 11 26 ... \ 37 17 3,239 Mooltan ... ; None. None. 1,146 Asnee ... 1 j l None. 1,577 Dera-Ghazee-Khan ... ' j None. None. 2,532 Dera-Ismail-Khan ... 1 None. I None. 119 Shahpore ... None. I None. 3,770 Eawulpindee ... 2 I 1 ... 3 None. On march in Kawulpindee District* ... 14 14 9 1,823 Hazara ... 1 ... I 1 None. 720 Nowshera ... 1 1 2 None. 876 Murdan ... ... \ 1 1 None. 7,632 Peshawur and outposts ... 1 ... 4 1 1 ... 1 ... 1 9 4 3,268 Kohat ... ... I 1 1 None. 2,088 Bunnoo ... I None. I None. Regiments on march and in boats in Bengal and Behab — 19th N. I. G. T. Road marching ahove Raneegunge 46 46 30 In Boats — 32nd N. I. near Dinapore 130 ... 130 75 34th N. I. below Cawnpore 70 70 30 34th N. I. below Dinapore 52 ... 52 33 73rd N. I. below Dinapore 50 9 59 37 43rd N. I. on Matabanga ... 164 64 30 70th N. I. on the Ganges 15 15 10 114,002 Army of the Presidency ... 70 8 57 206 83 66 115 145 108 32 303 30 1,223 578 * (Ist Sikhs) JyJJJ CHOLERA OP THE EUROPEAN AND NATIVE ARMIES AND JAILS, 1854-68. [Appendix JAIL POPULATION IN THE EPIDEMIC OP 1855-58. CHOLERA OF 185 6. ¦ ?,,., Niimbbb op Admissions into Hospitai, ineach Month. Total Stle^th A ™ IS " Adm ™ ToTAI Dimm. ow SION3 PER CENT. IOTAL ,q™ JAIL STATIONS. Pm^J mb I d™"™ of Deaths, gjj,™^ | during Jan. Feb. Mar. April. May. June. July. Aug. Sept. Oct. Nov. Dee. the Strength. thrYeah. Ybab - _ ! ' — Alipore ... 1,552 2 4 7 1 ¦¦• 6 1 20 ... 7 . Baraset ... 205 3 2 2 7 Jessore ••• 552 3 ••¦ i Kisbnaghur ... 427 1 1 •• ••• * ••• ft Moorshedabad ... 211 ... 19 107 ... 2 1 ••• 129 - >5 Hooghly ... 537 ... 1 2 2 ... 410 3 22 ... 13 Burlwan 473 1 3 4J ... 3 Bancoorah ... 316 1 - 1 j Purulea ... 183 •• ••• ••• •" Sooree ... 346 1 2 1 1 1 1 1 1 , 1 7 17 - 5 Malda ... 75 •• ••• ¦•• ••• | £' Dinagepore ... 922 42 1 43 , ... i Rampore Bauleah ... 716 ... 1 4 1 ... 1 1 ... | 8 j ... £ Rungpore ... 394 1 ... 2 2 ... 1 2 i 8 ••• & Bograh ... 112 ••• •" Mymensing ... 515 2 1 14 ... 4 Pubna ... 167 1 ••¦ ••_• Furreedpore ... 266 1 1 1 ... 1 ¦•• 4 1 Backergunge ... 397 2 ..... 6 8 3 1 14 4 2 40 - 17 Noacolly ... 194 •¦• "• Chittagbng ... 239 1 2 12 6 ••• \ Tipperah ... 409 17 7 24 ... 8 Dacca ... 682 9 9 ... 1 3 1 ... 3 9 ... 35 ••• J& i Sylhet ... 572 7 2 1 15 24 ... 1 50 - 26 Cherrapoonjee ... 37 Cachar - 35 1 ••• ••• Gowalparah ... 170 1 1 5 i 7 - 6 Gowbatty ... 165 3 3 Seebsaugor ... 123 Nowgong ••¦ 110 Tezpore ¦•• 153 1 1 Debroogbur ... 61 ••• ••¦ | Midnapore ... 624 ... 1 1 - \\ Balasore ... 116 1 ... 2 3 ... 6 Cuttack ... 261 1 1 ... ... 2 Pooree ... 98 1 ••• 1 Sumbulpore ... 155 ••• "• i Cbyebassa ... 140 Ranchee ¦• 203 - ;•• Hazareebaugh ... 934 1 17 4 22 ... 10 Mongbyr ... 660 ... 1 35 89 ... 1 10 1 1 ... 2 2 142 ... 5b Bbaugulpore ... 434 4 38 1 1 16 ... 60 i ... 38 Purneah ... 412 3 73 1 I 77 ... 50 Darjeeling ... 36 1 I l *¦ ••• Total ... ~1^389 928 202 256 24 12 16 10 30 46 86 30 749 4"87 375 24-37 Gyah ... 809 2 2 16 9 12 23 j ... 8 Patna ... 644 ... 1 8 16 1 1112 ... 31 j ... 5 Arrab ... 399 1 1 1 ••¦ » ... . ... Cbumparun ... 205 1 1 2 ... 4 ... 3 Mozufferpore ... 500 ... 3 4 1 1 8 3 ... 15 9 44 ; ... 13 Cbupra ... 373 | Gbazeepore ... 771 ... 1 1 2 2 ... 1 7 ••• J Benares ... 1,003 4 4 10 1 19 j ••• 7 ; Mirzapore ... 639 I 42 42 j ... 17 lAzimgbur ... 1,012 2 1 1 2 6 Jounpore ... 436 4 4 ... 2 Goruckpore ... 1,125 - 12 5 1 » »• 3 - Jails of Oude ... No Reco rds No Re cords No Re cords Etab ... 362 ... 1 8 20 1 30 ... 14 Humeerpore ... 158 3 3 ... 1 Oraie ... 154 4 - 4 ... 1 Futtehghur ... 949 1 56 3 I 60 ... 36 Cawnpore ••• 546 1 ... 2 I 3 ... 2 Banda ... 709 17 4 21 ... 8 Futtebpore .., 419 1 4 | 5 Allahabad ... 2,039 1 29 I 30 ... | 19 Total ... 13,252 "77 ~7~ IT 32 Us" ~92~ 40 23 23 10 6 2 348 2-63; 143 1079 Raepore ... 170 14 14 - 2 Bandhara ... 5 5 ... 1 Chanda ... 124 12 9 2 23 ... 9 Nagpore ... 570 24 6 13 ... 2 2 47 ... 18 Jubbulpore ... 1,733 1 51 49 101 ¦» 61 Carried over ... 2,597 25 6 18 63 74 4 ... ..'. 190 ... 91 CHOLERA OF THE JAIL POPULATION OF 1856 —continued. Average Number of Admissions into Hospital in each Month. Total Strength ,—, — Abmis- Admitted Died t»TT ••• 10 Seharunpore ... 204 ••• ¦•¦ | Bijnour ... 333 1 • J - ¦•¦ Deyrah ... 39 1 ... 1 2 Almorah ••¦ 114 8 ••¦ » - f \ Muzuffernuggur ... 226 ..16 12 ... ...... i 28 20 Moradabad ... 603 3i 11 • | ¦•• J4 ... 6 | ... Meerut - 941 72 75 1 j ... 148 ; ... 90 ... Muttra ... 93 j 1 1 Z ... I -I ... | Total ... 10,250 ..." 12~T ~ 7 oIF 357 127 11 ~7 14 ... 1,092 1066 j 459 4478 i| I I — ' — - — ji j Delhi -. 502 33 6 39 j .... 18 j ... Goorgaon •¦¦ 275 ¦ ¦¦¦ ••• ••¦ •" o i Rhotuk ... 308 2 ... 15 2 2 12 , J i Hissar ... 233 ... ... 1 1 2o . 2 ... » ... ( | Sirsa - 108 •• 1 |" x '" Thanesur ... 324 « •¦• ¦•• •¦• ¦¦• , 4 "' SSSI ::: % ::: ::: ::: E ::: ::: }. tli a ~ « E 2 . 7 z HosMarpore ... 432 ¦¦ j "j j Loodianah ... 275 , • - 1 j , Jullundur ... 367 1 •• ••• - g |" "2" 2 '..'. \\ Perozepore •¦¦ 495 ° ••• ••• & 2 ... 2ST ::: vS ::: ::: ::: ::: ~ ™ "i « »¦• ": ::: I « ::: I3M Sealkoto ••¦ 401 ¦ - ••• ¦•• "' , gjj _ 9 ... ;! Dhurmsalla ... 155 1 ¦•¦ 1() 8 - ~ | Goordaspore •¦¦ 445 _ _ __ ! i Goojramvalla ... 485 j Goojrat •¦¦ 268 - - 1 '" j ># , ... | Shahpore ••¦ 273 • #-> | _ _ t# I : Jhelum ... 267 J 2 ... 1 ... I Googaira ... 467 " Mooltan ••• 710 | )" Mozutfergbur ... 357 "" j '" Leia •¦¦ 518 _ _ ... ••¦ Dera-Ghazee-Khan... 381 _ ... ?, | Dera-Ismail-Kban ... 251 ••• j Kohat ¦¦¦ J-29 ]" | _ j Bunnoo ... 74 • •• ••• 2 ... 1 Rawulpindee ... 649 j 1 L ¦¦¦ _ | Hazara ••• 133 I Usr|T~"7"r » 888 8« 199 58 M - 866 *71 322 22-78 Jj i» p^^cv li5T T IT 2»r 296 iv l | 1^ ««»| lx !: ! !! EPIDEMIC OF 1855-58. CHOLERA OF 1857. GENERAL INDICATIONS OP DISTRIBUTION AFFORDED BY THE TABLES OF 1857- See Map of 1857. Cholera universally reproduced over and confined to the areas covered in 1855 and 1856. The exempted area of the year was the exempted area of 1856, namely, the north of the Punjab lying beyond the Jhelum. From this north-western limit to Nagpore in the south the epidemic prevailed in every district; and from Nagpore westward to Bombay cholera still occupied the epidemic highway. The great sufferings of the Armies in the field both in the western and eastern divisions show the continued vitality and the great power of the invading epidemic of 1855-56. Even up to the margin of the endemic basin its epidemic vigour was maintained, and few of the many detachments marching towards the northwest along the Grand Trunk Road leading out of Bengal Proper escaped an attack of cholera. [Appendix 63 CHOLERA OP THE EUROPEAN AND NATIVE ARMIES AND JAILS, 1854-68. No. Ill] EUROPEAN ARMY IN THE EPIDEMIC OF 1855-58. CHOLERA DEATHS OP 1857. This Table is constructed from the Death Rolls of the year ; the materials for the construction of a Talle of Admissions do not exist. Total PLACE OF DEATH. Jak. Feb. Mab. Apeil. Mat. June. July. Aug. Sept. Oct. Nov. Dec. £¦«» H Fort William, and Hospitals in Calcutta 1 * 3 } 2 5 1 \l6 [ 7 ? Dum-Dum ... ... •¦• ••• ••• ••• j ••• •" 29 Chinsurah ... ... ... 1 1 1 21 ... 1 S ... ... i " Raneegunge, and G.T. Road below Allahabad .. •¦¦ U 8 ••• ••• b lL ' ™ Dinapore ... ... '" ••£ g ;;; "4" 4 "3 "g 49 Benares Depot ... ... o « 1 6 Allahabad Depot ... ... »• * J '" 1 54 * Camps in Cawnpore District, and in Oude* ••¦ f* °' ° "' /v/ u- Lucknow Residency ... 14 18 9 4 Abea Invaded in 1856 — 1 Mhow ... ... 1 •• "" 3 Saugor ... ... •" 6 "• ¦" ' 5 Agra 2 12 ... Meerut ... ... •• ••• l ° 2 Roorkee ... ... 2 ... ... 12 Dugshaie ... ... " " ' o Subathoo ... ... 2 ... Umballa, and Troops marching to join the . 87 Delhi Field Force ... 1 62 22 ... 1 1 ... '\\ Camp before Delhi ... 49 133 54 U [ 19 '" — 1 cf T aho . rr + e "• - 26 ... "l '.'.'. '.'.'¦ 27 Umntsur ... ... None. Stations north-west of Lahore • * O Q 16 In the field with detached columns 6 ••¦ 6 On board River Steamers ... • "• Loss of the Aemy in 1857 ... 1 2 ri9""l9"l41~"l85 174 135 47 30 19 | 834 Sofe r D Kt^tSth%^^^^ B ™^ Preßide^ the foUoWing aS th6ir IOBS from cholera in 1867 : — - 64* H REGIMENT. 78lH REGIMENT. Adsuttbd. Dxed. Admitted. Died. June ... Berhampore 28 19 June ... Station not mentioned 12 4 G a >( >§i 8 4 July r.. Ditto ditto ... ... ... 22 17 " ... Steamer Berhampooter 5 2 August ... Oawnpore July ... Station not mentioned 38 8 September... Lucknow '„ ... Various Stations of Upper India 87 38 August ... Cawnpore ... ••• ¦•• ** ' ... Various Stations of Upper India... ... 120 42 September... Cawnpore ... ... - 14 6 October ... Cawnpore... ... - - 1 ••• , JAIL POPULATION IN THE EPIDEMIC OF 1855-58. CHOLERA OF 185 7. From June 1857 Civil authority was in abeyance in the North- Western Provinces and in Central Indiaconsequently the Jail Population is not represented for the last six months of the year in these Provinces. Average Number of Admissions into Hospital in each Month. Total Strength Apmis- Admitted Died I JAIL STATIONS. 0I? SIONS PEK CEN i- 1 Total per 1,000 Prisoners duhing I of iDeaths. of puking Jan. Feb. Mar. April. May. June. July. Aug. Sept. Oct. Nov. Dec. the Strength. Strength the Year. Year. Alipore ... 1,674 1 ... 17 12 1 2 5 12 1 42 ... 24 Baraset ... 178 ... 4 4 ... 1 Jessore ... 550 ... 1 3 6 10 ... 2 " Kishnaghur ... 418 ... _ Moorshedabad ... 135 ... .#. # iti Howrah ... Hooghly ... 674 ... "2259 ... 13 1 "2 ... ... ... 34 ... 12 Burdwan ... 497 ... ... 9 9 ... 5 Baucoorah ... 357 ... 6 2 1 9 ?( 2 Purulea ... 254 ... 1 ... l ... l Sooree ... 357 j ... ... 4 s].] 1 ... 1 4 15 4 Malda ... 57 1 ... ... 1 ... Dinagepore ... 908 ... ?[ ... 1 1 4 ... "l 1 ... ..[ ... 8 "5 Rampore Bauleah ... 515 ... _ 2 95 12 ... 109 ," 57 Rungpore ... 395 ... "' [ _ ... 1 ... 1 Bograh ... Si) ... ," ... . ?] .[[ ... Mymonsing ... 5St j ... "' 1 2 5 5 ... '" 1 1 ... ... 15 " " "g Pubna ... 1(57 I ... ... 1 ... 1 [ ... Furreedpore ... 354 I ... "] 1 % ... 1 2 ... 5 Backergunge ... 4(51 1 \ ... 5 . ... ... 7 1 15 ?', "2 Noacolly ... 241 | ... Chittagong ... 192 I ... [" ... 2 "] j" ... ".' ... "2 .'.'.' "i Tippcrali ... 457 I! ... Dacca ... 721 ... '" 1 2 ... 1 1 '" "i '" "fi "3 Sylhet ... 582 ... [" ... 1 ][[ ... ... 1 2 1 Chen-apoonjee ... 27 ... ... ... \ % . Cachar ... 36 ... Gowalparab. ... 132 19 3 ... 1 23 12 Gowliatty ... 15(5 ... [" 16 1 .'. yj ''[ jq Seebsaugor ... 119 ... Nowgong ... 93 ... [\[ Tezpore ... 119 ... \" ... ... ... ... [\[ ... Debrooghur ... 50 Midnapore ... 708 } ... 4 5 103 4 ... ..." ... 117 68 Balasore ... 80 ... Outback ... 304 I ... "2 ... "l '.'.'. "i "s i '.'.[ "l .'.'.' '.'.'. 14 '.'.' lb I '.'.'. Pooree ... 88 | ... ... 17 4 ... 12 6 Sumbulpore ... 68 ... 1 ... 1 1 Chyebassa ... 136 I ... [[ Ranchee ... ... 1 ... Hazareebaugh ... ... 1 1 5 ?', 7 4 Mougbyr ... 535 ; ... \\\ "2 1 'l |" "' "'. "l '." 5 3 Bhaugulpore ... 408 ... 1 ... 4 4 16 15 7 10 \ 1 58 .*.'! I 26 Purneab . ... 400 i ... 1 \ Darjoeling ... 39 ... ''^ Total ... 14,415 22 859 ,155 j36 143 65 11 16 616 7 544 877 268 18~59~|| I I ——————— gya . ... 486 ... 1 2 48 51 ... 22 £ atll \ -¦ 692 1 ... 2 ... 2 25 19 I 49 ... 20 Deegah ... 249 ... 3 5 4 18 2 ... 1 ... : .33 .. 11 •Af-ab -. 285 ... 1 1 1 3 1 7 Chumparun ... 276 3 1 26 4 j 34 '" 16 Mozutterpore ... 449 ... 9 8 1 18 6 Chupra ... 460 ... 2 41 3 '.'.'. '.'.'. '.'.'. ..[ ' 46 16 Ghazeeporo ... 643 ... ... 1 ... 5 3 2 2 j 13 '.'.'. 5 £ c . nares ••• 93<» 2 11 10 80 13 12 1 ... ! 120 ' 58 Mirzapore ... 556 1 3 2 1 ... 3 . j 10 " 5 Azimgbur ... 566 1 1 1 3 '" 1 I Jounpore ... 212 ... 7 1 8 3 Gomckpore ... 650 ... '.['. "5 S ... Z 100 .'.'." Z '.['. '..', "[ I 108 54 Jljtah Humeerpore . .. '"" Cawnpore Futtehpore ".'.'. \\\ '.'.'. \\[ \\[ \\\ f^ 31 9 Allahabad ... '" "' '" '" "" J Total ... 6..474 221220 50 34 212 160 41 14 2~| 549 I 233 ?". CHOLERA OF THE JAIL POPULATION OF 1857 -—continued. Average Number ov Admissions into Hospital in bach Monih. Total Strength Admis- Admitted Died phb tatt STATTONS „ °* SIONS HECEItI ' Total 1 m JAIL SiAiiuj\s. Pbisonebs during of Deaths. sißwroTH during Jan. Feb. Mar. April. May. June. July. Aug. Sept. Oct. Nov. Dec. the Strength. the Year. Year. Baepore ... No Return Bandhara ••¦ „ jSbbuTpTe '.'¦'. 1,307 1 '.'.'. '.'.'. '.'.'. 836"i"3 18 "3 '.'.'. '.'.'. '.'.'. 67 '.'.'. 44 '... Mundla ••¦ No Eeturn Sa^or '.'.'. 588 "'. '.'.'. '.'.'. '.'.'. 2"l"9 "% '.'.'. '.'.'. '.'.'. '.'.'. 20 '.'.'. 8 Nursingpore ... 316 9 9 ... 3 Lullutpore ... No Return sS '.'* 275 .'.'. '.'.'. '.'.'. '.'.". '.'.'. '.'.'. "i n '.'.'. "i '.'.'. Z is '.'.'. "c Baitool ... 194 Jeypore ... No Return ... Hoshungabad ... 280 || ... Mundlaisir ... No Return Ajmere ... 173 Beaur ... 106 ... Total i 6391113 37 3\ 1 110 ... | 61 Agra ••• 1 1 Etawah •¦• Mynpoorie ... ••• , ••• 1 Allyghur .•• ••• ••• ••• '" Bolundshuhur ... Shabjehanpore ... Bareilly 13 6 10 ... 2 Budaon ... Seharunpore ... 1 2 25 28 | ... 16 Bijnour ... Deyrah ... ... ••• ••• ••• Almorah ... ... 1 1 Mozuffernuggur ... ... ! Moradabad ... ... ; ... Meerut ... .. ] I ••• ••• ¦•• Total 1 3 7 1 1 2 25 40 ... 18 Tbanesur ... 284 if '. 1 12 1 ... 1 4 Kurnal ••¦ 92 iUmballa ... 594 3 4 2 9 ... 5 Hoshiarpore ... 163 3 3 ... 1 Loodianah ... 290 Jullundur ... 350 4 16 20 ... 5 Ferozepore ... 433 Umritsur ... 720 3 1 30 14 ... 1 ... 49 ... 17 Lahore ... 2,406 ... Sealkote ... 297 Dhurmsala ... 148 15 15 ... 8 Goordaspore ... 394 Goojranwalla ... 504 ... ••• ••• ••• | Gooirat ... 273 i Shahpore ... 371 ! ! Jhelum ... 273 | Googaira ... 416 | Mooltan ... 658 ... Mozufferghur ... 315 Leia ... 451 Jhung ... 420 ; Dera-(ihazee-Khan... 148 ' Dera-Ismail-Khan ... 303 Kohat ... 121 i Bunnoo ... 53 ... ••• ••¦ ••• ••• I Rawulpindee ... 886 1 1 •¦¦ 1 ! Hazara ... 161 ; Pesbawur ... 545 ... ... •¦¦ ••• y'oTAL ... 12,125 313 15 ... 52 34, ... 1 ... 109 ... 41 ... Pbesidency ... 25 13 81 jlB3 128 203 291 262 119 21 19 7 1,352 ... 621 ... I ¦o-PpGlluix 66 ! ¦i !i EPIDEMIC OP 1855-58. CHOLERA OF 1858. GENERAL INDICATIONS OF DISTRIBUTION AFFORDED BY THE TABLES OF 1858. See Map of 1858. Cholera extinct or at a minimum throughout the eastern division of the epidemic area and in Central India : generally revitalised in Rohilcund and the Punjab, within the cholera area of 1856 and 1857 ; and between May and November occupying- the exempted area of 1856 and 1857 in the north of the Punjab. The Table for the European Army shows that, while the eastern division of the epidemic area was nearly free from cholera (see remarks, page £1 of Report), the cholera of the succeeding epidemic (1859-62) was, in 1858, powerfully epidemic within the endemic province, giving warning that invasion of the epidemic area was imminent. The general affection of the Punjab, ending with the outbreak at Peshawur in November, indicates the persistence of the vitality of the invading cholera of 1856 in the north-west of the Presidency. Absolute exemption from fatal cholera in the eastern division is shown in the case of the Native Army. The invasion of Hazara in May and the vitality of the cholera up to November on the North- Western Frontier, is well illustrated in the Table for Native Troops. Among the Jail Population three deaths mark the minimum of the valley of the Ganges ; the occupied area, from Rohilcund to Peshawur, is the same shown in the Table for the European and Native Armies. In the jails of the Central Provinces only one fatal case of cholera was returned in 1858. In the War Provinces of the year, including Central India, no cholera appeared among the Armies in the Field. No. Hl] CHOLERA OF THE EUROPEAN AND NATIVE ARMIES AND JAILS, 1854-68. EUROPEAN ARMY IN THE EPIDEMIC OF 1855-58. CHOLERA OF 1858. AyEB AGB N CMBEB Otf ADMISSION S INTO HOSPITAL IN EACH MONTH. ADMITTED I j) lE]) pBB MTRHwfwn Total pbb Numbeb i ono nu STATIONS. FOB Admis- cent, ob of Z™™* Months. Jan. Feb. Mar. April. May. June. July. Aug. Sept. Oct. Nov. Dec. SIONS - gj^fara. DEATHS ' Stbength. Presidency Hospitals 5 23 51 2 35 32 13 ... 4 3 1 169 ... 101 Port William ... 770 1 2 12 19 5 11 20 14 ... 4 4 ... 92 ... 55 ... ! Dum-Dum ... 745 1 8 13 18 1 3 2 ... 46 ... 30 Barrackpore ... 1,272 ... 2 3 2 5 2 14 ... 5 ... ! Chinsurah Dep6t ... ... 5 120 32 1 1 60 ... 45 ... j Kaneegunge & Grand Trunk Ttoad ... ... 1 36 3 1 5 ... 3 1 11 ... 61 I ... 30 ... ! Berhampore ... 281 | 3 7 5 ... 1 ... | 16 ... | 7 ... j Total ... ... 8 40 15 23 14 41 73 43 7 7 18 ... I 289 ... 172 Darjeeling ... 137 I ... ; ... : Hazareebaugh ... 211 1 j 1 ... ... ... Dinapore ... 877 1 3 ... 2 ... 2 2 I 10 ... 1* ... ! Shahabad ... 1,352 1 3 11 2 17 ... 5 Sasseram ... 340 2 1 3 ... I ... ... Ghazeepore ... 435 12 3 1 7 ... | 3 Benares ... 511 1 ... 7 1 3 5 4 21 ... ! 7 Chunar ... 46 .. 1 j 1 Azimghur ... 504 ... 2 ... 2 j 4 ... Gorackpore District 1,077 2 1 1 4 ... I Oude ... 12,158 ... 1 5 6 5 2 ... 3 2 1 ... 2 27 ... I 5 Allahabad and Cawnpore Districts ... 4,788 4 15 2 12 2 4 2 ... { 23 ... | 11 i Total ... 22,436 5 221171813 10 16 4 5 2 5 118 "53 32 I*4B j Rohilcund ... 3,285 5 2 ... 7 j ... 1 ! ... Meerut ... 1,528 3 1 4 I ... 3 ... Delhi ». 1,411 1 ... 11 12 ... 1 ! ... ! Agra ... 883 1 ... 2 5 8 ... | 3 j ... | Agra District ... 420 1 ... j 1 ... j 1 ... I Total ... 7,527 1 19 516 ! 32 j 43 9 I*2o 1 i I Umballa ... 941 2 1 3 ... 