NationalLibraryOfScotland/medical-history-of-british-india huggingface dataset:
12
The events in each of the 28 families were noted on separate investigation
sheets, in which the names of every member present at the time of inoculation
were entered as either " inoculated " or " not inoculated. " The occurrences in
each household being entered in each sheet below the names, it was then easy
to compile the following table :—
Ward No.
1
1
1
1
2
3
"
"
"
"
"
"
„
„
4
"
"
"
"
,,
"
"
"
"
"
,,
"
"
"
"
"
"
"
House No.
2
8
63
67
24
1
15
20
29
39
42
48
49
7
8
10
12
13
18
26
30
31
34
35
53
80
84
89
90
Total ..
Number in
oculated in
the family.
3
4
3
3
1
2
2
3
3
4
1
5
1
1
2
4
2
2
3
1
1
4
2
1
2
4
5
2
3
71
INOCULATED.
Number of
Attacks.
4
...
...
...
...
...
1
1
...
1
...
...
...
...
1
1
...
...
...
...
...
1
...
1
...
...
...
...
...
8 (11.3%)
Number of
Deaths.
5
...
...
...
...
...
...
...
...
1
...
...
...
...
...
...
...
...
...
...
...
1
...
1
...
...
...
...
...
3 (4.2%)
NOT INOCULATED
Number not
inoculated in
the family.
6
1
2
2
1
2
3
4
2
3
2
3
5 . .
1
1
1
2
1
2
2
3
2
3
1
2
4
5
1
3
64
Number of
Attacks.
7
1
1
1
1
1
...
1
1
1
1
1
1
1
...
...
1
1
2
2
1
...
1
1
1
1
2
1
1
27 (42.2%)
Number of
Deaths.
8
1
1
1
1
1
...
1
1
1
...
1
1
1
...
...
1
1
2
2
1
...
1
1
1
1
2
1
1
26 (40.%)
The 71 inoculated members of the affected families had therefore 8 attacks,
of which 3 proved fatal, while the 64 not inoculated in the same families had
27 attacks with only one recovery. If the inoculated had suffered to the same
extent as their uninoculated relatives, they should have had 29 deaths from plague
instead of 3 only. The proportional number,—29—is reduced by 26, which is
equal to a diminution of 89.6 per cent. of mortality attributable to inocula-
tion.
The subjoined figures show the number of days which elapsed between
the dates of inoculation and the occurrence of a death from plague in these
families. The large figures refer to the number of days after the date of inocula-
tion, the smaller ones to the number of deaths on those days :
In the inoculated, deaths took place
9 l . . . 12 l and 14 1
In the uuinoculated „
„
3 2 , 41, 5 3 . 7 2 , 8 3 . 10 3 , 11 2 , 12 1 . .
15 1, 19 1 ,20 1 , 21,..
24 1
32 1 ... and 42 1 after inoculation.
Eight days, therefore, elapsed after operation before any deaths occurred
among the inoculated, while during this time 11 deaths from plague were
registered among the unprotected. The inoculation acted again at once, or at
least within the time necessary for the subsidence of the general reaction due to
the operation, just as it did before in the Byculla Jail.
15
Discarding the figures in the first row as being only approximate, the average
population for 15 weeks under " Not inoculated " and " Inoculated " respectively
is as in the following table, where also the occurrences. in each group are
shown :—
Average population.
Inoculated
24,631
Not inoculated
17,786
Deaths from
plague.
338
2,348
Percentage
mortality.
1-3
13-2
In other words, 1 in every 72 of the inoculated population died, while 1
in every 7 of the uninoculated succumbed to plague ; giving a reduction of mortal"
ity of 89'6 per cent, in favour of the inoculated.
11. Southern Mahratta Spinning and Weaving Company's Mill.—'The ex-
perience in this Company's mill at Hubli should be an object lesson to all mill-
owners in plague-stricken towns. On the 21st of June 1898 there were 1,173
mill-hands on the muster rolls. The table below shows the events as ascertained
at the close of the epidemic.
Inoculated twice
Inoculated once only
Not inoculated ...
Population.
... ... ... 1,040
... ... ... 58
... ... ...75
Total ...
1,173
Deaths from
plague.
22
8
20
Percentage of
mortality..
