1904.] L. Rogers — Special Report on Fever in Dinajpur Dist. 37 



figures. An examination of the death-rates per thousand from the 

 principal diseases reveals the fact that in the unhealthy thanas (1, 6, 6, 

 and 7) the cases returned under ncute and chronic fever and under 

 pneumonia are especially high as compared with the less unhealthy areas 

 (2, 3, and 4) : further the highest rate for children dying within a few 

 days of birth are also found in thanas (1 and 6), that is just the two 

 which have the highest fever death-rates. The highest rates for phthi- 

 sis are also met with in the unhealthy northern thanas 6 and 7. The 

 rates for bowel-complaints are irregularly distributed in this respect. 

 In line 21 the figures of the- total death-rate from cnses classed as mala- 

 rial fever, including those dying of complications, such as pneumonia, 

 dysentery and diarrhoea, are given, and they bring out clearly the fact 

 that the principal cause of the differences in the death-rates of the un- 

 healthy and less unhealthy circles is mainly due to the greater mortali- 

 ty from malarious diseases in the former class — a point of the utmost 

 practical importance, as it is among these cases that there is the best 

 chance of lowering the mortality and saving lives by proper sanitary 

 and prophylactic measures. This is in fact one of the most important 

 conclusions to be derived from the analysis of the tables, based on figures 

 whicl) have been collected with great care and trouble, and which are 

 at least very much more accurate than the ordinary statistical data 

 available. 



The relationship to the ground water-levels of the health of the 

 different areas shows that these local variations are dependent on the 

 physical characters of the country, which cannot be altered save by the 

 slow operations of nature in raising a deltaic tract or by the more rapid 

 action of severe earthquakes, such as that of 1897, which is said to 

 have improved the health of the Rangpur district, probably by slightly 

 raising the level of the country and thus allowing of better surface 

 drainage and more rapid drying up of the soil at the end of the rainy 

 season. 



The Seasonal Influence of Vaeiation in the Rainfall. 

 In this connection it will be convenient to refer to the seasonal 

 conditions which influence the mortality from fevers in different years. 

 It is unnecessary to go into detail on this point, as the results of a 

 close study of the monthly rainfall of different parts of the district and 

 the fever death-rates for the last ten years have only confirmed the very 

 close relationship between a marked deficiency of the rainfall and a 

 high death-rate from fevers, which I pointed out in 1897 in my report 

 on Kala-azar^ to have been characteristic of the Rangpur and Dinajpur 



1 Report on Kala-azar, 1893, 



