1904.] L. Rogers — Special Report on Fever in Dinajpur Dist. 31 



Lastly, the term " born feeble " lias been used to denote a very 

 common class in which infants die during the first few days of life, 

 being invariably returned under the head of " fever " by the bewildered 

 chaukidars. These cases form no less than 10 per cent, of the total 

 mortality thus returned, and account for a great part of the very high 

 infant mortality. In only a small proportion of these could a history of 

 premature birth be obtained, but as the informants were nearly invari- 

 ably men this proportion was probably too low. In a larger number it 

 was found on enquiry that the infant was small and thin at birth, al- 

 though syphilis does not appear to be nearly as common in the villages 

 as in the town. An attempt was made to ascertain if this mortality was 

 due to immaturity of the mothers or over-freqnent child-bearing, but the 

 husbands nearly always professed complete ignorance of their wives* 

 ages, or stated that it was from twenty to thirty even when they had 

 but one child. One important fact was, however, ascertained, namely, 

 that in a large proportion of the cases the mothers had suffered from 

 malarial fevers for some time in the last month or so before delivery, 

 while it will be seen from table IV that the majority of these feeble in- 

 fants were born during the height of the malarial fever season from 

 August to December. These facts point to the high infant mortality 

 being largely due to repeated malaria during pregnancy causing the birth 

 of many very feeble infants, which succumb in a few days after their 

 entrance into conditions which they are unfitted to withstand. The 

 other chief cause of the high infant mortality is diarrhoea, which is most 

 prevalent during the hot weather months. In several of these cases the 

 mother had died either during delivery or from puerperal septicaemia, 

 the infant being fed on cow's milk. As may easily be imagined its 

 chance of survival in a native village under such conditions is small. 

 Several of the early infant deaths occurred in the case of twins, while 

 males died as often as females. 



" Other causes " include two classes of cases, diseases rightly re- 

 turned under fever and those of which fever is not an essential symptom. 

 Among the former are puerperal fever 10 cases, or 1 per cent, of fever 

 deaths; peritonitis 5; meningitis 3; rheumatic fever (?) 1; and lym- 

 phangitis 1, making a total of 20, or 2 per cent. The second class in- 

 clude dropsy 19 cases; child-birth 5, or 05 per cent. ; tetanus neoni- 

 torum 5 ; old age 5 ; malignant tumours 3 ; small-pox I, cholera 3 ; and 

 one each of epilepsy, measles, liver abscess, asthma, bad feeding in an in- 

 fant, snake-bite, syphilis, epistaxis hsematemisisand drowning, all of which 

 had been returned under the head of " fever." Many of these mistakes 

 show obvious carelessness on the part of the chaukidars, but many of the 

 more common errors would appear to be due to want of some small 



