Notes on an Epidemic of Cholera in the Purnia District
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I several miles westwards). The greater part of this western half is open pasture land, being so sterile as not to be worth cultivating, crops being grown for the most part only near the rivers, and in irrigated plots close to villages. Two large rivers pass through this part of the district, the Little or Damdaha Kosi, about 18 miles west of Purnia town : and the Kala Kosi, some three miles west of the town ; the former is much the larger. Both are offshoots from the Great Kusi. In the north-western part of the district there is ?i[icjiimt (EonvimutiqaiionH. considerable inosculation of water-channels between the three branches of the Kusi, and the NOTES ON AN EPIDEMIC OF CHOLERA IN whole western half of the district is more or less PURNIA DISTRICT. cut up by hollows, dry in the hot weather, in the and full of water in the FEBRUARY?JUNE 1891. swampy cold, rains, which are the remains of old channels By Surgeon D. G. CRAUFORD, m.b., i.m. s., of the Great Kusi liiver. Several of these are Civil Purnia. OJfg. Surgeon, to be seen in and near the civil station itself, The district of Purnia, in which took place The water-supply of this western half of the the epidemic about to be described, is the most district is chiefly from wells, except actually on easterly district of the province of Behar, in the the banks of the rivers. The population of the Lieutenant-Governorship of Bengal. It lies eastern half of the district consists chiefly of between 25? 15' and 26? 35' north latitude, and low caste(Rajbansi) Hindus and of Mussulmans, between 87? 02' and 88? 35' east longitude. all semi-aboriginal, that of the western half consists of Bihari Its total area consists of 4,965 square miles. The mainly Hindus. population, according to the census of 1881, The Ganges-Darjiling Road, which, before was 1,848,687, and, according to that of 1891, the opening of the Northern Bengal Railway, some five cent. more. It is bounded on the formed the chief means of communication between per * north by JNipul, and in the extreme north-east- Calcutta and Darjiling, runs through Purnia almost the whole of ern corner by the hill district of Darjiling ; on district in its length in the the east by the districts of Jalpiguri, Dinajpur, plains from Karagola on the Ganges, near the and Malda; on the south by the River Ganges, S.-W. corner of the district to Titalya in the ex- beyond which lies the districts of Bhagulpur and treme N.-E. corner, 106 miles, on its way passing the Sonthal Parganas; and on the west by the through the civil station of Purnia. The Assam Great Kusi River, which separates it from North Behar Railway opened some three years ago, Bhagulpur and falls into the Ganges at the south- also runs through the district in two different western corner of the district. directions, commencing at Manihari, on the The eastern and western halves of the dis- Ganges it runs almost due north for some 20 trict are physically of very different character, miles to Katihar. an important junction, there the dividing line corresponding roughly with it divides in two: one branch running eastwards the Pauar River, which is in part an offshoot past Diuajpur to join the N. B. R. at Parbati- from the Great Kusi River, from which it pur; the other passing to the N.-W. to Achra takes off in Nipal, flows down through the dis- Ghat, on tlie Great Kusi River, in the N.-W. trict from N.-W". to S.-E., dividing it into two corner of the district. The Tirhoot State Rail- almost equal lateral halves; and finally enters way meets this branch on the opposite side of the Ganges at the S.-E. corner of the district. the river. This road and railway form the chief The eastern half is low-lying, mostly highly means of communication in the district. is divided cultivated, alluvial land, watered by a net- Administratively, the district into work of inosculating rivers, and containing three sub-divisions, and thirteen thanas or police numerous marshes. The water-supply is chiefly stations. The sadr or head-quarters sub-division derived from these rivers. The western half is comprises seven thanas, Purnia, Gondwara, more high-lying, and thickly overlaid with Damdaha, Manihari, Kadwa, Amur Kasha, sand deposited by the Kusi River in its gradual and Balrampur. Araria sub-division, in the westward movements. Less than two centuries N.-W. of the district, has three thauas, Araria, and ago this river passed southwards near, possibly, Matiari, Rauiganj, and Kishanganj sub- to the east of the town of Purnia, but has gradu- division, in the N.