NationalLibraryOfScotland/medical-history-of-british-india huggingface dataset:
29
Population.
Inoculated quarter, 296
Non-inoculated „
154
Plague cases.
Number.
*11
23
Percentage on
population.
3-7
14.9
Plague deaths.
Number.
8*
16
Percentage on
population.
2.7
10.4
The results shown in the above table are very favourable, and would be
even more so, if the Commission had not included the four cases among the unpro-
tected who lived in the inoculated quarter. Assistant Surgeon Dadachanji
also reports that about half the population of the non-inoculated quarter had
fled to the fields, so that, as the Plague Commission remark, " the advantage in
favour of the inoculated ward would be practically double that which is set
forth in the table."
The other community noted by the Commission consisted of the Tais, a
caste of Mussalman weavers and dyers, who lived in two quarters of the town
said to be " absolutely comparable." The following table is given by the
Plague Commission to show the incidence cf plague in the two quarters :-—
Population.
Inoculated quarter, 499 ...
Non-inoculated ,, 492 ...
Plague cases.
Number.
65
65
Percentage on
population.
13.0
13.2
Plague deaths.
Number.
23
47
Percentage on
population.
4.6
9.5
The Commission wind up their discussion of results among the Tais as
follows :—
" In spite of the fact that the prophylactic fluid was operative in reducing plague
mortality
it appears that it did not sensibly reduce liability to attack
by plague."
If the two communities had been strictly comparable such a conclusion
would be justified, but the Plague Commission themselves admit that, " We have
no details which will enable us to arrive at a judgment as to how far the two
Ghanchi wards contained comparable communities," and we know from Assist-
ant Surgeon Dadachanji's report that they were " about a third of a mile apart "
and that the epidemic had passed over the one community before it began in the
other. As regards the Tais, as the Commission themselves say, " it would
appear that both wards did not suffer from plague at one and the same time, so
that the figures of the two wards may relate to outbreaks of different severity."
The conclusion would appear obvious, then, that such a comparision as that
instituted in the case of these two communities, should never have been made,
and that any deductions drawn therefrom are of doubtful value.
22. Chawl at Colaba.—In February 1900 a series of plague cases occurred
in & " chawl" (or barrack like house) in the Colaba Ward of Bombay City.
The chawl was a single storey building containing 10 rooms arranged in two
rows, back-to-back, separated from one another by 7-foot partitions, but having
the roof-space common to all. All these rooms communicated with one another
by doors, with the exception of two at one end which were self-contained, but
these did not escape infection on this account. Three rooms did not furnish
any cases, though some uninoculated persons were living in them, The inhabit-
ants all belonged to a low caste of Hindus called Mángs, and would mix freely
with one another.
* Ν.Β.—Four of these belong to the uniuoculated community.
Β 42-8
30
Another building close to this was occupied by Gaolis or milkmen who
belong to a higher caste. When plague broke out among the Mángs, the
Gaolis noticed that rats were dying in their quarters and therefore wisely remov-
ed to the cowshed close by. They had no cases among them. Thus the isolat-
ed Máng community, numbering 61 persons, afforded a good opportunity for
an exhaustive enquiry ; and this was accordingly carried out by Dr. E. L. Hunt,
Inspector of Inoculation, and Dr. Arjani, Section Medical Officer of A. Ward,
acting under the direction of Mr. Haffkine himself. There is no doubt, there-
fore, of the thoroughness, or accuracy of the enquiry; for 57 out of the 61
inhabitants were either seen personally by one or other of the above named inves-
tigators, or if they had died meanwhile, the papers relating to them were secured
from the adjacent plague hospital where they had been treated.
The remaining four were not seen personally, as they had left the locality,
3 having gone to Poona, and one, a professional beggar, having disappeared in
the City of Bombay. Only one of these four had been inoculated, and none
of them were attacked. The statements of neighbours had therefore to be
accepted in these four cases ; with regard to all the other 57 inhabitants, docu-
mentary evidence has been submitted to Government and published by them
in full.
The first case of plague developed symptoms on the 1st of February 1900,
on the 2nd of the same month 7 were attacked, on the 3rd, 6, and then one case
occurred on each of the following dates, viz., 4th, 5th, 7th, 9th, 10th, and 12th
February. Altogether 20 attacks took place, with 12 deaths.
The inoculations had been done on various dates from 18th December 1899
to 29th January 1900. The one case among the inoculated was in the person
of a female, inoculated on 18th December, and attacked on 9th February ; she
recovered.
The following table shows the distribution of the inoculated and uninoculat-
ed, room by room, and the occurrences in each group ;—
Room Num-
ber.
