NationalLibraryOfScotland/medical-history-of-british-india huggingface dataset:
65
The epidemic Vapidly declined after the middle of May, and in July only 15 cases
Were recorded.
No village became infected during August, but three were infected during September
with 25 cases and 11 deaths.
The incidence and fatality of plague varied greatly in different villages : details of certain
villages are-given in the table below. It will be seen that in several villages over a quarter
of the inhabitants were attacked with plague. One village, Talwandi Malyán, lost a
quarter of its population from this disease :—
Table showing Particulars concerning certain villages in which Outbreaks of Plague
were severe.
Serial No.
1
2
3
4
5
6
7
8
9
10
Name of place.
Badduwal
Talwandi Malyán
Bhindar Kalán
Karyál
Da'a
Kishanpura Kalán
Pír Muhammad
Himmatpüra
Riman
...
Kussa
.
...
...
...
...
«i.
...
...
•»•
...
...
...
...
...
...
...
...
...
...
...
...
.V.
...
..
...
...
...
...
...
••
Census population in1901.
8,001
2,324
2,945
1,.587
751
4,042
711
2,802
1,405
1,046
Attacks.
342
666
587
301
103
421
109
755
382
306
Deaths.
372
558
342
226
78
359
72
537
253
193
PERCENTAGE OF
Attacks to population.
17.09
28.65
19.93
18.96
13.71
10.41
15.33
26.94
27.18
29.25
Fatality to deaths.
79.53
83.78
58.26
75.08
75.73
85.27
66.05
71.12
66.23
65.07
Class and character of the people, their hearing in
the presence of the epidemic and their attitude towards
plague measures.
(a). The population of the infected tahsils consists principally of Játs and Sikhs, a
very suspicious and conservative people, not
to be driven, though trustful where the confi-
dence has been gained. Their attitude in the
presence of the epidemic was one of sullen resignation.
At first all classes were absolutely determined not to accept any of the measures
recommended by Government. The Ját Sikhs were convinced that their great physical
strength safely guarded them against plague, and it was not until they became thoroughly
scared at the mortality amongst them that anything could be done with them.
Mr. Levi notes : " The Ját Sikh, however, did observe the precaution of not hanging
around funeral pyres, but the Musalmáns all through crowded around their corpses with
customary fanaticism."
The leading men behaved very differently in different villages. A few appreciated
the facts that Government was working for the benefit of the people, while a certain
number were actively opposed to plague measures.
As a rule there was no panic in infected villages, the sick were properly attended
to, and the dead promptly disposed of. In the village of Talwandi Malyán, however, which
has already been referred to, the people lost their heads and did not make proper arrange-
ments for the disposal of their dead. Corpses were left about the village and were eaten by
dogs, with the result that the dogs also died.
Contrary to the experience of most other districts the attitude of the trading classes
in the Ferozepore District was satisfactory. Mr. Miller, the Deputy Commissioner, writes : —>
" It is pleasing to think that Arorás and Baniyás have done good work during the
Hast cold weather. The Zira shop-keeping community are specially to be commended. This
•kept plague out of the place altogether."
7*
.There is little reason to suspect that plague cases' were reported more or deaths
less freely in the Lahore than in other districts, and this lowered case mortality can thus only
be explained by the assumption that the disease was less severe in the Lahore District than
in most other parts of the Province.
This is borne out by experience in certain villages and in the town of Kasur where
most of the cases of plague were seen by Medical Officers and in which the fatality of
attacks Was lower than usual the percentage fatality of attacks was 48-99, 50-67, in Bhija
40*47, in Raypur 42-62 and in but few villages in which cases of plague were verified by
Medical Officers was the percentage of deaths to attacks over 50.
The severity of the disease varied greatly however in different villages, in some of
which the outbreaks were very severe, as regards both the proportion of the population
attacked and the case mortality.
In the subjoined table are given particulars of certain villages in which the outbreaks
were especially severe.
