NationalLibraryOfScotland/medical-history-of-british-india huggingface dataset:
217
As stated, it was not till the 12th May that correct returns could be obtained, and
prior to that date all deaths in the city were returned in the hospital returns sent ;
so that I have thought it best to leave this out in the total of all hospitals and show it
separately. I believe that the admissions are fairly correct. These six, then, were
the hospitals which were opened for the treatment of the plague cases, and the total
numbers of treated, &c., are as follows :—
From 24th April to 21st June.
Admitted.
Hindoos ...
... 937
Hajeera (Bora) ...
91
Mahomedans
... 103
Khatri Mahomedans. 60
Khojah
do.
29
Total ... 1,220
Salaya Hospital (unreliable).
Fairly correct ... 235
Grand Total ... 1,455
* Discharged.
239
38
31
37
17
362
40
Died.
646
53
65
23
3
790
Remaining.
52
0
7
0
9
68
335 (doubtful).
Requirements.—The improvements which ought to be carried out in Gutch-
Mandvi are many.
1. The abolition of the present system of using the streets as latrines :
insistingthat all should use either their private latrines (which ought to be kept clean)
or the public latrines. The present latrines are badly constructed and ought to be
demolished. They are seldom, if ever, kept-clean, and I am informed that the cattle
are the scavengers ; considering that most of the animals supply milk for the use of
the people, the idea that they are partly fed on human excrement is too disgusting for
words.
2. The roads are badly constructed, narrow, and sandy. I doubt if there is a
good road in the whole city. There ought to be several broad roads made in the city
from the various gates,so as to allow of free ventilation. These roads must be properly
constructed. I would make a broad properly-constructed road, say, of about 20 feet
in width, round the inside of the city walls. The houses at present in many instances
are right up to the walls. I am aware that this is being attended to, and that many
are coming down ; but I would recommend a broad road which would be a means of
ventilating the city and preventing people using these places as latrines.
3. There are no drains to carry off the surface-water during the rains ; the
consequence being that the whole of the streets are one mass of mud. Drainage of
the city could be very easily carried out by a competent Engineer, considering the
nature of the ground.
4. The city walls are an obstruction to air. They might certainly be reduced
to half of their height, and the material used for paving the roads. I think if several
gateways of moderate size were constructed in these walls and grated with iron bars so
as to allow only of the entrance of air, it would be a great improvement.
5. The houses are in most, if not in all, instances badly ventilated. High stone
walls enclose the court-yard surrounded by rooms. This court-yard is used as a stable
for cattle and not kept clean. The rooms are crowded, dark, and gloomy. They
should have more windows to allow of light and air, and the high walls and gate-ways
either removed or brought to a reasonable height. Some of the lower rooms are
below the ground level, and I should think, in the rains, are very clamp.
55
221
In Mr. Atts, the Inspector of Bombay Coolies, the State obtained the services of a
most tried and experienced official. His duties were of the most arduous character,
having to be out in the city all day and amongst very insanitary and dangerous
surroundings, and for the most part of the time single-handed. His report quoted in
its place shows the amount of work he has done. His experience was also utilised in
the construction of temporary latrines which he has designed and made up.
The following is the list of the medical and nursing staff employed :—
Medical Staff.
Surg.-Lt.-Col. J. S. Wilkins, I.M.S.
Surg.-Capt.H. Dempster Mason,A.M.S.
Dr. K. B. Shroff.
Dr. R. M. Nanji.
Mrs. A. VanIngen, M.D.
Nurses.
Mrs. Remy, Senior Nurse.
„ Nesbitt.
Miss Home, died May 6th, 1897.
Mrs. Lys (resigned).
Miss Madden.
„ Neroy.
„ Katsch.
„ Jones.
Mrs. Pinsent.
„ Barnes.
,, Goulden.
Miss Mitchell.
„ Briggs.
,, Franklin. )
„ Oram
)
„ Steele
)
Attached to the Jairaj Peer-
bhai Khoja Memon Private
Hospital.
Hospital Assistants.
Gopinath Yeshwant.
Rajaram Shivram.