1
2
3
4
5
6
7
Number of Inmates and whether
inoculated,
1 Not inoculated
2 Inoculated
8 Not inoculated
3 Inoculated
6 Not inoculated
4 Inoculated
1 Not inoculated
2 Inoculated
4 Not inoculated
1 Inoculated
4 Not inoculated
5 Inoculated
3 Not inoculated
3 Inoculated
...
...
...
...
...
...
...
...
...
...
...
...
...
...
...
...
...
...
...
...
...
...
...
...
..
...
...
...
Number of
Attacks.
......
......
......
......
......
......
4
4
1
1
4
3
1
Deaths.
......
......
......
......
......
......
......
......
5
2
1
4
1
31
Room Num.
ber.
8
9
10
Number of Inmates and whether
inoculated,
( 3 Not inoculai cd ... ...
(2 Inoculated
...
...
(3 Not inoculated ... ...
(1 Inoculated ... ...
(4 Not inoculated ... ...
(.1 Inoculated
...
...
Number of
Attacks.
......
2
......
Deaths.
1
......
The inhabitants of rooms 1 and 10 which adjoined one another at one end,
but did not communicate directly with any infected room, may be deducted
from the above, as no oases of disease occurred among them.
This leaves 8 rooms to be taken into account, and these were inhabited by
53 persons of whom 32 were not inoculated and 21 had been thus operated on.
Each of the rooms contained a mixed population of inoculated and not inocu-
lated persons—
The 32 not inoculated had 19 cases with 12 deaths.
The 21
inoculated had 1 case with no death.
If the inoculated had suffered to the same extent as those not inoculated,
they ought to have had 12 cases with 8 deaths, but they only had 1 case which
recovered. This is equal to a reduction of 917 per-cent. in the case of attacks
in favour of the inoculated.
The fact that 21 of the inhabitants were away at work all clay, and only
returned to sleep at night, makes no difference between the two groups, for on
enquiry it was found that no cases of plague had occurred in the various places
where these people had worked. The infection, therefore, was localised in the
chawl, and no circumstance existed that in any way favoured the one group
over the other.
The following statement brings this out clearly :·—
Those staying at home all ( 16 Not inoculated had 9 cases.
day.
(16
Inoculated had
1ease.
Those going out to work ( 16 Not inoculated had 10 cases.
during the day.
(
5 Inoculated had
0 cases.
The uninoculatecl persons being equally divided between those who stayed
at home and those who worked outside, and the two groups returning almost
the same percentage of cases indicates that the source of infection was common
to both, and must therefore have been in the dwelling house itself.
The 53 inhabitants of the above 8 rooms were distributed by age as fol-
lows :—
Up to 10 years of age
Froto 11 to 50 years of age..
Above 50 years of age
11 Not inoculated had 7 cases with 2 deaths.
4 Inoculated had
0 cases with 0 deaths.
20 Not inoculated had 12 cases with 10 deaths.
17 Inoculated had
1 case with 0 death.
1 Not inoculated had 0 case with 0 death.
0 Inoculated had
0 case with 0 death.
D 42-
32
From the above it will be seen that the fatalities occurred mainly among
those from 11 to 50 years of ago ; that the children also show a number of
attacks, but with a smaller death-rate.
The sex distribution given below shews that the men were more suscep-
tible to the disease than the women, but had greater power of recovery. Every
one of the women attacked died, except the solitary inoculated sufferor.
Males
Females
...
...
...
...
...
...
21 Not inoculated had 14 cases with 7 deaths.
6 Inoculated had
0 case with 0 death.
11 Not inoculated had 5 cases with 5 deaths.
15 Inoculated had
1 case with 0 death.
23. The Jewish Community at Aden.—The Jews of Aden are a compact
body, living together in Section A of that part of the settlement known as the
Crater. Though Aden had no previous experience of the havoe wrought by a
visitation of plague, yet, owing to the enlightened action of one or two of the
leading men of this community, the majority had been inoculated, before any
concessions were granted by the authorities to those operated on. It has thus
once more been proved that it is by personal influence and rational explanation
that communities may be persuaded to operation, not necessarily by any conces-
sions granted by the local authorities. The first case of plague in Aden,
occurred on 11th March 1900, and the last on 13th June 1900.
The following shows the rise and progress of the epidemic in the total
population, and among the Jews separately :—
Among total population in March there were 32 cases ; among Jews alone 13 cases.
,,
»9
§>
,,
,,
,,
in April
in May
in June
,,
,,
,,
Total for the whole population—
183
141
12
371*
,,
,,
,,
,,
;
;
;
,,
; for Jews alone
89
11
0
113*
,,
,,
cases.
