Vital statistics

in 1875, 402 per mille. The following figures show the causes for the deaths recorded in 1877 :-Cholera, 0'4; smallpox, 29; fevers, 158; bowel complaints, 48; injuries, o'4; all other causes, 37 per mille. The birth-rate shown by the returns of 1877 was 39'5, varying between 47 in Akola and 35 in Wún District. The number of male births recorded was 109 for every 100 female births. Excess of births over deaths in Berar in 1877, 11:40 per 1000 of the population. In Assam, the system of registration in 1877 was that of Assam. formerly in vogue in Bengal, of which this Province until recently formed part. The returns were taken over certain selected areas, and the results were quite untrustworthy. The death-rate, as ascertained from these returns, was only 109 per mille, varying between a maximum of 29 and a minimum of 5. The registered number of deaths in Assam in 1876 was 933, and in 1875, 19°3 per mille. The following figures show the causes of the deaths registered in 1877 :-Cholera, 2'9 per mille; small-pox, o'3; fevers, 4'9; bowel complaints, 15; injuries, o'2; all other causes, 1 per mille. The births recorded in the selected areas were at the rate of 20 per mille, II being males and 9 females; the ratios varied between 34 and 10. The figures show an excess of deaths over births in Assam in 1877 of 4'9 per 1000 of the population. In British Burma, registration is declared by the Sanitary Commissioner (1877) to be even more defective than in the worst Provinces of India. The average death-rate, according to the returns, was 17'44 per mille, the ratio for males being 18, and for females 16 per 1000. In Myanoung, the deaths were returned at 119, and at Maulmain at less than 13 per mille. In the towns the mortality was 34 per mille, compared with 15 in the rural circles. The number of deaths registered in British Burma in 1876 was 14'79, and in 1875, 14'08 per mille. The following figures show the causes of the deaths recorded in 1877-Cholera, 2'47; small-pox, o'41; fevers, 8.85; bowel complaints, 2'34; injuries, o'18; all other causes, 3.15 per mille. The birth returns showed a rate of only 21 per mille; and this general average,' to use the words of the Report in 1877, 'is made up of such extremes that no reliance can be placed on the figures.' In one place the birth-rate was no less than 115 per 1000, in another it was under 6. The male births registered were 105 for every 100 female births. Excess of births over deaths in British Burma in 1877, 4 per thousand of the population.

British
Burma.

After what has been stated in the introductory paragraph of

this section, it is manifest that the figures quoted from the Report of the Sanitary Commissioner with the Government of India are of little or no value for the purpose of establishing the comparative healthiness or unhealthiness of the different portions of the country. To construct a comparative table out of the provincial returns would be misleading, if any attempt were made to use it for actuarial purposes. But tables on the following pages, 536-37, may be interesting as showing the defects and uncertainties of Vital Statistics in India. The wide variations in the birth and death rates for various Districts usually arise from different degrees of imperfection in the registration.

European

Health of the European Army.—The sanitary statistics of the Health army in India are, in every way, more trustworthy than those of the obtained for the general population; and as they have been Army. regularly collected on a uniform system for a number of years, it is possible to draw valuable inferences.

The sanitary history of the European Army during 1877 General was more favourable than that of any previous year of which statistics of 1877. the statistics are on record. The total strength of the European Army in India in 1877 was returned at 57,260 men; the admissions into hospital numbered 71,992 (1257 per 1000 of average strength); daily sick, 3196 (56 per 1000); deaths, 728 (12'71 per 1000). The corresponding ratios for 1876 were:-admissions into hospital, 1361 per 1000; daily sick, 56; and deaths, 15°32 per 1000. The averages for the five years 1871-1875 were as follows:-admissions into hospital, 1394 per 1000; daily sick, 57; deaths, 1762 per 1000. 'Not only,' writes the Sanitary Commissioner, 'do the results compare favourably with the averages of the five years 1871 to 1875, but, what is deserving of special notice, the admission-rate and death-rate are the lowest which have yet been attained.' Invaliding reached a minimum in 1876, when the ratio was 38 90 per 1000 of average strength. The figures for the Bengal Presidency separately were even more satisfactory, the mortality being only 1164 per 1000, much below what it had ever been before. In the Madras Presidency, the mortality was 16.83 per 1000, rather above the ratio for the preceding year. The mortality in the Bombay Presidency was 12'09 per 1000; invaliding in this Presidency was 48'04, a higher figure than had been obtained for seventeen years.

In all three Presidencies, the same diseases formed the ten Ten chief chief causes of sickness, with slight variations in the order in causes of [Sentence continued on p. 538.

sickness.

BIRTH-RATE AMONG GENERAL POPULATION IN INDIAN PROVINCES IN 1877.

DEATH-RATE AMONG GENERAL POPULATION IN INDIAN PROVINCES IN 1877.

The chief

causes of mortality.

Health in

Bengal and Madras.

Young

soldiers.

Causes of invaliding.

Sentence continued from p. 535.]

which they occurred. These ten were:-malarial fevers, venereal diseases, wounds and accidents, abscess and ulcer, respiratory diseases, rheumatism, diarrhoea, hepatitis, dysentery, and eye diseases. They are here given in the order of their frequency (1877) in Bengal. Malarial fevers, which stood first in both Bengal and Bombay (408 and 492 admissions per 1000 respectively), were replaced at the top of the list in Madras by venereal diseases (231 admissions per 1000); respiratory diseases and rheumatism, which took the fifth and sixth places in Bengal, were eighth and ninth in Madras; whereas dysentery and hepatitis, which came fifth and seventh in Madras, came ninth and eighth in Bengal, and occupied the same position in Bombay. The arrangement of the diseases in all three Presidencies in 1877 accorded generally, to a remarkable extent, with the experience of previous years; and the year may be taken as a typical one.

The ten principal causes of deaths in Bengal in 1877 were, in the order of their frequency: enteric fever, hepatitis, injuries, apoplexy, heart diseases, phthisis pulmonalis, malarial fevers, respiratory diseases, dysentery, suicide. In all three Presidencies, the ten forms of disease which contributed most to the death-rate were the same, with the exceptions that respiratory diseases did not form part of the list in Madras, nor malarial fevers in Bombay, and that cholera, which is not in the list just given for Bengal, occupied a high place in both the others.

The figures quoted in this section show that while the admission rate in Madras was lowest, in all other respects Bengal compared favourably with the other two Presidencies. It showed the lowest sick-rate, the lowest death-rate, and the smallest proportion of loss by invaliding. Cholera was not prevalent during 1877, and added but little to the mortality throughout India; of the cases which occurred, 65 per cent. were fatal. The experience of a number of years goes to show that enteric fever is in the main a disease of young soldiers new to India, the majority of sufferers being men in their first or second year. With reference to the great prevalence of venereal diseases in the European army, it is stated that the working of the lock hospitals in all three Presidencies during 1877 must be pronounced to have been more or less a failure.'

The most important diseases on account of which men were invalided in 1877 were:-general debility (12.63 per 1000), hepatitis (555), diseases of heart and large vessels (362), phthisis pulmonalis (3'14), dysentery and diarrhoea (2:56),