Rajendra Pillay.
Sayaji Shivaji.
Assistants.
Chunilal Narotamdas.
Bhutt.
P
alkhiwalla.
Students.
Rajaballi.
Mutkekar.
The following notes have been compiled from personal observation of over 1,200
cases in hospital, and a very large number outside, by Surg.-Captain H. Dempster
Mason, A.M.S.
PLAGUE La Peste (BLACK DEATH).
From a fair amount of evidence obtainable from different sources, it is highly
probable that the earliest manifestation of this disease occurred at the end of February
1897 ; that the patient had been brought by sea from the infected neighbouring port
of Karachi, and, owing to the feeble attempts at quarantine, was permitted to be nursed
in the segregation hut by relatives living in the village of Muska. Naturally enough,
plague then broke out in the house of the relatives, whence it spread to the town of
Mandvie and all the villages in the immediate vicinity.
Having once established itself, the disease found every condition favourable, not
only for its existence, but for its rapid development in the most virulent form.
Local conditions.
The conditions chiefly affecting its propagation are : a warm and humid atmos-
phere, the people living in marshy soil on the sea-coast and creeks : low, badly-
ventilated and overcrowded houses ; great accumulation of putrefying animal and
vegetable matter in the vicinity of the dwellings ; the most revolting filthiness in
personal habits, and the whole city little better than one large latrine, in such an
insanitary state that it requires to be seen to be believed. This condition appears, on
inquiry, to be such as might have been anticipated where no organised system of
scavenging had existed for centuries.
56
226
The same cannot be said of the Borah community, for, on the outbreak of the
epidemic, the whole sect was taken in hand by the headman and removed into
segregation huts outside the city and there kept in insolation. This and the fact that
571 out of a community of 1,500 were inoculated with Yersin's preventive serum
undoubtedly account for the low rate of mortality.
To the Khatri and Khoja castes, both numerically small, to a large extent the
same remarks apply.
The mortality also varies considerably with the day of the disease on which the
patient is admitted.
Of 100 non-inoculated cases from the Brahmapuri Hospital, from May 25th to
June 2nd, admitted—
First day ...
...
... 82 per cent. died.
Second „ ...
...
... 66
„
„
Third „
...
...
...
95
„
,,
Thus the third day is far the most fatal, and this experience has been endorsed at
all the other hospitals.
The general Mahomedan Hospital received patients from the city and the village
of Salaya where the sea-faring community exists, under much the same conditions as
the Hindoos in the city, except that there is less overcrowding, more light, and air.
Treatment.
Treatment—
(a) Preventive.
(b) Curative.
(a) Preventive methods consist chiefly in removal" of the conditions which
favour the development of the disease and, having become established, the limitation
of its spread.
The conditions favourable to the development of plague have already been
enumerated.
With regard to the limitation of its spread, the chief considerations are—
(a) Isolation of the sick under the best circumstances.
(b) Disinfection of all articles of clothing or bedding used by the patient and
of the house in which he has lived.
(c) Preventive inoculation of serum antipesteux prepared by the Pasteur Institute.
On account of the brief period of immunity conveyed by the usual dose of 10 cc,,
it is extremely difficult to prove the value of this method of treatment.
It has not been found possible to inoculate whole communities (every ten days).
The communities object, in which case it is not accurate to ascribe the absence of
plague to the immunising effect of the serum ; nevertheless, it is an extraordinary
fact that, out of 721 persons who have been inoculated once only, up to the present not
a single case of plague has developed. These cases have all been registered and are
composed of different castes living in different places.
Men of Borah community ... ... ... ...
Children „
„ ... ... ... ...
Men, women and children of Muska village ...
Men, women and children of Bada village (16 miles
from Mandvi) ... ... ... ... ...
380
191
110
40
It also seems clear that immunisation conveyed by the preventive serum becomes
rapidly less from tenth day to the twentieth day, when it may be said to be exhausted.
Sepoy Jayanak Tulnak, who died from plague, had been inoculated 20 days previously
to the attack.
(b) Curative—(a) General, (b) Special.
230
No.