It is manifest from the above that the Jews were badly infected from the
beginning, and it is interesting to compare the progress of the epidemic, with the
advance of inoculation among them. The epidemic reached its height on the
14th of April, when 10 attacks arc recorded, and thereafter declined steadily till
by the end of the month, the epidemic may be said to have ceased. Inoculation
advanced rapidly after the beginning of April, and by the 13th of that month
more than half the population had been operated on, and as more and more of
the unprotected passed over to the numbers on the inoculated side of the
account, so did the epidemic pari passu decline.
The following table, compiled by Assistant Surgeon Shapurji M. Mehta,
in charge of the Prince of Wales' Charitable Dispensary, Aden, who also carried
out the inoculations, will show the daily course of ovents :—
• Note.—The 113 cases include 26 concealed cases among the Jows discovered during the
census. These are not included in the total numbor of 371, which was obtained from the Municipal
register only ; no consus of the general population, other than Jows, having boon taken.
33
Date.
1900.
24th March
25th
2ßth
27th
28th
29th
30th
31st
,,
,,,,
,,,,
,,
,,,,
,,,,
,,
1st April
2nd
3rd
4th
5th
6th
7th
8th
9th
10th
11th
12th
13th
14th
15th
16th
17th
18th
19th
20th
21st
22nd
23rd
24th
25th
26th
27th
28th
29th
30th
,,
,,
)},,
,,
,,
,,
,,
,,,,
,,,,
„ ,,
,,
,,
,,,,
,,
„
,,
,,
,,
,,,,
,,,,
,,
,,,,
,,
,,
,,
,,
,,,,
,,
1st May
2nd
3rd
4th
5th
6th
7th
8th
9th
10th
11th
12th
13th
14th
15th
16th
17th
18th
19th
20th
21st
22nd
23rd
24th
25th
26th
27th
,,
,,
,,
,,
,,
,,
,,
,,
,,
,,
,,
,,
,,
,,
,,,,
,,
,,
,,
,,
,,
,,
,,
,,
,,
,,
,,
B42—9
...
...
• ..
...
...
...
...
...
...
...
...
...
...
...
...
...
...
...
...
...
...
...
...
...
...
...
...
...
...
...
...
...
...
...
...
...
...
...
...
...
...
...
...
...
...
...
...
• ••
• ••
...
• ••
• • •
a a a
...
...
...
...
...
...
• ••
...
• • •
• ••
....
...
...
...
...
...
...
...
...
...
.....
......
......
...
...
...
...
...
...
...
...
...
...
...
....
...
...
....
...
...
...
....
...
...
...
...
...
...
...
...
...
......
...
...
...
....
...
....
...
...
....
....
...
....
...
...
...
...
...
...
...
...
...
...
...
....
Number of
Inoculated
present.
2
2
6
6
41
41
56
56
95
130
150
245
358
463
465
579
728
975
1,105
1,196
1,401
1,398
1,398
1,467
1,461
1,460
1,457
1,441
1/140
1,439
1,614
1,622
1,652
1,685
1,694
1,689
1,651
1,642
1,586
1,610
1,545
1,545
1,54.5
1,484
1,489
1,504
1,492
1,488
1,489
1,489
1,494
1,503
1,490
1,487
1,493
1,510
1,509
1,500
1,511
1,522
1,522
1,525
1,536
1,536
1,531
Hague
Attacks.
...
...
...
...
...
...
...
...
...
...
...
...
...
...
...
...
...
...
2
1
...
3
3
1
...
1
...
1
1
...
...
4
2
1
...
1
...
...
...
1
...
...
...
...
...
...
...
...
...
...
...
...
...
...
...
...
...
1
...
...
...
...
...
...
...
Plague
Deaths.
...
...
...
...
...
...
...
...
...
...
...
...
...
...
...
...
...
...
...
...
...
1
...
1
...
...
...
...
...
1
...
1
1
...
...
2
...
...
...
...
...
...
...
...
...
1
...
...
...
...
...
...
...
...
...
...
...
...
...
...
...
...
...
...
...
Number of
Uninoculated
present.
2,602
2,602
2,597
2,595
2,553
2,551
2,536
2,536
2,497
2,467
2,439
2,341
2,227
2,118
2,114
1,995
1,844
1,593
1,457
1,341
1,131
1,124
1,119
981
976
975
969
966
965
957
781
720
673
631
603
601
588
558
503
475
454
428
426
400
368
353
346
341
332
332
327
318
296
288
282
259
258
252
222
211
201
197
186
186
186
Plague
Attacks.