Table showing particulars of places in which outbreaks of plague were especially severe
in t^e Lahore District.
-
6
tz
'\-
D
w
I
2
3
4
5
6
7
8
9
Name of place.
Cha.i^nw.'la...
...
...
Kotli Nathan
...
...
Kalis
...
...
...
Khathi Jaimal Singh
...
...
Bhikkiivind ...
.»
.»
...
Dili Ray
.«
Babaliana
,„
...
•»•
1
Olakh Atar ...
Natheh KhSlsa
1
£
Cu
0
cu
Wl
S3
a
6
3.759
398
780
492
387
864
1.330
717
ess
vi
M
1
<
422
35
107
50
302
57
140'
126
7i
c/5
-C
"rt
<u
Q
243
32
59
29
10S
' 36
»>3
64
53
PERCENTAGE OF
Attacks to population.
11-4
87
137
lt> - 2
78-0
6-5
10S
176
103
i
a
O
t»~>
li
fa
57-6
91-4
55'4
58-0
344
63'16
8071
50-S
74-65 '
It will be noticed that 87 per cent, of the inhabitants suffered from plague and that
91-4 per cent, of the cases of plague in the village of Kotli Nathan proved fatal.
The people, their bearing in the presence of plague,
and theif attitude towards plague measures.
(a) The population of the infected villages consisted for the most part of agriculturist
Sikhs and Muhammadans who have—the Sikhs'
especially—a reputation for independence of
character. Owing to canal irrigation, the lands
of most villages are well cultivated and the people are fairly well off.
Bearing.
Of their bearing in the presence of the
epidemic the Deputy Commissioner writes :—
" People have now pretty well come to regard plague, as they do other diseases, as
the act of God. But for a long time it was ascribed to the Sirkar working through the
' daktar log.' The most general idea was that Government had found, from the Census and
from the occurrence of recent famines, that the population was too large and consequently
h%pl given a sort of contract to the doctors to kill off so many lakhs.
" There was a very Widespread impression that doctors or doctors in disguise
were going about putting poison in wells. In very many villages guards were placed over
drinking wells which were watched day and night. A survey party working in ChuniAn
was assaulted in one village and had difficulty in other villages as they were thought
to be doing something to the wells. To a considerable extent these impressions have now
disappeared.
78
Table showing the number of persons inoculated and number performed by each Inoculator
in the Lahore Municipality from October 1901 to September 1902.
No.
1
1
3
4
5
Name of Inoculator.
Dr C A. Owen M D...
Miss A. L. Church M.D.
Captain E. S. Peck,
I. M. S.
Captain C H. James,
I. M. S.
Major H. C Hodgkins
Total
October.
...
•••
...
November.
...
...
December.
•••
...
January.
330
2
332
February.
21
3
47
71
March.
...
189
189
April.
...
918
918
May.
...
2980
2,980
c
3
•—1
...
236
236
1—1
5
...
4
9
August
8
...
8
September.
3
...
...
3
6
Total.
367
5
4.370
4
3
4,749
REMARKS.
Infection.
(i) It has already been mentioned that
infection was first introduced into Lahore City
by a woman from Siálkot.
Other centres of infection were caused by refugees from the muhallas first attacked
and from other infected places. Human intercourse was largely responsible for the spread
of infection through the city, but it is recorded by Mr. Calvert that in several quarters
no human beings were attacked until 8 or 10 days after mortality among rats was ob-
served, the first victim sometimes being a person who had handled the dead bodies of
the rats.
In the case of the first infected muhalla however—Muhalla Sathán—rat mortality
was not noticed until a month after the occurrence of the first case of plague.
Effects' of local conditions.
(i) But little reference is made in the Deputy Commissioner's report as to the effect of
local conditions upon the course and extent of
the epidemic. The most remarkable feature
of the outhreak is that in spite of infection having been introduced into several parts of
a thickly crowded city like Lahore, the sanitary condition of which leaves much to be
desired, in spite also of the attitude of the people to all measures for dealing with the dis-
ease which rendered their effective performance in many instances impossible, the mortality
from, plague was not much greater than it was.