55
56
57
58
59
60
61
62
63
61
65
66
67
68
69
70
71
72
73
74
75
76
77
78
79
80
81
82
83
84
85
86
87
88
89
90
91
92
93
91
95
Name.
Khimjf
Hansibai
Kalianji
Panchibai
Gangabai
Kanji
Pralimanbai
Ramdass
Parvatibai
Kanji
Wandubai
Manekbai
Champsi
Devkorebai
Dhyanbai
Virji
Manjibai
Kalidas
Amratbai
Gangabai
Eatanbai
Cooverbai
Motibai
Ladibai
Manekbai
Ramji
Govindji
Samji
Moolibai
Hansraj
Lakhmibai
Motio
Bamji
Sivji
Motibai
Lilbai
Panbai
Kara
Kamabai
Hirabai
Hadhnbai
...
...
...
...
...
...
..
..
...
•••
. ..
...
...
...
•••
...
...
...
...
...
...
...
...
...
....
...
...
...
...
...
...
...
...
...
...
...
...
...
...
...
...
...
...
...
...
...
...
...
• ••
...
...
...
•••
...
...
...
•••
...
...
...
...
• ••
...
...
• ••
...
...
...
...
...
• ••
...
...
...
...
...
...
...
...
...
...
...
Sex.
Male ...
Female.
Male...
Fomale.
Fomale.
Male ...
Female.
Male ...
Female.
Male...
Female.
" ...
Male ...
Female.
"
•••
Male...
Fomale.
Male ...
Female
" •••
"
•••
"
...
"
•••
"
•••
" ...
Male...
" ...
" ..
Fomalo
Male ...
Female.
Male ...
" •••
"
Female.
" ...
" ...
Male ...
Female.
" •••
" •••
Age.
60
18
21
12
25
10
5
35
30.
13
20
8
22
15
28
9
20
35
50
•••
42
20
7
40
48
41
40
40
50
25
14
6
8
18
35
20
40
20
70
25
35
How long
ill.
4 days
6 "
3 "
1 day
2 days
1 day
4 days
1 day
1 "
1 "
2 days
4 "
3 „
2 "
3 „
3 "
1 day
2 days
4 "
1 day
2 days
1 day
4 days
2 "
3 "
2 "
1 day
2 days
2 „
lday
2 days
2 "
1 day
1 „
3 days
1 day
3 days
3 "
2 "
3 "
2 "
..
...
...
...
• ••
•••
...
...
...
...
...
...
...
...
...
...
...
...
...
...
• ••
...
...
...
...
...
...
...
...
...
...
...
...
...
...
...
...
• ••
...
...
...
Admitted
to
Hospital.
1897.
28th May
"
"
" "
"
29th May
"
"
"
"
"
"
"
"
"
"
"
30th May
"
"
"
"
"
"
"
"
"
31st May
"
"
"
"
"
"
"
"
1st June
"
"
"
2nd June
...
...
...
...
...
...
••
...
...
...
...
...
...
...
...
...
...
• ••
• ••
• ••
...
• ••
•
•.
• ••
...
...
...
• •.
• ••
...
...
...
...
• ••
...
...
...
...
...
...
Buboes.
Right groin
Left groin
" "
Right groin
„ axilla
„ groin
Maxillary
Left groin
Right „
Left
"
Right „
" "
Left
,,
......
Right cervical
Left groin
......
Right & left groins
Nil
......
Left groin
Tenderness,
groin.
Left groin
„ axilla
" groin
" "
" "
" "
Nil
Left groin
,, axilla
„ cervical
„ inguinal
" "
" groin
Right „
.....
......
Right cervical
." "
"
groin
• ••
...
...
...
...
...
...
...
...
...
• ••
...
• ••
...
...
un
...
...
left
• ••
..
...
...
...
...
...
...
...
...
...
...
...
...
...
Result.
Died.
"
"
"
Discharged.
Died.
"
"
"
"
"
"
"
"
"
"
"
"
Discharged.
Died.
"
"
"
Discharged.
Died.
Discharged.
Died.
"
"
"
"
Discharged.