1
...
1
2
...
2
...
...
...
1
2
3
...
4
1
5
1
4
4
2
5
7
3
3
2
1
4
3
1
4
...
2
3
...
...
. 1
1
1
2
1
...
...
1
1
1
...
...
...
...
...
...
...
1
...
...
...
1
...
...
...
...
...
...
...
...
Plague
Deaths.
...
1
...
2
2
...
...
...
...
...
1
2
...
...
...
2
3
2
3
3
...
4
...
6
5
1
3
2
5
2
...
2
2
...
1
1
...
...
1
1
...
...
...
1
...
1
1
...
1
1
...
...
...
...
...
1
...
...
1
...
...
...
...
...
...
3á
Date.
1900.
28th May
29th „
30th „
31st „
1st June
2nd „
Total ...
Daily average . . .
Number of
Inoculated
present.
1,534
1,535
1,536
1,539
1,553
1,553
...
1,190
Plague
Attacks.
...
...
...
...
...
...
23
...
Plague
Deaths.
...
...
...
...
...
...
8
...
Number of
Uninoculated
present.
179
175
174
170
151
151
...
982
Plague
Attacks.
1
...
83
...
Plague
Deaths.
...
1
65
...
The above figures were obtained in the following way : The number in-
oculated day by day is taken from the inoculation register which was carefully
kept from the beginning, and in which was entered the name, age, sex, caste,
occupation, residence, date of inoculation, number of brew, and dose administered
nature of reaction resulting, and subsequently, date and result of attack if such
occurred.
The number of the uninoculated was got from a house-to-house visitation
conducted between the 15th and 24th July, justa month after the epidemic
had ceased, and when therefore events were still fresh in the minds of the people
and at the same time the fear of removal was no longer dreaded by them
This census was carried out by Assistant Surgeon Mehta with the help of
Mr. Salem Harun, a prominent member of the Jewish community, and who
knew personally most of its members. As the epidemic was over, and the fears
of the people quieted by the presence and assurances of one of their number in
whom they could trust, it is probable that the census represents the actual course
of events with great accuracy. The following information was obtained for each
houses-House number ; name, age, sex of each of the inhabitants ; whether in-
oculated or not, whether attacked by plague or not, date of attack ; recovery or
death, whether remained at home, removed to camp, or went out of Aden with
date ; and deaths from all causes.
The result of this enumeration showed that the Jews living- in the Crater
at the commencement of the epidemic numbered 2,614 · consisting of 842 males
940 females, and 832 children under 10 years of age. COnsisting of 842 males
The statements respecting cause of deaths were checked by comparison
with the Plague hospital register, and the municipal death register AU deaths
were certified by a Medical Officer, before any corpse was permitted to be dis
posed of, so that reasonable accuracy is thus secured. The only item remaining
unchecked was the plague attacks ending in recovery, which may passibly have
been successfully concealed during the epidemic But as Mr Mehta had gain.
ed the confidence of the people and was assisted by a gentleman in whom the
community fully trusted fand as no penalties could be fear after the epidemic
was over; it is probable that very few if any, such cases escaped enumeration
As a matter of fact 26 such concealed cases ending in Caped en T eration -
during the census operation. In the case of persons who were attacked by,
or died from plague, the fact of i n o c u l a t i o n n or ot her wi s e was al ways checked by, a t t a i ne d, and the figures may be accepted as substantially
pushed on through a lengthened period, it become neceassary to take an average
population when comparing the two groups of inoculated and uninoculated.
35
The following table has been thus compiled, to show the occurrences, using
this "average population " as a basis :—
Uninoculated
Inoculated
Daily Average
Strength.
982
1,190
CASES.
Number.
88
23
Per cent.
8-4
1.9
DEATHI.
Number.
65
8
Per cent.
6-6
0-6
Case
Mortality
per cent.
78-3
34.7
If the inoculated had suffered to the same extent as the uninoculated, they
ought to have had 100 cases with 78 deaths instead of 23 and 8 ; which is equal
to a reduction of 77 per cent. in attacks and 89'7 per cent. in deaths in favour of
the inoculated.
From the house-to-house investigation it was ascertained that out of 47
houses in which plague cases occurred, 31 were, at the time of the attacks,
inhabited by a mixed population of inoculated and uninoculated ; while 16 con»
tained uninoculated persons only.
The occurrences in these 31 families are as shown below.
Uninoculated
...
...
Inoculated ...
...
...
Strength.
179
246
Oases.
44
19
Deaths.
