NationalLibraryOfScotland/medical-history-of-british-india huggingface dataset:
126
For the month of May 1897.
Sex.
Male ...
Female ...
...
...
TOTAL
...
...
...
Remained.
3
2
5
Admisssions.
4
2
6
Total.
7
4
11
Cured.
3
2
5
Died.
3
2
5
Remaining.
1
...
1
Total.
7
4
11
REMARKS.
For the month of June 1897.
Sex.
Male
...
Female ...
...
...
TOTAL
...
...
. . .
Remained
1
...
1
Admissions.
4
...
4
Total.
5
...
5
Cured.
5
...
5
Total.
5
...
5
REMARKS.
0 Two cases were non-bubonic.
General Symptoms—
1. Headache.
2. Nausea and vomiting.
3. Enlarged glands—femoral, inguinal, axillary.
4. Injected eyes.
5. Stupid expression.
6. Delirium or coma.
General Treatment—
3. Pure air.
2. Careful nursing.
3. Stimulants and anodynes.
4. Foultioes to buboes.
Report of the working of the Bombay Port
Trust Hospital.
PEIVATE HOSPITAL NO. 22.
This hospital was established by the Port Trustees in a position convenient
to the Docks at a time when the only other plague hospital in existence was that at
Arthur Road. The dock labourers stood in such fear of being taken to the Munici-
pal hospital that they threatened to stop work and leave the City—a course that
would have been attended with the most serious inconvenience to the trade of the
Port. The prompt erection of a hospital for their separate use at once allayed their
alarm and averted the threatened consequences. The Trustees at the same time
arranged for the free grant of medical aid to the whole staff. The Medical Officer
in charge of the hospital attended daily at the Docks to look after the general
health of the men and prescribe for any found ailing.
127
The hospital was oponed on the 23rd December 189G. There were in all
five wards including one ward for observation cases. The remaining four wards
were used as follows :—
One male ward for serious cases.
One female ward for
do.
One male convalescent ward.
One female
do.
Besides the above wards, quarters for the relatives of the patients and other
necessary out-houses—such as dispensary, store-rooms, cook-rooms, dead-houses,
servants' quarters, &c., were also provided.
The Staff consisted of—
A Medical Officer, Dr. Shivdas Parmanandas, L.M. & s.
One Hospital Assistant lent by Government.
One compounder.
Seven ward-boys.
One cook and other servants, such as mehters, sweepers, &c.
Talle showing the number of patients treated during the respective months and the
results of treatment.
Month.
March
...
...
...
...
May
Grand Total ...
Remained.
1
2
10
4
No. of
Patients
admitted.
1
9
12
27
19
6
74
Admitted
moribund.
3
4
9
7
3
26
Result.
Recovered.
5
8
3
14
5
35
Died.
3
6
14
11
4
38
Remaining
under treat-
ment at treat
end of each
month.
1
2
10
4
1
1
By a special arrangement made with Dr. J. Pollen, the observation ward was
used for some time for suspected cases of plague sent from the Bunders. Twenty-
three such cases were admitted, out of which eighteen developed symptoms of
plague and were treated in the hospital.
The hospital was closed on the 31st May 1897, and the one remaining patient
was sent to the Arthur Road Hospital for further treatment.
Dr. Shivdas Parmanandas, the Medical Officer in charge, performed his duties
in a most praiseworthy manner and to the entire satisfaction of the Trustees.
When the Committee assumed charge of plague operations, suspected cases were sent to Modi Khana
Government Hospital No. 3 and Wari Bunder Government Hospital No. 8.
32
128
Report of Hindu Fever Hospital.
PRIVATE HOSPITAL No. 23.
This hospital was established on 28th January and has been under the continuous
general management of Mr. Wadia.
Medical Board.
Dr. Bhalchandra Krishna, Consulting Medical Officer.
Dr. G. B. Kher,
Medical Officers in charge.
Dr. M. G. Desai,
Dr. S. B. Jathar, Hony. Medical Officer for night duty.
Mrs. Thakubai Praidan, Nurse,
Members of the Working Committee.
Yijbhukandas Atmaram, Esq.
