47
Both the Plague Medical Officer and the Deputy Commissioner agree that the attitude
of the people towards inoculation is distinctly favourable. Major Hodgkins observes that
there were no religious or sound objection to it, but that the real Objection to it is the fever
and discomfort following the operation. Mr. Le Rossignol says that although the belief in
the efficacy of inoculation is gaining ground, it is difficult to persuade people to accept it
until plague breaks out among them, and inoculation is generally asked for when the outbreak
has run its course, hence making it difficult to estimate its efficacy.
The Deputy Commissioner mentions two villages—Jasso Mazára and Mazári,— in both
of which a large population of the inhabitants were inoculated when plague was rife, with
the result that the outbreak ceased almost immediately. Information is not availabe for insti-
tuting a comparison between the condition as regards the incidence and fatality of plague of
inoculated and uninoculated proportion of the population of infected villages.
There are records of 89 attacks among inoculated persons with 41 deaths, or a case
mortality of 4607 per cent, as compared with a case mortality of 57-67 per cent, among the
uninoculated population. The ratio of deaths to attacks at different periods after inoculation
is shown in Statement No. 9 (Appendix B).
(j) The spread of plague was very largely due to human intercourse, having been
Infection
carried from place to place either by persons
suffering from or incubating the disease or in
personal effects, chiefly clothes and bedding. Once introduced into a town or village the
spread of the disease was in a large measure due to rats.
The Plagne Medical Officer says : " four-fifths of the villages infected reported
excessive deaths among the animals prior to the outbreak of the disease among human
beings." It is probable, however, that in most instances the rats derived the infection from
human cases that were not reported, or from plague-infected effects, and that the epidemic
among human beings —as opposed to the previous isolated cases—were largely dependant
upon the outbreak among rats.
In some instances it appears probable that rats actually conveyed the plague from
an infected village to a neighbouring healthy one.
(k) The effect of climate upon plague has been incidentally referred to in describing
Influence of local conditions, climate, &c
the
course of the epidemic. With regard to
other conditions Major Hodgkins remarks :—
" It has not been practicable to make any comparison with respect to the influence of
sanitary surroundings, water-supply, and habits of the people, as they are, practically, similar
throughout the district. As regards soil, however, there is some reason to believe that
.where it is of a sandy nature with the sub-soil water within a few feet of the surface, the
conditions are not favourable to the prevalence of plague. Statistics of 22 villages
in the Bet—a tract bordering the Sutlej River and about 20 feet below the remainder of
the district—and 22 others on the higher land, appear to strengthen this view."
(l) Reference has already been made to mortality among rats. The Deputy
Mortality among rats and other animals.
Commissioner notes : —
" In villages infected during the previous season plague generally makes its re-appear-
ance first among the rats. Rats begin to die from 3 to 7 days before human beings are
attacked. In villages infected by imported cases rats die after the first few cases among
human beings.
" In Jullundur City the mortality among rats was very great and the disease was to a
great extent spread by rats. The Plague Officer has seen as many as fifty dead rats taken out
of a single roomed shop while it was being disinfected.
" The city sweepers kill many rats ; but the general public are averse to taking their
lives and content themselves with catching them alive in traps and letting them loose in
another part of the city."
The Plague Medical Officer says—
" There is no record of a high percentage of attacks among human beings where the
mortality among rats was excessive, nor is there evidence of relationship one way or
the other.
" The headmen of villages and medical subordinates on plague duty were enjoined
to instruct the people as follows. Rats found dead were not to be touched with the naked
hand, some kerosine oil was to be poured over the body, which was then to be covered
over with some dry grass or twigs and burned and buried on the spot found, if
practicable."