Malaria in Bengal

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8702759
K azi, Ih te sh a m
MALARIA IN BENGAL FROM 1860 TO 1920: A HISTORICAL STUDY IN A

COLONIAL SETTING
The University of M ic h ig a n Ph.D. 1986
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MALARIA IN BENGAL FROM 1860 TO 1920;
A HISTORICAL STUDY IN A COLONIAL SETTING
by
Ihtesham Kazi
A dissertation submitted in partial fulfillment

of the reqir. rement of the degree of
Doctor of Philosophy
(History)
in The University of Michigan
1986
Doctoral Committee:
Professor John H. Broomfield, Co-Chairman

Professor Thomas R. Trautmann, Co-Chairman
Professor Rhoads Murphey
Professor Gayl D. Ness
V Ml «D n r 87
/ I ''< \
E
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Extensive copying of the dissertation or publication of m aterial in excess of
standard copyright limits, whether or not the dissertation has been copy
righted, must have been approved by the author as well as by the Dean of
the Graduate SchooL Proper credit must be given to the author if any
m aterial from the dissertation is used in subsequent written or published
work.
To My ’Dadi', (Grandmother) Who Had Great Confidence in Me
11
ACKNOWLEDGEMENTS
I would have been the most intelligent of persons if I
could have followed the Chinese proverb of the three monkeys
by closing eyes, ears and mouth, and absolutely remained
silent. Because of not doing so I preferred to make more
enemies than friends. The encouragement of large number of
people who constantly helped me in my sojourn in the USA,
is very difficult to acknowledge here. They are the
strongest incentive to overcome the pressure of completing a
task which at times seemed unreachable. Professor John
Broomfield's punditic advice guided me through thick and
thin. He was a constant source of energy for me. But he did
not stay in Ann Arbor to see the end of my work. Professor
Thomas Trautmann filled that gap smoothly . I have greatly
benefitted from his critical comments and valuable
suggestions. Professor Rhoads Murphey and Professor Gayl
Ness lately made me a convert to their erudition. I enjoyed
all their critical insight into the problems that I was
trying to uncover. They made a deep imprint on me.
I shall be very ungrateful if I do not mention the
agony and suffering of my family including my parents,
uncles, aunts, brothers, sisters and in-laws who passed
every moment in anxiety to see me finish my never-ending
writing. They deserve appreciation for not losing their
hearts at all. My father Kazi Shamsuddin deserves high
111
compliments for his zeal of higher education and his
constant flow of letters remind me of that fact. My mother
Jamila Khatoon is a keen source of encouragement. Of all
the persons my wife Nadira endured the most and never lost
her faith on me. She had the misfortune of losing her mother
Mahabuba Khanam and a younger brother Mohsin for good while
we are in Ann Arbor. With the misfortunes, anxieties and
tribulations I have a pleasant time in the USA for all the
friendliness and support from friends like Kari, Ruhini,
Delia, Omair and Shankar to name only a few. My son Abeer
and daughter Swarna are the torch bearer of warmth and hope
for me.
My first step in the University of Michigan was
possible with the Fulbright Hayes scholarship I got. Later
the Dissertation Grants from Rackham Graduate School gave me
opportunity to work in the British Libraries. Further more,
Rackham fellowships kept me alive to see the end of the
tunnel. Mary Jarrett of Rackham Graduate School and Jannet
Rose of the Department of History deserve my sincere
gratitude for supporting me all the way to the end of the
game. I owe a lot to everybody in the University of
Michigan Libraries.
IV
TABLE OF CONTENTS
D E D I C A T I O N .................................. ü
A C K N O W L E D G E M E N T S ....................................... ii i
LIST OF T A B L E S .................. vii
LIST OF ILLUSTRATIONS ......................... viii
CHAPTER
I. INTRODUCTION .................................. 1
II. MALARIA IN B E N G A L ........................... 16
Malaria in Bangla Literature and

Tradition
The Early European Account of Fever
in Bengal
Investigation of Malaria in the Middle
of Nineteenth Century
Investigation of Malaria in the
Twentiethth Century
III. CONCEPT OF DISEASE AND M A L A R I A .............. 47
Humoral Theory of Disease in Europe

Humoral Theory of Disease in India
Malarial Knowledge in Ancient India
Miasmatic and Germ Theory in Europe
The British Perception of Disease
Application of Miasmatic Conception
in Bengal
IV INVESTIGATIONS OF MALARIA AND ITS TREATMENT . 73
Etiology of Malaria
Treatment of Malaria in the Past
Quinine Distribution and Controversy
Malaria, Mosquitoes and Man
Malaria Parasite
Cycle of the Malaria Parasite
Discovery of Alphonse Laveran
and Others
Ronald Ross and His Achievement
Final Solution of Malaria
V. SANITARY AND MALARIAL ADMINISTRATION IN

B E N G A L ....................................... 104
First Royal Sanitary Commission

Objective of the Commission
The Annual Public Health Reports
and the Sanitary Boards
Measures for Malaria Control
The Malaria Policy of the Government
VI. MALARIAL FEVER AND VITAL STATISTICS IN

B E N G A L ....................................... 134
History of Vital Statistics

Vital Statistics in Bengal
Census Reports
Inaccuracy of Vital Statistics and
Fever Death
The Indirect Effects of Malaria on
the Death Rate
VII. POPULATION AND MALARIA IN B E N G A L ......... 160
Population of Bengal before 1872

Population in Bengal after 1872
Effects of Malaria on the Population
of Bengal
Malaria and Population Growth
Correlation between Malaria and the
Birth-rate
Imperialistic Arguments of Population
Decline
VIII. ECOLOGICAL FACTORS CONTRIBUTING TO MALARIA

IS MALARIA EPIDEMIC NEW IN BENGAL? . . . . 227
Ecological Cause of Malaria

Ecological Change by Nature
Man-Made Ecological Change
Construction of Railways
Embankments and Roads
Controversy about the Past Prevalence
of Malaria
IX. C O N C L U S I O N .................................... 261
Economic Cause of Malaria

Administrative Failure to Cope
with Malaria
B I B L I O G R A P H Y ................ 284
VI
LIST OF TABLES
1. Population in Bengal from 1872-1921 . . . . 170
2. Density of P o p u l a t i o n ............ .. 171
3. Areas in which Population has Declined . . 175
4. Population Increase in Bengal from 1872-1921 183
5. The Deaths in Hooghly Districts, 1861-69 189
6. Population of Burdwan Division 1872-81 190
7. Average Deaths in Calcutta 1847-83 . . . 194
8. Deaths Due to Malaria in Districts 1906-7 196
9. Fever Indices of Districts 1912 and 1921 199
10. The Relative Prevalence of Fever Indices 204
11. Deaths Due to Malaria and Fevers in 1921 205
12. Deaths Due to Malaria in 1921 ........... 206
VI 1
LIST OF ILLUSTRATIONS
Figure
1. Life Cycle of the Malaria P a r a s i t e .......... 85
Maos
1. A Map of the Regions of B e n g a l .............. 168
2. Malaria Map of 1 9 1 6 ............................ 201
3. Map of Bengal Rivers and Railways, 1921 . . . 240
VI 1 1
CHAPTER I
INTRODUCTION
In February 1983 two artisans were recreating a piece
of the glorious past of British naval history by carving a
fifteen foot long figurehead from Canadian yellow pine to
decorate the bow of the battleship HMS Warrior. The day the
Warrior was launched in 1860 it was the most powerful
warship in the w o r l d . * It became an emblem of the imperial
past for the British but not for those upon whom its fire
power fell. Moved by the same historical passion which
impelled those artisans but in a less dramatic fashion and
from a reverse perspective I am trying to commemorate an
aspect of the British period in Bengal through a history of
malaria and its effect on the life and well-being of the
people, beginning at the same time when Warrior was ruling
the waves.
The British with their naval might and industrial
strength had a splendid success against their political and
economic rivals around the globe but made a poor showing
against the so-called diseases of the tropics, especially
malaria. This history of malaria and its impact in Bengal

is not a scientific treatise, a task for which the writer is
ill equipped. It is rather a historical narrative of the
rise and fall of malaria in Bengal including consideration
of conceptual problems about the identification of the
disease, its investigation in modern times, its relation to
public health administration, and its effects on the
population. Moreover, there is some discussion of the
ecological and economic causes of malaria. In the
nineteenth century malaria was one of the most important
public health problems in Bengal. This disease caused
difficulties of greater magnitude than any the government
had ever been called upon to face. The sanitary reports
published by the Governments of India and of Bengal provide
facts which prove beyond doubt that Bengal became malarious
in the middle of the nineteenth century. The climax was
reached at the end of the nineteenth century when Bengal
became more malarious than any other period of time, and any
other part of India and continued till the first quarter of
twentieth century and then ebbed considerably. In 1921 it
was estimated that at least 85 million cases of sickness
required treatment every year in Bengal which included
Bengal, Bihar and Orissa; and one third of this number was
considered as cases of malarial infection.* This estimate
did not make any allowances for relapses. It might be
observed that one third of the total population of Bengal
was composed of children who were especially liable to
suffer from malarial infection. On the average malaria

exacted an annual death-toll of about a million lives in
Bengal. In addition to the deaths, many millions of lives
were incapacitated by its effects from hard and strenuous
activities to carry out a meaningful life.
The importance of malaria as a cause of sickness, death
and economic disruption was indicated at different times by
the public health commissioners of the governments of India
and of Bengal. It was said that the combined effects of
cholera, plague and small-pox were responsible for less than
five out of every hundred deaths, whereas sixty percent of
the total mortality was ascribed to fevers, of which one
third to one fourth were probably due to malaria. This meant
that in an ordinary year malaria was directly responsible
for deaths of three to four times as many persons as the
other major diseases combined. In a year when a malaria
epidemic occured this high death rate was enhanced. In
addition to this colossal loss of human lives, several
million people suffered from the disease and incurred
financial loss of perhaps a billion rupees each year. There
was an ever increasing wastage of man-power and also of
efficiency in those that survived. In terms of losses it
was bound to be one of the most important human diseases
because of the physical, economic and even political loss
which followed in its train. It hampered the development
schemes by reducing the vitality of the working people and
with economic uncertainty it brought political unresb.
Malaria was not only the cause of most mortality, it

also worked as a predisposing cause of death from other
diseases. It was found in Bengal that people much
debilitated by malaria appeared to be predisposed to such
diseases as phthisis, dysentery and diarrhoea. It was
probable that many deaths ascribed to these diseases were in
fact due to malaria. In some parts of the province in
certain seasons not a single village escaped its ravages and
not a family in the village was left untouched. Although
epidemic malaria was quite rare in Bengal, this was more
than balanced by the high yearly average of sickness.
After the autumn harvest was over when activities and
contentment should have reigned, the bustle of life was
arrested by the shivering chills of malarial fever. A pall
of gloom spread over the population. "Men walk like living
ghosts with chattering teeth, sunken eyes, pale anemic face,
protruding ribs, distended abdomen with enlarged spleen and
liver, and hungry emaciated countenance."* This was a
common sight in malaria stricken villages of the nineteenth
century Bengal. But there was unseen suffering as well. In
his address to the Shibpur Engineering College in 1899,
Major Dyson the Sanitary Commissioner of Bengal said, "One
of the gravest evils, and one which is particularly felt by
the Hindus, is impotency so commonly found in water-logged
villages, which results from the deterioration of the health
produced by constant attacks by fever and presence of an
enlarged spleen."* Apparently his remarks had religious
bias but the matter brought to light one of the many evil
effects of malaria.
Apart from the suffering of the disease and the
resultant death-toll there was a tremendous financial loss
to the people and to the nation. It was estimated for India
in 1924 that the direct annual cost of sickness and death
resulting from malaria was between fifty and sixty million
pounds sterling.* The indirect cost should be much higher
and might turn out to be three to four times more. In Bengal
it was assumed by Bentley that millions of lives had been
sacrificed, thousands of crores of rupees had been lost and
many more people sunk to poverty.* Although no precise
figure was given by him the total loss of man power and man-
hours of labor must be considerable.
The period from 1860 to 1920, a span of sixty years,
has been chosen to deal with the malarial situation in
Bengal for a number of reasons. From the middle of the
nineteenth century to the first quarter of the twentieth
century is one of the most important segments of Bengal
history not only from the political and social point of view
but also from the sanitary and health point of view. In the
aftermath of the Great Revolt of 1857 a tremendous change
had taken place in the administration of the Indian
empire. The Revolt caused the British to make India a crown
colony and to assume direct responsibility for India rather
than just overseeing the Company's activity. Although the
Queen's proclamation assured Indians "prosperity and social
advancement", in reality neither came about. In fact, "the

empire was thus transferred from the company to the Crown,
but the Indian people paid the purchase m o n e y . " ’ Although
India was always considered a symbol of British greatness,
in reality it became a source of raw materials, and a foster
child to be 'civilized'. The British administration has been
both praised and condemned for the effects of their rule in
India. This was nowhere more pronounced than in health and
sanitary policies.
Unlike plague, malaria did not create any panic among
the British authorities. In fact malaria took more lives of
the inhabitants of Bengal than the British or the Europeans
because they were ill-fed, ill-clothed, ill-sheltered than
the Europeans. Moreover, some of the so-called tropical
diseases were quite new to the people of Bengal and they did
not have enough immunities to fight those diseases. Some
pertinent questions could be asked in this regard. When did
malaria became so acute a disease in Bengal? Was the
British policy of expansion and so called modernization of
communication a sort of "digging the channel to invite the
crocodile", to use a Bangla phrase, bringing malaria in the
wake of British supremacy in India? Or was it the policy of
economic exploitation that broke the camel's back and made
it easier for malarial parasites to infiltrate the weakened
body?
The danger of disease did not get the attention of the
government until the middle of the nineteenth century. It
was because of a series of epidemic fevers that started to

take a great toll of British soldiers that resulted in the
appointment of the Royal Commission. If the situation was
bad for an elite corps in terms of epidemics how much worse
it was for ordinary Indians may be imagined. In the
aftermath of the Crimean war in 1856 a strong commitment to
fight against infectious diseases arose. It was thanks to
the determination of Florence Nightingale, who impressed
upon the British government that unhealthy living conditions
kill more people than guns, that some change of attitude
took place. As in the Crimean war she took personal interest
in the public health situation of India. In 1859, a Royal
Commission was set up to look into the causes of mortality
of the British soldiers in India. Although the
recommendations of the Commission were centered around the
well-being of troops and the betterment of cantonments, they
included some provisions for the improvement of sanitary
conditions of the people in general. The subsequent measures
of health improvements of the people came as a byproduct of
this report. It was found that unless the sanitary
situation of the surrounding localities of the barracks were
improved, the military stations would not be able to cope
with diseases.
In accordance with the recommendations of the
Commission, the Sanitary Commission of the Bengal Presidency
was appointed in 1864. Although the Sanitary reports were
more concerned about the health and well being of the
European soldiers and sailors, they could not totally ignore

8
the conditions of the people of India. Unfortunately for
the people of Bengal several epidemics of fever broke out at
this period. What was recognized as a fatal disease in the
1860s continued unabated for more than half a century,
bringing millions to the scaffold of death and the whole
country took on a desolate look. The situation had been
described by Bentley in the following words.
There was little doubt that the outbreaks of epidemic

of fever ... which deciminated so many districts in the
lower delta from 1860 onwards, marked the transition
from a former comparatively salubrious state, similar
to that still observable in parts of Eastern Bengal, to
one characterized by a widespread prevalence of
malaria, such as we have seen to be the condition
existing in many parts of the Province at the present
ti m e . •
The malarial situation of Bengal got serious treatment
in the hands of Bentley. As a Sanitary Commissioner his
contribution in bringing this menace to the knowledge of the
government was enormous.
The development of a health care system was a
tremendous institutional change of this period, but its
implementation took a long period of time. The first medical
College was established in Calcutta in 1835 and it took
another twenty years for the foundation of a medical
hospital in Eastern Bengal. Through the endowment of Robert
Mitford, the Mitford Hospital and School was established at
Dhaka in 1858. Although the cultivation of cinchona as an
antidote to malaria was started in India in 1861 it took
another two decades before it became an important item of
commerce. It was also a period of international

consciousness. The importance of global health hygiene was
emphasised in the First International Sanitary Conference
that took place in Paris in 1851. This universal approach
to the health situation might have implications for sanitary
policies in India and Bengal.
The period of my research ends in 1920. Incidentally
from this date malaria was classified as a separate disease
in the sanitary reports of Bengal, instead of putting it
under the generic heading of fever. The termination of
World War I brought major changes to British policy in
India. Politics in India had became so radicalized by that
time that the government was left with few alternatives but
assurance of self-rule for India. Indians' expectations were
greatly heightened and the Home Rule movement was carried
on with vigor. Finally the crucial announcement came in
Parliament. The operative expression in the pronouncement of
Montague was "responsible government", which meant in modern
English politics that the executive is responsible to the
House of Representatives and must go out of office when it
loses the confidence of the House. The most characteristic
feature of the new constitution of 1919 was the introduction
of dyarchy in provincial administration, divided into
reserved and transferred subjects. The reserved subjects
were administered by the Governor with the help of the
Executive Council and the transferred subjects with the help
of the ministers who were members of the Legislature. The
transferred subjects included Local Self-Government, Public

10
Health and Sanitation, Education and Agriculture. The steps
towards progressive realization of responsible government
was taken in most of the vital issues of public utility. In
his address to the Bengal Legislative Council in 1921,
Field-Marshal the Duke of Connaught mentioned three problems
which were to be dealt with, one of them being education and
another industrial development. "The third is a higher
standard of health and vitality, particularly among the
inhabitants of your wide malarial tracts."*
By the turn of the century positive measures were
formulated by the Public Health and Sanitary Department of
the Bengal Government to deal with malaria. Special Deputy
Sanitary Commissioners for Malaria Research was created to
look into epidemic zones and to take anti-malaria
measures. Lantern Lectures were delivered by these
Commissioners to instruct the people how to control malaria.
In 1918 an interesting movement was inaugurated by Rai
Bahadur Dr. Gopal Chandra Chatarji, M.B., for assisting
Hindus and other communities to take precaution against
malaria by the creation of anti-malaria societies organized
on co-operative basis. The Director of Public Health in his
report of 1920 remarked:
This is a movement deserving of the greatest possible

encouragement and support, for it aims at establishing
the principles of self help and mutual co-operation for
the common good.
In the years between Great Revolt and World War I
economic imperialism became the main slogan of Indian
grievances. In the first half of the nineteenth century the

11
exploitation of the indigo farmers in Bengal and later the
ruin of handicraft manufacture in cotton textiles were local
manifestations of economic coercion that were seen as a part
of a pattern of British domination in Bengal. They were
events in the struggle for survival in the subsistence
economy. At the same time the government of India lowered
the duties on imports, so that for a time they were admitted
almost without charge. The economic backbone of the people
was broken and so was their health. The exploitation of the
colonial rulers and their henchmen, the zamindars, paved the
way for the growth of microparasites like malaria. It was at
this period of time that British imperialism was at its
height not only in India but also in Africa. Here it came
into contact with the most deadly of all malarial parasites,
the falciparum, carrying it around the globe. In Assam and
the northeastern part of Bengal tea plantations, first
established in 1850s, expanded so rapidly that by the end of
the century there were more than a half-million indentured
workers there. Because of the rising incidence of malaria in
this region workers fled to their native villages, and in
turn spread the disease. Moreover the construction of
railways and embankments not only created the conditions for
the breeding of malaria but also for the spread of it.
In the later years the government became aware of the
problem of malaria. Some of the measures such as supply of
quinine were quite effective for the malaria eradication
program although the budget was very small. Due to the

12
raising of political consciousness the Bangla newspapers
which were skeptical at first as to the benefits of quinine
began to demand quinine and other health programs. The
people were becoming more aware of the benefits of the
treatment of quinine which was the only remedy left to them
and their demand exceeded the supply provided by the
government. By 1920 it was found that the fever mortality
showed a decrease in all the divisions of Bengal except
Dhaka which was the last among Bengal divisions to fall
under the malarial scourge. Thus except several districts of
Eastern Bengal malaria was contained to a great extent.
The period of 1860 to 1920, although somewhat
arbitrarily delimited, contained a lot of political and
biological factors which acted together to make it an
important part of the British occupation of India. If the
period of our discussion is a period of consolidation of a
foreign power in India, it was also a period of severe
economic hardship, disease and dislocation, the aftermath of
which was the awakening of the Indians to challenge the
efficacy of British administration either in public health
or civil administration.
"The history of a disease, like the biography of an
individual, involves consideration of the past not less
(perhaps even more) than of the present."^" These words of
a Sanitary Commissioner of Bengal in 1869 are very pertinent
today. Although a vast amount has been written on the
political, social and to some extent economic history of

13
Bengal, the history of disease and health of the people has
been largely neglected. As the Spartans were aware of the
beauty of a superb body, so were the ancient Indian sages
who believed that good health is the epitome of
happiness. The colonial administrators were no less aware of
it but they were more concerned about the health of the
colonizer than of the colonized. When it became quite
apparent that a sickly bunch of subject people could not
turn the wheel of empire or provide them with the raw
materials that industry required, they looked to the health
of the man behind the plough. The lack of interest among
historians and social scientists of Bengal about the health
and disease situation is unfortunate. It has created a
serious gap in our knowledge about the condition of the
people of Bengal.
What W.W. Hunter justly said a century ago still
holds good: "Eloquent and elaborate narratives have indeed
been written of the British ascendency in the East; but such
narratives are records of English Government, or biographies
of English Governors of India, not histories of Indian
people. The silent millions who bear our yoke found no
annalist."He also lamented that the people were suffering
from painful diseases. Things have not changed much since
the days of Hunter. My effort to fill that gap will
certainly be inadequate, especially when concentrating on
one of the diseases from among a dozen fatal
ones. Nevertheless, the present effort to enact a scene of

14
malarial history in the drama of diseases and economic
deprivation might leave a partial epitaph for those whose
names were lost and whose agonies were hardly recognized. It
might not fulfill the wishes of Hunter, but it is my hope
that it may evoke interest among future historians to look
into the suffering of the people caused by malaria and other
d is ea se s.
15
Notes to Chapter I
Marnes M. Pepry, "Carefully Whittled, Three Tons of

Pine Turns to a Warrior", The Wall Street J o u r n a l . Feb.l,
1983, p. 1.
'Report of the Sanitary Commissioner for Bengal for

the Year 1921 (Calcutta, 1922), p . 32.
'Chandra Chakraberty, Malaria (Calcutta, 1924),

Preface.
*H.J. Dyson, Lectures on Hygiene Delivered bv the

Sanitary Commissioner of Bengal to the Students of the
Shibpur Engineering College. Howrah. in 1899
(Calcutta,1901), p. 27.
'John A. Sinton, What Malaria Costs Ind i a. Health

Bulletin No. 26 (Delhi, 1956), p. 23; Editorial, Indian
Medical G a z e t t e . Sept. 1923, p. 430.
‘Sinton, p. 23.
’The words of R.C. Dutt were quoted in Sir Percival

Griffiths' The British Impact on India, (Hamden. Conn..
1965), p. 401.
"Charles Bentley, Report on Malaria in Bengal

(Calcutta, 1916), p. 39.
'The Bengal Legislative Council P r o c e e di ng s. Vol. I,

First Session (Calcutta, 1921), p. 7.
"•D.B. Smith, "Epidemic Fever of Lower Bengal". A

Report of the Sanitary Commissioner for Bengal, to the
Secretary to the Government of Bengal, in the Judiciary
Department (Hooqhly. 25th March. 1969). p. 6.
""William W. Hunter, Annals of Rural Bengal (Calcutta,

1897), p. 6.
CHAPTER II
MALARIA IN BENGAL
Malaria in Bangla Literature and Tradition
Malaria like any other disease in a pre-modern society
played an important role in the life of the people of
Bengal. From the middle of the nineteenth century to the
first quarter of the twentieth century its presence was as
formidable as the plague in fourteenth century
Europe. Unfortunately it did not create a legend comparable
to that of Black death nor great works of literature like
the Decameron of Giovanni Boccacio, the famed poet of
Renaissance Florence. Hardly anybody had written about it in
the literature of early modern Bengal. Initially the
Europeans did not write as much about the menace of malarial
fever as they did about other diseases. Fever as a cause of
concern for everybody became apparent only in the first half
of the nineteenth century. It was a new phenomenon in the
history of public health of India, especially Bengal. Since
the middle of the nineteenth century, we find some indirect
references to fever, in literature, and other related
studies.
There is no direct reference to malarial fever in the
early modern literature of Bengal. The earliest reference
16
17
of the carrier of the disease, the mosquito, was given by a
satirist-poet known as the poet of transition. Ishwar Gupta,
who died in 1859, mentioned his terrible experience of
mosquitos at night in Calcutta."' His verse on the mosquito
menace can be rendered as follows;
At night the mosquito, at day the fly

I am in Calcutta driving them to ply.
Calcutta was very notorious for its unhealthy situation
from the beginning of its foundation. It was the second
largest city of the British empire after London but
inherited all the vices of an unplanned and ill conserved
city.
The first important reference of the disease was made
in Nitvananda's text Sitalir Jaqaran Pali in 1878, which
described symptoms of malarial fever in detail. It read as
follows ;
Kalandi is a quotidian (e k a v i ) fever; it seizes one at

the end of the day and makes even the greatest of
heroes ;nto helpless beasts. At a glance from cerebral
fever (s i ra iv a r. possibly cerebral malaria), I send one
to the house of death, having scorched him with "co
wife fever" (do satînâivar. i.e., when one ceases, the
other takes hold).
The terrible, tiger-felling tertian (p â l i ) makes the

bones and the flesh into soot, and sucks blood with
angry vigor. It obeys no medicine and enjoys the
patient at will; having seized him, it abandons him for
two days, then returns."'
The fever described has all the symptoms of
malaria. The author has described exactly the different
types of malaria as experienced by the people in those days.
There was an interesting description made by Pramatha
Chaudhuri (1868-1936), in one of his short stories Burnt

18
Offering about the physical structure of the palanquin
bearers who were most probably suffering from malaria and
the visible symptoms were enlarged spleens. It read;
The appearance of the bearers also amazed me. People

so reduced to skin-and-bone are probably not to be seen
outside a hospital in any other country. The ribs of
almost all of them protruded and the flesh on their
arms and legs hung as loose and twisted as string. The
very first thing one noticed about them was that one
part of their bodies, the abdomen, was unnaturally
distended and shiny. Without being a doctor I
perceived that livers and spleens vied with each other
in thrusting outward. It remembered me that I had read
in the Vrihadaranvaka Upanishad about the livers and
spleens of sacrificial horses being like mountains. I
realized for the first time that the lumps of meat
known as the liver and spleen may be appropriately
compared to mountains. It shamed me to see how devoid
of beauty and strength the human body can be! Such
bodies are an open insult to humanity."*
This short narration awfully depicted the malaria
ridden physique of the people of Bengal in the early part of
the twentieth century. The dearth of references to malaria
in Bangla literature can be explained by the fact that
malaria was considered as one of many types of fevers. By
contrast superstitions relating to other diseases such as
small pox and chicken pox, and the offerings to gods of
diseases by the Hindus are well known.
In an anthropological study of Santal medicine and
folklore Reverend Paul-Olaf Bodding says.
They [the Santals] have a superstition that witches

every year go to a place called K u nd u 1 i p u k h u r i ; from
this tank they bring back with them the germs of
certain diseases, specially epidemic ones, and in
accordance with what they bring any year the people
will have to suffer."*
The Santals were one of the earliest of inhabitants of
Bengal and their reference to epidemic diseases from a pond

19
sounds like the marshy connection of fever. It is said
that malaria prevailed among the Santals "far ahead of all
other disease.""' The account was written in the early part
of the twentieth century, when malaria was at its height.
From the middle of the nineteenth century government
reports abound with the menace of fever. Malarial fever
seemed to be in its early stage of virulence at this time as
it was termed as nutan i w a r . i.e. 'new fever.' "It made its
appearance towards the end of the rains, between the months
of July and August, in the year 1860. The place of its
first outbreak is not accurately k n o w n. "" ’ This was reported
by Raja Digambar Mitra, a powerful zaminder of West Bengal.
Although people called it nutan i w a r . it was officially
designated as "Burdwan Fever". They called it Burdwan Fever,
not from its first appearing but from its most virulently
raging there. It was said that the epidemic was killing
"numbers without number.""*
Another Bangla term also came into use with fever
disease probably because of its intensity. It was known by
the local people as iwar bikar or "unusual fever" as
translated by Surgeon-Major French, the civil surgeon of
B u rw an ." ’ The literal meaning of the word iwar bikar would
have been "the fever that makes some one delirious, or
mentally imbalanced." Dr. French described three types of
fever which he classified as ordinary intermittent fever,
mild remittent fever and malignant continued or remittent
fever. He said that the last was the fatal fever in Burdwan
20
and got the popular name of iwar b i k a r .
The symptomatic description of the term iwar bikar was
closer to the finding of Dr. Jackson who said, "In every
locality visited by me I found a multitude of chronic cases
with intermittent fever and a small number of acute cases
with extreme prostration and unconsciousness."'® According
to Dr. J. Elliot, the term iwar bikar went back to 1830 and
he first used it in 1863. He came across with the term from
the local people who called it iur beekar which was
identical with iwar b i k a r . He pointed to the fact that this
type of fever had been prevalent in Jessore and Nadia
districts for many years since the 1830s. According to
Dr. Elliot's estimation, the fever was malarial in nature
which he thought developed because of a congenial
atmosphere. He said:
...all the concurrent local circumstances which are

generally supposed to favor the development of malaria
are present in full force in most places I have
v i s i t e d . '"
The symptoms he referred to the fever as "congestive
remittent type" and the subsequent development of liver or
spleen inflamation, or both. The principal features by
which the disease had been characterized was hardly malaria
but later turned into malarial fever.
The three distinct characteristics by which Dr. French
described the fever symptoms very much resemble the malarial
infection. And he distinctly stated that those cases were
not enteric fever i.e. typhoid fever. But Dr. Fry in 1912
refuted this contention and he argued that most of

21
Dr. French's illustrative cases were typical "classical
enteric fever", except some which were "cerebral forms of
fatal malarial f e v e r " . " It might be possible that in
Burdwan an epidemic of enteric coincided with an epidemic of
malaria. Dr. Fry concluded:
How far enteric fever prevailed must remain a matter of

guess work, but the rest of the history is certainly
that of epidemic malaria and the parts then attacked
are now the seat of endemic m a l a r i a . "
When the malarial fever spread to most of Bengal it
came to be known as iwarasur.'* the Fever Demon. So it got
a new epithet in its protracted stay in the Bengal plains.
The iwarasur remained unabated till the first quarter of the
twentieth century. The terms iwarasur or iwar bikar were
local names given by the kabirais. the Ayurvedic physicians,
to show the intensity of the fever rather than the symptoms.
One of the most ingenious names for malaria in Bangla
was quinine iwar. " The Bengali kabirai in his abhorrence
of quinine fought back by blaming the imported quinine as
the cause of the disease rather than its remedy. The
quinine controversy went on for a long time and was
supported not only by kabirais but also homeopaths.
Long before the term "malaria" came to be commonly used
in Bangla vocabulary the symptomatic prognosis of the
disease kapani iwar (chill and fever) was also in vogue,
among common people of Bengal. It obviously denoted
malarial symptoms of fever that kept people shivering. On
the contrary, the outward sign of the disease in any patient
was the spleen which was known in Bangla as p i l e v .'* came

22
probably from the Sanskrit term plihan or Latin s p l e n .' ’ and
the disease was also known as pilev i w a r . So the disease
had undergone a number of lexical changes in Bengal before
it came to be known as malaria.
The Early European Account of Fever in Bengal
Narratives written by early European travellers were
inadequate in their treatment of the prevalence of diseases,
practically malaria, in Bengal. The diaries, biographies
and travel records that are available say little about the
public health situations in Bengal. Stray incidences of
unidentified diseases and the severity of the hot climate
which was an obsession to the homesick European seekers of
fortune are practically all we read of; malaria hardly got
any mention. Although there was no direct reference to
malaria in the first century of European arrival, there were
indirect references to an unknown disease which was
generally termed as fever and "bad air" of B e n g a l . " The
fever was long known to and described by Europeans,
especially British writers, as the disease of the East.
Perhaps without being sufficiently aware of the causes of
the disease, some of the older observers termed it Putrid
Intestinal Remitting, and Putrid Remitting Marsh Fever.
Gradually, various designations came to be in use such as
Jungle, Hill, Bilious Remittent, Marsh Remittent, or finally
Malarious Fever.'*
The British administrators were also very fond of

23
putting names to fever. When they were really bewildered
with a fever, they could not help but put a name-tag to it.
The fever acquired its name from the locality where it had
the most virulence at any period of time. So instead of
symptomatic or epidemiological name they put place names on
the disease. Malaria was known as "Rangpur Fever," "Nadia
Fever," and "Hooghly Fever," but it was most widely known
as "Burdwan Fever," for its prolonged and devastating
virulence in the district of Burdwan. Of all the place
names, the word "Burdwan Fever" stuck.
Apart from the ambiguity in naming of fever,
contradictory views were expressed by the Europeans about
the healthfulness of B e n r M . The earliest account of great
mortality in Calcutta written in the early part of the
eighteenth century was that of Captain Alexander Hamilton.
He mentioned 460 burials out of 1200 British inhabitants
during five months. Alexander Hamilton travelled to the East
from 1688 to 1723. He gave an interesting picture of
Calcutta hospitals. "The Company has a pretty hospital at
Calcutta, where many go in to undergo the Penance of
Physick, but few came out to give the Account of its
Operation."" Apart from Calcutta he was charmed by the
"healthful and fruitful" countryside of Kasimbazar, and when
he travelled around Dhaka he found that the "Country is
full of I n h a b it an ts ." " In an account of Major Kilpatric's
detachment of 240 men, stationed at Fultah, on the Bay of
Bengal, less than thirty were left alive between August and
24
December, 1756, because of f e v e r . " It is said that the
number of men buried in Bengal amounted to more than half of
all who died in the several hospitals in India, during the
whole term of Admiral Watson's command of British soldiers
in Bengal for a period of three years. If these figures
were true, then we have to recreate the so-called "Black
Hole" tragedy of Calcutta of 1756. The cause of death in
the prison house of Calcutta might be due more to the
indirect cause of fatigue and weakness due to fever and
other tropical maladies than to the direct cause of
suffocation. Calcutta undoubtedly was more unhealthy
compared to other regions because it was located in the
midst of swamps and marshes. Moreover, it was an important
trading link with the rest of the world including West
Africa, the home of malaria.
Dr. James Lind, the surgeon of the Drake East Indiaman.
in his dissertation on marsh fever of Bengal, wrote in 1762
that the fever raged in different places according to the
marshiness of the soil. He stated.
During the month of September, when the disorder raged

most, the remissions were very imperfect and obscure.
But on the return of winter, and the healthy season,
they become more regular, and the disease assumed the
appearance of an intermitting fever, to such a degree,
as, at length, not to be distinguished from i t . "
It seemed from his account that the fever came along with
the seasonal fevers like influenza and finally stayed with
the victim. He thus concluded that when the fever continued
for a considerable period of time it generally ended with
the death of many patients.

25
Some travellers also mentioned the unhealthiness of
the province. The Dutch traveller Stavorinus made some
conventional remarks about fever, which he thought was due
to the contagion of contaminated a i r . " Gradually it was
apparent that the severity of the disease had increased.
This was amply described by Warren Hastings, the first
Governor General of Bengal in 1774. He said:
The extraordinary unhealthiness of Moorshedabad which

seems to have been becoming worse year after year, has
forced most of the European functionaries to seek
residence at some distance These continued maladies,
... reduced the formerly population of Murshidabad to a
third of its original number....**
The Marquis of Wellesley wrote about the extraordinary
unhealthiness of Murshidabad and he was particularly wary of
the dreadful climate of Bengal." He had even stronger
remarks against the unhealthiness of Calcutta. In a Minute
dated June 16th, 1803, he wrote:
The increasing extent of population of Calcutta, the

capital of British empire in India, and the seat of the
supreme authority, requires the serious attention of
Government. It is now become absolutely necessary to
provide permanent means of promoting the health, the
comfort, and the convenience of the numerous
inhabitants of this great t o w n . * ’
Wellesley specified the defects which contributed its
unhealthiness as the extremely defective construction of the
public drains and water courses of the town. He also
mentioned about the absence of general regulations with
respect to the situation of the public markets.
From the first quarter of the nineteenth century an
increasing number of accounts speak of fever. From 1835 to
1863, a number of minor reports published by the government

26
concern fever and fever hospitals. Writing in the Fever
Hospital report, J.R. Martin stated that the native
inhabitants of Calcutta and its suburbs suffered enormously
from fever. It was said that "half of occupants of each
house died of fever" during the year 1833.** Some of the
estimates went beyond this figure. Although Martin
discounted some of the accounts as an exaggeration,
nevertheless he said that "the real amount of suffering must
be admitted to have been terrible."*’ These statements were
corroborated by a paper entitled "Observations by Baboo
Ramcomul Sein and Dr. Jackson, which commented that "fever
is unquestionably the most prevalent complaint in and about
Calcutta."" Among the various causes productive of fever
in Calcutta was the accumulation of filth and stagnant
water, shallow tanks with unwholesome water, digging pits
and holes and lastly unmetalled drains. These were
undoubtedly good habitats of mosquitoes as it is widely
known today. Finally, the Second Report of the Fever
Hospital in 1848 recommended major public health
undertakings for the city of Calcutta that would render its
climate comparatively salubrious, namely clearing of the
Sundarbons forest and draining of the Salt Water L a k e . "
After a lapse of more than a hundred years, the Salt Water
Lake project was completed only recently. Calcutta being a
port city, because of the concentration of Europeans in the
city who were most likely to be the modern carriers of
tropical diseases, fever was more noticeable in Calcutta

27
than any other part of Bengal. Calcutta got the greatest
attention being the capital of the British empire in India,
and the hub of diseases.
Gradually fever reports came from other areas of
Bengal. In 1838, Montgomery Martin spoke of the
unhealthiness of Rangpur which to him was worse than
Calcutta. About the fever situation in Rangpur he stated;
Fever is the grand disease, and in the well cultivated

part of the country this is very general. Every year
from the middle of August until about the 20th of
November, in parts of the country again, where there is
little cultivation, and where there are great forests
and thickets of reeds, and more especially near the
hills, autumnal epidemic is less violent, and fevers
are by far the most prevalent from the beginning of
April to the middle of June. It is said that a very
large proportion of the inhabitants have each year a
fever at either one or other s e a s o n s . "
The Europeans were in general, disenchanted more by the
"enervating heat of c l i m a t e " " of Bengal, which they more
often described in their diaries, than by diseases. Being
the inhabitants of a cold climate they could hardly endure
it. One of the most vivid descriptions of the climate and
that of mosquitoes was written by Colesworthy Grant, an
artist in 1862 about life and living in Bengal. He also
gave a sketch about the situation. He wrote:
With the nature of the climate of Bengal, you are

perhaps sufficiently acquainted to know, that our
attention and most cunning stratagems are continually
directed to one grand object, — the amelioration of
our condition — disarming of their potency, in effect
at least, the very beams of the sun — the spring of
man's joys, yet the source of our chief woes — during
at least six months of the year;...**
The same author when referring "to the mosquito, which
is but one — though the principal, and certainly the most

28
troublesome to man — out of the countless tribes of insects
which, you will readily conceive, so abound in the low and
marshy plains of Bengal," had drawn a sketch of a medieval
knight fighting the deadly enemy, the swarms of mosquitoes
with a shield and spear, clad in armour.** The cartoon
shows the knight in defensive posture, attacked by countless
enemies. It conveys two messages. Either the person is
particularly aware of the harm, if not malaria the
mosquitoes could inflict or he has chosen mosquitoes as
representative of all insects. Whatever may be the fact the
artist's letter to his mother published in 1862 is quite
significant for our purpose.
Investigation of Malaria in the Middle

of the Nineteenth Centurv
In the middle of the nineteenth century the health
situation in Bengal appears to have gradually deteriorated
to such an extent that the government became gravely
concerned about the physical welfare of the troops on whose
well-being depended the whole empire. Because of concurrent
flare-ups of the epidemic fevers, there had been a number of
special inquiries undertaken by the government to find out
the causes of general prevalence of the disease. The reports
could be classed into two categories. Those published in the
nineteenth century dealt with fevers in general and those in
the twentieth century dealt with malaria exclusively. The
first important inquiry of this kind was done by the Royal
Commission in 1859, which submitted its Report in 1863.

29
Apart from the usual Sanitary Reports, the nineteenth
century literature of malaria in Bengal centers around three
epidemic outbreak of fevers. These epidemics were as
follows ;
1. The epidemic in Nadia, Barasat and Hooghly, and
some villages in Burdwan which first attracted
attention of the government in 1861. It was
investigated by a committee usually known as the
Epidemic Commission and was reported by Dr. J.
Elliot in 1863.
2. The second important epidemic that got government's
attention was that of 1869. The epidemic became
severe in the districts of Hooghly and Burdwan and
gradually spread to the adjoining districts of
Midnapore, Birbhum and Bankura. Some villages in
the districts of the 24 Parganas, Nadia and Jessore
were also affected by the disease but the main
brunt was felt by the Burdwan Division. By 1874 it
started to abate, but it carried with it the name
of Burdwan fever for years to come.
3. The last significant epidemic of the nineteenth
century was the fever of Nadia and Jessore between
1880 and 1885. The enquiry into this epidemic was
done in 1881-82 and was generally known as Nadia
Fever Commission.
There were some minor epidemics in the nineteenth
century, of which the important ones were those of Dinajpur

30
and Rangpur districts. But these epidemics which took place
between 1872 and 1879 were not investigated by any special
committee. Since then, fever was a constant companion of
the people of Bengal.
The first great outbreak of fever in Nadia and Hooghly
districts in the years 1861 and 1862 led the government of
Bengal to appoint a committee to examine and report on the
epidemic. Dr. J. Elliot, the Civil Surgeon of Hooghly,
furnished in the following year a report on the nature of
the fever, and of the state of the towns and villages in
which it was prevalent. Dr. Elliot was the only medical
officer who had seen much of the disease. He visited the
infected villages, and saw the sick in their own houses.
For this reason his opinion regarding the type of the fever
and its character was of more value than that of other
medical officers who had neither seen nor studied the
diseases as he had done. He described the fever "...in
which the ordinary symptoms of severe remittent are
succeeded after the stage of shivering has passed by heat
and dryness of skin...."" According to him fever was a
manifestation of malaria, influenza and other infectious
diseases combined.
Tracing the history of fever, he pointed to the fact
that fever was prevalent in Jessore as early as 1825. From
1825 to 1831, fever became prevalent at irregular intervals.
From Jessore it passed to the adjoining district of Nadia,
and from Nadia it spread to Barasat by 1860, and from there

31
to Hooghly where it continued for five years. So it seemed
that malarial fever was rolling around Burdwan, Nadia,
Hooghly and Jessore for a considerable period of time, its
intensity and locale changing from time to time. In this
report the conclusions arrived at were very different from
those of Dr. Dempster who attributed the great prevalence of
the fever in irrigated districts of Northern India to a soil
made artificially damp with canal water. Dr. Elliot, on the
other hand, was of the opinion that the Nadia epidemic was
caused chiefly by bad conservancy and by the foul state of
the towns and villages. Among the causes of the fever he
cited, the presence of organic impurities, obstructed
circulation of air, jungle growing all around the villages
and, finally, the filthy habits of the people were the main
causes of the epidemic.*’ His remarks perpetuated the usual
misconception of the outbreak of epidemic diseases. The
filth theory had became dominant among health planners in
England at that time.
There were contradictory views expressed regarding
fevers in the reports of Sanitary Commissions. The first
Annual Report of the Sanitary Commission for Bengal came out
in the year 1864-65. It did not regard fever as a cause of
concern. Instead it put much emphasis on cholera and
typhoid as a danger to European soldiers. It recognized the
epidemic nature of the fever and added, "This fever,
although apparently a new disease, has only attracted
special attention during the last few years."** The second

32
report of the Sanitary Commission of 1865-66 initially took
the fever to be plague but the medical officer who was sent
to report on fever considered it of malarious origin and
named it "Billious Remittent Fever."*’
In subsequent reports of the Sanitary Commission for
Bengal there was a flood of statements by the civil surgeons
of different districts about the spread of malaria, not in
the guise of fever but with its actual characteristics. The
Sanitary Commissioner reported in 1869,
The fever of Bengal districts is, beyond all doubt, an

endemic malarious disease, due to local causes
chiefly want of drainage, partial or complete
stagnation of water-causes, and saturation of the soil
with moisture. It is not contagious. Its remissions
and exacerbations are more or less regular diurnally.
It is not characterized by a specific crisis or
relapse. It is a typical malarious endemic f e v e r . "
Dr. Sutherland, the Deputy Inspector General of
Hospitals of the Presidency Circle, had the same opinion.
He contended that "a fever of a highly infectious character
may originate and spread from intensified malarious
influence, aided probably by bad ventilation and emanations
from the bodies of the sick." He added, "It was a fever of
a pure malarious character in which quinine had its usual
antiperiodic effect."** His idea of fever was dominated by
the miasma concept of disease and he thought that the
treatment of quinine was sought due to the non-availability
of proper medicine. Sutherland agreed with the view of
Elliot that the fever was of infectious character for which
there was an excessive mortality. The disease was most
fatal among the rural populations.