"
Died.
"
"
"
"
Discharged.
Died.
"
231
Chapter
XII.
CONCLUSION.
In conclusion, it is desirable to draw attention to a few points in
connection with, the spread, the existence and the extinction of the plague
which have been drawn from personal observation during the time the
Committee has been serving.
The disease appears to be both infectious and contagious ; it is
exceedingly slow spreading, which enables its control if prompt action be
taken, a point of the highest importance on an outbreak being observed.
Even when apparently extinct, precautions must not be hastily relaxed,
as its complete eradication is a matter of great difficulty. All medical
opinions submitted to the Committee by the highest scientific represen-
tatives of each nation quite agree that the diplobacillus or the bacillus
of Kitasato is the active virus of the disease, and that this microbe has
peculiar properties by which it tends to develop and lurk under many
various circumstances. Further investigations on this matter do not
come within the scope of the Committee, but the consensus of opinion
by the experts in Bombay assisted the Committee to arrive at conclu-
sions as to the manner in which plague is spread.
Human agency has an undoubted and most powerful influence,
both through the actual person of the plague stricken, the infected
room in which the patient lies, and through everything likely to harbour
the microbes.
Amongst other sources of the spread of the disease throughout the
epidemic, the influence of rats has been shown in many extraordinary
ways. Grain depots are often the first centres in the spread of the
plague, the infection having been imported into the colony of rats that
haunt the depots, spreads amongst them, and they die in large numbers.
In this way the grain and grain bags are infected and become sources
of conveyance of the disease to human beings. The Committee have,
during disinfection, invariably treated those places where rats have been
known to die as plague-infected localities.
58
232
The following curious record is quoted as showing an early belief
in a connection between outbreaks of plague and the disease in rats :—
On the occasion of the capture and detention of the Ark by the Philistines
(I. Sam., ch. v.), their country was simultaneously attacked by a severe epidemic of
what may very well have been a type of plague. One of the symptoms, at
any rate, " emerods (hæmorrhoids) in their secret parts, " may represent
inguinal buboes. The mortality was extremely heavy. The complaint was
epidemic, ravaging the cities and the mofussil—"fenced towns and county
villages " (v. 18). It may also be noted that the Ark was seven months
in the possession of the Philistines before, superstitiously attributing the plague to
some supernatural vengeance or punishment, they turned it out of their country :
and that if the general life of the plague be correctly presumed to be about nine
months, then its disappearance about simultaneously with the dismissal of the Ark
may support the suggestion that this particular epidemic was of the plague type.
To this is to be added the singular coincidence that it was attended by either a plague
or a great mortality of mice—" that mar the ground " (vi. 5). Lastly, it may be
observed that the disease was plainly conveyed in the Ark and ox-cart to Bethshemesh,
where inhabitants received it with acclamations and cemeronies. 50,000 of these are
said to have died, and it was again superstitiously assumed that this was a punishment
for having looked into the Ark. It is very possible that it was a consequence of
handling the infected framework and hangings.
The disease in some of its types is probably spread by personal
infection from clothes, bedding, or by smoking the same hooka, the mouth-
piece of which is roughly dried (by possibly contaminated hands), as it is
passed on from one smoker to the next. The Oriental habit of
constantly cleaning all metal utensils in which food and drink are
stored with earth or sand scraped from the midfloor, or from the
roadways, which are often undescribably filthy, must likewise be a
fruitful source of danger.
These and many other points taken in connection with the insanitary
conditions in which the poorer, and in some particulars, even the wealthy,
classes live, make the suppression of the epidemic in India a very
difficult matter.
It must be remembered that in all large Oriental cities a very large
proportion of the population are very poor and cannot afford to pay the
rent of a really sanitary building ; they therefore are forced to live in
miserable shanties, dark, low, small, and built on insanitary sites, without
plinth, added to which, with a view to bringing the cost of this
habitation to the lowest point, 16 or 20 persons will sleep, eat and cook
in a space hardly sufficient for the requirements of four.
