ฆA - f ' ON THE \ / EPIDEMIC of CHOLERA of 1875, 1876 CENTRAL PROVINCES. i"1ปซMH'Ili "1ปซMH'Il . J BY Surgeon Major S. C. TOWNSEND, f. v. c. Sanitary Commissioner, it ' CENTRAL PROVINCES, NAGPUR: PRINTED AT THE CHIEF COMMISSIONER'S OFFICK PRESS. 1878. TABLE OF CONTENTS. SYNOPSIS. Paea. The object of the report 1 Means for the study of the laws that govern the recurrence of epidemics insufficient ... ... ... 2 An attempt to show the relation between atmospheric conditions and the rise and progress of the cholera epidemic of 1875-76, made in the Annual report of the Sanitary Commissioner with the Government of India for 1876 ... ... ... 3 The country delineated in Map No. I, and the spread of the epidemic over it, described in the first section of this report ... ... 4 The spread of the epidemic over particular districts described in the second section ... ... ...ป 5 Facts bearing on the relation of cholera to soil ... ... G The distribution of cholera in different districts, and among different classes of the population ... r 7 The bearing of the evidence collated, on the nature of cholera —. 8 The facts that militate against the theory which regards cholera as a product of the soil ; its occurrence under totally opposite conditions of soil ... ... ... ... 9 The character of the localities in which the first outbreaks of the epidemic occurred ... ... ... 10 The spread of the epidemic in gradually widening circles from these localities. 1 1 The rate at which epidemics spread, and the extreme heat and dry ness of the atmosphere under which the diffusion is effected ... 12 The partial and capricious way in which cholera visits populations dwelling on the same soil ... ... ... 13 The seasonal fluctuations of cholera do not correspond with those of malarial fevers ... ... ... 14 The seasonal fluctuations in the mortality from fever ... 15 The meteorological conditions favourable to the different forms of fever ... 16 The seasonal fluctuations in the prevalence of cholera ... 17 Cholera and malaria are found to differ so greatly in the manner in which they affect the population of a tract of country, that the former cannot be classed with malarial diseases ... ... 18 The seasonal fluctuations in the prevalence of small-pox ... 19 The season of the year favourable to vaccinia ... ... 20 The general similitude in the course and habits of cholera and small-pox affords good ground for assigning to cholera a place in the class of contagious epidemics ... .. ... 21 The evidence that cholera is a contagious epidemic, and that human intercourse supplies the means by which it is spread ... 90, &~i The origin of the epidemic of 1875, not the result of a miasma developed in the soil of the Gangetic delta and conveyed westward by air currents .. 23 Reason for believing that Benares and Allahabad farmed the centre whence the epidemic of 1875 spread over Central and Western India ... 24 The outbreak in the district of Bilaspur ... ... 25 The outbreak at Nasik ... ... ... 26 Ditto Khandwa ... ... ... 27 The first outbreaks of the epidemic of 1876 ... •.. 28 The outbreak in Sambalpur ... ... ... 29 Ditto Chanda ... ... ... 30 Ditto Mandla ... ... ... 3L Ditto Rewah ... ... ... 32 Ditte Betul ... ... ... 33 The influence of fairs and pilgrimages ... ... 34 2 Paea. The spread of cholera along the main lines of communication 35 The exempted areas ... ... ... 36 The direct evidence of importation ... ... 37 The nature and value of this evidence ?. ... 38 Tha gradual diffusion of the epidemic among the population ?. 39 The infection of cholera not communicable to all persons equally ... 40 The incidence of cholera on a population determined by some local condition, which either acts as a medium of communication or as a predisposing cause ... .-• ... 41 The facts that point to impure water as this condition. The annual prevalence of cholera in the Gangetic delta, and its liability to be aggravated by circumstances that tend to increase the impurity of the water. 42 The effect of drought in aggravating the prevalence of cholera illustrated by the epidemic of 1869 in Chhattisgarh and other examples ... 43 The effect of rain-fall in aggravating the prevalence of cholera ... 44 The preference that cholera shows for villages on the banks of streams ... 45 Numerous examples of the connection between cholera and impure water ... 46 The liability of certain places to cholera only at a certain season of the year. The town of Hoshangabad ?. • ... 47 ? • Ditto Bhandara ... ... ... 48 Ditto Chanda ... ... ... 49 Ditto Nagpur ... ... ... 50 The remarkable correspondence in point of time in the recurrence of epidemic cholera in the three towns ... ... 51 The effect of drought and rainfall on the water-supply of the inhabitants affords a better explanation of the frequent incidence of cholera on the same places, on the same or nearly the same dates in different epidemics, than theories of miasmata and air currents .., ... 52 The course followed by the epidemic in individual towns and villages also indicates connection with the water-supply of the inhabitants ... 53 The diminution in the liability of the population to cholera which has invariably followed improvements in the water-supply ... 54 The immunity from cholera of infants at the breast and the excessive liability of adult women ... ... ... 55 The great liability of the " low castes " who are debarred access to the better sources of water-supply ... ... 56 The mass of evidence presented warrants the conclusion that cholera is an infectious epidemic, and that its seasonal prevalence is determined by the action of drought and rainfall on the water used by the people ... 57 The nature of the relation between cholera and impure water ... 58 Impure water may serve as a medium of communication ... 59 Reasons for believing that it more often serves as a predisposing cause ... 60 Annually in the hot weather much of the water used by the people passes through a state of putrescence, and in the rains it becomes charged with putrescent matter from external sources ... ... 61 Facts from which it may be inferred that the material of cholera multiplies in water charged with putrescent animal matter... ... 62 The bearing of the relative prevalence and fatality of the disease in populations drawing water from different sources, on the nature of the rela- tion between cholera and impure water ... 63 The more violent outbreaks of cholera occur in small villages dependent on one source of water-supply ... ... 64 The fatality of the disease varies greatly, and apparently bears a close relation to the amount of putrescent matter in the water used by the people. 65 Jmpure water may serve as a medium of communication and as a cultivating fluid, but it more commonly operates by inducing a specific state of sys- tern favourable to the action of the infective material of cholera ... 66 3 Para. In its dependence for the action of its infective material on a specific state of system, cholera shows its affinity to other infectious diseases ... 67 Europeans under equal conditions are more susceptible than Natives to the infection of cholera, and the disease is also more fatal in them ... 68 This probably results from the difference of diet, but a local determining cause of epidemic outbreaks is as necessary with the European as with the Native, and facts indicate that this cause is commonly impure water. 69 The aggravated prevalence of cholera during times of famine not the result of debility induced by deficiency of food ... ... 70 The progress of enquiry retarded by attributing to general causes, effects that can only arise from a specific cause ... ...71 The period of the incubation of cholera appears to depend on the degree iii which the necessary predisposing state of system has been induced ... 72 Persons may remain infected and capable of infecting others for a considera- ble period without the disease being developed ... .., 73 The infection of cholera may spread in a body of men without an epidemic outbreak occurring ... ... ... 74 Conclusions ... ... ... 75 Measures of prevention based on these conclusions ... ..* 70 Tnland quarantine generally impracticable ... ... ib. Useful measures based on the same principle as that of quarantine may nevertheless be adopted, and the fact that cholera is an infectious disease, cannot be disregarded without danger ... ...77 Measures for the improvement of the water-supply of the people will prove most effectual for the permanent diminution of the prevalence of cholera ... ... ... 78 The work of improvement is encompassed with great difficulties, but is rendered more hopeful by the knowledge that every town and village supplied with pure water is rendered less liable to become a centre whence the infection may radiate ... ?, 79 SECTION I, Illustrated by Maps Nos. l A . and B. Pagb. Description of the country to which the "report applies, and which is delineated in Map No. I ... ... ... J Sources from whence the information contained in the report was derived ... 4 The climate ... ... ... 5 The nature of the water-supply, and its state 'at different seasons of the The season in which cholera chiefly prevails ... ... 10 The meteorology of 1875 compared with that of 1874 ... 13 The meteorology of 1876 ... ... ... ib. Cholera in the Central Provinces during the nine years 1868 — 1876 ... 14 The absence of cholera in 1874 .,. ... . .. Ib, TJie appearance of cholera in 1875— In Nas.ik and Khandwa ?, ... 16 4 Page. The epidemics that spread from these points — The northern epidemic ... 16 The eastern epidemic— The outbreak in the Bilaspur district ... ... 17 ? town of Mungeli ... ... ib. ?> The spread of this epidemic — Westward to Dongargarh ... ... 18 Eastward to Sambalpur ... ... ib. Northward to Mandla and Balaghat ... ... 19 Its further extension westward through Bhandara as far as the Kanhan river ... ... ib. Southward along the Kanhan and Wainganga rivers ... 20 The western epidemic — The outbreak in the town of Nasik ... ib. The spread of this epidemic in a north-easterly direction through Khandesh and Berar as far as the Kanhan river ... ... 21 Its extension northward as far as Chhindwara ... ... 22 southward along the Wardha river ... ... ib. 53 The outbreak at Khandwa ... ... ... ib. The spread of the epidemic thence to Indore and along the Agra road as far as Gunah ... ... ib. Up the Nerbudda valley to Harda and Hoshangabad, and thence by Bhopal to the western sub-division of the Narsinghpur dis- trict ... ... ... 23 The importation of the epidemic into Betul from Harda ... 24 The areas occupied by the epidemic of 1875 ... ... ib. The rate at which the epidemic spread in different parts of the country ... 26 The widest diffusion of cholera is effected during the hot and dry weather... ib. The mortality occasioned by the epidemic in the different districts of the Province ... ... ... 27 The subsidence, &c, and extinction of the epidemic of 1875 in October ... ib. Map No. 18. The first outbreaks of the epidemic of 1876 ... ... 27 The outbreak in the Sambalpur district, and the spread of the epidemic thence to the surrounding States and through Phuljhar to the eastern circle of Raipur ... *.. ... 30 •• . The outbreak in the Chanda district ... ... 32 The spread of the epidemic southward along the Wainganga and Pranhita rivers as far as the junction of the Godavari ... ... 33 Westward into Berar and northward into Wardha, Nagpur and Bhandara... 35 The subsidence of the epidemic in this part of the country in October ... ib. The outbreak at the Bamtek fair in the end of October and resuscitation of the epidemic ... ... ... 36 Evidence of the dissemination of cholera by the people returning from this fair ... ... ... ?. 39 The extension of the epidemic from Ramtek eastward along the routes through Bhandara to Dongargarh and thence to Raipur ... 41 The direction taken by this epidemic the reverse of that followed by the epidemic of 1875 ... ... ... 42 The outbreak at Mandla ... ... ... 43 The importation of the epidemic from Mandla into a village in each of the three districts of Balaghat, Seoni and Jubbulpore ... 44 The origin and spread of the epidemic in the Rewa territory ... 45 The epidemic in the northern portion of the Jubbulpore district .- 46 The epidemic in the southern portion and town of Jubbulpore ... 48 5 Page. The outbreak at Shahpur in the district of Betul, and the spread of the epidemic to other parts of the district 49 The importation of the epidemic into the Hoshangabad district by hill men from Betul 51 The spread of the epidemic from Hoshangabad westward into Nimar, eastward into Narsinghpur and Jubbulpore, and northward across the Vindhyas into the Bhopal territory ib. 53 The further spread of the epidemic from Bhopal to Saugor The prevalence of the epidemic in the different circles of the Saugor dis trict 54 ib. The first outbreak in the Damoh district The relative prevalence of the epidemic in the portions of the Damoh dis trict drained by the Sonar and Biarmi rivers 55 The seasonal course of the epidemic of 1876 corresponded very closely with that of the previous year ; it commenced with the setting in of the hot weather; continued to spread through the hot dry weather ; reached its maximum of prevalence in the second month of the rains, and ceased with the cessation of the rains in the end of September ib. 56 ib. In the course of the two years all the more populous districts were covered by the epidemic The exempted areas for the most part tracts of hill and jungle and remote from the lines of traffic The exempted area east of the "Wainganga and south of Chhattisgarh, including Bustar .*. ... ?, Ib, 57 ป?• The exempted area between Sambalpur and Orissa Slight prevalence of the epidemic of 1875-76 in the districts of the Satpuras, compared with the epidemic of 1868-69 58 ib. The cause of this in the Mandla and Seoni districts The evidence of the great saving of human life that has resulted from the suppression of the Mahadeo fair since 1865 ... 59 General description of the spread of the epidemic of 1875-76 over the country, and of the means by which it was effected ... 63 No evidence of a pandemic miasmatic influence simultaneously covering wide regions, or that the spread of cholera bears any relation to the prevailing wind ... 64 The extreme dryness of the atmosphere during the season in which cholera is most widely spread, unfavourable to the theory which regards air currents as the means by which the diffusion is effected ib. The direction followed by a cholera epidemic will coincide closely with the main line of communication ; and its rate of progress is influenced by the density of the population ib. Railways occasionally convey the infection of cholera to distant points, but they do not afford the means of communicating the infection which exists so abundantly along the lines of road Ib, 66 Consensus of opinion that human intercourse supplies the means by which cholera is spread For the production of the disease in individuals some other factor besides the communication of the infection necessary .., ib. SECTION 11. (Explanatory of tie Series of Maps Nos. 1I X to X) Map No. II, — Nimar— Description of the district ซ,, ... 67 CM 6 Page. Its climate ... 77 ?68 Water-supply ,— • • ..70 Health of population ... .. ..71 Liability to be invaded by cholera epidemics . . ... ib. Cholera in former years .. ... ... 72 On all occasions cholera has first appeared on the road which forms the main line of communication between Bombay and Central India ... 74 The outbreak in the town of Khandwa in 1875 ... ... ib. Cholera in Khandwa in former years ... ... 75 The epidemic of 1872 in Khandwa an example of cholera occurring in the same locality under opposite conditions of atmosphere and soil . . . ih. The relation of the seasonal prevalence of cholera to the nature of the water-supply ... .. ... 77 The spread of the epidemic of 1875 over the districts... ... 79 No evidence of a widespread influence covering the district, and affecting a large number of villages simultaneously ... ib. The outbreak at the temporary terminus of the Holkar State Railway ... ib. The outbreak at the Gutta quarries ... ... 80 „ „ Omkar Mandhata ... .. ib. ? „ Gokulgaon ... ... 81 The immunity of the coolies employed in the construction of two bridges on the Great Indian Peninsula Railway ... ... 82 Cholera in the Pandurna circle ... ib. s, ? villages on the Sukta river ... ... 83 „ „ „ on a stream parallel with the Sukta ... 84 „ „ „ Dhungaon circle % ... ... 85 The fort of Asirgarh, — cholera in former years ... ... 86 Cholera in the Burhanpur circle — „ „ town of Shah pur ... ... 87 ? „ „ Burhanpur ... ... 88 The mortality greater in the suburbs than in the town ... 89 Panjri, Daori, Sarola, and other villages ... ... ib. The epidemic of 1 876 in Nimar ... ... 90 Maps Nos. 111. and IV. (The District of Hoshangabad.) Description of the district ... ... ... ib. Sources of water-supply ... ... 91 Climate ... ... ... 92 It is only during the hot and dry season that cholera epidemics attain to any great degree of prevalence ... ... 93 The effect of the monsoon rains in reducing the prevalence of cholera ... ib. The epidemic oflS75 y —Map No. 111. The villages on the Gunjal^river .... ... 97 ? „ a stream parallel with the Gunjal ... ... 98 The village of Goraria and the neighbouring villages on the Nerbudda ... ib. I lIP 171 I\q ITPQ ATI fHP TVI fWOTi TM \7^T QQ -*- XI O V IXLaL CO vU. lUO JLVXv/J. cil I liVOl ••• ฆ - ซ *^ *ฆ The eastern portion of the Hoshangabad district, Map No. IV. — 100 The first appearance of the epidemic ... ... ib. 7 Page. Liable to cholera only in the dry season ... ... 103 The cause of this ••• ... ... 104 The Sohagpur circle .. • . ... 105 The town of Sohagpur ... ... ... ib. The Babai circle ... ... ... 106 The season favourable to the prevalence of cholera shortened by the early setting in of the rains ... ... ... ib. Map No. V. Illustrates an outbreak of cholera on the Oomur river, in the Xarsinghpur district -.. ... ... 107 Map No. VI. • Illustrates the spread of cholera on the Bhyranj river ... 108 The outbreak in the village of Kattunga close to the Cantonment of Jubbulpore ... ... ... U0 The epidemic of 1876 in the Nerbudda valley ... ... 11l More severe than the epidemic of 1875, owing to season favourable to the prevalence of cholera having been prolonged by unusual delay in the arrival of the monsoon rains ... ... ib. Affords conclusive evidence of cholera radiating from a centre of infection... 112 The epidemic in the Hoshangabad circle an example of cholera running its course wholly in the hot dry season ... ... 114 The epidemic in the Gadarwara circle an example of cholera running its course partly during the intense heat and drought preceding the rains, and partly after the rains had set in ... ... 1 1 8 The epidemic in the Narsinghpur circle an example of cholera running its course wholly during the rains ... ... 119 The epidemic in the towns of Narsinghpur and Kandeli . . . ib. Map No. VII. The epidemic in the basin of the Wan a river ... ... 120 The gradual spread of the epidemic from Nasik to the Nagpur country exhibited in Statement XXI. ... ... ... 121 The epidemic in the Nagpur district an example of the manner in which cholera spreads under the local and climatic conditions which the monsoon produces ... ... ... ib. The first appearance of the epidemic ; its almost simultaneous appearance in the villages on the banks of the Wana for a distance of nearly thirty miles ... ... ... ib. Ground for suspecting that bodies of persons who have died of cholera had been thrown into the stream ... ... ib. The prevalence of the epidemic in the different towns and villages on the stream ... ... ... 123 The villages on the Kistna stream ... ... 124 The villages on the Wana below the junction of the Kistna ... 125 The villages on the Bor river ... ... ... 126 The towns of Wardha and Sindhee and the neighbouring villages ซ. 127 The villages of Saildoh and Lonhara examples of severe cholera occurring in villages drawing water from a single well ... ... ib. The city of Nagpur. Immunity of the population supplied with water from the Ambajhari reservoir ... t%4 128 8 Map No. VIII. Page. The epidemic in the basin of the Kanhan river. Description of the area and the rivers by which it is drained ... ... 128 The first appearance of the epidemic ... ... 129 The greater number of the villages attacked situated on the banks of the rivers ... ... ... ib. The villages on the Chandrabagga river ... ... ib. The villages on the Kolar river ... ... 130 The Kanhan river, and the outbreak in the town of Khapa ... ib. The villages on the Kanhan below Khapa almost simultaneously affected ... 131 The villages on the stream between the Kanhan and Pench ... ib. The immunity of the villages on the Pench river compared with those on the Kanhan _ ... ... 132 The immunity of the villages on the banks of the Kanhan immediately below the junction of the Pench, and of the troops in the Cantonment of Kamptee ... ... ... ib. The mortality from cholera greater in the Kamptee bazars than in the city of Nagpur ... ... ... ib. The Kanhan basin presents great variety in geological formation, but the nature of the soil and sub-soil appeared to have no influence on the prevalence of cholera ... ?. ... Ib, Map No. IX. The Kanhan river from its junction with the Pench to its junction with the "Wainganga ... ... ... 133 The prevalence of cholera confined almost exclusively to the villages on its banks, and on the banks of one of its tributary streams ... ib. The epidemic appears to have reached the lower Kanhan from the eastward, and to have here met the epidemic that spread eastward from Nasik ... 134 The nature of the water-supply used by the inhabitants of the towns and villages on the large rivers „. ?, ... ib. Map No. X, The prevalence of cholera in certain villages on the Wainganga river ... 140 The town of Bhandara experienced immunity from cholera till the end of the season, when a remarkable outbreak occurred among the low castes using the water of one of the tanks .„. ... 143 Facts bearing on the theory which assigns to cholera an origin from the soil. ib. No formation confers immunity from cholera, and cholera prevails irrespec- tive of the nature and condition of the soil, and of the position of the town or village ... ... ... 143 Cholera prevails with equal severity under totally opposite conditions of soil. 144 Bhandara in 1869, and Chanda in 1869 and 1876, afforded examples of cho- lera prevailing during the tains when the water in the wells was rising, ib. Jubbulpore affords an example of cholera prevailing in the same locality under totally opposite conditions of soil, in one year under extreme drought, in another after the soil had been saturated by heavy rain ... 146 The epidemio in the town of Kaipur in 1869 an example of cholera prevailing under conditions of extreme heat and drought ... 147 The epidemic of 1871 and 1872 in St. Petersburg!! an example of cholera occurring under conditions of extreme cold, and when the ground would he frost bound and covered with snow ... .ซ• 148 9 PIGE. The soil theory based on the circumstance that in the Gangetic delta, where cholera is constantly more or less epidemic, the soil is alluvial, and the conditions are considered favourable to the development of malaria : but in other parts of India cholera shows no preference for alluvial soils, or for localities where malaria is more abundantly developed than in the Gangetic delta ... ... ... 149 The soil conditions under which cholera and malarial fevers are most prevalent, differ greatly in the Gangetic delta as well as in other parts of India, ib. The great density of the population in conjunction with exposed and polluted sources of water-supply sufficiently accounts for the more constant pre- sence of cholera in the Gangetic delta ... ... 150 SECTION 111. The distribution of cholera in different districts and among different classes of the population ... ... ... ib. The prevalence of the epidemic less in the sparsely populated tracts of country ... ... ... 151 The influence of density of population on the prevalence and spread of cholera subject to certain modifying conditions ... ... ib. The villages attacked fall into groups around certain centres or extend along the banka of streams ... ... ... 152 In all the districts the greater number of the villages escaped cholera, but the epidemic visited all the towns or centres of population ... ib. The severity with which the epidemic fell on the different towns varied greatly ... ... ... 153 The degree of prevalence dependent on the nature and condition of the water-supply ... ... ... ib. Towns in which improvements in the nature of the water-supply have been followed by diminution in the liability to cholera ... ib. The fatality of cholera varies greatly in different outbreaks, and probably depends on the degree to which the water is contaminated ... 155 The incidence of cholera on persons at different periods of life ; — the remarkable immunity of infants at the breast ... ... 157 The excessive liability to cholera of adult women ... ... ib. The excessive liability to cholera of " low castes" who are debarred access to the better sources of water-supply ... ... 159 STATEMENTS. No. I.— The distribution of the cholera epidemic of 1875 in the Central Provinces 2 II. — The dates of first cases and prevalence of cholera in the different circles and towns, Appendix IV. 111. — Average mean monthly temperatures of nine stations in the Central Provinces 6 8 9 IV. — The mean humidity observed at eight stations in 1876 V. — The average monthly rain-fall of 22 stations Via.— The chief features of the climate of the Central Provinces in 1875 ... •ฆ• #.. 11 Ml *•• 10 Pag* No. Vlb. — The chief features of the climate of the Central Provinces in 1876 ... ... ... 12 VII. — The number of deaths from cholera in each district during the nine years 1868— 1876 ... ... 15 VIII. — The number of deaths from cholera in different districts during each month of 1875 ... ... 28 IX.— The number of deaths from cholera in different districts during each month of 1876 ... ... 29 X. — Resultants of the wind directions recorded at the observatories in the Central Provinces in 1876 ... ... 65 Kb. — The meteorological conditions in each month of 1876 at Khandwa ... ... ... 69 XI. — The monthly mortality from cholera in the district of Nimar during the nine years 1868— 1876 ... ... 73 XII. — The deaths from cholera and the rain-fall measured in each week at Khandwa during the epidemic of 1872 ... 76 XIII. — The deaths from cholera and rain-fall in each week of the epi^ demies of 1875 and 1876 in the district of Nimar ... 78 XIV. — The meteorological conditions in each month of 1876 at Hoshangabad ... ... ... 92 XV. — The monthly mortality from cholera in the district of Hoshangabad during the nine years 1868 — 1876 ... 93 XVI. — The villages attacked by cholera in the western section of the Hoshangabad district in 1875 ... —95 XVII. — The villages attacked by cholera in the eastern section of the Hoshangabad district in 1875 ... ... 101 XVI Ib. — The spread of the cholera epidemic of 1876 in the Nerbudda valley ... ... ... 113 XVIII.— The spread of the cholera epidemic of 1876 in the Sadar circle of the Hoshangabad district ... ... 115 XIX. — The spread of the cholera epidemic of 1876 in the Gadarwara circle of the Narsinghpur district ... ... 119 XX. — The spread of the cholera epidemic of 1876 in the Sadar circle of the Narsinghpur district ... ... 120 XXI. — The spread of the cholera epidemic of 1875 eastward from Nasik to Chhindwara ... ... 122 XXII. — The number of cases of cholera reported from each village on the Wana river during the epidemic of 1875 . . 124 XXIII. — The prevalence of the cholera epidemic of 1875 over the Kanhan basin ... ป- ... 135 XXI V.-^-The prevalence of the cholera epidemic of 1875 on the lower Kanhan •• ... ... 139 XXV. — The cases and deaths from cholera in certain villages on the Wainganga river ... ?141 XXVI. — The prevalence of cholera in 31 towns of the Central Provinces during the two years 1875-76 . . .. 15* ซXXVII. — The cases of cholera in certain towns and rural circles arranged according to age (the incidence of cholera on persons at differ- ent periods of life) ซ. ... 156 ซ-.ป SIXVIII. — The cases of cholera in certain towns arranged according to class. (The relative prevalence of cholera in different classes of the pppulation) ?, ?, ... 158 11 APPENDICES. No. I. — Official correspondence with reference to the importation of cholera into Chhattisgarh by pilgrims from Jagganath. ll.— Official correspondence with reference to the annual fair at the Mahadeo cave in the Pachmarhi hills as a centre whence cholera waa frequently spread over the surrounding country; and the orders of Government prohibiting it. Extract from " Forsyth's Highlands of Central India," giving a vivid description of this fair, the place where it was held, and also of the destructive outbreaks of cholera that often occurred among the assembled multitude. 111. — The official report by the Officer Commanding, of the severe outbreak of cholera that occurred in a Detachment of Artillery descending the ghats from Mhow to the Nerbudda river in April 1865. IV. — Statement showing the dates of first cases and prevalence of cholera in the rural circles and towna of the Central Provinces in the years 1875-76. V. — A paper on the Calcutta drinking waters. The natural history of changes in the potable waters of tropical climates ; a general comparison between tank, well, and river waters in Bengal, by Surgeon W. J. Palmer, m. d, (republished from the Indian Medical Gazette). Errata in the Maps. MAP. No. lA. Date under Umerwara, Chhindwar* District, should be -—- instead of -—- 7" 1 " 18. „ Chaurai, Chhindwara District, should be -_-— instead of -yj- 11, „ Chorae should [bo - instead of — — - 4 * 1" 7 " „ Gokulgaon should be —^— instead of — - — 5 5 25 ",10'' " 7 „ Pangri ป 0 "10" 5 0 IV. a Mancha ,j ;) 6 VII. Omit date "31 -! from Kanhanpur, aouth^of Sindhee. it 23 'ป •• 6 " VIII. Under Huldolee and Borgaon Burra on Chandrabagga river insert date฿ — — & _^— Pulsoree between Kanhan and Pench, date should be _ -— instead of .. — — 19 " 12 " tX. Pate under Shahpur, (on the road to Raipur) should be _-^- instead of — g _ Errata in Report. Page 8, paragraph 29, last line ; omit " as." t , . ,t . 19. „ 62, for "from the villages in this direction. After the second week of July an out-break" read " from the villages in .this direction after the second week of July ; an out-break." „ 27, „ 99, first line, for "1875" read 1876. „ 28, Statement VIII. Total of September column for " 6,224" read 2,624. „ 30, paragraph 103, 3rd line, omit "from thia locality it Bpread." „ 39, „ 131, sth ? for "was read "were." „ 46, „ 151,5 th „ for " state" read " the." „ 49, „ 157, sth „ for " 1,000 " read " 10,000." „ „ „ ? 7th and Bth lines, for " amounted to 157 by the end of the month read " amounted to 157. By tu e end of the month." „ 65, „ 177, Bth line, /or "prior to this period when the heavy rains came down ;in some Jtb line, for "prior to this period when the heavy rams came down ; in some districts" read "prior to this period; when the heavy rains came down, in some districts." ? 71, paragraph 218, 2nd line, for "but" read "and." „ 72, „ 220, 3rd „ for ซ Khandwa " read " Khandesh." ? 79, „ 235,8 th ? for "compounds" read tc components." ? 81, n 245,2 nd „ for " north-west" read "north-east." ? 82, „ 247,13 th,, for "one of the questions" read " out of the question." „ 90, ? 274,15t „ for "no other cases" read "seven other cases," and jor " but" veal 11 and" ? 94, Statement, second footnote refers to 1869. ? 99, paragraph 255, Bth line, for "those" read " three."' „ 109, 3 1st line, for " remarkable at Esurpur. 20 deaths" read " remarkable ;at ICsurpur 20 deaths." ?111, paragraph 302, for " a slight local out-break" read "slight local out-breaks.'' „ 120, Bth line, for " 2nd week of July ; after the rains had set in the" rexd "2nd week of July after the rains had set in ; the. " „ 127, paragraph 313, sth line, for " 1876 " read " 1875." ? 131, ? 321, 24th line, for Dakhori " read " Wakhori." ? 132, „ 323, last line but one, omit "now." ? 141, Statement, for " Mandur " read " Mandwi." „ 155, paragraph 343, 4th line from bottom, for " had appeared in other towns ; probably " read "had appeared ; in other towns probably" APPENDIX No. IV.— Statement 11. Page 3, totals of Wardha district, number of villages attacked 1875, for "12" read Si 312 " and for ratio " 43 " read " 43." „ 5, date of Ist case at Khandwa in 1876, for "20th July " read " 13th July." HardaTin 1876, for " 12th June" read " 12th May. 1 in Birman Circle for " 18th June" read "Bth June." SYNOPSIS. 1. The object of this report which I have now the honor to submit is to describe the origin of the cholera epidemic of 1875-76, The object of the report. and ifcg gprea( } over a wide port i on o f India comprising the Central Provinces and the territories that surround them ; and to show with a view to preventive measures, the means by which the spread of the epidemic was effected and the local conditions which determined its incidence on particular populations. As these are questions on which opinions continue to be divided, it has been necessary to describe somewhat minutely the manner in which the epidemic affected the populations of numerous localities, and to illustrate these descriptions with maps and figured statements ; and as from this cause the report, with its appendices, has unavoidably become a bulky volume, it will be convenient to preface it with a synopsis of the general facts and their bearing on the above questions. 2. I may first premise that Ido not propose to deal with the wide problem of the laws which regulate the alternations of seasons of ]aw S Thich Or re g e uSe dy the ฃ epidemic activity with seasons in which the disease is turrence of epidemics at pre- comparatively quiescent. The means for investigating this sent insufficient. .• _. „ . „„:+ • r , oll fl฿,,; ฃIT ,+ TV rlool cn/vooefnllv question are as yet quite insufficient. To deal successfully with it we require observations recorded through a long series of years, of the variations in the prevalence of cholera among the general population, in relation with the meteorology of different seasons over the whole of India, and more especially of that part of it from which the disease is never entirely absent. The statistics of troops in cantonments and of prisoners in the jails, from their accuracy* afford valuable means for the study of certain points in relation to cholera, but inasmuch as these bodies of men do not partake in the movement and intercourse of the general population, and the insanitary conditions which render individuals receptive of infection, are less commonly present among them, they are less exposed to contact with epidemics and less liable to be affected by them. We accordingly find that it is almost invariably among the general population that the first indications of epidemic activity become manifest; the troops and the prisoners often escape altogether or remain for weeks unaffected, while cholera has been violently prevalent among the population of the adjoining town or surrounding villages. For evidence of this fact I need only refer to the pages of the report of the Sanitary Commissioner with the Government of India for 1876 ; it there appears that in every instance in which cases of cholera occurred in cantonments, the disease had previously become prevalent among the populations of the neghbouring town and villages. " It is therefore on recorded observations of the variations in the prevalence of cholera among the general population of wide districts, that we must chiefly rely for obtaining satisfactory evidence of the manner and degree in which these variations are related to or are dependent on meteorological changes, and their effect on the conditions of soil and water-supply under which the populations that suffer are living. 3. The mortuary statistics of the several provinces have during the last few years made great advances towards accuracy, and now ArfKTSS. ฃ twe t afford fairly trustworthy means for tracing the rise of atmospheric conditions, and the epidemics and their spread over the country ; and now " P ?de^ S) P mfdTin the te^ort that the collation of meteorological data recorded in all of the Sanitary Commissioner Dar f S o f India is entrusted to an organized department with the Government of India r . r ฐ, . , ซ^lซ*: f or 1870, under one head, ample means for studying the relation between cholera and meteorology will in future be avail- able. A commencement in this direction was made in the report of the Sanitary Commissioner with the Government of India for 1876 ; in the section of that report devoted to the history of the chief diseases among the people, I described in outline the spread of the cholera epidemic of 1875-76 over India, including Cashmere and Cabul, and I gave much statistical and other evidence regarding 2 the meteorological conditions that attended its rise and prevalence in several typical areas. It was shown that in Southern India the prevalence of the epidemic was terribly aggravated by the failure of the seasonal rains and consequent drought; that in certain districts of the Gangetic delta an equally terrible aggravation of prevalence resulted from an inundation by a cyclone wave ; that in the Gangetic plain the epidemic attained its greatest prevalence in the hot dry months of April, May and June ; that in the valley of Cashmere the epidemic first appeared in December, when the ground was covered with snow ; that in the arid tracts of country on either side of the Indus it prevailed under conditions of extreme heat and drought ; that it broke out in Candahar in the hot month of July, but did not appear in Cabul till the cold month of November. It was also shown that elevation has no influence on the prevalence of cholera ; that the disease was equally virulent and fatal at altitudes of from 7,000 to 11,000 feet as on the sea coast or in the delta of the Ganges. But in dealing with an epidemic spread over so vast an extent of country in a section of an otherwise rather bulky report, it was scarcely possible to give more than an outline of its progress and some general facts concerning the meteorological and local conditions that attended it. In this report the area dealt with is more manageable, at the same time it is sufficiently extensive for the purpose of investigating the means by which cholera is spread ; and the great variety in its physical characteristics renders it a most favourable field for the study of the conditions under which cholera prevails in particular localities. 4. The first few pages of the first section of the report are devoted to a description of the country and its climate ; in the remain- Mป?NoTa3 fhfrpfefd 5 of the section, the spread of cholera over the country the cholera epidemic over it, in 1875 and again in 1876, is described. In 1874 cholera ofThfreport 1 ! the first "**** had remained almost altogether absent from the whole area comprised within Map No. 1, with the exception of Orissa and the adjoining districts of Bengal, in which it is always more or less, epidemic ; in January 1875 also with the same exception not a case of cholera was reported from any locality within the area ; in the latter end of February, however, it suddenly became epidemic in the district of Bilaspur near the eastern border of the area, and in the latter end of March it appeared in the towns of Nasik and Khandwa, on the western border. From these points the epidemic spread in gradually widening circles throughout the hot dry season and through the first two months of the monsoon. Taking the whole area, it reached its maximum of prevalence in the latter end of July and beginning of August ; it then rapidly declined, and by the end of October its prevalence had ceased over nearly the whole of the area occupied in the previous months ; it, however, continued to linger in one or two localities till the middle of January, when it altogether disappeared, and there was an interval of three or four weeks during which the whole area delineated in the map, with the exception of Cuttack and Puri, was free of cholera. In the latter end of February, however, the disease re-appeared in the district of Sambalpur on the pilgrim route from Puri ; and in the course o.f the month of March it appeared at four other points within the area widely distant from each other. Radiating from these points the epidemic again spread through the hot dry months and the first months of the monsoon, and by the end of July had again covered wide tracts of country. Several of the districts over which the epidemic had spread in 1875 were again affected to a slight extent in 1876, but the epidemic of the latter year fell chiefly in the districts which had escaped altogether or which had suffered only to a slight extent in 1875 j the epidemic of 1876 was in fact chiefly an extension of the epidemic of the previous years. It again reached its maximum of prevalence in July, continued prevalent through August, and again, as in the previous year, declined rapidly in September, and became almost extinct in October. The outbreak at Kamtek prevented the complete subsidence of the epidemic that had pccurred in the previous year ; and it continued to linger in one or two districts 3 till the'rains of 1877 set in, when the epidemic that commenced in 1875 may be said to have finally ceased. In the course of the two years large portions of the area described were at different times covered, but wide tracts within its confines remained free throughout ; the causes of this exemption are described in pages 56 to 63. 5. In the second section of the report the spread of the epidemic over particular districts is more minutely shown with the The spread of the epidemic help of maps on a large scale. Map No. 11. shows the over certain districts, described in 11 ,ป i> • Z 1* \t- i j.i in the second section. spread ot cholera over the district of JNimar and the adjoining portion of Holkar's territory, for the most part a rocky and elevated tract of country. We find the epidernfc first appearing in the town of Khandwa, the chief town of the district, and the centre of the traffic of that part of the country ; next at the temporary terminus of Holkar's railway ; then at Mandhata, the holy island in the Nerbudda, to which pilgrimages are made from all parts of India. The diffusion of cholera over the district after the first outbreaks was gradual ; the map does not afford any evidence of a widespread influence overshadowing the district and affecting a large number of villages simultaneously ; the places first attacked were along the main lines of communication and at considerable distances apart ; but subsequently the viJlages attacked fell to a great extent into groups. In two or three instances the components of a group were on the banks of the same stream, and the dates on which the first cases were reported form a consecutive or nearly consecutive series. In other instances there is not this connection, and the dates fall at wide intervals of time. The population of several villages suffered severely during the hot dry months of April and May, but the epidemic became most widely prevalent while the heavy rains of the months of July and August were falling ; it declined through September, and ceased with the cessation of the rains in October. In 1876 the duration of the epidemic prevalence was shorter, it did not commence till after the rains had set in, and, as in the previous year, died out after the rains Jiad ceased. Maps Nos. 111. and IV. exhibit the prevalence of cholera in the Hoshangabad district, which occupies a portion of the Nerbudda valley, and consists of a strip of dense alluvial deposit. The first appearance of the epidemic in this district occurred in the month of April at the Railway station at Harda, where the trains by which the Native passengers chiefly travel stop for the night. In the course of the following fortnight other outbreaks occurred along the railway, and the epidemic commenced to spread among the general population. The history of the epidemic in this district again affords no evidence of a widespread influence simultaneously affecting the whole population ; less than 10 per cent of the villages suffered ; those that were attacked falling in groups chiefly along certain streams and rivers ; the weather when the epidemic first appeared was intensely hot, and the hygrometer showed the atmosphere to be for days together almost devoid of moisture. So long as this weather continued the prevalence of the epidemic increased, but with the setting in of the rains in the second week of June it at once declined ; it continued prevalent during the rains in three or four towns and large villages, and did not completely disappear from the district till the beginning of December. From the 10th of this month till the 21st March, the district remained free from cholera. On the latter date, Jiowever, an outbreak occurred in the centre of the district in a party of hill people, who had come from the adjoining district of Betul to assist in the wheat harvest. From this point the epidemic spread both east and west throughout the district, In this year, as in the previous one, the epidemic attained its greatest prevalence during the hot dry months, and declined immediately on the rains setting in, and ceased altogether with the cessation of the rains in the end of September. The spread of the epidemic in 1876 from the locality in which the first outbreak occurred through the whole length of the Nerbudda valley, eastward as far aa Jubbulpore, and westward as far as the western confines of 4 Nimar, is described in pages 111 to 120 ; and its gradual diffusion among the ; population of the different circles is clearly shown in Statements XVI I. to XX. In one part of the valley the epidemic ran its course completely during the hot dry months ; in another portion it attained its maximum of prevalence in the hot weather ; but many villages suffered severely after the rains had set in ; but nowhere in the valley did the epidemic continue to prevail after the rains had ceased. Maps Nos. V. and VI. illustrate the prevalence of cholera in certain villages on the banks of two streams in the Narsinghpur district ; none of the villages in the same locality, but removed from the streams, being affected A similar isolated outbreak in the cantonment of Jubbulpore. is described at pa^e 110, and illustrated by a sketch of the locality. Maps $os. VII. to IX. exhibit the spread of cholera over the basins of the Wuna and Kanhan rivers, which rise in the southern slopes of the Satpuras and flow through the districts of Nagpur and Ward ha. The epidemic of 1875, which spread eastward from JSasik, did not reach these districts till after the rains had set in (pages 121 to-139), and as it ceased with the cessation of the rains,, these maps furnish good illustrations of the means by which cholera is diffused while the rains are falling ; the diffusion was more rapid and partook more of the character of a simultaneous outburst than was the case in other districts ; but it was confined more strictly to the towns and villages on the banks of the rivers and streams. Map No. X. illustrates cholera prevailing in certain villages on the bank of one of the largest rivers within the area of Map 1., and affords a remarkable example of the prevalence of the disease being confined to several populations drawing water from a common source. 6. In pages 133 and 143 to 150, facts bearing on the relation of cholera to .. the soil and sub-soil are adduced ; no special relation is Facts bearing on the sup'- . ' V posed relation of cholera to found to exist between cholera and sou or any particular soil and sub-soil. -nature* • +.hprซ iซ r\n rrtฑ{ \\rxrioa] ฆfrrrmn.t.irm nnH Tin Innfl nf nature ; there is no geological formation and no kind of soil that confers immunity from cholera on the populations dwelling on it. Instances are given of cholera prevailing with equal severity on bare rock as on deep alluvial deposits. Cholera also is shown to have no special relation to any particular condition of soil; several instances are given of cholera occurring in localities in the early part of the rains, when the streams are carrying off the impurities that have accumulated on the surface of the ground during the long period of dry weather, and when the water in the wells is rising. Populations over wide tracts of country are found to be chiefly liable to suffer at this season of the year ; but on the other hand epidemic prevalence is found to decline and become extinct at the end of the rains when the saturation of the soil is every where most complete. Instances are also given of cholera prevailing with severity in the same localities under totally opposite conditions of soil and sub*soil ; in one year when the surface had been exposed to the sun during long periods of drought and the sub-soil water had become exhausted, and in another year after heavy rain had fallen and the wells were in process of being replenished by percolation through the soil. The table exhibiting the mortality from cholera at St. Petersburgh during 1871 and 18^2 (page 148) affords an instance of cholera prevailing under extreme cold, when the surface of the soil would be frozen or covered with snow. 7. In Section 111. the relative prevalence of cholera in different districts of the Central Provinces and among different classes of the in T dฃn\^ population is shown. It was found that on the whole the among different classes of the sparsely populated tracts of country suffered less than popu ation. those in which the population was comparatively dense ; but that the effect of density of population was in a measure neutralized by other conditions ; those conditions being chiefly, deficiency of traffic and communication with other districts, distance from the locality in which the first epidemic outbreak of the season occurred, and the time of year in which the 5 disease had appeared among the population ; and lastly, the condition of the tract of country in respect of water-supply. It was found that in all districts, even in those over which the epidemic was most widely spread, a very large proportion of the villages escaped, hut that without exception all the towns and large villages, which from circumstances formed centres of traffic, suffered. The severity with which the populations of these towns suffered varied ; and facts are adduced which tend to show that this varying degree of prevalence is dependent on the condition of the water used by the people. Statements Not. XXVI. and XXVII., page 154, show that in this country females are far more liable to suffer from cholera than males, and that this liability attaches especially to adult females between the ages of 20 and 50. On the other hand, infants at the breast are almost exempt from liability to cholera. At page 156, Statement XXVIII. it is shown that cholera falls very unequally on different classes of the population ; that while Mahometans and Hindus of the better castes "suffer in nearly equal proportion, the epufemic, as a rule, falls with great severity on the low castes who are debarred from drawing water from the same sources with the rest of the population ; and instances are given of the low castes in a village alone suffering, the other castes remaining free. Exceptions to this rule are, however, not infrequent, and instances are given in which the upper castes suffered while the low castes remained free. 8. We may now consider the bearing of the facts brought together in the The bearing of the evidence re P orfc on tlie question which is still a matter of controcoiiated on the origin and versy among observers in this country, whether cholera nature of cholera. • _ ji JJU a" * '4^^. is a disease produced by an emanation or miasma arising from the soil of the locality in which the suffering population dwells ; or whether it shall be given a place among those diseases which are produced by poisons developed and reproduced within the human organism and capable of being transferred from one person to another. 9. Some of the chief facts that militate against the theory which regards the soil as the essential site of the processes resulting! 1 in The facts that militate against the production of the material inducing- cholera will be the theory which regards cho- n i • It>o Jijo a ika j.u • *.i lera as a product of the soil. found in pages 103 and 143 to 150; the instances there — given of cholera occurring under totally opposite condi- Its occurrence under totally 5ป r ? , , .. ฐ .. . ,-, i ? ? . opposite conditions uf soil tiops ot soil and sub-soil are quite incompatible with this theory. 10. The same may be said of the whole course of the epidemic within the area described from its origin to its decline. After a year The character of the localities o f complete or almost complete immunity over the whole in which tirst outbreaks occur. .* ? ,. r , , J , • ,ซ*ป„ฆ. area, the disease appeared in the early months of 1875 in three or four localities at a distance from each other, but in none of these localities were the conditions of soil such as can be considered favourable to the production of a deadly miasma; the first outbreaks also occurred at the season of the year which is considered least favourable to the development of miasmata. So also in the following year, when after a period of quiescence of several weeks' duration, the epidemic again appeared at the same season of the year in four or five localities within the area. These localities were not the same as those in which the first outbreaks of 1875 occurred. In respect of soil, sub-strata, elevation and facilities for drainage, these localities differed greatly from each other, but in none of them were the conditions such as to lead one to expect that they would give origin to a widespread epidemic. The first appearance of the epidemic in these localities seems to me to be quite inexplicable on the theory which attributes to cholera an origin from the soil of each locality in which it appears ; and the same objections apply with equal force to that modification of the soil theory which regards the Gangetic delta as the constant source of cholera miasma, and that the epidemics that periodically spread over the rest of India are the result of this miasma produced in the delta and wafted beyond it by aerial currents* 6 • y There is no evident reason why a miasma emanating from the Gaagetic delta in the spring of 1875 should light first on certain villages in the Bilaspur district, or why it should traverse the whole width of the Peninsula to seek in the holy place of Nasik a soil suitable for its reproduction, leaving the intervening area unaffected. 11. While the origin of the epidemic of 1875-76 is thus inexplicable under the soil theory, so also is its subsequent course. In neimil^^gradlfaiij'wWeniiig^ tner y ear did the manner in which the epidemic spread cies from the sites of the first over the country afford any evidence of atmospheric influoutbreake. ii i _ •ji _... i i • ,1 _ * ฑ _j ence suddenly or rapidly overshadowing the country and evolving epidemic outbreaks in numerous places simultaneously ; but we find it spreading continuously in gradually widening circles from the points at which the first epidemic outbreaks occurred. The dates on Map No. lA, indicating the spread of cholera in opposite directions from Bilaspur to Mmmk in 1875, and the dates on Map No. 18, which show the spread of cholera in all directions from Hoshangabad in 1876, afford ample evidence that cholera epidemics do radiate from certain centres. The Statements Nos. XVII. and XXI (pages 113 and 122) also show how the appearance and spread of the epidemic among the populations of the several districts was delayed in proportion to their distance from the locality in which the first outbreaks occurred. 12. That the diffusion of cholera from these centres was not effected by aerial currents, is evident from the wind directions given in Statements Nos. VI. to X. and at the foot of No. XXII. dryness of the atmosphere under Moreover, the comparatively slow rate at which epidemic which the diffusion is effected. , , ? ? * , " , , r , . l -it* cholera ordinarily travels, and the tact that the spread of cholera in 1875 and 1876 over the dry regions of Central and Western India was mainly effected during the hot dry months, when the air is often for weeks together almost devoid of moisture, are opposed to the notion that air currents constitute the agency by which the morbific matter is diffused. It is scarcely consonant with received opinions regarding the nature and properties of a miasma that it can be conveyed through long distances and retain its active properties in an atmosphere at a temperature of 112ฐ and almost perfectly dry, (see Meteorological data at foot of Statement No. XVIII. page 117, also Appendix No. III.) 13. Another circumstance in the conduct of cholera which shows that it has no relation to the soil, is the very partial and capricious was- he in P which way in which it visits populations dwelling on soil of the populations dwelling on the same nature. In none of the districts that were covered same soil. ซ_ ? ? . ซ -, nnf - nr* _i - • ii.. t _ _ .r _ by the epidemic of 1875-76, not even in those where the soil was of the same character throughout, were half the villages visited ; and in all the maps we find in close proximity to the villages that were attacked others situated on precisely similar soil, yet remaining perfectly free; and not only this, but we find in the same locality, town or village, one part of the population suffering more or less severely from cholera, another portion remaining free; take for instance the cantonment ofKamptee (Map No. VIII.), — here we find a widespread epidemic of cholera involving many villages on all sides of the cantonment and even the population of the bazars, yet the European troops remained entirely free and the Native troops nearly so (page 132) ; and again in 1876 the Native population of the bazar suffered from cholera, but the Europeans again escaped. Yet Kamptee is not a particularly healthy station for Europeans. In both years the troops suffered severely from fever in common with the general population, and in 1876 there was great mortality among them from heat apoplexy. Even the small population of the villages exhibit the same phenomenon of one or more sections escaping cholera, while the others suffered severely (paragraph 346). 14. Again, if cholera were a disease of malarial origin, we should expect to The seaBO nai fluctuations of find its seasons of prevalence and quiescence correspondehoieradonot correspond with ing in some degree with the seasonal fluctuations in the those of malarial fevers. ™ o ,tซ1ซซซซ moiomal fw*™ Knf flu'o i'a ซ/~>f ftia * aaa prevalence of malarial fevers, but this is not the case. 7 The season when malaria is most widely prevalent in the Central Provinces, commences in the end of July or beginning of August, and continues till the month of January ; September and October being the months in which the greatest mortality from this cause occurs. Cholera epidemics, on the other hand, commence in February or March, continue to increase in prevalence through the hot months of April, May and June, and attain their maximum of prevalence either in June or July; they usually continue to prevail through the first part of August, but always decline rapidly in September, and become almost extinct in October. The fever season is in fact the season in which cholera declines and becomes extinct. 15. The first of the three diagrams which will be found in the case that .. ? contains the maps that illustrate this report, represents Diagram representing the - „ , C . r , ? r • ' S . ? seasonal fluctuations in the the fluctuations in the number oi deaths registered in the mortality from fever through Central Provinces under the head of fever through the a series of years. .__ i™-,ซป- & five years 1873-1877. "With our present means of collecting mortuary statistics, it is scarcely possible to show with exactitude the extent to which the population has suffered from the effects of malaria in any particular year or season. At all seasons of the year a very large number of deaths are registered under the head of fever, but about 30 per cent are deaths of infants under one year of age, and many have no doubt been the result of other causes ; and even of those fevers which have been the cause of death a very considerable proportion have not been of malarial origin. Nevertheless, after making due allowance for these sources of error, the diagram referred to represents in a remarkable degree what are known from experience to be the seasonal fluctuations in the prevalence of fevers in this part of India. In the course of the 5 years the number of deaths registered under the head of fever in any one month has never been under 6,000 ; taking therefore this number as zero, the monthly rise and fall in the numbers above it will represent very fairly the fluctuations in the fever mortality. It will be observed that the numbers approached zero annually in February with great regularity ; the mortality rises through March, April and May ; in June it again falls, and in that or the following month again approaches the zero figure. In July or A ugust the mortality again increases, and as a rule rises rapidly and continuously till October or November, when the maximum monthly mortality of the year is attained; it then usually falls rapidly to its minimum in February. The fever season, or the season in which malarial fevers are most widely prevalent, extends from about the middle of July, when the soil has become thoroughly saturated by the rains of the monsoon, till about the middle of November, when the surface over the greater part of the country has again become dry and hard. The prevalence of malaria varies in degree and in duration in different years, but usually it is not considered safe to go into camp in the districts till about the middle of November, and even then the jungle tracts are avoided; after February the country is considered free of malaria, and almost every part may be visited without fear. In the hot dry montfcs of April and May it is a common practice with European officers to sleep in the open air at night, and no harm results from it. The fevers then that cause an increase of mortality at this season of the year are not due to the effects of malaria then present, but are more probably the result, directly or indirectly, of extreme heat and dryness. In March there is usually a great and sudden rise of temperature compared with February, and April and May are the hottest and driest months of the year. The rains usually set in -about the middle of June, and even in the early part of the month thunder-storms with rain are frequent; the weather becomes appreciably cooler, the dry northerly winds give place to the south-west monsoon, and the moisture of the atmosphere increases considerably.* With this change in the weather the fevers of the hot season •Nots I. — For the chief meteorological features of the different months, see Statements 111. to Vl.a and b, pages 6to 12. The year 1875, the chief features of which are given in Statement Vla, may be taken as an average ye.tr, excepting that the rise of temperature in March was greater than usual. 8 decline, and the soil being not yet sufficiently saturated, the malaria is not yet developed in any quantity. The latter part of June and first weeks of July therefore form, next to the month of February, the healthiest season of the year. 16. It scarcely comes within the scope of this report to enter into the rela- The meteorological conditions tion between the variations in the meteorological features favourable to the different and the prevalence of fever in different years ; indeed forms of fever. ฑ i • r , ,• . • • . n? • j_\ i jฑ_ the series of statistics is not sufficiently prolonged to warrant definite conclusions on the subject; but in explanation of the diagram, I may here shortly state that the annual increase of mortality in March, April and May coincides with the rise in temperature and increased dryness of those months ; that the degree of prevalence of malarial fevers between August and November seems to depend greatly on the amount of rain that accompanies the monsoon ; but it is apparently greatly aggravated if an excessive rain-fall supervenes on a hot season in which the heat and drought has been abnormally severe and prolonged ; the decline in the prevalence of fever in November coincides with the setting in of the cold weather, and is rapid and complete in proportion as the temperature of this season is low and normal. The year 1873 was an unusually healthy year ; the temperature of the hot season was moderate, and the rain-fall of the monsoon was much below the average; the mortality in both seasons was comparatively light. 1874 and 1875 were on the whole average years ; we find the mortality rising with the increased temperature and dryness of the months of March, April and May, falling with the fall in the temperature and increased moisture of J une ; but rising again after the soil had become saturated with the rain of July ; reaching its maximum in October and falling again during the cold weather. 1876 was an abnormal year ; the temperatures of March and April were generally above the average ; in May the excess was very great; the dryness of these months also was greater than usual; with this excessive heat and drought the prevalence of the fevers of the hot weather was greatly aggravated. In the latter part of June the heat and drought, though to some extent moderated by thunder-storms, continued much above the average, and the regular rains did not set in till quite the end of the month; the mortality decreased from what it was in May, but it did not fall to the comparatively low figure that usually obtains in this month. The rains of July and August were excessively heavy, and with this excessive rain-fall supervening on the prolonged drought, the prevalence of malarial fevers rose rapidly, reaching a very high maximum in September; this extreme prevalence continued through October. In November the cold weather set in, and the temperature of this and the following three months was considerably below the average ; during this season the mortality decreased and fell to its minimum in February. The meteorology of 1877 was very different from that of 1876; the usual rise of temperature took place in March and the first part of April ; but the latter part of April and the month of May were cool and moist ; the mean temperature of May was 5 degrees below that of the corresponding month of 1876. The mortality of March and April was equal to that of the preceding year, but, the rise was checked in May. Ihe advent of the monsoon was delayed, and the rain-fall of June and July was much below the average ; the decrease in the mortality in June was comparatively slight, but it was continued through July. The rain -fall of August was nearly equal with the average, and the soil becoming saturated, the usual increase in the prevalence of malarial fevers commenced; but the rain-fall of September was below the average, and the mortality of this month and October was much below what it was in the previous year. The fall in temperature that usually takes place in November was in 1877 comparatively slight, and the temperatures of this month and December were 4 and 6 degrees below the temperatures of the corresponding months of 1876 ; in consequence apparently of the cold weather not setting in as usual in November, the decline in the prevalence of malaria that usually occurs in this month did not take place, and the mortality in December continued much; above the average. 9 1 7. We find then that the prevalence of malaria commences in July or „- , - August, according as the arrival of the monsoon is nor- The seasonal fluctuations in ,ฐ -, , , ฐ . . . . ,-. . , the prevalence of cholera mal or delayed ; it attains its maximum in October or through a series of years. November, and then declines, reaching its minimum in February. We shall find that the season in which cholera chiefly prevails is very different. In diagrams Nos. 2 and 3 I have exhibited the fluctuations in the prevalence of cholera and small-pox through the two five-year periods 1868 — 1872 and 1873 — 1877. In 1867 the Central Provinces and adjoining territories were free of epidemic cholera. In the early months of 1868 a few deaths were registered under the head of cholera, but at that time the registration of deaths was very imperfect and no details regarding these cases were given; the first epidemic outbreak of cholera occurred in the middle of April in a gang of coolies employed on the road between Jujjbulpore and Nagpur, which was then the main centre of traffic between the Gangetic plain and Western India; from this point the epidemic spread, its prevalence increasing through the months of May and June, and reaching its maximum in July ; in August it declined ; and by the end of October had almost disappeared. A few cases occurred in the months of November and December, but in January 1869 the disease again assumed epidemic activity; in February this became more manifest, and as the hot dry season advanced, it attained the proportions of a violent epidemic, reaching its maximum of prevalence in June; through July, August and September it declined rapidly, and by the end of October had again almost disappeared. In 1868 the rama of the monsoon failed almost entirely, and this failure of the rains was followed in 1869 by severe drought and scarcity of Water i which was not relieved until the end of the following June. Consequent on the scanty rain-fall in 1868 the development of malaria in the autumn of that year was comparatively slight, but the rains of 1 869 were abundant, and in September and October the mortality from fever was very great. The cholera epidemic of 1869 had spread from the Central Provinces and Berar southwards into the Nizam's territory, and in 1870 this spread southward contiuued, covering the whole of the Madras Presidency, but the Central Provinces remained free, with the exception of the lower portion of the Upper Godavari district which touches the Madras border, and a slight outbreak in the Hoshangabad district of the Nerbudda valley. This almost complete absence of epidemic cholera continued through 1 87 L . In May and June a few cases occurred in the city of JN'agpur and in Xagpur Central Jail, and in July and August there were a few cases in the town of Burhanpur close to the border of the Bombay Presidency, where slight outbreaks had previously occurred. In the end of December cholera appeared at the Harda railway station (para. 78) in the Nerbudda valley; from this point it spread to other places in the neighbourhood, and in March it appeared in Khandwa and along the line of road to Indore. The epidemic of this year was restricted chiefly to the Bombay Presidency, Nimar, and the lower part of the Nerbudda valley (paras. 220 to 222, and Statement XI,); it followed the usual course, spreading though the hot weather, attaining its maximum of prevalence in August, and dying out with the cessation of the rains. In 1871 the rain-fall had been scanty over the Bombay Presidency and Nimar, and in 1872 this part of the country suffered to a considerable extent from drought. In 1873 (diagram No. 3) cholera was brought in February into the Sambalpur district by a regiment marching through the district along the pilgrim route from Jagganath,* and the epidemic spread rather rapidly among the population through the month of March, but it died out again in April. In 1874 two doubtful cases of cholera were reported from the Mandla district ; one in June, the other in July : and in December a slight epidemic outbreak occurred in a remote corner of the $ambalpur district where it touches the Bengal Provinces ; but with these exceptions the whole Province remained free for the year. In February 1875 the epidemic which forms the subject of this report, commenced ; we find that its prevalence continued to increase through the non- malarial * Central Provinces' Saaitary Report for 1873. 10 season, and reached its maximum in August,* when the malarial season was setting in. In the third week of that month the epidemic commenced to decline, and by the end of October had almost disappeared. In February and March it again appeared, again continued to increase in prevalence through the non-malarial season, reaching its maximum in the end of July or beginning of -August ; in the latter part of that month it commenced to decline, and by the end of October had again disapppeared from the greater part of the country. This almost extinct epidemic was resuscitated in November by the pilgrims dispersing from the Ramtek fair; and although the epidemic declined again in December, it did not cease, but continuing present in the eastern districts, attained a considerable degree ef prevalence there in the month of June; it then declined and ceased in September. Jn October cholera was brought into the Saugor district by a number of immigrants from the North- West Provinces taking refuge from the effects of the drought which then threatened that part of the country ; but the season was unfavourable to the prevalence of cholera, and by the end of November it had again disappeared. 18. We find then that from this short comparative description of the __ , , , . fluctuations in the prevalence of malarial fever and Cholera and malaria are ? ,1,,. -i • m ? . ,1 • 1 • i found to differ so greatly in cholera, that they diner greatly in the manner m which. the manner in which they they a ff e ot the population of a tract of country. Malaria affect the population of a trace •' -n • 1 1 r 1 • i of country, that the former rises annually in the autumn months otthe year; it may be cannot be classed with malarial developed more abundantly in one year than another, diseases. . . . * , _ •', . . ** , . ซ but in September and October it is never entirely absent. It covers simultaneously the whole tract of country; there is no sign of its spreading from one looality to another. It is more abundantly developed in some localities than in others, and in these localities this comparatively greater prevalence recurs year after year. Cholera on the other hand affects a population violently in one year, and after a short period of prevalence, often not. exceeding a few days, seldom more than a few weeks, disappears and remains absent for a series of years. In the epidemic years of 1875 and 187G it firstappeared at a few points, and spread from these points in gradually widening circles, and in this way wide areas ultimately became involved ; but the units o,f populations within these areas were never simultaneously affected. One or two villages would be attacked in one week, three or four in the second, and the same number in the third, and so on, the epidemic disappearing from the villages first attacked, while it was at its maximum of prevalence in the second set, and before it had commenced in the third. This manner of spreading is best illustrated in Statements XVIII. — XX., (pages 115 to 120) which exhibit the spread of cholera in the Nerbudda valley in the hot weather of 1876. Take for instance Statement XVIII, which exhibits the prevalence of the epidemic in the villages within a radius of from 15 to 20 miles from Hoshangabad; there are 273 village^ in the circle, and of these 77 were visited by cholera ; the greater number in the 8 weeks between the 2 1 st of March and 1 6th May ; but it was never present in more than 23 villages in any one week. In Maps Nos. VII, and VI II, and Statements XXII. and XX III., which exhibit the spread of cholera over tracts of country in the rains, we do indeed find a large number of villages on the same stream almost simultaneously affected, but that in these instances water and not soil is; the chain connecting them, is evident from the fact that villages on the same soil, but removed from the banks of the stream, were attacked on later dates op escaped altogether ; of 124 villages in the JCanhan basin visited by cholera in vne six weeks between the end of July and the middle of September, 57 was the maximum number from which cases were reported in any one week (Statement XXII). We find moreover that the season in which cholera prevails does not by any means correspond with the season of malarial fevers. Cholera epidemics usually commence in February or March, when the prevalence of malaria has ? jf we take the whole area occupied by the epidemic which spread from Hasik, the maximum was attained is July. See Statement -&Xl., page 122, and para. 306. 11 declined to its minimum; they continue to spread while the non-malarial season lasts, and decline when the malarial season sets in, becoming almost extinct in October, when malarial fevers are most prevalent and fatal. So also with respect to locality, malaria is most abundantly developed and continues active longer in jungles and uncultivated tracts of country; cholera falls with the greatestseverity on the more cultivated and densely populated districts. The tracts of country in the Central Provinces in which malaria prevails with the greatest intensity, are the eastern portions of the Bhandara district (Map No. I.) or what is called the lake country, and the jungle tract that stretches along the northern base of the Satpuras from the Chota-Tawa to the valley of the Denwa, but in neither of these tracts did cholera prevail. Malaria is scarcely present at elevations exceeding 4,000 feet above sea level. The virulence of cholera is quito uninfluenced by elevation; in 1876 it prevailed with great severity in the highest localities of the Himalayas that are inhabited. It would almost appear that the conditions favourable to malaria are antagonistic to cholera; at any rate on the evidence that has now been adduced, it seems reasonable to conclude that the theory which assigns to cholera an origin from the soil, has no foundation on fact, and that cholera cannot be given a place among malarial diseases. 19. We may now compare the manner in which cholera affects the popular The se^onai fluctuations in tion of a country with the course taken by small-pox, a jthe prevalence of smaii-pox disease that is typical of the class of epidemics that through a aeries of years. „„,ป,„] U l,nm a n inf^nnroo Tn Mn O 9nnrl 3 spread by human intercourse. In diagrams Nos. 2 and 3 the fluctuations in the prevalence of small-pox are exhibited on the same field with those of cholera through the same series of years. Cholera being at least three times as fatal to the persons attacked as small-pox, in order more clearly to show the relative prevalence of the two diseases, the monthly numbers shown on the scale are multiples by three of the monthly numbers of deaths from smallpox given at the foot of the diagram. In 1863 the prevalence of small-pox was at no time very great; it reached its maximum in June, then declined, and fell to a very low figure in October. In November and December, however, the signs of renewed epidemic actively became very apparent ; the increase in prevalence appears to have been comparatively slight in January 1869, but in February, March and April it rose with extraordinary rapidity, and reached a very high maximum in the latter month. In May the prevalence declined, and fell rapidly through the months of June, July and August, reaching its minimum in Novem* ber; there was a slight rise again in December, but the epidemic had run its course, and the two following years found a period of comparative quiescence. It continued, however, present to an extent sufficient to exhibit the usual seasonal fluctuations. In November 1871 an increase in the monthly number of deaths marked the commencement of another period of epidemic activity, and the maximum of 1872 was considerably in excess of the maximum of either of the two previous years; in the two following years we find it each year rising to an increasingly high maximum in June, but falling again to its minimum in October. In November and December 1874 the rise that annually takes place at that season was unusually great, and in the following April a very high maximum was attained, though it fell considerably short of the maximum of 1869. In May the epidemic declined. Its fall through June, July and August was very rapid, and the annual minimum to which it as usual fell in October was lower than the minimum of either of the two previous years. The two years following this year of great prevalence, like the two years following the great epidemic of 1869, were years of comparative quiescence. We find from these diagrams that small-pox, like cholera, is restricted to a certain season of the year, its prevalence increases during the dry season, declines most rapidly during the rains, and reaches its lowest ebb at the end of the wet season. 20. It is the game with vaccinia: the season most favourable for vaccination _ ... , is from December or January to April or May, but oper- The season of the year fa- ? , . , J n '.„ ? .Ji . X . yonrabie to vaccinia. ations can be carried on very well till the rains set in; but after the rains Bet in, and especially during the latter 12 part of the rains,- a mtfch larger proportion of the' operations are unsuccessful and doubtful, and there is difficulty in keeping up the supply of lymph. There is also" difficulty in starting operations afresh in October and even in November, Many Civil Medical Officers are of opinion that the difficulty is greater in proportion to the degree in which the autumnal malaria prevails,' but the evidence is certainly not sufficient to establish this as af fact. 21. That dry ness of the air is favourable to the spread of small-pox as well as of cholera is evident from the great acceleration The general similitude ob- in the rise of the epidemic of 1869. In the dry season servable in the couiMe and r ฑi *. - c i I^.l^l • i • J. !.t habits of smaii-pox and cholera- ฐ* that year ot di ought both epidemics spread wall affords good ground for assign, extreme violence, both epidemics declined to a minimum mc to cholera a place in thte • xt • t 1 1 1 • 1 i class of contagious epidemics. m .November, and both remained comparatively quiescent during the following year's. In LS72 both exhibited increased activity in their respective seasons, b:th as usual declined to a mini* mum in October; after this the parallelism of their course was interrupted : while cholera remained quiescent during 1873 and 1874, became active in 15 75 and 1876, and quiescent again in 1877; the prevalence of smallpox increased annually in each of the three years 1873 — 76, and attained its highest maximum in April of the latter year. During 187 ft and 1877 it remained comparatively quiescent. Cholera also was very slightly prevalent in 1877, but now again in the hot weather of 1878, both epidemics are spreading simultaneously with considerable violence. The monsoon rains of 1877 were very partial, and in some districts very scanty, and the temperature and dryness of the air through the early months of the current year was unusually high, and apparently in consequence of these meteorological conditions, the period of quiescence following the cholera epidemic of 1876 has been shortened, and the epidemic activity of smallpox accelerated. But although, taking a series of years, the course of cholera does not run exactly parallel with that of small-pox, the two epidemics exhibit a great tendency to prevail simultaneously, and there are several points in which their habits correspond ; the prevalence of both is aggravated in seasons of drought ; with both, years of great epidemic activity are followed by )) r ears of quiescence. In years of prevalence, small-pox, like cholera, does not exhibit increased activity simultaneously over the whole country, but it spreads in different directions, the districts near the locality in which epidemic activity first became apparent being affected in one year, those at a greater distance in the next, and so on until it has spread over the whole area. It is remarkable that the epidemic of cholera of 1875-76 followed very closely the direction taken by the epidemic of small-pox of 1872* — 1875. The season in which small-pox chiefly prevails does not quite coincide with the cholera season; the rise in the prevalence of small-pox is strictly confined to the dry season, it never increases after the rains have set in; cholera epidemics always commence with the setting in of the hot dry season, and their widest spread is effected during the continuance of this season, but there is com-monly a great increase of mortality in the first and second months of the rains in the districts over which the epidemic has spread during the dry months. Smallpox, like cholera, first affects the districts which are most densely populated or' which are traversed by main lines of communication; but it spreads more slowly,-which may be due to the circumstances of the adult or moving population being to a great extent protected from the effects of infection. Cholera shows a preference for populations living on the banks of streams, while small-pox spreads indiscriminately over the population of all parts of a district, and its subsidence or quiescence is never so complete as that of cholera. But notwithstanding these points of difference, it will, 1 think, be allowed that cholera in the manner in which it affects the population of a tract of country shows a much closer affinity to small-pox than to malarial fevers, and this evident affinity affords good ground for assigning to cholera a place in the class of spreading epidemics. If there is a * See Central Provinces' Sanitary Report for 1875. 13 necessity for assuming the presence of a widespread atmospheric influence to />C3Ount for the prevalence and seasonal fluctuations in the prevalence of cholera, there is the same necessity in the case of small -pox ; both have well defined seasons in which they manifest epidemic activity ; with both, seasons of great epidemic activity are followed by seasons of quiescence more or less complete. That atmospheric influences may operate, either directly or indirectly, through the conditions by which the people are surrounded in predisposing individuals to be affected by their poison is probable ; but in whatever way they may operate, the disease will not be produced, unless the specific infecting matter is applied. 22. That cholera does belong to the class of spreading epidemics, and that „.. . it spreads by human intercourse, ample evidence will ta The evidence that human in- ป r, . -•' p ,1 • , mi • • i Jine evidence mat uuiuan m- ซ i • , -i p . 1 • ฆ mi • • 1 tcrcourse supplies the mean a found in the pages oi this report, lms evidence may by which cholera spreads. j^ presented under the following heads :—: — (a.) The origin of the epidemics of 1875 and 1876 in certain localities, and its spread from these localities as shown by the dates or the Maps Nos. IA. and B. (b.) The influence cf pilgrimages, fairs and other gatherings. (c.) The rapid spread along the main lines of communication and among the dense population, and the exemption of remote and sparsely populated tracts. (d.) The direct evidence of conveyance by human intercourse. (c.) The gradual diffusion of the epidemic among the populations of different circles. 23. The year 1874 was remarkable for the general quiescence of cholera -? . . . .. ? . over the whole of India outside the delta of the Ganges, The origin of the epidemic .. - _ . • , , x . ป ' of 1875, not the result of a or what is called the endemic area. In 1875 signs of t^G^rti' anfeou! epidemic activity became manifest very early in the year in veyed westward by air cur- Benares and the surrounding districts. The city of Benares is the great religious centre to which pilgrimages are made from the whole of India. Cholera is scarcely ever entirely absent from it ; even in 1874 cases occurred in every month of the year in the city or the district immediately surrounding it, and it was present there in the month of January 1875. At the end of January and beginning of February the annual religious gathering (Maghmela) at the junction of the Jumna with, the Ganges at Allahabad, 70 miles from Benares, took place. Several deaths from cholera occurred at this fair, and with the dispersion of the assembled multitude early in February, a marked increase in the mortality from cholera occurred in Allahabad and the surrounding districts, and in the course of the following months of March and April the epidemic spread over all the eastern districts of the North- Western Provinces and Oudh. Now this diffusion of the epidemic among the population of this part of the country in the early part of 1875 could not have been the result of a miasma emanating from the soil of the Gangetic delta and conveyed westward by air currents. In the first place, while signs of epidemic activity became very evident in the districts round Benares and Allahabad in February, no increased activity was observable in the district round Patna, 200 miles to the east, and so much nearer the delta, till the following month. The monthly mortality from cholera in the two tracts of country for the first 7 months of the year was as follows :— Deaths. ,* & a •<* a % A Fatna and surrounding districts ... 5,472,000 7 10 90 789 1,765 2,209 818 Benares ditto ... 4,230,000 13 124 695 2,375 1,488 0 276 14 It will be observed that the epidemic of the districts round Benares was- a Whole month in advance of the epidemic of the districts round Patna; the disr tricts of Sarun, Chumparan and Ghazipur, lying- between the two epidemic centres, remained free till April. Secondly, the prevailing wind at the time when the epidemic commenced around Benares and Allahabad,, was (according to the tables published by the Meteorological Reporter to the Government of India) from the north-west or towards the endemic area, and had been so for the four previous months. The winds that blow over the Grangetic plain are very regular. The south-east monsoon from the Bay of Bengal reaches Benares about the end of May or beginning of June, and continues to prevail till about the middle of September. In October the anti-monsoon or dry land wind from the north-west sets in, and blows with great steadiness till the end of April or beginning of May. Now there was no diminution in the steadiness of the anti-monsoon of 1874-75 to account for the greater prevalence of cholera in the Gangetic plain in 1875 compared with 1874. The epidemic of 1875 in the eastern districts of the North- Western Provinces and Oudh commenced, spread, and obtained its greatest prevalence while the dry land winds from the north-west were blowing, and declined as soon as the moist south-east winds from the Bay of Bengal arrived. At Hazaribagh, which, according to the air-borne theory of cholera, is I believe, considered to lie in the path by which the miasma passes from the endemic area and covers Central and Western India, and at Cuttaek on the margin of the endemic area further south, the wind directions observed were from the west till the end of June. The first outbreak of cholera in the Central Provinces and in Western India occurred in February and March, and by the end of June the epidemic was spread widely over the country. In endeavouring to arrive at the truth in this matter we must accept for guidance systematically recorded observations and statistics, and I assert without hesitation, that Mr. Blanford's meteorological tables and the mortuary statistics of thซ different Provinces for 1875 are altogether opposed to the notion that the epidemic of cholera, which in the course of that and the following year spread over India,, was due to miasma, conveyed by means of air currents fromthe Gaugetic delta. 24 . There is, however, good ground for believing that Benaresand A llahabad ? . not only formed the centre whence the epidemic spread Reason for believing that Be- , / ? XT ? -r T7 - , t> • i n t-ป n ares and Allahabad formed throughout the North- Western Provinces and the Punthe centre whence the epide. j^ b ut t h at the epidemic of Central and Western India nnc of 1875 radiated over J . \ , .. . . r c ? m , Northern, Central and Western derived its origin Irorn the same source. Ine first out- India. l-\ป>/3rป17-Q irป 1 Q7^ซ nnfnin fliQ nvan vi7ifl"ป nrKi/ili +1->ili f/i r\r\-n +• breaks in 1875 within the area with which this report deals, occurred in the district of Bilaspur in the eastern division of the Central Provinces, in the town of Khandwa on the western border of the Province, and in the town of Nasik on the Western Ghats in the Bombay Presidency. These outbreaks occurred in the healthiest season of the year, and there w*as no reason on the ground of unhealthiness why cholera should have appeared in these localities first of all others in this wide area; but in the facilities for conveyance by human agency from the centre of infection at Allahabad and Benares, there was quite sufficient reason for its appearance at these points.. 25. Bilaspur is about 350 miles distant from Allahabad;' the surrounding Tte outbreak in the district district had been free of cholera since the epidemic of of Biiaipur. 