33
There were reports from some districts which
sufficiently indicate the malarial nature of the fever.
Reporting from Faridpur, the civil surgeon Dr. Bholanath
Bose wrote, "The disease principally met with in the
district are, as might be expected, fever of a malarial or
paludal origin, of which the forms most prevalent are the
tertian and quotidian agues."*' Even for Dhaka city, the
civil surgeon Dr. J.F. Wise thought the health situation was
deteriorating and fever was common in all seasons. Fevers
of various characters, requiring different modes of
treatment, prevailed in the same district at not very
distant intervals. Although they seemed to owe their origin
to malaria, there were some seasons when fevers like
influenza and typhoid accompanied it that caused them to
assume different characters at different times. The problem
of identification became acute because malarial fevers and
other types of fevers were labelled by the same name and
were used interchangeably by the civil surgeons of the
period.
Before the beginning of the decade of 1870, fever
epidemics became more serious than before. In 1869, the
Sanitary Commissioner for Bengal after a wide-ranging tour
of different parts of Hooghly reported on the "so called
'Epidemic Fever of Lower Bengal.'" On his tour he found
that half of the population of a village named Pundooah had
disappeared in three years, since the publication of
Elliot's report. In other places, a similar or worse fate

34
awaited the people. In eleven villages he found the total
population had been reduced to one-third from 1863 to 1869.
The unhealthiness of the places he visited greatly exceeded
what he had anticipated. It was indeed very alarming. He
remarked:
The present state of the Hooghly District is most

lamentable. The blighting influence of malaria is
every where conspicuous, the people are subject to
constant and excessive sickness of an insidious nature;
their vigour is being sapped. Silent but sure
depopulation, on an alarming scale, is going on.
Then he added, "The prevailing malady is the endemic
malarious fever of the country, la fievre du p a v s . as the
French would call it."**
The Sanitary Commissioner was using the term malaria as
a synonym for fever as the French phrase la fievre du oavs
meant fever of the countryside. But malaria was commonly
applied to all febrile diseases. Louis Pasteur had
confirmed the germ theory in 1864 and it took another two
decades to recognize the parasitic origin of malaria.
Gradually the nature and symptoms of the disease and
the resulting effects of the fever became clear. In 1869 the
condition of the malaria stricken people had been vividly
described by the Sanitary Commissioner. He wrote:
On entering a village one is immediately surrounded by

poor miserable squalid creatures, with parchment-like
skin, lanky limbs, swollen feet, enormously enlarged
spleens, narrow chests, shoulder-blades staring out
from the body, puffy, sodden faces, and hearts and
arteries visibly pulsating and struggling under the
influence of poisoned and deteriorated blood. In a
large village, hundreds of such cases are visible. It
is almost impossible to imagine a more touching and
saddening sight....We thus see humanity reduced to one
of its most abject conditions: uncouth, cadaverous men
35
and women, surrounded by pitiably diseased children

moving silently about in a strong hold of malaria,
which they call their village home, where every draught
of water, and every breath of air inhaled, is poison.**
This description leaves no doubt that they were
suffering from malaria. But the cause of the disease was
thought to be due to the emanation of poisonous gas, the
miasma. This was the prevalent belief in Britain and Europe
carried through the ages since the time of Hippocrates.
In the later years, health officers were much more
clear in their identification of the malaria fever. In 1874
Surgeon David Wilkie was deputed to investigate the type and
cause of the "Burdwan Fever," a term which was widely used
in the subsequent years in Bengal. On the whole, the fever
was to him mostly of the intermittent type, some tertian and
in some places large numbers of remittent fevers having been
observed by him. He stated, "I have never seen any case
presenting symptoms differing from those of ordinary
malarious fevers."** His was the first conclusive
identification of fever as malaria. Almost all the cases of
malaria were found in the Burdwan circle.
Most of the later day physicians came to the same
conclusion. Writing in 1874 about the Burdwan fever.
Dr. French said.
Ever since I came into the district I maintained the

opinion that 'Burdwan Fever' was only an exaggerated
type of malignant form of the ordinary endemic fever of
Bengal, and similar to that observed in marshy places
and other unhealthy tracts...I wish again to place on
record my convictions that, no intelligent or well-
informed physician can mistake the type of the fever,
or diagnose it as any other than that which hitherto
has been known by the name of malarious or marsh fever.
36
Even if a single case had never been watched or

diagnosed, the number of spleen cases in the fever-
stricken tracts show this.**
Thus the identification of the malarial fever became
almost complete and uniform. But a new factor, namely,
typhoid was added to it. There were numerous other
testimonies by civil surgeons and other medical authorities
in Bengal about the contagious malarious fever that had
ravaged many villages. And sometimes the contagious fever
disappeared in certain years. The occurrence of such a
contagious factor in malarious fever was a difficult thing
to explain. It raised some tricky questions. How was
typho-malarial fever introduced into a locality? Was the
union of typhoid and malaria so intimate that the contagious
element became subject to seasonal influence with the
malarial? If the typhus element could be isolated from
malarial fever then it could have been easier to estimate
the true nature of malaria. The typho-malarial fever was a
complex manifestation of the Burdwan fever, which kept the
physicians and sanitarians in a perplexity for some time.
Later, the typhus fever abated and malaria emerged as the
dominant factor.
Dr. Wilkie in his investigations cited the findings of
a number of civil surgeons about the cause and symptoms of
the disease and came to the following conclusions:
Now, from the evidence above given, it will be seen

that, whatever the bad fever may have been, it was
preceded and accompanied, as well as followed, by a
marked increase of what was universally acknowledged to
be fever of the ordinary malarious type of the
c ount ry .*^
37
It is to be noted that the harmful effect and gradual
increase in the intensity of malarial fever became apparent
year by year. The characteristic symptom of Burdwan fever
became synonymous with malaria so as to have been mentioned
by all those who have written on the subject.
One of the major outcomes of the government effort to
identify the malarial fever was the Report of the Commission
to Inquire into the Causes of the Epidemic Fever in Nadia in
1882. In the Resolution of the Medical and Municipal
Department, the Lt . Governor, noticing the presence of a
malarious fever in Nadia appointed a commission to visit the
villages to examine carefully their sanitary condition and
the causes of their unhealthiness. A three member committee
under the presidentship of Dr. Robert Lidderdale found it
clear that fever had long been present in Nadia and was
never dormant for any length of time. The total number of
deaths from fever for the year 1880-81 was almost twenty
thousand.
The fever of 1881 did not differ from that described by
Elliot in 1863. It accorded with the description of the
diseases as was seen in Hooghly and Burdwan during the great
outbreaks in those districts. The Civil Surgeon of Nadia
called it "an ague intermittent, characterized by relapses,
which in the majority of cases terminated in splenic
enlargement followed by anemia."** Although the Commission
recognized the fever as malaria, it had some very peculiar
features, making it something apart from ordinary marsh

38
malarious fever. Its virulence had been so great as to have
led several sanitarians such as Dr. Jackson and
Dr. Sutherland to believe thatit was a contagious fever.
Dr. Jackson remarked that "it is intensified in old, effete,
decaying, rotting places, saturated with organic debris, and
that a fever, originally malarious, acquired either in
Jessore or Nadia contagious properties."*’ The report
finally concluded that in accordance with the germ theory
the fever was a contagious malaria. It had done havoc in
Nadia as in many other districts of Lower Bengal, and the
germs had so intensified as to cause a very virulent and
fatal type of malarial disease.
In all these reports, one thing was clear; scientific
investigation in India got low priority. Sanitarians stuck
to what they heard from Europe. For example, according to
the germ theory, disease is the result of the presence of
microorganisms or their products in the body. Thus the
epidemic disease requires a special contagion to produce it
and the surrounding conditions must have a potent influence
on its development. It seemed that the Sanitary
Commissioner and the health officers were aware of the germ
theory and that they applied it to the wrong place.
Although Charles Laveran, the French physician, had
discovered parasite organisms in the blood of patients
suffering from malarial disease in 1880 in Algeria, the
sanitarians in India were hardly aware of it or worked on
it. It took another twenty years for Ronald Ross of the

39
Indian Medical Service to find a connection between malarial
parasites and mosquitoes. Even Ross was unaware of the
discoveries of Laveran. In Bengal, fevers of the
intermittent types prevailed most extensively but remittents
also existed to a considerable extent, and typhoid fevers
were not uncommon. The problem of identifying the malarious
fever was always difficult because of the inadequate
facilities for investigation.
Investigation of Malaria in the Twentieth Century
Several inquiries into Bengal malaria were carried out
by several investigators and commissions in the first
quarter of the twentieth century. The only detailed local
inquiries concerning malaria had been those of Captain
Rogers in the riparian municipalities along the Hooghly in
1900, in Bogra in 1901, and in Dinajpur in 1904. A brief
enquiry was made in Faridpur by Captain Stevens in 1901.
The Malaria Committee of the Royal Society visited Bengal in
1901 in the course of their tour of India. It was
recognized in the Government Resolution dealing with the
provincial Sanitary Report for 1902 that benefits were
likely to accrue from such enquiries, and Captain Rogers'
report upon the Dinajpur district was the outcome of the
orders then passed.
The first major report on malaria in the twentieth
century was an indirect outcome of the Report of the
Drainage Committee of Bengal. The report was published in

40
1907 under the chairmanship of W.A. Inglis, which is
generally known by his name. This report included the
valuable researches of Captains Stewart and Proctor. These
officers demonstrated that there was much malaria in the
Presidency Division, and that the Nadia, Jessore and
Murshidabad districts were the most severely affected
districts.*' Owing to limitations of time, their valuable
work was curtailed and their conclusions on causation, modes
of spread and other epidemiological factors were considered
not final. The Drainage Committee published an admirable
report but because of the limited nature of its enquiry it
refrained from definite resolutions. It strongly
recommended the need for further research on the obstruction
of drainage and its consequent effects on malaria.
The following year Major Forster was engaged on the
research work for six months. He found only mild malaria
and expressed his opinion that the majority of enlarged
spleens were due to kala -a za r. (black fever) ** a disease
very close to the symptoms of malaria. Kala-azar might have
been overlapping with malaria in his place of investigation.
A report on the anti-malaria measures was carried out
by the Dinajpur Municipality during the period beginning of
1909 and ending by 1912. Dinajpur did not appear to have
been selected as a site for the carrying out of a special
scheme of anti-malarial sanitation. Bentley stated that
"the chief interest of the present report lies in the fact
that it records an attempt to combat malaria in a small

41
Bengal town on the lines laid down by Major Sir Ronald Ross,
in his Report on the Prevention of Malaria in Mauritius."**
It was an important investigation and recommendation was
made for anti-malarial measures.
The systematic investigations of local conditions that
were responsible for the occurrence of malaria in the Bengal
districts were not undertaken until the year 1911. The
first official report on malaria in Bengal was led by Major
A.B. Fry and his report was published in 1912. This report
was followed by another in 1914 by Dr. Fry.** These reports
were very limited in their scope and treatment of the
subject, covering only a few districts of Bengal. A more
comprehensive report was published in the year 1916 by
Charles Bentley, the Sanitary Commissioner for Bengal.
Bently made a few definite observations in the report. He
found that there were extraordinary variations in the
intensity of malaria in different parts of Bengal; the least
affected area was Eastern Bengal. He was of the opinion
that malaria did not have a long past history in Bengal and
thought it began half a century earlier. He found some
correlation between population growth and prevalence of
malaria and supported Ross's theory that the static malaria
ratio tended to decrease with the increase of the density of
human population. Apart from writing many articles on
Bengal malaria, his last report on this subject was
published in 1925,** which dealt mainly with economic
solutions to the malaria problem.

42
Although literature on malaria in India might be
traced back to antiquity as it was one of the oldest of
diseases, its endemic and epidemic prevalence in Bengal had
no long history. From the middle of the nineteenth century
malarial fever, originating from a small area in the Western
Bengal, gradually spread its virulence to the whole of
Bengal. There was a fear among health administrators in the
first quarter of the twentieth century that malaria would be
extended to the delta tracts of Eastern Bengal which at that
time were largely exempt from the disease. As to the
natural expansion of the disease, there was a strong
comprehension that there was a common origin to the cause of
the disease. But the cause of the disease was always
shrouded with misconception and myth. To the British
administrators the ready made answer to the problem was to
blame the people of filthy habits or the places of noxious
vapors. Most of the early reports were based on
preconceived ideas and it was only in the beginning of the
twentieth century the cause of malaria was unfolding itself
in India.
43
Notes to Chapter II
1 2 i
‘Shangib Kumar Bose, Ishvaroupta 0 Banola Sahativa
(Calcutta, 1978), p, 123. Iswhar Gupta died in 1859. He is
called the poet of transition because after him the modern
Bangla poetry found its own footing.
**Dyija _Nityanand$ Cakravartî, sitalir Jaoaran Pâli

Matsvadese sitala Devir Mahitmva Varnana. First ed.
( C a l c u t t a , 1 8 7 8 ) ( T e x t B ) , p. ÎÔ1 Quoted from Ralph
W. Nicholas and Aditi Nath_ Sarkar, "Fever Demon and the
Census Commissioner: Sitala Mythology in Eighteenth and
Nineteenth Century Bengal", Bengal Studies in Literature.
Society and Historv (Michigan, 1976), p. 21.
**Lila Ray (Ed./Tr.) Broken Bread: Short Stories of

Modern B e n g a l , from Pramatha Chaudhuri, Burnt offering
(Cal., 1957), p. 4. Pramatha Chaudhuri (1868-1936) saw the
worst part of the malaria ridden people of Bengal in his
lifetime. He was born at Pabna, educated at Krishnagar,
married into the Tagore family and edited the famous journal
'Shabuj Patra.' Nakul Chattopadhyaya — Tina Satekera
Kalakata (Calcutta, B.S. 1372), pp. 12-13.
**The Reverend Paul-Olaf Bodding, Studies in Santal

Medicine and Connected Folklore (Calcutta, 1925), p. 7.
I'lbi d .. 162.
*’Bholanauth Chunder, Raja Digambar Mitra. His Life and

C a r e e r . (Calcutta, 1893), p. 105.
*'Ib i d .. p. 103.
**Dr. French. See: Annual Report of the Sanitary

Commissioner for Bengal for the Year 1871 (Calcutta, 1873),
p. 45.
''Annual report of the Sanitary Commissioner for Bengal

for the Year 1872 (Calcutta, 1874), p. 54.
**Dr. Elliot, Reports on Epidemic Remittent and

Intermittent Fever Occurring in Parts of Burdwan and Nuddea
D i v i s i o n s (Calcutta, 1863), p. 19.
**A.B. Fry, First Report on Malaria in Bengal (Cal.,

1912), p. 4.
* *I b i d .. p. 4.
*'Nicholas and Sarkar: "The Fever Demon and the Census

Commissioner", p. 12
**A.B. Fry, Second Report on Malaria in Bengal

44
(Calcutta, 1914), p. 22.
* 'Samsad Enqlish-Benoali Dictionary (Calcutta, 1963),

p. 1310.
* 'The Oxford English Dictionary; A New English

Dictionary on Historical Principles (London, 1970), p. 637.
* 'Francois Bernier, Travels in the Mooul Empire.

A.D. 1656-1668, Revised and translated by Archibald
Constable (London, 1891), p. 441.
* ’James Ronald Martin, Influence of Tropical Climate in

Producing the Acute Endemic Diseases of Europeans (L o nd on ,
1861), p. 307.
''Alexander Hamilton, A New Account of the East Indies.

Vol. II (London, 1930), pp. 5-13. Hamilton, a Scotchman,
travelled in the East between 1688 to 1723.
* ^ Ibid., p. 7.
" J a m e s Ronald Martin, op. c i t .. p. 308.
*'James Lind, A Treatise on the Putrid and Remitting

Marsh Fever which Raged at Bengal in the Year 1762
(Edinburg, 1776), pp. 28-29.
''J.C. Stavorinus, Voyages to the East Indies.

Translated from Dutch byS.H. Wilcoke, Vol. I (London,
1969), p. 154. The Dutch Admiral who travelled to Bengal in
1768 mentioned in his memoirs a list of the diseases like
small-pox, dysentery and other tropical malady. He did
mention fever or ague which he thought was due to contagion,
a theory so prevalent at that time.
" T h e Marchioness of Bute, e d . , The Private Journal of

the Marquis of Hastings. K . G . . 3d ed. (Allahabad, 1907),
p. 278.
'‘Edward Ingram, ed.. Two Views of British India: The

Private Correspondence of Mr. Dundas and Lord Welleslev:
1798-1801 (Somerset, 1970), p. 52.
''Abridgement of the Report of the Committee Appointed

by the Right Honourable, the Governor of Bengal for the
Establishment of Fever Hospital, and for Inquiry into Local
Management and Taxation in Calcutta (Calcutta, 1840), p. 63;
Iris Butler, The Elder Brother: The Marauess Welleslev. The
Duke of Wellington's Eldest Brother (London. 1973). pp. 134-
135.
* 'Report of the Committee Appointed bv the Right

Honourable the Governour of Bengal for the Establishment of
45
a FeverHospital, and for the Inquiries into Local

Management and Taxation in Calcutta (Calcutta. 1839). p. 1.
" Ibid.. p. 1.
" Ibid.. p. 16.
*'Second Report on Committee upon the Fever Hospital

and Municipal Improvement: Containing Correspondence
Respecting the Warping and Draining of the Salt Water Lake
and the Unhealthiness of the Environs of Calcutta,
e t c .(Cal c ut ta , 1848), p. 1.
"Montgomery Martin, The Historv. Antiquities.

Topography, and Statistics of Eastern Ind ia . Vol. V, First
Indian Reprint (New Delhi, 1976), p. 483.
" S . C . Hill, Indian Record Series. Bengal in 1756-1757.

Vol. I (New York, 1968), p. xxii.
" C o l e s w o r t h y Grant, Anglo-Indian Domestic Life; A

Letter from an Artist in India to his Mother in England
(Calcutta, 1862), p. 2.
" Ibid. . 14.
' ‘Report on Epidemic Remittent and Intermittent Fever

Occurring in Parts of Burdwan and Nuddea Divisions
(Calcutta, 1863), pp. 21-23.
" Ibid. . p. 23.
*'First Annual Report of the Sanitary Commissioner for

Bengal. 1864-65 (Calcutta. 1865). p. 5().
*'Second Annual Sanitary Reports for Bengal. 1865

(London, 1867), p. 75.
* "Report of the Sanitary Commissioner for Bengal. 1868

(Calcutta, 1869), p. 534.
*'Minutes of the Proceedings of the Sanitary

Commissioner with the Government of India (Calcutta. 1868).
p. 534.
*'The Report of the Sanitary Commissioner for Bengal.

1868 (Calcutta, 1869), p. 75.
* 'Report by Dr. Smith. Sanitary Commissioner for

Bengal, on 'Epidemic Fever of Lower Bengal' in the Hooohlv
District (Calcutta, 1869), p. 1.
" I b i d . , p. 4.
46
*"Report of the Sanitary Commissioner for Bengal. 1874

(Calcutta, 1875), p. 43.
"‘I b i d . . p. 43.
' 'Ibid . , p. viii.
*"Report of the Sanitary Commissioner for Bengal. 1881

(Calcutta, 1883), p. xliii.
"* Ibid ., p. x l i i i .
" Report of the Drainage Committee. Bengal (Calcutta,

1907), Appendix I, p. x.
"A.B. Fry, Second Report on Malaria in Bengal

(Calcutta, 1914), p. 35.
‘"Charles A. Bentley, Report on the Anti-Malaria

Operations at Dinaiour (Calcutta, 1913), Preface, p. i.
‘"A.B. Fry, First Report on Malaria in Bengal

(Calcutta, 1912); Second Report on Malaria in Bengal
(Calcutta, 1914).
‘‘C.A. Bentley, Report of Malaria in Bengal (Calcutta,

1916); Malaria and Agriculture in Bengal: How to Reduce
Malaria in Bengal bv Irrigation (Calcutta, 1925).
CHAPTER III
CONCEPT OF DISEASE AND MALARIA
Generally speaking the background of the conception of
disease both in Europe and India was a three-fold one,
including magical, religious and empirical elements. All
three had been present to a greater or lesser extent in the
thinking which preceded modern medical knowledge. The
magical and religious ideas were no longer a prevailing
influence when the British reached India in the seventeenth
century, though the particular empirical conception of
disease which they inherited still played an important role.
The British conception of disease stemmed from the Greeks
who, influenced by the Egyptians, first led the way to an
art of healing based on observation and experience. But in
India and China, medical lore developed independently of
Egyptian experience. So there were differences between
European and Indian understanding of the cause of
disease. But there was probably some contact between Greek
and Indian systems in the Hellenistic period which accounts
for the fact that both have a theory of the humors. Although
there were some similarities between the two, the
dissimilarities prevailed. In a colonial situation the
European conception of disease got the upper hand, with or
47
46
without definite merit of its own, and was applied to
discover the cause of unfamiliar diseases like malarial
fever. This was the situation before the germ theory was
established.
Humoral Theory of Disease in Europe
Two ancient ideas which were prevalent among the
British conditioned their understanding of malaria. These
are — miasmas, or swamp airs, as a cause of disease, and
climate as an explanation of human characteristics such as
energy. To the Greeks, health was a question of balance and
symmetry. An early contributor to Greek medicine was Thales
of Miletos (c. 624-548 B.C.) whose declaration that moisture
was the primary cause of all things remained the basis of
later studies. Anaximentes (c. 550 B.C.) declared air
rather than the moisture, to be the primary cause.*® The
Pythagoreans contributed number and symmetry to medicine,
with four as the ideal number representing two pairs of
opposing f o r c e s . ‘‘ Empedocles (c. 492) postulated that
everything which existed is made up of four unchangeable
elements — air, fire, earth, water — which might be upset
by forces such as atmospheric conditions, faulty diet, or
wrong living. By the time of the Hippocratic Corpus (c. 460
B.C.), the four elements were associated with the four
cardinal humors in the human body — blood, originating in
the heart, corresponding to air; phlegm from the brain,
corresponding to water; yellow bile, produced in the liver.

49
corresponding to fire and black bile, sometimes known as
melancholy, formed the spleen, corresponding to earth.*’ It
has been hypothesized that the spleen was ranked as an
important cardinal organ because of the prevalence of
malaria in Greece, which caused frequent hypertrophy of the
spleen. The connection between marshy areas and enlarged
spleens, and various intermittent and remittent fevers, had
been established by Hippocratic tradition, which correlated
the consumption of marsh water with splenomegaly, along with
quartan fever and fatal dropsies. The unhealthiness of the
Pontine marshes since ancient times led many Romans to think
about malaria. Varro (116-127 B.C.) speculated that
marshes produce very minute animals carried by air which,
when they get into the nose and mouth, cause marshy
d i s e a s e s .*•
The theory of the four humors was further developed by
Galen in the first century A.D. when it was understood that
each humor, as well as each natural element, had the same
elementary qualities. Thus blood and air were both hot and
moist; yellow bile and fire, hot and dry; phlegm and water,
cold and moist; while black bile and earth were cold and
dry. The symmetry of Pythagoras was thus upheld in that two
pairs of opposing forces were recognized, dry and moist as
well as hot and cold. When the humors were normal in
quantity and quality and equally mixed, the state of
equilibrium prevailed and man was healthy; but if one humor
came to dominate, disease resulted.*’ Keeping this theory

50
in mind. Columella of the first century said that marshes
should not be permitted near habitations because their
noxious vapors could cause illness.
The theory of humors and marshes became even more
influential in medieval times when an extensive literature
developed in the monasteries with regard to the question of
the human constitution.’* Scholastic physicians and
scientists devoted much time to taxonomies which were
further stabilized by astrological works, where each type of
man became associated with a specific planet.
Humoral Theory of Disease in India
In India, Ayurveda, the Science of Life based on the
Vedas was developed systematically more than three thousand
years ago and made great progress both as a preventive and
curative system of medicine. This was perhaps one of the
earliest medical systems that laid stress on positive
health, a blending of physical, mental, social, moral and
spiritual welfare. The system dealt with knowledge of life
elaborately indicating measures for healthful living for
full span of life.
Ayurveda defined life as the union of body, sense, mind
and soul. The living man, the man of action (karma
p u r u s h a )’' is a conglomeration of three humors (tridosha).
seven basic tissues (saptadhatu) and three excretions
(trimala). These constitute the body matrix (d e h a ) and
Ayurveda has developed around this basic doctrine.

51
According to this system, a healthy person (s v a s t h a ) is one
in whom there is an equilibrium of the humors and the body
tissues, with normal digestive as well as excretory
functions associated with the gratification of the senses,
mind and soul. The disease is due to an imbalance of the
equilibrium of either one or all of the humors.
Just as there were three qualities of mind, there were
three components connected with the body whose equilibrium
or otherwise decided its state. They were the three hum or s ,
vata, pitta, and ka p h a . These three were the basic humors
(d h i t u s ) of the body, which were susceptible to imbalance
and in turn capable of vitiating other structural and
functional elements of the living body, thus causing the
morbidities of various kinds. They were termed dhatus since
they sustain and support the body when within proper measure
and in a state of equilibrium.’* This was called the
disease free state (arogata). But when they were in
imbalance and caused humoral factors concerned with the
healthy or the diseased condition of the body, this was the
fundamental doctrine tridhatu or tridhatu siddhanta of
Ayurveda. The treatise of Susruta , however, recognized
rakta (blood) along with other three humors and considered
the four doshas (maladies) instead of three determining the
origin, preservation, maintenance of three integrities and
dissolution of the body. Blood (rakta) was possibly given
equal importance the other humors by Sushruta since his main
field was surgery. Of the remaining humors vata was an

52
initiator and promoter of biological activity, incorporeal
and unstable. Pitta was responsible for the generation of
the body heat and certain psychological attributes of the
individual. The physical characters of the third member of
the dosha-trinitv. kapha. were heaviness, coolness,
softness, viscosity, stability, sweetness and sliminess.’*
These qualities were responsible for functions like keeping
structures together, contributing to body stability,
promoting the physique, providing strength as well as the
necessary resistance to disease and decay. It also provided
patience and fortitude. These two traditions, European and
Indian, created considerable difference in the application
and acceptance of diagnosis and treatment.
Malarial Knowledge in Ancient India
The existence of malaria as a distinct disease had been
well recognized by the ancient Indian scholars. They speak
of prevention as well as treatment. Ayurv ed a. one of the
parts of the Atharva V e d a , and the Charaka Samhita as well
as the Susruta Samhita all neatly describe different forms
of fever. Some of the earliest references to fever that we
find in the Atharva V e d a , composed as late as 1500 B.C.,
have close resemblance to malaria of today. It was
classified according to the paroxysm of the fever such as
quotidian (sadandim). tertian (tritivakam) and quartan
(vitrtiyam). It was also classified according to the
seasonal attack such as winter (s i t a m ) . summer (grai sm am )

53
and rainy season (v a rs ik a m). ’* Fevers of such nature were
common in the Northern India from Peshwar to Patna (Gandhara
to Magadha). Incidentally, Bengal was left out, because it
was beyond the sphere of Aryan influence.
Caraka and Susruta used the word iwara for the fever in
general. It was a generic name for the symptom, of whatever
diseases. Caraka of the second century A.D. identified
several types of iw a r a . some of which were close to malarial
fever. He compared the periodicity of fever with the seeds
sown in the ground as some take one day to grow, a case of
quotidian (anvedvreshaka). some three days in the case of
tertian (trtivaka). and some four days in case of quartan
(caturthaka). ’® When they matured they invaded the whole
body which caused the fever. The use of metaphors was
typical of the period.
The most well known ancient Indian medical document was
Susruta S a m h it a. which dealt in detail with many diseases
among which it gave a good picture of malarial fever. Fever
was diagnosed as the king of all bodily distempers.'*
Several types of fever and their symptoms were identified,
and finally, attributed to the bites of gnats. The santata
iwara (remittent or continuous) fever resided in the
vitiated rasa (serum) and blood of the organism, while it
was said that anyedvuh iwara was located in the contaminated
flesh of the body. Of all the i w a r as . the abatement of
vishama-iwara was always confounded with severe fever and
headache with little cure and remission.

54
Finally, Sushruta Samhita describes several types of
fevers which correspond very well with different types of
malarial fever. The type known as the tritivaka (tertian
fever) coming on every third day affects the meda (fat),
while the one called chaturthaka (quartan fever) coming on
every fourth day affects the bones and marrow. The fever
of anvedvushaka type thought to be located in bad flesh and
blood came on only once a d a y . ’’ The description of the
three types of fever could very well be compared with
quotidian, tertian and quartan types of malarial fever of
today. Susruta Samhita compared the advent of fever to the
ebb and flow of the ocean tides.
Both Susruta Samhita and Charaka stated that this kind
of fever was common in lowland or land at the foot of the
mountains. Besides these important references, Susruta
Samhita gave a direct reference to five species of
mosquitoes according to their natural habitation. Although
Susruta did not directly attribute fever to mosquitoes he
associated it to the bites of gnats of marshy lands.
Miasmatic and Germ Theorv in Europe
Over the centuries man has described and sought to
explain and to prevent infectious diseases. Supernatural
forces were gradually superseded in orthodox medicine by the
concept of an infectious substance which somehow produced
the signs of symptoms of disease in infected individuals.’*
It might have been the fourfold order of Paracelsus

55
(1493-1541), that helped the theory of miasma to become more
dominant during the early modern scientific e r a . ’* He
postulated that evil as well as good came from nature,
poison as well as remedies. Thus it was easy to believe
before knowledge of malarial parasites which lived in damp
swampy areas that people were made ill by breathing in the
odorous, poisonous miasmas and swampy airs.
Three major theories about the nature of the infectious
agent prevailed in the nineteenth century. The contagionist
theory held that infectious diseases were transmitted by
concrete substances which, according to the ancient doctrine
of contaqium animatum or v i v u m . were thought to be minute
organisms. A second view, the miasmatic theory, promoted by
the anti-contagionists, was that noxious gases or miasmata,
which arose from the ground or from decaying animal and
vegetable matter, had the capacity to produce disease in
individuals exposed to them. Thirdly, the zymotic theory of
infectious disease, alone indigenous to the nineteenth
century Europe, was based on an analogy between the
processes of infection and fermentation. It assigned to the
infectious material the properties of a ferment or chemical
"zyme" which acted upon the tissues to produce the specific
zymotic disease. The miasmatic and zymotic theories were
eventually replaced in the second half of the century by the
germ theory of disease which was a restatement of the
doctrine of contaqium vivum in terms of the activity of
pathogenic micro-organisms.
56
Thus for the greater part of the nineteenth century the
theoretical debates on the causes of disease continued
without resolution. The most prominent was the miasmatic
theory. Whenever encounters with malaria and other insect-
borne diseases were prominent the miasmatic theory
prevailed. During the nineteenth century a modified version
obtained, that poor sanitary conditions produced a local
atmosphere that caused diseases like malaria.
The rival germ theory of contagion had been clearly
advanced in the sixteenth century. This implied that
specific contagions were the sole causes of infections and
epidemic diseases. But early in the nineteenth century the
contagion theory was put on the defensive.** The third
position was adopted by those who tried to compromise the
miasmatic and contagionist theories and might be called
limited contagionism. This was the most widely held
theoretical position. Both miesmatist and contagionist made
use of unreliable information and biased observations as a
basis for reasoning. Moreover, neither group had any
knowledge of certain important links in the chain of
infection such as the human carrier and the insect host.
Thus the movement for sanitary reform that started in
England in the middle of the nineteenth century was based on
very imperfect knowledge of the actual causation of epidemic
disea s es .*'
The theoretical and experimental work which culminated
in the confirmation and the acceptance of the germ theory in

57
the 1870s and 1880s stemmed from two related areas of
scientific endeavor in the first half of the nineteenth
century, an investigation of infectious diseases and of
fermentation.
In 1835, Agasteno Barsi was the first to demonstrate
the causal relationship between a specific micro-organism
and a specific infectious disease. After the mid-nineteenth
century, new evidence for the implication of micro-organisms
in biological processes was presented in several areas of
scientific inquiry. One of the most important contributions
to the germ theory was Pasteur's work on fermentation in the
1850s and 1860s but it was not widely accepted until the end
of the nineteenth century.
The British Perception of Disease
The germ theory of disease was not accepted at that
time. Yet there was enough truth in the filth theory as a
whole that it worked under many circumstances. While the
Industrial Revolution was still to make a headway social
reformers like John Simon were speaking against filthy
residence, drinking water from ditches and unhealthy
situations in factories. Thus the filth theory came out from
a common sense approach to cleanliness and urban dwelling
problems. When the filth was cleared in England, the
incidence of typhoid and cholera was drastically reduced.
So it was rightly said that, "Indeed it is noteworthy that
the program of the sanitary reforms was based to large

58
extent on a structure of erroneous theories, and while they
hit upon right solutions, it was mostly for wrong
reasons." • *
The situation in India was greatly influenced by the
sanitary awakening in England. Historically, the fact that
played a prominent part in England in determining the
development of modern public health organization and
activity had been the rise of an industrial economy. Modern
public health systems of an industrial society took its
origin in England because it was the first modern industrial
country. As the new industrial system grew, more and more
workers were needed to man the factories. Labor had to be
brought to the factory wherever it was located and it was in
relation to the problems of the labor force that the
question of community organization for health protection was
to be raised and the means provided for dealing with it.
Jeremy Bentham and the group led by him known as philosophic
radicals proposed to deal with the public problems on a
rational and scientific basis. He did not in fact provide a
blueprint which was followed by all nineteenth century
administrators but he did supply ideas. Out of the
systematic study of social conditions led to the
consideration of public health. Edwin Chadwick, one of his
followers, was in charge of the Royal Commission on the
health of the towns. As a result he revealed the situation
which existed in the towns of England, and in 1848 Health of
Towns Act was passed. In 1858 an Act was passed for the
59
disposal of London sewage. The waves of public health
movement in England touched India also. In the following
year in 1859 a Royal Commission was set up to look into the
health problems of the British troops in India. They
contributed greatly to the development of social awakening
in their day, and on the basis of these studies called for a
whole series of reforms. Directly or indirectly, this small
group of people exercised a profound influence on their
contemporaries, and many of the far reaching changes in
English government as well as in economic and social
legislation in the latter part of the nineteenth century
were reforms of the kind for which they argued and fought.
Generally speaking, in England the impulse for sanitary
reforms thus did not come from the medical profession.
Furthermore, medicine still was bound by old traditions and
had little knowledge to contribute toward a solution of the
major problem which concerned the transmission of diseases.
The sanitary reforms were introduced into India not by
the Indians but by the British administrators who regarded
the safety of their health first over that of the Indians.
The sanitary reform movement of England swept India and
British perception of causes of disease was imposed on India
without looking into the indigenous health planning system.
This was particularly true after the first quarter of the
nineteenth century. But before that time there was little
evidence that western medicine was thought better than the
local system. Although the East India Company employed

60
British surgeons from the seventeenth century, the Company's
servants often used the help of Indian physicians, even when
the British medical help was available to them.** But the
table started to turn from 1822 when European medical
education began in Calcutta in that year. By 1835, when the
Calcutta Medical College was established, the western
medical system and health planning started to dominate the
whole scene.** "The Indian Medical Service had reached the
strength it was to retain until the 1920s, and they
dominated new developments."** The indigenous system of
medical education was abolished from the newly founded
medical colleges and instead western courses were
introduced, and instruction was conducted in English in all
these institutions. Likewise, with the Royal Commission
Reports of 1863, the sanitary policy was invigorated. The
sanitary system was controlled in line with British model
and the services were meant first for British nationals
especially British soldiers and then for the Indians. As a
secondary consideration the health of the Indians was
considered because it was impossible to build a water-tight
compartment against infectious diseases for the privileged
few without taking any measures to keep the surrounding
environment free of diseases.
Application of the Miasmatic Conception in Bengal
In the train of Western ideas of causation of diseases,
the influence of the atmospheric-miasmatic theory of Britain

61
was to last long in Bengal. This concept was destined to
play an important part in the development of public health
policy in the nineteenth century Bengal. The Sanitary
Reports of the 1860s and 1870s and the reports of the civil
surgeons of the districts of Bengal and the subsequent Fever
Commission Reports were influenced by this theory. The
generalized view was that epidemic fevers were due to
miasmas arising out of organic matter. While this idea was
absolutely erroneous, it provided a basis for action in the
public health policy and administration.
A survey of the fever epidemic reports and sanitary
reports gives a picture of the policy pursued in Bengal.
The epidemic of Nadia, Barasat, Hooghly and Burdwan for the
first time attracted the attention of the government in
1861. This epidemic was investigated by Dr. J. Elliot in
1863 and he was very much impressed by the miasmatic theory.
He thought the disease prevalent in stagnant rivers filled
with vegetation, which was a source of poisonous emanations.
He remarked: "In addition to the usual sources of malaria,
effluvia and emanations from decomposing animal remains have
been added, which must have tended to establish disease of a
malignant type in localities already foul and bad."*' His
views conformed to the prevailing notion about the causes of
diseases and the term malaria was used in its literal sense.
The first Sanitary Commission Report of 1864-65 carried
the same miasmatic conception of diseases and also added to
it the contagion theory. The report maintained that the

62
main causes of the fatal fever which had prevailed in the
Burdwan division were miasma, polluted drinking water and to
some extent contagion. It found that the conditions most
favorable for the propagation of the fever were the filthy
situations in which the people live. Although the Sanitary
Commission for Bengal in the following year (1865) asserted
that the disease had its origin in a certain specific poison
propagated from man to man, the general mode of thinking
revolved around the filth theory of disease. So the report
summarized it in the following words:
Whatever may be the origin of the disease, or the

manner in which it spreads, we may conclude with
certainty that it finds the best possible conditions
for its propagation in the horrible and almost
incredible filth in the midst of which the people live.
We have described elsewhere the state of Calcutta, the
capital city of these same Bengalees, and have declared
that no parallel to its filthiness can be found in any
other part of India with which we have any
acquaintance.*•
The unsanitary condition of Calcutta was perhaps due to
its unplanned growth rather than to the habits of the
people. The remark showed his frustration and failure to
keep the city in a good shape. The first British-built
capital of India became proverbial for its shabbiness and
unhealthy condition. The investigations of different health
officers into the outbreak of Burdwan fever originated many
theories but the most common were the miasmatic and filth
theories.
Succeeding commissions of enquiry recorded their
opinion about the main causes of the fatal fever of Bengal
in the same terms. Generally, they linked fever to miasma.