1 ... 1 Dugshaie ... 176 2 11 j 4 ... 1 Subathoo ... 59 | ! - ... ... ... : ... | Kussowlie ... 46 i I I ... ... J ... I ... !| Phillour ... 110 I | ! ... ... j ... i ... I Jullundur ... 898 | ... 23 11 • 34 j ... ; 22 ... ! Ferozepore ... 740 ... ! ... ... I Meean Meer ... 1,317 j ; ... ... j ... ... CampKamokee ?. ... I 24 \ 24 ... j 15 ... i Lahore Citadel ... 64 j ... ... ... ... I Umritsur ..• 361 ; I ... ... ! ... ... j Govindghur ... 123 \ ', ... ! ... I ... ... i Mooltan ... 273 ' ... ' ... ... | ... ... | Dera-Israael-Khan ? , 148 ! . . . j ? . ... ... Kangra ... 18 I \ ... . I i i ... ... i ... < ... ! Sealkote ... 896 | | .. ... i ... | ... | Dhurmsalla ... 7 j ... .. ... j ... j Rawulpindee District 1,039 I 4 ... 2 6 | 12 ... 8 ! ... Attock ... 196 I i ... [ ... I ... | Nowshera ... 412 2 ... i 2 ... 2 ... ' Campbellpore ... 319 ! ... | Peshawur ... 2,027 4 3 ... 7 \ ... 7 ... I Murree ... 114 40 4 j 44 ... 31 ... | Total ... 10,244 8 24335 35 4 3 .., 130 \ 127 87 850 j Bengal Pbesidency 43,771 13 47 60 91 42 92 167 112 62 20 26 6 738 T6B 401 9-16 • This man actually died on board a River Steamer; the case should not have been taken with Dinapore. CHOLERA OP THE EUROPEAN AND NATIVE ARMIES AND JAILS, 1864-68. NATIVE ARMY IN THE EPIDEMIC OF 1855-58. CHOLERA OF 185 8. [Those stations only are noted at which cases of cholera toere returned during the year.'] Number of Admissions fbom Cholera in bach Month. j total Total i j| Stbbnoth at STATIONS — • Admissions Deaths August 18S9. of the op the i Jan. Feb. Mar. April. May. June. July. Aug. Sept. Oct. Nov. Dec. Ybar. Thai. ' 1,503 Calcutta ...' ... 1 8 5 1 9 9 7 ... 1 4 ... 4 1 44 20 BaEBACKPORE CIBCLE ...#*###*#*###* # #1 Easteen Bengal and Assam — j f Sylhet ... ... 3 3 2 Jamalpore ... ... 5 ... 5 g; 5,070^ Purreedpore ... ... | ... ... ... 19+ 45f ... 64 36 !! Gowhatty ... ... I ... 2 ... 3 1 3 1 10 3 Debrooghur ... ... | ' 1 1 \l Wae Peovinces of 1858 — Behae, Benaees, Oude and J Cawnpobe — f Dorundah ... ... ... 1 1 None. I j Chyebassa ... ... 1 ... 1 ... , ti "" 2 None! j! 9**«ti 1 1 Meean Meer ... ... 3 1 ... 2 6 1 Ferozepore ... 1 1 None.' Dera Ismael Khan 1 j j 2 1 I Bunnoo ... .... ... ... '" [[[ '" _ '"j 1 NoneJ 45,021«{ Kohat ... , .. 2 1 18 ... 39 18 j Peshawur ... ... 1 2 ... 2 2 ... 7 7 1 : 22 14 Attock ... 1 I i None.! Campbellpore ... 1 . .. ! i None. P Abbottabad ... ... 4 ... is i' 2 ... ['[ '..' [['A 34 17 1 Eawulpindee ... 1 5 1 ... 1 ... 8 4 Camps in the Punjab 16 ..] ... ijg ... 34 19 On the Berhampooter ...... 3 3 2 Onthemarch ... ... j ... ! 1 '3 [[ '" [" '' 4 None.) 95,247 Aemy of the Peesidenct . . . I 2 6j8133119 48 20 94798 ! 4 305 146 * The Monthly. Returns of the Barrackpore Circle for 1858 are wanting, t Kamroop Regiment. CHOLERA OP THE EUROPEAN AND NATIVE ARMIES AND JAILS, 1854-68. No. Hl] JAIL POPULATION IN THE EPIDEMIC OP 1855-58- C Ho^^r lBs , Avebaoe Admissions into Hospital in each Month. j JOTJ 0TA *" Admitted Total Died pEE Strength '*™Ji «» PBB cent. Deaths ]mOn .. TATT STATIONS STRENGTH — — — . — _ _ BIOMS OF mTH , I,OOO OP JAII- BIAIIUHB. yOR THB THE I 0F OF THE STRENGTH. Year. Jan. Feb. Mar. April. May. June. July. Aug. Sept. Oct. Nov. Dec. y^"* j Strength. Ybab. Alipore ... 1,824 ... 363 14 8 919 5 1 4 2 1 129 i ... 60 Baraset ... 202 2 1 - 3 ... ... Jessore ... 510 28 23 51 ... 17 Kishnaghur ... 494 6 6 ••• ; Moorshedabad ... 225 Howrah. ... 58 ••• ¦•• ••• -Hoogbly ... 810 32 5 6 4 1 1 17 23 18 8 ... 1 116 ... 35 jßurdwan ... 562 ••• 23 ... ... 23 ... 13 ... Bancoorah ... 473 ... ••• 1 1 ... 1 ••• •" Purulea ••¦ 389 ... 3 ... | ••• 1 Sooree ... 438 1 ... 1 ... ••• 2 -• I Malda ... 46 •• ••• ••• Dinagepore ... 812 3 ... 3 1 1 1 ... ... 9 ... 2 : Eamporo Bauleab ... 441 26 30 ••¦ 56 ... 28 ... Rungpore ... 412 1 ... 1 ••¦ I 2 ... 2 ... jßograh ... 137 1 ••• •¦• J Mymensing ... 513 1 •- 1 ••• 1 ••• ••' ••• "• iPubna ... 211 2 1 ¦•• 3 Furreedpore ... 313 1 ••• •¦• 10 17 ... 28 Backergunge ... 433 1 5 ... 8 3j 17 ... 9 Noacolly ... 276 1 ••• | 1 jChittagong ... 184 ¦•• - ¦•• I ••¦ Tipperah ... 522 ••• ••• ¦ Dacca ... 663 ... 1 2 2 2 ... ... 2 4 1 14 ... 5 Sylbet ... 405 1 2 - 3 ... 1 Cherrapoonjee ... 22 Cachar ... 80 ¦•¦ ••• Gowalpara ... 135 Gowbatty ... 180 ... 1 ••• '•• | Seebsaugor ... 109 1 ••• 1 Nowgong ... 75 ••• ••• ••• ••¦ Tezpore ... 165 ... 3 »• 3 ... I Debrooghur ... 46 I ••• ••• ••• Midnapore ... 832 49 57 ... 1 ¦•• 10 ? ••• 43 > Balasore ... 91 3 ... 1 ... •¦• 4 ¦ Cuttack ... 322 2 2 ••• 8 1 13 ... 9 Pooree ... 94 ••• •¦• '•• I Sumbulpore ... 249 Cbyebassa ... 115 •¦• ¦•• . ••• ••• Banchee ... 320 3 1 ••• f. ... 3 Hazaieebaugh ... 414 2 4 6 3 15 ... 4 Mongbyr ... 762 ••• ••¦ ••• ••• ••• | Bhaugulpore ... 609 63 3 2 ... 2 ... ... 70 ... 40 Puineah ... 337 1 1 2 ••• 1 Darjeeling ... 34 ! ••• ••• ••• ••¦ Total ... 16,344 ~35* 14 193 144 29 108 48 37 21 27 31 6 j 693 4-24 290 17"8O Gya ... 400 10 10 ... 7, iPatna ... 750 1 1 2 lArrah ••• 139 •¦• Chumparun ... 270 ... 1 ... 1 1 1 4 2 1 2 \ 13 Mozufferpore ... 416 1 1 Chuprab ... 365 ¦ ••¦ »• jGbazeepore ... 637 1 ••• x Benares ... 1,447 1 Mirzapore ... 446 1 1 Azimghur ... 259 Jounpore ... 175 ••• Goruckpore ... 417 ••• Lucknow* ... 666 I (^) Etab ... 147 J Humeerpore ... 92 j Futtebgbur ... 247 ¦¦ Cawnpore ... 275 1 ••• 1 ! Banda ... 353 lAUababad ... 635 ; ... '.'. i 1 ••• 1 Total ... 8,193 ... 1 1 3 3 1 6 13 1 2 31 '38 10 T22 • This waß the only jail of Oude occupied in 1858, excepting Fyzabad, which was open fora few months only. The months in which these two admissions I occurred cannot now be traced. J[ CHOLERA OF THE JAIL POPULATION OF 1858— continued. AvEKAGE AWfISBIOHSJHTO HOSPITAL WIACHMOHTH. TOTAL_ ADMITTED TOTAL Dnn , „, I JAIL STATIONS. Stkength . . BlO ns PBB o c * lfT - 7/™ 1,000 of :l F YeIb. E Jan. Feb. Mar. April. May. June. July. Aug. Sept. Oct. Nov. Dec. j EE ™ E Stbength. Ybab. rBE »«H.j| Kaepore ... 266 • • Bandhara ... 238 1 L Chanda ... 110 ¦• Nagpore ... 605 1 1 Chindwara ... 135 Jubbulpore ... 1,287 1 £ Mundla ... 2 j Dumoh ... 243 1 X Saugor ... 575 Nursingpore ... 316 : Seonee ... 234 •• ... 1 ' } '" ¦•• Baitool ... 187 1 1 "' l Sehore ... 70 Hoshungabad. ... 366 ••• Mundlaisir ... 337 j Ajniere ... 188 Beaur ... 135 Total ... 5,292 ~ ~7T 3 2 3 8 -15 1 '19 Agra ... 989 Etawah ... 21 Mynpoorie ... 266 AUyghur ... 524 Bolundshuhur ... 82 ••¦ ¦ ••• Shahjehanpore ..¦ 378 Budaon ... 354 ••¦ Bareilly ... 563 2 1 3 Seharunpore ... 363 2 1 8 Bijnour ... 155 1 1 ... 1 3 Deyrah ... 79 I Almorah ... 150 1 1 Mozuffernuggur ... 563 1 1 - 1 ... 3 Moradabad ... 681 I ... 1 1 ••• 1 Meerut ... 1,005 4 1 6 ... 2 Muttra ... 193 1 1 2 ••• 1 Total ... 6,866 ... ... ... 11 2 7 5 2 111 21 I '83 6 -94 Delhi ... 646 17 17 ... 12 Rhotuk ... 312 1 1 2 Hissar ... 270 ' Sirsa ... 179 j Kurnaul ... 400 ' 1 1 ••• 1 Umballa ... 632 j 1 1 2 ... 1 Hoshiarpore ... 100 ! ... 12 12 ... 6 Loodianah ... 302 Jullundur ... 345 Perozepore ... 450 Umritsur ... 647, 2 ... 1 ... 3 Lahore ... 2,363 ! 2 I 2 Sealkote ... 385 j Dhurmsala ... 174 Goordaspore ... 307 ¦•• ••• ••• ••« i Gooj ran walla ... 489' | Goqjrat ... 311 [ - Shahpore ... 451 j .. Jhelum ... 285 j Googaira ... 222 Mooltan ... 668 I •¦• Jhung ... 409 I Dera Ghazee Khan... 119 Dera Ismael Khan . . . 332 i Kohat ... 110 Bunnoo ... 43 Eawulpindee ... 935 Peshawur ... 420 6 ... 6 ... 4 Attock (a gang) ... 1 ... 1 Hazara ... 180 1 ... 11 12 ... 2 Total ... 12,486 1 13 1 13 20 12 ... 7 ... 58 '47 26 2-08 j Bengal Presidency 48,681 36 15 197 151 36 112 74 78 36 30 39 7 811 1-67 334 6-86 '¦' 72 No, EPIDEMIC OF 1859-62. First Year, 1859. — Cholera epidemic from the east, occupying and confined to the eastern division of the epidemic area : cholera extinct within the western division. Second Year, 1860. — Cholera universally reproduced over the eastern division : in the south, invading Nagpore and the Central Provinces generally in March : extending with the monsoon to the north and west, hut cut short in its advance along the line which formed the southern boundary of the famine tract of 1861, the country to the south of this line being the cholera tract of 1860 : Meerut, Rohilcund, and the Punjab still an exempted province as in 1859 ; for the cholera of the east made no progress across the Doab from east to west, and, as noted above, the cholera advancing from the south-west and south was also prevented from entering this area. Third Year, 1861. — Cholera generally reproduced over the eastern division of the epidemic area, but having no longer the aspect of a moving cholera : universally reproduced in April and May over the portion of the western area invaded in 1860 ; and from this tract invading with the monsoon from south-east to north-west the area exempted in 1859 and 1860, the limit of the year being reached in the same week as in the parallel invasion of 1856 : limited in its north-western extension to the same area of primary invasion as in 1856, the north of the Punjab still remaining an exempted tract. Fourth Year, 1862. — Cholera extinct or at a minimum over the eastern division of the epidemic area : generally manifested both in the spring and in the monsoon season over the portion of the western division covered in 1860-61 : invading the exempted tracts of 1861, with the exception of the Doab between the Jhelum and the Indus : appearing on the frontier in April, and persisting until the first week in November, when the epidemic of 1859-62 became extinct in Northern India. 74 EPIDEMIC OF 1859-62. CHOLERA OF 1859. GENERAL INDICATIONS OF DISTRIBUTION AFFORDED BY THE TABLES OF 1859. See Map of 1859. Cholera epidemic from the east, occupying and confined to the eastern division of the epidemic area : cholera extinct within the western division. The Table for the European Army shows the universality of the invading epidemic in the eastern division, and also in the endemic province. No fatal case .of cholera was reported from any station to the west or north of Bareilly. The Table for the Native Army also indicates the universal occupation of the division of the epidemic area exempted in 1858; and only two fatal cases are noted in the western division out of a force of 46,236. The Jail Table shows a distribution exactly parallel. Of two fatal cases recorded in the western division, the one is not authenticated as a case of cholera ; the other, which occurred at Ajmere in October, was probably a precursor of the invasion of 1860, having its representative in the October cholera of Rajpootana of October 1866 preceding the invasion of 1867.* * The eases at Ajmere were indicative of the movement of the invading cholera of the year on the northern epidemic highway. The cases returned from the jails of Central India evidently mark the progress of the same invading cholera on the southern epidemic mgnway; and although our Indices are so trilling, it is certain that this was the same cholera which reached Bombay m May, (see laDle, page lio,; as in 1818, and which was widely spread throughout the Bombay Presidency towards the end of 1859, as in 1868. The movement ol May was universal from the east as far as to Humeerpore and Jaloun, and I find that premonitory cases were thrown out beyond tins .western limit into the Gwalior District, for two admissions and a death occurred at Gwalior on May 6th among the men ot the Bombay Artillery. This was the northern margin of the tract occupied in the movement of May, and we may infer that the cholera moving irom the east in ims, month covered as an aura, or in substance, the entire epidemic tract between Chota Nagpore and Bombay ; the very ear y appearanoe oi cnoiera as far west as Nimar in the first days of March 1860, causes me to conclude that this cholera was revitalised from the cholera ol uecemoer 1859, and was not a cholera primarily invading from the east in that month. CHOLERA OF THE EUROPEAN AND NATIVE ARMIES AND JAILS, 1854-68. EUROPEAN ARMY IN THE EPIDEMIC OF 1859-62. CHOLERA OP 1859. Avbbagb Ncmbbbo* Admissions into Hospital in each Month. | Total ArMITTED Strength _ Admib- per CKIrT . Numbeb i 000 of STATIONS. hnf „ »"™. At-"« Dba^hs. s t-rJ of occu- j Jan. Feb. Mar. April. May. June. July. Aug. Sept. Oct. Nov. Dec. | the Stbength. Stbength. PATION. YKAB, Presidency Hospital ... 1 1 ... 1 2 ... 1 5 1 12 - 6 »J Fort William ... 1,311; 1 2 5 1 ... 2 2 1 14 - J Dum-Dum ... 1,(511 | 1 2 ... 113 1 13 ... 130 ... 77 Barrackpore ... 1,428 1 8 1 ... 2 450 210 1 ... 79 ... 36 Chinsurah Dep6t ... 425 j 1 1 1 4 2 ••• «J Raneegunge ... 506 ; 2 1 - ... J * Berhampore ... 466 [ 10 3 2 15 ••• » Total ... 8,747 4 118 6 7 6 4 166 927 1 1 250 4"35 135 23-49 Darjeeling Depot (9 months) ... 108 •• "" "{ Hazareebaugh ... 370 ... ... 1 5 ... ... •• ••• <> I ••• * Dinapore ... 1,518 112 12 9 3 7 3 1 30 ... 8 Shahabad District ... 815 ... 1 ] % '" "\ Sasseram ... 350 ... 1 ... ... • ••• x • - Ghazeepore ... 790 ... 13 3 5 1 18 - » Benares Hospital ... 95 ... 1 ... •¦¦ 1 ••• ••• •¦¦ - * "* 9( . Benares ... 1,315 ... 1 311 918 1 2 1 ... 46 ... 26 Azimghur ... 427 ... 3 ... ... 1 ... 2 1 ... 7 Goruckpore ... 670 •• Goruckpore District 930 ... ... 1 ... 1 ... * "* Oude District ... 1.905 1 ... 1 Gondah ••• 919 1 ••• ... "' "A Fyzabad ... 1,342 3 ... 1 ••¦ 4 Sultanpore ... 666 ••• ••• ••• ••• -j . Raeßareilly ... 1,011 ... ... ... 1 1 ••• - * Seetapore ... 947 2 ... 1 ••• ••• J? #1> V 9 Lucknow ... 3,320 ... 1 3 ... 1 3 44. 22 1 ... ... 75 ... 42 Futtehgurh ... 808 ... ... 1 ••¦ ••• ¦•• J. " - ;¦; Cawnpore ... 1,372 12 1 244 4 2 ... ... 85 54 Allahabad ... 2,504 1 38 111 13 18 52 1 3 ... 1 238 ... l-» Allahabad and Cawnpore General Hospi- .» tals ... 1 1 2 7 54 6 2 24 5 ... ... 1 103 - 47, Banda District ... 838 1 2 26 1 2 2 34 Calpee,Oraie,and other Detachment Stations 737 ••¦ "j Shahjehanpore ... 688 1 7 '" I Bareilly ... 823 1 ... L Total ?. 25,265 8 210 69 193 47 71 195 37 13 5 5 640 2-53 338 13-38 Moradabad ... 440 • Meerut ... 2,146 1 L Allyghur ... 216 Muttra ... 405 •• Delhi ... 1,400 ... 1 1 1 6 Eoorkee ... 37 Land oaf Depot (8 months) ... 106 •" Nynee Tal Depot \ (10 months) ... 332 Total ... ~ 5,009 ~ 1~ ..."... 1 1 4 '° 8 Agra ... 1,293 1 1 3 5 '•• Gwalior and Morar... 1,198 •• "1 Gwalior District ... 598 ••¦ 1 Total ... 8,089* ......... 1 1 3 ... 1 « ' 20 || 111 1 -....- ¦ 1 ¦ ! — I 5 lg CHOLERA OF THE EUROPEAN ARMY OP 1850 — cdntinne& • ..._ _-- . - -- - — _. _ AvEBAGB NUMBEB OW AMIMIOKB IXIO HoBPIIAL IN EACH MONTH. TOTAL- A^ mTJ} \ STATIONS. ™r U p B kbiod dvring . ° FAF Ar _ I^°™, Avehaol T okoccu° Jan. F6b. Mar. April. May. June. July. Au* Sept. Oct. Nov. Dec. the | DkA ™' StWWWH. M Umballa ... 1,581 ... • ... 2 ¦ J Dugsbaie (7 months) 566 1 ••• 1 Subathoo (8 months) 938 ... 1 ¦ •¦• 1 | — Kussowlie Depot (8 months) ... 202 ! ••• Phfflour ... 189 ••¦ | Jullundur ... 934 [ ••• I Ferozepore ... 1,070 | ••• MeeanMeer ... 2,041 [ 1 '• 1 ••¦ Lahore Citadel ... 170! ¦•• Umritsur ... 407 1 - i | Govindghur ... 102 i ••• ••• *" I Mooltan (10 months) 1,030 | ... 1 1 * [ Dera Ismael Khan , . . 221 j Kangra ... 83 1 1 1 Sealkote ... 1,600 | ¦•¦ Jhelum (6 months) .. 532 EawulPindee ... 1,467 1 l I Attock (9 months) ... 199 i ! ¦ Nowshera (9 months) 771 j 1 ••• l \ ••• | ••• | Campbellpore ... 347 | I i ••¦ Peshawar ... 2,640 I ••• «• ••• j ••• I ••• j ••¦ I ••• j lurree Depot (6 months) ... 370 | •¦¦ ••• I Total ... 16,004 1 2 3 ... 3 1 1 l| I 12 ¦ "07: Bengal Pbesidency 55,104 9 7 32 67 206 55 77 370 47 41 6 7 924 1-68 478 867 II NATIVE ARMY IN THE EPIDEMIC OF 1859-62. CHOLERA OF 185 0. Numbkb of Admissions from Cholera in each Month, j Total Total I SIBKNSTH OF "STATIONS ¦ ADMISSIONS DEATHS I July 1859. M4UU " 5 ' of thb of thb Jan. Feb. Mar. April. May. June. July. Aug. Sept. Oct. Nov. Dec. Yeah. Yeab. Bengal Propeb — 1,689 Calcutta ... 3 12 1 5 ... 5 5 2 ... 8 2 I 43 11 231 Dum-Dum ... ... | ... 1 1 ..." ••• ... 2 None. 1,322 Barrackpore ... ... ! 3 5 ... 5 ... 13 5 859 Berhamporo ... 1 1 ... ... 2 4 2 618 Julpigoree ... •• ... ... None. None. Eastern Bengal and Assam — ! 923 Furreedpore ... ... ! 6 ... 1 ... j 7 5 242 Sylhet ... ... ! 2 ... 2 1 235 Cachar ... ... i 1 1 ... 9\ None. 398 Chcrrapoonjee ... ... •¦• 2 ... 2 1 163 Gowalparah ... ... None. None. 565 Gowhatty ... 1 ... ••• 1 2 None. 176 Tezpore ... ... 1 ... 1 ... I 2 1 48 Nowgong ... ... - ... 3 1 4 2 1,008 Stations of Upper Assam ••• ... j None. None. Eastern Division of the Epidemic Area — Behah, Ben- j ARES, OUDE, AND CAWNPORE — 779 Dorundah. ... ... 1 1 None. 220 Darjecling ... 1 1 None. 766 Bhaugulpore ... 1 2 ... ... 5 8 : 2 654 Dinaporo ... ... ] 17 1 ... 18 8 786 Benares ... ... i ... None. None. 8,297 Camps in Benares and Oude... j 19 9 4 1 ... 24 13 1,233 Fyxabad ... ... ! 1 •• 1 ... I 1I 1 2 1 797 Kae Bareilly ... ••• I ... || None. None. 1,355 Lucknow ... ... J 1 35 10 ... 46 16 1,779 Scetapore ... j None. None. 946 Sbalvjehanpore ... ... j ... I 1 1 1,821 Bareilly ... ... ! ... ! 1 I . It 1 1,127 Futtehglrav ... ... j ... j None. None. 475 Banda ... ... j None. None. 3,722 Cawnpore ... ... 18 42 ... ... 55 23 1 Camps, Cawnpore District 3b' 11 ... j 47 14 783 Allahabad ... ... ... 1 ... 1 .. 