29
8
Case mortality.
65.9
31.2
The results shown here, when compared with those in the former table,
bring out clearly once more the danger to inoculated persons arising from the
presence of uninoculated members in their families. In spite of this however it
is found that if the inoculated had suffered to the same extent as the uninoculated
members of these houses then should have had 60 cases and 39 deaths, instead of
19 and 8 resp
reduction of 68.3 per cent. of cases
and 79.5 per cent. of deaths in favour of the inoculated,
The next table shows the distribution of the cases with reference to the
time intervening between inoculation and attack.
Attacked
,,
,,
,,
,,
,,
,,
,,
,,
,,
,,
on the day of inoculation ...
one day after ,, ...
two days „
„ ...
three „ „
„ ...
four „ „
„ ...
five „ „
„ ...
Six
„
,,
„
...
seven „ „
„ ...
eight „ „
„ ...
nine „ „
„ ...
ten
„ „
,, ...
more than ten days after ...
inoculation ... ... ...
Cases.
3
3
3
...
2
1
2
...
...
2
7
Deaths.
3
2
...
...
...
1
...
...
...
2
...
Mr. Mehta concludes from the above table that " partial protection is
achieved after three days after inoculation, and the maximum of protection is
reached after ten clays " ; but it is quite admissible to argue that, as the percent-
ao-e of case mortality is the same on the first day and the tenth after inoculation,
and shows varying results on the intermediate days, the protection really varies
very little after the first day has elapsed. It is certain however that inoculation
36
within the incubation period, does not decrease the chance of recovery,—as has
been stated by some eminent authorities,—but on the contrary diminishes the
liability to death. This latter conclusion does not rest merely on this instance
but on evidence that has been accumulating during the past three years, as the
result of many similar investigations in all parts of the country where these
prophylactic inoculations have been tried. (Vide Dhárwár, p. 18, supra.)
24. Yeroada, Jail.—It has been on several occasions observed that when
a population living more or less under control,—such as a regiment, or
the inmates of an asylum or jail,—are entirely or almost all inoculated, the
epidemic of plague at once stops. Again this sequence of events was witnessed
lately in this large central jail situated near the town of Poona. The first case
occurred on the 5th of October 1900, and the last indigenous case on the 17th of
the same month. A solitary imported case afterwards occurred on the 26th Octo-
ber in an under-trial prisoner newly admitted from Poona where plague was pre-
valent.
Cases of plague occurred on the following dates, viz. :—
1 on the 5th October. ")
1 „ ,, 12th
„
)
2 „ „ 17th
„
)
Total ... 4 cases.
All in prisoners who had been some months in
jail.
Inoculation was begun on the 10th October, and was practically'complete by
the 17th, when 1,658 prisoners had been operated on. Of the above 4 cases, all
died but one, who had been inoculated 4 days previous to attack. The other 3
were attacked before they could be inoculated. Since then, no more indigenous
cases have occurred.
From the above observations it may be taken as proved—
(a) That inoculation is harmless.
(b) That when given in the incubation stage (i.e., before signs of plague
are apparent) it has—in many cases at least—the power of aborting the
disease.
(c) That inoculation confers a high degree of immunity from plague,
and so reduces very greatly the number of attacks.
(d) That when, in spite of inoculation, a person is attacked, his chances
of recovery are very greatly increased,
REPORT ON SURRA
IN
EQUINES, BOVINES, BUFFALOES
AND
CANINES,
TOGETHER WITH AN ACCOUNT OF EXPERIMENTS
CONDUCTED WITH THE
TRYPANOSOMA OF RATS, BANDICOOTS AND FISH,
BY
ALFRED LINGARD,
Bachelor of Medicine and Master of Surgery, Dunelm ;
Diplomate in Public Health, Cambridge ;
Fellow of the Bombay University ;
Professor of Comparative Pathology and Bacteriology,
Civil Veterinary Department, India.
VOL. II, PART I.
With 3 Illustrations and numerous Charts.
BOMBAY :
PRINTED AT THE GOVERNMENT CENTRAL PRESS.
1899.
PLATE I.
HORSE No. LXXXIX.
Shewing the condition of the Animal on the 50th day of Disease.
PLATE II.
HORSE No. LXXXIX.
Shewing the condition of the same animal, after having undergone successful treatment.
LIST OF ILLUSTRATIONS.
1. Horse No. LXXXIX.—Showing the condition of the animal on the 50th day of the disease ... Frontispiece.
2. Horse No. LXXXIX.—Showing the condition of. the same animal having undergone successful
treatment with Arsenic
...
...
...
...
Ditto.