Dwarkadas Dharamsi, Esq.
Tribhowandas Mungaldas, Esq.
Ghanasham Nilkanth Nadkarni, Esq.
The Hon'ble Daji Abaji Khare.
Kushaba Chapaji Kale, Esq.
Narayen Ganesh Chandawarkar, Esq. Sadashiv Sakharam Hande, Esq.
Bhaskerrao Balkrishnaji Pitale, Esq. Bhiwa Ramji Nare, Esq.
Govindji Thakersi Mulji, Esq.
Waghu Hanmantrao Boble, Esq.
Ghelabhai Haridas, Esq.
Honorary Secretaries.
Dr. Bhalchandra Krishna.
Narayan Trimbak Vaidya, Esq.
DETAILS OF CASES,
Admissions 331, of which 254 were fatal : 61 of these within 12 hours ; 50
within 24 hours ; 9 within 48 hours ; and 134 after that period. Buboes were
present in 196 cases. Localised as follows :—
1. Femoral ... ... ... ... ... ... ...
2. Inguinal ... ... ... ... ... ... ...
3. Axillary ... ... ... ... ... ... ...
4. Cervical ... ... ... ... ... ... ...
5, Parotid ... ... ... ... ... ... ...
78
47
57
6
7
The general death-rate was 76.74, the highest but one of all hospitals.
Report of Khoja Plague Hospital.
PRIVATE HOSPITAL No. 24.
This hospital opened on 26th April 1897. Admitted seven cases, of whom
four died.
At present on reduced footing.
Cases ...
Recovered
Died
...
...
7
... 3
... 4
Of these four one was of a pneumonic type, and death
took place 30 hours after admission. Two others
also ended fatally within 24 hours.
Medical Staff.
1 Hon. Medical Offecer.
1 Apothecary.
1 Manager.
1 Nurse,
129
Dharavi Hospital.
PRIVATE HOSPITAL No. 25.
Dharavi Hospital was a private institution built by owners of tanneries for
their employes on the waste land between the Dharavi tanneries and Mahim
Railway Station. It consisted of two wards capable of holding about ten beds
each and some necessary out-houses. The staff consisted of one Medical Officer,
Dr. Rajabally M. Putei, L. M. & s., one resident compounder, one non-resident
Eurasian day-nurse, one resident Mahratta night-nurse, five ward-boys, one
chuprassi, one cook, and two sweepers.
The hospital was used solely for plague cases and suspects found among
the employes at the Dharavi tanneries. It was opened on the 5th of April and
closed on the 31st of May 1897. There were 76 admissions, of whom 37 died and
39 recovered. The institution admirably answered the purpose it was intended for,
as the plague which was raging in Dharavi soon disappeared when the cases were
isolated by being sent to this little hospital. The above-mentioned four hospitals
were all in charge of Surgeon-Captain W. E. Jennings, M.B., District Medical
Officer for No. 10 District.
Forms of Plague.
Two forms of plague noticed—
1. Glandular.
2. Non-glandular.
Types or Clinical Headings.
A. Nervous—
Symptoms :
1. High fever.
2. Sudden unconsciousness.
3. Delirium.
B.
Typhoid—
Symptoms :
1. No hyper-paresis.
2. Raised temperature (103).
3. Weak and atonic pulse.
4. Coated tongue.
5. Diarrhœa.
6. Muttering delirium.
C. Pneumonic—
Very contagious. Always fatal ; duration two to five days.
D. Convulsive—
Chiefly children under 15.
Symptoms :
1. Albuminuria.
33
130
General Symptoms.
α. Atonic and frequent pulse.
b. Hurried respiration, inconsistent with pulse and temperature.
c. Pinched and anxious feature with twitched expression.
d. General prostration.
e. Vomiting and constipation (rarely diarrhoea.)
f. Gland in glandular variety—
(1) Tender.
(2) Ecchymosed with
(3) Inflammation of cellular tissues.
(4) Glandular suppuration in favorable cases.
DECISION OF CAUSE OF DEATH.
In Corpses, Useful Symptoms—
1. Presence of gland.
2. General congestion.
3. Supplementary history of case.
In Non-glandular Cases—
Failing history of case, the microscopic examination of viscera.