2 1| I 9,546 Westebn Division of tiie Epidemic Area — Agea and Central India ••• If 1 1 12,509 Meerut and Western Rohilcund ... 1* 1 ji 2 11 24,181 Punjab ... ... j | ¦¦¦ :! None. ; None. 79,753 Army of the Presidency 6 12 1 11 20 28 27 123 34 j ... 19 12 j 292 ; 110 * A fatal case of Deyrah : probably belonging to tlie cholera of the previous year. t A fatal case at Seronge iv Central India; piobably a true forerunner of the invasion of 1860. 79 J x -£ CHOLERA OF THE EUROPEAN AND NATIVE ARMIES AND JAILS, 1854-68. [ Appendix , ¦ — - JAIL POPULATION IN THE EPIDEMIC OF 1859-62. CHOLERA OFIBS 9. Avuhaoti i Admissions into Hosfitai, in bach Month. J°™ Admitted ' Total m li "* J* ****** iIJIM LH* __ _ ?, T^w _ Tim "" "KB I JAIL STATIONS. *™? — ™«» "JT UTS Ybak. Jan. Feb. Mar. Apl. May. June. July. Aug. Sept. Oct. Nov. Dec. Ybab i Strength. Ybab. Alipore ... 1,766 5 1 3 5 2 534 2 ... 113 3 74, ... I 30 Baraset ... 248 | ••• i Jessore ... 554 \ ... 3 1 1 ••• 5 ••• ••• •.. I Kishnaghur ... 332 Moorshedabad ... 161 I ••• ••• •" ¦•• Howrah ... 69 I 1 1 ••• ;•• Hooghly ... 776 4 5 3 4 ... 112 ... 33 1 ... 54 ... 16 ... Burdwan ... 632 ... 1 7 41 6 ... .. 2 57 ... 45 Bancoorah ... 474 ... 5 1 ... 1 ... ... 7 •¦¦ *> Purulea ... 351 j ... ¦;¦ ••• Raneegunge ... 8 I ... Sooree ... 413 i ... - ••• ••• "' I Malda ... 48 I ... ... 1 1 ... 2 ... ... Dinagepore ... 730 | 9 3 12 ••¦ 4 Rampore Bauleah ... 529 4 3 24 ... ... 31 ¦•• I 15 Rungpore ... 360 1 1 15 ... 2 ... ... 19 | Bograh ... 163 ! 4 1 ... ... ... ••• 5 - 2 Mymensing ... 487 .. ••• Pubna ... 150 ... ... ... ... 1 1 ••¦ ¦•• Furreedpore ... 393 i ... 1 2 ... ••• 1 1 5 ... 2 Backergunge ... 459 9 ... 1 22 1 33 ••¦ 22 Noacolly ... 313 2 ... ... I 2 Chittagong ... 248 ... ... ... I ••¦ Tipperah ... 445 .. .. Dacca ... 671 1 ... 1 4 ... ... 2 ... 1 1 9 ••• 6 Sylhet ... 386 ..'. 1 1 ... .'.'. 2 ... 1 Cherrapoonjee ... 38 ' ••• •¦• Cachar ... 78 ... 12 3 1 ... ••¦ i 6 ••• 6 Gowajparah ... 113 ... • 4 3 3 10 ... 8 Gowhatty ... 166 '.'. ... ..'. ... .'.." ... ... 1 ... ... 1 ••• 1 Seebsaugor ... 104 I Nowgong ... 68 ... ... ... ... ... . 8 2 ... 10 ••« 5 Tezpore ... 140 j Debrooghur ... 65 j ... Midnapore ... 739 ! ... 10 '..'. 1 1 12 Balasore ... 100 1 . 1 ••• 1 Cuttack ... 285 \ '.'.'. "4 2 ... 6 ... 4 Pooree ... 101 I ... 2 1 ... ... 3 ••• 1 Sumbulpore ... 160 Chyebassa ... 154 ... ... ... ... ... 2 2 4 ... 3 Ranchee ... 310 ! 113 ... I ... 6 ... 5 Hazareebaugh ... 295 . ... 1 ... 1 ••• ••¦ — Monghyr ... 444 ..'. 12 ... ... 21 2 1 36 ... | 18 Bbaugulpore ... 481 ... 39 1 7 36 9 92 ••• 39 Purneah ... 314 ... ... 190 18 - ••• 109 j ••• 60 I Darjeeling ... 38 j ... ... 2 2 Total ... 15,359 11419 j 44 144 104 ~53~ 70 45 12 50 57 16 628 : 4-09 288 1875 1 ============== Gya ... 472 I 1 ... 1 2 Patna ... 723 1 ... 1 18 25 2 47 ... 25 Anah ... 214 1 ... ... ... 12 1 1 | 6 ... 4 Mozufferpore ... 353 ?.112 3 — 7 ... 5 Chumparuu ... 226 ... 1 3 2 ... ... 1 7 ... 1 »•• Chuprah ... 322 13 2 ... 1 9 3 28 | ... 11 Ghazeepore ... 644 ... 1 1 2 : Benares ... 1,104 „[ 5 2 1 ... ... 8 ... 3 Mirzapore ... 379 .'. 1 ... 1 ... 1 Azimghur ... 277 ... 1 1 ••• ••• ••• Jounpore ... 251 ... ... Goruckpore ... 594 '\ ... 1 2 ... 1 Baraitch* ... 114 , "'. .[[ ] ,(<, (< Fyzabad* ... 142 ... ... ... ... ... ..'. ... ... ... ... 1 ... 1 Sultanpore* ... 97 ... ... ¦¦• ••• Rae Bareilly* ... 54 ... '" "' ' '] [[ \[\ .[[ Luckhimpore* ... 39 Lucknow ... 469 .., ... [[[ ?, i 8 1 10 ••¦ 7 Oonao ... 40 '" tii ... 1 1 Seetapore ... 43 Etah ... 151 ;;; ;;; ;;; ;;; ;;; ;;; ;;; ;;; ;;; ;;; ;;; ;;; Humeei"pore ... 91 ... ... ... ... ... Oraie ... 48 ... ..'. \" t '" "' '" '" [[[ ... ... '"' Futtehghur ... 278 Cawnpore ... 75 j ... 1 Banda ... " "j 1 ... 1 Nagode ... 66 ... ... '". ".[ 3 "'. ... ..." ¦'» ... 3 ... 1 Allahabad ... 1,459 [ _ 20 26 6 14 18 79 ... 49 Totai, ... 8,725 ... 1 5 82232 29 ~30~ 17 19 38 6 207 2"37 109 12-49 I * an y °f these jails were occupied for a few months only. CHOLERA OF THE EUROPEAN AND NATIVE ARMIES AND JAILS, 1854-GB. 81 No. lIU CHOLERA OF THE JAIL POPULATION OF 1859— continued. Average Admissions into Hospital in each Month. A^^s Admit- Total j DIED pEE | JAIL STATIONS. S ™,f Z oTt^e ™* "^ |j Yeab. Jan. Feb. Mar. April. May. June. July. Aug. Sept. Oct. Nov. Dec. ybab ; Stben( *th, Yeab. 'j Eaepore ... 275 j ••¦ I Bandhara ... 225 j ••• ¦, •¦ ¦¦¦ ••¦ i Chandah ... 141 ••• Nagpore ... 490 Chindwarra ... 252 ¦• ••• j Jubbulpore ... 1,156 ••• j Dumoh ... 135 ••• j Saugor ... 317 ••• ' Nursingpore ... 303 . ... I Jhansi ... 211 ••• j ••• ••• ••¦ j Seonee ... 237 1 1 I Baitool ... 200 .» j ... I Sehore ... 66 .. Hoshungabad ... 230 Mundlaisir ... 299 1 1 • Ajmere ... 220 2 j ... 1 Beaur ... 87 ••• '" '" '"I Total ... 4,844 1 3 4 -08 1 -21 | Muttra ... 108 \ | Agra ... 1,911 ••• ••• I Etawah ... 159 Mynpoorie ... 177 Allyghur ... 224 ¦• Bolundshuhur ... 155 1 Shahjebanpore ... 304 1 ¦¦• 1 Bareilly ... 567 j ••¦ I Budaon ... 285 I Seharunpore ... 138 Bijnour ... 176 ... 1 1 1 2 5 Deyrah ••• 63 Almorab ... 157 1 1 j ••• J Mozuffernuggur ... 222 Moradabad ... 360 | Meerut ... 1,413 I ••• " - Delhi ... 484 Goorgaon ... 142 ••• "_ '" I Total ... 7,045 ?.1111 2 1 ... 1 ... 8 '11 Rhotuk ... 193 ' Hissar ... 177 Sirsa ... 208 •¦ ••• •¦ ; ¦•• ••¦ Kurnaul ... 219 1 ... 2 3 ... 1 Thanesur ... 249 : Umballa ... 594 ; Simla ... 68 : Hoshiarpore ... 148 Loodianah ... 316 Jullundur ... 330 Ferozepore ... 360 ••• ••• Umritsur ... 408 W Lahore Central ... 2,167 W | Sealkote ... 352 I Dhurmsala ... 164 Goordaspore ... 212 Gooiranwalla ... 435 ¦•¦ Goojrat ... 258 (1) I Shahpore ... 373 ••• Jhelum ... 195 Googaira ... 306 Mooltan ... 447 Mozufferghur ... 261 - Jhung ... 345 ••• | Dera-Ghazee-Khan... 97 Dera-Ismail-Khan ... 228 ••¦ - Kohat ... 104 Bunnoo ... 55 Hurreepore ... 109 Rawulpindee ... 720 Peshawur ... 421 j. -j ••• - •¦ j^_ "^_ Total ... 10,729 .................. 1 ... 2 7 -07 1 -09 Bengal Pbesidency "*46,702 "l 4 "iT 10" 753 ~m 17 Toi 17 ~32 72 96 22 854 TB3 399 | 8-64 J EPIDEMIC OP 1859-62. CHOLERA OF 1860. GENERAL INDICATIONS OF DISTRIBUTION AFFORDED BY THE TABLES OF 1860. See Map of 1860. Cholera universally reproduced over the eastern division : invading in the south, Nagpore and the Central Provinces generally, in March : extending with the monsoon to the north and west, but cut short in its advance along the line which formed the southern boundary of the famine tract of 1861, the country to the south of this line being the cholera tract of 1860: Meerut, Rohilcund, and the Punjab still are exempted provinces as in 1859; for the cholera of the east made no progress across the Doab from east to west, and, as noted above, the cholera advancing from the south-east and south was also prevented from entering this area. Notwithstanding the explanations given in connexion with the occurrence of the four fatal cases among the European Troops in the exempted tract of the year, which occurred at Delhi, Ferozepore, and Meean Meer, these ought probably to be reckoned as genuine cases of cholera, and true precursors of the invasion of 1861. Two parallel cases are noted among Native Troops, occurring the one at Meerut and the other at Deyrah. The distribution to the east and south of the lines limiting the exempted tract is typically displayed in the Table for the European Army. The Table for the Native Army indicates the invasion of Eastern Bengal in the spring months, and of Assam in the last four months of the year ; the universality of the spring cholera over the eastern division of the epidemic area ; the occupation of a limited portion of Central India with the monsoon ; and the exemption of Meerut, Rohilcund, and the Punjab. The Table for the Jail Population is also typical for the distribution of the cholera of 1860. A fatal case which occurred in the Goorgaon Jail in August, indicates the north-western limit of the invading cholera. To the south and east of this limit as far as to Nagpore, the universality of the invasion is displayed, and the dates of the occupation of the different stations on the southern epidemic highway indicated. CHOLERA OF THE EUROPEAN AND NATIVE ARMIES AND JAILS, 1854-68. lxxxv EUROPEAN 4RMY IN THE EPIDEMIC OF 1859-62. CHOLERA OF 1860. Averagb Number of Admissions into Hospital in each Month. Total Strength Admis Admitted Dtftipkb DURING *?*"• PER INcMBKR STATIONS. the DUBWG- CEIrT - OF OF Avekagl P occupa° F Jan - Feb - Mar - A P rU - Ma J- June - Ju 'y- Au S- Sept- Oct Nov - Deo - THE Strength DeA ™' Strength, tion. Yeae - Presidency Hospitals 16 22 3 ... 2 1 44 ... 25 Fort William ... 1,198 ... 11 8 3 20 13 2 1 1 59 ... 40 Dum-Dum ... 1,242 ... 5 ... 16 .. ... 1 1 14 ... 6 Barrackpore ... 1,501 ... 4 4 7 1 1 2 19 ... 32 Chinsurah Depot ... 117 ... 3 ... 2 2 1 1 ... 9 ... 1 Raneegunge Dep6t .. 308 ... 2 16 10 ... 28 ... 10 ... Berhampore ... 270 i ... ... ... ... | Total ... 4,636 ... 25 28 13 27 14 4 2 I 2 1 11 2, 129 278 69 1488 I I Darjeeling, on march Hazareebaugh . . . 663 ... 4 1 5 ... 1 ... Dinapore ... 887 ... 1 2 8 7 3 2 23 ... 8 Dehree ... 230 ... 1 .. 17 9 4 5 27 ... 20 Ghazeepore ... 555 21 115 2 ... 12 1 ... 142 ... 69 Benares ... 1,447 ... 2 28 6 1 1 7 1 1 ... 47 ... 33 Azimghur ... 248 4 6 10 ... 6 Goruckpore ... 098 4 ... 11 15 ... 10 Gondah ... 965 12 10 22 ... 18 Fyzabad ... 1,054 1 27 1 ... 29 ... 20 Lucknow ... 2^216 '.'.'. .'.'. 1 7 1 ... 1 9 16 ... ... ... 35 ... 22 Cawnpore ... 1,228 ... ... 5 12 1 '.'.'. 219 "i ..'. ..'. '.'.'. 43 ... 24 j Allahabad ... 2,460 ... 220 19 2 ... 2 2 1 1 5 ... 54 ... 27 j Allahabad and Cawnpore General Hospitals .. 10 12 3 ... 3 28 ... 11 Nagode ... 225 26 26 ... I 15 Humeerpore ... 101 Shahjehanpore ... 510 1 3 4 ... 3 Total ... 17,368 ... 16 109 255 25 31 21 j3B 22 6 9 ... j 532 306 j 299 17-22 i Moradabad ... 463 ; ... ... ... ... Roorkee ... 443 Landour Depot ... 155 ... ... ... ... Nynee Tal Depot ... 326 1 ... Total ... 4,775 1 1 1 1 4 -08 1 j -21 Muttra ... 358 ... 42 8 ... 50 ... 24 Agra 1,238 1 ... 77 36 1 I 115 ... 59 Morar ... 1,379 2 15 130 25 1 1 ... j 174 ... 87 Gwalior District ... 526 I •-• ••• ... ... I Jhansi (11 months) 583 31 1 32 j ... 13 Saugor ... 968 ... 1 ... 1 ... 7 1 ... 1 n | — 4 Jubbulpore ... 805 1 ... 3 1 1 1 ... 1 8| ... 5 Total ... 5,708 ... 1 ... 3 2 1 ... 25 282 71 4 1 1 390 683 192 3364 I * Probably a case of true cholera, but described as a typical case of cholera biliosa^ | CHOLERA OP THE EUROPEAN ARMY OF 1860 —continued. Average Number of Admissions into Hospital in each Month. Total ?„,.„ Strength A ™ IS " per Numb™ I Dl ™ »» DURING SIONS QF QF 1,000 OP STATIONS. THB PERIOD DURING AvBRAQE DeathS . L^f"*™ OF Jan. Feb. Mar. April. May. June. July. Aug. Sept. Oct. Nov. Dec. the Strength. strength. OCCUPA" i I-, \ !i. TION. Umballa ... 1,892 Dugshaie (7 months) 1,014 Subathoo (9 months) 990 Kussowlie Depot ... 145 •¦ ••• Phillour ... 147 Jullundur ... 816 • ¦•• "1 Perozepore ... 1,086 A • ••• \ '" i MeeanMeer ... 2,036 3 ... 1 ••• 4 ... 1 Lahore Citadel ... 236 •• •••' ••• ••¦ Umritsur ... 470 | ••• L l Govindghur ... 100 i ••• ••• ••• Mooltan ... 536 • I Dera-Ismael-Khan... 109 ... 1 *- Kangra ... 103 Sealkote ... 1,387 Jhelum ... 120 Rawulpindee ... 1,945 Attack (9 months) ... 169 — Nowshera ... 812 Campbellpore ... 146 Peshawur ... 2,400 ¦•• ••• Murree Depot ... 166 ••• '" "¦ Total ... 16,414 ... T~ 3 ... ]___J__J___! __^_ S _ H Bengal Pbesidency ~7~59~"l60 ! 274 ~57"5l 51323 97 12 22 3 | 1,106 2-26 589 12-04 it JJJ ] CHOLERA OF THE EUROPEAN AND NATIVE ARMIES AND JAILS, 1854-68. IXXXVU NATIVE ARMY IN THE EPIDEMIC OF 1859-62. CHOLERA OF 1 S G 0 . Number of Admissions from Cholera, in each Mo.vih. j Total Total a -_«••• „¦ " Admissions Deaths uZ 1860 STATIONS. 0F THB of the Jan. Feb. Mar. April. May. Juno. July. Au?. Sept. Oct. Nov. Dec. j Year. j Yeab. Bengal Proper — 800 Calcutta ... 15 7 8 2 1 .. ... 1 25 11 1,730 Barrackpore ... 1 1 7 ... 2, 16 1 ... | 28 10 320 Berhampore ... ••• 1 1 I "¦ 1 ¦•¦ I 3 None None-577 Julpigoree ... ... 1 - 1 H 5 1 ... ••¦ I 19 & Eastern Bengal and Assam — 418 Furreedpore ... 2 * 1 416 Dacca ... 2 ... 3 ... ... 1 ... 6 ; 2 331 Sylhet ... 2 1 ... 1 £ 280 Cachar ... 2 ... 1 •¦• 668 Cherrapoonjee ... 1 1 j ! 202 Gowalparati ... 1 1 ... 1 •¦• 1 j Behar, Benares, Oude, and Cawnpore — no 1,010 Dorundah ... ... 4 1 ... 3 ... ••• 1 ... » °\\ 231 Darjeeling ... ... ... - 1 ¦•• ••¦ ••¦ - I \ f: 590 Bhftugulporo ... ... 2 11 ••• | « £ 489 DehreoGhat ... ... 3 1 10 9 ... ... ••• j 23 17 873 Dinapows ... ••• 1 6 5 1 1 ... 1 1 j 313 Segowlie ... 1 ••• ¦•¦ i J. ~. 1,250 Benares ... 5 10 3 16 13 ... 47 24 574 Joanpore ... ... ••• -¦ No » e j Nona . 894 Gorackpore ... ••¦ 10 2 3 ... lo 4 1,180 Gondah ... ... 19 '18 ... - 37 21 769 Baraitch ... ... - ... 1 4 2 - j J 527 Fyzabad ... 2 9 ... ... j 11 *\\ 572 Eaeßareilly ... ... ••• ... ... } J * 1,308 Lucknow ... »¦ - 2 25 6 1 1 ... 3 3S 17 1,277 Seetapore ... ... ... 1 ••• ••• 1 ! 2 JJ one one-381 Futtehghur 1 ¦'¦ i 1 Non^ 736 Humeerpore 12 ° 1 V i i X « 1,024 Cawnpore ... 4 7 4 2 2 ; 3 ... 1 I 23 6 706 Allahabad .. 3 8 8 1 2 ... 22 14 650 Nagode ... ••• '" Agra and Central India— 608 Nowgong ... ... ••• 1 o tj i «on ti • '2 2 JNone. 1,620 Jhansi ... ••• ¦•• ••¦ « ••• | * , 729 Ao-ra .. 1 ... 5 2 ! o O • •*" Agra ••« ••• ?, o 1,823 Morar ... ••• - ••• f ' 5 ! UQU Q J 456 Goonah ... ... ••• 17 ' » & 311 Augur ... 4 I' i 5 S q qo9 i Stations of Central Tndia, south 9)392 i and west of the above group ... ¦¦• ... j ! None. None. 8,399 Meerut and Kohilcund ... 1 ... 1 1 1 1 5 25,913 Punjab ... ... - j None - None - Regiments marching or in Camp — ..„ „„ Camp Calcutta -. ... 2 ... 85 13 ... ••• | 100 db „ Grand Trunk Road ... ••• ... 20 ... j 17 „ Raneegunge 2 ... - } „ Gwalior District ... ••• ... 4 ... 4 6 „ near Agra ••¦ ... 3 1 Army of the Presidency ... 4 15 164 126 61 72 19 31 29| 55 83 8 667 309 » At Meerut in June, and at Deyrah in September, probably true forerunners of the epidemic of 1861. JAIL POPULATION IN THE EPIDEMIC OP 1859-62. CII OLE ft A OF 18 60. AvEKAGE NtJMBEB OF ADMISSIONS FROM ChOLEBA IN EACH MONTH. TOTAL ADMITTED j TOTAL n JAtt STATIONS, tag" j 1 *£* «>™ 2™ I*? the Yeah. | Jan. Feb. ! Mar. April. May. June. July. Aug. Sept. Oct. Nov. Dee. of™ ; Strength. ' Yeak. j ' thknb th.; Alippre ... 1,896 I ... 233 30 2.. 8 3 3 .... 1 82 ••• I 42 j ... i Baraset ... 246 1 1 ... 1 1 '? ... 4 ... j j Jessore ... 445 ... ... .. ••¦ ... ... ' Kishnaghur ... 359 3 2 1 ... 1 1 ... ... # 8 ...I : Moorshedabad ... US ... ; Howrali ... 76 112 ... 2 ['.', ... 6 ... 1 I : Hoogkly ... 672 ... 39 8 18 7 7 81 13 53 226 ... 87 Burdwan ... 583 2 2 2 2 1 ... l ... 10 ! ... I 3 ... I Baneoorah ... 310 ... 1 2 ... 12 12 1 ... ... j 28 j ••¦ 11 ... \ Purulea ... 286, ... .'.. ... 24 2 ' A ... 26 ¦•• 12 ; Raneegunge ... 13 ... j ... ... ? ... | Sooree ... 3154 1 ... ... ... 1 .. 2 ••¦ 1 ...I Malda ... 53 ... l \ ... i| ... . ... | Dinagepore ... 45s 6 ... ... ... 11 24 3 ... 1 l 46; ... ' 17 , Ram pore Bauleab. ... 539 ... 9 j ... _ 9 ... 4 ... Rungpore ... 300 ' j2 '" ' ... 1 " ... 3 ... 2 ... 1 : Bograh ... 13S If ! ••• 1 \\\ ... 1 ! Mymensing ... 459 I 23 37 6 1 ... ... 67! ... 18 i Pubna ... ]36 j 9 ... 9 I ... 6 . Furreedpore ... 384 2 9 2 1 2 11 ... | 17 ... 2 Backergunge ... 401, ... .'.. 11 3 ..'. 5 I 19 1 ... 12 ... Noacolly ... 298 ••• ... j ••• ! Chittagong ... 405 1 '[[ '.' "i\ ... j 1 ; Tipperah ... 394 1 ... ; ... ... ... | ; Dacca ... 500 ll 8 3 .. 12 ... J 9 ! Sylhet ... 391 | I ... I \ Cherrapoonjee ... 51 ... ... ... ! ; Cachar ... 94 ... ... j Gowalparak ... 10J 48 i ... 4 11 "" ... 63 ... ' 48 1 Gowhatty ... 136 1 ... 1 12 12 "3 ... I 29! - I 20 Seebsaugor ... 100 1 ... 2 i 2 ! .2 ..7 ••• ' ;5; 5 Nowgong ... 46 I ... .'.'.' 'A ... ,"," 5 ][[ '" 5 ... 3 Tezpore ... 200 ... Debrooghur ... 92 2 1 18 21 i ••• 10 Midnapore ... 629 ... 1 32 il5 ...140 7 '..'. ... 4 ... I 199' ... I 93 ... | Balasore ... 107 j ... 1 ... ... 1 ... ... 2 ... ! 1 Cuttack ... 276 ! Oil ... 14.. 1 16 ... 4 Pooree ••• 59 ... 1 2 4 1 8| ... 2 ; Sumbulpore ... 154 ... 1 8 3 12 i ... 9 j Chyebassa ... 136 ... ... ' ... ... j Ranchee ... 332 2 i'l 13 i 5 21 ." '. . 62 ... 33 j ... j| Hazareebaugh ... 473 1 1 49 7 .1 59' ... 30 .Monghyr ... 401 1 23 7 5 .. ... 36 ... 19 ... Bhaugulpore ... 297 38 29 | 67 1 ... i 30! ... j Purneah ... 322 1 ... 3 38 2 ... 1 ..'. '.['. ... \ 45 i ... 20 | i Darjeeling ... 36 2 .. ... 2 | 1 ... Total ... 14,335 jj 10 j6O f 178 [ 232 161 12311 231 61 j4l | 26,131 23 61 1,210 1 8"44 j 549 1 3830 Gya ... 459 5 2 ... 1 2 57 67 ... 37 Patna ... 456 [ 2 1 12 '21 1 1 38 ... 14 Arrah ... 340 13 3 ... 90, 1 . 98 I ... 48 : Chumpanan ... 178 I ... ... Mozufferpore ... 395 "i 6 9 1 ! ... 32 6 ... ... j 58 ... 1 20 ! Chuprah ... 373 16 3 1 10 17 12 59 26 1 Ghazeepore ... 760 I ,, B enares ... 1,176 2 1 .['. '.'.'. '.'.[ 40 3 ... '.'.'. ... 46 I ... 19 '.'.'A Mirzapore ... 270 ! I 7 4 I 11 7 Azimgbur ... 234 1 "3 1 1 "' ''" ..'. '.'.'. "| 6 ... 1 .'" Jounpore ?, 88 Goruckpore ... 696 15 5 "' '" ... ..'. . 20 ... 7 .'" Baraitch ... 106! 2 ... 2 '.. Fyzabad ... 259 1 4 ... '.'.'. '.'.'. "i ..'. 1 7 .'., "flf Gonda ... 66 I 1 1 1 Rae Bareilly ... 65 '" Sultanpore ... 83 3 \ "3 |" "2 Pertabgbur ... 72 ... ... 2 ... ... 