2.11
13.79
26.66
If the 1,098 inoculated persons had remained as susceptible to plague as the
75 not inoculated, they ought to have lost 293 by death instead of 30· only, a
difference of 89.7 per cent, in favour of the inoculated.
12. Employés of the Southern Mahratta Railway, Hubli.—These persons
were living in barracks, and in the Railway yard apart from the general popula-
tion of Hubli town. They were under close daily inspection by English officials,
who formed a committee for this purpose, with Dr. Chenai as their medical
adviser. The results given below may therefore be regarded as accurate to a
high degree, the numbers dealt with not being excessive, and the supervision
strict. Inoculation was begun early in June 1898, and after its introduction
plague cases appeared on 29 different dates between 11th June and 6th October
of that year.
The actual occurrences are shown in the following table :—
Dates on which
occurrences
happened.
June
11
29
July
5
9
11
13
14
19
20
21
22
; ; 23
Inoculated.
Once.
41
439
385
365
365
337
335
344
344
344
344
844
Twice.
0
235
471
552
552
597
603
821
821
821
821
821
Total.
41
674
856
917
917
934
938
1,165
1,165
1,165
1,165
1,165
Attacks.
...
...
...
...
...
...
...
1
...
...
Deaths.
Not inoculated.
Popula-
tion.
1,794
1,243
1,063
1,063
1,129
1,125
1,120
880
880
881
882
886
Attacks.
2
2
2
1
1
2
1
2
2
2
1
2
Deaths.
2
1
2
3
1
2
1
1
2
2
1
1
Total popula-
tion living
in Railway
yard.
1,835
1,917
1,919
1,980
2,046
2,059
2,058
2,045
2,045
2,046
2,047
2,051
16
Dates on which
occurrences
happened.
August
„
„
„
„
„
„
„
„
„
„
„
„
4
5
6
9
10
12
21
22
28
24
25
26
30
September 1
„
October
„
21
6
9
• • •
• • •
• • •
• • •
• •
• • •
• ••
• • •
• • •
• • •
• • •
• • •
• • •
• • •
• • •
• • •
• • •
Inoculated.
Once.
297
297
297
297
215
215
245
234
151
224
210
287
292
342
64
134
84
Total attacks and deaths
Twice.
880
880
880
880
965
968
1,132
1,146
1,231
1,253
1,272
1,277
1,354
1,375
1,697
1,713
1,723
• •
Total.
1,177
1,177
1177
1,177
1,180
1,383
1,377
1380
1,382
1,477
1,482
1,504
1,646
1,717
1,761
1,847
1,807
Attacks.
• • •
• ••
• • •
• • •
1
• • •
2
•••
1
1
...
2
1
1
...
1
•••
11
Deaths.
• • •
• ••
...
...
...
• • •
• • •
...
• • •
...
...
1
1
...
...
• • •
...
2
Not Inoculated.
Popula
tion.
862
827
827
834
831
829
619
618
615
520
516
418
333
261
102
31
65
...
Attacks
3
2
1
2
...
2
2
1
• • •
• • •
1
• • •
• • •
1
1
...
1
37
Deaths.
• • •
11
...
...
...
• • •
1
...
...
...
1
• • •
• • •
1
1
...
1
23
Total p o p u l a t i o n living
in Railway
yard.
2,039
2,004
2,004
2,011
2,011
2,012
1,996
1,908
1,997
1,997
1,998
1,982
1,979
1,978
1,863
1,878
1,872
The above table may be summarised as follows ; only premising that 2
deaths from plague in the uninoculated. which occurred in persons who were
not permanent residents of the yard, though temporarily living there at the time
of attack, are deducted :—
Twice inoculated
Once
„
...
...
...
Numbers.
990
270
760
Attacks.
6 (0.6%)
5 (1.8%)
35 (4.6%)
Deaths.
1 (0.1%)
1 (0.3%)
21 (2.7%)
In the above table, average populations have been taken in each case as
the numbers present varied on each date when plague appeared ; the numbers
inoculated steadily increasing while those not inoculated decreased corre-
spondingly.
If the 1,260 inoculated had suffered to the same extent as the 760 not in-
oculated they ought to have had 58 cases and 34 deaths, instead of 11 and 2
respectively. The number of cases therefore appears reduced by 81.03 per cent.
and the deaths by 94.1 per cent.
