NationalLibraryOfScotland/medical-history-of-british-india huggingface dataset:
AGENTS FOR THE SALE OF MADRAS GOVERNMENT
PUBLICATIONS.
IN INDIA.
The Superintendent, NAZAIR KANUN HIND PRESS. Allahabad.
M. C. KOTHARI, Bookseller, Publisher and Newspaper Agent, Raopur Road,
Baroda.
R. SUNDER PANDURANG, Kalbadevi Road, Bombay.
D. B. TARAPOREVALA SONS & Co., Bombay.
THACKER & Co. (LTD.), Bombay.
THE BURMA BOOK CLUB (LTD.), 240-A, Merchant Street, Rangoon, Burma.
THE BOOK COMPANY, Calcutta.
BUTTERWORTH & Co. (LTD.), 6, Hastings Street, Calcutta.
R. CAMBRAY & Co., Calcutta.
THACKER, SPINK & Co., 3, Esplanade East, Calcutta.
RAMAKRISHNA & SONS, Lahore.
THE UPPER INDIA PUBLISHING HOUSE (LTD.), Lucknow.
CITY BOOK COMPANY, Post Box No. 283, Madras.
The Superintendent, DIOCESAN PRESS, Vepery, Madras.
HIGGINBOTHAMS (LTD.), Mount Road, Madras.
THE LAW BOOK DEPOT (LTD.), 15 and 16, Francis Joseph Street, Madras.
S. MURTHY & Co., Madras.
G. A. NATESAN & Co., Madras.
P. R. RAMA IYER & Co., Madras.
P. VARADACHARI & Co., Booksellers, 8, Lingha Chetti Street, Madras.
S. VAS & Co., Madras.
THE THEOSOPHICAL PUBLISHING HOUSE, Adyar (Madras).
THE UNIVERSAL PUBLISHING Co., Bezwada (Madras).
E. M. GOPALAKRISHNA KONE, Pudumantapam, Madura (Madras).
THE MODERN STORES, Salem (Madras).
THE SRIVILLIPUTTUR CO-OPERATIVE TRADING UNION (LTD.), Srivilliputtur
(Madras).
S. KRISHNASWAMI & Co., Teppakulam Post, Trichinopoly Fort (Madras).
NIVASARKAR, Manager, " Hitawada," Nagpur.
IN STRAITS SETTLEMENTS
THE FEDERAL RUBBER STAMP Co., Penang.
NOTICE.
Official publications may be obtained in the United Kingdom
either direct from the office of the High Commissioner for India, 42,
Grosvenor Gardens, London, S.W. 1, or through any bookseller.
12
(h) Though early diagonosis, prompt isolation of smallpox patients in
suitable hospitals, effective disinfection, supervision of " contacts," and other
such public health methods are invaluable, they are no substitute for vaccination.
23. In letter No. 1250, Health, dated 4th September 1925, the Government
of India required information regarding the number and situation of smallpox
hospitals in the Presidency, the number of patients treated therein and their
vaccinal condition, etc. Information on these points was called for, and the follow-
ing figures have been consolidated from district reports. Only seven institutions
exist for the isolation and treatment of smallpox patients in this Presidency.
1,292 cases were treated therein in 192 , but an additional 160 patients were
accommodated in sheds provided for general infectious diseases. As regards the
vaccinal condition of these 1,452 patients, details are available for only 1,411:—
(a) Vaccinated as evidenced by one or more cicatrices … … …
(b) Stated to have been successfully vaccinated but no vaccination cica-
trices present ... ... … … … … … …
(c) Stated to be unvaccinated or unsuccessfully vaccinated but no vacci-
nation cicatrices present
...
...
... … … …
(d) Previously unvaccinated but vaccinated during the incubation period
of smallpox … … … … … … … …
(e) Stated to have been successfully revaccinated ... … … …
839
334
153
8
77
1,411
In view of sentimental and religious objections to hospital treatment, only an
infinitesimal proportion of smallpox cases is isolated in these institutions and few,
if any, are other than adults. As most of the smallpox in this Presidency occurs
amongst young children, these statistics, therefore, do not represent the vaccinal
state of the population taken as a whole.
24. The salient features in the administration during the triennium under
report are (1) the inauguration of a complete District Health Scheme and the
appointment of Health Officers in a large number of municipalities, by which
facilities have been afforded for epidemiological studies, for improved preventive
measures and for increased supervision of subordinate staffs, (2) the substitution
of lanoiine lymph by glycerine lymph, (3) the increase in the success rate
which now stands at the high figure of nearly 95 per cent, (4) the large increase
of 1,107,000 in the total number of vaccinations performed as compared with the
previous triennium, (5) the progressive increase in the rate of infantile vaccina-
tions, and (6) the steady decline in the incidence of mortality from smallpox.