2 Hurdui ... 70; \\, ... ... [][ Durriabad ... 32' 1 ... "j 2 Luckhimpore ... 13 j ' j Lucknow ... 663, 9 ' "j '_'' '[[ '[ '" 10 "4 Seetapore ... HO 1 I Oonao ... 57 j ... '' Etab. ... 141 i ... ' " "i ' j "i ' Futtehghur ... 410 1 ..'. 1 '" '" ; Cavvnpore ... 62 ! i Banda ¦•• 116 ... ... ..'. 3 ... ..'. "3 I ; Humeerpore ... 100 I Oraie ... 104 i ... ... ,„ ... ... ?[ 1 Nagode ... 94' ... ... '" ..'. "i '"' "" [[[ '" "[ " [[[ 'Allahabad ... 1,595 10 1 2 ... ... ..'. ... ,„ ... 13 8 Total ... 9,652 1 ... 15 60 36 21 117 137 48 7 1 1 449 4-65 197 20-41 I CHOLERA OF THE EUROPEAN AND NATIVE ARMIES AND JAILS, 1854-68. IXXXIX CHOLERA OF THE JAIL POPULATION OF 1860 — continued. Average Number of Admissions from Choleba in each Month. Total \ DM rr TE D Total JAIL STATIONS. *™ ft« the Year. Jan. Feb. Mar. April. May. June. July. Aug. Sept. Oct. Nov. Dee. °yy e ™ X Strength. | Yeah. »™ BIfoTH - Eaepore ... 305 6 6 2 1 15 ... 10 Bandhara ... 226 1 8 19 28 ... 11 Chanda ... 160 28 ... 2 30 ... 15 Nagpore ... 557 • # ... * # (44) ... (15) ChindwaiTa ... 231 Jubbulpore ... 1,108 ,„' Mundla ... 44 27 1 28 ... 9 Dumoh ... 132 | ... Saugor • ... 358 11 | \i ... 6 Nursingpore ... 200 2 j 2 ... 1 Lullutpore ... 253 ! Jhansi ... 192 ... j ... Seonee ... 278 2 6 8 ... 3 Baitool ... 128 1 2 3 ... 2 Seliore ... 85 ... ... ... ... , Hoshungabad ... 234 | 2 2 ... 1 ; Mundlaisir ... 131 j 18 1 19 ... 8 ' Ajmere ... 189 j • Beaur ... 76 j ! .. | ... Total ... 4,887) j251857 29 16 1 190 389 81 16-57 I Muttra ... 147 j ! Agra ... 1,890 801 7 808 ... 173 ; Socundra ... 190 8 | 8 ... 2 Etawah _ ... 121 I ... * Mynpoorie ... 159 , 1 Allyglmr ... 193 1 j ... ... ... ... Boiundshulmr ... 120 Shahjehanpore ... 331 1 1 Bareilly ... 690! 2 3 5 ... 1* Budaon ... 295 ... ... ... ... Seharunpore ... 133 ... ... ... ... ; Bijnour ... 278 2 2 Deyrah ... 55 ... ... ... ... : Almorah ... 146 ! 1 1 2 ... Mozuffernuggur ... 87 ... ... ... ... I Moradabad ... 216 1 1 ... 1 Meerut ... 2,096 I Delhi ... 249 I : Goorgaon ... 158 l| I l] ... 1 Total ... 7,554 ... | ... 3 6 1 18101 810 8 J 828 10-96 178 23-56 1 1 Rhotuk ... 213 I ... j ... j ... ... I : Hissar ... 263 ... Sirsa ... 225 Kumaul ... 257 ... ! Thanesur ... 361 I i Uinballa ... 561 ... 1 lj ... Simla ... 42 ... ¦ Loodianah ... 256 ! ... Jullundur ... 365 ... ... I Ferozepore ... 306 TJmritsur ... 373 ... j ... ... ... ... J Lahore Central ... 1,567 ••• „ City ... 494 ... .' | Sealkote ... 333 ... ... I ... Dhurmsala ... 150 ... j Goordaspore ... 155 ... j ... | Goojranwalla ... 339 j ... ... ... ... I Goojrat ... 238 Shahpore ... 295 • ... ... ... ' Jhelum ... 158 ¦•• ... ... ... ! I Googaira ...- 313 ... ... ... ... II , Mooltan ... 328 ... ... Mozufferghur ... 243 I ... ... I Jhung .. 270 ... ! ...I Leia ... 99 ... I ¦•• ... ... ... ... Dera-Ghazee-Khan... 54 ! .., Dera-Ismail-Khan . . . 232 ... ... ... ... Kohat ... 121 Bunnoo ... 77 ' Hurreepore ... 50 ¦•• Rawulpindee ... 700 Peshawur ... 388 I ... Total ... 9,826 1 j 1 '01 Bengal Presidency 46,254 1 11 55 221 322 255 281 194 989 82 j 138 24 62 j 2,678 5-79 1,005 2173 * Returned as cholera biliosa. EPIDEMIC OF 1859-62. CHOLERA OF 1861. " GENERAL INDICATIONS OP DISTRIBUTION AFFORDED BY THE TABLES OF 1861. See Map of 1861. Cholera generally reproduced over the eastern division of the epidemic area, but having- no longer the aspect of a moving cholera : universally reproduced in April and May over the portion of the western area invaded in 1860 ; and from this tract invading with the monsoon, from southeast to north-west, the area exempted in 1859 and 1860, the limit of the year being reached in the same week as in 1856 : limited in its north-western extension to the same area of primary invasion as in 1856, the north of the Punjab still remaining an exempted tract. The history of the cholera of 1861 is typically exhibited in the Table for the European Army. The appearance over the east is shown, with the general want of epidemic vigour. In the west, the reappearance of cholera at Morar, Agra, and Muttra marks the revitalisation of the cholera of 1860 ; and the cholera occupying the invaded tract of the year is typical for the geographical distribution of the epidemic. The exempted areas within the boundaries of the invaded tract were the same as in the invasion of 1856. The Table for the Native Army indicates the presence of cholera over the eastern division, but with much diminished strength ; the universality of the invading cholera in the northern epidemic highway between Agra and Ajmere, and its absence to the south and west ; the invasion of Meerut and of the Punjab as high as Meean Meer, and the almost entire exemption of the northern districts of the Punjab lying beyond. The cases occurring in the Punjab in April were apparently true forerunners of the monsoon invasion. The cases in the Frontier Force of November and December were, with one exception, which was reported from Abbottabad, from the outposts beyond Dera-Ismail-Khan. They indicate the route by which the cholera of 1861 passed into Cabul; for while these were occurring cholera was virulently epidemic in Bhawulpore to the east and in Cabul to the west. The Table for the Jail Population shows a distribution precisely the same as is shown in the case of the European and Native Armies, [Appendix TTTTPn'DP A "NT A"PT\/TV T"NT rPTTP PDTTYIP'II/rTr l HU I 1 Q£Q PS) JcjUllUrJiiAJN AlUVli IIN IxlHj JljrlJJjljiVlHj Ur loDy-04. CHOLERA OF 18 61. Average ' Number of Admissions into Hospital in each Month. Total tw™ Strength Amus Admitted Died | : DURING j oTniii I PEB CENT. NUMBER PER 1,000 ; STATIONS. the period durhto ° P ° F 0F j! occupa- Jan - Feb - Mar - A P ril - Ma y- June - Ju 'y- Au " Se P f - Oct Nov - Dec> THB Strength DeAIHS- StlengthJ- TlON. TBAB> ! ! Presidency Hospital ... 115 7 4 1 19 ... 9 ... || Fort William ... 1,056 3 2 8 2 3 | 18 ... I 9 ! Dum-Dum ... SO3 5 6 ! 11 ... \ 4 Barrackpore ... 1,141 113 13 3 1 | 13 ... 6 \ Chinsurah Depot ... 204 2 I 2 ... 2 I Raneegunge „ ... 140 4 2 ; 6 ... 3 j Berhampore ... 275 Debroogurh ... 70 ! j ... ... [ Total ... 3,689 4 316 15 G 3j 1 2 ... ! ... j 50 jj 135 24 6-51 - :-]-¦ ¦— : I Darjeeling Depot ... $0 I ' •¦• ! •¦• ••• I Sikkim Field Force 562 ... I Hazareebaugh ... 846 1 .. ... ... 2 8 ... j ... ; Dinapore ... 783 !' 2 ... 1 3 I ... I 2 i Benares ... 737 I ... 1 1 i ... j 1 i •¦• I „ Rajghat ... 160 ; ... 2 1 ... j 3 ! ... j 8 Goruckpore ... 907 j j ••• Gonda ... 921 ... 1 1 ••• •¦• ¦•• ; ; Fyzabad ... 1,114 '" "' ... ... ... 3 ... ... "2 5 j ... j 1 i Eae Bareilly ... 648 ... ... I ••• I Lucknow ... 2,215 j 1 ... ... 2 6 9 ! ... ! 8 j Seetapore ... 682 i ... •¦¦ I ••¦ ••• , Futtehgurh (10 " j months) ... 434 j 11 ... 11 ... \ 5 Cawnpore ... 1.230 1 ... 8 9 10 19 ... • 1 ... 48 ... j 35 Allahabad ... 1,277 4 j 2 20 4 ... 2 j 32 ... j 21 „ General Hospital 113 1 1 ... 5 8 ... ... 1 ... I 16 , ••• | 10 Nagode ... 203 j .'.' ... ... 1 j 1 j ••• | ••• I ;Shahjehanpore I (9 months) ... 525 j , i ••• Bareilly ... 1,188 1 3 l ••¦ 5 Total ... 14,58ri~1~7 r~"5"~lF"l7~39"l 52 ™6~ 2 2 1 137 94, 86 5-90 - r A j Moradabad (9 months) 459 | 1 1 2 j ... | 2 j Nynee Tal ... 310 ••• ••• j I Landour ... 132 ••• ! Roorkee ... 588 ... 1 1 < ¦¦¦ ••• i i Meerut ... 2.535 | 1 1 ... 88 27 ... 1 H8 ••• 87 ; ... Delhi ... 1,327 ... ... 1 1 81 1 i 84 ... 50 ; Total ... 5,049 12 1~7 170 30 ... 1 j ... ... 205 : 4-OG ! 140 2773 \\ 1 I 1 II jj Muttra ... 347 10 9 I 19 •¦• 4 - j Agra ... 1,220 1 103 1 8 1 1 114 ••• f! \ Morar ... 1,106 I 64 j 133 13 ••• 210 ... 152 ... Gwalior Citadel ... 244 2 6 ... ... I 8 ... 7 Jhansi ... 623 ••• ••• ••• ••• | Lullutpore . 176 ••• •-• j ••• •• j] Nowgong ... 240 ••• ••• ••• ••• j Saugor ... 860 I •¦• ••• ••• ••• j Jubbulpore ... 861 ... 1 I 1 j ••• ! Total ... 5,677 ~* ~7 "77 ~ ~ ~T T79" 156 IT ~~Z ... 352 6"20 232 4087 | — .J 23 CHOLERA OP THE EUROPEAN ARMY OF IS6I —continued. Average Numbeb of Admissions into Hospital in each Month. Total Strength | al°a 1 °^ al Admitted Died DURING aumia pEB CBNT NUMBEB pbb 1 000 STATIONS. the pehiod du'riwg 0F 0F op occ°upa. Jan - Feb - Mar. April. May. June. July. Aug. Sept. Oct. Nov. Dec. the | j£™k. | *""' ta£££ TION. | » BAB - Umballa ... 1,820 10 57 4 71 | - 53 ¦ Dugshaie (7 months) 1,055 j Subathoo (8 months) 1,019 I ... ... | ... | ?" I KussoTvlie ... 223 ... ... ; ... ... i ' PhUkmr '.'.'. 125 Z Z ¦¦¦ ¦•• Z '.'.'. '.'.'. .'.'. .'.'.' "! Z '.'.' Z '.'. '.'.'. Z ! Jullundur ... 1,015 ... 1 ... 1 Ferozepore ... 889 ... ! ... 2 . • 2 ... 4 ... 1 ... i MeeanMeer ... 1,700 ... 661 64 725 ••¦ 450 . I ; Lahore Citadel ... 149 I ... 39 7 | 46 - 29 ...I ! Umritsur and Govindghur ... 481 50 50 ... 41 : Mooltan ... 734 ... ... | ... i 1 Dera-Ismael-Khan... 106 ... ... ..' j : Sealkote ... 1,494 1 1 Kangra ... 98 ... : Rawulpindee ... 1,846 | ... ¦ | ... | l Attock ... 184 ... ... ... I | Nowshera (11 months) 805 I Camphellpore (7 months) ... 339 ...I ... Peshawur ... 1,955 1 1 ... 2 Murree ... 229 ... | ... I Total ... 15,900 ... 1 210 757 128 ... 2 ... 900 5"66 574 36*10 I! | Bengal Pbesidenct 44,879 6 5232924 21 399 995 148 8 4 1 1,663 371 1,065 2373 I 94 CHOLERA OF 'HE EUROPEAN' AND NATIVE ARMIES AND JAILS, loOi-DO. NATIVE ARMY IN THE EPIDEMIC OF 1859-62. CHOLERA OF 1861. Number of Admissions from Cholera iit each Month. J°'* l Total ™ H STATIONS. , ~ o^l ; August 1861. j au _ F e b. Mar. April. May. June. July. Aug. Sept. Oct. Nov. Doc. Yeab. Yeah. Regiments on the march ... 5 3 4 3 8 7 ... 30 12 Bengal Proper and Assam — 1,059 Calcutta ... 2 4 ... 4 1 ... ... 1 1 1 ... I 14 5 963 Barrackpore ... 3 3 3 1 ... ... 10 4 334 Berhampore ... 1 2 ... ... ... ... * 169 Julpigoree ... ••• 2 4 1 1 ... ... ... 8 t» 240 Sylhet and Out-posts ... | ... 1 ... 5 6 <* 254 Dacca ... ••• 1 ! ••¦ ... ¦•• 4 jj % 302 Cherrapoonjee ... 1 1 ... ••• n2n 2 I ~ 343 Gowhatty ... ••¦ 1 23 ... 24 7 148 Gowalparah ... 1 ••• •¦• ••• __ •» 58 Tezpore ... - ••• ¦•• i Nor- None 816 Upper Assam ... 3 3 1 1 2 1 ... j 11 & Behar, Benaees, Oude, and Cawnpore — 493 Darjeeling ... 6 5 ... 2 ... ... ... M I 6 204 Dorundah ... ... 1 3" ... j J None 277 DehreeGhat ... 2 * 532 Dinapore ... ••• ... 1 1 ... 1 ••• 6 \ L 135 Segowlie ... ... ... ... ... ®on% W 686 Benares ... ... 1 ... 3 1 6 1 ... ••• " y 547 Jounpore ... ... - None ; None ; ! 618 Goruckporo ... 1 1 1 ... 1 ... 4 l 423 Fyzabad ... 1 1 ... - AT 2 one one-372 Gonda ... ll ••• None None 633 Lucknow ... ••• I ... ... 1 ••¦ ... 1 4'4 ' ••• - V v 1,018 Seetapore I ... ... 1 - ... - } I*™' 351 Futtehghur ... ... I ... 1 ... - ••• - J. None None-876 Cawnpore ... ••• ••• ... ... 1 8 9 ... 2 ... ••• | *> * \ 303 Banda ... - ... - ... 4 2 ¦¦• | J x j 378 Humeerpore ... ... ... 1 1 ... j AT 2 Tone-501T one one-501 Allahabad ... - j None - None - j Central India, Agra, Meerut, and eohilcund— 958 Erinpoorah ... ... ... None None 696 Sirdarpore ¦•¦ •¦¦ - ... ¦¦• • 1 - AT S 600 Kherwarrah '; ... ... ... - g one - em A None. None. SJ a"" »h I"" •- ¦"¦ N ° ne - None None-498 (jroonan ... AT AT 701 Lullutpore ... ® o™'0 ™' JJone. 532 Jhansi ! • N T one - JJ 963 Nowgong I ... ... ... •¦¦ - None - gone. 533 Jubbulpove - •» 1 1 ... I 2 None. 895 Deolee ... .. ... .. 1 1 v 2 S 755 Beaur ... ... - ... - - No^ 533 Ajmere ... ... • - 4 11 3 ¦•• ? -w 1,438 Morar ... 1 * None None-619 Agra ... ... 4 10 7 21 3 1,028 Delhi ... ... 1 3 ... 1 28 8 41 9 763 Meerut ... ... - 4 2 ° * 750 Deyrah ... ... 2 1 18 6 1 t 28 7* 363 Eoorkeo S° ne - ® One ' 345 Moradabad ... - None. 563 Almorah ... ® 0 ™- JJone. 824 BareiUy • •• oue - 1 ® one ' 600 Shahjehanpore | | None. None. ! i Carried over ... 9111722593161j 60 18 | 10 4| 9 | 311 105 * Goorkhas. CHOLERA OV THE NATIVE ARMY OF 1801 —continued. Number of Admissions ruoii Cholera in each Mouth. Total Totai i Stbength i Admis- n of STATIONS. : ¦ bionsofJ UK «ns I August 1861. Jan Feb Mar April May .j June _ July _ Aug _ Sept Oct _ Nov . Dea y ™E °^ E *w I Brought forward ... 9111722593161 60 18 10 4 9 311 105 j; 823 Umballa ... 4 j 4 2 887 Jullundur ... j None. None. { 512 Ferozepore ... 48 6 I 54 30* ; 1,187 Mooltan ... ..'. ... None. None. 640 Dhurmsala ... None. None. I 450 Goordaspore ... 1 1 \ 431 Sealkote ... < ... 1 1 ?, • ?, ... ['[ "' ... 1 None. 694 Meean Meer ... ' 38 2 1 41 16 f 260 Umritsur ... ' ... 16 *„ ,"' ... JigJ iq 10* 1 811 Eawulpindee ... None. None. ¦ 50 Murree ... ' None. None! ! 461 Attock ... ... j 1 1 None. 1,993 Peshawur ... ... ... ... ... 1 2 .. 3 1 I 8,747 Punjab Frontier Force ... 1 ... 2 4 ...8 1; 16 8 i 46,437 Aemy of the Presidency ... 9111725j59 33 63 102 89 18 12 10 448 173: ll_ II i 1 * Goorkhas. CHOLERA OF THE EUROPEAN AND NATIVE ARMIES AND JAILS, 1854-68. No. Hl] 97 JAIL POPULATION IN THE EPIDEMIC OF 1859-62. CHOLERA OF 186 1. AvEBAGE NIJMBEB OV ADMISSIOKS FROM CHOLEBA IIT EACH MONTH. AD*"S Admitted TOTAL jj lE]j j, eb JAIL STATIONS Stkength __ SIO nY "»«»*. »™ JAIJJ DlftllUMD, DTTBING „ „ OP THE c 0V °J StBENGTH. the Yeab. Jan. Feb. Mar. April. May. June. July. Aug. Sept. Oct. Nov. Dee. , Ykab Stbbngth. Yeae. Alipore ... 1,759 5 7 6 1 4 1 2 3 ... 1 30 ... 11 Baraset ... 184 1 ... 1 ... 1 1 4 ... 1 Jessore ... 540 2 ... 2 4 ••• <* Kisbnaghur ... 349 1 J Moorshedabad ... 156 1 *' ••• x Howrab ... 99 1 1 2 ••• ;•; Hoogbly ... 713 432 20 4 1 6 14 12 6 4 103 ... 15 Burdwan 7.. 567 2 5 12 1 11 ••• 3 Banfoorah ... 306 1 3 1 5 ... Purulea ... 224 10 5 15 | ... 9 Baneegunge ... 13 ••• I ••• ;•• Sooree ... 275 4 23 1 28 ... 17 Deoghur ... 120 j ••• ••• ••• •" Nya Doomka ... 75 ••• ••¦ ••• ••• ••• Eajmehal ... 196 1 6 ... 1 8 ... 3 Malda ... 39 2 1 3 ... ... Dinagepore ... 369 1 ..: 1 ... 1 3 ••• £ Eampore Bauleab ... 494 2 4 4 2 ... 12 ... | 6 Rungpore ... 293 1 1 ¦ ••• 2 ••• I 1 Bograh .„ 171 ••¦ i ••• ••• ••¦ Myniensing ... 555 ... 10 9 18 16 ... 53 ... 27 | Pubna ... 215 4 1 5 ... 3| Furreedpore ... 404 1 1 ... 2 ... ... 1 ... 1 1 1 ... 8 ... 1 Backergunge ... 293 1 5 1 2 1 4 14 ... 8 Noacolly ... 205 ... Chittagong ... 386 - ••• Tipperah ... 375 ... 1 1 - \ Wcca ... 543 3 4 ... 5 2 1 15 ... 6 Sylhet ... 356 ••• | Cherrapoonjee ... 40 ••• ••• -••• Cachar ... 116 ••• ... ... •• •¦• ••• ••• ••¦ •• Gowalparah ... 154 2 ... 1 2 ... 2 ... 6 Gowhatty ... 153 1 1 Seebsaugor ... 83 Nowgong ... 45 1 ••• ¦•¦ 1 ••• »" Tezpore ... 212 ¦•• ••• - Debroogbur ... 124 ••• 1 ••• \ Luckbimpore ... 25 6 6 ... 4 Midnapore ... 497 12 3 15 »• 5 Balasore ... 108 2 1 - 3 , Cuttack ... 238 - 1 •¦• 1 Pooree ... 21 •• - ••• i Sumbulpore ... 85 ... 2 ... 2 ... Cbyebassa ... 158 1 ... 1 210 2 16 1 ... 8 Eancbee ... 227 5 8 2 15 ... 12 Hazareebaugb ... 468 1 2 ... 3 I Mbnghyr ... 288 1 10 3 ... 3 17 .» J Bbaugulpore ... 362 33 1 ... 34 ... 14 Purneab ... 311 ••• •• •¦• ••• ••¦ Darjeeling ... 32 1 1 ••• l Total ... 14,021 7 1 81 109 93 49 39 18 22 42 26 14 451 322 178 12-69 Gya ... 374 2 7 1 10 I ... J Patna ... 394 2 31 33 ... 14 Deegab. ... 213 27 ... 11 11 2 51 ... 13 Arrab ... 445 1 1 ... 2 2 6 ... 3 Cbumparun ... 178 •• ••• ••¦ ••¦ ••• Mozufferpore ... 381 131 6 1 2 ... 41 ... 10 Cbuprab ... 326 1 ... 13 14 ... 7 Gbazeepore ... 688 ¦•• i ••• Benares ... 1,397 1 ... 1 _? ••• •>• — Mirzapore ... 275 1 218 21 ... 11 Azimgbur ... 263 1 ... 1 * Jounpore ••• 99 Carried over .., 5,033 3314123 77 1 ... 2 2 ... j 180 .... 62 ¦ 23 f 'IIOTjER A. OF THE EX. ROPt AN AND rIA 1 1 » -t* a*vjhiii Strength, tion. : Yeab. Presidency Hospitals & Chinsurah Depot 403 1 ... 4 11 3 5 15 ... 12 Fort William ... 880 ... 1 ... 7 2 ... 5 1 ... 16 ... 13 Barrackpore ... 768 *. Berhampore ... 296 1 ... 1 ... 1 ... Raneegunge ... 462 ... ... ... ..• Debroogurh ... 51 1 1 ... 1 ... Total ... 2,457 ... 1 1 7 3 ... 5 1 ... 18 j "73 15 6-11 Darjeeling Dep6t (8 months) ... 105 | Darjeeling ... 133 | Hazareebaugb. ... 1,101 1 1 ... 2 ... 1 Dinapore ... 655 1 1 2 ... 4 Benares ... 1,142 I 1 ... 1 ... ... Goruckpore ... 483 Gondab ... 787 Fyzabad ... 1,264 Eaeßareilly .... 587 Luckuow ... 2,093 1 1 2 ... I Seetapore „. 606 1 1 ... i ... Futtehghur ... 549 , I ... ... I ... Cawnpore ... 1,259 ... | ... I ... I Allahabad ... 1,107 i „ General Hospitals ... 95 I 1 12 ... 1 Nagode ... 236 ... ... ... ... Shahjehanpore ... 530 ... 1 1 1 3 ... 3* Bareilly ... 1,096 Total ... 13,823 1 1 2 2 3 1 ... 2 2 1 15 '11 5 -36 Moradabad ... 428 ... Loboogbat (8 months) ... 77 NyneoTal (8 months) 339 I 1 1 ... ... Landour (7 months) 201 ... ... ... ... I Roorkee ... 611 Meerut ... 2,038 1 ... 1 24 26 ... - 52 | ... 32 I Delhi ... 1,170 j ... i Total ... 4,677 1 ... 124 27 j 53 1-13 32 6-84 Muttra ... 502 ... j Agra ... 1,153 2 1 63 ... 66 ... j » Gwalior Fortress (10 months) ... 237 1 2 23 26 ... i 20 Morar .... 1,048 I ... 19 21 22 4 66 ... i 39 Seepree (7 months) ... 164 1 1 ... j 1 Jhansi ... 767 11 40 51 ... 37 Nowgong ?. 251 Saugor ... 832 | ... I ... Jubbulpore ?. 847 •¦• ¦•• ••• ••¦ Total ... 5,695 1 ... 2 33 148 22 4 210 369 146 25-64 ? These three cases belong properly to the cholera of the province lying to the west. 24 CHOLERA OP THE EUROPEAN AND NATIVE ARMIES AND JAILS, 1854-68. I A. odbti ri i t CHOLERA OF THE EUROPEAN ARMY OF 1862— continued. AvBBAGB NCMBBB OP ADMISSIONS INTO HOSPITAI IN BACH MONTH. TOTAL ADMITTED STBENGTH AdMIS " i PEB CENT. NuMBEE *?IE»? IE » «« STATIONS. "pZTo" »"«"» A yma.c» Deaths. A««aS« occupa- Jan. Feb. Mar. April. May. June. July. Aug. Sept. Oct. Nov. Dec. the s TBBNQ t H . Stbengtu. tiok. Ybab - I Umballa ... 