03
per cent.
13. Dhárwár Jail.—In October 1898 p]ague appeared in this iail as well
as m the town of Dhárwar situated in the Southern Deccan.
The population of the jail varied from 360 to 380, but on the date of in-
oculation it was 374. Before inoculation was performed 5 cases of plague, of
which one was imported, and 4 in old residents of the jail, occurred all ending
in death. After inoculation of the entire jail population, only one case followed
two days after operation, but he recovered.
followed
14. Broach.-—A town of 40,168 inhabitants situated on the sea-coast 200
miles north of Bombay. Owing to the advent of plague, and conseauent flight
of many of the inhabitants, only about half were found present when a census was
taken on 16th March 1899. The average population for the previous when a census was
is estimated by those on the spot as 27,000, and this number is therefore adopted
for statistical purposes, in the figures given below, which are taken from a report
submitted by Dr. Burjorji Sorabsha, the medical officer employed by the Parsi
Panchayat to perform inoculation among the members of their community
17
The table below shows at a glance the events in the two sections :—
Population.
Inoculated ...
Not inoculated
1,970
25,030
Cases.
6 (0-3%)
564 (2-2%)
Deaths.
4 (0-2%)
460 (1-8%)
If the inoculated had suffered in the sanie proportion as the uninoculated,
they should have had 44 cases with 36 deaths, instead of 6 and 4 respectively.
The number of cases amongst the inoculated appears therefore to have been
reduced by 86.8 per cent. and the number of deaths by 88.8 per cent.
Taking the Parsi community by itself we find that during the period from
October 1898 to March 1899, they numbered on an average 1,843 persons, of
whom 1,080 were inoculated. The following occurred :—
Population.
Inoculated ... ... 1,080
Not inoculated
... 763
Cases.
2 (0-2%)
9 (1-2 %)
Deaths.
1 (0-1 %·)
5 (0-6%)
If the inoculated Parsis had suffered in the same proportion as those not
inoculated, they should have had 12 cases with 7 deaths, instead of 2 and 1,
respectively. Inoculation appears therefore to have reduced the number of
cases by 83.3 per cent., and the deaths by 85.7 per cent.
Another community which shows striking results from inoculation is that
of the tailors of Broach. These numbered 225, and were all living in a camp
outside the town, under similar conditions as regards dwellings, mode of living,
etc., Of this community 90 were inoculated, and 135 remained uninoculated.
The following table shows the incidence of plague among them.
Population.
Inoculated ...
...
90
Not inoculated
...
135
Cases.
0
10 (7-4%)
Deaths.
0
6 (4-4%)
15. Dhárwar—A town of some 32,000 inhabitants situated in the Sou-
thern Mahratta Country, 13 miles from Hubli, and the head-quarters station of
the Southern Mahratta Railway. Plague broke out here during August 1898,
and inoculation work was begun almost at once by the Civil Surgeon, Lieutenant-
Colonel Davidson, I. M. S., and afterwards continued and practised on a large
scale by Dr. Miss Corthorn, who was sent there on special duty, and from
whose report the following figures are taken. During the 12 weeks covered
by this report, from September 2nd to November 16th 1898, the population
actually residing in the town numbered on the average 21,088, the rest having
fled to the fields or jungle in the neighbourhood. Of these persons, 2,367 were
operated on once, and 1,864 twice ; while 16,848 remained uninoculated.
The table below shows the incidence of plague among the inoculated and
uninoculated :—
Average population
Inoculated
Not inoculated
on present.
... 4,231
... 16,848
Cases·
129
MOO
Deaths.
54
889
Case
incidence .
3-01%
6-5%
Case
mortality.
4-1-8%
80.8%
B 42—5
18
If, therefore, the inoculated had remained as susceptible to plague as their
fellow townsmen they should have shown 270 cases with 223 deaths, instead of
129 and 54, respectively. The number of cases therefore appears reduced by
52.2 per cent., and the mortality by 75.7 per cent.