Plague among rats or other animals.
(k) Reference has already been made to mortality among rats : no other animals were
noticed to have suffered from plague and no
measures were taken for the destruction of
rats. The Municipality offered a reward of 1 pice for every two rats destroyed, but in no
case was the reward claimed. People usually threw the dead bodies of rats found in
their houses into the streets, whence they were removed by the Municipal sweepers and
burnt.
Type and severity of the disease.
(l) The cases of plague which occurred in Lahore City and Municipality were nearly
all of the bubonic variety, only one case of
septic plague having been recorded and was
for the most part of a mild type, the fatality of indigenous cases having been only 47-11
per cent,
The disease was entirely confined to the native community and chiefly to the
poorer classes; with this exception no special liability to or immunity from attacks of plague
on the part of any particular classes were noticed,
19
Recommendations.
(m) The Deputy Commissioner recommends that complete arrangements for inocu-
lation should be made in the cold weather, and
thinks that if the operation ever became fashion-
able the demand for it would be great, and if not met would result in a loud outcry.
He supports Mr. Calvert and Captain Peck in recommending that chemical dis-
infection should be restricted in the city to houses the owners of which ask for it. The
Commissioner, however, dissents from this opinion; he points out the favourable results that
have attended the disinfection of infected houses during the epidemic and compares the
state of six months' plague in Lahore with three months' plague in Gujránwála, where little
or no disinfection was carried out. In the Civil Station the Deputy Commissioner considers
disinfection should be insisted on.
The Deputy Commissioner considers the employment of European Officers on plague
operations in the city inadvisable, but with this also the Commissioner disagrees, and re-
marks " that except for European supervision, advice, remonstrance and encouragement, there
would probably have been no exception at all " to the general uselessness of the Sanitary
Ward Committees.
Mr. Atkins concludes : " Regrettable as it is we must wait till the people learn by
suffering before we can help them as we would. "
AMRITSAR DISTRICT.
Review of the epidemic.
48. Although imported cases of plague had occurred in the Amritsar District on a few
occasions since the first appearance of the
disease in the Punjab there was no epidemic
of plague in this district until the year under report.
This year however in addition to an outbreak in the city 59 villages were reported
as infected with plague.
The following table shows the number of infected places and the number of plague
cases and deaths in each tahsil :—
Tahsíl.
Amritsar City
Do.
Tahsíl
Tarn Táran do.
Ajnála
do.
•«•
...
...
...
Total
Population.
161,039
164,462
325 576
209 869
860,946
Cases.
189
1 706
1,154
96
3,145
Deaths,
118
1,054
630
35
1,837
REMARKS.
Of the epidemic Mr. Maclagan, the Deputy Commissioner, writes:—
"Excluding a case or two in the city the first appearance of the plague was in
the middle of March when it broke out almost simultaneously in the city itself, at Bath
(on the road between Jullundur and Tarn Táran), and at Pakhanpura (on the road between
Gurdáspur and Amritsar). It extended to some villages near Bath, and then broke out in
a group of villages in the immediate south-west of Amritsar City and in the city itself.
By the beginning of May it had taken a hold on a fairly large tract south-west of the
city and then crept up along the Ajnála road towards Ajnála. The disease was never
however at all serious in the Ajnála Tahs 1, where it soon died out. In the end of June it
disappeared from the Tarn Táran Tahsíl and subsequently existed only in Amritsar City
and in the neighbourhood of Pakhanpura on the Gurdáspur road, where it had begun in
March."
80
In the table below are shewn the cases of plague in the Amritsar District through-
out the year under report, week by week.
Table showing the course of the epidemic of plague in the Amritsar District weekly
from the beginning of October 1st, 1901, to the end of September 30 th 1902.