1,767 I 4 4 I ... 2 Camp Umballa ... 293 Dugshaie (9 months) 914 ••• ••• •" ••• Subathoo ... 810 Kussowlie (7 months) 422 I Phillour (8 months) 218 Jullundur ... 1,165 ••• ••¦ ••' MeeanMeer ... 1,362 1 87 38 2 128 ... 68 Ferozepore ... 967 1 4 5 ... | 4 Lahore Citadel ... 154 5 4 1 10 ... I 0 Govindghur and Urnritsur ... 532 I 2 11 17 30 ... 15 Mooltan ... 1,117 1 1 Dera-Ismail-Khan ... 98 ••• ;•• ••• Sealkote ... 1,438 5 9 14 ... 10 Kangra (8 months)... ]10 ••• ' ••• Dhurmsala (7 I months) ... 43 ••• •" ••• •¦• | Jhelum (7 months).,. 156 Eawulpindea ... 1,591 1 1 i Campbellpore(6 months) ... 350 ••• ••• ••• ••• Attock ... 195 Nowshera ... 722 ... 2 2 ... 2 Peshawur ... 1,970 73 14 13 63 5 ... 168 ... 97 Murree (7 months)... 296 ••• ••• ••• i Total ... 15,930 ~ ...... 2~ 6 ... 74 129 81 65 5 1 363 228 203 j 1274 I Bengal Pbesidency 42,980 2 2 7 14 13 4 136 306 103 69 11 7 674 T57 413 961 CHOLERA OF THE EUROPEAN AND NATIVE ARMIES AND JAILS. 1854-68. NATIVE ARMY IN THE EPIDEMIC OF 1859-62. CHOLERA OF 1863. Numbeb of Admissions from Cholbba in bach Month. Total Total Strength of stations — Admissions Deaths JULT 1862. BiAiiuniD. op IHB | ov THH Jan. Feb. Mar. April. May. June. July. Aug. Sept. Oct. Nov. Dee. Yeab. Yeab. Bengal Peopee and Assam — 700 Alipore and Calcutta ... 1 1 3 5 ... 4 4 3 21 10 1,352 Barrackpore ... ... 1 ... 1 3 1 1 ... 7 I 1 303 Berhampore ... 3 3 1 1 961 Julpigoree ... ... None. None. 564 Sylhet ... 2 2 4 None. 811 Cherrapoonjee ... 1 1 2 2 1,360 Gowhatty and Lower Assam 4 ...... 4 2 1 1 2 14 6 1 683 Upper Assam ... 5 4 1 1 11 3 Behab, Benaees, Oude, and Cawnpore— 492 Dorundah ... None. None. 418 Dinapore ... 11 2 2 3 ... | 9 2 377 Segowlie ... 1 ... ... ... I 1 None. 470 Benares ... ... None. None. 566 Jounpore ... ••¦ ... „ None. None. 388 Goruckpore ... ... None. None. 640 Fyzabad ... ... ... • ... None. None. 1,316 Lucknow ... 2 2 None. 1,050 Seetapore ... 1 1 1 1 ... ... ... 4 None. 488 Allahabad ... 1 1 2 1 817 Cawnpore ... 11l ' 3 None. 650 Nagode ... '. ... 1 1 I None. 633 Banda ... ... ... None. I None. 589 Humeerpore ... „ None. None. EOHILCTTND AND MeEEUT— • 688 Skahjehanpore ... None. None. 742 Bareilly ... - None. None. 336 Moradabad ... None. None. 346 Roorkee ... ••• None. None. 1,103 Meerut ... ... 7 * 2 291 Allyghur ... 1 1 1 598 Delhi ... ••¦ 11l I 3 I 1 752 Deyrak ... 3 ... I 3 1 3 709 Almorah ... »• 2 ... 2 1 Centeal India and Agba— 477 Augur ... ••• ... 1 1 ... 2 ! None. 499 Goonah ... ... ••¦ None. None. 707 Kherwarrah ... ... ... 1 1 1 624 Sirdarpore ... ••• None. None. 904 Deolee «• ••• None. None. 953 Erinpoorah ... ••• - None. None. 682 Agra ... ••• 1 ... 1 1 ... | 3 None. 1,629 Morar ... ¦••2 14 7 5 795 Jhansi ... ••• ••• 2 2 1 486 Nowgong ... ••• None. None. 633 Lullutpore ... ••¦ ••• None. None. 651 Simla Hills ... ... ••• None. None. 484 Kurnaul ... •¦• ... - None. None. 979 Umballa ... 1 1 6 8 8 210 Jullundur ... ¦•• None. None. 660 Ferozepore ... ¦¦• None. None. 1,001 Mooltan ... ... ••• ... None. None. 646 Dhurmsala ... , 3 3 1 400 Sealkote ... ... ••¦ 3 3 None. 614 Meean Meer ... ... ••• ... 1 5 5 H 449 Umritsur ... ... - 4 4 2 1,056 Rawulpindee ... ••• None. None. 2,908 Peshawur ... 1 ... 13 .. 1 21 2 ... 38 22 749 Rawulpindee District ••• 1 I 1 M Feontiee Foece — f Abbottabad ... ••• ... 1 , 1 None. Murdan ... - ... ... 2 2 None. Kohat ... ... 1 8 31 12 52 25 Iftra , Bunnoo ... 17 27 l 45 18 iu.oo-ls Dera-Ismael-Khan ... None. None. Dera-Ghazee-Khan ... None. None. Raianpore ... ••• None. None. fc Tat ... 1 2 3 3 On Board Steamers on Ganges and Bhurmpooter 1 23* 11 26 19 | Onthemarch ... 4 ••¦ 1 5 2 . 51,040 Abhy of the Peesidenct ... 2 11 13 32 78 26 52 31 16 38 12 6 317 '147 • The 25th Native Infantry on the Ganges. Cholera broke out on the day on which the Steamer left Mirzapore. cv i CHOLERA OP THE EUROPEAN AND NATIVE ABMIES AND JAILS, 1854-68. [ Appendix I JAIL POPULATION- IN THE EPIDEMIC OF 1859-62. CHOLERA OF 1863. AVEBAGB NCMBEE OS ADA DM ISBIO»S INTO HOBPI.AL I* WCH MOKTH. j£™£ Dim,,, jail stations - ::i:: Jan . ™. Mar . **. *? .^r^. ** «* ** n &£ AHpore ... 1,823 8 15 4 5 6 2 7 1 6 2 56 ... 13 Baraset ••• 136 Jessore ••• 621 Kishnaghur ••• 506 ••• ... ••• •¦• "J "j Moorshedabad ... 187 ••• ... ••• l — ¦•¦ * SSt ::: ™ "i "* »m 'i ::: a s "a a i "2 126 v -r, P J -a.n 10 i ..." 14 ... o ... Burdwan ... oby lo ••• 1 k , Bancoorah ... 367 1 ... ••• 1 ••• ¦ i , I "" "' '"" Purulea ... 200 ... ... X Raneegunge ... 18 ••• ... •¦• Sooree ... 261 ••• ... ••• "« "j Deogbur ... 75 1 ••• ... 2 - •¦• : - , 6 , '" q " # ' Rajinebal ... iB2 ... 1 2 7 - 1 2 - 1 - X J "' ? Maldah ... 53 1 ... i '" X "' Dinagepore ... 480 ••• ... I 9U "c Rampore Bauleah ... 444 1 ... 1 23 1 ... •• *« Rungpore ... 459 1 ••• ... ... *¦ Bogi-ah ... 191 .. ... ... "", Mymensing ... 403 1 ... ... ... ••• •'¦: Pubna ... 142 1 ••• ... •" '•¦ 10 o Purreedpore ... 433 ... 1 6 2 ••• ... ••• l | \.i \ '" %_ Backergunge ... 447 3 6 4 ... Lti j Nbacolly ... 208 ••• ... : - " "a I Chittagong ... 3 8 5 ... ... 1 ... ... ... 1 ¦¦¦ Tipperah ... 475 ... ... ¦ :•• 'U Dacca ... 441 ... ... 3 1 ••• 1 ••• 5 f' "• J Sylhet ... 435 ... ... ... 838 ... - 2 ? Cherrapoonjee ... 27 ••¦ •¦¦ "" "q '" "a Cachax ... i 66 2 4 J ... ••¦ J - g Gowalparah ... 199 ... ... ... 1 1 ... l ' A '" a '" W Gowhatty ... 159 | ... ... ... ... ... 4 .. 4 ... 4 Seebsaugor ... iql ••• ... ••• Nowgong ... 64 ... ... ... ... • Tezpore ... 181 j - - ••• ••• ¦•• I YA "* Debrooghur ... 373 ... 3 2 6 1 I Vi ' Midnapore ... 433 ... ... ... ... ••• ¦" Balasore ... 128 I •¦• * I o " 1 Cuttack ... 292 1 1 ¦•¦ ... 2 ... 8 j - J Pooree ... 19 ... ... ,„ 1 ••¦ | r Sumbulpore ... 15^ Itj 1 ••• 1 I Chyebassa ... \qq ••• ••• "" I Ranchee ... 210 ... ••• ••¦ '" "' '" Hazareebaugh ... 070 ... ... ••• j ••• ••¦ ;•; Monghyr ... g Z ... .1 25 ... ... 1 - « ~ JJ ~ Bbaugulpore ... 334 ... 27 ... 1 — ii Purneah ... 454 j 1 ... ... j i - Darjeeling ... 26 I Total ... 14,695 6 5 56 174 57 16 25 27 13 18 18 12 427 j 2-91 j 147 10-00 I Gyah ... 421 1 1 * j - J Patna ... 398 10 J ? ...3 Deegah ... 149 3 i 3 An-ab ... 443 Chumparun ... 191 Mozufferpore ... 401 Chuprah ... 324 1 ... 1 1 1 2 ... 1 7 Gbazeepore ... 650 I 1 '•¦ ••• ••• Benares ... 1,718 1 ¦•• ... 1 Mirzapore ... 320 1 '" ••• ¦" Azimghur ... 425 1 ... 1 Jounpore ... 280 Goruckporo ... 737 ... Gonda ... 55 Carried over ... 6,512 1 ... 2 2 2 14 ... 4 ... 1 26 ... 6 CHOLERA OF THE JAIL POPULATION OF 1862— continued. ?,„,., Numbbb of Admissions into Hospital in each Month. Total j Admitted j -rOTALr 0TAL Dted per SMENOTH ADMIS " i PEK ° ENl|! - ni=ATHS I 1,000 OF JAIL STATIONS. jor*he SIOIfS .° F of the Avkhagk Yeab. Jan. Feb. Mar. April. May. June. July. Aug. Sept. Oct. Nov. Deo. EE ™ E ' s^enoth. I Yeab - Stren(}th \ Brought forward ... 6,512 1 ... 2 2 214 ... 4 ... 1 26 - | 6 Baraitch ... 118 1 1 ¦•• 1 Fyzabad ... 766 1 1 | Sultanpore ... 498 Eae Bareilly ... 172 ¦•• Pertabghur ... 133 ... ••¦ j Hurdui ... 98! ... I Luckhimpore ... 79 , 2 2 Durriabad ... 85 1 1 •¦• 1 Alumbagb. ... 921 1 1 2 ... | Oonao ... 95 2 i 2 ... I ... Lueknow ... 882 1 ... 1 ... 6 1 | 8 j ... ... j ... ; Seetapore ... 428 I 2 ... 1 3; ... 2* ... Etah ... 173 I Humeerpore ... 93 j .. ... Oraie ... 104 i Futtehghur ... 520 •¦¦ I ••¦ ••¦ I Cawnpore ... 245 ••• ••• ••¦ I Banda ... 163 I ••• j Nagode ... 85 Allahabad ... 1,979 ... 1 1 I 2 ... 1 Total ... 14,149 ... 2 6 9 3 3 316 ! ... 5 ... 1 48 j 34 11 -78 l i Raepore ... 505 28 1 29 ... 11 Bandhara ... 302 j ! Chandah ... 126 j ••• : ••• | j Nagpoi'e ... 574 1 1 | ••• 2 j Chindwara ... 181 ... j ••• •¦• ; Kowtah ... 78 i, •¦¦ ! ••¦ Mundla ... 63 ... 7 ... ! ... j 7lj ••• j 3 Jubbulpore ... 1,124 ••• ••• j Dumoh ... 150 ! j j Saugor ... 379 1 ... ! ••• ••• I Nursingpore ... 249 ¦•¦ ••• I Lullutpore ... 129 ...... ¦•• ••• Jhansi ... 134 | ... I i ••• j ••• I ••• Seonee ... 278 ... j ••¦ j Baitool ... 182 ! ••¦ I Sehore ... 38 \ ¦•• ••¦ j Hoshungabad ... 276 I ... j Mundlaisir ... 165 : ... ! | ......... •¦• ••¦ j ••¦ i Ajmere ... 235 5 7 11 i I 23 ••• j l \ Beam- ... 148 ... ... 2 j « j ... j 1 ! Total ... 5,316 ~7 ~~ ~ ... 543 15 ........... 63 M 9 26 4-89' ' ' -- Muttra ... 88 i ¦•¦ I ¦•¦ ' ;•¦ Agra ... 2,209 23 23 ... j 12 | „ Secundra ... 332 ••¦ ••• j Etawah _ ... 107 | ; ••• ] - j ¦" Mynpoorie ... 210 ••¦ ••• I Allyghur ... 246 | ••• ! Bolundshuhur ... 192 i | I ••• j ¦•¦ j ¦•• l| Shahjehanpore ... 363 | ,' ... < ¦•• ••¦ j •¦• |] ••• . •¦• Bareilly ... 1,768 I i Budaon ... 201 | » Seharunpore ... 133 I ••• ¦•¦ | Bijnour ... 162 1 ... j ! ••• i 1 j ••• | ••• Deyrah ... 53 ! ¦•¦ ; ••• I ••• | •¦¦ | Almorah ... 11l 4 6 | ••• -10 I ... 0;, Mozuffernuggur ... 93 ... ••• ¦•• i ••• i Moradabad ... 286 •¦• j ••¦ ' Meerut ••• 1,342 I ••• J ••• ' ••¦ I Delhi ... 424 j ! Goorgaon ... 41 Total ... 8,361 I 4 723 34 j -41 | 17 j 2-63 j * Returned as cholera biliosa. I . . — ? v — CHOLERA OF THE JAIL POPULATION OF 1862— concluded. ...... Nombee of Admissions into Hospital in bach Month. Total Admitted ToTAt d ibd PEE I AvKKAtus ADMIS- PER CENT, DEATHS 1 000 OF JAIL STATIONS. 8t ™ (WH " " "^ Av £ AM o- the Avbbage thbYeab. Jan. Feb. Mar. April. May. June. July. Aug. Sept. Oct. Nov. Dec. °?? E ™ B | S imngth.| Yeab " S™™"-! Rhotuk ... 261 • ¦•• I •¦• Hissar ... 259 ; 5 5 ••• j f Sirsa ... 344 1 ••¦ i Kurnaul ... 54 1 1 ••• ¦•¦ | Umballa ... 539 •¦• ••• I Loodianah ... 204 1 % . 1 ¦•• l Jullundur ... 303 | Ferozepore ... 401 ... Umritsur ... 585 ••• ¦•• ¦•¦ Lahore ... 2,109 1 81 12 94 ... 41 Sealkote ... 277 33 33 I ... | 10 Dhurnisala ... 173 ... 1 3 4 ... I £ \ Goordaspore ... 277 •• ••• ;•• I Goojranwalia ... 430 49 2 51 ... 16 Goojrat ... 317 ... Shahpore ... 268 ... Jhelum ... 311 ... ... 3 3 Googaira ... 350 ... Mooltan ... 880 ... Jhung ... 341 Dera-Ghazee-Khan . . . 34 Dera-Isinael-Khan . . . 312 ••¦ •¦• ••• I Kohat ... 114 1 1 Bunnoo ... 67 Eawulpindee ... 764 , ••• ¦•• ••• Peshawur 371 j 23 23 46 ... 23 Total ... 10,345 ... ...... 1 3 7 25 163 17 24 240 232 93 8"99 Bengal Peesidenct 52,866 6 7 62 184 63 35 103 244 30 47 18 13 812 T54 294 5"56 \ No, » EPIDEMIC OF 1863-66- First Year, 1863. — Cholera epidemic from the east, invading and confined to the eastern division of the epidemic area : entering the Central Provinces and occupying the southern epidemic highway in June and July. Second Year, 1864. — Cholera generally revitalised over the eastern area, but repressed from active manifestation by the peculiar meteorology of the year : absent from the Northern Provinces, which remained uninvaded in 1864 : in the south, universal throughout the Central Provinces in every station on the southern epidemic highway. Third Year, 1865. — Cholera still general over the eastern area: still universal and in force as a great epidemic in the Central Provinces, which were covered from sea to sea : invading the western area from the southeast, but confined as a powerful epidemic to the districts south of the Jumna, in which the mortality was very great. An offshoot from the body of cholera epidemic to the south of the Jumna, which was weak in itself and was checked in its progress towards the north-west, entered Meerut and Rohilcund in May, and remained in vitality until November. Fourth Year, 1866. — Cholera dying out throughout the Central Provinces : nearly extinct over the eastern area in the districts unaffected by the new epidemic of the year: nowhere in epidemic strength in the western division of the epidemic area. The cholera history of 1866 embraces the details of two separate epidemics — of the dying epidemic of 1863-66, and of the new epidemic invading from the east, between July and November, chiefly indicated in these Tables by the Statistics of the Jail Population of the Behar Provinces. EPIDEMIC OF 1863-66. CHOLERA OP 18 63. GENERAL INDICATIONS OF DISTRIBUTION AFFORDED BY THE TABLES OF 1863. See Map of 1863. Cholera epidemic from the east, invading and confined to the eastern division of the epidemic area : entering- the Central Provinces and occupying- the southern epidemic highway in June and July. The universality of the eastern invading cholera of 1863 is thoroughly illustrated in the Tables for all the types. As Jhansi was the last district lying to the west reached in the eastern invasion of 1855, and Jaloun in the invasion of 1859, so in 1863 Agra was the station lying furthest to the west touched by the invading cholera. This limit is illustrated in the Tables for all the three types; and even the day of the invasion was typical, for as in previous epidemics, the jail at Agra was first struck on the 20th May. The three fatal cases at Kohat and Abbottabad in April, shown in the Table for the Native Army, were apparently derived from the remains of the great frontier cholera of 1862. Elsewhere, the cholera of J 860-62 is exhibited as dead throughout the western division. In the Jail Table, the invasion of the Central Provinces in June by the cholera invading from the east, and the general occupation of the southern epidemic highway, requires specially to be noticed, as showing the origin and date of invasion of the great cholera of the Central Provinces of 1864 and 1865. Ijj Oj lIIJ cholera op the eukopean and native armies and jails, 1854-68. cxiii I CHOLERA OF 1863. AvEBAGE | NIJMBEB OF ADMISSIONS INTO HOSPITAL IN EACH MONTH. ToTAt Stbbngth I *,?„„ Admitted n DURING A ™ IS - PEBCENT. NUMBEB D ™ PKK STATIONS. THEPBKIOD duewo OF OF ' ° F occ°cpa- Jan - Feb " Mar - A P riL Mfl y- June - Ju] y- Au &- Se Pt- Oct - Not - Dec - D me * ss A Jength. Deaths - Strength. TION. YEAB. Presidency Hospitals & Chinsurah Depot 402 j 1 2 1 4 ... 4 Troops and Invalids on the march ... . . . i Fort William ... 745 1 ... 1 2 1 ... 5 ... 4 Dum-Dum(9 months) 648 1 I 1 I ... l Barrackpore ... 439 ; 1 1 2 ... 1 Berhampore ... 223 ... 1 1 Total ... 1,893 ... 1 1 2 1 ... 12 1 ... 9 , -48 6 3"17 Darieeling Depot (8 months) ... 10 ° ! Darjeeling ... 246 ! i<( _ _ _ #<< Hazareebaugh ... 730 2 1 3 ... 3 Dinapore ... 925 1 1 ... 1 1 4 ... 3 Benares and Rajghat 1.210 1 ... 1 12 26 2 2 44 ... 35 Azimghur&Jounpore 336 Gondah ... 815 I „, Eae Bareilly (10 months) ... 402 ... Lucknow ... 2,420 ... 23 15 1 7 46 | ... 25 Seetapore ... 592 ... , ... Futtehgurh ... ' Cawnpore ... 1.162 ... 10 6 1 17 ... *24 Allahabad ... 1,054 j 1 3 ... 26 24 I 54 ... 44 „ General Hos- Nagode ... 214 ... j Shahjehanpore ... 539 , Bareilly ... 916 Total ... 13,099 4 ... 2 14 3 1 79 55 9 8 175 134 136 1038 j | Nynee Tal (8 months) 283 ?. j ! Landour (7 months) 216 ! Roorkee ... 587 | Moradabad ... 393 I Meerut ... 2,024 j Gwalior Citadel ... 241 ... ... ... ... I I Morar ... 1,192 Seepree (8 months) ... 164 i Jhansi ... 742 I Nowgong ... 215 I Saugor ... 845 1 i ... ii§ Total ... 5,860 1 21 13 35 -59 21 3"58 • Seven deaths from Choleraic Diarrhoea have been included in the mortality from Cholera. CHOLERA OF THE EUROPEAN ARMY OF 1863 —continued. _ ~ Avbbagb Numbbb of Admissions into Hospital in each Month. Total »«™™™« s =r r*i -p »™»hw? STATIONS. THEPEBIOD DURING A°* DEATHS DD A VBBAGE OCCOTA- jEn - Feb> Mar - ApriL May- JUne< JU ' y- AUg ' SePt> ° Ct ' N<>V ' De °' T ™E STBBH-QTH. ' SIBMGTH - TlOJf. Umballa ... 1,683 1 1 ¦•• 1 Dugshaie (10 months) 825 Subathoo ... 860 • ¦•¦ Kussowlie (6 months) 242 „ Depot ... 402 ' PhiUour ... 90 Jullundur (11 months) 787 Ferozepore (11 months) ... 838 ••¦ — I Meean Meer (10 months ... 1,363 Lahore Citadel ... 153 Umritsur and Govindgurh ... 409 ••• ••¦ "• Mooltan. ... 1,042 | Dera Ismail Khan ... 96 , •• • •• • " ' Sealkote (10 months) 1,318 ••• Kangra ... 93 I Dhurmsalla ... 30 ••• ••• ••¦ ••• Jhelum ... 74 • • • • ¦ • RawulPindee(B 1 months ... 1,652 1 1 ¦¦¦ x \ Campbell pore (6 months) ... 347 I ••• j Road-making Detachment ... 200 j I Attock ... 148 I I I Nowshera (9 months) 659 ••• i Peshawur ... 1,720 j j Murree (7 months) ... 363 ••• ••• ¦•• ••• Cheerat (s months)... 409 Eusufzaie Field Force Total ... 15,660 1 ... 1 2 -01 2 "13 Bengal Peesidency 41,351 4 1 317 3 2 101 69 10 11 3 1 225 -55 | 169 409 CHOLERA OF THE EUROPEAN AND NATIVE ARMIES AND JAILS, 1854-68. NATIVE ARMY IN THE EPIDEMIC OF 1863-66. CHOLERA OF 1863. Number of Admissions prom Choleba in each Month. Total Ad- Total Stbength missions Dbaths of Stations. OF THE op THE August 186 S. Jan> Peb> Mar _ April May> June Ju , y Aug gept Oct Nov _ Dec ybab. Ybab. Bengal Proper and Assam — 646 Fort William ... 1 1 1 5 3 8 ... ... ' 2 ... 21 8 600 Alipore ... ... ... ... ... I None None 1,2C2 Barrackpore ... ¦¦• ... ... ... 2 2 9 "5 2 I 20 10 440 Dacca ... ¦¦• ... •- ... ••• ... None None 485 Chittagong ... ... ... ... ... 1 ... ... ... ... 1 1 782 Sylhet ... • • ... ... ... ... None None 647 Jowaie ... ... ... ... ... 1 ... 1 1 661 Gowhatty ... ... ... ... ... 2 1 ... 1 4 1 ... 9 3 576 Cherrapoonjee ... ... ... 1 3 1 ... 12 2 ... 10 2 675 Upper Assam ... ... ... ... ... ... None None 1,085 Julpigoree ... ... ••¦ ... 