Orientals are most conservative, and are wedded to many insanitary
customs which have been inseparably connected with their life and
233
religious prejudices for centuries. It is therefore no easy matter to avoid
friction in enforcing the measures proved to be absolutely necessary in
the elimination of plague, and in doing so, while the greatest firmness is
desirable, every consideration must be given to the ignorant opposition of
the masses to measures of which they fail to see the advantage.
The following steps however are, I consider, absolutely necessary to
the suppression of the plague. Segregation of the sick out of their own
dwelling houses, removal of all persons from the room in which the
patient was seized or has been lying sick ; evacuation of the whole house
if this is possible ; destruction of the clothing, bedding, &c., which has
been in use by the patient ; the thorough disinfection of the house ; the
thorough cleansing and flushing of all privies and bathing places ; the
removal of portions of the roof where such obstruct sunlight and air
entering the dwelling. It may be added that the prevention of over-
crowding is of great importance.
It is an interesting and highly satisfactory fact that remarkably few
of the officers or employés engaged on plague work, and especially on
disinfection, suffered from the disease. Of the coolies working within the
City of Bombay who caught plague, only three or four are recorded ; of
the gangs sent to Cutch Mandvi, five developed plague in the place itself
and died, and three after they returned to Bombay while under observation.
Of those sent to Colaba district, none are recorded as having taken the
disease. But it is to be regretted that Dr. Desai, the Medical Officer in
charge of the Hindu Hospital, and Dr. Davda, in charge of the Dariastan
Hospital, succumbed to the disease while in the execution of their duty.
At Cutch Mandvi, Nurse Home died after only a few days' illness,
as did also Sister Elizabeth (Fille de la Croix) who nursed at the Govern-
ment Hospital at Mahim. Two Hospital Assistants—one at the Jamsetjee
Bunder and one at the Mahim Hospital—caught the disease ; the former
died and the latter recovered. Three Military ward orderlies are
recorded as having died of the disease contracted while engaged on
hospital work.
It will be observed that the above number of casualties represent a
very small proportion of the percentage of the total number of employes,
and in that light the result of the precautions taken to prevent infection
amongst the staff must be regarded as satisfactory. The Committee
cannot conclude this report without acknowledging the support and
assistance rendered throughout the time they have been sitting by the
234
Municipal Commissioner, Mr. P. C. H. Snow, the Joint Plague Commis-
sioners, Surgeon-Major Reade and Dr. Lowson ; the Commissioner of
Police, Mr. E. Vincent, his officers and men ; the Collector of Customs,
Bombay, and the officers and men of the Preventive Service ; also by
Mr. G. W. Roughton, A.-D.-C. to H. E. the Viceroy, who substantially
helped the Committee in the formation of Mahomedan Hospitals ; the
Health Department under Brigade-Surgeon-Lieutenant-Colonel Weir ;
and by the Fire Brigade under Mr. Nichols, Chief ; and they desire to
express their best thanks for the good work done by the Sisters, Nurses,
and by all departments.
30th June 1897.
W. GATACRE, BrIGDR.-GENL.,
Chairman, Plague Committee.
P. C. H. SNOW.
H. P. DIMMOCK.
C. C. JAMES.
Examined by
W. F. CAHUSAC,
Secretary.
Appendix No. 3.
The following tables give the total staff placed in each district who commenced operations as soon after the Plague Committee was constituted as possible. The strength
of the various staffs shewn was adhered to until the decline in plague at the latter end of May, when a reduction was effected.
DISTRICT No. 1.
1 DISTRICT MEDICAL OFFICER OF HEALTH.
UPPER COLABA.
POPULATION
HOUSES
•••
•••
•«•
• ta
... ...
4,335
164
Hospital.
1/2 Section, 10 beds..
1 Ambulance.
Staff for House-to-House Visitation.
2 British Non-Commissioned Officers.
10 British Soldiers.
Disinfecting Staff.
1 Sub-Inspector.
1 Muccadum (Overseer).
25 Mea,
Sub-divisional Medical Officer
Non-Commissioned Officers
British Soldiers ...
Total...
... 1
...
3
... 10
... 14
CENTRAL OFFICE.