Owing to the careful way in which the records of the inoculation work
were kept it is possible to pronounce an opinion on the effect of inoculation on
those actually in the incubation stage of plague. In Dhárwár 74 individuals
developed plague within 10 days of operation. As 10 days is generally admitted
to be the limit of the incubation period, we may assume that many of these
persons had already the plague germs in their bodies at the time of inocula-
tion. The following statement shows that the death-rate at no time exceeded that
among the uninoculated population (80.8%) and was generally very much
below this. It is evident then that inoculation of persons incubating plague,
does not do any harm, but on the contrary increases their chance of recovery.
Inoculated with plague actually developed
...
Developed plague on day of inoculation ....
...
„
„
within 2 days of inoculation
...
,,
,,
4
,,
,,
,,
,,
o
,,
,,
,,
6
,,
,,
,,
,,
,,
,,
10
,,
,,
,,
Total within 10 days of inoculation
Cases.
5
5
13
7
19
25
74
Recoveries.
4
3
9
2
8
21
47
Deaths.
1
2
4
5
11
4
27
Percentage of
Mortality.
20-0
40.0
30.7
71.4
57-8
16-0
36.5
16. Gadag.—A town in the Dhárwár District of some 23,000 inhabitants.
Plague appeared here shortly after Dhárwár itself was attacked. From Dr.
Miss Corthorn's report of her work there, the following information has been
obtained.
In the 28 weeks from 18th November 1898 to the end of May 1899, which
is the period dealt with in the report, the incidence of plague was as fol
lows :—
Average population.
Inoculated once, 1,365
„
twice, 11,639
Not inoculated, 4,163
Cases.
32
161
278
Deaths.
14
69
216
Cose
incidence.
2.3%
1.4%
6.6%
Case
mortality.
43.7%
42 8%
77.7%
If
the
13,004 inoculated had suffered to the same extent as those not
inoculated, they ought to have had 868 cases with 674 deaths instead of 193 and
83, respectively ; a reduction of 77.7 per cent. and 87.6 per cent. respectively.
17. Selgamm Cantonment.—A severe epidemic broke out in Belgaum Town
and Cantonment m April 1899 and continued throughout May, June, July and
August. In the Cantonment inoculation was vigorously pushed by the local
Plague Committee, who carefully watched and recorded the results These are
given in the table below, which has been compiled from the Belgaum Collector's
19
Week ending
12th May 1899
19th
26th
do.
do.
2nd Jane 1899
9th
16th
23rd
30th
do.
do.
do.
do.
7th July 1899
14th
21st
28th
do.
do.
do.
4th August 1899
11th
18th
25th
do.
do.
do.
1st September 18
8th
do.
•••
•••
•••
•••
•••
•••
•••
•••
•••
•••
•••
•••
•••
•••
•••
•••
99..
••
Number
inoculated
during the
week.
•••
898
451
231
199
165
74
113
310
648
1,151
1,254
1,145
313
546
Total Population...9,543.
A Inoculated.
B Uninooulated.
9,543
A
B
" A
B
" A
B
" A
B
" A
B
" A
B A
" B
A
"
B
A
"
B
A
"
B
A
"
B
A
"
B
A
"
B
9,052*
A
B
8,674*
A
B
1,230
8,313
2,128
7,415
2,579
6,964
2,810
6,733
8,009
6,534
3,174
6,369
3,248
6,295
3,361
6,182
3,671
6,872
4,319
5,224
5,470
4,073
6,724
2,819
7,869
1,674
8,182
870
8,048
626
Weekly numbers of
Cases.
14
34
10
17
5
31
3
27
10
32
1
45
2
34
1
33
3
47
4
71
6
51
4
30
4
24
12
18
5
6
Deaths.
8
19
4
6
3
19
21
3
21
3
26
19
2
22
1
31
1
50
4
33
3
36
2
15
3
15
3
6
* Cause of decrease proba-
bly flight.
Only 2 cases and 2 deaths in the whole Canltonment.
77
134
8,947
A
B
9,064
A
B
8,590
375
8,749
315
3
1
...
5
...
1
3
Taking the average population for each of the groups, The following sum-
mary of the above is obtained :—
Average Inoculated population present throughout
the epidemic
Average uninoculated
do.
do. ...
4,842
4,558
Cases
78
506
Deaths.
40
346
Percentage
mortality on
average
population.
0.83
7.59
If therefore the inoculated had suffered to the same extent as the uninocu-
lated, they should Have had 637 cases with 367 deaths instead of 87 and 40,
respectively. The number of cases therefore appears to be reduced by 83.8
per cent., and the deaths by 89.1 per cent.
