28 L. Rogers — Special Report on Fever in Dinajpiir Dist. [Supplt. 



This table presents several points of interest. In' the first place 

 it brings out the fact that all varieties of diseases are returned by the 

 village chaukidar as " fever, " a point which will be further illustrated 

 when I come to discuss the cases classed above under " Other causes." 

 The most striking evidence in this connection is the fact that although 

 in the figures for the Dinajpur district for 1902 only 007 per thousand 

 deaths were recorded under the head of " Dysentery and Diarrhoea," 

 yet we find that among the cases returned as " fever " in the circles 

 investigated no less than 163 per cent, belonged to this class, while in 

 many other cases diarrhoea and dysentery were present as complications 

 of malaria, phthisis and other diseases. The total death-rate of the 

 district from fevers having been 37 per thousand, it is evident that the 

 death-rate under dysentery and diarrhoea should have been about 4*5 

 per thousand, instead of 0"07, or in other words, only one case out of 

 63 dying of these bowel-complaints were correctly returned. Of 

 course both dysentery and diarrhoea are often accompanied by fever, 

 which tlie village chaukidar may well consider to be the primary cause 

 of death, but the fact remains that the figures yearly published in 

 the voluminous tables of the Sanitary Commissioner's annual report, 

 the yearly variations of which have to be carefully explained, are, to 

 say the least of it, grotesquely inaccurate and necessarily so under the 

 present conditions of reporting. These cases of bowel-complaints, 

 together with the deaths classed as " born feeble " (a term which will 

 be explained presently) and many of those under " Other causes, " 

 together make up almost one-third of the total, all of which have been 

 incorrectly returned under the head of " fever. " 



Secondly, the proportions of the different diseases correctly re- 

 ported under the head of "fever " are most instructive. Thus we find 

 pneumonia accounted for the largest proportion of deaths, namely 

 21 -7 per cent., then came " Chronic malaria " 18*5 per cent., thirdly 

 Acute malaria 133 per cent., and not far behind Phthisis no less than 

 9 per cent., while Bronchitis and Enteric accounted for the greater 

 part of the remaining cases. It will be instructive to compare these 

 figures with those I obtained for another purpose some time ago by 

 analysing 950 consecutive post-mortems on cases from the medical 

 wards of the Medical College Hospital, in order to ascertain the most 

 frequent causes of death likely to be returned under " fever. " At the 

 same time the diagnosis made in fatal cases occurring in the Dinajpur 

 hospital during the last two years may be given. These figures are 

 shown in table III, but in comparing them with the results of the 

 Dinajpur village enquiry certain points must be carefully borne in 

 mind. The most important of these is the question of the ages of the 