63
polluted drinking water and air, deficient ventilation, and
to a certain degree to contagion. Later, the commissions
conceived that the disease had its origin in specific
poisons without describing what it could be. The
accumulation of miasma or poison or, for that matter, any
other harmful substances was thought to be generated due to
unsanitary conditions in Bengal cities and villages.**
The fact of the matter was that for ages harmful
materials such as night soil and garbage had been allowed to
remain in and about the houses and compounds of the cities.
The water in the wells was horribly polluted because of
filth finding in way into the wells, and the river waters
were also fouled by the excreta and dirt cast along the
banks of the rivers. The villages were covered by fetid
swamps, foul tanks, stinking drains and uncontrolled hedges
and jungles. In short, no one could deny that the air which
people breathed in the cities and some villages was not
pure, the water which they drank was dangerously polluted
and the soil on which they resided was damp and undrained.
The decomposed materials piled up for generations creating
horrible health hazards. This was a common situation in
most of the cities in Bengal.
Even the Eastern districts which were healthier than
the Western ones were undergoing the same type of problems.
A typical example of such a complaint could be found in the
statement of the civil surgeon of Dhaka district. The civil
surgeon said:
64
...I am of opinion that the city and district of Dacca

are deteriorating in healthiness. I think there can be
no doubt of this. As regards the city no scavenging
can be said to be carried on. The night soil lies
where it falls, and is washed into the river by
periodic rains. As no steps are taken to remove the
filth from the city, it is year by year accumulating in
the midst of the people, and poisoning the atmosphere
on all s i d e s . ’•
There were some other causes cited for atmospheric
poison and water pollution. It was thought to be due to the
cremation rites of both Hindus and Muslims. For the Hindus,
because of the high price of fire wood, corpses were only
partially burned and then thrown into the nearest bheel or
river.
The bodies of the poorer classes are treated in a still

more disgusting manner? the lips of the dead person are
touched with a burning piece of wood, the body is then
sunk in a river or other water-course by means of
water-jars, tied round the neck, a bamboo stake is
driven through the belly into the bed of the stream;
where the banks are high, the place selected is some
ghat at which the people bathe and procure drinking
water.*!
For the Muslims burial was no better. The banks of the
tanks were a favorite resting place and in most other cases
the dead were buried within a few feet of dwelling houses,
among the most densely inhabited quarters. The desire of
the deceased of being put to rest where their ancestors were
buried before them was a paramount passion. Because of
periodic inundations, the graves could not be dug deep.
These practices created health hazards. Such unsanitary
burial or burning of the dead was cited in substantiation of
the miasma or poison theory by the sanitarians in Bengal for
the spread of malarial fever. Among other diseases, the

65
presence of fevers "characteristically mark their terrible
influence on the pot-bellied, spindle-shanked, feeble, and
pallid creatures who survive its ravages,"** remarked the
Sanitary Commissioner, indicating the prominent features of
malarial fever. All the diseases were thought to be
propagated due to a single cause, miasma or atmospheric
poison.
In the 1870s, the prevalence of fever in the Burdwan
and Nadia districts raised several questions as to the
nature of the disease. Among others, it was suggested that
it was a disease of an intermittent or remittent type and
was generally thought to be caused by the emanations from
marshy soils and was termed marsh effluvium. The civil
surgeon of Burdwan saw the epidemic fever of Burdwan related
to the "malarious atmospheric wave and poisoning every
village through which it passed."** The civil surgeon of
Birbhum writing in 1872 thought fever of malarious origin,
whose poison had a great effect on the nervous system. The
civil surgeon of Midnapore said, "The fever is said to be
due to the action of poison called malaria for want of a
better n a m e . " ’* Dr. Jackson contended on the other hand
that a fever originally malarious acquired either in Jessore
or Nadia contagious properties and that in virtue of this
contagion, the disease spread over to the western part of
Nadia and later Khulna.** But the sanitary Commissioner for
Bengal, Surgeon Major J.M. Coates, refuted the idea of
contagion or infections in the fever.** Various causes were

66
assigned for the origin and spread of Burdwan fever and one
that was foremost in the minds of the sanitarian and civil
surgeons was the miasma.
There was a nineteenth century revival of these
speculations from classical antiquity that culminated in the
theory of miasma. As late as 1886, G.M. Sternberg, who
appeared to have been an authority on malaria, rejected the
theory that the disease was caused by living micro
organisms.*' The total disagreement among scientists about
the nature and cause of the disease showed the limitation in
scientific experiments and investigations in Bengal.
The futile nature of investigations and the spread of
malaria had gone to such an extent that the British
authorities began to question their own judgment. One of
them. Dr. Sutherland, remarked:
The Natives, with some justice, I think, complain, that

we have assigned too much importance to jungle, rank,
vegetation in tanks, and local impurities in the towns
and villages; they have been dismayed by our cutting
down more of their trees than they liked, and by our
harassing them by sanitary measures which they do not
see produce any salutary result. It is evident to them
that the cause of the endemic lies deeper, and in this
opinion they are probably right. If the disease we had
to combat was cholera or typhus, no doubt the sanitary
measures referred to would have had the best result,
but the fever is the effect of a marsh poison, and to
remedy this we must carefully attend to the conditions
under which it is produced.**
His assessment of the situation was correct but his
prescription followed the age-old myth. There was it seemed
a whole range of opinion arose as to the cause of malarial
fever but all of them centered around the same solution. On
the whole, the conception of health and the cause of disease

67
was envisioned by the Europeans and put into practice on the
Indian environment without much scientific support. Old
theories were renewed to obtain some central principle of
action without tangible results. This had very much
hindered the improvement of health of the people when the
question of epidemic disease like malaria had to be dealt
with. The static situation of public health programs raised
doubts of the efficacy of health planning by the Europeans
in India. The most stringent comment came from none other
than Florence Nightingale. She said:
Are not the theories we have had, too, not of Indian

produce, but of European manufacture?
And have they in reality anything whatever to do with

public health problems?
The questions to be dealt with are either questions of

fact or they are nothing. No speculative matter should
ever peep out of or creep into public health reports
intended to lead to practical action.'*
By raising these questions, Florence Nightingale showed
her keen sense of understanding of the Indian public health
problem, although she herself was moved by the filth theory
as was practiced at that time in England. In fact
Nightingale was asked by the British government to give her
suggestions for Sanitary Improvements of British India in
the light of the recommendations made by the Royal
Commission in 1863. She made some searching commments about
the degeneration of the public health system in India
although she believed that "the people of India were more
civilized and more cleanly than almost any nations of
Europe."!'"She was pointing to the fact that sanitary

68
problems must be carried out by the people themselves
without the intervention of the government.
Although the change in the attitude towards bio-medical
research had taken shape inEurope in the middle of the
nineteenth century, it did bring about the desired change
in England but not in India. In a series of experiments
conducted in the late 1850s and 1860s, Louis Pasteur of
France demonstrated the microbial growth and he found in the
1860s and 1870s that specific microbes were responsible for
infectious diseases. Joseph Lister began to apply Pasteur's
ideas on microbial infection to the problem of putrefaction
in surgical instruments. The publication in 1876 of Koch's
research on anthrax provided crucial evidence in support of
the germ theory of disease.At the same time, Pasteur
further lent weight to the bacterial theory of disease.
Finally, in 1880 a French physician, Alphonse Laveran
identified the malarial parasite in Algeria. These events
ushered in an era of great productivity in medical science
but they hardly touched Indian soil.
Even after the discoveries of Pasteur and Laveran, the
Sanitary Commissioner of Bengal, F.W.A. De Fabeck, continued
to believe in the old theory. He expressed his views in
1882 in the following words;
Again if the malarial agency has its origin, as there

seems every reason to conclude it has, in a humid
nidus, the deduction is inevitable that it must exist
in some form, and that probably its most active one, in
the water not only of districts notorious for air-borne
malarial fevers, but also in others where, atmospheric
agency having apparently no mephitic activity, we have
the far more serious water-borne, or what are sometimes
69
called, aquamalarial fevers. In either case, the most

careful attention to the drinking supply is manifestly
indicated.‘•*
Examples of this nature could be profusely cited as to
the non-acceptance of the germ theory by the sanitarians or
administrators of India or Bengal. It is probable that in
India experiments done by Laveran were not known to British
Indian scientists till 1888. For that matter, India and the
world had to wait a few more years until the discovery of
the malarial cycle of parasite in man and mosquito by a
British Indian surgeon, Ronald Ross. Since then, Kuhn's
method was applied in research on various parasitic
diseases. Kuhn explained the way in which scientific
theories were accepted and articulated by the scientific
community.!'* Before that time, British officials in Bengal
merely relying on the various manifestations of the filth
theory of diseases, preached that cleanliness is next to
godliness. It was due to the existence of a dichotomy
between medical theory and sanitary practice*''that the
public health system lagged behind, and the remedy against
malarial fever suffered.

70
Notes to Chapter III
‘'George Sarton, A History of Science (New York, 1952),

pp. 177-78, 332 and 386.
‘‘Henry E. Sigerist, Civilization and Disease (New

York, 1943), p. 149.
‘’William H.S. Jones, Malaria and Greek History

(Manchester, 1909), pp. 23-81.
‘•W.H.S. Jones (with an English Translation),

Hippocrates (Cambridge, Harvard University Press, 1939),
Vol. I, pp. 83-85.
“ Mark F. Boyd, "Historical Review," Malari ol oo v .

M.F. Boyd, ed. (Philadelphia, 1949), Vol. I, pp. 11-12.
’"Henry E. Sigerist, Man and Medicine (New York, 1943),

p. 126.
’ipriyadaranjan Ray, H. Gupta and M. Roy, Susruta

Samhita (Calcutta, 1980), pp. 9-10.
’*A. Lakshmipathi, Ayurvedic School of Medicine. Theory

and Practice (New Indian Institute of Culture, Bangalore,
India, 1952), p. 2-5. Kaveraj Kunjalal Bhishagratna (Ed./
Tr.), The Sushruta S a m hi ta . Vol. I (Varanasi, India, 1963),
pp. li-liii.
’'Priyadaranjan Ray, H. Gupta and H. Roy, Susruta

(Calcutta, 1980), pp. 12-14.
’‘Ralph T.H. Griffith (ed./tr.); The Hymns of the

A tharvaveda. Vol. I, Chowkhamba Sanskrit Studies, Vol. LXVI
(Varanasi, India, 1968), pp. 30-31.
’"Priyavrat Sharma (ed./tr.): Caraka-Samhita. Vol I,

Ayurveda Series, No. 36 (Varanasi, Delhi, 1981), pp. 251-57.
’‘Bhishagratna, Kaviraja (ed./tr.): Sushruta S a m hi ta .

Vol. Ill, Second ed. (Varanasi, India, 1963), pp. 169-70.
’’Ibid, pp. 178-179.
’*W. Bulloch, The History of Bacteriology (London,

I960), pp. 3-13. The author has a good survey of ancient
theories of the nature and causes of infectious disease.
’’George Rosen, A History of Public Health (New York,

1958), p. 288.
••W.H. McNeill, Plaques and Peoples (New York, 1976),

p. 235.
71
**C.E.A. Winslow, The Conquest of Epidemic Diseases

(Wisconsin, 1943), p. 1.
•*G. Rosen, OP c i t .. p. 225.
“ George Rosen, pp. c i t .. p. 199.
* ‘D.G. Crawford, History of the Indian Medical Science.

1600-1913 (London, 1914), p. 64.
* *Ib i d ., pp. 64-66. See also C. Leslie,

"Professionalising Ideology of Medical Revivalism,"
M. Singer (ed.). Entrepreneurship and Modernization of
Occupational Cultures in South Asia (Durham, 1973);
P. Hehir, The Medical Profession in India (London, 1923).
“ Roger Jeffery, "Recognizing India's Doctors: The

Institutionalization of Medical Dependency, 1918-39," Modern
Asian S t u d i e s . 13, 2 (Cambridge University Press, Britain,
1979), p. 303.
*’J. Elliot (Dr.), Report on the Epidemic Remittent and

Intermittent Fever Occurring in Parts of Burdwan and Nadia
Divisions (Calcutta, 1863), p. 16.
“ First Annual Report of the Sanitary Commissioner for

Bengal (Calcutta. 1865). p. 59.
“ Memorandum on: Measures adopted for Sanitary

Improvements in India u p to1 the end of 1867. Together with
Abstracts from Sanitary Reports hitherto forwarded from
Bengal. Madras, and Bombay (L o n d o n , 1868), p. 40.
“ Report from Sanitary Commissioner for Bengal. 1868

(Calcutta, 1869), p. 98.
“ Ibi d. . p. 101.
“ Ib i d.. p. 123.
“ Ib id .. p. 230.
* *Annual Report of the Sanitary Commission for Bengal

for 1872 (Calcutta, 1879), pp. 58-60.
* * Ibid.. p. vii.
*‘Report on the Burdwan Fever by Dr. David Wilkie.

Surgeon Medical Service on Special Dutv in Burdwan (Burdwan,
28th Feb., 1875), p. xii.
“ Mark F . Boyd, "Historical Review," in Malarioloov

(Philadelphia, 1949), pp. 12-13.
72
’"Report on Measures Adopted for Sanitary Improvements

in India, from June 1869 and June 1870: together with
Abstracts of Sanitary Reports for 1868. forwarded from
Bengal. Madras and Bombay (London, 1870), p. 273.
*"Florence Nightingale, "Sanitary Improvement of

British India," from Report on Measures Adopted for Sanitary
Improvements in India (London, 1870), p. 42.
!""Ibid. p. 41.
!"‘Margaret Felling, Cholera. Fever and English

Medicine; 1825-1865 (Oxford University Press, 1978),
p. 295.
!"‘Fifteenth Annual Report of the Sanitary Commissioner

for Bengal for the Year 1882 (Calcutta, 1883), p. 39.
!"*T.S. Kuhn, The Structure of Scientific Revolutions

(London, Chicago: 1968). His concept of the way in which
scientific theories were accepted and articulated by the
scientific community was expressed in this book.
!"‘Margaret F e l l i n g , op. c i t .. pp. 295-296.

CHAPTER IV
INVESTIGATIONS OF MALARIA AND ITS TREATMENT
Though the knowledge of malaria, "the king of
diseases", as the ancient physicians called it, is as old as
antiquity, the scientific investigation and treatment of
this debilitating disease is quite recent. Only in the
beginning of the twentieth century has considerable progress
been made in the causes and treatment of malaria. To
understand Bengal malaria we need to focus on these
developments and the contribution of Ronald Ross, the Indian
born British scientist, in identifying malaria
parasites. Some elucidation of malaria etiology and
treatment will be useful in analyzing the effects of the
disease.
Etiology of Malaria
Malaria is one of the most widely distributed diseases
cf the present time, evidences suggest that its roots going
back to the antiquity of human existence. But the term
malaria was not in use until the middle of the eighteenth
century.!®* The term malaria in its literal meaning has no
scientific validity but it has acquired its place in almost
all the languages of the world, and also used in scientific
73
74
usage. The word malaria, which is derived from the Italian
word for bad a i r , ! ® ‘is not directly related to the cause of
infection; it is the term commonly used since the
scientifically more appropriate term — plasmodiosis — has
never come into wide use.*®’ In short, malaria is the
accepted name denoting the disease or condition of infection
in man, caused by parasites belonging to the genus
P la sm o d i u m . There are about a hundred species of Plasmodia
of which at least twenty different species of Plasmodia
reside in monkeys and higher apes, and others live in birds
and reptiles.
Human malaria is probably as old as mankind and until
very recent times outbreaks of the disease influenced the
course of history. The earliest indications of human
disease suggestive of malaria come from ancient Egypt and
are found in a papyrus after 7th century B.C., which
describes measures to be taken against the entry of disease
laden, fever-provoking vapors into houses. The Papyrus
Ebers, 1550 B.C., refers to the association of fever and
splenomegaly.!®* Inscriptions on the walls of the temple of
Dendera in Upper Egypt contain the word AAT, denoting an
intermittent fever which recurred annually at the same
season and was associated with the Nile River floods.!®*
The first accurate clinical descriptions of malarial
fevers are given by Hippocrates in 400 B.C. He mentions the
classic symptoms of chills, fever, and sweating and analyzes
the characteristic periodicity of various forms of malaria

75
and its topographic aspects“ ®. He possibly recognized the
infections caused by Plasmodium falciparum as the most
dangerous of fevers.
Western medicine adhered to his treatment of malarial
diseases, until the advent of cinchona bark. Malarial
fevers are quite well known in ancient China and India. The
Indian literature of Ayurveda, Caraka Samhita and Susruta
Samhita, gave masterful details of different types of
malaria.
Treatment of Malaria in the Past
Just like most other diseases, the treatment of malaria
in pre-historic periods mainly consisted of methods aimed at
driving away spirits presumed to be causing the disease.
The measures mainly consisted of exhortation and penance,
magic and protective amulets, and attempts to please the
gods to drive away devils of disease by magic, sacrifice and
prayer. In the civilized societies as in China, India or
Egypt, some types of medicine were found to treat the
disease.
Certain herbs and the bark of trees, collected under
specified conditions, were also used at a prehistoric
period. The earliest known textbook of medicine, the Great
Herbal of the Chinese Emperor Shen Lung, which dated from
3000 B.C., mentions a remedy for fever. The Chinese used
the root of chanq shan and leaves of shun chi for
intermittent f e v e r s . I t is noteworthy that some alkaloids

76
have been recently isolated from these plants which proved
to have anti-malarial properties.
Hippocrates believed more in the rational treatment
than magic. He advised rest, massage, hydrotherapy, control
of diet and change of residence for the treatment of
malaria. He also prescribed purgatives asafoetida and vine
with controlled diet during paroxisms of fever.***
Galen, the famous physician, presented drugs to promote
vomiting, copious urine and excretion of bile, and also
advocated hot baths, controlled diet and in certain cases
bleeding. During his time, certain curious remedies also
came into vogue like the "spider treatment," in which
spiders were taken as medicine in various forms or used as a
charm or amulet.!!’
In India, some of the medicines used by the Ayurvedic
practitioners were close to that of Roman treatment.
Basavarajuyam prescribed bugs for the treatment of malaria.
He said, "that 5, 7 and 9 live bugs taken with betel leaf on
three successive days will cure intermittent fever
accompanied by chill. In the Andhra country, this was
used as a secret remedy by many Ayurvedic physicians.
Prescriptions of similar nature could be found in ancient
Indian writings. For disease of the blood with enlarged
glands Vaqbhat recommended pigeon droppings with honey. It
is also said that spider's web taken as pellets was a very
popular remedy for malaria. The popular folk medicine for it
in Eastern Bengal was a mixture of paste of hot chill and

77
dried fish, which is known as v a r t a . There is plant by the
name t u l s i , used by the people which was "known to act as a
defense against mosquitoes and as a prophylactic to
m a la ri a. " ! ! “There are other species of plants such as
p a r n a s a . which helped to control mosquitoes.
Charms had a role to play in relieving the sufferer of
malaria. One English gentleman in India told a story of how
he was cured by a charm, which he related in the following
words :
In my first fever a native was so anxious to charm it

away that I allowed him to stroke my legs with the
branch of a sacred tree. The fever soon disappeared,
and I had probably confirmed the man in his belief in
cha rm s.“ '
Before the advent of cinchona and even after its
introduction, severe purging followed by massive doses of
calomel was more or less the standard treatment of malaria.
After that, cinchona bark or its alkaloids, mainly quinine,
was the only specific remedy in use for malaria.It was
extremely popular with European physicians in Bengal.
Quinine was used with castor oil and magnesium sulphate. In
one instance, it was found that castor oil and quinine
mixture brought signs of insanity to a patient. Other
than quinine, arsenic and its preparations were used in the
treatment of malaria for many years in Bengal. Fowler's
Solution, a popular patent medicine originally used for
insanity was an arsenical solution.*“'This potassium
arsenite solution is quite harmful for the patient.
The discovery of Stovarsol, a preparation which

78
contained about 27 percent of arsenic, was thought to have
opened a new phase of treatment of benign tertian malaria.
It was said that "these substances act indirectly by their
tonic action on the body rather than by any marked direct
parasitical effect on the Plasmodium of the disease."***
Robert Markham first introduced the cinchona tree in
British India in 1861.*** But quinine as an extract from the
cinchona tree was in use in India before that time. Quinine
was a regular drug for malaria. In general quinine,
cinchona, arsenic and chiretta were the drugs most used as
antidotes in India. Chiretta is a bitter herbal medicine
used for any type of fever in Bengal. Quinine was useful,
though in many cases with some side effects. It said that
it caused deafness and possibly other injuries to the
p a t i e n t s . ***
Quinine Distribution and Controversy
In Bengal quinine distribution through post offices and
offices of the Vaccination Department in pice-packets of
five grains was commenced in 1892 and has been steadily
pushed since. In 1903, the quantity contained in a packet
was raised to seven grains and in 1906 the village schools
were utilized as distributing centers. The object in view
was is to bring every village within five miles of some
source of supply. There was frequent evidence of a
prejudice existing among people against its use, to which
Capt. Stewart and Lt. Proctor refer.***

79
Quinine became a controversial medicine among the
Indian kabirai and homeopath practitioners and they started
to oppose its indiscriminate use. In a leading article in
the Amrita Bazar Patrika the editor challenged Major A. B.
Fry's contention that quinine was good for people. The
article read like this;
Then, is it a fact that quinine is always an

effective curative agency? Apparently Major Fry is not
aware or has not thought proper to disclose the fact
that the Italian Malaria Commission have in their late
report mercilessly pricked the quinine bubble. Most of
the medical authorities examined by them have not only
roundly questioned its efficacy, but have declared that
they have given up quinine treatment in view of renal
and other troubles supervening in consequence thereof.
In this country also even laymen know, as a matter of
common experience, that repeated administration or
rather mal-administration of quinine often brings about
troublesome sequelae which more than counterbalance
any so-called benefits to be derived from the drug and
which make most patients prefer the disease itself to
the unpleasant effects of the so called cure.***
In another article in the Hindoo Patriot one reader
opposed the views of Dr. Fry who favored maximum use of
quinine for malaria. Dr. Fry was the Special Deputy
Sanitary Commissioner for Malarial Research in Bengal in
1912-1914. The reader made his arguments as follows:
They [the people] were not opposed to quinine or any

other drugs in the allopathic pharmacopoeia. For
years, this confidence was kept up, but the advance of
malarious fevers and indiscriminate big doses of
quinine in season and out of season had shaken their
faith in allopathic medication. They saw clearly that
quinine was not only useless, but harmful in many
instances. The observation of the people is quite
clear on this point. They perceive that those who take
quinine suffer the most. It must be said that quinine
has a charm, but that is transitory. It has the power
of suppressing the paroxysms of fever, but real cure is
not effected. The after effects of quinine are worse
than the disease itself, and relapses are more frequent
in quinine cases than in others, so that public
80
confidence in quinine has been shaken at its roots and

the people either take to homeopathy or to kabiraii
system of treatment.***
He then quoted from a German scientist, one Professor
Koch, about the evil effects of quinine, such as anemia,
enlargement of the liver and the spleen, dropsical swelling
and symptoms of incipient consumption.
In reply to this letter. Dr. Fry maintained that the
writer of the letter made some skillful omissions from the
text of Koch to prove his case. Dr. Fry then commented:
The omission in this case hides the fact that Koch is

arguing in favour of a continuous use of quinine in the
treatment of a case of malaria and is describing the
results of treating a malaria case only during the
paroxysms and by a few large doses, which all agree is
wrong pr a c t i c e .* *‘
The articles in the Amrita Bazar Patrika and the Hindoo
Patriot were only a few of many written in some Indian
newspapers to show the harmfulness of quinine. The Bengal
sanitary authority was aware of the fact that such articles
in the newspapers would damage popular use of quinine.
Whatever might be the assertion of the government about so
many advantages of quinine, the people became quite
apprehensive about it. In fact quinine had definite side
effects such as giving the skin a yellow taint, creating
nausea, vomiting, deafness and even abortion for women, but
they used it in large quantities year after year because
there were no other alternatives.
Malaria. Mosquitoes and Man
The chemotherapy of malaria had to wait a long period

81
of time before it was established and accepted. Before that
the primitive people found an intimate connection between
man, mosquitoes and malaria. It is presumed that the
disease has its origin in Africa, which is said to be the
cradle of human evolution. Some malariologists believe that
the mosquitoes carried the infection of malaria from Africa
to other parts of the world.
There are more than 300 species and subspecies of
mosquitoes; at least three-fourths of the species live in
the tropics or subtropics. The Anopheles mosquito has made
malaria one of the greatest killers the world has ever
known, bringing death to hundreds of millio ns . ** ’ Most of
the 370 or so species of anopheline mosquitoes have the
potential of transmitting malaria, but probably fewer than
eighty-five are major vectors of human malaria. It was
sarcastically stated by Andrew Buchanan that "there was no
sudden jumping to the conclusion that mosquitoes carried
malaria, and that they had a fair trial before they were
pronounced guilty."***
Malaria Parasite
The microorganisms causing malaria are commonly
referred to as malarial parasites. This term is usually
restricted to the family of Plasmodia. There are nearly 100
species of Plasmodia. The zoological classification of
plasmodia is complex and even today there is considerable
"difference of opinion with regard to taxonomic position of

82
the parasite causing falciparum malaria."*** There are four
generally recognized species of malaria parasites of man.
The name and date of discovery are as follows;
RECOGNIZED SPECIES OF MALARIA PARASITE

Name of Parasite Discoverer and Date
P. malariae Laveran, 1881
P. vivax Grassi and Feletti, 1890
P. falciparum Welch, 1897
P. ovale Stephens, 1922
Infections caused by the various human species of
plasmodia have been given a number of colloquial names,**"
such as benign tertian, quartan, malignant tertian and ovale
tertian. But these names have become obsolete.
Some authors refer to the mosquito as the definitive
host while man and animals are regarded as intermediate
hosts of the malaria parasite. This nomenclature may be
zoologically correct since the sexual development of
plasmodia is the more important function in the spread of
the species.
Of all the species of human plasmodia, P. falciparum is
the most highly pathogenic, as is indicated by the name
m a l i g n a n t , often applied to the type of malaria associated
with it. It is the chief infection in areas of endemic
malaria in Africa and is also responsible for the great
regional epidemics in South Asia and Sri Lanka. Infections
due to two or more species of malaria parasites are not

83
uncommon. In endemic malaria areas mixed infections are
particularly frequent; there is a tendency for one species
of the parasite to predominate at the expense of the other.
Where mixed infections were noticed, the P. falciparum is
generally a common factor.
A definite diagnosis of malaria infection is
established on finding of parasites in the blood. But
malaria in general is confused with any other fever. Even
more difficult are the initial stages of fever in many virus
diseases before the rash and other symptoms appear. The
diagnosis of malaria is always a matter of clinical
analysis. The only certain means of diagnosing an infection
is the detection of the plasmodium by microscopic
examination of the blood. It is stated that "the presence
of malaria parasites in the blood is a sign of infection but
not necessarily a cause of the disease."*** That is because
persons who have resided for many years in malarious areas
may have become immune to malaria. Parasites may reside in
the blood but without any symptoms of the disease.
Cycle of the Malaria Parasite
Let us look into the life cycle of the malaria parasite
and see how it works. The malarial parasite is a small
unicellular protozoon of the genus Plasmodium. A specialized
form of the parasite known as sporozoites is injected into
the blood stream by an anopheline mosquito. It migrates to
the liver and there develops and divides to produce

84
merozoites, the form that infects red cells. The merozoites
reenter the blood stream and bind to the red cell membrane.
A mechanism is activated that causes the merozoite to rush
in the cell membrane, which closes around it. Enclosed in a
vacuole, the parasite grows, digesting hemoglobin to acquire
the amino acids to make its own proteins. There they
multiply as the parasite's nucleus divides several times
until the cell bursts, causing the physical signs of the
malaria di se a s e . * ’* If the victim is again bitten at this
stage, the gametocytes can enter the mosquito and develop
into porozoites, allowing the cycle to be repeated. (See
Figure 1).
When one is struck by malaria, the fever recurs in
several characteristic patterns. The characteristic
periodic fever of malaria results from the synchronous
release of merozoites, and of toxins produced by the
parasite throughout the body. In the case of P. f alciparum,
this release takes place every 48 hours, the period of the
parasites' developmental cycle in the red cell. The fever
and the debilitation that accompany it are major symptoms of
malaria. However, in P. falciparum, there is a more lethal
effect. The infected cell develops knobs on its surface, in
the capillaries where it stays until the parasite is mature.
When a large number of cells are concentrated in a vital
organ such as brain, death may resu l t. *”
There are two phases in the development of malaria
parasite, an asexual cycle in man and a sexual cycle in the

85
Figure 1.
LIFE CYCLE OF THE MALARIA PARASITE
86
a
87
mosquito. Malaria cannot be transmitted from man to man by
the mosquito until the parasite has undergone a cycle of
development in it, which takes about two weeks. Similarly,
the parasite cannot survive in the mosquito unless it has
arrived at a particular stage in its development, the
formation of mature male and female forms before the insect
takes its blood meal. This is reached in a primary attack
of malaria, about ten days after the first appearance of
fever symptoms, and about three weeks after the patient has
received his first infective bite.
Discovery of Alphonse Laveran and Others
The scientific investigation of malaria and its cause
did not start until the middle of the nineteenth century.
Some scientists noticed peculiar grains of pigment in the
blood and organs of persons suffering from malaria, although
they did not recognize that these were living organisms.
The first person to give a detailed description of the
malarial parasite was Laveran, a French army surgeon who was
working in a military hospital at Constantine, Algeria.
The discovery of Alphonse Laveran, in November 1880, of
the parasitic agent of malaria was one of the milestones in
the history of medicine. It fitted neatly into P a s t e u r ’s and
Koch's concept of the microbial causation of disease and
destroyed the still lingering belief in the role of some
obscure miasmatic factors.*” L a v e r a n ’s magnificent proof of
the plasmodial origin of the infection was honored in 1980,

88
the centenary of this great event. In the discovery of the
malaria parasite, one must not forget the contributions of
other scientists whose observation or intuition paved the
way for further developments. One should mention the
Italian physician, Grovanni Rasori, who wrote in 1846 that
"intermittent fevers are produced by parasites which renew
the paroxysm by the art of this reproduction."*” In 1847,
Heinrich Heckel von Helmsbach described some pigmented
granules found among the blood corpuscles; Virchow's
drawings of these bodies were published in 1858. A number
of Russian workers and particularly Afanasiev described
during the next twenty years similar findings in patients
who died of "pernicious intermittent fevers" and came very
close to guessing the true nature of the pigmented bodies in
the capillaries of the central nervous system. But the
priority of stating clearly that the bodies seen inside the
red blood cells are "elements parasitaires" belonged
positively to Lave ra n. *” He was awarded the Nobel Prize in
physiology of medicine in 1907.
And yet it took some time for Laveran's discovery to be
fully accepted, as the belief persisted in some circles that
the "bacillus" of m a l a r i a * ’’was the true agent of infection.
The discovery of Laveran was not even known to the Indian
medical circles. Ross acknowledged that he did not hear of
the discovery until 1888. Further progress of new knowledge
advanced rapidly because of Danilewski's major work on the
plasmodia of birds, Mitchnikov's recognition of the human

89
and animal parasites, Romanowsky's introduction of a new
method of staining of malaria parasites in blood films and
finally MacCallum's observation and explanation of the
formation of microgametes. Rarely in the history of
biological science has so much been achieved in the short
period of two decades.
The fact that nearly every discovery rests upon formal
observations or notions is even more strikingly true with
regard to the mosquito-malaria concept. Many controversies
disputed the role of Mason and Ross in this respect,
claiming that the credit for it should be shared with
others.
Finally in 1892, some five years before Ross, Pfeiffer
influenced by Koch, suggested that Laveran's hypothesis of
blood-sucking insects transmitted the disease had found a
good basis. But once again, the hypothesis lacked
scientific proof, and the ultimate solution of the mechanism
of malaria transmission was due to Ronald Ross.
Ronald Ross and His Achievement
Great honor in the field of malaria research attended
the work of an Indian Medical Service man, Ronald Ross. It
would not be out of place to give a life sketch of Ross to
show how a person devoid of special interest in the field
and with a frustrating service condition in a colonial
situation in India could achieve great results in scientific
investigations.
90
Ronald Ross was of English and Scotch parentage and his
father was a well-known soldier. General Sir Campbell Ross.
Ronald Ross was the eldest of a family of ten. He was born
in Almora, India, in the fateful month of May 1857. As a
boy, his desires were to become an artist or a soldier but
his father insisted on his becoming a doctor with a view to
putting him into the Indian Medical Service. Here at least
was one case in which a career which was forced on an
unwilling victim was justified by its results. It is said
that Ross retained a subconscious resentment against his
father, for he never took kindly to the service and got out
of it at the earliest possible moment.
During his student days, his interests were more in
music and poetry than in medicine, and he took a low place
in the entrance examinations for the I.M.S. in 1881, one
year after the important discovery of Laveran of the malaria
parasite in human blood. During the first few years of his
service, Ross engaged enthusiastically in the pursuits of
poetry, mathematics, music, and fiction writing. His
devotion to all these pursuits showed his lack of interest
in his own field of study. When he first took leave in
1888, he was disillusioned and depressed and his own account
of the condition suggested that he was a victim of
n eurasthenia.*’*
During this leave he studied bacteriology and took the
newly introduced diploma in Public Health, and entered into
matrimony. On his return to India from England, he showed

91
an interest in malaria but failed to recognize the parasite
which had been discovered ten years previously by Laveran.
He regarded the discovery as a mistake or even a fraud. And
he accepted his ignorance when he remarked;
Though it was certain that malarial fever is caused by

parasites in the blood, and though the disease had
actually been communicated from man to man by the
inoculation of the blood of infected persons, still in
1894 we did not even guess, much less know for certain,
how these parasites manage to pass from sick to the
healthy under natural conditions.* ’ ’
Instead of studying mosquitoes, he wrote much poetry
and worked hard at mathematics which he liked most. On his
second leave to England in 1894 he was »"hown the error of
his ways regarding the malarial parasite through making the
acquaintance of Manson, who showed him specimens of crescent
bodies in the blood of malarial patients. In those days new
scientific discoveries in medicine were not so speedily
recognized by the profession as they now are and Ross
himself had the painful experience of lack of receptivity
of his own discoveries by members of his own service. His
acquaintance with Manson was probably the turning point of
his career, for thereafter he became possessed of a mania
for the study of malaria.**' When he returned to India his
first obsession was to test Manson's view that the
flagellating bodies which are given off from the crescents
were a phase in the life history of the parasite and were
the first stage of a development which took place in the
mosquito. The after stages were wrongly believed by Manson
to consist in the escape of the developed parasites from the

92
body of the mosquito into drinking water in which the
insects were drowned. Acting on this belief Ross attempted,
without success, to reproduce the disease by giving the
water in which infected mosquitoes had died to human beings,
including himself. In 1896 he wrote to Manson that the
belief was growing in his mind that the disease was
communicated by the bite of the mosquito. Manson was not at
all prepared to agree, as he believed that mosquitoes bite
only once.
The first experiments made by Ross at Sigur Ghat gave
him the idea that all kinds of mosquitoes might not be
capable of carrying the infection, and he made the
acquaintance for the first time of "dapple winged"
(anopheles) mosquitoes. His previous work had been done
with "grey" and "brindled" forms, viz., culex and stegomyia.
After much work and much official discouragement he obtained
some dapple winged mosquitoes, probably Anopheles st eo h e n s i ,
fed them on an infected person and in four days saw early
developmental forms in the stomach wall of the mosquito.
Having satisfied himself of the reality of this discovery he
reported it to headquarters. As Ross suspected, he was at
once ordered to leave his station and was finally
transferred to a non-malarious station, where his duties
were of the most trivial nature. After a few months the
intervention of Manson and Fayrer secured for him the
opportunity of carrying out his researches in Calcutta for
six months, "this being, I believe, the first case of the

93
kind," he remarked.*** During this period he was expected to
investigate not merely malaria but also kala-azar in Assam.
In Calcutta there was a difficulty in finding suitable
crescent bodies in human beings, so Ross took up work on the
proteosoma of birds, believing that the life cycle of this
parasite would be similar to that of the human malarial
parasite. Within a short time he worked out the full life
cycle, demonstrating the collection of sporozoites in the
salivary glands of the infected mosqui to es .***He showed that
the parasite could be conveyed to uninfected birds by the
bite of infected mosquitoes.
After his successful experiments he wrote in his diary
"In Exile," a poem. This poem has been quoted in different
ways; sometimes the words are changed, sometimes letters are
capitalized. It has been changed by Ross himself several
times. A few days after writing it, a modified version of
the poem was sent to his wife. It read;**’
This day relenting God

Hath placed within my hand
A wondrous thing; and God
Be praised. At His command.
Seeking His secret deeds

With tears and toiling breath,
I find thy cunning seeds,
0 million-murdering Death.
1 know this little thing

A myriad men will save.
0 Death where is thy sting?
Thy Victory, 0 Grave?
Ross regarded his work as being proof of the infection,
not only of birds, but of human beings by the bite of
infected mosquitoes. But the final demonstration of the

94
truth of this belief was denied him. He had to turn to kala-
azar , a disease which did not really interest him; and by
the time that his period of special duty was over he was so
exhausted that he had to take leave to England. Before
leaving India he was assured that there would be no
difficulty in obtaining permission to take up his work on
his return, but no official guarantee could be given him.
He had been disillusioned by official indifference in the
past, and perhaps his overworked condition made him
intolerant of official formalities, so he retired from the
service to complete his work without restriction.
It is most unfortunate that he was allowed to leave
India without receiving even a formal expression of thanks
from Government. But for the encouragement and the friendly
interest shown in his work by one or two medical men, it
must be admitted that he received but little sympathy or
recognition from his colleagues in Calcutta.
In January 1927, Sir Ronald Ross was at Calcutta, and
attended the inauguration by Lord Lytton of the monument
commemorating his discovery. In front of the Presidency
General Hospital an effigy of the discoverer was set in the
pediment and an inscription recalled the following words;
In the small laboratory 70 yards to the south east of

this gate Surgeon Major Ronald Ross, I.M.S., in 1898
discovered the manner in which malaria is conveyed by
mosquitoes.* * *
Today still stands the red-brick Victorian building of
S.S. Karnani Hospital, better known as the P.G. or
Presidency General on Lower Circular Road, Calcutta, where

95
Sir Ronald Ross broke the back of the dreadful mass killer
malaria. From here he used to send his servant Mahomed Bux
"in search of mosquitoes, getting them to bite the poor
fellow on his return, but finally discovering that this was
how malaria happened."**®
The discovery of Ronald Ross did not create head lines.
In the commemorating ceremony of Ronald Ross’ effigy in
1927, Colonel J.H.D. Megaro, of the I.M.S., remarked:
It is astonishing that so few of the inhabitants of

Calcutta know of the existence of the little laboratory
a few yards from this spot in which Sir Ronald Ross
made one of the greatest discoveries in the history of
the world.
He remarked also that, although more than twenty-eight
years had elapsed since the discovery was made available,
"we are only beginning to scratch the surface of the vast
mine of wealth it has placed in our h a n d s ." ** ‘Thus in the
little laboratory in the grounds of the Presidency General
Hospital there was enacted a drama of greater importance to
the world than the battle of Britain and yet hardly any one
in Calcutta knew even of the existence of the laboratory.
It must be admitted that Ross suffered from the
possession of an artistic temperament which was a source of
considerable unhappiness to himself, and perhaps it was
owing to this characteristic that he was able to appeal only
to the select few who had the vision to see the greatness of
his work. Even Manson who helped and encouraged him at
every step did not realize the magnitude of his discovery at
first, and it was only little by little that the scientific

96
world began to appreciate the vast potential change which
his work had brought about on the future of humanity in
malarious countries. Ross himself expected that others
would appreciate as keenly as he did himself that the next
logical step would be to put into practical effect the
lessons of his discovery, but the poor response to his
appeals and efforts to secure a hearing in regard to this
added to the disillusionment which embittered his after
life.
Had Ross been a calm philosopher he would have waited
patiently. We forget that the very faults of genius may be
essential parts of its make up. Ross himself may be excused
for thinking that the opposition which he encountered
hindered him in his work, and it is just possible that he
might have lost the spur which pushed him to the highest
pitch of energy. When he retired he received ample
recognition from such men as Laveran, Lister and Manson. In
spite of the fame and prestige which surrounded him, he
found that a triumph in research in tropical diseases could
only secure for him an offer of a post at the Liverpool
School of Tropical Medicine on 250 pounds a year with a
guarantee of three years, and even this offer was hedged
around with restrictions. Ross felt the rebuffs and lack of
recognition more keenly than the honors later came to him,
and it is not surprising that he should make bitter
comparisons between the vastness of his discovery and the
reward which it received. The Nobel Prize in 1902 of nearly

97
8,000 pounds was almost the only substantial reward which he
received. He always felt that he was not amply rewarded for
a discovery which must be worth untold millions of pounds to
humanity, apart altogether from the vast toll of death and
suffering which it prevented. But his discovery got due
recognition in his life time. Ross's enthusiastic
persistence in his investigation remained a subject of high
admiration in the years to come. It is to be remembered
that Laveran was awarded a Nobel Prize five years after Ross
in 1907, for a discovery which he made twenty years before
Ross.
It is not improbable that many years had elapsed before
the total impact of the discoveries of these scientists was
estimated at its proper value by the general public or even
by scientific and medical men. These discoveries were of
fundamental importance and it was perhaps thought that the
malaria problem would be solved once for all in the first
decade of the twentieth century and the disease would be
banished from the globe.
Final Solution of Malaria
During the twentieth century, serious research was done
on malaria control. Larvicides in the form of oil or Paris
green were introduced for preventing the breeding of
mosquitoes in different types of water. Wider use of these
and other methods of mosquito reduction demonstrated the
practicability of controlling malaria. This was followed in

98
India with the concept of "naturalistic control" based on
the knowledge of the breeding habits of species of Anopheles
involved in the local transmission of the disease.
The next landmark of the modern history of malaria was
the development of a synthetic anti-malarial drug. Ever
since the early seventeenth century, first the Peruvian bark
and then quinine were the only reliable remedies for
prevention of malaria and its treatment. The ravages of
malaria experienced during the First World War and the
difficulties of securing cheap supplies of quinine
stimulated a line of research in Germany aiming at the
discovery of synthetic anti-malarial drugs. One of them was
brilliantly accomplished in 1924 by Schulemann's discovery
of pamaquine. Later, the development of atebrin known as
mepacrine or quinacrine changed the course of the Second
World War when the shortage of quinine was acute. Other
valuable drugs were developed in the subsequent years.
The roles played by biochemistry, pharmacology in
studies of malaria parasitism are evident. The present
degree of control of disease-producing organisms is largely
due to the effective use of chemical agents that prevents
vectors from successfully transmitting pathogenic agents.
If pharmacology and biochemistry provide such a powerful
chemical arsenal, why then have the problems of malaria
parasite not been solved in half of the world's population?
In part, this is because the parasitologist,
pharmacologist, biochemist and malariologist have not

99
effectively combined their special talents and training to
deal with the problems at hand. They view the host-parasite
relationship as the blind man saw the elephant. We may
recall the poem "The Blind Man and the Elephant" by John
Godfrey Saxe, which reads, in p a r t : * * ’
It was six men of Indostan

To learning much inclined.
Who went to see the Elephant
(Though all of them were blind).
That each by observation
Might satisfy his mind.
The Third approached the animal.

And happening to take
The squirming trunk within his hands.
Thus boldly up and spake:
"I see," quoth he, "the Elephant
Is very like a snake!"
The Sixth no sooner had begun

About the beast to grope.
Than, seizing on the swinging tail
That fell within his scope,
"I see," quoth he, "the Elephant
Is very like a rope!"
And so these men of Indostan

Disputed loud and long.
Each in his own opinion
Exceeding stiff and strong.
Though each was partly in the right.
And all were in the wrong!
Standing at the last quarter of the twentieth century
we have realized that although mosquito-malaria problem
seemed to be so simple as was first supposed, and that there
are many unforseen difficulties to be overcomed before
malaria can be successfully controlled. At the end, we
quote from Ross who said:
The history of malaria contains a great lesson for

humanity — that we should be more scientific in our
habits of thought, and more practical in our habits of
100
government. The neglect of this lesson has already

cost many countries an immense loss in life and in
prosperity.* *'
With all our advancement in medical science malaria is
still a great problem in most of the countries of the third
world. It is so because we have addressed the malaria
problem as the blind men of India looked to the different
parts of the elephant separately but not as a whole. We do
not see the forest for the trees.