Although these are all matters of gratification to the department and its officers,
it must not be forgotten that every year a large number of unprotected individuals
is added to the population, and the vaccination campaign must be carried on
with ever-increasing vigour if smallpox is to be kept under control and finally
eradicated.
OOTACAMUND,
A. J. H. RUSSELL, C.B.E., M.A., M.D., D.P.H., Major, I.M.S.,
11th June 1926.
Director of Public Health, Madras.
54
Statement No. VII showing inspection work done by the Health Inspectors during the year 1927-28—cont.
Districts.
1
Vizagapatam.
Ranges.
2
Anakapalle … …
Bimlipatam
…
…
Bobbili
…
…
Chipurupalli … …
Chodavaram
…
…
Gajapatinagaram …
Narasapatam ... …
Palkonda
…
…
Parvatipuram ... …
Salur
…
…
…
Srungavarapukota …
Vizagapatam ... …
Vizianagram ... …
Yellamanchili ... …
Grand total ...
Number of Health Inspec-
tors.
8
1
1
1
1
1
1
1
1
1
1
1
1
1
1
266
Number of villages inspected
by Health Inspectors.
4
116
118
132
262
235
179
147
314
245
117
135
277
189
145
43,591
Total number of cases
vaccinated.
5
5,393
6,259
4,198
10,136
10,301
8,298
7,751
9,594
7,325
3,477
8,336
4,582
8,289
7,928
1,753,748
Number of days spent on
inspection duty.
6
268
261
234
264
268
261
260
239
257
222
243
229
257
250
66,428
Number of cases verified by
Health Inspectors.
7
4,978
5,548
4,021
8,663
9,644
7,771
7,008
6,203
6,871
3,351
5,693
4,574
8,329
7,420
1,543,482
Total number of successful
cases as reported by
Health Inspectors.
8
3,654
4,108
8,574
6,728
6,492
5,180
5,438
4,591
5,210
2,972
4,389
3,661
6,059
5,901
1,268,808
Percentage of successful
cases to the total number
inspected as reported by
Health Inspectors.
9
73.4
74.1
88.9
77.7
67.3
66.6
77.6
74.0
76.8
88.7
77.1
80.0
72.7
79.5
82.2
Proportion per cent of
inspection by Health
Inspectors to total num-
ber vaccinated.
10
92.8
88.6
95.8
85.5
93.6
93.6
90.4
64.7
93.8
96.4
89.9
99.8
100.5
93.6
88.0
REPORT
ON THE
BUBONIC PLAGUE IN BOMBAY
BY
BRIGADIER-GENERAL W. F. GATACRE, C.B., D.S.O.,
CHAIRMAN, PLAGUE COMMITTEE,
1896-97,
WITH
PLANS.
Bombay:
PRINTED AT THE "TIMES OF INDIA" STEAM PRESS.
1897.
REPORT
ON THE
BUBONIC PLAGUE IN BOMBAY
BY
BKIGADIEE-GENEEAL
V. F. GATACEE, C.B., D.S.O.,
CHAIRMAN OF THE PLAGUE COMMITTEE
1896-97.
BOMBAN|
:
PRINTED AT THE TIMES OF INDIA STEAM PRESS.
224997
18 9 7.
CONTENTS.
CHAPTER
I
General Report ... ... ... ... ...
II
Hospitals
...
...
...
...
...
...
III
Medical Aspect of Plague
...
...
...
...
IV
Land Traffic Inspection
...
...
...
...
V
Sea Traffic Inspection and Observation Camps ...
VI
Description of No. 10 District (typical of the
Sanitary Work)
...
...
...
...
VII
House-to-house Visitation and Disinfection ...
VIII
Bandora Slaughter Houses ... ... ...
IX
Foreign Missions ... ... ... ... ...
X
Kolaba Report
...
...
...
...
...
XI
Cutch-Mandvi Report
...
...
...
...
XII
Conclusion
...
...
...
...
...
Appendices ... ... ... ... ...
PAGE
1
19
137
153
161
169
177
193
199
201
207
231
235
Corrigenda.
Page
7, margin, to "Staff" add "Capt. W. W. Chitty, 19th B. I."
Page 47, last line, for "Morley" read "Morey."
Page 199, line 16, for "Privat-O'ocent" read "Privat-docent."
