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Credit: Dr. Rogers' report on kala-azar / [A. Stephen]. Source: Wellcome Collection.
![same districts in accordance with seasonal causes, usually excess or deficiency of the rainfall, is well- known. If two unhealthy 3 ears succeed each other something approaching to local epidemic of malarial fever may occur. Is it then surprising that three or more successive unseasoual years, such as could only very seldom occur may pro¬ duce a spreading epidemic, or that the succession of five out of six years of greatly deficient rain¬ fall in the early seventies should have started the ftangpur-Assam epidemic which is still actively spreading up the Brahmaputra valley, or that a rapid silting up of the main river of such a district as Jessore might originate a similar epidemic ? Such epidemics have doubtless occa¬ sionally occurred for centuries past. The diffi¬ culty of proving by direct evidence the intro- in which the germs of disease have beeD arti- ficiall}' intensified, let us take the case of pneu¬ monia, which ordinarily is not au infectious disease, yet every now and then it becomes so, and attacks whole families, or large numbers of a regiment, as occasionally happens on the North-West Frontier of India, where instances have occurred of sick attendants over other cases being struck down by the disease, which has in sometimes onty been eradicated when the troops were placed under canvas. The relation of Pestis minor to true plague appears to be a similar instance. In the same way 1 maintain that in the case of travelling epidemics of malarial fever, the germs of the disease have become intensified, as it were in Nature’s laboratory, by conditions duction and spread of an intensified and infec- unusually favourable to their vitality, until tinus form of malarial fever into a notoriously they attain to the power of being communicated malarious district by human intevcoui'se is | from one person to another either directly necessarily well nigh insuperable, but that a j through the air, or indirectly alter passage malarial fever may be introduced into an island \ through the soil. I shall not attempt to give previously free from it by means of human | here my views as to the exact way in which the intercourse and may there spread in the form of j infection takes place, as I hope to do so in another an epidemic is proved by the case of Mauritius place, and this paper has already exceeded the and Reu^pn. Up to 1865 malarial fever was 1 limits 1 had intended. unknown in these islands, and is still unknown ; The hope ot being able to throw any light in the neighbouring island of Rodrigues. At 1 °n the vastly important subject of the Lower the date mentioned it was introduced by coolies Bengal malarial lev er epidemic must be my ex- from India, and such a fearful epidemic ensued, cuse for raking up such a much discussed, but that one-third of the inhabitants of the islands are said to have died in the course of four years, while in 1867 alone there were 31,920 deaths out of a population in the area affected not exceeding 130,000. Moreover, the disease re¬ mains there to the present day but in a, milder form. It is worthy of note that this epidemic took place at the very time that the “conta¬ gious malarial fever” w7as raging in Burdwan, and although I have not yet been able to ascer¬ tain whether any of the Indiau coolies, who are said to have carried the disease to Mauritius, actually came from the infected areas in Bengal, yet I venture to suggest that this was very likely the origin of the Mauritius outbreak. now partly forgotten, subject. Dr. ROGERS’ REPORT ON KALAAzAe. The following is an abstract of remarks by Surgeon* Colonel A. Stephen, M.B., Principal Medical Officer and Sanitary Commissioner, Assam, in a letter forwarding the above report to the Secretary to the Chief Commissioner of Assam :— Leaving Calcutta on the 16th of April 1896, Dr. Rogers visited Dhubri, Gauhati, Shillong and Tezpur, in order to learn the views of the Civil Surgeons of those places on the disease which he was about to investigate, and in due course This proposition is to some extent supported by arrived at Nowgong, the capital of the district the following opinion recorded by Dr. French ' iu which the disease was at that time most when writing in 1871 of the Buvdwan epidemic, “ it appears to me to be identical with the epidemic fever of the Mauritius of 1866-67.” It must be carefully noted that I do not say that all malarial fevers are infectious, but only that, uuffer extraordinary circumstances, malarial fevers ma}7 be intensified until they become so, and may then be spread by human intercourse to places situated on a suitable soil. This explains all the facts of both the Lower Bengal and Rangpur-Assam outbreaks. Unfortunately it is incapable of scientific demonstration as long as we are unable even to cultivate the malaria] organism, but it derives much support from recent bacteriological work on other germ diseases. Leaving on one side all the instances prevalent, and which he was requested to con¬ sider as. fcr the time being, his head-quarters. He spent the next five months in the Nowgong District in investigating the disease. During these months he studied the cases of the disease which he met in the Nowgong dispensary and jail, and in a large number of infected places in that district, including a considerable number of tea-gardens. In October he proceeded to Shillong in order to study the minute pathology of the organs of persons who had died of kald- dzdr in the Nowgong District, and on whom he had performed postmortem examiu&tions. He afterwards visited Sylhet to study cases of ordi¬ nary chronic malarial fever there, and to notice the differences, if any, between them](https://iiif.wellcomecollection.org/image/b30476616_0003.jp2/full/800%2C/0/default.jpg)