3 I 4 None 424 Bhaugulpore ... ... ... ... ... None None Behar, Benares, Oude, and Cawnpore — 578 Dorundah ... ••¦ ... None None 670 Dinapore ... •¦¦ 1 2 1 2 1 1 ... 1 9 1 380 Segowlie ... ••• ... None None 563 Benares ... ... ... ... ... 1 1 1 1 3 ... 1 8 5 533 Goruckpore ... ... 2 ... 2 2 578 Fyzabad ... ... ... ... ... None None 1,717 Lucknow ... ... ... j 4 3 1 ... 1 ... 9 2 483 Seetapore ... . •¦• ... I ••¦ ... None I None 449 Futtehgurh ... ... ... ... ... ... 1 ... ... ! ... ... ... 1 None 594 Cawnpore ... ... ... 1 ... 1 ... 1 ••¦ ... 3 1 347 Banda ... ... ?. ¦¦• ... •¦• ... None None 455 Humeerpore ... ••• ... ... ... ¦•• ... None None 602 Nagode ... ... ... • 1 ... 1 ... ... ... ... 2 1 643 Allahabad ... ... 1 3 1 2 ••¦ ... 7 4 ROHILCUND AND MeERTTT — 365 Shahjehanpore ... ... None None 1,146 Barellly ... ••• „ ¦•• ... None None 376 Koorkee ... ... ••• ... None None 587 Almorah ... ... None None 129 Deyrah ... ••• ••• ... None None 732 \ Moradabad ... 1 „ None None ( Allyghur ... J '" 482 Meerut ... - 1 ••• ... 1 None | 683 Delhi ... ... ... None None Central India and Agra — 499 Augur ... None None 498 Goonah ... ... None None 707 Kherwarrah ... ... 1 ¦¦¦ ... 1 None 611 Sirdarpore ... None None 1,488 Deolee ... ¦¦¦ •• ... None None 953 Erinpoorah ... ... None None 704 Agra ... ... 2 2 1 1,154 Morar ... ... 1 ••• ... 1 1 1,054 Jhansi ... None None 488 Nowgong ... ... | None None 685 Lullutpore ... ••• I None None CHOLERA OF THE NATIVE ARMY OP 1863— continued. Stbmtgth Number of Admissions itbom Choleba in each Month. J Total ToTAL of Stations. missions Dsaths Jan. Feb. Mar. Apl. May. June. July. Aug. Sept. Oct. Nov. Dec Yeab. Ykae. Brought forward Punjab — 666 Simla Hills ... None None 719 Umballa ... None None 948 Jullundur ... ... None None 708 Ferozepore ... • I None None 475 Umritsur ... ... j 1 1 None 673 Dhurmsalla ... None None 777 Meean Meer ... None None 918 Mooltan ... ... | None None 1,087 Eawul Pindee ... , j.. ... None None 4,675 Peshawur ... None None Kohat ... ... I ... ... .. 3 1 | 4 2 Bunnoo ... 11l I 2 ; None Murdan ... None ; None 1034 9 -! Abbottabad ... 1 1 j i ' "'] Dera Ismail Khan None None Dera Ghazee Khan None None I Rajanpore ... None i None I Tak ... I None None j I Troops on the march ... 2 j ... ... 14* 16 ! 11 52,144 Akmy of the Phesidency ... 4 3 ] 4j 21 10 21 11 25 111 ; 6 6 14 136 57 ! ! ' j * Goorkha Company of 9th N. I. on the march from Fyzabad to Luoknow. 116 CHOLERA OF THE EUROPEAN AND NATIVE ARMIES AND JAILS, 1004-00. ( 1 1 1111 1 1 I " 1 1 \ OF THE FUR OT*E AN AJfl D NATIVE Alt 51 1 FS A^D JATI In^ l-n8 JAIL POPULATION IN THE EPIDEMIC OF 1863-66. CHOLERA OF 186 3. AvEHAGE NDMBEH OF ADMISSIONS INTO HOSPITAL IN EACH MONTH. TOTAL ADMITTED ToTAt DIED PBB TATT B opoccu- I Jan. Feb. Mar. April. May. June. July. Aug. Sept. Oct. Nov. Dec. BlOirs - «£j"£™ Dbathb - Stbbngth. PATION. DTBEHOTH. Hospital Ship Bentinck ... 74 Kidderpore Hospital 1 1 1 2 ... 5 ... 3 Chinsurah Dep6t 1 3 ... 4 ... 3 Allahabad General Hospital ... 37 ... 1 2 ... 1 1 ... 1 ... | 6 ... 5 Invalids, Recruits, and Time-expired men on the march ... ... Port William ... 790 ... 2 ... 1 1 1 ... 8 7 I ... 2 1 Dum-Dum ... 592 ... 1 ... 1 2 ... 1 I Barrackpore ... 455 1 2 3 ... 2 Berhampore ... 202 ... ... Bhootan Field Force Total ... 2,002 ... 3 1 4 1 1 ... 2 12 -60 5 2-50 Sinchal, Darjeeling... 219 Darjeeling Dep6t ... ]44 Hazareebaugh ... 938 Dinapore ... 968 I 1 5 1 ... 1 8 .. 5 Benares ... 1,081 I 114 1 7 ... 6 Jounpore ... 149 Azimghur ... 198 1 1 ... 1 Fyzabad ... 964 1 1 ... I 1 Raeßareilly ... 333 | Lucknow ... 2,470 54 1 j 55 I ... 39 Seetapore ... 653 Futtehgurh ... 551 I ... ... Cawnpore ... 1,131 1 ... 4 1 6 ... 6 I Allahabad ... 950 2 11 13 ... 112 Nagode ... 198 ... ... I Total ... 10,333 2 2 2 2 9 6 66 2 91 -88 70 677 Shahjehanpore ... 539 Bareilly ... 881 1 1 ... 1 NyneeTal ... 279 I Landour ... 188 Moradabad ... 337 Roorkee ... 546 , I ... ... I Meerut ... 1,880 I Delhi ... 964 I ... | Muttra ... 503 ... ... I Total ... 5,950 1 1 -02 l -16 Agra ... 1,036 Morar ... 1,051 I Gwalior Citadel ... 207 | Seepree ... 148 Jhansi ... 686 ... ... ... ... ft Nowgong ... 213 I 1 1 ... I 1 Saugor ... 817 I ... 1 1 2 ... 2 Jubbulpore ... 757 1 1 Total ... 4,854 1 1 ... 1 1 4 -08 3 -62 CHOLERA OF fHB WmOPEAK AND NATIVE ARMIES AXD JAILS, 1854-63. CHOLERA OF THE EUROPEAN ARMY OF 1864— continued. Avehaoe Numbsb of Admissions htto Hospital in each Month. Abkittbd I D __ I STBESGTH ' . j TOTAL PKB CBNT. NUMBBB ! I^)^_ B BTVTION9 Dcmifo Admib- or ow I aVmai™ ™™T Jan- Feb. Mar April. May. June. July. Aug. Sept. Oct. Nov. Dec. «<>"¦ I ££££ D^ ras - W pAiioir. Umballa ... 1,635 ... ••¦ | ••¦ - | ' ••¦ Dugshaie ... 799 •••. | Dugshaie DepBt ... 53 ... ••• . •*' ; Kussowlie ... 236 ... • ••• ••¦ . Kussowlie DepBt ... 402 ... ••• i ••• ••¦ Subathoo ... 882 Phillour ..: 105 ... . ... - Jullundur ... 893 i Ferozepore ... 890 Mooltan ... 934 ... ... ••• Dera-Ismael-Khan... 98 I Sealkote ... 1,319 j ... Kangra ... 123 •• ••• Umritsur ... 601 Fort Lahore ..; 132 - — I Meean Meer ... 910 1 ... 1 ¦•• •*¦ Rawulpindee ... 1,671 ... Campbellpore ... 423 — ••• ••¦ ••• Attock ..: 145 | Murree Convalescent Dep6t ... 316 Road-making Detachments, Murree Hills 605 Nowshera ... 807 Peshawur ... 2,012 I ••• — ••• I Nundcote Dep6t .„ 103 I "' ••• ••• I Troops on the march (Punjab) Total ... 15,886 | ... 1 1 ... 1 '°6 Troops on the march, i Bengal and N.W.P 9 15 24 ... 12 Bengai, Pbesidency 40,385 ... 5 15 22 5 4 10 6 68 5 6 2 148 -33 103 2"55 CHOLERA OP THE EUROPEAN" AND NATIVE ARMIES AND JAILS, 1854-68. No NATIVE ARMY IN THE EPIDEMIC OF 1863-66. CHOLERA OF 1864. ._„„.-,. NUMBEB OP APMISSIOITS FBOM CHOIEBA IV EACH MONTH. TOTAL JVV.BICA.UJfi AIJAII9* Til? » Til ' Strength STATIONS. 1 1 ~~ SIONS O ;in 'ybab! B Jan. Feb. Mar. April. May. June. July. Aug. Sept. Oct. Nov. Dec. °Yeab? Yba». Kegiments marching ... 3 2 3 1 ... j 9 2 Bengal Peopee and Assam — 388 Fort William ... ... 1 ... 13 2 ... 16 6 576 Alipore ... 4 2 1 ... 1 8 1,341 Barrackpore ... 1 ... 4 1 2 8 3 171 Berhampore ... ... | •• None. ® on %\ 584 Dacca ... ... I 9 6 9 4 112 7 1 4O 21 333 CMttagong ... ... I None, i None. 412 Cherrapoonjee ... ... ... 1 T 1 168 Cachar ... ... None. None. 455 Sylhet ... ... 10 1 1 ¦¦¦ 1 ••• !•* 10 , ]88 Gowalparah ... 2 361 Gowhatty ... ... 2 1 2I XT 5 __ 2 139 Nowgong ... None. None. 210 Tezpore ... None. None. 647 Debrooghur ... ... 1 ... 1 ... 1 i 3 None. 883 Julpigoree ... ... 5 ... ••• • t jj J 1,922 Bhdotan Force (2 months) ... 5 2 7 d Behae, Benaees, Oude, and Cawnpoeb— 602 Dorundah ... ... 465 Bhaugulpore ... ... ! 587 Dinapore ... ... j 1 4 5 1 355 Segowlie ... ... I ••• •• 551 Benares ... ... 11l ••• . d 630 Gomckpore ... ... ••• ••• ••• 679 Fyzabad ... ... 2 2 2 1,588 Lucknow ... ... 2 1 ° 478 Seetapore ... ... 1 1 ••• 796 Cawnpore ... ... 383 Banda ... ... 1 ... 1 2 431 Humeerpore ... ... »,v 570 Nagode ... ... 1 * ••• 518 Allahabad ... ... ... ... 2 2 2 Centeal India and Agea— 497 Goonah ... ... i 1 • ... 497 Augur ... ... ] 1 3 4 * 4 612 Sirdarpore ... ... i 1 1 2 869 Erinpoorah ... ... 916 Kherwarrah ... 1,113 Deolee ... ... ... 709 Lullutpore ... ... I 11,109 Jhansi ... ... i 469 Nowgong ... ... 1,582 Morar ... ... I ••• I 608 Ag ra ••• •¦• j EOHILCUND AND MEEBUT — ' 309 Shahjehanpore ... ... I 1 J 866 Bai-eilly ... ... 2 2 895 Eoorkee ... ... 2 2 524 Almorah ... ... 120 Deyrah ... ... 391 Moradabad ... ... ! 1 1 '817 Meerut ... ... J ••• i 411 Allyghur ... ... [ 1 647 Delhi ... ... | | ••• | 10,504 Punjab ... ... j ! It 1 9,348 Punjab Fbontiee Fobce 3J 3 1 61,077 Aemt of the Peesidenct ... None None 12 29 42 22 6 6 4 9 16 7 153 68 • Theße cases occurred in outposts. t A case at Umritsur ; no explanation is given regarding this case. X At Kohat. _l| f CHOLERA OF THE EUROPEAN AND NATIVE ARMIES AND JAILS, 1854-68. JAIL POPULATION IN THE EPIDEMIC OF 1863-66. CHOLERA OF 1864. AvBBAGB NtTMBKR OF ADMISSIONS INTO HOSPITAL IN BACH MONTH. TOTAL ADMITIBD Numbeb DIED MJB l| STATIONS. B*°*™*8 *°*™* Jan. Feb. Mar. Apl. May .jjune. July. Aug. Sep. Oct. Nov. Deo. b^onT* O £*£2J2" Db^ hs - Smtob. Alipore ~ 1,793 2 4 14 19 7 3 3 3 4 1 6 3 69 ... 17 Baraset ... 139 1 ... ••¦ - J ••• ~ Jessore ... 489 46 1 ... 47 ... 22 Kishnaghur ... 363 3 1 | 4 rf Moorshedabad ... 186 ••• ••• ••• I ••• "' Howrah ... 127 1 .. ••• - ••• 2 - J - \ Hoogbly ... 451 ... 17 2 3 1.4 ... 1 28 ... 7 Burdwan ... 411 4 4 ¦•¦ « ••• * Bancoorah ... 395 ... 8 31 3 42 ... 16 Purulea ... 183 ••• "• Eaneegunge ... 26 ... 2 1 d Sooree ... 285 ••• ••• ••• Rajmehal ... 169 233 35 ... 14 Deogurh ... 89 1 l \ Malda ... 72 ... ••• ••• •" Dinagepore ... 462 670 8 ... - 84 ... 37 RampVe Bauleah ... 394 ... 10 45 7 1 ••• 63 ... 18 Rungpore ... 323 3 ••• ... ... 3 ... 1 Bogra ... 171 ... ••• 1 - 1 ¦•• 1 Mymensing ... 474 ••• ... »•• ••• I ••• •• Pubna ... 141 ... 14 2 2 8 26 | ... 10 Furreedpore ... 410 ... 1 ••¦ ••• ¦•¦ 1 I ••• A. Backergunge ... 495 3 219 7 ... 1 6 5 1 44 ... 17 Noacolfy ... 224 1 ... 4 6 ... 2 Chittagong ... 327 ? 1 ... } - - Tippelh ... 398 1 ... 1 - 1 Dacca ... 463 1 1 2 2 ... 6 | ... 1 Sylhet ... 359 - ••• . Cherrapoonjee ... 17 ... ••• ••• ••• ¦•• Cachar ... 211 ... 1 1 8 ... 10 | ... 7 Gowalparah ... 149 ... 3 1 11 5 2 1 23 | Gowhatty ... 153 ... 3 ... | 3 - 2 Seebsaugor ... 123 i •¦• Nowgong ... »* ••• ! Tezpore ... Ay « ••• | ••• •" Debroogbur ... 125 1 1 •¦• «•« ••• h Midnapore ... 544 ... 2 3 ... 1 6 ... 4 Balasore ... 210 ... ••• ••¦ Cuttack ... 353 1 4 5 ... 3 "poorGG (t# o2i ?, ... ... , ¦¦( ¦»• ••• ••• ••• ..• ••• ••¦ * t# •••it Sumbulpore ... 175 ?, ..." ... 58 9 ... I 67 ... 46 Chyebassa ... 215 112 4 ... | Ranchee ... 290 ••• ••• j Hazareebaugb. ... 439 Monghyr ... 362 1 ••< ;¦• ••• | Bbaugulpore ... 359 | 5 24 12 15 1 57 ... 10 ... b Purneah ... 522 ••• ••• Daqeeling ... 51 2 | 2^ Total ... 14,441 6 47 140 265 81 36 19 11 6 8 24 12 655 454 250 17"31 Gyab. ... 339 1 1 - 1 Patna ... 467 2 24 1 1 28 ... | 8 Deegab ... 76 Arrab ... 499 1 5 6 ... 3 Chumparun ... 203 1 ... 4 ... 5 ... 3 Mozufferpore ... 433 1 13 1 ... ... 15 Cbuprab ... 440 | 1 1 1 1 1 1 2 1 9 ... I 1 I Gbazeepore ... 662 i ... 4 4 ..I 3 1 Benares ... 1,306 2 1 2 44 49 i ... I 26 Mirzapore ... 351 ... 2 11 4 ... I Azimgbur ... 358 ... 4 4 ... 1 Jounpore ... 269 , ¦•• ••¦ ••« ••• Goruckpore ... 727 2 3 20 11 6 42 ... 19 Gondab ... 92 Baraitcb ... 107 Pyzabad ... 988 56 56 .. 19 Sultanpore ... 528 49 5 54 ... | 18 Rae Bareilly ... 135 j ... Pertabgbur ... 162 1 1 ... »¦ Hurdui ... 148 Luckbimpore ... 115 Lucknow ... 2,550 3 3 | •«• Seetapore ... 779 1 II ... 1 Etab ... 206 1 , - 1 Humeerpore ... 133 I ... i ••• | Oraie ... 128 Futtebgurh ... 404 Cawnpore ... 279 j Banda ... 258 8 ... 8 | •¦• 3 Nagode ... 116 ... Allahabad ... 2,192 1 ... 101 ... 1 103 ••• 28 Totai ... 15,450 ... 6 10 101 56 148 15 53 2 1 1 1 394 255 136 8"80 CHOLERA OF THE JAIL POPULATION OF 1864— continued. NITMBBB OF ADMISSIONS INTO HOSPITAL IN EACH MONTH. A^mttttiti .\iim ]it i' " | DIFD PFE Average ________ . Total pee cbnt. jNumbeb i 000 of oTATTrnms Strength Admis- of of .'„.„, STAIIONB. HTnus AviKnn TVk*tith AVEEAGB Yeab. Jan. Feb. Mar. Apl. May. June. July. Aug. Sept. Oct. Nov. Dec. Steength. Sstbength. Baepore ... 343 43 43 ... 23 Belaspore ... 81 5 ° ••• ° Bandhara ... 417 ••• ••¦ ••• Chanda ... 170 1 12 1 .. ... 14 ••• 5 Nagpore ... 559 ... ... 24 3 1 - 8 ••• 9 Chindwara ... 100 Kowtah ... 68 Sironcha ... 30 Mundla ... 59 Jubbulpore (Civil) ... 471 ••• i Jubbulpore (Thuggee) 565 | Dumoh ... 207 \ I ••• , ••• ••• Saugor ... 348 17 23 3 3 46 ... 16 Nursingpore ... 192 Lullutpore ... 259 ... j Jhansi ... 298 ••• ••• •¦•• Seonee ... 268 4 6 10 ! ... 6 Baitool ... 163 •• i Sehore ... 95 .51 6 j ... j ... Hoshungabad ... 272 ••• ¦•• "' Munfllaisir ... 148 3 *» ¦¦¦ i | Ajmere ... 229 ... •• | •" I Beaur ... 103 1- | "' '" Total ... 5,448 ~~~... 25 15 18 50 18 23 3 3 155 2"85 63 11-56 Muttra ... 243 "• Agra ... 1,963 | „ Secundra ... 257 ••• •" i Etawah ... 183 ••• Mynpoorie ... 340 •¦• ••• Allyghur ... 165 I ••• ' "¦ Bolundshuhur ... 141 Shahjehanpore ... 258 Bareilly ... 1,449 I ••• Budaon ... 212 Seharunpore ... 204 Bijnour ... 230 Deyrah ... 67 Almorah ... 130 Mozuffernuggur ... 97 Moradabad ... 357 I 1 ¦•• • •• 1 — \ Meerut ... 1,415 Total ... 7,641 1 1 ' 01 Delhi ... 299 Eohtuk ... 218 ••• Hissar ... 219 Sirsa ... 211 Kurnaul ... 48 ••• | ••• ••• Umballa ... 866 | 1 I 1 " - Loodianah ... 745 Jullundur ? 332 Ferozepore ... 441 Umritsur ... 554 Lahore ... 1,644 Lahore Female Jail... 168 Sealkote ... 191 Dhurmsala ... 137 ••• ••• •¦• Goordaspore ... 295 ... Goojranwalla ... 330 ••• Goojrat ... 264 Shahpore ... 239 -•• Jhelum ... 220 | ¦•• | Googaira ... 315 j ... ... Mooltan ... 653 - Jhung ... 268 ... ... | - •¦• I •¦• Dera-Ghazee-Khan... 42 ••• ••• ' Dera-Ismael-Khan . . . 255 •• Kohat ... 113 Bunnoo ... 91 I ••• Eawulpindee ... 763 •. Peshawur ... 308 ... ••• •" ••• " Total ... 9,630 1 _•_ _®_ _J_ 10 Bengal Peesidency 52,598 6 53 175 382 155 234 52 88 11 12 25 12 1,206 2-29 450 856 EPIDEMIC OF 1863-66, CHOLERA OF 1865. GENERAL INDICATIONS OP DISTRIBUTION AFFORDED BY THE TABLES OF 1865. See Map of 1865. Cholera still general over the eastern area : still universal, and in force as a great epidemic in the Central Provinces, which were covered from sea to sea : in the north, invading ' the western area from the south-east, but confined as a powerful epidemic to the districts south of the Jumna, in which the mortality was very great ; an off-shoot from this body, which was weak in itself and was checked in its progress towards the north-west, entered Meerut and Rohilcund in May, and remained in vitality until November. The Table for the European Army shows that few stations in the east escaped cholera in 1865. The distribution shown in the western division is typical; the cholera of Jubbulpore and Saugor is the representative of the great southern cholera of the year, and to this the cholera of Jhansi and Morar was directly added on. The invading cholera of the last weeks of May and the first week of June is also typically represented. The great prevalence of cholera in the local corps of the west of Central India, indicating the northern limit of the cholera of the south, is seen in the Table for the Native Troops ; and in this Table there is exhibited also the fact of the northward extension to Jhansi and Morar. A single admission at Deyrah in May is an indication of the invasion of Meerut and Rohilcund from the south. The Jail Table of the year exhibits perfectly the geography of the cholera of the south and west in 1865. It shows the universal prevalence in the Central Provinces between March and August, the advance northward as far as to Etawah, and the out-runner of May thrown forward as far as Hissar. The cases noted at Sealkote and Montgomery are not authenticated as cases of cholera. W o TTJ 1 CHOLERA OF THE EUROPEAN AND NATIVE ARMIES AND JAILS, 1854-68. CXXXi EUROPEAN ARMY IN THE EPIDEMIC OP 1863-66. CHOLERA OF 1865. AVBBAGB I NUMBEE OB ADMISSIONS INTO HOSPITAL IN BACH MONTH. ADMITTED „„ __ Strength , > — Total pbb cent. Number x 000 op BTATTnVSJ DURING AdMIS- : OF OF AvKKAGB STATIONS. pbbiod . , , i , , nf „„ n ., sions. Average Deaths e£™"*°" of occu- Jan. Feb. Mar. Apl May. June. July. Aug. bept. Oct. Nov. Dee. Strength. Stbength. PATION. Kidderpore Hospital ... 1 1 " Chinsurah Depot ... ... Allahabad General o I Hospital 1 1 * Invalids, Kecruits, and Time-expired 1 1 , men on the march I Bhootan Field Force 145 1 ... 3 ... 1 5 ••• 3 Fort William ... 789 1 ¦ •• ••• ••• "• - J Dum-Dum ... 717 1 10 1 - 1 \ 13 ••• ™ Barrackpore ... 357 j- '" - Berhampore ... 147 1 Total ... ~lfi2B ~~7T ~T ~12~ ~7T.7~7 ... 1 ... 1 15 '74 13 6-41 Darjeeling ... 915 Darieeling Depot ... 39 « Pansnath Depot ... 28 Hazareebaugh ... 851 •• "¦ ••• ••• •" Dinapore ... 1,062 .. 1 2 | J »• J Benares ... »»» 4 t | Azimghur ... 204 ... I ••• "¦ I ••' Fyzabad ... 953 13 13 - U Rae Bareilly ... 386 ¦ •• ••• - ••• ••• ••• •• Lucknow ... 1,884 1 2 14 6 ... 23 ... <20 Seetapore ... 583 Futtehghur ... 203 •• ••• ••• ••• ••• ••• •" Cawnpore ... 880 ¦ * , Allahabad ... 1,013 6 ... ... 5 3 , 14 ... 10 Nagode .- 176 3 3 | ... 3 ToTAt ... 0,917 4 ....... 27 £' 3 ... 19 10 ... 1 2 68 -68 55 5"55 Shahjehanpore ... 484 •• ••• ••• •" BareiUy ... 853 d 3 I NyneeTal ... 307 Landour ... 208 Moradabad ... 254 Roorkee ... 554 • ••• ••• ••• I ••• ¦" Meerut ... 1,783 I 1 ... 11. 3 ...8 Delhi ... 434 I Muttra ... 394 •¦¦ "• I Total ... 5,122 ... ..7 ...... 1 ......... 3 1 T~~. 6~ ' ~ 4 -78 US. ::: iSS I ::: ::: ::: ::: ::: ::: "i a"i ¦'- ' '¦¦ a "j Gwalior Citadel ... 213 I 2 2 ... * Seepree ... 152 ••¦ Jhansi ... 667 1 l Nowgong ... 208 ••• , ••• ••• "' Saugor ... 820 625 31 ... 18 Jubbulpore ... 688 7 7 j Total ... 4,689 I .................... 844 1 53 I*lB 34 725 CHOLERA OF THE EUROPEAN AND NATIVE ARMIES AND JAILS, 1854-68. CHOLERA OF THE EUROPEAN ARMY OF 1865 —continued. i..,,.. Numbbb of Admissions into Hospital ik each Month a^bbaujs Admitted tw^t. *>» Strength _ ToTAL PBE CBWT . n PMBH b *™L peb STATIONS. BUBl bi°d I Admis- op of Avebage T of oßco B cc I v- D Jan. Feb. Mar. April. May. June. July. Aug. Sept. Oct. Nov. Dec. SlOlfS ' siJbnoth. Dbaths - ' Strength. PATION. Umballa ... 