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6. To meet prejudices against promiscuous segregation, communities in the
various districts objecting to the ordinary isolation hospitals should be per-
mitted to opea as many selected and approved hospitals as may be necessary for
the purpose. Vacant houses, huts, tents or ships in the harbour may be used
for the purpose.
7. To meet the difficulty of housing the evicted healthy persons tempo-
rary accommodation might be required, and could be erected on any available
open land, but much might be done by utilising houses already more or less
deserted. Houses that have been vacated for sis weeks, owing to the occurrence
of plague cases, might be found suitable.
8. To meet the serious difficulty of the concealment of cases, all house-
holders should be made responsible that all serious cases of illness should immedi-
ately be reported to the Health Department of the Municipality. On receipt of
such a report the Municipal Medical Officer should visit the case, and if it should
prove to be one of plague, the person reporting might be suitably rewarded.
In the case of chawls, it might be necessary, not only to make the landlord
responsible, but also to compel him to keep a representative constantly on the
premises to report cases of sickness in the same manner as a householder. The
concealment of cases of severe sickness should be made a penal offence. To
ensure the efficient reporting of cases of plague, house to house visitations by
Municipal Medical Officers should be carried out daily in all infected localities.
9. Meanwhile the present measures for opening up and cleansing of
drains, gullies &c., disinfecting of roads, burning of dead rats &c., should be
continued ; but we consider that the practice of burning sulphur in opea spaces
and in open houses is useless and had better be discontinued.
10. We consider that an extensive mortality among rats in any locality
may be taken as an indication that there is a risk of the appearance of plague
among human beings there residing, and that on the occurrence of this pheno-
menon, all rat-holes should be dug up and thoroughly disinfected, either by fire
or by means of a strong solution of chlorinated lime. Hat-holes should also be
carefully disinfected wherever found in an infected house.
11. A set of simple rules for the guidance of the people should be drawn
up in the various vernaculars and circulated both by printed notices and by
criers. Such rules should direct attention to the necessity for free and efficient
ventilation, the prevention of overcrowding and the necessity of cleanliness
both of the person and of the dwelling. The whole contents of dwelling rooms
should be well aired and exposed to sunlight once a fortnight ; bedding and
clothing should be so treated every clay. Special care should be enjoined in
keeping clean all injuries or skin abrasions even of the slightest description,
They should be washed with disinfectants obtaiued from the Municipality and
protected by plaster, or clean bandages, or otherwise. Householders and land-
lords should bo compelled to wash and lime wash all houses and rooms which on
inspection are found to be dirty. Such lime washing will obviously give an
opportunity for exposing the contents of a room to sunlight and air. Persons
coming in contact with the sick, especially if contaminated with secretions,
should be instructed to carefully wash all exposed skin surfaces with carbolic
lotion of 1 in 20 strength.
12. In order to increase the accuracy of the death returns and to obtain
a better check on the progress of the disease, a Medical Officer should be
stationed at each of the places for the disposal of the dead, and should be em-
powered to examine bodies in all suspicious cases. As a general rule, this
examination need only be external.
13. With regard to general measures, it may be noted that overcrowding,
deficient ventilation of houses and rooms, accumulated dirt in rooms and
passages, are frequently present and obviously require to be dealt with, where
necessary, by compulsion. The opening up of crowded localities for the free
perflation of air is urgently needed. The crowded and insanitary burial
grounds present in the midst of thickly populated districts should be closed on
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