101
Notes to Chapter IV
Herms and M.T. James, Medical Entomology (New

York, 1961), p. 185; D. Drysdale Anderson, The Ready
Reference: Medicine and Suroerv Monograph on Malaria
(Atlanta, Georgia, 1930), p. 1.
*®‘R. Horsfall, Medical Entomology (New York, 1962),

pp. 336-337.
**’Julius P. Kreier, M a l a r i a . Vol. I (New York, London,

1980), p. 2.
***P.C.C. Granham, Malaria Parasite and Other

Haemosporidia (Oxford, 1966), p. 3.
*®’A Halawani and A.A. Shawarby, "Malaria in Egypt,"

Journal of Egyptian Medical Association. Vol. 40 (Cairo,
1957), pp. 753-792.
**'H. McNeill, Plaques and People (New York, 1976),

p. 102; Cecil Alpert, Malaria and Its Treatment: In the
Line and at the Base (New York, MDCCCC XIX), p. 1.
**’Leonard J. Bruce-Chwatt (Ed.), Chemotherapy of

M a l a r i a . (Geneva, 1981), p. 9.
‘*’Ananthaswamy Rao, Malaria in India. Malaria Institute

of India, (New Delhi, 1958), p. 3.
*’’Ib id . . p. 3.
’’ *A. Lakshmipathi, Ayurvedic School of Medicine: Theory

and P r a c t i c e . The Indian Institute of Culture, Transaction
No. 16, (Banglore, December 1952), p. 4.
’’’Dr. John Wilson, "Menace of Mosquitoes", The

Bangladesh Obse rv e r. Feb. 28, 1984. p. 5.
” ‘A.C. Newcombe, Village. Town and Jungle Life in India

(London, M C M V ) , p. 376.
Ill
Bruce-Chwatt, op. c i t .. p. 10.
” *S.C. Sen Gupta, I.M.F., "Temporary Insanity Following

an Attack of Malaria," The Indian Medical Gazette (Calcutta,
September 1929), p. 508.
’’ ’Major J.A. Sinton, "Studies in Malaria with Special

Reference to Treatment," The Indian Journal of Medical
R e se ar ch . Vol. XIV, No. 1 (Calcutta, July 1926), p. 227.
’’"Ibid. . p. 227.
102
’’’Donovan Williams, "Clements Robert Markham and the

Introduction of the Cinchona Tree into British India, 1981,"
The Geographical J o ur na l, Vol. cxxvii, pp. 4 (Dec. 1962),
pp. 431-442.
’’’A.C. Newcombe, op. c i t .. p. 376.
’’’G.E. Stewart and A.H. Proctor, Report of the Drainage

Committee. Bengal (Calcutta, 1907), pp. ix-xxx,
’ ’‘Major A. B. Fry, First Report on Malaria in Bengal

(Calcutta, 1912), p. 25.
’’’A.B. Fry, Second Report on Malaria in Bengal

(Calcutta, 1914), p. 33.
’’ ‘Ibid . . p. 34.
’’’Lewis T. Nielsen, "Mosquitoes the Mighty Killers,"

National Geographic. Vol. 156, No. 3 (Washington, D.C.:
September 1979), p. 429.
’ ’"Major Andrew Buchanan, Malarial Fevers and Malarial

Parasites in India (Calcutta, 1903), preface to second
edition.
’’ ’Leonard J. Bruce-Chwatt, Essential Malariologv

(London, 1980), p. 10; Sir Gordon Covell, P.F. Russell et
al.. Malarial Terminology. Report 2, the Draft Committee
appointed by WHO, Series No. 13, (Geneva, 1953), p. 11,
henceforth, malaria terminology.
’’’D. Drysdale Anderson; op. cit. p. 1; Jaswant Singh,

Lieut. Colonel and Dr. Rajindar Pal, "Instructions for
Collecting and Forwarding Mosquitoes", Health Bulletin
NO. 13, 5th ed. (Delhi, 1956), p. 1.3.
’’’Leonard J. Bruce-Chwatt, op. c i t .. p. 77.
’ ” G. Piekaski, Medical Parasitology (Leverkusen, 1962),

p. 58; Milton J. Friedman and William Trager, "The
Biochemistry of Resistance to Malaria," Scientific America.
Vol. 244, NO. 3 (March, 1981), p. 154.
‘*’Report to the Administrator. Agency for International

Development (Washington, April, 1982), p. 40; Bruce-Chwatt,
OP. c i t .. pp. 13-26.
’’ "William D. Foster, A History of Parasitology

(Edinburg, London, 1965), pp. 156-162.
’’"Jaime Jaramillo-Arango, The Conquest of Malaria

(London, 1950), p. 10.
103
’’‘Irving P. Delappe, "Research in Parasitology: The

Perspective of the National Institute of Health," from The
Current Status and Future of Parasit ol oa v . Ed. Kenneth
S. Warren et. a l . (New York, 1981), p. 84.
’ ’’Ronald Ross, The Prevention of Malaria (New York,

1910), p. 44.
’’•Ronald Ross, Memoirs: With a Full Account of the

Great Malaria Problem and its Solution (London, 1923),
p. 75.
’’ ’Ibi d.. p. 125.
’ "'Anathaswamy Rao, Malaria in India (New Delhi, 1958),

p. 25.
’"’Ronald Ross, The Prevention of Malaria (New York,

1910), footnote of p. 44.
’"’Ronald Ross, "Observation on a Condition Necessary to

the Transformation of the Malaria Crescent," British Medical
J o u r n a l , Vol. I (1897), p. 251; "On Some Peculiar Pigmented
Cell Found in Two Mosquitoes fed on Malarial Blood," British
Medical J o u r n a l . Vol. 2 (1697), p. 1786.
’ "’Ronald Ross, M e m o i r s . p. 227; Desmond Doig: Calcutta:

An Artist's Impression (Calcutta. N.D.), p. ix.
’""Desmond Doig, op. c i t .. p. ix.
’"•Geoffrey Moorhouse, Calcutta (London, 1971), p. 66.
’"‘Reported in the Indian Medical Gazette (March 1927);

Quoted in R.L. Megroz, Ronald Ross: Discoverer and Creator
(London, 1931), p. 27.
’"’John Godfrey Saxe, "The Blind Man and the Elephant,"

Poems by John G. S a x e . 30th edition (Boston, 1969).
’"•Ronald Ross, The Prevention of M a l a r i a , p. 48.

CHAPTER V
SANITARY AND MALARIAL ADMINISTRATION IN BENGAL
The active promotion of public health is a
comparatively modern conception. India has a long history in
public health planning. The ruins of Mohenjodaro and
Harappa demonstrated how well developed was the sanitary
system in those cities. In moder" times Europe led the way
in the development of health administration both in
legislative and organizational aspect. Under the British
administration, only a century ago, awareness of the control
and improvement of health of the individuals and the
community was felt. It was stimulated by the growth of
knowledge in some branches of medical sciences that took
place in the latter half of the nineteenth century. Although
the assimilation and application of this knowledge was a
gradual process for any country it was particularly so for
Bengal. The economic gain in health investment was realized
by the authorities very late only when it was was found that
any debilitating disease was detrimental for economic
exploitation. But sanitary reforms started for different
reasons in India.
104
105
First Royal Sanitary Commission
The high mortality rates among troops in the middle of
the nineteenth century drew the attention of the British
Parliament to the appalling health conditions of India. The
mortality of the European army was found to be 69 per
thousand and in the jails it was from 84 to 120 per
thousand. In such a situation the British authority in
India was in jeopardy as the empire depended on the health
and well-being of its soldiers. A Royal Commission was
appointed by the Government of India in May 1859 to enquire
into the sanitary state of the army. The Report was
submitted in May 1863. The Royal Commission made a number of
recommendations. It suggested the creation of a Sanitary
Commission at each Presidency in India, these Commissions to
be so constituted as to represent the various elements of
the government such as civil, military, engineering,
sanitary, and medical. It was intended to give advice and
assistance in all matters relating to the public health,
particularly the sanitary improvements of towns, prevention
and migration of epidemic diseases, and generally to
exercise a constant oversight on the sanitary condition of
the population both European and Indian, and finally to
preventing sickness and di s e a s e . ’*'In accordance with this
recommendation Commissions of Public Health were
established in the provinces of Bengal, Bombay and Madras in
1864. It was determined that the President of the Commission
should be a civilian, the secretary a medical officer and

106
the commission should incorporate three other members, one
medical and two military officers. The President and
Secretary were to devote their whole time to work for the
commission but the other members would perform their duties
in addition to those of their regular offices. This severely
restricted the performance of the commission.
The Sanitary Commission in Bengal was originally
constituted with a view to get an annual report on public
health "treating of all the subjects that probably fall
within its cognizance, and showing what has been done and
proposed during the y e a r . " ’'’It was suggested that the
Report would be prepared for the calendar year. Although
the Annual Report of the Sanitary Commission for Bengal was
published regularly since 1864, sometimes it failed to get
it done at the end of the year.
Objective of the Commission
The primary objective of the commission was to find
ways and means for the decrease of mortality in the army and
to suggest improvements of sanitary conditions in the
barracks. But it was emphatically stated that these
objectives could not be attained unless measures were also
taken for the improvement of the public health generally and
the prevention of the more obvious causes of disease among
the community at large. It was argued that the mortality
rate among soldiers could not be checked unless civilians
around the barracks in general were made aware of the

107
hazards of living in unhygienic conditions.’*’Writing in
1866, The Governor-General in Council was of the opinion
that the time had come for establishing a system which
should ensure constant attention to the requirements of the
public health throughout the country. It had been stated in
the following words:
The reasons which led to the appointment of

Sanitary Commissions in three Presidencies are well
known. The primary objective the Government had in
view, was the improvement of the sanitary state of the
army, but it was obvious that this objective could not
be fully attained unless measures were also taken to
guard against the numerous removable causes of disease
which almost everywhere exist outside the limits of our
cantonments. It was impossible suddenly to create the
machinery for carrying out all that was required, not
only for the immediate protection of the health of the
troops but for the care of the public health
g enerally.’*’
The health of the army was the primary concern of the
government because the integrity of the empire and its
expansion depended on the efficiency military man-power. But
it soon became clear that the army could not be kept in an
ivory tower without any association with the surrounding
people who were submerged in an abyss of diseases of which
malaria was one of the most formidable. The Annual Reports
of the Sanitary Commissions for Bengal made frequent
references to malarial fever and the possibility of its
attacking European soldiers. The fever had been prevalent
not only among prisoners but had been attacking the general
population in many parts of India. Some authorities were
concerned about the fact that it might be connected with
"the epidemic fever which lately proved so fatal in some of

108
the districts of B e ng al " .’**
The Despatch of the Secretary of State about the
epidemic fever in Bengal was read with great interest. Both
the government of Bengal and the Secretary of State in their
correspondence indicated that epidemic fever which prevailed
in the districts of Bengal had received, in the words of the
Secretary of State, "careful and discriminating
attention".’**The Secretary persuaded the War Office
Sanitary Commissioner to take positive measures against the
dangerous epidemic fever. The Army Sanitary Commission in
its reply mentioned the inadequacy of the materials which
it received, stating nevertheless that "the fever is
essentially a palludial, and it hence follows that the
remedial measures required are those which arrest the
development of m a l a r i a . " ’**
Meanwhile the Government of India was very unhappy
about the dark picture of the health situation in India
depicted by the Royal Commission and forwarded a Despatch by
Colonel Norman, Military Secretary to the Government of
India, pointing out erroneous conclusions drawn by the Royal
Commission. On the question of mortality of the British army
in India of 69 per thousand he pointed out that it was not
correct, because the average was arrived at by taking the
total deaths of the Royal Army in India from the beginning
of the nineteenth century to 1856, which included great
expeditions like Marhatta War, the Burmese War and the
disasters of the Afghan Wars. He argued that these

109
extraordinary situations could not represent the current
rate of mortality of the British Army in India. Reviewing
the return of deaths in different provinces, the Government
of India showed that in 1864 the rate of mortality of the
whole British Army in India was not over 20 per
thousand. ‘ The death rate was below that of the British
soldiers in England and other colonies. He also expressed
his surprise at the failure to mention the sanitary and
health measures taken by the Government of India for the
army and the people.
In spite of the disagreement between the two
authorities some positive decisions came forward in the
final report of the Royal Commission. The Commission
proposed some measures for the improvement of the health and
fever situations in India. These were as follows;
a) A detailed survey of the districts to settle the
levels and drainage outfalls.
b) Drainage of the district towns and villages on the
principles usually adopted for draining off low,
marshy places and for preventing accumulation of
bad water.
c) Providing and maintaining a pure water supply in
villages because impure drinking water was a source
of fever.
d) Clearing the land and cultivating the cleared land
in and around villages for better ventilation;
otherwise rapid growing vegetation i Bengal

110
created an unhealthy situation of miasma,
e) Finally it was proposed that as fever in the
villages was more intense in its action than
cities, sanitary police were required for
supervision of the villages.***
These proposals were made on the prevailing common
sense notion of the causation of numerous diseases such as
fever of general types, malaria and other infectious
diseases. As the prevailing notion of diseases was centered
around miasma the measures were all against creation of
putrifaction. Whatever its weakness any sanitary measures
had some beneficial results. The attention of the
government was naturally directed to the health of the
military establishments, but that of the civil population,
mostly European and to some extent Indian, was not neglected
altogether. Some of the measures proposed or executed were
for the interest of the general population. Of the principal
measures affecting the programs of public health which had
occupied the attention of the government, out of twelve
proposals five of them directly concerned the general
population, such as, medical education of the Indians,
vaccination, statistics and registration of disease,
sanitary literature and finally sanitary reforms in towns
and v il l a g e s . * * *
The Annual Public Health Reports and the Sanitary Boards
Since 1864 the Annual Public Health Reports were

Ill
published at the end of each year. In these reports an
attempt was made to review all the happenings regarding the
health of the people, and the measures taken by the
government in addressing any health situation. It published
all the reports from the districts with the comments of the
district health officers. It contained items such as births
and deaths, rise and fall of population, any spread of
infectious or epidemic diseases, distribution of these
diseases in the province, the apparent and immediate causes
which made for a recrudescence or retrogression of epidemic
disease, the amount of distribution of rainfall and the
prices of common commodities. All these together with a
short review of the activities of the public health
department made up the bulk of the ordinary annual sanitary
reports. The current year's happenings were compared with
the previous year, and also of the previous five or ten
years' accomplishments were compared with the current
year. It claimed to have collected a mass of authentic and
scientific evidence on the subject of medical topography,
causes of sickness and death, pilgrimage, conservancy and
epidemics, which was "well worth of permanent record".**'
David Smith, the Sanitary Commissioner for Bengal in
his report emphasized the utility ofsuch reports.
According to him a single sanitary report displayed in
detail the public health evils and requirements of all the
districts comprised under the Lt. Governorship of
Bengal. "The report is of great length; yet I ventured to

112
state that nothing is now submitted to the Government which
is not of real practical importance in its bearing on the
welfare of the people of this c o u n t r y " * h e commented. The
annual public health report used to explain health
situations in a simple manner. But the writers of the
reports had been conscious that their comments in each
y e a r ’s happenings were superficial. Actually many of the
happenings that were reported were surface ripples on the
sea of the biological existence of the people of
Bengal. With all the best expectations it was impossible
within narrow limits to prevent the sanitary problems of
more than thirty millions of people of the then Bengal whose
public health interests involved questions of very wide
range, and where budgetary allocations were very meagre
compared to the needs of the people at large.
In 1888, Lord Dufferin issued a resolution drawing the
attention of the local bodies and village unions to their
duties in the matter of sanitation; and consequently
sanitary boards were formed in every province. But
comparatively little success attended these efforts except
in the large towns. Each sanitary commissioner had only one
assistant to work with him and apart from the lack of
adequate technical staff, the main emphasis continued to be
laid on the development of medical relief. Medical
administrators were incapable of providing preventive
medicine because of limited resources and planning. The size
of the needy and sickly population was so vast that the

113
government had to limit its efforts to curative
medicine.**'One of the best efforts of Dufferin could not
produce the desired fruits. On one side sanitary measures of
western countries were applied to India without regard to
the fundamental differences of western and eastern
civilizations and of the conditions of the life in tropical
countries. On the other hand the people and the
administrators were not sufficiently prepared for any kind
of change and reform.
The subsequent horrors of plague were very much felt by
the Europeans, and the discoveries resulting from medical
advancement created a real commitment in Europeans and
Indians alike to preventive measures. An increasing number
of people realized the dangers to which they were exposed by
existing conditions, and to appreciate the economic value of
health and the wastefulness of sickness and premature
death. The government of India roused itself from its
slumber in this regard, and brought some change. From 1898,
the Government of India brought uniformity in all the
provincial sanitary reports by having ten sections with the
same contents. This brought conformity and regularity in
collecting information and formulating plans. In 1908
imperial grants amounting to Rs. 3,000,000 a year were made
to local governments. But the allocation of money for
health measures were very inadequate. It was stated that
"the expenditure under the head 'Medical* was lower in
Bengal than in any of the larger Provinces, though probably

114
there is no province more in need of hospitals and
dispensaries." »‘»
Measures for Malaria Control
In August 1909, the Government of India addressed
several local bodies and administration on the subject of a
proposal by the Sanitary Commissioner with the Government of
India that a permanent organization should be formed to
enquire systematically into problems both practical and
scientific with malaria in India. They pointed out that
because it was essential that the people of the country
should be persuaded to adopt the measures that might be most
suitable to the areas in which they lived, schemes for an
organized attempt to deal with the malaria problem
throughout India must be framed. For this reason the
Governor General in Council had decided to convene a
conference to examine the question and to draw up a plan of
campaign against malaria. The conference was opened at Simla
by His Excellency, the Viceroy in October, 1909. The nature
of the proposed organization for dealing with malaria in
India was outlined in the conference in the following way;
a) A committee was to be established in each province
of three or four members personally interested in
the malaria problem, enjoying the confidence of
local government and prepared to obtain information
and supervise local enquiries.
b) Every autumn each provincial committee would

115
delegate under orders of the local government one of
their members to attend a meeting of a general
committee at Simla. The general committee would
consist of the provincial delegates and the Sanitary
Commissioner representing the Government of India.
c) The Government of India would appoint a Central
Scientific Committee consisting of Secretary and
Sanitary Commissioner with power to add to their
numbers.
The conference strongly supported the establishment of
this organization and the Government of India agreed to the
resolutions and recommendations as to the need for detailed
"investigation of the epidemiology and endemiology of
malaria in India."***In addition to sanitary conferences
held on malaria there were conferences held by local
governments. Three all India sanitary conferences had been
convened over which Sir Harcourt Butler presided as member
of the Governor General's Council. These conferences were
attended by non-officials as well as officials and
professional sanitarians. It was realized, though late in
the day, that a healthy citizen was of more service to the
empire than an ill one.
The year 1911 was a historic one in the development of
sanitary and medical science in India as it was in that year
the government of India created the Indian Research Fund
Association, the first attempt to put medical and public
health research in India on an organized basis. The aim of

116
this organization was to initiate, aid, develop and co
ordinate medical scientific research in India, to promote
special inquiries and to assist in the study of diseases,
their prevention, causation and remedy. The control and
management of the association were given in a governing
body, the president of which was the member in charge of the
department of education of the Government of India. The
governing body was assisted by a scientific advisory board
of which no less than three members had seats on the
governing body. They had the responsibility to examine all
proposals in connection with scientific objects of the
association and reported about the importance and
feasibilities of these proposals. In 1914 the board was
constituted with the Director General, Assistant Director
General (sanitary) of the Indian Medical Service, the
Sanitary Commissioner with the Government of India, the
Director of the Central Research Institute, at Kasauli, and
the Officer in Charge of the Central Malaria Bureau, Sir
Ronald Ross had been elected as an honorary consulting
member to the board.
To this research fund the Government of India made an
annually recurring grant of five lakhs of rupees. Moreover,
since the constitution of the new department, the
government of India relieved the Home Department of
education and sanitation, imperial grants had been made to
local governments and administrations. These had rendered
the execution of some schemes which a few years ago seemed

117
beyond the limits of financial possibility. The movement for
sanitary reform in India was at the point of take off.***
For a number of years the Indian Research Fund Association
sponsored a number of researches including studies in
malaria, malnutrition, plague, cholera, leprosy and kala-
a z a r . Some of the inquiries originally instituted under the
Research Fund developed so successfully that they became
semi-permanent in nature. The most important of them was the
Malaria Survey of India which was ultimately taken over in
part, and developed as a permanent Central Government
Institution, named the Malaria Institute of India.
There had been progress although the rate did not
always keep pace with time. The truly remarkable
improvements effected of late years were in the health of
the army. But as soon as the soldier became unfit for active
service, he left the army and formed part of the civilian
population giving a better look to the health care
program. But the over all situation in the countryside did
not develop to any significant degree. This could be seen in
the very slow growth of population throughout the country
which has been discussed at length in the Chapter
"Population and Malaria in Bengal". Lord C u r z o n ’s
Government took up with vigor the reorganization of the
sanitary department. Research institutions were started and
an appointment of Sanitary Commissioner with the Government
of India was created. The function of this officer was to
advise the Government of India upon sanitary and

118
bacteriological questions and to settle with local
governments on which an advance should be made. The
arrangement was not completely successful. Among the
disadvantages, was the separation of research from clinical
work which deterred men from entering the department, and
the office work in connection with research prevented the
Sanitary Commissioner from wide and constant touring in the
affected areas. The organization was modified in
1912. Henceforth, the Sanitary Commissioner became an
independent adviser to the Government of India in all
technical and sanitary matters. But all questions of
personnel as well as the administration of the
bacteriological department and research generally had been
placed under the control of the Director General, Indian
Medical Service, with the Sanitary Commissioner as his staff
off icer.
In the same year the Government of India provided for a
large increase in the number of deputy Sanitary
Commissioners. The appointment of Health Officers were made
first class for large municipalities; and of second class
for the small towns according to the proposals received from
the local g overnments.* ‘‘Twelve additional appointments of
deputy sanitary commissioner, thirty-five appointments of
the first class, and a large addition to the number of
second class health officers was sanctioned in the
subsequent years. The number of appointments seemed to be
quite large but in actuality, compared to the size of

119
population, the service was very limited. The Government of
India also advised local governments to take powers where
these did not exist, to require a municipality to appoint a
health officer, and to veto the appointment of an unfit
person. Such powers already existed in the Bombay
presidency, and had been taken by legislation in Bengal. The
Government of India recommended every municipality to
employ one or more trained sanitary inspectors in proportion
to the population. In addition the civil surgeon in every
district was the sanitary adviser of the local
authorities. Training was also given to medical graduates
and licentiates of the Indian Universities for posts of
second class health officers. But very soon the reluctance
of the public and the apathetic attitude of the government
let most of these trained officers leave their profession,
and only few joined the posts under the local bodi es .*‘’This
proved very harmful to the sanitary movement in India.
The policy of the Government of India was to keep the
control of research to itself, but to decentralize other
branches of sanitation. While the general direction of a
policy of public health remained with central government all
detailed control and executive actions were left to the
local governments. The sanitary commissioner with the
government of India was a touring officer empowered to
consult and confer informally with local governments and
their officers upon matters connected with sanitation. He
was not permitted to encroach upon the authority of local

120
governments over the officers under their c o n t r o l ‘•In
every province sanitary boards were created with varying
powers, some being merely advisory, others having authority
to sanction schemes and allot funds. These boards were
composed of officers belonging to medical, sanitary,
engineering and other branches of the civil services with
the addition of non-officials. The Government of India
viewed it with favor and believed that such an appointment
would result in an increase of efficiency.
Arrangements for training the superior sanitary staffs
got the attention of the government but the chief difficulty
was to provide courses in practical hygiene and in the study
of the bacteriology and etiology of tropical
diseases. Meanwhile, a British diploma in Public Health was
required of candidates for the post of deputy sanitary
commissioners and health officers of the first
class. Obviously it was meant to restrict Indians from the
higher positions.
The Malaria Polic,/ of the Government
Since the first report of the Sanitary Board of Bengal
was published, the Board in 1912 held a conference with the
Malaria Committee of Bengal to consider joint action with
the Committee for investigating schemes for malarial
areas. The joint conference found common ground to deal with
water supply, sewerage and drainage to check
m a l a r i a . *‘’Finally in 1917, the Sanitary Board was

121
amalgamated with the Provincial Malaria Committee. This new
Board was constituted of a President, Vice-President, seven
members and two member joint secretaries, one of whom was a
Sanitary Commissioner for Bengal and the other a Sanitary
Engineer for Be n g a l . * ’* After its amalgamation with the
malaria committee it received progress reports of the anti
malaria operations from different parts of the province.
The problems of public health in India were vitally
complicated by the vector borne diseases like malaria which
played a prominent role in the spread of diseases. But the
number of trained personnel were limited in this field. By
1914 a substantial beginning had been made for the
development of a department of public health, and the
Indians were enlisted for it. The posts of deputy sanitary
commissioner and health officers were opened to Indians. As
health officers and sanitary engineers gradually relieved
deputy sanitary commissioners of much of the inspection and
routine work, it was hoped that the latter would be free
enough to deal with communicable diseases and epidemics,
and to consider issues of public health wider than those
which they were able to review.
The administrative changes brought about in the
provinces by the Act of 1919 were also accompanied by
certain detrimental effects. These were in the fields of
local government health administration. The health officers
had no incentive to do their work effectively, nor had they
any power to proceed with their regular work without being

122
harassed by the local government bodies, and were considered
but salaried o ff i ce rs .* ’*Moreover, the medical graduates and
licentiates who joined the newly started D.P.H. class in
1919 under the Calcutta University were supposed to be
absorbed in provincial service. But the Government of Bengal
changed its decision in view of the protests of the local
bodies. The resistance of the local bodies against the
interference by the government became more pronounced with
the political polarization created due to the partition of
Bengal and its annulment in 1911.
By 1921 there was a strong reluctance on the part of
professional men to accept service under Municipal Councils
because of distrust of each other. Over and above there was,
in reality, a dearth of trained people to fill the
positions. The situation became alarming when it was found
that in Bengal excluding Calcutta there were 115
municipalities with only twenty-two health officers. The
situation both in Madras and Bombay was the s a m e . * ’* This
was a major hurdle for sanitary measures and improvements in
public health activities.
As far back as 1914 the Government of India stated that
its policy was to decentralize branches of health
administration by transferring them to provincial
governments. The Government of India Act of 1919 gave
statutory sanction to this transfer of function. Medical
administration including hospitals, dispensaries and asylums
and provisions for medical education, public health and

123
sanitation including vital statistics, with certain
reservations in respect of legislation by the Central
Government, were transferred to the provinces. In addition,
in the provinces the ministers responsible to the
legislature were entrusted with the administration of such
departments as health, education, agriculture and co
operatives.*’*The results of these changes were of marked
character. The ministers were anxious to promote the growth
of education, medical relief and preventive health measures
as far as the funds permitted. The establishment of trained
public health staffs for rural and urban areas which the
Commissions of Public Health had recommended in the sixties
of the last century was taken up in earnest. But the
organization of such services did not make any serious
headway because of financial constraints. Nevertheless,
there had been since that time far greater public health
activity in the provinces than ever before.
In the field of research there was some
progress. Research was slowly lifting the veil which hid the
secrets of disease and mortality, and opened up fields for
future generations. The discovery by Ronald Ross on the
part played by the mosquito was a landmark in the history of
public health not only for India but for the whole
world. The policy of the government since the days of Lord
Curzon was the establishment of laboratories for the study
of problems of public health throughout India. The functions
of the central laboratory were original research and the

124
preparation of training for scientific workers. The function
of the provincial laboratories were diagnosis and special
research connected with local conditions. A research
laboratory and school of tropical medicine was established
at Calcutta. The Central Research Institute was established
at Kasuli. The Central Malaria Bureau and Entomology Section
was at first a part of the Central Research Institute,
Kasauli. In 1926 the work of this section was continued as
the Malaria Survey of India. The aims of this institute
were to gather information and give advice on malaria
problems in the country. Its main function was to initiate
enquiries on malaria, to carry out research into the
transmission, prevalence and prevention of malaria, to carry
out anti-malaria measures based on this research, to carry
out clinical investigation, in the treatment of malaria, and
it also carried out affiliated research on other vector
borne diseases.
The local governments were also alive to the importance
of research and by 1914 in several provinces officers were
engaged in investigating the causes underlying the
prevalence of malaria and devised suitable schemes for
addressing this debilitating disease. Malaria surveys had
brought to light important and unexpected facts regarding
the causation of malaria in particular localities.*’’In
Bengal the enquiries of Major Fry, Captain Stewart,
Lt. Proctor, Charles Bentley and Ronald Ross had disclosed
various aspects of malaria and its etiology. They in their

125
various surveys showed that malaria could undermine the
public health policy of the Government of Bengal. The
surveys and research led to the formation of guidelines for
malarial sanitation in Bengal and other parts of
India. These were as follows;
a) The conditions and causes underlying the prevalence
of malaria vary greatly in different places, and no
one anti-malarial measure is suitable for all areas.
b) Quinine both as a preventive and curative agent is
of great value to the individual. There should be no
relaxation in the efforts to educate the people in
the use of quinine, and its sale by the shopkeepers
in the rural areas is encouraged.
c) The regular administration of quinine to children in
schools during the malarial season is a practical
measure of easy application and of proved utility.
Quinine if properly administered was a valuable
weapon in the fight against malaria.
d) In anti-larval operations it was not necessary to
abolish all breeding grounds of mosquitoes, even of
known carriers of malarial infection. A marked
amelioration in health conditions would ensue if the
chief breeding grounds of the malaria-carrying
mosquitoes were cleared.
e) Even with initial expense, those anti-malarial
measures should be chosen which act automatically,
are independent of outside help and permanent in

126
their effects. Those which require regular
repetition, a constant attention and active co
operation on the part of the people, were seldom
effective.
f) The treatment of permanent collections of water was
important whether it be effected by water tidiness,
through sloping of banks and clearing of weeds, or
stocking with fish of proved utility as mosquito
destroyers, or by both m e t h o d s . * ’*
The government had arranged training program for
instructing in eradicating malaria. The course was so
planned that each member of the group took an actual part in
the preparation of a malaria survey which would eventually
be the basis of a practical scheme of malaria
prevention. Medical officers in civil and military
employment undergone such training. The Lucknow Sanitary
Conference recommended that a malariologist and an engineer
should be deputed to study the malaria control program in
Italy. The Italian malaria control program was taken as a
model by Bentley in Bengal, especially the "bonoficazione"
m e t h o d . * ’* It is a method of improving agriculture and
health simultaneously. The emphasis is without applying
specific measures against malaria parasites, anti-malaria
projects could be combined with improvement of agriculture
through water regulations and irrigation. The effect of
silt deposition on the malarial conditions of the deltaic
areas in Bengal had received considerable attention and a

127
number of experiments were conducted by the Sanitary Board
of Bengal. Along with the practical measures, training of
sanitary staffs became the primary consideration of the
government. The setting up of the Calcutta School of
Tropical Medicine in 1920 was a significant step, and
starting of the diploma of public health course there in
1922 completed the ground work for an all pervading concept
of public health and sanitation.
The Royal Commission, the Sanitary Commissions of India
and its counterparts in the provinces, the Sanitary Boards
and the Sanitary Engineering Departments put forward far
reaching recommendations from time to time to the government
which included the employment of trained public health
staffs, expansion of training and research facilities and
also plans for different projects. These recommendations
were hardly carried out, and no comprehensive policy with
regard to the development of preventive health service were
laid down. If the government had been sincerely alive and
keen to redress the situation, it would have founded public
health services for the needy and the poor section of the
community, t’ e majority of whom lived in rural areas. The
Act of 1919 put the responsibility of medical
administration, public health and sanitation on the
provinces without any guarantee of finances to implement
the system as proposed. Most of the high-sounding plans fell
through for the lack of funds.
Thus in all these years of efforts the system of public

128
health did not yield very encouraging results. As late as
1920 the birth rate in Bengal was 28.0 per thousand of the
population and that of death rate 32.7, and the mean for
previous five years was 32.1 . *” Although 1918-19 was an
exceptional year because of influenza epidemic, which
coupled with malaria created the lowest birth rate record
since 1892. Among the towns of Bengal, eight including
Calcutta returned a death rate exceeding 40 per thousand of
the population. In 1870 the death rate was reported to be
only 4.1 per thousand, which seemed to be very unlikely.
Even if we make this figure six times more, as it was
thought by the Sanitary Commissioner of Bengal that "not
more than one sixth of the deaths are registered", the death
rate was less than that of 1 9 2 0 . * ’* It showed how vulnerable
the situation had become over the years in the absence of a
coordinated system of public health. As late as 1870
Florence Nightingale showed her dismay at the administration
of public health in India.
In a letter to the Bengal Social Science Association,
Florence Nightingale was urging the authorities to be
compassionate to the needs of the people. She pointed out
that some portion of the great work of sanitary reform must
be carried out by the people without the intervention of the
government. She urged that except major public works which
should be done by the government, the minor ones should be
executed by the people themselves. She said: "The
cultivators of a country are its health improvers." * ’’But in

129
reality neither the idea of initiating local responsibility
nor the government undertaking worked very well in
India. Forty years earlier than Florence Nightingale one
British administrator was quite apprehensive of British
policy in India.The words of Sir Thomas Munro were more
appropriate than anything else in this regard. He said:
Our great error in this country, during a long

course of years, has been too much in attempting to
better the condition of the people, with hardly any
knowledge of the means of which it was to be
accomplished and without seeing to think that any other
than good intentions are necessary. It is a dangerous
system of government in a country, of which our
knowledge is very imperfect, to be constantly urged by
the desire of settling every thing permanently. To do
every thing in a hurry, and in consequence wrong, and
in our zeal for permanency, to put the remedy out of
our reach.***
Even in later years when the Indians were in charge of
certain branches of administration, the situation did not
improve. Because of a growing nationalist tendencies, the
distrust and apprehension about the motives of the
government made many measures inoperative. One incident will
suffice on this point. In 1921 the minister of Local Self
Government, Surendranath Banerjea, once known as the
uncrowned king of Bengal politics, went to Barisal, one of
the districts of eastern Bengal, to speak about the benefits
of sanitary improvements. He himself was doubtful of its
acceptance to the people. He said in his speech:
I had come to promote sanitation, equipped with

all the resources and the organization of the
Government. But even such a boon, so vital to the
people, was un-acceptable when offered by the
government, even in the person of one who not long
before was hailed as a public benefactor. I was
reminded of the words of Aeneas in Virgil : timeo
130
Danaos et dona ferentes — I fear the Greeks even when

they came with gifts in their hands. The feeling was
not universal; perhaps it was not even general. But it
was there, a living factor in the local public
sentiment, blatant and demonstrative.***
This type of apathy and mistrust of the people against
a colonial government is quite natural. A French doctor by
the name of Frantz Fanon working in colonial Algeria
experienced a similar or even worse situation.*** So the
policies of the British administration in the spheres of
public health did not succeed because of the inherent
weakness of the colonial system. Without any sincerity of
purpose no system can earn the confidence of the
people. Begun as a means to keep the British troops healthy,
the idea of public health transcended its objective but did
not reach close to the level of any European
country. Misgivings about the policies of the colonial
government with regard to public health never left the minds
of the people.
131
Notes to Chapter V
* *’Report of the Roval Sanitary Commission. 1 8 6 3 . Vol. I

(London, 1863), pp. v-xvi. In 1901 more than one third of
the European population were military personnel. See
Hamilton Israel, The English in India and Passing of Empire:
The Anglo-Indian in Defense of Authority. 1905- 1 91 0.p. 2.,
A Ph.D Dissertation in History, the University of Michigan,
1966.
* *"First Annual Report of the Sanitary Commission for

Bengal. 1864-65 (Calcutta, 1865), p. 1.
*'*I b i d .. p. 1.
* *'The Orders from the Secretary of State to the

Government of India, no. 1044, dated "9th February 1864. It
described in detail the nature of the work the Commission
was expected to perform.
* *'Minute Bv His Excellency, the Governor-General of

India, concurred bv other Members of C o u n c i l , dated January
9, 1866.
* *’Annual Report of the Sanitary Commission for Bengal.

1864-65 (Calcutta, 1865), p. 58.
* *’Despatch from the Secretary of State to the

Government of India. No. 32, dated November 30, 1868.
* *’Abstract of the Proceedings of the Sanitary

Commissioner with the Government of India. 1869 (Simla,
1870), p. 27.
' * ’Report on the Extent and Nature of the Sanitary

Establishments for European Troops in Bengal. Madras and
Bombay Presidencies. Letter No. 80, dated Agra 12 April
1861, (Calcutta), p. 160.
* *'Report of the Sanitary Commission for India. 1869

(Simla, 1870), p. 28.
* ’’Memorandum on Measure Adopted for Sanitary

Improvement inIndia u p to the End of 1867. together with
the Abstracts of the Sanitary Reports hitherto forwarded
from Bengal. Madras, and Bombay (London. 1866). p. 19.
* ’"Annual Report of the Sanitary Commission for Bengal.

1868 (Calcutta, 1869), p. 6.
' " Ibi d.. p. 5.
' ’'Report of the Health Survey and Development Committee

Vol. I (Calcutta, 1946), p. 23.
132
'‘'Proceedings of the Lt. Governor of Bengal. Municipal

Department; Branch Local Self-Government (Calcutta,
Jan. 1898), p. 9.
'*’S.P. James, ed. Transactions of the Committee for

Study of Malaria in India. No. I (Simla, July 1910), p. 2.
" ' Q u o t e d from V.R. Khanolkar, Fifty Years of Science in

India (Calcutta, 1963), p. 5.
' " Indian Sanitary Policy (Calcutta, 1914), p. 8.
' ‘’Correspondent, "Public Health Organization in India",

Indian Medical R e c o r d . Vol. xlvi (Calcutta, October, 1926),
p. 318.
lit
Indian Sanitary Policy. 1914 (Calcutta, 1914), p. 9.
'‘'Annual Report of the Sanitary Board. Bengal. 1912

(Calcutta, 1913), p. 23.
;
1 1 0
'Annual Report of the Sanitary Board. Bengal. 1917
(Calcutta, 1918), p. 35.
' ’'Indian Medical Re co r d , p. 318.
‘’'Editorial, "Colonel King on Sanitation in India", The

Indian Medical Gazettee Ad ve r t i s e r . (Calcutta, September
1923), p. 429.
'’'Anil Chandra Banerjee, Indian Constitutional

Documents Vol. iii (Calcutta, 1961), p. 59.
'’’Indian Sanitary Policy. 1 9 1 4 . p. 17.
'’'Ibi d. . pp. 17-18.
' ’’Charles A. Bentley, Malaria and Agriculture in

Bengal; How to Reduce Malaria in Bengal by Irrigation
(Calcutta, 1925), pp. 156-60.
' ’’Annual Report of the Sanitary Commissioner for

Bengal. 1 9 2 0 . (Calcutta, 1922), p. 1.
^ ’'Annual Report of the Sanitary Commissioner for Bengal

' ’’Letter from Florence Nightingale to the Bengal Social

Science Association, London, June 1870, from the Report on
Measures Adopted for Sanitary Improvements in India, from
June 1869 to June 1870 (London, 1870), p. 288.
' " G . R . Gleig, ed. Sir Thomas Munro: Extracts from his
Correspondence and Private Papers (London. 1830). pp. 381-
133
382.
^" Su re n d r a n a t h Banerjea, A Nation in Making; Being the

Reminiscences of Fifty Years of Public Life (Calcutta,
1925), pp. 351-352.
'"Frantz Fanon, A Dying Colonialism. "Medicine and

Colonialism" (New York, 1965), pp. 121-145.
CHAPTER VI
MALARIAL FEVER AND VITAL STATISTICS IN BENGAL
There is a distinct connection between prevalence of
malarial fever and the state of population growth in a
country. We have suggested through evidence that epidemic
fever was a relatively new phenomenon in Bengal, the
virulence of which caught the attention of the government in
the 1860s of the nineteenth century. We shall try to
determine the relation of malaria to population density in
Bengal from 1860 to 1920. Before we do so, we shall look
into the background of our sources of information such as
vital statistics and the census reports, and verify their
authenticity. The history of our vital statistics is very
much linked with the development of this system in Europe.
Let us first look into the statistical classification of
diseases in England and Europe, and see how British India
was influenced by it. In fact every change that had taken
place in in Europe had some ripples in India, and the
coincidence of the dates of change would prove that
contention.
Historv of Vital Statistics
The modern statistical study of disease to deduce
death-rate, disease prevalence and other measures of vital
134
135
statistics of a population of a particular geographical area
is of very recent origin. The utility of a uniform
classification of causes of death was strongly recognized at
the first International Statistical Congress, held at
Brussels, in 1853. While a century has contributed
something to the scientific accuracy of disease
classification, there are many who doubt the usefulness of
attempts to compile statistics of disease, or even causes of
death, because of the difficulties of classification.
Fortunately for England the progress of preventive
medicine owes to a great degree to William Farr ( 1807-1883)
— the first medical statistician. He not only made the best
possible use of the imperfect classifications of disease
available at the time, but tried to secure better
classification and international uniformity in their use.
The movement generated by Farr in England had its ripples
in India also. The Government of Bengal in 1869 ordered the
general registration of vital statistics, and the actual
operation of collecting statistics started the next year.
The International Classification of Disease was revised
at Paris in 1864, and was revised further in 1874, 1880, and
1886. Although acceptance of this classification was never
universal, the general arrangement, including the principle
of classifying diseases by anatomical site, proposed by
Farr, has survived as the basis of the International List of
Causes of Death. Following his precepts some measures were
taken by the Government to improve the vital statistics

136
which were far below the international standard.
The International Statistical Institute, the successor
to the International Statistical Congress, at its meeting in
Vienna in 1891, charged a committee, of which Jacque
B ertillon^*3(1851-1922) of France was the chairman, with the
preparation of a classification of causes of death. The
classification prepared by Bertillon was based on the
classification of causes of death used by the City of Paris,
which, since its revision in 1885, represented a synthesis
of English, German, and Swiss classifications. In Bengal
since 1892 real improvement took place in collecting vital
s ta ti st ic s.
The Bertillon Classification of Causes of Death, as it
was at first called, received general approval and was
adopted by several countries, as well as by many cities. It
was suggested that the classification be revised every ten
years. Bertillon continued as the guiding force in the
promotion of the International List of Causes of Death, and
the revisions of 1900, 1910, and 1920 were carried out under
his leadership. After his death the World Health
Organization took over responsibility with the Sixth
Revision and its concern with the ICD is written into its
Constitution.
Vital Statistics in Bengal
Although vital statistics are an important aspect for
the measurement of the impact of a disease on the

137
population, it did not develop in Bengal as early as in
Britain. Unfortunately, no system of registration was at
work in Bengal in the first half of the nineteenth century
whereby reliable mortality returns could be obtained. All
that could therefore be deduced from the enquiries could
only bring a realistic picture of the disease stricken
villages of Bengal. The systematic records available for
the causes of diseases were generally the sanitary
commissioner's annual reports which came into being since
1864. Initially the report was in the nature of a survey
but later it gave a comprehensive analysis of registered
births and deaths. But the inaccuracy of the reports and
those of other mortality surveys were a cause of concern for
persons dealing with health planning.
The inaccuracy of mortality reports was recognized by
the health officers long ago. Dr. S. Elliot in his report
on Epidemic and Intermittent Fever pointed out that the
mortality reports issued by the police were full of errors
and "only approximate to truth". They either took no
trouble to get correct information or the people were
reluctant to give information because they were not sure of
the purpose of such facts.i'* Generally the people were
suspicious about mortality inquiries and their non
cooperation was due to the reverence for the diseased and a
desire to respect his or her privacy.
This is one side of the story. On the other hand,
there are cases in which because of lack of interest among

138
government officials in mortality, leading citizens issued
death reports. A memorandum to the Government of Bengal
drawn up by some of the leading zamindars of Hooghly
district focused on mortality due to fever. Commenting on
the memorandum. Dr. Smith said;
That your Memorialists are unable to furnish accurate

statistics to show the total mortality caused by the
epidemic during the last few years, but they have
endeavored to collect the Mortuary Returns of villages,
and the result tends to show that in some instances the
deaths amount to more than one-half the population and
in many others to not less than one third.i''
The memorandum submitted a list of villages and showed
the relative change of population from 1862 to 1869. Dr.
Smith thought the figures to be biased, but later he had to
revise his views. After visiting the district himself, he
remarked, "I thought it probable that they were very
inaccurate; and all that I am anxious now to record is the
fact that they appear to be much more the truth than I had
expected to find t h em ." ^* ‘ This was the nature of situation
with regard to mortality statistics in Bengal.
The general registration of vital statistics throughout
Bengal was governed by Government orders issued in 1869.
The registration of deaths had been in operation in Bengal
since the year 1870, but not very effectively. Subsequently
by an act of the Legislative Council of Bengal in 1873 power
had been authorized to the Lieutenant Governor to direct
that all births and deaths be registered. Under the
provision of this act, the registration of the mortality
statistics was done in almost all the city areas and

139
municipalities in Bengal. The results had been so
unsatisfactory that one or more town and rural circles of
each district were selected from among the general circles
for more careful recording of births and deaths. This was
an attempt to collect improved statistics what was known as
the select area system. Under this system the districts of
Bengal, excluding those which had been transferred to the
Chief Commissioner of Assam, were divided into 636 circles
or stations for the general registration of deaths. Of this
number 77 were towns and municipalities and 559 were rural
circles. The areas selected for more accurate registration
of deaths and births were 139 in number, of which 76 were
urban and 63 were rural areas. While the registration in
most of the urban and rural selected tracts and in the town
areas of the general circles was fairly carried out, the
reverse was the case with registration in the rural general
circles. Most of the town areas were better supervised and
checked than the rural.
The sanitary authorities, both of the Government of
India and the Government of Bengal came unanimously to the
conclusion that the system of selected areas had not ledto
satisfactory results. Although the selected areas had
throughout shown a higher reported death-rate than general
circles, there were strong grounds for believing that those
more favorable results had been artificially produced. In
one district for instance, the Lieutenant Governor had been
informed that the civil surgeon's clerk was found to have