In Doubtful Cases—
1. Previous history.
2. Period of illness.
3. Premonitory symptoms.
General Treatment·—·
1. Liq. hydrarg. perchloride (large doses, 1½ to 2 oz. in 24
hours).
2. Free stimulation.
3. Ether, digitalis, and strychnia.
4. Quinine when fever is controiled.
5. Food, easy of digestion, administered recumbent and in
moderation.
Order of Susceptibility—
Hindu, Bania, Mahomedan, Parsee, Europeans.
Order of Fatality in Types—
Favorable—Glandular and non-nervous.
Unfavorable—Pneumonic and convulsive.
Mortality—60 per cent.
Order of Age Susceptibility—
1. Young adults.
2. Children.
3. Aged.
Order of Sexual Mortality—
1. Males.
2. Females.
Proportion—5 to 2.
131
Report of Hajee Cassum Joosub's Hospital.
PRIVATE HOSPITAL No. 26.
This hospital, date of closing (July 1st) was established by the Mahomedan
community of the Rangari Moholla by public subscription among its leading members
for the relief of the community and in aid of the Plague Committee. Opened on the
8th of April, it has admitted and discharged one patient.
Hospital Board.
Hajee Cassum Joosub, President.
„ Ismail H. Hassun.
„ Ahmed H. Hassun.
„ John Mahomed Latib.
,,
Mahomed Sulimau.
Hajee Hassum Curim.
,, Da wood Ismail.
„ Noor M. Abootalib.
„ Moss S. Patel.
„ Mahomed Joosna, Secretary &
Treasurer.
Hospital Staff.
Superintendent Medical Officer, Dr. Sidney Smith, M.D.
Medical Officer in charge, Mr. Fernandez, L.R.C.P.&S.
1 Manager and steward.
1 Cook and Ward boy.
1 Dhobie.
1 Sweeper.
Course of the only case admitted.
Male, 45 age admitted 4th day after seizure.
SYMPTOMS—3rd day—
High fever (105°).
Muttering delirium.
Very low heart action.
TREATMENT—
Careful nursing and free stimulation.
Combined at first with sedatives.
ISSUE—
Convalescence retarded by broncho-pneumonic complication.
Local treatment of affected glands.
Emplastrum Ammoniaci.
Hydrargyri.
Linseed poultices.
Abscess formed through suppurated glands, freely opened and dressed twice,
with drainage, boric cotton, and light bandage, abscess cavity having been washed
with weak solution of perchl. of mercury.
Discharged cured after 27 days in hospital.
Note.—This case is instructive as it shows the advantage of hospital nursing and careful medical attend-
ance without which the patient must have died.
132
Report of the Telugu Hospital, Kamatipura.
PRIVATE HOSPITAL No. 27.
Established by subscriptions for the benefit of the Moonore Caploo commu-
nity known here as the Telugu Foolmalie caste. Tills hospital was opened on April
14th in a building (rent free) known as Anvola Ellapa's Dharamsala. Though its
closure is fixed for July 1st, it is to be re-opened on any reappearance of the
epidemic.
Hospital Board.
Mr. Karadi Lingoo, President.
„ Mauajee Rajoo, Vice-President.
Mr. Abbajee Abboo, Treasurer.
„ Mullo Laxuman, Secretary.
Medical Officer.
Dr. P. J. Svami.
Hospital Staff.
Ward boys 3.
Dhobie
1.
Ayahs 2.
Sweepers 2 (supplied by Municipality).
STATISTICS.
Cases
...
...18
Convalescent in hos-
pital, June 19 ... 1
Discharged ...
... 7
Died
...
...
10
In this hospital eighteen cases in all were
with the results as marginally noted.
treated
General Symptoms—
1. Of the ten fatal cases, admitted in an advanced
state of plague ...
2. Developed pneumonia
3. Underwent Dr. Yersin's treatment ...
6
2
1
General Treatment—
Mercury with stimulants.
Report of St. George's Hospital.
This hospital admitted, from 11th November 1896 to 3rd July 1897; 95 cases,
of which the following are details :—
Cases
...