WEEK ENDING SATURDAY
October
5th
Do.
12th
Do.
19th
Do.
26th
November 2nd
Do.
9th
Do. 16th
Do.
23rd
Do.
30th
December 7th
Do.
14th
Do.
21st
Do.
28th
January
4th
Do.
11th
Do.
18th
Do.
25th
February 1st
Do.
8th
Do.
15th
Do.
22nd
March
1st
Do.
8th
Do.
15th
Do.
22nd
Do.
29th
April
5th
Do.
12th
Do.
19th
Do.
26th
May
3rd
Do.
10th
Do.
17th
Do.
24th
Do.
31st
June
7th
Do.
14th
Do.
21st
Do.
28th
July
5th
Do.
12th
Do.
19th
Do.
26th
August
2nd
Do.
9th
Do.
16th
Do.
23rd
Do.
30th
September 6th
Do.
13th
Do.
20th
Do.
27th
DO. 30th.
...
...
...
...
...
...
...
...
...
...
...
...
...
...
...
...
...
...
...
...
...
...
...
...
...
...
...
...
...
...
...
...
...
...
...
...
...
...
...
...
...
...
...
...
...
...
...
...
...
...
...
...
VILLAGES.
DURING WEEK.
TOTAL UP TO DATE.
Declared infrected
...
...
...
...
...
...
...
...
...
...
...
...
...
...
...
...
...
...
...
...
...
...
...
...
...
...
2..
...
...
3
4
13
14
6
3
6
1
1
...
...
...
...
...
...
...
...
...
...
• ••
...
...
...
...
Declared free
...
...
...
... ...
...
...
...
...
...
...
....
...
...
...
....
...
...
... .....
... .....
....
• •«
....
2•
...
...
...
...
....
...
•««
...
14
...
...
14 14
...
...
5
...
4.
• ••
• ••
...
I
....
...
...
Cases
...
...
...
...
...
... ...
...
...
...
...
... ...
...
...
...
...
...
... ...
...
1
2
5
60
43
97
92
116
110
134
632
632
331
369
97
46
25
7
6
2
1
...
11
1
5
6
2
7
14 6
Deaths
...
...
...
...
...
...
...
...
...
...
...
...
...
...
...
...
...
...
... ...
...
1
...
2
7
31
31
54
42
69
78
95
296
335
184
241
75
35
7
2
I
5 2
3
3
5
2
Cases
...
...
...
...
...
...
...
...
...
...
...
...
...
...
...
...
...
...
...
... 1
3
8
8
111
208
300
416
526
660
1.176
1, 808
2, 198
2 529
2 898
3,041
3,000
3.073
3,079
3,088
3,090
3,091
3092
3,093
3 104
3,105
3,110
3116
3,118
3,125
3,139
3.145
Deaths
...
...
...
... ...
...
...
...
...
...
...
...
...
...
...
...
...
... ...
...
...
1
1
3
30
61
115
157
226
304
399
695
1,030
1,234
1,418
1,659
1,734
1,769
1,789
1,794
1,797
1 804
1,806
1.806
1,806
1,807
18l3
1, 818
1,820
1824
1,827
1,830
1835
1,837
REMARKS.
81
Although the epidemic was not very extensive or severe, a few villages suffered
seriously both as regards the incidence and fatality of plague. A list of such villages is
given below. It will be seen that in one village Ibban Khurd 20 per cent. of the population
was attacked with plague :—
Table showing the highest percentage of attacks to population and of fatality to attacks
in the Amritsar District.
Serial No,
1
3
3
4
Name of place.
Bath ... ...
Ibban Khurd ...
Baháru
Talwandi Ghuman
...
Census popu
lation in 1901
2,106
547
1,296
611
Attacks.
376
110
172
77
Deaths.
244
63
130
53
Percentage Of
Attacks to
popul a-
tion.