140
drafted a circular to the select thanas, informing the
police that the Sanitary Commissioner was not satisfied with
the number of deaths and they were to "be sure to make the
people die faster."**’Even where no positive instructions
were given, some of the inflated mortality figures were
suspected. In 1877, this system was abandoned, and only
places in Bengal from which statistics were more accurate
than the average were the town areas, to which the
provisions of Act IV of 1873 had been extended.
Before the year 1877, as the registration of births and
deaths was extremely imperfect and consequently of little
value, it was discontinued under the orders of the
Government of Bengal. At the request of the Government of
India, however, the matter was reconsidered, and it was
decided that births should be registered in first class
municipalities only.^** Since then birth registration was
revived in almost all the towns in Bengal. The registration
was done in 134 out of the 148 municipal towns.
But the palpable inaccuracies of the vital statistics
of Bengal deprived the Sanitary Department Annual Reports of
much of their value. It had rendered a detailed examination
of the elaborate tables, maps and diagrams in the reports
but all these efforts were practically worthless. Year
after year, the Sanitary Departments confessed that the
statistics given did not furnish any safe ground for any
deductions. It was in 1892 that things began to change.
The Sanitary Commissioner, Dr. W.H. Gregg, said in that

141
year:
"...I am glad to be able to report a very decided

improvement, which is due to the change of system
inaugurated last year under the order of the government
of Bengal, and to the active personal interest which
the district officers one and all now take in the
registration of these most important d a t a . " ^ * ’
Up to the end of 1891, the registration of births was
confined to the towns of the province and was carried out by
municipal agency. The Imperial Act VI of 1886 which
governed the registration of births and deaths was not in
effect for some years. Registration in Bengal did not
become general until 1891, and records before that date were
not reliable. From the year 1892, it had been extended to
all rural areas and entrusted to the police who were
responsible for all vital statistics. The chowkidars or
village watchmen were provided with hath-chittis (hand
books) in which they recorded all domestic occurrences.
Each district in Bengal had been divided into thanas or
police jurisdiction units. The headquarters of each thana
was the police station which was usually centrally located.
Each thana was further subdivided into chowkidari unions, a
collection of groups of villages. The smallest unit was the
village, or villages, comprising the beat of the
"chowkidar" * *'or village watchman. Each of these men has
roughly 100 houses in his charge. The chowkidar was the
official on whom the registration of births and deaths
actually depended. He was generally a low caste man, and
usually illiterate. He had to attend the police station
twice a month, or weekly in places, and gave his report of

142
births and deaths which were recorded by the police station
writer, a literate constable trained for the work. Each
chowkidar was supposed to keep a written record of each
death and birth but he had to get this done for him by some
literate man in the village. The particulars such as age,
sex and cause of death were the only things that were
recorded. If he was sincere, there would not be many
omissions of births and deaths as he was constantly on his
beat and knew all the inhabitants of the locality.
The facts that were reported were entered in a register
and kept for the purpose. The figures were periodically
arranged and forwarded to the magistrate or the civil
surgeon of the district, who had to examine them and
eventually submitted them to the Sanitary Commissioner. The
data were then tabulated and exhibited with his criticisms
and remarks in his report which he annually laid before the
Government on the health of the province of the preceding
year. It can be seen that the foundation upon which the
whole superstructure was built was the village watchman.
Census Reports
The best demographic materials in Bengal were available
from the census. The first systematic attempt to ascertain
the whole population of India by actually counting heads was
made between 1867 and 1872. Various survey schemes were
contemplated under the East India Company between 1769 and
1855 and under the Crown between 1858 and 1869. The earlier
143
efforts were fragmentary and unsystematic. In 1869, a plan
was submitted to the Governor General in Council for a
Statistical Survey and an Imperial Gazetteer of India. This
plan attempted to overcome the defects of previous survey
schemes. It took twelve years to complete the new
undertaking, but it succeeded where others failed and it
furnished an elaborate account of each of the 240 districts
then comprising the 15 British provinces covered. The
result was published in 100 printed volumes and condensed in
the Imperial Gazetteer of In d i a .***which was published in
1881, in nine volu me s . The Survey provided a rare and
useful body of knowledge. The Census followed by the Survey
reports filled the gaps of information but most of the time
reaffirm the census reports. It was a landmark in Indian
statistics.
The census reports on Bengal were remarkable not only
for the information itself but for the diversity of
information it covered. Bengal contained millions of people.
The superintendent of census operation in Bengal writing to
the Secretary to the Government of Bengal in 1891 said that
the statistical enquiry of Bengal was one of the largest in
its type in the world. He wrote, "Amongst countries, whose
populations have been scientifically enumerated, the United
States of America stand second to the Lower Provinces of
Bengal in number of inhabitants."^ **He was taking in terms
of a Bengal that consisted at that time the Province of
Bengal proper, Bihar, Orissa and Chota Nagpur. In 1872

144
Bengal Proper had a population of 35 millions of people and
that of Lower Provinces of Bengal 67 millions. Most of the
people of Bengal were illiterate and lived in a rural
setting. The census investigation gave a variegated picture
of Bengal life. Sometimes it did not provide any statistics
but usually there were just enough statistics to give
empirical underpinning to the conclusions presented. The
census allowed in "wide-ranging curiosity to lead them into
many bypaths and have gathered statistics on a fascinating
multiplicity of topics".'Among them the reports on
diseases and calamities were of particular interest to
us. As a result, they have enormously enriched our knowledge
of the country in nearly every branch of scholarship.
The most outstanding defect in the Census Reports like
that of Sanitary Reports, was the absence of any column for
malaria. The vast majority of deaths were returned under
the generic head of fever. The Census Commissioner in 1911
asserted that mortality due to malarial fever was very small
but in reality in an investigation in Burdwan found that out
of the 70 percent of the deaths ascribed to fever, half of
them were due to malaria.'**
In reporting on malaria the Census reports heavily
relied on the vital statistics and the malarial reports
published by health officers. So in reality, the census
reports reproduced some of the faulty statistics which were
already known, rather than an independent set of figures.
In addition to the census there has long been an

145
attempt in Bengal to gather statistics on disease. There
were annual reports on medical relief that covered
vaccination (beginning in 1861) and hospitals (beginning in
1852). There were numerous special reports on epidemic
diseases. There were reports covering mortality in the
army, in the jails and in particular cities going back to
the first half of the nineteenth century. Since the initial
concern was with mortality, the statistics on death were
gathered first. These reports only provided us with a bit
of rough estimation.
Inaccuracy of Vital Statistics and Fever Death
Although the inaccuracy of the early statistics should
have been well known, they were not infrequently utilized as
conclusive evidence in the determination of health policy.
Further, the recorded death rates as given in the Sanitary
Reports were calculated upon the unadjusted figures of the
preceding census. In decades between censuses the rates of
mortality to some extent showed incorrect results.
Moreover, the circles of registration did not go below the
thana, and the area of a thana was sufficiently large to
permit of great variations in the circumstances of different
portions of it. According to the Drainage Committee Report
enquiries during 1905 detected the omission to register only
.72 percent of the deaths checked.'"'This seemed to be very
unlikely because of the large amount of omissions we found
in the later years.
The extraordinarily low birth-rates reported from a

146
number of towns also supported the view that registration
was extremely inaccurate. Thus in 1911, investigation of
Chittagong town brought to light the fact that 41 percent of
vital occurrences were unrecorded; a similar house to house
enquiry in a portion of Dinajpur town in 1912 revealed 35.5
percent of deaths and 31.7 percent of births unreported. In
a paper read before the Sanitary Conference of Madras in
1912, Dr. B.B. Brahmachari showed that during the period
1903 to 1908, the percentages of omission in the Police
Register of death in that municipality varied between 66.2
to 78. The recording of vital statistics in rural areas in
Bengal was more inaccurate than urban areas. A house to
house enquiry in some villages in Faridpur district brought
to light 453 deaths of which 132 or 29.13 percent had not
been recorded at all.'**
Finally, the total death rate as recorded in later
years might be reasonably accurate, but the classification
of the causes of death dependent upon the acumen of the
village chowkidar was notoriously misleading. The situation
could be much worse as so many other agencies such as
qhat w al s. p an ch av et s . p a t w a r i e s . headman of villages, tax-
darogahs in some districts, kotwals in some cantonments were
employed to record information for births or deaths.
In dealing with the causes of death in the late
nineteenth and early twentieth century in Bengal, the vital
statistics recognized eight classes, namely, cholera, small
pox, plague, fever, dysentery and diarrhea, respiratory

147
diseases, injury and all other causes. To the mind of the
reporting agency "fever" was the category within which it
was simplest to place the majority of deaths which did not
present the well-defined symptoms of cholera, small-pox,
injury, and to some extent, plague. That the term "fever"
was not synonymous with malarial fever was a commonplace
weakness of the sanitary reports. The first attempts in
Bengal to analyze the mixed total returned as deaths from
"fever" was made by Captain Rogers, in the course of a
special inquiry in the Dinajpur district in the year 1904.
By questioning the surviving relatives regarding the
circumstances of 1,104 deaths reported as from "fever," the
conclusion was arrived at, that nearly one-third of the
cases returned under the head "fever" which included 90
percent of all deaths in Dinajpur district were incorrectly
classified. While two-thirds were correctly returned, less
than half were due to malarial fevers, and the rest due to
various chronic d i s e a s e s ’The histories of these diseases
were not sufficiently identified to enable them to be
accurately diagnosed. The procedure adopted was admittedly
imperfect, but in the absence of any recorded examinations
of cases of illness during the life time of the patients, no
alternative method of comparison was available.
In the three districts of Jessore, Nadia and
Murshidabad where Stewart and Proctor made their
investigation, the histories of illness was obtained from
relatives of 835 persons who died from 1905 to 1907 and

148
whose deaths had been registered as "fever". The table that
was formulated covered the twelve months from January to
December, and common diseases of eight types including
malaria acute and chronic. From the table it appeared that
acute and chronic malaria together were responsible for 36.1
percent, or one-third, of the deaths registered as "fever."
The seasonal incidence began to rise with the onset of the
rains, continued to increase through the autumn and was
heaviest in December. Phthisis was responsible for 7.5
percent, and dysentery and diarrhea for 12.3 percent of the
"fever" deaths.*** These figures however, did not represent
the total mortality due to these diseases. Persons much
debilitated by malaria appeared to be predisposed to such
diseases as phthisis, dysentery and diarrhoea, so that many
deaths ascribed to these diseases were primarily due to the
continuous suffering of malarial infection.
In another table, the age incidence of "fever" deaths
enquired into, the results showed that a nearly half of the
deaths due to acute malaria occurred in children under 5
years, and that about half of the deaths due to acute and
chronic malaria were under 10 years. While taking spleen-
rates in the districts of Nadia, Jessore and Murshidabad,
627 children of 1 year and under, were examined, of these
202, or 32 percent, were suffering from enlarged spleen; and
had probably several attacks of malaria. The large
infantile mortality due to malaria was not surprising when
large proportions of them had suffered repeatedly from the

149
disease, and when most of them left untreated. Out of 291
"fever" deaths in children under 10 years of age, 89 or 30.6
percent were due to acute malaria, and 58 or 19.9 percent,
to chronic malaria. In the case of adults over 20, out of
440 "fever" deaths; 60, or 13.6 percent, were due to acute,
and 57 or 12.9 percent, to chronic m a la r ia .**’There f or e, the
proportion of the "fever" deaths due to malaria was greater
in children than in adults. Still mortality among adults
directly from malaria was quite high. The deaths of adults
due to malaria might be attributable to the fact that many
people did not get efficient treatment with quinine, as
among persons properly treated, malaria was not a fatal
disease except in a small proportion of cases.
The diminished birth-rates in the districts of Jessore,
Nadia and Murshidabad was also to be ascribed at any rate in
part to the great prevalence of malaria, both by causing
abortion or still-birth, and by lessening the reproductive
powers in persons debilitated by continued attacks.'*® The
analysis of 835 deaths scattered over three districts,
Jessore, Nadia and Murshidabad led to the conclusion that
acute and chronic malaria together were responsible for
rather more than one-third of the deaths registered due to
fever. This result was analogous to the findings of Captain
Rogers in Dinajpur.
Looking at the the approximation of deaths attributed
to other causes, some of these deaths might also be due
indirectly to malaria. The Drainage Committee thought that

150
some useful purpose would be served by an elaborate
calculation from the "fever" death rate due to malaria. It
also accepted that one-third only of the deaths returned
from "fever" were caused directly by malaria. Among
children under 10, the propagation for both chronic and
acute malaria was far higher and was calculated to be 50.5
percent; among adults over 20, their percentage was 26.5. So
the average death due to malaria was 38.5 percent. The
corresponding proportions of deaths for malaria measured by
Captain Rogers for children and adults were 48.2 and 31.2
respectively. The average of deaths from malaria from
Roger's figures turned out to be 38.7. Thus the results of
both the investigations are very close.
Let us turn to some data which had been obtained as
the result of certain investigations that were carried out
in the Galsi thana of the Burdwan District in the years
1907, 1908, and 1909. According to this investigation in
1907, 2,311 deaths were registered in this thana, of which
1,726 or 32.6 per mille of population were ascribed to
fever. Investigation, however, showed that only 18.41 per
mille should have been so returned. In 1908, of 3,107
deaths, 2,141, or 40.61 per mille, were ascribed to fever.
Further inquiry reduced this ratio to 21.68 per mille. In
1909, there were 1,490 deaths, of which 995 were returned as
deaths from fever, or 19.52 per mille. Inquiry reduced this
ratio to 8.30 per mille. Pardey Lukis thus remarked, "From
this and other information of a similar nature, we can, I

151
think, assume, as a working hypothesis, that certainly not
more than half of the deaths ascribed to fever are actually
caused by malaria — possibly very much less. Even so, the
position is sufficiently serious."'®* These enquiries were
carried out by questioning parents and relatives of the
deceased at varying periods after deaths, and cases not
obviously due to other diseases were left under the heading
"malarial fever"; so that in all probability the proportion
was not too high.
The figures arrived at in Bengal was more or less close
to the figures of other malarial regions of India. In the
Annual Reports of the Public Health Commission of the
Government of India, the proportion of death due to fever
had been given as about one-third, while Hehir (1927)'®'
thinks that from one-third to one-fifth would be a fair
average. Christopher, Sinton and Covell (1931) remarked
that "it has been computed from the study of vital
statistics in various parts of India that, of the total
deaths attributed to "fevers," only from 30 to 50 percent
are actually due to malaria. The percentage is probably
higher during epidemics and in hyperendemic areas."'®'
Several investigations had been carried out in different
parts of India in attempts to determine what proportions of
the reported "fever" deaths were probably due to malaria
directly. In hyperendemic areas (spleen rate 60 to 80
percent), malaria appeared to account for from 40 to 50
percent of the "fever" mortality. In areas of high

152
endemicity (spleen rate between 25 and 50 percent), the
proportion was about 30 percent, while in areas of lower
endemicity the figures might be about 10 percent.
The figures, very approximate as they are, suggest,
however, that there was some degree of correlation between
this proportion and the amount of malaria present, as judged
by the splenic index.
Major Fry in 1912 collected data to establish the true
value of the statistical returns of deaths from fever. His
results indicated that two-thirds or more of the deaths
reported under the "fever" heading and classed as malaria
had no connection with the disease.*®* This did not agree in
the main with the conclusion first reported by Rogers in
Dinajpur, and later by Stewart and Proctor.
Phthisis, pneumonia, endemic fever, measles, and
tetanus were common diseases in Bengal. All deaths from
these diseases were returned under the "fever" heading. On
his own assertion, if two-thirds of the fever deaths had no
connection with malaria, it was assumed that one-third would
be malaria. But there was another point of disagreement
with Fry and later investigations. He found that the fever
curve was generally pushed up in sympathy with the rise in
cholera "which meant that a certain portion of the cases
were wrongly returned as fever,"***he asserted. This
contention of Fry did not hold good in subsequent
investigations.
153
The Indirect Effects of Malaria on the Death Rate
The indirect mortality from malaria might be caused
either by the infection predisposing to death from other
causes in the patients, or might act indirectly on the
uninfected dependents of the malarious patients. Numerous
research efforts had pointed out that an increase in the
incidence of malaria was followed by a rise in general
sickness and in the mortality from other causes. On many
occasions it had been observed that as soon as the
beneficial effects of the anti-malarial measures were felt,
there was a distinct, and often conspicuous, fall in the
general mortality.
In one study, the detailed vital statistics collected
by Brahmachari (1923) from three adjacent malaria localities
in a rural district of Bengal, some interesting points
emerged. When severe malaria invaded one of these areas
(Bokhara), apart from a rise in malaria mortality of over
400 percent, the recorded non-malaria death rate rose about
2 1/2 times. In succeeding years when the malarial
mortality had fallen again markedly, while non-malaria death
rate also fell, the latter still remained higher than in the
adjacent areas. These later effects probably represent the
action of other diseases in causing mortality among a
population weakened by chronic malaria. When the malaria
incidence was at its highest, it seemed probable that many
of its victims succumbed to other acute infections within a
comparatively short period.

154
Watson in 1924 stated that, under ordinary
circumstances, the death rate in a malarial area was two to
five times that of a similar community free from
malaria. The Report of the Roval Commission on Agriculture
in India* " (1928) pointed out the importance of malaria as a
predisposing cause of death from other diseases in India.
The death rate in infected children after the first year of
life was mainly due directly to the intensity of the
parasitic infection, although secondary affections might
play a role in terminating the patient. Among adults, on
the other hand, indirect mortality was usually a more common
cause of death among individuals weakened by this disease.
The Twentieth World Health Assembly defined the causes
of death to be entered on the medical certificate of cause
of death as "all those diseases, morbid conditions or
injuries which either resulted in or contributed to death
and the circumstances of the accident or violence which
produced any such injuries."**’ The purpose of the
definition was to ensure that all the relevant information
was recorded and that the certifier did not select some
conditions for entry and reject others. It will be noted
that the definition does not include symptoms and modes of
dying.
The problem of classifying causes of death for vital
statistics is relatively simple when only one cause of death
is involved. However, in many cases two or more morbid
conditions contribute to the death. In such cases, it has

155
been the traditional practice in vital statistics to select
one of the causes for tabulation. This cause has been
variously described in the past as "the cause of death,"
"primary cause of death," "principal cause of death,"
"fundamental cause of death," etc. In order to make uniform
the terminology and procedure of selecting the cause of
death for primary tabulations, it was agreed by the Sixth
Decennial International Revision Conference that the cause
to be tabulated should be designated the underlying cause of
death. The Ninth International Revision Conference defined
the underlying cause of death as "the disease or injury
which initiated the train of morbid events leading directly
to death.":''In order to secure uniform application of this
principle, it is implicit that the medical certification of
the death should use a form recommended by the World Health
Assembly. It is assumed that the certifying medical
practitioner is in a better position than any other
individual to decide which of the morbid conditions led
directly to the death and to state the antecedent
conditions, if any, which gave rise to the cause. Today the
medical certificate for death is very precise and clear, and
it elicits information which facilitates finding the
underlying cause of death when two or more causes are
jointly recorded.
The registration of deaths was started in Bengal in
1870. The responsibility of reporting deaths to the nearest
police station was laid on the village watchman, an

156
illiterate person. The reports from the police stations were
than sent to the magistrates or civil surgeons of the
district, who after checking them send them to the Sanitary
Commissioner of Bengal. Here the reports are tabulated and
presented to the government as an annual report. In Bengal,
as in most other countries, the attempt to register births
and deaths had not been very successful. The failure was
mostly to register all births and deaths. Also for births
and deaths the amount of ancillary information obtained was
wholly inadequate. The occurrence of the birth that was
recorded did not provide information on religion,
occupation, residence, caste or age of parents, or the birth
order. Sometimes some of this information was gathered but
not published. The death certificate usually contained only
a statement as to the cause of death and not the possible
contributing causes, because of the scarcity of doctors and
the ignorance of the registering officials. In the
publication of statistics, only eight causes of death were
given including, of course, "other causes" which was in
effect an invitation to avoid responsibility. This is
particularly true in our assessment of malaria.
It had been found that "easy-chair examinations of
district statistics, if followed by comments on the returns
and instructions for future guidance, frequently give rise
to a rapid improvement which can be traced at once to false
statistics intended to bring the district figure up to the
assumed s t a n d a r d . ’Practically it amounted to this, that

157
when a village's figures had passed through the police to
the magistrate or civil surgeon, they were almost always
unable to check them. They were afraid to do so from a
distance, fearful of more confusion, and complicated error
with falsification. Moreover, because they were doing their
duty without responsibility they never looked back about the
consequences.
It is said that "the history of collection of vital
statistics in Bengal is the history of an unequal struggle
maintained with insufficient means, and not with infrequent
changes of policy, by over-worked officials against the
apathy or the open hostility of the masses."**' This was the
remark of a Census Commissioner, who seemed to be more
sympathetic to the officials than to the people. The
constant manipulation of the mortality figures might put a
good face on a bad situation without advantage to people.
With such incomplete and inadequate registration the
assumption might be that Bengal vital statistics were
useless. This is not wholly true. In various ways, the
registration figures could be used for estimates that must
have come near the truth. It also helped in discovering the
trends that had some validity. When combined with the
census returns, vital statistics throw considerable light
on the pattern and virulence of a particular disease. The
pooling of death registration with census life tables and
special studies of epidemics yields a considerable body of
sound information.
158
Notes to Chapter VI
‘•'Jacques Bertillon is well known for his compilation

of the Classification of the Causes of Death. The Abstract
published in Transition of the 15th International Congress
of Hygiene and Demography (Washington,1912), p p . 52-55.
‘••J.Elliot, Report on Epidemic Remittent and

Intermittent Fever Occuring in Parts of Burdwan and Nuddea
Divisions (Calcutta, 1863), p. 8.
*•‘D.B.Smith, Report of Dr. Smith. Sanitary Commissioner

for Bengal, on "Epidemic fever of Lower Bengal", in the
Hooghly District (Calcutta, 1869), p. 2.
* *'Ibid. . p. 3.
‘• ’Finance D epartment. Sanitation, (Calcutta, 1877),

p. 1.
‘• 'Annual Report of the Sanitary Commissioner for Bengal

‘'’Annual Report of the Sanitary Commissioner for Bengal

‘’•A.B. Fry,First Report on Malaria in Bengal.

(Calcutta, 1912), p . 5.; Bentley, "Note on Some Points of
Interest Regarding Vital Statistics", Supplement to the
Indian Journal Medical Resea rc h . Vol. V. (Calcutta, 1914),
pp. 177-179.
‘’‘Imperial Gazetteer of India. Calcutta, 1881.
‘ ’•Census of India. 1891, Bengal (Calcutta, 1893), p. 1.
‘ ’’Kingsley Davis, Population of India and Pakistan

(Princeton, 1951), p. 4.
‘’•Census of India. Vol. 5., Bengal, Bihar, Orissa and

Sikkim, Part. I. (Calcutta, 1913), p. 157.
‘’•Report of the Drainage Committee of Bengal (Calcutta,

1907), p. 4,
‘’•Bentley.Report on Malaria in Bengal (Calcutta, 1916),

p . 6.
‘ ’’Report of the Drainage Committee of Bengal (Calcutta,

1907) , p. 5.
‘ " Ibid. . p. XI.
‘’’Captain Stewart, Final Report on the Districts of

159
Jessore. Nadia and M u r s h i d a b a d . Appendix I, No. 38.

(Calcutta, March 1907), p. XII.
'"'Ibid. . P. XII.
Pardey Lukis, "Malaria in Bengal".Records of the

of the Malaria Survey of Indi a. Vol. I, (Calcutta, 1930),
p. 141.
*“*Sinton, What Malaria Costs India. Health Bulletin

No. 26. (Calcutta, 1956), p. 3.
^"'Ibi d . p. 4.
***Fry, First Report on Malaria in B e n g a l .(Calcutta.

1912), p. 35.
'"'Ib i d. p. 5.
'" "The Report of the Royal Commission on Agriculture in

India. (Calcutta, 1928), p. .
'®'Manual of the International Statistical

Classification of Diseases. Injuries, and Causes of D e a t h .
Vol. I, World Health Organization (Geneva, 1977), p. 763.
'" 'I b i d ., p. 763.
'"'Census of India.B e n g a l . Vol. I (Calcutta, 1883),

p. 63.
" "Ibid. . P. 62.

CHAPTER VII
POPULATION AND MALARIA IN BENGAL
The impact of malaria on the population of Bengal was
devastating. Before we assess the effects in detail we
should look into the demography of Bengal at the beginning
of British rule. The population record of Bengal is full of
contradictory figures. But we will be able to discover a
pattern in the relation of past population growth to the
incidence of malaria.
Population of Bengal before 1872
The information regarding the early population of
Bengal was not only scanty but unreliable, based on
guesswork or rudimentary calculations. In 1787 Sir William
Jones thought that it amounted to 24 millions, including
part of the United Provinces then attached to Bengal. Five
years later Colebrooke placed it at 30 millions. Thomas
Twining travelling in India in 1792 made some remarks about
the prosperity of and population of some cities of
Bengal. He said:
This fine country enjoying a rich productive soil

and watered by numerous rivers, is divided into several
districts,the principal of which are - Burdwan, Nuddea,
Rajshye, Burbhoom, Midnapore, Jessore, Dinajpore
etc. The principal modern cities are Calcutta,
Moorshedabad, and Dacca besides numerous large towns,
160
161
equal in size and population to many cities and even

capitals, of Europe.**'
In a period of half a century most of the districts
mentioned above started to show a decline in population due
to epidemic fever and other diseases. Since the famine of
1770, when a large scale depopulation took place, Bengal
seems to have recovered itself in less than twenty-five
years. Adam Smith writing in 1776 in his Inquiry into the
Nature and Causes of Wealth of Nations, thought the
population of Bengal declining, due to bad management of the
company. To him the economic conditions deteriorated due to
unemployment "want, famine and mortality". And he concluded
that, "This perhaps is nearly the present state of Bengal",
that resulted depopulation.***In reply to Wellesley's
inquiry in 1802 for several districts, the trend toward a
growing population was evide nt .**'The reports for Midnapur,
Burdwan and 24-Parganas showed that there was a considerable
improvement in population and agriculture in the beginning
of the nineteenth century. Hamilton Buchanan reported for
Rangpur and Dinajpur districts in 1808 a good size of
population, numbering three million for each of t h e m . **"The
estimated population of Bengal Presidency, excluding Assam
and Orissa, in the famine period was 10 millions according
to Grant's analysis in 1786. The Fifth Report gave it as 27
millions in 1812. It looked as if the population of Bengal
was growing at a spectacular rate like other countries of
the world. In 1825 the population of Lower Bengal was
calculated by Martin to be 37 millions. As there were

162
157,384 villages and roughly 7.5 million houses, the
population was calculated by taking five inmates to every
house which gave the nearest approximation of 37
millions. " 'Lower Bengal included at that time Bihar and
Orissa. In spite of the doubtful assumptions of this
estimate the figure seemed to be reasonable. But ten years
after, according to the reports of Adam, the population of
Bengal in 1835 was 35 millions.
In 1857, the population of Bengal was more than 40
millions, as estimated by Marshman. The census of 1872 gave
the figure of 42 millions for the Presidency and 37 millions
for Bengal proper. This meant that the population was not
increasing as expected and the reason for that was not far
to seek. In 1872 for Bengal proper, the average density was
389 per square mile. But the average density varied
considerably from district to d i s t r i c t ‘Burdwan,
Murshidabad and Birbhum had much less population density
than Hooghly. From the middle of the nineteenth century
reports were pouring in about the epidemic fevers in
Burdwan, Nadia and Jessore. Undoubtedly the fever was
costing enormous numbers of lives. The stories reported
from some of the areas put the decimination of population to
half of its original number.**' The death figures though not
wholly reliable gave a rough idea about the declining rate
of growth of population of Bengal. The period before 1872
showed that the population curve did not rise uniformly. For
example malaria swept out the population in Dinajpur and

163
Rangpur in the first half of the nineteenth century. But
these loses were made up by Santal emigration. In 1860 Major
Sherwell reported that Dinajpur contained a population of
forty thousand only.* “ This figure is hardly believable.
Possibly he meant the town of Dinajpur instead of the the
district.
The population in Burdwan in the year 1861 was
calculated by Bentley to be two and a half million. He
wrote:
Having regard to the fertility and prosperous state of

Burdwan and its well-known comparative salubrity prior
to 1861, I should not hesitate to assign to it higher
population per house than the average; but assuming
only the average rate of 5.7 persons per house, the
population of the area included in the present district
of Burdwan could not in 1861 have been less than 2 1/2
m illions.* * ’
According to the census of 1872 the population of
Burdwan was 1.5 million. In less than twenty years the
population of Burdwan instead of increasing had gone down to
half to the original figure. Dr. Elliot estimated that in
1872 prior to the outbreak of the fever in Burdwan the
density of the population was not less than 750 per square
mile whereas in 1911 it was only 572. In the like manner
Lt. Col. Crawford stated of Hooghly district.
It would appear that, before the fever broke out, the

Hooghly district must have had a population of
something like 2,000,000 and that during the 20 years
the fever lasted, the population fell by about 50 per
c ent .* * *
The decline of population in Burdwan and Hooghly
referred to by Dr. Elliot and Col. Crawford continued till
the end of the nineteenth century. Not only these areas but
164
many other parts of Bengal as well were affected by loss of
population.
David Smith, the Sanitary Commissioner of Bengal, in
his report of 1868 thought the population of Eastern Bengal
was decreasing. But he qualified it by saying.
There are no statistics to go by; but from enquiries

made among the people I have satisfied myself that the
population of all old villages, (and these form the
majority ) is diminishing. On the other hand, whenever
a new village is planted, population rapidly
increases.* * *
It should be noted that the population estimates that
were available before 1872 were less than
satisfactory. Earlier attempts were mostly guesswork and
their reliability depended on the ability and method used by
the observer. This was evidenced by the fact that Hamilton
in his Gazetteer put the population of Dhaka, the most
important city of East Bengal, at 150,000 but less than
twenty years after, in 1823, Bishop Heber estimated the
number of inhabitants of Dhaka at 3 0 0, 00 0 .* *'But in 1872
Dhaka had a population of 1.8 million and that of Dhaka city
69,000 thousand according to the census report. The
population of Dhaka however, was reduced due to economic
stagnation, a good index for disease to take place.
On the inaccuracy of population estimation the Royal
Commission stated;
In Bengal, Bihar and Orissa, which we had under

control for nearly a century, no nearer approximation
has yet been made to ascertain the number of our
subjects, than the clumsy and inaccurate contrivance of
roughly ascertaining the houses and huts in villages or
districts, and then supposing a fixed number of mouths
in each houses (say five or six). The fallacy of such
165
estimates is now admitted, and the rulers are looking

to see the value of a correct and full census....**'
Although population estimation was not accurate in most
areas the graphic descriptions of the devastations of
villages by the epidemic fevers was very touching in many of
the accounts. The decline of population in some parts of
Western and Northern Bengal became an established fact as
pictured in the census reports.
Population in Bengal After 1872
Since the first census was done in 1872 much water had
flowed under the bridge. At first public interest in the
census was slight. The officials concerned did not regard
the census as anything more than a mere count of
heads. Still a convenient starting point for the study of
population and disease in Bengal would be 1872 because
presumably reliable population statistics were available
from that year.
From the census records we can identify a few important
trends in the change of population growth in Bengal. First,
from 1872 to 1921 there was a declining or stationary
population in many parts of Western, Central and Northern
Bengal. Secondly, there was a rapidly growing population in
most districts of Eastern Bengal. Thirdly, there was a
period of growth followed by one of a diminishing rate of
growth and then by another spectacular decline in the years
between 1910 and 1920. Little importance has been attached
to the diminishing rate of population in Bengal before the

166
first census.**‘Ironically when the first census was
undertaken in 1872 the population of Bengal had already
started to decline due to the emergence of the epidemic
fever known as "Burdwan fever". It is interesting to note
that the first census report did not elaborate the epidemic
fevers of Bengal that had ravaged the Western and the
Central parts of Bengal for more than a decade. But in a
casual manner it did mention the effects of the epidemic
fevers that left the deserted remains of ruined houses as
the people who survived fled out of fear, some of them dying
in the process of fleeing.**'All these were enough to give
an impression of how perilous the fever had been. The
epidemic fever that lasted for decades had carried off a
large number of Bengalis.
Dr. French, the civil Surgeon of Burdwan thought that
the population of Burdwan was growing before the outbreak of
the epidemic. According to him;
Overpopulation has existed for a long time in

Bengal. My report, however, applies to Burdwan. The
last census gives for Burdwan a total population of
2,031,508 souls, or 580 to the square mile. Before the
outbreak of the epidemic fever we may safely assume
that the population was 2,708,677, or about 750 to the
square m i l e . * * ‘
Dr. French attributed the fever to the over-crowding
of the district. He thought that because of over-population
air and water became polluted and the food supply
diminished. He seems to have been overwhelmed by the theory
of Malthus.
The decline and growth of population is a valuable

167
index to the disease situation of a country or region. The
progression and regression of population from census to
census provided therefore a valuable testimony of the
general health conditions obtaining during each decade. The
attached graph will show the percentage of expansion of
population in every divisions of Bengal from 1872 to 1921
The growth of population can only occur in two ways, by
birth and by immigration; and it can be checked or prevented
by three factors only, increased mortality, decline in the
number of births or emigration. In the light of these
factors we can read much of the health history of Bengal
during the fifty years of our study. Ignoring for the
present the effect of migration which was very nominal, the
regions that show a remarkable growth of population must
ordinarily have much higher birth rates or much lower death
rates or both than those where the population has been more
or less stationary or where the rate of growth has been much
slower or retarded. In brief the areas with the faster
growing population were much more healthy than those where
expansion had been diminished. On the other hand regions
whose populations actually declined must obviously had been
unhealthy. In that situation increasing death-rate and
falling birth-rate indicate that the normal growth rate had
been checked or that an actual decline had occured due to
the predominant prevalence of certain diseases.
In Bengal the pattern of population growth was not
uniform. Some regions had extraordinary growth and others

168
Map 1.
A MAP OF THE REGIONS OF BENGAL
169
HAR NORTHER
BEKCAL
Regions of Bengal
Map 1.
A MAP OF THE REGIONS OF BENGAL
170
were depressed. Variations between different regions of
Bengal will give us some clues to the nature of change.
Bengal could be divided by its main river systems into four
natural divisions, viz.. Western, Central, Northern and
Eastern Bengal. (See Map 1). Since the first census of 1872
there had been remarkable variations in the rate of total
growth of the population in those four regions as can be
seen from Table 1.
TABLE 1
VARIATION OF POPULATION IN BENGAL, 1872-1921
Population Population 1872-1921

Regions in 1872 in 1921 increase
in thousands in thousands per cent
Western Bengal 7,604 8,050 + 5.9
Central Bengal 7,403 8,481 +14.6
Northern Bengal 8,045 10,345 + 28.6
Eastern Bengal 11,065 18,837 + 70.2
Total 34,117 45,713 + 34.0
SOURCE: Census of India. 1921, Vol. V, Bengal,
Part II, p. 4.
The rate of growth of population in the four natural
divisions were very wide, especially between Western Bengal
and Eastern Bengal. The rate of increase of population has
some direct relationship with the density of population over

171
the years. Let us look the population density in the four
regions of Bengal in Table 2.
TABLE 2
DENSITY OF POPULATION, 1872-1921
Area in Density Density Increase

Regions square per square per square per sq.mi.
miles mile 1872 mile 1921 1872-1921
Western Bengal 13,948 545.2 577.1 + 32
Central Bengal 14,779 500.9 573.9 + 73
Northern Bengal 19,235 418.2 537.8 +120
Eastern Bengal 22,879 483.6 823.3 + 340
Average — — 487.0 628.0 +141
SOURCE: Census of India. 1921, Vol. V, Bengal, Part
II, p. 4.
The density of population in the different regions of
Bengal was not uniform as can be seen in the table. The
extraordinary development of population in Eastern Bengal
was due entirely to natural growth by excess of births over
deaths. There were few towns and no important industries to
attract immigrants, and this natural division also, as a
matter of fact, had lost rather than gained by
migration. This area afforded therefore an example of normal
expansion occuring in an agricultural population living
under relatively favorable conditions. The economic and

172
natural conditions were obviously different in the other
divisions, some of which possessed important industries
which attracted immigrants in large numbers. Western Bengal
for example possessed coal, iron and related industrial
enterprises. Central Bengal had a number of towns with many
mills and factories and Northern Bengal included areas with
a good number of tea gardens. Estimates of the gain by
migration from these and other causes were difficult but the
excess of emigrants in 1901 and 1911 respectively was found
to be about 6.3 and 7.4 per cent of the population in
Northern Bengal and 5.5 and 8.8 per cent in the Central
Beng al .**'Much of the expansion in this latter division was
undoubtedly due to immigrants to its many towns. Western
Bengal on the other hand lost nearly as many by emigration
from certain of its rural areas as it gained by immigration
into its towns and industrial tracts. In Eastern Bengal
population movement was insignificant.
From the Table 2 we see that the average density of
population over the whole of Bengal in 1872 was 467 and in
1921 was 628 per square mile, excluding the Hill districts
of Darjeeling and Chittagong Hill Tracts and Tripura
State. There were great inequalities in distribution of
population even in the plains. The area with a density of
300-750 persons per square mile covered two thirds of
Western and Northern Bengal and nearly two thirds of Central
Bengal but only 22.5 per cent of Eastern Bengal. The area
with more than 750 per square mile covered about one fifth
173
of Western and Northern Bengal and somewhat less of
Central Bengal, no less than 44.3 per cent of Eastern
Bengal. The heavy density of population in Eastern Bengal
might further be judged from the fact that 21.5 per cent of
the total area supported over 1050 persons per square mile,
as compared with 3.3 per cent in the Northern Bengal, 4.3 in
the Central Bengal, and 6.3 per cent in the Western
B e n ga l. * * *
The population Eastern Bengal continued to increase
and in course of time surpassed other regions. The increase
of 8.3 per cent. in the decade 1911 to 1921 in Eastern
Bengal might be contrasted with the decrease in the Western
Bengal of 4.9 percent and the practically stationary
population of Central and North Bengal. The heavy density
of population and the greater increase of population in East
Bengal was due to the greater productive capacity of its
soil as well as a better natural sanitary conditions.
Even in East Bengal the population density was not
uniform. East Bengal was comprised of Dhaka Division,
Chittagong Division and Tripura State. The Tripura State had
a mean density of 93 per square mile and Chittagong Division
534, but if we take Dhaka Division whose mean density was
809 in 1921, and in 1881 it was 586 per square mile, we find
that the increase in this division had been greater than in
East Bengal generally. If the process was carried a further
step forward, we would see that Mymensingh, one of the four
districts of Dhaka Division, showed a density of over 1200

174
in 1921 and an increase of more than 60 per cent since 1881.
Mymensingh had a mean density of 752 in 1881 which was
greater than the density of England and Wales in the 1920s
which was about 700 per square mile. In spite of being
almost entirely a rural area which had no industrial
development, except the increase in the value of the
agricultural products such as jute, its density per square
mile had increased over 500 per square mile over a period of
forty years. The progressive increase of population in the
most densely populated parts of the country was a very
significant fact because contrary to the generally accepted
Malthusian view held by most of the sanitarians, the
population of Mymensingh, and for that matter East Bengal,
grew even further without a significant increase of malaria
or any other diseases.
What would the population of the Western, Central and
Northern, be respectively in 1921, if they had expanded
since 1872 by more than 70 per cent, the rate of growth
which had actually occured in Eastern Bengal? Western
Bengal would have nearly five million. Central Bengal nearly
four million and Northern Bengal over three million more
people. The province would have possessed a population
greater by more than twelve million than it did at the end
of 1921 census, that is roughly more than fifty eight
million against forty-six million, why was it that expansion
did not occur? A partial explanation is to be sought in the
fact that for a very long period the population of large

175
areas in the several divisions ceased to expand at a healthy
rate. But a factor of even greater importance is the actual
decline of population that took place in tracts covering
many thousands of square miles. The area in each natural
division in which population showed a decline at each of the
five census enumerations is shown in Table 3.
TABLE 3
AREAS IN SQUARE MILES IN WHICH

POPULATION HAS DECLINED
Regions 1872-81 1881-91 1891-01 1901-11 1911-21
Western Bengal 7,149 5,027 1,428 5,339 11,515
Central Bengal 2,590 4,444 4,488 5,262 7,126
Northern Bengal 6,534 5,483 3,878 3,175 6,964
Eastern Bengal 6,476 1,109 2,180 1,388 465
Total 22,749 16,063 11,974 15,164 26,070
SOURCE: Birij Narayan, The Population of India
(Lahore, 1925), pp. 156-158.
With the exception in the period of 1872-81 the decline
of population affected a relatively small area in Eastern
Bengal at each succeeding decade. The cause of the large
area found decadent in 1881 was the tidal wave of 1876 which
affected much of Barisal and Chittagong and parts of
Noakhali and Comilla districts and resulted in an appalling
loss of life. The figures of the last decade give the best
176
idea of the relative conditions of the different parts of
the province. They show that 83 percent of Western Bengal
was decadent, 60 per cent of the inhabited parts of the
Central Bengal was in a similar condition and 36 per cent of
the Northern Bengal was affected by decline of
population. In Eastern Bengal only 2 percent of the total
area showed a reduced number of inhabitants.
An examination of the census returns for the years 1872
and 1921 showed that depopulation was no new phenomenon in
the districts of Western, Central and Northern Bengal. For
example Burdwan district showed a decline of population in
twelve thanas in 1872-1881 numbering to 150,000 and a
further loss of 40,000 in nine thanas in 1891. Between 1891-
1901 it showed a recovery and only one thana area recorded
loss of population. The population of the district increased
by 4 per cent between 1901 and 1911 but again it showed a
loss of population of 6.5 percent over the previous decade
in the census of 1 9 2 1. ** ’Similarly the Birbhum district
showed a very heavy loss for the decade numbering to 86,000
persons in certain areas at the census of 1881 and a further
loss of 17,000 in 1891. In the decade of 1891-1901 there was
no loss in any thana area. In the census 1911 it was found
that population grew further but in the 1921 census Birbhum
showed a loss of population almost 100,000 and Bankura
district showed a loss for the decade in two thanas at the
census of 1881, totalling 22,000 and ten years later a
further loss of 17,000 was recorded from four thanas. At the

177
census of 1901 one thana only recorded a diminished
population. In the overall record the district gained
population in the census of 1911 but in the next census of
1921 it showed a loss of population by more than 100,000. In
the overall record the district was a depressed area.
Midnapore district likewise showed an extensive loss of
population, numbering over a 140,000 persons at the census
of 1881 and a further decline of nearly 100,000 in the
population of the decadent parts of the district in
1891. Although in 1901 only three thanas showed a decline of
population in 1911 it gained population. But by 1921 it lost
more than what it gained in preceding decade. Hooghly
district suffered an extraordinary decline in population
between 1872 and 1881. Out of total of 13 thanas, 11 had
lost population by 1881 to the extent of 160,000 persons,
and ten years later 5 thanas had lost nearly 40,000
more. The census of 1901 also showed a further decline in
the population of 7 thanas. The pattern of Hooghly was the
same as that of other neighboring districts in both 1911 and
1921 census. Howrah which showed no decline in the census of
1911, only suffered a trifling loss of 3,000 in 2 thanas
between 1872 and 1881. In the overall population estimation
the district gained population at the end of each census
decade. Indeed the increase of population was only 5.7 per
cent from 1911 to 1921.*'"
Turning to Central Bengal, we find that the 24-
Parganas recorded a decline of population in nine thanas out