Central Office near Afghan Memorial Church.
3 Ambulances and Bullock Gharry.
Stores.
Disinfecting: Inspector.
1 Non-Oommissioned Officer.
1 Health Inspector.
Telephone No. 223.
Office Staff.
1 Clerk.
1 Do.
1 Timekeeper.
6 Military Sepoys.
TOTAL STAFF.
Inspector ...
Sub-Inspectors
Clerks
Timekeeper
...
...
•a«
.*•
• ••
...
.»•
...
Total...
Grand Total ... 03.
«••
•».
...
...
• •*
1
5
3
1
9
LOWER COLABA.
POPULATION
HOUSES
...
....
•••
•«»
...
...
13,622
1,194
Hospital.
1 Section, 20 beds.
2. Ambulances.
Sub-divisional Medical Officer.
Staff for House-to-House Visitation.
3 Sub-Inspectors or Muccadums (Natives).
2 Police Sepoys.
10 Military Sepoys.
Disinfecting Staff.
1 Sub-Inspector.
1 Muccadum.
25 Men.
Muccadums (Overseers)
Military Sepoys
Police Sepoys
Coolies
...
•••
...
••>
•••
...
...
«a.
Total...
...
«a.
...
• a.
M
...
2
16
2
50
70
237
DISTRICT No. 2.
1 DISTRICT MEDICAL OFFICER OF HEALTH.
FORT, NORTH.
POPULATION
...
•••
•••
•••
HOUSES
...
...
...
...
...
Justices of the Peace.
G. W. L. Jackson, Esq.
Dr. 0. H. F. Underwood.
Bomanshaw Êntee, Esq.
Bustomjee N. Jijibhoy, Esq.
Dr. Jahangir J. Kursetji.
Hormasji C. -Kolawalla, Esq.
Dr. Nanabhoy N. Katrak.
N. J. Gamadia, Esq.
Edalji Nasarwanji, Esq.
Dr. Byramji Darabshet.
Dr. Temulji B. Nariman.
Bomanji B. Patel, Esq.
Dr. B. B. Shroff.
Pramroz R. Joshi, Esq.
3,951
469
Staff for House-to-House Visitation,
4 Sub-Inspectors or Muccadums (Natives).
6 Police Sepoys.
24 Military Sepoys.
Disinfecting Staff.
2 Muccadnms.
70 Men.
FORT, SOUTH.
POPULATION
...
... 32,847
1,195
1 Sub-Divisional Medical Officer.
Central Office close to Queen's Statue.
4 Ambulances.
1 Bullock Gharry.
Stores.
Telephone No. 1048.
Office Staff.
1 Head Clerk.
2 Clerks.
1 Timekeeper.
2 Bamosees (Watchmen).
4 Ambulance Sepoys.
1 Health Inspector.
Justices of the Peace.
G. W. Roughton, Esq.
Dr. Davar.
W. Pearson, Esq.
Balkrishna Kirtikar, Esq.
F. Hutchinson, Esq.
District Hospital, Mody Khana
No. 1 Section, 20 beds.
1 Lady Doctor.
Staff for House-to-House Visitation.
2 Sub-Inspectors or Mucoadums.
4 Police Sepoys.
16 Military Sepoys.
Disinfecting Staff.
1 Inspector.
2 Muccadums.
50 Men.
ESPLANADE.
Justices of the Peace.
W. Greaves, Esq.
E. B. Baikes, Esq.
W. B. Young, Esq.
Sassoon J. David, Esq.
J. N. Tata, Esq.
Staff for House-to-House Visitation.
2 Sub-Inspectors or Muccadums (Natives).
4 Police Sepoys.
16 Military Sepoys.
Disinfecting Staff.
1 Muccadum.
25 Men.
Total Staff.
Clerks
Timekeeper
Ramosees (Watchmen)
Ambulance Sepoys
Inspector
Sub-Inspectors
Mucoadums (Overseers) ..
Police Sepoys
Military Sepoys
Total
1
...
2
1
...
2
...
4
...
1
...
8
...
5
... 145
...
14
...
56
... 239