17.84
20. 10
13.27
12.60
Fatality
attacks.
64.89
57'27
75.58
68.83
REMARKS.
It is possible, as will be seen later, that the high case mortality which was reported
from some villages was due to concealment of cases.
The people their bearing in the presence of plague,
and their attitude towards plague measures.
(a) Of the classes and character of the population, Colonel Mulroney, the Civil Sur-
geon of Amritsar, writes that in most villages
they were mixed communities of agriculturists
—Hindús, Muhammadans and sweepers.
Bearing.
In city and in some villages, where the outbreaks of plague were severe, consider-
able alarm was shown by the people,
many of whom fled : flight was especially
noticeable on the part of the Márwári residents of the city.
The Deputy Commissioner writes that the dead were disposed of in the ordinary
way, but the number of mourners was generally much smaller than usual, and in the city
the city persons ready to remove corpses were Bikáneri coolies.
Attitude towards plague measures.
Everywhere, though less in the city than elsewhere, rooted dislike was shown by
the people to official interference.
Effect of epidemic on agriculture, &c.
(b) Of the effects of the epidemic on
agriculture, &c, Mr. Maclagan writes : —
"Agriculture was not affected in any way by the plague. A few schools were closed
for a time and a few cases in the law courts were postponed in consequence of the outbreak,
but no serious inconvenience was felt in these directions. The city trade was, however, to
some extent affected especially that in cloth which is conducted by Márwár traders and
the owners of shops in the Márwár quarters lost a good deal of rent. The octroi for May
fell off a good deal, but nearly recovered in June."
Measures to prevent outbreak in uninfected places.
(c) The exclusion of outsiders was tried in several villages, but as it was carried out
by the people themselves, the success was
only partial.
Surveillance over outsiders was not exercised in the city or elsewhere.
Information.
(d) Information regarding plague occurrences was obtained from Patwárís who
submitted returns for the Civil Surgeon.
These returns were checked as regards deaths
by comparison with the Patwárís' returns. The Deputy Commissioner remarks that in every
part of the district, including the city, there was a tendency to conceal cases, and that
outbreaks were in many instances only detected by a comparison of the mortality returns
with the normal.
Evacuation,
(e) Very little was done in the way of
evacuation.
82
The Deputy Commissioner writes :—
• (l Evacuation was not much resorted to, the educated classes, retired military men, &c, r
sometimes left their homes, and cases were noted in which men left the village site and lived
on wells. In some villages the people adopted a suggestion of the Civil Surgeon's and lived
on their roofs."
s
.
(/) No mention is made of the effect of
egrega ion.
guc j i evacua t-j on as was adopted.
The Civil Surgeon states that the segregation of sick and contacts was not observed
at all except in the city and only in the cases of attacked persons who were treated in the
Municipal Plague Hospital ; he adds that medical treatment was not accepted in villages and
only to a slight extent in the city.
(g) Very little disinfection was done and was chiefly confined to the city. The only
.
village in which more than one or two houses
Disinfechon.
were d j s j n f ecte( j was g ath . th ; s being the firgt
infected village, an attempt was made to carry out disinfection thoroughly, but owing to
the opposition of the people, operations had to be discontinued everywhere except in the
city, where many infected houses were disinfected. There was strong objection to any sort
of disinfection by official agency.
Altogether 214 houses were chemically disinfected, of which 136 were in the city of
Amritsar and most of the remainder in the village of Bath. Phenyle 1 in 100 was the only
disinfectant used both for houses and personal effects.
Of the results of disinfection Colonel Mulroney writes that out of 136 disinfected
houses in the city only 3 became reinfected, while in the village of Bath 18 per cent,
of the disinfected houses became reinfected. The Deputy Commissioner mentions that a
few villagers bought phenyle and attempted disinfection themselves, but that these cases
were very rare.