1,477 I I ¦•• I Dugshaie ... 889 1 1 Kussowlie Depot ... 606 1 1 ¦ 2 ... I 2 Subathoo ... 601 ¦¦¦ ••• I Phillour ... 78 1 1 ••• | Jullundur ... 776 ¦¦¦ I ... I Ferozepore ... 788 ••• ••• ••• I Mooltan ... 867 Dera-Ismael-Khan . . . 99 Sealkote ... 1,185 I Dhurmsala ... 83 ••• j Kangra ... 121 - Umritsur ... 147 i Fort Lahore ... 136 - ¦¦¦ i MeeanMeer ... 1,038 ' Eawulpindee ... 1,450 Campbellpore ... 408 - ••¦ I Attock ... 156 I ... ... I MurreeDep6t ... 376 ... ... [ Road-making Detachments, Murree Hills 643 ... •¦• I Nowshera ... 611 '' •¦ | Peshawur ... 1,740 | ( Nundcote Depot ... 130 1 I I — Troops on the march (Punjab) Total ... 13,880 2 11 4 "03 2 -14 Troops on the march, Bengal 3 j 3 ... 2 Troops on the march, N. W. Provinces... ... •- ... 1 ! 1 ... 1 Bengal Pbesidenct 37,210 5 1 4 28 21 4 10 64 14 2 2 5 160 -43 116 312 CHOLERA OF THE EUROPEAN AND NATIVE ARMIES AND JAILS, 1854-68. cxxxiii NATIVE AKMY IN THE EPIDEMIC OP 1863-66. CHOLERA OF 1865. Number of Admissions fbom Choleba in each Month. Total Total Avkhagb __^_ Admissions Deaths of Stbength ov STATIONS. — ' ~ of the the xhb Ybab. Jan Feb- Mar , April, May , June _ j u iy # Aug , ss e pt Oct. Nov. Dec. Yeab. Yeab. H ... Regiments marching 13 ... 2 9 ¦ 1 7 ... 32 15 Bengal Peopee and Assam— 1,287 Calcutta ... ... 1 8 2 6 6 1 2 5 2 1 ... 4 38 17 778 Barrackpore ... ... 1 1 ... 4 2. 4 - 13 8 466 Dacca ... ... 5 16 ... 3 ... 3 5 1 ... 24 8 448 Cherrapooniee ... 1 1 551 Sylhet ... ... ... 1 113 6 88 Nowgong ... ... 2 2 569 Debrooghur ... ... ... 2 3 5 2 5,084 Bhootan Force ... ... ... ... ... 56 67 36 5 1 4 ... 20 2 191 113 Behab, Benaees, Oude, and Cawnpoee — 358 Bhaugulpore ... ... 1 ... 2 ... 4 3 ... 10 5 551 Dorundah ... ... 626 Dinapore ... ... ... 338 Segowlie ... ... ... „, ... ••• •¦• 595 Benares ... ... 2 1 1 4 2 620 Goruckpore ... ... ... , 705 Fyzabad ... ... 2 5 7 6 1,569 Lucknow ... ... ... 2 1 ... 3 2 367 Seetapore ... ... ... 372 Banda ... ... ... ... 1 1 573 Cawnpore ... ... ... 10 10 4 574 Allahabad ... ... ••¦ I 501 Nagode ... ... 1 1 1 3 1 2 Centbal India and Agba— ISirdarpore ... ... 8 1 p 6 Erinpoorah ... ... .. 1 1 2 Kherwarrah ... ... , 2 2 29 2 7 42 23 Augur ... ... ... 1 2 ... 1 - 4 4* Goonah ... ... t 428 Lullutpore ... ... ... 437 Nowgong ... . ... •¦• ! ••• j 921 Jhansi ... ... 17 4 12J (5 1,165 Mora* ... ... ... ... 1 8 9 j 7 647 Agra ... ... 1 1 1 Meeeut and Rohilcund— 276 Shahjehanpore ... ... ••• | 824 Bareilly ... ... 1 ••• 1 563 Almorah ... ... 100 Deyrah .., ... 1 l§i 516 Roorkee ... ... 388 Moradabad ... ... 859 Meerut ... ... Allyghur ... ... ... I 589 Delhi ... ... ) , ... I 10,543 Punjab— ... ... 1 1 j None. 9,964 Punjab Fbontieb Foece 3 11 1 6 J 2 51,064 Abmy of the Presidency ... 2 22 8 74 110 67 50 25 24 14 32 9 437 240 i , . . ==^™s. * All in outposts. t Two cases in May amonsr Camp followers. j While returning 1 from furlough, attacked near Jhansi ; cholera was epidemic at the time all around Jhansi. § A case of genuine cholera, indicating the invasion of Meerut and Rohilcund at this time. 30 CHOLERA OF THE EUROPEAN AND NATIVE ARMIES AND JAILS, 1854-68. JAIL POPULATION IN THE EPIDEMIC OP 1863-66. CHOLERA OF 1865. • — NUMBEB OF ADMISSIONS INTO HOSPITAL IN EACH MONTH. »„„„««..„ yii'Min mi T)tpi\ ¦cc II Avbbage . 1 Total pee cent. Numbeb j onoo ¦! QTATTONS STBENGTH AdMIS- OV I OF AVERAGR I STATIONS. „„ m^ M^ gept Qct Noy Dcc HONB , gA ,, = DEAIH , SiEEiroi X Alipore ..: 1,811 2 6 ... 2 1 3 36 13 3 66 ... 25 ... Baraset ... 102 ... 1 - 4 5 3 Jessore ... 534 | ... . ••• ••• Kisbnagbur ... 333 I ... 1 ... 1 ... * - l Moorsbedabad ... 204 ... •• ••• ¦•• ••• Howrah ... 152 ... 2 ... 1 ... ... ... ••• 1 ••• £ ... 1 Hooghly ... 578 2 6 1 ... 1 2 1 2 15 ... 6 Burdwan ... 487 ... ... 1 1 ... 2 ... 1 ... 5 ... ... Bancoorah ... 480 ... ... 12 18 ... 30 ••• b Purulea ... 174 ... ... ... •• Kaneegunge ... 28 ... ... 2 • ••• ¦ Sooree ... 245 ... I ••• ••• "' Eajmebal ... 136 ... ... ... 12 » ' 12 ... 4 Deogurh ... 79 ... 2 2 ... 1 Malda ... 55 ... ••• ... ¦ ••• ••¦ ¦¦• Dinagepore ... 443 ... 1 ... 1 | Rampore Bauleali ... 425 ... 2 ... Bungpore ... 355 ... Bograk ... 124 ... •¦• - ••• ••• - •¦• I Mymensing ... 418 ... 1 - 3 ,£ ••• % Pubna ... 136 ... 1 14 - - 15 - A Fureedpore ... 436 ... ••• • ••¦ ••• "' Backergunge ... 407 ... ... 4 ... 5 •¦• ••• 4 ... Id i Noacolly ... 173 ... ... ... ••• "" "1 Chittagong ... 304 ... 2 ... * ••• A \ Tipperah ... 374 | ... ••• •• Dacca ... 474 I 2 ••• •¦ - % •" ¦¦ Si ::: S ::: ::: i ::: ;; » "« ::: ::: ::: £ I ::: : « : « = Gowalparah ... 140 ... ... 1 2 6 »• , ... Gowhatty ... 154 ... 20 .., - 20 ... 11 Seebsaugor ... 81 ... ••• ... Nowgong ... 43 ... ••• ... ••• ••• I •" Tezpore ... 214 ... 8 0... 21 ... '15 ... 9 Debrooghur ... 122 ... ... 1 » ••• 1 ••• * Midnapore ... 616 ... ••¦ 1 1 Balasore ... 227 I 1 1 Cuttack ... 398 I ... ••¦ • ••• •" Pooree ... 77 3 2 5 ... 3 I Sumbulpore ... 148 ••• ... Chyebassa ... 142 ... ••• ••• ••• ••* Eancb.ee ... 279 2 1 ... 1 9 1 ... 1 ... 15 ... 9 Hazareebaugb. ... 626 1 1 ••• ¦•• Mongbyr ... 378 4 18 ... '13 ... 6 Bbaugulpore ... 341 3 2 1 6 ... 1 Purneab ... 420 44 ... ••• [44 | ... 23 Darjeeling ... 72 Total ... 14,598~ 5T 25 106 \34 27 9161069 37 3 j 348 238 148 10-15 I Gyah ... 475 Patna ... 433 1 32 ... .. 33 ... 14 Deegab. ... 419 22 5 18 ... 36 ... 15 Arrab ... 433 1 1 2 Cbumparun ... 235 Mozufferpore ... 477 ... 1 ••• 1 •>¦ 1 Cbuprab ... 484 34 8 6 25 73 ... 24 Gbazeepore ... 705 ... ••• | Benares ... 1,193 ! ... 2 2 ... 1 Mirzapore ... 431 j Azimgbur ?. 474 ... 1 1 ••• 1 ••• Carried over ... 5,759 ... 1 1 55 34 9 13 26 9 ... 148 ... 56 I j H i " " |[ II f CHOLERA OF THE JAIL POPULATION OF 1865— continued. Numbee or Admission's into Hospital is each Month. £2S£ — — iZt. -™ NN T BE rDo-1r D o-1 FOE THE auans QJf AVEEAGE "* I AvEBAGE Yeab. Jan. Feb. Mar. April. May. June. July. Aug. Sept. Oct. Nov. Dec. SlOlrs> Sibekgth. • Stbength. ud ... 5,759 ... 1 1 55 34 9 13 26 9 ... 148 ... 56 258 j ¦• ••• ••• •¦• ••¦ 664 2 & ... * ••- 136 450 1 ••• | KaeJJareilly ... 130 3 3 ... 1 Pertabghur ... 146 Hurdui ... 123 I Luckhimpore ... 112 •- Lucknow ... 2,619 •• ••¦ ••• ••• Seetapore ... 875 130 I 31 ... 11 Etah ... 201 Humeerpore ... 129 Oraie ... 105 ••• •¦• , Futtehgurb. ... 432 | - Cawnpore ... 265 Banda ... 289 1 ••• •¦• Nagode ... 72 1 ... ... \ - \ Allahabad ... 2,346 ... 8 8 ... | 2 Total ... 16,848 ... 1 l" 66 2 1372143 26 9 ... 196 1-20 75 4"59 Raepore ... 385 542 316 5 ... 1 72 ... 40 Belaspore ... 75 - 1 ••• £ ••• I Bandhara ... 294 5 43 1 49 ... £ "~51,228 Aemt of the Peesidenct ... 5 9 37 18 24 20 11 10 3 ... 34 5 176 90 • This case occurred at Deolee; it is the most westerly indication to us of the cholera of Agra and Rajpootana of November. CHOLERA OP THE EUROPEAN AND NATIVE ARMIES AND JAILS, 1854-68. JAIL POPULATION IN THE EPIDEMIC OF 1863-66. CHOLERA OP 1866. " AVEBAGB NUMBBB OF ADMISSIONS INTO HOBMTAL a BACH MOKIH. | ffigg" Svmß DIJDM, || STATIONS Stebwgth "• Admis- op of Averaop fob the Jan> Feb Mar April May _ Jnne July Aug ss e p t , Oct . uov. Deo. bions. Avbeage IDeaths. Stbbm "!l ieab. Strength. J Alipore ... 1,904 1 6 9 3 5 41 8 2 4 6 2 ... 86 ... 24 Baraset ... 178 ... 1 1 Jessore ... 539 ... 1 1 2 Kishnaghur ... 344 ••• ¦•• ••• • •• Moorshedabad ... 255 1 ... 1 1 3 ... I Howrah ... 191 1 19 11 13 .. 7 Hoogbly ... 642 ... ... 10 ... 2 ... | 4 ... 6 19 41 ... 17 Burdwan ... 573 ... ... ... 10 4 ' ... 14 ... 0 Bancoorah ... 622 ... ... 1 2 1 3 ... ... ... 7| ... 3 Purulea ... 326 ... 8 3 ... | 11 ... 7 Raneegunge ... 57 ... ... 3 ... 6 ... ... 9 ..8 Sooree ... 373 ... ... 1 ... . 1 ... 1 Rajmehal ... 129 ... 1 1 12 ... ... 14 ... 6 Deoghur ... 103 ... 1 ... 1 3 1 1 .. ••• ... 7 ... 3 Malda ... 61 ... 1 .» 1 Dinagepore ... 392 ... ... 2 1 •¦• ... 3 Rampore Bauleah ... 445 ••• ... 2 1 ... 1 ... 4 ... 1 ... Rungpore ... 369 ... ... 19 ..11 ... ... 21 ... 3 Bograh ... 126 | ... - ... - ... Mymensing ... 404 I ... '" ••• ... ••• ¦•• ••• Pubna ... 143 ... ... 3 16 2 3 ••• 24 ... 7 Furreedpore ... 404 ... Backergunge ... 380 I ... 2 3 2 ... ¦•• 1 8 .. 5 Noacolly ... 215 ••• ••• Cbittagong ... 243 1 ... ••• ... 1 ¦•¦ 1 Tipperab ... 353 ¦¦¦ 1 1 Dacca ... 449 •¦¦ ... 3 3 •¦• ... 6 ... 5 Sylhet ... 394 ... 10 ... •¦• ... 10 ... 4| Shillong ... 38 I •¦• •• ... ••• I Cachar .. 216 ... 5 1 2 1 ... .. ... •• ... 9 ... 6 Gowalparab ... 136 •¦• 6 2 ... 1 9 Gowbatty ... 225 - 3 1 ... 1 - ... 5 1 ... 2 Seebsaugor ... 101 ¦•• 1 •• ... ¦•• ... 1 ••¦ 1 ••• Nowgong .. 66 ••• Tezpore ... 170 I 1 1 ... Debroogbur . . 96 ••• 4 1 ... 5 ... 2 Midnapore ... 814 ... 21 6 ... . 13 2 ... ... 42 ... 23 I Balasore ... 564 22 23 1 33 3 5 2 89 ... 37 1 Cuttack ... 856 ... ... 8 6 3 66 36 42 31 4 3 17 216 ... 113 Pooree ... 394 ... ... 14. ... S 3 1 1 2 2 ... ... 26 ... 12 Sumbulpore ... 131 ••• ... I Cbyebassa ... 228 ... ... 25 1 43 15 25 20 2 5 I 136 ... 84 Rancbee ... 235 1 ll ... 1 Hazareebaugb ... 689 ... 1 ... 130 22 1 ... ... ... 154 1 ... 76 Monghyr ... 468 ... 1 1 ... 1 11 ... 14 ... 6 , Bhaugulpore ... 341 3 9 1 ... 1 32 46 ... 16 I Purneab ... 343 2 2 ... 1 Darjeeling ... 72 •-• , Total ... 16,794 642 136 82__85_183 221 164 58 18 11 _3gj 1,044 6-22 495 I 2948 Gyah ... 649 I 16 3 2 ... 1 ... I 22 I .... 12 I Patna ... 571 13 4 22 8 47 ... 18 j Deegah ... 605 2 ... 4 ... 13 59 78 ... 28 | Arrah ... 492 1 29 36 ... 7 15 .. 88 ... 32 Cbmnparun ... 286 1 17 2 20 ... 14 Mozufferpore ... 457 1 1 ... 72 74 ... 17 Chuprab ... 499 1 2 27 47 2 ... 3 82 ... 19 Ghazeepore ... 630 Benares ... 1,170 Mirzapore ... 357 Azimghur ... 338 ... ... ... ... ••• Jounpore ... 287 Goruckpore ... 708 ... ... ... ... ... Gonda ... 951 1 I 1 Baraitcb ... 158 I ... ... I Fyzabad ... 762 I ... ... Sultanpore ... 227 Rae Bareilly ... 102 I Pertabgbur ... 135 1 ... 1 Hurdui ... 134 ... 1 1 Luckbimpore ... 93 1 1 ... ... ... Lucknow ... 2,619 Seetapore ... 786 Etab ... 205 j ... ... i Humeerpore ... 202 Oraie ... 88 Futtehgurh ... 415 .. 1 1 ... I 1* Cawnpore .., 322 ' ... ... ... Banda ... 352 ..' ... ... | "Nagode ... 84 ... ... ... i Allababad ... 2,403 ... I Total ... 17,088 1 18 6 730 177 140 12 10 16 ?.. 416 243 141 825 ? The Medical Officer in charge remarks that thiß case did not come under his personal observation. [ Appendix CHOLERA OF THE JAIL POPULATION OF 1866 —continued. Numbbb of Admissions into Hospital in bach Month. AVBBAGB _ ToTAL £ BB D BB ™ D NrMBEE DI»PM STATIONS. Admis " °* °* AvSage FOB THE ..._. Avnman Diuttth AVIEiOB Ybab. I Jan. Feb. Mar. April May. June. July. Aug. Sep. Oct. Nov. Dec. SlOlrs - sJbjiwgth. X Stbemgth. Raepore ... 440 57 18 75 ... 44 Belaspore (8 months) 40 ... i Bandhara ... 179 4 I 4 ... 2 Chanda ... 173 3 2 I 5 I ... 2 Nagpore ... 885 7 17 ... 2 Chindwara ... 86 Wurdah ... 54 I Sironcha ... 56 2 3 5 ... 4 Mundla ... 72 1 .. ... ! 1 ... i 1 Jubbulpore (Civil) ... 480 2 2 ... 2 Jubbulpore (Thuggee) 587 I Dumoh ... 107 I ... Saugor ... 238 ... | Nursingpore ... 150 Lullutpore ... 115 1 1 Jhansi ... 207 I Seonee ... 188 | ... Baitool ... 94 I ... ... I Sehore ... 82 ... ; Hoshungabad ... 208 Nimar ... 136 I ... Ajmere ••• 299 | | Beaur ... 84 Total ... 4,956 | 1 61 33 5 I 100 2-02 | 57 11-50 Muttra ... 148 Agra .« 1,787 1 1 ... 1 „ Secundra ... 59 Agra District (10 338 ... I months). Etawah ... 346 Mynpoorie ... 379 Allyghur ... 341 I ... ... I Bolundshuhur ... 175 I ... I ... ... I Shahjehanpore ... 273 I Bareilly ... 1,515 ... Budaon ••• 291 ... .., Seharunpore ••• 249 Bijnour ••• 143 Deyrah ••• 50 ... ... ... ... ... Almorah - 116 ... ... j ... | Mozuffernuggur ... 117 | ... ... I Moradabad ... 241 i I Meerut ... 1,275 | Total ... 7,787 1 1 -01 | 1 -13 Delhi ..• 299 I ... Kohtuk ... 220 , Hissar ••¦ 184 Sirsa ••• 254 ... ... ... ••• I Kurnaul ••• 105 ... | ... Umballa ... 496 I „ GangatJhugger 202 ... Loodianah ... 188 .. Jullundur ... 305 Ferozepore ... 375 ... ... Umritsur ... 675 ... ... ... Lahore ... 1,883 ... Lahore Female Jail 193 ... . ... Sealkote ••• 279 I Dhurmsala ... 119 Goordaspore ... 270 Goojranwalla ... 349 ... Goojrat ... 238 | Shahpore ... 256 Jhelum ... 241 Montgomery ... 313 | Mooltan ... 773 I ... ... Jhung ... 383 Dera-Ismael-Khan ... 274 .. . ..... Kohat ... 286 Bunnoo ... 122 Kawulpindee ... 92 Peshawur ... 898 I ... '. Totai, ... 10,697 Bengal Pbesidenct 57,322 6 42 155 188 92 213 459 338 75 28 27 38 1,561 272 694 12-10 145 CHOLEKA OF THE EUROPEAN AND NATIVE ARMIES AND JAILS, 1854-68. 146 EPIDEMIC OF 1866-68. CHOLERA OF 186 7. GENEKAL INDICATIONS OP DISTRIBUTION AFFORDED BY THE TABLES OF 1867. See Map of 1867. The Central Provinces the exempted area of the year : cholera universal in Upper India from the Behar Provinces to the North-Western Frontier. Cholera became universal in the eastern division subsequent to revitalisation within the area covered in 1866 and to the invasion of that portion of the province which remained unoccupied after the completion of the epidemic movement of 1866. The invasion of Cawnpore and Banda was typically displayed in May, but the strength of the eastern invasion was determined towards the north, causing- the great epidemic of Goruckpore, Northern Oude, and Shahjehanpore, while the Doab and the districts south of the Jumna were comparatively exempted. Throughout the western division, after the middle of April, the invading cholera of 1866 was revitalised, and covered Northern India universally, from the line limiting the exempted area in the south to the frontier. The cholera of 1863-66 was dead in the Central Provinces, and no portion of the epidemic of 1866-67 was determined towards the south or south-west. The universality of cholera over the eastern division, and the revitalisation in the western division of the cholera of November 1866 in April and May 1867 with the simultaneous advance from the Jumna to the North-Western Frontier, and the persistence of the revitalised and invading cholera up to the close of the monsoon in September, is beautifully exhibited in the Table for each of the types. In the Table for the Jail Population the absolute exemption of the Central Provinces is a feature especially to be noticed. No. Ill] CHOLERA OP THE EUROPEAN AND NATIVE ARMIES AND JAILS, 1854-68. cxlix F EUROPEAN ARMY IN THE EPIDEMIC OP 1866-68. CHOLERA OP 1867. Average Number of Admissions into Hospital in each Month. _ o ""„ , Total Admitted Died peb SS ™ T ™ Admis- per cent. Number 1,000 op STATIONS. the period SIONS OF THB 0F THE «» 7,7.™ Jau - pp e b - Mar. April. May. June. July. Aug. Sept. Oct. Nov. Dec. of thb ] Average Deaths. Average pation Ybaßi SIBBirSTH - Strength. Chinsurah Depot ... ... 2 1 1 4 ... 2 I Recruits, Invalids, and Time-expired men on march ... Port William ... 739 i 1 1 1 .. 3 ... 2 Dum-Dum ... 472 ... 1 ... 1 ... 1 Barrackpore ... 357 1 ... 1 | ... 1 ... | Berhampore ... 126 . ' ... ... ... ... i Total ... 1,600 1 | 1 ... .. 1 ...... 3 ... 5_ '31 I 4 2J50 Sinchal, Davjeeling... 518 ¦•¦ I ... ... I Darjeeling Depot ... 145 Parisnath Depot ... 22 Hazareebaugh ... 876 1 ... 1 ... 1 Dinapore ... 907 1 1 .. 1 ... 1 Benares ... 595 Fyzabad ... 887 2 1 3 ... 2 | Rae Bareilly ... 393 ••• .. I ... I Lucknow ... 2,535 17 3 11 | ... 6 Seetapore ... 574 ... 4 4 8 | ... 6 Futtehghur ... 286 I .. ... ... I Cawnpore ... 691 ! ... .. 1 ... 2 I 3 ... 2 1 Allahabad ... 958 2 26 28 I ... 18 I Nagode ... 203 | ... ... I Total ... 9,580 I 3 _: ?37 7 - 1 ¦•¦ ! 55 -58 I 36 376 II Shahjehanpore ... 47! ™ " ™ ™ ~. ... I ... 23 1 Z T. ™ 24 ~ 19 T" Bareilly .. 805 1 ... 1 1 ... 3 ... I 2 Nynee Tal Depot ... 343 I ... ... | Landour Depot ... 205 Roorkee ... 360 I ... ... [ Moradabad ... 299 j 4 3 7 ... 5 I Meerut .. 1,579 | ... I 16 106 1 123 j ... 112 Delhi ... 3511 1 1 ... 1 ... | Muttra ... 412 1 1 ... 1 ... I Total ... 4.747 1 .. 1 ! 2 5 43 107 ! 1 .. 1 159 j 335 140 29-49 !i Agra ... 967 Z ~ ~~. ~. ~ Z. ™ ™ Z Z Z Z. Z. Z | Morar ... 868 14 8 2 15 ! ... 10 Gwalior Citadel ... 219 15 2 8 ' ... 4 Seepree ... 149 I ... Jhansi... ... 608 ' ... Nowgong ... 193 | ... Saugor... ... 657 I -. Jubbulpore ... 634 ... ... ... | Total ... 4,246 j ..._ ... . ...... 1 513 I 4 _ 111 23 -54 j 14 3-30 Umballa ... 1^329 Z Z Z. 4 22 1 Z Z 2 ~ Z !7! 29 ™ 22" !7 Dugshaie ... 805 Kussowlie Depot ... 327 1 1 ... 1 Subathoo ... 751 1 ... 8 3 26 2 40 | .. 19 Phillour ... 68 ... Jullundur ... 788 | 12 12 I ... 9 Ferozepore ... 773 3 12 1 16 ... | 8 I Mooltan ... 763 | ... ... I Dera-Ismail-Khan ... 101 i ... ' Sealkote ... 1,262 | ' . . ... Dhurmsalla ... 107 1 ... 1 j ... 1 Kangra ... 73 i ... ! Govindghur ... 138 I 1 1 I ... 1 Fort Lahore ... 140 2 11 4 ... | 2 I Meean Meer ... 1,030 ... 6 862 10 | 86- j ... 52 Rawulpindee ... 1,352 ... ... ... ... Cambellpore ... 406 ... ... ... j Attock ... 160 I ... I Road-making Detachments, Murree Hills 644 ...I Murree Depot and Family Camp ... .346 ... 5 2 7 I ... i 3 Nowshera ... 730 5 5 ' ... 2 Peshawur ) ,„. ( 163 106 4 i 273 ... 162 Cheerat \ lj/o4 £ 1 1 ... 1 Troops on the march, Punjab ... ... ... ... , Total ... 