1869, or for a period of 5 years; but in January 1875 very large numbers of the people had gone up to the Magb mela at Allahabad, and it was among these pilgrims on their return in the latter end of February that cholera first appeared ; and in every one of some thirty villages visited by the epidemic in the months of March and April, the first person attacked had either returned from Allahabad, or had visited one of the villages to which cholera had been brought by these pilgrims. At first the epidemic made little progress, but early in May the chief centre of the traffic of the district becoming a centre of infection, the surrounding villages over a wide circle, became involved in the epidemic, and it spread along the line of chief traffic towards Nagpur (pages 16. to-20j. 15 i 26. Nasik is more than 700 miles from ฆ Allahabad but is connected' with it by railway; it is situated on the Western Ghats, nearly The outbreak at Nasik. ,_ r\i\n r ฑ. l. j.l -i • ฆ i i i v. 2,000 feet above the sea, and is considered a very health} place, but it is one of the chief places in lndi>ป to which pilgrimages are made, and at the time of the outbreak of cholera one of the chief festivals was being held (pages 20, 21). From this point the epidemic may be traced on Map No. IA, radiating, in different directions, and, in the opinion of the Sanitary Commissioner for Bombay,. Nasik formed the centre whence the whole of the Bombay Presidency was ultimately covered Its progress in a north-easterly direction from Nasik has been described in pages 20 and .2l, and in Map No, IA, it may be traced, by the dates of first cases traversing the collectoeate of Khandesh in April, entering, the province of Berar early in May, crossing the boundar} r which separates that province from the Central Provinces in the middle of July, reaching the district of Chhindwara, the terminal point to which it spread, in the beginning of September. , 27. Khandwa is an important town on the eau iv vi ซ. , season, and had lingered in one town after it had died : out The outbreak m Ch^nda. . ",ป_. , ? ... B , Li ..,-,. v_j , ? . in the rest of the district; it had, however, disappeared from this town for two months, when in the last week of March it broke out in thirteen villages. In not one of these villages had a case of cholera occurred in the previous season, but a large fair had assembled for the Shivratri festival at a place a. few miles from the town in which the epidemic had lingered longest, andthe people had dispersed from this fair only a few days prior to the Tig-appearance ? of, cholera. 16 The epidemic spread from this part of the Chanda district southward along the course of the Wainganga and Pranhita rivers, reaching Sironcha at the junction of the latter river with the Godavari in the middle of June. Westward it spread into Berar, and northward into the Bhandara and Nagpur districts ; to the east of Chanda the country is very sparsely populated, and in this direction the epidemic did not spread (pages 32, 35). 31. The outbreak of cholera that occurred in the town of Mandla in the . • „ .. middle of March was attributed to importation by pil- Tlie outbreak in Mandla. ... T ? ? ,x , , f • grims from Jug-gernauth. An outbreak had occurred in this town in the previous August and September, but the mortality had not been great ; and on this occasion also, although it was the first place attacked in a district of very wide extent, the outbreak was very slight and of short duration, but several villages in the neighbourhood which were attacked subsequently to the outbreak in the sudder town suffered severely. From Mandla and its neighbourhood as a centre, cholera was conveyed in a singular manner to isolated villages in the three districts of Balaghat, Jubbulpore and Seoni, which touch Mandla on the south, on the north, and on the west. The village to which it was conveyed in the Balaghat district lay in a very remote and sparsely populated tract of country which cholera very seldom visits, and on this occasion it did not extend beyond the village into which it was imported. The village in Jubbulpore to which cholera was conveyed also lay in a remote part of the district, and special measures were taken to isolate it, and no extension of the epidemic from this point ensued. From the village in Seoni to which cholera was conveyed from Mandla, it was communicated to another village, and then to several others (pages 43 to 45J. 32. Another centre of infection was formed in the month of February in ..,.,-. the Rewah territory, which occupies part of the Vmdhyan The outbreak m Rewah. , A „ . ->> 1 . i i i ,1 en • j. • # l> 1 ฑ plateau. A tair had been held on the bnivratri festival at a spot near the main road to Benares, and cholera broke out among the people assembled; from this point the epidemic spread over a considerable area, and ultimately crossed the Kaimur hills into the Jubbulpore district (pages 46, 47). 33. A fifth centre from which the epidemic radiated in 1876 over a wide _, ? ?„ . , extent of country, was formed in the Betul district of the The outbreak in Betul. _, , x, ?, -r . n i •.<••<•* Satpura range of hills. It first appeared in the village of Shahpur, — a Police station and the chief market of a wide circle of villages. Cholera had reached the district of Betul in 1875, but not a case had occurred in Shahpur or in the circle of villages of which it is the centre. A fair had been held on the Shivratri festival some days prior to the outbreak, at a plain within the circle, and at the time of the outbreak the inhabitants of the district were migrating in large numbers by the road which passes through Shahpur into the Nerbudda valley, to assist in the harvest. A week later an outbreak, of cholera occurred among those people employed in the harvest in the Hoshangabad district of the valley, and by them the epidemic was conveyed to a considerable number of villages, and a centre of infection was thus formed in a populous tract of country. From this centre the epidemic spread east and west in the Nerbudda valley, and crossing the river it ascended the Vindhyas, reaching Bhopal in April, Saugor in May, Damoh in June and July (pages 49 to 55, and Statement XVII., page 115). 34. In the account that has been given above of the manner in which the several centres of infection were formed whence the epi- influence of fairs and pii- demic was diffused among the surrounding populations, grimages. & & rrr the influence of pilgrims to the great shrines held in vene- ration in different parts of the country, and of the fairs and religious gatherings at these places, in promoting the diffusion of cholera over the country, is plainly perceptible. Some of the holy places, as the city of Benares, and the shrine of Jnggernauth at Puri, are apparently permanent centres in which the infection of 17 cholera is renewed and multiplied, and whence it is conveyed by pilgrims and professional mendicants to other shrines of more local sanctity in different parts of the country, and by this means the people assembled at these shrines on the chief festivals become infected, and spread the epidemic among the surrounding populations. One of the chief festivals, perhaps the one most generally observed in Central and Western India, is the Shivratri, which falls in the latter end of February or beginning of March, as the hot and dry season is setting in ; and it seems probable that the circumstance of the first signs of epidemic activity usually becoming manifest at this season, is in some measure connected with the numerous gatherings that take place on this festival. The evidence given in Appendix 11. of the evil effects of the great gathering which in former years annually took place on this festival at the Mahadeo cave in the Par-hmarhi range, in promoting the diffusion of cholera in the surrounding districts, taken in connection with the evidence given in pages 59 to 6 1 of the remarkable diminution in the frequency of cholera epidemics and the alteration in their course, which through a period of now thirteen years has followed its suppression, must be considered conclusive of the influence which these gatherings have in spreading cholera. But if further evidence in support of this fact were needed, it is amply furnished by the account given in pages 36 to 41 of the revival of the epidemic of 1876, after the outbreak at the Kamtekfair in November 1876, when the disease had almost disappeared from the country; but for this revival, prolonging the existence of the epidemic through the season when it usually subsides, it is probable that the mortality which occurred in the eastern districts in 1877 (para. 179) would have been avoided. The frequent occurrence of outbreaks of cholera in marriage parties also affords evidence of the danger of gatherings of people in an epidemic season. 35. The spread of cholera primarily along main lines of communication is another fact that points to human intercourse as the The spread of cholera along means by which cholera is spread. In Maps IA. and the main lines oi commumca- -!->•.ฆ. i ? * n 1 • . i ij tion. -t>. it may be seen that generally speaking the dates along the main lines of traffic are earlier than those at a distance from them ; but the clearest evidence to this fact is afforded by the spread of cholera in 1875 along the lines taken by the grain carts from Mungeli to Nagpur, through the jungle tracts of Bhandara (Map IA. paras. 55, 62 and 63), and its spread in the reverse direction along the same routes in November 1876 (paras. 136 to 141, Map No. IB.) ; also the spread of the epidemic of 1875 from Khandwa along the route through Malwa and Central India, and along the line of railway up the Nerbudda Valley (Maps Nos. 11, 111 and IV, paras 235, 244, 279 and 288). Railways, however, though they may convey infection rapidly to distant points (para. 301), do not apparently favour the diffusion of cholera among the population of a given tract of country so much as the slower modes of travel (para. 203). 36. The evidence which the areas that escaped cholera contributed to the fact that cholera is dependent on human intercourse for the means of spreading, is chiefly given in pages The exempted areas. 56 to 62. We there find that these areas were sparsely populated tracts of country not traversed by any main lines of traffic. The first of these areas referred to fpara. 183) comprises a vast tract of country, many thousand miles in extent, lying between the Tel and Pranhita rivers (Maps JNos. lA. and B.) ; it is said to be occasionally visited, but it has certainly remained free of cholera during the last 13 years, in the course of which all the more populous tracts have been twice or three times covered. In para. 184 reference iง made to the tributary hill states which lie between Orissa and Sambalpur ; the aboriginal tribes inhabiting these tracts, having little communication with the Hindu population of the plain districts, ordinarily experience immunity from cholera, and this immunity was extended to them through both the epidemic years of 1875-76, though the inhabitants of both Orissa and Sambalpur suffered in both years ; and 18 that this immunity is due solely to the fact of their being removed from intercourse with the Hindu population on either side of them, is shown by the fact of their suffering severely in a season when the stream of pilgrims from Juggernauth was diverted from the route ordinarily taken by it, and made to pass through the hill states. We next have the comparative immunity of the inhabitants of the districts of the Satpuras ; and that their immunity in 1875-76 is attributable to the absence of main lines of communication and comparatively little intercourse with the more populous districts, is shown by the fact that in the previous epidemic of 1868-69, when, from special causes, the traffic through them was unusually great, the districts of Mandla and Seoni suffered severely ; and in the case of the district of Chhindwara the relation between the liability to cholera and the facilities for human intercourse, is still more plainly evident, the large portion of this district lying above the ghats, which before the suppression of the Mahadeo fair suffered almost annually from epidemic cholera, having remained practically free of the epidemic for the thirteen years that have since elapsed (paras. 1 86 to 1 97). Evidence of the same nature is afforded by the partial manner in which the populations of the different districts were affected. Even in those districts which were more widely covered by the epidemic, a very large proportion of the villages escaped, but on the other hand, the towns and bazar villages which formed centres of traffic, were without exception visited (para. 340). 37. From all these broad facts we derive the conclusion that human inter- course supplies the means by which cholera spreads over The direct evidence of im- the country, and by accepting this conclusion it has been possible to give a consistent account of the spread of the epidemic in the two consecutive years over the greater part of the area to which this report refers. In this account, the details of the spread of the epidemic over the districts have been extracted from the reports of the medical and civil officers, and from the Police reports furnished to me at the time ; and the history of the epidemic in almost every district furnishes facts confirmatory of the conclusion arrived at. The circumstances attending the appearance of the disease in several districts have been already alluded to in this synopsis, and in addition to these, I would refer the reader particularly to the account of the importation of cholera in 1876, from Sambalpur into the villages in the eastern circle of the Raipur district (paragraphs 106 and 107); to the appearance of the epidemic in the district of Saugor (167), and in the Damon district (172) ; the outbreak in the village of Cheela Chown (290) ; the outbreak on the Oomer river, in the Narsinghpur district, illustrated by Map V. (296) ; the outbreak in the cantonment of Jubbulpore (301); and the outbreak in the village of Saildoo (314). 38. It may perhaps be said (as has been said before regarding reports of cholera among the general population) that the evidence The nature and value of having 1 been furnished by persons prejudiced in favour this evidence. „,, & . . ? ฆซ'*.•• . „ r . J ? , of the opinion that cholera is an infectious disease, or by native agents, whose truthfulness and judgment in such matters cannot be relied on, it cannot be accepted as conclusive. The evidence given in this report, including besides the dates of first cases, and the circumstances attending them, the monthly mortality among the population of the different districts, has been collected by agents under four or five different Governments and Administrations, and it has all passed through the hands of European officers charged with the administration of the country, well acquainted with the people, and accustomed to weigh evidence and to estimate the value of facts reported by native agents. It is no doubt the fact that the great majority, if not all, of these officers do hold the opinion that cholera is conveyed by human intercourse, and this general consensus of opinion among a large number of persons who have had the most practical knowledge of the circumstances under which cholera spreads, is strongly in favour of the correctness of the conclusion at which they have arrived, and it seems a little absurd to argue that, having formed an opinion on facts that have 19 come under their observation, they are therefore disqualified from correctly judging of the significance of similar facts. Many of the incidents referred to in the preceding page came under the immediate cognizance of the medical and civil officers; the outbreak at the Railway station of Harda for instance, and the outbreak in the .Jubbulpore Cantonment, and the first appearance of the epidemic in the town of Saugor ; there can be no doubt of the facts having occurred as related, and they seem to me to leave little room for doubt as to their significance. So also with regard to the reports by the Police and other native agents ; the native population is no doubt strongly imbued with the belief that cholera is spread by human intercourse, and very frequently of themselves adopt measures founded on this belief, but their interest in proving the fact is not so lively as to induce them on all occasions to invent a narrative which has no foundation, and even if they made the attempt, it would be quite impossible that the narratives they would invent would bear the impress of truth that those given in this report possess. Take for instance the accounts given of the formation of the centre of infection at Mandla and its communication thence to one village in each of the three districts of Balaghat, Seoni and Jubbulpore. It was a remarkable phenomenon that within a month after the outbreak at Mandla, the disease should appear in three isolated villages in remote tracts of country widely distant from each other, and from the common centre ; but in each case the history given by the people and reported by the Police affords an explanation of the occurrence which satisfactorily accounts for the phenomenon, and which is certainly more credible than that three policemen living in three different districts should have the capacity for inventing the incidents narrated, and that their narratives should afford a satisfactory explanation of what is otherwise inexplicable. I have no wish to disparage the intelligence of the Police of the Central Provinces, but their best friends will scarcely claim for them that they are a body of novelists. 39. But the evidence to the fact that human intercourse supplies the means by which cholera is spread over the couutry does not The gradual diffusion of the epi- consist only in these narratives of importation ;no demic among the population. . +W^,. TT fW U oa U aan n A~ nnn ~A L Aiป~ +kซ other theory that has been advanced regarding the nature of cholera affords an equally satisfactory explanation of the spread of the disease from the several centres as shown in Maps Nos. I A. and 8., or of its gradual diffusion among the population as shown in the numerous Statements. In Statement No. XVII. (page 115) for example, we have the epidemic gradually diffused in two directions from a central point over a tract of country more than three hundred miles in length ; and in Statements XVIII. to XX. we find exhibited the same gradual diffusion among the villages of the circles into which this tract of country is divided ; again in Statement XXI. (page 122), we have the same gradual diffusion over a still wider extent of country. That these statements do show a gradual diffusion of the epidemic, and that communication from village to village affords the most satisfactory explanation of this gradual diffusion, can scarcely be denied, and no amount of bias or prejudice could make the statistics collected by numerous agents over tracts of country, thousands of square miles in extent, fall so as to give support to a theory, if that theory did not afford the true explanation of the fact. 40. From the circumstances attending the origin of epidemics, the manner in which they spread over certain tracts of country, The infection of cholera not com- , ?." ' , i r ? municabie to all per฿ona equally. leaving others exempt, ana from the numerous instances of importation from one place to another, we arrive at the conclusion that cholera is not a product of the soil in any particular locality, and spread from thence over the country by air currents. But while the evidence that cholera is an epidemic disease spreading like other diseases of the same class by means of human intercourse, appears to me conclusive, there are numerous facts which show that the disease is not communicable to all persons or to all populations equally ; the inhabitants of one village will suffer severely, while those of another, a mile or so distant, will suffer comparatively little or escape altogether ; and even in the same village one caste or section of the inhabitants 20 will suffer, the others remaining free. Experience also shows that it is a comparatively rare occurrence for attendants on patients suffering from cholera in a well regulated hospital to contract the disease ; and that although adult women are more than any other class among the native population liable to cholera, infants at the breast are almost exempt. 41. This apparent contradiction indicates either that all persons are not 0 . . equally and at all times susceptible to the infection The incidence of cholera on a A- , X ? . ... ... „ \. ... • particular population determined by oi cholera, or that ordinarily for the communication or some local condition which serves c holera from one person to another some special as a medium of communication or ? . r . *, , a 8a 8 a predisposiug cause. medium is necessary ; or in other words, that the mci dence of cholera on individuals, or on the population of a particular town or village, is determined by the presence of some special condition, which either serves as a medium for the communication of the infection, or which by inducing a certain state of system in individuals, renders them liable to be acted on by the infection. 42. The facts that point to contaminated water as this condition are both numerous and convincing. Cholera is most constantly The facts that point to oontami- ? . i .• .c -i j i A c j.i_ nated water as this local condition, epidemic among the population oi the delta or the The annual prevalence of cholera Ganges and of the eastern portion of the Gangetic in the Gangetic delta, and its liabi- i • .i • i .• . i i ji Hty to be aggravated by ckcum- plain ; this population is extremely dense, and draws stances that tend to increase the j ts wa ter-supply almost totally from sources exposed impurity of the water. m ?VJ J f to contamination from without and deterioration from exposure to the sun and rapid evaporation. Cholera is most prevalent among this population at the season of the year when its sources of water-supply have become stagnant and have been for a long time exposed to dry winds and rapid evaporation. Outside this area of constant prevalence, in tracts of country in which the population draws its water-supply to a large extent from wells more or less imperfect, as well as from rivers and streams and tanks, cholera may prevail severely in the hot dry weather when the water-supply is scanty ; but its prevalence is apt to be greatest at the commencement of the rains, when the sources of water-supply are being replenished and contaminating matters are being washed into the streams and tanks, or conveyed by filtration into the wells. Cholera is least prevalent when this process of replenishment has been completed, and while the water-supply continues abundant and in motion. The prevalence of cholera is liable to be aggravated by circumstances that tend to increase the contamination and deterioration of the water-supply which occurs annually at certain seasons. The violent and abnormal outburst of cholera which ensued in certain districts of the Gangetic delta upon the general contamination of the water-supply by putrefying bodies, that resulted from the inundation by the cyclone wave of October 1876, is one example of this fact; and. the extreme prevalence of cholera among the population of the elevated plateaux of Madras and Bombay, which suffered from the great drought of that year, is another. 43. The excessive prevalence of cholera in the Central Provinces in the hot weather of 1869 affords another instance of an The effect of drought in aggrava- ? . , i i j i i , tj ting the prevalence of cholera iiius- epidemic aggravated by great drought. It was most trated by the epidemic of 1869 in marked in the districts of Bilaspur and Raipur, which Chhattisgarh, and other examples. ฃ . , . „„ , . * , , *~ ' form the great plain of Chhattisgarh, where the watersupply is drawn almost entirely from tanks and other exposed sources ; and the following figures exhibit the monthly mortality in that tract of country from cholera in the epidemic of 1869, compared with the mortality in the epidemic of 1875:- J Deaths from cholera in Chhattis- i' * -• ซ a o> *ง "a ~ 111 i i ซ II- 1 11 2 1869 62 199 2,505 7,731 6,029 2,335 682 28 19,571 1875 7,93 32 725 1,383 1,745 2,145 600 134 76 34 6,967 21 In 1869 cholera had been imported into the Bilaspur district in the end of February ; there were several severe outbreaks in March and April, but they were confined within a limited circle ; early in May, however, an outbreak occurred among a large body of people assembled on some famine relief works ; these people immediately dispersed, and their dispersion was followed by a terrible epidemic, involving the population of the whole plain ; at the time of this outbreak, the drought was very severe and the water everywhere scanty and impure. In many villages the tanks were completely dry, and the inhabitants had to go long distances for water ; in others the little water that remained in the tanks was foul and putrid ; this state of drought was not relieved till the last week of June, when the monsoon rains set in : the mortality from cholera then declined, but with cholera material spread so widely over the country, and the exhausted sources of water-supply being chiefly replenished by surface drainage, the prevalence of the epidemic could scarcely be otherwise than great through the first month of the rains. In August, however, when the sources of supply had been in a manner replenished, and the surface cleansed, the excessive prevalence subsided, and the epidemic ceased with the cessation of the rains in September.* In 1875 cholera was, as we have seen, imported into the Bilaspur district in the end of February, by a large number of pilgrims returning from Allahabad, and several village populations were at once affected ; but the rains of the previous monsoon had been much above the average,! and in the spring of 1875, the water-supply of the people was more abundant than usual; under these conditions the epidemic showed but little disposition to spread ; it had in fact almost died out in April ; but in May, when the water in the tanks had for some weeks longer been exposed to a hot sun and scorching winds, the condition favourable to the spread of cholera became more common ; at this time an outbreak occurred in a central town, and the epidemic spreading thence found the condition favourable to its reception more commonly present ; the mortality increased through the months of May, June and July, but it was slight compared with the mortality of the corresponding months of 1869, and the epidemic did not attain its maximum of prevalence till the month of August ; the mortality in this month was nearly the same as in the corresponding month of 1869, and it is evident that the excessive mortality in the previous months of that year was due to the excessive drought under which the population was then suffering. The epidemic of 1876 in the Nerbudda Valley, described in pages 111 to 120, is again another instance of cholera prevailing under extreme heat and drought. The meteorological data given at the foot of Statement XVIII. (page 115); the description of the outbreaks in the towns of Jubbulpore and Kaipur in 1869, given at pages 146 and 147 ; the account of the terrible sufferings from cholera of the detachment of Artillery that marched from Mhow in April 1865,1 all show that extreme drought is favourable to the prevalence of cholera. 44. On the other hand, this report furnishes abundant evidence that rain- fall is equally with drought a condition that favours The effect of ram-fail in aggra- the spread and prevalence of cholera. Statements rating the prevalence of cholera. ttttt jtv / rto j ซซ\ l al *. • l- a*. VIII. and IX., (pages 28 and 29), show that in both the epidemic years, 1875 and 1876, the mortality from cholera increased greatly in the months of July and August, or during the first six or eight weeks of the rains. After the heavy rains of July and August had scoured the surface of the ground and flushed the streams, the epidemic declined ; and in both years it almost entirely ceased with the cessation of the rains in October. The primary effect of the monsoon rains is to increase the prevalence of cholera, but ultimately their action proves beneficial in cleansing the surface of the ground and replenishing the sources of water-supply. In every district, no matter when the epidemic • Central Provinces' Sanitary Beport for 1869. t The monsoon rainfall measured at Baipur in 1808 waa 34 inches; in 1874 it waa 70 inches. J Appendix 111. 22 commenced, whether in March, as in Chanda and Hoshangabad, or in July, as in Damoh, the almost complete subsidence in October is equally evident ; this close relation between rain-fall is very plainly exhibited in the description given in pages 123 to 139 (with the accompanying Statements) of the spread of the epidemic in 1875 on the Wuna and Kanhan basins. 45. Again, the preference that cholera shows for villages situated on the banks of rivers and streams which form the sole or The preference that cholera ex- chief source of water-supply for the inhabitants, is Inbita for villages on the banks of , ?,. , ? /ป 1 r . • 1 > streams. additional evidence of the connection between water- supply and cholera. In all the district maps we find the villages that were visited by cholera grouped to a great extent along the banks of rivers and streams, and in many instances the dates of the first cases form a consecutive series from above downwards. Instances of this grouping on banks of streams occurring in the dry season will be found in Maps 111., IV., and V. ; but it is more common during the rains, and is therefore most plainly exhibited in Maps VI. to X. This preference of cholera for villages on the banks of streams is not due to miasma rising from the bed, or to a swampy condition of the margins, for the beds of several of the streams on which cholera prevailed severely were rocky, and, as a rule, the banks rise abruptly to a great elevation above the bed, and afford remarkably dry and healthy sites ; in fact much of the land on the margin of the rivers is rendered barren and unculturable by too rapid drainage. 46. These broad facts, the influence of drought and rain-fall on the season- able prevalence of cholera, and the preference cholera Additional evidence of the con- exhibits for populations depending for their water on nection between cholera and impure /• i i • ? • .• t 1 ฑ water. sources of supply exposed to contamination and dete- rioration from other causes, plainly indicate a close relation between the disease and impure water. More direct evidence of this connection and of the influence of impure water in determining the incidence of cholera on particular populations will be found in all parts of this report ; but I would refer the reader more particularly to the account given of the spread of cholera along the Pranhita river, and its abrupt arrest at the junction of that river with the Godavari (paragraphs 117 to 122); the outbreak at the Kamtek fair (paragraph 127) : the spread of cholera in the northern part of the Jubbulpore district (paragraph 152j ; the outbreak among the coolies at the Gutta quarries (paragraph 237), contrasted with the immunity of the coolies employed in constructing the bridges on the railway in the Nimar district (paragraph 247) ; the outbreak at Khiraila and Islampur (paragraph 249) ; the outbreak at Shahpur near Burhanpur (paragraph 265) ; the slight prevalence in the town of Burhanpur, compared with the high rate of prevalence in the suburbs (paragraphs 266 and 267) ; the outbreak in the village of ELuttangha close to the cantonment of Jubbulpore (paragraph 301); the villages of Saildoo and Lonhara (paragraph 314); the villages on the Wuna river (paragraphs 307 and 308); the severity with which the epidemic fell on the towns and villages on the Kanhan river in contrast with the immunity of the villages on the Pench (paragraphs 320 to 324) ; the outbreak in the villages on the Wainganga river (paragraph 327) ; in the town of Bhandara (paragraph 329). 47. Another and very important class of facts bearing on the relation The liability of certain places tฐ between cholera and water-supply, are those which cholera only at certain eeaeons o s h ow the liability to cholera of certain places only at tneyear. __^ • *r xi. rpi_ x t_r -rr -iL_ certain seasons of the year. The town of Hoshan- Thetownof Hoshangabad. gabad affords an instance of a place liable to cholera only in the hot dry weather. In 1869, and again in 1876, the epidemic ran its course before the rains had set in, but in 1875 it did not reach the town till the rains were approaching, and it appears to have been suppressed by the first falls of rain (paragraph 291), 23 48. The towns of Bhandara and Chanda (paragraphs 331, 332) furnish illustrations of places liable to cholera only after the rains have commenced. In 1866 cholera prevailed The town of Bhandara. severely in the district of Bhandara during the hot weather, but it did not become epidemic in the town till the month of July, the first case occurring on the 20th. In 1869 cholera again reached the district in the hot weather, and a few cases occurred in the town in the month of May, but it did not become epidemic till after the rains had set in, the first cases of the epidemic outbreak occurring in the week ending the 24th^July. In these two epidemics of cholera, epidemic prevalence commenced on the same or nearly the same date ; on referring to paragraphs 329 and 331 it will be seen that at this time the water in the wells used by the people was beginning to rise, and that action based on the observation of this circumstance to all appearance prevented the recurrence of the epidemic at the same season in 1875 and 1876, or restricted its prevalence to the women washing in the tanks. 49. The illustration afforded by the town of Chanda is equally remarkable. From Dr. Jameson's report (quoted by Macnamara) it appears that in the epidemic of 1818, although The town of Chanda. all the surrounding country was suffering from cholera in May, the town of Chanda remained free till after the rains had set in. In paragraph 332 of this report we find the same fact recorded with reference to the epidemics of 1869 and 1876. In 1869 the monsoon had set in about the 24th June ; no cases occurred until the week ending the 24th July (the same week in which the epidemic in the town of Bhandara commenced), the fifth week after the monsoon had set in, and the epidemic reached its maximum of prevalence in the week ending the 14th August. In 1876 cholera had been prevalent in the district since the commencement of the hot weather ; and a few cases which were not fatal occurred in the town in the course of the month of June, but the disease did not become epidemic till after the rains had set in. With the first falls of rain an outbreak occurred among one section of the community, but the general population remained free till the fifth week after the rains had set in, when the water in the well used for observation had commenced to rise, and the epidemic reached its maximum of prevalence in the week corresponding with the week of greatest prevalence in 1869. 50. The statistics of the epidemics of 1866 and 1869 in the city of Nagpur, furnish an equally striking illustration of the mci The town of Nagpur. dence of cholera on the same locality at the same season of the year, and of the relation of this coincidence to the rain-fall and water-supply. The following figures give the number of cases of cholera reported weekly in each year during the prevalence of the epidemic with the weekly rain-fall. \B&jT mmm '~ mm ~ mmmmm ~ mmm ~^^^~ m^~ mm ~~ m ~ mm ~ 1869. - ____________________________ MM _ — o ฉ Rain. g Rain- g fall, 8 fall. S Week ending Week ending ฐ . Inches. o"S Inches. ,o"3 ( gปg _. *-g June ... ...23 4-00 ... June ... ...26 2.13 ... July .., ...31 2-20 ... July ... ... 3 I*9B 1 „ 7 3-70 ... „ 10 2-58 ... 28 0-80 95 " 31 079 19 August ,„ ... 4 5-40 63 August 7.; r ... 7 1-86 81 11 4-70 178 „ 14 1-53 160 „ 18 3-00 201 „ 21 0-63 139 25 I*Bo 88 „ 28 431 113 September ,i7 ... 1 '90 33 September... r ... 4 250 76 „ 8 2-20 12 „ 11 103 32 635 640 24 In both years cholera had been prevalent in the surrounding district in the dry months, the city remaining free ; but in both years it broke out in the fifth week after the rains had set in ; it also reached its maximum in the corresponding week of the two years, then declined and died out. That this close correspondence in the course of the epidemic in the two years was due to the effect of the rain-fall on the water-supply, is evident from the following fact. The water-supply of the city of Nagpur during these two epidemics was derived from wells; and in the quarters in which the epidemic chiefly prevailed the wells were situated along one of the main drainage channels, or close to tanks receiving the surface drainage of the city area; between 1869 and the epidemic year of 1875 a radical change in the nature of the water-supply had been effected, and in the latter year and again in 1876 the resident population of the city using the new supply remained exempt (paras. 315 and 342). 51. The history of cholera in the three towns of Nagpur, Bhandara, and _? ... . Chanda may be shortly stated as follows :—ln: — In 1866 The remarkable correspondence ? , J , " . . ? ซ• . % . *. xt in point of time in the recurrences cholera became prevalent in the districts oi JNagpur of epidemic cholera in these three an( j Bhandara during the hot weather; the towns towns. , „ . ? . & ' , ? remained free at this season, but in the week ending the 21st July, or the fifth week after the monsoon rains had set in, cholera appeared in both towns simultaneously, and attained its maximum of prevalence in the week ending the 12th August, or the fourth week after its first appearance. In 1869 cholera became widely spread over the Central Provinces and Berar during the hot dry weather ; the towns of Nagpur, Bhandara and Chanda, remained free during this season, but in the week ending the 24th J uly, or the fifth week after the monsoon rains had set in, and when the water in the wells was beginning to rise, cholera became epidemic simultaneously in all three towns ; in all three towns also the epidemic attained its maximum prevalence in the week ending the 14th August, or the fourth week after its commencement. In 1875 and in 1876 cholera again became epidemic over the country, but in the interim changes had been effected in the water-supply of Nagpur and Bhandara; all three towns were visited by cholera in the course of the two years, but there was no correspondence in the periods of prevalence. In Nagpur and Bhandara the epidemic affected only small sections of the population, but in Chanda it was more generally diffused, and reached its maximum of prevalence in the week ending the 12th August, corresponding to the week of greatest prevalence in the three towns in 1869, 52. The circumstance of cholera appearing at certain stations and towns on the same or nearly the same dates in epidemic The effect of dronght and rain- seasons separated from each other by intervals of fall on the water-supply of the po- . r , 111 • i c 1 puiation affords a better expiana- several years, has been adduced as evidence or a cnotion of the frequent incidence of lera-producing atmosphere suddenly occurring over cholera on the same places on the ฆ,*ฆ-,ฆ, ฐ r • -i 1 same or nearly the same dates in the whole country, or ot miasma conveyed by air Smau STi C c^nts heorieS ฐ f currents that have passed over the Gangetic delta suddenly covering wide areas; but it seems to me that the illustrations.l have here given of the liability of certain places to cholera at a particular season of tho year, and at that season only, afford a far more satisfactory explanation of the means by which these coincidences are brought about ; that they are really the result of atmospheric changes (of heat and rapid evaporation in one season and rain-fall in another) on the water-supply of the population. Sources of water-supply subject to deterioration from exposure to heat and evaporation are more common in the smaller towns and villages, and the effect of unudual drought in aggravating the prevalence of cholera among the general population has been shown in the excessive violence of the epidemic of 1869 in Chhattisgarh. li* the large towns and stations the water is generally sufficient in quantity, but it is too often liable to pollution by the percolation of impure matters into the wells during the rains. The monsoon rains set in with great regularity usually between the 15th and 25th June ; the first falls are 25 absorbed by the parched soil, and it is not until the third or fourth week of the rains, and until the heavy falls of July come down, that the water reaches the wells by percolation from the surface ; and it is at this time that these instances of cholera breaking oat simultaneously at stations widely separated from each other, and at the same stations ou the same dates in different epidemics, are more apt to occur. The time during which these places are liable to cholera is comparatively short, not more than three or four weeks, and it is therefore scarcely matter for surprise that several should be attacked on the same dates, and that the dates on which any one place may be attacked in recurring epidemics should often coincide. Similar coincidences occurring in the dry weather are no doubt often due, as I have before pointed out, to the fairs and religious festivals that recur annually on nearly the same dates. The above illustrations also explain what I have before noted, that the statistics of troops and prisoners dwelling in the large stations do not give the first indications of the presence of cholera in a tract of country, and are therefore valueless as a means of tracing the rise and progress of cholera epidemics. Cholera is often for many weeks prevalent among the surrounding villages before it appears among the population of the town or station. 53. The manner in which cholera breaks out and its subsequent course in individual towns and villages, as exhibited in numerdul?to 88 S a e nd vmlgi aiso^ndt ous statements in this report, accords better with the cates connection with the water, theory that assigns to contaminated water an importeupply of the inhabitants. . • • , • ซj i iซ ปซi F * ant part in promoting epidemic prevalence than with any other. In the towns and larger villages we usually find a large number of cases occurring in the first week, but the maximum of prevalence is not attained till the second, third or even fourth week ; it then subsides, but isolated cases continue to occur for several weeks. Sometimes, however, it happens that isolated cases first occur for several weeks, and then all of a sudden an epidemic outburst takes place, which as suddenly subsides ; the outbreak at the Gutta quarries (paragraph 237) ; in the town of Doloriya (paragraph 289) ; in the town of Babai (Statement XVIII.), are good illustrations of this kind of attack. In the smaller villages, many of which have only one source of water-supply, the attack is usually more sudden, and the duration of the epidemic very short, a great number of cases occurring in the first week, few or none in the next. The outbreak in the village of Goraria (paragraph 284), in which 60 cases of cholera occurred in a population little over 400 in the space of 6 days, is a remarkable instance of this suddenness of attack ; the village of Cheela Ohown (paragraph 290) is another ; other instances will be found in the Statements. It is difficult to imagine a miasma emanating from the soil and decimating a population in the course of a few days, then disappearing, not to recur again for years, for it by no means follows that a village which has suffered in one epidemic will suffer again in the next. As a rule, villages that had passed through a visitation of cholera remained free during the remainder of the epidemic, although other villages in their immediate neighbourhood might be attacked ; but in some instances two distinct outbreaks occurred ; the village of I tarsi, in Statement XVIII., affords an instance of this occurring in continued dry weather; but several instances appear in the next Statement which illustrates the spread of cholera in a circle of villages during the transition period between the hot weather and the rains, one outbreak occurring before the rains set in, and the other after heavy rain had fallen. In the majority of these instances the villages were large, and drew their water supply from more than one source, from a etniarn which would retain only water in stagnant pools at the end of the hot weather, and from one or more wells. 54. In further evidence of the connection between cholera and impure water, we have the good effects that have followed The diminution in the liaoili'v of • • .1 „ * ฆ*... , 1 r j. the population to cholera which has improvements in the water-supply of towns, in invariably followed improvements diminishing or removing the liability of tho porn the water-supply. •ซ,1ป*:^ 1ฐ o ปfl^v r),,.; n <* fk* <™\A^; n r>**ซ,ซซ /ซo^o_ pulation to suffer during the epidemic season (para* 26 graph 342). To no other cause than the radical change in the nature of the water-supply can be attributed the remarkable immunity of the city of Nagpur, during both the seasons of 1875 and 1876, when cholera was prevailing with such virulence in the immediate neighbourhood (paragraphs 314 and 315) ; instead of the 600 cases and upwards that occurred in each of the two years 1866 and 1869, 58 cases only occurred in 1875 and 78 in 1876, and in many of these cases the disease had been contracted elsewhere. In the small town of Seoni also, where a radical change in the nature of the water-supply had been effected, instead of the 80 and 124 deaths which occurred in 1868 and 1869, there were only 4 deaths in 1876 ; and in other places in which the watersupply had been improved, corresponding diminution in the mortality from cholera has followed. 55. Lastly we havo to refer to the very remarkable facts disclosed in Statements XXVII. and XXVIII., which show the The immunity from cholera of relative liability to cholera of persons at different ages, infants at the breast and the ex- ป Ivr J 111 • r vmป , 1 cessive liability of adult women. oi different sex, and belonging to different classes or castes. These Statements of themselves afford almost certain proof of the connection between cholera and impure water. With regard to the liability of persons at different ages, we find that infants at the breast are practically exempt ; that out of over 11,000 cases of cholera, only 65 were infants under one year of age ; that while the deaths of infants registered under the head of fever and other causes amount to nearly 30 per cent of the deaths at all ages, of the persons attacked with cholera scarcely one in two hundred was an infant under one year of age ; in many towns in which cholera prevailed with exceptional severity not a single infant suffered ; we find also that this immunity from cholera is to a great extent continued to children up to the age of two or three, but that children above three years old, who are able to run about by themselves, are far more liable to cholera than persons at any other period of life. We next find that boys are more liable to suffer from cholera than girls ; but that adult women, whose daily occupation renders them more liable to use impure water, suffer in far greater proportion than adult males, although in respect of fever and other causes of mortality the liability of women is much less than that of men (paragraphs 344 and 345). 56. This very remarkable evidence to the relation between cholera and _? . M ?,,, . . . water-supply receives additional confirmation from the The great liability to cholera of _ 1 • i *i -i •. j • eu i ivvutit ฑv *. ฑv the " low castes" who are debarred tact plainly exhibited in statement A A V l ll., that the acces^to the better sources of water, low caste Hindus who are excluded from the better sources of water-supply are liable to cholera in nearly double the proportion in which the Hindus of the better castes and the Mahomedans suffer. Numerous instances in which one caste in a village suffered from cholera, while the others remained free, are referred to in paragraph 346, and as an instance of the same kind I may here refer to the complete immunity of the European troops in the cantonment of Kamptee, while the native population of the surrounding villages and of the cantonment bazars was suffering. 57. The mass of evidence of which a synopsis has been presented in the _. ... . . preceding paragraphs, must, I think, be allowed to The mass of evidence presented r . . n I .• , l ,-, i ? ? xue mass vi cviucuce jiici-khiuu - . • " : •] . ,-. i . ? ? warrants the conclusion that cbo- point irresistibly to the conclusion that the prevalera iB an infectious epidemic, and j ence o f c h o lera is closely connected with impure that its seasonal prevalence is de. # J # r •ermined by the action of drought water ; that impure water is not. merely one cause the people* 11 ฐ Q thC water ' suppljr of among others contributing occasionally to produce an outbreak of cholera, but that it is the insanitary 27 condition which (among the native population) determines the prevalence of cholera, the season in which it will spread, and the degree of severity with which it will prevail. It would be too much to say that every case which occurs when cholera is epidemic is produced by the use of impure water, but the connection between epidemic outbreaks and impure water is so nearly universal, as to afford good reason to believe that if the water-supply of the people throughout 1 ndia, but more especially in Bengal and the eastern districts of the North-West Provinces, could be preserved from the action of the deteriorating causes to which it is now so generally exposed, cholera would cease to be epidemic. I may now, I think, claim to have demonstrated by conclusive and irrefragable evidence two fundamental facts regarding cholera ; firstly, that it belongs to the class of infectious epidemics, and that when it spreads over a tract of country, human intercourse supplies the means by which the infection is conveyed ; secondly, that its seasonal prevalence and its incidence on particular populations is determined by the presence of certain impure matters in the water used by the people, and that drought and rain-fall are the chief agents in rendering the water impure. 58. That each of these facts affords a practicable basis for preventive measures, is shown by the good which has resulted The natnre of the relation be- from the suppression of the Mahadeo fair, and the tween cholera a ud impure water. i r j. J.i i ฑ- /> , L r supply of pure water to the population of the city ot Nagpur ; but this synopsis would be incomplete without some attempt to extract from the report the evidence it may contain as to the nature of the relation between these two facts. Is impure water simply the medium by which the infection of cholera is communicated to individuals, or does it operate by predisposing the individuals using it to be acted on by the infection when they happen to be brought in contact with it ? This question is not easy of solution, and I make no pretension of solving it definitely. Our knowledge of the intimate nature of infectious diseases, and of the infective process is, as yet, too imperfect to permit of any positive opinion on this question ; there are, however, certain features in the manner in which cholera spreads, and its seasonal prevalence, that seem to me to throw some light on it. 59. In former investigations into this subject, I had not been able to satisfy myself that cholera infection is directly com- impnre water may serve as a me- rnunicable through the medium of water, but there dium of communication. „ .n. n , . ... * are many facts in this report which seem to me to leave no room for doubt that this does occur. In all the maps, but more especially in Nos. V., VI., VII., and VIII., we see that not only was cholera chiefly confined to the villages on the banks of the rivers, but the dates on which the first cases occurred are so nearly consecutive, and they follow one another so closely in point of time, that no other explanation than that the infection of cholera was conveyed in the stream seems possible. The evident connection between the case of the sepoy in the hospital tent in the cantonment of Jubbulpore, and the outbreak among the Bassores in the village of Kuttangha, seems explicable only on this ground. 60. On the other hand, the inference of direct communication by water is 1-1 • . .1 .1 ... - " not applicable to the wide spread of cholera during JZฃSXgSZฃฃ?ZZ dry months of the year, its aggravated prevalence in seasons of unusual drought, its sudden decline in the latter part of the rains, and its almost complete quiescence during the subsequent three or four months of cold weather. These facts appear to be best explained on the supposition that impure water more frequently operates by predisposing persons to be recipients of the infection of cholera, or by inducing the disease in persons who have been previously infected. 28 61. It must be borne in mind that the water-supply of this country is almost entirely furnished by the rains of the mon- Anrnaiiym the hot weather much soons, that during eight months of the year lir.tle or of the water used by the people ?. . ฐ. , •, A , ? J ฆ% ? ,-. passes through a stage of putres- no additions are made to it. At the end of the cenoe, and in the rains it becomes mo nsoon it is generally abundant and fairly pure, but charged with organic matter irom . 1 • -i j c external sources. as soon as the rains cease, the exposed sources ot supply become subject to the action of deteriorating causes. Many kinds of animalcule that swarm in the tanks during the rains die when the water becomes exposed to an unclouded sun and drying winds, and in this way the water, even of tanks not liable to pollution from external sources, becomes unwholesome as the hot weather advances ; and it is a fact that the water in a very large proportion of the tanks used by the people in those districts in which tanks form the chief source of supply, annually passes through a stage of putrefaction, (paragraph 337, and Appendix V.). This stage supervenes sooner or later in the dry season, according to the depth and volume of the water, and for the same reason the amount of decomposing matter is proportionately greater in some tanks than in others ; in some the water becomes horribly offensive, in others the products of decomposition will be scarcely perceptible as the hot dry season advances ; also many of the rivers and streams cease to run, and when the stream ceases to be sufficient to keep the water in the deep pools fresh, many kinds of animalcules die, and the water becomes clouded and impure. The extent to which the people are reduced to the use of water in this state, of course becomes greatly aggravated in seasons of unusual drought. During the drought of 1869 the inhabitants of many of the villages in Chhattisgarh continued to use the water of the tanks until the fish died and floated on the surface.* In paragraph 265 of this report we have an instance of an outbreak of cholera occurring in a population using water in this state. During the rains the water-supply becomes charged with organic matter from external sources. 62. The probability that persons using water in this condition should be predisposed to be acted on by cholera infection when Facts from which it may be in- brought within its influence, will be generally allowed : ferred that the material of cholera ป , '7i i /• l i • i f .•_ซ ? multiplies in impme water. but there are also facts which seem to justify the conclusion that the infective material of cholera if added to impure water multiplies rapidly, or has the power of conferring upon the organic matter contained in the water, infectious properties identical withjits own. Infective material introduced by women washing clothes or otherwise, into a tank or stream containing water in the condition I have above described, would in this way produce a violent epidemic. The rapid spread of cholera along the villages on the Wuna and Kanhan rivers (paragraphs 308 to 320), both receiving a large amount of organic matter in proportion to their volume, seems to be best accounted for in this way. In both these instances, not only was there good reason to believe that the streams were contaminated with cholera matter, but at the villages themselves the portion of the river resorted to by the people was polluted with sewage from lucal sources, and it seems not improbable that the cholera infection conveyed in the stream communicated iufectious properties to the local pollution. The immunity of the villages on the Pench river (paragraph 323), and the abrupt arrest of the epidemic at the junction of the Godavari river with the Pranhita (paragraphs 120 to 122), would seem to show that a large river flowing through a sparsely populated country, and therefore containing sewage matter only in a state of extreme dilution, is incapable of conveying infection. 63. A very important class of facts bearing on the nature of the relation between cholera and impure water, consists of those The bearing of the relative pr*. which show the relative degree of prevalence and the Talence and fatality of cholera, in - , i.. * i,l impure water. wells, and from these sources at different seasons oi the year. Statement XXVI., 'page 154) exhibits the * Central Provinces' Sanitary Report for 1869, pages 86 and 134. 29 prevalence of cholera in 31 different towns of the Central Provinces in the years 1875 and 1876, and it will be there seen that the ratio of cases per 1,000 of population ranged from I*6 per 1,000 in Nagpur, which is supplied with water brought in from a large reservoir through iron pipes, to 68 and 69 per 1,000 in Mungeli and Gadarwara, dependent chiefly on streams in which the water at the time was nearly stagnant ; and to 75 per 1,000 in Wardha, supplied partly from a stagnant nala and partly from wells sunk in a very porous soil and without tubes. 64. But the towns being generally supplied with water from numerous sources, some of which may be comparatively pure, do r The most violent outbreaks of no fc 80 often afford examples of violent outbreaks of cholera occur in the email villages. ? , ? l . v v • r j ja cholera, as the smaller villages which are dependent on a single source of supply. The following table, reproduced from my annual report for 1869, exhibits the mortality from cholera in relation to amount of population in nearly 4,000 villages that were visited by the epidemic in that year :- - co ฆ • ฃ• c Iti 1 p Villages in which the deaths from cholera were *S ฉ ซ ป.ฉ 5 ฃ to . to _- a - 0 ฎd g a ฃbl o .2 fej g.s lsฃ '-ss-s S5 cultivating fluid, but it more com- prevalence during seasons or drought, when much of moniy operates by inducing a , s P e- the water used by the people is stagnant and putrecitic state of system favourable to ,„ • / , 1 1 T- i • ฆ% i • the action of the infective material, scent, and rrom the relation that evidently exists between the fatality of the disease and the quantity of foul matter in the water, we may infer that water charged with decomposing animal matter becomes subservient to the spread of cholera in two ways ; it may serve as a cultivating fluid suitable for the increase or propagation of the infective matter, at the same time serving as a means of communicating this matter to individuals, or it may operate by predisposing persons using it to be acted on by the infective material. It is almost impossible to decide in which of these two ways the impure water may have operated in any particular instance, but I believe that its more common function is that of a predisposing cause ; that the putrescent animal matter commonly operates as a determining factor in the production of the disease ; that it produces a specific state of system favourable to the action of the specific infective material ; and that unless this specific state ฉf system is induced, the infective material will not give rise to that violent disturbance of the organism which constitutes cholera. 32 67. In this dependence for its development on a certain specific state of system, it appears to me that cholera shows its in its dependence on a specific affinity to other infectious epidemics ; for the instate of 9yBtem for the action of its /...*'..,ซ i, f j ฃ infective material, cholera chows its iectlVe material 01 Small- pOX tO produce US Specific affinity to other infeotious dis- di sease there must be a corresponding specific coneases. .... .' „ ? r . ? -^ f • ซ , -, dition in the organism of the individual infected ; this condition is innate, and natural in almost every one, but it appears to be subject to modification, either directly or indirectly, by seasonal influences, and is more strongly developed in the dry season of the year ; it may be removed by an attack of small-pox or by vaccinia, and after a series of years it may be reproduced. In the case of scarlet fever the predisposing state of system is generally present in children and young persons, more commonly absent from adults, but there is no doubt that it may be intensified and perhaps produced by insanitary surroundings. With cholera the predisposing state of system appears to be adventitiously produced by the introduction into the organism of animal organic matter in a state of putrescence or decomposition. Impure water is the more common means by which this matter is introduced, but it is very probable that air laden with emanations from a sewer or cess-pool or latrine, or rendered foul by overcrowding and deficient ventilation, may serve the same end : these conditions, however, are not so generally present among the native population of this country as impure water, and do not therefore so evidently regulate the seasonal course of an epidemic. 68. Europeans placed under equal circumstances are more susceptible than natives to the action of cholera infection. The cholera Europeans tinder equal arcum- death-rate of the European troops stationed m the stances are more susceptible than ฆ„ ITi .j - JL ฃ . L ioซ n i QC/t ™ซ a natives to the infection of cholera, Bengal Presidency for the nve years 1860 — Io64ซ was and the disease is also more fatal io*7l per 1,000 ; for the ten years 1865 — 1874 it was in them. „ r .. '- ' , , / i. ... ซ j.t_ jซ 5* per 1,000; the cholera death-rate of the native army for the ten years 1867 — 1876 was 3*7 per 1,000. Of late years the mortality from cholera in both armies has been decreasing, but in the epidemic of 1875-76, the difference was still considerably in favour of the Native troops, the death rates being for the European soldiers 3 40, for the Native 1*77 per 1,000. In individual outbreaks the contrast is often still more decided : the severest outbreak among the troops in 1876 occurred in the Peshawar garrison ; here the number of Europeans attacked was equal to 56 per 1,000 of strength, while among the Native troops the number attacked was equal to only 12 per 1,000. Cholera is also far more fatal to Europeans than to Natives. The deaths per cent of cases among the European and Native troops and among the prisoners in jail for the two years 1875-76 were as follows :— European troops ... 69 per cent. Native troops ... 55 „ Prisoners in jail ... 45 „ In Peshawar, of 63 cases among the Europeans, 45, or 71 per cent, were fatal ; of 42 cases among the Native troops, 19 only, or 45 per cent, died. Of 24 cases among the Europeans at the Murree convalescent depot, 22 or 91 per cent, proved fatal ; of 190 known cases among the native population, 111, or 58 per cent, were fatal. 69. As the conditions of life in respect of water-supply, conservancy and dwellings are in favour of the European, compared This may be due to the difference w ith the Native soldier, this much greater liability of in diet, but a local determining . . - , . j,, !ฐ! ฐ r . v< iป A i, cause appears to be necessary with the former to cholera and the greater iatality oi tne in him, is probably due to the difference in diet, the specific state of system necessary to the action of the infective material being more readily induced and more strongly developed in the flesh-eating European than in the native, whose diet is almost 33 wholly vegetable. It is quite conceivable that the proclivity to cholera may be induced in the European by errors in diet alone ; but that epidemic outbreaks are dependent upon some local determining cause, is rendered evident by the beneficial results that almost invariably attend removal of the infected body from the locality in which an outbreak has occurred ; and that this local cause is most commonly impure water, is probable from the circumstance of outbreaks occurring at certain seasons of the year, either in the hot weather or in the early part of the rains (most commonly the latter) when the water-supply is more liable to become impure, and also from the circumstance that in the only two places where European troops are located, Fort William and Mianmir, in which a radical change in the nature of the water-supply has been effected, the liability to outbreaks of cholera has diminished in a very marked degree. 70. The aggravated prevalence of cholera which commonly, though not always, attends famine consequent on drought, has been attrichoTerainSeT^ffamt^noTthe buted to the influence of want and starvation in prore฿uit of debility induced by defi- ducing a proclivity to cholera, but there is really no ground for assuming that physical debility, however it may be produced, has any influence in determining an attack of cholera ; we have seen that the European soldier is more liable to cholera than the sepoy, and that in both it proves more frequently fatal than in the native convict ; and it will scarcely be contended that the diminutioa in the mortality from cholera observable in both troops and convicts of late years, has been effected by more abundant food. It is, moreover, a matter of common observation during epidemic outbreaks, that the strong man is quite as frequently struck down as the weak and sickly one ; and I believe that the spare man has a better chance of surviving an epidemic than the man of full habit ; the varying degree in which cholera prevails ia different localities and at different seasons of the year, lends no support to the notion that poverty and deficiency of food has any influence on it ; it has been shown above that the prevalence of cholera and its fatality varied greatly in different villages in close proximity to each other, the populations of which were equal in conditions of life ; and we have seen that in epidemic seasons cholera runs a definite course, attaining its maximum of prevalence in June and July, subsiding or dying out in October or November ; but the poverty of the people is not greater in the former months than in the latter. In my report for 1869 (para. 686) I showed that in that year of drought and famine, it was by no means the case that cholera prevailed most severely in the districts where the scarcity of food was greatest; so also in the famine of 1877 in Southern India, the first effect of the failure of the monsoon rains of 1876 was a terrible increase in the preva* lence of the cholera epidemic which had commenced in the previous year ; but this aggravated prevalence of cholera subsided as soon as rain fell, and long before the distress and mortality from famine had reached its highest point. I showed, moreover, in my report for 1869 that it was quite possible to keep relief camps crowded with starving people free from cholera ; so also in the famine districts of Madras and Bombay, though immense bodies of men were everywhere collected on relief works, as a rule they kept remarkably free from cholera. An outbreak of cholera is more likely to take place at a marriage feast than in a famine relief camp where proper sanitary arrangements are carried out, and 1 believe that one day's surfeit is more likely to bring on an attack of the disease than a week on short rations. The poorer classes are no doubt more frequently subject to the determining cause of cholera, but that cause is not poverty or deficiency of food. 71. I have been induced to dwell on this point, because the progress of enquiry into the nature and cause of cholera is retarded b y T attSS 8 g by assigning to general causes, effects which can only effects that can only arise from a arise from a specific cause. The symptoms of cholera specific cause. 'I'M • n. nr j i • ,i are precisely similar in the well-fed man and in the man suffering from starvation, and whether the disease occurs under the excessive 34 heat of India or the excessive cold of a Russian winter ; and it is more than probable that wheresoever or in whomsoever it is developed, it is the result of the same specific cause or condition ; and our only hope of successfully combating the prevalence of the disease, lies in the discovery of this specific cause or condition ; but we are not likely to reach this goal so long as we are content to attribute epidemic prevalence to such general and indefinite causes, as poverty and distress, aerial currents, and conditions of soil, which are quite undetermined. 72. The period of incubation of cholera appears to vary considerably, and .. . . . . to depend upon the decree in which the predisposi- The period of incubation of cho- . r * m , , , ป ? ,• ฃ ji lera appears to depend on the de- tion or state ot system suitable lor the action ot tne gree in which the predisposing atปte infective material has been induced. In paragraphs 1 44, of system has been induced. trt . ~,_ . -n i r j r*u * 152, 158, 290 and 315, instances will be found of the attack supervening in less than 24 hours after the infection had been applied ; but one of the most remarkable instances of this kind occurred in the Chhindwara hills in 1869 ; on the 23rd April, about sunset, a woman suffering from cholera arrived at the village of Jhilmilli ; she did not enter the village, but lay down at a well about 50 yards outside, where she died. The Kotwal buried the body that evening, and the next morning this man, his son and his daughter were all seized, and died in a few hours. In the course of the same and the following days (the 24th and 25th) 26 other persons were attacked, or 29 in all out of 125 that formed the total population of the village ; of the 29 attacked, all died ; on the 26th the survivors fled into the jungles. The only source of water-supply was the well near which the woman died ; it was a surface well or jhirria, quite unprotected, and the water it contained wae foul and offensive. In this instance the Kotwal was attacked in about 12 hours after he buried the body of the woman, and before 48 hours had elapsed, the disease had been developed in 23 per cent of the inhabitants of the village. In the outbreaks described in paragraphs 106, 142, 146, 167, 280 and 296, from two to four days intervened between the importation of the infection and the first case among the resident population. 73. But although it appears from these instances that in cases where the . , t , . susceptibility to the action of the infective material Persons may remain infected and , - 1 • 1 • i 1 i i* ซn l oapabie of infecting others for con- has been previously induced, the disease will be Biderabie periods, without the disease developed after the lapse of periods varying from a being developed. _ r ฃ i A i_ Fir few hours to three or four days, there are facts from which it may be inferred that individuals may remain infected and capable of infecting others (paragraphs 144 and 152, Murwara) for considerable periods, and that the infected state may eventually pass off without causing an attack of the disease. But if, while this infected state continues, the determining condition of system should be developed, the symptoms of cholera will supervene. It has been shown above that the fatality of the disease varies with the strength of the determining condition, and that in some epidemic outbreaks the disease is of a comparatively harmless character ; and that in all outbreaks, excepting some few extraordinary instances, the greater part of the population suffers no ill effects from the infection. It may be observed too in all the Statements that give the weekly prevalence of cholera, the epidemic attains its maximum of prevalence in the first, second or third week, according to the number of the population; it then declines and ceases to be epidemic ; but casual casss occurring through several weeks show that the population remains infected, and if during this period, through the operation of rain-fall or otherwise, the determining condition be induced in a fresh number of persons, a renewed epidemic outbreak will take place. Statements XVIII. to XX. (pages 115 to 120) and the epidemics in the towns described in pages 144 to 147 afford the best examples of this occurrence. In the course of epidemic outbreaks which come under close observation, cases not unfrequently occur in which the attack appears to have been brought on by errors in diet or excess in drinking, and in which there is reason to believe that 35 but for the systemic disturbance so produced, the symptoms would not have supervened ; and with regard to pilgrims dispersing from the large religious gatherings, it is a matter of common observation, that the period intervening between the time of their leaving the fair and the date on which the attack of cholera supervenes varies greatly ; some may be attacked almost immediately, others not for many days or even weeks, and after they have travelled long distances. Very striking evidence to this fact is clearly set forth in the account given by the Sanitary Commissioner with the Government of India in his fourth annual report of the manner in which cholera was spread over the country in 1867 by the pilgrims returning from the Hurdwar fair; similar evidence is afforded by the account given in Appendix I. of this report, of the pilgrims returning from Juggernauth ; the development of the disease in these pilgrims being attributed to the hardships of the journey and the impurity of the water obtainable on the route. In paragraph 132, which describes the spread of cholera by the people returning from the Ramtek fair, evidence to the same effect will be found ; in several instances the attack of cholera did not supervene until the individual had reached his home, and after periods varying from 6 to 18 or 20 days had elapsed since the assemblage at the fair had dispersed. These instances seem to me to be best explained on the supposition that the infection of cholera, as of other diseases of the same class, may be latent in the system for long periods, and that diseased action will not supervene unless evoked by the specific insanitary condition necessary to its development. 74. The origin of the epidemic in the Chanda district (paragraphs 110 to 113) affords good ground for believing that infection The infection of cholera may may spread in a body of people, but that no epidemic epread in a body of men, and no ri 1 ปii . 1 1 1 . i ซ.•ป•"• ซj outbreak of the disease occur. outbreak will take place unless the essential insanitary condition is present. Ihe outbreak in the Betul district in the same year (158,159) was apparently an instance of the same kind ; and similar instances are given in pages 171 and 172 of my report on the cholera epidemic of 1869. Instances also often occur of isolated cases occurring among a population through several weeks, without the disease becoming epidemic, until after rain has fallen ; and it frequently happens that although the native population of the neighbouring town or bazar may suffer in the hot weather, the troops in cantonments will remain free till after the monsoon rains have set in ; in some of these instances the epidemic outburst may be due to direct pollution of the watersupply with cholera matter, but in such cases as those of Chanda, Bhandara and Nagpur related above, it seems more probable that it was the result of the action of water charged with ordinary sewage matter, on populations previously infected. 75. The conclusions regarding the nature of cholera, the means by which it is spread, and the conditions that determine its mci Conclusions. dence on particular populations which seem to me fairly deducible from the facts described in this report, are :—: — (I).— That cholera is never a product of the soil of the locality in which it occurs. (2). — That the spread of cholera over and beyond India is not effected by the means of air currents that have passed over the Gan^etic delta or other locality in which the disease is considered to be endemic. (3). — That cholera belongs to the class of infective epidemics, and that human intercourse supplies the means by which it spreads. (4). — That the infective material of cholera may multiply or increase in water containing sewage or other animal organic matter in a state of decomposition. (s.)— That the infective material of cholera when introduced into the human organism will not produce the symptoms which constitute the disease, unless a certain state of system suitable for its action in this manner has been previously induced. 36 (6.)— -That in India this state of system is more commonly induced by the use of water charged with putrescent animal matter, and that the seasonal prevalence so characteristic of cholera in this country, is the result of the action of drought and rain-fall in charging the water-supply of the people with impurities of this kind. '7.) — There is reason to believe that the state of system suitable for the malefic action of the cholera infective matter may be induced by inhaling air in a confined space, laden with emanations from a sewer or cesa-pool, or otherwise contaminated with putrescent animal matter, also that it may be induced by errors in diet ; and it is not improbable that it may occasionally arise through faulty action of the excretory and depurating organs, but in this country these conditions are not sufficiently common to affect the seasonal course of an epidemic. 76. It follows from these conclusions that measures for the prevention of . , cholera must be directed towards limiting the spread Preventive measures based on ... . ซ ? f i • , ฐ r j these conclusions. of the infection by human intercourse, or towards • removing the insanitary conditions which are the Quarantine generally impracticable. . ฐ . , • • * • • • J * most common determining causes of epidemic outbreaks. Genera! measures based on either of these principles are no doubt encompassed with great difficulties ; attempts to limit the spread of the infection have commonly foiled, and it will be easily understood why this should be, if (as there is good reason to believe) the infection of cholera may lie latent in the system for considerable periods, and if it may be conveyed and communicated by persons apparently in perfect health. The difficulties in the way of establishing barriers which shall effectually prevent intercourse between one part of a country and another are almost insuperable ; even with regard to a particular class of persons known to be infected, as pilgrims returning from the large religious gatherings, attempts to prevent their passage will almost always prove futile (Appendix I) ; and while they fail of their object, they inflict great hardships oil the people, and afford the police opportunities for oppression and extortion. 77. But although effectual inland quarantine may be impracticable, it does not follow that precautionary measures against cholfira Useful measures based on the should have no reference to the fact that the disease came principle as quarantine may, . i , * • . aujx-j however, be adopted ; and the fact is spread by human intercourse. Abundant evidence SSrtSSiS^wiS^tdS! will be found in tMs re Pฐ rt fnd the appendices of ger. the influence of pilgrimages to the holy places, and the large gatherings that take place at them, on the chief festivals, in giving origin to epidemics and promoting their diffusion over the country. The time may not yet be ripe for suppressing or authoritatively limiting these pilgrimages and fairs, but by keeping prominently in view the fact that they are a great evil, and occasion much mortality and misery among the people, the practice of resorting to them may be discouraged, and the way towards suppressing the more dangerous of them may be prepared. In the Central Province* certain fairs have been suppressed, and the time of holding others has been changed, and no one acquainted with the facts doubts that these measures have been the means of saving thousands of human lives. The evil effects of the numerous marriage parties which unfortunately occur in the hot weather, when the population is most susceptible to cholera, have also been made evident in this and former reports, and it is now considered quite justifiable to discourage them in epidemic years. There are many other occasions on which the fact that cholera is communicable from person to person cannot be ignored without great danger, but perhaps the most important is the assemblage of troops for service or for manoeuvres. It is scarcely probable that any one, even of those who discredit the communicability of cholera, would have sufficient confidence in his opinion to. bring a regiment actually suffering from cholera to a force collected for service ; but if, as there is reason to believe, the infection may lie latent in a body of men, 37 for a considerable period, it would not be safe to add to the force a regiment in which cases of cholera had lately occurred, although they may for the time have ceased ; neither would it be safe to march a regiment to the place of assemblage through a district in which cholera was at the time epidemic. 78. But while I believe that views which discredit and keep in the back- T riL . ground the fact that cholera is a contagious epidemic, Improvement of the water-supply ฐ - i , ?i i i i r of the people will prove the most are fraught with danger and weaken our powers of mitigating the ravages of an epidemic, it may be admitted that measures directed solely to preventing or limiting intercourse are capable of only partial application ; and that for the permanent diminution of the prevalence of cholera, we must look to measures for the removal of the specific local condition which determines the incidence of an epidemic on particular populations, and without which apparently the infective matter remains inactive. This condition we have shown to be, most commonly, water charged with animal matter in a state of decomposition ; and the most radical of preventive measures consists in supplying the people with water not subject to deterioration by exposure to a hot sun and drying winds, and not liable to contamination by the surface drainage of an inhabited area, or by the filtration of rain-fall through a polluted soil. 79. In urging on the Administration the adoption of measures for the improvement of the water-supply of the people, with a The work of improving the water, view to the mitigation of the ravages which cholera supply of the people encompassed . ? .- 5 . . . & , .. . , with great dimcuities, but rendered periodically commits in the more populous districts of more hopeful by the knowledge tlie Province, lam well aware of the difficulties by that every town or village supplied , ป . J with pure water is rendered less which the Subject IS encompassed. DO long as the iXion m^r^te? 6^ 6 when ฐ c mass of the people continues as at present apathetic in the matter, the general application of measures for improving the water-supply, which must include improved conservancy and strict attention to cleanliness of surface, by the central authority, to the thousands of villages comprised within each district, is practically almost impossible ; but an abundant supply of pure water is so inestimable a boon to a community in this climate, that all legitimate influence in promoting improvements of this nature may well be brought to bear on municipalities and the more influential and intelligent of the land-owners ; and the good effect on the public health which will surely follow such measures wherever they may be carried out, can scarcely fail ultimately to enlist the co-operation of the people themselves ; and here also the demonstration that cholera is a disease that spreads only by human intercburse comes beneficially into play : the knowledge that every central or municipal town and every bazar village, in proportion to the thoroughness with which improvements of the nature indicated are carried out, is rendered less liable to become a centre whence the infection may radiate over a wide circle, renders the prosecution of the work of improvement a more hopeful task, and affords greater encouragement for perseverance than is compatible with a belief in theories which regard the soil surrounding every village as a probable source whence under some unknown and undefined conditions, cholera miasma may emanate, or which attribute epidemic outbreaks to a pandemic influence overshadowing wide regions simultaneously and indiscriminately. By giving due prominence to each of the two factors in the production of cholera, the communication of infection from without and a known local predisposing or determining condition, we obtain greater preciseness of aim in carrying out preventive measures than is afforded by any other theory ; and that the presence of these two factors is essential to the spread of cholera over the country, I confidently appeal to the evidence given in the pages of this report. Simla : 1 nth June 1878.) S. C. TOWNSEND, Sanitary Commissioner, Central Provinces. Beport on the epidemic of Cholera of the years 1875 and 1876 in the Central Provinces. 1. The object of this report is to trace the progress of the epidemic of cholera which in the course of the two years 1875 and 1876, spread over the Central Provinces and the territories adjoining them ; and to describe more minutely the manner in which the epidemic affected certain districts and localities, and the conditions which apparently determined its incidence on particular towns and villages. 2. The report is illustrated by the following maps :—: — No. I. A, showing the extent to which cholera spread over the Central Provinces and adjoining territories in 1875. No. I. B, showing the extent to which the epidemic spread over the same country in 1876. 3. The progress of the epidemic is indicated on these maps by the dates on which the first cases of cholera occurred in the different sections into which the country is sub-divided. 4. Maps II to X. are on larger scales, and show the villages and towns attacked by cholera in certain districts and localities, and the date on which the disease first appeared in each. Section No. I. 5. This section, which must be read with the assistance of maps No. I. A. and 8., is devoted to a general description of the country and the spread of cholera over it in the two years 1875 and 1876, The country delineated in map No. I. comprises the great central portion of India stretching from the Eastern to the Western Ghats, a distance of over 700 miles, and from the Vindhyas to the Godavari river, a distance of nearly 500 miles. This wide tract of country, as is well shown in the map, is very mountainous ; it in fact includes the two great ranges, the Vindhyas and the Satpuras, which stretch across India and mainly occupy the country between the 20th and 25th parallels of latitude. The general direction of these hill ranges is from east to west, but offshoots from them sub-divide the country to the north and south, and by interposing sparsely populated tracts of hill and forest between the more open and more densely populated districts, delay the progress of epidemics and render their passage from one district to another. more easy to be traced. 6. The whole area comprised within the limits above described, contains about 250,000 square miles (considerably larger than France), with a population of about 20,000,000. Of this area 118,000 square miles are taken up by the Central Provinces, while the remainder is occupied by the northern districts of the Bombay Deccan, Berar and the Native States under the Central India Agency. The Central Provinces also includes several Feudatory States of wide extent which are not directly under British administration. 7. From the Native States and Feudatoryships information of the first appearance and general prevalence of epidemic cholera is obtained, but mortuary statistics are not systematically collected. While therefore the spread of cholera in each of the two years 1875 and 1876 over the whole of the country within the limits delineated in the map will be generally traced, the more minute descrip* 2 tion of the means by which the diffusion of the epidemic was effected and the mortality occasioned by it, will be confined to the districts directly under the administration of the Central Provinces. 8 The topographical divisions into which these districts are naturally arranged, and the extent to which each district suffered from the epidemic, are shown in Table I. STATEMENT L— Showing the distribution of the ChoUra epidemic of 1875-76 in the Central Provinces. * " " |" "1 ! II I" i i n | i b ii DiTisions and Districts. g ฃ gป 'S •& *SoS o "ฃ 2 •ง I i J. if |i IE ซ towST™ ... W U63 319,962 86 911 235 7-4 2-85 BilTsDur ' ... 2,769 2,179 516,722 313 2,526 186 14-4 4-89 Jaipur I'!; ... 6,828 3,072 883,246 413 4,554 129 13-4 516 Total ... 10^958 6,4141,719,930 812 7,991157 12-7 4-65 Bala^auXht) .!!" ... 1,867 621 218,313 20 61 100 3-2 -28 Ehandara ... ... 3,922 1,560 564,813 153 866 144 9-8 1-55 Chbindwara (Saosur) ... 1,088 269 99,510 62 581 91 23-3 5-84 Naapur 3,734 1,634 631,109 418 2,812 169 25-5 4-40 Wardha •ป 2,379 872 354,720 374 2,458 149 43ซ8 694 Chanda Z ... 5,378 1,369 456,790 279 3,799 85 20-4 8-32 Sironcha ... ... 924 223 24,425 19 155 26 8-5 6-35 Total ...19,292 6,548 2,349,680 1,325 10,732 122 197 4-48 Sitpura Division. Mandla ... bซ 4,719 1,831 213,018 31 236 45 l'l I'll Balaghat (Baihar) ... 1,268 414 61,888 5 8 47 1-2 -13 Seont 3,072 1,453 321,623 68 445 103 4-6 1-37 Chhindwara (above Ghats) ... 2,184 1,044 165,681 39 192 76 37 1-16 Betul ... 4,042 1,183 278,857 237 1,678 69 200 602 Burhanpur ... 1,109 150 70,540 13 240 63 8-7 3-40 Total ... 16,394 6,0751,111,607 393 2,799 68 6-5 2-52 Nerbudda Division. Nimar 2,230 444 140,684 78 644 63 17-6 4-58 Hoshancrabad ... ... 4,222 1,339 440,186 395 3,000 104 29-5 6-82 Narsinabpur ... 1,916 966 339,395 308 4,285 177 319 12-63 Jubbulpore ... 2,158 1,61& 382,926 136 1,289 177 B*4 3-37 Total ... 10,526 4,364 1,303,19! 917 9,218 124 21*0 717 Vindhyan Division. Murwara ... ... 1,574 715 145,933 26 240 93 3*6 1-64 Sauaor . . 4,005 1,868 527,725 216 2,995 132 11*6 5-68 Damoh ... ... 2,799 1,124 269,642 124 817 96 11-0 3-03 Total ... 8,378 3,707 943,300 366 4,052 113 9-9 4-30 Central Provinces ... 65,548 27,1087,427,708 3,813 34,792 113 14*0 4-67 3 9. The Mahanadi or Eastern Division comprises the hills and plains which form the basin of the Mahanadi. This division extends altogether over an area of more than 40,000 square miles, but not much more than a fourth of this area is included in the khalsa, or districts immediately under British administration ; the remainder is occupied by Feudatory States; the khalsa, however, includes the great plain of Chhattisgarh and (he Dekhantir of Sambalpur, which together contain nearly three-fourths of the whole population of the division. The Feudatory States are for the most part tracts of hill and jungle, and very sparsely populated. 10. The traffic connections of Chhattisgarh, which comprises the districts of Bilaspur and Raipur, lie chiefly through Bhandara with Nagpur, to which it exports annually immense quantities of grain. The intercourse of the Sambalpur country is chiefly with Orissa by way of the Mahanadi ; but the great pilgrim route from Benares and Allahabad and the whole of Northern India to Pooree or Juggunnath, after crossing the hills east of Amarkantak, traverses the district of Bilaspur, and crossing the Mahanadi at Seorinarain passes through the State of Sarangarh and the Dekhantir, or southern portion of Sambalpur, to Sonpur, where it again strikes the Mahanadi, and thence follows the course of the river in its passage through the Eastern Ghats which separate Sambalpur from the maritime province of Orissa. 11. The Wainganga Division comprises the districts south of the Satpura range, which are drained by the Wainganga and Wardha rivers. Its genera] surface declines towards the south from 1,000 feet above the sea at Nagpur to 650 feet at Chanda and 360 at Sironcha. The population of this division is contained chiefly in the districts of Nagpur and Wardha and portions of Bhandara and Chanda districts. South of the main road from Raipur to Nagpur, and east of the Waingunga river, a tract of country, comprising the southern circles of Bhandara and the Zamindaries of Chanda, is chiefly occupied with hill and forest and very sparsely populated ; while further south lies the independent State of Bastar, a wild tract of hill and forest, which, according to the census of 1872 ; contained a population of little more than 6 to the square mile. • 12. West of the Wardha river, which in this direction forms the boundary of the Wainganga Division, is the province of Berar, which extends westwards as far as the junction of the Puma river with the Tapti, where it becomes conterminous with the Khandeish collectorate of Bombay. It comprises the rich plain lying between the Satpuras and the Adjunta range, and extends southward as far as the Painganga river. Between this river and the Godavari is a tract of hill and jungle which is very sparsely populated. 13. The Satpuras, which forms the third Topographical division of the Central Provinces, stretch westward from Amerkantak to Asirgarh. This great range, which occupies upwards of 16,000 square miles of the Province, is more than 100 miles in width at its widest part, but contracts at its western extremity into two narrow ridges, between which lies the portion of the valley of the Tapti that forms the district of Burhanpur. The greater part of this division consists of barren rock or hills covered with dense forest, but it also contains plateaus and valleys of rich soil, many of which are of wide extent and well populated. The plateaus of Seoni, Chhindwara and Betul which contain the greater part of the population of this division are from 2,000 to 2,500 feet above the sea, while many of the peaks rise to 3,500 or 4,000 feet. 4 14. The Nerbudda Valley, which forms the fourth Topographical division of the Province, is a narrow tract lying between the Satpuras and the Vindhyas and stretching from Sehora and Jubbulpore to Khandwa, a distance of 300 miles. For the greater part of its length it is a rich alluvial country containing a population of considerable density ; but west of Harda it is much covered with jungle, and Nimar, the more westerly district of the division, is in physical characteristics more allied to the plateaus of the Satpuras. This division is traversed through its whole length by the Great Indian Peninsula Railway ; and at Jubbulpore the branch of the East Indian Railway, which crosses the Vindhyas by Rewah, completes the line of communication between the populations of "Western India and the more dense populations of the Gangetic Valley among which cholera is endemic, while at Khandwa the Indore State Railway brings Malwa and the other States of Central India into connection with the same line of communication. 