178
of 29 in the 1881 census. But in 1891 only two thanas showed
a decline, in 1901 there was a small loss in certain areas
in the north of the district but as there was some change in
the boundary it was difficult to estimate the total
loss. The growth of population from 1901 to 1911 was 17.1
percent, which was a considerable gain, but from 1911 to
1921 the increase was only 7.9 per cent. This meant that
population declined due to the rise of epidemic diseases, as
there was no other evidences of natural calamities. The
census of 1881 disclosed a gain in population in every thana
of the Nadia district, but that of 1891 showed a loss of
population in 14 out of 21 thanas. The decline in these
areas numbered more than 50,000 people. At the census of
1901 a further decline was discovered in 6 thanas. From 1901
to 1911 there was a loss of 40,000 people and it increased
to 130,000 during 1911 to 1921. The picture was quite
bleak for the district. The Murshidabad district showed a
decline of population in 13 thanas, amounting to 58,000
people at the census of 1881, and the succeeding census
showed a further decline in 9 thanas numbering to about
15,000 people. At the census of 1901 also, 7 thanas recorded
a loss of 19,000 people. From 1901 tO 1911 there was total
gain of 40,000 people in the district, and from 1911 to 1921
the loss was more than 100,000 people.
Every thana of Jessore district showed a gain of
population at the census of 1881. But the census of 1891
showed a decline in 13 thanas numbering to a total loss of

179
over 70,000 people. And the census of 1901 disclosed a
further decline in 17 thanas, that totalled more than 80,000
people. From 1901 to 1911 there was a loss of more than
50,000 people and again from 1911 to 1921 the loss declined
to 20,000 people. This district showed a continuous decline
of population for forty years. Khulna district also
experienced a decline in five thanas at the census of 1881,
and a further loss in 3 thanas in the next decade. The
census of 1901 also disclosed a decline in the same number
of thanas. But the total picture of the district was
encouraging. It gained population from 1872 to 1921, in each
of the census decades.
In the Northern Bengal, Rajshahi had been decadent for
a long period of time. The census of 1881 disclosed a loss
of population in seven out of 14 thanas. The total decrease
amounted to nearly 50,000 people. There was a further
decline at the census of 1891, numbering to over 60,000
persons and a further loss of nearly 30,000 people in 6
thanas in the census of 1901. In actuality the district
itself gained population in each of the census enumerations
but in a decreasing rate. For example it gained 20,000
people between the census year of 1901 to 1911 but in the
decade of 1911 to 1921 it was reduced to 9,000 only. Pabna
did not begin to show a loss of population until 1891 when
there was a decrease in three thanas. The loss in those
areas was about 14,000 people. In 1901 there was a further
loss of 24,000 people. But on the average the district

180
gained a population of about 60,000 people in the decade of
1891 to 1901. In 1911 it came down to 7,000 people but the
year 1921 saw a total loss of 32,000 people in the whole
district. Rangpur which at the census of 1911 showed a loss
of population in only one thana, suffered a serious decline
in 11 thanas between 1872 and 1881 of over 80,000 people.
The census of 1891 disclosed a further loss, amounting to
68.000 in half of the thanas of the district. The census of
1901 showed a further loss in 5 thanas, numbering to about
15.000 people. The district seemed to be progressive as it
gained population in each of the decades from 1901 to
1921. In the decade of 1921 it gained 120,000 people but it
was half of the previous decade. Certain thanas of Dinajpur
district declined in population between 1872 and 1881. These
six thanas lost 20,000 people. In 1891 four of the same
thanas had suffered still further loss, but the decline in
population was very small. In 1901 only one thana, which had
been decadent since 1872 showed further decline. The
district continuously gained population till 1921. But the
decade of 1911 to 1921 the growth was only one per cent. The
census of 1881 disclosed a small loss in several thanas of
the Malda districts, and there was also a slight decline in
three thanas at the census of 1901. From 1901 to 1911 there
was a tremendous gain of population in the district, an
increase of 120,000 people. But from 1911 to 1921 the
district showed a population loss of almost 20,0 00 .“ *
When we turn to Eastern Bengal we find that with the

181
exception of Faridpur, none of the districts showed decadent
areas of long standing. I.i raridpur, Bhushna thana had been
steadily losing populatiw.*.’ since 1872, and Pangsa thana
showed a decline of nearly 24,000 persons at the census of
1891. This great loss was said to be in part due to the
mistaken counting of the population with Nadia. But the
census of 1901 showed a further loss in Pangsa as well as
Bhushna. The decline of population in the north-western
part of the district was observed in 1911. In the overall
makeup the district continuously gained population up to
1921. Barisal district was generally healthy but a small
area had been decadent since 1891. In this district the
population figure rose up in each of the census decades in a
progressive rate. But Barisal together with Noakhali and
Chittagong lost population heavily from the cyclone of
1876.
Thus a slow decline in population was observed in
different parts of Bengal especially in certain areas of
Western, Central and Northern regions. In Eastern Bengal,
the losses of population in Faridpur had been confined to
one portion of the district. It might be that when the
population had ceased to expand rapidly and was in most
cases in decline it was because local circumstances, as for
example the food supply, were not especially favorable to
expansion. But an actual loss of population meant very much
more than a lessened rate of expansion. It pointed to the
definite change of climate and ecology or other conditions

182
vitally affecting the welfare of the population which had
made the reduction of the numbers inevitable. About the
decay of the region the Imperial Gazetteer stated that it
occured when the climate which had previously been healthy
underwent an "unexplained change for the w o r s e " .“ 'Knowing
what we now do of the causes of tropical disease we can
safely affirm also that a corresponding increase took place
in the number of anopheles mosquitoes which were harboring
malaria parasites and hence the unexplained change for the
worse of the former healthful climate of Bengal. A serious
decline of population indicated that a definite change had
come over the affected area. The most prominent and best
recognized change in relation to the people was to be seen
in the great increase of fever which was one of the marked
symptoms of malaria.
The paradox of the pattern of decline and rise of
population in Bengal was that it was not only the most
densely populated part of the world but it was also one of
the most densely populated provinces of India. Nevertheless
it was far below the growth rate of other countries of the
world. Table 4 gives the figures of the growth rate of
population from the first census to 1921.
It will be seen from these figures that except for the
last decade the population had been growing at a fairly
uniform rate since 1872. This meant that the factors
governing the population growth remained constant. In the
period from 1911 to 1921 the rate of growth fell from 8 per
183
TABLE 4
POPULATION INCREASE IN BENGAL FROI 1872 to 1921
Total
Year population Increase
in millions per cent
1872 34.6
1881 37.02 6.99
1891 39.81 7.53
1901 42.89 7.73
1911 46.32 7.99
1921 47.60 2.76
SOURCE; Bengal Census R e p o r t . 1921, p. 434.
cent to 2.7 per cent. This fall was chiefly due to the
effects of war and the great influenza epidemic and also due
to a better recording of vital statistics. Considering the
last decade of the table as not normal the increase in
population from 1872 to 1911 was 33.8 per cent. It is also
very interesting to note that between 1872 and 1921 there
had been a total increase of only 13 million people in fifty
years which was very negligible compared to some regions of
the world. During the same period the real increase of the
population as a whole was 37.54 per cent in fifty years. If
we compare it with Britain, Japan and the U.S.A between
1871-1941, we shall see that in Britain the increase was 57
per cent, in Japan 120 per cent and in the U.S.A. 230 per
184
cent.':' According to the Proceedings of the World
Population Conference. 1927, the population of Europe
increased almost by fifty percent from 1870 to 1920, which
is much higher than the population growth of B e n g a l ‘This
slower growth rate of population in Bengal was due largely
to the higher death rate rather than a lower birth rate. In
fact what is known today as the demographic transition in
the industrialized countries began as early as 193 0’s. It
culminated in the convergence of birth and death rates that
finally brought their growth down to zero.''*On the contrary
there is no such signs of transition in Bangladesh or India
even in the near future. In recent times, especially after
the 1 9 5 0 's the population of the subcontinent was growing in
a faster rate than those of the developed countries grew
during the phase of their rapid population growth. It
clearly shows that in our period of discussion the
population of Bengal, if not decreasing as a whole, was not
increasing in an expected pattern.
This slow growth of population as compared with other
countries was not the result of any preventive check
exercised by the inhabitants. As a matter of fact the birth
rate of Bengal was higher than most of these countries. In
the decade between 1901 and 1910 the birth rate and death
rate in Bengal were 36.8 and 32.5 per thousand
respectively. In England they were 27.2 and 15.4 per
thousand. The death rate was much higher in Bengal and in
fact infant mortality was three times greater in Bengal than

185
E n g l a n d . ‘It should be remembered that the birth and death
rates as recorded in Bengal were considerably lower than
actual rates, owing to the fact that a large portion of
births and deaths went unrecorded. Obviously the high death
was due to cumulative effects of malarial fever and other
diseases, and the absence of elementary application of
sanitary facilities in the villages of Bengal where more
than ninety per cent of population used to live and even
live today.
Effects of Malaria on the Population of Bengal
To measure the effects of malaria both direct and
indirect on the rate of population growth is not an easy
task. Bengal offers a copious supply of statistics but they
must be used with much caution. The chief objective in
measuring the demographic impact, namely a quantitative
assessment of the effects of diseases like malaria on
general health, is impossible to attain. We can however
make a qualitative assessment using vital statistics and
other records available. The data are notoriously inaccurate
in Bengal, as previously discussed.
The most important difficulty is the presence of a
great deal of evidence which shows that endemic and epidemic
malaria is a great debilitator of the physique and mind. It
tends to reduce markedly the general healthiness and
resistance to disease in the population at risk. It can
aggravate substantially the mortality effects of other

186
diseases. Yet such deaths were generally entered in the
records as due to enteric fever, measles, influenza and even
kala -a za r. and not as due to malaria.
All these considerations point to the ambiguity
inherent in the very concept of "cause of death". The human
body is subjected throughout its lifetime to a series of
events of which the affliction of a certain disease is only
among the most important. It responds to each of these
events in some definite way, and many of them leave
permanent effects, and finally the body ceases to
function. But whether the body passes away at a certain time
depends both on the actual event which occured at that time
and the whole past history of the particular person up to
that time. It is in a philosophical sense very difficult to
find an appropriate place in this picture for the concept of
"cause of death", still we do it for the sake of convenience
and out of the fascination for keeping records.
With all these limitations certain hypothesis can be
advanced about epidemic and endemic malaria in
Bengal. Judging from the frequency of crisis mortality in
seasons and years in which epidemic disease took place in
certain districts or regions, malaria played a major role in
checking the population growth. The decline of particular
regions or districts or a thana might even be explicable in
part by endemic as well as epidemic malaria. The areas which
had suffered the most had several things in common such as a
high incidence of mortality and high spleen index. Most of

187
the villages that suffered adjoined jungles and stagnant
waterways.
Malaria and Population Growth
Historical demography in relation to a disease is a
difficult pursuit in any age or country, especially in
Bengal where reports were either exaggerated or minimized by
the many government functionaries who contributed to them.
In fact considering the colonial situation the surprising
thing is that there are so many references and reports
relating to the despoliation due to fever and the resulting
dislocation and depopulation of villages after villages and
even district after district in the different regions of
Bengal. One of the earliest records left by Elliot, Civil
Assistant Surgeon on special duty to enquire into the fever
in 1863, contained a vivid account of the frightful ravages
that were brought by it. He thus stated what he saw in the
tour of inspection in Hughli and Barasat.
The deplorable state of some of these places can only

be know by visiting them; but as a general rule, the
greater portion of villages in both districts are
overgrown with jungle and brushwood, more particularly
those in which fever has been prevalent for three or
four y e a r s .*'’
In the twenty one villages visited by him in Hooghly
in 1862, he found that "four-fifths of the population either
have been or affected, and fully 20 per cent have been
died."::'
Early in 1864 a special commission was appointed to
investigate this fever and their report gave a lamentable

188
account of the ravages of the fever in the districts of
Burdwan, Hooghly, Nadia and 24 Parganas. "Villages were
almost depopulated. At Culna, three fourths of the
inhabitants were carried off."'''In many parts of Bengal
population steadily decreased for a number of years. A
heavy mortality from fever was invariably reported from
those places, and the total of recorded deaths usually
exceeded the births year after year. As early as 1861
Martin reported that out of an average 8700 troops stationed
in Bengal proper, there were 4722 cases of fever in seven
year s .: ‘"Dr. D.B. Smith, the Sanitary Commissioner for
Bengal, made the following remarks about the devastating
effect of malaria on the population of Hooghly in 1869;
The present state of the Hooghly District is most

lamentable. The blighting influence of malaria is
everywhere conspicuous, the people are subject to
constant and excessive sickness of an insidious nature;
their vigour is being sapped. Silent but sure
depopulation, on an alarming scale, is going o n . : "
The death figures of the district of Hooghly was
unprecedented. It was said that one third of the total
population died in five years from 1863 to 1869. In a
memorial to the Government of Bengal, some of the leading
zamindars of Hooghly presented this horrible decline of
population in several villages.' ‘'The figures of deaths as
they appeared in the Memorial is shown in Table 5. The
figures in the table show that out of the total population
of 27,111 the death due to malarial fever was 17,285, the
death rate of which was nearly 64 per cent.
Now if we look at the population figures of the Burdwan

189
TABLE 5
THE DEATHS IN HOOGHLY DISTRICT, 1861-1869
The year
Name of in which Population Population Number of
the villages epidemic before the in 1869 deaths
appeared epidemic
Tribeny 1861-62 1,932 1,287 645
Bansberria 1861-62 2,165 1,465 700
Pundooah 1862-63 6,971 1,749 5,222
Dwarbashing 1863-64 784 1,748 1,959
Meygshur 1864-65 982 320 662
Dwarhatta 1866-67 4,182 1,137 3,045
Sumushpore 1868-69 3,859 1,122 2,737
Mamoodpore 1868-69 1,527 590 937
Allah 1868-69 1,155 520 635
Dhuneakhally 1868-69 1,112 415 697
Chakpore 1868-69 483 397 86
Total 1861-69 27,111 9,786 17,325

.......... 1
SOURCE : Report of Dr. D.B. Smith. Sanitary
Commissioner for Bengal, on "Epidemic Fever of Lower
Bengal" in the Hooohlv District (Calcutta, 1869), p. 2.
Division alone during the ten year census period of 1872-
1881, we shall see a net decrease of over four hundred
thousand of people, that is 15.2 per cent of the total
population of seven districts. The changes of the

190
populations in these districts were due to the well known
"Burdwan Fever", which ravaged this Division for a
considerable period of time. The decline of population in
the Burdwan Division was as follows. (See figure 6)
TABLE 6
CHANGES IN POPULATION IN
BURDWAN DIVISION, 1872-1881
Increase Percent of
Regions Decrease variations
Burdwan Division -210,707 -2.7
Burdwan District -92,027 -6.2

Bankura District +73,155 +7.5
Birbhum District -59,357 -6.9
Midnapore District -27,377 - 1.1
Hooghly District -144,617 -12.4
Howrah District +39,516 +6.6
SOURCE: Report of the Bengal Census. 1881 (Calcutta,
1883), Vol. II, para. 151.
Burdillon, the Deputy Superintendent of Census
operations in Bengal in this period estimated the death toll
in the Burdwan Division at over two million. Of the total
loss of population in the whole Division at least one third
or more was due to malaria, because malaria fever was
spreading in epidemic proportions during that period of
time. The effects of fever on the population was depicted in

191
the census report of 1881 in the following words.
Like the waves of a flowering tide it [fever] touched a

place one year and receded, reached it again next year
with a greater force and again receded, repeating this
process till the country was wholly submerged and the
tide passed further o n . ' "
It was believed that even greater desolation took place
by the fatal Burdwan fever during the previous decade. The
total deaths from the Burdwan fever were estimated to be
more than seven hundred thousand.* " T h e Sanitary Commissions
report abounded with harrowing tales of the fever. The
decline of population in Burdwan Division was the history of
the famous Burdwan fever. The ravages of the disease had not
been repaired even after two decades. The ruined villages
had not been rebuilt, and jungles flourished where populous
villages once stood. Many of the villagers fled their homes
because of fever and most of them did not return. "The
impaired powers of the survivors had not sufficed to fill
the smiling land with a new p op ul at i on ". " 'That the fever
was malarious was universally admitted at that time without
knowing its etiology. The Sanitary Commissioner for Bengal,
writing in 1874, said that the f e v e r ,originally malarious,
acquired, either in Jessore or Nuddea, contagious properties
and then carried into Burdwan and the other districts of the
Burdwan Division.
The spread of the fever to the northern districts was
evident from the first census report. It was reported at
that time that in Dinajpur the deaths from fever mortality
was 22.05 per thousand of the whole population. In the

192
subsequent years the rate increased, and over 36,000 deaths
were reported in 1877, from fever. In Rangpur due to the
prevalence of fatal fever there had been a considerable
movement of population, and the Rangpur fever became a part
of "a proverb in B e n g a l " . " * According to the report of the
civil surgeon eighty per cent of the living population were
anemic or suffered from enlarged spleen, a common symptom
of malaria. Of the twenty percent of the population who were
considered healthy, "one half would not be considered so in
the European sense of the word", the civil surgeon
contended.:*'From the fact that the rich were no more exempt
from sickness than the poor, he rightly inferred that the
unhealthiness of the district was not due to poverty but to
malaria for which the whole country was suffering.
Like any other districts of Northern and Western Bengal
the towns, presumably with better sanitary provisions, had
been suffering from the same spell of malarial fever. The
concern over malaria in the towns had been evoked in the
statements of a British physician as early as 1856. This
physician. Dr. Begbie by name remarked;
This rare exposure of European children to concentrated

malarious influence is, be it remembered, the daily and
hourly fate of thousands of our native fellow subjects,
living in Indian towns. Who shall wonder that
Dysentery, Cholera and Fever decimate the
population? " •
He sadly remarked that the Indian towns remained
"unchanged, from what they were two thousand years ago".»**
He thought Calcutta was exempt from such disease, but this
was not true. The marshy areas of Calcutta were and remain
193
the prime breeding grounds for malaria. According to a
Commission of Enquiry on Calcutta for a period of 1867-1883,
it was found that there had been no real improvement in the
health of the city.On the contrary, if the figures were to
be trusted it would appear that the public health was in a
s hamb le s.
The average annual mortality from each of the principal
diseases in Calcutta, from 1867 to 1883 will be found in
Table 7. The Table appears to show that the fever rates had
an increasing trend except in the last period, while the
deaths from "other causes" also showed a large and
consistent increase. Both these factors were partly or
wholly due to an increase of malaria which accounted for 34
per cent of the total death tolls. Deaths from all other
factors might also include malarial fevers. Malarial fever
thus prevailed to a reasonable extent not only in the city
itself but also in the districts around Calcutta.
Malarial fever was one of the greatest destroyers of
lives in Bengal. According to the most reliable figures it
accounted for almost one death in every five. Its impact on
the population figure is undeniable. Malaria frequently was
more closely associated with declines in population than was
famine even during the famine era of 1896-1901. During the
epidemics the worst afflicted tracts had death rates of
several hundred per thousand. A particular strain of malaria
which ravaged parts of Northern Bengal had first been
noticed in 1869 among Garo hillmen. They became so

194
TABLE 7
ANNUAL AVERAGE DEATH FROM DISEASES, CALCUTTA 1847-1883
Bowel Other
Period Fever Cholera complaints Smallpox causes
1867-68 3,763 3,228 2,406 36 3,481

1869-71 3,884 1,978 1,729 74 3,479
1872-74 4,663 1,151 1,358 57 3,517
1875-77 4,947 1,648 1,709 286 4,996
1878-80 4,893 1,110 1,598 794 5,313
1881-83 3,608 1,990 1,417 74 5,754
Total 25,758 11,105 10,217 1,321 26,540
Per Cent 34.37 14.80 13.63 1.76 35.40
SOURCE: Report of the Commission Appointed under the
Section 28 of Act IV (B.C.) of 1876 to Enquire into Certain
Matters Connected with the Sanitation of the Town of
Calcutta (Calcutta, 1885), p. 8.
terrorized that they intoxicated the sick and then set fire
to their houses, killing the people inside. Similar
experience had been recorded by Andrew Fraser, Lt. Governor
of Bengal. He said:
We found that blind panic had seized the villages

causing them to desert their houses and property and
take to flight into the jungle with ruthless disregard
of the sick and the dying. These were often locked up
in their cottages and left, with nothing but a jar of
water, to meet their fate.»'®
195
Anthropologists have noted this behavioral pattern as a
defence against epidemic diseases to ensure the safety of
the living.
From the beginning of the twentieth century the
government became concerned about the problem of fever and
several investigations were undertaken. A malarial survey
was done by Captains Stewart and Proctor in 1907, in the
districts of Jessore, Nadia and Murshidabad. In these three
districts they visited, they examined 13,514 children below
the age of 12. Of these, a total of 7,550 had enlarged
spleens, giving a total spleen rate of 55.9 per cent. In
Jessore the spleen rate was 62.3 per cent, in Nadia, 66.1
per cent, and in Murshidabad, 41.1 per c e n t . » "
In this enquiry it was also recorded that of the 835
deaths reported the acute and chronic malaria together were
responsible for more than one third of the deaths registered
as due to "fever".»®»The findings of their report is given
in Table 8.
In the districts in which depopulated areas were
commonly seen such as Jessore, Nadia, Murshidabad and also
Burdwan, Birbhum, Bankura, Rangpur and Faridpur, the spleen
index was generally very high. Stewart and Proctor who
examined 190 villages situated in the three former districts
during the Bengal Drainage Commission Report found malarial
cases quite high as seen in the table. Major Fry in his
later reports also confirmed the view that these districts
generally presented evidence of a very high incidence of

196
TABLE 8
DEATHS DUE TO MALARIA IN THREE DISTRICTS, 1906-1907
Number
Area of of fever Malaria Malaria
enquiry deaths acute chronic
enquired into per cent per cent
Jessore 398 10.2 14.8
Nadia 195 16.4 23.6
Murshidabad 242 21.6 13.6
TOTAL 835 16.06 17.33
SOURCE: G.E. Stewart and Proctor, Final Report
on the Districts of Jessore. Nadia and Murshidabad
(Calcutta, 1907), p. x.
malaria. Depopulation was also very high in the districts
mentioned above. Dr. Brahmacharia, the Deputy Sanitary
Commissioner in the Presidency Circle, confirmed the
severity of malaria in his circle. He said that there were
hardly any villages left which had no patient suffering from
malaria. In most of them "the disease has secured a firm
footing with its focii in chronic patients almost in every
house in t h e m . " * " Stewart and Proctor in their survey found
that persons debilitated by malaria appeared to be
predisposed to such diseases as tuberculosis, dysentery and
diarrhoea. For that reason many deaths ascribed to these
diseases were primarily due to malaria, they concluded. The

197
constant presence of malaria had far flung consequences
with regard to the decline of population in those districts.
A systematic enquiry was made by C.A. Bentley, the
Director of Public Health, Bengal, between 1911 and 1916,
into the extent and distribution of malaria. Using the
results of investigations by various medical officers during
the same period, Bentley was able to trace a very close
correlation between the changes of the population of the
decades 1901-1911 and the prevalence of malaria as indicated
by the spleen index and fever index. A close correlation
could be traced between the changes of population in 1911 to
1921.
Bentley, in the Malaria Conference at Madras, produced
a letter from a zamindar of Bengal who was lamenting the
death of people in one of the villages under his
jurisdiction. The pathetic effects of malaria was amply
illustrated in the letter which read as follows:
Sir,
I have the honour to say I am an inhabitant and
also a zamindar of a village named M a dh ab pu r....
which is now on a verge of depopulation, owing to
malaria. The village is lying on the river Kumar
which is about to be sealed up. About twenty years
ago we had more than a thousand people in our
village, but now we have only a hundred men. What
a horrible thing it is!"***
Burdwan, Birbhum, Bankura, Midnapur and Hooghly in
Western Bengal were at one time relatively free of malaria
and were recognized as healthy places but later became
notorious for malaria. Surendranath Banerjee speaking in the
Imperial Council in 1916 showed his great concern for the

198
spread of malaria in Birbhum, his home district. He said;
Birbhum is a well known district in Bengal. At one time

it was a health resort? it used to be within my
recollection. Today the health-conditions of the place
have completely changed. The Sanitary Commissioner of
Bengal, in his Report for 1914, says that it tops the
grim list of recorded mortality arising from malaria
fever in the whole province.***
He then recounted the havoc caused in the district of
Nadia which was the birthplace of Chaitanya and where Warren
Hastings, the first Governor-General of Bengal, built a
house for "health and change". "Today, my Lord", he said,
"it is a plague spot, malaria fever counting its victims by
thousands and ten thousands."
In Eastern Bengal some of the localities became
malarious in the later days. Tangil in th district of
Mymensingh, Manikganj in the district of Dhaka and the
northern portions of the districts of Faridpur became
malarious which were formerly free of the disease. The
admitted increase of malaria could only be explained by the
fact that there had been a corresponding increase in the
spleen index. The mean malaria mortality rates of the
different districts of Bengal showed a high degree of
correlation with their fever indices. As there were no
malaria figures before 1921 we shall have to depend on the
fever indices to make an assessment of malaria. The
following table would show the relative intensity of malaria
district by district throughout the province of Bengal. It
was prepared by pooling the dispensary figures of each
district, and taking the ratio of fever cases to sickness of

199
all kinds admitted for treatment during the years of 1912
and 1921. (See Table 9).
TABLE 9
FEVER INDICES OF DISTRICTS :1912 AND 1921
1912 1921 1912-1921

Regions per cent per cent increase per cent
Western Bengal 37.72 53.00 15.28
Central Bengal 31.65 41.60 9.95
Northern Bengal 25.37 35.56 10.19
Eastern Bengal 7.90 17.45 9.55
Average 25.66 36.90 11.24
SOURCE: Annual Report of the Sanitary
Commissioner for Bengal for the Year. 1922
(Calcutta, 1923), p. 61.
An examination of the table shows that in the year
1912, in Western Bengal 37.72 per cent of the sickness was
largely due to malarial fever and on the other hand Eastern
Bengal had only 8 per cent. In the same year according to
the reports from the districts in the Burdwan district 54.4
percent of the sickness was probably due to malarial fever,
in Jessore 42 per cent, and in Birbhum over 39 per
cent. The districts of Burdwan and Birbhum are in Western
Bengal and Jessore in Central Bengal. On the other hand,
only just over 4 per cent admissions were due to malaria in

200
Noakhali and Comilla. These districts are in Eastern
Bengal. The rates of Faridpur and Barisal would have been
very low but for the fact that certain areas in both the
districts showed a prevalence of malaria in excess of the
average. The extreme west of Dhaka district showed a greater
amount of malaria than the remainder of the district. In
Western and Central Bengal there were a few pockets in which
the incidence of the disease was greatly below the average,
but still much more than the Eastern Bengal in general
prevalence.
If we now compare the fever indices from 1912 to 1921
we would see that while there were no signs of improvement
in Western and Central Bengal, there was evidence of an
increase of malaria prevalence in most of the districts of
Northern and Eastern Bengal. In Western Bengal, the Burdwan
and Hooghly districts, over 50 per cent, or more than half
of all the patients treated at the dispensaries were
suffering from attacks of malarial fever. At the opposite
extreme of the list was Comilla, in Eastern Bengal where in
1921 only 10.4 per cent of the patients admitted for
treatment were suffering from malaria. Compared with the
corresponding figures for 1912, there appeared to have been
a very general and great increase in the prevalence of
malarial fever throughout almost the whole province. This
increase was proportionately much greater in the Eastern
Bengal than elsewhere. In fact, if we were to judge by the
increase in the proportion of the diagnosed cases of

201
Map 2.
MALARIA MAP OF 1916
202
M a la ria in Bengal
■ N rC N S E LV M A L A R IO U S
M A LAR IO U S
4 ÛSS M A L A R IO U S
S L IO M T L Y m a l a r i o u s
I
Map 2.
MALARIA MAP OF 1916
203
malarial fever, the disease was more than double in Eastern
Bengal what it had been ten years previous. But compared to
Western, Central and Northern Bengal malarial fever was
still very low in Eastern Bengal. The lessened incidence of
fever in Eastern Bengal was the main cause of its better
health. Malarial fever was two times more prevalent in
Northern Bengal, two and a half times more prevalent in
Central Bengal and three times more prevalent in Western
Bengal than in Eastern Bengal and hence the differential
growth of population in the different regions of Bengal.
(See Map 2).
With regard to the statistical survey of fever cases in
Bengal the enquiry is being done on two lines. The
dispensary figures of each region in the province in 1868,
1912 and 1921 were taken to ascertain which areas appear to
have lost population due to fever. The dispensary figures
seemed to be quite reliable and our population estimation
of different regions had comparable results in relation to
diseases, especially fever. Table 10 gives a good picture
of the relative prevalence of fever in different regions of
Bengal, between 1868 and 1921. The fever indices are
measured according to the percentage of person in a
community who had been ascertained to have had malarial
fever during a given period. In our study the figures that
we got for the period between 1912 and 1921 seemed to be
more accurate than the ones for the period before.
Increase of malaria in parts of Eastern Bengal which in

204
TABLE 10
THE RELATIVE PREVALENCE OF FEVER INDICES
1866 1912 1921

Regions per cent per cent per cent
Western Bengal 21.9 35.4 48.5
Central Bengal 17.3 33.2 44.7
Northern Bengal 22.3 25.2 36.8
Eastern Bengal 9.3 15.4 34.3
SOURCE: Fifty-fifth Annual Report of the Director of of
Public Health for Bengal for the Year. 1922 (Calcutta,
1923), p. 32.
the past were comparatively free from malaria is directly
attributed to the haphazard construction of embankments.
Over and above there had been a great increase of water
hyacinth, a considerable increase of unplanned village roads
and in certain areas of Mymensingh there had been an
increase of railway lines because of jute tradings. These
conditions greatly lessened flow of water and created good
breeding grounds for mosquitoes and hence malaria.
Although there was overwhelming evidence that the bulk
of the population of Bengal was suffering and dying from
malaria there were no serious attempts on the part of the
government to investigate and isolate malaria from other
febrile diseases. For the first time on record, the Annual
Report of the Director of Public Health in its returns of

205
1921 made an attempt to differentiate between the various
febrile diseases as causes of death which had previously
classed under the common heading 'fever'. The new sub
heading included malaria, enteric fever, measles, relapsing
fever and kala-azar; and the 'other fevers’ included
influenza, pneumonia and phthisis. Malaria was the cause of
death for 68.8 per cent of the provincial total fever
deaths. According to this report the deaths due to 'fever'
were as in Table 11.
TABLE 11
DEATHS DUE TO MALARIA AND FEVERS IN 1921
Per cent
Sub-head Number of total
Malaria 737,223 68.87
Enteric 5,693 0.53
Measles 1,537 0.14
Relapsing fever 6,798 0.63
Kala-azar 1,552 0.14
Other fevers 317,565 29.66
SOURCE: Fifty-Fourth Annual Report of the Director
of Public Health. Bengal. 1921 (Calcutta, 1922), p. 23.
Out of the provincial total of one million fever deaths
malaria was the cause of more than seven hundred thousand
cases which was 68.8 per cent of the total. Of the total
206
deaths from malaria in Bengal almost twelve thousand took
place in the cities and the rest in the rural areas, where
more than ninety five per cent of the people lived. In that
year the malaria deaths in different regions of Bengal were
in Table 12.
TABLE 12
DEATHS DUE TO MALARIA IN 1921
Malaria deaths Fever deaths

Regions per thousand due to malaria
of population in per cent
Western Bengal 18.5 77.6
Central Bengal 18.0 78.5
Northern Bengal 24.3 86.0
Eastern Bengal 13.9 72.8
S O U R C E : Annual Report of the Sanitary Commissioner for
Bengal for the Year, 1922 (Calcutta, 1923), p. 60.
Even as late as 1921 Bentley, the Director of Public
Health for Bengal, could not accept this total of deaths due
to malaria as correct. He thought that deaths due to malaria
were only one half of the figures reported in Table 12. As
a dedicated government official his endeavor to arrest
malaria in Bengal earned him a good name, and the large
figures reported did not reflect well on his efforts.

207
Correlation between Malaria and the Birth-rate
If we look at the distribution of malaria in the
different regions of Bengal it will be seen that in Western,
Central and Northern Bengal the areas that had lost
population were almost all situated in the regions of severe
malaria. Conversely many of the areas which had gained in
population considerably were in fact outside the zone of
intense malaria. Even in Eastern Bengal, which was by far
the most populous and healthy region, the only areas that
had decline of population were those in which malaria was
most prevalent. The facts seemed to justify the concern and
commonly held belief that malaria was the essential cause of
depopulation that had been going on for a considerable
period of time.
Malaria was associated with low birth rates among the
reproductive population. If we compare the fever indices of
Bengal districts with the ratios of births and the child
populations of the corresponding areas we would see a
definite relationship between low birth rates and smaller
number of younger children with high incidence of
malaria. Conversely, a high birth rate went with lowered
incidence of malaria as is seen in most of East Bengal. This
was also reported by Stewart and Proctor in their
investigations in three districts. They concluded that the
diminished birth rates in those districts was to be
attributed to the great prevalence of malaria. They found
that malaria caused abortion or still birth and lessened the

208
productive powers in persons debilitated by continuous
attacks of malaria. In the case of Faridpur district a
comparison of the mean birth rate and the spleen indices of
the different thanas provided a good example. It shows that
in a malarious district like Faridpur the birth-rate tended
to be lower than the average. On the other hand malaria
undoubtedly increased the proportion of miscarriages.
Moreover, Stewart and Proctor showed that malaria is a cause
of still birth. Christophers in his report on the Punjab
epidemic of 1908 saw similar effects of malaria. There were
grounds to believe that in Bengal the proportion of still
birth was much more in the malarious than the non-malarious
regions.
We have already seen that malaria had a tremendous
effect on the mortality rates of the different districts of
Bengal. It exhibited a high degree of correlation with their
respective fever indices. A similar correlation was
observed between fever and spleen indices by Stewart and
Proctor, and later established as a means of determining
malaria incidences. It would also appear that in malarious
areas the death rate among children under 10 and old people
over 60 also tended to exceed those observed in non-
malarious parts. As regards the evidence relating to deaths
among infants and young children, it has been observed that
malaria seems to exert the most permanent action upon young
lives unless the infants acquire the sickle-cell anemic
characteristics.
209
In the districts in which depopulated areas were
commonly seen such as Burdwan, Birbhum, Dinajpur, Nadia and
Rajshahi the spleen index was generally very high. It was
assumed quite logically that throughout Bengal the presence
of malaria tended to be associated with declining birth
rates on one hand and increasing death-rates on the
other. In certain tracts notorious for fever and
characterized by abnormally high spleen indices the recorded
deaths usually exceeded the births, with the result that the
population declined. Decadent tracts of this kind were to be
found in each of the four natural divisions of Bengal, but
they were far more common in the Burdwan and Presidency
Divisions than in Chittagong Division. The districts of
Burdwan, Birbhum and Nadia were very decadent in terms of
population. The Sanitary and medical reports and the
successive census enumerations that we have discussed in the
previous chapter show that for the period of sixty years
these districts were notorious for the prevalence of malaria
and the decline of population. But these places were not
always decadent, for Burdwan and Birbhum were once famous
for their healthfulness, and Nadia , Hooghly and Jessore
before the middle of the nineteenth century not at all
unhealthy. It was found that all these districts formerly
supported far denser populations than they did
afterwards. Moreover the changes were not very gradual and
were marked by a phenomenal rise of fever. The observation
pointed to an invariable association of a high incidence of

210
malaria with a condition of gradual depopulation. It
naturally led to the conclusion that an intensification of
malaria had increased the mortality and so brought about the
reduction of population. Depopulation leads to the
abandonment of cultivation, the increasing growth of jungle
and the greater neglect of tanks. So it tended to bring
about a condition more and more favorable to the development
of the anopheles mosquito and hence malaria.
But there were certain exceptions to the rule that
malaria caused the decline of population. There were areas
in Bengal where in spite of the presence of malaria the
population was steadily increasing. For example, the
population in the thana of Kalaiachak in the Malda district
the population increased considerably since 1891 despite a
high spleen index among children. In Dhaka and Madhupur
jungle area of Mymensingh malaria as shown by the spleen
index was quite high, but the population increase was also
quite considerable. This phenomenon may be explained by the
fact that the people in certain regions of Bengal became
resistant to malaria. In general the decrease of population
in any locality in which malaria existed in some degree
must lead to an increased prevalence of infection. So once
the population was in a decreasing rate, if malaria is not
otherwise arrested, the disease will linger for a long time
to come, affecting the natural growth of population. On
theoretical grounds there are reasons for supposing that the
process of depopulation might tend to increase with the

211
incidence of malaria. In the past there has been a good deal
of attention directed to the mathematics of malaria by Ross
and Me Kenderic who came to the conclusion that depopulation
is "co-incident with an infection of malaria".*''
Throughout the period of our discussion of Bengal
history around 1860 to 1920 the population growth of Bengal
was governed not by fluctuations in the birth-rates but by
the change in the death rates. In some of the years when the
population declined or even remained static, the reason
invariably lay in some great epidemic or famine or natural
calamity or a combination of any of these, that took
millions of lives. In the normal years when numbers
increased the reason lay in the relative absence of
epidemics or any natural calamities. Even in such ordinary
years the death rate was still high as a result of the
presence of endemic malaria which became a part of the whole
existence of the people of Bengal. But since the malaria
fever was surpassed by an even higher birth rate in general
throughout the province population grew moderately. Except
for Eastern Bengal the situation in other regions was not
encouraging at all, and the tremendous increase of
population in Eastern Bengal kept a favorable balance of
population for the whole province. We have seen that among
other diseases malaria prevailed constantly in some areas in
severe epidemic forms and in others in less severe. The
first great malarial fever epidemic was that of 1860s,
subsequent ones occuring almost at ten year intervals, the

212
last one being that of 1918. In 1918 the epidemic was
generally seen as influenza but in fact the death toll was
enhanced because of the presence of malaria along with
influenza.
It is impossible to say what proportion of total
deaths are attributable to the malarial fever but it might
safely be assumed that, whatever the mortality, the amount
entered under the rubric "fever" was usually high and the
greater part of the excess over the normal was due to
m al ar ia .* *’ According to the first official malaria record
in 1921, malaria caused 68.8 per cent of the total fever
deaths. Malaria was undoubtedly one of the outstanding
diseases affecting the population of the agrarian society of
Bengal, It was not a temporary phenomenon, like cholera,
plague in the last decade of the nineteenth century or the
influenza in 1918, disappearing after a brief spell of
terrible ravage. It broke out spasmodically, after short
intervals, devastating the major portions of rural Bengal.
Since the birth rate did not give a clear picture of sharp
fluctuations and since emigration was negligible, it seems
quite understandable that one of the chief factors
responsible for the slow growth of population and at times
decline in certain regions in Bengal had been epidemic and
endemic malaria.
There have been some excellent theoretical treatment in
the field of economic and demographic effects of malaria
eradication in Sri Lanka and Guyana. Although the main

213
focus of these studies was to find the economic impact of
malaria eradication but in doing so they proved that malaria
eradication invariably give rise to population
growth. Peter Newman constructed a model showing two
separate causes for population growth, one due to the
malaria eradication and the other to all rest of the causes.
Newman's study proves that 60 percent of the increase in
the rate of population growth in Sri Lanka between 1931-46
and 1947-60 was due to malaria eradication. But for Guyana
the rate of growth was only 40 percent.**'In another related
study Robin Barlow devised a model for tracing the effects
of malaria eradication also for Sri Lanka using data
collected over a period from 1947 to 1966. His model also
shows that there is a positive correlation between malaria
eradication and population g r o wt h. ** ’In other words these
studies prove that without eradication of malaria there
would have been a corresponding decrease of population.
Imperialistic Arguments of Population Decline
The period which followed the middle of the nineteenth
century constituted one of the most intriguing times in the
history of population and disease in Bengal. In common with
other societies in which the great mass of the people was
employed in agriculture, and in which technical progress was
limited, the size of the population of Bengal did not grow
as rapidly as in other countries. It was a period of
declining population in most regions of Bengal and the

214
overall growth rate was very marginal. The failure of
population to rise as expected posed a severe test for many
current theories concerning the causality of demographic
change. Most of the administrators and sanitarians during
the British period sought to interpret the stagnant
demographic situation in Malthusian or Social Darwinian
terms. Bentley, Fry and Ross were greatly influenced by the
laws of population enunciated by Malthus and extended by the
social Darwinists. By arguing that the size of the
population was determined by racial factors, they relegated
the disease to the status of a mere function of the ability
to survive theory. Let us look at the Malthusian theory of
population itself and see how it was accepted and
interpreted by the British social engineers.
In 1798 Malthus' work An Ess av on the Principle of
Population as It Affects the Future Improvement of Society,
with Remarks on the Speculations of Mr. Gordin.
M. Condorcet. and Other Writers was published. The sixth
edition of the book came in 1826 during his lifetime. The
history of mankind according to Malthus demonstrated that
population always tended towards the limits set by
subsistence and contained within those limits by the
function of positive and preventive checks, which would take
the form of either 'misery' or 'vice'.**"Much of Malthus's
influence on his contemporaries and much of the controversy
surrounding him not only derived from his principle of
population but his rigid views of society. He asserted that

215
"poor laws" existing at that time in England, a system of
relief for the poor, would only have the effect of
increasing the population and raising the prices of
provisions. These arguments became a political force in
England during the first half of the nineteenth century when
these measures were under discussion.***
Fifty years after the publication of the Essav on
Population, Darwin was led to apply Malthus's doctrine to
the whole animal and vegetable world and the result of his
work. On the Origins of Species bv Means of Natural
Selection, or the Preservation of Favoured Races in the
Struggle for Life published in 1859, laid the foundations of
modern biology and produced a revolution in the theory of
evolution. Now let us look into the principle of Darwin and
how it was manipulated. Darwin established a new approach to
nature and gave a fresh impetus to the conception of
development. He found a method for the understanding of
society through schemes of evolutionary development and
organic analogies. The ardent follower of of D a r w i n ’s
principle was Herbert Spencer who applied the biological
scheme of evolution to society. He offered a comprehensive
world view uniting everything in nature from protozoa to
politics. The most popular catch-word of Spencer and other
social Darwinists, "the struggle for existence", taken from
Malthus and the "survival of the fittest", coined by Spencer
himself when applied to the life of men in society suggested
that nature would provide the opportunities to the best

