so L. Rogers —Special Report on Fever in Binajpur Dist. [SappU. 



We have, then, clear evidence that phthisis plays a very important part 

 in the death-rate of Bengal villages as v^ell as of the towns, and the 

 disease was especially prevalent in the larger villages with more nume- 

 rous substantial houses with impermeable walls, in which the people de- 

 light to shut themselves up in at night as closely as possible in the cold 

 weather months. Several well-marked cases of the disease were seen in 

 the villages, while it will be seen from tables II and VI that the disease 

 was most prevalent in the northern and coldest thanas. It must, how- 

 ever, be remembered that malarial fever plays a most important 

 predisposing part in the production of pulmonary tabercalosis, so that 

 the high rate in the northern parts of the district may be partly dae to 

 their malarious character. This predisposition is well seen in tv?^o 

 different class of cases, — firstly, in the case of adolescents, in which 

 phthisis frequently makes its first appearance as a seqael to chronic 

 malarial fever, and, secondly, in middle-aged people in whom old and 

 latent tubercle of the lungs becomes fatally active as a result of the 

 resisting powers being broken down by malarious attacks, as I have 

 often seen in the Medical College post-mortem room. 



The only other form of fever which requires comment here is 

 probably enteric. The correctness of the diagnosis of these cases from 

 the history of the illnesses obtained is open to greater question than in 

 most of the other forms of fever deal with, and in no case was a clear 

 history of haemorrhage from the bowel obtained. Cases were, however, 

 met with in every circle visited of two to four weeks' continued fever 

 without signs of pneumonia or other cause, some of which I feel sure 

 were enteric cases. The figures must only be taken as indicating that 

 the disease does occur in the villages in small numbers, while this is 

 supported by the fact that one case was seen in the jail recently, and the 

 diagnosis confirmed post-mortem, and another case was diagnosed in the 

 hospital at Dinajpur about a year ago. That the disease is common 

 enough in Calcutta among natives I demonstrated^ some three years 

 ago, while I have since that time seen cases in Chota Nagpur, and 

 obtained positive serum reactions for typhoid in the blood of several 

 cases sent from that part of Bengal, and have no doubt it occurs not 

 very rarely in the province. 1 have not, however, obtained any evidence 

 durino" this enquiry of its being at all a common cause of death in the 

 Dinajpur district, so am inclined to think that the figure of 1'8 per 

 cent, of fever deaths shown in table II is approximately correct, although 

 probably somewhat under the mark. It was not found to be especially 

 prevalent among children. 



1 Typhoid as a common continaed fever of natives. — Indian Medical Gazette, 

 January 1902. 