15, The districts of Murwara, Damoh and Saugor, which form the Vindhyan Division of the Central Provinces, occupy the central portion of the Vindhyan range. Rewah and the States of Bundelkhund occupy the eastern portion of the range, while the territories of Bhopal and Indore extend over the western por? tion. This division, though much broken by hill and rock, contains many fertile valleys and plateaus; and the density of the population is nearly double that of the population of the Satpura range. 16. For statistical purposes each district is sub-divided into a number of rural circles. The vital statistics of the Central Provinces are collected by the Police, and as a rule the statistical rural circles correspond with the Police circles, of which the Police station is the centre. In each circle there are a number of out-posts subordinate to the Police station, and at all of these stations and outposts reports of births and deaths are received and registered ; altogether the number of Police stations and out-posts in the Central Provinces at which the vital statistics of the rural population are collected amounts to 510. 17. Reports of deaths are made by the kotwars of each village to the station or out-post to which the village may belong. In the case of deaths from ordinary causes the reports are made on fixed days once or twice a week, accoring to the distance of the village from the station ; but in the case of cholera the order is to report at once, and Police have standing orders to ascertain, so far as may be practicable, the date on which the first case in a village attacked with cholera, occurred, whether the person attacked was a resident or a traveller, and, if the former, whether he had previously been from home. The Police also are required to inspect the village and report on its state in respect of cleanliness and on the nature of the water supply. The information gained is entered in a printed form supplied for the purpose, and this is sent in to the Sudder Police office, at the end of each week a return compiled from these reports is furnished to the Sanitary Commissioner. 18. In some districts the standing orders with regard to these reports are not strictly carried out, merely the dates of occurrence of first cases being given, and when it is considered that many of the out-posts are situated in remote tracts far removed from supervision by European officers, and that many of the villages are as much as 8 or 10 miles or even more from the Police stations or out-posts to which they belong, it cannot be expected that in all instances the dates of the first cases given are strictly accurate ; but as the kotwars of the greater number of villages in each circle are required to make their appearance at the station on fixed days in each week, whether a death or birth has occurred or not, it is not probable that in many instances the dates are far wrong ; and I think it may be fairly argued that when information, collected over a wide ares 5 by numerous agents quite unconscious of the use that will be made of it, imperfect though it may be, points in a certain direction, the evidence would be stronger and more conclusive in that direction could greater accuracy be attained. Moreover when the appearance of cholera in a district is reported, the Civil Surgeon usually himself goes out to ascertain the circumstances attending the outbreak, or a hospital assistant is deputed for the purpose. 19. In the series of maps Nos. II to X, in which the spread of cholera over districts or more limited areas is shown, the date of the occurrence of first cases of cholera in each village is given. In maps Nos. lA. and B. the dates of the first cases in each rural circle of the Central Provinces and in certain districts and localities of the adjoining territories are given. The dates which indicate the first appearance of the epidemic in localities outside the Central Provinces have been obtained from various sources. The reports of the Sanitary Commissioners of Bombay and Berar have furnished the dates for the districts of those Provinces ; while those that refer to the Native States under the Central India Agency have been extracted from returns furnished to the office of the Sanitary Commissioner with the Government of India, or from the reports of the Residency Surgeons which have been placed at my disposal by Dr. Ross, Deputy Surgeon General of the Saugor circle. 20. With the information obtained from these sources I have been enabled to exhibit on maps Nos. I A. and B. clearly and with fair accuracy the spread of cholera over a very wide extent of country in two successive years. 21. In the series of maps Nos. II to X the spread of cholera among the populations of certain districts and localities is shown more minutely and in greater detail than has yet been attempted. Every village attacked by the epidemic is indicated, and the date on which the first case occurred in each. 23. Statement No. II (Appendix No. IV attached to this report) is explanatory of maps Nos. I A. and 8., and also to some extent of the larger series. It gives the dates on which the first cases occurred in each town and rural circle of the Central Provinces; the month in which the epidemic attained its maximum of prevalence; the number of villages attacked in each circle; and the number of deaths reported. 24. Before describing the epidemic it is necessary to give a short description of the climate of the country over which it spread. Statement No. 11l gives the average monthly temperature of the Province. 25. Over so wide a country exhibiting great variety in its physical characteristics there will of course be much variety of climate. On the plateaux of the hill -ranges the temperature is lower than in the plains below ; the climate of the districts north of the Satpuras is also cooler than that of the districts south of the range. The humidity of Sambalpur, in the extreme east of the Province, and of Chanda and Sironcha in the south, is somewhat greater than prevails in the western and northern districts ; but as might be expected from the position of the country partly within the tropics, as well as from its elevation and consequent rapid drainage, the chief characteristics of its climate for a great part of the year are great heat and extreme dryness. 6 STATEMENT 111.— Average mean monthly temperatures of nine stations in the Central Provinces. J g ft II & I 111 1 I I I II I Feet. Sambalpur ... ... 451 4—5 66-2 71*1 79-2 90-2 93-8 86*8 79-0 79-6 81-2 79*0 71-6 67*3 78-8 Raipur ... ... 960 6—7 66-8 69-9 791 88-2 92-8 855 78-4 79 1 79-4 76-9 70*2 66-6 77*7 Chanda ... ... 682 5—6 67-9 74-1 81*5 89-8 92-4 85*8 793 791 78-9 760 70-0 66-7 78*5 Nagpur ... ... 1,025 6—7 68-5 73-8 81-9 88-4 93-3 85-9 78-7 78-7 78-9 769 70-9 678 78-6 Seoni ... ... 2,030 4 631 68-3 76-7 83 ! 8 87"5 81-9 75-6 75-1 75-8 71-4 656 63-3 74-0 Jubbulpore ... ... 1,351 7 61-7 66-2 75-1 85*4 90-9 86-7 78-5 77-8 78-5 736 66-0 62-0 75-2 Saugor ... ... 1,7C6 5—6 62-9 68-3 78-1 84-9 88-6 83-9 76-8 75-0 76-4 75-3 7M 65"7 75-6 Pachmarhi ... ... 3,504 3 58-0 62-5 73-3 79-8 83-6 78-9 69-1 68*7 69-6 66-2 58-4 57*9 68-8 Hoshangabad ?. ..... 1,020 6—7 66-5 71-2 79-8 88-4 93-5 86-8 78-8 78-3 79-5 77*3 71-5 GB-3 78-3 Mean ... 64-6 69-5 78-3 865 90-7 86-7 77-1 76-8 77-6 74-7 68-4 65-1 76-2 7 26. The weather usually continues cool till the end of February ; but in March the temperature rises rapidly, the increase of the mean temperature of March over that of February ranging from 8 to 12 degrees or even more. Subject to occasional depression after thunder storms the heat continues to rise till the end of May or beginning of June. Taking the mean of the 6 years 1871-1876, the last week of May and the first week of June are the hottest weeks of the year, the average mean of the temperatures recorded for those weeks at the several observatories of the Province exclusive of Pachmarhi being 9l c B. If the setting in of the rains is delayed the temperature will continue to rise ; in the week ending the 10th June 1876 the mean of the temperatures recorded at Hoshangabad was 97ฐ and at Jubbulpore 95 ฐ0. The maximum temperatures in shade recorded in that week rose to 111ฐ at Jubbulpore to 112ฐ at Hoshangabad and to 114ฐ at Nagpur. Usually, however, the clouds and thunder storms that presage the coming monsoon prevent any rise of temperature after the first week of June. 27. The rains commonly set in between the 15th and 20th June, and their advent is at once followed by a marked fall in the temperature, the average difference between the mean temperatures of the first and last weeks of June being more than 12 degrees. The rains continue to keep the temperature low through the months of July, August and September; but in October, though the night temperatures fall considerably, the days are hot, and the cold weather does not set in till after the 15th November. Northerly or land winds prevail for nine months of the year ; taking the average of the wind directions recorded at 12 stations during the year 1875, 47 per cent were northerly, 26 per cent southerly, 19 per cent due west, and 6 per cent due east. The deviation of the northerly wind is to the east from October to February, when the direction gradually veers to north-west, which is the true direction of the hot winds that prevail with increasing strength from the middle of March to the beginning of June, when winds from the south become more frequent. The monsoon does not often set in before the third week of June, but it then blows with steady strength across the whole Province. In some seasons south-easterly directions of the wind are recorded at Sambalpur in the month of May, but when the south west monsoon has set in it blows almost as steadily and with nearly the same velocity at Sambalpur as at Nagpur. 28. With the rise of temperature in March there is a corresponding decrease in the humidity of the atmosphere, (Statement IV); and this dryness increases as the hot weather advances, attaining its maximum in April and the early part of May. At Nagpur, in 1875, even in March the relative humidity computed from the dry and wet bulb thermometers at 4 in the afternoon was often as low as 5 (Sat=loo), and the mean humidity at that hour for the months of March, April and May was only 13. The extreme dryness of the atmosphere indicated by these observations will be better understood when I state that in England the relative humidity during the dryest months of the year is seldom below 60ฐ. In Calcutta, the mean humidity of March, which is there the dryest month of the year, is 73ฐ. In the beginning of June as the monsoon approaches, the humidity of the atmosphere perceptibly increases, and during the continuance of the rains it maintains a daily mean of about 80 ; but in October, as soon as the rains have ceased and the northerly winds set in, the humidity again rapidly decreases, and in November falls to 50. * 8 STAIEMENTIV.—Showiny the mean humidity observed at 8 Stations in the Central Provinces in 1876 (Saturation=lQO). • ** *< •: Station!. ฃ S . -g ง3 *g & IIIIiIt I I ! I 1 I Jubbulpore ... 57 48 3G 22 26 53 84 84 83 64 54 50 55 Hoshangabad ... 52 42 29 21 28 53 84 85 ฃ0 54 46 47 52 Pachmarhi ... 46 33 33 18 28 55 91 92 87 58 51 48 53 Khandwa ... 41 28 30 20 29 47 78 78 79 49 44 43 47 Seoni ... 3G 24 23 16 18 41 65 75 6Q 52 47 45 42 Nagpur ... 46 33 30 19 22 50 77 77 73 52 45 46 48 Raipur ... 55 59 51 26 27 53 82 79 81 06 55 53 57 Chanda ... 56 58 44 35 36 59 76 79 78 68 56 53 58 Monthly mean ... 47 41 35 22 27 51 80 81 78 58 50 48 51 29. During the rains the whole country is covered with verdure, but in November the high lands begin to look brown and dry ; and the kharif crops, which have been sown with the commencement of the rains, ripen. The wheat and other rabi crops which are sown in October ripen in February and March, but long before this the surface of the ground, as everywhere, becomes burnt and hard. SO. The annual average rain-fall of the Province, recorded at 21 stations for the 11 years 1866-76, is shown in Table V. The heaviest annual rain-fall occurs at Pachmarhi, the highest plateau of the Satpuras ; but of the stations at lower elevations the fall ranges from 27 inches at Burhanpur to 64 at Burha, which lies under the south-eastern extremity of the Satpuras. In fact the rainfall is found to increase both north and south of the Satpuras as the monsoon travels eastward until it meets the eastern end of the range ; Burhanpur and Ivhandwa having the lowest fall, Burha and Jubbulpore the highest, with the 31. It will be observed that the average mean rain-fall of the Province is 48 inches, of which 45 J inches fall in the monsoon months from June to October, and only 2^ inches in the remaining eight months. This small quantity is distributed in showers pretty equally over the several months, but these showers are seldom sufficient to have any appreciable effect on the water-supply of the country. The country is, in fact, in ordinary years solely dependent for its supply of water on the rain-fall of the monsoon ; streams, tanks and wells, which are filled by percolation from the surface, or some nala in close proximity, form the sources of supply. At the end of the rains and for four or five months afterwards it is sufficient, and, where not heedlessly polluted, of good quality j but from February onwards it progressively deteriorates. In March the smaller rivers cease to run and present only a succession of stagnant pools, the water in wells which at the end of the rains were full (in many places, to within a foot of the surface of the ground) rapidly falls, and by the end of the hot weather fails altogether, so that in many parts of the country the population during the hot and dry season of the year annually suffer from scarcity of water. Much also that is used is highly impure. 32. The people are generally quite regardless of all precautions against accidental pollution of the sources whence they draw their water, — they bathe their persons and wash their clothes in the same stream or tank from which they 9 STATEMENT V. — Average rain-fall at 22 stations in each month for 11 years 186G-7G. Sambalpur ••• 112 121 0.70 074 058 1066 1597 1442 816 261 ฉ'12 003 56*3* 4-35 51-99 Bilaspur ... 0-57 016 TO4 0 50 043 903 1222 10-27 6 47 V 36 013 034 42-54 2-70 39-84 Raipur ... 0-30 025 057 058 049 9*Bl 1553 1285 7-92 196 033 012 50-74 2-19 4855 Sironcba ••• ฐ"ฐ9 015 o*3l 0 28 084 5 88 1101 961 1023 2*87 027 010 41-66 1-67 39-99 Chanda • •• o*o9 020 091 043 056 7*43 14*70 1031 9*05 1*59 015 013 45-57 2-19 43-38 Wardha ••• ฐ' 45 ฐ 15 ou ฐ"32" 32 ฎ Q1 5 ' 66 10 " 95 8 " 48 6 ' 90 1>94 ฐ 07 ฐ 03 35 ' 73 1#67 34 '06 Nacpur ••• 0"68 027 033 0-44 038 7"6G 1010 807 849 T6O 005 0 09 43-17 2-10 39*07 Bhandara ••ฆ 099 0-21 061 00l 035 762 1602 1193 938 159 016 007 49-47 2-67 46-80 Balacrhat (Burba) ... 0-30 044 0-25 053 043 12-56 2201 1648 924 107 000 016 63*51 1-95 6156 Mandla ••• 0-43 053 065 034 048 967 1870 1296 716 123 006 030 52-50 2-43 50*07 Seoni ฆ•• 0-38 0-15 054 055 o*sl 988 1580 11*72 8 74 1*43 o*3o 072 5073 2*13 48-60 Uhhindwara ... 0*57 021 o*Bl 017 0 30 945 H'lB 796 8 71 1*46 011 026 41-21 2*06 39-15 Betul .. o*2l 018 0*57 041 035 7*51 12 98 8 71 9*50 097 015 o*l6 41-72 1-72 40-00 Burhanpur ... o*l6 o*3B o*ol 004 0 27 471 822 605 655 0*79 013 039 27-72 -86 26-86 Khandwa ... o*4o o*2B 004 o*lo 023 6*53 1137 7*Bo 682 0 49 002 0*23 34-34 1-05 3329 IHoshangabad ... 0-34 001 000 000 0*24 597 1446 13*97 11*24 069 003 0-24 47*20 -59 46-61 Pacbmarbi ... 0-21 009 010 002 o*2B 10*56 2906 2042 1774 038 000 C 15 79-04 -70 78-34 Narsingbpur . 0-15 0*27 0*23 o*3l o*3B 10*54 17*04 13*78 9*29 134 0 00 015 53-51 1-34 52-17 Jubbulpore 0-46 0*26 055 015 0 34 9*06 22*41 15*40 10*43 105 0-03 021 60*37 176 58-61 Murwara M 0 o*4o 0*23 013 0*36 810 18*45 1435 5 96 0*96 000 013 50*16 2-22 47"94 Damob 0-50 o*lo 019 0*24 018 6*85 2022 14*45 1019 1*69 001 o*2B 54*92 I*2l 53-71 Saugor ... 0*57 021 o*lo 019 0 33 7*61 21*23 13*56 10*33 115 003 023 55*55 1-40 54-15 Mean ... ' 464 6 -28 -40 -32 -41 B*3l 1603 1108 902 1*37 -10 *21 48*90 1-86 47*03 10 draw their water for drinking, or use as a latrine the nala within a few feet of the well which forms the common source of supply. But not only does the water-supply suffer from the habits of the people, it deteriorates from natural causes ; during the rains and subsequent months the tanks and shallow wells, and even some of the deeper ones, swarm with frogs, insects and animalculse, a considerable portion of which die as the volume of water decreases with the advancing hot season, and from this cause much of the water passes through a process of putrefaction in the months of March, April and May. The first rains after the setting in of the monsoon are in great part absorbed by the thirsty soil which during the months of drought has become baked and hard ; the remainder carrying much impure matter from the surface of the ground finds its way into the streams and rivers. With the heavy rains of July the wells become affected by percolation, and by the middle of August the soil has become saturated and the sources of water-supply everywhere replenished; while in the mean time the surface of the ground has been scoured and freed from the accumulated impurities of the dry months. The first effect of the rains as regards the water-supply is to load it with impurities, but ultimately they restore it to a fair degree of purity and replenish the sources whence it is derived. With the cessation of the rains the liability to accidental pollution is diminished, and during the four or five months succeeding an average monsoon rain-fall, the water-supply of the people is sufficient in quantity and of fair quality. 33. The prevalence of cholera in these Provinces is in a marked degree seasonal ; all the wide spread epidemics of which there is record have commenced in the early months of the year, and experience shows that if March and April pass by without cholera having appeared in some part of the Province, immunity for the year may be counted on. If, however, it appears in March or April it may be expected to spread through the hot and dry months, and in seasons of unusual drought will attain its maximum of prevalence before the monsoon sets in ; but ordinarily the prevalence will continue to increase till after the heavy rains of July and August have fallen. It will then rapidly decline, and with the cessation of the rains in October will cease to be epidemic. From October to March is ordinarily a period of immunity from epidemic prevalence. Table VI a. exhibits the chief features of the climate of the Province in 3.875. A description of the meteorology of 1875 will be found in the Sanitary report for that year. It will be sufficient here to reproduce the following summary. 34. The chief characteristics of the meteorology of 1875, compared with former years, were unusual cold in the latter half of January and first week of February ; an abnormally high temperature extending from the latter end of February to the end of March ; almost entire absence of rain in March and April, and great dryness of the atmosphere in those months. The monsoon was attended with heavy rain-fall in the last week of June and through July, and again in September. The rain-fall of October also was unusual, The temperature was much below the average through October and November, and slightly so in December. 35. The month of March 1875 was marked by the commencement of an epidemic of cholera, which in the subsequent months spread over large portions of the Province ; and as the experience of former years has shown that it is in the early months of the year that epidemics of cholera arise, a comparison of the meteorological conditions of the early months of 1875 with those of the corresponding months of the previous year, which was marked by complete immunity from the disease, becomes a subject of much interest. 11 STATEMENT Via, — Showing the chief features of the climate of the Central Provinces in 1875. Temperatures. ' Mean ... 63-6 69-5 811 88-3 91-2 84-0 773 770 776 74-5 67-6 65-8 76-5 1 •ป/r r • ป7q.q Q/(.i a*7.*7 in2.o iak.q o-.c oo.Q oo.fc QK.t; ok o oi >7 on o Qซ.Q i Mean of observations recorded at Mean of maxima ... 78'y 84-1 \)7'7 H)dฐ2 105*8 90-5 83*8 83*b 000 85*2 Br7 80-3 88 - 8 io observatories Mean of minima ... 51-3 572 668 757 80-3 77*2 73-5 729 72-7 66-1 556 539 66-9 J Mean relative humidity ... 56 56 35 29 25 58 81 80 78 65 52 57 56 Mean of Nagpur and JubWpore. (Direction ... 572 W N" 60 E N66WN46WN61 W 543 WS4B WN76W N49W N 36 E N 54 EN 33 E ... Resultants of directions recorded ซ4 Mean daily movement in \ I V 62 79 85 100 H6 162 169 134 112 79 48 51 102 Mean of observations recorded at j ? 1 10 observatories. Rain-fall, inches ... 0-24 0-46 0-01 o*lo 0-45 10-66 20-71 11-00 1060 2-02 0-00 0"O9 56-74 Mean of quantities measured at 22 stations. 12 STATEMENT VI h.— Showing the chief features of the climate of the Central Provinces in 1876. Mean .. 66-8 69-9 78-2 87-3 92-7 88-0 77-7 77-6 76-5 74-2 68-3 63"3 767 10 Observa- Mean of maximum... 82-5 86*8 937 103*1 104-4 99-9 84-4 84-6 84-8 87-0 83-1 793 89-5 Do. Mean of minimum... 535 55-1 65-1 73*9 81-4 80-2 74-6 734 71-4 63-6 55-6 497 66-4 Do. Humidity, mean ... 47 41 35 22 27 51 80 81 78 58 50 48 51 8 do. . i Direction ... 19N45W 23 N 3 E31N50W25N 7 W67N45W 58N78W 77S 60W38N 71W 66N57W57N 2ESIN 48E37N 27E Seoni Observag I Daily movement ( in miles ... 59 64 91 91 146 159 175 133 116 79 59 50 101 10 Observatories. Kain-fall, inches ... [ 0-16 ... 0-11 382 17*51 14-11 9-30 0*37 ... ... 45-38 Mean of 22 stations. ฆ 13 36. The mean temperature of January 15 74 was equal with the average, while in 1875 it was much below the average ; and this low temperature continued to the end of the first week of February ; during the remaining three weeks of February 1875 the temperature was higher than in the corresponding period of 1874, but the mean temperature of the first week of March in both years was equally above the average. The second week of March in 1874 was marked by a decided fall of temperature, and the weather continued unusually cool through the next four weeks. In 1875, on the other hand, a remarkable rise of temperature occurred in the second week of March, and the temperature continued much above the average during the next four weeks. The mean temperature of March 1875, ascertained by observations at 11 observatories in the Province, was no less than 5*5 higher than the mean of the temperatures recorded at the same observatories in March 1874. 37. The temperature continued higher through April 1875 than in the corresponding month of the previous year, but the difference was not so great as in March. The temperature of May in the two years was nearly equal. The rain-fall of the first 5 months was below the average in both years, tho deficiency being greatest in- the months of March and April. 38. The humidity of the atmosphere is normally very low in this Province throughout the first 5 months of the year. In February 1875 it was slightly greater than in the corresponding months of 1874, but it waa lower through March, April and May. 39. I have before stated that the normal direction of the wind blowing over this Province during the first 5 months of the year is from the north with more or less deviation to the east and west. During January the deviation was more often to the west than in the corresponding months of 1874, in February it was more to the east ; through March, April and May the wind directions were in both years more than usually constant from the north-west. 40a. The excessive temperature of March, and the greater dryness of that and the following months constituted the chief features in which the meteorology of the early part of 1875 differed from that of the corresponding period of 1874. The rains of the monsoon were heavy and above the average in both years. 40&. Table No. Ylb. shows the chief meteorological features of 1876. The temperature of January was considerably higher than in the corresponding month of the previous year, that of February was nearly the same in the two years. The temperature of March 1876 was 3ฐ below that of 1875, April also was cooler by Iฐ, May was 1-|ฐ and June 494 9 hotter than the corresponding months of 1875. The temperatures of July and August were about the same as in the previous year, September was 1ฐ cooler, October and November differed very little from those months of 1875 ; but December waa 2^ฐ cooler. The atmosphere was generally dryer during the dry months of the year than in the corresponding months of 1875, the difference being greatest in January, February, June, October and December. The direction of the wind was more northerly in January and in June ; much the same as in the previous year during the remaining months. The rate of movement of the wind correa* ponded very nearly in each month of the tvs T o years, 14 The rain-fall during the first five months was even less than during the corresponding months of 1875. The setting in of the monsoon rains was also delayed till the end of June, and the rain-fall of this month was not equal to half the average. The rain-fall of the next three months, however, exceeded the average ; and in parts of the country, heavy floods occurred in the first week of September. The rains, however, ceased in the third week of September, rather earlier than usual ; and the rain-fall of October was below the average. Taking the whole year, the rain-fall wais a little below the average. 41. Table VII. shows the mortality from cholera in the different districts of the Province in each of the nine years 1868-1876. Full information regarding the cholera of 1868-69 and subsequent years will be found in the annual sanitary reports of the Province ; and I will only remark with reference to this table, that in the course of the nine years the Province has been twice covered by wide-spread epidemics, by that of 1868-69 and that of 1875-76 which we are now about to describe. In 1872 only, of the five years that intervened between these two great epidemics, was there any noteworthy mortality from cholera. In that year a severe epidemic prevailed in the Deccan districts of the Bombay Presidency, and spreading thence through Berar, reached the districts of Wardha and .Nagpur south of the Satpuras, and also crossing the range by Burhanpur, it spread up the Nerbudda valley ; but its prevalence in these Provinces was confined chiefly to the district of Nimar. In the following year, a sharp outbreak in Sambalpur coincided with the arrival of an infected regiment from the neighbourhood of Juggernath ; but the epidemic did not spread beyond Sambalpur, -and ceased in April. 42. In 1874 the Central Provinces experienced almost complete immunity from cholera; only 14 deaths were registered under this head in the whole year. Of these, 2 occurred in the Mandla district — one in June and the other in July — and 12 in one village in the north-east corner of the Sambalpur district in December. The surrounding territories also enjoyed a like immunity, and this was continued through the first two months of 1875. 43. In Orissa only of the neighbouring territories was cholera prevalent during January and February. It is always more or less epidemic there, and it has been frequently brought from thence into the eastern districts of these Provinces by pilgrims returning from Juggernath, but it was not from this quarter that the epidemic of 1875 derived its origin. 44. The first warning that cholera might become epidemic in these Provinces was received from Allahabad in the first week of March, the military authorities there reporting to the Officer Commanding at Jubbulpore that cholera had broken out in the districts of Allahabad and Jaunpur ; and the annual statements appended to the report of the Sanitary Commissioner of the North- West Provinces show that in February an epidemic accession of cholera had commenced in both those districts and also in Benares, and in the district of Mirzapur.. On the 2nd March cholera appeared in a village close to the Railway station at Sutna in the Rewah territory, about midway between Allahabad and Jubbulpore, and on the 19th it broke out in the town of Rewah. 45. On the Bth March the Deputy Commissioner of Bilaspur reported that cholera had broken out in a village 12 miles to the north of the Sadar station, and it was subsequently ascertained that the first case had occurred on the 23rd February in a party of pilgrims who had returned through the Rewah territory from the Magh mela at Allahabad. Within the next fortnight, outbreaks of cholera occurred in other villages of the Bilaspur district, in one village of the Raipur district, and in the Feudatory States of Pandhuria and SaktL 15 STAIEMENT VlL— Showing number of deaths from cholera in each district in each year 1868 to 1876. — I ' 1 6 Sambalpur ... 319,962 ... 710 ... 1 ... 30912 254 658 1,944 6-08 Bilaspur ... 516 722 4 9,386 20... 2,525 1 11,986 23-10 Raipur ... 383,246 3 10,165 I•• 4,449 105 14,723 16-67 Wainganga Division. Balaghat(Burha) 218,313 250 478 61 789 3-61 Bhandara ... 564,813 468 954 5 261 605 2,293 4-06 Chhindwara(Sao- ,' nr - a ~ A 8ur \ 99 510 -40 30 5M 15 G5l 6"ฐ46 "ฐ 4 Nagpur I!! 63 l i;io9 498 1,292 '"l 7 '"%i 2,111 701 4,634 7-S4 Wardha ... 354,720 371 1,759 1 2 267 2,015 443 4,858 13-70 Chanda ... 456 790 49 740 7 1... 551 3,248 4,5% 10-Ob Upper Godavari 24,425 5 ... 32 20 135 192 7-86 Satpura Division. Mandla ... 213,018 1,219 4,343 2 47 175 5,786 27-16 Balaghat(Baihar) : 61,888 ... 126 J \ fllf 11 Seoni ...[321,623 2,250 1,899 6 3 442 4,600 14-30 Chhindwara 9 . q:> (above ghats)... 165,681 119 73 84 108 384 232 Betul ... 278,357 19 411 320 1,303 2,108 756 Burhanpur ... 70,540 11 117 ... 2 165 226 ... 521 7J9 Nerbudd a Division. Nimar ... 140,684 1 500 ... 2 849 10... 423 223 2,008 14-27 Ho฿hangabad ... 440,186 33 2,379 58 5 153 1 ... 629 2,371 5,629 12-79 Narsinghpur ... 339,395 573 4,325 50 93 4,192 9,233 27 20 Jubbulpore ... 382,926 3,895 3,473 1 ... 62 2... 11 1,278 8,722 22-73 Vindhyan Division. Murwara ... 145,933 240 1,347 26 214 1,827 12-52 Saugor ... 527,725 256 9,376 20 2,975 12,627 23 93 Damoh ... 269,642 34 3,196 15 817 4,062 15-06 Ter Vm " 7,427,708 10,338 57,079 10419 1,592 34414 14,643 20,124 104,257 14-04 16 46. In all these places the outbreak followed closely on the return of some of the inhabitants who had been to the mela at Allahabad. This mela is held annually in the end of January and beginning of February at the junction of the Jumna with the Ganges, and is one of the most important and largely attended 47, Towards the end of March cholera appeared on the western confines of the Province. On the 22nd March it broke out in the town of Nasik on the Western ghats, 2,000 feet above the sea, where the river Godavari takes its rise, and one of the chief places of pilgrimage in Western India. On the 27th March the disease appeared in Khandwa, the point of junction of the Indore State Eailway Avith the Great Indian Peninsula Railway, and on the sth April an outbreak occurred at the temporary terminus of this railway, 22 miles south of Indore. 48. Thus by the end of March cholera had appeared in an epidemic form at three different points on the confines of the Province very remote from each other. At this time the whole area shown in Map No. IA, with ths exception of these widely separated localities, was free of cholera ; but subsequently spreading from these points the epidemic covered the greater part of the country. 49. The epidemics that spread from these several points will be described as the northern, the eastern, and the western epidemic. A reference to Map No. 1A will render the tracts of country occupied by each of these epidemics easy of comprehension. The northern epidemic was a part of the cholera which spread over the districts of the North-West Provinces south of the Ganges ; and the southern boundary of the country occupied by it is formed by the Kaimur range, or that part of the Vindhyan escarpment which overlooks the head of the valley of the Sone, the extension of this epidemic into these Provinces was very slight. In May an outbreak occurred in the town of Murwara on the norther border of the Jubbulpore district and connected with the Rewah terrK tory by trade and means of communication. Subsequently a few cases were reported from three villages in the Sleemanabad circle, but the epidemic did not cross the low hills and tract of jungle which lie between Murwara and Sehora and form the water parting of the Sone and Nerbudda rivers. Later on, in the end of August, a sepoy returning from the North-West to Bombay was seized with cholera in Jubbulpore, and was apparently the means of communicating the disease to the inhabitants of a small village within the Cantonment boundary ; but this so far as is known is the only instance that occurred in J875 of importation of the disease from the Gangetic into the Nerbudda water-shed. In the end of August and beginning of September a few cases of cholera occurred in the town of Shahgarh in the north of the Saugor district ; these were probably due to importation from the Bundelkund country, where the disease had been for some time prevalent. 50. The spread of the eastern epidemic was at first confined chiefly to the country drained by the Seonath, the first great tributary of the Mahanadi, and which comprises the great plain of Chhattisgarh ; as I have before stated, the first appearance of the disease coincided with the return of pilgrims- from Allahabad. The people of Chhattisgarh follow the custom common in many other parts of India of carrying a portion of the ashes of deceased relatives to the Ganges ; and the Magh mela held at Allahabad in the end of January and beginning of February is the festival at which this duty is most frequently performed. 51. In 1873, from Brahminical reasons, and in 1874, o\* ing to a scanty harvest, these pilgrimages to the Ganges had not been performed from Chhattisgarh; but in 1875 very large numbers went up and returned in the end of February and beginning of March. The route taken by these pilgrims lay across 17 the hills of Pendra north of Bilaspur that form the water parting of the Mahanadi and the Sone rivers, thence along the base of the Maikal range to Sohagpur, and then across the Kaimur range to Kewah where it joins the main road to Allahabad and Mirzapur. The country through which this route lies is chiefly hill and jungle, and very sparsely populated. Not being directly under British rule, there is no registration of deaths, and consequently no information as to whether cholera prevailed along the route when the pilgrims were returning ; 12 deaths from cholera occurred at the fair, and the disease was said to have been present among the pilgrims on their way back, but trustworthy information on this point was not obtainable. 52. It is, however, certain that the first cases in the Bilaspur district occurred in parties of these pilgrims ; the first case reported was that of a woman who was taken ill on the 22nd February, a few miles within the border of the Bilaspur district, and from thence was carried on the following day to Jier home, in the village of Guniari, 12 miles from the Sadar town. On the same day, (the 23rd), two other pilgrims who had returned to Guniari with the woman first attacked, were seized with cholera, On the same day also a male pilgrim of the same party who had returned to the village of Beltokri, a mile from Guniari, was seized, After this, the disease spread among the inhabitants of these two villages, and by the Bth March, when tho matter was inquired into, 18 persons had been attacked in Guniari, of whom 7 had died, and 15 in Beltokri, of whom 6 had died. Pilgrims of the same party belonging to three other villages in the same circle were attacked with cholera after returning home, but in these instances the disease did not spread among the villagers. A few days later, on the sth March,, the disease was brought by a returning pilgrim to the village of Dunaili in the Surgaon circle, and on the 15th it broke out in the village of Kusdool, south of the Seoaath river, in the Lown circle of the Raipur district, to which a large party of pilgrims had returned a few days previously. Cholera ljad also been brought by returning pilgrims in February and March into the Zamindari States of Sakti, Kenda and Panduria, that Ue in the hills on the northern border of Bilaspur, 53. Numerous points had thus become infected in the early part of March by the return of these pilgrims ; but the conditions favourable to the spread of cholera were not apparently at that time common in the district, for although by the end of March cases had occurred in 22 villages in different parts of the district, in many of them the number of cases had not exceeded one or two, and in none had the prevalence been severe ; the total number of deaths in February and March amounted to 100. In April there was a marked decline in the prevalence of the disease ; 8 fresh villages only were attacked in the course of the month, and the number of deaths amounted to 32 only. In fact, m the last week of April, deaths from cholera were returned from one village only, and there was every reason to hope that the epidemic would prove abortive and die out. 54 In the first week of May, however, a severe outbreak occurred in the town of Mungeli consequent on a marriage feast to which people belonging to the villages in which cholera had prevailed in the previous month had come ; the first cases occurred on the 3rd and 4th of May among the people assembled fpr the marriage, and the disease subsequently spread very rapidly among the population of the town. By the 15th of the month, 248 cases, of which 106 proved fataj, had occurred among a population of 4,350. The violence of the epidemic then abated, but cases continued to occur until the end of July and beginning of August, 55. Now Mungeli is the principal market for that part of the district, and in the three weeks following the outbreak in the town, cholera appeared in upwards of 40 villages in the rural circle of Mungeli and the circles of Lormi 18 and Nowagarh which adjoin it, and the total number of deaths in the district in the month of May rose to 498. In a very large proportion of the surrounding villages in which cholera appeared subsequently to the outbreak in the town of Mungeli, the first cases were persons who had either visited Mungeli, or who had fled from the place during the epidemic. The epidemic also soon crossed the border into the Simga circle of the Raipur district, an outbreak occurring in a village near Simga, in the second week of May, the first cases being persons who had arrived from Mungeli ; and about the same time it appeared in the Kawarda Zamindari, to the west of Mungeli. The epidemic also spread along the road that leads in a south-westerly direction from Mungeli to Dongurgarh, the mart to which the greater part of the produce of the western portions of JBilaspur and Raipur is brought for exportation to Nagpurand Kamptee. This route traverses the circles of Nowagarh in the Bilaspur district, of Damda in the Raipur district, and the Khairagarh Zamindari. The first outbreak occurred in Nowagarh circle on the 6th May, in the Dhamdah circle on the 13th, in Khairagarh on the 29th, and on the sth June it broke out in the town of Dongurgarh. 56. On the Ist June cases of cholera occurred in a village south of the main road, reporting to the Sunjari out-post of the Balod circle ; and on the 3rd, a violent outbreak occurred in the town of Nandgaon. On the same date also, cases occurred in a village of Dhamtari circle further south, and on the 20th June, in a village in that portion of the Kajitn circle which lies west of the Mahanadi — beyond this, to the east of the Mahahadi, there was scarcely any extension of the epidemic, three villages belonging to the Rajim circle on the east, of the river were attacked in August, and in the same month cases occurred in three villages on the Sambalpur road that report to the Nowagaon out-post of the Aurung circle ; but no cases occurred in the villages reporting to Panduka and Sihawa which lie to the south of the road to Sambalpnr. 57. In the eastern circles of Bilaspur district also, the epidemic attained to a very slight degree of prevalence. In the Seorinarain circle the number of deaths was little over 1 per 1,000 of the population, and in Saragaon there ฆwere only 8 deaths in a population of 68,000. In the Mungeli and Surgaon circles, on the other hand, the mortality was 10 nearly per 1,000. In the Balod circle of the Raipur district it was 12*5, and in the Drug circle, 10*6 per 1,000. There are no statistics of the mortality in the Nandgaon Zamindaries, but it is known to have been very great. The epidemic in fact fell with the greatest severity on the population of the villages around Mungeli, and of the villages of the Balod circle south of Nandgaon. 58. The extension eastward of the epidemic into the Sambalpur territories was delayed till the 10th of July, when it appeared in a village of the Chandrapur Zamindari, but this outbreak was not followed by any prevalence of the disease in this locality. Later in the month an outbreak occurred in Lapunga in the extreme north of the Sambalpur district close to the border of the Chota Nagpur territories, and subsequently ten villages in this circle suffered. On the 20th August the disease appeared in the town of Sambalpur, and subsequently spread to some of the surrounding villages. Cholera visited 32 villages only in the Sambalpur district, and the total number of deaths amounted to 254, of which 108 occurred in the Sadar town. The epidemic was in fact confined to the circles north and east of the Mahanadi ; the populous Dekhantir or portion of the district south of the river remained entirely free, as did also the large" Zamindaris of Sonepur, Patna and Kalahandi, which lie to the south of the Sambalpur district. The area covered by the epidemic in this direction was strictly bounded by the Mahanadi ; all the territories on the right bank, or to the south of the river, remained free. It would appear also that the states to the north of Sambalpur escaped the epidemic; for, in reply to my application for information on the 19 subject, the Commissioner of Chota Nagpur informed me that no reports of any outbreak of cholera had been received from Sirgoojah or any other of the Tributary States. 59. In August a party of Baildars belonging to a Survey party returning from Mungeli to Jubbulpore through the Mandla district stopped at Maharajpur, a large village on the bank of the Nerbudda opposite the town of Mandla; the woman in whose house these men stopped was taken ill of cholera, and died on the 14th August ; the disease then became prevalant in the village, and some persons residing near where the woman who was first attacked lived, came over to the town of Mandla. A woman and a child of this party were seized while in Mandla, and the disease then spread in the town ; 24 cases and 14 deaths occurred in Maharajpur, and 32 cases and 13 deaths in Mandla between the 14th August and the 1 7th September. 60. While cholera was prevalent in Maharajpur and Mandla, a man who had been engaged in a civil suit in Mandla returned to his house in Pendrai, a police station on the Thaoor river, which forms the boundary between the Mandla and Seoni districts ; he was taken ill with cholera immediately on his return and died on the 27th August ; the disease then broke out among the residents of the village, and subsequently spread to two other villages on the Mandla side of the river, and to two villages on the Seoni side. On enquiry it was ascertained that bodies of persons who had died of cholera at Pendrai had been thrown into the river. 61. In the last week of May a party of Gonds, inhabitants of two villages in the hills of Balaghat, descended into the plain to purchase chillies ; cholera broke out among them on their way back, and two died; and a Gond of a third village, who had been down to a bazar in the plain, was taken ill of cholera on his return, and died: subsequently his wife suffered from the disease, but she recovered. When these events were reported at the Behir station-house, police were posted on the different passes to prevent the people from going down into the plains, and no more cases of cholera occurred in Balaghat. 62. The greater part of the surplus produce of the great plain of Chhattisgarh is exported to Nagpur and Kamptee ; part goes by the main road through the town of Bhandara to Nagpur, and part to Dongergarh, where it is bought up by agents of firms in Bombay, Nagpur and Kamptee, and thence conveyed to the two latter places by the road that passes through the northern portion of the Bhandara district, following the line that the railway from Nagpur will eventually take. After leaving the plain, both these roads pass for 30 miles or more through low hills covered with jungle, more or less dense, in which the villages are small and far apart. On both roads the traffic is very active during the dry months of the year, or from January until the end of June, when it almost entirely ceases. Cholera appeared on both these routes through the Bhandara district. On Ihe upper route it first appeared in the village of Durikussa on the 19th June, and it subsequently appeared in three other villages on this route, the total number of deaths reported being 27. By this time the rains having set in, traffic in this rou^e had almost ceased, and no cases of cholera were reported from the villages in this direction. After the second week of July an outbreak, however, occurred on the 14th July in a village in the Ramtek circle of the Nagpur district, which from the circumstances seemed to be due to importation from the east; out at this time cholera had reached the Nagpur district from the west, and the eastern and western epidemic began to overlap each other. 63. On the lower or main route from Chhattisgarh through Bhandara, cholera appeared first in the village of Deori, about 5 milea from the Baghnadi river 20 which forms the boundary between the district of Bhandara and Raipur, the first persons attacked being residents of the village, who had been to Dongergarh, A little later an outbreak occurred in a gang of coolies employed on this road between Boorbooj and Sakoli, and cases occurred in seven villages on or close to the road in this part. On the 12th June, an outbreak confined to persons of the Dher caste, took place in the village of Shahpur on this road, west of the Wainganga river and not far from the town of Bhandara ; on the 7th July it appeared in the village of Bela also on this road a few miles west of Bhandara, and it continued in this village till the 20th of the month. On the Ist August the disease appeared in the town of Mahoda where the main road crosses the Kanhan ; this is a great halting place for carts and cartmen belonging to Raipur, and a traveller from the Raipur direction is said to have died on the encamping ground some days prior to the outbreak in the town. 64. From this point the disease followed the course of the Kanhan to its junction with the Wainganga, and then along that river to the north of the Chanda district. The epidemic from the west had already reached the upper part of the Kanhan, and cholera was very prevalent in the town and villages on its banks; but the outbreak at Mahoda and the villages in the neighbourhood appears to have been a part of the eastern epidemic, and it was along the line of the Kanhan that the two epidemics met. 65. So far as priority of outbreak, and the dates on which successive outbreaks occurred subsequently at other places may be taken as evidence, the western epidemic took its origin at Nasik, and it appears to have had a second point of departure at Khandwa. It is, however, not impossible that both Nasik and Khandwa may have derived infection from Allahabad or Benares where cholera had a month previously become active and spreading, for in both ot these places pilgrims congregate from all parts of the country, and from Benares especially devotees depart on pilgrimage to all the important shrines in India. Nasik; is one of them ; Omka Mandata, the holy island in the Nerhudda 40 miles north of Khandwa, is another to which there is a continuous stream of pilgrims throughout the dry season. The railways are now very extensively utilized by people making pilgrimages to the different shrines, persons of the upper classes often taking with them a large following, and any pilgrims travelling: by train to Mandhata, whether from Allahabad or from Nasik, must necessarily alight at Khandwa. 66. Evidence that cholera was actually imported into either place is wanting ; but in seeking for the origin of an epidemic, it is right that the facilities, for importation should be considered and pointed out. If the supposition that the outbreak in these places was the result of importation from elsewhere, is rejected for want of sufficient evidence, and we seek for a cause of the origin in the local conditions of these places, we find that they are not such a.s are supposed by many to favour the production of cholera. 67, Na^sik is reputed one of the healthiest stations in India, it lies on an open plateau of the western ghats, 2,000 feet above the sea, The country around is fertile and well cultivated, while the site of the town is rocky and well situated on the banks of the Godavari river, not far from its source. The bed of the river is broad and rocky, but the stream is shallow ; it, however, forms the chief source of water-supply for the population, and all classes, resort to it for bathing and washing as well as for drinking water, and it is probably to this circumstance, in conjunction with its being an important place of pilgrimage, that it owes its liability to outbreaks of cholera ; the population of the town numbers 35,000, 10,000 of whom are Brahmins. Khandwa is similarly situated on a rocky plateau on the northern slope of the Satpuras, and will be more particularly described hereafter. At Nasik only o*o7 inch of rain had fallen during the mpnfch of March, and at Khandwa none had fallen ; the temperature wss much abyo^ the average, and the dry northerly winds had set in, 21 68. One death had been registered under the head of cholera in the city of Bombay oa the 3rd January, and another some time in February : with these exceptions the whole or the Bombay Presidency was free of cholera prior to the outbreak at Nasik. Nowhere in Western India had cholera showed signs of epidemic activity. In assigning a cause for the outbreak at Nasik, we are therefore left to the alternative of development from local conditions, or importation of infection from beyond the Presidency : the local conditions are not such as to render it probable that the place would give birth to epidemic disease ; on the other hand, importation of cholera infection from Allahabad or Benares was quite possible, and the character of the place as one to which pilgrimages are made, and the circumstances under which the outbreak occurred render it probable that this did occur. 69. The Sheoratri festival had been held on the 6th of March, and the Holi was being celebrated at the time of the outbreak. The first known case occurred on the 22nd March in the person of a Gosain or religious mendicant who had come from Dwarka, the holy place in Guzsrat. Cholera, however, was not prevalent at the time in that part of the country. 25 cases, 10 of which proved fatal, occurred in the town between the 22nd and the end of the month. 70. The town of Nasik is 6 miles from the line of Kailway ; and on the 9th and 10th April cholera appeared at Igatpuri and at Niphar, the nearest stations on the line — one towards Bombay and the other northward towards Bhosawal. On referring to map No. IA. it will be seen that the dates there given of the appearance of cholera in different localities (which have been extracted from the reports of the Sanitary Commissioners for Bombay and Berar) give evidence of the gradual diffusion of the epidemic in all directions from Nasik. Cases commenced to occur in Bombay on the 3rd April, in Poona city on the llth, in Dhoolia, the head quarters of the Khandesh collectorate, on the 30th April ; and the first cases in the Buldana district of Berar occurred on the 9th May, the first case being that of a man who had come from an infected place in the Bombay Presidency. The Akola district was reached on the 22nd May, the Amraoti district on the 20th June, and Ellichpur on the 15th June. 71. The epidemic did not cross the Wardha river, which forms the boundary between Berar and the Central Provinces, till the 14th July : on that date an outbreak occurred in the village of Dewalwara, on the left or the eastern bank of the river. The first case was one of three women who had visited a village in the Amraoti district, and who returned suffering from cholera ; from this point the epidemic spread to other villages on the river, and the town of Arvi was soon infected. Annually large numbers of the inhabitants of the districts of Nagpur and Wardha, seek employment in Berar during the hot weather, returning to their homes after the rains have set in when the cotton sowing is finished. The number returning in July 1875 was unusually great, and it was probably by their means that cholera was chiefly introduced into these districts. On the 22nd July an outbreak occurred in the village of Dhamna (see map No. VII.) on the Wuna river, through which persons returning from Berar to Patansaongi, Saoner, Khapa and the surrounding villages would pass, and in the course of the next few days the disease appeared in all the villages on the bank of this stream for many miles of its course. On the 25th an outbreak occurred in a village in the Saoner circle (Map No. VIII.), and on the 26th the first case occurred in the town of Khapa (Map No. VIII.) on the Kanhan river, and from this point the epidemic rapidly spread down this river as far as its junction with the Pencil opposite the cantonment of Kamptee. 22 72. The line of the Kanhan to this point may, as I have said before, be taken as the limit of the spread of the western epidemic towards the east ; it here met and overlapped the epidemic which had advanced from the eastern districts. 73. Extending northward from the Nagpur district the epidemic spread into the Chbindwara district. On the 3rd August it reached the village of Kamakona, where the road from Nagpur to Chhindwara crosses the Kanhan river, and on the same date it broke out in the town of Lodikhera, a few miles further on. These places are below the gbats, and the prevalence of the epidemic in the Chhindwara district was chiefly confined to the submontane sub-division of Saosur, which is drained by the Kanhan and Jam rivers. The town of Chhindwara above the ghats was reached on the Ist September, and on the sth a village in the circle of Umerwara, to the north of the Sadar town, was attacked, but the epidemic spread no further in this direction. The total number of deaths in the Chhindwara district was 650, but of these 566 occurred in the circles below the ghats, being nearly 7 per 1,000 of the population, while in the larger portion of the district above the ghats only 84 deaths, equal to o*4 per 1,000 of the population, occurred. 74. South of Nagpur and Wardha the epidemic entered the Chanda district from Berar in the beginning of August, having been brought by a person returning from Wun on the other side of the Wardha river. Its prevalence was chiefly confined to the circles of Warora and Segaon, which lie on the left bank of the Wardha, but isolated outbreaks occurred lower down in the Dhaba circle, near the junction of this river with the Wainganga. A branch of the eastern epidemic, as I have before explained, followed the course of the Wainganga river in the east of the Chanda district as far south as Garchiroli, but the wide tract lying between these two rivers remained free until the following year. 75. Further south in the Upper Godavari district, a narrow tract along the left bank of the Pranhita and Godavari rivers, cholera prevailed slightly in the end of August and beginning of September ; but the appearance of the disease in this remote locality was due to importation from the JNizam's territory on the other side of the river, and was probably an extension of the epidemic from Nasik along the more southern route through Poona, Sholapore and Hyderabad. 76. The branch of the western epidemic that spread northward to Malwa and Central India, and in a north-westerly direction up the Nerbudda valley, apparently had its departure from Khandwa, or rather from the line of road which at Khandwa brings Indore and Central India into connection with the main line of communication between Bombay and Northern and Eastern India. 77. The first cases of cholera occurred at Khandwa on the 27th March, and between this date and the 11th April 24 cases were reported, of which 10 proved fatal. On the 12th April cases occurred on the holy island of Mandhata, On the sth April it appeared at Choral Chowki, the temporary terminus of the Indore State Kail way from whence the road to Indore ascends the ghats. On the Bth a severe out- break occurred at the bullock tram chowki, on the ghat 5 miles north of Choral. On the 9th the first cases occurred in the city of Indore; spreading northward from Indore we fiiid the epidemic appearing at Fathaban on the 10th May, and in this month it became generally prevalent over western Malwa. Beowra, on the road to Agra, was reached on the 15th May ; and later in the same month it appeared in the Gunah territory, having been brought by gangs of cooJies returning from works on the Indore State Railway. The first cases in the Bhopal territory occurred in the middle of May, but Sehore was not reached till the middle of J une, 23 78. Following the Great Indian Peninsula Railway from Khandwa up the Nerbudda valley, the disease appeared at the Bir station, a case occurring there on the 20th April, and another on the same date in the town of Mundi close by. On the 22nd cholera appeared at Harda, the station on the railway where the mixed trains by which the natives chiefly travel stop for the night, and it is worthy of remark that in the epidemic of 1872, the first outbreak of cholera in the Nerbudda valley occurred at the Harda station. 79. In 1875, the first case that occurred wa3 in one of three men belonging to the gang of coolies at Choral Chowki, who, on cholera breaking out there, had deserted and come to Khandwa ; but hearing cholera was there also they came on to Harda. An hour or so before reaching that place, one of them was seized with vomiting and purging, but he managed to elude the Hospital Assistant placed on duty at Harda to examine the passengers arriving by the trains, and the next morning, the 23rd, was found dead by the side of the stream that flows past the station. On the morning of the 26th a child, and on the evening of the same day a woman, both living near where the man had lain, were seized with cholera, and both are said to have used water from the stream. On the same day also a mac, who had passed the previous night at the Harda station, was seized with cholera at the ballast quarries on the Kalamachok river, and brought in by the ballast train to Harda. On the 29th April an outbreak occurred in a gang of 200 coolies employed in ballasting on the line between Harda and Seoni, the ballast being brought from the quarries on the Kalamachok river. One man was found dead in the ballast train at the Seoni station on the morning of the 29th, and four others were removed suffering from cholera Some cases occurred subsequently among the people living around the Seoni station and also in the town. • 80. On the Ist May a marriage party from Nimar brought cholera with them to the village of Mohal, 12 miles west of Harda., and a few days afterwards another party passing through this village carried the disease to Hundia, where the road from Harda to Bhopal crosses the Nerbudda. On the sth May a brahmin returning from Khandwa brought cholera to the village of Chepa Deori on the Guivjal, from whence it spread to several villages on the banks of that river. On the ] 3th May a slight outbreak occurred in the village of Piparia, a Railway station a few miles beyond Sohagpur, the first case being a woman belonging to a gang of coolies at work further west on the line, and who arrived at Piparia suffering from cholera. 81. But although cholera had thus been brought to many points in the Nerbudda Valley in the course of April and May, the epidemic did not spread very rapidly among the population, and the mortality occasioned by it was comparatively slight. In Mimar it almost disappeared for a time in the end of May, but commenced to spread again in June after the rains had set in, and the greatest mortality occurred in August. In Hoshangabad, on the other hand, the greatest mortality occurred in May and June ; during the rains the prevalence decreased and was confined to two or three large towns and villages ; there was a slight revival of prevalence in October and November, and one village was attacked so late as the 10th December. 82. In the Narsinghpur district the prevalence of the epidemic was limited to a few villages in the western sub-division into which the infection was apparently imported in the beginning of June from the Bhopal side of the river where cholera had been prevalent since the middle of May. 'Ihe epidemic also appeared 1 24 in August in two villages of the Saugor district, close to the border of Bhopal on the Bhyrang river, and from thence it spread to villages on the banks of the same river in the portion of the Narsinghpur district that lies to the north of the Nerbudda. 83. The mortality from the epidemic in the three districts of the Nerbudda Valley was as follows :—: — Nimar ?, 423 ... 3* per 1,000 of population, Hoshangabad ... 629 ... I*4 do. Narsinghpur ... 93 ... o*3 do. 84. In the Betul district the first outbreak of cholera occurred in the third week of May in a Gond village on the Mooran river, about six miles from the Hoshangabad border. Some 15 people were attacked, of whom 4 died. A large feast had been held in the jungle near this village two or three day 3 previously. In the same week an outbreak also occurred in Badnur, the sudder station of Betul ; there had been several marriage parties in the bazar the previous week, and the first persons attacked were two men who had returned from a marriage party at Harda ; 12 persons were attacked of whom 4 died. "While cholera was prevalent at Badnur, a man of the Khumar caste went from Badnur to the village of Khairee, in the valley of the Tapti, where a weekly bazar is held : he was seized with cholera on the 31st, and in the course of the next few days 3 others were attacked. In the first week of July an outbreak occurred in the village of Gaola, three miles from Khaire^, and from thence the disease was carried to the neighbouring village of Emkher. The outbreak in Gaola was complicated by a remarkable prevalence of round worms. 124 peoplซ were attacked, of whom 35 died in about 10 days, and the Hospital Assistant sent out to treat the sick reported that all discharged round worms with the evacuations from the stomach and bowels. From this time cholera became prevalent in the district. It prevailed chiefly in the rocky country on both sides of the Tapti, extending to the south and south-east towards the Berar border, but in the beginning of August it spread eastward into the Amla circle, and thence across the border into one village of the Batoria circle of Chhindwara, but there was no great prevalence of the disease in this direction. The total number of deaths from cholera registered in the Betul district, amounted to 325 or I'l6 per 1,000 of the population. 85. The areas occupied by the different epidemics, the diffusion of which has just been described, may be briefly stated as follows :: — ฆ 86. The eastern epidemic was confined chiefly to the plain of Chhattisgarh, or that portion of the basin of the Mahanadi which is drained by its first great tributary the Seonath, and the direction of its spread was chiefly westward. There was an off-shoot eastward along the northern bank of the Mahanadi. but it was confined to a very narrow tract, and its progress was very slow ; although the epidemic commenced in Bilaspur in February, it did not reach Sambalpur, 120 miles to the east, till the end of August. There is not the slightest evidence connecting this epidemic with the endemic area of Orissa. The whole of the country lying between the Mahanadi and the Tel rivers and the States of Kalahandi, Bamra and the tributary Mahals, which lie to the east of those rivers, remained entirely free of cholera in 1875. So also was the country south of the Eaipur district and the whole basin of the Indrawatti which is occupied by the 25 territory of Bustar. Sirgujah and the other States to the north of Sambalpw also remained free. These tracts are, for the most part, hill and jungle, and are very sparsely populated. 87. The epidemic crossed the hills which form the water parting of the Seonath and Nerbudda, at one or two points, and there were slight outbreaks in the hills of Balaghat and in Mandla ; from the latter place it crossed into the Wainganga country at Pindrai, but it attained t& no degree of prevalence in th s- th;s-direction. In the Mandla district the number of deaths registered was only 47, and in Balaghat only 4. 88. Following the traffic routes^ which in a westward direction traverse the hills and jungles separating the Seonath aud Wainganga water-sheds, the epidemic reached the Kanhan, and following the course of that river and the Wainganga to the south of the Chanda district occasioned considerable mortality in the towns and villages on and near the banks of those rivers ; but the country lying between the Wainganga and the Chhattisgarh plain continued almost free of the epidemic. Of 261 deaths fro-m cholera registered in the Bhandara district in 1875, 203 occurred in the circles through which the Wainganga flows. 89. The line of the Kanhan south of Mahoda where it is crossed by the eastern road from Nagpur (Map IX.), and of the Wainganga after it has been joined by the Kanhan, may be taken as the limit of the extension westward of the eastern epidemic* 90. The western epidemic, as I have before shown, had two points of departure—Nasik and Khandwa. The epidemic from Nasik, or that part of it which affected these provinces, spread through Khandesh and thence through Berar to the Wardha and Nagpur districts of the Central Provinces ; but in these districts its diffusion was chiefly confined to the country drained by the Wardha river and its tributaries and the upper portion of the Kanhan. A line continued from the junction of this river with the Pencil (Map VIII.) by Nagpur to the Wuna river (Map VII.) at Boree and thence along that river to its junction with the Wardha, may be taken as the limit of the extension of the western epidemic eastward. North-west of the Kanhan the prevalence of cholera was very slight ; in the district of Chhindwara above the ghats only 84 deaths from cholera were reported, and the districts of Seoni and Balaghat remained entirely free. 91. Th 6 portion of the western epidemic which spread from Nimar, crossing the Vindhyas to Indore and Mhow occupied Malwa, extending as far north as Gunah and westward as far as Bhopal, but it did not reach the Vindhyan districts of these provinces. The districts of Saugor and Damon remained entirely free with the exception of a few cases in the extreme south of the Saugor district where it touches the district of Narsinghpur, and two 'or three cases in the extreme north which were probably due to importation from Bundelkhund. 92. Spreading up the Nerbudda Valley between the Vindhyas and the Satpuras the epidemic occupied the country on both sides of the river. In the Hoshangabad district, south of the river, its prevalence was confined chiefly to the area between the railway and the river* and it did not extend eastward beyond the Kobeja Komi river (Map IV.) ; Bankheri the easternmost circle of the district remaining entirely free, but in the Bhopal territory north of the river it extended more to .the eastward, and off-shoota from this direction reached the- 26 Nar3inghpur district north and south of the Nerbudda (Maps V. and Vl.} ; but with the exception of slight outbreaks on its western border the district of Narsinghpur remained free of cholera in 1875 as did also the district of Jubbulpore which forms the head of the Nerbudda Valley. The off-shoot of the epidemic from the Nerbudda Valley which reached Betul in May occupied at first the central circles of the districts, but it subsequently spread southward to the Tapti valley where it met an extension of the epidemic from Berar ; the northern circles of the district remained almost free. 93. With regard to the rate of progress with which the epidemic was diffused over the country, an inspection of Map No. 1 A. shows very plainly that there was no sudden development of cholera over a wide area. The epidemic appeared at certain points separated from each other by nearly the whole width of the province, and from these points it spread in different directions, and its rate of progress was by no means rapid. It first appeared at Bilaspur in the end of February, and for many weeks was confined to the villages in the neighbourhood of those into which it was first imported. There was no diffusion over a wide circle till after the outbreak in the town of Mungeli, it then became rapidly diffused among the villages of which Mungeli is the centre of traffic and intercourse, and spread by rapid but distinct steps towards Dongergarh, the point to which the traffic from that part of the country tends ; it reached that point on the 4th June, and about the same date it appeared on the main road between Raipur and Bhandara ; by the 12th June it had reached a village on that road 6 miles west of Bhandara. Thus a point 150 miles distant from Mungeli, but connected with it by a line of great traffic was reached within five weeks, but places remote from this line of traffic, to which this epidemic ultimately extended, were not reached till several months later. Cholera did not appear in the remote circle of Wairagarh till September, or in Mul and Garchiroli till November. So also with the western epidemic ; cholera broke out in the town of Nasik on the 22nd March and appeared in the neighbouring rural circles of the collectorate in the first 10 days of April ; Dhulia, the central town of the adjoining collectorate of K'handesh, was not reached till the end of the month, and the epidemic did not enter Berar till the 9th May ; Omrawuttee, the eastern district of the province, remained free till the middle of June ; the Wardha river was not crossed till the middle of July ; no case occurred in the town of Nagpur till the 13th August, and the town of Chhindwara above the ghats was not reached till the Ist September. 94. Another circumstance which the map renders evident is that the widest diffusion of cholera is effected during the hot and dry weather. It is true that in a tract of country over which the epidemic has spread during the hot and dry weather, the number of towns and villages involved and the amount of mortality may increase greatly after the rains have set in, but the extension of the epidemic in distance from the locality of its first departure is mainly effected during the dry seasons ; when extension does take place during the rains it is mainly effected through the agency of rivers and streams, The rains of the south-west monsoon of 1875 set in during the 2nd and 3rd weeks of June and from Map No. 1 A. it is apparent that the spread of cholera took place to a far greater extent prior to the end of June than subsequently. The diffusion of the eastern epidemic over Chhattisgarh and as far west as the Wainganga river was effected almost entirely before the middle of June ; after the rains set in the extension was limited to the course of the Mahanadi eastward, and southward along the course of the Wainganga. The western epidemic spreading from Nasik reached the eastern districts of Berar, Ellichpur and Omrawuttee by the middle of June, after this its extension was confined chiefly to the districts of Wardha and the western portion of Nagpur, and in these districts its prevalence •was confined chiefly to the towns and villages on the bank of the Wardha, Wuna (Map VIL) and Kanhan rivers. In the Nerbudda Valley the extension of the epidemic ceased almost entirely after the rains set ir>, and the same fact iซ observable with respect to the countries north of the Vindbyas. 27 95. Table No. VIII. shows the mortality from chobra in the different districts of the Province in each month of the year 1875, and Table IX. gives the same information for the following year. In 1875 the epidemic attained its maximum of prevalence in the Hoshangabad district of the Nerbudda valley in May and June ; in the other districts the greatest mortality occurred during the heavy rains of July and August, but as the rains ceased the epidemic everywhere rapidly declined. The number of deaths from cholera fell from 6,224 in August to 2,624 in September and to 465 in October. In the month of December only 58 deaths from cholera were reported from tbe whole Province, and of these 34 occurred in Raipur. By the middle of December the epidemic had quite died out in that district, and in the last fortnight of the year it survived only in one small village of the Hoshangabad district and in the town of Garchiroli in the remote east of the Chanda district ; it was present in this town at the close of the year and caused 12 deaths in the month of January 1876, the last case occurring on the 27th. Here the epidemic of 1875 terminated, and from this time till the 21st February (when an outbreak occurred in the Sambalpur district), or for a period of nearly one month, the whole province remained free of cholera . 96. Outside the Central Provinces also the territories that surround them, and with which they are in frequent communication, were with one exception at this time free of cholera. To the south cholera was prevalent throughout the early months of the year (187G) in the Madras Presidency, in Hyderabad and in the Southern Mahratta districts of Bombay ; but the intercourse between these territories and the Central Provinces i 3 too remote and indirect to have had any influence on the revival of the epidemic in the Central Provinces. In Berar and the collectorates of Khandesh, Nasik and Ahmednuggur, the cholera which had prevailed so severely in 1875 had died out, and a like extinction of the epidemic had taken place in the territories of Indore, Bhopal and Rewah which border these Provinces to the north-west and noith. The districts of Ohutia Nagpur which border the Sambalpur territories belonging to these Provinces on the north-east remained free till March ; only in the Orissa districts of Puri and Cuttack, where cholera is always more or less epidemic, was it active in January and February, and there it was prevailing in considerable force. 97. It may be said briefly that the epidemic which in 1875 had covered a great part of the Central Provinces and the surrounding territories, became extinct or dormant in December and January ; that there was then a period of a month during which the whole area delineated in Map No. I. was free of cholera with the exception of the districts of Cuttack and Puri. 98. On the 21st February 1876 cholera appeared in the district of Sambalpur south of the Mahanadi. On the 22nd March cases of cholera were reported from three villages in the neighbourhood of Garchiroli in the Chanda district, east of the Waingaoga river. On the 11th March an outbreak commenced in the town of Mandla. On the 23rd February it broke out on the Rewah plateau of the Vindhyas. On the 13th March an outbreak occurred oa the plateau of Shahpur in the Betul district of the Satpuras. 99. Thus we find that in point of time the origin of the epidemic of 1875 corresponded very nearly with that of the previous year. By the end of March cholera, had appeared at several points within the province or near its borders, and from these points its diffusion may be traced over the areas subsequently 28 STATEMENT VllL— Deaths from Cholera registered in different districts during each month of the year 1875. Months. Districts. f1 1 i i i i I 1 I l_j_j_ Mahanadi Division. Sarabalpur 16 77 137 24 254 Bilasptir .... ... 7 77 32 498 604 466 748 79 14 ... ... 2,525 Raipur 16 ... 227 779 1,279 1,397 521 120 76 34 4,449- Wainganga Division. Bhandara 45 4 42 35 85 45 5 261 Nagpuc 60 1,541 481 29 2,111 Wardha ... 31 1,355 541 69 19 ... 2,015 Chanda ... 167 283 33 59 . 9 551 Upper Godavari ... ... 11 7 2 ... 2Q Satpura Division. Mandla ... 7 38 2 47 Balaghat ... .. ... 2 2 4 Seoni 3 3 Chhindwara 454 190 6 650 Betui ... ... 12 ... 55 116 129 9 4 ... 325 Burhanpur 13 ... 3 179 31 226 Nerbudda Division, ffimar 21 34 40 63 180 43 26 13 3 423 Hoshangabad- 10 192 158 50 63 91 39 19 7 629 Narsinghpur 15 17 30 31 .. ... 93 Jubbulpore 1 1 7 2 U Vindhyan Division. Murwara ... 18 8 ... ... ... • Saugor M 4 20 Damoh ••• ••• ••• Total 7 93 77 984 1,654 2,220 6,224 6,224 465 237 58 14,64$ 29 STATEMENT IX. — Deaths from Cholera registered in different districts during each monih of the year 187 C Months. ฆ Districts. Mltฃil! I I I I I Mahanadi Division. .Sambalpur 7 46 20 90 204 72 102 46 66 ... 5 658 Bilaspur ••ฆ ... ... ... ... 1 ... ... 1 Raipur ... 40 52 1 12 105 Wainganoa Division. Bhandara 75 132 96 13 230 59 605 Nagpur 2 2 19 101 62 38 456 30 701 Wardha 23 15 177 81 53 88 6 443 Chanda ' ... 12 ... 122 247 514 851 624 600 150 i 76 51 3,248 Upper Godavari 46 24 65 ... 135 Satpura Division. Mandla 41 78 ... 21 28 7 ... 175 Balaghat 3 1 42 19 65 Seoni 18 39 17 94 130 2P 22 82 11 442 Chhindwara 2( 6 ... 83 5 123 Betui 107 172 282 130 75 433 106 29 19 ... 1,353 Burhanpur ... ... ... ... ... Nerbudda Division. Nimar 2 15 117 74 15 223 Hosbangabad 86 441 738 742 248 83! 29 4 2,371 Narsioghpur 42 1,358 1,854 858 80 4,192 Jubbulpore 2 11 48 67 532 492 116 K> ),278 Vindhyan Division. Murwara 37 134 39 4 214 Saugor ... 18 331 1,265 1,141 216 4 2,975 I Damoh 6 112 556' 139 4 817 Total ... 12 7 407 1,032 1,825 3,835 5,176 5,062 1,234 260 1,076 198 20,124 30 covered. It will be convenient to describe the diffusion of the epidemic of 1876 from these several points in the order of the outbreak above given, and I will begin with Sambalpur. 100. On referring to the map No. TA, illustrating the spread of the epidemic of 1875, it will be seen that it spread eastwards from Bilaspur along the left or north bank of the river, reaching the town of Sambalpur late in August. The epidemic of 1869 reached Sambalpur from the same direction, but the more common source whence the Sambalpur country is invaded is from Puri, and the time of invasion corresponds with the return of the pilgrims from the Dole Jatra at Juggernath in February and the early part of March. 101. In my report for 1873 very plain evidence was given that cholera was in that year brought into the Dekhantir of Sambalpur by pilgrims from Juggernath, and by a regiment of Native Infantry which had come up from the coast along the pilgrim route ; the epidemic of 1876 in the Sambalpur district had apparently its origin from the same source. 102. The cholera which in the previous year had spread along the northern bank of the Mahanadi had died out in October, and the part of the district south of the river (the Dekhantir) had remained entirely free. In 1876 it first appeared in this part of the district in the village of Lebdi in the Sohela circle, which is traversed by the pilgrim route. The first case was that of a pilgrim from Juggernath, and the second the schoolmaster of the village who had Attended upon the pilgrim ; others in the villages were subsequently attacked, and by the 26th February 11 cases had occurred of which 7 were fatal ; the inhabitants then as is usual in this part of the country deserted the village, and no more deaths from cholera were reported. In the next week the disease appeared in the neighbouring villages of Bitch wa and Huldipailli in the Sohela circle and in Nawapailli of the Bargarh circle. The first case in Bitch wa was that of a woman who had been to Lebdi and was attacked the night she returned. Regarding the first case in Huldapailli no information was given, but the first case in Nawapailli was a girl who was attacked on her return from Huldapailli. In the third week the epidemic spread to two fresh villages, and in each of them the first persons attacked had visited villages in which the disease had previously broken out. In this way the epidemic spread slowly, one or two fresh villages being attacked in each week. 103. For six weeks after the first outbreak the epidemic in the Sambalpur district was almost confined to the villages of the Sohela circle north of the main road to Raipur: from this locality it spread, but in the beginning of May it spread across the Barha Pahar to the villages of the Ambabona circle which lie between the hills and the southern bank of the Mahanadi. The first village in which the disease appeared in this circle was Ambabona itself, and the first person attacked was a man who had been to the village of Oordana in the Sohela circle when cholera was present there. In the following week it broke out in another village of this circle to which it was brought by a person returning from the Sarangarh State ;it subsequently spread to 7 other villages and continued prevalent in this locality till the middle of June. 104. North of the river the first village attacked was Rampur in the Lapanga circle, east of the Ebe river, the first case occurring on the 2nd July ; but the epidemic prevailed only to a slight extent in the portion of the district to the north and east of the river. Four deaths were reported from one village in the Mura circle, and in the Lapanga and S udder circles the mortality amounted to 12 and 3 per 10,000 respectively. The greatest mortality occurred in the Sohela circle where it first broke out, and here the mortality amounted to 69 per 10,000. 31 The maximum of prevalence was attained in the week ending the 3rd June when 117 deaths were reported from 16 villages in the Sohela, Ambabona and Bargarh circles. In the Sudder town 22 deaths (or 20 per 10,000) occurred between the end of July and the middle of September. The total number of deaths in the whole khalsa during the year amounted to 658, equal to 20 per 10,000 of the population. 105. The Sambalpur khalsa is surrounded on all sides by Feudatory States and Zemindaries ; no statistics are collected from these States, but reports of the appearance of cholera, small-pox or other unusual sickness are sent to the Deputy Commissioner. From these reports it appears that cholera in 1876 spread southward from the Sohela circle into the Borasamba State in April ; Patna was not reached till the end of June. An outbreak occurred in the Sonpur State in March, but the epidemic did not become prevalent over the State till July, and in the latter part of the same month it appeared in Kalahandi. The State of Bamra which lies to the east of Sambalpur remained free till August, and the Tributary Mehais which lie in the hills between Sambalpur and Orissa do not appear to have been affected. To the north-west the epidemic spread along the pilgrim route into the Sarangarh State in February, and about the same time into the Pbuljhar State which lies between the Sambalpur khalsa and the Jonk river. 106. This State is traversed by the main road to Kaipur, and on this road the village of Pirdha, lying within the confines of the Raipur district and belongin 1 to the Nawagaon out-post of the Arung circle, was attacked by cholera in the latter end of March under the following circumstances :—: — On the 20th March, a party of 10 pilgrims from the direction of Sambalpur arrived at the village and encamped on the border of the village J tank ; one of the party who was ill with cholera died that day, and was buried not far from the tank. On the 22nd two persons, residents of the village, were seized with cholera; on the 23rd two more, and two others subsequently, altogether six residents of the village, of whom four died ; the water-supply was reported to be scanty and bad. 107. On the 27th two persons died of cholera in the village of Samoodha belonging to the Arung circle, one of whom had visited Pirdha. On the 11th April a mendicant from Joonagarh who arrived that day at the village of Acholi in the same circle, but to the west of the Mahanadi, was taken with cholera and died the next day ; but no case occurred among the residents. Between the 11th and 14th April 14 persons were attacked with cholera in the village of Bhowzing in the same circle, and the disease was said to have been imported by a party of women of the Teli caste who had returned from the Phuljhar State by the main road, one of them having been taken ill by the way. The outbreak in this village was severe, 89 cases, 47 of which were fatal, were reported between the 11th April and the 6th May. The epidemic spread to two villages in the adjoining circle of Lown in the latter end of April, but with the exception of a doubtful case in the town of Arung on the 6th June, no cases were reported after the 20th May. 108. From this time the whole district remained free of cholera till December when it appeared on the western border of the district ; but thia time it came from the west, and its advent from this direction was an extension of the epidemic of the Wainganga basin which originated in the Chanda district, and which I will now describe. 109. The Chanda district lies between the Wainganga and Wardha rivers with a narrow strip along the left or eastern bank of the former river. The population is chiefly collected in the open country that stretches along the left 32 bank of the Wardha and the right bank of the Wainganga, the centre of the district stretching through its whole length from north to south is occupied by a broad tract of hill and jungle which is very sparsely populated. To the east and south also the district is bounded by hills and dense forest, the population of which is less than 20 to the square mile. HO. In 1875 cholera had spread across the Wardha river from Berar, and had occasioned considerable mortality in August and September in the Warora and Segaon circles, but it had died out in October. The epidemic had also entered the eastern portion of the district by way of the Wainganga river, and 11 villages on its banks had suffered in September, but here also it had ceased by the end of that month. Cholera prevailed in one village in the Wyragarh circle that occupies the northern portion of the strip of open country on the east of the river from the 11th September to the middle of November, the last case occurring on the 20th November. On the 10th November it broke out in the town of Grarchiroli and continued to prevail there until the latter end of January. The Civil Surgeon of Chanda visited the town at that time and found a large portion of the people using for drinking the water of a tank which was much polluted ; he directed the people to give up using the tank water and to resort to the wells of which there were several in the town ; the epidemic then ceased in the town, the last case occurring on the 27th January. From this time no case of cholera was reported from any locality in this part of the country for a period of six weeks. 111. In the week ending the Ist April cholera was reported to have appeared in 13 villages in the eastern or Wainganga portion of the district ; three of these villages in which the first cases occurred on the 22nd March were within a few miles of Garchiroli, two on the road south to Chamursi and Markhundi, and one north of Garchiroli on the way to Armori, in which town cases occurred on the 27th. The other villages were in the Mul and Tullodhi circles on the other sides of the Wainganga, and five of these were large places with populations ranging from 1,300 to over 4,000, and in which bazars are held. In not one of these villages had a case of cholera occurred in the previous season. 112. Unfortunately no information regarding this outbreak of cholera, or the first cases that occurred in the different villages, was furnished at the time, but a fair had been held at Markhundi in the sandy bed of the Wainganga river, 14 miles south of Garchiroli, which had been attended by over 30,000 people from that part of the district ; this fair had commenced on the 23rd February, the date of the Shivratri festival, and the people did not disperse till the 1 6th March, a few days prior to the first outbreaks of cholera. 113. In the course of the next three weeks the epidemic appeared in 15 other villages in the Wainganga circle, and in the third week of April it crossed to the Wardha side of the district. The large annual fair which is held annulaly at the Mahakali temple, just outside the town of Chanda, commenced to assemble on che sth April and continued till the sth May, and it is estimated that 80,000 people, chiefly from Chanda and Berar, attended the fair in the course of the month ; this fair is a purely commercial one. The water-supply which is very good is derived from several wells close by, all of which had been cleaned out before the fair took place, and the Police had special orders to prevent their being polluted. On the 19th and 20th April several cart-loads of rice were brought to the fair from the direction of Mul, with the carts that came on the 19th thero were five men suffering from cholera, and with the carts that came on the 20th there were six more cases ; the carts and cartmen were at once removed, and no outbreak of cholera occurred at the fair. The town of Chanda also remained free at thia time ; but in the latter end of April and beginning of May, when the people who had attended the fair were returning to their homes, cholera appeared lo follow in their track. On the 23rd April cholera broke out 33 in the village of Junoone, 7 miles south-east of Chanda town, and on the 6th, 11th and 13th May in three villages to the west of the town on the road which crosses the Wardbato the Wun district of Berar, and on the 19th May its appearance in that district was reported. On the 24th April it appeared in a village of the Segaon circle, 20 miles north of Chanda, and on the 26th in a village cloee to the town of Warora ; on the Bth May it appeared in the town itself, and on the 15th it broke out among the people employed at the Warora coal mines. 114. In the beginning of June the epidemic spread towards the border of the Wardha District, and between the 7th and 20th 6 villages on the banks of the river in that direction suffered ; but on the whole the Wardha portion of the district suffered comparatively little. In the Sadar circle 16 villages out of 115, and in Warora 16 out of 137 villages were attacked. The Segaon and Chimur circles, which comprise the greater part of the central tract, remained almost entirely free ; only 2 out of 106 villages in the Segaon circle and 3 out of 168 in Chimur were visited. The epidemic prevailed most extensively in the circles that lie along the banks of the Wainganga. In Brabmapuri 36 out of 159 villages suffered, in Tullodi 21 out of 151, in Mul 50 out of 153, and in Dhaba 19 out of 90. In Wairaghar, on the other side of the river, 10 villages only out of 147 suffered; but in Chamursi 29 out of 143 were attacked, and in many of these villages the mortality was very great. In 5 villages in the Chamursi circle, with an aggregate population of 2,680, 77 deaths occurred in March and April; and the town of Chamursi lost 161 out of a population of 3,260 (equal to nearly 50 per 1,000) between the 27th May and 10th June. 115. The maximum mortality in this district was attained in the week ending the 10th June (before the rains set in) when 310 deaths were reported from 26 villages, but the epidemic was more widely diffused a month later ; in the week ending the Bth July 177 deaths were reported from 36 villages. 116. The villages attacked in the circles to the east of the Wainganga were within a few miles of the river, in fact the population is chiefly collected along the bank of the river; the hills and jungles approach very near the river, and among them the villages are for the most part small and widely scattered ; the village of Yenghana in the Ranji Zemindari, 15 miles from the river, was the most distant point eastward reached by the epidemic, this village suffered severely in June, 24 deaths occurring in a population of 600 ; a weekly bazar, attended by about 300 people, is held at Kanji 3 miles from Yenghana. 117. Southward the epidemic extended along the course of the Wainganga, which after its junction with the Wardha becomes the Pranhita. Immediately south of the Chanda district, and stretching for 20 miles along the left bank of the Pranhita, is the Ahiri State, a tract of dense forest, and lying from 7 to 12 miles inland from the river are the Government forest reserves. From information which Captain Doveton, the Conservator of Forests, was good enough, to obtain for me it appears that cholera entered the Ahiri tract on the sth June, and between that date and the Bth of July attacked the four villages of Chichgundee, Dewalmari, Ghur Ahiri and Moodanungoo; the two first are on the bank of the river, Ghur Ahiri about a mile off, Moodanungoo 6 miles inland and about a mile from Alapilli, the station of the Forest Department. In Dewalmari 30 deaths occurred, but in the other 3 villages the number of deaths was comparatively small, — in Chichgondee 7, Ghur Ahiri 8, and in Moodanungoo 4, Cholera wasalso prevalent at this time in the village of Soonumpailli, on the opposite bank of the river in the Nizam's territory. 