216
competitor. Unfortunately this concept was used for the
purpose of imperialism and militarism. Imperialists called
upon Darwinism in defense of the subjugation of weaker
races. They pointed to The Origin of Species which referred
in its subtitle to The Preservation of Favoured races in the
Struggle for L i f e .*** Darwin had been talking about pigeons,
but the imperialist saw no reason why his theories should
not apply to men. Darwin himself had written in The Descent
of Man of the likelihood that backward races would disappear
before the advance of higher civilizations.***
Social Darwinism as an explanation of the facts of
supremacy has long been tested in India. The imperialist
could point to the harsh fact of the elimination of the
unfit as an urgent reason for cultivating the material
v ir t u e s . ** *It thus became a new instrument in the hands of
the empire builders as an instrument of race and struggle.
On the other hand with the characteristic Darwinian emphasis
upon race fertility the social Darwinist dwelt upon the
great population potential of the English people and the
opposite of it among the Indians who were dying without
numbers because of epidemic diseases. There were many
Social Darwinists among the British in India who based their
arguments on these theories.
The low birth rate of the population had been explained
by Bentley, the Sanitary Commissioner for Bengal, in the
following manner:
This would seem to show that the relatively low

birth-rates met with in the more malarious districts of
217
Bengal must not be compared with small birth-rates of

civilized countries, but should be looked upon as the
natural complement of high death-rates occuring
there. The low birth-rates of the civilized countries
are invariably associated with low death-rates, and as
is well known are due to the action of the preventive
check upon population, whereas in the case of Bengal
low birth-rates are the result of disease, and must be
considered as therefore as evidenced of the working of
Malthus' positive check on population.***
Bentley like all of his contemporaries was heavily
influenced by the writing of Malthus. His reference to
Europe as civilized and India as not came from the
ethnocentrism of a Briton who belonged to the ruling
establishment. If his arguments were taken at face value,
France would be more civilized than England since it had a
lower birth-rate and death-rate at that time. But Bentley's
diagnosis that malaria was the underlying factor in the low-
birth rates in Bengal was correct.
Bentley, then, saw the disease stricken-people of the
province as the best example of the application of the
Social Darwinian principle. He said:
And as it usually happens that the more primitive races

of mankind live in the countries and under such
conditions as are especially suited to the existence of
the malaria parasite, it has come about that a very
close association is to be observed between primitive
man and malaria; and usually the more primitive a race
is, the larger the proportion which is infested with
malaria parasites, and the more complete the tolerance
they exhibit to its presence.***
Bentley had no hesitation in saying that in "India, a
large proportion of the people are found to harbour
astonishing numbers of such ecto and endo-parasites".* *’
Even a scientist like Ronald Ross was heavily
influenced by such doctrines. On these issues he has

218
written as follows:
There must be a great complex of causes which produces

racial predominance and decay - a complex of still
greater intricacy in the case of man _____ Such a
conception (which can of course be enunciated here only
in the briefest manner) will force itself especially on
those who have had opportunities of knowing many races
of mankind. What is it that causes the infinite
diversity of type and ability? Why, for example, in
India, do we obtain under much same conditions of race,
climate, and government so many different types, from
that of the brave and massive Sikhs to that of the
timid and feeble inhabitants of many
localities? Success in war must be rather a result than
a cause. The wisdom of individual rulers can exert but
a temporary effect. Doubtless marriage customs, by the
substitution of paternal selection for sexual
selection, must exert a bad effect on the eugenics of
some races. Overcrowding may act by the greater
facilities which it gives for the dissemination of
parasitic diseases, by the production of poverty, or by
some other, and as yet unknown means. Vices,
superstition, misgovernment, and finally intellectual
decadence, life failure in war, are probably secondary
to the original causes.***
In the same blatant fashion a British historian invoked
the Malthusian doctrine in support of the continuance of the
British rule in India. He said:
It might well happen that India, abandoned once more to

her own resources, would furnish a striking vindication
of Malthusian doctrine; that the "positive checks" war,
vice, misery, and disease would again begin to
operate, and that by this means the pressure of
population upon subsistence would be averted. Under
British rule that pressure has been averted by means
less p ai n f u l . * *’
It is very interesting to note how the same theories
were applied by different authorities in support of opposing
arguments. While Marriot thought the British Government
prevented a Malthusian scenario happening in India, it had
infact already taken place in Bengal if we accept the
judgements of Bentley and Ross. In fact these different

219
authorities united in a passion for empire, and were
motivated by racial superiority, and their period was one
in which eugenics was more discussed than art. But they did
not hesitate to blame the people of India for all the
sufferings of disease they encountered.
All these self-assured authorities failed to see the
validity of Karl Marx's criticism of the Malthusian
principle of population. Half a century after the appearance
of the Essays on Population. Marx branded Malthus "a
shameless sycophant of the ruling classes" and "a bought
a d v o c a t e " “of those who opposed a better life for the poor
people of England. Of Malthus's arguments of poverty as a
natural condition, and misery a necessary check to
population growth, Marx claimed that Malthus was selling
scientific and moral arguments to selfish opponents of the
Reform Bill. To Marx the real problem was not too many
people or too little food, as causes of disease or famine,
but that under private ownership capitalism distributed the
means of subsistence unevenly. Contrary to the belief of
Malthus, both Marx and Engels denied that "the law of
population is the same at all times and at all places". On
the contrary they predicted that "every stage of development
has its own law of population".*’*
In fact there were some serious errors in the analysis
of Malthus. He failed to foresee the development of
transport and colonization which took place in the
nineteenth century. Moreover, he underestimated industrial

220
progress upon output and cost of production of agricultural
produce. He has supposed that the great increase in British
population taking place in his time because of doles from
the government. Subsequent research has shown that the
birth-rate was not rising and the great increase of
population was due to the fall of death rate. His views that
better conditions would increase births has not been borne
out by experience. In many parts of the world birth rate
despite the living conditions far more favorable than those
in England of Malthus, has fallen below the replacement
level.
It is interesting to note that the Malthusian theory
was able to exercise an enormous influence. One of the main
reasons was that the conditions which Malthus described,
such as the widespread poverty and disease among the working
people, was real in England at that time; and in the first
quarter of the twentieth century the condition of the people
of India or Bengal was all the worse under British
rule. Looking into one aspect of his arguments Malthus's
proponents in India thus made an attempt to prove his
principle to be right to justify their conclusions.
But the primary biological error of social Darwinists
was their effort of ignoring the fact that the cause of
progress was not the struggle of man with his environment
only, rather the struggle of man with man. Another error was
the misinterpretation of the 'fittest' as the strongest or
even the most brutal, while to Darwin it meant merely the

221
best adapted to existing conditions. Because of the colonial
situation in India, the British administrators used the
doctrine of Malthus and of Social Darwinism as a tool to
justify domination. Whatever might be the facts of the
past, the population debate is not over yet. It has taken a
new dimension with the declining population growth in
Britain and an increasing rate of population growth in
B e n ga l.
Nowadays the demographers, doctors and historians have
engaged in a number of inconclusive debates about the cause
of mortality decline in Britain, whereas we are arguing
about the increase of mortality in Bengal. For Britain some
of them have cited nutritional improvements, as building up
resistance to infectious d i se as e .* ’* Others have pointed to
medical or para-medical intervention that increased life
expectation.* ’*A third group has emphasized the importance
of public health measures.*’ * There is no agreement about
the appropriate weight to be placed on the contribution of
each factor. But there is no disagreement about the fact
that all of these factors collectively or separately brought
a decline in mortality. McKeown concluded that medical
intervention has affected life expectation in a way which is
very negligible or negative.* ’*He has established beyond
question that the decline of infectious disease in
nineteenth century Britain antedated the isolation of
infective agents. In fact public health education and
nutrition had greater significance in protecting people

222
from diseases than medical intervention. But in Bengal
neither medical nor health education or nutritional factors
were working to save the situation and naturally people fell
prey to one or many of the diseases.

223
Notes to Chapter VII

2 11
Thomas Twining, Travels in India (London, 1893),
p. 124.
***Adam Smith.An Inquiry into the Nature and Causes of

the Wealth of N a t i o n s , p. 56.
* *“Chittabrata Pal it.Tensions in Bengal Rural Society.

(Calcutta, 1975), p. 159.
**«Francis Hamilton Buchanan, R a n c o u r . Book II. pp. 2-6.
* *“Durgaprasad Bhattacharya and Bibhavati Bhattacharya,

ed. Asiatic R esearches. Vol. XVII, (Calcutta, 1832), from
Census of India 1861, "Report on the Population Estimates of
India (1820-1830)", (Calcutta, 1963), pp. 117-123.
**“Bengal Administration Report. 1872- 18 73 . (Calcutta,

1874), p. 119.
'‘ ’Report on the Epidemic Remittent and Intermittent

Fever Occuring in Parts of Burdwan and Nuddea D iv i s i o n s .
(Calcutta, 1863).
***D.Bhattacharya and B.Bhattacharya, pp. 326-27.
* *’Royal Commission on the Sanitary State of the Army in

India. Vol. I, (London, 1863), p. 509.
* *“Annual Report of the Sanitary Commissioner for Bengal

for the Year 1 8 7 2 . (Calcutta, 1874), p. 56.
''*Report of the Sanitary Commissioner for Bengal for the

Year 1 8 6 8 (Calcutta. 1869). p. 100.
* **Durgaprasad Bhattacharya et al. pp. 326-327.
***Royal Commis si o n, p. 509.
* * “H. Beverley.Report on the Census of Bengal. 1872

(Calcutta, 1872), p. 86.
**“Census Report. 1 8 7 2 . Appendix B, "Selections from the

Reports of District Officers".
* *'Annual Report of the Sanitary Commissioner for Bengal

for the Year 1 8 7 2 (Calcutta. 1874). p. 56"^
** ’Ibid. . p. 322.
**“Census of India. 1921, pp. 4-6.
**’Census of India. 1921, Vol. V, Bengal,Part I

224
(Calcutta, 1923), p. 44.
**“Census of Indi a. 1921, p. 44.
* * * Ibid., p. 44.
**“Imperial Ga ze t t e e r . India, Vol.VII (Oxford, 1908),

pp. 229-30.
**“Kingsley Davis, Population of India and Pakistan

* *«Margaret Sangar éd.. Proceedings of the World

Population Conference (London, 1927), p. 114.
**“Ronald Freedman and Bernard Berelson, "The Human

Population", Scientific A me r i c a n . Vol. 231, No. 3,
Sep. 1974, p. 32.
**«K.B. Saha, Economics of Rural Bengal (Calcutta,

1930), p p . 252-256.
* *’Supplement to Calcutta Gazette. April 18, 1863,

pp. 159-60
* *“Ib id ., p. 157.
* *“Memorandum on Measures Adopted for Sanitary

Improvements in India u p to the End of 1867. Together with
the Abstracts of the Sanitary R e p o r t s . (London, 1868),
p. 40.
*«“James Ronald Martin, Influence of Tropical Climates

in Producing the Acute Endemic Diseases of E u ro pe a ns .
(London, 1861), p. 307.
*«“David Smith, the Sanitary Commissioner for Bengal for

the Year 1869, in his Despatch to the Secretary to the
Government of Bengal in the Judicial Department (Hooghly,
the 25th March, 1869), p. 1.
* «“Ibid. . pp. 1-2.
“«“Census of India. 1 8 8 1 . Vol. I, (Calcutta, 1883),

p. 58.
''«Report on the Condition of the Lower Classes of

Population in Bengal (Calcutta, 1888), p . 5.
“ «“Census of Ind ia . 1881, Bengal, Chapter V, p. 57.
“««Ibi d. . p. 53.
I bid.. p. 54.
225
“«“Harburton Begbie, Introductory Remarks to a Course

of Lectures on the History of Medicine (Edinabura. 1856).
pp. 56-57.
'«'Ibid.. p. 3.
'“•Sir Andrew Fraser, Among Indian Raiahs and Rvots

(London, 1911), p . 22.
'“'G.E. Stewart and Proctor, Final Report on the

Districts of Jessore. Nadia and Murshidabad (Calcutta,
1907), p. X.
'“'Ib id .. p. XI.
*“'Forty Ninth Annual Report of the Sanitary

Commissioner for Bengal for the Year 1916 (Calcutta, 1917),
p. 17.
'“«C.A. Bentley, "Some Problems Presented by Malaria in

Bengal," Proceedings of the Third Meeting of the General
Malaria Committee Held at Madras.Nov. 18-20. 1912 (Simla,
1913), p. 71.
'““Surendra Nath Banerjee, "Resolution in the Imperial

Council: Reprevention of Malaria, 1916", Records of the
Malaria Survey of India (Calcutta, 1930), Vol. I, No. 2,
p. 144.
' “‘Bentley, "Some Problems Presented by Malaria in

Bengal," p. 2.
'“’The Imperial Gazetteer of I nd i a . Vol. II (Oxford,

1908), p. 229.
'““Peter Newman, Malaria Eradication and Population

Growth: With Special Reference to Ceylon and British G u y a n a .
Michigan, 1965.
'“ 'Robin Barlow, The Effects of Malaria E radication.

Michigan, 1968.
'«•Thomas Malthus, An Essay on the Principle of

Population as it Affects the Future Improvement of
Society....(1798). C h a p . ,2,4,and 7.; Thomas Malthus,
Population;The First E s s a y . Paper back ed. (Ann Arbor,
1959), p p . 4-6.
'«'Gunnar Myrdal, Population: A Problem of Democracy

(1962), pp.14-17.
'«'Gertrude Mimmelfarb, Darwin and Darwinian Revolution

(London, 1959), pp. 347-351.
226
'''For a discussion of Darwin's share in responsibility

for Social Darwinism, see Bernhard J. Stern.Science and
Soci et y. Vol. VI, (West Lafayette, Indiana, 1942), pp.75-78.
'•♦Carlton J.H. Hayes.A Generation of Materialism. 1871-

1 9 0 0 . (New York, 1941), pp.12-13, 246.
'«“Bentley,Report on Malaria in Bengal (Calcutta, 1916),

p. 60.
'••Bentley,(Simla, 1913), p . 63.
'•’Bentley, (Simla, 1913), p . 63.
'•“Ronald Ross, W.H.S. Jones and Ellett, A Neglected

Factor in the History of Greece and R o m e . (Cambridge, 1907),
p p . 2-3.
'•'John A.R. Marriot, The English in India; A Problem

of Politics (Oxford,1939), pp. 303-8.
'’“Herman E. Dale, "A Marxian-Malthusian View of Poverty

and Population," Population S t ud i es . Vol. 25, No. 1, pp. 25-
27.
'’•V.I. Lenin, "The Working Class and Neo-

Malthusianism", Collected W o r k s . XIX, pp. 255-57.
' ’'Thomas McKeown, The Modern Rise of Population London,

1976. -------
' ’'"Fifty Years of Medicine" The British Medical Journal

(1950), No. I, p. 61.
' ’•F.B, Smith, The People's H e a l t h . London, 1979.
' ’“McKeown, The Modern Rise of Population. London, 1976.

CHAPTER VIII
ECOLOGICAL FACTORS CONTRIBUTING TO MALARIA

IS MALARIA EPIDEMIC NEW IN BENGAL?
Ecological Cause of Malaria
The British colonialists seldom noted the ecological
disturbances due to the expansion of railways and roads, and
at the same time neglected the waterways such as canals and
rivers, which for centuries served the need for
transportation. while the engineering works increased
facilities for communication, in many cases they were
responsible for a great increase in the prevalence of
malaria. Engineers and contractors had often been accused by
health officers for creating certain conditions which led to
mosquito breeding. In construction of roads, railways,
irrigation projects or in the layout of new townships they
created burrow pits, quarry pits and badly designed
culverts. In the construction of large engineering works,
the contractors naturally tried to complete projects as
cheaply as possible. They often took no heed of or did not
realize the disastrous to health and prosperity which might
follow upon their careless operations. Apart from creating
conditions for the development of the diseases,
communication networks also spread diseases. Commenting on
227
228
the harmful effects produced by man-made malaria Frederick
Cartwright remarked:
Roads meant easier and faster travel and new diseases

are able to pass more swiftly along such roads,
striking down unprotected populations in mass pandemics
before resistance to the invading organism could be
d evelo pe d. '’‘
The harmful effects produced by man-made malaria has
been recognized a long time ago. Some of the best work on
the tracing the cause of malaria in Bengal was done by
Bentley, and in the Punjab by Christophers. They hardy
touched in depth on the environmental causes of malaria. Ira
Klein has filled that gap to some extent in recent
y e a r s . ' ’ ’But it needs very detailed study. Bengal was one
of the few regions where the development and spread of
malaria was to a great extent due both to the neglected and
disturbed ecology.
Ecological Change bv Nature
Let us first look to the neglected state of ecology in
Bengal. The rivers of Bengal was once an important highway
for trade. They were quite enormous and they served both the
purposes of communication and drainage system with so many
tributaries. Travelling inthe eighteenth century William
Hodges was surprised to see the vastness of these rivers
and he compared them with oceans. He said, "The rivers I
have seen in Europe, even the Rhine appears as rivulets in
comparison with these enormous water ." '’* But a century
later some of the rivers had taken a different turn either

229
for natural reason or for human interference.
Under natural conditions a deltaic river system
performs a double function. During low water the b i l s .
khals, and the central channel serve the purposes of
drainage, carrying off water from the depressed land
surfaces of the lateral river basins. But in the flood
seasons the water courses cease to be drains but take the
character of irrigation channels. It is due to this system
of natural irrigation that the active deltas become
fertile. But this natural phenomenon has attracted little
attention in Bengal. On the other hand irreparable damage
has been done owing to the restrictions of free river flow
as a direct consequence of the construction of thousands of
miles of embankments. These embankments were designed either
for the controlling of the rivers or for the purpose of
railways or roads. Whatever their objects their effects had
been the same, preventing the natural drainage systems.
Let us first look to the neglected state of ecology in
Bengal. Siltation and river decay became common in
virtually every malarial district of Bengal. Siltation of
rivers occurs naturally, but it was aggravated by the
interference with the natural drainage system by railway and
river embankments. These combined together conspired to
bring about widespread waterlogging, agricultural decline
and consequently spread of m a l a r i a . I t has been rightly
said by Nirad Chaudhury, "We inherited the tradition that
the river once had its day, but what we saw was only its
230
improvised age."'*'
An examination of the topographical map of Bengal and
its river system would show that a large portion of the
province was deltaic. Central Bengal or the parts south of
the Padma, between the Bhagirathi on the west and Madhumati
on the east, was formerly the Ganges delta. But it has
gradually been raised above flood level, depositing enormous
siltation. Western Bengal contained the deltas of the Kasai,
the Damodar, the Ajai and the Mor and part of the delta of
the Ganges, which was very much silted up. North Bengal
north of the Padma was wholly alluvial. In spite of its
proximity to the hills, the general level of the country was
very low and suffered from obstructed drainage.'*' East
Bengal, or the country east of the Madhumati, including the
present delta of the Ganges and Brahmaputra, were in the
process of land formation, which is till going on, and has
remained healthier than other regions.
The problem of siltation and the death of rivers, and
the subsequent spread of disease, were thought by some
engineers of Bengal to be as much the result of human
agency as any natural change in the course of rivers. One of
them, S.J. Majumdar, thought that in Central and Western
Bengal human interferences with rivers had caused unique
problems. He believed that if no improvement could be
obtained the region could in course of time revert to swamps
and jungles and would be infested with malaria.'"'There
could be no doubt that obstructed water flows of this type

231
helped spread malaria, district upon district. In
Murshidabad where the Bhagirathi was degenerating, malaria
fever was the great scourge of the district. The whole of
the center and the east of Rajshahi were characterized by
O'Malley as a swampy water-logged depression in which fever
was rife. He reiterated what Bentley had been trying to
impress upon the government so long. O'Malley explained the
situation by saying:
The drainage system in short, disjointed, and the bils

which should get an influx of fresh water annually are
left to stagnate. These bils are mostly shallow and
their number is large --- The great Challan Bil has
now largely silted up — all facts which help to
corroborate Dr. Bentley's theory about the cause of
m al a r i a . *•'
A similar pattern existed in the districts of Burdwan,
Malda, Nadia, Jessore and Rangpur between disrupted
irrigation and drainage, and the increase of malarial
fever. Bhola Nath Banarji, the Executive Engineer in charge
of Special Drainage Division, who was investigating
conditions in Jessore, stated that:
It will not be out of place, if we note that the tracts

away from the river and places which complain of
scarcity of water and where bils and pits dry up such
areas, are not free from malaria as it ought to be, if
dampness alone was the cause of malaria.'**
His report suggested that whenever the drying up of the
delta tracts is carried beyond a certain point
intensification of malaria resulted. Certain other very
important facts were also brought to light in the course of
Bentley's investigations which showed that conditions in
respect of malaria differed in various parts of Bengal.

232
Opposite to this effect was the flooding up of the
countryside with spill water from the rivers, which had the
effect of flushing the bils and channels and kept the
mosquito out of its breeding center. It was said that "a
village situated on a live river is ordinarily much more
healthy than one lying upon the banks of a dead
river". " ‘Hence the increase of malaria in the delta tracts
of Bengal was directly attributed to the silting up of the
rivers and obstructed condition of the drainage
system. Although two members of the drainage committee.
Captain Stewart and Lt. Proctor, did not believe that the
primary factor in the causation of malaria was bils or
rivers, nevertheless all factors would suggest that shallow
bils and dead rivers were not conducive to good health.
Man-Made Ecological Change
Changes in delta rivers and channels were often due to
natural causes but there was reason to believe that many of
those that had occured in the delta rivers and channels of
Western and Northern Bengal were man-made. These human
causes directly or indirectly led to the spread of
malaria. The improvement of communications almost invariably
meant the construction of roads and railways, which in the
delta areas entailed the multiplication of
embankments. These embankments, specially designed to avoid
floods, eventually led to the disorganization of the river
systems and consequently the dislocation of natural flush

233
and drainage. The increase of malaria almost invariably
followed the embanking of the deltaic areas in Bengal. The
construction of embankments themselves led in the first
place to a great amount of excavations and resulting burrow-
pits that created breeding places of mosquitoes.
In the early 1860s when the outbreak of epidemic
malaria first attracted attention in Bengal the occurrence
of the disease was ascribed to the construction of
embankments. The chief exponent of this theory was Raja
Digambar Mitter, the Indian member of the first committee
appointed by government in 1863 to enquire into the causes
of the epidemic. Among the instances mentioned by the Raja
was the construction of extensive embankments in the
villages around Halishahar to Kancha ra pa r a. '•‘The people in
these villages suffered from a severe type of fever, which
broke out exactly in the order of time in which the railway
embankments progressed and passed along their eastern
borders. The Raja laid much stress on defective drainage as
the most important cause of fever. But his ideas were hardly
accepted at the time, not even by professional engineers or
sanitarians.
During the years 1867 and 1868 an elaborate enquiry was
held, the results of which was examined by the Chief
Engineer in 1869 in which he arrived at the conclusion that
roads and railways in Bengal had not obstructed the drainage
of the country to create any harmful disease. But he
suggested that some obstructions were inevitable and should

234
be remedied. This question cropped up in the reports of
sanitary officers but no one was able to discover that
epidemic malaria had followed the railway lines. In 1873,
reporting on the epidemic fever in Burdwan and Birbhum,
Dr. C. J. Jackson, Sanitary Commissioner of Bengal,
describing the epidemiology of fever was of opinion that
the spread of the disease exhibited a remarkable and
persistent association with the lines of communication. He
said.
The main cause to which attention of late has been

mostly directed is the subsoil drainage, and there can
be no doubt to any one who has studied the subject that
the natural drainage of the country has been interfered
with in many ways of late years; amongst these may be
mentioned the many embanked roads that have been thrown
up during the past 16 years. These roads must
materially interfere with the drainage of a country
whose inland communication was principally water; these
roads must also very materially influence the drainage
of the village near which they p a s s . * * ’
In 1877, a Committee was especially appointed to
investigate certain localities in which it was alleged that
the drainage had been obstructed. Lt. Governor came to the
conclusion that while Raja Digambar H i t t e r ’s theory of
artificial obstructions was possibly right in some respects
the outbreak of fevers had no connection with the
development of roads and railways. Between 1878 to 1880 the
need of efficient drainage was urged by the local
authorities to the government with no positive response.
Some enquires were made in 1881 about the situation. The
subject was especially discussed by the Nadia Fever
Commission of 1 8 8 2 . and after a protracted local enquiry the

235
conclusion was that the outbreak of fever could not be
attributed to local obstruction to drainage because of roads
and railways. Finally, with reference to the riparian
municipalities of the 24-Parganas, Captain Rogers noted in
1900 that the places with the highest spleen rates lay for
the most part to the east of the railways while the reverse
should be the case if the unhealthiness were mainly due to
the obstructed drainage caused by the railways. So the
general notion before the twentieth century was that malaria
was not primarily due to the obstruction of the drainage
system nor would it be cured by their removal.
Finally a Drainage Committee was appointed by the
Government of Bengal in 1906 to inquire into the causes of
malarial fever in Bengal, and the possibility of undertaking
some remedial m e a s u r e s .*•‘Now due attention was given to the
long time debate that the gradual changes in many channels
in the Ganges delta had affected the health of extensive
areas in Bengal, especially the Presidency Division. The
purpose of the Drainage Committee was fourfold: first, to
ascertain in which areas malaria was most prevalent at that
time, secondly, to investigate the causes of the disease,
and in particular to determine whether it was due to
obstructed drainage, thirdly, to decide whether a drainage
scheme was practicable in the malaria affected area, and
finally, to prepare a list of practicable drainage schemes
for the whole division. The investigation had been confined
to the Presidency Division because it was probably the most

236
malarious area at that time. Moreover, this division
comprised the area in which "the factor of defective
drainage was most apparent."*'' The committee thought that
the construction of the embankments might have done injury
to health, not so much by obstructing the course of drainage
but from the manner in which the earth was heaped and
excavated. Pits had been left undrained and these places
became breeding grounds for mosquitoes. The committee
observed that "a village situated on a live river is
ordinarily more healthy than one lying upon the banks of a
dead river."* " T h e obstruction of drainage due to the
constructions of embankments or the decaying of rivers in a
natural way were only a few among others and possibly more
dangerous sources of malaria.
Construction of Railwavs
The building up of railway started in the middle of the
nineteenth century. In fact the first opening of Calcutta to
to Ranaghat railway was started in 1862 and by 1872 there
were no less than 900 miles of railway, mostly in Western
B e n g a l . * ’*It is interesting coincidence that in the very
year the railway was built there were reports of fever
epidemics. According to the Bengal District Gazetteers.
Burdwan, the change situation was recorded in following way;
Before 1862 the district was noted for its

healthiness, and the town of Burdwan particularly was
regarded as a sanitarium. In fact it was customary for
persons suffering from chronic fever to come to Burdwan
where cure for the disease was common. But in 1862 the
terrible epidemic fever ... crossed the border of
237
Burdwan. Thence it spread gradually but steadily over

the district, following the main lines of
communication, until it was fairly established in all
the eastern thanas.*’*
The epidemic fever of Burdwan was attributed to the
obstruction of the natural drainage system because of river
and railway embankments. Some of the embankments were built
for irrigation purposes. The embankments changed the courses
of rivers like Damodar and Ajoy and silted and dried up
smaller channels and streams. It was found that villages
that stood on badly drained areas suffered most with fever
and the villages on higher grounds with good natural
drainage escaped fever. The story of railway development
was the beginning of the malaria epidemics for the people of
Bengal. This was examplified in the following words.
Railways are a most prolific source of Anopheline

breeding places and malaria of virulent type, and this
applies equally to old established lines with burrow
pits, badly designed culverts, and collection of
standing water along the line, and to newly opened up
sections where the engineering operations involved, may
frequently make conditions favorable for malaria where
previously they were unfavorable.***
"More railways, more malaria" became a common saying in
Bengal. The areas once considered as sanitaria later because
of railway networks became the hotbeds of malaria. The
construction of railway lines created burrow pits, quarry
pits, badly designed culverts and thus created conditions
for collection of standing waters along the lines. The
fallow pools of water became the most prolific source of
mosquito breeding areas. In a report on the epidemic fever
submitted to the government by the commissioner of the

238
Presidency Division in 1874, the following passage occurs;
"It seems possible that the very severe fever that prevailed
in Belgurria, just north of Calcutta, nearly every year, may
have owed its origin to railway embankments."*** In 1878 the
Sanitary Commissioner commenting upon the epidemic during
the construction of the Jessore and Faridpur roads recalled
the fact that a similar outbreak occured when the Grand
Trunk Road was being constructed. The sanitary report of
1884 alluded to an epidemic of malaria which broke out when
the railway was being constructed between Dacca and
M y me ns in gh . * * * Again, fever became intensely prevalent from
1896 onwards during the construction of the Assam-Bengal
Railways from Gauhati to Lumding. The sanitary report of
1907 also contained the following references to an outbreak
of fever in Murshidabad;
The Civil Surgeon is strongly of opinion that the

newly constructed Murshidabad branch of the Eastern
Bengal Railway has affected the public health. He says
that railway engineering authorities have been guilty,
as elsewhere, of taking absolutely no means of draining
the pits and hollows by the side of the embankment, and
he is convinced that in such a malarious neighbourhood,
especially as that of Murshidabad town, this has led to
increased unhealthiness and should be remedied.***
Similarly an outbreak of malaria in the Malda district
was blamed on the extension of railway by Major Young in
1910 and an outbreak of malaria took place in the
Murshidabad district which coincided with the construction
of new line ther e. *’’In later days Bentley thought that the
areas of greatest railway construction in Bengal in the
1920s were the most intensely malarial sect i on .***(See Map

239
3).
Summing up the whole situation of the railway network
in Bengal we come to see that there was a good correlation
between malarial infection and railway distribution. West
Bengal had a rate of malarial infection of ninety persons
per thousand and was best served by the railways in
proportion of its total area. In Central Bengal where
malaria was next most severe, there was about seventy
percent as much railway mileage per unit of area. Northern
Bengal had about half as much mileage and similarly lighter
malaria rate. Eastern Bengal, with a malarial problem only a
fraction as severe as that of West Bengal, had only a
quarter of the mileage in proportion to total area. How ill-
founded and anti-people was modernization through railway
transportation was not realized even by the worst enemy of
imperialism, Karl Marx, who mistakenly thought that the
railway would bring tremendous change to the feudal
structure of Indian society. In fact the advent of the
railway brought a marked deterioration in the health and
well being of the community. All the more there was hardly
any serious attempt made to redress the health problem due
to railway. This type of apathy was observed by Senior
White who said:
From the point of view of the Malariologist a

railway is a Euclidean straight line. It might
therefore be thought that any attempt to control
malaria along its route would be foredoomed to
futility, unless powers of entry and work on
surrounding property were granted. For this reason very
little has in the past been attempted towards the
control of malaria on railways.**’
240
Map 3.
MAP OF BENGAL RIVERS AND RAILWAYS, 1921
241
SIKKIM
NEPAL
B H UTA U
«
1 ,
Cemilf 2
\ É
»
BUR M A
Map 3.
MA P OF BENGAL RIVERS AND RAILWAYS, 1921
242
Embankments and Roads
Similar unhealthy results followed due to the
embanking of rivers for the purpose of flood protection.
The earliest known example of an outstanding break of fever
followed the embanking of the river Nabaganga in 1858. A
similar outbreak was reported in Krishnanagar thana in the
Hooghly district in 1873 as a result of the embankment.*•*In
1893 the magistrate of Murshidabad stated that the
prevalence of fever in that district was largely due to the
embankments protecting that district. Subsequent
investigations had shown that this was true, as was proved
by the investigations made by Stewart and Proctor in the
Murshidabad district. Villages were examined on the east
bank of the Bhagirathi and the results were quite
surprising. The mean spleen index of 26 villages outside the
embankment was 27.0 per cent, whereas 29 villages inside
gave a mean spleen index of 60 per cent.''^
It had been observed on numerous occasions that
following the construction of embankments there was a great
local extension of malaria incidence on both sides of the
embankments. Changes of this kind was reported in the
railway embankments in Birbhum, Murshidabad, the Sara Bridge
and also Sara-Sirajganj railway embankments. The embanking
of the Delta tracts of Bengal was first begun as a measure
of flood prevention, as in Burdwan, Murshidabad and Nadia;
then for roads in Jessore and finally for railways. At that
time few realized that the process was loaded with

243
danger. None but Raja Digambar Mitter explained that
epidemics of fever were due the construction of embankments
because he realized that these were obstructing the drainage
system.
Another factor is that there was a serious apathy on
the part of the government to maintain the embankments, and
also the channels along side of the embankments. The
neglect of the embankments was largely due to the built in
weakness in the provisions of the Permanent Settlement.
Under Regulation XXXIII of 1793, provisions were made for
annual repair of embankments in different parts of the
country at the expense of the g o v e r n m e n t . ' W h i l e the large
works were to be done by the government, there was complete
vagueness as to what constituted large projects. On the
other hand, while the obligation of the zamindars to
construct and maintain all other embankments and drainage
works was recognized, no machinery was evolved to enforce
it. Acts were passed in 1851 and 1873 redefining the power
of different authorities but the cumbersome process of
approval of plans did not help in promoting it, rather it
"helped to keep the status quo of negligence".*®'
All these reflect some inherent weakness in the
administration of the different branches of government by
the colonial authorities in Bengal. If government is based
on the motto of maximum profit for minimum cost the result
is always disastrous for the people. This was quite evident
in the letter of Lord Lawrence to Charles Wood, the

244
Secretary of State for India, at Whitehall with reference
to the railway and canal schemes:
Our main object should be to complete the railways . .

. which are the great arteries . . . but I doubt if
most of them will pay in our present financial
difficulties. I am for postponing them all. What seems
to me of very much more importance is the question of
irrigation. . . . We are at our wits' end for revenue:
any increase of taxation is sure to produce
discontent. Is it not a kind of political suicide
cutting from under our feet one great source which is
available, namely from the construction of irrigational
works? * " *
The main purpose of the railways, embankments or
irrigation schemes was to enhance revenue of the state. The
widespread prevalence of malaria was certainly due to the
serious ecological disturbance created by the government due
to an inapt and greedy policy of exploitation. Through its
effects, the whole population of Bengal suffered, the
majority of whom were agriculturists, so that thousands of
acres of land remained uncultivated, or imperfectly
cultivated. The economic and human loss was colossal.
Controversy about the Past Prevalence of Malaria
In the history of malaria in Bengal, two distinct views
regarding the past prevalence of malaria had been frequently
put forward for discussion by the sanitary commissioners and
the civil surgeons. In the first place, there were some who
assumed that malaria had always been extremely prevalent in
nearly all the regions of Bengal. They maintained that
there had been no great increase of malaria in any period of
time. This argument was mostly held by the Drainage

245
Committee of Bengal, chaired by W.A. Inglis. His view was
supported by some among the most prominent health officials
such as Captain Stewart, Captain Proctor and Major Fry, all
of whom had the distinction of writing reports on malarial
fever in Bengal. These civil servants were not prepared to
take the blame for the suffering of the people which they
have seen with their own eyes. Seeing themselves as saviours
of the people and the country, they tried to pin the blame
on anything but misgovernment and blamed the health
behavior of the people.
The others who held the contrary opinion, put the
argument that many areas of Bengal that were once free of
malaria became seriously affected by the disease in the
middle of the nineteenth century. The strongest proponents
of this view were C.A. Bentley and Dr. Forster. Bentley had
done the most extensive survey of the different aspects of
malaria in Bengal. He had a genuine desire to mitigate the
suffering of the people through investigation and analysis.
His arguments were supported by Indian officials and
political leaders such as Raja Digambar Mitter and
Surendranath Banerjea. Long before Bentley or Banerjea,
Raja Digambar Mitter, a member of the Legislative Council,
spoke about the harmful effects of the obstruction of
drainage in causing fever in Bengal.
The important point on which we need to focus is that
some of the investigations done prior to the establishment
of the theory of the conveyance of malarial infection by

246
mosquito pointed to the sudden virulence of the disease due
to embankments. The mosquito-malaria theory got its real
footing from the date of Major Ross' researches of 1897-98,
the fruition of which took a few years more. Since the
beginning of the mosquito theory, several special enquiries
were done into the causes of malaria in Bengal. Most of
these reports pointed to the fact that malaria was of recent
origin in Bengal. But the notable exception was the
Drainage Committee Report of 1907.
The Drainage Committee Report held the view that
malaria had always been extremely prevalent in Bengal.
After briefly reviewing the history of malaria in the
Presidency Division, it came to the conclusion that there
was little justification for the belief that the
contemporary condition of malarial fever was of recent date.
The report unequivocally asserted that the prevalence of
malaria was of long standing and the disease had long been
present in Bengal.*®* But the statement of the Drainage
Committee Report in this regard was disproved by subsequent
reports. The investigations undertaken since 1907 brought
to light the fact that malaria was little present in most
parts of Bengal before the middle of the nineteenth century
and its effects were almost non-existent. The investigation
done by Major Foster in 1909 in Murshidabad found a very
negligible number of children with enlarged spleen.
Although he surveyed a limited area, it proved that malaria
was not rampant throughout Murshidabad.*®* Again, some of

247
the areas which Stewart and Proctor investigated in 1907 in
the Presidency Division were less malarious but in five
years time, became malarious. Fry, in his investigation in
1912, found that the areas which were little malarious in
previous investigations became more malarious afterwards.
Moreover, he found that the areas which had epidemic malaria
became the seat of endemic malaria. Even then he held the
view that malaria had a long history in Bengal. This he
justified by saying that;
The charge has been made that malaria is a new thing in

Bengal and is due to the extension of roads and
railways and their blocking effect on drainage. This
short history is sufficient to shew that malaria was
severe long before railways were b u i l t. ** ’
He was referring to the report of the civil surgeon of
Burdwan, Dr. French, who attributed the problem of malaria
to the unplanned development process. Fry was right when he
said that silting was not a new phenomenon in Bengal,**'but
he built his arguments on the silting factor as the only
cause of the disease. Major Fry was one of those British
civil servants who thought that any admission of failure on
the part of the administration to control the malaria
problem would undermine the capacity of the British
government in India.
One of the most thorough investigators of malaria was
Charles Bentley, who worked in the Bengal Sanitary
Department for a longer period of time than anybody else.
In his numerous writings in different journals, and
especially in his reports on malaria, he pointed to the fact

248
that malaria in Bengal was a recent phenomenon. Writing in
the Report of Malaria in Bengal in 1 9 1 6 . he stated;
In regard to the history of Bengal malaria, and the

questions as to whether there has or has not been an
increase of the disease in comparatively recent times,
an examination of existing records seems to afford
overwhelming proof that many areas now suffering
intensely from malaria enjoyed a relative immunity some
50 to 60 years ago.*®*
If his assessment was correct, the deteriorating
malarial situation started in Bengal in the middle of the
nineteenth century. Northern Bengal and Murshidabad were
unhealthy at the beginning of the nineteenth century but
there were grounds for believing that the greater part of
Lower Bengal was comparatively free from malaria. Although
Calcutta, from the day of its foundation, appears to have
been unhealthy, Hooghly and Chinsura were once looked upon
as healthy resorts by the Europeans in Bengal.
Bentley divided Bengal into Eastern Bengal, Central
Bengal, Northern Bengal and Western Bengal and he found that
there was an extraordinary variation in the prevalence of
malaria from the eastern to the western part of Bengal.
According to his estimation the intensity of malaria was as
follows;
The greater portion of the Burdwan Division, west of

the Bhagirathi is intensely malarious. Central Bengal
or the Presidency Division is also an area of intense
malaria. But as soon as we pass over the Madhumati
into Eastern Bengal malaria became less prevalent and
with the exception of few small areas nearly the whole
of the country east of the Ganges and Jamuna
(Brahmaputra) is comparatively free of the disease.***
In the early sixties of the nineteenth century long
before all these reports were published when outbreaks of

249
epidemic fever first attracted attention in Bengal, the
occurrence of this disease was ascribed to the construction
of embankments. The chief exponent of this theory was Raja
Digambar Mitter, the Indian Member of the first committee
appointed by the Government in1863 to enquire into the
causes of the epidemic fever.Digambar Mitter, when seeking
to explain the epidemics of malaria that occurred in
association with the construction of embankments, suggested
that they were due to water logging by which he meant
obstructed flow. Mr. Mitter said;
This dampness can only arise from excessive moisture in

the sub-soil, owing to the disturbance in the drainage
of the place, occasioned most probably, by the
diversion in the course of the river, aided perhaps by
a number of roads running transversely to the direction
of the drainage.***
When the medical men and engineers were asked to
investigate water logging, they looked for evidence of the
saturation of the soil. At that time the saturation of the
soil ordinarily implied accumulation of excess water beneath
the soil. And failing to discover much evidence of this,
they declined to admit that water-logging was the
explanation of the epidemic fever. If they had enquired
into the question of obstructed flow and an increase of the
surface water in the affected tracts, they would have found,
asin fact many of them did find, evidence of this on all
sides. As a matter of fact, since the middle of the
nineteenth century, embankments were spread out in the
western part of Bengal through construction of railway
roadbeds. The construction of embankments added to the

250
siltation of the rivers and canals, and created more
breeding places for mosquitoes.
The argument that malaria was a relatively recent
phenomenon was put forward by no other than Surendranath
Banerjee, one of the most eminent of nationalist
leaders. His resolution to the Imperial Council on malaria
is worth quoting:
My Lord, I have the honour to move the Resolution which

stands against my name. The terms of the Resolution
are these:
That this Council recommends to the Governor-General in

Council (a) to instruct the Provincial Government to
take vigorous measures for the prevention of malaria,
and (b) to publish an annual statement showing the
progress made by each province in this matter.
My Lord, I confess to a sense of personal concern in

the question to which this Resolution relates. I come
from a Province which may be said to be the home of
malaria. It would be no exaggeration to say that some
of the fairest parts of my beloved Province have been
decimated by this terrible scourge. There are
districts in which the death rate exceeds the birth
rate, owing tothe prevalence of malaria. My Lord, I
live in a village in Bengal. I have with my own eyes
seen villages, once the abode of health, happiness and
plenty, now a crumbling mass of dilapidated structures,
overgrown with jungle, with a solitary inhabitant here
and there, pale and anemic, suffering from malaria
fever, but resolutely clinging to the ancestral
homestead, as if mounting guard over the sweet
reminiscences of the past. Some of the healthiest
districts have suffered grievously from malaria.
Birbhum is a well known district in Bengal. At one
time it was a health resort; it used to be so within my
recollection. Today the health-conditions of the place
have completely changed. The Sanitary Commissioner of
Bengal, in his Report for 1914, says that it tops grim
list of recorded mortality arising from malarial fever
in the whole province. Take another district, the
Nadia....At one time it was a health resort. Tradition
says that Warren Hastings the first Governor General of
Bengal, built a house there which he used to visit for
health and change. To-day, my Lord, it is a plague
spot, malarial fever counting its victims by thousands
and tens of thousands.***
251
His remarks reaffirms the fact that malaria was
recently introduced in many districts of Western Bengal. The
places which were known as health resort became the hub of
malaria. The question as to how and from where malaria came
to Bengal or for that matter to India in epidemic
proportions has been echoed to day. In this regard the
theory of Kingsley Davis has held the field. He said:
There is one important reason why India was, during the

last two centuries, the home of great epidemics. She
was being exposed to foreign contact for the first time
on such a great scale. The nature of bacterial
parasitism is apparently such that, at least in many
cases, a natural immunity is built up after a number of
generations of exposure. Hence isolated and stable
communities do not suffer much, because they have
developed a natural immunity to old infections and are
not exposed to new o n e s .* * *
Davis then compared the epidemic situation in Europe which
started at the end of the Crusades. The introduction of new
diseases and their dissemination by the Europeans to the
inhabitants of the Americas was attributed to foreign
contact. Even some of the recent studies done on African
diseases came to the conclusion that contact with colonial
rulers and traders brought a new and more complex disease
environment for the people of Africa.*** But this theory was
opposed by Ira Klein who argues against the late effect of
the contact of the diseases because the British took control
of India in the middle of the eighteenth century. He
maintained that in the 1 8 9 0 's and later epidemic malaria and
cholera and other diseases took place in the areas in which
they had been endemic. He explained the spread of malaria
to the migration of laborer from one place to the other.***

252
There is no doubt that the mobility of the laborers
from the rural setting to the industrial belt and back to
the villages caused the spread of diseases within Bengal and
other parts of India once they were infected. But the
question remained unanswered as to the origin and the sudden
influx of the infection. In that case the probability of
foreign contact as explained by Davis is more plausible. In
a report on malaria in the islands of Indian Ocean Ronald
Ross found that Malaria came to Mauritius in 1866 and to
Reunion in 1867 and it was absent from Seychelles and
Rodrigues when he was making the report. He concluded that
malaria came to the above islands through foreign
contact.** ‘It is to be noted that malaria epidemic became a
factor in the health administration of Bengal in the middle
of the nineteenth century and not before that. Incidentally
at this period British imperialism was at its peak in
empire building in Africa. All the areas the British
controlled in Africa such as West Africa, South Africa, and
Egypt were infected with malaria and even the West Indies
earned notoriety for its malarial fever.**’
There is an abundance of literature on the European
encounter with malaria in Africa.**' In fact Leo Spitzer put
forwarded an interesting theory that the development of
segregation between whites and blacks was due among other
things the fear of being infected by malaria. To avoid
the the natives the Europeans took refuge to hilly areas
which are relatively free from mosquitoes and other

253
vectors.**’ Early European activities in Africa were limited
by exceedingly high death rates due to vector borne
diseases.**"Another point of consideration is that West
Africa was the main source of P. falciparum, the most
malignant of malarial parasites. Coincidentally the cause of
most deaths in Bengal was P. falciparum. An authoritative
epidemiologist has said, "Epidemics of malaria may occur
when the parasite is introduced into a region with a large
nonimmune population." * * *This had happened in the Soviet
Union after World War I when more than five million cases
were reported. The same thing happened in Kent, England
after World War I, where a few hundred cases were
notified.*** As late as 1930 Brazil was invaded by A.
qambiae from Africa.*** In fact malaria was originated in
A frica,**‘and spread out in different parts of the world
through human migration and contact.
As malaria became a proverbial disease in Bengal from
the middle of the nineteenth century, it seems most probable
that malaria in modern times was carried over to India from
Africa by the Europeans. Moreover, tuberculosis and plague
were also unknown to the Indians before late the nineteenth
century and these diseases began first in the cities and
later spread over to the c o untryside.**‘Similarly Calcutta
and the closest districts around it were the first victims
of malaria in Bengal.*** Moreover, the railway networks
started from Calcutta and the prevalence of malaria had a
good connection with this network. In a malaria survey of

254
the city of Calcutta, Charles Bentley in his forward to the
report concluded that Calcutta was the epitome of malarial
conditions in B e n g a l . " ’ Calcutta, the capital of British
India and the second largest city of the British empire
was abandoned as the Capital in 1911. It was said at that
time that the change occured for political reasons. Now it
seems that its unhealthy atmosphere in terms of physical
wellbeing also contributed in the change of its status.
Rhoads Murphey introduced some interesting arguments
about the ruin of ancient Ceylon. Of all the causes of
abandonment of Raja Rata (King's country), the "shattering
affects of invasion" followed by famines and "malaria,
coming in on the heels of invasion and thriving on disused
irrigation w o r k s " ,**'seemed to him the most important cause.
Almost the same thing happened in Bengal but in a different
course. It was because of mismanagement of the irrigation
and embankment systems man-made malaria became a fact of
life.
Although the exact causes of an epidemic malaria are
unknown there are some immediate and accumulated causes that
work together for the introduction and the spread of the
disease. This has been explained by Bruce-Chwatt in the
following words:
The increased susceptibility of the local population

may be due to some social or other upheavals such as
war or a natural disaster, both of them resulting in
poor housing, poor sanitary facilities and
malnutrition.**'
This type of upheaval for Bengal or for India was no

255
other than the Sepoy Mutiny of 1857 which ravaged the whole
country and the society. In the wake of the Sepoy Mutiny
there were few peasant uprisings in Bengal, the most
important of which was the Indigo Revolt of I 8 6 0 . " * As to
the nutritional state of the people the Civil Surgeon of
Hooghly R. F. Thompson wrote in 1872, "The well-to-do
recover sooner with the aid of nutriment within their reach,
but the sufferings of the poor and labouring classes are
intensified by extreme poverty, and it is here the mortality
is great." ***The situation was ripe for any infectious
disease.
Although ancient Indian texts gave good account of
malarial fever of different types, it seemed to have lost
its virulence in course of time. But European expansion in
Africa in the nineteenth century brought in its wake the
most malignant of malaria parasites, the P. Falciparum. It
was reintroduced in India through Bengal. Our evidences
strongly suggest that epidemic malaria of the nineteenth
century Bengal has a recent history. It is basically
connected with the overseas expansion. Once fatal traits of
malaria reached Bengal, the newly built communication
networks put it to the interiors of Bengal. This was not an
isolated phenomenon in Bengal. Many areas in the world
experienced series of epidemic disease in the middle of the
nineteenth century, a phenomenon generally attributed to the
breakdown of relative isolation and the spread of disease
through increased intercommunication. New diseases were

256
introduced and familiar diseases spread more rapidly.