18. Artillery Followers, Belgaum.—Major Forman, R.A.M.C., sends the
following particulars relating to the inoculation of the Native followers of the
49th Battery, Royal Field Artillery, who since plague broke out have been
under medical inspection twice daily.
These people, numbering 334, reside in lines 3/4 mile from the nearest bazar.
Plague appeared on the 31st of May, 1899, and between that date and the 7th
20
of July there were 23 cases of plague with 17 deaths among those not inoculated.
Inoculation was begun on the 5th of June and carried on as follows :—
5th June
17th „
21st „
26th „
30th „
3rd July
6th „
10th „
15th „
1899,
,,
,,
,,
,,
,,
,,
,,
,,
Total
10
6
22
36
42
56
67
49
23
311
inoculated.
,,
,,
,,
,,
,,
,,
,,
,,
Neither attacks nor deaths have taken place among the 311 inoculated, up
to date (10th September 1899), and they are still kept under [medical inspection
twice daily.
19. Mauritius.—The following account of inoculation work in the Island
of Mauritius is compiled from the report submitted by Captain J. S. Stevenson,
I. M. S., to the Director, Medical and Health Department, there, and published
, by command of His Excellency the Governor of Mauritius.
The mortality in Port Louis (population 54,000) was above the average
death-rate of the past ten years from the end of March 1899 till the beginning
of November of the same year. Inoculation was introduced in May, but people
did not come forward in large numbers till the end of June, at which time
plague deaths were numerous in the town. The table below, compiled from
Captain Stevenson's report, relates to the period from 1st July to 30th Decem-
ber 1899 inclusive, " a period which corresponds to the most serious rise in the
plague death-rate and its gradual decline to normal." The figures cannot be
used as an exact demonstration of the effect of inoculation, for no census of the
population was taken, several thousand people had left the town, and conceal-
ment of cases to a large extent prevailed. Nevertheless, as an indication, they
are interesting.
Population.
Inoculated ...
Not inoculated ...
6,816
47,184
Plague, attacks.
66 (0-96%)
826 (1-75%)
Plague deaths.
38. (0-55%)
708 (1-50%)
If the inoculated had suffered to the same extent as the uninoculatea, they
ought to have had 119 cases with 102 deaths instead of 66 and 38 respectively ;
a reduction of 44.5 per cent. in the case of attacks and .627 per cent. in the
case of deaths in favour of the inoculated.
Although in Port Louis, as a whole, accuracy was not attainable, yet in
certain small groups of persons it was found possible to observe events so closely
that reliable data are forthcoming.
Mauritius Dock Camp.—In this camp live Madrasis and Indian Musal-
máns brought to the island under a labour contract. They live in a dozen or
more barrack-like buildings placed close together, and covering 5 or 6 acres of
ground. Some of these dwellings are double-storied, but all are dark, ill-venti-
lated and insanitary, and 12 families inhabit each block.
The first case of plague occurred on 6th July 1899 and the last on 21st
November.
Inoculation was begun on 1st July and was rapidly completed, almost all
the people submitting on account of the privileges offered. At the end of Sep-
21
tember about 90 of these people went to an evacuation-camp. Up to this time
the following had occurred :—
Population.
Inoculated
...
423
Not inoculated ...
13
Plague attacks.
13 (3.04%)
7 (53.8%)
Plague deaths.
6 (1.38%)
6 (46·1%)
If the inoculated had suffered to the same extent as those not inoculated,
they ought to have had 228 cases with 195 deaths instead of 13 and 6 respective-
ly ; a reduction of 94 .2 per cent. in the attacks and of 96.9 per cent. in the
deaths. By the end of September plague had almost ceased in the vicinity of this
camp, and only one more case occurred in an uninoculated individual. None of
the inoculated contacts developed plague, and on no occasion did more than one
case occur in any one room. Captain Stevenson remarks on this and says, " I do
not see that this result can reasonably be put down to anything but the fact that
these contacts were all. inoculated."
Engrais Mauricien Camp.—"This camp held 70 men and 82 women and
children. Thirty of the men and 6 of the women and children were inoculated in
July. Plague attacked the camp in October and 13 oases occurred in the first
fortnight of that month, none of whom had been inoculated. The camp was
then evacuated and its inmates inoculated with the exception of 37 individuals."