118. South of ihe Ahiri Zemindari the Upper Godavari district stretches for 100 miles along the left bank of the Pranhita and of the Godavari after its junction with the Pranhita ; it is chiefly a tract of jungle with a population of only 26 to the square mile ; the country en the opposite bank of the river forma & portion of the IS imam's territory* 34 On tho 16th June the Civil Surgeon of Sironcha reported that cholera had broken out in two villages of the district, — Rajoontal and Vencutapur on the bank of the river — one 25 miles, the other 1 0 miles north of Sironcha. On enquiry it was ascertained that at Kajoontal the first case occurred on the 11th June, and that 7 persons had been attacked, of whom 3 had died. At Vencutapur there had been 15 cases, 7of which had been fatal. One of the inhabitants of this village had been to Alapilli in the Ahiri Zemindari, and on his return was taken ill and died. 119. By the end of the month 45 deaths had been reported from 5 villages in the northern part of the district. The epidemic then ceased for a fortnight, but on the 18th it appeared in the town of Sironcha, the first person attacked being a resident who had not been from home. Up to this time the epidemic had been confined to the villages north of Sironcha, but on the Ist August the Civil Surgeon reported : — " I regret to say that cholera is spreading here since I wrote to you ; it appeared at Nuggrurn, a village on the banks of the Pranhita, three miles south of Sironcha. Out of 13 cases reported 8 proved fatal. Cholera has now appeared in the Dhers' quarter of Sironcha, 2 deaths yesterday and 3 fresh cases to-day. The disease appears to be conveyed by water. We have had it in nearly all the villages by the river north of this, and I now learn it is in all the villages on the opposite bank in the JVloglai or Nizam's territory. " Within the past week two bodies have been found floating in the river ; one is novf known to have been thrown in afier death from cholera, and it is believed that in the other case also death resulted from the same cause. This is a fruitful source of disease ; we can control the custom on our side of the river, but we cannot prevent the residents in the Moglai from so acting. We have issued stringent orders prohibiting people using river water during the freshes and whilst cholera prevails on the banks ; but I believe the people resort to the river after dark and so elude observation." 120. The epidemic ceased in the town of Sironcha on the 16th August, and no cases were reported from the district after the 19th. In the town of Sironcha, ฆwith a population of 2,250, 18 deaths occurred, but in the village of Nuggrum there were 91. cases, 31 of which were fatal. This village is situated at the junction of the Pranhita with the Godavari, and draws -its water-supply solely from the Pranhita. 121. No village situated below the junction of the Pranhita with the Godavari suffered from cholera ; the village of Asarelli, situated below the junction and the largest village in the Sironcba Taluq, escaped altogether ; so also did the village of Kala Shivaram on the Godavari opposita Nuggrum. West of the junction of the two rivers the country through which the Godavari flows is a wide tract of hill and jungle with a very sparse population, which so far as is known was free of cholera in 1876. 122. Extending eastward from the Upper Godavari district and a dependency of it, is the Feudatory State of Bustar, also a wide territory of hill and jungle extending over 13,000 square miles, but with a population of only 78,000, or little more than 6to the square mile. In this state the village of Gungaloo, about midway between Sironcha and Jugdulpur, the residence of the .Raja, suffered from cholera in June, and it was said to have been imported there from Ahiri; with this exception the territory remained free. The Indrawati river which drains this territory, joins the Godavari a few miles from Sironcha, and below this point the Taluqs of Noorpoor, Albaca and Chirla belonging to the Upper Godavari district stretch for SO miles along the river ; in none of these taluqs did cholera appear. The junction of the Pranhita 35 with the Godavari formed the limit of the extension southwards of the epidemic of the Wainsancra basin. 6""6 123. Extending westward from Chanda the epidemic as before described crossed the Wardha river into the Wuri district of Berar in the middle of May, and from thence it appears to have extended further westward into the district of Bassiin, which it reached in July. In the middle of July also it appeared in the south-west portion of Buldana, the most westerly district of Berar; but whether it reached this point from the east or west is not clear. The epidemic which had continued to prevail in Madras and the South Mahratta country of the Bombay Presidency had reached Poona in June, Ahmednugger and Nasik in July. Khandesh remained free till August, when the epidemic appeared at Bhosawal the point of junction of the Nagpur btailway with the main line; but no cases were reported from the districts of Aurangabad, Jalna or Mominabad throughout the year. Hingoli also remained free till the beginning of August, when it appeared in the Mursee Taluq, 20 miles from the cantonment; and 24 cases, 6 of which were fatal, were reported from that locality between the sth and the 26th of the month. 124. In May the epidemic which I shall presently describe as originating in the Betul district of the Satpuras had spread down the ghats and reached the plain country of Ellichpur. In July it spread thence into the Oomrawuttee district; but the xAkola district remained free till September. Altogether the prevalence of cholera in Berar was comparatively slight, the ratios of mortality from this cause for 1876 being only 12 per 10,000, while the rate for the previous year was 102 per 10,000. 125. The epidemic entered the Wardha District early in June, the first cases occurring on the 7th in a village on the right bank of the Wardha river belonging to the Alipur circle which borders on the Warora circle of the Chanda District, but the epidemic did not spread much in this locality, only 4 villages suffering. On the 27th July it appeared in the town of Wardha, the first case being a man who had arrived from Oomrawuttee, and a severe outbreak followed. A month earlier, or the 26th June, a solitary case had occurred in the cantonment of Kamptee. In the first week of July two more cases of cholera occurred in Kamptee, and on the 10th one case in the city of Nagpur. On the sth July a case occurred at Mahoda, where the Eastern road crosses the Kanhan river. At this time also the epidemic was spreading northward from the Chanda district. On the 30th June an outbreak occurred at Pauni in the Bhandara district, on the Waingunga, close to the border of the Chanda district ; a feast to the Brahmins had been given there, and a Brahmin who had come to this feast from Nagbir in the Chanda district, was the first person attacked. On the sth July it appeared in the village of Garada, between the town of Pauni and Bhandara, and on the 13th it broke out in the town of Tumsar 18 miles north of Bhandara. 126. Thus by the middle of July the epidemic had become distributed to several central points in the districts of Wardha, Nagpur and Bhandara. The towns of Tumsar and Wardha suffered severely, and a few cases occurred in Nagpur, Kamptee and Ramtek in August ; but in neither of these districts did the epidemic at this time attain any great degree of prevalence. In the week ending the 26th August 33 deaths from cholera were reported from 9 villages in the Bhandara district, 32 deaths from 7 villages in the Nagpur district, and 37 from 5 villages in Wardha. From this time the prevalence of the epidemic declined, till in the week ending the 28th October 12 deaths only were reported from 3 villages in the three districts, and there was every reason to expect that the epidemic would die out as had been the case in the previous year when it had been much more prevalent. In fact the number of deaths from cholera reported from the whole Province in October 1876 was little more than half the number reported in the same month of the previous year; but an outbreak of the disease at the fair held at Ramtek in the first week of November changed the usual course of events. 36 127. Ramtek lies 25 miles north of Na^pur ; it, is a holy place of great repute, pilgrimages are made to it from great distances at all times of the year and a fair is held annually in the beginning of November ; the town is situated at the southern foot of a ridge of hills which rises abruptly behind the town to a height of 500 feet ; on the highest point of the ridge is the temple of Ramchandra with other smaller temples around it ; below the ridge on tne north side and about 1J miles from the town is the holy lake and the small village of A mbara at its western end. The chief objects of religious interest are the lake and the temples on the ridge ; in the former the pilgrims deposit a portion of the ashes of any relatives that may have died since their last pilgrimage ; bathing in the tank is one of the chief ceremonies of the pilgrimage, and drinking some of the water is a part of the ceremony. The booths and the great mass of people attending the "fair occupy the space below the bund : here there are two small baolis which afford water for drinking, but the supply is insufficient for so large a multitude, and many, no doubt, use the water of the tank for drinking as well as for cooking and washing, Ihe tank is a large one, and, in some parts, very deep, but notwithstanding this, the bathing in it of so many thousands of persons must render the water very foul ; and Colonel Waddington, the Deputy Commissioner, who was present, states that at the time of the outbreak it had become " stinking." 128. The number of people attending this fair is seldom less than 100,000 ; but in 1875, owing to the rainy season having continued till the end of October and greatly interfered with the sowing operations, the attendance at the fair was comparatively small and did not exceed 75,000. In 1876, however, there was an unusually large attendance, the number returned in the official return amounting to i 75,000. Unfortunately too the festival on which the fair annually assembles fell unusually early this year, the great day being on the Ist November ; in the previous year it fell on the 2lst November, or three weeks later. But although the chief day fell on the Ist, the fair had commenced some days previously, and many had come and gone before that day, and the number actually assembled at one time was probably a few thousands short of the number returned as having attended the fair from its commencement. The outbreak of cholera occurred on the 31st October, and between this date and the sth November, 42 cases, of which 34 were fatal, were reported by the Police to have occurred at the fair. On the 3rd and 4th the assemblage broke up and dispersed, but between the 4th and 6th, 46 cases, of which 36 were fatal, occurred in the town of Ramtek. In the course of the week following 11 cases occurred in Ramtek and 7 among the resN dents and people remaining at A mbara where the fair was held, but by the 12th the epidemic had ceased in both places. 129. The effect on the surrounding country, however, was not so transient ; many of the people returning- to their homes died by the way ; others reached their villages carrying the disease with them and communicated it to their families and neighbours, thus lighting up afresh an epidemic which had nearly become extinct. 130. The statement on the following pa^e exhibits the amount of cholera existing in the districts from which the fair is chiefly attended, for some weeks prior and subsequent to the outbreak among the peop'e assembled. It will be observed that in the week ending 2sth October, that is, in the week prior to the outbreak at the fair, cholera was present in only 10 of the many thousand villages comprised within th^ 8 districts shown in the statement, and that 7 of these villages were in the more distant districts of Betul and Seoni. In the weekending the llth November, that is, in the week subsequent to the outbreak, it was present in 110 villages, the great majority of which lay in the district, of Nngpur and in the district of JBhandara which adjoins the Tafcsil of Ramtek where the outbreak 37 Statemeni showing the prevalence of cholera prior and subsequent to the outbreak at Ramteh fair. Week ending— 14th Octo- 21st Octo- 28th Octo 4th No. 11th No- 18th No- 25th No- 2nd Pecem- 9th Decem- ISth Pecem-7th Ootober. ber. bcr. ber. vember. vember. vember. vember. ber. ber. ber. 8 * ฐ Diซfcicfc. ~ s * I 1I 1 a | Betul ... ... 12 1 6 1 4 5 8 6 21 12 5 7 10 1 2 3 2 Chhindwara :.. 9 13 20 24 5 34 4 14 1 1 Seoni ... 1 5 1 4 2 13 1 4 8 13 14 22 7 14 7 8 1 2 Balaghat "... 8 10 8 11 7 21 3 4 3 14 3 1 Bhandara ?. 1 8 114 11 35 62 35 4c 18 47 14 31 8 22 2] 2 Nagpur ... ... 3 6 5 15 3 5 1 6 4 44 34 167 34 112 28 8* 20 74 8 24 3 7 Total ... 8 9 8 34 5 13 10 33 17 85 110 278 130 265 78 242 57 162 25 70 11 15 38 131. The following details, extracted from the reports and returns sent in from the several districts, will render the operation of the people returning from the fair in spreading the disease more evident. In Betul cholera had been prevalent sinซe the middle of March, but it had declined greatly in prevalence since the beyinninij of September, and in the week prior to the outbreak at liamtek, was confined to a few villages west of Multai; on the 4th November, however, cases occurred in the town of Muitai and in 2 villages east of that town in the direction of Ramtek, and in the course of the next four or five days isolated casts occurred in 5 other villages in the same part of the district. In Chhindwara a few cases had occurred in August and in the beginning of September, but none had been reported through the six weeks prior to the fair ; in the week following the dispersion of the assemblage, the disease appeared in 9 villages, having been brought back, according to the police reports, by people returning from the Kamtek fair. In Seoni, cholera, though never at any time very prevalent, had been present in the district since the month of May, but in the latter end of October it was confined to one or two villages in the north-eastern part of the district, and no cases occurred in this locality after the end of the month, but between the sth and Bth November, 23 eases and 13 deaths were reported from 8 villages on or near the line of road from Rarntek, and in the following week a sharp outbreak was reported from a village in the north-west of the district, the first cases being persons who had returned in the previous week from the fair, and from this village it was conveyed to another village in the same neighbourhood ; between the i>th November and the end of the month deaths from cholera were reported from 22 villages belonging to 10 station-houses and out-posts in the southern arid central parts of the district. An outbreak of cholera had occurred in a village in the extreme north of the district of Balaghat in the middle of March, but from that time till the beginning of November the whole district had remained free of the disease; on the 13th November, however, the Deputy Commissioner reported that 14 persons had been attacked in the village of Singhori in the south of the district, of whom 6 had died ; the first cases were 2 persons who had returned from the fair at Ramtefc on the 7th. In the same week cases of cholera were reported from bix other villages in different circles of the district, and in the following week the disease appeared in 5 other villages of the same circles. In Bhandara, cholera had been prevalent throughout the rains, but at the time when the fair was held, the disease was present only in the town of Mohari an. ... Khurad ... Golab, Kurmi, the person first attacked, had been to Dongargarh ; two others were taken ill the same day. Bhelai out-post of Khutkhoj ... Kidar, Kurmi, the first person attacked, had visite4 Head-qua r te r s Dongargarb ; he was seized on the 19th, and died Circle. on the 20th. 9 others were subsequently attacked. Head-quarters Cir- Dhuneli .. Juggannatb, Chamar, was taken ill at Sonpela in the cle. Drug Circle when on his way to Nagpur, and returned to the village. Simga ... Chuttad ... Ram Singh, Kurmi, was taken ill on the 31st Deeemon his return from Dongargarh ; another person was attacked the same day. Dhamda ... Gondahi ... A man who had been to Dongargarh was attacked with cholera on the 2 1st December, and died the next day. Two others were subsequently attacked. 139. Subsequently, on the 23rd January 1877, a sharp outbreak of cholera took place at the village of Charod near Rajim (which was also due to importation from Dongargarh) rendered it advisable to prohibit the assembling of the large annual fair at Rajim which was due in the beginning of February. On the 7th February the epidemic appeared in the Sadar town, the first cases being cartmen who had come from the direction of Simga. 140. The spread of the epidemic eastward, after the outbreak at Ramtek in November 1876, is very clearly shown in Map No. IB by the successive dates along the two routes through the districts of Bhandara and < 'hhattisgarh ; and 1 would draw attention to the same routes on jVlap No. lA. The successive dates there show the spread of the epidemic in May and June along these routes in the reverse direction, or westward from Mungeli and Raipur to Bhandara and Nagpur. 141. It is perhaps worthy of remark that on both these occasions the epidemic spread in the direction opposite to that of the prevailing wind. The * normal direction of the wind is N.W. and S.W. in these provinces during the months of May and June, and N.E. and E. during November and December. 43 The following are the resultants of wind directions observed at Nagpur and ฆRaipur for the above months of 1875 and 1 876 :—: — NAGPUR. P.AIPUR. _.. .. Daily mesn _.. .. Daily mean DirecUon. movements. Direction. movements IQ7 , ( May N. 60 W. . . l6omiles. N. 73 W. ... 135 miles. iisii) - m {June N. 77 W. 184 „ S. 56 W. ...183 „ 1Qt _, $ November N. 58 E.... 86 „ N. 20 W. ... 776 „ lb7b -) December M. 62 E.... 74 „ N. 6E. ... 51*3 „ 142. We have now to describe the outbreak that occurred in the town of Mandla and the epidemic that spread from thence. In 1875 the district of Mandla had remained entirely free of cholera till the middle of August when an outbreak occurred in the Sadar town, apparently due to importation from the Bilaspur district ; the outbreak was slight, 17 deaths only occurring, the last on the 2 1st September. The outbreak of 1876 commenced on the 11th March, and is thus described by Dr. Kidd, the Civil Surgeon :— "Cholera appeared in Mandla on the 11th March. A child four years of age was 1 attacked with vomiting and purging on the 11th, and died on the morning ot the 12th. The child resided in the Koshta* Mohulla, about 100 yards from the Chowramau Ghat, from whence the people of the Mohulla draw their drinking water. ISot far from the house where the child lived, three other cases occurred during the night of the 12th and the following morning. The disease kept within a few Mohullas, all near each other, to the east of the town and opposite the Chowraman Ghat, and as far as 1 could ascertain the people drew their water from this ghat. I prohibited the use of this water as I believed it had become foul, aud directed the people to resort to wells ; the epidemic lasted from the 11th to the 18th Match. One child died on the 26th, and was said to have been taken ill the same day ; but j believe it was ill before that. 26 cases occurred with 1 5 deaths ; the disease was severest up to the sth day, viz. the loth March, 18 cases with 12 deaths occurring in that period. The Koshta Mohulla suffered most, losing 10 out of 16 cases. Mandla was indebted for this outbreak to a party of Juggernath pilgrims who had passed through Mandla; they had remained at Chowraman Ghat for the day and night. It was not until after the disease appeared in Mandla that it was ascertaiued that one of their party had died on the 6th or 7th March not mauy miles distant, and it was on ihe 7th that the party remained in Mandla." "On the 17th March cholera appeared in the village of Binaika; this village communi- cates daily with Mandla, being only 2 miles distant, grass and wocd being brought in from thence." " On the 19th the disease appeared in the village of Koorgaon, 2ฃ miles distant, which 143. Between the date of the outbreak in Mandla town and the end of April, 11 villages in the rural circle of Mandla, 3 in the adjoining circle of Bichwa to the south-east, and 1 in the circle of Naraingunge to the north-west were attacked. In several of these villages the mortality was very great ; in one close to Mandla town, with a population of only 81, 20 cases of cholera, 18 of which were 44 fatal, occurred in the week ending the Bth April ; there was thus a focus of infection formed in and around Mandla, and from this focus the infection was conveyed to distant localities. 144. On the 16th March an outbreak of cholera occurred in the village of Gourambar in the Parsaman circle of the Balaohat district, the circumstances of which are thus reported by the District Superintendent of Police :—: — "On the 12th March one Bolah Brahmin left Mandla with his sister. On the 13th his sister was taken ill with cholera near the Halone river but they came on to Gourambar ; there the Brahmin engaged the 4 men noted in the margin to carry his sister to Rajahdar ; the men returned home the same night. The following morning Sooba's sister Sooba. Halve. Manjee Sudhai. was attacked with cholera and died on the 16th ; the next day (17th) Dharmal Gond was attacked and died on the 19th. This man's mother was attacked on the 22nd, when she, with the rest of the villagers, fled to the jungles where the woman died on the 24th : no other cases of cholera were reported from this village. A little while subsequently a woman of the village of Pondi in the same circle, returning from a village in the Mandla district, was attacked with cholera and died, but no other epidemic outbreak occurred in this neighbourhood. It is a very wild part of the country ; the villages very small and distant from each other." 145. On the 24th April cholera was reported to have appeared in the village of Gobaria in the Keolari Circle of the Seoni district, and a hospital assistant was sent out to treat the sick and make enquiries : he reported that on the 10th or 11th April one Babu Ojha, the owner of the village but residing in Mandla, had arrived in Gobaria with his elephant driver and two other servants ; the distance from Mandla is about 40 miles, a high range of hiils forming part of water-shed of the Nerbudda and Wainganga rivers lying between the two places: on the 13th the Babu ordered Brijlal one of his servants to return to Mandla in charge of a stock of grain ; the man had not proceeded far when he was seized with symptoms of cholera and returned to Gobaria. On the 14th 4 people residents of the village were attacked and of these 3 died. The villagers then arranged to do poojah ; but on the 15th four more deaths occurring they became terrified and fled into the jungles. The hospital assistant arrived on the 27th ; the villagers were then returning to the village, and he found one sick woman among them whom he treated ; after this date no more eases occurred in the village. Between the 13th and the 27th 25 cases occurred, of which 17 died. On the 12th May a large marriage-party came from the village of Barragoe to the village of Kumkheira close to Gobaria, Chotan the Malguzar of Barragoe forming one of the party ; at the time when the harat arrived at Rumkheira, Mohan Lai the brother of Chotan, Malguzar of Barragoe, was suffering from vomiting and purging ; Chotan returned home on the 13th, was taken ill on the 14th and died on the 15th. A very severe outbreak followed in the village of Barragoe, 60 cases occurring in the course of the next 16 days, of which 42 proved fatal. The hospital assistant reported that the village of Barragoe was in a dirty state, and that the people were much inconvenienced for want of drinking-water, their only supply being derived from holes dug in the beds of nullahs. 146. From Barragoe the epidemic was carried to the neighbouring villages of Bumhoria and Chargaon, and from Chargaon to Khapa and Keolari. From Keolari the epidemic spread to Kaniwara, and gradually to the Khari and Ari Circles in the south of the district. It was also carried from Keolari westward to the village of Bhimghur in the Chuppara Circle ; but until August the epidemic was mainly confined to the eastern and south-eastern circles which lie in the valleys of the Saugor and Hirri rivers. In August, however, after the 45 disease had become prevalent in the town and district of Jubbulpore, outbreaks occurred on the main line of road between Jubbulpore and the town of Seoni, and a few cases occurred in Seoni itself; again, later in November the disease was brought into a number of villages by people returning from the Ramtek fair. Although the epidemic was present in the district from the middle of April to the end of December it was never at any tima widely prevalent ; of 1,278 villages in the district, 67 only were visited by cholera, and the number of deaths was 442, or 15 per 10,000 of the population ; 30 of the villages attacked lay in ths Keolari and Khari Circles, and 268 or 60 per cent of the deaths occurred in them. 147. The following account of an outbreak of cholera in the Jubbulpore district, that was apparently due to importation from Mandla, is given by Dr. Rice the Civil Surgeon of Jubbulpore :—: — " Oq the 22nd March Lalman Gond, the malguzar of the village of Nurrye in the Bareila Circle of the Jubbulpore district arrived at Mandla to purchase stamped paper; he left again the same day; slept the night at the village of Burkheri ; passed through Naraingunge the next day, and reached Nurrye on the 24th. On the 28th, or four days after his arrival home, he was seized with cholera about 4 A. M., and died the next day. While ill Lalman was attended by his nephew Maree Gond ; this man was taken ill with cholera on the 31st three days after Lalman was seized, and on the same day five other Gonds, two Mahras, two Kachis and a brahmin were attacked :in all 11 cases in one day. The disease continued among the people till the 7th April, or for 11 days, and in this period 28 cases with 11 deaths occurred out of a population of 230, equal to 121 and 48 per 1,000." " The village of Nurrye lies in the hilly country south-east of Jubbulpore, and is situated on the bank of a small stream which, after a course of about six miles, flows into the Nerbudda; the villagers use the water of this stream for all purposes ; it was said to have been good at the time of the outbreak, and the stream running, though beginning to break up into the half stagnaut and stagnant pools which form the water supply of a large number of villagers in the hot weather." 148. Dr. Kice states that the report of the outbreak reached Jubbulpore on the &nd April, and that two policemen and a hospital assistant were at once sent to the village ; the place was cleaned up, and communication with surrounding villages cut off. It was possible to do this completely, as the villagers in these localities are accustomed t<> have supplies stored up. There are seven villages within a mile of Nurrye, and the police out-post of Dongaria is about 1-J miles distant, the aggregate population being over 1,200. No case occurred in any of these villages, either on this occasion or later on. 149. The district of Jubbulpore had remained singularly free of cholera during 1875, and in 1876 no case had been reported prior to the outbreak at Nurrye ; subsequently also the district remained free till the 14th May when it appeared in the Sehora Circle. The origin of cholera in this part of the district was not traced to importation from any locality in which the epidemic was then prevalent, but by this time cholera had become widely spread over the country ; besides the outbreaks already described in the adjoining districts of Mandla and Seoni, the epidemic had advanced far up the Nerbudda valley, of which the Sehora circle may be considered a portion, but its appearance in this locality was more probably connected with the epidemic which had been prevailing for more than two months previously in the Rewah territory north of the Kaimur hills. It will be remembered, in the account I have given of the first appearance of cholera in the Central Provinces in 1875, that very soon after the report of its having broken out at Allahabad information was received at Jubbulpore of its appearance 46 near Sutna, on the line of Railway between Allahabad and Jubbulpore, and the circumstances were apparently much the same in 1876. Four deaths from cholera had occurred in the town of Allahabad in January, three in February, and in Benares two deaths from cholera had been registered in January, and 143 in February ; in the latter month also 23 deaths from the same cause had been registered in the Mirzapur district. 150. In the latter end of February, a fair at which about 10,000 people "were assembled, was held at Deo Talao, a large tank in the Mhowgunj district of the Rewah territory, about 40 miles north-east of Rewah, and half a mile from the main road to Mirzapur and Benares. On the day of the Sheoratri festival, (23rd February), a brahmin who had come to the fair from Baijnath was seized with symptoms of cholera shortly after partaking of some of the bread that is distributed on this festival, and died in four hours. The next morning six other persons were attacked ; the people then became alarmed, and dispersed. The Medical Officer to the Bhaghelkhund agency, Doctor Goldsmid, from whose report I have extracted the above account, proceeds to state that very soon after the dispersion of this fair news began to be received of the extension of the epidemic along the routes that would be taken by the people returning to their homes ; from Mhowgunj, from Bardee on the Sone to the south-east, from Sohagee and Sitalha to the north, from the town of Rewah, and from Govindgarh, 12 miles to the south of Rewah. From this time it spread among the villages around these centres, and caused great mortality in the months of April and May. Jn the latter end of June it broke out in the town of Sohawal, a little to the west of Sutna, and about the same time a sharp outbreak occurred in a village, three miles south of Nagode, where a large barat or marriage -party had assembled. In June also the epidemic spread to Punnah. The greatest mortality in the Rewah territory occurred in the months of April and May, but it continued prevalent till September, when it died out. In the course of the seven months, March to September, 1,087 deaths from cholera were reported. 151. In the previous year the first cases of cholera within the boundary of the Central Provinces south of the Kaimur range occurred at Murwara on the 16th May. In 1876 the epidemic first appeared on the 14th May about 25 miles further south at the village of Hurdooa, situated between the northern road and State Railway, and about midway between Sehora and Sleemanabad. 152. The following account of the outbreak and spread of cholera in this part of the district is extracted from Doctor Rice's report :-— " On the 13th May one Surjoo, chamar, resident of Hurdooa, went to the village of Mahola, a mile distant, to assist at a marriage feast. He was taken with the symptoms of cholera while there, and returned at once to Hurdooa where he died about noon of the 14th. On the 1 5th four cases of cholera occurred in the village; on the 16th six; and on the 17th, five. The disease continued till the 3rd June, or for 20 days, and during this period 65 persons were attacked, of whom 45 died, out of a population of about 450. On the 25th May a constable on duty at Hurdooa up to the 24th was seized with cholera on his way to Mujgaon and died the same day. " The water-supply of Hurdooa is derived from two wells ; at the time of the outbreak of cholera neither of them held more than two feet of water ; there was a layer of mud at the bottom a foot deep and very offensive, and this was stirred whenever the water was drawn." "On the first appearance of cholera in this village a hospital assistant was posted there with a supply of medicines, and the Tahsildar of Sehora was deputed there with a Police guard to isolate it as much as possible, and prevent any of the villagers visiting the Railway Station or neighbouring villages* and also to have the village and the wells cleaned out." 47 " There are about 20 villages within a circle of four miles round Hurdooa, but in none uf them did cholera appear till the 7th June ; on that day, an Aheer, by name Boray, an inhabitant of the village of Aitwa, four miles east cf Hurdooa, was attacked with cholera. It was said that he had visited Hurdooa in search of stray cattle, had returned on the 7th June, and was seized immediately on reaching home. A woman and two girls were attacked on the same day. On the Bth there were three cases, and on the 10th one, altogether eight cases, five of which were fatal." " Between the Bth and 10th four cases occurred in the village of Bareili." " Between the 7th and 10th eighteen cases, eleven of which were fatal, occurred in the village of Burgurh ; and on the 10th a single case in the village of Kalsi." "Thus, between the 7th and 10th June, 31 cases, 16 of which were fatal, occurred in these 4 villages, they are situated about half a mile apart on the banks of the Silpuri nala. In the rains and for some months subsequently, this is a good sized river, but at the time of the outbreak of cholera it was broken up into pools, with only a small stream trickling from one to the other. " The water of this stream forms the sole water-supply of these villages; it is used for washing cloths and other domestic purposes, as well as for drinking; and the Hospital Assistant sent to render aid to the sick reported that the stream and its banks were polluted in all directions by the villagers. " On the 10th June the epidemic appeared at Puduria; on the 15th at Deori and Mungela; on the 17th at Mungeli, these four villages forming a group on the banks of the same stream three or four miles below Aitwa. "On the 15th June cholera appeared in the village of Hurgarh on the Hiran river, about six miles south-west of Mungela; on the 19th at Barghi; and on the 24th at Bhatadone, also on the Hiran, about a mile further west. " The Silpuri nala falls into the Billora nala, and that into the Hiran, 3J miles above Hurgurh. Bhatadoni is 3| miles south-east of Sehora Town, the Sehora Road Railway Station and the adjoining village of Khitola being midway between them. The first case of cholera in the town of Sehora occurred on the 25th June, and the first case in Khitola on the 2nd July. The first case in Sehora was that of a grain-dealer who had just returned from purchasing grain in Bhatadoni, Moorta, and other villages in the neighbourhood. The epidemic continued in the town of Sehora for six weeks, and in that time 331 persons were attacked, of whom 60 died, equal to 32 and 1 5 per 1,000 of the population. " Extension of the epidemic to Muiwara. "On the 10th June cholera appeared in the Murwara circle, north of the localities in which the outbreaks above described occurred. "It was reported that a family of mendicant brahmins, consisting of husband, wife and daughter, inhabitants of Jholi three miles east of Murwara, had been on a begging expedition through the villages along the road between Sleemanabad and Sehora including the group near Hurdooa; the} returned home on the 9th ; the mother and daughter were seized with cholera on the 10th and died on the 12th; the father of the family was seized on the lltb and died also on the 12th. Two persons of the Kurmi caste living about 50 yards from the brahmins, were attacked on the 13th aod died the same day. Altogether 7 persons were attacked in this village, of whom 6 died. "On the 11th the epidemic appeared in the village of Kherwa three miles from Jholi ; on that day Sadho Tewari of Jholi came to inspect some land belonging to him in Kherwa, and sat for about an hour in the house of one Bahadur Roal ; on that afternoon Kalna, son of Roal, a child of 3 years of age was attacked with cholera, and died that night. In the course of the following five days nine inhabitants of this village suffered from cholera, of whom two died. 48 "Sadho Tewari frequently visited the house of the brahmins at Jholi while they were ill of cholera." The circumstances attending the outbreak of cholera in these two villages were ascertained by Kunj Bihari Lai, Hospital Assistant in charge of the dispensary at Murwara, of whose intelligence Doctor Rice speaks highly. 153. About this time the epidemic was imported into Myhere by a large barat or marriage-party that arrived there from the Jubbulpore district. 154. In the course of the months of May and June cholera thus became established in the Sehora circle of the Jubbulpore district and in Murwara. In July and August the mortality rose considerably, but the prevalence of the epidemic was confined chiefly to the circles in which it first appeared, and which are traversed by the main road. In the Sehora circle 41 villages were visited by cholera, equal to 15 per cent of the total. In Mujhouli, the circle adjoining Sehora on the west, six villages only out of 112 were visited, and in Mujgaon, the circle immediately to the east, 12 out of 162; while Knndun, the circle further to the east, remained entirely free. In Sleemanabad circle 7 villages out of 109 were attacked, and in Murwara 11 out of 285; but Bhartala to the west remained entirely free. Burhie to the east also remained free till August, when 24 deaths occurred in 4 villnges, and Bijeragogarh escaped with 4 deaths in one village. 155. "While this cholera (which was apparently an extension of the epidemic of the North-Western Provinces) was spreading in the northern portion of the Jubbulpore district, the epidemic of the Nerbudda valley, which will be described presently, was approaching the southern confines of the district through the adjoining district of Narsinghpur. On the Ist July an outbreak occurred in the village of Matapur, in the south-west corner of the district not far from the confluence of the Hiran river with the JSerbudda, the latter river forming the boundary between the districts of Narsinghpur and Jubbulpore On the 3rd another village in this neighbourhood was attacked, and on the 7th the first cases occurred in the city and station of Jubbulpore. Whether the epidemic was imported into the city from the north or the south is not known, nor is it a matter of much importance ; the first case occurred in the Orphanage attached to the Church Mission, and this case was followed by 15 more cases among the orphans in the course of the next 5 days. On the 7th also a man living in the city but employed as a punkha cooly in the European barracks was attacked. On the 10th two more cases occurred in the mohulla in which this punkah cooly resided, and two persons travellers, one from Saugor and the other from Banda via Murwara, were also attacked on this day. The disease had by this time become established in the city, but its spread to the different sections was comparatively gradual; of the 15 sections or mohullahs, into which the city is divided, seven remained free till the 20th July, All, however, eventually suffered more or less ; the disease continued epidemic till the middle of August, and cases continued to occur here and there till the end of the month. 211 deaths were reported, equal to 49 per 10,000 of the population. In the cantonment 4 cases only occurred, and in the Civil Station, besides the orphans, only three. 156. There are 335 villages in the rural circles of Jubbulpore, but no outbreak of cholera was reported from any of them till the 23rd July, or 16 days after it had appeared in the Sadar town and station ; subsequently 17 were attacked, and 138 deaths were reported, equal to 20 per 10,000 of the population. The greater number of these villages were in the trap country to the south-east of the cantonment. 49 157. Altogether in the district 138 villages were visited by cholera, or about 9 per cent of the whole number ; and the number of deaths reported was 1,283, equal to 33. per 10,000 of the population. The circles of Sehora and Patun suffered the most, the mortality in these circles being 53 and 40 per 1,000 respectively. The epidemic reached its maximum of prevalence in the week ending the 12th August when it was present in 47 villages, and the number of deaths reported amounted to 157 by the end of month, or in the week ending the 2nd September. The number of villages in which the disease was present had declined to 15, and the number of deaths to 33. The last cases were reported ia the week ending the 14th October. 158. The outbreak of cholera in the Betui district, and from which the ฆepidemic that subsequently spread over the Nerbudda valley and the Vindhyan districts had its origin, was apparently a resuscitation of the epidemic which had prevailed in the Betui and Hoshangabad districts during the hot weather and rains of 1875. In Betui the epidemic of 1875 had been confined to the central and southern circles ; it had prevailed with some severity in the central circle of Badnur, and cases continued to occur up to the middle of .November, but the northern circle of Shahpur had escaped entirely. It was, however, in the town or principal village of this circle that the epidemic first appeared in 1876. The circle of Shahpur lies on the northern slope of the Satpuras, and borders on the Hoshangabad district, it comprises a sandy plateau for the most part covered with jungle, the population is very sparse, and the villages small and far apart ; the soil of the open spaces is very light and sandy and culturable c-nly in the rains. I happened to be marching through the district in the middle of March, and was at Shahpur a day or two after the outbreak ; there had been no rain for three months, in fact only o*l7 inches had been registered since the -cessation of the monsoon rains in the previous September: the dry northerly winds had set in, and the temperature of the week preceding the outbreak was above the average : the country was everywhere dry and parched, and the small streams that intersect it were reduced to sandy beds with little or no water visible. 159- On the 13th March the appearance of cholera in the village of Shahpur was reported : on that day, a woman of the Charaar caste, resident of Shahpur, returned about sp. m. from a village 3 miles distant ; she had been seized with the symptoms of cholera about two hours previously ; in the course of the following night 5 persons were attacked; on the 15th two more; on the 18th one, and on the 20th one, altogether 10 cases of which three were fatal ; all were of the Chamar caste and living in the same quarter. The village is situated on the south bank of the Machna river, and as the bank formed of sandstone rock rises abruptly between 30 and 40 feet above the stream, the site is well drained and dry. Being a Police Station and the chief halting place on the road to the Railway aod Hoshangabad it is frequently visited by European officers, and the conservancy is fairly attended to ; and when I inspected the village 3 days after the outbreak I found it clean and in good order. The Chamars live in a quarter by themselves a little separated from the rest of the village, and lower down the river. There are several good wells in the village, the depth of the water from the surface of the ground varying from 28 to 32 feet; the upper castes use the well water for drinking, and the river water for cooking. The Chamars had no well, and used the water of the river for all purposes. Clothee, cooking vessels, 50 &c, were all washed in the river, and as the Chamars drew their water from the river after it had passed the village, it must have been far from pure : there was a fair stream running at the time past the upper part of the village, but it formed a deep still pool at the point where the Chamars drew their water. No case occurred in the village except among the Chamars; but a gaoli (or cowherd) living in a solitary hut on the other bank of the river opposite the Chamar's quarter, and drawing water solely from the river was attacked on the 15th and died on the 17th. 160. Shahpur contains a population of 1,500; it is the only large village in the circle, it is a Police psst, and the chief bazar in that part of the district is held there. At this time the Gonds who form a large portion of the population of Betul, were flocking in large numbers to the Hoshangabad district to assist in the wheat harvest which was then about to commence. On the 23rd February (Sheoratri festival) there had been a gathering of about 2,500 at Bopali Mahadeo, a place in the jungles about 14 miles east of Shahpur to which persons from Berar on one side and Hoshancrabad on the other may have come; but it consisted chiefly of inhabitants of the district. The fair continued for four days, and many people from Shahpur had gone to it. The Holi festival had commenced on the 10th March and had been continued through the 11th and 12th. 161. That the outbreak of cholera at Shahpur was the result of these movements of the population cannot be affirmed with certainty, but it would appear that at this time this place had become a centre of infection. On the 13th, a man of the Kurmi caste returning from Shahpur to his village of Bugoli in the Sadar circle, about 24 miles distant from Shahpur, was attacked with cholera and died shortly after his arrival ; seven people of this village were subsequently attacked. On the same date, the 13th, a party of five persons on their way from Hoshang.ibad to Berar halted at Shahpur; one of them was seized with cholera and died there ; another the next day midway between Shahpur and Betul. On the 14th the appearance of the disease in the village of Mara 10 miles to the west of Shahpur was reported. On the 15th it broke out at Jowari, 12 miles to the east and two miles from the Bopali Mahadeo where the fair had assembled. On the 17th a prisoner who had been brought in that day from a village in the Shahpur circle was seized with cholera in the Betul Jail. 161. By the 25th March the disease had appeared in 12 villages of the Shahpur circle and in one of the adjoining circle of Badnur, and by the end of the month 99 deaths from cholera had been reported from 26 villages in the Shahpur circle and 3in Badnur. The first cases from the Chicholi circle to the west of Shahpur were reported on the sth April, The southern circle remained free till the latter part of April, but between the 22nd and 30th of the month no less than 30 villages in the circles of Bhaisdye and Atner were attacked ; the first villages attacked were near the Berar border, and the greater number of them were on or near the road that descends the ghats to Ellichpur, but two lay in the hills some 25 miles to the west. It was in this part of the district in the rocky country that lies between the valley of the Tapti and Beiarand to the south of the Multai and Atner plateaux that the epidemic prevailed with the greatest violence; the greatest number of deaths were reported in May, but there was great mortality again. in August, and the epidemic did not die out here till the end of October. 51 162. The epidemic in the Shahpur circle was short-lived; the greatest mortality occurred in the month of March, and it had ceased entirely by the middle of May. The consequences, however, of this outbreak were not so transient, for the epidemic was conveyed from this locality into the populous districts of the Nerbudda valley and ultimately spread over a very wide extent of country. There was at this time, as 1 have above stated, a considerable influx of the Gond population of Betul into the Hoshangabad district to assist in the wheat harvest that was then commencing ; I met large parties as I was coming up the road from Itarsi to Shahpur between the 14th and 17th March. On the 2lst March cholera broke out in a party of Gonds and Kurkus who had arrived at the village of Bessaronda 10 miles south of the town of Hoshangabad, seven persons were attacked on that day, all of whom died ; the party immediately broke up and dispersed, and in the course of the next six days cases of cholera were reported from 12 villages in that neighbourhood, and in 8 of these the first case was a Gond or Kurku who had belonged to this party from Betul. On the 24 ch also a Gond was attacked in the village of Burkhera close to the border of the Betul district but belonging to the Seoni circle of the Hoshangabad district. From this time the number of villages attacked increased daily, but for nearly a month after the first outbreak the epidemic was confined chiefly to the villages of the Sadar circle and to the Sadar town in which it appeared on the 30th March. The greater part of the villagers were at this time busily occupied in the harvest passing night and day in the fields, and the majority of the cases occurred among them. The villages of the Seoni circle attacked during this time were chiefly the Gond villages in the jungle tract near the hills. 163. After the middle of April the epidemic spread more rapidly, and reached its maximum of prevalence in the last week of May when 173 deaths were reported from 70 villages. It continued very prevalent throughout the month of June, but declined rapidly in July after the heavy rains set in. The epidemic prevailed with the greatest severity in the circle of Bankheri which borders on the Narsinghpur district, and in the circles of Lokurtalai and liehetgaon which border on the Betul district ; the sparsely populated tract of Charwa in the extreme west scarcely suffered at all, and the Mundi circle of the Nimar district which borders on the Charwa circle of Hoshangabad, which is also very sparsely populated, escaped entirely. The epidemic, however, broke out in two villages of the Kimndwa circle in the middle of July, and in the beginning of the following month it spread to the adjoining circle of Dhungaon. At the same time it prevailed in Holkar's territory across the Nerbudda, but it appears not to have reached the city of Indore above the Ghats, With the exception of two cases in the city of Indore on the 29th April* the whole of Malwa remained free throughout the year, nor did the epidemic spread southward across the Satpuras into Burhanpur. 164. Extending eastward up the valley of Nerbudda the epidemic reached the district of Narsinghpur in the middle of May, the first villages attacked being a group on the Nerbudda river north cf Gadarwara; it is said that the disease had previously appeared in villages on the Bhopal side of the river. On the 23rd the first case occurred in the town of Gadarwara. On the 18th May it appeared in a village near the hills south of Gadarwara, and on the 21st it broke out among the people employed at the Coal Mines at Mohpani ; the out' break here ia thus described by Dr, Skipton, the Civil Surgeon :— 52 '* The first person taken ill was a woman belonging to the villago of Beenar, this place is just outside the boundary of the Coal Company's land and consists of from 50 to 60 huts, inhabited by people who wont in the mines. The woman was a tobacco seller, and was in the habit of frequenting the neighbouring villages in pursuit of hor trade. The village of Beenar is situated on rocky ground, and is approached from the direction of the coal mines by crossing a small nala which runs into the Sita-rewa river along a deep ravine bordered by scrub jungle, and this place is much fouled. The water of this nala collected here and there into little pools is used by the people for drinking ; there is a well also close by, but it is comparatively little used, the people preferring the water of the nala. Chota Jubbulpore (commonly spoken of as Mohpani, though the proper village of Mohpani is a couple of miles to the south) consists of about 100 houses or huts built on the land of the Company, with a population of about 400. Many of these people take their water from the pools above named, but the better classes resort to a spring near the Sita-rewa river that winds through the Company's land after coming out from among the hills which almost encircle the place, from this spring which is well protected and looked after, the European establishment draw their water. The epidemic continued among the people at these two villages for about six weeks, and out of 167 cases of cholera reported by the Police, 102 were fatal. None of the European establishment suffered. Some ten or twelve of the dead bodies were thrown into a very deep pool of the Sita-rewa river, about a mile below the Coal Company's station; but they were taken out again under the supervision of the Police and properly buried at a distance from the stream. There had been no rain for seven months, and the water remained only in the deep pools, the stream between them being exceedingly shallow." 165. The epidemic became very prevalent in June in the western portion of the district and in the Birman circle which lies to the north of the Nerbudda. The town of Gadarwara suffered very severely in June and the early part of July. A solitary case occurred in the town of Narsinghpur on the 29th May, but cholera did not become epidemic there till July. The eastern circles of Chhindwara and Mungwani also were not reached till the beginning of July when the rains had set in and the epidemic prevailed here with far less severity than in the western circles of the district. The epidemic of the Nerbudda valley crossed the Nerbudda into the Jubbulpore district also in the beginning of July, and here it met the epidemic which I have before described as spreading southward from the Rewah territory, north of the Kaimur hills. 166. The epidemic of the Nerbudda valley also spread northward from Hoshangabad across the Vindhyas into the Bhopal Territory, and thence into the Saugor and Damoh districts of these Provinces. The first cases in the Bhopal Territory across the Nerbudda were reported about the 20th April from Murdanpur and ot.her villages on the bank of the river opposite Hoshangabad. On the 28th April a fatal case occurred in the Bhopal Battalion in Sehore, and on the Bth May the first cases among the native population of the Cantonment were reported. On the 11th May cholera broke out in the town of Bhopal, and between that date and 16th July 764 cases, of which 316 were fatal, were reported from a population of about 30,000 ; the greater number of these cases occurred before the 10th June. The epidemic prevailed severely in other towns and villages of the Bhopal territory in June and July, but it appears to have ceased in the end of July or beginning of August. 167. Immediately to the north of Bhopal is the State of Bhilsa belonging to Gwalior. Cholera was present in this State and in the States of Tonk and Gunab, further north, in July and August ; but the time of its first appearance 53 in these localities, or whether it reached them from the north or from the south is not known. But spreading to the north-east from Bhopal the epidemic entered the Saugor district in the latter end of May, the first cases within the boundary occurring at Rahetgarh on the 23rd. The first person attacked belonging to the town was a servant of the Chief Constable, but two days previously two travellers from Bhopal had died in the serai. At first it was said that these people died from sunstroke, but from subsequent enquiries there appears to be little doubt that they were eases of cholera. In the course of the next fortnight 54 persons were attacked of whom 23 died. On the 31st May a Constable who had come into Saugor town, on duty was attacked with cholera and died. On the same day a Brahmin Pandit who had returned from Rahet* garh.to his home in the town of Saugor was attacked with cholera and died the next day. On the 3rd June a Mussulman living in the same quarter was attacked about 6 a. m., and before 3 o'clock on that day 3 more cases occurred, all these people living close to where the Pandit lived and drawing water from the same source. On the 4th another case occurred in the same locality. After this occasional cases were reported from the same quarter until the night of the 17th when 17 people were attacked. The epidemic then spread through other sections of the ซrhanpur ... 70,540... 11 117... 2 165 226 ... 521 7-39 Niraar ... 140,684... ] 500... 2 84910... 423 223 2,008 14-27 Hosbangabad ... 449,977... 33 2,37958 5 153 1 ,.. 629 2,371 5,629 12-51 Betul ... 278,857... 19 411 325 1,353 2,108 7-56 ฆns cc ( Above the .2 v ) Ghats... 165,681.. 119 73 84 108 384 2-32 •ง * ) Below the O^( Ghats... 99,510... 40 30 566 15 651 6-54 Nagpur .. 631,229... 498 1,292 1 7 24 2,111 701 4,427 7-34 Wardha ... 354,720... 371 1,759 1 2 267 2,015 443 4,858 13-70 Bhaudara ... 564,813... 468 954 5 ... 261 605 2,293 4-06 i 193. It will be seen that twice in the course of the ten years, in 1868-69, and again in 1875-76, the districts were more or less covered by epidemic cholera ; that although in one year (1872) of the five intervening 1 between these two epidemics, cholera became prevalent in the districts traversed by the main lines of communication, in none of them, with the exception of Nimar, did it prevail with severity, and the two hill districts of Chhindwara and Betul, in •which, prior to the suppression of the fair, the disease is said to have appeared annually, experienced complete immunity during the whole five years. 194. But it is not only in the less frequent recurrence of epidemics that the effect of the suppression of this fair is evident. The course taken by subsequent epidemics, their rate of progress, and the time of the appearance of the disease in different districts are all very different. After the outbreak of cholera at the fair in 1865 the appearance of the epidemic was reported simultaneously in the first ten days of March from every district given in the above table, and its advent from the direction of Mahadeo was in all cases traced ; at the same time also it reached Berar. If we now refer to Map No. lA. in which the spread of the epidemic of 1875 over these districts is traced, we find the successive dates indicating the gradual progress of the epidemic after its outbreak at Nasik in March, through Kandesh in April and May, through Berar in May and June, through the Wardha and Nagpur districts in July and August, and not reaching Chhindwara above the ghats till the Ist of September. The same gradual rate is observable in the progress of the epidemic of the same year up the Nerbudda valley. The epidemic first appeared at Khandwa on the 27th March ; no case occurred in the Hoshangabad district till the latter end of April, and the confines of the Narsinghpur district were not reached till the beginning of June. The epidemic was imported into Betul from the Nerbudda valley in May, but it did not spread to the border of the Chhindwara district till the end of August. So also with the epidemic of 1876 (Map No. IB) which originated among the population of the Shahpur plateau of the Betul district in the middle of March. By a local movement of the population it was conveyed into the adjoining district of the Nerbudda valley within a few days of its first appearance, but it did not reach Bhopal to the north till the end of April ; Nimar to the west remained free till July ; it also spread southward down the ghats which separate Betul from Berar, appearing in the Bllichpur district in the middle of May, but the Wardha and Nagpur districts remained free till the beginning of June. An outbreak occurred in the beginning of August in a village of the Umerwara circle of the Chhindwara district, which was due to importation from Narsinghpur, but with this exception the district remained free of cholera till after the dispersion of the Kaintek fair in November. Instead then of the sudden and simultaneouซ 62 outburst of cholera over all these districts which followed the dispersion of the multitude assembled at the Mahadeo fair in 1865, we find that in 1876 the radiation of the epidemic from a focus formed in the same hills, but not having the same means of being conveyed, was slow and gradual. 195. In the course of the ten years 1856 — 1865 cholera appeared five times in the town of Nagpur in the end of February or beginning of March. In the course of the ten years 1867 — 1876 cholera did not once appear earlier than the end of June or beginning of July. 196. The extent to which an epidemic of cholera will spread over a district and the number of deaths that it will occasion, will also be very much modified by the season in and circumstances under which it is imported. In tracing the progress ฆof the epidemics of the two years 1875, 1 87^6, we have shown that the diffusion over the country is -chiefly effected during the hot and dry months, that the mortality continues to increase till the middle of August, and that then the epidemic begins to die out ; if therefore a large number of centres of infection are formed early in March by the influx of infecfced pilgrims, a more violent epidemic will result than if the diffusion were effected slowly by the ordinary intercourse among the population. The numbers of deaths recorded from cholera in the different districts in 1865 are, as I before said, acknowledged to be much below the truth, but they nevertheless show that the epidemic of 18^5 in these districts was far more severe than any that have since occurred. In that year 1,858 deaths were registered between March and July in five towns and the villages of a portion of the Seoni sub-division of the Hoshangabad district. In the epidemics of 1869 and 1876 the number registered in the whole district was in each year under 2,500. In Nimar, including Burhanpur, 2,610 persons were carried off between March and October 1865, more than double the number that has occurred in any epidemic since, in fact the aggregate number of deaths from cholera in Nimar in the whole ten years that have since elapsed amounts to only 2,509. In the Nagpur district 3,022 deaths were returned between the becfinnin^ of March and November 1865, and the Deputy Commissioner recorded his opinion that this number was far below the truth. Severe as was the epidemic of 1875 in this district the number of deaths (2,111) was nearly a third less than that returned in 1865. In Betul 1,462 deaths were recorded in 1865, a higher number than was recorded in 1876. The district of Chhindwara, however, exhibits the greatest contrast. The reports furnished at the time show that the epidemic of 1865 fell with especial severity on this district, but unfortunately returns were made only from three towns in the district and from the pargana of Chand and three other villages above the ghats. The population of this pargana including the three other villages was 23,800, and amont? thia population 433 deaths, equal to 20 per 1,000 of the population, were recorded. In the course of the ten years 1867 — 1876, the aggregate number of deaths from cholera returned from the whole area above the ghats containing a population of 166,000, amounts to 384, equal to little more than 2 per 1,000 of the population. These figures I think suffice to prove the wisdom of suppressing the Mahadeo fair ; there can be no doubt that the measure has been the means of saving thousands of human lives. 197. We find then that the comparative immunity from cholera of the hill districts of the Satpuras during the epidemics of 1875-76 is not due to their elevation, their better drainage or cooler climate, but simply to the circumstance of their population being sparse and living remote from the lines of traffic by which the infection was imported into the more populous districts. In fact the populations of these districts appear to be peculiarly liable to suffer from cholera when exposed to the infection, for, when in former years circumstances operated to divert traffic through them, and the infection of cholera by this means reached them, they suffered severely, and moreover the liability of the population 63 of these districts to cholera has been illustrated in these two years in the district of Betul. The infection was accidentally imported into the Sadar town in the end of May 1875; from thence it spread among the population of the surrounding villages ; its diffusion was slow in 1875 and limited to a small portion of the district, but it lingered late into the cold weather, and it was among the population of this district that in the commencement of the hot season of 1876 the disease re-appeared first in this part of the country, and a focus was formed whence it radiated to all the surrounding districts. 198. In the foregoing pages I have described the diffusion of cholera in two consecutive years over wide areas of the Central Provinces and of the territories adjoining them, and it will scarcely be denied that the course of the epidemic and the circumstances attending it in each of the two years plainly point to human intercourse as the agency by which the diffusion was effected. In the first of the two years cholera was present nowhere in the Provinces, or adjoining territories included within the area under report, prior to the dispersion of the great religious gathering at Allahabad, early in February. By the end of March it had appeared at four points within the area under report. One of these points, Sutna, is in a tract of country adjoining the district of Allahabad and connected with it by main lines of communication. The appearance of the disease at another of the four points, Bilaspur, was coincident with the arrival of large numbers of people from Allahabad, and in all the outbreaks that occurred for some weeks subsequent to the arrival of these people connection was traced to them, or to populations which had been infected by them . With respect to the appearance of the epidemic at the other two points, Nasik and Khandwa, evidence of importation by human agency is wanting, but the position of both places and the circumstances attending the outbreak of the epidemic point to importation of infection as the most probable cau&e. Prior to the appearance of cholera at these places it had broken out at the grreat fair at Allahabad, and it had also become epidemic in Benares which, from its being the chief centre of religious pilgrimage in India, is also a focus whence cholera infection radiates. Though several hundred miles distant from Allahabad and Benares, Nasik and Khandwa are directly connected with both places by railway. Nasik is a place to which pilgrimages are made from all parts of India, (it has in fact been called the Benares of Western India) ; one of the great Hindu festivals had been celebrated a few days prior to the outbreak of cholera, another festival was being celebrated at the time, Khandwa is a place of traffic on the main line of communication between Western and Central India, and the point of the departure from the railway to Omkhar Mandhata, one of the most venerated places in India, and we find cases of cholera occurring on the road towards Central India and at Mandhata a few days after its appearance at Khandwa. Again, if we consider the circumstances under which cholera re-appeared at several points after its subsidence in the end of 1875, we find it first appearing in five localities within the area under report. Into three of these localities importation from beyond the boundaries of the Province was traced, in the other two, although cholera had not prevailed actually in them during the previous year, there had been gatherings of people in their neighbourhood to which people had come from localities and districts in which cholera had been prevalent up to a late period of the previous season. 199. And if in these instances where actual evidence of importation is wanting, we seek for local causes for the development of the epidemic, we do not find in the localities the conditions which are supposed by many to contribute to the generation or reproduction of epidemic poisons. 64 200. Moreover, in tracing the diffusion of cholera over the country, we do not find the slightest evidence of an atmospheric influence suddenly or rapidly overshadowing the country, and evolving epidemic outbreaks of chclera in numerous places simultaneously. We find on the contrary the epidemic first appearing at a few points to which it might easily have been imported from localities where it was previously present, and then spreading from these points gradually in a manner quite consistent with the ordinary traffic and movement of the population. Table X. gives the wind directions recorded during each month of the year 1876 at ten stations of the Province, and which may be taken to represent normal directions which prevail annually at different seasons, but a reference to Maps Nos. 1 A. and B will show that neither in 1875 or 1876 did the spread of cholera bear any relation to the prevailing direction of the wind. It will be observed that at all stations nearly the same directions are recorded, and that for the greater part of the year the prevailing direction is from the north-west ; yet in 1875 while the epidemic from Nasik and from Khandwa was spreading in a north-easterly direction towards Nagpur and up the Nerbudda valley, it was at the same time spreading from Bilaspur and Mungeli in a south and westerly direction also towards Nagpur. So also in 1876 we find the epidemic spreading in various directions from the different localities in which it first appeared, without any general relation to the prevailing direction of the wind. 201. The comparatively slow rate at which epidemic cholera ordinarily travels, and the fact that the spread of cholera over Central India is mainly effected during the hot and dry months when the air is often for weeks together almost devoid of moisture, are opposed to the notion that air currents constitute the agency by which the morbific matter is diffused. 202. A cholera epidemic in spreading over the country does no doubt commonly follow one direction more than another, but this direction will coincide very closely with the main line of communication, and its rate of progress over a tract of country will be in a great measure influenced by the density of its population. If the diffusion is effected by the dispersion of a large fair in the early part of the dry season, as in the case of the Mahadeo fair in former years, it will not be so much restricted to the main lines of communication and the denser popu lation, but in 1875 and again in 1876, although the influence of fairs in the diffusion of cholera was sufficiently evident, the spread was mainly effected by the ordinary intercourse and traffic of the population, and we find it first appearing in towns and villages on or near the main roads, populations remote from these not being involved till later, or escaping altogether. 203. Railroads do not apparently accelerate the progress of cholera through a country ; remarkable instances of the conveyance of cholera infection by railway have been given in this report, but such instances are comparatively rare and it is evident that a line of railway having its stations well supplied with good water and conservancy carefully attended to, does not afford the means of communicating cholera which exist so abundantly along the lines of road. Cholera continues to be conveyed to distant points by pilgrims visiting the holy places and attending large religious gatherings, or by companies of Brinjarras and cartmen conveyiug the produce of the country to distant markets, toiling along the road by day and encamping for the night at the same tank, or on the bank of the same stream, all using water from the same source and almost invariably polluting it. But as the traffic of the country becomes more effected through the agency of railways, it may be expected that although the infection of cholera may occasionally be conveyed to distant points by means of them, the diffusion of epidemics among the population will become slower and more dependent on the casual intercourse 65 STATEMENT X. Resultants of the wind directions as observed at the Stations in the Central Provinces in 1876. Sambalpur ... „. 85 N 7ฐ W 80 N 79 W 55 N 54 W 54 N 43 W 56 S 63 W 62 S 63 \T 81 S 67 W 57 S 88 W 24 N 88 W 52 N 29 W 67 N 21 W 79 N 55 W Kaipur 55 N 28 E 37 N 41 E 79 N 13 E 31 N 12 W 51 S 85 W 78 S 37 W 96 S 46 W 54 S 59 W 57 S 64 W 40 N 26 W 70 N 20 W 64 N 6 E Nagpur ... ... ... 34 N 54 E 25 N 45 E 37 N 65 W 27 N 46 W 55 H 29 W 56 N 48 W 79 N 89 W 64 N 72 W 65 N 67 W 34 N 22 E 62 N 58 E 49 N 62 E Seoni ... ... ... 19 N 45 W 23 N 3 E 31 N 50 W 25 H 7 W 67 N 45 W 58 N 78 W 77 S 60 W 38 N 71 W 42 N 71 W 68 N 38 E 50 N 60 E 38 N 52 E Jubbulporo , 40 N 52 W 27 N 56 W 42 N 24 W 49 N 29 W 74 N 38 W 67 ป 82 W 88 S 89 W 60 N 74 W 65 S 85 W 30 N 83 W 27 S 7 W 31 N 26 E Saugor ... 42 N 3 E 29 N 2 W 19 N 41 W 39 N 43 W 70 N 54 W 75 S 87 W 77 S 68 W 64 S 89 W 33 s 76 W 67 N 56 W 51 N 16 W 48 N 4,4 E Pachmarhi 43 N 47 W 46 N 27 W 62 N 55 wl 45 N 23 W 76 N 43 W 74 N 59 W 90 ป 81 W 62 N 76 W 66 I 67 W 57 N 2 E 51 N 48 E 37 N 27 E Hoehangabad 28 N 6 E 20 N 41 E 35 N 4 W 15 N 9 W 84 N 82 W 76 N 83 W 88 S 80 W 66 S 86 W 76 S 89 W 49 S 5 W 70 N 65 E 68 N 65 E Khandwa ... ... 30 N 51 E 25 N 1 E 57 H 40 TV 42 N 5 W 79 N 60 TV 60 N 71 W 89 N 89 W 87 N 8S W 81 X 73 W 52 N 11 W 51 N 43 E 46 N 50 E Chanda 89 N 84 E 5 N 9 W 30 H 34 W 17 N 8 W 26 N 38 W 51 S 87 W 84 S 82 W 81 N 66 W 63 N 53 W 53 N 50 E 59 N 34 E 47 N 84 E Sironcha 34 S 37 W 34 N 77 W 50 S 64 W 80 S 74 W 74 N 85 W 66 N 63 W 55 N 29 E 78 N 19 E 49 N 39 E 66 between village and village, the gatherings at local fairs and week'y bazars, or at marriages and other festivals. In tracing the spread of cholera over the country during these two years, numerous instances of the importation of the infection by these means into localities previously tree have been related, and many more might have been given, but it was scarcely necessary, fur year after year in the sanitary reports of these Provinces evidence of the spread of cholera by these means has been adduced, and not in the sanitary reports of the Central Provinces only but since evidence on the subject has been systematically collected, every report in which an attempt has been made to trace the spread of cholera among the general population of the country has contained abundant evidence to the same effect.* In fact we may say that while cholera spreads over the country in a manner which necessitates the inference that some agency is engaged in spreading it, the evidence that points to human intercourse as the agency in operation is conclusive, and that no evidence has been adduced to show that it is, or can be spread by any other means. 204. Lastly we have the evidence afforded by exempted areas that sparse populations remote from the main lines of traffic are more seldom reached by the epidemics that involve the denser populations, that tracts of country which have suffered severely from cholera while traversed by main lines of traffic have remained comparatively exempt when the traffic has been diverted to other routes, and lastly that measures adopted with the view of limiting the spread of cholera solely on the ground that the spread is effected by human agency, and which would be wholly without reason excepting on that ground, have been followed through a series of years by the results which they were intended to produce. 205. But while the evidence of the operation of human intercourse in effecting the diffusion of cholera is thus conclusive, there are, on the other hand, many facts which show that the communication of cholera from person to person, or from one population to another, is subject to certain conditions which are not at all times and everywhere present ; that for the development of the disease in individuals some other factor besides the communication of the infection is necessary, or that infection is ordinarily communicated by means of a medium which is not everywhere accessible to it. Much evidence has been adduced to show that persons attending on patients in hospital suffering from cholera are not liable to catch the disease, and although the evidence is by no means conclusive, and many cases have been related in which the attendants have been infected by the patients on whom they have been attending, it must be acknowledged that probability is in favor of the attendants on the sick in hospital not taking the disease, and not only this, but as we shall show hereafter, cholera falls with very different degrees of frequency on different classes of the population and on persons of different ages, that even in districts over which cholera has been more ฆwidely diffused more than half the villages will escape, that in one village people of one caste will suffer, and in a second village auother caste, the other castes remaining free, that while adult women suffer more frequently than any other class of the population, infants at the breast are practically exempt. 206. Moreover, everywhere in India the prevalence of cholera is distinctly seasonal, and this characteristic is shown in a very marked degree by the epidemics that spread over the Central Provinces ; they spread during the hot and dry • Notr. — British India, inclusive of Burraah, is divided into 9 Governments and Administrations to each of which .ป Sanitary Commissioner is appointed, whose duty it is to give annually a history of the chief diseases that have prevailed in his Province during the year. In 1875 cholera prevailed iv every Province, and every Sanitary Commissioner, with the exception of the Sanitary Commissioner of Burmah, states his opinion that cholera is spread by human intercourse, and gives evidence to this effect. In Burmah the number of deaths from cholera was small, and the Sanitary Commissioner doubted whether the disease was epidemic. 67 months, attain their maximum of prevalence in the height of the rains and cease with the cessation of the rains, the population in ordinary years being exempt from cholera between October and February. At this season even if by the dispersion of an infected body of people the infection is conveyed to a large number of towns and villages, as happened in the case of the Hamtok fair in November last, the populations are but little amenable to its influence. In several of the villages to which the infection was conveyed, it proved harmless, and its effect on the population generally soon subsided. We have then to ascertain what is the condition which assists or is supplementary to the conveyance of cholera by human intercourse, and without which infection is ineffectual. In England the majority of observers, and in this country those who have had most opportunities of investigating cholera among the native populations, have arrived at the conclusion that impure water is the supplementary condition which facilitates the spread of cholera ; but in order to show how far this is the case and what is the nature of the connection between cholera and impure water, it is necessary to trace the diffusion of the epidemic among the population more minutely than has been done in the preceding pages. 207. With this view I have had prepared, with the assistance of the Surveyor General, an admirable series of Maps Nos. II to "X, in which the spread of the epidemic in certain districts and localities is minutely shown. The discussion of the spread of cholera in connection with these maps forms the subject of the next Section of this report. SECTION 11. 208. This section is explanatory of the series of Maps Nos. 11. to X. Nimar. — The district of N"imar is a wide tract of rocky country ; the main range of the Satpuras forming the watershed of the Tapti and Nerbudda divides it into two portions, the statistics of which are kept distinct, the Tapti basin, including the circles of Asirgarh and Dewali, forming the statistical district of Burhanpur, while the district of Nimar proper comprises the Nerbudda country north of the range. This again is naturally sub-divided into two portions, the Khandwa plateau which forms part of the water catchment of the Chota Tawa, a tributary of the Nerbudda ; and the northern portion, the drainage of which is carried into the Nerbudda by two small streams, the Kavery and the Kurug. 209. The drainage of the district as may be seen in the map is very rapid. The Tapti river has a fall of 200 feet between Burhanpur and where it is crossed by the railway at Bhosawal, a distance of about 30 miles. The rivers Abna and Sukta which with the Chota Tawa drain the Khandwa plateau, have broad rocky channels deeply cut below the general surface of the country. The Nerbudda where it enters the district is flanked by rocky hills of considerable elevation ; from these it emerges into open country a little above Mortakh a, 68 where it is crossed by the railway bridge, the rails on which are just a hundred feet above the summer level of the river. From the bank of the river the country rises rapidly on either side, the difference of level between the bank of the river and the crest of the ridge above the Khandwa plateau being over 500 feet, while towards the Yindhyas the incline is still more rapid. 210. Throughout the district, excepting in a few spots near the Nerbudda, the geological formation is a continuation of the overflowing trap of the Deccan which is here of great thickness. As is commonly the case in a trap country, the surface of the plateaux is undulating exposed rocky ridges and uplands, alternating with hollows which are partially filled with disintegrated trap or shale, this again being covered with black soil of varying depth. In the valley of the Tapti round Burhanpur, the substratum is a yellow sandy alluvium, but over the greater part of the district there is no subsoil, that is, the black culturable soil where it exists rests directly on the trap shale or rock from which it has been formed. The immediate neighbourhood of all the larger rivers is invariably cut up by a net-work of ravines. The breadth occupied by these ravines varies from a few hundred yards along the smaller streams to five or six miles on either side of the Nerbudda and Tapti ; and the total area rendered unculturable from this cause is very large. Taking all the causes of barrenness into account, hill ranges and their ramifications, exposed rock, the ridges and uplands and ravines, more than half the area of the district is quite incapable of cultivation. The culturable residue also being much scattered and concealed in hollows below the more prominent naked ridges, Nimar presents a very bleak and barren appearance. Cultivation is chiefly confined to the monsoon season. 211. A great part of the district is covered with jungle; the valley of the Tapti, with the exception of an open area within a few miles of the town of Burhanpur, the Satpura range, and the valley of the Chota Tawa* are almost wholly covered with jungle, and a large part of the northern sub-division is occupied by the Punassa reserved forest. The population is very sparse ; the population of the Burhanpur district (exclusive of the town) is only 33 to the square mile, and the greater portion of this is in the neighbourhood of the town, while that of .Nimar proper is not more than 63 to the square mile. 212. Table X gives the main features of the climate of the district as observed at Khandwa in 1876 (the first year during vrhich complete observations were made). In January and February the temperatures are moderately low, though somewhat higher than the average of other stations in the province ; the rise of temperature in March is very marked, and from this time till the middle or latter end of June, when the rains set in, it ranges very high. During the rains the temperature falls, but it still continues slightly higher than the average of other stations, but this slightly higher temperature as indicated by the thermometer is amply compensated by the steadiness and high velocity of the winds. The most remark able feature of the climate of Nimar is the persistence of northerly winds, and their comparatively high velocity during the hot weather and rains. Through every month of the year in 1876 the prevailing direction of the wind was more or less northerly, and in every month the mean daily movement greatly exceeded the average of the province. The mean daily movement of the wind observed at Pachmarhi is high, compared with other stations, but it is considerably below the mean of Khandwa. This increased velocity of the wind is perhaps due in a measure to a draught created by the gap in the Satpura range, through which the railway passes south of Khandwa. 69 TABLE X, — Showing the meteorological condition in each month of the year 1826 at Khandwa. Temperature. Mean daily maximum ... 871 90-2 96-8 106-9 108-4 103-1 88-3 85-4 84-5 91-0 86-3 83*3 92-5 Mean daily minimum ... 51*9 52-9 66-3 72-6 82-3 80-8 74-6 73-2 70-7 622 55-0 49-8 66-0 *Mean daily temperature ... 682 70-1 79-4 88*2 93 9 905 79-0 780 764 76-0 700 65-7 78-1 tMean relative humidity ... 41 28 30 20 28 48 77 77 78 49 44 43 47 Rain-fali ... ... 1-02 7*34 1218 529 ... 2583 Total. Prevailing direction of wind ...30N 51E25N 1E59N40W42N 5W 79N 60W60N 71W 89N89W87N 85W81N73W52N 11W 51N 53E46N 50E Mean daily movement of wind... 64-6 689 132 134 271 282 237 210 170 93 68 60 149 • Mean daily temperature computed from minimum and temperature at 16 hours. f Mean humidity computed from minimum wet and dry bulb and wet and dry bulb at 16 hours. 70 The annual rain-fall of Nimar is lower than that of any other district of the Province. The average quantity measured at Khandwa during the eleven years 1866 — 1876 is 34*30 inches, of which 33 inches fall during the monsoon months, June to October, and a little over 1 inch in the course of the other seven months, (see Table V.) The average annual rain-fall measured at Asirgarh exceeds the rain-fall of Khandwa by 2 or 3 inches ; but at Barhanpur it is considerably less, being only 27 inches. The monsoon rain-fall of this district is, however, subject to greater fluctuations than occur elsewhere ; in the course of the eleven years, for which the average is given, the quantity measured during the monsoon at Khandwa has varied from nearly 55 inches in 1867 to 17 inches in 1871. The annual rain-fall was below the average in 1875 and in 1876 ; in the former year the deficiency was slight, but in 1876 it was as much as 9 inches, or 26 per cent below the average. 2 13. The rocky nature of the country, the high temperature, the comparatively small rain-fall, and the prevalence of northerly winds blowing from the arid tracts of Central India, all contribute to produce great dryness of thft atmosphere ; and we accordingly find that for nine months of the year, the mean relative humidity is very low ; even during the rains it is less than in other parts of the Province, and as soon as they cease, it falls very rapidly. 214. But notwithstanding the comparatively small rain-fall, the dryness of the climate, and the generally rapid drainage of the country, the population is not so badly off for water in the dry season as might be expected. In April and May the smaller rivers cease to run, and in the larger ones, as the Abna, the Sukta and the Chota Tawa, the stream becomes very shallow, and water at that season becomes scarce in the uplands and along the main roads. But the villages lie chiefly in the hollows, and here generally after an average monsoon, water is procurable at a depth of from 15 to 25 feet below the surface, throughout the hot weather, for the rain-fall rapidly draining off the uplands and filtrating through the porous shale which partly fills the hollows, is retained by the hard impermeable basalt below. "Wells can without difficulty be sunk in the shale, and this is suiaciently firm, that a masonry lining is not necessary to prevent the sides falling in. Very few of the wells therefore have masonry tubes ; many even of those that are called palcka, being only lined to the depth of a few feet; the shale is very porous, and the wells fill rapidly after heavy rain. In September and October the surface of the water will commonly be less than 4 feet from the surface of the ground. 215. The following statement, compiled from returns furnished in 1872, exhibits the nature of the water-supply of the villages in the three sub-divisions of the Kimar district : — 5 I 1 l= 5 I~J I ?| JM| Ste I** Sปb-divi.ion. - ซ- |j fj |SซJ .gfi- S fe.s fe s ft -3 8 sjga a -si si si a i g-g egg I |- I 1 I* !ซi 2 ! Mortakha ... 142 36 37 ... 33 ' 36 Kbandwa ... 329 118 173 ... ... 38 Burhanpur ... 128 41 26 1 53 7 I J 71 A pakka well is one that is wholly or partially lined with masonry, and has the mouth protected by coping. A kacha well is without lining or coping. The rain-fall of 1871 in Nimar was very scanty, and the number of villages dependent on streams that ceased to run in the hot weather was greater than usual in 1872. 216. The jungle tracts of Nimar have the reputation of being very malarious, and so far as our mortuary statistics afford the means of judging, the district generally is unhealthy. The following figures show the average annual mortality from the chief causes of death in Nimar, compared with the rates for the whole Province : — . „ Rowel om **^iซ i — - - Nimar ... 35-36 23-1 1 337 167 158 Burhanpur ... 30-60 21-fiS 315 132 0-82 Central Provinces ... 20-9S 1428 2'ol 1-26 j 156 217. In its annual rate of mortality from fever Nimar exceeds every other district of the Province, and allowing that registration of deaths may be more efficient in Nimar than is the case generally in other districts, I believe that the above figures represent truly the fact that the diseases which in this country are registered under the head of fever prevail there to an extent that is much above the average. It is, however, remarkable, that while in nearly every other district of the Province the number of deaths registered from fever is much higher in September and October than at any other time of the year, in Nimar the mortality from this cause in April and May generally equals, and sometimes exceeds, that of September and October. The months of February and July, and (when the rains are not delayed) June, are the healthiest months of the year. 218. The rate of mortality from bowel complaints in Nimar is exceeded in several other districts, but the cholera death rate is very little in excess of that of the Province generally, while in Burhanpur it is not above half the average bf the Province. But although many districts of the Province suffer more severely from cholera when epidemics visit them, there is no district which is more liable to be invaded by epidemics. In former years it was among the districts that suffered from the Mahadeo fair ; of late years the traffic through it has greatly increased, and in epidemic seasons it is one of the first districts attacked. In the course of the 18 years, 1859 — 1876, cholera was absent from the district only in six. 219. Concerning the epidemics prior to 1864, no history exists. In that year it entered tho district from the Bombay Presidency, appearing in Burhanpur and Asirgarh in March, both these places suffering severely, and then passed on by Bunvai and the Simrole ghat to Indore. 72 In 1865 the appearance of the disease coincided with the dispersion of the pilgrims from the Mahadeo fair in the beginning of March. The epidemic of this year was very severe ; it prevailed with the greatest severity in March and April, abated in May and June, but increased again in July and August after the heavy rains had set in. In this epidemic the Khandwa plateau suffered most severely, the mortality being as high as 21 per 1,000, while the Burhanpur circle in the valley of the Tapti suffered only to the extent of 7 per 1,000. The pargana of Barwai, on the northern bank of the Nerbudda, which has since been transferred to Holkar, was then British territory, and records show that cholera had appeared in the town and villages in March, and that the town suffered very severely. It was in April of this year that a detachment of Artillery on descending the Sirnrole ghat from Indore, suffered so terribly from cholera. The report of this catastrophe by the officer in command is given as Appendix 111. of this report, and it affords a striking example of severe cholera occurring under conditions of extreme heat and dryness of atmosphere, and also a marked illustration of the connection between cholera and impure water. Through 1866 and 1867 the whole district appears to have remained free of cholera. 220. Table XI. gives the monthly prevalence of cholera in the ten years 1868 — 1877. In 1 868 cholera (see paragraph 188) had spread from Seoni through Nagpur and Berar as far as Khandwa. In September a few cases occurred in the town of Burhanpur, and in December a severe outbreak occurred in the town of Sunawad, belonging to Holkar, on the main road to Indore, and in the following month it broke out in the town of Khandwa ; in this year the prevalence of the epidemic was confined chiefly to the first four months of the year ; it almost ceased in May, and the increase after the rains set in was comparatively light. 1870 was a year of immunity. In 1871 cholera was again prevalent in the city of Bombay, and in Nasik from the beginning of the year. And early in April a slight out-break occurred in the town of Khandwa. Seven cases occurred, of which one only proved fatal. In July and August three cases occurred in the town of Burhanpur, and in August there were three cases in the village of Borgaon on the main road where it debouches from the pass under Asirgarh on to the Khandwa plateau. 221. In 1872 cholera was again present in Nasik in the early months of the year ; about the middle of March it appeared at Bulwara, on the road to Indore, north of the Nerbudda. Between the 21st and the end of the month several cases occurred in the town of Khandwa; on the 26th the epidemic broke out in the village of Rushia, on the road between Khandwa and the river. On the 28th a case occurred in the town under the fort of Asirgarh ; on the 9th April the disease appeared in Burhanpur. 