13,570 _5 191 131 91 40 18 476 3;51 283_ _ 2Q-86 || Troops on the march, Bengal and N. W. Provinces ... Bengal Pbesidency 34,603 2 8 197 132 106 134 137 1 4 1 722 209 479 13-84 33 CHOLERA OF THE EUROPEAN AND NATIVE ARMIES AND JAILS, 1854-68. cl NATIVE ARMY IN THE EPIDEMIC OF 1866-68. CHOLEEA OF 186 7. i,--..,, i Number op Admissions into Hospital in each Month. Mm ] TT M OO Z o ir »™ MS™ P obsTbva- P Jan. Feb. Mar. Apl. May. June. July. Aug. Sept. Oct. Nov. Dec. j Yeab. Ybab - Strength. TION. X Dun. (9 months) ... 015 j 9 11 ... 1 ... 210 | 24 15 1 Barrackpore •¦• 953 ... ± Berhampore ••• 128 | | • ••¦ ••¦ ••• ••• Dacca - 320 j ... 1 1 1 Cacbar ... 242 5 5 2 1 Cherrapoonjee and Shillong 834 ... 2 ... 1| V 4.56 Gowhatty ••• 348 .. ¦ ••¦ ... Nowgong ••• 87 j •• •• •¦• f- •• * £ Tezßore ••• 424 ' X 5 X '" "« ",* 1 8 3 Debrooghur ... 912 1 1 1 ... 1 * 1 1 8 3 BuxaDooar ••¦ 698 j *¦ »• -I Julpigoree ••• 522 j ... Bhaugulpore ¦•¦ 460 . . ¦ ¦•• ••• ¦•• ••• - ••¦ ••• J Dinapore - 639 | 2 4 12 ... ... | g 6 Segowlie ... 293 j ... ... ... •• ... ... i ... ... Benares ••• ! 8 .. 1 | 3 2 Goruckpore ••• 623 | ••• Pyzabad ••• 681 j ... ... ... ••• ... L-know -. 1,590 2-3 . ... 6 k 3.73 Seetapore ¦•• 3 ••• l l I 6 6 Futtohghur •¦• 184 j •• • ... Cawnpore ••• ?96 i »• 1 V 1 Banda •¦¦ 300 ; ... ... ... ... Allahabad •¦• 627 j - 7 7 4 Na Delhi ... 287 | Rohtuk ... 217 Hissar ... 210 ... i Sirsa ... 243 Kurnaul ... 98 ... Umballa ... 487 „ Gang at Jhugger ... 201 1 1 ... I 1 Loodianah ... 184 ... i ... ... ... Jullundur ... 326 Ferozepore ... 363 ... ... ... ... .•• II Umritsur ... 571 I 3 3 5 11 ... 4 Lahore, Central ... 1,917 | Lahore Female Jail 166 11 ... 1 ... 12 ... ! 9 Sealkote ... 265 Dhurmsalla ... 112 6 6 ... 2 14 ... 7 Goordaspore ... 246 ... ... ... ... Goojranwalla ... 356 I 12 4 ... 7 ... 4 Goojrat ... 234 Shahpore ... 267 Jhelum ... 252 Montgomery ... 323 Mooltan ... 660 Jhung ... 390 Dera-Ghazee-Khan... 361 | 2 2 ... 2 Dera-Ismael-Khan . . . 298 Kohat ... 11l Bunnoo ... 86 Eawulpindee ... 869 ... ... ... ... Sohan (Temporary Jail) ... 112 13 1 ... 2 16 I ... 9 Peshawar ... 406 | 211 13 ... 5 Total ... 10,506 22 21 17 11 5 76 I '71 41 390 Bengal Peesidency 54,962 5 2 83 98 113 29 72 106 76 12 30 6 632 115 271 493 II cliv EPIDEMIC OP 1866-68. CHOLERA OF 1868. GENERAL INDICATIONS OF DISTRIBUTION AFFORDED BY THE TABLES OF 1868* See Map at the beginning of the Report. Cholera manifested over many portions of the area invaded in 1867, but generally diminished in volume or extinguished, in relation to the fact that the distribution of the cholera of 1867 was not limited by the boundaries of Northern India, and that the body of the epidemic was diffusely spread beyond the boundaries of Hindostan : much repressed also over Upper India by the meteorological conditions of the year, especially throughout the western division of the epidemic area : the tract south of the Jumna exempted in 1867, still, in 1868, an area of absolute exemption; and the Cawnpore district and the districts adjoining, which formed an area of comparative exemption in 1867, still an exempted area, perhaps altogether free from cholera, geographically added on to that lying south of the Jumna : the cholera of a new epidemic (IS6B-G9J invading, from within the endemic area, Chota Nagpore and the Central Provinces between March and May, and before the end of the year becoming universal on the Southern Highway and throughout the province of the South-West Monsoon. The Table for the Jail Population shows the almost total exemption of Upper India from cholera in 1868. No fatal case occurred among the prisoners west of Allahabad ; the jails of Oude, Rohilcund, Agra, and the Punjab, show no fatal case of cholera. The occupation of the Central Provinces is very clearly indicated in this Table. The cholera of Jubbulpore and Saugor of the European Army also marks the invasion of the exempted area of 1867. No fatal case is shown in the Table for European Troops in Upper India west of Lucknow j but the wide range of the admissions of August must not be overlooked, since in all probability it points to the invasion of a cholera which with a different meteorology would have shown itself in much greater strength. The two eases at Lucknow and Morar in December are to be noted as occurring at an unusual season ; and as indicative of epidemic movement, they have a significance of an importance beyond what the mere fact of their occurrence might suggest. CHOLERA OF THE EUROPEAN AND NATIVE ARMIES AND JAILS, 1854-68. EUROPEAN ARMY IN THE EPIDEMIC OF 1866-68. CHOLERA OF 1868. Average Number of Admissions into Hospital in each Month. Admjttrti Stbength Total A " MIITKU DURING . ADMIB- PEB NtIMBTB DIED PKB STATIONS. the period sfoZor The ° ° F Aveklgel occupa- Jan - Feb - Mar - A P ril - M *y- Juno - Ju 'y- Au &' Sept- Oct. Nov. Deo. Y ™" Average °saths. I stbength. TIOIr liiAK. Strength. Chinsurah Depot ... 1 .. 6 5 7 1 ... 1 *21 ... *17 InvalidsjJßecruits, and Volunteers on march 1 ... 1 ... 1 Fort William ... 858 2 1 11 5 ... 5 Dum-Dum ... 555 Barrackpore ... 441 2 2 ... 1 Berha m p o r c (9 months) ... 261 1 ... 2 ... 5 8 ... 5 Total ... 2,059 3 12 2 5 1 1 ! 15 73 11 5-34 Darjeeling (11 months) 446 Darjeeling Depot (9 months) ... 105 Hazareebaugh ... 104 ... ... ... ?' Dinapore ... 854 1 1 2 ... 1 Benares ... 603 1 1 ... ... ... I 2 ... 1 Fyzabad ' ... 829 ... ... ... | [[[ Lucknow ... 2,215 '.'.'. 1 ..' 6 1 .'." ... 1 9 ... 7 Seetapore (9 months) ' 553 Futtehghur ... 232 '," Cawnpore ... 722 3 3 I .. ? Allahabad ... 910 1 1 2 I ... 2 I Total ... 7,438 1 ... 1 ... 11 4 1 18 | -24 11 1-48 Shahjehanpore (9 months) ... 437 ! Bareilly ... 894 I j ... Nynec Tal Depot (8 months) ... 337 : Landour Depot (7 months) ... 206 ! Roorkee ... 320 ... : ... ... ... ... Sappers, Chuckrata Road (9 months) ... 17 j . ... ... .. Moradabad (10 months) ... 313 I ... ... j Meerut ... 1,616 1 1 : 2 Muttra ... 425 ... ... ... ... ... .'.'. ... ... .'" ... ... ... Total ... 4,582 1 1 , 2 -05 Agra ... 908 2 1 3 Morar ... 784 1 1 2 Gwalior Citadel ... 220 ... ... ... ... Seepree (10 months) 146 Nowgong ... 185 I Saugor ... 763 1 ... 2 i 3 i ... 2 Jubbulpore ... 633 j 310 3 16 ... 12 Total ... 4,170 3 10 3 4 1 2 ... 1 24 -58 14 3-36 * In connection with prevalence of cholera in Lower Bengal, the repeated outbreaks of the Chinsurah Depot should not be lost sight of. CHOLERA OP THE EUROPEAN AND NATIVE ARMIES AND JAILS, 1854-68. CHOLERA OF THE EUROPEAN ARMY OF 1868— continued. AvEBAGB NUMBEB OF ADMISSIONS INTO HOSPITAL IN EACH MONTH. TOTAL ADMITTED DIBD SIS Iu KblnK b1nI H j Admis- pek cent. Numbeb peb 1,000 STATIONS. xhe™d «o» «™ »«. I °* Jan. Feb. Mar. April. May. June. July. Aug. Sept. Oct. Nov. Dec. y Stbength. Sibbkgth. OCCUPA" Umballa ... 972 Dugshaie (10 months) 727 ••• ••¦ Kussowlie Depot (8 months) ... 380 % ••• Subathoo (9 months) 670 Phillour (11 months) 70 Jullundur (9 months) 750 ••• ¦¦• Ferozepore ... 817 Mooltan ... 774 Dera-Ismael-Khan . . . 99 ¦•• Sealkote ... 974 Dhurmsalla Depot (7 Umritsur and Go- | vindghur ... 130 ••• Fort Lahore ... 84 • • • Meean Meer ... 988 ••• Rawulpindeo (11 months) ... 1,170 ••• Campbellpore (10 months ... 364 ... ••• Attock ... 162 ••• ••• Huzara Field Force ... | ••• Murree Depot (7 months) ... 284 Family Camp near Murree (5 months) 78 ¦¦• ••• •¦• ••• ¦•• • Koad making Detachment Murree Hills (3 months) ... 647 ••• ••¦ „ Dalhousie Hills (6 months) ... 186 Nowshera ... 553 ( Peshawur ... 1,676 ; Troops marching in the Punjab ... ••¦ I j "' "' '" Total ... 12,576 ! j j ••• Troops on the march, Bengal and N. W. - o Provinces I 3 1 2 ... j 6 ... 3 Bengal Presidency 31,560 ... 1 61010 20 816 5 3 4 4 j 87 '27 57 1-81 Mq JJJ] CHOLERA OP THE EUROPEAN AND NATIVE ARMIES AND JAILS, 1854-68. ClvH NATIVE ARMY IN THE EPIDEMIC OP 1866-68. CHOLERA OF 1868. Average Number op Admissions into Hospital in bach Month. Admission Died fer strkngth lotal rate pfr total 1,000 of DURING T " ~ D *"°" CENT. OF DEATHS AVERAGE STATIONS. this pkhiod ™ Strength or the Strength °*' Jan. Feb. Mar. AprU. May. June. July. Aug. Sept. Oct. Nov. Dec. Y r»» fob each Year. in each occupa- r J IEAB - Province. Province. TION. I Fort William ... 620 1 1 J"I f2 * Alipore ... 672 19 2 ... 1 1 ... 1 If J I)uin-Dum ... 619 1 1 1 2 ... ... 1 ... 1 7 3 Barrackpore ... 1,044 1 1 2 ... 1 5 4 Berhampore ... 12(3 ••¦ ... ... • ••• ••• Dacca - 355 3 1 1 ... ... Cachar ¦•• 338 ••• ... ... Shillong and Cherra- « si poonjee ... 890 | ... ... ... 8 4 1 ... 13 )¦ '66 U ... J- 251 Gowhatty ... 350 j ... ... ¦•• Tezpore (11 months) 423 j ... ... ••• ••• Nowgong ...• 87 ••• ... 1 1 % \ Debrooghur ... 887 ... 1 - 1 * l BuxaDooar ... 637 ... ... •¦• ... ¦Julpigoree ... 556 ... ••• .J Bhaugulpore (11 months) ... 407 j ... .. ¦¦• - J f- ••• ¦> Hazareebaugh | (11 months) ... 110 I - ••• | I ¦•• I I Dinapore ••• 600 j ... ... ••• ••• 1 A I l Segowlie ... 306 ••• ••• ••• Benares ... 5(33 ••• ... 1 i x I Goruckpore ... 605 ••• ... ... Fyzabad ... 726 ! ••¦ ••• J -i ' _* Lucknow ... 1,917! ... ... 1 1 2 \> ' U j2 }- 1 27 Seetapore (9 months) 394 1 ... - ... Futtehghur ... 189 ... ¦¦• ••¦ Cawnpore ... 644 ... 1 ••• I Banda ... 364 ... ... ... ¦¦ ... ••• ••• Allahabad ... 785 | ... ... 1 ... - 1 ... 1 ... 2 1 6 5 1 Nagode (10 months) 743 ¦•• ... ••• |J L ¦•• J Shahjehanpore ... 252 ••• 11 [ ••• Bareilly ... 961 ... 1 ••• ... 1 l Eoorkee ... 452 Eoad-making Detachment, Chuckrata Road (9 months) ... 405 ... ... I ••• L -08 '" }• "20 Almorah ... 618 \" ... 1 ... 1 Deyrah ... 120 ... Moradabad ... 428 ... ... ... Meerut ... 998 | ... Allyghur (8 months) 518 I ... ••• ••• ••• | j ¦•¦ Delhi ... 694 ... 2 ... 2|J I, - J Agra (11 months) ... 710 ... ... ... ... ••• ••• I Morar ... 1,742 ... Jhansi ... 752 ... Nowgong ... 430 Jubbulpore ... 741 ... Augur (11 months)... 265 ••• I -03 «{ "' \- "16 Mehidpore (llmonths) ... 391 ... Deolee ... 211 ... ••¦ j ¦•' Saugor ... 823 ... ••• I "J I Malligaum ... ••• 2 i I Umballa (10 months) 837 ... ... ... | ••• J r'" < Simla (8 months) ... 141 ••• ••• ••• — Loodianah ... 107 Jullundur ... 540 I ... Ferozepore ... 508 ... Mooltan ... 1,137 "• "' J Dhurmsalla (B months) 670 ••• Bukloh (8 months)... 515 . ... ... ¦" ••• UmHtsur ... 152 ••¦ •¦• | •" j. "01 «{ •" }¦ ... MeeanMeer ... 803 ' ¦•• ••¦ Rawulpind cc (llmonths) ... 1,222 ! ... "• ••• | Attock ... 173 ••• ••• ••¦ ••• | Peshawur ... 4,062 ; 1 •" ••• l \ '" Hazara Field Force ... I Troops on the march, I Punjab ... ... j | J *- ••' J Troops on the march, Bengal and N. W. „„ ,„ Provinces ,*2O ... '" ' d Z6 '" 16 '" | Bengal Pbesidenct 40,770 ITT 414 512 9 7 4 3 2 7. 93 | -23 | 45 TlO I • 7th Native Infantry on board boats on the Bhurmpooter. t The 26th Native Infantry on the march eastwards from Mehidpore and Auj?ur. |j ' 35 CHOLERA OF THE NATIVE ARMY OP 2868— continued. AVBRAQE I NCMBBB OF AUMISBIQNS INTO HOSPITAL IK BACH MONTH. ADMISSION DIED PKlt I b ™™ Total BiIB)PEB total 1,000 of I STATIONS THE PERIOD *,™t CI!NT - 0P DD * ATHSi AVERAGE STATIONS. the «""°d sions I Stmbnotu of ihk I strength . * Jan. Feb. Mar. April. May. June. July. Aug. Sept. Oct. Nov. Dec. 9* IHE for each Yeas. in each tion." I Province. [ Province. Augur ... 239 Goonah ... 307 | Sehore ... 870 Sirdarpore ... 356 ... ... ... ... Kherwarrah ... 616 Erinpoorah ... 848 Deolee ... 745 j I ... Jeypore ... 66 Centbai, India Foece 4,047 Murdan ... 897 Abbottabad (9 months) 1,484 1 1 I ... I Kohat ... 2,424 I ... I Bunnoo ... 1,028 ... Dera-Ghazee-Khan... 1,385 Dera-Ismael-Khan ... 1,721 Rajanpore ... 410 ... ?. ... ... I Bhawulpore ... 260 Peshawur (7 months) 574 Huzara Field Force (5 months) ... 1,761 ... Punjab Fbontieb Fokce ... 10,308 1 1 | 158 CHOLERA OF THE EUROPEAN AND NATIVE ARMIES AND JAILS, 1854-68. No. Ill] 1854-68, CHOLERA OP THE EUROPEAN AND NATIVE ARMIES AND JAILS, 1866-68. JAIL POPULATION IN THE EPIDEMIC OP CHOLERA OP 1868. AvBRAGB NUMBBB OF ADMISSIONS INTO HOSPITAL IN BACH MONTH. AbMIB t^CENI ToTAL DIED PEB JAIL STATIONS. S ™™™ _- sions o* " »^« thbYkab. Jan. Feb. Mar. Apl. May. June. July. Aug. Sept. Oct. Nov. Dec. 77 B ™ | Strength. Ybab - Stbength. Alipore ... 2,451 1 5 11 1 5 5 1 ... 1 1 4 2 37 ... 12 Baraset ... 130 ••• •¦• ••• Jessore ... 766 ... 1 1 1 12 4 ... 10 ... 1 Kishnaghur ... 368 1 3 ... 4 ... ... Moorshedabad ... 158 1 1 2 ... 2 Howrah ... 141 ... 1 ... ... J - J Hooghly ... 549 4 ... 2 6 ... 2 Serampore ... 27 ••• Burdwan ... 324 9 9 ¦•¦ •¦• Bancoorah ... 496 5 5 ... & Purulea ... 141 ••• Raneegunge ... 31 Sooree ... 302 ¦• — ••• RajinehalandPafcour 111 2 5 ... i •¦• 4 Deojjhur and Sub-divisions ... 89 •• ;•• ••• »¦ Maldah ... 88 ... 2 ... 1 1 1 7 12 ... 3 Dinagepore ... 402 3 5 4 12 ... 1 Eajshahye ... 532 3 37 17 1 1 59 ... 37 Rungpore ... 399 Bograh _ ... 191 14 ... 14 ... 8 Mymensing ... 395 1 1 ••• ••• ••• Pubna ... 149 1 1 Furreedpore ... 409 ... 1 1 2 Backergunge ... 522 10 ... 9 1 9 4 33 ... 19 Noacolly ... 247 Chittagong ... 231 1 H i 2 ••• 4 Tipperah ... 323 1 5 6 ... 1 Dacca ... 427 2 1 1 1 16 ... 5 Sylhet ... 366 Shillong ... 44 ••• ••• ¦•• ••• Cachar ... 181 1 4 ... 5 ... 2 Gowalparah ... 137 1 1 Gowhatty ... 183 Seebsaugor ... 100 Nowgong ... 80 Tezpore ... 170 1 1 Debrooghur ... 83 2 1 3 ... 1 Midnapore ... 496 1 1 Balasore ... 136 ••¦ ••• Cuttack ... 388 11 ... 1 Pooree ... 85 Sumbulpore ... 73 Chyebassa ... 121 Ranchee ... 231 1 1 ... 1 Hazareebaugh, Cen- Hazareebaugh, District ... 217 Monghyr ... 354 1 ... 1 1 3 Bhaugulporo ... 302 2 1 3 ... 1 ... Purneah ... 309 Darjeeling ... 53 Total ... 15,160 2 10 29 57 51 9 10 7 2 9 42 30 258 170 110 7"26 Gyab ... 361 Patna ... 399 1 4 1 1 4 ... 2 1 1 15 ... 6 Deegah ... 620 13 5 5 1 1 16 ... 4 Arrah ... 351 ... 1 3 1 5 Chumparun ... 246 1 1 ••• 1 Mozufferpore ... 293 3 3 ... 1 Chuprah ... 265 1 1 •¦• •¦• ••• I Ghazeepore ... 461 Benares, Central ... 961 1 1 ... 2 ... 1 Benares, District ... 439 ••• ••• ••• ••• I Mirzapore ... 249 1 1 ... 1 3 ... 1 ... Azimghur ... 327 ••• ••• ••¦ ••• I Jounpore ... 165 Goruckpore ... 556 5 1 6 ... 5 Bustee ... 109 Gonda ... 568 Baraitch ... 199 Fyzabad ... 1,028 Sultanpore ... 466 ••• ••• ••• ••• Rae Bareilly ... 184 •¦• «•• ••• ••• I Pertabghur ... 196 Huisdui ... 271 I »•_ ••• -I Carried over ... ... ... 1 ... 4 11 7 12 7 4 2 2 2 52 ... 19 CHOLERA OP THE EUROPEAN AND NATIVE ARMIES AND JAILS, 1854-68. CHOLERA OF THE JAIL POPULATION OF 1868— continued. i ~ ~ II AVEHAOE NUMBEB OF ADMISSIONS INTO HOSPITAL IN BACH MONTH. TOTAL ADMITTED fOTAt DIED PER T.tr CTiTrnMQ Strength A"f""A "f"" MB OKST - Deaths 1,000 of JAIL STATIONS. FOB THB signs «f O p thk Atbbaqe Yeab. I Jan. Feb. Mar. April May. June. July. Aug. Sept. Oct. Nor. Dec. y b ™ sVren,,th Yeab> SIBBIfG TK. Brought forward ... 1 ... 4 11 7 12 7 4 2 2 2 52 ...I 19 ! Luckimpore and Kheree ... 183 ... ... ••• •¦¦ Lucknow, Central ... 1,698 Lucknow, District ... 839 Seetapore ... 883 _ Nawabgunge ... 82 Oonao ... 159 ... ... ¦•• ... Humeerpore ... 165 Oraie ... 128 Futtehghur, Central 499 Futtehghur, District 290 | Cawnpore ... 370 j ... ... Futtehpore ... 338 , Banda ... 381 j I Nagode ... 77 j Allahabad, Central... 1,848 | 2 2 ... 2 Allahabad, District..; 558 Total ... 17,400 ... 1 2 4 11 7 12 7 4 2 2 2 54 "31 21 I*2l Raepore ... 391 Belaspore ... 69 Bandhara ... 122 ... ... ... ... 'Chanda ... 132 ... JNagpore ... 913 1 ... 1 2 ... 2 Chindwara ... 72 Wurdah ... 57 Sironcha ... 20 | Mundla ... 49 2 2 ... 1 Jubbulpore ... 694 Dumoh ... 91 Saugor ... 208 Nursiugpore ... 140 1 1 ... 1 ... Lullutpore ... 166 Jhansi ... 234 ... | Seonee ... HO 2 2 ... > Baitool ... 50 Sehore ... 107 Hoshungabad ... 290 Nimar ... ... 61 Ajmere ... 377 Beam- ... ... 87 Total ... 4,440 4 2 ... 1 7 *16 6 T35 Muttra ... 198 Agra, Central ... 1,802 ... Agra, District ... 348 Etawah ... 228 Mynpoorie ... 325 ... ... ... ... Allyghur ... 359 j ." Bolundshuhur ... 131 Shahjehanpore ... 257 ••¦ ••• ••¦ •¦• Bareilly ... 1,175 ... ... ..[ \\[ ?, ,„ '„] ... Budaon ... 285 Seharunpore ... 161 Bijnour ... 158 I '" Deyrah ... 43 , Almorah ... 135 ! 1 ... 1 Mozuffernuggur ... 119 "* f ... ... Moradabad ... 253 Meerut, Central ... 1,103 ... ' Meerut, District ... 151 ?[ ..[ '"' "" \" t '['_ \ J \\ '" ?[ ... 1 Total ... 7,231 1 ~ 1 ... ... ... T7 2 -Q3 CHOLEHA OP THE EUROPEAN AND NATIVE ARMIES AND JAILS, 1854-68. No. Ill] 161 CHOLERA OF THE JAIL POPULATION OF 1868 —concluded. AVEBIGE N«HM. O. ABHIBBIOITB 1«O HOBPITH W KAOH MOK.H. £«« £„ £o«Al DI«D P« JAIL STATIONS Strength , _ sions of op TJ£E A ' VEBAGE Te^ Jan. Feb. Mar. April May. June. July. Aug. Sept. Oct. Nov. Dec. °™ s™B^s ™ 8^ Yeab - S™ ekgih - Delhi ... ... 253 Kohtuk ... 185 Sirsa ... ... 268 ... Kurnaul ... 98 I Umballa ... 603 Umballa Gang at Jhugger ... 219 Loodianah ... 166 Jullundur ... 331 ... ... ... Ferozepore ... 338 Umritsur ... 535 Lahore, Central ... 1,849 Lahore Female Jail 150 Sealkote ... 301 ••• - I Dhurmsalla ... 114 ... ... Goordaepore ... 225 Gooj ran walla ... 382 Goojrat ... 250 | Sha'hpore ... 329 ' ••• Jhelum ... 264 | Montgomery ... 346 Mooltan ... 691 Dera-Ghazee-Khan... 367 i Dera-Ismail-Khan . . . 332 ••• ••• ¦•• Bunnoo ... 100 ••• ••• ••• ••• Eawulpindee ... 1,213 Peshawur ... 423 ••• •¦• •" ••• '•' Total ... 11,056 _^ ••_ _•_• - •» »• -_ __•_ - Bengal Peesidenct 55,287 "T 17171" ~62~ 20 24 15 71144 32 321 -58 | 137 246