in India are entered under the category of **fever," and allowing for inaccuracy of diag nosis it has usually been assumed that about two-thirds of the deaths so recorded may be a-cribed to malaria. Recent investigations made in special areas, however, suggest that this proportion has been considerably overestimated and that malaria only accounts for from one-fifth to one-fourth of the number of reported fever cases, the remainder being cases of dysentery, pneumonia, phthisis and other diseases.

as

In the last few years the prevalence of an affection which is the cause of considerable mortality called Relapsing Fever has received considerable attention by the Health Department. This disease has been diagnosed common in most parts of the country, specially in the northern provinces and in the Central Provinces and Berar and Bombay, but the extent of the mortality which can be ascribed to it antot at present be estimated. Nor can figures. be given of phthisis whichis undoubtedly responsible for considerable mortality; especially in the towns of western India, the deaths from this disease in Ahmedabad amounting in 1918 to 5 per mille of the population. All other factors in the health of the people have been overshadowed by the influenza epidemic of 1918 and 1919 which has dominated the popu lation figures at the 1921 census.

Influenza :-The influenza epidemic of 1918 invaded India in two distinct waves. The first infection apparently radiated from Bombay, but it is impossible to say where the more virulent virus of the second invasion came from.

The rural areas were most severely infected, the reason probably being that while villages have little advantage over towns in the matter of overcrowding, sanitation and ventilation the urban areas have the benefit of qualified medical aid and organised effort. Mortality was specially high among adults (20-40), particularly among adult females, the disease being generally fatal to women in pregnancy. At the worst period whole villages were absolutely hid desolate by the disease. There was some times no means of disposing of the dead, crops were left unharvested and all local official action was largely paralysed, owing to the fact that the majority of the official staff were put out of action by the epidemic. To add to the distress the disease came at a period of widespread crop failure and reached its climax in November when the cold weather had set in; and, as the price of cloth happened at the time to be at its highest, many were unable to provide themselves with the warm clothing that was essential in the case of an illness that so readily attacked the langs. The disease lasted in most provinces well into 1919 and gave a high mortality in that year in Bengal and the United Provinces. Even after it had subsided there were in the Central Provinces, Bombay and Burma mild recrudescences later in the year, while local outbreaks continued over the country during the next two years.

There is no direct means of ascertaining the mortality from the epidemic. Various estimates

have been made based on the excess mortality over some suitable mean. The average of these calculations gives a total number of deaths in the areas under registration of about 7,100,000 in 1918, to which must be added, as the results of similar calculation, another 13 million deaths in 1919, giving a total recorded mortality of nearly 8 millions in the two years. Even this, however, must be a substantial under estimate since, owing to the complete breakdown of the reporting staff, the registration of vital statistics was in many cases suspended during the progress of the epidemic in 1918.

The total influenza mortality for India is put at between 12 and 13 millions. This is a conservative estimate. Even this estimate males the influenza mortality, a large part of which occurred in three or four months, exceed by nearly two millions the total estimated deaths from plague in twenty years. On an estimated case mortality of ten per cent the total number of persons affected was 125 millions or two-fifths of the population of India. There was a further reaction on the birth rate.

Houses and

Families.-The average number of persons per house has not changed in the last decade, though there was a decline between 1881 and 1911. The trend of the figures varies in different provinces, but they do not afford substantial ground for any material inference. It would, for example, be expected that the incidence of the influenza mortality would fall fairly evenly upon the individual households and would therefore cause a reduction in the number of persons per house. It does not appear to have done so either in Bombay, the United Provinces, the Central Provinces, or Rajputana, while in Bengal, where there is a rise in the population, there is a fall in the size of the household. The invite a discussion on the condition of the joint figures are unsatisfactory, and though they family it is doubtful if they can really be held to illuminate it. The general opinion of the Provincial Superintendents is that they do not do so and that other indications do not show that the joint family system has yet undergone any radical change, at any rate in the agricultural tracts of the country.

NOTES.

(1) The figures for the Provinces are inclusive of the States attached to them except in the case of Madras where they exclude Cochin and Travancore.

The Actual and Natural population shown in this table is less by 56,500 persons owing to the exclusion of Aden where Table XI was not compiled.

Columns 2 and 6-Persons not enumerated by birth-place or whose birth-place was not returned have been included in these columns.

Columns 4 and 8-The figures against India in columns 4 and 8 represent emigrants to foreign countries, details of which for 1921 will be found in Subsidiary Table V of Chapter III.

It

Future Population of India.--A study of the growth of the population of India and the problems which it presents is vitiated by the abnormal conditions of the past decade. was pointed out in the census report of 1911 that the rate of increase of population between 1872 and 1911 was equivalent to about 19 per cent., and that at this rate the population would double itself in about a century and a half. The real increase in the last fifty years in the population of India is just over 20 per cent. At this rate the doubling will take another 190 years. But calculations of this kind, though of interest, can hardly be taken seriously. Almost every one of the last five decades has witnessed some special disaster. A severe famine in South India checked the increase in the decade 1872-1881. The decennium 1891-1901 was dominated by the great famines of the closing period. Growth in Northern and Western India was checked in the succeeding decade by plague and we have had in the past decennium an epidemic which has caused more concentrated mortality than any previous calamity. The decade 1881-1891 alone

The progress of urbanisation in India-if there has been any progress at all-has been very slow during the past thirty years, the whole increase being less than one per cent. An examination of the statistics shows that whilst towns with populations above 50,000, increased by over 16 per cent. in the decade, the increase was considerably less in those

1881-1891. 1901-1911.

7.0

7.3

13.9

5.2

11.1

13.3

8.5

9.8

5.7

6.5

0.6

8.2

between 5,000 and 50,000, whereas the population of towns between 10 to 20 thousand did not keep abreast of the progress of the general population of the country. The sta tistics reveal the gradual decadence of the medium-size country town and the growth of the larger cities under the influence of commercial and industrial development