222. The rains of the monsoon of 1871 had been very scanty, the quantity measured at Khandwa having been only 17 inches and at Burhanpur only 12 inches. The epidemic of the year that followed this scanty monsoon was severe both during the hot weather and rains. In 1873 the appearance of cholera in the district was confined to two villages. In February two deaths which occurred in a village on the Indore road were reported by the Police to have been from cholera, but as no other cases followed they were not registered under this head. In the end of October a sharp outbreak occurred in a village half a mile off the same road ; the first case occurred on the 30th October, and in the course of the next ten days 20 cases followed, of which 10 were fatal. In 1874 there was no cholera. 73 TABLE XL — Showing the monthly mortality from cholera in the district of Nimar, inclusive of Bur7i-anpu* t during the years 1868 to 1876. 1869 ... 17 80 211 117 12 29 42 59 50 ... ... ... 617 292 11872 ... 40 183 202 206 230 210 43 ... ... ... 1,014 4 79 g 1875 ... 3 34, 34 43 24-2 211 43 26 13 3 652 308 Total ... ]/ 80 254. 337 149 278 531 599 218 41 23 4 2,531 11*97 74 223. We find then that on all occasions on which the first entrance of cholera into Nimar is recorded, the disease has first appeared on or near this road, which is the main line of traffic between Bombay and Central India. 224. We now come to the epidemic of 1875, the spread of which is shown in Map No. 11. In 1875 the first appearance of cholera in the district of Nimar occurred in the town of Khandwa. Prior to its appearance here, it had appeared nowhere in Western India, with the exception of Nasik where it had broken out on the ,__i](i iYiarcii* •> The first cases at Khandwa though reported by the Police as cholera were not allowed to be registered as such, the Civil Surgeon considering them cases of choleraic diarrhoea ; and here I may remark that the unwillingness of Medical officers to recognize first cases of cholera and the distinction they make between choleraic diarrhoea and cholera have frequently in this and former epidemics been obstacles in the way of tracing the origin of outbreaks in the sadar towns, which, as they are often the first, are for that reason the most important. Doctor Abbott, the Sanitary Commissioner for Berar, reports that the cholera statistics of the district of Ellichpur for the whole season were vitiated in consequence of the Civil Surgeon insisting that the cases reported by the Police as cholera were only choleraic diarrhoea. 225. In the latter end of April, after outbreaks of cholera had occurred elsewhere in Nimar, I visited Khandwa, and the Civil Surgeon, Doctor Fleming, subsequently furnished me with the following note regarding the first cases in the town : — "On the 27th March two cases of cholera were reported to me as having occurred dur- ing the previous night in Bahmanpura. On visiting the house I found that a boy Tej Singh, aged 8, had died, and that his sister Dhayab, aged 12, was ill. She was suffering from choleraic diarrhoea and had vomited several times. The same evening a case was reported in jail, exhibiting similar symptoms, but which turned out to be merely a case of gastric disturbance from the presence of round worms. " Next day three fresh cases were reported, two of which I found to be cases of worms ; the third exhibited the same symptoms as the girl Dhayah ; he died on the following day. On the 30th March another fatal case was reported, that of a woman residing in the same house in which the first two cases occurred. " This makes four cases of choleraic diarrhoea, with three deaths in the same neighbour- hood. All these people use water from the large cistern in Forsyth gunj. No special cause of the sickness could be ascertained." It will be observed that the Civil Surgeon does not admit the cases in which worms were evacuated to be even cases of choleraic diarrhoea, but tbe evacuation of worms during an attack of cholera is so common an occurrence ( see paragraph 88), that I believe all these cases may be regarded as cases of cholera. After this, cases continued to occur in different parts of the town, and between the 27th March and 11th April, 24 cases of this diarrhoea were reported, of which 11 proved fatal. Subsequently instances occurred of travellers being taken ill with cholera, but there were no cases among the residents. 226. The town of Khandwa lies on basaltic rock, which in most places is exposed, in others covered with a layer of shale. At the end of March and beginning of April the whole country is dry and burnt up ; no rain had fallen since 27th February, when a fall of a little over an inch was registered. The water in the wells was from 20 to 40 feet from the surface of the ground in different parts of the town. 75 227. The water-supply of Khandwa is derived partly from wells, but chiefly from a small reservoir about f mile from the town, formed by a dam across the Rameshwar stream. From this it is led by an iron pipe into two large open cisterns or tanks in the lower part of the town and one on a higher level. When the Rameshwar reservoir is full, the water finds its way by gravitation into the low level cisterns. The high level cistern is only used on bazaar days, and then it is filled by means of a steam pump from a well on the border of the reservoir; when the water in the reservoir is low, the low level cisterns are filled daily from the well. On account of the expense, the daily use of the pump is delayed as long as possible, and at the time of the outbreak of cholera in March 1875 it had not been brought into use, but the level of the water in the reservoir was only just sufficient to allow of the low level cisterns being filled by gravitation, and when I was at Khandwa in the middle of April the water was nearly stagnant, and an unpleasant looking scum had formed on the surface. The pump was then brought into use and worked daily from morning to night to keep the cisterns full, and the reservoir was drained dry and cleared out. The water of the reservoir was analysed in 1871, and pronounced by the analyst to be of indifferent quality. At the same time the water of one of the wells much used was analysed, and pronounced to be bad. 228. The reservoir and the stream from which it is filled are too near the town to be altogether safe from accidental pollution, but all practicable measures are taken to prevent the water being defiled. The conservancy of the town also is well looked after, and when I inspected the place shortly after the outbreak, I found it clean in all parts, and the sanitary arrangements working well ; the insufficiency and imperfect nature of the water-supply were the only grounds for complaint. 229. In former years the town of Khandwa had not always escaped with so slight an epidemic as in 1875. In 1869, 130 deaths from cholera were registered, 103 of which occurred in the first four months, and the remainder between July and September. In 1872, 165 deaths from cholera were registered between March and September, and as the site of Khandwa in respect of geological formation and drainage resembles that of a large number of villages on the plateau, I give in Table XII. overleaf the number of cases of cholera registered in each week of the epidemic of 1872 in juxtaposition with the rainfall measured in each week and the depth of the sub-soil water from the surface of the ground at the end of each week. This table exhibits cholera occurring in the same locality under very opposite conditions of atmosphere and soil. 230. The rain-fall of the monsoon of 1871 had been scanty, and had ceased in September ; from that time till 30th March, or for a period of 6 months, there had been no rain. The first case of cholera occurred on the 21st March, the patient being a Bania resident in the Bombay bazar ; the second case occurred on the 25th, and the third on the 26th, both being Bania residents in the same bazar. By the 30th, 43 cases had occurred, 19 of which were fatal. The people of the Bombay bazar use water of the Rameshwar reservoir. This outbreak continued till the last week of April ; a second shorter and milder outbreak took place in the second week of June, which ceased in the last week of the month when the heavy rains set in; a third and severe outbreak occurred in the fourth week of July, when the water in the wells was approaching the surface. The well from which the measurements of the sub soil water at Khandwa are taken is situated a short distance from the bank of a large tank or reservoir which partially fills in the 76 TABLE XII. — Showing the deaths from cholera and rain-fall measured in each week at Khandwa during the epidemic of 1872, also the depth of the sub-soil water from the surface of the ground at the end of each week. Population of Town, 14,119. Cholera. Kain.fall. Week ending from surface Remarks. Cases. Deaths. Inches. Cents. of ground< March 9th... ... ... ... ... 38 4 16th \ 38 10 23rd... 1 1 ... 40 8 First case of cholera on 21st, second on 25th. 30th... 43 19 0 06 41 2 Slight rain fell on the 30th with thunder. April 6th... 34 18 0 06 41 6 Do. 6th do. 13th... 24 13 41 9 20th... 8 8 0 86 41 8 Do. 15th and 16th with 27th... 15 12 41 10 thunder. June Ist ... 42 0 }* Well dry. f 5 Bth... 1 1 0 11 42 0 Case of cholera on 6th ; rain fell on | S 15th... 20 12 0 11 42 0 J 2nd case of cholera on 9th; rain ซ• fell on 11th and 15th. [ s 22nd... 4 4 0 27 42 0 Kaiu fell on 19th to 21st. t i ri! 1 3n ''ฐ in ot.i i I i cq 44 010 L... 1 A X *JO 1 *i -otli. ... ... o Uซ> — */ 77 rains, but owing to the nature of the substrata it does not retain" water long. The ฆwell is excavated in the hard basalt much below the level of the tank, and the rapid rise of the water after the first heavy rains in the last week of June and the first week of July was the result of drainage from the tank rather than of percolation from the surface through the superficial shale or murain, and it was not until the water had risen to within 10 feet of the surface of the ground that the third outbreak occurred; this also like the first outbreak ran its course in about five weeks and then ceased. The first outbreak was confined to the people drawing water from the cisterns ; so also would the second probably have been, for at that time the wells were dry, and all but the Balais and other low castes resort to the cisterns. During the third outbreak a. large portion of the population would be using water from the wells; but unfortunately no enquiry was made at the time with respect to the source whence the people who were attacked with cholera drew their supply. 231. This table, however, showing the prevalence of cholera in Khandwa in 1872, very fairly illustrates the conditions under which it prevails over the district generally. The inhabitants of the villages are liable to suffer from cholera in the hot weather, or in the rains, according to the nature of the source whence they draw their drinking water. If they depend upon streams and shallow surface wells they will be liable to cholera in the hot dry weather, and again when the rains contaminate the streams with surface impurities. Villages dependent upon wells sunk in the porous superficial formation will suffer when the heavy rains of July and August are falling, and the wells fire being filled by percolation from the surface. Many villages again derive their water-supply from both streams and wells ; the former being the most convenient, the people will resort to them as long as the water is at all drinkable, and then fall back upon the wells. J?.nd this is probably the explanation of the decline which takes place towards the end 232. In ordinary seasons, as I have before described, the majority of the villages in Nimar obtain a fair supply of water from wells during the hot weather, but in the hot weather of 1872, owing to the scanty rain fall of the previous monsoon, more of the streams ceased to run, and the water in the wells became Bcantv or failed altogether. Accordingly, in that year, the choiera of the hot weather was severe (see Table XI.) In 187b i on the other hand, although the epidemic entered the district, and the Radar town was attacked about the same time as in 1872, the cholera of the hot weather was comparatively light, while in the rains of the two years the mortality was nearly equal. 233. Table XIII. exhibits the prevalence of cholera in the towns and villages of the district in the two years 1875 and 1876. Of the 68 villages that suffered from cholera between April and December 1875, 12 were a ttacked before the rains set in, 53 while the rains were failing, and 6 only after they had erased, It will be observed that no great number of villages were attacked until the heavy rains in July came down : that the number of villages suffering and the number of deaths increased rapidly till after the heavy rain in the second week of August. In the following week, though the number of deaths was less, the maximum number of villages suffering was attained. Yroxn this time the prevalence of the epidemic rapidly declined. The heavy rain that fell in the first week of September was not followed by any increase of cholera, and if* tha few villages that were attacka i aft3L' the rains ceased, the number of cases was few, and the proportion of deaths to cases comparatively small. 78 TABLE XIII. — Showing choUr a and rain-fall in encli iveek of the epidemic of 1875 and 1876 in the district of Nima . 1875. 1576. Cholera. Bain-fall. Cholera. Itain-fall, _____ ___ _ , Z a 1.3 Week ending. ? Week ending. sfl 111 |J ป ri 111 ll . > y. _: c_> sj ฆ o April 10 tli 1 8 ... 08 May ~lst S 0 .' April 29tli 1 2 Bth 4 18 15th 6 J3 22nd 3 3 291h June sth 1 1 ... ... June /tli 12tb 3 5 0 52 lOih 19th 5 15 2 14 _ 7th 50 26th 5 9 1 55 24th July 3rd 5 17 0 08 July Ist 0 52 10th 9 42 2 60 Bth 1 ... 2 98 17th 9 5S 1 65 15th 2 1 1 70 24th 12 71 2 45 22nd 2 5 _ 86 3 1st 14 67 1 25 2?th 2 8 ... 30 August 7th 13 42 ... 49 August sth 2 3 ... 27 14th 10* 39 5 21 12th 6 7 0 02 2lst 22 57 ... 41) 19th 10 32 0 08 28th 15 40 ... 80 26th 14 34 4 22 September 4tl 10 36 ... 47 September 2nd 13 44 7 59 11th 6 10 8 II 9th 11 32 4 31 18th 5 8 1 87 16th 9 10 ... 90 25th 7 11 ... 45 23rd 8 14 ... 08 October 2nd 9 13 30th 5 10 9th 5 8 October 7th] 3 2 36th 3 4 14th 5 10 '23rd 3 5 2 1st 2 2 30th 2 1 28th 1 1 November Oth 3 2 ... ... November 4th 13th 2 4 December 4th In 187G the prevalence of the epidemic in Nimar was confined entirely to the rainy season ; it attained its maximum of prevalence rather later than in the previous j'ear, but it will be observed that the rains were delayed in 1876, and that no heavy rains occurred till the first week of July. 234. We may conclude then from these facts that the district of Nimar, though liable to severe outbreaks of cholera in the hot season, particularly if the drought usual at that season has been aggravated by a deficiency in the rain-fall of the previous year, ordinarily suffers most during the rains while the process of replenishing the sources of water-supply is going on, when the impurities that 79 have accumulated on the surface of the soil daring the long dry season are being washed into the streams, or convened into the wells by percolation through the superficial strata. 235. If we now trace the diffusion of cholera over the district in 1875, in respect of time and locality, as exhibited in the map, we find that it was by no means sudden or rapid. There is no evidence of any wide-spread influence suddenly overshadowing the district and affecting a large number of villages simultaneously. The first places attacked were along the main lines of communication, and at considerable distances apart ; but subsequently the villages attacked fall to a great extent into groups. In two or three instances the compounds of a group are on the banks of the same stream, and the dates on which the first cas^s were reported form a consecutive or nearly consecutive scries. In other groups there is not this connection, and the dates fall at wide intervals of time. 230. After the first outbreak of the epidemic at Khandwa in the last few days of March and beginning of April, we find it appearing next at Choral Chowki, the temporary terminus of the Holkar State Kailway at the foot of the Simrole ghat, 15 miles north of the Nerbudda and 22 miles south of Indore. The outbreak at this place is thus described by Dr. Beaumont, the Kesideacy Surgeon at Indore :—: — " The first case occurred on the sth April, one case on the 6th, another on the 7th, two "on the Sth. These first five cases occurred in coolies employed on the railway " works, none of whom had been away from the neighbourhood for several " weeks. On the Bth a severe out-break occurred at a bullock train chowki on " the Indore road, 5 miles north of Choral. Nine persons lived at the chowki ; " of these, six were attacked, and five died within 24 hours, as well as two Baniaa 'ซ living in a hut across the road, who died on the 9th. Two cases occurred in " the city of Indore on the 9fch." The outbreak at Choral Chowki was severe ; the population numbers about 3,000, and consists chiefly of coolies and other people employed on the line, traders' agents and cartnien connected with the traffic on the road : 46 persons were attacked between the oth and 28th April, and of these 19 died. The only source of water-sup ply at the chowki, excepting for the railway officials, was the bed of the Choral stream, which then contained only stagnant pools.* It was at Baee, a mile or two north of Choral, that the detachment of Artillery on its inarch from Mhow in April 1865 contracted the cholera which proved so fatal to it (Appendix III.); and the note given below describes the difficulty in procuring water that still exists on this road. * Note.— The Simrole Ghaut which leads from the Deccan to the plateau of Central India is, observes the Pioneer, painfully connected, as some of our readers will remember, with the story of the fatal march from Mhow in April J865, when a party of Artillery, with details, being despatched from that station in the hot season, suffered severely in descending the ghaut, and were driven to take refuge in the large and still unused iron-works of Barwai. Just in proportion as the shrinking waters of the Nerbudda facilitate the passage towards Central India as far as they are concerned, so does thซ Simrole Ghaut, with its five miles of steep gradients nnd rock escarpments, forbid all but the best equipped and carefully provided travellers from ascending to the plateau above in the scorching da3'S of April and May. In those months there is no water fit to drisdj to be got in the pass. The Btream, which is a foaming torrent during the rains, has dwindled to a very small brook ; nnd though, dammed up under the large bridge at the foot of the ghaut, it makes a show of bright water, there is very little of it. At the thickly-populated terminus of the Indore State line, known as Choral Chowki, the approaching water famine of the season is a serious mater. The railway has dug its oปvn well, and probably all the people employed on or about tho extensive works going on — already the line is made twelve miles beyond Choral — are adequately provided for ; but this does not help the villagers. When the Maharaja Hoikar went to Calcutta to meet tho t'rinca of Wales, a petition was presented to him at the Choral station, praying that he would provide some additional water-supply. The townspeople, chiefly of the poorer Bania and other trading classes, offer to give Bs. 200, and the Maharaja promised a similar sum. But it was repiesanted that even Ks. 40i) would go a very little way towards digging such a large well as tho community require, the ground being hard trap-rock. On His Highness' return fro.n the Eastern capital, the matter was again pressed on his attention and that of the Dewan, the result being that the Maharaja consented to increase the Us. 250 (which the people then proposed to anb&eribe) iip to Rs. 1,000. The sufficiency of this sum even, may be doubted ; but if the work is once begun, its urgency will surely suffice to carry it through. The question is— Will it 'je ready by Hay ?If the rook has uot been struck to some purpose by then, cholera trill reappear, and many will be iti victims at Choral Chowki.— Times of India, March 1876. 80 237. The Choral stream joins the Nerbudda near Barwai, and at this time a large bod}' of coolies was employed at the Gutta quarries near this point. Dr. Beaumont thus describes the outbreak of cholera among these people :—: — " Here tlio circumstance would point to fouling of tho water-supply with cholera " excreta as a probable cause of the exceptional severity of the out-break. " About 1/200 work-people and their families were assembled at the quarries, " and the only water procurable was from small stagnant pools in the dry bed "of [the Choral river. Odd cases had been occurring from tho 18th April, in " all about 15 cases, when suddenly on the 4th June 21 persons were attacked, " and between that date and the 18 th, 142 cases occurred, of which 104 proved " fatal, most of them in a few hours. On the 17th, 1J inches of rain fell within " a few hours, flooding the Choral river; the epidemic abated, and only 0 cases " occurred afterwards. The disease appeared to be literally washed away by the " flushing of the river." 238. I find on reference to the weather report of the Nimar district that a fall of 52 cents of rain was registered at Mortakha, on the bank of the river opposite to Barwai, on the 30th May, four days prior to the outbreak among the coolies, and 26 cents again on the ltith June. These showers were probably the means by which fcecaf impurities were conveyed into the pools used by the coolies, while the heavy rain of the 17th scoured and cleansed the whole stream. 289. One of the first places visited by the epidemic after its appearance at Khandwa was the holy island of Mandhata in the Nerbudda river. Tho island has a superficial area of about five- sixths of a square mile. Towards the northern branch of tho river the slope is not in most places very abrupt, but its southern and eastern faces terminate in bluff precipices 400 or 500 feet in height. It is cleft in two by a deep ravine running nearly north and south, the eastern portion containing about one-third of the whole area. The southern bank of the river is as precipitous as Mandhata, and between them the river forms an exceedingly deep still pool full of alligators and large fish, many of which are so tame as to take grain off the lower steps of the sacred ghats. The rocks on both sides of the river are of greenish hue, very boldly stratified, and said to be of hornstone slate. On Mandhata, the shrine of Omkar (a form of Siva>, and on the southern bank that of Amareshwar (Lord of the immortals), are two of the twelve great Lingas which existed in India when Mahmud of Ghazni demolished the temple of Somnath, A. D. 1024.* 240. The place is consequently held in great sanctity, and it is frequented by a constant stream of pilgrims. Devotees come in large numbers from Benares and other parts of the Ganges valley, as well as from all parts of Central and Western India. Two fairs are held annually, one in Kartik (m November), when from 20,000 to 25,000 people assemble ; the other on the Sheoratri festival, which in 1875 fell on the 6th March and was attended by 10,000 people. The fairs are held, and the pilgrims chiefly encamp, on the southern bank of the river. There is no record of any outbreak of cholera havino- occurred at these fairs, but the pilgrims returning from them have been frequently credited with promoting the diffusion of the disease throughout the country.! 241 . In the outbreak that took place in April 1 875 the first case was that of a Gfosain, or religious mendicant, who was attacked on the 12th ; on the samo dato a resident of the" small village of Dhukie, on the southern bank, who had been over to Mandhata, was seized, and died on the 13th ; another ca.se occurred m ••ฆ Central I'rovince* Gazetteer." f ฃซc Central Provinces' Sanitary Report for 1869, pages 60 and 172. 81 this village on the next or following day. Between the 12th and the 17th six deaths from cholera occurred on the island ; one case occurred subsequently on the Ist May, and again another on the 13th November. The population on the island at the census of 1872 was 970. The town is substantially built ; the people use the water of the I* erbudda for all purposes, and as the river for nearly forty miles above Mandhata flows through a tract of rock and forest almost without population it reaches the island pure, but the current through the deep pool is slack in the hot weather, and the water below the island would be to some extent contaminated by the people ; moreover the bodies of any persons dying of cholera on the island or on the opposite bank would most probably be thrown into the river. 242. On the 18th April cholera appeared in the village of Gowl, where the country road from Mandhata branches off to Mundi and Hoshangabad in one direction and to Dungaon on the other. The outbreak in this village was rather severe, 24 cases, 15 of which were fatal, occurring between the 18th April and 4th May in a population of 550. This village suffered again more severely in the rains of the following year, when GO cases, 27 of which were fatal, were reported. The water- supply is drawn chiefly from a well. On the 24th the disease appeared in the village of Nettengaon, between Gowl and Dungaon, and here 15 cases, 8 of which were fatal, occurred in a population of 228. The water-supply here also is drawn from a well. 243. At Dhungaon a traveller from Jowra in Central India died on the 18th April, but no other cases followed. 8 place is a police and dak station, and one of the chief halting places for travellers along the road. It is situated on high rocky ground, and is dependent for water on one well 27 feet deep in the encamping ground, which in ordinary seasons retains a good supply of water, but in 1872 this well ran dry, and the people suffered severely from holera in the hot weather and again in August. On the 14th April a traveller died of cholera at Mortakha ; no other cases occurred here at this time, but between 14th June and the 17th July, 13 deaths from cholera occurred, chiefly among the workmen employed in the construction of the railway bridge across the Nerbudda ; 9 deaths also occurred among the coolies between the 11th September and 20th November. 244. On the 20th April cases occurred at the Railway station of Birand in the town of Mundi, one in each place. The case at Bir was a Bania who had returned from Mundi, and the case at Mundi was a woman of the same caste. In the last week of April and first few days of May outbreaks occurred in three villages belonging to Holkar, a little to the west of the main road, but not being in British territory they are not shown in the map. 245. On the Ist May the epidemic attacked the village of Gokulgaon, 4 miles to the north-west of Khandwa. A barat or marriage party had assembled from Khandwa and the surrounding villages at Sehora, 2 miles from Gokulgaon. A little girl who had been taken with this barat to Sehora, was seized with what appeared to be fever there, and was brought home to Gokulgaon on the Ist May. In the course of the afternoon of that day she was seized with vomiting and purging, and died that night. On the next day 4 persons living in the immediate neighbourhood of the house where the child died were seized with cholera, and by the 7th 30 persons had been attacked, of whom 10 died. The water-supply of the people that suffered from cholera was drawn from a well which at that time had a fair supply of water in it. Dhers and low castes drawing from other well? in which the water was in appearance not 82 ,so good, escaped altogether. There was no cholera at Sehora at this time, and no deaths were reported from there till the month of October, when 11 cases, 4 of which were fatal, occurred. It is, however, remarkable that a man belonging to Khandwa who had joined the marriage party at Sehora, returned from thence suffering from the premonitory symptoms of cholera, and died on the 10th May. 246 On the sth May a Grosain with his disciple (chela) travelling by rail from Indore was taken out of the train at Khandwa suffering from cholera, tie had been taken ill at Barwai. On the 6th a resident of Mortakha who had been over to Barwai was taken ill, and died. On the 7th May cholera broke out in the village of Palsud, on the road three miles from the Bir railway station, and on the 12th at Bamangaon, a small village close to the Jawar station. 247. Between the villages of Sehora and Palsud, the Great Indian Peninsula Railway crosses two large nalas, the bridges over which had been swept away in the floods of the preceding monsoon, and were being rebuilt during the dry weather of 1875. As it was of great importance that these bridges should be completed, and the continuity of the line secured before the ensuing rains set iv, large bodies of coolies were employed at both places. When therefore cholera appeared in the district, these coolies became the source of much anxiety to all concerned, and every precaution was taken to protect them. Conservancy rules were strictly enforced, good wells were sunk, and sentries placed over them to see that they were not polluted. Sentries were also placed over the stagnant pools in the nalas night and day to prevent the people resorting to them ; both places were frequently inspected by the Deputy Commissioner, the Civil Surgeon, and the resident Engineer. Quarantine under the circumstances was one of the questions, but in order to obviate the necessity for the people going to the surrounding villages, bazars were established and supplies sent out from Khandwa ; not a single case of cholera occurred at either place. 248. Towards the latter end of May the epidemic declined, and the week ending the 29th May formed an interval, during which no case of cholera was reported from the district. On the 31st May, however, we find the epidemic again appearing in a group of villages round the town of Pandhurna. A woman who had come to this town from a village of Holkar's, was seized with cholera on the Bth May, but she was treated outside the town under a tree, and no other cases follower] at that time. On the 81st May cholera appeared in the village of Syedpur, and four cases occurred in the next two or three days. No rain fell at Khandwa before the 9th June, but a fall of over an inch was measured at Asirgarh on the 30th May, and it is not improbable that some fell at Syedpur ; the water-supply there is partly from a well and partly from a stream. 249. On the 7th and Bth cases were reported from the villages of Khiraila and Islampur. These villages are situated opposite each other on the banks of the Sukta river. There is one kacha well in Khiraila, but at the time of the outbreak of cholera, the people of both places were drawing water from holes dug in the bed of the river. At the last census, Khiraila had 924 inhabitants, and Islampur 409. Many of the inhabitants of Khiraila are dyers, who carry on most of their work in the river. 32 cases of cholera occurred in Khiraila, and 19 in Islampur — 51 in all, between the 7th and 26th June. 47 of these cases were reported before the 19th, and 4 in the week ending the 26th. Nearly 6 inches of rain fell at Asirgarh between the 16th and 19th, and we may conclude the Sukta river was thoroughly flushed by this heavy fall. The epidemic ceased almost simultaneously in both places. 250. In the first week of August cholera re-appeared in the town of Pandhurna, and this time it became epidemic, and prevailed with severity till the end of the month, when it ceased. It continued, however, in the villages of this 83 group till December ; but it is remarkable that the villages of Rustumpur and Borgaon, the two largest villages of the group, with the exception of Pandhurna, escaped altogether. Rustumpur escaped also in 1872; in Borgaon there were nine deaths from cholera in that year from a population of 2,000. Pandhurna suffered in both years, losing 19 persons in 1872, between April and August, and 39 in 1875, out of a population of 2,500 — all three villages are situated on high rocky ground, and all depend on wells for their water-supply, but in Pandhurna the drainage appears to be more rapid. I find it recorded in the Sanitary Report for 1872, that though the wells in the town are numerous, there are only two that do not fail in very dry seasons. There was a singular outbreak in Pandhurna again in April 1876. On the 29th six persons were attacked with vomiting and purging, and two died. Four lived in the same house, the remaining two in different parts of the town. Dr. Cullen, who enquired into the matter as soon as it was reported, doubted whether the cases were true cholera, but was disposed to attribute them to the extreme heat of the weather ; the maximum thermometer in shade at Khandwa registered a temperature of 112ฐ on the 29th, when the cases occurred. No cholera had been reported from anywhere else in the district previously, and none occurred for more than two months afterwards. 251. After the heavy rain that fell between the 16th and 19th June 1875, there was showery weather for the next fortnight. A fall of 2 45 inches was registered at Asirgarh on the 24th ; but as only 2 cents fell at Khandwa on that day, it would appear that the heavy rain at Asirgarh did not extend much over the Nerbudda catchment. 252. On the 22nd cholera broke out at the village of Haplan, on the Sukta river, and from this village we find the disease spreading to six other villages on the banks of the same stream ; and the dates of the first cases reported, with one exception, fall in a consecutive series from the 22nd June to the 7th July. The following table gives the number of cases reported from these six villages in each week while the epidemic prevailed .: — O ฐ Cases reported in the week ending Total. O a ... ฉ^ v Date of first Village c Jane. July. Augnst. ""' g ฃ case. 6 ' .3 SJ-J cL ?} 1 ' . fU c 9 & 26th. 3rd. 10th. 17th. 24th. 31st. 7th. 14th. I ฃ3 Io <1 22nd June. Haplan ... 325 4 2 2 ... 8 4 24-6 500 25th June. Diplan ... 154 1 1 ... 6-5 ... 28th June. Juswari ... 1,782 ... 12 19 21 9 6 3 ... 7031 392 44-20 6th July. Bairia ... 477 3 8 2 18 6 27-2 46-15 28thJune. Bamgarh... 2,091 ... 6 8 8 10 2 3414 16-2 4MB 7th July. Sirri ... 145 15 4 10 4 68-9 40-0 Total ... 4,974 5 20 31 42j 25 8 5 ... 13659 29-3 4338 *Rain-fall ..Inches. 2-23 0-06 327 1-46 2-12 1*43 0-77 0-08 • 41 can of registers at Asirgarb and Khandwa, 84 These villages are all situated on the banks of the Sukta, and with the exception of Sirri, the inhabitants use the water of the river for all purposes, — bathing, washing cloths, and drawing water for drinking, from all parts indiscriminately. 253. Jaswari and Bamgarh suffered in 1872, and were subsequently inspected by Pr. Brake (then officiating as Sanitary Commissioner for the Central Provinces), who thus describes them in the report for that year : — " Jaswari mainly consists of one long street on the rocky bank of the rocky Sukta river. It was fairly clean, but some sweepings and filth were found on the river side. Cholera appeared on the 25th July, and between that date and the 11th August there were four cases, three of which were fatal. " Bamgarh is built on a high bank of sedimentary deposit resting on basalt rock at the confluence of the Bam and Sukta rivers, the Bam on the east flowing in a sluggish stream from bank to bank, the back on this side being much intersected by ravines on the north-west of the town ; the Sukta river with rocky bed largely exposed and bank much less cut into ravines. The whole place was exceedingly filthy and discreditable to the Malguzar and the Municipal Committee. Both banks were covered with manure and fouled down to the water's edge by human excreta,, the bank on the Bam side with its deep ravines, by far the worst. There was no demarcation of the river for drinking and other purposes, and women were drawing water all along the banks of the Bam below points where it was being fouled at tliH time. Cholera appeared on the 30th June, and remained till August 12th, when there had been 80 cases and 50 deaths. The deaths had reached the number of 4ฃ on the last day of July, one mouth from the date of the first case." 254. In 1872 then the mortality in Bamgarh was more than double what it was in 1875, the number of cases being over 38 per 1,000 of the population ; while Jaswari, which suffered so severely in 1875, escaped with only four cases in 1872. It would appear probable from this and from the fact that the other villages on the Sukta which suffered in 1875 escaped in 1872, that in that year infection of the water of the Bam was the cause of the great severity with which: the epidemic fell on the inhabitants of Bamgarh, while in 1875 it was the water of the Sukta that was infected. In fact the incidence of cholera on a population during an epidemic is very much a matter of accident, — the condition, or the material suitable for the reception of the infection, may be present, but the infection may or may not be applied. The inhabitants of the small village of Sirri are said to draw witter from a well, but the nature of the well is not stated.. 255, Several weeks after the epidemic had disappeared from these villagesit appeared in the village of Urdulan, some miles higher up the Sukta. 14 cases, 7 of which were fatal, occurred here in a population of 118,. between the 25th September and 9th October. Three weeks earlier the disease had appeared in the village of Takli, situated on a feeder of the Sukta, but the epidemic here was very mild ;1 1 cases occurred between the 2nd and 18th September (2 only of which were fatal) in a population of 882. One case occurred subsequently in the week ending the 2nd October, but no connection by water is traceable between the outbreak here and that at Urdulan. Two or three villages on the stream between the two were unaffected. 256. Running parallel into the Sukta at a distance of from 11 to 2 miles is a small stream, three villages on which suffered from cholera; the dates of first cases here also are consecutive, but they are all a month later than the 85 Sukta series. The following table shows the progress of the epidemic in these three villages :—: — _——_—— . — — —— Cases reported in week ending Total. _ , o g Dates of first Village. a August. Septr. a *j eases. .2 S • 2 a. ฆs g 3 งซ 31st. 7th. 14th 21st. 28th 4th. | I ฐ 8 * 26th July ...Tairabi ... 351| 10 22 14 46 15 131-0 32-5 10th Augt... Saigwal ... 289 6 11 2 2 21 8 72-6 38-0 19th Augt... Lohari ... 433 4 1 5 10 1 23-0 10-0 Total .. 1,073 10 22 20 15 3 7 77 24 71*7 31-1 Rain -fall at Khandwa... 1-25 0-49 *5-21 -49 -80 -47 i The outbreak at Taimbi was severe, but it ceased after the heavy rain that fell on the Bth August. At Saigwal the first case occurred on the 1 Oth, or the second day after the heavy rain, and the epidemic was much less severe than at Taimbi, while at Lohari it was remarkably mild, only one case of the 10th that occurred proving fatal. 257. Towards the end of the rains the disease usually becomes less fatal, but it is worthy of remark that, taking the whole series, the villages on this small stream suffered much more severely than the villages on the Sukta, where the volume of water was. much greater. 258. The villages to the east of the Sukta and Ohota Towa rivers escaped cholera. 13 villages belong to the Piplode circle, but from none of these was cholera reported. Nor did the epidemic reach any of the villages north of the railway that report to the Jubgaon out-post. In the village of Punassa, lying in the centre of the forest, four cases occurred between the 17th and 21st of August, but no other village in this locality suffered. 259. Several villages of the Dhangaon circle in the basin drained by the Kurug river suffered, but none very severely ; the two largest villages are Barud and Beria. In Barud 30 cases occurred, the greatest number between 14th and 28th August, but seven only proved fatal. In 1872, 24 cases occurred between the 19fch and 29th June, and 12 proved fatal. In 1876 cholera again prevailed in the latter part of August; eight cases were reported, three of which were fatal. The river is the source of watersupply. Beria experienced remarkable immunity from cholera in all three epidemic seasons. In 1872 three cases were reported in April ; in one of these cases the disease had been contracted at Mortakha, and another of the cases was a doubtful one. Neither in 1875 nor in 1876 was a single case reported. The town is thus described by Dr. Brake, who inspected it in March 1873 :—: — •' Beria is an important town, built on very rocky ground on the bank of the Kutia nala. There are three good pakka wells and a baoli ; the last most used. Water is also • 410 inches on ath; slight showers on succeeding dปy. 86 brought by an open aqueduct from the Lachora lake, 2ฃ miles to the south, which besides irrigating 300 acreB of land, feeds the Kutia nala. The ground where there is any depth of soil is damp, and near the lake there is a reedy swamp. Fever, as might be expected, is said to be very severe. The town was very clean." 260. In the circle of Asirgarh there are 30 villages, but none suffered in the epidemic of 1875-1876. The fort of Asirgarh overlooks the valley of the Tapti from a height of about 1,300 feet above it, the rock which constitutes the fort rising abruptly about 800 feet from the low range of hills which form its base, the last 150 or 200 feet being a perpendicular scarp of basalt surmountable only at one angle by means of steps. The area on the top of the rock is about 60 acres in extent. The water-supply is derived solely from tanks, which are filled from the surface drainage of the area of the fort. Great attention is paid to the cleanliness of the surface, and arrangements are in force for filtrating and keeping the water as pure as is practicable under the circumstances, but the condition of the water-supply has, from time to time, been the subject of 261. The garrison of the fort consists on an average of about 100 European soldiers, and the same number of Native troops. The native town, which lies at the base of the rock, and from which the garrison draws its supplies, contains a population of about 2,500. Both the garrison and the native town escaped cholera during the epidemic of 1875-1876; but it would appear from the following information which Surgeon Wilkins now in charge of the garrison has been good enough to extract for me from the Garrison records, that, in all former epidemics of which there is any record, the garrison suffered more or less : — "In 1859 two fatal cases occurred, — one in July and one in September; both were among the Native troops. " In 1360, in March, a fatal case again occurred among the Native troops " The next epidemic took place in April 1865, when seven cases were recorded ; five among the Native troops (4 men of the 9th Native Infantry and 1 Native Office* of the 26th Native Infantry) ; one in the jail which then existed; the seventh case being an officer of Her Majesty's 33rd Regiment, who had contracted the disease below. Of these seven cases, two of those among the Native troops proved fatal. " In the next epidemic which prevailed in the district, that of 1869, the European troops, consisting of a detachment of Her Majesty's l-23rd Fusiliers, only suffered. The first case occurred on the 15th February. A soldier was admitted early in the morning and died in the afternoon. On the 16th two slight cases were admitted. On the 17th a soldier was brought into hospital at 8 a. m., and died at 4 p. m.; after this the greater portion of the men were removed to the Lai Bagh, a place a little distance below the rock and native town. During their stay there a fewmen complained of colic and diarrhoea, but no marked case of cholera occurred. On the 26th February the men returned to the fort." 2616. From information kindly furnished me by Doctor Hunter, Surgreon General, Bombay Medical Department, it appears that 14 cases of cholera occurred in the months of March, April and May 1864 in the detachment of the 15th Native Infantry that then formd the Native portion of the garrison. We thus find that in the course of the 18 years 1859 — 1876 cholera appeared five times in the garrison on this rock, and that with one exception the outbreaks occurred in the dryest months of the year, February to May. 262. The first of the soldiers attacked in 1869 had been employed on tbe Gun road between the fort and the Native town, and is said to have drank freely of water from questionable sources. He had also been in the town below. 87 263. I visited Asirgarh a few days after this outbreak in February 1869, and ascertained the following circumstances :—: — Three deaths from cholera had been registered from a village in the neighbourhood in the Ist week of February, and a small fair had been held at the town below the fort a few days before the soldiers were attacked. It was not then known that cholera had appeared in the town, but on the following day when enquiry was made, two children were found suffering from what was called choleraic diarrhoea, and in the course of the next few days 25 cases of cholera were reported, 12 of which were fatal. All or nearly all of the people attacked were Dhers. The site of the native town is formed of hard basalt, and the water-supply of the general population is derived from deep weils sunk in the rock. The Dhers, however, are restricted to the use of a tank on the rock above the town on the road between it and the fort. 264. In 1872 three cases of cholera occurred in the native town; one in March (a man working on the high road which passes below the town), and three in the latter end oi' June. None of the garrison suffered. 265. Of 100 villages in the Burhanpur circle, 10 only suffered from cholera in 1875, and the majority of these were in the neighbourhood of the town of Burhanpur. The epidemic appeared in the large village or town of Shahpur, 5 miles south of Burhanpur, on the 6th April, ten days after its appearance in the town of Khandwa ; and it is remarkable that this was the only place in the Burhanpur circle that suffered from cholera in the hot weather. The town is situated on the high bank of the Amraoti stream. The soil of the site and of the country round is a light alluvium, so extremely friable, that when 1 inspected the place in January 1876 the road from Burhanpur was almost impassable, from the depth of the dust The bank on which the town is situated rises 50 feet or more above the stream, and is much intersected by ravines, r lhe water used for drinking is derived to a great extent from the stream ; there are several wells in the town, but the water in them lies at from 30 to 50 feet from the surface, and in the majority it is saline and unfit for drinking. The stream runs over a pebbly bed, and below the town forms a pool of considerable depth. From this pool the water for drinking is chiefly drawn ; the women also resort to it for bathing and washing cloths. The bank of the stream generally is much defiled, particularly a ravine opening into the pool. On the outbreak of cholera being reported, the Hospital Assistant in charge of the dispensary at Burhanpur was sent out to make enquiries, and he reported that the water of the*po<ปl had become stagnant and bad, and the Malguaar had told him that the day before cholera appeared the fish in the pool had died. The weather was very hot and oppressive at the time with thunder clouds, and a fall of 8 cents of rain was registered at Burhanpur on the Ist. This quantity in the state of the soil then existing, would not have been sufficient to wash impurities into the water, but the inhabitants attributed the circumstances of the water going bad to the rain, and it is possible that mure may have fallen at Shahpur than at Burhanpur. On the 6th April two women were seized with cholera. On the 7th nine persons. Between the 6th and 19th, 35 persons suffered, of whom 13 died. On the Hospital Assistant's report reaching Khandwa, orders were issued to prevent the people using the water of the stream ; and a guard was placed over the pool. Theie was no evidence ol the outbreak here having been due to importation of infection from elsewhere. The population is chiefly agricultural, and it is not on any line of traffic. With the exception of Khandwa it was the first place in the district visited, and no other outbreak occurred subsequently in the neighbourhood till after the rains had set in. It is not impossible that infection may have been imported, but if cholera can be developed de novo from local conditions, the condition of the water-supply existing at Shahpur at the time of the outbreak 88 was certainly favourable to its development. A second outbreak occurred in this village in July after the rains had set iv, and when the conditions of the soil and atmosphere were altogether changed. 4l cases, 23 of which were fatal, were reported between the 10th July and 24th August; of these, 35 cases and 20 deaths occurred in the weeks ending the 17th and 24th July. Between the sth and the 12th July 5$ inches of rain were registered at Burhanpur, and what was deep dust in April would have been converted into mud. 266. Cholera appeared in Zeinabad on the left bank of the Tapti on the 17th June, and in the town of Burhanpur ten days afterwards. No cases were reported to the police till the 3rd July ; but from subsequent enquiries it appeared that 3 cases had occurred between the 27th and 29th June. Burhanpur is a walled town, containing a population of 29,303, and many parts are densely crowded. Conservancy arrangements have been greatly improved of late years; but there are difficulties in the way of carrying out airangements of this kind. All the old houses of the better classes are provided with cesspools sunk in the deep alluvium on which the town is built, and the people cannot be induced to give up the use of them for other arrangements that would be less convenient and more expensive. The cess-pools are usually from 20 to 25 feet deep — they are seldom or never emptied — and from the long coarse of years during which they have been in use, the sub-soil and sub soil water under the town and for some distance round must be contaminated by them. The average annual death rate for the six years 1870-1875 ('28*70) is considerably above the average of the towns of the Province, and epidemics of measles and small-pox which have occurred of late years have assumed an unusually fatal form. Cholera, however, though it visits the town in every epidemic, does not prevail with severity. In the epidemic of 1869 it escaped with only 17 deaths ; while in Khandwa, with half the population, the deaths numbered 130. In 1872, 9.3 deaths from cholera wore registered in Burhanpur and 165 in Khandwa. In 1875 Khandwa, probably owing to improved conservancy and care of the water-supply, had the advantage ; the known deaths from cholera being only 16 or I*l per ],000; while in Burhanpur they amounted to 75 or 2*5 per 1,000. The chief source of water-supply in Burhanpur is a series of wells stink in the alluvium of the valley near the hills and collected in a reservoir some miles distant, from whence it is led by a closed conduit into the town and distributed t's per 1,000 of the whole population, but it was very unequally distributed among the different classes The Hindus, who form 69 per cent of the population, suffered at the rate of 3*o per 1,000. Among the Mohammedans, who form 25^ per cant of the population, and who on the whole are the wealthier class, but who use the water of the wells in larger proportion than the Hindus, the cases of cholera fell at the rate of 7 per 1,000, or more than double the rate at which the Hindus suffered ; while the Dhers and other low castes, who 89 form 5J per cent of the population, suffered at the rate of 10| per 1,000. Now the Dhers are not allowed to approach the cisterns and to draw water for themselves, though some of the Hindus will fill their vessels for them • under theso circumstances a large proportion of the low castes resort to the Tapti for water. In the suburb of Ahmedgird close outside the town wall, the population of which is 2,369, twenty deaths from cholera were reported. According to rate of deaths to cases that occurred in the town, the number of cases in Ahmedgird would have been about 40, or 18 per 1,000 of the population. The water service does not extend to Ahmedgird, and the people depend entirely upon wells. 267. On the left bank of the Tapti, opposite but a little below Burhanpur, are the suburbs of Zeinabad and Jysingpura, containing together a population of 1,807. The bank of the Tapti here rises from 50 to 60 feet above the stream, and the ground is stony and barren. There are one or two wells which are used by some of the richer people, but the water is upwards of forty feet from the surface of the ground, and the great majority of the people draw water from the river, after it has passed Burhanpur. The first case of cholera in these suburbs occurred on the 17th June, and between that date and the end of July there were 79 cases, 36 of which were fatal— the number of cases being equal to 43*7 per 1,000 of the population. In these suburbs on the open bank of the river, where, excepting in the matter of water-supply, the conditions were far more favourable to health, the Dumber of cases of cholera in proportion to the population was just ten times greater than in the walled and crowded town of Burhanpur. 268. Two small villages in the rural circle suffered severely ; On the 25th June the epidemic was imported into Panjri, an isolated Gond village in the jungle on the Utowli river, where it emerges from the hills, and in the course of July carried off 40 out of a population of 238. The number of cases reported was 48, more than 200 per 1,000 of the population. The first case in this village was a Gond, who had been to the village of Asalgaon in Berar where cholera was then prevalent. The water-supply of this village is drawn partly from the river, and partly from a jhirria or spring. Nearly the whole of this part of the Utowli valley is covered with jungle, and there appear to be no villages between Panjri On the sth July it attacked the small village of Daori, the inhabitants of which number only 61 ; and of these, 18 suffered and 11 died, the number of cases being equal to 30,0 per 1,000 of the population ; the water-supply is drawn from a kacha well. The first case in Sarola occurred on the 26th July, and between this date and the 15th August 7 cases were reported, of which 1 only was fatal. The population of Sarola is 575 ; there are 4 wells in the village> 80 feet deep lined with brick, but the people chiefly use water from the river. 269. It will be found as a rule that a small village will suffer from cholera more severely than a large one, and this is no doubt due to the circumstance that in nearly all the larger villages there is more than one source of watersupply, and the chances are against all being equally polluted, while the smaller villages are for the most part dependent on one source of water-supply, and that either a small shallow well or a jhirria or a small stream ; and, as we have found in the villages on the Sukta and the stream parallel to it, the disease in the villages on the smaller streams will be more severe than in the villages on the larger rivers where the volume of the water is greater. 270. From the village of Loni 10 cases of cholera were reported between the 10th and 24th July, from Biroda 9 cases in the last week of the month, and 6 from Bahadurpur in the same week ; these are villages with populations of 90 between 1,600 and 1,900. In all the water-supply is drawn almost entirely from wells. In Loni and Biroda^ the sub-soil water in the rains is near the surface ; these two villages suffered rather severely in 1872. 27 1. The last village in the Tapti valley that suffered from cholera was Dhertalai, in the Dewali circle ; it is between 30 and 40 miles higher up the valley than Burhanpur, but close to Melghat, the hill tract belonging to Berar, where cholera was prevalent in 1875 ; 14 deaths from cholera were reported from this village between the 17th August and the 4th September : the population of the village is 554 (chiefly Kurkoos). 272. With the cessation of the rains the cholera of 1875 in Nimar rapidly declined, and died out in the end of November, 273. In the following year (1876), with the exception of the cases of what appeared to be cholera that occurred at Pandhana on the 29th April, the whole of Nimar remained free of the epidemic through the hot weather, though it had continued prevalent in the adjoining district of Hoshangabad since the middle of March. It appeared, however, in July, after the rains had set in. The setting in of the rains in 1876 was delayed, and no heavy rain fell in Nimar till the 3rd July, when a fall of 2^ inches was registered at Khandwa. On the 6th a case of cholera occurred in Khandwa, the sufferer being a man in the employ of the Great Indian Peninsula Eailway, and residing in the station yard ; this case proved fatal in the following week. 274. No other cases occurred subsequently in Khandwa, but on the 13th tow cases occurred in the village of Sirigaon, four miles north of Khandwa, and between that date and the sth of August, 25 cases occurred in this village. The disease appeared in another village in this neighbourhood on the 20th July, and in a third on the sth August. In the week ending the 12th August two more villages in this circle were attacked, and in the same week the epidemic appeared at Gowl, on the road to Mandhata, one of the first villages attacked in the previous year ; in the same week also a case occurred at Mortakha, where the road to Indore crosses the Nerbudda ; the epidemic then became prevalent in Holkar's territory across the Nerbudda, and the number of villages involved continued to increase till the last week of the month, when heavy rain fell for several days together. After this the epidemic declined, and finally ceased in October. Altogether in 1876, 23 villages of the Nimar district were visited by the epidemic, and 223 deaths were reported. The prevalence of the epidemic was, however, confined to the portion of the district north of the Satpuras. The circles of Asirgarh and Burhanpur remained entirely free. MAPS Nos. HI and IV. 275. The district of Hoshangabad, which is delineated in Maps Nos. 111. and IV., occupies the central portion of the Nerbudda Valley, and geologically consists of a strip of deep alluvial deposit, stretching for 150 miles between the Satpura range of hills and the Nerbudda river, and varying in width from 12 to 25 miles. The elevation declines from about 1,200 feet at its eastern to about 900 feet at its western extremity. The district is crossed by numerous streams in their course from the Satpuras to the Nerbudda ; these streams all run m deep channels, and the fall being rapid, the drainage is everywhere good ; indeed Irom the rapid slope of the surface from the hills to the Nerbudda the land is much scored by ravines, and wide areas are from this cause rendered unculturable. lhe soil is for the most part a rich dense loam, very retentive of moisture, but in the section of the district east of the Tawa river it contains a larger admixture ot sand. Wheat is almost the only crop cultivated ; this is sown in October and November and reaped in March and April, and during this time the district within 12 or 15 miles of the river is one vast wheat field. The district extends over 4,316 square miles, containing a population of 450,000 ; but as the area includes wide tracts of 91 hill and forest the incidence of the population varies in different parts. In the central or Sadar sub-division, the population falls at the rate of 210 the square mile ; but in the Harda, or western sub-division, which comprises the most extensive tracts of forest, the population falls at the rate of only 70 to the square mile. 276. The water-supply is derived to a large extent from rivers and streams ; as a rule these run very low in the hot weather, and the water is then dammed back or the people dig holes in the beds, which are generally sandy ; the water in these holes is bright and clear in appearance, but as the cattle are watered and clothes are washed in the pool close by, and the bed of the river is too often the latrine of the village, the clearness of the water is often deceptive. The average annual rain-fall of the district is 47 inches ; but on the Satpuras, which flank the district on the south along its whole length, the fall is much greater ; at Pachmarhi, for instance, the average annual rain-fall amounts to 78 inches ; the streams that cross the valley are therefore subject to high floods and are quickly flushed when the rains set in ; they receive but little of the drainage of the valley, and as the populated portion of their catchment area is small in proportion to the tracts of hills and forest, the amount of contamination they may derive from the villages on their banks is at this time immensely diluted. In most of the larger villages there are good wells, and although the river water is generally preferred where it is equally accessible, the wells are resorted to in the rains when the streams are muddy. The depth of water below the surface of the ground varies in different parts of the valley ; on the banks of the Nerbudda and other large rivers, wells, to retain water at all seasons of the year, must be sunk to a depth of from 60 to 80 feet ; but over the greater part of the valley the level of the sub-soil water is from 25 to 35 feet below the surface of the ground ; owing to the density of the soil the wells are not readily effected by percolation from the surface. The following figures show the rise of the water in the wells of the Narsinghpur and Hoshangabad jails during the rains ; the well at Hoshangabad is near the bank of the Nerbudda river, that at Narsinghpur is not near any stream. Hoshangabad. Narsinghpur. Eaiu-fall in previ- Depth of water Rain-fail in previ- Depth of water ous mouth. from surface of ous month. from surface of ground. ground. Inches. Feet. Inches. Feet. Ist June ... 000 59 0-20 33 Ist July ... 902 59 23" 10 32 Ist August ... 2379 51 28-60 27 Ist September ... 11-31 49 13-85 25 Ist October ... 18*72 47 876 24 92 Table XIV. — Showing the Meteorological condition in each month of the year 1876, Hoskangabad. II 1 I , s i * I ! | ill - Temperature, I Mean daily maximum ... 84*2 85-6 94-1 105-5 1078 101-8 82-1 82-9 841 89-4 85-1 83-6 905 Mean daily minimum ... 52-6 53 9 63-9 752 80-4 82-3 75-3 74-3 72-5 65-2 570 498 669 * Mean daily temperature ... 674 68-7 771 86 2 93"5 91-3 77-9 774 77-5 76-7 701 65*0 774 t Mean relative humidity ... 52 42 29 21 28 53 84 85 80 54 46 47 52 Rain-fall ... J 0-C2 ... ... 4-36 1518 1858 1002 ... ••• ••• 48 ' 16 Prevailing direction of wind ...NE&NW E&W NE&W W&NE W W W&SW W W&SW NE&wi NE&E NE&E Mean daily movement of wind... 56-4 1007 757 757 94-5 1290 163-5 971 917 66*1 51*1 59* 88*4 *ฆ Mean daily temperature computed from minimum ,and temperature at 16 hoars, f Mean humidity computed from minimum vt_t and dry bulb and wet and dry bulb at 10 hours. 93 Table XV. — Showing the monthly mortality from cholera in the district of Hoshanga bad during the years IS68 — 1876. YeM - I fi' ซ I' i I I ฆ &1 * III|Iซ*I I I I 1 |ฃ 1 4 Cn % < S h, ฃ ซg oo O fc Q H Wg PU 1868 1 20 12 33 007 1869... 39 6 12 72 666 1,182 330 b'6 6 2,379 528 1870 1 ... 17 16 23 1 58 o*l3 1871 5 5 0-01 1872... 31 11 1 1 5 27 30 47 153 034 1873... 1 1 0-00 ฃ 1874 $ 1875 10 192 158 50 63 91 39 19 7 629 139 3 1876... 86 441 738 742 248 83 29 4 2,371 527 Total... 71 17 99 525 1,596 2,100 669 274 157 90 19 12 5,629 1251 277. Statement XIV. exhibits the chief features of the climate of the district as observed in 1876. The rain-fall is confined almost entirely to the monsoon months, or from 15th June to Ist week of October ; the average fall for the 7 months November to May being little more than half an inch. During the monsoon the weather is cool, and from November to February cold north-easterly winds prevail ; but from March to the middle or latter end of June, when the rains set in, the weather is intensely hot and dry ; in no part of India in the hot weather is the heat and dryness of the climate more intense than in this part of the Nerbudda valley ;at times during the months of April and May the hygrometer shows the atmosphere to be almost devoid of moisture. It is during the hot and dry season only that epidemics of cholera attain to any great degree of prevalence. > Statement XV. gives the monthly mortality from cholera in the district during the nine years 1868^-1876, and it will be seen that in each of the three years 1869, 1875 and 1876, in which cholera spread over the district, the epidemic prevalence rose during the hot dry months, and subsided during the months of the monsoon. The effect of the monsoon rains in reducing the prevalence of cholera in this locality is more clearly shown by the following table, which gives the number of deaths from cholera reported in the weeks prior and subsequent to the setting in of the monsoon in each of the three epidemic seasons. It will be observed that in 1869 the first storms that usher in the monsoon occuvred in the week ending the 26th June, and that the decline of the cholera prevalence commenced in this week and continued through the subsequent weeks. In 1875 the monsoon set in a week earlier, and the decline of cholera was hastened to the same extent. In 1876 a heavy thunderstorm occurred at Hoshangabad, but it was a local storm, and the rain-fall was confined to the central portion of the district, while cholera was at the time chiefly prevalent in the eastern and western sub-divisions. The monsoon did not set in till tho first week of July, and cholera continued to increase ; in the second week of J uly very heavy rain fell, and the prevalence of the epidemic at once subsided. 94 1869. 1875. 1 86. rt ซซ <3 c 2 ,S S .5 '•$ t 2 4 8 ' * -2 c a ซซ c a ซn J II 1 J 111 j l_ Inches. Inches. Inches. May 29th ... 2*o May 29th ... 62 May 27th ... 173 June sth ... 339 June sth ... 53 June 3rd 0"64 86 „ 12th ... 314 „ 12th ... 46 „ 10th o*o 87 „ 19th ... 308 ? 19th 1*34 19 „ 17th *340 125 „ 26th \ 208 „ 26th 5-46 18 „ 24th 0 0 175 July 3rd I QQA 128 July 3rd 2-22 4 July Ist 032 126 „ 10th f yy ' 84 76 „ 10th 2-44 15 „ Bth 165 165 „ 17th ) 47 „ 7th 11-46 7 „ 15th 7-54 40 „ 24th 2 27 „ 24th 5-47 7 „ 22nd 373 24. „ 31st 3-50| 49 ? 31st 494 4 „ 29th 236 12 278. Map No. 111. comprises the Harda and Seoni divisions of the district, the river Gunjal forming the boundary between them. For statistical purposes rhe Harda division is sub-divided into four circles. The circles of Charwa and Reliatgaon include the villages near the hills to the south of the railroad ; the circles of Mandla arid Harda lie chiefly to the north of the rail-road; the outposts of Harsood and Bularie belong to the Mandla circle ; Jogakulan, Hundia and Gundagaon to the Harda circle. The Seoni division is sub-divided into two circles ; the villages that report to the Seoni station and the out-posts of Pugdhal and Babir forming the northern circle, while the southern includes the villages that report to Lokurtallai and Nundurwara. The number of villages in each of these circles, the total population, and the mortality from cholera in the two years 1875 and 1876 will be found at page 5 of the statement (compiled from the monthly returns) which forms Appendix IV. of this report. The annexed statement, compiled from the weekly returns, gives the number of cases and deaths from cholera reported from each village in 1875. The number of deaths there given do not quite correspond with the totals of the monthly returns. With our present means of collecting statistics such discrepancies are scarcely avoidable, but the statements on the whole give a fairly accurate account of the prevalence of cholera in the different localities. 279. The first appearance of cholera in the Hoshangatjad district in 1875 occurred at the Harda railway station, where travellers, by what is called the " mixed train," stop for the night. It will be remembered that pholera after appearing at Ehandwa in the latter end of March, had broker} put severely among the coolies employed on the IJolkar State Railway. A large proportion of these coolies were " Purdesees" or men belonging to the Upper Provinces, and on the 22nd April three of these men arrived at Khandwa and started thence by the mixed trail* for Jubbulpore. One of the three waง seized with symptoms of cholera aq hour or two before reaching Harda ; he managed to elude the Hospital assistant who had been placed on duty at the station to treat and isolate all travellers arriving sick by the trains, and on the follqwiflg morning was found dead by the side of the stream which flows past t\\e town and station. On the night of the 25th, a girl, and in the course of the following day, a woman, were seized with cholera ; both resided within 200 yards of where the man lay, and both were in the habit of using the water of the stream, in fact the • A heavy thunderstorm at Hoshangabad. No rain was measured at either of three other raingange stations in the district. f Partial storms occurred on and after the 19th. The first general fall of rain occurred on the 27th. 95 Statement of villages attached with Cholera in the western section of the Boshangabad District in 1875. B I c & -o Duration a Date of I* o**0 ** -S I Remarks. Town or village. .g reported. ฐ ฆ epidemic. 3 It j ' 1 l_ ji 1 Charwa 1 Purwan ... 860 June 14th 2 2 ... Not marked on map. Circle, J Oodah ... 877 „ 23rd 3 2 ... pj fMohal .. 349 May Ist 24 6 10 days. ฃ Roorur ... 154 „ 3rd 1 1 r S Killode ... 75 „ sth 3 1 U<( Piplani ... 374 June 25th 1 1 | Korawur ... 867 „ '-'3rd 9 5 ง Rolgaon ... 1,220 „ 14th ... 10 12 days. ฃ I Panditalai ... 225 „ 21st 4 2 f Kulharda (Railway Station)... 1,855 April 22nd 22 7 J Cases occasionally till HardaTown ... 7,315 May Ist 17 9 I ... November . * Bhyrogarh I. , , ... 133 „ lit I 1 1 f ••• Khin P ?orahj BuburbB ... 394 „ 11th 4 2 ) g Hundich "' 1,658 May Bth 12 6 21 days. I I JagaC ::: ฃ;; nth "c 5 At when re^ 4-( Bhomar ... 644 „ Zlst 1 ••• tiirnino- from Har g|Nimgaon ... 394 „ 22nd 1 1 .^ turning trom Mar. f SeonfTown "'. 7,979 April 29th *15 *8 ... Burhanpura (Railway Station.. 75 „ *9 *5 5 cases 29th* * Including hallway r J April, 4 cases coolies. 14th August. ChupaDeorj . 475 May oth 48 14 21 days. Nujshi ... 371 „ 13th 59 29 15 days. Kotra ... 1,258 „ 13th 12 4 ซ Bisspneo ... 1,023 „ 14th 4 ... g Goraria ... 436 „ 14th 68 40 7 days. r S-{ Sohpur ... 1,764 „ 14th 20 8 10 days. „ ! Bhitiaheer ... 131 May 18th & | I Chandgarh ... 131 May 18th 3 2 Bhamsadehi ป 4ซtn ... ,o | Chandpura .... 147 „ 30th ... 2 j Dumawur ปฆ 30th ... 2 Roopadeh ... 397 „ 14th 1 ... Chahirkhera ... 809 „ 9th 4 3 Golegaon ?. 103 June &th 1 ... ( Nundunwara ... 871 May 19th 1 ... 3 • Lokurtallai ... 859 June 3rd 51 18 12 days, nl^^oorujpur .. 223 „ 6th 33 10 9 days. g 2 .\awulgapn ... 263, ? 6th 6 1 Jฐ Ranipur ... 236 „ 10th 1 1 I Jammoonia ' May 1 1 v 96 stream was the only source of supply for tlie residents of this locality. Between the 26th April and the Ist May 12 more cases occurred among the people living around the station, but the town remained free till the following week. At this time a gang of 200 coolies were employed ballasting on the line between Harda and Doloriya (Map IV), the ballast being brought from the Kalamachuk river; many of the men lived in Harda, and the ballast train usually stopped there for the night. On the 28th one of these men was brought into Harda from the Kalamachuk river suffering from cholera; that night the train stopped at Seoni, many of the coolies sleeping in the waggons. During the night six of these men were attacked and one of them was found dead in one of the waggons on the morning of the 29th, the others were removed for treatment to a hut erected for the purpose ; but two of them subsequently died. In the course of the three following days, five other coolies, residents of Seoni, who had been working on the line with the coolies from Harda, but who had not been to Harda, were attacked at their homes near the railway station ; in the course of the following week five cases were reported from the town of Seoni. 280. On the 26th April a marriage party came from the Nimar district to the village of Mohal on the Sianee river, about 12 miles west of Harda, and a boy belonging to this party was said to have suffered from cholera by the way. On the morning of the 30th a woman belonging to the village was seized with symptoms of cholera shorly after returning from the river, where she had been to fetch water ; another woman was attacked about three hours afterwards ; other cases followed the same day, and by the Bth May 17 cases had been reported. Seven more cases occurred in the following week ; altogether twenty-four cases in a population of 350. On the 4th May another marriage party,* on its way to Hundia, passed through Mohal, stopping for two hours on the bank of the river to take food, and arrived at Hundia on the sth. On the Bth, three children, residents of Hundia, were attacked with cholera, and in the course of the following fortnight six more cases were reported. One of the children attacked on the Bth belonged to Nimawur, on the other side of the river, and was taken thither by its mother. Nimawur is in Holkar's territory, from whence returns are not regularly furnished, but it was reported at Harda that cholera was present there on the 16th. On the sth May a Brahman belonging to Chupa Deorion the G-unjal river, who had attended a marriage in the neighbourhood of Khandwa (paragraph 245), returned to his home suffering from cholera ; he recovered, but on the Bth a second case occurred ; and by the 1 5fch nine cases had been reported. The epidemic had thus been introduced into five places, and from these it spread to many others. 281. The town of Harda is the chief centre of population and traffic in this part of the valley, and in previous epidemics, as in that of 1875, had been the first place attacked ; in 1869 the appearance of the disease coincided with the arrival of a party of pilgrims from Onkar Mandhata; in 1872, as in 1875, it broke out in the suburb surrounding the railway station. But although thus liable to frequent visitations of cholera, the disease does not prevail with great severity. The population of the town, including the railway suburb, at the census of 1872 was 9,170. In the cholera epidemic of 1869, 74 deaths were reported; in 1872, 8, in 1875, 18 (including those that occurred at the railway station) ; and in 1876, when the epidemic was more widely spread over the district than in the previous year, only 3 deaths occurred. The town is built on alluvial soil overlying granite rock, which crops up in places in and near the town; it is well drained, and great attention has been paid to conser- • From about the 20th April to the 10th June is the period during which marriages among the Hindus are chiefly performed, and often ou these occasions the number of people gathered together amounts to two or three hundred or more. 97 vancy. The water-supply is defective ; there are numerous wells, but the water in the majority of them is saline, and the people depend for their supply of drinking water in a great measure on the stream which flows past the town and station ; great care, however, is taken to preserve it from pollution ; and in 1875, as soon as the first cases of cholera occurred, temporary wells were sunk at a little distance from the stream. The village of Mohal is situated on the high bank of the Seoni river, and the water-supply is drawn from a deep pool below ; there was very little current at the time of the out-break, and the water had been fouled by steeping sun or hemp in it. Hundia lies on the bank of the Nerbudda, 60 to 80 feet above the stream. At the time of the out-break the village was found to be very foul ; the watersupply is drawn chiefly from the river, which at this point flows over a rocky bed ; there are pools among the rocks, in which there is very little current, and in which the women wash clothes, and at the same time draw water for drinking; but there are no large villages on the bank above Hundia, and the river water is not much contaminated. Five deaths from cholera from a population of 1,658 were reported between the Bth and 29th May, and one on the 18th September. In the Harda sub-division, the epidemic did not prevail to any great extent ; the sparsely populated circle of Charwa indeed remained almost entirely free, and in none of the villages of the other circles that were affected was the mortality very great. 282. The village of Chupa Deori, on the Gunjal, however, formed a centre whence the cholera spread to a large number of villages. The Gunjal, like most of the rivers in this part of the country, runs very low in the hot weather ; in April, May and the early part of June, the water lies chiefly in in long deep pools with a very shallow stream running between them ; the bed is in some parts rocky, in others it is formed of coarse sand or shingle ; at Chupa Deori it forms a deep pool immediately under the bank on which the village is situated. As there is no sand in which the people can dig holes in which to filter the water, they draw direct from the pool, and, as usual, wash clothes and bathe in the same part. The out-break of cholera here was severe ; 48 cases, 14 of which were fatal, occurred between the Bth and 29th May in a population of 475. Kotra, two miles higher up the stream, is a much larger village, having a population of 1,258; but here only 1 2 cases of cholera occurred, 4 of which were fatal. The village is a little removed from the river, and the greater part of the population draw water from a very fine well in a garden outside the village ; but the people living near the river draw water from it, and all resort to the river for washing and bathing. The first person attacked with cholera was a girl living in the part of the village near the well, but all the other cases occurred among the people using river water. Bhimgaon, the village on the bank of the river next below Chupa Deori, also has a good well in a garden, from which the general population draw their water ; the Balahis, or low castes, of which there are two families in the village, were the only people using the water of the river. The only persons attacked with cholera, were the Kotwar or village messenger, and his son's wife, both Balahis ; these cases were not reported at the time, and the date on which they occurred was not given. At Nahur Kolla, two miles below Bhimgaon, there was no cholera; the people depend upon the river entirely for water ; but between the bank, and the stream there is a wide bed of sand and shingle, and the people draw their water from holes dug in the sand instead of direct from the stream. At Gadrapur, opposite to Nahur Kolla, the stream runs directly under the bank, which' is rocky, and the people are obliged to draw direct from the stream ; here six deaths from cholera occurred between the 17th and 29th May. At Nyagaon also the conditions of 98 water-supply were similar to those of Gadrapuf, and here five deaths from cholera occurred in the same week. 283. Running parallel with the Gunjal is a stream on which the villages of ISfirkhi, Bissonee and Sohpur are situated. At Nirkhi it is little more than a stagnant nala, but the water is deep and is said to last throughout the hot weather. In the hot weather of 1875 this nala formed the chief source of water-supply of the village j there was a small well in the malguzar's enclosure, but it was not accessible to all the population. Cholera broke out here on the 1 3th May, and it was said to have been imported by persons from Ghupa Deori; the out-break was very severe ; 59 cases, 29 of which were fatal, occurring between the 13th and 29th May in a population of 371 ; 38, or two-thirds of these cases, were reported in the week ending the 22nd May. After this severe visitation, the malguzar cleaned out and put in repair an old well not far from the nala, and was constructing a new one when I inspected the village. A little below Nirkhi the stream is joined by another larger one, and the combined stream under Bissonee and Sohpur has a fair volume of water. Cholera appeared in both these villages on the 14th May, but in neither was the outbreak severe. In Bissonee there were 4 cases, none of wjrich were fatal. At Sohpur, 20 cases, 8 of which were fatal, occurred in a population of 1,764, Sohpur is the bazar town for the villages in this locality, and the bazar day fell on the 12th, the day but one before the first cases of cholera occurred there and in Bissonee and Groraria. 284. The village of Groraria is situated on high ground at the edge of a deep water-course or nala. This nala when I inspected the place in January was nearly dry, and in the hot weather would be quite so ; the water-supply of the place is drawn from two wells, one on the bank of the nala opposite to that on which the village is situated, the other close to the edge of a smaller nala which contained pools of foul stagnant water, and was apparently the latrine of the village ; the water in this well was on the same level as the foul water in the nala, and there was not more than 6 feet of soil between them ; the mouth of this well was flush with the surface of the ground, and quite without protection. The out-break of cholera in this village was terribly severe, and all who suffered drew water from this well; there were 62 cases, 40 of which proved fatal, from a population of 486 ; the first 2 deaths occurred on the 14th, 5 on the 15th, 5 more on the 16th, 19 on the 17th, 7 between the 18th and 20th, 2 occurred subsequently, the last on the 28th. The people said that the bodies of those who died were buried, and the same was said at Sohpur and other villages j but the custom of throwing bodies into the sacred JSerbudda and also occasionally into others of the larger rivers, though strictly forbidden of late years, has not been wholly suppressed even in British territory ; no preventive measures are in force against it on the otfyer side of the river, and it is possible that the prevalence of cholera in the cluster of small villages on tlie Nerbodda that followed the out-break in Sohpur and CJoraria may have resulted from, infringement of the orders against this custom. Two deaths from cholera occurred in the village of Chandgarh, the point on the river nearest Goraria, one on the 18th May, and the other on the 20th ; and at Bhilia-aheer, the nearest point to Sohpur, 4 deaths occurred in the same period. At the village of Bhainsadehi one and a half mile from the river, three deaths from cholera occurred, one on the 28th, one on the Ist June, another on the 6th. At Chandpura, the point on the Nerbudda nearest to Bhainsadehee, one death from cholera occurred on the 30th May, another on the 2nd June ; and on the 4th June three more deaths occurred at Bhilia-aheer below Chandpura, an interval of 15 days having elapsed since the deaths that occurred in this village between the 18tji and 20th May ; altogether in Bhilia-aheer 7 deaths occurred in a population of 131. The villages on the bank of the Nerbudda are entirely dependent on the river for water ; the pools m the river are of great depth, and in the hot weather the current through them 99 Is very slow in many places under the banks where the current sets towards the opposite sicle, there is scarcely any movement. Bhainsadehi is a larger village than Goraria, but only 3 deaths from cholera occurred in it, one a Kajput, the other two low castes. There are two good wells in the village which supply the upper caste with water, but the low castes are obliged to draw water from holes dug in the bed of the nala below the village. The village of Chapragahun, which lies between Goraria and Sohpur, escaped the epidemic altogether in 1875, so also did Pugdhal near the railway. At Golegaon, to the east of Nirkh, one case occurred on the sth June. These villages have good wells, and the water-supply is fair. Pugdhal, however, suffered to some extent from cholera in the hot weather of the following year, when the epidemic again spread over this part of the district ; 9 cases occurred between the 19th April and 13th May, and 5 in the week ending the 15th July, but of these 14 cases, only 2 proved fatal ; in Kotra also there were 12 cases and 2 deaths in May 1876 ; and in Bissonee, 4 cases and two deaths ; but in Chupa Deori, Nirkhi, Goraria and the small villages on the Nerbudda which suffered so severely in 1875, not a single case occurred in the following year. 285. In the latter end of May 1875 and beginning of June the epidemic spread to a group of villages on the Gunjal and its tributary the Moran nearer the hills than the group just described. The village of Bhadogaon on the Gunjal was the first attacked, and here 22 cases of cholera, 12 of which were fatal, occurred between the 26th May and the sth June ; a Constable sent out to report found a dead body in the river. On the Ist June 2 cases occurred in Lilaria, a collection of huts a little below Bhadogaon, containing only 15 persons. On the same date also the first of these cases occurred in the village of Sontarai, to the west of Bhadogaon ; and on the 3rd the epidemic appeared in Lokartalai, on the Moran river. The bank of the river on which Lokartalai is situated rises 40 feet above the stream, which here forms a long still pool ; the smaller village of Soorujpur is on the opposite bank at the lower end of the same pool ; both villages tire entirely dependent on the river for water, and draw direct from the pool. In Lokartalai, 51 cases of cholera, 18 of which were fatal, occurred between the 3rd and 15th June in a population of 859 ; and at Surujpur, 33 cases, 10 of which were fatal, occurred in a population of 223 between the 6th and 15th. Heavy rain fell over the Betul hills where the Moran rises, between the 12th and 15th. The village of Bankabhairee, on the bank of the river, about a mile below Surujpur, escaped cholera in 1875, but suffered severely in the following year. 122 cases were reported between the 23rd April and the 27th May, but 19 only proved fatal ; in this year only 2 cases occurred in Lokartalai, and none in Surujpur. The population of Bankabhairee in 1872 was 720 ; the village is on a very high bank, some 60 feet above the river bed, and there being a wide expanse of sand and shingle between it and the stream, the people draw their water from holes or jhiriahs dug in the sand near the edge of the stream ; no rain fell in the valley or over the hills above, prior to or during the time that cholera prevailed. In 1875 cases occurred at Kanipur and Nowalgaon, villages four and five miles below Lokartalai, but none were reported from these villages in 1876. 286. The town of Seoni has a population of nearly 8,000 ; the drainage oi the site is defective, and in the rains much of the ground around lies wet and swampy ; there is a stream on the west side of the town, but it ceases to run in the hot weather; the water-supply of the people is drawn almost entirely from wells. There are between 50 and 60 wells in the town, all of which have good masonry tubes ; in December the water level in these wells was on the average about 10 feet from the surface of the ground ; in the rains it rises to within 4 feet ; towards the end of the dry weather it falls to 12 or 14 feet, and a few of the wells run dry, but there is no scarcity of water at any time. The place is considered malarious and unhealthy, but cholera does not often prevail with seventy. 100 In 1869 61 deaths from this cause were registered ; the greater number occurred in the months of iMay and June before the rains set in, and among the low castes using water of the stagnant nala. At that time also many of the wells were out of repair ; since then the conservancy arrangements of the town have been greatly improved, and the wells have been cleaned out and repaired. In 1875, as before described, cholera was brought into the place by the ballast coolies from Harda ; but besides the coolies that were then attacked only 9 cases were reported from town, 3 of which were fatal ; these cases occurred between the Ist May and the sth June. In 1876 24 cases, 11 of which were fatal, occurred between the 13th and 27th May, and 2 subsequently, one in June, the other in July. Chuttiskhera was the only village in the neighbourhood of Seoni that suffered from cholera in 1875, and it was said to have been imported by coolies from the railway. Four cases occurred in the week ending the 15th May. At Nundurwara, to the south of Seoni, one case occurred on the 19th May. In 1876 the epidemic reached this part of the district a month earlier, and having more time to spread among the villages before the rains set in, the number that suffered was much more numerous. In 1875 10 villages in the northern and 7 in the southern circle were visited by cholera ; in 1876 25 villages in northern and 26 in the southern suffered (see Appendix IV. page 5). 287. Map No. IV. gives the eastern portion of the Hoshangabad district ; for the purpose of collecting vital statistics this portion of the district is divided into five circles. The Hoshangabad, or sadar circle, includes the villages to the west of the Tawa river and also a few villages near the Nerbudda to the east of the Tawa ; the Babai circle includes the villages reporting to the Sangakhara and Bikor out-posts and a large number of villages in the Dinwa valley j the Sohagpur circle, which extends from the stream east of Semree to the Komi river ; the Bankhiri circle takes the countries between the Komi and the Doodhi rivers ; and lastly the circle of Singhnama takes the villages in the upper portion of the Denwa valley and the Pachmarhi hills. The annexed Statement gives the mortality in each village visited by the epidemic ; the number of the villages and the total population in each circle will be found at page 5 of Appendix Tyx This division of the district is more densily populated than the western division, the villages are larger and nearer together ; its physical characteristics also differ slightly from those of the western section ; the valley is somewhat narrower, and as the rivers receive the drainage of the Mahadeo group of the Satpuras, the formation of which is sandstone, the beds of the river are formed^ of deep sand, the water almost disappearing in the hot weather, but always obtainable a foot or so from the surface ; the soil also near the river contains a larger admixture of sand and is more porous. 288. Cholera made its first appearance in this part of the valley along the line of railroad. On the 3rd May, and again on the 11th, travellers who had passed the previous night at Harda were taken out of the train suffering from the disease at E tarsi ; they were carefully isolated in a hut provided for the purpose, and no other cases among the residents followed. On the 18th a Bania travelling from Harda towards Jubbulpore was seized with cholera while in the train and taken out at Sohagpur ; the usual precautions were taken, and do cases occurred among the residents during the next ten days. By this time, however, the coolies employed on the line had been the means of conveying the infection to several villages in this part of the district. After the out-break in the gang employed in ballasting between Harda and Seoni on the 29th April the coolies dispersed, and were said to have gone eastward ; on the sth May the Head Constable at Bagra telegraphed to the Inspector at Harda that two men had died from cholera in the gang employed at the former place ; on the 12th, a party of coolies arrived ac the Piparia station, two of them suffering from cholera; by the 15th seven case* 101 No. X V l L— Statement of villages attached with Cholera in the eastern section of the Hoshangabad District. Town or village. is Date of Ist case ฃ"ง S Duration of fiemarkg. aj *5 reported. "2 2 'a epidemic. ฆa Bi 1 ง a 5 _* a a f Itarsi ••• 1,67.5 3rd May 2 2 ... Travellers. Mukoriya ... 470 12th „ 1 ... ... The person attacked ChulaChoure ... 366 19th „ 30 20 ... was returning from Gora ••• 915 25th „ 38 21 10 days. a village near Seoni. Chandla ... HI 2nd June 1 ... Hoshangabad Town ... 5,301 sth „ 24 14 7 days. „ Cantonment ... 2 1 3 Dungerwara ••• 624 12th „ 11 ซ Raipur ... 2,438 14th „ 11 O Sawulkhera ... 580 15th „ 1 ... P Doloriya ... 1>874 29th May 119 60 2 months. ซ<{ BheraKheree ... 319 29th June 17 11 14 days. p Soopurlee ... 332 7th July 3 5 Khurkheri ... 890 24th „ 1 1 w Amanpoora ••• 211 31st „ 11 ft Simree ... 1,032 7th August 2 1 BunmuDgaon ... 662 12th „ 8 4 8 days. Moharee .. 794 26th „ 11 Kulmamra ... 202 23rd June 1 ... Putlai ... 158 6th July 1 ... L Saenkhera ... 1,630 Ist Septr. ... 14 10 days. Babai ... 3*960 23rd „ 74 34 24 days. 3 Chowrahet ... 1,239 26th Septr. ... 18 From 26th Septr. to 2nd +4 r Octr. and 6th Novr, to W 13th November. Jhalsur ... 158 22nd „ ... 3 Munwara ... 789 13th „ 13 10 6 days. Pulnee ... 1,250 31st October 3 1 I. Talkerhi ... 612 6th Novr. 18 15 6 days. f Powsar Pipureea (Railway Station) ... 1,141 13th May 10 5 10 days. Hutwas ... 1,327 22nd „ 2 1 Sitaree ... 105 19th „ 4 2 Thingawarie ... 121 19th „ 7 2 Pondie ... 315 15th ? 25 11 10 days. Kujrota ... 243 23rd „ 4 2 2 Tenghara ... 371 sth June 4 1 3 Mancha ... 1,040 sth ... 4 Semree (near Mancha) ... 331 ... 1 1 g Bhutgaon ... 1,177 sth „ 5 2 gซ{ Agarah (near Bhutgaon) ... 493 sth „ 2 2 j_j Sohagpur Town and Rail- 28th May and the water-supply is drawn from wells, of which there are many in the town, but when I inspected the place the greater number were out of repair ; there is a nala outside the town, but it .contains water only in the rains ; the place was very foul and offensive. 293. At Sohagpur, which is the chief town of this part of the district, the first case of cholera as before described, was that of a $ania, who was taken out of the train on the 18th May suffering from the disease. IJaving passed the previous night at Jlarda, the man died on the 19th ; the usual precautions were taken, and no cases occurred among the residents during the next ten days ; but on the 28th tjhe epidemic broke out among the people living in the neighbourhood of the railway station. 