REPORT by the Plague Committee appointed
under Government Resolution No. 1204/702 P. on
the Epidemic, extending from the 2nd of
March till the 30th June 1897, with a short
account of the preceding period.
Chapter I.
GENERAL REPORT.
Under Government Resolution No. 3045/2269-P., dated 2nd June
1897, Brigadier-General Gatacre, C.B., D.S.O., was asked to prepare a.
report as regards Bombay City with, special reference to the period
since the constitution of the Committee of which he is Chairman.
The following is a brief description of the operations conducted
by the Municipal authorities up to the time when the Committee was
appointed.
August 1896
to
December
1896.
Breaking out in the month of August in the Mandvi District, the-
plague had made comparatively little progress up to the beginning of
December. That month was marked by a sudden rise in the mortality,
from 130 on the 1st, to 292 on the 28th December, which spread the
alarm far and wide. Up to that date there were many people who made
light of the whole affair, but when the excess mortality (over the normal
for the previous five years ) for the first week of December was" seen to
be no less than 591, while the total excess mortality for the month
of December was 4,559, it became evident even to these that the-
situation was serious.
Figures.
Perhaps one reason for the comparatively little alarm among the-
public of Bombay up to December may be found in the fact that the
total daily mortality was not published. The plague mortality, or
rather the mortality reported by the Health Department, was, it is true,.
given out ; but it was not generally understood then how difficult it was
for various reasons to get at the true figures.
2
Many causes contributed to this, but the chief among these were the
«dread entertained by all classes of the population of being removed to
hospital, and the fear of having their houses invaded by a disinfecting
staff. Their prejudice against hospitals was so strong that it is no
exaggeration to say that most patients actually preferred to die in their
houses to going to hospital, where they would have had a much better
chance of recovery. Part of this repugnance was, no doubt, owing to
the fact that there was. only one hospital (the Municipal Hospital for
infectious diseases in Arthur Road) for the accommodation of all
Pastes and classes, ; but 'whatever defects there may have been in
the accommodation, the distrust of European methods was their
main objection, founded on a baseless belief that all patients were
•operated on during life and their bodies given over to the dissect-
ing room after death. Needless to say in the present case these
fears were groundless ; none the less they were universally held, and
had the effect of making the detection of cases extremely difficult. Another
motive for concealment was the dread of having their houses disinfected
and the bedding, &c, of the patient burned. At the time when the plague
was at its height it was not possible to obtain high-cáste coolies to
carry out the necessary measures, and the measures themselves were
not only considered useless by the people, but vexatious and oppressive
in the extreme.
Registration
System.
The registration system, moreover, was not equal-to such an occa-
sion. The karkoons who-are stationed at the burning ghats and burial
grounds for record work are obliged to be content with whatever cause of
death is assigned by the funeral party, and in the case of plague, where
they had these motives for concealment, the true cause of death was
generally disguised.
From all these causes the official statistics of the plague as compiled
by the Health Department cannot be relied on. The chart given in
Appendix No. 4 shows the divergence of the death-rate from the normal,
rand, in the absence of any other disturbing cause, most of these excess
•deaths must beheld to have been plague deaths. But in some months
the reported plague deaths are less than a third of the excess thus
revealed. On the hypothesis that the excess was due to plague, we
arrive at a plague mortality of 19,849 from the outbreak to the end of
"February, when the Committee was appointed.
Measures
taken by the
Municipal
Executive.
From the moment of the first outbreak of the • plague the efforts of
the Health Officer had been directed mainly to the disinfection of the
houses in which cases had occurred. Gullies were flushed down, houses
lime-washed, privies and house connections attended to in the most
thorough manner .by the officers of the Health Department, the Drainage
Engineer, and the Fire Brigade. "I am glad to be able to assure
Government," wrote the Surgeon-General after his inspection of the scene
of the outbreak in the first week of October, "that the utmost energy is
being displayed by the Health Department of the Municipality in the
infected area."
3
These efforts were again recognised in the memorandum drawn up
by the Medical Practitioners of the City in January and submitted by
the Director-General, Indian Medical Service, to the Government of India
on January 16th. On receipt' of this note, the Governor-General in
Council, while recommending " even stronger measures," stated that he
" had learned with the greatest satisfaction of the untiring energy which
has been displayed by the local authorities in the thorough and systematic
cleansing and disinfection of the infected parts of the City."