257
Notes to Chapter VIII
" ‘Frederick Cartwright and Michael Biddiss, Disease

and History (New York, 1972), p. 3.
*"Ira Klein, "Malaria and Mortality in Bengal, 1840-

1921", The Indian Economic and Social History R ev i e w .
Vol. IX, No. 2, June 1 9 7 2 . “ ---------
"•William Hodges, Travels in India. During the Years

1780, 1781. 1782, 1783. (London, 1793), p. 33-43.
* " R a d h a k a m o l Mukeriee.The Changing Face of Bengal: A

Study in Riverine E c o n o m y , (Calcutta, 1938), pp. 76-77.
••"Nirad Chaudhuri.The Autobiography of an Unknown

Indian(Berkley, 1968), p. 5.
Ib id ., p. 75.
" * S . C . Majumdar, Rivers of the Bengal D e l t a (Calcutta.

1942), p. 93.
:•'Bengal District Gazetteer. XXXIII, "Rajshahi",

(Calcutta, 1916), p. 70.
" ‘C.A. Bentley,Relations between Obstructed Rivers and

Malaria in Bengal (Calcutta, 1913), p. 2.
* * 'Rejjort of the Drainage Committee. Bengal (Calcutta.

1907), p T s E ------
" ‘C.A. Bentley.Malaria and Agriculture in Bengal: How

to Reduce Malaria in Bengal bv Irrioation(Calcutta. 1925).
p. 35.
* * 'Report of the Sanitary Commissioner for Bengal for

the Year 1874 (Calcutta, 1874), p. 90.
'••Government of B e n g a l . Resolution No. 1379, Medical,

dated 26the March, 1906.
" • Report of the Drainage Committee. Bengal (Calcutta,

1907), p T i l -----
2 9 9
Ibid. p. 32.
" ' House of Commons Sessional P a p e r s . Feb 1913- March

1913, Vol. 62, "East India (Railways), Administration Report
on the Railways in India, For the Year, 1911" (London,
1912), p. 130; N.K. Sinha, ed.,The Historv of Bengal (1757-
1 9 0 5 ) (Calcutta. 1967), p. 369.
2 9 2
J.C. Peterson, Bengal District Gazetteers. Burdwan
258
(Calcutta, 1910), p. 78.
" ' K . C . Chose, "Railways and Malaria".The Indian Medical

G a z e t t e , Vol. LXII (Calcutta, March 1928), p. 169.
*’‘Report of the sanitary Commissioner for Bengal for

*’‘Report of the Sanitary Commissioner for Bengal for

‘’‘Report of the Sanitary Commissioner for Bengal for

the Year 1 9 0 7 (Calcutta. 1908), p. 17.
" ’A.B. Fry,Second Report on Malaria in B e ng a l .

(Calcutta, 1914), p. 36.
‘‘C.A. Bentley, "Some Economic Aspect of Bengal

Malaria", The Indian Medical Gazettee Advertiser (Calcutta,
Sep. 1922), pp. 324-326.
*’*R.Senior-White, "Studies in Malaria, as it Affects

Indian Railways", Indian Medical Gaze tt e. Vol. L X I I , Feb.,
1928, p. 55.
‘*"Report of the Sanitary Commissioner for Bengal for

the Year 1 8 7 3 (Calcutta. 1874). p. 90.
'•'Stewart and Pr o c t o r ,Final Reports on the Districts of

Jessore. Nadia and M u r s h i da ba d(Calcutta. 1907), pp. xiii-
xiv.
*"*H.L. Harrison,The Bengal Embankment M a n u a l (Calcutta.

1911), p. 68.
‘*'A Review of the Legislation in Bengal Relating to The

Irrigation, Drainage and Flood Embankments(Calcutta. 1911),
p. 6.
'•‘Quoted from Sir George Dunbar, A History of India:

From Earliest to Nineteen Thirtv-nine (London, 1949),
p. 539.
'•‘Report of the Drainage Committee. Bengal (Calcutta,

1907), p. 16.
'•‘C.A. Bentley, Report of Malaria in Bengal (Calcutta,

1916), p. 28.
'•’A.B. Fry, First R e p o r t , p. 4.
' " Ibid. , p. 4.
'•’Bentley, Malaria in Bengal (Calcutta, 1916), p. 74.

259
'I'lbi d.. p. 12.
'I'Bholanauth Chunder, Raia Diaambar Mitra. C . S .I . î His

Life and Career (Calcutta, 1893), p. 121.
si'Surendra Nath Banarjee, "Resolution in the Imperial

Council Representation of Malaria. 1 9 1 6 ." Malaria Survey of
India, Vol. I, no. 2 (Calcutta, March 1930), p. 154.
'Kingsley Davis.The population of India and Pakistan

'Mario J. Azevedo, et. a l . . Disease in African

History; An Introductory Survey and Case Studies (Durham,
1978), pp. 4-5.
" “Ira Klein, "Death in India, 1871-1921", Journal of

Asian S t u d i e s . Vol. XXXII, No. 4, 1973, p. 645.
" ' R o n a l d Ross, Report on the Prevention of Malaria in

Mauritius (London, 1908), pp. 27-44.
" ' H a n s Zinsser, Rats. Lice and H i s t o r v (Boston. 1935),

pp. 388-396.
" 'Windwood Reade, Savage Africa. (New York, 1864),

p. 85.
" ’Leo Spitzer, "The Mosquito and Segregation in Sirre

Leone", Canadian journal of African S t u d i e s . Vol. 2, No. 1,
Spring 1968, pp. 49-61.
" " H . M . Feinberg, "New Data on European Mortality in

West Africa: The Dutch on Gold Coast, 1719-1760," Journal of
African History. Vol. XV (1974), pp. 357-71; Philip
D. Curtin, The Image of Africa: British Ideas and and
Action. 1780-1850 (Madison, 1964), pp. 177-97, 343-62.
'"Thomas C. Jones, "Malaria", in Cecil's Textbook of

Medi c in e, ed. Paul B. Beeson et al. (Philadelphia, 1979),
pp. 566-68.
'''Thomas Mckeown, The Modern Rise of Population

(London, 1977), p. 113.
’" B r u c e - C h w a t t , op . c i t . . pp. 133.
" 'Ibi d. . p. 1.
" ' C y a n Chand,India's Teeming Millions (London, 1939),

pp. 120-21., Kingsley Davis.The Population of India
" ‘Nirmal Kumar Bose, "Calcutta: a Premature

260
Metropolis", in Cities (New York), p. 67.
" ’M.D.T. Iyengar.Report on the Malaria Survey of the

Environs of C al c u t t a (Calcutta. 1928).
"•Rhoads Murphey, "The Ruin of Ancient Ceylon", The

unknown there are some immediate and accumulated causes
Journal of Asian S t u d i e s . Vol. XVI, No. 2, Feb. 1957,
pp. 181-200.
" ’Bruce-Chwatt, o p . c i t . . p. 137.
"•A. Rasul, A Story of Indigo Revolt (Calcutta, I960),

p. 43.
'''Annual Report of the Sanitary Commissioner for Bengal

the Year 1872 (Calcutta. 1974). p. 61.
CHAPTER IX
CONCLUSION
The economic impact of colonialism on the health of the
population of Bengal was devastating. All the gifts of
civilization such as wars of conquest, slavery, forced
labor, importation of diseases and finally the take over of
the richest and the most productive land for export of crops
rather than local food supply, brought vast suffering in the
form of famine, malnutrition and finally death due to
disease.
Economic Cause of Malaria
At the earliest stage of British occupation of Bengal
the main concern of the Company's Government was to obtain
the revenue through taxation or extortion. The agrarian
policy was geared to the necessity of obtaining stable and
"surplus" income from land. With the progress of the
Industrial Revolution the emphasis on surplus revenue had
transformed into demand for raw materials for the British
industries. The British land policy in India had two major
determinants, gearing up the exploitation in the interest
261
262
of British trade and industry and to create a class of
collaborators to buttress the Empire. Cornwallis introduced
the Permanent Settlement in Bengal to regenerate the
economy. Instead of turning the zamindars of Bengal into
economic entrepreneurs they turned into social
parasites. When the Mughal system was working properly a
zamindar was not, formally at least, a property owner. Under
the new system the zamindar received a property right and
also remained a tax collector. The British now took nine-
tenths of the revenue the zamindars received from his
peasant tenants leaving to the zamindar the remaining
tenth.'"In such a situation "British policy merely
intensified the trend toward parasitic l a n d l o r d i s m " . " '
British rule in India created a great external demand
for agricultural raw materials. "But the expansion of
output was achieved mainly by the expansion of cultivation
rather than by an improvement in yield per acre."''* For the
over all Indian situation the result was that the rate of
crop out-put was far lower than the growth rate of the
population.''“This phenomenon was explained as expansion
without growth, in other words a 'static expansion'. The
Indian agriculture during the British period remained
backward.
In most countries agricultural development was
regarded as the precondition for industrial development.
But the in the "absence of rapid industrialization the urban
market could exercise no pull on agricultural

263
productivity". " ‘This was the situation in Bengal which led
iotedars. i.e. the landholders, to invest in the
moneylending business than in agriculture. Moreover because
of a lack of support from the British government for
industrialization, agriculture did not improve. " 'Whatever
economic surplus was there the landlords, money-landers who
could be termed as internal macroparasites and the
conquerors, the external macroparasites absorbed or took
away the surplus. "Hence economic stagnation continued
throughout the British era and indeed into the present
d a y . " " * It is rightly said that the essential parasitic
structure of ownership, credit and marketing simply 'skiiraned
cash crops off the surface of an immobilized agrarian
s o c i e t y ' . " ’Most of the British economic historians could
not accept this view fully but conceded the economic impact
of British policy in India. Barrington Moore, an American
historian, noted that in researching the Indian chapter of
his impressive book he at one point "suspected that the
parasitic landlord might well be a legendary social species
created by Indian nationalists and semi-Marxist
w r it er s" .' ’"The evidence he assessed., however, persuaded
him that parasitic landlordism was very real indeed. In
reality the situation was aggravated by the shortage of
labor supply in the fever stricken districts. The vitality
of the survivors from malaria made them incapable of hard
and strenuous work that rice cultivation required.
The Indian nationalist of the nineteenth century

264
counted the evil effects of the British rule in complete and
partial destruction of the indigenous industries. The idea
of economic imperialism might be set around 1867 when
Dadabhai Naoroji started his crusade against British
imperialism in India. It was in his paper England's Debt to
India, read before a meeting of the East India Association
in 1867, that he first put forward the idea that Britain
was extracting wealth from India "as the price of her rule
in India", that "out of the revenues raised in India,
nearly one-fourth goes clean out of the country", and that
India was consequently "being bled". " ' B y 1873 when he
prepared the first draft of his famous paper on the Povertv
of India, his views on the drain were beginning to be
formulated. Dadabhai gave the lead in analysing the factors
responsible for the economic and physical suffering, and he
was soon followed by a galaxy of exponents of economic
exploitation in the last decade of the nineteenth century.
Ranade, Joshi, Gokhale, G.S. lyenger, Wacha and Dutta were
some of the prominent names whose contribution in this field
was enormous.'*'
The main point of their economic thinking was the
theory of economic drain, which in simple words implied the
constant flow of wealth from India to Great Britain, in the
form of excess of exports over imports, the balance being
the tribute India had to pay to maintain the expensive
machinery, civil and military, of foreign rule. They
revealed that the Indian taxpayer had paid richly for his
265
own servitude insofar as all the wars of territorial
expansion were financed out of the Indian revenues. The most
important constituent of the drain was the remittance to
England of a part of their salaries, incomes, and savings by
English civil, military and railway employees, lawyers and
doctors; and the payment in England by the Government of
India of the pensions and allowances of returned English
officials. Another fundamental drain from India was that of
the Home Charges of the Government of India or the
expenditure incurred in England by the Secretary of State on
behalf of the Indian Government. The Home Charges consisted
of payments of interest on the Indian public debt and the
guaranteed railways, the cost of military and other stores
supplied to India, and the civil and military charges paid
in England on account of India, including the cost of the
Secretary of State's establishment at the India Office
etc. The major sources of the drain were the profits of
private foreign capital invested in trade or industry in
India. This drain was causing lack of capital growth,
industrial development and finally creating enormous poverty
among the Indians.
Dadabhai was the first prominent national leader to
proclaim the existence of absolute poverty in India. In
1876 he declared that "India is suffering seriously in
several ways and is sinking in poverty",and that "the masses
of India do not get enough to provide the bare necessities
of life".'"'Thus he made poverty his special subject and in

266
1895 he declaimed that the Indian "is starving, he is dying
off at the slightest touch, living on insufficient f o o d . " " *
Another prominent Bengal leader who stressed the drain
theory and propagated it through his writings and other
public activities was R.C. Dutt. Though a late converter to
the theory he made up for the time-lag with equal
enthusiasm. In a speech delivered at the Conference of the
Committee of the National Liberation Federation in England
in 1901, he declared the drain theory to be "unexampled in
any country on earth at the present day", and asserted that
"if England herself had to send out one half of her annual
revenues to be spent annually in Germany and France or
Russia, there would be famines before long. " " “He
substantiated this point on the economic effects of
external expenditure. In the preface to the first volume of
his Economic Historv of Indi a. R.C. Dutt made this point
quite distinct. He said,
....taxation raised by a king, says the Indian poet, is

like the moisture of the earth sucked up by the sun, to
be returned to the earth as fertilizing rain; but the
moisture raised from the Indian soil now descends as
fertilizing rain largely on other lands, not on
In di a . '* *
He did not forget to point out that this did not happen
under the worst of Afghan and Mughal emperors. In the later
part of the book he laid the following sin at the head of
the drain;
So great an Economic Drain out of the resources of a

land would impoverish the most prosperous countries of
the earth; it has reduced India to a land of famines
more frequent, more widespread, and more fatal, than
any known before in the history of India, or of the
267
w o r l d . '*’
Similarly in the preface to the second volume he
criticized England being the richest country of the world
for having failed to stop levying annual contribution from
the poorest country like India and emphasized that this
contribution "drains the life-blood of India in a
continuous, ceaseless flow". He was a very vocal advocate of
both the drain theory, and the theory that the heavy land
revenue impoverished the country. He made an attempt to
establish a direct relationship between these two theories
and show that the drain was mainly paid out of land revenue
and therefore impoverished the p e a s a n t r y . " *
The assertions that British rule ruined India were
thoroughly investigated and Daniel Thorner after a
meticulous analysis of census data provided no ground for
any deindustrialization between the period of 1881 to 1931.
But he said;
There can be no dispute with a flat statement that

India's national handicrafts have declined sadly from
their pristine glory....The ruin sooner or later, of
the old style craftsman was an integral part of the
Industrial Revolution as the coming of the factory
s y s t e m . '* »
But his statement ignored the difference in stage of
development between England and India. Bengal was the first
stronghold for a British commercial monopoly. In short the
economy of Bengal had a long history of relative stagnation
both in agriculture and cottage industry.
Most of the economic historians of India like Tapan
Raychaudhuri and Bipan Chandra indignantly refuted the view

268
advanced by Morris D. Morris that the Indian economy
experienced significant growth during the nineteenth
century. "Recent village studies reveal a marked pattern of
socio-economic stagnation in rural India."**'According to
Raychaudhuri from the economic standpoint there was hardly
any significant change until after World War I. " ‘Although
most of the Western historians tried to undermine the
allegation of the parasitic role of colonialism our study
of the spread of microparasitic infectious disease only
confirms the views put forward by Indian economic
historians about the economic stagnation.
Studies in the decline of population in Europe showed
that deficiency of food supply was one of the reasons for
the intensity of the disease. Thomas McKeown has quite
eruditely substantiated this view in his book on population
growth. " 'This was well observed in Bengal too. In a
situation of scarcity of food supply, the economically
underprivileged people suffer the most. One of the
officials in Bengal said that, "the class visited most
severely by the fever has been the lowest class, that of the
daily labourers, which class is also notoriously the
poorest, the worst fed, clothed and h o u s e d . ' T h e effect of
the economic situation on the health was understandable. In
1864 Sir John Lawrence, then Viceroy, said, "India is on the
whole a very poor country; the mass of the population enjoy
only a scanty subsistence." Nine years later repeating his
opinion before the Finance Committee, he said that the mass

269
of the people were so miserably poor that they had barely
the means of subsistence. In 1881, William Hunter, an
eminent member of the British Indian administration, told
the British public that 40 million of the people of India
"go through life on insufficient food. " " ‘The report of the
Burdwan Commission of 1873 gave an elaborate and careful
description of the economic condition and its impact on the
health of the people. The words of Babu Bagala Mukherji is
worth quoting which reads like this;
Among the poor classes, whenever the earning a

family consisting of three or more members depending
upon him for their support happens to be first attacked
and prostrated, not only does he himself die, but the
surviving members of his family fall victims to the
ravages of the fell disease one after another within a
short time after his death, a man so circumstanced can
scarcely lay aside from his daily wages more than
sufficient to support himself and his family for more
than two or three days at the most....The majority of
the masses of the people are circumstanced as described
above, and this simple fact fully explains why a great
number of deaths occurs among them. It must be borne in
mind that poverty of food is not the primary cause of
fever, although evidently it serves to be the exciting
cause of death among p o o r . " *
Most of the local officers explained the falling living
standard as the cause of death. But they assumed a growth
of population at a faster rate than that of increase in
agricultural production. This assumption has little validity
in view of a population stagnancy in most regions of Bengal.
In the later half of the nineteenth century the
government became aware of the allegations of economic
distress and the inadequacy ofthe nourishment of the
people. In view of this fact the Secretary of the Revenue
and Agriculture Department, Government of India, wrote on

270
1887 to P. Nolan, Secretary to the Government of Bengal, to
make an enquiry of it. It was stated in the letter that the
object of the enquiry was "to ascertain whether there was
any foundation for the assertion frequently repeated that
the great part of the population of India suffers from a
daily insufficiency of food, and if there was any truth in
the statement, in regard to any section of the people, to
determine whether remedial measures can be d e v i s e d . " " *
Accordingly attempts were made in different districts to
collect data bearing upon the standard of living of the
people. In view of this notification the Government of
Bengal collected data on items such as land holding of each
ryot, the utensils they use, the ornaments the women wore,
and how much they spent on necessities like food, clothing
and social ceremonies. But the report ignored any cost
people incur in respect of any disease. Finally the report
concluded by saying that, "The question of the condition of
the masses in Bengal has long occupied the attention of
Government, but such is the intrinsic difficulty of the
subject, that no decisive result has been hitherto
obtained."'*'It reminded us about the economic prosperity of
East Bengal and mentioned that the condition of the people
of Hooghly was much better than that of English people. But
the Enquiry of 1888 showed that "even in normal years
certain classes of population, particularly landless
labourers and menial servants, subsisted on insufficient
food ... keeping a substantial portion of the lower classes

271
of the agricultural population below subsistence level.""*
But the condition of the peasantry in the Eastern Bengal was
described by the Government as prosperous and that in
Western Bengal as fairly good. But in the Chittagong
Division of the prosperous East Bengal, it was stated by an
Indian officer that "the struggle for existence is becoming
h arde r" . " ’This was however, dismissed by the government as
an inaccurate statement of the true condition of the people
of the division.
If we compare the standard of living between England
and India that would prove how wretchedly an average Bengali
lived compared to his counterpart in England. It was
estimated that average income per head for an Indian was £8
in 1931, while the corresponding figure in England was
£95. It is said,
India is poor. What is not true is that India has

become poorer. The lowest estimate of the income per
head obtained by the Simon Commission for 1921-22 was
£5.11s. but in 1901-2 it was £ 2 . " *
In the later years of his viceroyalty. Lord Curzon
confessed that there was "enough and far enough" of poverty
in India. " ‘The official per capita income estimates
released by Major Baring and Lord Curzon, revealed in a
striking manner the utter poverty of the Indian people. He
calculated that India's per capita income had gone up from
Rs. 27 in 1882, to Rs. 30 in 1898. " ' I n fact these figures
were calculated to prove that Narojoi's estimate of Rs. 20
as the per capita income was wrong. Thus by the close of the
nineteenth century belief in the existence of the large

272
scale poverty in India had acquired currency among educated
Indians. The most oft quoted extracts of Sir W.W. Hunter,
was that "Forty millions of the people of India habitually
go through life on insufficient food", and Sir Charles
Elliot's remarks that "I do not hesitate to say that half
the agricultural population never knows from one year's end
to another what it is to have a full m e a l " . " '
Even if we take the figure of 1931 the people of India
were twelve times below the English in living condition. On
such a low income it was most probable that many people were
starving and consequently becoming prone to diseases.
Quite often the British administrators put the blame
for poverty on the size and growth of population. In fact
the rate of growth of population was very meagre as we have
seen in the preceding chapter. In any case a miserable
living condition did not necessarily go together with dense
population for most of the West European countries were more
thickly populated than Bengal.
It is very difficult to substantiate how poorly the
people were nourished because there are no reports except a
few passing remarks. The Bengali newspaper Sulabh Dainik
described the lot of the Bengali peasant in the following
words:
He has lost his vitality, he has lost his substance,

his very life-blood has been sucked dry, and he is,
economically speaking, no better than a bag of dry
bones. He is half-fed, he is half-clad. His daily food
consists of a small quantity of rice and a large
quantity of roots and leaves of plants. He has never
tested a delicious dish in his life. His clothes are
torn to tatters. His homestead is a hovel and ill
273
protects him from the inclemencies of w e a t h e r . " *
In a historical survey of Rajshahi district from 1881
to 1891 the causes of death due to fever was recorded. It
came to the conclusion "the diseases of various kinds took
a heavy toll of human lives. The members of the labouring
classes because of their under-nourishment possibly suffered
the most in this r e s p e c t " . " *
Administrative Failure to Cooe with Malaria
In such a situation death due to diseases like
malaria was only a question of time. The number of deaths
in Bengal from malaria was an economic factor of serious
importance. It was estimated that in each year one million
people died of malaria. If this be the death figure then the
suffering and productivity loss would have been ten times
more. But the government had shown a tremendous apathy in
executing some substantial plan to cope with the malaria
problem. There were no dearth of reports, schemes and
proposals but all were thrown away when the question of
financial consideration surfaced. In 1914 the Indian
Research Fund Committee made grants to the tune of
Rs. 50,000 for an experimental sub-soil drainage scheme but
this proposal did not meet with the approval of the
Government of India and the grant was withdr aw n .'**In 1916
the government showed its inability to take any measures to
combat malaria. The resolution that was adopted read as
follows ;
274
The Governor in Council welcomes a noticeable access of

public interest in the problems associated with malaria
and regrets that, owing to financial stringency, he is
debarred from attempting a more extensive anti-malarial
campaign.'‘’
One of these well intentioned policy of inaction was
seen when the government wanted to handle the malaria
problem as was done in Greece and Italy. But as usual it
fell through. The Sanitary Report of 1920 stated the
incident as follows:
The cost of treating the population of Bengal with

quinine on the scale that is done in Greece ... would
amount to at least 2 crores of rupees per annum at the
present prices, but the great expansion in the demand
of quinine that would follow any such attempt would
probably double the price. These considerations render
it unlikely that the malaria problem of Bengal can be
solved by any agency of q u i n i n e . " *
These were not rare examples of colonial
exploitation. The only motto of good government was to run
it at a minimum cost for maximum profit. This could be seen
in the estimation of John Bright in 1858, who found out that
the single city of Manchester spent larger sums of money on
water supply alone than the British authority did on public
works in the fourteen years throughout its vast e m p i r e . " *
It is important to ponder the widely observed
phenomenon that the regression of malaria in the Northern
Europe and the U.S.A. began before there were anti-malaria
programs based on knowledge of transmission. This fact
suggest that malaria was eliminated because of a general
rise in the standard of living, with increased nutritional
food supply, better sanitary facilities and improved land
use. So the causes which made the disease felt most in

275
Bengal were poverty due to economic strain, deficient vital
energy due to endemic malarial fever and the apathy of the
government to spend the needful money. The economic
considerations played the final role in all these
factors. To support these considerations Bentley took
recourse to the doctrine of Malthus. The Census Report of
1921 paraphrases Bentley's views in the following words:
He holds that in large measure malaria is not the root

cause of depopulation, but appears in localities which
suffer adverse economic conditions and keeps down the
population by a less obvious, but essentially parallel
train of reactions to those by which starvation
produces the same result, depopulation, in the acutest
stress of economic conditions, famine.
He summed it up by saying "malaria manifests itself in
Bengal as the instrument of adjustment of such growth to
economic conditions".'"*
The person first in Bengal to question the British
administration was none other than Romesh Dutt, who had
greatly benefitted himself from the British rule. He said:
"The poverty of the Indian population at the present day

is unparalleled in any civilized country; the famines
which have desolated India within the last quarter of
the nineteenth century are unexampled in their extent
and intensity in the history of ancient or modern
t i m e s .' "
Romesh Dutt saw the devastation of famines as directly
due to the economic mismanagement. To the Indian economist
famines were clear proof of India's poverty and their ever
increasing extent and mortality was an infallible index of
the growing poverty of the country. The standard of the
living of the poor stratum of the population was extremely
low, so low that it could not perhaps be pushed down any

276
further. In other words the material condition of Bengal was
that of stagnation at a low level of poverty, creating a
situation of the possibility of more famines and malaria
like epidemics. In fact the Famine Commission of 1943
regarded "food scarcity and famine as being possible factors
in the genesis of severe malaria e p i d e m i c s . " ' "
The concern against malaria was evoked by both
sanitarians and politicians alike. Chitta Ranjan Das, one of
the outstanding leaders of Bengal politics, speaking about
the health and hygiene situation in Bengal squarely blamed
the government for its failure in controlling malaria in the
province. In a public speech in Chittagong in 1918, he
pointed out a death-chart for five years from 1911 to 1916
due to malaria which cost an average of one million lives
each year. He said.
Are we to believe that this fell disease [malaria]

could not have been eradicated if the Government had
taken active steps in this direction? Do you believe,
gentlemen that if the government is nationalized
-- effectively nationalized — we cannot get rid of this
disease? It is a matter of supreme importance to us, to
the growing nationality of Bengal. It means that every
year there is an increase in the number of deaths, it
means want of strength, it means decrease of national
vitality, it means that not a very distant day we will
be reduced to such a condition that it will be
impossible to regenerate us. (hear, hear). I have given
you only the number of people who die every year. But
we do not see all over the whole country malaria-
stricken people living by chance as it were — carrying
on by some means or other, their miserable load of
existence? The whole of Bengal is full of these people
and yet what has the Government done? ('nothing') Yes,
practically n o t h i n g . * "
The irony of the fact is that C.R. Das, better known as
'Desh Bandhu', i.e. friend of the country, himself died of

277
malaria in 1925.''*
In an address to the District Boards of Nadia, Jessore
and 24-Parganas in 1918 the Governor of Bengal, Lord
Ronaldshay, openly accepted the malarial plight the people
were suffering. It showed how ill-prepared the government
was till that time to address the havoc of malaria. He said.
The particular disease with which I propose to concern

myself this morning is malaria. It is not the only
disease that I desire you to help me to fight; perhaps,
the most widespread and the most virulent of all
diseases which afflict the people of Bengal....I
frankly confess that I was shocked at the grim tragedy
which my enquiries disclosed. Every year there occur in
Bengal from 350,100 to 400,400 deaths from this cause
alone. But a mere enumeration of the deaths gives but a
faint idea of the ravages of the disease. It is
probable that at least a hundred attacks ofmalaria
occur for every death, and it is estimated that this
disease alone is responsible for 200,000,000 days of
sickness in the Presidency every year. This gives an
idea of its results from an economic point of view. Its
spectral finger may also be traced in the diminution of
the birth-rate, as well as in the increase of the
death-rate, with the result that in the worst malarial
districts the population shows a serious d e c l i n e . ' "
That malaria was a great killer in Bengal was
recognized as we have seen from the middle of the nineteenth
century, and continued to be recognized by everybody high or
low but there were no crash programme taken to solve the
problem once for all. Statements of this kind from
responsible people were only sufficient to convey an image
how the disease in its endemic form grew steadily, and
relentlessly killed the vitality of the people. There were
some anti-malaria programs in the later days. But these
appeared to have been sporadic and limited primarily to
periods of epidemics and to areas of special interest to the

278
government, such as areas of agricultural and industrial
production for export and areas of concentrated British
population as in cities. " ‘The British administration in
India especially in terms of national welfare that included
health and sanitation fell far short of what could have been
expected from it. To take a balanced view of British rule in
India we should look to what Pannikar said:
It was the theme of the first generation of Indian

economists that India had actually been impoverished by
a system of veiled commercial and economic exploitation
and that the wealth drained from India was the cause of
the misery of the masses. Whatever the truth of this
charge, it is undeniable that the government of India
from 1858 to 1921 confined their activities mainly to
the collection of revenue, the maintenance of peace and
defence of India's frontiers, the minimum essential
functions of government, and undertook schemes neither
for the reorganization of the society, nor for raising
the moral and material standards of the people, nor for
increasing national wealth of the c o u n t r y . " ’
In fine we come to the conclusion that the study of
the history of a disease is not limited to that disease
alone. It encompases other important aspects of society of
which we only covered briefly, issues like politics,
population, ecology and economics. Of all factors the
economic cause of disease is the most important. Economic
imperialism is as old as civilization. It has some constant
features and empires have always meant to rule over others
and exploit them for the benefit of the mother country. The
imperial power possessed superior strength and also superior
mechanisms of exploitation. It was rightly said by Tylor
that ,"The Imperial people exploited those over whom it
ruled and yet at the same time thought it was doing them
279
good. No Empire without a mission or no Empire without a
profit, in reality or i m a g i n at io n. "* "
In fact economic imperialism created a congenial
condition for the malarial parasite to expand its domain.
It thrived on misery, malnutrition and starvation. An
understanding of the history of a disease like malaria in
Bengal is only a tip of the iceberg to the extent of the
suffering the people had undergone due to the exploitation
first by the British imperialist and then by the
epidemics. Although the British have gone the diseases have
not gone totally. Malaria had been reduced but not
eliminated. It has reappeared in some places by becoming
resistant to DDT and eating up the vitality of the people.
The history of disease unlike most other social
sciences is not practical or policy oriented for the purpose
of manipulating the social environment. As with natural
sciences some are concerned with 'knowing' rather than with
'doing', with knowledge and understanding rather than with
policy and practice. But all must have some concept of the
future. If history is a social science, it seem to be the
least oriented towards the future, the most concerned with
'knowing' and the least with 'doing'. Yet all speculations
are based on the knowledge of the past. If it is rightly
said that the knowledge of history is more than anticipated
experience, then our knowledge of the history of malaria
could bring some foresight for the future. The function of
a history of disease is not just to provide raw materials

280
for abject lessons to emulate or avoid but to show how men
have coped with their environment of disease which in fact
threaded with economic injustices and ecological
d is tu rb an ce s .
281
Notes to Chapter IX
**'Irfan Habib, The Agrarian System of Mogul India.

1556-1707. (London, 1963); S. Gopal, The Permanent
Settlement in Bengal and Its Results (London, 1949), pp. 17-
18.
' " B a r r i n g t o n Moore Jr., Social Origins of Dictatorship

and Democracy (Boston, 1966), p. 346.
* " M . Mufakharul Islam, "Expansion Without Growth in in

British Indian Agriculture: Explanations Reviewed",
Bangladesh Historical Stud ie s. Vol. Ill, 1978, p. 102.
" • G e o r g e Blyn, Agricultural Trends in India 1891-1947;

Output. Availability and Productivity (Philadelphia, 1966),
Cha ps . V and V I .
'•‘Rajat and Ratna Roy, "The Dynamics of Continuity in

Rural Bengal Under the British Imperium: A Study of Quasi-
Stable Equilibrium in Undeveloped Societies in a Changing
W o rl d" , Indian Economic and Social Historv R e v i e w . June
1973, p. 127.
" ’M. Islam, Bangladesh Historical S t u d i e s , p. 114.
**"Barrington Moore, Jr. Social Origin of Dictatorship

and Democracy (Boston, 1966), p. 316.
" ’Cited by D. Rothermund, Phases of Indian Nationalism

(Bombay, 1970), p. 264.
' " B a r r i n g t o n Moore, Jr., op. c i t .. p. 356.
"'Dadabhai Naoroji, Povertv and UnBritish Rule in

India.. pp. 38, 565.
*"R.C. Majumder (General Editor), Struggle for

Freedom. Bombay, 1969.
"'Dadabhai Naoroji, Poverty and UnBritish Rule in

India. (Delhi, 1962), p. 1.
' " D a d a b h a i Naoroji, Essays. Speeches and W ri t i n g s , ed.

by C.L. Parekh (Bombay, 1887), Appendix A, p. 63; Imperial
Gazetteer of India. 1908, Vol. IV., p. 194.
'‘•R.C. Dutt, Speeches and Papers on Indian Ques ti on s.

1901, 1902 (Calcutta, 1904), p. 21.
'"R.C. Dutt, Economic History of In d i a . Vol. I,

(Calcutta, 1908), pp. xi-xii.
" ’Ibid., p. 420. Also see pp. 213, 344, and 528-529.
282
3 4#
Dutt.Economic Historv of Ind ia . Vol. II, pp. 372-3.
" ’Daniel and Alice Thorner, "De-industrialization in

India, 1881-1931", Land and Labour in India. (Bombay, 1965),
p. 70.
"•Eric Stokes. The Peasant and the Rai (Cambridge.

1978), p. 37.
" ' T . Raychaudhuri, 'A Reinterpretation of Nineteenth

Century Economic Hi s t o r y ' , Indian Social and Economic
History Revi ew , Vol. v (1968), pp. 98-9; M.D. Morris et al
ed. Indian Economy in the Nineteenth Century; A Sympo si um .
(Delhi, Indian Economic and Social History Association,
1969).
’" T h o m a s McKeown, The Modern Rise of P opulation.

London, 1976.
" ’Bengal General Pr oceedings. Sep. 1875, Collection 4-

7/8 Whinfield, Magistrate of Burdwan to the Commissioner,
(Calcutta, 1912), p. 7.
" ‘Quoted from Ram Gopal, British Rule in India

(Bombay, 1963), p. 15.
’" M a j o r Fry, First Report on Malaria in Bengal

(Calcutta, 1912), p. 7.
’*‘Report on the Condition of the Lower Classes of

Population in B e n g a l . Letter NO. 44F-8-1 dated August 17,
1887. (Calcutta, 1888), p. 1.
’" I bi d. , p. 2.
’" B . M . Bhatia, "An Enquiry into the Conditions of the

Agricultural Classes in India, 1888", In Contributions to
Indian Economic H i s t o r y . Ed. Tapan Ray Chaudhuri (Calcutta,
1960), p. 82. 0
’ " Ibid. . p. 82.
’‘•Sir Young Husband, Dawn in India; British Purpose and

Indian Aspiration (London, 1913), Reprinted, p. 95.
’ ‘'Lord Curzon, Speeches Vol. iii (Calcutta, 1904),

p. 49.
3 4 2
Ibid. . Vol. ii, p. 290.
’ ‘’These remarks were repeated in numerous articles and

books. See for example Neoroji's Spee ch es . p. 587; P.C.
Roy, The Poverty Problem in India (Calcutta, 1895), p. 115.
Sir W.W. Hunter was the Director General of Statistics to
283
the Government of India and Charles Elliot was the Member of

the Governor General's Council.
" ‘Quoted from Bipan Chandra, The Rise and Growth of

Economic Nationalism in India (New Delhi, 1966), pp. 10-11.
" • Q u o t e d from Safiuddin Joardar, "Some Thoughts on the

Labouring Classes in Rajshahi in the Later Part of the
Nineteenth Century", Bangladesh Historical Studies.
Vol. Ill, 1978. P. 138.
" ‘General Department, Sanitary, Resolution no. 809 San.

Calcutta 20th Sept., 1915.
" ’Municipal Department, Resolution no. 554 San.,

Calcutta August 1916.
’‘'Annual Report for Bengal for the Director of the

Public Health for the year 1920 (Calcutta, 1922), p. 16.
" ‘J.Strachey, India; Its Administration and Progress

(London, 1903), p. 233.
" • Census of India. 1921, Vol. V, Bengal, Part I, p. 37.
" ' R a m e s h Dutt, Economic Historv of I n d i a . Ministry of

Information Government of India , (Delhi, I960), pp. XIII-
XV.
’’’John Woodhead, Famine Enquiry Commission; Report on

B e n ga l. (Delhi, 1945), p. 121.
" • C h i t t a Ranjan Das; India for Indians (Madras, 1921),

Third Enlarged Edition, pp. i47-148.
" ‘J.H. Broomfield, Elite Conflict in a Plural Society

(Berkley, 1968), pp. 204-220.
'’'Lord Ronaldshay in Bengal; Being a Selection from his

Speeches as Governor of Bengal 1917-1922 (Calcutta, 1923),
pp. 103-104.
’ ’‘Harry Cleaver, "Malaria, the Politics of Public

Health and the International Crisis", The Review of Radical
Political E co no mi c s. Vol. 9, No. 1, Spring 1977, pp. 86-88.
’ ’’K.M. Panikkar, A Survey of Indian H i s t o r v . (Calcutta,

1956 ), p. 210.
’ ’•A.J.P. Taylor,"The meaning of Imperialism", In

Imperialism, ed. Henry A. Turner (New York, 1976), p. 197.
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MALARIA IN BENGAL FROM 1860 TO 1920: A HISTORICAL STUDY IN A

The University of M ic h ig a n Ph.D. 1986

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A dissertation submitted in partial fulfillment

Professor John H. Broomfield, Co-Chairman

Microfilmed or bound copies of doctoral dissertations submitted

I would have been the most intelligent of persons if I

could have followed the Chinese proverb of the three monkeys

by closing eyes, ears and mouth, and absolutely remained

silent. Because of not doing so I preferred to make more

enemies than friends. The encouragement of large number of

people who constantly helped me in my sojourn in the USA,

is very difficult to acknowledge here. They are the

strongest incentive to overcome the pressure of completing a

task which at times seemed unreachable. Professor John

Broomfield's punditic advice guided me through thick and

thin. He was a constant source of energy for me. But he did

not stay in Ann Arbor to see the end of my work. Professor

Thomas Trautmann filled that gap smoothly . I have greatly

benefitted from his critical comments and valuable

suggestions. Professor Rhoads Murphey and Professor Gayl

Ness lately made me a convert to their erudition. I enjoyed

all their critical insight into the problems that I was

trying to uncover. They made a deep imprint on me.

I shall be very ungrateful if I do not mention the

agony and suffering of my family including my parents,

uncles, aunts, brothers, sisters and in-laws who passed

every moment in anxiety to see me finish my never-ending

writing. They deserve appreciation for not losing their

hearts at all. My father Kazi Shamsuddin deserves high

constant flow of letters remind me of that fact. My mother

Jamila Khatoon is a keen source of encouragement. Of all

Mahabuba Khanam and a younger brother Mohsin for good while

we are in Ann Arbor. With the misfortunes, anxieties and

tribulations I have a pleasant time in the USA for all the

friendliness and support from friends like Kari, Ruhini,

Delia, Omair and Shankar to name only a few. My son Abeer

My first step in the University of Michigan was

possible with the Fulbright Hayes scholarship I got. Later

16. O t h e r ____________________________________________________ _