12 cases only, 2of which were fatal, occurred on that day and the next, and 3 cases were reported in the following fortnight ; there was again a slight out-break when the rains first set in, 8 cases being reported between the 3rd and 12th July. A third out-break (this time in the town) occurred in October after the rains had ceased. 27 cases were reported in -the week ending the 16th, and 21 in the course of the following fortnight. The stream that flows past Sohagpur has only a short course, and almost ceases to run early in the dry weather ; it is then dammed back and a long popl formed ; the water of this pool is used for washing and watering cattle, and by the lower classes for drinking. On the west, or station side of the river, there is only one well, and that is very deep ; in th,e town, the site of which is lower, the wells are numerous, but the soil is sand} T and porous, and many were dry in the hot weather. Sohagpur has suffered severely from cholera in all epidemics of which •there is record ; it is liable to it at all seasons, but it prevails :nore severely in the hot weather. The following figures give the epidemic prevalence at the different seasons in the throe epidemics of 1869, 1875 and 1876 :—: — During the hot Daring .the rains After the raine. Total weather. Cases. Deaths. Cases. Deaths. Cases. Deaths. Cages. Deaths. 1869 ... 13J 78 131 78 1875 ... 15 % 8 5 48 21 71 28 1876 ... 65 36 24 14 ... ... 89 50 Total ... 211 116 32 19 48 21 291 156 106 A fortnight after the out-break at the Sohagpur station in the end of May 1875 the rains set in, and very few villages in the Sohagpur circle besides those abovementioned suffered from cholera in the hot weather of that year. A single case occurred at Gol on the 29th May between the 31st May and the 12th June. Wine cases were reported from the village of Pala Deoie ; and on the 12th a single case was reported from the village of Sutwasa, on the Nerbudda, four miles east of Sangakhera. 294. The Babai circle also sufferred but little in the hot weather. One case was' reported from the village of Aree, midway between Babai and Cheela Chown on the Bth June, and 2 cases from the small village of Bankhen, on the Nerbudda, between 16th and 19th; on the 23rd there was a case at Moondepar, and between that date and the end [ of the month 6 cases occurred at Kajulkree ; by this time the rains had set in, and through July tins circle remained free of cholera. It will be remembered, however, that a violent epidemic out- break had taken place in Doloriya in the last week of July, and that it continued prevalent there and in the neighbouring villages through August. On the Ist August a case was registered at Bikore, and in the week ending the 26th August the disease became epidemic in the town of Babai, the first case occurring on the 23rd; between this date and the 18th September 74 cases were recorded, 34 of which were fatal. The water-supply of Babai is derived almost wholly from wells ; the soil for a few miles to the east of the Tawa river is much mixed with sand, and is therefore more porous than in other parts of the valley. The prevalence of cholera in 1875 was confined to two sections of the town, one in which the malguzar's house is situated, the other a suburb inhabited by Brinjaris. "When I inspected the town it was fairly clean, but there were foul puddles round some of the wells. The depth of the water from the surface in the rains is less than 20 feet. From Babai the epidemic apparently spread to several other villages ; on the Ist September it appeared in Sanghakhera, on the other side of the Tawa ; on the 13th and 22nd in Jhalum and Marwara, tc the north of Babai ; on the drd and 4th September cases occurred in Chichliand Buruhowie, two villages on near the road to Sohagpur; in the end of the month it became epidemic in the villages of BaharpurandChourahit; on the sth and 7th October it appeared in Banskapa and Bode, villages between the road and railroad and within a short distance of Sohae-pur- and on the 16th it re-appeared in that town. On the 22nd 4 deaths from cholera were reported from the village of Gondeekhaire, in the jungle to the south of Sohagpur. On the 3lst cases occurred in Patmi, near Sanghakhera ; and between the 6th and 1 3th November a severe outbreak occurred in Talkasi, in the same neighbourhood. The last appearance of the disease was at the small Gond village of Bori, in the jungles to the south of Hutwas ; here 13 out of 91 inhabitants wereฐattacked on the 17th and 1 8th December, and 10 died. This village is described as situated on a hill surrounded by jungle, the soil sandy, the water-supply drawn from a pool in a nala with a very small stream running through it, the nala and the ground around much defiled. 295. Although there were several severe outbreaks of cholera in this part of the district in the hot weather, they did not occur till towards the end of this season In no large centre of traffic and population did the disease become prevalent till the end of May or beginning of June, and by the 15th June the rams had set in • the epidemic had therefore only a short portion of the season most favourable to its spread remaining. During the rains the towns of Doloriya and Babai became centres of infection, and a number of villages within their influence suffered but altogether the epidemic of this year was confined to a few localities. Gondeekhera and Bori were the only villages in the jungle tract under the hills that suffered, and the population in the valley of the Denwa escaped entirely. The circle of 107 Bankheri, the easternmost circle of the district, remained entirely free ; but to the east of the Doodhi river, which forms the boundary between the Hoshangabad and Narsinghpur district, the epidemic became slightly prevalent in June. MAP No. V. 296. This map refers to an out-break of cholera that took place in the end of the hot weather of 1875 in the Narsinghpur district near the Doodhi river, which forms the boundary between that district and Hoshangabad. In Map No. IV. it was shown that cholera did not in 1875 spread into the Bankheri circle of the Hoshangabad district, which lies on the west of the Doodhi; and prior to its appearance in the villages shown in this map not a case had occurred in the Narsinghpur district on the east of the river ; it had, however, reached some villages iv the Bhopal territory to the north of the Nerbudda. On the 31st May a man of the Teli caste came from the village of Sunnapur in Bhopal to Detpur ; he was raken ill after crossing the Doodhi at Anjundeh, the village above Digsura, but came into Detpur ; there he died the next day, and his clothes were subsequently washed in the Oomur steam, on which all these villages are situated. No cases of cholera occurred among the inhabitants of Detpur ; but on the 4th and sth June 5 cases occurred in the village of Dhanora, 3 of which were fatal ; on the 10th 4 deaths from cholera were reported at the Saenkhera station from the village of Khairi, the first case having occurred on the Bth or 9th; and on the 11th 3 deaths were reported from Saitan, a woman of the Ahir caste and two Chamars. The woman had been to Khairi and back the day she was taken ill ; one death occurred subsequently at Dhanora. These four villages are at some little distance from the Oomur river, but the soil on which they lie is nearly pure sand, the water is at a great depth below the surface, and welJs could not be constructed without engineering appliances ; they all therefore depend entirely on the stream for water. Detpur and Dhanora draw water from opposite sides of the same pool, but Dhanora from a point a little below Detpur. Khairi is less than a mile from Drnmora across the land, but considerably more by the stream ; Saitan is about a mile from Khairi. When I visited these villages in December there was a good stream running, but in the beginning of June it would be very small ;at this time the people dig holes or jbiriahs in the sand at the edge of the stream, and each caste has its separate jhiriah. Of eight persons attacked at Dhanora six were Gonds. Of 40 houses in the village the Gonds occupy 7 only. At Khairi of the 7 persons attacked all but one were Brahmins. One of the fatal cases at Khairi was a. child recovering from small-pox. The population, cases, and deaths in each village were as follows :—: — Cholera. Detpur ... 441 1 1 Dhanora ... 337 8 4 Khairi ... 237 7 4 Saitaa ... 309, 8 3 \ ฆ Saenkherahas a population of nearly 3,000, Banwari over 1,500; but in neither of these places nor in any other of the neighbouring villages did a case of cholera occur at this time. Six or seven weeks later cholera became prevalent in a few villages in the adjoining circle of Panagarh ; and between the 19th and 22nd August 2 cases, neither of which were fatal, occurred in the village of Digsura. 108 MAP No. I. 297. This map shows the prevalence of cholera on the Byranjh river, which rising in the hills in the south of the Saugor district flows through the range that separates the Saugor and Narsinghpur districts, and after crossing the narrow plain south of the hills joins the Sindhore, a tributary of the Nerbudda. Sahijpur is situated on high ground, the land around is good wheat land, and well cultivated. The plain to the south of the hills consists of stiff clay soil, very suitable for wheat, and in years when the rain-fall of the monsoon has been abundant yields excellent crops. Owing, however, to the rapid slope of the plain towards the Nerbudda, the land near the river is greatly intersected by ravines and a considerable area thereby rendered unculturable. At Oomurpanee, near the edge of the clay deposit, excellent iron ore is found; this is excavated and taken to be smelted at Tendukhera, which from its situation close under the hills has an abundant supply of wood. The Byranjh river retains a fair supply of water even in the hot weather ; it flows between high clay banks and over a bed of coarse sand and pebbles. The majority of the villages on this tract of country have good wells, but the water is very deep below the surface ; and in the hot weather the wells are useless, they happen to be near a river, run very low, and water becomes generally scanty. The population of this tract suffers severely from cholera in epidemic seasons, but the time most favourable to its prevalence is the hot season. The following figures show the monthly mortality from cholera in the Birman circle of the Narsinghpur district (of which the area given in the map south of the hills forms a part) in the three years 1869, 187*5; 1876. Year. April. May. June. July. August. September. 1869 ... ... 3 77 476 61 1 ... 1875 ... 10 51 1876 ... 343 585 79 12 When the out-break occurred in 1875, the season most favourable to the prevalence of cholera had passed ; the epidemic continued only for ten days or a fortnight, and was limited to the villages on the Ifyranjh river. 298. The following statement gives the number of deaths reported from each village that suffered :— Number District. Population. Date of Ist case. of deaths reported. Sahijpur ... ... 1,455 14th August ... 15 Nadia ... ... 172 24th „ ... 2 Imjlrana ... ... 1,126 23rd „ ... 12 Esurpur ... ... 763 sth September ... 20 Imulleea ... ... 350 6th „ ... 5 Kalheri ... ... 3GO „ „ ... 5 Tekapar ... ... 471 26th August ... 9 Bhama ... ... 720 6th September ... 10 Prior to the out-break at Sahijpur cholera had been prevalent in Bhopal and also in the Narsinglipur district south of the Nerbudda; but it had almost ceased in both localities, and no evidence of its importation into Sahijpur could b& traced. 109 So also with regard to Imjhuna, no direct evidence of importation was obtained; there are, however, circumstances that point to importation from Nahijpur. The malguzars or proprietors of the two places bein^ influential persons of the same caste (Lodhis) and near relatives, there was frequent communication between them, and the first person attacked with cholera in. each place was a Lodhi. Major Loch, the Deputy Commissioner of Saugor, who inspected Sahijpur and Nadia not long after the out-break, states that both villages were clean, excepting that at Sahijpur in the rains, where the brook is too full to allow of the people crossing it, the ground between it and the village is much fouled. There are several good wells in the village, but the water of the brook is also used by some castes for drinking and by all for washing. Nadia consists of two small hamlets, one on the bank of the stream, the other three-quarters of a mile distant, and drawing water from a well ; the two deaths from cholera reported occurred in the hamlet on the brook, in the other there was no cholera. At Dholee, on the stream 3 miles below Nadia, there was no cholera ; the population of this village numbers 220, and they have a good well; the first village on the stream after it has passed through the hills is Kummurea, which has a population of 465, there are good wells in the village, but a numerous caste (Dbanooks) living close to the river draw their water from it ; here also there was no cholera in 1875. Imjhuna with the adjoining hamlet of Kairooa lies on high ground above the stream, and is well drained on all sides by ravines and water-courses ; there are numerous well?, many of them on the bank sloping towards the stream, and the water in them being at a moderate depth from the surface, they form the chief sources of supply ; the women, however, resort to the stream tor washing clothes and drawing water for domestic purposes, and they were the chief sufferers from cholera. The first attacked, as I have above stated, was a man of the Lodhi caste j a woman of the same caste was one of the next persons to suffer, but nearly all the others were women of the more common castes. Of 15 persons attacked, 5 were males and 8 females above 12 years of age, 2 were children. At the three next villages, where the conditions of water supply- were much the same as at Imjhuna, the greater mortality among the women was even more remarkable at Esurpur. 20 deaths were reported, 8 males and 12 females ; the first case was that of a man who was taken ill while out tending cattle near the bank of the river, the next was a man living in the same house with the first ; of the remaining 18, 3 only were adult males, and of these, 2 were Chamars who would not be allowed to draw water from the village wells ; the other 2 males were boys of 8 and 10. Of 5 who died at Imulleea, 3 were females and 2 males, and of the latter one was a Chamar. Of 8 cases at Kulheri, not one was an adult male, 4 were women, 2 girls of 6 and 7 years, and 2 boys of 4 and 5 years. Tekapur is situated on very high ground, and water not being obtainable fron wells, the people depend entirely on the stream : I was told tit the other villages that cholera had prevailed very severely here, but the malguzai had concealed the fact and reported the deaths as deaths from fever. 9 deaths were entered in the register kept at Dobhee as having occurred in Tekapur between the 26th August and 9th September ; of these 7 were males and 2 fem;iles. Judging by what I was told, the number of deaths from cholera in this village probably exceeded the number entered under the head of fever. Gunjee consists of two small hamlets some distance apart, with from 10 to 15 huts in each ; at each hamlet there is a good well with water in January less than 10 feet from the surface : no cholera was reported from this village. At Bhama there are wells, but they are deep, and they had not the appearance of being much used: of the 10 persons that died here, 2 were adult males, 4 adult females,, 2 boys and 2 girls. Manukpur lies at some distance from *>hv stream, and the chief source of water-supply is a well sunk in low ground about 200 yards from the edge, and in January the water in this well was close to the surface. In the rains the ground between this well and the river would be swamped ; no cholera was reported. In Bikor also, which is on the Sindhore river below the junction of the Byranjh, there was no cholera. 299. Tn 1875 the prevalence of cholera in this circle was confined to these villages on the Byranjh river, but in 1870 the epidemic reached this part of the 110 district before the monsoon rains had set in, and in the course of June and July a very large number of villages suffered, many of them very severely. Of 71 villages that report to the Dhobhee outpost, 20 were affected ; and in the village of Dobee, which has a population of 2,3(50, 143 cases ot cholera, 67 of which were fatal, occurred between the 7th and 30th of June or before the rains set in. Of 34 villages that report to Tendukhera, 23 were visited by cholera in 1876 ; and in Tendukhera itself 162 cases, 102 of which were fatal, occurred in a population of 3,034 in the month of July after the rains had set in. The water-supply of Dobhee is drawn chiefly from wells, in which the water in January was 30 feet from the surface ; in the end of the hot weather many of the wells were dry, and in 1876 the monsoon rains were very late and did not set in till the end of .June. Tendukhc ra depends for its water-supply on wells sunk at the edge and in the bed of the stream that joins the Byranjh two miles lower down ; in the hot season this is a dry water-course and much defiled. 300. The following* Statement shows the number of cases of cholera in 1876 in the villages on the Byranjh south of the hills, referred to in the above account of the outbreak that occurred in 1875. Cases reported in the week ending 3rd 10th 17th 24th Ist Bth 15h 22nd 29th sth Khummurea ... 28th June. 2 9 3 5 3 ... Imjbuna ... 10th „ ... 1 7 ... 5 1 Isurpur ... 29th „ 2 2 81 1 Emullia ... 6th July. 7 4J Kalheri ... 26th June. 2 7 7 Tekapar ... 7th July 2 2 4 ... Bhama ... ... Manukpur ... ... ? Notwithstanding that cholera was raging at Dhobi, a few miles off, these villages remained free until the latter end of June with the exception of one case at Imjhuna ; but when the rains set in all that had suffered in the previous year with the exception of lihama were again almost simultaneously affected, but the prevalence was comparatively slight. 301. The sketch on the other side illustrates a remarkable out-break of cholera that occurred in the cantonment of Jubbulpore in September 1875. A sepoy of the 24th Bombay Native Infantry returning from leave from Sialkot arrived at Jubbulpore on the evening of the 27th August; he had left Sialkot on the 24th, and symptoms of cholera had come on while he was in the train. On arriving at Jubbulpore he put up for the night in the serai near the railway station, but on the following morning (28th) he was taken to the hospital of the 16th Madras Native Infantry; he was at first put into a separate building, but was subsequently removed to a tent on the edge of the stream that flows past the hospital, where he lay till the 30th, when he died. The hospital sweeper was directed to take the excreta of the patient across the stream and bury them. On the banks of the stream some 300 jrards below the point where the tent was pitched were a few huts, one on the right bank occupied by a sweeper (not the sweeper employed in the hospital), 8 or 10 on rocky ground above the left bank occupied by Bassores or basket makers ; these huts form a separate hamiet at a little distance from the village of Kuttungha. On the Ist September cholera brokeout among the inhabitants of these huts, nine cases occurred among the Baseores, one on the Jst September, another on the 3rd, six on the sth, and one on the 9th ; seven of these were fatal ; the wife of the sweeper living in the hut on the right bank was attacked and died, but the date of her case was not given by the police. PORTION OF THE CANTONMENT OF JUBBULPORE. Scale 8 inches = 1 Mile. 111 The village of Kuttunghais situated on dry sandy soil ; when I subsequently inspected the place it was not as clean as a village on the outskirts of a large military cantonment should be ; the Bassores' hut had been burnt after the outbreak, but the site was a healthy one, rocky, dry and well raised above the stream. The water-supply of the village of Kuttungha is derived from wells ; but the Bassores as well as the sweepers, being low castes, were not allowed to draw water from the village wells ; they said they did not drink the water of the stream, and pointed out as their source of supply a square pit with some water at the bottom, which they called a well. The sweeper also pointed out a similar pit on the right side of the stream as his source of supply : the muuth of the sweeper's pit was over-grown with weeds, and showed no sign of being resorted to ; the water in both pits was disgusting in appearance, while that of the stream was clear and sparkling. It is generally difficult to get at the truth from the natives in these matters, and as the Bassores' huts had been razed on account of this out-break of cholera, the difficulty was in this case enhanced ; but admitting that in this case links in the proof of communication by water are wanting, it does not seem to me that all connection between the case of the sepoy and the out-break among the Bassores can on this ground alone be denied. The cantonment of Jubbulpore contains a population of over 16,000, the adjoining city 45,000 ; the district extends over 2,000 square miles and contains over 1,600 towns and villages. With the exception of two travellers who arrived by train in the town of Jubbuipore sufferirig from the disease, one in the preceding April, the other in May, not a single case of cholera had occurred in any of the above communities lor two years prior to the arrival of the Bombay sepoy on the 27th August; in fact at this time the Byranjh river, the out- break on which has just been described, was the nearest point at which cholera was prevalent, and that is 80 miles distant; under these circumstances it is difficult to reject the inference that there was some material connection between the case of the sepoy and the out-break among the Bassores, and it seems most probable that the water of the stream was the medium of communication. The epidemic did not spread beyond these huts. On the 27th September and again on the 23rd, pilgrims bound for Mecca arrived at Jubbulpore by rail suffering from cholera, but they were isolated, and no other cases followed. 302. Maps Nos. V. and VI. and the sketch just referred to illustrate a slight local out-break that occurred in the upper portion of Nerbudda valley in 1875 ; it did not in that year become prevalent to any extent anywhere east of the Sohagpur circle of the Hoshangabad district (Map IV). We shall show presently that the dry season is the most favourable for the spread of cholera in the Nerbudda valley. In 1875 the epidemic did not enter the populous portion of the valley till the end of April, or till the hot season was far advanced ; this was shortened by the early arrival of the monsoon rains, and under these circumstances the epidemic obtained but little hold on the population, and its prevalence was confined to a few localities. In 1876, on the other hand, the epidemic entered the valley five weeks earlier, and the hot season was prolonged by unusual delay in the arrival of the monsoon rains. The manner in which the epidemic entered the valley was also very different in 1875, it was brought by rail to a railway station in the lower part of the valley and was from thence conveyed to other places along the line, but it was possible in nearly all cases to adopt measures of isolation, and in fact in none of the large towns in the valley did cholera become epidemic till late in the season or until the rains were on the point of setting in. In 1876, on the other hand, cholera was brought into the middle and more populous part of the valley by the immigration into it from an infected district of a considerable body of people employed in the harvest and working with the resident population of the district ; by their means numerous centres of infection were at once formed ; the chief town of the district became involved a few days after the first out-break and other towns quickly followed ; the epidemic thus obtained a strong hold on the population in the centre of the valley, and from this locality 112 it spread in all directions. It has been averred that cholera does not spread, that it never radiates from a centre, but the epidemic of 1876 in the Nerbudda valley affords a remarkable instance of its doing so. In Map No. 1 8, the Nerbudda valley may be seen extending between the Vindyas and Satpuras from Jubbulpore and Patun to Khandwa and Dhungaon in the district of Nimar, a distance of nearly 300 miles. The dates given in the map indicating the first appearance of cholera in the different registration circles show one consecutive series extending eastward from Hoshangabad (where the epidemic entered the valley from Betul) as far as Jubbulpore, and another extending westward from the same point as far as Khandwa and Dhungaon ; Jubbulpore and Khandwa at either extremity of the valley being reached by the epidemic at about the same date in the beginning of July. Six cases of cholera had occurred in April in a town of Nimar in which cholera had prevailed severely in the previous year (page 83) ; but with this exception the whole district had remained free till July, The Rewah epidemic had "crossed the low hills that form the water-parting of the Nerbudda and Sone rivers in May, and some villages in the Sihora circle north of Jubbulpore had suffered (pages 46 to 48), but the circles of Patun and Jubbulpore, which comprise the upper portion of the Nerbudda valley, had remained free till July. The spread of cholera from the centre of Hoshangabad in two opposite directions so plainly apparentin the map is equally evident in Statement No. XVII, which gives the monthly mortality from cholera in the 20 circles of registration into which this long tract of country is divided. The distance of the centre of each circle from the point of out-break is also given, and the date of the first cases of cholera. The first out-break occurred in the Hoshangabad circle on the 21st March, and by the dispersion of the party of immigrants in which it occurred, several villages of that circle became infected ; in the course of the remaining ten days of the month cases due to the same cause were also reported from one village in the Seoni circle to the west of Hoshangabad, from one in the Babai, and from one in the Sohagpur circle to the east. The circles west of Hoshangabad are much occupied with jungle, and the population being comparatively sparse, the mortality from cholera was proportionately less in these circles than in the more densely populated portions of the valley, but the evidence of the epidemic spreading westward is sufficiently plain. In the Hoshangabad circle the epidemic attained to a considerable degree of prevalence in March, and reached its maximum in April ; in the Seoni circle there was considerable prevalence in April, but the maximum was not reached till May. In Harda and Behatgaon no cases occurred till May, and the maximum of prevalence was not attained till June. The Charwa circle of the Hoshangabad district and Mundi circle comprise together a wide tract of jungle which is very sparsely populated ; only 5 deaths were reported from the Charwa, and one only from the Mundi circle. It is indeed probable that but for the assistance of the railway and pilgrims, the epidemic would not have passed through this belt of sparsely populated country. On the 6th July a man resident in the railway station yard at Khandwa was attacked with cholera ; on the 13th the epidemic appeared in a village four miles to the north of Khandwa, and in the beginning of August it broke out in a village in the Dhungaon circle on the road to the shrine of Onkar Mandhata. In the circles east of the locality of the first out-break the mortality was much greater than in the western circles, but the spread of cholera through them was not much more rapid ; it reached the Gadarwara circle, 75 miles to the east, about the same time that it reached the Charwa circle, 70 miles to the west. In the Sohagpur circle, a case due to importation from the place of the first out-break occurred on the 26th March, but no other case occurred till the 26th April ; the maximum of prevalence was attained in this circle in May ; in the next two circles no cases occurred till after the middle of May, and the maximum was not reached till the following month. In Karabgaon and Birman the first cases occurred in June and the maximum was reached in July. On the 29th May, after the epidemic had become prevalent in the western circle of the Narsinghpur district, a solitary oase occurred in the sadar town, but no epidemic out-break took place there till the latter end of June, and the maximum prevalence was not attained till the month 113 STATEMENT No, XV IL— Showing the spread of the Cholera epidemic of 1876 in the Nerbudda Valley. v — ' Deaths from cholera. Oso s IS 1 5 Circle. j -g ฃ Date of first case. . -? a ' * ฆs 3 SI 6 s j . s a s a 1 S. "-gi |i 1 I II ill t | I * If! I I 1 1 P I 1I 1 .( Dhuugaon ... 24,5*0 15010 th Augt. 32 37 8 77 313 45 0-20 %) Khandwa ... 53,836 115 13th July 14 80 34 7 135 251 C 3 024. HI Do. Town „. 14,119 ... 6th „ 1 5 2 8 -57 & [ Mundi ... 15,234 95 Ist Septr. 1 .".. 1 07 40 018; f Charwa ... 15,854 70 19th May 3 2 5 "S" S2 V Mandla ... 12,372 6319 th „ 9 13 7 10 39 315 | . Handia ... 22,410 561 11th „ 32 45 2 79 353 y 69 022 < Hehatgaon ... 20,860 5613 th „ 62 85 45 ... 4 196 940 | " Harda ... 96,762 50 2nd „ 83 136 2 6 ... 227 2'35J | <; Seoni ... 74,250 25 24th March. | 2 104 214 67 5 ? 392 5-28 82 023 1 I Hoshaiigabad ... 71,137 ... 21st „ 180 318 153 ;s8 40 5 ... 4 638 8-97) 9ni n .. ft o Babai ... 39,68b 1527 th /. 3 14 46 36 4 1 103 260 { 2Od ฐ o0 ' I Sohagpur ... 65,542 32 { *ป * \ 1 5 123 112 82 60 25 408 6-23 j m(^ I Bankheri ... 31,102 54 16th May ... 48 255 63 2 368 1183 ) f Gadarwara and Burha ... 93,458 75 18th „ I 41 871 613 82 1ซ 1,625 1739 ( 212 052 W Birman ... 52,661 90 Bth June. 343 585 79 12... ...... 1,019 19-35 193 0\54 jjf' rf .' Karabgaon ... 50,210 901.3 th „91 394 215 38 738 U7O \ % t ] Narsinghpur ... 74,650 105| | } 1 53 217 342 8 621 832 L 150 0"50 I Mungwaui and Chhindwara... 68,416 125 sth July ... 125 140 4 269 3 93 J , , .{ Patun ... 64,8541 13515t „ ... 104 138 15 ,\. 257 396) ฃ ฃ SU Jubbulporo Town ... 43,223 ... J7th „ 130 80 1 211 ; 488 V 173 0*69 *-> p 2 ( Jubbulpore .. 68,808 155 23rd „ ... 12 101 25 138 2-01 J S Total ...1,074,026 86 441 815 2,147 2,445 1,377 224 19 7,554 703 114 of August. The circles that became involved after the end of June, when the rains had set in, suffered compaiatively little. 303. The three following statements are given with the view of illustrating the manner in which the epidemic spread among the villages within the circles and the conditions of climate under which it prevailed. For this purpose I have selected thecircle of Hoshantrabad, in which the first out-break occurred; part of the Gadarwara circle in which the epidemic prevailed during the period of transition, from the hot dry season to the rains ; and the Nareinghpur circle, in which the epidemic did not become prevalent till after the rains had set in. To select for this purpose a circle at either end of the valley which had not become involed in the epidemic till the period of its decline had arrived could only mislead. The first appearance of the epidemic of 1876 in the Nerbudda valley occurred at the village of Bessarondah, 5 miles north-west of Itarsi (Map No. IV). A large party of hill men had come from the Betul district vid Shahpur (where cholera had broken out some days previously (para. 49), to assist in the wheat harvest, and had encamped outside the village, Since their arrival they had been employed in reaping the wheat at Bessarondah and other neighbouring villages, and while so employed had mixed with the resident population. Cholera broke out among the people on the 20th March and they at once dispersed, the majority making for their houses in the hills ; between the 20th and 27th cases of cholera were reported from 19 villages ; 11 of these belonged to the Itarsi, 3 to Kesla, which is on the road to Betul, 1 each to Doloriya, Seoni, Lokurtallai, (Map III.) Babai and Sohagpur. In 13 of the 19 villages the first cases were hill men belonging to the party in which the first out-break took place, in the remaining six the persons first attacked were residents, but hill people from the infected locality had previously come to the place. Of 39 villages reporting to the Itarsi out-post, 23 were visited. The Kesla circle lies among the hills, and contains only 15 small villages inhabited by Gonds ; the epidemic visited 5 villages, but in 2 only did the number of cases exceed one; none of the villages reporting to the sadar station were visited before the disease had become epidemic in the town. Of 60 villages reporting to the station-house, 13 were visited by cholera in the Doloriya and Babai circles. Although the epidemic was imported by persons from the scene of the first out-break, it did not spread till after the towns had become infected. 29 villages report to the Doloriya out-post, and of these 21 were visited. 13 villages report to Tegunia, but 2 only suffered. 122 villages report to the Babai station, but the grater number are in the Demva valley and in the jungles at the foot of the hills, and none of these suffered ; the 9 villages of the circle from which cases of cholera were reported were within 5 miles of the town. Of 14 villages belonging to Bikore, the large village of Sangakhera was the only one visited, and here only 3 cases were reported. Altogether the number of villages reporting to the stations #iven in the table amounts to 278, and of these 77 were visited by the epidemic in 1876. In several of the villages it prevailed with severity, in others only solitary cases occurred ; in many of these solitary cases no doubt the disease was not contracted in the village from which it was reported, but I have thought it better to let (hem appear in the statement. The duration of the epidemic prevalence in a town or village depends very much on the number of the population. In the town of Hoshangabad the maximum prevalence was not reached until the fourth week from the commencement of the epidemic, and cases continued to occur through, several weeks subsequently. In the villages all or the greater number of cases frequently occurred within the first week or ten days after the first case. In several instances a village was subjected to two distinct epidemic out-breaks, but in all these instances the villages were large and possessed more than one well or other source of water-supply. In Itarsi for instance the supply is drawn from wells, but the water of all the veells within the town is saline, and the people depend for drinking water on three or four wells sunk near the edge of nalas or ravines at some distance outside. 115 STATEMENT No. XVIII. — Showing the spread of the Cholera epidemic of 1876 in the Hoshangabad Circle. Cases of Cholera in week ending — XT , . .„ „ , ? „ , , , March. April. May. June. July. .Name of town or village. Population. Date of Ist case. t t i 18th. 25th. Ist. Bth. 15th. 22nd. 29th. 6th. 13th. 20th. 27th. 3rd. 10th. 17th. 24th. Ist. Bth. 15th 22nd. ฆ ltarsi Out-pott. — Beesarondah* ... 419 21st March ... 743 2 4 ... .20 BoriTalai* ... 404 21st „ ... 1 ... 3 ... 1 ... \. ... 5 Itarsi* ... 1,675 22nd „ ... 1222113110 3 9 1 81 Teeruthpur* ... 116 22nd „ ... 5 5 Mahiragaon ... 844 22nd „ ... 111 6 6 ... " .. 21 Rohinah* ... 453 23rd „.. 1 ... i Joogharpur* ... 672 24th „ ... 1 12 9 ... 2 5 1 \\\ 30 Taroondah ... 143 24th „ ... 3 ... 9 2 1 15 Eangaewah ... 270 25th „ ... 2 2 1 , ' '.. 5 Palasdeo ... 178 26th „1 ' ... 1 Pathrota ... 1,244 27th „ 8 1 9 Rasulpur ... 1,730 30th „ 1 3 7 11 13 Sonasamree ... 722 sth April 10 23 8 2 ... 43 Bhuttie ... 272 9th „ 1 '.' , ... . 1 Dehri ... 172 12th „ . 1 1 Barodhia Khurd ... 244 13th „ 2 9 11 Dhoorpur ... 127 15th „ ... 4 ... 4 Sontalai ... 733 23rd „ 6 " '.. 6 Sunkhera ... 1,630 11th May 1 2 6 19 11 ...I 39 Somulwara ... 517 11th „ 2 27 6 2 37 Ghatlee ?. 421 15th „ 1 '. 1 Cheepeekhapa ... 103 29th „ ... 3 3 Dhokera ... 800 Ist June ... 3 2 1 6 Kesla Out-post. — Morepani* ... 238 27th March 1 1 MadeeKho* ... 76 27th „ 1 [ 1 Sohali* ... 183 27th „ 8 8 Chunkar ... 15 26th April ... 1 1 Dhoatram ... 104 25th „ 9 9 Hoshangabad. Hoshangabad T. 15,301 30th March 1 13 21 20 30 16 9 10 5 .. 2 1 4 3 6 3 ... 144. Pawarkhera ... 170 sth April ' 3 2 1 6 116 STATEMENT No. JCFIZ/.— Continued. Cases of cholera in week ending — xr c x -ii t, i i.- t, l c c i March. April. May. June. July. .Name of town or village. Population. Date of first case. vj •> Total. 18th. 25th. Ist. Bth. 15th. 22nd. 29th. 6th. 13th. 20th. 27th. 3rd. 10th. 17th, 24th. Ist. Bth. 15th. 22nd. Andhiaree ... 182 Bth April 6 6 Malikheri ... 745 12th „ 1 1 2 Bhaikheri ... 626 16th „ 12 12 7 1 32 Phepurtal ... 536 21st „ 1 2 ... 3 Beyara ... 629 23rd „ 5 2 4 4 15 Raipur ... 2,438 29th „ 20 10 5 1 36 Pathroree ... 252 3rd May 1 , 1 Boodwara ... 308 7th „ 3 3 Puradah ... 346 Bth „ '.'. 1 1 Nitaya ... 336 14th „ 3 .. 3 Dasmonee ... 11l 20th „ 7 7 Dolariya Out-post — Bamooriyah* ... 146 27th March 11 15 ... 118 Dolariya ... 1,874 Ist 4pril 9 10 3 1 23 Amnopura ... 211 9th April 1 1 \ 2 Pathair ... 158 „ 8 8 Sooperli ... 332 12th „ 7 7 ... 3 17 Koondra Kheri ... 226 „ „ 1 ... 9 10 Doodoogaon ... 330 „ „ ... ... 1 1 Dhamnee ... 254 16th „ 9 12 ... 12 Pathlai ... 158 19th „ 1 ... 2 3 Soomulkhera ... 580 18th „ 1 1 Niyagaon ... 762 22nd „ 18 13 7 38 Kalmasura ... 202 27th „ 3 ... 1 4 Tekhur ... 776 28th „ 3 7 3 13 Moharee ... 794 29th „ 1 1 2 Sonkheri ... 179 Ist May 1 1 1 3 Chundpura ... 147 16th ',] 1 1 Chandwar ... 513 Ist July ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 18 18 117 PrnmlT + l Xซ 2Ofi r No. of villages. ... 9 IS 17 19| 19 23 20 19 12 7 5 4 3 3 5 2 4 ... 73 dOjiW \No. of cases. .. 22 74 98 104 92 169 109 75 57 36 13 11 21 16 7 24 9 ... 937 Mean relative humidity ... 27 32 28 16 16 16 19 22 26 31 31 46 36 58 62 56 76 88 89 ..'. Maximum ... 96j 97 97 103 104 112 110 111 113 106 112 107 112 1-09 99 104 99 88 S6 ..'. Direction ... NE NE NS NE W SE W W W W'NW NW NW W W W W W SW miles ... 109 62 45 83 105 76 39 59 69 115 88 141 86 130 172 128 148 148 200 Weekending ...18th 25th Is Bth 15th 22nd 29th 6thl 13th 20th 27th 3rd 10 17th 24th Ist Bth 15th 22nd March. April. May. June. July ? In these vilUgea the first oaies were hill men belonging to the party in which the first outbreak occurred. 118 At the foot of the statement, with the number of cases of cholera reported from the whole circle in each and the number of villages from which they were reported, I have given the meteorological conditions that obtained in the corresponding weeks. On referring to Map IV, it will be seen that the valley is at this point narrow ; the Vindyas rise immediately from the north bank of the river, and the distance from the river southwards to the foot of the Satpuras is not more than 14 miles ; the fall of the country towards the Nerbudda is rapid, the difference of level between the railway at 1 tarsi and the bank of the river being 70 feet, while from the top of the bank to tli6 water there is another fall of 70 feet. Nowhere within the area was the level of the subsoil water less than 30 feet from the surface, in many parts it was very much more ; we may therefore exclude changes in the level of the soil water from the possible conditions favouring the outbreak. No rain had fallen since the previous October, a period of between five and six months, during which the surface of the ground had been exposed to the action of a hot sun and dry northerly winds ; at the time of the outbreak the ground was therefore thoroughly dry and parched ; the wheat crop is very short and affords but little protection against the sun, and even this was being removed ; no marked or sudden change in the atmospheric conditions is observable, but the heat and dryness of the air was rapidly increasing. Frequently, during the months of March and April, the relative humidity was below 10 (saturation being=lCo), and the quantity of vapour in the atmosphere scarcely appreciable ; no rain sufficient to appreciably alter the condition of the surface fell till the end of May, and by this time the prevalence of cholera had declined; in fact the epidemic in this part of the valley commenced, reached its maximum prevalence, and declined during a period of great heat and dryness ; in other circles at a distance from the locality of the first outbreak, as may be seen in the preceding statement, the maximum of prevalence was attained in the still greater heat of May and June. 304. The next statement gives the prevalence of cholera in the Gadarwara circle of the Narsinghpur district, 75 miles from the locality of the first outbreak. This circle, which occupies a portion of the most densely populated part of the valley, did not become involved in the spreading epidemic till after the 20th May ; it had therefore been subject to the great heat and dryness of the season for two months longer than the Hoshangabad circle ; when the epidemic appeared there no rain had fallen for seven months ; the ground was every where burnt and hard ; the sources of water supply well nigh exhausted ; even large rivers at the Sitarewa and the Sukhur, which cross the valley in this part, being reduced to nearly stagnant pools with little if any stream visible between them. A thunderstorm gave 30 cents of rain on the 16th June, but with this exception no rain fell till the 30th June, and the rain-fall of the following week was light ; the heavy rains did not set in till the week ending the 15th July. The first village in the circle attacked lay between the town of Gadarwara and the Mohpani coal mine; the first case occurred there on the 22nd May, and this was followed the next day by cases at Mohpani and in Gadarwara, the outbreak among the people employed at the coal mine has already been described (page 52). The town of Gadarwara is situated on the bank of the Sukhur river below its junction with the Sitarewa ; it has numerous wells which yield good water, but the majority of them are very deep, and large numbers of the people, particularly inhabitants of the sections nearest the river draw water from it ; it was in these sections that the epidemic chiefly prevailed, and it fell with great severity upon the women employed in washing in the river. The greatest prevalence of the epidemic fell in the third and fourth weeks after its commencement ; it declined during the fifth week, but there was a slight increase again in che sixth week after the rain that fell on the 30th June; very heavy rain fell in the week ending the 15th July, and after this the epidemic soon disappeared. The Sukhur is a river of considerable size, and flows for a long distance in the hills before it reaches the populated plain. 73 villages report to the Gadarwara station-house, and of these 41 or 56 per cent 119 were visited by the epidemic ; the weekly prevalence in 27 of these villages is shown in the statement ; many suffered very severely, but it will be seen that the great majority of them were attacked and the epidemic attained its maximum of prevalence in the circle before tho 30th June, when the rains set in ; of the villages that were attacked subsequently none suffered severely. In several of those, however, in which the prevalence had declined before the arrival of the rains, there was renewed epidemic activity after they had set in. STATEMENT XIX. — Showing the spread of the Cholera Epidemic of 1876 in the Gadawara Circle of the Narsinghpur District. Cases of Cholera in weeks ending Name of town or Popu- Date of Ist *> g village. lation. Case. >>ซ. * - - - - E ~ ~ " I. 3 o "3 3 ฃ ,—• ,d "ป ฃ. r) JX '"* JTJ^ ,4 .4 5 m 5 CvjeC-"i-INrHOO-H823rd „ 2 15 36 89 87 50 66 33 14 11 3 ... 2 408 3. Mohpani ... 1,19323 rd „ 3 5 19 4 3] 4. Kunurgaon ... 26629 th ? ... 9 36 10 • 65 5. Benar ... 69630 th „ ... 6 34 61 15 3 U9 6. CherraKulla ... 998 4th June 3 ... 11 ... II 6 7 1 89 7. Cham Chonee ... 220 sth ? 1 19 9 ) ... 29 8. Amgaon ... 1,169 6th ? 7 6 6 6 9 26 6 1 •• .. <>7 9. Konria ... 3,249 Sth „ 3 36 49 94 27 7 2J6 10. Bahani ... 1,44710 th „ .. ... ... 16 4 I ... 14 9 3 47 *1. ChunderKera ... 38711 th „ ' 3 21 15 3 l| 43 12. Barah ... 2,587 14 th ? 15 6 6 2 9 9 4 42 13. Snndamur ... 13816 th „ 3 10J ... 13 14. Sujwara ... 1,388|16th „ 34 35 ...I 3 21 3 4 100 15. Pulhera ... 22317 th ? 7 ... 6 4 17 16. Piparia ... 164|17th „ . 14 3 18 4 39 17. Bhaiaa ... 447|16th ? 1 13 4 18 36 18. Murhwani ... 442j1!4th „ 31 10 ... ... 4L 19. Kolotia ... 70429 th „ 5 7 12 20. Bodere ... 687J30th ? 11 6 2 19 21. Khairi ... 290113 th July. 3 ; 3 6 22. Nandnair ... 37614 th ? 3 8 23. Chorebarehta ... 40916 th ? ... 2 2 24. Ghatpiparia ... 53226 th „ 1 5 1 7 25. Pipurpani ... 48ป| Ist August 4 4 26. Bareli ... 31817 th „ ... m 3 5 ... 8 27. Kajrota ... 22722 nd ? | 5 ... 5 Tซt,l Pซn, l.tmn J Cases ... 14 47 146 245 275 257 202 109 76 29 11 4 B 15 1 1,436 Total Population .- j Villagea ... 3 5 9 11 13 13 13 12 10 7 3 1 2 3 1 Rain-fall at Gadawara, inches j -SO ... TBO 220 B'9o 120 0-30 190 030 40j ... 340 305. The next statement shows the prevalence of the epidemic in the town of Narsinghpur and the surrounding villages. Narsinghpur is 30 miles distant from Gadarwara, and the epidemic did not reach this locality till a month later. A man of the sweeper caste, resident in the town, was attacked on the 29th May; but no other case was reported from the circle till the 23rd June, when a case occurred in Eandeli. Narsinghpur and Kandeli together form the sadar town and station of the district; they are situated within a mile of each other on either side of the Singri river, Kandeli a little below Narsinghpur. The Singri river rises at the foot of the hills, and in the hot weather contains water only in stagnant pools ; many of the people, especially of the low castes, use the water of the stream, but the supply of the general population is drawn chiefly from wells. There are numerous wells in both places ; some are sunk near the river or at the edge of ravines, and in others the supply of water is kept up by filtration from a large tank in the upper part of the town ; but by the end of the hot weather the water is more than 30 feet below the surface in most of the wells, and the supply becomes scanty. 120 In many of the wells moreover, as is the case in nearly all the towns and larger villages, the water is saline and unfit for drinking. One inch that fell on the 16th June was the first rain measured since the previous October, a period of 8 months; none fell again till the 4th July, from this time falls of rain were frequent, but they were light until the third and fourth weeks of the month when they were heavy and continuous. Although the tirst case occurred in 'Kandeli on the 23rd June, the cases did not become numerous either there or in Narsinghpur till the 2nd week of July ; after the rains had set in the prevalence of the epidemic declined during the heavy rains that fell in the third and fourth weeks of July, but rose again in the two following weeks ; it then again declined, and had finally ceased by the end of August. The epidemic prevailed with rather greater severity in Kandeli than in Narsinghpur, but in neither was the prevalence nearly so great as in Gadarwara. The low castes suffered in greater poportion than the rest of the bindu population, but the epidemic fell with the greatest severity on the Mahomedans; cholera did not become epidemic in any village of the circle till after it had become prevalent in the Sadar town and station ; subsequently 15 out of 66 that report to the station-house suffered, and in several of them the prevalence was severe. STATEMENT XX. — Showing the prevalence of Cholera in the Sadar circle of the Narsinghpur district. Cases of cholera in weeks ending. .o _ , -.___ _ , Town or Village. | ~ Jane. July. August. Sep. "5 o oj ฆ O 3rd 10th|l7th 24th Ist Bth jlftthJ22nd 28th sth [ 12th|l9thJ26th 2nd . _ . . j , Kaudeli ... 4,881 23rd June 12 4 14 12 7 21 32 6 99 29th May & Narsinghpnr ... 7,549 27th June 1 7 9 25 17 9 21 21 9 9 1 129 Chorepipuria .., 876 2nd July 29 3 2 34 Gethwanee ... 370 13th „ 1, 3 4 Lokeepur ... 9991 15th „ | ... j 6 3} 10 Bunijgaon ... 320 18th ? ) 13. 8 9 4 ... 1 ... 35 Kathatia ... 146 Ist August j I 5 3 2 2 ... 12 Bagwara ... 107 Ist ? I ... | ... • 3 1 4 Fiparia ...j 260 Ist „ j ... j 9 19 25 7 5 66 Tupla [ 569 6fch ? ! ... I ... ••• ... j ฆฆ• 3 ... 3| ... 6 Surgee ... 182 7th ? , - < ... 4 ... 1 ... 5 Sashahoo ... 842 7th ? ... 4 4 Raukipipuria ... 263 Bth „ j 2 12 12 ... 26 Ranki ... 384 13th „ j l 2 8 4 14 Masurdha ,„ 406 14th „ , 3 1 ... 4 Koondee ...j 152 19th ? I J ... j 8| ... 3 (Villages 1 2 3 41 5 4J 7 11 7 10 3| 17 Total ... 18,875 \ Cases .. 1 1 9 42 43 50 27 69 96 59 52 10 1 459 (Kain-fall 10j 208 202 407 6-32 2-y5 0-92 1-94 7-80 4-J6| ... Eatio of total cases per 1,000 of total population = 24 - 3 2. 306. Map No. VII. exhibits the prevalence of cholera in 1875 in a part of the Nagpur country which lies to the south of the Satpuras ; it is a hilly region with an elevation above sea level of from 900 to 1,500 feet ; the geological formation is chiefly trappean, and the greater part of the surface is rocky or thickly strewn with nodular trap, but in the lower lands the rock is covered with a layer of rich black soil of varying depth. The main drainage channel of the area given in the map is the Wuna river, which rising in the hills above Bazargaon forms after its junction with the Bor and other streams, one of the chief tributaries of the Wardha river (Map No. 1). Above Bori it is never at anytime a large river; annually in the hot weather the stream becomes very small, and in very dry seasons ceases to run. It has not, like the larger rivers that cross the Nerbudda valley, a long course through waste land, but its banks are occupied almost from its source 121 by villages, of large size. In the upper part of its course it receives little drainage from its eastern side, the land rising abruptly and forming the water-parting between the Wardha and Wynganga drainage systems (Map No. I.); but on its western side there is a strip of rich land four or five miles in width, closely occupied by villages ; lower down this strip of land expands into a wide plain with a population of considerable density ; and the Wuna river receiving the waters of the Nand from the east, and the Bor and Dhamna from the west, becomes a river of considerable size. The whole of this area had remained perfectly free of cholera until after the middle of July. The out-break of the epidemic of 1875 at Nasik and its spread thence has been described in pages 21 and 22, and in the following statement I give merely the statistics that show the gradual spread of the epidemic through the populations intervening between the locality in which it originated and the area now described, and to this statement I have added the monthly rain-fall of the several tracts of country, as it goes far to explain the different degrees of epidemic prevalence in them. It will be obvious that the cholera of Nagpur in 1875 cannot be fairly taken as an example of the period in which the conditions most favourable to the ?spread of cholera are most generally present in the country south of the Satpuras, for there is every reason to suppose from the experience of former years (page 62) that had the epidemic been imported into the Nagpur and Wardha districts in the early months of the year it would have found the conditions necessary to its diffusion and prevalence very generally present. Owing however to this part of the country having remained entirely free of cholera until after the monsoon rains had set in it affords a clearer illustration of the manner in which an epidemic spreads under the local and climatic conditions which the monsoon produces. 307. Annually in the early months of the year a considerable portion of the labouring population of Wardha and Nagpur migrates into Berar for employment, and remains there until after the planting of the cotton in June and July, when they return to their homes. It was at this time that cholera first appeared within the areas delineated in Maps No. VII. and VI I I ; an out-break had occurred in the Arvi circle in the east bank of the Wardha river (Map Mo. I. A) ; on the 14th July and eight days later the epidemic appeared within the area of Map No. VII. Cases of cholera were reported from Khondalee and Bazargaon, small towns on the road by which the people returning from Berar would travel on the 28th and 2yth; but the first epidemic out-break occurred in the village of Dhamna near the sources of the Wuna stream ; a cart track leaving the main road about midway between Bazargaon and Bheead crosses the Wuna stream atths head of the village of Dhamna and thence passes on to Kulmeshwar, Patunsaonghi, Saoner and Khapa, large towns that appear in the next map of the series (No. VIII.). The report of the out-break of cholera in this village reached Nagpur on the 23rd July, and according to the report, 10 persons had been attacked in one day ; the number of cases that occurred subsequently was not registered in the weekly returns, but the epidemic was severe, and I was given the names of 28 who died. The people draw their water almost exclusively from the stream; and at the side of the road, where it crosses the river, I found a very foul nala opening into stream just above where the women draw water. In the small village of Rohna, a mile below Dhanjna, 8 cases of cholera occurred ; the exact date of the first case in this village is not given, but following the course of the stream below these two villages as far as Bori, a distance of nearly thirty mile?, we have a consecutive series of dates on which first cases of cholera occurred in the villages on its banks, all falling within the next week ; below Bori the dates are not quite so regularly consecutive, but they continue for another 20 noiles to show that the villages drawing water from the river were attacked within a short time of the first out-break, while those at a distance from the river or not dependent on it for water escaped altogether, or suffered at a later date. There was good ground for suspecting that some of the bodies of those who died at Dhamna and elsewhere were thrown into the stream, either partially burnt, or without being burnt at all ; indeed in one case sufficient 122 STATEMENT XXL — Illustrating the spread of the cholera epidemic of 1875 from Nasik eastward to Ghhindwara % J Deaths in each month. Distance n. ity of Ist Date of Ist Case. Miles . งซ3_2*^3ง'dS t> o g Bombay i Nasik , - 734,386 ... March 22nd 10 481 1,014 610 386 201 93 14 3 ... 2,812 J 'I Khandesh ... 1,028,642 90 April 16th 26 809 1,060 2,825 870 22 12 6,224 W. Berar ... Buldana and Akola ... 846,436 190 May 9th 239 3,405 7,964 2,259 Q79 19 14,255 E. Berar ... Ellif-npur and Amraoti. 733,578 270 June 15th 125 2,093 1,897 930 179 39 ... 5*263 i WardhaandNagpur... 987,829 340 July 14th 91 2^896 1022 98 19 ... 4126 Central Prn 1 ) nearest point. ... 450 August 3rd vinces 1 chhmdwara -f 265,191 ... ... 454 190 6 650 vmces. ... ( ) furthest point, ... 520 Sept. sth. IP • .'// Number of btations. Nasik ... 4 -03 -14 28 -11 -31 12-44 19-45 11-86 14-53 '37 -03 1-41 60-96 Khandesh ... 5 04 "04 -09 '11 04 6-50 873 673 10-25 -25 ... -25 3303 West Berar ... 8 -18 -26 5*85 594 458 10*57 -77 ... -36 2852 East Berar. ... 6 ... -51 -02 '02 0-02 7-02 9-57: 520 823 175 ... -16 32-51 Nagpur & Wardha. 2 ... 11l ... -13 124 11-36 16-75 748 716 618 51-41 Chhindwara ... 1 015 070 ... 0-27 018 979 14 ! 50 459 16-73 2-71 ... 052 50-14 * The furthest point reached by this epidemic was Umerwara, on the hills that form the water-parting between the Wainganga and Nerbudda river systems, (page 22 and Map No. 1 A). 123 proof was obtained, and the offender punished. In ordinary times the upper castes burn their dead by the river side, and throw the ashes into the stream, while the low castes dispose of their dead by burying ; but in wet weather, when wood is scarce and expensive and many deaths occur in a short space of time, the difficulty in the way of burning would be very great. The low castes would have no hesitation about throwing their dead into the rivers when the number was great. 308. Statement No. XXII. gives a list of the villages on the bank and drawing water from it, from Dhamna to its junction with the Bor river, with the number of inhabitants and the number of cases of cholera that were reported in each week at the several station houses and out-posts. I inspected a great number of these villages and others within a short distance of the river as soon as the weather permitted of my going into carap. The conditions surrounding those on the river were very much the same, excepting that in some there was a margin of sand in which the people could dig holes or jhiriahs and in this way roughly filter the water. Jn the villages away from the river the water-supply was drawn sometimes from wells, but more frequently from a small rivulet in which the supply was at this time plentiful. The village of Sungum opposite Kyree makes the first break in the series of dates, but the inhabitants do not in the rains draw water from the river, but from the small stream running into it close by the village ; three cases of cholera were reported in the week ending the 2 1st August, the first having occurred on the 19th. Hingna is a large untidy village lying on both sides of the stream, the left or east bank is rocky ; on the other side there is more soil; both banks rise high above the stream. The stream forms the sole source of water-supply for both sections, and both suffered equally from cholera. The four villages on the river between Hingna and Gumgaon all suffered from cholera ; the four villages on the cart track that runs parallel with the river all escaped ; Monda is situated on high ground with black soil well cultivated all round it ; the water-supply is drawn from three wells sunk in black soil and moorum (trap shale) ; the water in the rains was less than 3 feet from the surface. Panjru also draws its water-supply from a well, but the water was from 15 to 20 feet from the surface. Kirmuta also has a well ; Soormurka is a small village with a population of only 97 ; its water-supply is derived from the stream that joins the Wuna close above Goomgaon. Goomgaon is the property of one of the Nagpur Kanees who has a house there ; the village is composed of better houses than most others in this part of the district and the place itself was fairly clean ; but the ravines leading into the stream both above and below the town were much fouled. The stream forms the sole source of water-supply, and it runs immediately under the upper part of the town, so that there is no sand in which the people can dig jhiriahs for filtering the water. On the other side of the stream under Kotarwara there is a considerable expanse of sand which the people utilize for this purpose ; in this village only 3 cases of cholera occurred ; this village is also rather higher up stream than Gumgaon ; 1 23 cases of cholera, 66 of which were fatal, were reported from Gumgaon. Wells sunk outside the town would probably retain water at from 16 to 20 feet from the surface ; there is in fact an old well, but the people say the water is hard and saline. The small village of Dhanolee, about a mile below Gumgaon, suffered very severely in proportion to its population ; here also the stream flows close under the bank on which the village is situated ; in the next village, Khanolee, belonging to the same proprietor, there was no cholera ;it is at a little distance from the river, and depends entirely on a well with a good tube of cut stone set in lime and with a good coping, the water 16 feet from the surface. Th 6 village of Siroor and the small hamlet of Turukmaree both draw water from the "Wuna and both suffered from cholera. Kirmutra with only 31 inhabitants ; and Kenhee Boozoorg, with 78, are both at some distance from the stream ; in Kirmutra no case occurred ;in Kenhee there was one case on the 30th August*. About twothirds of the town of Bori is on the left bank of the river, and the remaining third • 50TE.~-Pl.oces having a mark agaiust Ui-ir names as Chichola opposite Keeahee are uninhabited village areas. 124 on the opposite bank ; there are several wells in the town, but the water they yield is more or less saline, and the river water is used almost exclusively ; the approaches to the town and bed of the river were much fouled, but more down stream than above ; the same number of cases of cholera in proportion to the population were reported here as at Gumgaon, but the mortality was considerably less, and this may perhaps have been due to the increased volume of water below the junction of the KUhna stream, the catchment area of this stream being: rocky and barren; all the villages on it, with the exception of Takulghat and Kanholi, are very small, and the contamination of the stream would be comparatively slight. STATEMENT XXII.— -Showing the number of cases of cholera reported from each village, on the river Wunna during the epidemic of 1875. Cases of Cholera, reported in week 8 -g ending g.* 3 Popula- Date of lat Case. , - ฐ - tion. xi+i ja •** ซ JjJjj o* o 5 3 g 3 3 ฃ3 ฃ ฃ H H Dhumna ... 981 22nd July. 10 28 28 Rohna ... 181 8 ... ? ป \ Koldangie ... 393 22nd „ ... 4 4 5 13 4 Bheead ... 804 24th „ ...14 3 8 18 38 14 Mungrool ... 279 24th „ ... 2 4 6 Khyree Buna ... 156 27th „ ... 4 10 2 16 6 Sungum ... 202 19 th August 3 3 3 Hingna ... 2,877 27th July. ... 5 19 16 31 5 76 38 Sooklie ... 405 27th „ ... 2 7 9 6 Tuklie ... 160 30th „ ... 1 1 ... 1 * * Khurka ... 276 27th „ ... 5 6 ... 6 17 7 Soomthana ... 105 27th „ ... 3 4 1 8... U 7 Gumgaon ... 2,997 27th „ ...26 52 30 12 3 123 66 Kothaiwarah ... 398 3rd August 1 2 3 3 Dhanolee 198 29th July. ... 2 14 2 1 ... 19 15 Siroor ... 514 30th „ 10 4 1 3 18 Toorakmaree ... 40 Ist August 3 1 4 . Boric ... 3,039 29th July. 49 10 66 1 126 41 Mushala ... 50 1 ] — Doodhalee ... 40 4th August 4 4 Jypur ... 75 29th July 11 H 3 Ridhora ... 696 Ist August 6 2 5 13 3 Wingaon ... 118 9th August 12 1 ...... 4 4 Dehlee ... 332 10th August 5 5 3 Ashta ... 883 25th July 24 15 Burburee ... 357 Ist August 7 ' 5 Wagsoor ... 154 Ist August 6 4 10 4 Randli ... 668 Ist „ 12 9 12 33 10 Saiwa ... 243 11th „ 1 1 f Total ...17,924 ... 10 76 233 101 16113 2. 638 303-f Nagpur ... 337, 724, 045, 4-08, 3-65, 022, 258, 1-42. Rain-fall ... ฃ Wardha ... 560, 2-40, 10, 3-02,2-80, '52,1-55, ... Rates of total cases per 1,000 of population=3s-65- 309, The population of Kanholi is returned as 1,975 ; the site of the village is rocky and rises high above the stream ; but the rock being formed chiefly of trap shale which is excavated without much difficulty, there are many wells within the village, the depth of water from the surface varying with the distance from the stream. The stream forms a deep pool about 30 yards wide, which extends wader the greater part of the town, but lower down the bed expands and the 125 stream flows over large stones and boulders ; the bed continues of this nature through the greater part of its course. Where there are two sources of watersupply it is almost impossible to get trustworthy information as to which is most resorted to ; but as a rule, the people prefer river water, using the wells only when the stream is flooded and muddy. Kanholi suffered from two distinct out-breaks of cholera, the first in the third week of August, when 67 cases and 15 deaths were reported ; and the second in the end of September and beginning of October, when 57 cases and 22 deaths were reported ; altogether 124 cases, of which 37 were fatal. For four miles along the river below Kanholi there are no villages ;in the course of the next three miles there are four small villages, the aogregfate number of inhabitants amounting to 254 only. From these villages no cholera was reported. Keenhi Khoord, a small Gond village on the top of a trap hill a couple of miles from the Kishna stream, suffered severely ; 23 cases, 10 of which were fatal, occurring among 78 inhabitants ; the first case was that of a girl attacked while returning from the bazar at Bori ; the second a woman living in the adjoining house ; the third the daughter of the second woman. The water-supply was drawn from a small well in a field of jowari below the village, the water in which was at the time close to the surface. The population of Takulghatis returned as 1,928, the village itself is on rocky ground well above the stream, but all around is deep black soil under cultivation ; the bank of the stream was by no means clean, but the chief place of resort for the purposes of nature was the area of an old fort a little down stream from the village ; the inhabitants draw water for drinking solely from the stream ; there are wells in the village, but the water they contain is saline and unfit for drinking, and the wells in the fields outside which yield sweet water are too far off; the stream was rapid, running over a rocky bed. 27 cases of cholera were reported and 16 deaths. 310. Between Bori and Takulghat, a distance of nearly five miles by the river, there are no villages. Mushala and Doodala, the next villages below Bori, have less than 100 inhabitants between them ; from Doodala 4 cases of cholera, one of which was fatal, were reported in the week ending the 7th August. In Mushala, one case not fatal was reported to have occurred on the 30th August. In Jypoor 11 cases occurred among 75 inhabitants, but 3 only were fatal. In Jftidora also out of 13 cases, only 3 were fatal. The villages on the banks of the river between Bori and Ashta are, with the exception of Ridhora all very small ; and as the banks of the main river are high, the inhabitants of the villages on the east bank resort for water to the small streams running down from the hills on that side. One or two of these suffered ; but generally at later dates than the villages drawing water from the river. Baila is a town with over 5,000 inhabitants, but it is at some distance from the Wunna, and its drainage falls southward to the Nand river ; its water-supply is derived from two wells sunk at the edge of a large tank ; 94 cases of cholera, 29 of which were fatal, were reported between the 6th August and the 7th September. About the date of the first appearance of the epidemic in the village of Ashta, there is some uncertainty. This village and Dehlu being in the Nagpur district report to Bori, 10 miles distant, instead of to Sindhi, which though nearer and more accessible is in the Wardha district. No report of cholera from either village was made till the 20th August, but the 25th of July was given as the date of the first appearance of the disease at Ashta and the 10th of August at Dehlu, the state of the weather and the road being given as the excuse for the report not being made sooner. No written record was kept, and the only information I could get out of the Majguzar of Ashta was that the first case occurred on (Itwar) Sunday, and that he heard of the disease having appeared at Burbura about the same time. As the Ist of August, was also on a Sunday and the first cases at Burbura, Wagsoor and Kandla, villages on the river below Ashta, were reported at Sindhee to have occurred on that day, it may have been that it was on this Sunday that the first case occurred at Ashta ; I have however let the date given stand. Below the junction of the Nand river the bank of the Wunna is very high and steep ; there are very 126 few villages close to it, and those that are, do not, all of them, draw water from the river. Omra has a well, the number of inhabitants of Ourungpur is returned as only 19 ; (Jhakoor is a mile off the river ; Pardu has a good well in a field outside the village ; at Nundpoor the stream of the Wunna flows under the opposite bank, and the people draw water from the small stream which is crossed, by the road to Mandgaon ; the first case of cholera occurred here on the 2b'th ; at Saiwa opposite, where the people draw water from the Wunna, a case occurred on the llth ; from Saingaon, which is the next village drawing water from the Wunna, 4 cases were reported in the week ending the 14th* The town of Mandgaon escaped cholera ; it lies at a considerable distance from the river, and the water-supply is derived solely from wells. 311. By this time cholera had crossed the Wardha river from Berar lower down and had become epidemic in the town of Hinganghat (10 miles from Mandgaon), the chief centre of population and traffic in this part of the country. On the Ist August also the first cases occurred in the town of ISmdhee, and from this time we find the epidemic spreading generally over the villages on the plain ; but prior to this time all the towns and villages attacked had been either on the roads which people returning from Berar would traverse or on the Wunna stream, and we have found the daces of the first cases in the towns and villages on the banks of the stream falling in a nearly consecutive series for more than 50 miles of its course. 312. The Bor flows through a rocky barren country for many miles before it enters upon the more populated plain. Moreover the epidemic had become widely prevalent over the country before any village on it was attacked ; few, if any, of the towns and villages on its banks and dependent on it for water escaped cholera, and several suffered severely ; but the dates do not present so long a consecutive series as in the case of the Wunna. Hingnee suffered very severely, 129 cases, 66 of which were fatal, occurring in a population of 1,850. The surroundings of this village are very much the same as at Kanholi. It is situated on high ground (60 or 70 feet) above the Bor river, which here flows over a wide bed of pebbles. The subsoil of the site consists of trap shale or moorurn ; there are numerous wells, in which the depth of water from the surface varies from 10 to 50 feet ; the water is nearest to the surface in the wells farthest from the river, the drainage of the greater part of the town, being from the river bank towards a small stream or nala that flows at the back of the town ; this stream joins the river about the point where the people draw water. The wells are said to yield water fit for drinking, but where there are two sources of supply it is impossible to ascertain the extent to which each is resorted to. From being enclosed between the river and the stream, both of which would often be impassable for days together in the rains, the village must at that season become very dirty, for in addition to the population about 1,000 head of cattle are kept. Mowye has two wells, and of four fatal cases that occurred here two were Dhers, who would not be allowed to draw water from the wells. Kenhu, with a population of 78, had 3 cases of cholera ; from Bamhai, on the other side of the river, with a population of 3 02, no cases were reported. Daklu is at a distance from the river and, the inhabitants resort to a small stream, which is nearer. The village of Ghorar suffered severely ; the site is formed of hard basalt, and the river which forms a long still pool under the village forms the sole source of water-supply ; 37 eases of cholera were reported, of which 17 were fatal. Sailoo, which is crossed by the western road, was attacked earlier ; there are numerous wells in the town, in some the water is sweet, and the people say they use it in preference to the river water. 105 cases of cholera were reported, of which 44* were fatal, but the epidemic fell chiefly on the women and children ; of the 44 who died, 26 were adults, 5 men • Note. — The date 31-7 in the map, under Kanhampur, is an error ; there was no cholera in this village, bat la another villago of the same name close to Hinganghat. 127 and 21 women, and 18 children, under 12, 9 of whom ware boys and 9 girls. The population of the town is returned as 3,050. Nearly all the villages on the Bor below Sailoo suffered more or less, but I did not inspect them. Nearly all the villages on the Dhamna river also suffered, and the dates on which they were attacked form a nearly consecutive series from above downwards. 313. The town of Wardha, notwithstanding the great prevalence of the epidemic in the surrounding villages, escaped altogether in 1875, but suffered severely in the following year, when cholera was was very little epidemic in the district. The water-supply is drawn chiefly from wells. During the epidemic of 1876 the bazars were suspended. The town of Sindhee suffered severely ;it is situated on rocky ground forming the bank of a small stream ; there are a good many wells in the town, the water in which in the rains is about 15 feet from the surface, but it is saline, and most of the wells were dry in the hot weather. Three wells sunk near the edge of the stream yield sweet water, and the better classes probably draw from these wells as long aป they contain water ; but in the hot weather two of them run dry, and then deep holes are dug in the bed of the river ; during the rains and for some months subsequently a large portion of the population draw water from the stream itself or from excavations in the coarse sand at the edge, but the bed is rocky, and what sand there is, is very shallow. The banks of the stream and the ravines that intersect them are as usual much fouled, and the women wash clothes &c, in the stream. The wife of one of the police constables was attacked on the Ist August, but the disease did not become epidemic in the town till the following week ; between the 7th August and the 25th September, 133 cases were reported, of which 34 proved fatal Here, as at Sailoo, the women were the chief sufferers. ( )f the 133 cases reported, 84 were females, 49 males ; the population of the town is nearly 5,000. The Sindhee bazar is the chief market for this part of the Wardha and Nagpur districts, and the market day previous to the out-break had been held on Friday the 30th, or the day but one before the Ist case occurred. The epidemic prevailed very extensively in this circle ; of 64 villages that report to the police station, cases of cholera occurred in 42 ; of the 22 that escaped, 1.4 contain less than 100 inhabitants. There were, however, one or two good villages in the immediate neighbourhood of Sindhee that escaped the epidemic ; in Hiloree, 3 miles to the west of Sindhee, with 3:^6 inhabitants, only one case occurred,, and that was not fatal. Digraj, two miles to the east, with a population of 542, experienced a like immunity ; both these villages lie in rich cultivated land, and! the water-supply is drawn almost entirely from wells ; on the other hand in Pullusgaon, surrounded by soil of the same nature but on the same stream with Sindhee, and drawing water to a great extent from the stream, 10 cases; occurred in a population of 843 ; Gour, on the same stream, with a population of 80, had 4 cases; and Bhosa, with a population of 369, had 15 cases. 314. But though a good well sunk in dense soil forms the safest source -of water-supply for a village, a bad well placed under circumstances tfoafc render it liable to contamination is a source of greater danger than an open stream. The village of Sildoh on the western road four miles north of Sindhee furnishes an instance. The population of this village is returned as 113; the sole source of water-supply is a small well sunk about 8 feet in the trap rock ; in the rains the well is full, so that water can be dipped out with the hand, in the hot weather it runs nearly dry ; close to the well and nearly on a level with its mouth was a dirty drain containing stagnant water. 35 cases of cholera were reported from this village, 18 of which proved fatal. The first cases occured in the family of a man of the Lodi caste who had fields in the adjoining village of Khurka, and lived sometimes in one place and sometimes in the other. The man was first seized with cholera at Khurka, and he and his wife and son died there ; the daughter-in-law then came with her child to Saildoo ; on her arrival there the child was taken ill and died ; within a day or two the epidemic broke 128 out among the residents, and between the Ist and 18th September the above number of persons suffered. The village of Lonhara to the north of Bazargaon furnishes a similar instance. This village, as may be seen in the map, lies or. the high land that forms the water-parting between the Wunna and Kolar river:. (Map VIII) ; the rock here is sandstone, and the soil light and porous. There are several wells in the village, but the water in them has become saline through pollution of the soil, and all classes use for drinking the water of a well in a field outside the village ; in November the water in this well was about 5 feet from the surface, in the rains it would be up to the mouth ; close to the well was a foul puddle two or three feet deep in which pigs were wallowing ; the only protection to the mouth of the well was a Gircle of large rough stones. 110 cases of cholera, 42 of which were fatal, occurred in this village between the 30th July and 14th August; the number of inhabitants is returned as 458. 315. In the city of Nagpur, which at the census of 1872 had a popula' tion of over 84,000, 58 cases of cholera, 31 of which were fatal, occurred between the 13th August and the loth September. In former epidemics the population of the city always suffered severely; but in 1872 pure water was brought in through iron pipes from the Ambajhiri tank on the high land 4 miles to the west of the city, and during the two epidemic seasons of 1875 and 1876 ifche population supplied by the new water service have been exempt, In the end of July and beginning of August 1875, three or four cases occurred among people who came into the city from the surrounding villages, but no resident suffered till the 12th August, when a woman living in the 2nd division was attacked ; she was taken to the hospital a mile distant, and on the following day, the 13th, the woman employed to nurse her and the nurse's daughter were attacked ; on the 15th, the disease broke out in a small bazar near the hospital. At this time, neither the hospital nor the suburb in which it is situated had been supplied with the Ambajhiri water. A few cases also occurred in the Sitabaldi bazar under the fort, and the sufferers were chiefly low castes who had been prevented resorting to the standards, and women washing clothes in the neighbouring stream. In the following year after the out break of cholera at Ramtek in November, there was a large influx of infected persons, many of whom suffered from cholera after their return, but the resident population remained almost exempt. MAP No. VIII. 316. Map No. VIII represents a basin between 20 and 30 miles in width in which we find several rivers converging into one ; the rocks that form the sides and floor of this basin present great variety ; the hills to the west in which the Chundrabagga and Kolar rivers take their origin are trappean. At the edge of the trap following the line of the Kolar or from Kaloid to Kamptee is a strip of sandstone, broken here and there by rocks of the crystalline series* while to the east of the Kanhan the formation is wholly crystalline. In some of the small valleys in the trap hills the rock is covered with a layer of rich black soil, but the surface is for the most part rocky or thickly strewn with with modular trap. Between these trap hills and the Kanhan river is a wide plain, (the substratum of which is a stiff clay ; this is covered with rich black soil v,e*y retentive of moisture and suitable for wheat ; east of the Kanhan the soil is too light for wheat, and is cultivated chiefly during the rainy season, when if the rains are abundant, it furnishes good crops of jowari (sorghum). The drainage of the basin is very complete and rapid in the plain at a distance from the river 5 water is obtainable from wells at a depth of from 20 to 30 feet from the surface.; on the banks of the rivers if the bank is sloping, water may be readied at depth*? varying from 20 to 50 feet, but in many parts the banks the Kanhan and 4^Jich riss abruptly to a height of from Q0 to 80 feet; the 129 construction of wells is not attempted, and the inhabitants of the villages at these points depend solely on the river for water. The Chundrabagga and Kolar have their sources within the basin, and are comparatively small streams ; the Kanhan and the Pench rise in the Satpuras, and both run a course of upwards of 100 miles before they meet. In the rains they are large rivers, but they fall very quickly ; in high floods at the end of August or beginning of September the flow in the main channel at Kamptee often exceeds 30,000 cubic feet per second ; by the end of N ovember, or si* weeks after the rains have ceased, the flow falls to about 300 feet per second, and the river becomes fordable ; and by the end of May the flow is little more than 40 feet per second, and the stream is not much more than ankle deep. These rivers run in very deep channels and seldom overflow their banks ; this, however, happened to the Kanhan in the beginning of September 1876, and the town of Khapa and the cantonment of Kamptee where the bank is rather low suffered considerable damage. 317. The number of cases of cholera reported from each village visited by the epidemic that spread over the basin in August 1875 is shown in Statement No. XXI If, where the villages are arranged according to the catchment areas on which they lie. For the rain that fell over this basin during the epidemic period I have given at the bottom of the statement the quantities measured at Chhindwara, which lies on the watershed of the Kanhan and Pench, and at Nagpur 10 miles south of Kamptee ; the rain ceased in the week ending the 2nd of October. Isolated cases of cholera occurred on the 31st of July afc Kalmeshwar and Patunsaonghi, towns traversed by the country road which passes by Dhamna and Lonhara (Map VII ) but the first case within the area occurred at the small village of Gondee Mohgaon, in the hills among which the Kolar takes its rise. A Brahmin had come here from Katol, a town 1 2 miles to the west on his way to Mohgaon, and was taken ill at Gondee Mohgaon ; in the followiug week three cases among the residents were reported at the Peepla out-post, but the dates on which they occurred are not given. On the 26th a case occurred in the town of Khapa, on the Kanhan, and in the course of the following week we find it spreading along the course of tfyis river as far its junction with the Pench. 318. It will be observed that the greater number of the villages attacked with cholera, lay alonsf the banks of the rivers ; very few of the villages in the open plain, the inhabitants of which would draw their water from, wells sunk in the stiff clay suffered. In the town of Kalmeshwar only 6 cases occurred. The stream shown in the map is at some distance from the town and retains water for only a short period; the inhabitants, therefore, depend on wells far their supply ; the water of the wells within the town is unfit for use, and the people resort to wells sunk in the cultivated ground outside ; of the 4 persons who died of •cholera, one was a dyer and 3 were low castes, who would uot be allowed to draw water from the wells with the other Hindu population. As the Chundrabagga river retains very littje water in the hot weather many of the villages on its bank haye wells ; the large village of Dfyapawara, however, has no well; the bank is here very steep, and the people depend on the stream for water. The approach to .the village from Saonair is by a ravine leading into the pool above the village, where the women were employed in washing ; and this ravine was very much fouled ; for domestic use the women drew water from holes sunk in a hes. of s.an there was no cholera. At Gorunda 2 cases occurred, a man who had gone across to Mhusdee, returning suffering from cholera, and subsequently his wife was attacked and died* Saleye was the last village on the Pench that suffered, and the outbreak was severe ; but here the people were not at the time drawing water from the stream, but from a stagnant pool left in the bed after the floods had receded* The large village of Mahoolee^ opposite Saleye, escaped cholera ; the inhabitants now draw water directly from the river, which flows close under the bank. 324 The villages of Rohuna, Kamptee, and Pipra, below the junction of the two rivers, and all of which are dependent on the river for water, had no cholera ; the village of Beena on the opposite side suffered rather severely; the village is at a distance from the river, and the water supply is here drawn from two wells sunk in the ravines leading towards the river j the soil is almost pure sand. The force quartered in the Cantonment of Kamptee consists of two batteries of Artillery, a regiment of British Infantry, a regiment of Native Cavalry, and two regiments of Native Infantry. Not a single case of cholera occurred among the European troops, officers or men ; the native troops also escaped almost entirely. Among the native population of the bazars 84 cases were reported, 64 of which were fatal. The water-supply of the troops is drawn from wells, and that of the Europeans is carefully filtered ; the wells are sunk in a fairly dense alluvium with a superficial layer of black soil, the depth of water from the surface varying from 30 to 50 feet ; the water-supply of the native population is also chiefly drawn from wells, but many of these wells are close to the stream which runs through the bazar ; the first persons attacked with cholera were low castes, using water drawn directly from this stream. Of the 64 persons who died, 29 were males and 35 females. The mortality among the native population of the Kamptee bazars was low, compared with that of the other towns and villages on the Kanhan ; but it was nearly four times as high as the mortality of the city of Nagpur, 10 miles distant. The number of deaths in Kamptee was equal to I*3l per 1,000 of the population ; the number that occurred in Nagpur was equal to o*3B per 1,000. 325. The tract of country delineated in Map No. VIII. presents great variety of physical characteristics, and before leaving the description of the cholera epidemic that spread over it in 1875, it may be of advantage to draw attention to the very different conditions of soil and sub-soil under which cholera occurred, and how little direct influence the nature of the soil and sub-soil apparently had upon the prevalence of the disease. We have found that it prevailed with great severity in the villages among the trap hills, which are almost invariably built on rock ; the villages in the open plain either built on or surrounded by deep soil and stiff 133 clay suffered but little, provided they were at a distance from the rivers but villages having the same surroundings in respect of soil and cultivation but situated on the bank of a river and dependent on the river for water suffered severely. Perhaps the villages of Goomthee, Koraree and Beena, within a short distance of Kamptee, afford as good an instance as can be given of villages in which cholera prevailed under very different conditions of soil and geological formation, the atmospheric conditions being identical. Goomthee lies in the open plain surrounded by dense alluvial soil. Koraree is shut off from the Kolar river by a line of rocks formed of saccharine limestone, or coarse marble, while the village is built on a deposit of red gravel ; Beena is situated on soil which consists almost entirely of sand : but though differing in the nature of the soil on which they were situated, they were alike in drawing water from sources liable to contamination. The water-supply of Goomthee was at the time drawn chiefly from the stream near which it lies : Koraree and Beena draw their supply from wells sunk in the porous gravel and sand. The composition of a soil has no direct influence on the development of cholera, and no soil confers immunity on the population residing on it ; but inasmuch as the water-supply in respect of abundance and purity varies considerably in different strata, the geological character of a tract of country has a very important bearing on its liability to cholera. As a rule, cholera prevails with the greatest severity when the substratum is basaltic ; in this formation the storage of water is difficult, the drainage is rapid, the streams quickly run dry. Wells are constructed in the porous superficial stratum, but are seldom sunk into the hard basalt, they run dry early in the hot weather and fill quickly when the rains set in, the water is therefore scanty in the hot weather and much contaminated during the rains. The substratum underlying the greater part of Berar, the whole of the Wardha district, and the western half of the Nagpur district, is basaltic, and the whole of this country is very liable to suffer severely from cholera. We have seen that the villages on the rich clay deposit at the edge of the trap very generally escaped. East of the Kanhan and l J ench the formation is crystalline, and in this formation the water-supply is generally good and abundant ; the storage of water in tanks is very generally practised, and wells which will retain water in the hot weather can be sunk without difficulty. This formation extends over the eastern and south-eastern portion of the Nagpur district, and nearly the whole of the Bhandara district, and the population of these districts are much less liable to suffer from cholera. The epidemic of 1875 that reached Nagpur from the west scarcely spread at all to the east of the Pench river ; a few cases had occurred on the Northern road in the beginning of August. The town of Ramtek suffered slightly in the month of August and September, and in October some villages on the Waicganga river in the Bhandara district were affected, but altogether the prevalence of the epidemic in this direction was very MAP No. IX. 326. Map No. IX represents the Kanhan river from its junction with the Pench to its junction with the Wainganga. In this part of its course it flows through a wide plain of rich alluvium. The prevalence of cholera was confined almost exclusively to the villages on its banks and on the banks of one of its tributary streams. In describing the epidemic of the area given in Map No. VIII., it was observed that the villages on the Kanhan immediately below the junction of the Pench, and using the water of the river (paragraph 324), did not suffer from cholera ; so also in the present map the villages on the banks of the river for the first seven or eight miles below Kamptee escaped : only two, Khandala and Niluj, use the water of the river, and they are very small, but there is evidently a want of correspondence between the cholera of the upper and lower Kanhan. The dates of the first cases in Mounda and the neighbouring 134 villages being, prior to the date on which the first cases were reported at Karaptee, there is indeed reason to believe that the epidemic reached the lower Kanhan from the east rather than from the west, or rather that at this point the epidemic which had been advancing westward from Bilaspur met the epidemic which had spread eastward from Nasik (Map No. IA. and pages 19-20). Cholera had been very prevalent in Bilaspur and Kaipur through the months of May and June, and in the beginning of the latter month it had got upon the roads which traverse the jungles that lie between Kaipur and Bhandara. Several villages on these roads had suffered in the course of the month of June, and ifc had reached as far as the village of Shahpur on the road four miles west of Bhandara, where 7 cases occurred between the 12th and 19th June ; but with the setting in of the rains the traffic on these roads nearly ceased, and as the population of the greater part of the tract traversed by them is very sparse the epidemic did not spread, and had almost died out in July. It was present, however, in the village of Bela, on the road two and a half miles from Bhandara, in the week ending the 24th July, and in the same week 3 cases were reported from another village on the road a few miles east of the Wainganga. On some day in the following week a traveller from the eastward was seized with cholera, and died on the encamping ground at Mounda where the road crosses the Kanhan. On the Ist August cases occurred at Mounda and four other villages in the neighbourhood ; three of these villages are on the road between Mounda and Kamptee. Mounda, moreover, is the chief bazar place for all the surrounding villages, and the bazar day previous to the outbreak had fallen on the 30th July, on the day but one before the outbreak. Four of the villages in which cases of cholera occurred on the Ist are on the banks of the Kanhan and dependent on it for water ; the fifth, Tharsa, draws its supply chiefly from wells, but it has a a stream running through it, which is no doubt used to a considerable extent j no epidemic out-break occurred in this village till the fourth and fifth weeks after the first case, but in the four, the inhabitants of which use the water of the river the epidemic spread at once, and attained its maximum of prevalence in, the next or the following week. As the rains were at this time pretty constant, the river would be daily receiving a large amount of foul matter, but at all these four villages there were local sources whence the water was polluted at the spot whence it was drawn. At Sonagaon the bank of the river rises at least 80 feet precipitously above the stream, and the sole approach to the river was by a ravine which was greatly fouled. At Jhooralthe conditions were much the same. At both these places the current is in midstream and is slack at the point where the water is drawn. Under Mathun the river in the rains forms a broad shallow, in which there is very little current. At Mounda the river runs under the bank, the village stretches for about half a mile along the bank, and the sewage is conveyed into the river by a ravine that bisects the village about the middle. The number of cases in proportion to the population and the mortality in proportion to the cases was less than at the other places. Several of the villages on the banks of the river below Mounda suffered from the epidemic, but from the greater number no cases were reported. The banks are here very high, and in many instances a broad bed of sand intervenes between the village and the stream ; in the rains the water-courses and small streams leading into the river would furnish more convenient sources of supply, or the people would draw their water from holes sunk in the sand when it was not covered by the flood ; in some instances too the people would draw from stagnant pools left in the bed after the high floods had receded. The nature of the water-supply on the larger rivers and its relation to cholera is better illustrated in the next map of the, series. The village on the area of this map that suffered most severely from cholera was Gouree, where 43 cases, 24 of which were fatal, occurred in a popu* lation of a little over 800 ; here the water-supply was drawn entirely from $ tank, 135 STATEMENT No. XXIII. — Showing the prevalence of the Cholera epidemic of 1875 over the Kanhan basin. Cases of cholera reported in the week ending. . ~ • j 1 — - (h O Fame of town or village. Date of lat case. Population. July. August. September. October. 