M. Haffkine also, in his minute attached to the report of the
Manser Committee, expressed his opinion that the measures of disinfection
already being carried out by the Health Officer were in accordance with
the best recognised principles of sanitation and were not in need of
alteration. As to their effect, however, opinions are divided. The
district of Kamatipura, which had been thoroughly cleaned before
the plague attacked it, was afterwards visited by a severe outbreak, and
it can readily be understood that, owing to the concealment of so many
cases, it was impossible to disinfect all the infected houses, for the good
reason that they could not be discovered.
As His Excellency the Governor pointed out in his letter to the
Ohairman of the Standing Committee of the Municipality, the very
thoroughness of the process was enough to prove that the plague could
not be stamped out by disinfection alone, and the attempt to enforce
other methods broke down as soon as it was made.
On October 6th, the Municipal Commissioner issued a proclamation,
under Section 434 of the Municipal Act, to the effect, that all cases
were to be segregated, their houses disinfected, by force if necessary,
and their sick to be taken to hospital ; no provision, however, was
made for the accommodation of different castes in different wards or
hospitals. It was not explained that the relatives of the patient would
be allowed to attend him, or that the prejudices of the various castes
in the matter of food, &c, would be respected. Such a storm of protest,
therefore, was raised by the proclamation of October the 6th that, after
consultation with the Commissioner of Police, who anticipated a riot,
the Municipal Commissioner modified the proclamation on the 14th of
the same month, and issued a public proclamation* to this effect at the
end of the month. This meant that segregation was greatly restricted.
In the absence of caste hospitals, no one would bring their sick
out of their houses, and from this, time, till the Plague Committee was
appointed, it may be said that there was no organised effort to
segregate the sick or their families.
Hospitals.
If, however, segregation had really been carried out at this period,
great difficulty would have been experienced in finding the necessary
accommodation for the sick ; besides Arthur Koad, there were no other
hospitals of any sort for the reception of plague cases, and it was not
* See Appendix No. 1.
4
till the end of December that the Farsees established a hospital for
their own community, and the Jains built another, in the compound of
the Arthur Road Hospital for themselves, and a private hospital for the
employés of the Port Trust was opened December 23rd.
In December, His Excellency the Governor of Bombay generously"
offered the use of the old Government House at Parel to the Municipal
Commissioner for the use of sufferers from the plague. As, however,
no use was made of it, the General Officer Commanding the Bombay
District offered, in the month of January, to equip and start it as a
plague hospital if the Municipality would provide the funds. This was
accordingly done under Government sanction, and a hospital opened
there on the 18th February, equipped for 150 beds, but capable of expan-
sion to a total of 250. Originally intended as a convalescent hospital, it
was soon filled up by the overflow of patients who could not be taken in
at Arthur Road, and it therefore received acute cases. It was at this time
in contemplation to open a hospital at Grant Road under the direction of
Dr. Dallas ; but when the Committee took over plague operations,
there were only two hospitals, i.e., Arthur Road and Parel. The difficulty
of obtaining trained nurses was great, and but for the generous offer
of the All Saints' Sisters to nurse the Arthur Road Hospital, and for
the assistance given by the Military in equipping the Parel Hospital,
the one would have had no nursing staff, and the other would not
have been in existence. The total hospital accommodation at this
time was less than 300, while approximately 900 to 1,000 plague deaths
were taking place weekly.
Telegram
from the Secre-
tary of State,
January 18th.
In the meantime the European nations had been growing more and
more alarmed ; quarantine had been imposed at all the chief continental
ports, and the state of affairs in Bombay had moved several Powers to
press for " restrictive measures."
Public attention, too, had been attracted by a passage in the Queen's
Speech to Parliament, in which Her Majesty announced that she had
instructed Her Government to take the most stringent measures for the
eradication of plague.
Again, the Bombay Government, writing to the Government of India
on February 23rd, announcing the successful introduction of the Military
in the equipment of the Parel Hospital, concluded with these significant
words :—•
" I am to add that His Excellency the Governor in Council anticipates
great indirect benefit from a measure which brings the Military into
touch with the Civil Authorities in organising measures for preventing,
the spread of the plague, and it is not improbable that the Civil
Authorities may before long be driven to seek considerable assistance at
the hands of the Military."
6
It is essential that the hospitals should, as far as possible and
practicable, be open to the friends and relatives of the patients, wha
should be, as far as possible accommodated near them and encouraged
to come and see for themselves that the patients are well cared for.
Everything that can be done is to be done to avoid creating a feeling
of distrust, and I hope that those employed under you will, by combining
persuasion and explanation with firmness, avoid this evil. Every
advantage should also be taken of the services of natives of influence.