...
...
95
Recoveries ...
... 58
Deaths
...
...
37
Of the 58 recoveries there were 30
males
16 females, and 12 children;
and
of the 37 deaths—males 24,
females
7, and children 6.
Statistics of Nationality.
Caste.
Europeans
...
...
...
...
Domiciled Europeans
...
...
Eurasians ... ... ... ...
European Jews
Asiatic Jews
Native Christians
... ... ... ...
Cases.
5
8
25
2
4
10
Deaths.
1
4
8
1
2
8
Per cent.
20
50
32
50
50
80
135
When the trained nurses from England arrived and took over charge from
the Bandora Sisters, the patients manifested the greatest grief at losing them. They
clung to them, weeping bitterly, imploring them not to leave them, and asking
pardon for all their former acts of rebellion.
It was during her attendance on the patients at the Mahim Hospital that
Sister Elizabeth, whose death has already been referred to, caught the attack, of
which she died.
On the 18th March, seven of the Clare Road Sisters (the Nuns of Jesus and Mary)
went to the Grant Road Hospital to work under Dr. Dallas. They were accommodated
in quarters in the Northbrook Gardens erected for the purpose. The Sisters stayed
there till May 14th, On their leaving, the patients displayed many touching marks
of gratitude, and many of those who recovered are still in the habit of visiting the
Sisters at their Convent.
The special features of the plague from the point of view of the Sisters who had
to deal with it, were the state of filth in which the majority of the patients arrived,
the sickening odour of the buboes, and the violence of the patients, many of whom
had at first to be tied down to their beds to prevent their leaping out in an attempt
to escape. The fortitude with which the Sisters faced these horrors in the perform-
ance of their self-imposed tasks was well rewarded by the triumphs over the
prejudices of their patients and by the evidences of the gratitude felt by them. In
other measures, necessary and well-managed though they were by the officers in
charge of them, taken for the suppression of the plague, the people at large at best
gave a silent acquiescence. But the record of services rendered by the Sisters, and
the gratitude evoked by them, forms one of the most pleasing pictures in the history of the
plague.
The following Circular was issued by the Plague Com-
mittee to all District Medical Officers on April 20, 1896 :—
" In some of the Private Hospitals some of the Conva-
lescent Patients have been discharged much too soon. Plague
Patients must not be discharged for at least one month after
all acute symptoms have subsided."
137
Chapter
III.
The Medical Aspect of Plague.
The medical officers working under the Committee both at the Government
and Private hospitals were directed to submit their views regarding some of the most
salient features of Plague, and the following interesting results of their investigations
and observations are recorded. The forms and types of Plague are distinguished by
some into simple bubonic and pneumonic plague only, by others as plague (with buboes
and without buboes) ; all the variations on these two forms being grouped under
symptomatic evidences of complications, associated with one or other form. Another
variety is included by several writers under the names of the gastro-intestinal-
mesenteric, enteric, or abdominal form, and there is a tendency to indicate a fourth
variety with marked brain symptoms as a cerebral type, and a fifth or nephritic form.
Some few very rare cases occurred in which carbuncles were the prominent symptom.
In the bubonic form the disease is characterised by the development of glandular
swellings in some one of the gland areas, the femoral, the inguinal, the axillary, or the
cervical regions, and each may again be classified as a mild or severe form of the type.
The mild form was sometimes unaccompanied with marked febrile symptoms. Certain
such cases may be described as an abortive form of Plague, and are characterised by
the formation of buboes, fever of a low type, and slight constitutional disturbance.
They terminate in recovery in about 10 days. The proportion of the types seemed to
vary with the progress of the epidemic in the later months of its prevalence, as shown
by the following table of observations from the Cutchi Memon Hospital :—
With Buboes ...
Without Buboes..
In the
beginning.
Mild form without febrile symptoms ...
Mild form with febrile symptoms
With lung complication
...
Without lung complication
2%
1 %
95%
1 %
1%
Later.