(h) Inoculation was confined to the city of Amritsar where 1,508 persons were inocu-
Inoculation.
lated. Of these Colonel Mulroney notes 279 were
• Policemen and 350 School boys and Teachers.
Colonel Mulroney states that there is no objection to inoculation on religious grounds,
Jaut the people dislike it and in villages it is believed that inoculation causes the spread of
plague instead of checking it.
The table given below shows the number of inoculations performed by each operator
in the Amritsar District, monthly :—
1
Names of Inoculators.
Lieutenant-Colonel T. R.
Mulroney, M.D.
Senior Assistant Surgeon
Mehr
Chand, Rai
Bahadur.
Miss. A. N. Desouza, M.D.
Assistant Surgeon K. C.
Singh,a.
Total
March-
27
...
•v
...
27
April.
56
UQ
...
...
May.
...
...
...
1,030
1,030
June.
...
28
155
183
July.
...
...
V
2
2
August.
...
...
...
...
...
September.
5
...
...
86
9 1
Total.
88
28
1.273
1,508
No injury was observed to follow inoculation and no inoculated person was attacked
with plague.
(;') Infection was in every case believed to have been conveyed by human intercourse.
T , ,.
The Deputy Commissioner writes that there was no
Infection.
>
F
L ^
c ,,
-,.
,
• ' •
'
reason to suspect the conveyance of the disease by
grain or food.
83
Influence of local conpitihns.
(j) Nothing particular was noticed concerning the influence of the local conditions
in the villages; in the c ity the disease was
chiefly limited to over-crowded and badly-
ventilated quárters.
Rat mortality.
(k) Mortality among rates was, the Deputy Commissioner notes, observed in every
severe outbreak. It occurred from a week to a
fortnight and was followed without an interval by
the outbreak itself.
There were no data to show whether severe mortality among men was concurrent
with special mortality among rats.
Colonel Mulroney states that although rat mortality was observed in many houses in
the city, in only a few instances was it followed by the occurrences of plague cases.
Type and severity of the disease.
(l) Nearly 90 per cent, of these cases of plague was of the bubonic variety, of the
remainder about half were pneumonic and half
septiccemic cases.
Classes affected.
(m) Plague attacked all classes, but the most affected were Márwárís (in the city),
Telis, Baniás and others following in-door occupa-
tions. Women and children suffered more than
men. No person on plague duty was attacked.
Treatment.
(n) Colonel Mulroney mentions that leeches were found for the relief of pain in
buboes, applied six at a time and repeated if neces-
sary on the third day.
Recommendations.
Mr. Maclagan writes :—
" The only suggestions that I would venture to make on the basis of the experience
of this small outbreak are—
(1) that anything approaching to compulsion either as regards disinfection or as
regards inoculation should be carefully avoided
(2) that the Medical staff employed should as far as possible be natives of this
part of the Punjab, whom the people will understand and trust."
The latter recommendation is strongly endorsed by the Commissioner,
Mr. Younghusband.
Staff and establisement.
(0) The following Medical Officers and subordinates were employed on plague duty
in the district:—
(1) Lieutenant-Colonel T. R. Mulroney, I.M.S., Civil Surgeon, in addition to his
ordinary duties.
(2) Assistant Surgeon Rái Bahádur Mehr Chand, in addition to his ordinary
duties.
(3) Assistant Surgeon Keron Chandra Singha and two Hospital Assistants.
GURDASPUR DISTRICT.
Review of epidemic.
4g. The epidemic of plague in the Gurdáspur District during the year under report
originated as a recrudescence of the disease
after the subsidence of the epidemic of the
previous year—the first to occur in the district.
By October 1st, 1901, 17 villages in the Shakargarh Tahsíl were already infected, and
in December the disease appeared in the Batála and Gurdáspur Tahsíls ; it was not until
February that the Pathánkot Tahsíl became infected.
The epidemic was a severe one. There were outbreaks in 765 villages and towns, and
25,868 cases of plague with 16,479 4eaths occurred,