The following table shows the events both before and after evacuation.
The number of deaths is not reported :—
Inoculated
Not inoculated
Population.
(Before evacuation ...
(
After evacuation ...
( Before evacuation ...
(
After evacuation ...
36
115
116
37
Plague attacks.
4(3.4%)
13 (11.2%)
4 (10.8%)
Of the four inoculated cases, one developed symptoms one day and another
three days after operation.
Albion and Colonial Dock Camps.—In these camps the whole of the
inhabitants were inoculated, and there is therefore no unprotected population
living under the same conditions for comparison, It is not then possible to
say what would have happened had the inhabitants not been inoculated. In
the Albion Dock Camp with 500 inhabitants there were 12 cases of plague with
6 deaths, or a percentage of 2.4 and 1.2 respectively. In the Colonial Dock
Camp with a population of 70 there were 10 cases of plague with 7 deaths, or
14.2 and 10 per cent. respectively.
Several interesting examples are given in this report of the effect produced
by the inoculation of the coolies working on the sugar estates. The result was
invariably good, and it is therefore only necessary to refer briefly to the more
striking examples.
L'Espérance Estate.—Attached to this sugar estate is a camp of over 1,100
persons. On October 2nd a case of plague was discovered and on the 5th of
the same month 159 of the inhabitants were inoculated. No more could be
operated on as the stock of vaccine in the island was exhausted. Before the
new supply arrived in the course of six weeks the following had occurred ;—
Population.
Inoculated ...
... 159
Not inoculated
... 956
Plague attack·.
4 (2.5%)
68 (7.0%)
Plague deaths.
1 (0·6%)
54 (5-6%)
Β 42—6
28
Name of Street.
Dheberwad
Taiwad
Machiwad
Ghanchiwad
...
...
...
...
...
...
···
Name of non-
inoculated persons.
Nil.
1. Havaboo
2. Fat ma
3. Aitaboo
4. Amanboo
5. Devji...
6. Havli
7. Kasam
8. Moosa
9. Kasi ...
···
...
...
...
···
otate of health as recorded at
the time of inoculation.
Pregnant
Do.
Do.
Old
······
···
...
...
...
···
...
...
...
···
···
...
...
Healthy ; absent at work...
Pregnant
Healthy ; absent at work...
Do.
Do
do.
do.
...
...
Result.
Recovered.
Died.
Do.
Recovered.
Died.
Do.
Do.
Do.
Do.
The above may be summarised as follows :—
Healthy
Sickly
...
...
...
...
...
...
... = 36
... = 26
Cases.
4
5
Deaths.
4
3
If the 36 healthy uninoculated persons be compared with the 1,018 in-
oculated, the following table may be constructed :—
Population.
Inoculated, 1,018
Not inoculated, 36
...
...
...
...
Cases.
84 ( 8 . 2 %)
4 (11 . 1 %)
Deaths.
31 ( 3 . 0 %)
4 (11 . 1 %)
Case mortality.
36 . 9 per cent.
100 . 0 „ „
If the inoculated had suffered in the same proportion as the healthy
uninoculated, they ought to have had 118 attacks with 84 deaths instead of 84
and 31 respectively ; a reduction of 25 . 6 per cent. in the case of attacks and of
63 . 1 per cent. in the case of deaths in favour of the inoculated.
Thus, when the "sickly " are excluded from the calculation, a reduction of
the attack-rate in favour of the inoculated is seen. The smallness of the
reduction in this case should not be adduced as an argument to show the little
effect of the prophylactic, for such small numbers as are found here on the
uninoculated side are always liable to have the balance destroyed by a single
addition to one side or other of the account.
The Commission further compare the incidence of plague in two commu-
nities of the same caste, but living in separate parts of the town of Bulsár. The
first of these was the Grhanchis (or oil-pressers), and the following is the table
given by the Plague Commission as showing the occurrences in the two quarters.
The population of the inoculated quarter is got by adding both inoculated and
uninoculated together. The uninoculated persons in the inoculated quarter
numbered 35, and they furnished one-third of the cases and half the deaths
in this community ; and this should be kept in mind when studying the
table :—