5 %
20 %
65 %
5 %
5 %
The table also shows that as the epidemic proceeded an increase took place in
the mild types of Plague with buboes and with or without febrile symptoms, and
also in the non-bubonic types, whilst there was a corresponding decrease in the
severe forms of the bubonic types. This result is due to an attenuation of the poison,
and a diminution of the virulence of infection by the passage of the virus through
many individuals ; also the converse may occur, and cases of the mild form undoubt-
edly occurred in the month of October 1896, in certain districts, which were followed
by a severe outbreak of the disease, Byculla being a particular instance. These mild
eases might be importations from a badly-infected region which, unless promptly
segregated, might be the means of starting a large and severe epidemic amongst an
unprotected population. A warning of this kind seems to have occurred in Calcutta, and
it is possible that the active measures taken with regard to a few mild cases in that
city, and subsequent careful inspection of ingress traffic may have prevented the disease
from gaining a foothold there.
35
138
Reviewing opinions generally, the following is a rational classification of forms
of Plague :—
1. With enlarged glands (gravity according to symptoms
and severity of attack) ...
2. Without enlarged glands (almost always fatal)
...
Femoral.
Inguinal.
Axillary.
Cervical.
Tonsilar.
Septicœmic.
1 Pneumonic.
Mesenteric, enteric or
Gastro-intestinal.
Nephritic.
t Cerebral.
The characters of the forms and types are due to a variation in the method of
entry into the body of the poison which is the direct source of the disease and
common to all. The forms and types may be mixed so as to produce a combination of
the characters of two or more, and each may be varied by a degree of intensity, mild,
severe, or hæmorrhagic. The hæmorrhagic condition is more often associated with
those types of the disease in which the glands are not enlarged, and is always most
grave as it shows great destruction of the blood constituents. The hæmorrhages
may be petechiæ, or extravasations or exudations from the mucous tracts.
It must be carefully observed that the diagnosis of a type is not made upon
the complications which are likely to occur in all. Many cases of the form with
buboes show complications affecting the lungs or the brain ; but the type is a
definite one, and the complications are distinct from the evidences of a type.
The relative proportion in which the different types occur is fairly represented
by the following records :—
Port Trust Hospital.
Enlargement of cervical glands
,..
...
„
axillary „
„
femoral, inguinal glands
„
mixed variety
„
abortive ,,
In No. 10 District :—
With enlargement of glands generally
„
,,
femoral and inguinal glands
„
„
axillary
Gastro-enteric type ... ... ... ...
Signs and Symptoms.
About.
5½ per cent
14
„
48
„
2½ „
28
,,
... 85 per cent.
... 60 „
... 17 „
9
,,
... 12 „
... 3 „
The possibility of such a classification of plague as the foregoing shows that each
type has characteristic signs and symptoms due to the typical development of the
case, but at the same time there are certain general symptoms common to all cuses
which are due to the virus, the fountain-head of all the manifestations of the disease.
These are now well known, and with them are associated the different features of some
one or more types, so that the general symptoms are the basis of the diagnosis of the
disease, while the local or visceral conditions constitute the revelations of the type.
The onset is, as a rule, very sudden, and commences with a more or less severe
rigor, followed by a rapid rise of temperature, or there may be only a sudden rise of
temperature. The countenance has an expression of fear ; there are nausea and often
145
This material is obtained in the serum of an immunized animal, the horse being
selected as the best subject for the process.
By a series of elaborate operations the animal is inoculated with the virus through
such degrees that it is finally brought to a stage of great immunity to lethal doses of
the active microbe. It is then found that the serum of the blood of such an animal
when injected into another effectively hinders the reproduction of the bacilli and the
formation of toxines. When the subcutaneous injection of this fluid in measured
quantities (all determined by careful experiment) is made into the body of a person
already attacked with plague, it mingles in the tissues and circulating fluids, and by
its action is expected to restrain a further development of the bacilli.
It is therefore clearly of the first importance to apply the treatment in the earliest
possible stage of the disease before any great numbers of the bacilli have developed
and before any large quantities of the toxine have been produced in the system.
When Dr. Yersin commenced his operations in Bombay, he extended the treat-
ment to all classes of patients in every part of the city, so that it was impossible for
any one but himself to compare his results. He communicated them to the Com-
mittee according to the accompanying statement, and they fell far short of the
expectations and hopes of the public and of the medical profession.