-E. of the district, includes ally worked its way westwards till now it forms three thanas, Kishanganj, Kaliaganj, and the western boundary of the district, fully thirty Bahadurganj. Of these divisions, the whole of miles west of Purnia town. (Even since the Araria sub-division, and the first three thanas of sadr western half current survey map of the district wns planned, the sub-division, form the between 1840 and 1850, the river has worked of the district; the other four thauas of the 34 INDIAN MEDICAL GAZETTE. [Feb. 1892. and the whole of sndr sub-division, Kishauganj held without any sanitary precaution, but great sub-division, form the eastern half. This divi- improvement in this respect has been effected of sion is almost exact; except that part of Araria late years. The Civil Medical Officer of Puriiia in the western east Panar thana, half, lies of the in his special report on the cholera epidemic of River, and part of Kadwa and Manihari thana?, 1889, attributed the spread of the disease to the the eastern so. in half, lie west of it, it is quite crowds returning home on the break up of the The respective areas and populations (1881 fair of that year. The Deputy Sanitary Com- census) of the two halves sire as follows: west, missioner of Darjiling Circle, however, who also 2,403 square miles; 788,735; east, 2,553 square reported specially 011 that epidemic, seemed miles; 1,059,952. doubtful as to whether any blame really attach- The district of in its was Purnia, though general ed to the fair. This year, 1891, the fair later physical characteristics much more akin to Bellar than usual, from 23rd Febuary to 8th March, to endemic area of than Bengal, lies within the and it was attended by a comparatively small cholera, and has always been a district notorious number of people. And this year's epidemic for cholera prevalence. It is one of those dis- had broken out before the beginning of this year's tricts in which cholera is known to have existed fair. of and prior to the historic epidemic 1817, The epidemic of 1889, whether originating at also from the disease in thai suffered severely Karagola fair or not, began in February, the year. The earliest cholera statistics available, month in which the fair is usually held, but did 1859 out of 310 refer to the jail. In May pris- not attain epidemic proportions until March. oners were attacked and in jail 109 by cholera, In April it reached its maximum, a very rapid In March 1863 out of 551 in 60 died. prisoners, fall followed in May, and in June there were twelve 211 were of whom 124 days attacked, hardly any deaths. In January 1889 only 24 died. In April and May 1867 there were 69 deaths from cholera occurred, 9 in the western cases with 43 deaths. Since 1859 cholera has and 15 in the eastern half of the district. In in the almost been epidemic district, legularly, February there were 125 deaths, 107 in the west- the odd a verv every second year, years showing ern, and only 18 in the eastern half. In March much heavier cholera mortality than the even 6,198 deaths from cholera were registered, of ones. The chief exceptions are little cholera in which 5,572 took place in the western, and 626 1865 and 1883, odd years; and severe cholera in in the eastern half. In April 10,232 deaths oc- 1878, 1882, 1886, and 1890, even years. The curred, the western half contributing 8,150, and same total of cholera mortality, however, which the eastern 2,082. I11 May the number sank to fifteen years ago would have been considered a 625,of which 400 occurred in the western half and severe epidemic would now be considered small, 225 in the eastern. In June 65 deaths occurred, with enormous in comparison the totals registered 15 in the west, and 50 in the east. From July, the during the past few years. Part of this increase west of the district, remained free from cholera, number of no in the deaths registered, doubt, only 11 deaths being registered during the six be due to better still it is may registration; months, but a few cases continued to occur in the difficult to resist the conclusion that the epide- eastern throughout the second half of the year. of recent more mics years have really been fatal On the whole, the entire western half of the than those recorded in the earlier Re- years. district suffered very severely from cholera gistration is still imperfect enough ; indeed, it is during March and but of the eastern to April, impossible hope for anything like complete; only Kadwa, Amur, Kasba, and Manihari until it is as difficult in as it Kishan- registration India, thanas showed any great mortality.