Black-water fever : being the first report to the Advisory Committee appointed by the Government of India to conduct an enquiry regarding black-water and other fevers prevalent in the Duars / by S.R. Christophers and C.A. Bentley.

  • Christophers, S. R. (Samuel Rickard), 1873-1978.
Date:
1909
Catalogue details

Licence: In copyright

Credit: Black-water fever : being the first report to the Advisory Committee appointed by the Government of India to conduct an enquiry regarding black-water and other fevers prevalent in the Duars / by S.R. Christophers and C.A. Bentley. Source: Wellcome Collection.

Provider: This material has been provided by London School of Hygiene & Tropical Medicine Library & Archives Service. The original may be consulted at London School of Hygiene & Tropical Medicine Library & Archives Service.

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    IO It has been supposed that the patient himself must be stmck by the extra- ordinary change in his urine ; and no doubt he is, if he knows that the disease from which he is suffering is Black-water Fever; but in a district where it is not believed to exist, and among a community who have only heard vaguely of the dread disease, a man may overlook the condition of his urine and not suspect that he is suffering from Black-water Fever. All these points are well exemplified in the case we have referred to from Purulia. It was only because he was travelling to Calcutta at the time and was taken to the General Hospital that this man came under observation ; also in spite of passing though a typical attack of the disease he did not know that he had Black-water Fever, and had he been in his own district the attack would certainly have gone unrecorded, for he and one other European were living alone in a remote part, many miles from the nearest civil station. Black-water Fever therefore does occur in India ; but it is evidently con- fined to certain localized tracts, and there can be no doubt, as has been main- tained, that it is rare in the practice of the average Indian physician. In this fact lies one of the most powerful arguments for the view of the malarial origin of Black-water Fever, yet based on the grounds of geographical distribution. The areas we have especially mentioned as centres of Black-water Fever are all tracts at once differentiated from the usual conditions in India by the intensity of their malaria. Assam, the Duars, and the Darjeeling Terai we shall consider in detail later. It is only necessary in the present connection to say that they are notoriously malarious districts. The Jeypore District is a hilly intensely malarious tract, where the European and native residents alike suffer severely from malaria. Canara, on the west coast of India, is also a hilly district with a heavy rain- fall, and it is interesting to note that before the occurrence of Black-water Fever was actually recorded by Christie, Stephens and Christophers, judging from physical and other features, had already indicated this district as one likely to yield cases of Black-water Fever. Chota Nagpur is an extensive tract of hill country largely occupied by aboriginal tribes, mentioned by Hirsch as one of the most malarial parts of India. Later on in this memoir we shall be able to picture what residence in such districts entails to the European and even to the native of India. But these conditions are not general throughout India in spite of an im- pression to the contrary among those who are unfamiliar with life in this country. Malaria exists as a rule, it is true, but in a degree in no way comparable to its intensity in the Black-water Fever districts. Europeans also, for reasons into