Many influential gentlemen of the various communities, most of whom
are Justices of the Peace, have offered their services, and I have great
confidence that the assistance they will render you will be really
beneficial.
In carrying out these measures, you will have at your disposal the
whole staff already employed in plague operations in the City of Bom-
bay. You are empowered to add to their number and to arrange and
organise them in what you consider to be the most effective way.—I •
am, & c,
SANDHURST.
The Notification appointing the Committee was made under the-
Epidemic Diseases Act, III of 1897, the last four Sections run as
follows :—-
1. The Committee are invested with all the powers conferred on,.
or vested in, the Municipal Commissioner of Bombay by
Sections (relating to the exceptional powers which the
Commissioner can assume on the outbreak of an epidemic)
of the Municipal Act, and by the Notification of the Com-
missioner, dated October 6th, 1896, Sections 422, 423,,
424, 425, 426, 427, and 429, and by the Notification
No. 228-P of the Governor of Bombay in Council, dated
February 10th 1897, and the Committee are empowered
to take any of the measures authorised by the said Sections
and Notifications.
2. The Municipal Corporation of the City of Bombay and all
the officers and servants of the Corporation, and all
public servants and all persons employed by the Com-
mittee shall carry into effect, without delay, any measures
which may be ordered by the Committee.
3. All expenses incurred in carrying out such measures shall, in
the first instance, be paid out of the Municipal Fund of the
City of Bombay; but the Municipal Commissioner or the'
Corporation may recover from any person any amount
which such person would, under similar circumstances, be
liable to pay to the Municipal Commissioner or the Cor-
poration under the City of Bombay Municipal Act, 1888.
4. On the requisition of the Committee, the Commissioner of
Police shall give such assistance as may be necessary to'
enforce immediate compliance with any order of the-
Committee.
7
The action of Government was generally approved ; one paper
remarked with apprehension that " a Brigadier-General sitting in the
chair has an uncomfortable appearance of something like a resort to
martial law," and some of the few members of the Corporation who were
still in Bombay entered a sort of protest against the appointment, " in
which," as one member observed, " the very existence, position, and
life of the Corporation were involved."
* Staff.
2nd Lieut. A. J.
Thompson, K.A.
Lieut. G. Wornef ord,
44th Gurkhas.
T.J. Strangman, Esq.,
Barrister-at-Law,
On the 2nd of March the Committee appointed Major W. F.Cahusac, D.A.A.G., Bomb
and formed a small staff of such officers and others as were available
in Bombay.* The office was located on Malabar Hill in the house of
the Chairman, conveniently situated for the members of the Committee.
Organisation
and Disposition
of Medical Offi-
cers.
The first step taken by the Committee was the division of the City
into ten districts, due regard being observed to density of population
and number of houses, the Census districts of the City being taken as
a foundation. Each of these districts was placed in charge of a
responsible Medical Officer. Some delay was experienced in obtaining
the services of Commissioned Medical Officers, but the following—
Surg.-Lt.-Col. H. HAMILTON, I.M.S.,
Surg.-Major H. E. DEANE, A.M.S.,
„
J. C. CULLING, A.M.S.,
Surg.-Capt. J. E. BEOGDEN, A.M.S.,
Surg.-Lt. H. A. L. HOWELL, A.M.S.,
C. K. MOBGAN, A.M.S.,
Surgeon R. S. BEENAED, R.N.,
were finally detailed for plague duty, and placed under the orders of the
Committee. No. 10 district, comprising the northern half of the island,
was placed in charge of Surgeon-Captain Jennings, I.M.S., who had
been appointed Extra Health Officer of Bombay in December 1896,
on being relieved of his duties as Acting Health Officer of the Port.
Messrs. Britto and Shroff, Local Practitioners, and Assistant Surgeon
Pettigrew were also placed in charge of districts. By the Notifi-
cation already quoted, all the Municipal servants had been placed
at the disposal of the Committee. The Inspectors and the Disinfecting
Staff already working under the Health Department were thenceforward
directed by the District Medical Officers, the same plan being adopted
with regard to the extra men working under the Drainage Department.
It was, however, found necessary to largely add to the number of the
men engaged in lime-washing infected houses. They were assisted in
their work by Sub-Divisional Medical Officers drawn from the Native
Medical Practitioners of the City.
Plan No. 1 attached to this report shows the districts, each in a.
distinctive colour, and in the margin a reference square of the same tint
gives the name of the District Medical Officer, with those of the Census-
districts and the population of each with the number of houses.