Statement of Cases treated by Dr. Yersin s anti-plague serum.
17 cases treated on 1st day of illness
17
„
2nd
12
„
3rd
,,
3
,,
4th
1
„
5th ,,
Total of 50 cases treate
Cured
15
...
Mortality... 12 per cent.
Died
2
Cured
11
...
... 35 per cent.
Died
6
Cured
6
...
,,
··· 50 per cent.
Died
6
Cured
1
...
,,
··· 66 Per cent.
Died
2
Cured ...
Died
1
Cured 23
d...
„ ... 34 per cent.
Died
17
Cases treated classed by Nationality.
2 European
9 Eurasians
23 Hindus
7 Mahomedans....
10 Parsees ...
37
Cured
... 21
Mortality
Died
Cured
... 5
Died
...
4
C
ured ... 13
Died
... 10
Cured
...
5
died
...
2
Cured
...
9
Died
... 1
... Nil.
... 44 per cent.
... 43 per cent.
... 28 per cent.
... 10 per cent.
148
(2) The rates of mortality are thus distributed among the hospitals :—
The returns of 2 hospitals lie between
Do.
0
do.
Do.
2
do.
Do.
4
do.
Do.
4
do.
Do.
9
do.
Do.
7
do.
Do.
3
do.
Do.
0
do.
Do.
1
do,
...
···
...
...
···
···
...
...
...
...
...
...
...
...
...
Per Cent.
0—10
10—20
20—30
30—40
40—50
50—60
60—70
70—80
80—90
90—100
1. The highest rate is 100 per cent.
2. The lowest rate is 0.0 do.
3. The mean of these 50
do.
Falkland Road ...
Khatri Mahan ...
Wari Bunder ...
Cases.
3
2
56
Deaths.
3
·..
28
RETURN showing the Mortality from Plague, Percentage of Deaths
and Cases in all Hospitals.
A.—GOVERNMENT HOSPITALS.
No.
1
2
3
5
6
6a
8
10
Ï4
15
16
17
18
19
District Hospital.
Pilct Bunder
... ... ...
Jamsetjee Bunder
...
...
Modi Khana ...
Charni Road
...
Grant Road
...
Foras Road, Police ... ...
Wari Bunder
...
...
...
Arthur Road
Parel Government House
Sion
...
...
...
...
Bandora ...
...
...
...
Worli
...
...
...
...
Ripon Road, Jullaia ... ...
Cases.
34
33
18
70
374
28
56
22
321
304
67
41
44
50
Deaths.
20
19
6
45
225
16
28
8
180
196
23
32
11
22
Sections.
Upper Colaba ...
Lower Colaba ...
Fort, North
...
Dhobi Talao ...
Market
Tardeo
Tarwadi...
Mazagon
Khetwady ...
Sion
...
...
Mahim
Bandora
Parel
Byculla ... ...
Death rate
per cent.
of Cases.
58.8
57.5
33.3
64.2
33.3
28.1
50.00
36.3
56.07
64.4
34..3
75.04
25.00
44.00
B.-PRIVATE HOSPITALS.
District
No.
3
District Hospital.
DeSouza
Street,
for
Lohaua, Cutchi, Hallai
Gogari community.
Modi Khana, for Sahebs
Servants.
Mint Road, by Govindji
Thakersi Mulji,
for
Bhattias.
Jackaria Musjid Street,
for Cutchi Memons.
Clive Road, for Dussa Sa
Bannias.
Memon Mohulla Street,
for Hallai Memon.
Kolsa Street, by Haji Cas-
sum Mitha, for Memon
Sunnis.
Carried over ...
P.
P.
P.
P.
P.
P.
P.
...
Admissions
79
82
33
19
47
3
1
772
Deaths.
20
62
25
8
31
2
0
448
Sections.
Fort, South
Esplanade
......
Mandvi, Chackla.
Oomurkhadi Don-
gri.
······
......
Death-
rate per
cent. of
Cases.
63.2
75.6
75.7
42.1
65.9
66.6
0.0
···