2 ฃ . , . to It 31st 7th 14th 21st 28th 4th 11th 18th 1 25th 2nd 3 3 o o | t J J^ H Chundrdbagga Catchment. Oondhaee ... August 23rd ... -714 3 ... 3 1 Kalumbhee ... do. 19th ... 604 ? ... 3 8 3 Sailoo ... do. do. ... 250 ... 4 1 Kulmeshwar ... July 31st ... 4,738 ... J 1 2 3 $ 4 Oopenwahee ... August 19th ... 1,079 12 17 29 12 Khyree ... September 2nd ... 302 2 ... 2 1 Punjra ... August sth ... 71 ... ... ••• • •ฆ ••• 4 ... ... ... ... 4 2 Bamhoree ... September 2nd ... 591 ... ... ... ... ... 8 ... ... ... ... 8 1 Jhomkee ... August 10th .. 279 2 6 2 Oobalie ... do. 24th ... 1,326 3 2 5 3 Soukham* ... do. 15th ... 133 ... 14 3 8 6 Chargaon* .. do 17th ... 296 ... 4 7 1 12 3 Soosundra* ... do. 21st ... 764 10 10 Soosundree* ... do. 25th ... 85 ... ..- ... ... 1 ... ... ... ... ... 1 Soanki* ... do. 10th ... 255 ... ... 2 6 8 2 IMohgaon ... October 10th ... ... ... ... ... ... ... .. ... ... ... ... 11 3 Peepra ... August 18th .. 764 ... 7 5 ... 12 6 Murha Saongee ... do. do. ... 298 2 4 ... 6 4 Wadhona* ... September 4th ... 210 3 3 6 2 Dhapawura Burra* ... August 12th ... 3,902 3 29 22 9 63 26 Do. Chota* ... do. 25th ... 631 421 7 1 Dhoorkhera* ... do. 28th ... 241 ... ] ..' 1 .., 136 STATEMENT No. XX///.— (Continued.) Cases of cholera reported in the week ending . *a , , — ฆ . , a o Name of town or village. Date of first case. Population. July. August. September. October. 2 ฃ _ฆ ______—* ____— — — — — — ฆ" •———ฆ—ฆ—-—__———_—_ป ฆ ซ 43 _i O — J 31st 7tb Hth 21st 28th 4th 11th 18th 25th 2nd 3 3 o o I H Eh Kolar Catchment — (Continued.) Gondee Mohgaon ...July 25th ... 198 1 3 4 1 JalamJhurree ... September 12th ... 243 ... ... ฆ •• ••• ••• ••• ••• 1 ...... 1 1 Teshti฿urha ... August 17th ... 999 2 20 6 ... 28 7 Do. Chota ...September 6th ... 433 1 1 l I Mohgaon ... do! 6th ". 777 ... ... 19 30 18 4 71 33 Peepla ... do. 4th ... 1,515 ... 7 82 7 8 54 15 Oomree ... August 18th ... 1,087 ..'. 12 4 3 19 17 Saonair* ... do. 11th ... 5,295 1 25 7 2 1 36 12 Baoroojwara* ... do. 7th ... 336 11l 3 3 Putka Khairee* ... do. 17th ... 425 112 4 4 Malurgaon* ... do. sth ... 132 ... 13 4 ... 8 2 Manargin* ... do. 22nd ... 465 ... ••• 211 ... 4 1 Taklee* ... do. 19th ... 448 11l 3 3 Kotooree ... do. 28th ... 224 3 ... ... 3 3 Koosumbhee* ... do. 20th ... 223 2 2 6 10 8 Patunsaonghi* ...July 31st ... 4,983 1 ... 6 36 41 1 ... 85 42 Thandoolwanee ... August 29th ... 126 2 2 2 Peepla* ... do. sth ... 188 ... 13 4 ... ซ8 4 PudreeKhapa* ... do. 21st ... 204 33 3 Daheegaon* ... do. sth ... 436 ... 16- 7 1 Nanda* ? do. 9th ... 136 2 2 ... Goomthi ... do. 19th ... 261 3 8 8 19 9 Googlee ... do. 9th ... 251 1 1 ••• Koraree ... do. Ist ... 1,294 ... 1 5 12 4 ... ... 22 12 Wariiigaon* ... do. 7th .. 580 9 9 4 V 137 1 I I " 111 I ฆ Kanhan Catchment, Raebaura ... August 26th ... 94 ... 1 1 ... 2 1 Kailod ... do. 23rd ... 4,387 ... 2 6 11 23 42 25 Nundoree ?.. do. 14th ... 443 1 1 1 Ramporee ... do. 31st ... 355 1 1 ... Mangsa ... August 21st ... 665 5 ... 5 3 Chargaon ... do. 23rd ... 296 4 7 1 12 3 Buraigaon ... do. 25th ... 570 5 5 I Khoobala ... do. 23rd ... 820 7 17 24 16 Kochee* ... do. 13th ... 570 25 25 12 Bawangaon* ... do. Ist ... 208 ... 2 ... ... ... ... ... ... ... 2 1 Oomree . ... do. 23rd ... 72 4 17 ซ. ... ... ... 21 19 Khapa* ...July 26th ... 8,007 2 34 30 29 6 1 102 55 Ramdongree* ...August Ist ... 18 ... 2 ... ... ... ... ... ... ... 2 2 Dobunghat* ... do. Ist ... 123 ... 1 ... ... ... ... 1 1 Neemthalai ... September 2nd .. 500 5 5 4 Koothoola ... August 21st ... 821 ... ... 6 .. ... ..] 6 6 Kumapoor ... do. 23rd ... 200 ... ... C ... ... ... ... ..." 6 6 Anjnee ... September 7th ... 2(35 ' ... ...... .3 31 Thigye ... August 23rd ... 282 \ 4 3 ... '„. 7 4 Wakoree ... do. 13th ... 2,371 ... ... ... 14 8 "! ..] ... ... ... 22 22 Chicholee* ... do. 4th ... 226 ... 1310.. 14 8 Muhadoolu* ... do. 4th ... 182 ... 1 3 ... .... 4 2 Duheegaon* ...July 30th ... 1,003 115 3 ... ... ..'. [". '", 19 9 Gosarwara ... do. 18th 240 ... 10 6 2 ... ... ... ... 18 18 Essapoor* ... do. sth ... 451 ... 10 9 ... ' ... "' '?[ '" ".' [[[ 19 19 Wahnee* .... do. 6th ... 413 ... 10 6 3 19 11 Pardee* ...July 31st ... 279 ... 843 15 5 Rohni* ... August Ist ... 381 ... 89 3 ... ... mmt \\[ ... t% [ 20 20 Thamuswari ... do. 10th ... 415 6 ... ... "* m 6'" 3 Setaiwar* ... do. 6th ... 555 ... 7 5 ... ... '" [][ ''" [[[ "] 12 3 Benaigaon* ... do. 6th ... 570 ... 25 " .. .... 7 7 Dorlee* ... do. 14th ... 443 5 1 ... ..'. " '". ," 6 4 Bena ... do. 9th ... 1,395 8 12 3 ... ... ... 23 23 Kamptee Cantonment ... do. 7th ... 48,831 13 29 26 13 3 84 64 138 STATEMENT No. ZX///.— (Continued.) — ปฆ—^ ...___ Cases of cholera reported in the week ending. 1, Kame of town or village. Date of first case. Population. July ' August< September. October. J | 31st 7th 14th 21st 28th 4th 11th 18th 25th 2nd 3 3 j. g g _ Stream between Kanhan and Pench. Paindree ... August 14th ... 185 3 3 ... Karumwhar* ... do. sth ... 991 ... 1 ... 62413 10 Degulwara* ... do. 29th ... 137 33 3 Pulsoree* ... do. 30th ... 150 66 6 Gondhee* ... do. 30th ... 294 ... 12 12 6 Soordwara ... September 10th ... 257 _ 2 ... Nwaigaon ... August 24th ... 132 '.'.'. '.'.'. ..[ Z'" 1'" 4"4 ... ... ... 9 6 Betowlee ..August 24th ... 158 ... 62 ." ... 8 3 Amgaon ... do. 28th ... 243 1 ... ... 1 1 Parseoni ... do. 9th ... 3,902 1 7 19 1 28 14 JPalora* ... do. 29th ... 586 11 11 5 Ohichbowan ... September 9th ... 69 ... 7 7 4. Nagaikhomd ..'. August 3 kt ...' 390 6 16 8 30* 24 Mhusdee* ... do. 26th ... 250 3102 15 7 BuTdiaree* ... September 9th ... 259 5 ... 5 ... Ourunda* ... do. lGth ... 789 22 2 Great Northern Road. Parada ...August 4th ... 709 ... 2 2 2 Wagholee ... do. 4th ... 50 ... 1 ... 1 2 1 Khundala ... September 10th ... 323 118 ... 10 3 Ramtek ...AugustSth ... 7,045 16.. 12.. 1 .... 11 6 Pm , T ? f Cases ... 5 121 206 376 355 285 108 58 25 ... f1,544 -j-855 urand lotai ...^y illages 4 24 31 45 57 49 23 n 4 124 _ __. Ml r-d-.) / Chhindwara - 2-69 I*ls 1-48 T96 ... 4-08 933 201 TO9 0-22 rvain-iaii ... j Nagpur e> 7 . 24 - 45 4 . 080 8 365 22 2-58 142 2 92 '25 "11 * Towns and villages dependent on the water of the main stream. f The figures in these two columns do not accurately represent the proportion of deaths to cases. From several villages only the deaths were reported. In some instances the deaths of persona attacked in one week and dying in th-j next, would not appear in the weekly returns, from which this and the other statements have been compiled. 139 STATEMENT XXIV. — Showing the prevalence of cholera in 1875 on the Loioer Kanhan. Cases of cholera reported in the •week ending Name of town or village. Population. Date of first case. jj u ly. August. September. October. 31st 7th 14th 21st 28th 4th 11th 18th 25th 2nd. Cases. I Deaths. Road from Raijpur. Shahpur ... 403 June 12th 7 3 Bela ... 474 July 9th 7 2 Bbandara ... 11,433 August 15th 39 14 Goomthalao ... 1,085 do. 31st 9 7 Tharsa Stream. ITharsa ... 1,192 August Ist 3 2 2 8 31 2 48 14 Ajungaon ... 447 do. 25th 1 1 ... 2 2 Dhamungaon ... 180 do. 27th 6 9 1 ... 16 4 Nowagaon ... 90 September sth ... ... ••• ••• ••• 1 •?• ... ••• 1 1 Korar ... 515 do. 9th 3 3 3 ' Gowree ... 817 August 9th ... 43 24 Khuraree ... 320 do. 30th 1 1 1 Kanhan River, Sonagaon .., 1,046 do. Ist 4 20 15 39 15 Mounda ".' 2,964 do. Ist ... ... 723 9 9 48*. 12 Bamdaiwara ... 308 do. 13th 1 2 3 1 Panmara .!! 335 do. 15th ... !..* ... 4 !'.'. '.*', '4 8 8 Peepree Z 474 do! 10th !!! !!! !!! 2 4 3 !.! 1 *..'. ... ... 10; 2 Charghat ... 154 September 25th 9 9, 2 Wainganga River. ' Pandhee ... 185 do. 2nd ••• 4523 3 13 6 Urjoonee ... 239 August 30th :. ... 1* 1 Oomree ... 112 do. 14th 5 5 2 Ambhora Khoord ... 409 do. 29th 3 3 3 tJewnapoor ... 836 do. 29th 1 1 1 rpTi t Cases'" ~ ... 21 62 62 45 47 17 23 12 362J 166 lotal ...| villages 5 8 12 10 7 7 1 1 2 30 ... T? fl inf a lir i, f Kamtek IjlTo "T2O ~To 2-80 ... M 0 I*Bo 4-20 -80 00 ... ... Rain-fall (inches)... I Bhandara J 6 . 13 4 .q 5 5 - 82 487 -45 2'hl 2-39 2-88 2-0 -10 ... I ... 140 MAP No. X. 327. Map No. X. shows the position of certain villages on the Wainganga river that suffered from cholera in October and November 1875. The Wainganga ia the main drainage channel of the Nagpur country (Map No. I.), and in a former part of this report (page 20 and pages 32 to 34) the spread of cholera along its banks from where it receives the Kanhan to where it falls into the Godavari has been traced. The portion shown in the map is above the junction with the Kanhan ; the volume of its stream is somewhat larger than that of the Kanhan, and it has a broader bed of sand, but its banks are not so high and precipitous ; it here flows through an open undulating plain, the soil of which is alluvial, but containing a large admixture of sand, and rice forms the staple crop cultivated. The villages are nearly all built on high ground, formed of either rock or gravel. As water ia in most places easily obtainable from wells at a moderate depth below the surface, wells form the chief sources of water-supply ; where the river flews conveniently near, the villages on the banks draw water from it; but in many places a wide bed of loose sand intervenes between the bank and the stream, and renders the latter difficult of access. Near a great number of villages, particularly those to the east of the river, there are one of more tanks, but the water of these is not used for drinking, excepting by some of the low castes. 328. In the month of June and the early part of July cholera had appeared in a few villages along the Eastern road, and in August and September several villages on and near the Wainganga below the junction of the Eanhan had suffered ; but the district to the north and north-east of Bhandara remained free of cholera till the 23rd September, when it appeared in the village of Chandori on the Waingaga, 12 miles above Dhiwarwara, where the upper road from Raipur to Kamptee (page 19 Map No. I A.) crosses the river 18 cases, 8 of which were fatal, occurred in this village between the 23rd September and the 4th October ; subsequently the village of Lahan Khurdee on the river, a short distance above Chandori, was attacked, and 12 cases were reported between the 17th October and 2nd November. The first case in Dhiwarwara occurred on the 12th October, and on subsequent dates the disease appeared in the four other villages indicated in the map above Bhandara. A solitary case occurred at Harda, where the lower road to Raipur crosses the river, on the 2^th September, and another on the 20th November. 328 A. The statement on the opposite page shows the number of cases and deaths reported from each of the five villages. From Dhiwarwara the reports appear to haive been made every other day, but. when the severe out-break at Mandwi became known daily reports were required. 1 inspected the villages of Mandv&i, RailgaOn, Khaniari, Suraiwara, and Taukli on the Bth November, accompanied by the Deputy Commissioner and the Civil Surgeon, and on a subsequent occasion 1 visited the villages of Kuturna and Khyri. JSio information regarding the first cases that occurred at Dhiwarwara was furnished in the weekly reports; the village depends for water upon an old channel of the river ; when cholera appeared the rains had scarcely ceased, and a part of the stream would have been flowing through this channel, but as the river fell this stream would decrease and finally cease. The riป_>ht bank of the river in this part does not rise so abruptly as the left bank; a broad bed of loose sand separates the village of Taukli from the stream, and as there are several good wells in the village, the people use the water of the river but little. At Kothurna also there Is a good well, and though the low castes use the water of the river, they get it from holes in the sand. At Khyree, during the rains, and for some time afterwards, the people use the water of the small stream that runs close by. At Manduf the banjk of the river rises precipitously above the stream ; the site and the ground around for some distance is rocky, the formation being laterite and 141 No. XXV. — STATEMENT of 'cases and deaths from cholera in certain villages on the TPainganga river. Dhiwarwara. Mandur. Bailgaoo. Khamari. Suraiwara. Rainfall. Cases. Deaths. Cases. Deaths. Cases. Deaths. Cases. Deaths. Cases. Deaths. ha J dara (inches. ) Get. 11 1 , 0 ฆ.. ป•. ปฆ• ฆ•. ป•ซป • ซ •ฆ• 12 23 \ 4 , ... ... 0 : 09 24 ) 0-59 25 * >36 15 030 28 \.\ '.'.'. 6 2 ... ..'. 1 1 ..'. 29 30 5 3 2 2 3 1 31 4 3 5 1 1 1 1 2 3 3 3 6 2 4 2 2 1 5 ... ... ... ... ... ... ... .•• ... ... ?, 6 ... ... 6 1 Total ... 12 4 82 35 6 2 17 11 7 2 Population. 239 419 55 492 100 conglomerate ; water is drawn solely from the river, the approach to which is through a narrow ravine ; the current at this point was in midstream, and in the place where the people weie drawing water there was little or no current ; the approach to this point was very much fouled, and as usual the washing of clothes and cooking utensils was performed at the same place where the women were drawing water. The first person attacked was? a woman of the Teli caste, the next was a Dher, and after him his wife and two children ; between the 15th and the 2 1st 11 cases occurred ; but the severest out-burst occurred between the 23rd and 26th, ,36 cases occurring in three days ; and it will be observed that in the course of the three days 23rd to 25th, nearly an inch of rain was measured at Bhandara, a sufficient quantity to wash the tilth of the ravine into the river at the point whence ithe people were drawing their water, Khamari is well placed on the bank of the river ; the soil is den^e and clnyey, and in wet weather the village would be muddy ; but wheu JL was there, a few days after the outbreak, 142 the surface was quite dry. The first person attacked here was a youth, a servant of a Brahmin living jn Bhandara, who possessed land both in Khamari and Mandur : this lad had been to Mandwi on tho 28th nnd carae back sufferinsf from cholera. The next two persons attacked were women not living near where the lad died. The water-supply here is drawn from a pool formed by a back-water with little current through it, and clothes were washed in the same pool. The village of Suriawara consists of two parts, the larger part about 3 furlongs from the river and drawing its water-supply from wells ; the smaller portion containing about 100 inhabitants situated on the edge of the river bank, and dependent for water entirely on the river; it was only on this small hamlet that cases of cholera occurred. The bank at this point is about 30 feet above the stream, the site was very dry and clean-looking, the surface of the ground being thickly strewn with ฆwhite quartz pebbles, but as usual the ravines that intersect the bank were much fouled. The pool from which the water-supply is drawn is shut off from the main stream by a ridge of sand, and when I was at the village the stream flowing through this pool was very small; a week or ten days earlier the quantity of fresh water flowing into this pool would have been a little greater. The small village of Bailgaon is situated, like the others, high above the stream, and the site is rocky and dry, the current here sits under the bank, and the people draw dir: :t from the stream ; no cases occurred among the 55 inhabitants of this village till the 3rd November, when 6 cases occurred iv the course of a few hours. On referring to the annexed statement it will beseen that by the Ist November the epidemic had almost ceased in all the villages, only one case occurring on that day. On the 2nd no case occurred in any of the five villages. On the 3rd, we find cases occurring in all the villages of the series with the exception of Diwarwara. This circumstance seems to point to some special circumstance simultaneously affecting the inhabitants of these villages. It is possible that the epidemic spread from village to village by direct intercourse between their inhabitants ; the appearance of the disease at Dhiwarwara was probably due to importation, and there is evidence that this occurred with respect to Khamari ; moreover the fact that all the villages attacked lie on one side of the river, those on the other side remaining free, also points in this direction ; on tha other hand the fact that the river forms the corumon source of water-supply to all the affected villages and that the dates of the first cases fall in a consecutive series according to the position of the villages on the bank of the river, seems to point to the communication of infection through the medium of the water. The supposition of communication by means of the river also best accounts for the simultaneous recurrence of cases in four of the villages after the epidemic had apparently ceased. The volume of the river was at this time very large ; but it is not more unreasonable to suppose that a large volume of running water may convey infecting material through a distance of a few miles, than to suppose that it may be so conveyed by atmospheric currents. 1 may here note that throughout the month of October the wind directions registered at the observatories at Raipur and Nagpur were almost constantly N.E. and E.,. so that any miasma arising from the river bed would be carried away from the affected villages and towards those on the opposite bank which did not suffer from cholera. 329. The town of Bhandara lies at some distance from the river; the natural drainage of the locality is good, but it is considerably interfered with by the numerous tanks which surround the town on all sides ; to the east of the town between it and the river the ground is low and swampy, and the channel of the river is narrowed by rocks a short distance below ; this low ground is liable to floods, which sometimes reach the town and station ; this happened twice in 1875. Many of the low castes draw water from the numerous tanks, but the water-supply of the general population is drawn from wells ; the water of the wells within the town is saliae, and the wells most used are situated near 143 the drainage channel that runs between the town and station. In former epidemics the population of the town had suffered severely from cholera ; in 1866 150 deaths were reported, and in 1569 180, the number of inhabitants being 11,500; these severe epidemics had occurred in the months of July and August, when the water in the wells was beginning to rise. When therefore the epidemic of 1875 was approaching Bhandara from Raipur I pointed thia circumstance out to the Deputy Commissioner, and suggested that special care should be taken to protect these wells. The Deputy Commissioner accordingly closed the wells that seemed to him most liable to contamination, and took measures for protecting the others, while strict conservancy of the whole locality was enforced. In the epidemic years of '875 and 1876 the population experienced remarkable immunity. In 1875 two deaths occurred on the 15th of August and a third on the 4th October. These cases were all of people belonging to the same caste (Telia or oil-makers), but between the 19th and 29th November a remarkable out-break occurred among the low castes using the water of one of the tanks ; most of the persons attacked were women employed in washing in the tank. On and about the 19th numbers of people were passing through the town returning from the Ramtek fair, and it is worthy of note that a fatal case of cholera occurred on the 20th at Khurda where the road crosses the river. In the course of the ten days 26 persons were attacked with cholera, and of these all but 2 were low castes ; the 2 belonging to other castes were males. Of the 24. low castes, 6 were children under 12, 4 boys, and 2 girls ; 18 were above 12 years of age, and of these 4 only were males and 14 females. The low castes constitute about 14 per cent of the total population of the town. In the following year cholera again visited the town in the month of July, and 41 deaths occurred ; this time the low castes did not suffer, but the epidemic again fell chiefly on the women. Of 26 persons between the ages of 12 and 50 attacked, 5 only were males and 21 females. 330. From the fact of the towns and villages that suffered from cholera having been so generally situated on the banks of rivers and streams, I have been naturally led in this section of the report to dwell very much on the connection between cholera and water-supply ; I do not, however, forget that for many years common opinion has assigned to cholera a.n origin from the soil, and that this theory has been lately advocated ; in/deed I was myself inclined to adopt it before my duties led me to inquire into the subject; a short experience of practical inquiry was, however, sufficient to convince me that this theory fails to meet the varied and opposite conditions under which cholera occurs. Probably no country, certainly no part of India presents a greater variety of rock and soil than the Central Provinces, yet although cholera may find the conditions necessary to its prevalence more frequently in one rock than another, there is no formation which confers immunity on the population dwelling on it. Virulent out-breaks perhaps occur most frequently in the trap formation, but out-breaks equally yirulent and fatal not unfrequently occur in populations dwelling on sandstone or crystalline rock and alluvial deposits. So also with regard to position. ; a large proportion of the cholera villages shown in the maps lay on the banks of large rivers ; but many that suffered were situated in the open plain or on the tops of hills. An illustration jndeed might have been furnished from the district of Bet ill of an epidemic confined chiefly to villages situated on rocky hills and stony uplands. The most violent epidemic of cholera I have had to investigate occurred during the drought of 1869 among the population of the volcanic p 1 teaux of the Mandla district, which form part of the watershed of Eastern at;d Western India (Statement Vll. and page 58). We find cholera also prevailing witty equal severity under totally opposite conditions of soil when it has been parched and burnt by long continued drought and exposure io the sun of April and May, and after it has been saturated by the heavy rains of the monsoon. The Nerbudda valley presents a long 144 tract of alluvial deposit ; in one part of this valley the epidemic of 1876 ran its course in the hot dry months of April, May and Juns, before the rains set in ; it reached another part at some distance from the locality of the first outbreak while the hot weather was still continuing, and attained its maximum of prevalence during the intensely hot weather that precedes the arrival of the monsoon ; but many villages were attacked after heavy rain had fallen, indeed in some instances the same villages which had suffered in the hot dry weather experienced a revival of the epidemic after the rains had commenced. In the rocky circle of Bhai&dye, in the Hetul district of the Satpuras, cholera prevailed with great severity in the dry month of May, and again with nearly equal severity in the wet month of August (paragraph 161.) 331. The following are a few illustrations of the physical conditions (particularly of the state of the soil and the level of the sub-soil water) under which local out-breaks of cholera have occurred. I may here remark that for the observation of the rise and fall of the level of the sub-soil water in the different localities, wells have been selected as remote as possible from the water-courses, tanks and excavations which are commonly so numerous in native towns. Many of the wells, however, from which the people draw water for drinking are in close proximity to such places and would be liable to be affected at the commencement of the rains before water could reach the well under observation, by percolation from the surface. The observations of the subsoil water level were commenced in 1869, but unfortunately not before the middle of July, after the rains had set in ; but in that year of drought the subsoil water was many feet below its usual level, and by the end of the hot weather the wells were nearly everywhere dry, and it was some time before they began to be affected by the rain-fall. The first statement exhibits the weekly prevalence of cholera in the epidemic of 18C9 in relation to the rain-fall and changes in the level of the sub-soil water in the town of Bhandara, and furnishes an illustration of cholera prevailing severely in a locality during the rains and afier the water in the wells had commenced to riss. Cholera in the toun of Bhandara in 18G9: population 11,433. Week ending. JJnly. August. September. 17th 24th 3lsfc 7th 14th 21st 28th 4th 11th Deaths from cholera. ... 3 27 49 62 29 7 2 ... Rainfall (inches) 4-30 2"84 5;96 ... 204 1-31 435 00 0-25 Depth of sub-soil water ft. ft 1 ft. in. ft. in. ft. in. ft. in. ft. in. ft. in. ft. in. from surface of ground. 28 28,25 10 23 723 10 24 421 1016 1116 10 The site of the town of Bhandara is formed of laterite mixed with a good deal of clay. The nature of the water-supply used by the inhabitants has been described in connection with Map No. X (paragraph 329). I need here only remark that the veils from which water for drinking is chiefly drawn would be affected by rain-fall sooner than the well used for the observation of the level of the sub-soiJ water. 145 332. The next statement exhibits the weekly prevalence of cholera in 1869 and 1876 in the town of Chanda, and furnishes an illustration of cholera prevailing in two consecutive epidemics in the same town at the same season of the year. The well used for the observation of the sub-soil water in 1876 waa not the same as the one used in 1869. Cholera in the town of Chanda : population 15,233. A f** ~ Cholera. -g | * Cholera. a ฐฐ2O2 O a M |ฐ Week ending. Z *g ** ซ^ Week ending. 'Z <3 v 6 1 mi t i -I till i f ft. in. ft. in. July 3rd 60 July Ist '7717 5 2 2 „ 10th 1-20 „ Bth -78 17 5 64 12 „ 17th 4-2027 11 „ loth 4-40 17 5 32 6 „ 24th 17426 9 ... 12 „ 22nd 2-2717 4 9 2 „ a Ist 254 25 3 ... 20 „ 29th 2*9016 10 18 8 August 7th 3-0724 3 ... 93 August sth O'l3 lG 9 38 11 „ 14th 0-7222 8 ... 106 „ 12th 2-46 16 6 128 38 „ 21st 010 22 11 ... 27 „ 19th 0-3816 3 37 10 „ 28th 3-6319 4 ... 15 „ 26th 4-5215 11 28 9 September 4th 4-72 17 1 ... 6 September 2nd 539 14 10 11 6 „ 11th 0-3715 ... 2 „ 9th -8114 4 5 2 „ 18th 1-7P14 „ 16th l-65'3 6 13 7 „ 25th 6-95 10 „ 23rd 2-5012 5 5 2 Total ... 363 281 Total ... 390 110 The rock that underlies the town of Chanda is sandstone belonging to the coal measure series, and tbe superficial soil contains a large admixture of sand. The pc ople draw their water chiefly from wells, but a portion of the population use the water of the river, digging holes in the sandy bed. There is also a large tank outside the walls to which the women resort for washing clothes. In 1869 the district suffered severely from the drought of that year, and at tbe end of the hot weather the water in the wells was very much lower than usual. A few showers occurred in the latter part of June, but no heavy rain fell till the 12th July. Cholera did not reach the district till the latter end of June, and no cases occurred in the town till after the middle of July ; the epidemic then spread rapidly, and the mortality was great. The prevalence of the disease was by no means equally distributed over the town ; the greatest number of deaths occurred in the south-west quarter where the well water is saline, and the people draw their water from jhiriahs in the sandy bed of the river. The Dhers also suffered in greater proportion than the other castes.* It will be observed that at the time of the out-break the level of the water in the wells had commenced to rise. In 1876 cholera had been prevalent in the district since the early months of the year (page 30). A few cases had occurred in the town in the course of June, but it did not become epidemic till after the rains had set in. There were two distinct out-breaks, the first was almost entirely confined to a part of the town inhabited by Dhers ; in the second out-break the epidemic was distributed more generally among the population ; when the disease first broke out the rain-fall had not been sufficient to affect the level of the water in the well used for measurement ; but when the second out-break occurred the water level had * Sanitary Report for ?86J. 146 commenced to rise. The number of cases among the Dhers and low castes in this epidemic equalled 50 per 1,000 of the total number of the low caste population; among the general population the number of cases amounted to only 16 per 1,000. Of 218 adults (between the ages of 12 and 50) attacked, 86 were men and 132 women. The epidemic was remarkable for its mildness j of 390 cases reported, only 110 died, the number of deaths being equal to only 27 per cent of the number of cases ; in the first four weeks of the epidemic the percentage of deaths to cases was under 20. In the epidemic of 1869 363 cases were reported, of which 281 or 77 per cent were fatal ; it is probable that in the epidemic of 1869 some of the milder cases were not reported ; but there can be no doubt that the disease was very much more fatal in that year than in 1876. The comparative mildness of the last epidemic may perhaps have been in some measure due to to the fact that in the interval between the two epidemics good conservancy arrangements on the dry earth system had been introduced into the town and all the wells had been put in repair. 333. The next Statement shows the weekly, prevalence of cholera in the town of Jubbulpore in 1869 and in 1876, and is a remarkable illustration of the disease occurring in the same town under totally opposite conditions of soil and sub-soil : — Cholera in Juhbulpore: population 43,223, 1869. 1876. I Jg-d Total. | J| Cholera. v a _, c 3 2 3 a m S P . ____ .3 oo co Weekending. ซs-ฃ VVeek epding. "SJ g 1 -I! - - 3 sis, - J I I 1I 1 - I I I I** 1 I Aprill7th ... 3 ... 12 ... „ 24th ... ฃ ... 52 ... May Ist ... ฃ ... 85 ... „ Bth ... p, ... 69 ... „ 15th ... $ ... 64 ... „ 22nd ... ... 45 ... „ 29th ... g^ ... 86 ... ... ft. in June sth ... ซg ... 27 June 3rd ... 15 7 „ 12th ... ฉ5 g ... 3(, 10th ... 16 4 „ 39th ... sซs ... 17 „ 17th 0-4616 8 „ 26th 2-17 * ... 23 „ 24th 1-4016 9 July 3rd 2-70 ft. 19 July Ist 1-0916 11 „ 10th 4-50 23 .. 23 „ Bth 7-3215 10 3 1 „ 17th 5-4(i 20 5 „ 15th 3*78 13 10 16 10 „ 24th 9-07 18 ... 5 ? 22nd JO-48 7 10 55 23 „ 31st 7-68 16 ... 9 „ 29th s'4V> 2 0 124 69 August 7th o*BB 13 .. 7 August sth ซ -67 2 8 103 55 „ 14th 0-(>2 IS ... 4 „ 12th 3-27 2 11 61 33 „ 21st 3-C3 [18 3 „ 19th 2-25 1 10 20 II „ 2Sth 315 1? „ 26th 512 1 2 4 2 September 4th 207 V September 2nd 1-68 1 3 5 ... Total ... 541 Total ... 391 204 147 The substratum underlying the town of Jubbulpore is disintegrated granite and very porous. The water-supply is derived chiefly from wells; many of the wells are, however, in close proximity to tanks, and the water in them is simply the water of the tanks filtered through a very porous material ; the tanks are more or less filled by surface drainage from the area of the town. The drought of 1869 fell very severely on the district and town of Jubbulpore. In April, May and June, wells over thirty feet deep were dry, and deepening them was found of no avail, the water in the substrata was exhausted, and the people were reduced to great straits for water; the better classes fetched it from a distance, and the poorer classes were dependent upon holes dug in the beds of tanks, and other precarious sources. Cholera had commenced to spread in the districts in the month of February, but no cases occurred in the town till after the middle of April; it then spread with rapidity, and, as may be seen in the table, occasioned great mortality. No rain fell through the months of April and May or until the last week of June, and during this period the heat was intense; the mean temperature of the month of May was 97ฐ, the mean of the daily maxima temperatures J.lO, the mean relative humidity of the atmosphere during the same month was 16 (Sat. being = 100). The prevalence of the epidemic had declined before the rains set in, but many deaths continued to occur through several weeks after the rains had commenced, and the epidemic did not finally cease till the end of August; but, on the whole, the prevalence during the rains was comparatively light. In 1876 the epidemic had reached the northern part of the district in May, but the southern circle, in which the sudder town is situated, did not become involved till the beginning of July (paras. 155 and 165), and no cases .occurred in the town till the 7th; from that time till the middle of August it prevailed with severity., but it ceased about the same time as the previous epidemic. The epidemic of cholera at Khandwa in 1872, described at page 76 of this report, affords an example of the disease prevailing in the same locality in the hot weather and again in the rains of the same year. The site of Khandwa is formed of hard basalt denuded of soil. 334. The next statement affords another illustration of a very violent epidemic occurring under conditions of extreme heat and drought. Cholera in the town of Ralpiir in 1869 ; population 19,116. Week ending May. June. July. 15th 22nd. 29th sth 12th 19th 26th 3rd lOth 17th 24th I 31st I Cases ... IHO 561 314 102 J4 3 12 20 28 8 I Cholera. < ( Deaths $1 30$ 139 32 8 1 5 9 13 5 1 Mean daily maximum temperature in shade ...a08 <3 109ฐ108ฐ108 c 'lo6 c> lo6 c 102ฐ 91ฐ 86ฐ 88ฐ 83ฐ 88ฐ Rain-fall (inches) 0-14 0-01 ... 001 ... 2-20 445 320 2-80 12-58 0-53 _^ I The town of Raipur is situated on high ground, and the formation consists of laterite overlying hard limestone, The water-supply is derived to some extent from wells, but the mass of the population use the water of tanks. The 148 tv ells are, many of them, over 40 feet deep, but at the time of this out-break of cholera they were all dry, and the little water that remained in the tanks was putrid. The mean temperature of the month of May was 97ฐ; the first rain that would appreciably affect the surface of the ground fell on the 22nd June. 335. For an example of cholera prevailing under the local conditions induced by snow and frost we must go beyond India, and the following statement showing the monthly mortality from cholera in St. Petersburgh daring the epidemic years of 1871 and 1872 will make the series of illustrations of the varied states of climate and soil under which cholera may prevail complete. Cholera in St. Pelersburgh ** population 050,000, "™ 187T! 1372. ~" *~ utUti liilllffft*l*f !lfi Total ' ' ] ~ i Deaths ... 3 515 1 3 2 4 3 4 186 341 100 105 98 66 601,103 108 99 1 618 731 315 13118 12 45 4,200-i I We see here that cholera first assumed epidemic activity in the month of August 1870, and attained to a considerable degree of prevalence in September. In October and November it declined, and continued comparatively quiescent during the next three months, but it remained present, and in the month of March suddenly assumed great activity, a far greater number of deaths occurring in this month than in any other months of the two years. Through April and May it was comparatively quiescent, but became active again and attained to a high degree of prevalence in the months of June and July; during the subsequent months it again declined and almost ceased in November, but in December it again showed a disposition to increase. [am unable to show the meteorological and soil conditions that obtained during each month of the two epidemic years, but the following statement, the data of which I have extracted from l)rs. Lewis and Cunningham's recent report, gives the mean temperatures observed at St. Fetersburgh during each month of 1875, and these may be taken to represent approximately the temperatures of the different seasons. >ป is *: •ป ฃ ฆ JB JS a SJ i _ฃ ฃ 5 i til gog o ฃ Mean temperature i (Fahrt.) ... 60>56 O> 5 17ฐO IS^S! 30ฐ2 47ฐ5 59ฐ7 65ฐ 7 58ฐO 48ฐ0 35ฐ 0 24ฐ0 Bฐ-6 35ฐ0 From this statement it appears that the mean temperature of the month of March, when cholera attained its highest prevalence, was probably 14 degrees below freezing point, and we may infer that the surface of the ground at this time was frozen and covered with snow. The months of June and July, when the epidemic again attained a high degree of prevalence, are the hottest months of the year, the temperature of these months being aboat the same as that of the same months in England. • Note.— For this table lam indebted to a report kindly lent me for perusal by Mr. Netten Radcliffe. 149 336. We find then that the epidemic at St. Petersburgh, taken by itself, equally with the epidemics in Central India, furnishes evidence to the effect that cholera may attain a high degree of prevalence in the same locality under very opposite conditions of soil and climate ; and when we contrast the conditions tinder which the disease prevailed so severely in St. Petersburgh, in the month of March 1872, with the conditions that attended the violent epidemic out- breaks that occurred in Jubbulpore and Kaipur in the month of May 1869, the evidence that cholera has no direct relation to any particular state of the atmosphere or to any particular condition of the soil becomes conclusive and irrefragable. A disease that can prevail with virulence when the thermometer indicates 15 degrees of frost, and also when it rises daily to 110, the hygrometer at the same time indicating the air to be almost absolutely dry, and again after weeks of heavy rain when the atmosphere is laden with moisture, cunnot be directly dependent on any state of the atmosphere. A disease cannot be a product of the soil if it can prevail in one locality with equal severity when the ground is bound by frost or covered with snow, as where these conditions are reversed by the warmth of summer, and if it can prevail in another locality both when the ground is parched and burnt by exposure through several months to hot winds and a tropical sun, and when the same ground has been saturated by heavy rain At the same time the fact that the prevalence of cholera is seasonal, that cholera is more liable to prevail in certain localities under one set of atmospheric conditions, and in other localities where these conditions are reversed indicates that its prevalence is subject to the action of the atmosphere on some one of the local conditions under which populations dwell, and the evidence that has been adduced in the previous pages seems to me conclusive that the water-supply of the people is the one condition which is thus influenced by atmospheric changes and thus brings changes in the state of atmosphere into relation with cholera. There is no need to adduce evidence that both rain-fall and drought have a tendency to render water unwholesome and unfit for use, tind that frost and snow may produce the same result is more than probable. I have no knowledge of the nature of the water-supply of St. Petersburgh, but from accounts lately published, the conservancy of the city seems to be most imperfect at the best of times, and to be especially inefficient during the winter months; and where the air is fouled by emanations from defective latrines the water-supply cannot be safe. 337. The theory that assigns to cholera an origin from the soil is based almost entirely on the circumstance that it is constantly present in the delta of the Ganges, which, in the alluvial nature of its soil, the high level of the subsoil water, and its moist climate, is supposed to present the conditions most favourable to the development of malaria ; but the history of cholera in other parts of India shows that it is not dependent on these conditions, and there are many parts of India where malaria is more constantly present and more destructive to life than in the Gangetic delta, but where cholera is a comparatively unfrequent visitor. Moreover the seasons in which cholera finds the conditions most favourable to its prevalence do not coincide even in the delta of the Ganges with the seasons in which the prevalence of ague gives evidence of the most abundant elimination of malaria. Cholera attains its maximum of prevalence in the months of March and April, when fever is comparatively little prevalent. Cholera is least prevalent in September, when the prevalence of fever increases rapidly. In most other parts the seasons of cholera and fever are more distinctly separated ; over nearly the whole of India fever is least prevalent in the months of June and July and the early part of August, most prevalent in the months of September, October and November. Over nearly the whole of India beyond the Gangetic delta, cholera attains its maximum of prevalence in the months of May, June and July, declines through the months of September and October, and becomes quiescent or extinct in November. 150 The cholera season in the delta of the Ganges extends from November to May t. c., through the dry season of the year, and its period of greatest prevalence comprises the months of March, April and May. During this period the surface of the ground is dry, and the natural drainage of the sub-soil most complete; if, therefore, cholera is a disease produced by an emanation from the soil, all received opinions concerning the conditions favourable to the development of such emanations and the measures necessary for their removal are wrong; but finding that fever, which is generally acknowledged to be a malarial disease, does attend ji water-logged soil, and that its prevalence is mitigated by bringing about those conditions of soil and sub-soil under which cholera attains its maximum of prevalence, we conclude that both diseases cannot have the same or a similar origin, and consequently exclude cholera from the category of malarial diseases. On the other hand, the theory that connects the prevalence of cholera with impure and contaminated water finds ample confirmation in the constant presence of the epidemic in the Gangetic delta. The population of the delta is little short of 600 to the square mile, probably the most dense rural population in the world; this dense population draws its water-supply from the rivers on the banks of which it dwells, from stagnant bheels and creeks, or from tanks, in all of which the water is subject to pollution from surface drainage, and to the deterioration from exposure to the sun and rapid evaporation. In conjunction with this dense population and these exposed sources of water-supply, there is utter \v r ant of conservancy or endeavour to preserve the water from pollution; the banks of the rivers and the nallas that lead into them are used as latrines, and the people wash their clothes in the same tanks from which they draw water for drinking. The annual death rate of the population is probably not less than 40 per 1,000, and the greater number of the dead are thrown into the rivers and nallas, or are buried in the borders of the tanks. Cholera is most prevalent among this population in the months of March, April and May, when the rivers are low, when the bheels and khalls are stagnant, and when the impure water in the tanks is most concentrated ; it is least prevalent during the months of August and September, when the surface of the soil has been washed and scoured by heavy rains, when the rivers are in flood, when the water in the khalls is kept in motion, and wl^en the concentrated foulness of the tanks has become diluted. The reports of the Sanitary Commissioner for Bengal, particularly the report for 1876, furnishes ample evidence of the intimate connection between cholera and contaminated impure water, and a valuable paper published a few years ago by Surgeonr Major W. J. Palmer, the Chemical Examiner to the Government of Bengal, shoivs conclusively that even in tanks situated favourably in respect of removal from external sources of pollution, the water which is pure and wholesome at the end of the rainy season becomes progressively impure as the dry season advances, and becomes absolutely unfit for human consumption before the rsjns of the following monsoon set in, SECTION 111. The distribution op Cholera in different districts and among different CLASSES OF THE PoPOLATIOtf. 338. The general results of the epidemic of the two years 1875 and 1876, and the various degrees in which the populations of the several districts of the Central Provinces were affected by it, are shown in the Statement at page 2 of this report. Jn Statement No. 11. which forms Appendix IV., the prevalence of the epidemic in the towns and rural ciroles of the several districts is given in greater detail. It will be seen in Statement No. I. that out of 27,108 towns 151 and villages in the Province, 3,813 or 14 per cent were visited by cholera in tho course of the two years, and that the total number of deaths from the same cause amounted to 34,792, equal to 4*67 per 1,000 of the population. The prevalence of the epidemic was very unequally distributed over the Province. Taking the primary topographical divisions we find that the Satpura Division suffered the least; only 6^ per cent of the villages were attacked, and the mortality was only 2*52 per 1,000, a little more than half the mean rate of mortality for the whole Province. In four of the six districts of this division the rate of mortality was little more than 1 per 1,000, and in two only one per cent of the villages were attacked: the Satpura Division is the most sparsely populated of all the divisions of the Province. The Mahanadi Division, or the portions of it that are under the direct administration of Government, contain the greatest number of persons to the square mile ; the percentage of villages attacked, and the ratio of mortality in the division was just double that of the Satpura Division. The epidemic attained its greatest prevalence in the Nerbudda Division, and the influence of density of population in modifying the prevalence of cholera was very evident in the varying degrees in which the different parts of this division suffered in 1876 (Statement XVII). Taking the whole division, the percentage of villages attacked and the ratio of mortality were just three times what occurred in the Satpura Division : the population of the Nerbudda Division, though not quite so dense as that of the Mahanadi districts, is nearly double that of the Satpura Division. 339. But while, on the whole, the sparsely populated tracts of country suffered less than those in which the population is more d9nse, each division furnished exceptions to the general rule, and it is evident that the influence of density of population on the prevalence and spread of cholera is subject to modifying conditions : these conditions are chiefly extent of traffic and communication with other districts, distance from the locality in which cholera is endemic, or in which the first epidemic out-break of the season occurred, and lastly, the condition of the tract of country in respect of water-supply : all these conditions contributed in various degrees to modify the incidence of the epidemic on the populations of the different districts ; for instance the district of Sambalpur, from its proximity to the shrine of Juggernath, and from its being traversed by one of the chief pilgrim routes, is very frequently visited by cholera, but it is remarkable that epidemic prevalence is never so severe there as in the districts of Bilaspur and Raipur (Statement VII, page 15) ; this is probably due to its more abundant water-supply. The geological formation of the district is crystalline, the facilities for the storage of water are greater, and the tanks are larger than in the other two districts, the rain-fall of the spring months is much greater and the climate is more moist, it is not therefore so subject to the violent our-bursts of cholera that are apt to occur in the hot weather in the districts of Raipur and Bilaspur. The districts of Balaghat and Bhandara again are on the crystalline formation ; Balaghat also is very remote, and its communication with other districts limited. Bhandara is traversed by great traffic in the hot weather between Raipur and Nagpur, but the routes by which it is approached from Kaipur, and by which cholera is usually imported, run through a wide tract of jungle, which is very sparsely populated. The district of Ward ha lies wholly in the trap formation, which I have above explained, is more liable than any other formation to severe cholera ; it has, moreover, a comparatively dense population, and active communication with other districts. Sironcha or the Upper Godavari district, though remote and very sparsely populated, suffered severely from cholera, but all the villages attacked were on the banks of the Pranhita, which is the continuation of the Wainganga, and this river, as I have before explained, (pagt a 33-34) supplied the means by which the epidemic was imported. Burhanpur and Betul were the only districts of the Satpura division that suffered severely ; Burhanpur is traversed by one of the chief lines of communication, and is closely surrounded by more populous districts, in which the epidemic was extremely prevalent. Betul lies in the hills, but is traversed by the lino of communication between the Nerbudda valley and Berar ; cholera obtained admittance 152 early in the epidemic of 1875, and continued prevalent both in that and the following year, finding the conditions most suitable to its prevalence in the trap hills that lie between the Tapti and Berar. The mortality rose higher in the district of Narsinghpur than in any other district of the Province; the population is dense, and the epidemic attained its maximum of prevalence at a season ฆwhen, owing to prolonged delay in the arrival of the monsoon, the water-supply of the inhabitants was almost exhausted. Jubbulpore has an equally dense population, but the mortality from the epidemic was comparatively light; the district lies at a greater distance from the locality in which the first out-break of the epidemic occurred ;it was subjected to the epidemic in one only of the two years, and in that year the epidemic did not reach the more populous portion of the district until after the monsoon had set in. These circumstances will explain the absence of regular and definite correspondence between the mortality from the epidemic in the different districts and the density of the population. 340. The several maps will have shown how the villages attacked fall into groups around certain centres or extend along the banks of rivers and streams leaving wide areas altogether free ; in no district did the number of villages attacked equal 50 per cent of the total number. This immunity of so large a proportion of the villages was, no doubt, due in a measure to the absence from many of them of the condition that renders populations amenable to the infection ; but in many cases it was in all probalitity due to the infection not having been imported or applied, and this is rendered the more probable by the fact that the towns or centres of the populations did not experience a like immunity. In Statement 11, (Appendix IV), the statistics are given of 72 towns scattered over the different districts of the Province ; many of these from their small size are scarcely worthy to be called towns, but they are all civil or police stations and bazar towns in which the traffic and intercourse of a wide circle of villages centre. Of these / 2 centres of population, only 2, Khurai, a small town in the north of the Saugor district, and Burha, which forms the civil centre of the Balaghat district, escaped cholera in the epidemic years of 1875 and 1876 ; and that their immunity was due rather to the infection not having been imported into them than to the absence of the local conditions that favour the prevalence of cholera, is evident from the fact that both became infected in the course of 1877. ]n February of that year Burha became involved in the epidemic that ensued upon the dispersion of the people from the Ramtek fair in the previous November ; and in the following October cholera was imported into Khurai by immigrants from the North- West Provinces seeking refuge from the famine that then threathened. In the districts over which the epidemic spread in 1876 as well as in 1875, the towns suffered in both years. In the Nagpur district, for instance, there are 12 towns having populations above 4,500 (the statistics of which are kept separate from those of the surrounding circles), and 1 ,634 villages ; in the epidemic of 1875 ll of the 12 towns and only 325 or 20 per cent of the villages suffered ; in 1876 10 of the towns suffered, including the one that escaped in the previous year, but only 93 or 5 per cent of the villages suffered. In the Wardha district there are 8 towns and 872 villages in 1875, 7 of the towns and 35 per cent of the villages suffered ; in 1876 5 of the towns (including the one that escaped in the previous year) but only 7 per cent of the villages were attacked ; in neither district were the villages that were attacked in 1876 as a rule the same as those that had suffered in the previous year. That this greater liability of the towns to be visited by cholera is not altogether due to the conditions necessary to the development of the disease being more generally present in them than in the villages, is evident from the fact apparent in the numerous statements given in the preceding sections, that the mortality in villages that are attacked is, as a rule, far greater in proportion to the population than in the towns. 153 341. Statement XXVI. overleaf shows the extent to which certain towns of the Central Provinces suffered from cholera during the two epidemic seasons of 1875 and 1876: the relative proportion in which males and females suffered from the epidemic in these towns is also given, as well as the proportion of deaths to cases! It will be seen that the epidemic fell on very many of these towns with great severity, in others the prevalence was comparatively slight, and we argue from this varied degree of prevalence that the incidence of the disease on particular populations is dependent on some local condition which is not constant, and which is therefore probably removable j and as an indication of what this local condition is, and also as a proof that it is removable, it is satisfactory to find the city of Nagpur with its pure water-supply exhibiting a degree of prevalence in remarkable contrast with that of every other town that appears in the statement. Notwithstanding that the city was subjected to infection in both years, the number of cases in the two years was equal to only 1-6 per I.COO of the pupulation, and the mortality to only 1 per 1,000. The small town of Wardha, 50 miles from Nagpur (Map No. VII), exhibits the highest rate of prevalence ; the population bavin* increased considerably since the census of 1872, the rate of prevalence was not quite so high as it appears in the statements, but making due allowance for this it was very severe. The town lies on the trap formation, and the watersupply is drawn partly from a nearly stagnant nala and partly from shallow wells sunk in the porous superficial strata, the majority of them being without tubes. The condition of many of the other towns given in the statements has been described in the preceding section of the report, and I need refer here only to a few of those which have not been noticed previously. The greater part of the town of Saugor is built on hard vitrified sandstone ; the water-supply is drawn partly from the large lake on which the town is situated, and partly from wells sunk in low ground below the rock and closely surrounded by dwellings. Kehli and Garhakota are on the Sonar river, and are to a great extent dependent on it for water. In Jubbulpore the water-supply is drawn chiefly from wells, the water of which is to a large extent supplied from tanks contaminated with surface drainage ; the prevalence in this town was much greater than appears in the statement, a very large number of deaths from cholera having been registered under other heads. Hinganghat is on the Wunna river below the portion described in Map VII; cholera prevailed chiefly in the old town, which lies on the river and depends on it for water ; in the new town, which lies at a distance from the river and depends chiefly upon wells, there was very little cholera. The main water-supply of Burhanpur is brought by a closed conduit from a distance (see pa^e 88). Lodikhera is dependent for water almost entirely on the Jam river, a small tributary of the Kanhan. Bilaspuris dependent partly on a river and partly on wells sunk in a stratum of sand; cholera^ prevailed here chiefly in the rains. Mungeli is built on a rocky site, and draws its watersupply from a river which has a rocky bed ; the cholera epidemic ran its course in the month of May, when the stream had nearly ceased to run. In Sambalpur the epidemic prevailed in September, when the people were drawing water chiefly from tanks. 342. In a few of the towns measures more or less radical have of late years been taken with the view of improving the water-supply of the people, and it will be profitable to compare the mortality in these towns in 1875 and 1876 with their mortality from the same cause in the previous epidemic of 1869. 1869. 1875. 1876. ' Number Rate Number Kate Number Kate of per of per of per deaths. 1,000. deaths. 1,000. death. I.OUO. Nagpur ... ... 84,441 405 47 32 0-4 61 07 Seoni „„. ... 9,557 124 13- ... 0- 4 04 Khandwa ... ... 14,119 130 9-3 10 12 8 o's Damoh ... ... 8,189 154 19 4 ... 0- 2i 2 5 Bhandara ... ... 11,433 180 15*5 14 1-2 41 36 Raipur ... ...I 19,116 601 316 30 I*s *7o *3 8 •1877. STATEMENT XXVI.— Showing the prevalence of Cholera in 31 towns of the Central Provinces during the years 1875 and 1876. | **>**>•• No. o< „ปซ,.<>< cholera. I •ฃฃฃ* T O W N 8 . 1 I 111 3^134 114 ail 1 Sangor... ... ... 16,179 1. ' 31,119 3R6 1 !?„ 745 22-6 ฃi 23> 9 154 149 303 42 08 8931 4066 I 1 2 Deori .. ... *.. 3,824 'XTJ 7,769 JO9 227 280 tป* 292 61 tt 106 55 96 8814 4670 2 3 Rehli ... ... ... 2,172 4,406 82 183 378 41*5 52 108 63-41 85-45 59 02 3 4 Garahakota ... ... 4,455 ' 0 * 9,085 160 2 *ฐ 388 359 *•;* 42-7 86 196 5375 48-25 50 52 4 5 Hatta ... ... ... 3,060 6,158 39 86 127 1p 2.J 140 19 46 4872 6745 53 49 5 6 Damoh... ... ... 4,188 ' , 8,189 16 37 38 J?" 45 817 500 4289 4594 6 7 Murwara ... ... 1,644 . '- 2,885 91 oฐ*0 ฐ* 172 554 596 49 .** 93 53 85 64 33 6407 7 8 Jubbulpore ... ... 23,366 :ป* 43,223 206 414 8-8 ™* 96 109 214 5379 6049 6169 8 9 Sehora... ... ... 2,049 3,988 71 Ig3 347 %i * 484 20 45 65 2817 86 89 33-71 9 10 Narsinghpur ... ... 6,971 ,'_- . 12,4051 2,405 132 251 18 9 202 86 67 153 6515 6630 6096 10 11 Gadarwara ... ... 3,303 „''" 6,068 184 420 557 ฐX , 69 " 2 93 125 218 S 0 " 54 52-97 60-48 11 12 Ho฿hangabad ... ... 8,699 15,301 Hi 173 128 113 73 26 y9y 9 6577 4194 6723 12 13 Harda ... ... ... 5,076 9,170 38 57 7 5 *'J 62 13 1 20 3421 3684 3509 13 14 Bohagpur ... ... 4,340 7,552 28 *? 60 g. 5 XUU ? . 9 v v 2& 5Q . O S4 . 3a 41 . 6? 14 15 Mandla... ... ... 2,650 *22 4,936 20 " 41 7 6 ฆ'* 83 10 15 60 0 23-81 3659 15 16 Tumsar... ... ... 3,895 7,367 808 0 l fe 0 20 5 24-4 32 65 400 3300 3611 16 17 Bbacdara ... ... 5,772 S',* 11,433 22 66 38 J?^ 49 12 1ป 31 5455 65-88 55 36 17 282 8 Mohari... ... ... 2,955 ฃJ& 6 ซ ( 83 19 41 64 Jซ 6 . 7 g ,9, 9 42<11 50 . 0 46 . 34 l 8 19 Nagpnr.. ... ... 43,746 am 84,441 81 136 19 A* 16 59 29 888 8 7284 62-73 64 "71 l 9 20 Kanboli ... ... 995 . ป™ f 1,975 63 ,ฐJ 124 633 \ 62-8 21 38 33 33 27-87 80*86 20 21 Wardha.. ... ... 2,036 *ปป-' 3,562 HI 266 693 "*'ฆ 747 70 6S 123 49 65 42-4 4639 21 22 Hinganghat ... ... 4,917 9,415 70 155 142 iฐ] 16-5 15 36 21-43 24-73 2258 22 23 Sindee... ... ... 2,427 4,867 49 133 20-2 *?"* 273 15 34 3061 25 56 23 24 A"i ... ... 6,830 ••**ป 12,759 46 _JJ 112 67 J!'* 8 8 7 19 15"22 1818 16 "97 24 25 Chanda.. ... ... 7,982 ,?"ฃ* 1f?,233 171 880 214 2 ฎ'f 23 4 63 62 105 310 84-88 2763 25 26 Burhanpur ... ... 15,275 29,303 81 131 53 _ป'ซ 45 48 27 75 59 26 840 67"25 26 27 Lodhikhera ... ... 2,638 6,219 112 t JJ 208 425 39 9 60 115 53-67 67-29 6529 27 28 Bilaspur ... ... 3,305 6,454 124 \ Qi 227 275 35 2 56 106 4516 48-87 * 6 " 70 28 29 Mungeli ... ... 2,111 •ป** 4,392 160 299 75-8 ฐ} o 68 1 68 6ป 131 425 45.32 43 ' 81 29 30 Sambalpur ... ... 5,402 11,020 163 325 302 28 ' 8 295 60 48 108 3681 jg-ss 3323 30 31 Raipur (1877) ... ... 9,752 *ป•" 19,116 106 w 191 109 •"* 10 0 41 ซ4 75 386 40-0 392 31 Total 212,013 193,880 495,893 3,141 6,411 148 W'* 158 1,472 3,ป74 2,846 46-86 4j-oป 4439 Note. — The several totals in this and the following Statement do not in all instances quite correspond with the totals given in other Statements; in some ca฿es the details of sex and age were not given. 155 The list is a small one, but the comparison of the mortality of the two epidemics affords great encouragement for undertaking similar measures in other towns. In Nagpur, formerly the people were dependent for water upon wells and tanks in and around the town ; in 1872 water was brought in from a large reservoir four miles distant ; there are small protions of the city to which the water service does not reach, but it is being gradually extended as funds become available. At Seoni, formerly the inhabitants were dependent chiefly upon a large tank, which was partly filled by drainage from the town area; this has now been diverted, and the tank is filled periodically from a large reservoir, two miles distant. At Khandwa the source of water-supply is the same as in former years, but greater care is taken to preserve the reservoir from pollution, and by the use of a steam pump the cisterns in the town are kept more liberally supplied during the hot weather : the water-supply of this town is, however, still insufficient and liable to pollution. At Damoh the chief source of supply is also the same as in former years, a large tank on the outskirt of the town, hut the catchment area has been enlarged and fenced, and great care taken to preserve the water from pollution ; the greater number of those attacked in 1876 were low castes, who were not allowed to draw water from the preserved tank (Statement XXVIII). The nature of the improvement at Bhandara has been described in paragraph 329. The great out-break of cholera at Raipur in 1869 has been already referred to ; since then deeper wells have been sunk, the catchment area of the principal tank enlarged, and the water, instead of being drawn direct from the large tank, is first filtered through the dam into a smaller tank. These arrangements have no doubt greatly improved the water-supply of the town, but the improvement is not sufficiently radical to ensure the safety of the inhabitants from cholera, especially in seasons of unusual drought. 343. Reverting again to Statement XXVI., we may note that in the majority of the towns the number of females attacked with cholera greatly exceeded the number of males. Taking all the towns, the number of cases among the males was equal to 14*8 per 1,000 of the male population; while the cases among the females equalled 16 9 per 1,000; in some of the towns this disproportion was very great. At Rehli and Garakhota while the males suffered at the rate of 38* and 36' per 1,000, the cases among the females were equal to 45* and 49* per 1,000. At Sihora the cases among persons of the two sexes were in the proportion of 35 to 68, at Gadarwara 55 to 85, and at Wardha 69 to 82. In a few the males suffered in excess of the females. It appears, however, that although the women are more liable to be attacked by cholera it does not so frequently prove fatal with them as with males ; while the cases among the males proved fatal at the rate of nearly 47- per cent, the rate of fatality among the females attacked was only 42 per cent. The cause of the greater liablity of the women to suffer from cholera will be alluded to presently. The last column of the statement gives the percentage of deaths on the number attacked. It will be seen that the percentage varied from 17 at Arvi to 64 at Nagpur ; the high fatality at the latter place was no doubt due to the fact that many of the persons attacked had tr avelled from Ramtek after the symptom of the disease had appeared in other towns ; probably some of the slighter cases were not reported, but there can be little doubt that the fatality of the disease does vary greatly in different out-breaks, and it probably depends upon the degree to which the water is contaminated. 344. Statement No. XXVII. (overleaf) shows the incidence of cholera on the persons at different periods of life : in this statement the ages of upwards of 1 1,000 persons attacked with cholera in 31 towns and a large number of villages in different parts of the Province have been tabulated according to the classioficatin adopted in the census of 1872, and at the foot of the statement 1 have STATEMENT XXVII.— Showing the number of cases of cholera in certain Towns and Rural Circles of the Central Provinces according to age. All ages. Under 1 year. I—2 2—3 3—6 6^12 12—20 20—30 30—40 | 40—50 u j^J[ฃ. fe Towns or "Bural Circles. j? ,s, s 6 t ฃ * * • ฃ ฃ ji jj 1 Eaugor ... ... 566) 879 745 1 ?, 5 R iol * 65 8S 58 *' 7 45 ** 68 ra 44 5? 39 ?* 41 1 2 Deori ... ... 109 113I 13 227 1 .. 2 G 8 * 19 14 22 13 10 * 7 17 ** 15 tf 7 ** 8 r 3 8 Rehli ... ... 82 331 183 1 3 4 3 7 8 19 li 30 W 6 B 13 2S 10 *1 2 ,™ 1 ,ซ 3 4 Garhakota ... ... 160 *-ซ* 388 2 9 4 8 7 31 * 3 22 ~IJ~ lJ 15 31 36 C*l jg •• 16 J ป 3 7 4 5 Hatta ... ... 39 ซ86 1 ... 713 7 ... snl-2 * 4 1 5 6 Damoh ... ... 16 Stt 37 1 ... 4 4 ... 31- 2 " 4 ,?ป 173 i 6 7 Mnrwara .. ... 91 Bl 172 1 ... 6 2 4 5 9 l!) 24 1* 4 13 22 - ; 16 ™. 5 * 1 .ฃ 7 8 Jubbulpore ... ... 206 ฃ03 414 1 ... 6 a 15 2;] 39 ! L 28 J ( ป 37 ' : 42 V- 15 , 24 ป 8 9 Sehora ... ... 71 W. 193 } \ ... 24 3 8 }l 17 W 7 -0 19 ;? 9 }2 3 .J 2 ,? 9 10 Narsinghpur ... ... 132 US 251 1 „, 3 1 6 4 25 20 17 ' 11 H 20 111 1 17 ?,T 4 . 17 r 29 :„ 10 11 Gadarwara ... ... 184 *' ;5 420 1 7 2 3 6 3 15 l 0 26 'ฆ> L 13 1ป 33 ! 39 •>* 24 26 ป 11 12 Hoshangabad ... ... 11l M 173 4 1 2 ... 4 3 3 8 12 6 6 '•* 28 ia 25 * 18 ฐ 9 , 12 13 Harda ... ... 88 U67 ... 113516G 15 - 7 - . 4 ••• .1f 13 14 Sohagpur ... ... 28 Si 60 ... T.. 1 2 1 — 2 v 6 li 4 3 % „• fll • 1 * I * 14 15 Mandla ... ... 20 21 41 s ... 8 ... 3*12 3' 4 * ... * 6 ••• .15 16 Tumsar ... ... 80 100 180 2 ... 2 2 6 4 12 l 6 f ' 14 H Is ' '- * 9 J * 4 * 7 7 16 17 Bhandara ... ... 22 81 56 1 1 2 4 8 il 8 •ป 1 5 4 10 "... * 3 t 17 18 Mohari ... ... 19 '** 4] 3 ... .ซ 153j3 5 H 5 j 2 ••• - ... ilB 19 Nagpur ... ... 81 65 136 1 2 4 8 <ป 16 7 7 4 31 - ฆป 11 ,ซ 8 ฆ• 8 19 20 Kanhdi ... ... 63 Gl 124 3 3 3 21 lj 9 s 6 13 9 10 3^7 -%• 2 ซ ?0 21 Wardha .„ ... 141 128 266 12 JO 6 2 26 13 29 W 18 21 22 ' J 15 '* 4 " 9 21 22 Hinganghat ... ... 70 &5 15S 5 :l 4 5 U 13 20 M 6 IS U 23 6 4 5 * 2 I 22 23 Sindee ... ... 49 8i 133 12 2 8 l - 10 i* 13 JO 7 i 0 4 v 8 ? 8 J 23 24 Ar vi .., ... 46 66 112 7 3 5 11 6 14 6 •"• 9 10 8 n 3 _ G 1 ,t ... .4 24 25 Chanda ... .. 171 20i 380 1 14 3 3 2 14 I 8I 8 41 ~J 24 o7 30 ri 11 Z9 21 x " 22 " 2S 26 Burhanpur ... ... 81 60| 131 7 4 4 1 15 16 * > 8 9 18 * J 4 6 3 * 26 27 Lodhikhera ... ... 112 OS 208 3 3 9 5 17 I 9I 9 36 -' 12 1G 13 13 6 * 7 * 9 " 27 28 Bilaspur ... ... 124 103 227 .... 9 6 6 30 17 18 20 12 14 3) ฃ1 11 8 14 6 * 28 29 Mungeli ... ... 160 139 299 1 8 5 3 4 7 28 27 50 4J lc 4 35 - l 19 1:5 7 * 1 2 29 30 Sambajpur ... ... 163 IG3 325 7 0 6 3 20 7 23 24 17 40 52 - 'ฆ' 23 ?3? 3 9 6 2 30 51 Baipnr m ... 106 85 191 1 ... 2 4 2 7 11 ** 26 '•> 16 6 22 -' 13 *• 10 ? 3 ™ 31 297 villages in the Bilaspur District ... 1,285 1.133 2,418 3 4 29 17 61 4'J 250 ป5 803 833 131 103 199 l!: 0l !:0 118 117 72 * J 119 ll '* 153 villages in the Jubbulpore District. 696 821 1,520 7 11 7 lfi 42 19 96 W 123 2^ii 97 110 2 1 "' 96 I- 3 67 V* 61 i Arvi Circle (Wardha District) ... 246 253 499 1 1 19 10 10 111 1 63 25 54 &8 25 41 24 lil 'i 35 2l 14 *- li * Damoh District ... ... 180 ];i 351 1 2 6 4 5 5 20 14 35 L's 22 13 26 4 'ป 31 88 17 / 18 *ซ 3 villages in the Seoni District ... 84 67 ... 1 4 3 7 10 2 6 10 10 6 ll 1 a 4 • Total „. 5,582 5,70 i 11,286 30 s7 163 131 1 244! 10} 860 7G7 1,123 ฃCT 606 C7S 1,016 1,191 687 745 417 BS9 436 491 Male. Female, .ซ-*•• ป•ฆ Ratio of cases of cholera per 1,000 living. 1771 19il 18'S3 20 2 5 257 224 210 218 13-1 ISO 17-3 il-0 164 19"" 17-4 *p"8 22-7 az B ; Deaths from all causes in the Central , _ _-. Provinces in 1874 per 1,000 living... 24*95 HS>6 235 1434 134 9 32-2 274 108 81 8-7 Gซ 8-9 7 8 130 Iฐ' 21-9 10* i 68 4 ••• 157 given for the sake of comparison the ratio of deaths from all causes in the Central Provinces in 1874 per 1,000 living at the different periods of life. The first remarkable feature in this table is the almost complete immunity of infants under one year of age. Of the 11,000 cases tabulated, 65 or little more than 2 per 1,000 living at that age were attacked; in 1874 (a season in which cholera was not prevalent) the deaths in the Central Provinces from all causes at the same period of life were equal to 140 per 1,000 living; in that year deaths among infants were equal to 27 per cent of the total deaths from all causes ; of the persons attacked with cholera, scarcely one in two hundred were infants under one year of age. Of 745 cases of cholera registered in the town of Saugor, one only was under one year of age ;in Jubbupore, out of 414 cases, not one was an infant. In Wardha, also Lodikhera, Bilaspur and San> balpur, all towns in which the number of cases exceeded two hundred, not a single infant was attacked. The statistics of the villages also afford evidence of the immunity of infants from cholera ; of 2,400 cases returned from 297 villages in the Bilaspur district, only 7 were infants under one year of age. The statistics of the European army in India also bear witness to the fact that infants at the breast are not liable to cholera. Native women in this country continue to suckle their children through the second year of life and often for longer. Our census did not give us the number living between the ages of 1 and 2, and 2 and 3 years, but it will be seen in the statement that the number of cases of cholera among children between ] and 2 years of age, though much greater than among infants under 1 year was small, compared with the number among older children ; but among children between 2 and 3 and still more among childen at ages from 3 to 6 years, when they would be able to run about by themselves, the number of cases of cholera increased to such an extent as to raise the ratio of mortality for the period of life between 1 and 6 above that of any other of the periods into which the term of life is divided. Among children between 6 and 12 the liability to cholera, though still very great, is less than among children between 3 and 6 ; next to very young children, young persons between 12 and 20 show the least liabilty to cholera, it increases rather at subsequent period of adult life, and is relatively high among old people above 50. 345. Another fact of equal importance with the immunity of very young children which this table demonstrates, is the excessive liability to cholera of adult women. It was apparent in the previous table that the number of cases among females greatly exceeds the number of cases among males ; but this table shows that it is to the adult women between the ages of 20 and 50 that this excessive liability to cholera attaches. In the population of the Central Provinces the males exceed the females in the proportion of 104 to 100; in the towns the excess of males is generally greater than in the rural tracts. The mortality among males from all causes is annually much greater than among females ; in. 1874, for instance, the death-rate of the male population was nearly 25 per 1,000, that of the female population was only 22 ; and as may be seen at the foot of the statement this relatively greater mortality among males obtains- at all periods of life. After the age of 1 year the liability to cholera is also greatest among males up to the age of 6 ; at the next period of life, 6 to 12; the liability of the two sexes becomes almost equal, that of the females slightly exceeding that of the males. In the subsequent periods of life this excess becomes greatly augmented, and is most marked between the ages of 20 and 40. Among- old people above 50 the liability to cholera of the two sexes is about equal, Now to any one who is at all acquainted with the habits of the people of this country, the doctrine of a close connection between cholera and water will furnish a ready explanation of this excessive liability to the disease of adult women ; the chief occupation of the Ilindu women of all but the highest classes is drawing water and washing clothes ; a person entering a village in the early morning will find the female population of all ages, from young girls to old women, drawing water from the STATMEENT XXVIIL — Showing cases of Cholera in the Towns of the Central Provinces according to classes. Population. Cases of cholera. Class per cent of total population. Causes per 1,000 of each class. jf 0> | Name of Town. ' j " i Low castes, Alahoinedans. All others. Low castes Malio- All others. Low castes Mahome- All others. Low caates. Mahome- All others. medans. dans. dans. 1 Saugor ... _ 6,304 5,157 19,598 175 161 409 20-45 16-57 62-98 27-50 31-22 20-86 2 Saogor Cantonment ... 3,087 4,110 7,339 44 63 70 21-24 2827 5049 14-25 15-33 9-53 3 Rehli ... 1,086 476 2,844 86 12 85 24-65 1080 6455 79-19 25-21 29-85 4 Garhakota ... ... 3,232 956 4,917 202 26 160 35-58 10-30 54-12 62-50 27 78 32-54 5 Deor i ... ... 1,526 925 5,318 87 27 113 19-64 11-91 6845 57-01 29-19 21-24 6 Damoh ... # 1,496 1,179 5,488 23 411 1833 14-44 67G0 15-37 339 2*oo ' Hatta ... ... 1,980 374 3,804 44 10 33 32-15 o*l2 62 26 22-22 26-74 8-68 8 Munvara ... 323 341 2,221 66 6 100 11-20 11-82 76-98 20433 1760 45-02 9 Sehora ... 707 42 8 2,553 97 987 17-73 10-73 71*54 137-20 2103 30 49 10 Jubbulpore ... 6,286 9,273 27,664 65 121 218 14 54 21-46 64-00 10-34 13-05 780 11 Jubbulpore Cantonment... . 2,896 2,923 6 146 7 ... 5 24-20 24-43 51*37 242 ... -81 12 Narsingbpur ... ... 1,527 871 5,156 37 26 24 20-21 11*58 68-26 ( 2423 29-85 16-29 13 Kandeli ... . 981 559 3 311 22 22 60 20-22 1152 68-26 22*43 3936 18*12 14 Gadanvara ... ... 713 882 4,473 46 69 305 11-75 14-54 7371 6452 78 23 6818 15 Sohagpur ... ... ],000 1,902 4,650 6 21 33 13-24 25-19 61-57 600 11-04 7-10 16 Hoshangabad ... ... 2,779 3,455 9,067 22 51 100 IS*l6 2258 59*26 7-92 14*76 11*03 17 Harda ... ... 389 988 7,793 8 16 33 424 10*78 84-98 20-57 16*19 423 18 Khandwa ... ... 2,052 3,181 8,886 7 ... 7 14*54 22*53 62-93 3'4l ... *78 39 Burhanpur ... ... 1,627 7,523 20,153 17 53 6] 5-55 25-68 68-77 10*45 7*05 3*02 20 Mandla ... .. 876 841 3,219 7 5 29 17*75 17*03 65 22 799 5*95 9-01 21 Lodikhera ... „ 1,112 417 3,690 30 14 164 2131 799 70-70 26-98 33*57 44 44 22 Tnrnsur ... ... 1,637 401 5,329 44 5 131 22-22 5*44 72*34 26"88 ]247 24*58 23 Mohari ... ... 859 388 4,836 4 1 36 14*12 6*38 79*50 4*66 2*58 744 24 Bhandara ... ... 1,628 1,450 8,355 9 2 45 1424 12*68 73-08 553 1-38 5-39 25 Wardha ... ... 576 529 2,457 62 33 171 16-17 14*85 68*98 107*64 62 38 69 59 26 AiTi ... ... 1,463 1,357 9,939 20 15 77 11*47 10-63 77 90 13-67 11-05 7 75 27 Hingnee ... ... 535 167 2.094 14 4 42 1913 5*98 74-89 26-17 23-95 20-05 28 Sindee ... ... 654 519 3,694 31 12 90 13-44 1066 75-90 47*40 23*12 24*36 29 Hinganghat ... ... 1,555 1,047 6,813 15 13 127 16-52 11*12 7236 9-65 12*42 18 64 30 Kanholi ... ... 270 117 1,588 15 8 106 13-67 5*92 80*41 55*56 25*64 6675 Si Nagpur ... ... 8,936 11,585 63,920 20 20 96 10*58 13*72 75*70 2-24 1-/3 1-50 32 Chanda ... ... 3,520 1,294 11,419 177 13 190 21*68 7-97 70*35 5028 1005 16*64 33 Raipur ... ... 4,310 3,596 11,210 9 14 168 22 54 18-81 58-64 208 3-89 14-08 34 Munereli ... ... 684 312 3,396 117 31 151 15-58 7*lo 77*32 171*05 9936 44 46 85 Bilaspnr ... ... 914 979 4,561 40 23 164 14*16 1517 70*67 43*76 23-49 35*96 36 Sainbalpur ... ... 1,112 817 9,091 22 33 270 10 09 7*42 82*49 19*78 40*39 29*70 Total ... 70,692 71,299 307,292 1,697 938 3,969 1573 15-87 68*40 24-01 13*16 12*92 159 source of supply, whatever it may be, and during the day large numbers will be employed in washing clothes or cocking utensils in the tank or stream ; the water they take home for domestic U3e they may draw from a well or from a hole dug in the sand at a distance from the stream, but they themselves no doubt often drink of the water in which they are washing. In many the of towns the number of females between the ages of 20 and 30 that were attacked with cholera was nearly double that of the males of the same age. Rehli, Grarakhota, Sihora, Gadarwara and the villages in the Jubbulpore district are remarkable insances in which this occurred ; in most of these places the water-supply is drawn to some extent from wells, while the women resorted to the neighbouring stream or tank for ฆwashing. On the other hand, in the villages of the Bilaspur district, the number of males attacked was rathei in excess of the number of females ; but in this district and Raipur the whole population, male as well as female, drink water from tanks, and often from the same tanks in which the washing is done. In some towns the number of males attacked greatly exceeded the number of the females, and this would no doubt be explicable by local circumstances. The greater prevalence among the males at Hoshangabad, for instance, is probably explicable by the fact that at the time of the epidemic a large portion of the population was employed in the fields on the wheat harvests. At Harda the epidemic fell chiefly on the men employed at the Railway station ; at Nagpur a large proportion of those attacked were men who had been to the Kaintek fair. Two important facts bearing on the etiology of cholera are brought into prominence by this statement, viz. that infants at the breast under one year who, as a rule, drink no water, are, as a rule, exempt from liability to cholera ; while adult women, who are more likely than any other class to make use of impure water, are more than any other class liable to cholera. 346. Statement XXVIII. on opposite page shows the relative prevalence of cholera among certain classes of the population. Though the lower classes of the natives of India have but little regard to the purity of the water which they drink, their prejudices regarding defilement, in a religious or social sense, are very strong. In in some towns and villages each caste will have a separate well, or if the water is drawn from a stream or tank each caste will draw from a different hole in the sand, or from a different part of the tank. The Mahomedans are found chiefly in the large towns, and they commonly live in a quarter by themselves. Where there is one well or other source of supply all the better castes of Hindus will draw from- it, and the Mahomedans are not excluded ; but there are certain low castes or out-castes, as Mehters, Mangs, Dhers and Chamars, who are not allowed to approach within a certain distance of the well or tank ; sometimes they are allowed to bring their vessels, and Hindus will fill them, but they are not allowed themselves to draw water ; under these circumstances the low castes are frequently driven to very inferior sources of supply. In course of this report instances have been referred to in which the low castes in a village have alone suffered from cholera (paras. 159 and 329), and many other instances might be, adduced. In paragraph 245 one instance is given in which the low castes escaped, while the other sections of the population suffered. In Statement No. XXV 111., 6600 cases of cholera returned from 36 towns, having an aggregate population of nearly half a million, are classified according as they occurred in Mahomedans, low castes, and Hindus of all other castes : taking all the towns, the Mahomedans and low castes happen to form numercially nearly equal portions of the total population, the numbers of each class being about equal to 16 per cent of the total. It will be seen that the Mahomedans and better castes of Hindus suffered from cholera in nearly equal proportion, but the ratio of prevalence amongh te low castes was nearly double the ratio of the other two classes. This 160 greater prevalence of cholera among the low castes was however by no meam uniform : in not a single town were the rates of prevalence among 1 the three classes equal; in not more than one or two were they even approximately equal; in the majority the ratio of cases among the low castes preponderated, and in many instances this preponderance was enormous; in several instances, however, notably in Hoshangabad, in Lodikhera, in Hinganghat, in Raipur and in Sambalpur, the low castes suffered much Jess than either the other Hindus or the Mahomedans; in Raipur while the general population suffered at the rate of 14 per 1,000, the rate among the low castes was only 2 per 1,000. The Mahoraedans are, on the whole, better off, and a little higher in the social scale than the mass of the population ; taking all the towns, the rate of prevalence among this class was nearly the same as among the Hindus of the better castes : in some towns, how ever, there was a great difference; in Saugor, Jubbulpore, .Narsinghpur and Ehandeli, Burhanpur, Mungeli and Sambalpur, they suffered far more severely than the Hindus ; in Murwara, Sihora, Chanda, Raipur and Bilaspur the number of cases among them was relatively small. In respect to soil and sub-soil, position and drainage, the circumstances under which these several classes lived in the different towns were much the same, but in respect of water-supply they differed, and it is to this difference, I believe, that the varied degrees in which they suffered from cholera must be attributed. Appendix I. From the Commissioner, Chhattisgarh Division, to the Deputy Commissioners, Chhattisgarh Division, — No. 68, dated 4th January 1875. I have the honor to call your attention to letter from Secretary to the Chief Commissioner, JSo. 1315—181, dated 10th May 1866, (a. copy of which being of old date is forwarded for reference), and to point out that this letter contains " standing orders" regarding measures to be taken by district officers connected with the visits of pilgrims to Jagganath through their districts, so as to prevent the spread of cholera ; and I beg the instructions contained in this letter may be carefully considered and promptly acted upon. Copy of letter No. 1315 — 131, dated 10th May 1866, from the Assistant Secretary to tlie Chief Commissioner, Central Provinces, to the Commissioner, Chhattis'yarh Division. [General.] The Chief Commissioner having recently marched through the district of Bilaspur, and having had the advantage of consulting the local authorities, desires me to offer the following observations regarding measures of sanitary importance. 2. With a view to prevent the unnecessary spread of cholera, orders were issued directing measures to be taken to prevent pilgrims to and from Jagganath, passing through the districts of your division, and the district officers wore authorized to turn them back from their frontiers. Mr. Temple has been credibly informed that notwithstanding the above precautions, the pilgrims did make their way into the Chhattisgarh country, and not only that, but they also brought cholera into more than one village in the Bilaspur District. This year perhaps these orders were not issued quite early enough to enable the district authorities to prevent entirely the ingress of these pilgrims, but to guard against the possibility of anything of the kind occurring again at any future time, I am directed to request that the following may be understood to be standing orders on the subject. All the civil officers of your division must be aware on what date the great assemblages at Jagganath are held, and at about what time the advent of pilgrims in large numbers is expected ; aud being acquainted with these facts, each Deputy Commissioner and his District Superintendent should make such arrangements as shall entirely prevent any pilgrim* of this particular class coming within his boundaries. All such persons should be turned back from the border, and given to understand that they must find some other road to their destinations than through the populated plains of Chhattisgarh. If they are put to inconvenience hereby, it is to be regretted ; but unhappy experience indicates the necessity of exercising authority to save human life from destruction by cholera. There are, however, other routes in the neighbouring hill country, which they can take without causing harm, or at least so much harm. 3. With reference to fairs, lam to observe that although it is highly desirable that they should be in every way encouraged in proper seasons of the year, inasmuch as they are conducive to the growth of trade, and the increase of the wealth and prosperity of the people, yet it should always be borne in mind as a standing rule that after the Ist March no fair should be permitted to assemble, and that all which are assembled at the end of February must disperse by the prescribed date. 4. There is every reason to believe that if the above orders are strictly carried out, cholera, which is, and for some time has been, endemic in Chhattisgarh, will sensibly diminish in frequency and malignancy, and Mr. Temple will hold district officers responsible that the above orders meet with that discreet and considerate attention which they are expected to receive. 2 5 Although heretofore much cholera has douhtless been brought in 0 Chhattisgarh by ml฿rims yet you doubtless bear in mind that in almost every town and village of your dm, 5S f exists a very probable cause of endemic and constantly recurring cholera, and that is the^inferiority^ and impurity of the tank water used by the natives tor drinking purposes In many " Le sma/tan/in which the water is stagnant for ™l™^ฃ* ***' 1S the only source of the supply of water for drinking and also for every other purpose. In this tank the inhabitant, of the village quench their th . irst t b athe, and ™sฃ their troubling themselves to preserve even one pure for drinking purposes. 6. The Chief Commissioner knows that you have thi. mปttซr tantsS, preserve at least one free from defilement, and in places where there i. only one tank, a well should be dug as soon as practicable. 7 Mr Temple is aware that considerable progress has been made in the construction of wells, and I am now to express his hope that the exertions which have produced even tin* modicum of result will never be relaxed, From C. Bernard, Esquire, Secretary to the Chief Commissioner of the Central Provinces, to E. C. Bayley, Esquire, Secretary to the Government of India, Simla,— No. 3519-312, dated Nagpur, the 30th August 1867. I am directed to acknowledge the receipt of your endorsement No. 3292, dated 12th August, forwarding copy of the Sanitary Commissioner's letter ontho Report published by the Constantinople Cholera Commission. 2. Before adverting to the special points on which an expression of the Officiating Chief Commissioner's opinion is invited, I am to solicit per•ln this paragraph Major Mai- mission to offer a very brief comment on para. 9of Major lescn had stated that •• cholera Malleson's letter.* In former years epidemic cholera did un- fortunately visit the jails of these Provinces from time to time, but the increased attention paid to sanitary matters, and the special measures taken under Sir R. Temple's administration, have borne much fruit ; and the subjoined figures, Mr. Morris would fain hope, show that epidemic cholera is no longer " domesticated" in our jails. In the year 1864 cholera attacked eightf jails once, one jail twice, and carried off 106 prisoners. fln five of these jails, only 21 cases of cholera occurred. In the year 18(55 cholera attacked tenj jails once, two jaila twice, and one jail thrice; and carried off 143 prisoners. $In seven of these jails, only 23 cases of cholera occurred. In the year 1866 cholera attacked eightง jaila once, and carried off 60 prisoners. ง In seven of these jails, only 1 4 cases of cholera occurred. In the year 1867 (eight months of which have passed) cholera has, as yet, attacked no jail, and carried off no prisoners. Although cholera has happily become a less frequent visitor in our jails than it was, still there is no reason why the Sanitary Commissioner's suggestions in para. 9 should not be carefully carried out, and the Inspector of Jails has been instructed to take measures for giving them full effect at all our Central Jails. 3. With reference to paras. 11 and 12 of the Sanitary Commissioner's letter, lam to submit that, in these Provinces, the measures hitherto taken for preventing the development of cholera at, and its propagation from, fairs and religious gatherings have hitherto proved 3 efficient. Those measures are, briefly, that every such gathering is attended, and its sanitary management directed, by the Deputy Commissioner or one of his subordinates. The only two large gatherings of a half-religious, half-commercial nature, held in these Provinces during the unhealthy season, have been either prohibited, or allowed to continue in a modified and comparatively harmless form. 4. As observed by the Sanitary Commissioner, the difficulty in supervising and keeping in health pilgrims on their return from fairs is less easily overcome ; the only pilgrims who have yet caused anxiety in this respect in these Provinces, are the pilgrims going to, and returning from, the temple of Juggernauth at Puri. The people pass through Chhattisgarh and Sambalpur on their eastward journey in the months of January and February, and they return during April and May. Many of these returning pilgrims are poor, more or less insufficiently fed and weakly. They cannot bear the heat, the long journeys, and the want of good water. They consequently contract cholera, which they carry with them along the roads and into the villages which they pass. 5. In order to obviate one of the supposed causes of cholera in Chhattisgarh, the Supreme Government (the Foreign Department), in the year 1865, granted certain concessions to people who might sink wells and provide Chhattisgarh villages with drinking water. Some thousands of these wells are complete, or nearly complete, and their water may, it is hoped, help to keep healthy both residents and travellers in those parts. 6. In the spring and summer of 1866 special measures were taken to keep the returning pilgrims off the Great Eastern road, the path they used formerly to take between Sambalpur and Raipur. The efforts then made were so far successful, that cholera was, to a considerable extent, kept off the Eastern road and out of the town of Raipur, but the pilgrims seem to have scattered over the country to the north of the road, and to have made their way to their homes through the northern pergunnahs of the Raipur and Bilaspur districts, and through the Chief ships of the Upper Mahanadi Valley. In these parts epidemic cholera certainly carried off many lives in 1866. So far as our mortuary statistics for that year go, the cholera death-rate stood thus :—: — For the year 1866, cholera deaths per mille of the inhabitants — Nagpur Division (excluding Bhandara) ... ... ... 2*7 Bhandara District ... ... ... 7*o Nerbudda Division ... lm ... o*l Jubbulpore Division ... ... ... o*3 Chhattisgarh Division, including Upper Godavari District ... 4*l It will be thus seen that it was only in the districts of Bhandara, Raipur, Bilaspur, and Sambalpur that there was much cholera. It is through these districts that the Puri pilgrims pass. It should, however, be added that in 1866 the dearness of provisions in Cuttack may have had its effect in weakening the pilgrims and making them liable to succumb to cholera. 7. In the spring and summer of the year 1867 there has been comparatively little cholera, but then the nnmber of pilgrims passing through Chhattisgarh has been much fewer, owing, it is supposed, to the deterrent effect of the high prices prevailing at Cuttack. * 8. Still it must be admitted that the steps hitherto taken to check the flow of cholera from the East coast have not been sufficient, and next year further efforts will be made, either by establishing quarantine stations at Sonpur, or at some place on the Mahanadi between Sonpur and Sambalpur, or else by arranging for medical and other relief at such places. There may, perhaps, be difficulties about providing funds, inasmuch as Sonpur is a comparatively poor independent Chiefship, and the local funds of the Sambalpur District are exceedingly small. 9. la the present state of society in these Provinces,' and especially in those parts where special measures may have to be taken, a special legislative enactment, empowering. Government to take the steps adverted to above, does not seem needed. In towns and cities the Municipal Committees, acting under the Municipal Laws, will have full authority to do all that is necessary ; but in thus offering an opinion, that the executive Government can at present do all that may be required, the Officiating Chief Commissioner would refer only to these Provinces. He does not feel able to express au opinion/on the arrangements which may be needed at a place like Hardwar, and in districts such as lie between the Ganges and the Jumna. 4 No. 4626, dated Simla, the 18th September 1867. Copy forwarded to the Sanitary Commissioner for Bengal for information, with reference to his No. 312, dated the 26th of May last. order, (Signed) A. H. HARINGTON, Offg. Under-Secy. to the Government of India. From C. Bernard, Esquire, Secretary to the Chief Commissioner, Central Provinces, to E. C Bayley, Esquire, Secretary to the Government of India, Simla,— No. 5051-367, dated Nagpur, the 18th October 1867. In continuation of my letter No. 3519-312, dated 30th August, and special reference to para. 8 thereof, I am directed to submit copy of a letter which the Officiating Chief Commissioner has caused to be addressed to the Government of Bengal. 2. Mr. Morris trusts that His Excellency the Viceroy in Council may be pleased to approve of this Administration's having asked the Government of Bengal to assist in preventing returning pilgrims from Puri from disseminating cholera in Chhattisgarh. _______ From C. Bernard, Esquire, Secretary to the Chief Commissioner of the Central Provinces, to the Secretary to the Government of Bengal, — No. 367, dated Major Malleson's letter, regarding the recommendations made by the Cholera Congress of Constantinople, has doubtless been under the consideration of the Government of Bengal. It was forwarded to the Chief Commissioner of these Provinces for report as to the measures which could be adopted for enforcing quarantine on pilgrims who might be returning from fairs or religious assemblages where cholera might be prevalent. 2. The Chief Commissioner had the honor to report thereon that all the large fairs and religious assemblages, which used to he held in these Provinces during the trying season of the year, namely, from the 15ch February to the Ist June, had either been stopped, or had been so brought under control and limit, that they had ceased to become centres or sources of •ou 1,-th.j lii rr infectious disease. There were formerly three* such assem- Bhan^bX BhadracheUam ' Ho - blages, half-religious and half-mercantile, from which, year after year, cholera used to be disseminated up and down these districts. Daring the spring of 1866 and 1867 no cholera at all was engendered at any of these assemblies. 3. At the same time, though it had thus been possible to prevent disease being hatched at fairs and large gatherings in the Central Provinces, it was very difficult indeed to prevent cholera being spread by pilgrims or travellers returning from large gatherings in other Provinces. The principal assemblage from which cholera has hitherto been brought into these Provinces is the fair or gathering at the temple of Juggernauth in the Puri District, and on this point it is that the Chief Commissioner ventures to trouble the Government of Bengal. 4. For several years running, cholera has been spread over Sambalpur, Chhattisgarh, and parts of Bhandara and the Satpura country by pilgrims and travellers who appear to be returning from Juggernauth to their homes in Central and Western India. The disease first shows itself among these people during the months of March and April. The Chief Commissioner is not sure whether there is any specially great attraction, or particular festival, at Puri in March or April. It may, perhaps, be the case that the ordinary stream of pilgrims find those months the most convenient for visiting the shrine. However this may be, the fact remains that very large numbers of returning pilgrims stream across Chhattisgarh during the months of April and May, and it is very difficult to establish sufficient and effectual quarantine in the semi-independent territory which lies between Sambalpur and Puri. 5 5. The Officiating Chief Commissioner had directed the local authorities in Sambalpur and Chhattisgarh to do what they can in the matter, and he has authorized the temporary quarantine stations at Binka and Rampore. But he desires me to ask you to lay the enclosed papers before His Honor the Lieutenant Governor, and to submit for his consideration whether it would be possible in any way to operate at Puri on the centre from which the disease radiates. 6. It may, perhaps, be the case that the returning pilgrims do not always, or even often, bring with them cholera or its seeds from Puri. Probably the disease is often engendered on the road among bands of tired, impoverished pilgrims, who are returning home at an inclement season, through a wild country, where food may be scarce and water bad ; still it seems fairly probable that the returning pilgrims would not be subject to the disease if they came in smaller numbers, in a less destitute condition, and at a more seasonable time of the year. 7. If the executive authorities of Orissa could do any thing towards preventing Central India pilgrims from starting, to return by the laud route at any time after the 10th or 15th February, then very much sickness and misery would be saved to the pilgrims themselves, and the principal cause of the pestilence, which annually visits Chhattisgarh, would be removed. If once pilgrims of this kind reach the Sambalpur frontier on their return journey, it would not be practicable to turn them back, it would be expensive to keep them in quarantine for long ; and even if they were quarantined on the border, the risk would remain th;it fatigue and privation during a six week's journey uuder a tropical sun, acting on frames which might be weakened by want and fasting, might engender cholera among the pilgrims after they had passed into the Chhattisgarh country. 8. The Officiating Chief Commissioner is aware that the executive government in Orissa might find difficulties in the way of enforcing any such order, but he deems it right to lay the foregoing statement of the matter before the Government of Bengal, aud would be glad to be favoured with the views of His Honor the Lieutenant Governor. From the Commissioner of the Chhattisgarh Division, to C. Bernard, Esquire, Secretary to the Chief Commissioner of the Central Provinces,— No. 4021, dated the Ist October 1867. I have the honor, with reference to your No. 3821-349 of 18lh ultimo, to forward copy of Captain Cumberlege's No. 2258 of 26th idem, touching the impracticability of preventing pilgrims proceeding to, and returning from, Juggernauth, owing to the length of the open frontier to be watched, as proven by experience of last year, when, on finding themselves impeded on the main roads, they broke up into small parties, and taking bye-paths, disseminated more widely the disease it was in contemplation to keep out. 2. In a jungly country, such as Sambalpur and Chhattisgarh generally, there are, and ever must be, vast expanses of hill and dale, affording shelter and intersected with unfenced bye-ways, which it would require a perfect cordon of Police to guard effectually. 3. A couple of posts may, however, be established, if the Chief Commissioner authorize them, at Binka and Rainpore, as proposedjby Captain Cumberlege. From the Deputy Commissioner of Sambalpur, to the Commissioner of the Chhattisgarh Division, — No. 2258, dated the 26th September 1867. With reference to the Secretary's No. 3821-349, dated the 18th instant, a copy of which was received under your endorsement No. 3874 of the # 21st idem, I have the honor to report as follows :— 2. It is an undoubted matter of fact that scarcely a year passes that cholera does not show itself along the eastern roads of this district, and that the same may be attributed to the pilgrims returning from the immense annual gatherings at the temple of Juggernauth at Puri; but, with an enormous frontier like ours, I much doubt whether any really satisfactory arrangements could be made for establishing one or more quarantine stations for the purpose of detaining pilgrims afflicted with the disease. 6 3. In the first place, it must be remembered that our frontier is some 200 miles from Puri, where the disease is contracted, and the pilgrims would, as soon as they heard of the establishment of a quarantine station, turn off in every direction long before they camewithin its vicinity, and after turning its flank, would re-appear on the old route, where they were least expected, having meanwhile spread cholera among the villages on their way. 4. Last year we succeeded, to some extent, in warding off cholera from certain large towns and villages on the Great Eastern road ; but, as soon as the pilgrims heard that measures were being taken to keep those affected with cholera in quarantine, they broke up into small parties, and each taking a line of its own, spread the disease all over the country. 5. The only really efficacious plan for stopping the spread of cholera is to limit the great annual gatherings at Puri; but if this cannot be done, then let the quarantine stations be established at or near the fountain-head of the disease, way wait until it has spread over thousands of square miles of country. 6. I can, if the Chief Commissioner thinks fit, establish two quarantine stations — one at Binka on the Mahanadi on the Great Eastern or Raipur and Son pur road ; and anothe at Rampore, on the Nagool road ; but I much fear that, as soon as their establishment ber comes known, the^pilgrims will avoid those routes altogether and spread all over the country From E. C Bayley, Esquire, Secretary to the Government of India, to. J. H. Morris, Esquire, Officiating Chief Commissioner of the Central Provinces — No. 6064, dated Simla, the 31st October 1867. I am'directed to acknowledge the receipt of your Secretary's letter of the 18tta instant, No. 5051-367, and of its enclosure, and in reply to state that the Governor General in Council approves of the action taken by you in asking for the co-operation of the Government of Bengal, to prevent the dissemination of cholera in the Central Provinces by pilgrims returning from Juggernauth. 3 Appendix 11. From the Secretary to the Chief Commissioner, Central Provinces, to the Secretary to the Government -of India, Foreign Department, — No. 3705—329, dated the 2Qth iSep- For the last few years cholera has, in the early spring time, regularly appeared in the districts of Nagpur, Chhindwara, and in the lower Nerbudda Valley. Common report has usually attributed the outbreak of the disease to the concourse of pilgrims at the shrine of Mahadeo, beneath the Mahadeo peak of the Pachmarhi range. 2. Last spring the ravages of cholera in and about the road leading to Pachmarhi were particularly extensive, and in the month of March Mr. Temple addressed to the Commissioner of the Nerbudda Division, within whose jurisdiction Pachmarhi lies, a letter enquiring what could be done to prevent cholera breaking out at Pachmarhi and spreading itself over the surrounding district. 3. A part of that letter lam here to extract :: — • " (5.) The concourse of pilgrims at the Mahadeo shrine on the Pachmarhi hills is a case in point. This year it appears cholera, owing to the unseasonable showers, broke out early in the year, and with peculiar virulence among the pilgrims. Into most of the considerable towns and villages between Nagpur and Chhindwara, into the cities of Nagpur and Kamptee, and into many out-lying villages below and above the ghats, returning pilgrims have brought cholera. It was only this morning that Mr. Temple, when visiting an out-lying village of the Kamharpanee Pargana, situated on the crest of the ghats, found that a single Bania, returning from Mahadeo, had brought cholera to the village of Chandkerpore ; had himself died of it there, and the disease which he had brought, had, within six days, carried off four of the inhabitants of that small village ; and three more were lying ill when Mr. Temple was there. " (6.) If a single pilgrim, and he not a poor man, or in any way peculiarly liable to the disease, could bring so much sorrow to a small village, the amount of disease which scores, or even hundreds of pilgrims might spread when passing through towns like Saoner, or cities like Nagpur and Kamptee, may perhaps be estimated. " (7.) It will probably be within your recollection that in 1860 a similar epidemic visited Chhindwara and the northern parts of the Nagpur district ; so dreadful were the effects of the scourge, that at some of the towns along the Chhindwara road, the Chief Commissioner has, within the last two years, been shown the cairns where the bodies of travellers who died of cholera were half buried. It was said at the time, and it has generally been believed since, that the cholera of 1860 first appeared among, and was disseminated by, the pilgrims to the shrine of Mahadeo. It would seem then that twice within the last five years has the assemblage of pilgrims at Mahadeo, in the month of March, been the cause of the appearance and spread of cholera in the Chhindwara and Nagpur districts. ft (8.) Further, it is to be remembered that the bulk of the Mahadeo pilgrims, in going to and coming from the shrine, must pass through, or close to, the existing sanitarium of Mohtoor : and the rendezvous of all the pilgrims, Mahadeo itself, is in the immediate neighbourhood of the proposed sanitarium of Pachmarhi. It would seem therefore that if the interests of these two sanitaria alone were looked to, this administration is bound to take some steps to prevent risk of the epidemic being carried systematically every year into the only sanitaria which these Provinces possess. if (9.) The Chief Commissioner would now wish you to take the matter into your serious consideration, and he would be glad to learn your opinion as to the possibility of counteracting the ill effects of the concourse of pilgrims at Mahadeo ; and if you should cansider it impossible by any ordinary sanitary, 4 quarantine, or other regulations, to prevent epidemic disease from attacking the Mahadeo pilgrims, Mr. Temple would be glad to know -what measures you would propose to take with the view of either discouraging entirely the recourse of pilgrims to Mahadeo, or of encouraging them to visit the shrine at some other less dangerous time of the year." 4. In reply, the Commissioner, Nerbudda, after consulting the several Deputy Commissioners of districts bordering on the Pachmarhi hills, reported to the following effect :—: — " (Uh,) The ascertained facts and the opinions of the Deputy Commissioners seem to justifyj ustify the following conclusion :—: — " (1.) Whereas, during the last three months, cholera has been very prevalent throughout the length and breadth of this division, attended at some points with lamentably large loss of life, there was no cholera in this division anterior to the outbreak at Pachmarhi. ** (2.) There was no cholera in any district until the Pachmarhi visitors re-appeared, homeward bound. " (3.) In each of the four districts from which reports have been received, it has been clearly ascertained that the first victims were the returning visitors from Pachmarhi, and the people with whom they came in contact. Ci (4.) There is no certain information of cholera having broken out anywhere, independently of the infection caused by returning Pachmarhi visitors. " (5.) Therefore, although no man can say whether, had the Pachmarhi assemblage been non-existent, cholera would, or would not, during the past three months have broken out from some other centre, and some other cause ; yet, so far as man can judge, it is a positive fact, with which no speculations should interfere, that cholera in this part of India, this year, has been the result of *' human intercourse," and that its centre and its cause were the Pachmarhi assemblage, and the outbreak there. This is further attested by what follows. " (6.) For the first few days after the infection in each district, before its ebb and flow made it rriore or less general, carrying it at length two and a half months after its outbreak into Narsinghpur with intensified virulence, the disease did not spread to any distance from the main route of the returning visitors. " (7.) It did not spread during that period into the Narsinghpur district at all, because almost no one goes to Pachmarhi from the north-east. I was on the spot at the time, and although in Chhindwara, whence I had just come, the people's mouths were full of talk about the cholera. Hardly any one seemed to know anything about it in Narsinghpur. No one goes to Pachmarhi from that quarter. Consequently there were no returning visitors and no cholera. (7.) This is not a solitary instance of cholera breaking out at the annual Pachmarbi assembly. It has frequently done so before. It is a matter of considerable notoriety among the people of the country. " (8.) The circumstances of the case, as described by the Deputy Commissioner of Hoshangabad in his 2nd paragraph, are peculiarly conducive to the generation of the seeds of contagious disease at Pachmarhi. Long marches through a desolate country bring the visitors in a state of fatigue, and ill supplied with the ordinary necessaries of life, to the place of resort, where, instead of relief, their fatigues and privations are increased in a manifold and somewhat horrible degree. 5 " (9.) This is 1 not capable of remedy, ordinarily. Arrangements such as arซ proposed by the Deputy Commissioner of Chhindwara in bis 2nd and 3rd paragraphs might constitute a remedy. But although I have no advantage over the Deputy Commissioner of Chhindwara as regards inspection of the actual locality, yet I have been oc the hill within two or three miles of it, and I can fully understand the Deputy Commissioner of Hoshangabad, who has attended the gathering, when he says, (paragraph 6), that the place, from its want of water and from its natural features, cannot be so ordered as to ensure health and accommodation for a crowd. J believe proper arrangements of this kind to be practically impossible. " (5.) These nine positions seem to lead to no other than this, viz. :—: — " (10-) There is only one alternative, viz., to interfere authoritatively at once, and to prohibit this dangerous annual gathering altogether." 5. The Officiating Chief Commissioner, on receiving this report, asked the Commissioner for further information which would show that in former years the cholera had originated at the Mahadeo fair. After searching through the several district offices, no specific report upon former cholera epidemics were to be found ; but each Deputy Commissioner has submitted a report, which shows that according to the received belief in the neighbourhood, and according to the most reliable oral information, the cholera which visits the Nagpur country and the Nerbudda Valley every year, takes its rise at the Mahadeo fair. tj. The Judical Commissioner on being consulted, considered that if there were strong and reasonable probability that the assembling of people at the Mahadeo fair worked danger to human health and human life, it would be right to stop such an assemblage as a nuisance. 7* The Commissioner reported that no loss would accrue to any one by stopping this fair, except the loss of gifts which three Bhopa families are in the AitaMsonVTreaties ฐ ' habit of receiving from pilgrims. Any compensation which might be required to make up for the loss of these offerings would not, the sum considered, amount to more than Rs. 200 a year. 8. On a consideration of the whole question of the regularity with which cholera has visited us for the last three or four years : of the circumstances that the Cantonments of Kamptee, Hoshangabad and Sitabaldi, as well as the sanitaria of Chhindwara and Mohtoor lie on the very pathstvhich the epidemic takes from the Pachmarhi hills, — for all these considerations Mr. Campbell decided that the annual gathering in the end of the month of February at Mahadeo should be prohibited. 9. Instructions have, accordingly, been sent to the Commissioner, Nerbudda, who will send intelligence of the prohibition to -Malwa, Bhopal, and Berar, whence numbers of the Mahadeo pilgrims come. The Commissioner has also been requested to report as to the compensation which should be given to the three Bhopa families. 10. In submitting this account of what has been done, the Officiating Chief Commissioner would hope that His Excellency the Viceroy in Council may be pleased to approve the prohibition of the Mahadeo fair. From the Secretary to the Government of India, Foreign Department, to the Officiating Chief Commissioner, Central Provinces, — No 2048, dated 13th October 1865. In reply to your Secretary's letter, dated 26th ultimo, No. 3705—329, I am directed to inform you, that under the circumstances represented, the Governor General in Council approves of the prohibition of the Mahadeo fair, but sees no necessity for granting compensation to the Bhopa families on this account. 6 From the Deputy Commissioner of Hoshangabad, to the Commissioner Nerbudda Division, No. 2218, dated 7th October 1865. I have the honor, in reply to your No. 2516, forwarding copy of letter, dated 26th June last, from Secretary to Chief Commissioner to yourself, to state as follows : —From the enquiries made by me it appears that, prior to the last 10 years, cholera used to visit this district generally every third year, but in latter years, the times of visitation have been more frequent and uncertain. It has appeared after it had first broken out at the iS Mela" held on the Pachmarhi hills. In 1864 and 1865 cholera appeared first at the Mela ; in the former year 10 persons died from it on the spot it was held, and last year 200 ; the people on these, as on former occasions, dispersed to their different homes, spreading the disease wherever they went. This year the disease eutered the district somewhere about Sohagpur, and travelled first in a westerly direction through Sohagpur, Babai, Hoshangabad, Seoni, and so on, to Harda and back again ; it then seems to have gone easterly and on to Gadarwarra and JSTarsinghpur, vice versa. From the enquiries I have made, and my recollection of outbreaks of cholera in former years, as also the past, I believe the disease generally has its origin or breakout first at the Pachmarhi " Mela," and from thepce it spreads in every direction. Fiom the Secretary to the Chief Commissioner, Central Provinces, to the Commissioner, Nerbudda Division, No. 3648-324, dated 22nd September 1865. With reference to your letter No. 3465, dated 15th September 1865, and previous correspondence, regarding the outbreak of cholera at Pachmarhi, I am directed by the Officiating Chief Commissioner to state that it is quite clear that the public health demands that the Mahadeo fair, which is held at Pachmarhi, must be prohibited ; and I am to request that you will take the necessary steps for having this done. 2. The Deputy Commissioner of Hoshangabad should be instructed to take every means, in communication with other District Officers, Political Agents, &c, to inform all intending attendants at the fair that the fair has been prohibited. 3. lam to add that the Officiating Chief Commissioner will be prepared to take into consideration any reasonable claim to compensation on the part of the rtiree Bhopa families, ฆwhich may arise from the fair haying been prohibited. From the Commissioner,, Nerbudda Division, to the Secretary to Chief Comrriissioner, Central Provinces, No. 3887, dated J7th October 1865. With reference to your No. 3648-324, dated 22nd ultimo, conveying the Chief Commissioner's instructions prohibiting the Pachmarhi fair, I have the honor to annex copy of my No. 3681 of this date, to the Deputy Commissioner, Hoshangabad, on the subject, for the Chief Commissioner's information and approval. 2. To the Commissioners of Nagpur and Berar I have sent a copy of the correspondence for " information and any action which may seem to them to be requisite in their divisions/ 3, Also to the Commissioner of Jubbulpore I have sent a " copy of the correspondence, " incase he may consider it desirable to inform the public, in some portion of his division, of " the measure now ordered." c 4. To the Resid nt at Indore I have sent a copy of the correspondence, stating that if it should appear to him desirable that the public of some of the States and Provinces under his superintendence should be informed of the prohibition, I should feel obliged if he would adopt such measures to that end as may seem to him most judicious. 7 From the Commissioner, Nerbudda Division, to the Deputy Commissioner, Hosbangabad, No. 3881, dated 17th October 1865. With reference to previous correspondence on the subject of cholera in your district, I have now the honor to annex a copy of my report on the subject to the Chief Commissioner, No. 2074, dated Ist June last, and the Chief Commissioner's instructions thereon conveyed in Secretary's No. 3648-324, dated 21st ultimo. 2. You will see that the Chief Commissioner has come to the conclusion that the public health demands that the Mahadeo fair at Pachmarhi should be prohibited, and that it now becomes your duty to adopt means of informing attendants at the fair, that it has been prohibited. 3. I have accordingly to request your early attention to these instructions. You will be good enough to report to me when they shall have been duly carried out. 4. You will understand that the Chief Commissioner's instructions relate only to the annual gathering which takes place at the spring of each year; there is no intention to prevent ordinary visits to the Pachmarhi caves at any time. 5. lam not sure in what manner you will think it best to proceed in the execution of these instructions ; but if you should consider the issue of any general notice to the public necessary, I request that a draft of it be first submitted for approval. In drawing up such notice you would doubtless see the desirability of being explicit in respect of the causes which fraye rendered the prohibition necessary. The main thing to inform the public in whatever mode you might convey the information would be, that inasmuch as the generation of cholera, whenever large assemblages take place at Pachmarhi, has become a matter of notoriety, and as the mortality in all adjacent districts from cholera spread from that centre, has become serious, so the Administration has been obliged to regard all such assemblages in that locality in the light of a public nuisance, and to prevent their taking place in future accordingly. That in consequence of this you had instructed the police to prevent large numbers of persons from congregating at Pachmarhi in future, and that all such congregations, including the annual fair in the spring of the year, would be prevented accordingly. It would be added, that while all large assemblages would thus be preyented, the police would not interfere with small parties who might visit Pachmarhi at all seasons in the usual manner. Whatever mode you may choose for informing the public as above, should, J need hardly say, be adopted with judgment and consideration. 6. It will be in conformity with the Chief Commissioner's instructions, that you communicate on this subject with other District Officers, Political Agents, &c, of adjacent tracts, in order that the same action which you may take, modified if necessary to suit circumstances, may be taken in all districts, to whose public it may seem desirable to communicate the information. In carrying out this part of the Chief Commissioner's instructions, it will, I Deputy Commissioners : Narsinghpnr, Nimar, Betul, and Cfahindwara. Political Agent, Bhopal. believe, suffice that your direct communications should be made to the officers noted on the margin, and I will prepare them for the communications you may make, by sending a copy of this correspondence to each of the Deputy Commissioners noted. The Political Agent at Bhopal would of course be guided by instructions from Indore. I will communicate with the Kesident there ; but as your district marches with Bhopal, it may be convenient that the Political Agent should hear from you direct. 7. I will myself also communicate the prohibition of the fair to the Commissioner of the Nagpur Division, and the Commissioner of Berar, in order that the information may be conveyed to the public of those provinces if the Commissioners should think it desirable. 8. With reference to Mr. Bernard's 3rd paragraph, I request that you will after due enquiry report on the subject of compensation to the Bhopa families for any loss which may arise from the fair having been prohibited. From the Secretary to Chief Commissioner, Central Provinces, to the Commissioner, Nerbudda Division, No, 3964-351, dated 25th October 1865. Your No. 37, dated 17th October 1865, regarding the Mahadeo fair. The Officiating Chief Commissioner approves of the action taken, and the instructions issued by the Commissioiier in respect of notifying the stoppage of th is fair. 8 The following extract from " The Highlands of Central India", by Captain Forsyth, gives a vivid description of the nature of this fair, of the place where it was held, and also of the destructive results that ofceu followed upon oucbreaks of cholera among the multitude assembled: — " But to return to my doings at Pachmarhi after this long digression. Towards the end of February numbers of Hindu pilgrims from the plains to the great shrine of Siva in tbe Mahadeo hills began to pass my camp. They usually encamp at the foot of the hill below the shrine ; and besides the road over the plateau, come by a way which leads through the Denwa valley below the Pachmarhi scarp. Several other roads lead in from the south, all of which are rugged and difficult, and are traversed in fear and trembling by the pilgrims. About this time I crossed over from Pachmarhi to visit the opposite plateau of Mohtoor, which was also at that time under examination as a possible site for a sanitarium in these Provinces^ The Denwa valley lay between, necessitating a- descent and ascent of about 2,500 feet each way. On my return from Mohtoor on the 26th of February, I found tbe little plain in the Denwa valley below the shrine, through which my road lay, swarming with the pilgrims^ some forty thousand of whom had collected in this lonely valley in a few days, and were now crowding up into the ravine where the cave is situated — a ravine through which a week or two before 1 had tracked a herd of bison ! " Most of these annual gatherings of pilgrims are, to the majority of the Hindus who attend them, very much what race-meetings and cattle-shows are to the more practical Englishman — an episode in their hard-worked and rathซr colourless existence, in which a nominal object of little interest in itself is made the excuse for an " outing," the amusements of which chiefly consist in bothies for the sale of all sorts of miscellaneous articles, universal gossiping, of the elders, and peep-shows and whirligigs for the younger members. 11 Doubtless at all these gatherings there are a certain number of genuine pilgrims,, whose end in coming is the performance of sacred rites at these holy shrines at such holy seasons, for the fairs are all held at times when the worship of the local deity is held to be particularly efficacious. But generally their number is no greater a proportion of the whole than is that of the " members of the ring" in a Derby crowd. Such gatherings usually occur near the large centres of population, where solemn temples crown some sacred eminence by the holy Nerbudda. But the gathering at the Mahadeo shrine was of another character from these holiday outings ; it draws it* multitudes into a remote and desolate valley surrounded by the " eternal hills' 7 where the Great God has his chiefest dwelling place in these central regions. No gorgeous temples or impressive ritual attract the sight-seer. The pathways leading to the place are mere tracks, scarcely discernible in the rank jungle, and here and there scaling precipitous rocks, where the feet of countless pilgrims have worn steps in the stone. Young and old have to track out these paths on foot ; and all the terrors of pestilence, wild beasts, and the demons and spirits of the waste surround the approach in their excited imaginations. Arrived at the foot of the holy hill, the pilgrim finds neither jollity nor anything more than the barest requirements of existence awaiting him. His food is dry parched grain, his couch the naked earth, during his sojourn in the presence of the Mahadeva. Should he be among the first to arrive, the tiger may chance to dispute with him the right to quench his thirst at the watering-place in tbe Denwa river.* Those who come to a place like this for pleasure must be few indeed. "On my way back to Pachmarhi, as I passed through the assembled multitudes, many of them were starting, after a dip of purification in the holy stream, to scale the heights that contain the shrine. My way also lay up the pilgrims' pass ; and as I went, I passed through numerous groups of them slowly toiling up the steep ascent of nearly two thousand feet. Both men and women formed the throng ; the former stripped to the waist and girded with a clean white cloth, the horizontal marks of red and yellow which distinguished them as worshippers of Siva, being newly imprinted on their arms and foreheads. The women retained their usual costume ; but the careful veiling of face and figure, attended to on common occasions by high caste ladies, was a good deal relaxed in the excitement of the occasion. Signs of religious fervour there were none. All were talking and laughing gaily— now and then shouting out " Jae, Jae, Mahadeo !" (victory to the Great God). The cry *Ah I went to Hohtoor on this occasion I saw the track of ft tiger where the pilgrims drink, They had not then arrived, of coune, 9 raised by each as he took the first step on the hill was tflVen up by all the forward groups, till it died away in a confused hum among the crowd who had already reached the shrine, far up in the bowels of the hill. Gloom and terror are the last sentiments in the religious feeling of the Hindu, even when approaching the shrine of the deity who has been called the Destroyer in their trinity of gods. It is considered sufficiency meritorious to perform such a pilgrimage as this at all, without further adding to its misery by wailing and gnashing of teeth. They believe it will do them good, because the priests say so; but they do not think it necessary to weep over it, and ' r boil their peas" when they can Hut at the best, it is a hard clamber for those unused to toil. The old and decrepit, the fat trader, and the delicate high-bred woman, have to halt and rest often and again as they labour up the hill. The path was a zigzag; and at every turn some convenient stone or rocky ledge had been worn smooth by these restings of generations of pilgrims. " For a long way before the shrine was reached, the path was lined on either side by rows of religious mendicants and devotees, spreading befure them open cloths to receive alms, clothed in ashes picked out by the white horizontal paint-marks of the followers of Siva, >vith girdle of twisted rope and long-felted Jocks, hollow-eyed and hideous, jingling a huge pair of iron tongs with raoveable rings on them, and shouting out the praises of Mahadeo. The clang of a large fine-toned bell, and the bum of a multitude of voices reached our ears, as, surmounting the last shoulder of the hill, we entered the narrow valley of the shrine. A long dim aisle, between high red sandstone cliffs and canopied by tall mango trees, led up to the cave. The roots of the great mangoes, of wild plantains, and of the sacred chumpuu,* were fixed in cracks in the pavement of rock, worn smooth by the feet of the pilgrims, and moist and slippery with the waters of the stream that issues from the cave. " The cave itself opens through a lofty natural arch in a perpendicular sandstone cliff; and for about three hundred feet runs straight into the bowels of the hill. It is without doubt natural; and a considerable stream of clear cold water issues from a cleft at its further end. Here is set up the little conical stone (lingum) which represents the god, and attracts all these pilgrims once a year. No temple made wiih hands, no graven image, nothing of the usual pomp and ceremony of B rah mi uical worship, adorns this forest shrine. Outside on a platform a Brahmin sits chanting passages in praise of the god, and of the local Sivite gospel (the Rewa Khanda) ; and a little way off an old woman tolls the great bell at intervals. But within there is co officiating priest, no one but a retainer of tl>e aboriginal chief whose right it has been from time immemorial to act as custodian of the shrine and to receive the offerings of the pilgrims. No pilgrim ever brings more up the hill with him tban he means to offer ; for he may take back nothing— his last rupee, and even the ornaments of the women, must be left on the shrine of the god. Before passing into the cave, the pilgrim leaves with the Brahmins outside (along with a sufficient douceur) his pair of small earthen vessels for the receipt of holy water. These they fill from the stream, seal up, and return to the pilgrim, who then proceeds to make the tour of the holy places on the Mahadeo bills. This takes him the whole of the remainder of the day. At each place a cocoanut ia offered ; and little pilo3 of stones like children's card-houses are erected at some point of their peregrinatious, to signify a desire for a mansion in kailas — the heaven of Siva. Many of the places which should in theory be visited are very inaccessible, such as the top of the Ohaorudeo peak and very few of the pilgrims make the whole round. " I sat for some hours io the ravine sketching the entrance to the cave, an 1 the pictuiv esque throng about it. A few sulky looks from the professional religionists, and a drawing closer of their garments by the ladies, when they saw my occupation, were all the notice I met with. The bright colouiing which gives such a charm to congregations of Hindus was heightened by the general holiday attire of the worshippers on this occasion; and in the mellowed light from above, which percolated rather than shone through the canopy of foliage, would have formed a subject worthy of a much better artist than myself. It was hard to believe that all this gay gathering had come in a day, and would go in another, leaving the valley again to the bisou and the jungle-fowl. Unlike most shrines wheie such pilgrimages occur, no one remains to look after the god when the pilgrims are gone. The bell is unslung and taken away, being evidently looked upon as the ouly thing of value in the place. When I first visited the cave, 1 found that the Great Cod had been better attended to by the wild be ists of the forest than by his human worshippers — a panther or hyaena having evidently been ia the daily habit of leaving the only offering he could wake before his shrine ! *Michelia chavvpaca. 10 ? * * * * *' But the powers of evil were not yet to be baulked of their victims. The British Government could prevent deluded and drugged devotees from casting themselves over the Bir-kali rock ; but it could not deprive Kali and K.il-Bhairana of their fell executioner — the cholera demon. Year by year, the pestilence invaded the encampments of the pilgrims. •Sanitary science would say that it arose from the germs of disease brought from the festering gullies of the great cities and pushed into activity by the exposure, bad food, defiled neighbourhood, and poisoned water, of the pilgrim camp.s. But the Hindu saw nothing in it but the wrath of the offended divinity claiming his sacrifice. Year after year the gatherings were broken up in wild disorder. The valley of the cave, the steep hill-side, and that green glade in the sal forest, were left to bury their dead, while the multitude fled affrighted over the land, carrying far and wide with them the seeds of death. Everywhere their tracks were marked by nnburied corpses : and the remotest villages of the Nerbudda valley and the country of the south felt the anger of the destroying fiend. A pilgrim fleeing from the fatal gathering could find no rest for the sole of his foot. The villages on his road closed their gates against him as if he were a mad dog; and many who escaped the disease perisKed in the jungle from starvation and wild beasts. At last, after a terrible outbreak ot cholera in 1865, the Government prohibited the usual gathering at the Mahadeo cave. The people made no complaint. They do not seriously care about these things when left alone by the priests ; and here the priests were satisfied by the continuance to the hereditary custodians, on whom they were dependent, of their average income from the pilgrimage, in the form of a pension. It is very different when their ga'ns are affected. Two years ago a cholera epidemic threatened in Nimar, and the pilgrimage to Omkar Mandhatta was closed by order. The priests and guardians of the shrine were up in arms at once, basing their objections entirely on the money loss they would suffer. Since the closing of the Mahadeo pilgrimage, the deities of destruction have been baulked of their prey. The valley ot the Denwa, although now opened up by a good timber road made to penetrate the sal forest, no longer witnesses the annual pilgrim congress. The cave of the shrine is silent and "The interruption to the business of the country caused by these cholera outbreaks used to be terrible. Whole villagesปwere sometimes swept away. In May of 1865, I had marched nearly 20 miles to a small Gond village on one of the pilgrim tracks, in the district of Betul. I had been eluding the tracks of cholera the whole of the hot season, and had escaped without a single case of the disease in my camp. My people were almost exhausted with such a long march in the height of the hot season ; and I joined them at the village, likewise much knocked up by a long exploration in the hills. I found my tent-pitcher and one or two others who had arrived, struggling to pitch the large tent, without the usual assistance rendered by the villagers at the camping place. They placidly told me that the village was no longer the home of the living, every one in the nouses being dead of cholera! The only living object in the place was a white kid, wandering about with a garland round its neck. It was the scape-goat which these simple people, after the manner of the Israelites of old, send out into the wilderness on such occasions to carry with it the spirit of the plague. Tired out as we were, it was death to stay in this place j so we re-loaded the things and inarched 8 miles further, straight into the jungle; and at night-fall pitched our camp by the bank of the wild Tawa river, far from human habitation. No one was seized by the disease; and during all my marching, humanly speaking I believe owing to proper sanitary precautions, I never had a single case in my camp." — Forsyth'i "Highlands of Central India" pp. 165, 170. Note. — There rm been no cholera in villages of the Denwa valley aad the jungles of Mahadeo hills since 1865, the last year in which the fair assembled. S, C T. 11 Appendix 111. From Lieutenant H. Stevenson, Commanding Details Boyal Artillery, to the Adjutant Royal Artillery, M. D. A. Mhow, — dated Camp Hursora, the 22nd April 1865. In obedience to the orders of the Commanding Officer, I have the honor to furnish the subjoined report of the march of the detachment under my command. 1. In obedience to the orders T received, and in accordance with a route furnished me, I marched in command of a detail consisting of 98 men, 9 women and 16 children, on the morning of the 12th instant. Through the kindness of Colonel Carmichael, C. 8., we were played out of Mhow by the Band of Her Majesty's 103 rd Foot ; every man was sober, and during the march no one fell out. I encamped 10 miles from Mhow, about one mile to the right of the Simrole village ; there I obtained plenty of shade and excellent water. 2. On the 13th I halted. 3. On the 14th I marched at 2A. M., and descending the Simrole Ghat encamped at Bhai, about seven miles from our first encampment. The men were in good spirits, and no one fell out on the road. The tents were all pitched by sun-rise. The heat however at this place was intense, and continued through the night ; but all continued well. 4. On the loth I marched at 1-45, and descending the Bhai Ghat we encamped at Balwara, distant about 8ฃ miles from Bhai. I was unable to obtain any shade from trees at this place, and the heat was more intense than the day before. During the march no man fell out, and I had every reason to suppose that every one was well ; at 10 a. M. however, a mau came to hospital complaining of diarrhoea and vomiting : he was treated by the Medical Officer most assiduously, but all was of no avail, and he died of cholera at 4 P. M. ; at 2 P. M. a woman, Mrs. Daugherty, was also seized with choleraic symptoms ; but there were no other cases during the day. 5. On the 16th I marched at 1-45 A. M. on Burwai, distant 11ฃ miles. As we started one other man was taken ill, but the remainder marched as well as usual, though they were evidently depressed in spirits, the heat having prevented any attempt at sleep the night before. In hopes of obtaining a good rest for them, I moved the whole detachment into the iron-works. I placed the hospital in a detached building, and in a short time all were comfortably settled ; 1 here ordered double rations of tea and salt to be issued. I obtained a supply of charcoal, and had all the driukiug water filtered through it. There were three admissions into hospital early in the morning ; but after that, till the afternoon, all appeared to be well. Mrs. Daugherty died on the inarch, and I buried her at midday. I sent a mounted despatch into Mhow for more medical aid, for Dr. Mathieson being in very dplicate health, was becoming alarmingly ill himself, consequent on his untiring exertions, and it was quite evident that unless he obtained some relief I should soon be deprived of his services. Three of the morning admissions died during the day ; but there were no more admissions at 7 P. M., and I was in hopes that the worst was over- 6." On the 17th, at day-break, I was informed that two admissions into hospital, and one death, had taken place during the night, and on my arrival at the hospital I found a large number of applicants for medicine ; this decided me on changing my quarters at once ; I moved on about ฃ of a mile at right angles to the prevailing wind, and prevented all communication with the hospital. Of the applicants for medicine in the morning, six had teen admitted into hospital ; up to 6P.M. no man was admitted into hospital from the new camp, but a little later two more were taken ill, and I again decided to move my camp. During this day there were altogether twelve admissions and six deaths, including one child. Indepeudently of these, nearly every woman and child was more or less ill. To add to oui distress, Mr. O'Neill, the Apothecary, utterly worn out, became seriously ill, and Dr. Mathiesoa had become so reduced by his illness (severe diarrhoea) that he was hardly able to walk. 7. On the 18th, at lA. if., f started forSanawad, situated four miles across the Nerbudda Iver. I took spare carts with me for any men that might be taken ill during the march, nly two men were, and I reached my encamping ground before sun-rise. I here found plenty trees and excellent water. The patients had borne the march very well, and the men's irits began to revive ; still there were a great many applicants for medicine. At 7-30 a. m. was joined by Staff Assistant Surgeon Simpson and Mr. Hospital Steward Cordeiro, from how, and never was medical aid more gladly welcomed. But in spite of all human efforts, c disease seemed only to spread and rage more virulently than ever ; five admissions auraise. 22. Where all have behaved so well, it is hard to draw comparisons, but I cannot refrain from especially mentioning the names of Serjeant Harman (now ill in hospital through disease, brought on solely by hard work), Corporal Chappel and Bombardier Evans ; these three deserve any reward that can be bestowed upon them ; also I beg to mention Corporal Dunsford, Bombardier Martin, Gunners Kerr, Lucy, Fennegan, Stewart, Trill, and Iree, and Drivers Aggett and Rabbett. The assistance I have received from all these men is such as can only be appreciated by one placed in such distressing circumstances as I have been. 23. It still remains for me to mention those who perhaps deserve the greatest praise of all. Never I believe in times of peace have English women and children been exposed to such bitter trials as those with me have during the last ten days. Nobly have they borne all, no complaining, no hesitation in obeying my directions. They have borne all with patient resignation : themselves ill, some seriously so, all their children ill, some with cholera, the rest with burning fever, they have united in consoling one another, and striving to see who could give the least trouble. 24. In closing this report, it is with deep regret that I have to report, for the information of Government, the gross misconduct of Ist Class Hospital Assistant Mahomed Idrows ; this man was attached for duty to the detail under my command ;he never exerted himself like any one else, but still his services, such as they were, could not be dispensed with in such a state as we were. At Sunawud, when I had settled to return to Mhow, he came and asked my permission to proceed to Bombay, as he was under orders to go there before he was attached to my command. I positively refused to allow him to go, and expressed my surprise at a man of his profession wishing to desert us in such a time of need. Nevertheless be deserted us in the middle of the night. It of course remains for Government to decide whether a man who deserted us when his services were so urgently required, is worthy of further employment in the public service. ฆ*.. 25. I have now closed my report. It lias become somewhat lengthy, but events such as we experienced are not described in a few words. In conclusion, I trust the Colonel Commanding will feel satisfied with the way in which all under me have behaved. 14 List of casualties which occurred amongst the details under the command of Lieutenant H. Stevenson, Royal Horse Artillery, from the 12th to 22nd April 1865. No. Rank and Names. diaease^ Place " Remarks. 1 Driver Deen, Alfred ... 15thAprill865 Balwara Cholera. or , t\ i 1 ail. En route to ) 2 Iliiiropeau woman, Daugherty ... lota „ B w f " 3 Gunner Flannery, James ... I6th „ Barwai. „ 4 ? Quinn, William ... 1 6th „ „ „ 5 Driver Welsh, Thomas ... 16th „ „ „ 6 Child Tighe, Bridget ... 16th „ „ „ 7 Corporal West, Horace ... 17th „ ? }t 8 Acting Bombardier Hinds, William... 17th ? ? „ 9 Gunner Yeates, Abraham ... 17th „ „ „ 10 Serjeant Daws, Thomas ... 17th ? „ Proper name James Daw, H. late Barrack Ser-11 Gunner Halliday, Job ... 18th „ Sunawad. Cholera. 12 „ By ford, Henry ... 18th „ „ „ 13 „ Mansel, Devis ... 18th „ „ „ u| „ Beeley, Samuel ... 18th „ 351 „ Ford, Richard ... 18th „ „ „ 16 Driver Warren, Frederick ... 18th „ „ „ 17 „ Symonds, Samuel ... 18th ? ? „ 18 Child Walters ... 18th „ 19 Child Walters ... 18th „ „ Atrophy. 20 Child Tighe ... 18th „ „ Fever. 21 Driver Whalen, John ... 19th „ N. Balwara. Cholera. 22 Private Daugherty, Charles ... 19th ? „ Sun-stroke. 23 Serjeant Major Nolan, Daniel ... 19th „ Hursoi'd / Cholera. 24 Gunner Pygle, Benjamin ... 20th „ Hursora. „ 25 „ Doyle, John ... 19th „ En route to ) Hursora. / 26 Driver Warry, Joseph ... 20th „ Hursora. „ Camp Hursora, ] (Signed) H. STEVENSON, Lieut., the 22nd April 1865. J Commanding Details R. A. APPENDIX m IV. fpi) STATEMENT 11. Showing the dates of first cases and prevalence of cholera in the different circles and towns of the Central Provinces in the years 1875 and 1876. .5 .-=,ง I g-9 m Number of deaths ** ** a Dates of first cases. Month of greatest gj Number of villages from cholera ซg .ซ m•ง prevalence. ฃ attacked. during the ฃ.5 > year. || J g, g Name of Town , v J . * ง .orCircle ฐ g S ts S "SoS o ฃ 1875. 1876. 1875. 1876. |g 5 1875. 1876. 1875. 1876. .2 | ฃ .s8ซ Ji | I*l JSfl p., , , , Sambalpur. Sambalpur T. 20, Augt.27 July Septr. Augt. ... 11,020 108 22 ... 11797 Bargarh T. ... do. ... Augt. ... 2,015 27 ... 133-99 Ambabona R. C. ... 5, May ... June 106 18,886 ... 9 ... 48 6-49 25 41 Sohela 21, Feby. ... June 157 40,569 ... 13 ... 279 8-28 6877 Bargarh March ... June 391 121,02.5 ... 20 ... 219 5*12 1810 Sambalpur ... 29, Augt. 21, Augt. Septr. Augt. 169 57,698 18 6 50 16 14-20 1143 Mura ...29, July. 2. July Augt. July 160 33,276 4 1 32 4 313 1081 Lapanga ...21, July. ( '2, July do. July 180 35,473 10 5 63 43 8-33 2987 Total District ... 1,163 319,962 32) 54 253 658 7-39 2822 Bilaspur. Bilaspur T. 6, Marcb ... July 6,454 ... ... 127 ... ... 25939 Ratanpur T. ... ... .. 5,111 1 ... ... 1*95 Mungeli T. 4, May 4,392 131 ... ... 2988 Eatanpur E, C.7, March ... June ... 192 59,880 8 ... 40 ... 3-96 668 Lormi ...19, May ... June ... 229 30,779 36 ... 190 ... 18-46 6173 Mungeli ...^ Nowaghar ... >6, March ... June ... 614 132,748 153 ... 1,022 ... 27-27 9651 Thakhtpur ...j ISghat I"/. } 28, Feby. ... May ... 295 63,587 50 ... 623 ... 16-89 9797 MustorT ;;;}2l,Feby. ... Augt. ... 380 96,421 52 ... 287 ... 15-16 3334 Seorinarain ...26, June October July ... 172 54,922 12 ... 96 1 6-98 1236 Saragaon ...29, March 297 62,428 2 ... 8 ... 0-88 117 Total District 2,179 516,722 313 ... 2,525 1 14-37 4888 Raipur. Raipur T. 7, June ... Augt 19,116 30 ... ... 1569 Dhamteri T. 22, July ... July 6,023 27 ... ... 44 82 Drug T. 7, June 3,361 67 ... ... 2000 Arung T. ... 20, April ... April ... 3,863 ... 4 ... 1036 Rajim T.lO, Augt 2,808 1 ... Baiod ...18, June ... Augt 388 103,980 108 ... 1,304 ... 27-69 12540 Drug ... 6, June Deer. June Deer. 260 92,516 54 4 949 11 21-56 10715 Damda ...13, May ... June ... 271 83,384 41 ... 415 ... 1519 49 70 Seemga ... 8, May ... June ... 413 118,8*6 64 ... 348 ... 1553 2928 Lown ...13,March May Aagt. May 318 71,762 16 1 120 34 535 1939 Raipur ...15, May Deer. July ... 307 97,700 45 4 405 1 1617 4155 Dhamteri ... 3, June ... Augt. ... 430 140,146 51 ... 646 ... 1.178 4420 Sehawa ... ... 114 11,997 Panduka ... ... 79 16,087 Rajim ...20, June Auo-t. ... 168 34,378 11 ... 78 ... 651 2124 Arung ...17, July 11, April Augt. April 172 52,293 11 2 59 51 756 18 82 Nawagaon ... 10, Augt. 22, March ... March 152 18,986 ... 1 ... 4 066 210 Total District ... ... ... 3,072 883,246 401 12 4,449 105 1344 5156 Balaghat (Baihar) Parsamau ... 2, June 13, Mar. June March 47 4,684 113 4 426 1067 Behir .. 30, May ... June ... 182 20,692 3 ... 8 ... I'6l 144 Paraswara ... ... ... 106 18,281 Mau ... ... ... ... 79 18,231 Total District ... ... ... "„, ... 414 61,888 4 14 4 Ml 129 , !—! — 2 > ~ Number of deaths >** ,& a Dales of first cases. Month of greatest & Number of village? from cholera "$ .ซ m ฃ prevalence. -5 attacked. during the 5 ~ . *> y ear - งJ2 % m Name of Town or -g • "^ Circle. I ฃ-งฃ<ฃ o o 1875. 1876. 1875. 1876. || "3 1875. 1876. 1875. 1876. .fi.|ฃ o งซ * I** Balaqhat (Burha.) Burba T 2,216 Burha R. C 137 51,261 Lanji 19, Novr ... Novr. 248 67,436 ... 5 ... 26 2-02 386 Wara Seoni 4, Novr ... Novr. 150 66,959 ... 6 ... 19 4-00 2-84 Katanghi 15, Novr ... Novr. 86 30,341 ... 9 ... 16 1047 527 Total 621 218,213 ... 20 ... 61 2-42 280 Total District 1,0*5 280,101 4 21 4 65 246 243 Bhandara. Tumsur T. ... 13, July ... July ... 7,367! 82 ... 111-25 Pauni T 15, Augt.3o, June Augt. July ... 8,973 33 10 ... 4792 Bhandara T. 15, Augt, 26, July Novr. Augt. ... ll.Jdffl 14 41 ... 48-10 Mohari T. ... 21, July ... Augt. ... 6,083! 38 ... 62-86 Rampaili R.C. ... 7, Sepr. ... Novr. 166 69,270 ... 5 ... 9 3-01 1-30 Tirora ... 23, Sepr. 29, July Octr. Novr. 179 61,683 2 23 12 88 13-97 16-21 Kamtha 8. Novr ... Novr. 97 58,821 ... 4 ... 8 4-12 136 Ambgaon ... 19, June 10, Novr. June Novr. 149 69,521 4 9 27 12 812 5*60 Sakoli ...13, June 6, Novr. June Novr. 136 39,895 3 9 4J 32 B*B2 9"02 Burburj ... 5. June 16, Novr. June Novr. 92 20,167 4 3 10 h 7-61 8-91 Chisgarh ... 29, Novr. ... Deer. ... 56 14,060 1 ... 4 ... 1-20 2-84 Arjuni ... 11, Sepr. 15. Augt. Septr. Augt, 154 52,393 1 4 12 17 325 5-53 Pauni ...15, Augt. 30, June. Octr. Septr. 198 51,668 10 14 52 52 12-12 20-12 Bhandara ...J2, June 5, July Octr. Novr. 173 48,246 18 11 92 63 167<3 32-12 Mohari 13, July ... Novr. 160 45,233 1 27 1 145 175 32-27 Total District 1,560 564,813 44 109 261 605 9-81 1531 Nagpur*. 4 Narkher T. 3, Octr. 20, Novr. Octr. Deer. ... 7,159 4 14 ... 2513 Katol T. 30, July 7, Novr. Augt. Deer. ... 6,488 43 5 ... 7306 Kalmeshwar T. 31, July ... Augt 4,738 4 844 Mnhopa T ... 4, Novr. ... Novr ... 5,572 42 ... 75-38 Saoner T.'ll, Angt. 5, Novr. Augt. Novr. ... 5,295 12 10 ... 41-54 Patunsaonghi T. 31, July 4, Novr. Augt. Novr. ... 4,983 42 2 ... 8830 Khapa T.J26, July 7, Sepr. Augt. Septr. ... 8,007 49 85 ... I(M'9O Ramtek T. 8, Augt. 4, Aug. & Augt. Novr. ... 7,045 6 48 ... 7664 31. Oct. Kamthi T- 7, Augt. 26, June Augt. Novr. ... 48,831 64 5S ... 24"97 Nagpur T. 13, Augt. 10, July Augt. Novr. ... 84,441 82 61 ... 31-00 Bela T. 5, Augt. ... ' Augt 5,012 29 57-86 Umrer T. 24, Augt. 6, Novr Septr. JNovr. ... 11,39-1 5 10 ... 131 5 Narkher R.C.I ... 14, Novr. Augt. Novr. HO 45,48!' ... ) 4 ... 40) Qi , Katol ...(30, July. 7, Novr. Augt. Novr. 118 82,189 56 f 1 331 2 f Bazargaon ...I ... 31, Augt. Augt. Septr. 106 24,857 ... j 2 ... 16 I Sft Bori ...J 22, July. 10, Novr. Augt. Novr. 183 41,442 71 j 6 524 28 f zo Ba Kalmeshwar ...30, July 4, Oct. Augt. Novr. 60 24,210 23 3 133 7 43 58 Saoner ... f 25, July. 11. Sep. Augt. Octr. 114 39,314 79 ) 8 415 45 I - fi Parseoni ...J ... 6, Augt. Augt. Novr. 136 43,136 ... J 13 ... 57/ Ramtek ... 14, July 5, Augt. Augt. Novr. 165 36,178 21 22 70 10.1 22 43 Nagpur ... 1, Augt. 4, Novr. Augt. Novr. 224 47,049 26 2 128 10 12 29 Mohoda ... 1, Augt. 1 5, July Augt. Novr. 155 38,426 32 20 164 37 34 46 Mandhul ... | ... 30, July Septr. Augt. 131 86,310) .. 9 ... 69) 1 ., „tnrer ... j 15, Augt. 26, April Septr. April. 123 23,414 jl7 3 56 4\ tal District ... 1,634 631,229 325 93 2,111 701 255 44-5 3 A. STATEMENT ll— (Continued.) S ซ i / oil m Number of deaths jf.s q.- Dates of first cases. Month of greatest Si Number of villages from cholera ฉ r-< .S prevalence. ซ attacked. daring the ฃ:g fc fl v *t * 1.9 Is Name of 1 own ซ,_, • 5 "S ซ ซf or Circle. ฐ J -^g 1875. 1876. 1875. 1876. -So 9 1875. 1876. 1875. 1876. .2 3 & o o Wardha. Arvi T.... 4 Augt. 3 Novr. August. Novr. ... 12,759 48 3 ... 39-97 Wardha T 29 July. ... August. ... 3,562 132 ... 370-57 Deori T.... 4 Octr. ... October. ... ... 5,558 11 ... ... 19-77 Hinganghat T..... 29 July Deer. August. ... ... 9,415 60 1 ... 64-78 Ashti T. ... 14 Augt. ... ditto ... ... 4,262 41 ... ... 96-20 Sindhi T.... 1 Augt. 2 Novr. ditto Novr. ... 4*867 35 24 ... 49*52 Sailoo T.... 5 Augt. lONovr. ditto Novr. ... 3,047 44 1 ... 3-28 Allipur T. ... 15 Augt. ... ditto ... ... 3,488 .. ... 20 ... ... 57'34i Ashti ... 12 Augt. 22 Octr, ditto Novr. 69 30,211 45 3 247 22 69-57 55-69 Karinja ... 30 July.l 22 Novr. ditto ... 91 40,940 12 1 103 2 14 40"00 Arvi ... 14 July. 3 Novr. ditto Novr. 82 ' 24,543 39 15 176 11 65-85 28-86 Deoli ... 6 Augt. October. ditto Novr. 101 51,486 38 2 260 8 39-60 43-93 Wardha ... 11 Augt. 17 Augt. ditto Septr. 120 41,659 65 16) ซj 7 k iฑ r f 67-5 ) r . O q AUipur ... >... 7 June. ... August. 101 37,303 ... 7J d/ ฐ1 6*93 fbo J * Sindhi ... 1 Augt. 2 Novr. ditto Novr. 123 33,204 66 7 I o, q ซ j 59-35 109 Q . Girrur 63ept. ... October. 66 9,939 ... 3 / 6 * 6 ™ \ 4-55 J JJ ' y> Hinganghat ... 31 July. 9 Sept. ditto ditto. 119 38,477 47 8 252 35 46-22 58-71 Total district ... ... ... 872 3,54,720 12 62 2,015 443 4-3 69-29 Chanda. Chanda T 30 June. ... August. ... 16,25S 1 104 ... 14-61 Armori T 27 March ... July. ... 5,271 29 ... 55-01 Warora T.... 24 Augt. 28 April ... May. ... 3,584 ... ... 6 40 ... 128-35 Warora ... 6 Augt. 26 April. August. August. 137 39,4u5 41 16 204 202 41-61 103-03 Segaon ... 27 Augt. 23 April. Septr. April. 106 26,563 10 2 125 28 11-32 55-50 Chanda ... 1 Augt. 19 April. August. May. 115 42,423 • 7 16 10 57 20-0 15-78 (Jhimur ... Augt. 3 April. Septr. April. 168 44,262 3 3 67 17 3-57 19-41 Brahmapuri ... 23 Augt. 26 March Septr. August. 159 53,083 11 3C 48 453 29-56 176.76 Tullodi 24 March ... April. 151 57,84G ... 21 ... 320 13-91 55-33 Mul ... 14 Novr. 25 March Novr. June. 153 60,922 1 50 14 1,088 33-33 180-88 Dhaba ... 29 Augt. 27 May. Septr. August. 90 23,350 2 19 9 231 23-33 102-77 Armori April. ... Septr. \- . 21,991 ... 2 ... 10 f _, R 1 4-57 Wyragarh ... 5 Septr. 10 April. October. June, j 14 ' 24,973 1 8 23 93 \ '*ฐ ( 43-67 Uarcbiroli ... 10 JNovr. 22 March Novr- March. ป -.„ 11,744 1 5 44 96 f 9nQR i 119-21 Chamursi 2 April. ... June. [ i4d 25,140 ... 24 ... 480) yo f 190-93 I Total district ... ... ... 1,369 4,56,790 77 202 551 3,248 20-38 83-17 Sivoncha. Sironcha T 16 June. ... August. ... 2,242 18 ... 80-29 Sironcha ... 22 Sept 11 June. Septr. Je.&Aug. 97 12,273 2 12 4 117 14-43 98-59 Veerapur ... 30 Augt. ... ditto. ... 76 6,168 1 ... C ... 1-32 9-72 Cherla ... 19 Septr. ... ditto. ... 50 3,742 4 ... 10 ... 8-0 26-72 Total district ... ... ... 223 24,425 7 12 20 135 8-82 63-46 Mandla. Mandla T.... 31 Augt. 11 March Septr. March. ... 4,936 17 15 ... 64-82 Maharajpur T.... 14 Augt. ... ... ... ... 1,677 *14 ... Pindrai 8.C. ... 27 Augt. ... Septr. ... 100 17,661 3 ... 13 ... 3-00 7-36 Bichwa ... ... 26 March ... April. 202 31,144 ... 4 ... 17 198 5*45 Indri ... ... ... 74 16,264 Maudla .. 14 Augt. 11 March Septr. April. 384 42,843 7 11 .17 86 4-69 23-88 Narainganj 19 March ... July. 351 !8,097 ... 3 ... 33 0-85 18*23 Ramgarh ... ... ... 149 10,274 Kukramut ... ... ... 81 10,225 .Bamni ... ... ... 65 8,404 Selwar ... .... ... 120 13,332 fchahpura 22 June. ... June. 305 38,161 ... 3 ... 24 0-98 629 Total district ... ... ... 1,831 2,13,018 10 21 61 175 1-14 11-1 ) I , : ฆL *ifiฐt sbwa in Monthly Return*. ___^ Z__^ 4 STATEMENT ll.— (Continued.) .5 S5 ' 5 2 a dumber of deaths j*-ป ' Dates of first cases, Month of greatest & Number of villages from cholera 3 ซ Sซ prevalence — attacked. during the ,ฃ "3 S "* '? year. a ฃ•ง Name of Town __ d . ง~ |3 g ~ or Circle. .2 * 1? rง g & 1875. 1576. 1875. 1876. •ง•ซ 3 1875. 1876. 1875. 1876. .2*53 ฐ o |8 ฃ ฃซ>ป ) -og Seoni T 14 Augt. ... August. ... 9,557 4 ... 4*lB J.akhnadon T 30 Augt. ... Septr. ... 1,539 1 ... 6*50 Khorai R. C 5 Novr. ... Novr. 62 11,050 ... 12 ... 33 19*35 28-32 Seoni 8 Novr. ... ditto. 208 44,552 ... 2 ... 26 0-96 5-83 Mohgaon July. ... July, 73 16,154 ... 11 ... 55 15-07 34*04 Khari 20 July. ... August. 192 52,955 ... 15 ... 81 7*Bl 15-29 Kaoavara (Keolari) ... 13 April. ... -ditto. 223 48,288 1 15 3 187 673 38*73 Gbanssoor ... ... ... 175 24,688 Kahaui ... ... 16 May. ... May. J99 30,578 ... 2 ... 7 I*ol 2-29 Lakhnadou 19 Augt. ... August. 133 21,711 ... 2 ... 11 I*so 5-06 Chapara 14 July. ... ditto. 188 30,506 ... 8 ... 37 4*26 12-12 Total district ... ... ... 1,453 2,92,178 1 67 3 442 4*61 15*13 Chhiridwara. (Above Ghats.) Chhindwara r J\... 1 Septr. „, Septr. ... ?. 8,626 .ป. ... 14 ... ... 16*23 Batoria ... 28 Augt, ?. August ... 141 17,613 1 ... 17 ... 0*56 9-65 Umret ... ... ... 157 23,343 Umerwara ... 1 Septr, 6 Augt. Septr. $fovr. 169 30,391 4 2 13 53 3-55 21*64 Chowrai 1 Novr. ... ditto. 188 40,817 ... 16 ... 48 8-51 11-76 Chhindwara ...10 Septr. Novr. Septr. ditto. 261 44,200 10 36 4 4*60 9-04-&umarpani ... 11 Augt, 5 Novr. August. ditto, 128 16,965 2 2 4 3 312 4-11 j Total ... ... ... 1,044 1,81,955 17 22 84 108 8-74 10-55 (Below Ghats.) Lodihkera T.... 3 Augt. Deer. August 5,219 114 1 ... 22034 Pandurna $.... 13 Augt. 9 Novr. ditto 5,218 8 2 ... 19-ltf Saosur ... 3 Augt. 28 Augt. ditto. Septr. 127 47,080 47 3 382 9 39*37 91-04 Pandunia ... 14 Augt. 10 Novr. ditto. Novr. 142 ?5,719 9 3 62 3 8-45 25*25 Total ... .„ ?. ... 269 83,23.6 56 6 566 15 23-27 69*20 Total district... ... ... ... 1,313 2,65,191 73 28 650 123 7-6 29*16 Betul, Betul T.... 12 Augt. 29 March. Septr 4,593 34 1 .7. 76*20 Multai T 5 Novr. ... Novr. ... 3,371 6 ... 17*79 Shahpur R. C 13 March ... March. 140 22,193 ... 27 ... 172 19?29 77*50 Chicholi ... 15 Augt. 5 April. August. June. 194 39,663 7 10 8 157 8-76 41-59 Budnur ... 24 May. 13 March. August. August. 200 48,985 37 23 140 90 30-00 46-95 Amla ... 31 May. October. Septr, ... 161 36,168 9 4 63 11 8-07 20*45 Bhysdye 22 April. .!. May & At. 176 29,430 ... 42 ... 566 23*86 192-33 Atner ... 28 July. 29 April. Septr. August. 135 38,910 16 40 41 337 4i>4B 105*84 Multai ... 23Aiigt. 10 May. Septr. May. 113 421,358 17 3 39 11 17-70 8*63 Dondwa $oyr. tM $fovr. 64 J7,}86 M , ? ?, 2 3-13 1.18 Total district... 7m ;;; 73 V.T 1,183 2,78,857 86 151 525 1,353 20-03 60*10 r 5 STATEMENT 11.- -(Continued.) .5 rs -cj *< •" Number of deaths ** "** ฐ" a Dates of first cases. Month of greatest g, Number of villages from cholera -g ,g „-2 prevalence. .5 attacked. during the ฃ~ . t ? ear - S3 || S Name of Town __ _ j ฐ g rf * 5, or Circle. <= .2 S^S o'So ta P< ซ ฉBe 1875. 1676. 1875. 1876. jf 1 1875. 1876- 1875. 1876. o|ฃ .gง~ z iiim i , Burhanpur. BurhanpurT. ... C, July ... July 29,303 75 ... ... 25-59 AsirgarhK. C 30 7,417 Burhanpur ... 6, April ... July ... 100 33,820 12 ... 151 ... 12*00 44-64 Dewali ...17, Augt. ... August ... 20 3,236 1 ... 14 ... 5-00 43-26 Total District 150 73,776 13 ... 240 ... 8-67 32-5 Nimar. KhandwaT 27, March 6, July April August ... 14,119 *16 8 ... 16-1 Mundi฿. C. ... 20, April 1, Sept. May ... 81 15,234 3 ... 25 1 3-70 17-06 Dhangaon ... 12, April 10, Augt. August Sept. 108 24,580 16 10 123 77 24-07 88-36 Khandwa ... 27, May 20, July August August 168 53,836 24 13 159 135 22-02 52*73 Pandhana ... Bth May 28, April August ... 74 2(5,989 12 1 98 2 17-57 37-05 Peeplod 13 2,690 Total District 444 137,448 55 23 421 223 17-57 46-9 Hoskangabad. SohagpurT. ... 19, May 1, May Octr. May ... 7,552 27 52 ... 104-60 Hoshangabad T. ... 5, June 30, March June April ... 15,301 14 91 ... 71-52 SeoniT. ... 29, April 30, April April May ... 7,979 3 27 ... 37-01 HardaT. ...28, April 1, June April ... ... 9,170 9 3 ... 13-10 Bankheri 1' 13, May 2,130 7 ... 32*8i> OharwaT 24, Mayl 1,147 1 ... 8-71 Bankheri R. C 16, May ... June 165 24,051 ... 46 ... 341 27-88 141-90 Hinganama 28, May ... June 26 4,921 ... 3 ... 20 11-54 40*64 JSohagpur ... 13, May 26, March June June 208 57,990 22 41 77 356 30-29 74-64 Babai ... 8, June 2 7, March August May 141 39,688 13 11 94 103 1702 49-63 Hoshangabad ... 8, May 21, March May April 154 55,836 19 60 145 547 51-30 122-13 Seoai ... 29, April 24, March May May 101 51,516 15 25 101 131 39-60 45-02 Lokhartallai ... 19, May 24, March May May 94 14,755 7 26 32 234 35-11 180-27 Harda ...23, April 2, May June June 88 87,592 ) ,ซ A o cc 145) ซ, 9 on. ?jo Handia ... May May ... June 87 22,410/ " 4ti ฐ 6 79) W 20 6 * Kehatgaon ... 11, May 13, May May June HI 20,860 6 24 29 196 27-03 107-85 Mandla ... 1, May 19, May May June 77 12,372 7 9 28 34 20-78 50-11 Charwa ... 3, June 19, May ... 87 14,707 2 3 4 4 5-75 5-23 Total District ... 1,339 449,977 104 291 629 2,371 29-50 66-67 Narsinghpur T. ... 25, July 23, June ... July ... 12,405 2 142 ... 116-08 Oadarwara T. ... 27, Augt. 23, May ... June ... 6,068 1 235 ... 388-66 Ohhindwara ฿. C 12, July ... August 160 38,583 ... 30 ... 164 1875 42-50 Mangwani 5, July ... July 112 29,833 ... 12 ... 105 10-71 35-20 .Narsinghpur 23, June ... August 173 62,245 ... 57 ... 479 32-95 76-95 Birman ... 23, Augt. 18, June ... July 146 52,661 5 61 35 939 45-21 184-95 Karabgaoa 13, June ... July 162 50,210 ... 43 ... 738 26-54 146-98 Gadarwara ... 4, June 30, May June June 100 41,728 14 45 55 878 59-00 216-60 Barb* .18, May ... June 113 45,662 ... 41 ... 512 36-28 11204 Total District... 77. 7.1 966 339,395 19 289 93 4,192 31-88 126-25 * Fire only shown in Monthly Returns, 6 STATEMENT ll.— (Continued.) / "~ Number of deaths J^ Dates of first cases. Month of greatest S Number of villages from cholera "3.3 ป"ฆฃ prevalence. ~ attacked. during the la3w 1 ye^ || • |ง Name of Town _.• _ -go*g o * , u% g ~ ฃ or Circle. . J p.ซJ ฐ o^ 1875. 1876. 1875. 1876. \\ \ 1875. 1876. 1875. 1876. ||o .||ซ ฐ * "~" " _ Jubbulpore T. 4, April 10, July ... July ... 43,223 4 211 ... 59-74 Do. Caatt. ...27, Augt. 7, July 11,965 7 4 ... 9-lป Behora T. ... 25, June ... July ... 3,988 60 ... 150-46 Punagarh T. ... 15, Augt 3,875 2 ... J'lb Garha T. ... 12, July ... July ... 4,230 ... 25 ... 59 10 Mujhouli R.C. ... 20, July ... Sept. 112 19,343 ... 6 ... 37 5-o6 19 13 gefiora 14, May ... July 277 62,789 ... 41 ... 333 14-80 53 03 Muj/aon 2,July ... July 162 29,021 ... 12 ... 84 7-41 289* Kundam 196 21,947 ... ••• Barella - Z 28, March ... April 78 18,802 ... 5 ... 49 6-41 26% Bar-i 5, July ... August 178 30,081 ... 12 ... 88 6-74 29-25 Jubbulpore 23, July ... August 335 68,808 ... 17 ... 138 5-07 20-0b Patan 1, July ... August 277 64,854 ... 43 ... 207 15-52 39 63 Total District . . . Z. Z. Z. " 1,615 382,926 ... 136 11 8-42 _Jฎ*^ Murwara. Murwara T. 16, May 25, June ... July .... 2,885 IS 48 ... 228-77 Bhartala EC 133 25,478 ... ... ... ••• Sleemanabad ... 19, May 14, July ... July 109 23,131 3 7 8 65 9-17 31-55 Murwara 9, June ... July 285 44,471 ... 11 ... 73 3-86 16-41 Bijeragogark 4, Sept. ... Sept. 91 20,255 ... 1 ... 4 1-10 1-97 Burhi 15, Augt. ... August 97 29,713 ... 4 ... 24 4-12 8-07 Total District . . . Z. Z. Z. ... 715 145,933 3 23 26 214 3-64 1647 Saugor. Saugor T. ... 1, June ... July ... 31,119 441 ... 141-71 Do. Cantt 6, June ... July ... 14,536 146 ... 100-44 Garhakota T. ... 13, July ... August ... 9,085] 210 ... 2JI-1* Khurai T. ... ... 4,965| ... ... - Kehli T. ... 14, July ... July ... 4,406 107 ... 242 85 Deori T ?. 28, June ... August ... 7,769 ... 116 ... 14929 Eabatgarh E.O ... 23, May ... June 138 37,074 ... 7 ... 69 5-07 18-61 Khurai l.July ... August 198 35,501 ... 3 ... 52 1-52 14-65 Khimlassa 30, June 190 47,057 1 - ฐ' 21 Barodia ... Iฐ9 28,685 Sau'o I: 31, May ... July 264 69,419 ... 35 1 329 13-26 47"39 S 21,' june ... July 85 33,452 ... 24 ... 321 28-24 90-96 Banda 7, June ... July 187 45,363 ... 14 ... 79 7-49 17-41 Shahgarh .. 31, Augt 9, June 103 26,087 1 2 4 2 2-91 2-29 Rehliฐ ... ... 19 June ... August 318 86,152 ... 69 ... 682 21-70 79-16 Deori ...14, Augt. 10, June ... July 276 47,055 ' 2 59 16 420 22-10 Total District ... ... ... ... ZT 1,868 527,725 S 213 20 2,975 11-56 56-75 Damon. Damoh T. ... 28, July ... August ... 8,189 21 ... 25-64 Hatta T. ... 20, July ... August ... 6,158 ... 43 ... 69-83 Tejgarh B.C. ... 17, Augt, ... August 203 35,424 ... 4 ... 16 1-97 4-51 Jabbera 21, Au^t. ... August 250 44,182 ... 5 ... 16 2"00 3-Q* Kmoh 27, June ... August 168 35,597 ... 9 ... 41 5-36 11-02 thuria ... 10, July ... August 125 46,956 ... 54 ... 378 43-2 80-50 ttiagarh 19, July ... August 92 26,579 ... 23 ... 161 25-0 60-57 Hatta ...] ... 31,Julv ... August 214 50,502 ... 20 ... 44 9.30 8-74 Mariadeh 22, July ... August 72 16,055 ... 9 ... 97 12-5 60-41 Total District ...~ Z. ~ ~Z~ 1,124 269,642 "~7" "124~~ 11-03 3030 the Rrovince* ". ... 27,1087,408,074 1,882 1,93114,668 20,124 14 47- APPENDIX V. ON THE CALCUTTA DRINKING WATERS: THE NATURAL HISTORY OR CHANGES IN POTABLE WATERS OF TROPICAL CLIMATES : A GENERAL, COMPARISON BETWEEN TANK OR WELL AND RIVER WATER IN BENGAL, Surgeon W. J. Palmer,, m. d. ( Re-published from the Indian Medical Gazette.) The quality of water contained in the different tanks varies as the tank is more or less; exposed to deteriorating influences ; some of them have a reputation, based for the most part on forgotten traditions, for yielding unusually good water, and the conservatism, of the place is willing to uphold such reputation against adverse arguments or appearances ; for example — it was stoutly denied a few days ago by one of the servants in a large Calcutta hotel, that a. glass of dark coloured, foul-smelling drinking water could possibly be bad, because it had been brought from the Lall Diggie ; again, it is not uncommon to find people sending long distances, for water from the tank opposite the Bengal Club (Oenerali talao),. notwithstanding that its water has been regularly replenished for years past by the overflowings of a culvert, conta-ning water pumped up from the midst of the shipping in the port. In addition to such accidental circumstances as these, however, analyses of the water of the same tank in different months of the year prove that water which is pure and wholesome at the end of the rainy-season necessarily becomes progressively impure as the dry season advances, and frequently becomes absolutely unfit for human consumption by the following month of June. A few examples will; make this evident, and in order to simplify the comparison, only two results, viz., the amount of " free" and of " albuminoid ammonia" yielded by a million parts of water, from the same tank in different months of the year, will be referred to j these two special sets of results being selected because they indicate the most important contaminations regarded from a sanitary point of view :—: — Source of the water. v -g ฆ M H b -ป g. j8 I 1 a P "S d • d s ฃ _ I I I I I J I I I I IJ_ Tank in the Alipore Parade Ground. Free Ammonia ...0-06 0-07 ... 1-60 ... I*2o ... 010 C'o6 ... Albuminoid do. ... o'l4 0-80 .. 1-50 ... I*oo ... 077 o'4B ... Eastern Tank on the Fort Glacis. Free Ammonia 0-02 0-09 ... I'OO 0-03 ... 0-06; Albuminoid do. 052 o*9o ... o'9B 095 ?. 0-4O Western Tank on the Fort Olacis. Free Ammonia 0-04 0-08 ... 0-19 0-08 0-05 ... Albuminoid do. 0-56 030 ... 0-84 I'OO 0-28 ... Generali Talao, Bengal Club. Free Ammonia 0-06 0-16 0-90 Albuminoid do. 0-38 o*so 062 Tank at General Hospital. Free Ammonia 0-04 0-15 O'W Albuminoid do. 0*22 I*lo 054 Calcutta new water -supplij. Free Ammonia 0-06 0-05 0-08 0-09 0-08 0-05 0-06 0-O3 Albuminoid do. o*lo o*lo 0-16 o'l4 0-11 o*o7 006 0-0? 2 The ordinary sources of contamination and causes of deterioration in tank waters may be 'thus enumerated : Ist. — The dust of towns and roads, with all its various impurities, constantly being blown into them. 2nd. — The solution of progressively increasing portions of foul matter from the surrounding soil ; foul soluble matters are abundantly present in such sewage-soaked soils as are found in all places where no systematic conservancy arrangements exist. It might at first sight be supposed that water would cease to be contaminated by such accumulations of sewage matter after the first few years, i. c., when once they had been dissolved out of the soil immediately surrounding the tank ; but the rapid deterioration of water in tanks as advantageously situated as those on the Fort Glacis, where the surrounding surface is so carefully guarded, — and cleanliness so efficiently secured, shows that some source of contamination beyond mere dust must exist; abuudant evidence is obtained that the neighbouring soil far and near is sewage-soaked, whenever any excavation takes place ; so long as this is the case, and the sides of the tank remain permeable, the foul matter will he constantly attracted towards the purer water, through the sandy porus soil by the universal law of diffusion acting through constantly increasing distances. 3rd. — The water deteriorates also by evaporation ; for while the absolute amount of noxious matter in the tank is constantly increasing, the quantity of pure water is concurrently decreasing under the influence of dry winds and a hot sun, and by these conjoint actions, the relative proportion of impurity in the water by the end of the hot season is inordinately increased. All these baneful influences acting together would suffice to render the water of Calcutta tanks loathsome, disgusting, and quite unfit for use long before the next rainy season brought a fresh supply of pure water, unless they were in some degree neutralized ty the simultaneous operation of natural purifying influences ; these may be regarded as — Ist. — The consumption of all organized matter by the several gradations of living creatures from the most minute infusoria to the largest fish. 2nd. — At the same time that rapid evaporation is caused by the powerful heat rays of a tropical sun, its chemical rays aided by a free supply of oxygen, cause rapid consumption of all dead or decaying organic matter, converting them into carbonio and nitric acids, which are not only innocuous and inoffensive compounds, but, by impartiug an agreeable and refreshing flavour to water, actually convert a once nauseous and unwholesome fluid into an agreeable beverage. If these several sources of contamination and means of purification were at ail evenly balanced, the quality of the water would continue tolerably uniform all the year round; the facts elicited by chemical analysis, however, prove that this is not the case, the contaminating influences at work in Calcutta being unfortunately by far the more powerful; they also illustrate what I have ventured to call the natural history of tank water in tropical climates, i. c., its progressive deterioration from natural causes, in certain seasons, and its renewal in others. In the lowest line of the above table, results are given of analyses of the river water taken from a point 18 miles above the city : these contrast so favourably with those of the tank waters at the worst season of the year, as to prove that the purifying influences are much more energetic in rivers than in tanks, being increased and intensified by the constant flowing motion, by the free play of air upon the surface of their expanded and shallow waters, and also by the existence in them of more abundant animal life. In the vicinity of large towns they are at the same time frequently more exposed to contaminating influences, as is notably the case at Calcutta ; yet even here analysis proves that water taken from the Hooghly River 16 miles higher up than the city, is much purer than Calcutta tank water at all seasons of the year, but especially so in those months when the best tanks only yield a fluid utterly unfit for human use, viz., in May and June ; for example while tank water deteriorates from its point of greatest purity in October to the extent of 67 parts per million by the following January, and 260 parts by the next month of May,* river water in the same month was found to have suffered deterioration only to the extent of 5 and 13 parts per 1,000,000 respectively. This is a most remarkable fact, especially when viewed in connection with the alterations in the proportion of chlorides in the river water at different seasons ; these are found to increase so much more rapidly in the dry months of the year than in those tanks which are uninfluenced by the tides as to leave no doubt but that sea-salts are carried up the stream as high as Fultah, the point whence the new Calcutta water-supply is taken ; and if sea-salts are so carried, it is in the highest degree probable that much of the filth and refuse thrown in the river near the city is carried up at the same time ; this latter, however, being destructible matter, liable to undergo decay and change, must in the course of its transit through the intervening sixteen miles of • Vide Table. 3 river to be almost entirely converted into those innocuous substances above referred to ; indeed, •chemical analysis affords proof that this is the case, for while in December the river water only yielded half a part (o*s) of ammonia of nitrates and nitrites per million, the amount rose as high as (3*75), nearly four parts, per million, by the following month of May ; this increase being due to the decomposition of animal organic matter. This great superiority of river over tank water, even where the conservancy of the streams is disregarded, is a most important and interesting fact ; interesting as proving the rapid decay of organic matter of large tropical streams in the hot season of the year, when the water is shallow, and the winds blow freely over its surface ; and important as affording evidence that an unlimited supply of good drinking water is always available in Calcutta, even in the hot parchedup season, when tank water is often scarce and always unwholesome. The Hindoo population have always preferred to use river water whenever it was attainable, but the home habits of Europeans in this country frequently lead them to prefer the water of wells or tanks; though this preference no longer exists in Calcutta, well water is generally used in other parts of the Presidency, even by people who dwell on the banks of the large rivers. The fact is, that every river in India is subject to the most unpleasant and loathsome forms of pollution and contamination before one's eyes, and in the light of day ; to perceive that the soil of cities is equally defiled, requires an act of conscious thought or reflection ; and moreover, to know that this defilement is much more permanent than that of rivers, notwithstanding all that has been said in praise of the dry-earth-system of conservancy, an acquaintance with some of the results of recent experimental investigations is necessary. A valuable collection of such results is already accumulated and published in the reports of analysis of potable waters in the Bengal Presidency ; in the following table a few of these are abstracted to illustrate the cornparativa purity of well and river waters, and in order that the comparison may be made more readily, only three facts in connection with each analysis are referred to, viz., first, total solids, indicating the total amount of impurity without reference to its equality ; secondly, the amount of volatile matter contained in the former, indicating the quantity of organic contamination, either vegetable or animal ; thirdly, chlorides ; the proportion of these whenever they do not exist in the soil or water naturally, indicates the quality of the volatile matter above referred to; whenever a large amount of cbloridss exists, the volatile portion is probably due to excrementitious pollution, and where only a small amount is found, the volatile ingredients probably have had a vegetable origin. to Grains per gallon or .H w parts in 70,000. %S% a, &* •Date. Source of Water. _ „ ง Remarks. .-- v though there does not appear to be any River Ravie ... 11"7 o'6 2 - 2 O'29j j constant relation between it and the I, amount of animal organic matters, or ฆ —ฆ 1 .. ' Leven between it and the volatile matter. Rannil Pindee — Sept., 1867 ... Average of wells ... 289 B'fi 0-6 051 River Leh ... 195 15 0-6| 039 Dehra Ghazee Khan — March and April, Average of wells ... 42 7 1"8 8 7 062 1 g 69 ... Dehra Ismael Khan — Average of wells ... 37 2 I's sB 0-47 Eiver Indus ... 107 08 13 o'o9 Peshawar — I April, 1868 ... Average of wells, &c. . 27-4 21 20 0-50 Station Canal ... 12 1 07 0-5 030 Nowshera— • May, 1868. ... Average of wells, &c. . 18"2 098 0-8 0-27 Cabul River ... 97 045 0 6 051 Delhi — i The avera.ee of nitrates in the Delhi Average of wells ... 750 7*B ... j ... Wells was 15 grains per gallon, chlo- RiverJnmna ... 12"0 TO ... | ... | rides not estimated. Muttra — December 1867 ... Average of wells, &c. 396 20 108 051 Agra — January 18 ... Average of wella, &c. . 454 4-1 Ul-2 0"47 June, 1868 ... Jumna River, above Muttra ... ]33 08 13 026 I 4 1 Grains per gallon or Ajj parts in 70,000. & ฃ Date. Source of Water. ~ 7" ซj Remarks. ll fl I If o c. Fvttehgurh — r April, 1869 ... Average of wells ... 34-3 2-2 46 054 1 Ganges ftiver ... 91 I' 7 H* 07 ฐ Allahabad — March, 1869 ... Average of wells ~ 331 I*l 3-9 ••• Benares- December, 1868 ... Average of wells ... 25-9 1-3 2-8 ... Chunar — September, 1869 ... Average of wells ... 34-8 I' 4 4 3 ... Ditto ... Ganges River, near Chunar ... 8-7 I*4 0.7 ••ฆ Ally oar h — August, 1869 ... Average of wells ... 35-1 26 5-7 0-44 Ganges Canal ... 89 0 8 05 045 Dinapore — Sept. and Oct., 1868. Average of wells ... 592 55 10-3 031 River Soane ... 102 3 0 0-4 061 J The Rivor w>ter wa- stagnaat Eiver Ganges, Chunar ... 87 I' 4 07 ••• Cat the time of analysis. Berhampore — Get. r Nov. and Dec. Average of wells ... 3M 23 87 ... 1867 ... River Bhagiruttee ... 15-4 1-2 0-6 ... Fyzabad — June, 1867 ... Average of wells ... 18-6 1-8 1-8 017 River Gogra ... U'l 0 8 I*7 008 — — — — ________ _ - _____ — — Jubbulpore — May, 1868 ... Average of wells, &c, ... 210 19 4-1 076 Nerbudda River ... 115 26 10 0-40 Puchparie Nullah ... 71 10 07 043 . Jhansie — Kov. and Dec, 1867. Average of wells ... 251 4-9 2-4 053 Betwa River ... 98 10 1-1 021 1 ________-___-—-—-__—--———— 1 Morar — August, 1868 ... Average of wells ... 29-6 2-1 5-7 051 Morar River ... 9*B 13 15 021 Attock — } This well had been deepened May, 1868 ... Average of wells ... 123-3 3-8 28-0 ... ฃ 134 feet through rock, but no ad) vantage was gained. River Indus ... 5-14 03 0-2 ... December 1868 ... Well No. 1, in Fort ... 1330 11-5 33-4 ... \ This analysis proves that the River Indus ... s*l 03 0-2 ... \ contamination is local, due to May, 1868 ... A well outside the Fort ... 217 I*4 1"2 ... J the accumulated refuse of years. Umritsnr City — December, 1869 ... Average of city wells ... P6'2 6-1 156 ... Worst of ditto ... 127-4 11-5 47-6 ... Best of ditto ... 4&-5 3-5 4-2 ... Average of water obtained by | borings with Norton's tubes ... 1327 11 •& 54-0 Worst of ditto ... 4781 434 189 0 ... Best of ditto, through a bed of clay ... 21-7 3*5 2-8 ... Outside the City a boring, 70 yards from the walls ... 245 315 2'B ... A ditto one mile distant ... 2^6 2*4 2-J Baree Doab canal The two last examples are the most remarkable ฆ. No. 1 well in the Attock fort has beeu deepened at great expense, but the water continues as foul and unfit for use as ever ; this fort is situated on a rock, and has been inhabited for many years, during the whole of which time the surface soil and fissures of the rock have become progressively more and more aewage-soaked, until the water which finds its way from purer sources through the filthy soil becomes mere liquid-sewage before it reaches the well. London sewage yields 134 grains per gallon of total solids, of which 19 are soluble volatile matter, and 26 chlorides : the water of well No. 1 in the Attock fort, though yielding less volatile matter than this, gave a much, higher proportion of chlorides, thus affording proof of a greater original impurity than London sewage,, and. this is the fluid the defenders would have to drink incase of a siege ! The curse 5 with which Itabshakeh threatened the people of Judah white on the walls of the city of jeru~ salem would surely be fully experienced by the inhabitants of Attock I That the contained chlorides are not derived from natural sources, appears evident frotn the fact that the water of distant wells round about yields less than 1ฃ grains per gallon, while the river water at the base of the fort contains less than ฃ a grain in the same quantity. The Umritsur waters are scarcely better than those of Attock ; the several analyses made at this place prove beyond question that the soil of the city is thoroughly saturated with excrementitious matter, for^ notwithstanding that much filth finds entrance to wells by their unprotected mouths; water obtained from the Water-bearing stratum in the city, by means of Norton's tubes, was even more foul than that of the wells ; the constant withdrawal of water from the wells appearing to have the effect of cleansing to a certain extent the earth through which their natural supply percolates. All sewage of the city has for years been allowed to gravitate into large depressions within the city walls called Dabs and into the fosses of old fortifications ; fluid obtained from a boring 42 feet west of one of thes& fosses contained more than three times as much total solids, and than seven times as much chlorides as London sewage ! ! This statemeut is so startling as to be scarcely conceivable, but the figures are copied from accepted and trustworthy records of analyses, and it must be remembered that while each of the inhabitants of London are supplied with from 40 to 50 gallons of ฆwater daily, the people of Umritsur had to be content with much less than this, and the Umritsilr sewage would be proportionately more concentrated. No river is found very near to this city, but the Baree Doab Canal actually conveys water into the city tanks, which are used for bathing purposes ; unfortunately no analysis of its water has been made, but it is probably as good as that of the canal at Peshawar, which yields fairly pure water. Although it would be highly interesting and instructive to trace the connection between the health of these several cities and the quality of their water-supply, it is not my purpose to do more herฉ than note, that while in the opinion of all medical practitioners whom I have had an opportunity of consulting; severe diseases, and especially cholera, have decreased to an almost inconceivable extent since the new water-supply became available in Calcutta^ there is equally good evidence to show that Umritsur is becoming more and more unhealthy as its water progressively deteriorates. Thus the city has only existed about one hundred years^ and the first known visitation of cholera was in 1805 j it was revisited by severe outbreaks in the years 1813, 1827, 1845, 1856, 1862, 1805, 1867, and 1869 ; the later intervals extending only over two years, while the former, when the soil Was less contaminated, were respectively seven, fourteen, and eighteen years apart. One of the borings in this city penetrated a bed of impervious clay which had protectee the underlying earth from contamination by soakage; the water from this had almost the samd chemical characters as that obtained outside the city. This result contrasts with that at Attock, where the water obtained from a great depth was as impure as that nearer the ear face* DIAGRAM No. I, ILLUSTRATING THE SEASONAL FLUCTUATIONS IN THE PREVALENCE OF FEVERS IN THE CENTRAL PROVINCES. Area 65,000 Square Miles THROUGH THE FIVE YEARS 1873—1877. Population 7,500,000 i Lithographed at the Surveyor General's Office, Calcutta, June 18JS DIAGRAM No. 11, ILLUSTRATING THE SEASONAL FLUCTUATIONS IN THE PEEYALENCE OF CHOLERA AND SMALL-POX IN THE CENTEAL PEOVINCES, Area 65,000 Square Miles THROUGH THE FIVE YEAES 1868—1872. Population 7 500.000 no DIAGRAM No. in, ILLUSTRATING THE SEASONAL FLUCTUATIONS TN THE PREVALENCE OF CHOLEEA AND SMALL-POX IN THE CENTRAL PROVINCES THROUGH THF. FIVE YEARS 1873— ISC7. Maps illustrating the Report on the Cholera epidemic of 1875-76 in the Central Provinces. Map illustrating the spread of the epidemic over the Central Provinces and adjoining territories in 1875 No. I A. •••I Map illustrating the spread of the epidemic over the same area in 1876 „ I B. Maps illustrating the prevalence of cholera in the Nimar district in 1875 ii. Maps illustrating the prevalence of cholera in the Nerbudda Valley in 1875 III& IV. Map illustrating an out-break of cholera in certain villages on the Oomur river in 1875 v V. Map illustrating the spread of cholera on the banks of the Bhyranjh river in 1875 „ VI. Map illustrating the prevalence of cholera over the Wuna basin in 1875 „ VII. ••• • Map illustrating the prevalence of cholera over the Kanhan basin in 1875 „ vin. Map illustrating the prevalence of cholera on the lower Kanhan in 1875 „ ix. Map v illustrating the prevalence of cholera in certain villages on the Weingunga river in 1875. X ปป Diagram illustrating the fluctuations in the prevalence of fevers, cholera and small-pox. >ปฆ v i M ฆ* h'--JLh '--JL MAP 7&) PJ "ฆฆ ฆ 9 iajcS C,3^lr 1 g v ฆ MAP NO. 11. ILLUSTRATING THE SPREAD OF CHOLERA OVER THE NIMAR DISTRICT, 1875: LITHOGRAPHED FROM AN ORIGINAL SUPPLIED BY THE SANITARY COMMISSIONER, CENTRAL PROVINCBS, at the Surveyor General' 3 Office. Calcutta, May 1576. Taken from District Nimar. ฑVJ-X\.-C -L^t KJ . _LJLฑ, ILLUSTRATING THE SPREAD OF CHOLERA OVER THE WESTERN SECTION OF THE HOSHANGABAD DISTRICT, 1875. Taken from District Hoshuuga"baJ, LITHOGRAPHED FROM AN ORIGINAL SUPPLIED BY THE SANITARY COMMISSIONER, CENTRAL PROVINOHSB, at the Burveyor General's Office, Calcutta, .Tune 1876. MAP NO. IV. ILLUSTRATING THE SPREAD OF CHOLERA OVER THE EASTERN SECTION OF THE HOSHANGABAD DISTRICT, 1875. *Mซ*X /W& B c 3^ 7^ '* 7*7 * MAP NO. IV. TRATING THE SPREAD OF CHOLERA OVER THE EASTERN SECTION OF THE HOSHANGABAD DISTRICT, 1875. 4 App&U^x. M^<> # C2>ซc?r IE 7 % Taken from District Hoshungabad. LITHOGRAPHED FROM AN ORIGINAL SUPPLIED BY THE SANITARY COMMISSIONER, CENTRAL PROVINCES, at the Surveyor General's Office, Calcutta, June 1876. I LITHOGRAPHED FROM AN ORIGINAL SUPPLIED BY THE SANITARY COMMISSIONER, CENTRAL PROVINCES, at the Surveyor General's Office, Calcutta, June 1876. MAP NO. V. ILLUSTRATING AN OUTBREAK OF CHOLERA ON THE OOMUR RIVER, IN THE NARSINGHPUR DISTRICT, 1875. ttyp' iUpjT VC& C^Tl^ fT7Q LITHOGRAPHED FROM AN ORIGINAL SUFFLIKD BY THE SANITARY COMMISSIONED, CENTRAL PROVINCES, at the Surveyor General's Oifice, Calcutta, May 1876. I ILLUSTRATING THE SPREAD OF CHOLERA ALONG THE BYRANJH RIVER, IN Yhe SAUGOR & NARSINGHPUR DISTRICTS, 1875. mm UTHOGRAPHED FROM AN ORIGINAL SUPPLIED BY THE SANITARY COMMISSIONER, CENTRAL PROVINCES, at the Surveyor General's Office, Calcutta, May 1876. MAP NO. VII ILLUSTRATING THE SPREAD OF CHOLERA OVER THE WUNA BASIN, in the NAGPUR & WURDHA DISTRICTS, 1875. LITHOGRAPHED FROM AN ORIGINAL SUPPLIED BY" THE SANITARY COMMISSION'S!!., CENTRAL PROVINCES, at the Surveyor General's Office, Calcutta, April 1876. MAP NO. VIII ILLUSTRATING THE SPREAD OF CHOLERA OVER A PORTION OF THE KANHAN BASIN IN THE NAGPUR DISTRICT 1875. : >f^e^aUyL Jฃ /TJip - 13^71 3^7 r- / 8 7 MAP NO. VIII STRATING THE SPREAD OF CHOLERA over A PORTION OF THE KANHAN BASIN IN THE NAGPUR DISTRICT 1875. &Pp***<*t X _ ftvtp WU .Ir ' / r -LITHOGRAPHED FROM AN ORIGINAL SUPPLIED BY THE SANITARY COMMISSIONER, CENTRAL PROVINCES, at the Surveyor General's Office, Calcutta, April 1876. LITHOGRAPHED FROM AN ORIGINAL SUPPLIED BY THE SANITARY COMMISSIONED, CENTRAL PROVINCES, at the Surveyor General's Office, Calcutta, April 1876. I MAP NO. IX ILLUSTRATING THE PREVALENCE OF CHOLERA ON THE LOWER PORTION OF THE KANHAN RIVER 1875. MAP NO. IX ILLUSTRATING THE PREVALENCE OF CHOLERA ON THE LOWER PORTION OF THE KANHAN RIVER 1875. /• 'Pewz>/x X /MAP-JJL VJ^'3 cs^lX )7. I LITHOGRAPHED FROM AN ORIGINAL, SUPPLIED BY THE SANITARY COMMISSIONER CBNTKaL PROVINCES, at the Surveyor General's Office, Calcutta, April 1876. LITHOGRAPHED FROM AN ORIGINAL SUPPLIED BY THE SANITARY COMMISSIONER, CENTRAL PROVINCES, at the Surveyor General's Office, Calcutta, April 1876. MAP NO. X ILLUSTRATING THE PREVALENCE OF CHOLERA IN CERTAIN VILLAGES ON THE WEINGUNGA RIVER 1875. \ LITHOGRAPHED FROM AN ORIGINAL SUPPLIED BY THE SANITARY COMMISSIONED, CENTRAL PROVINCES, at the Surveyor General's Office, Calcutta, April 1876.