NationalLibraryOfScotland/medical-history-of-british-india huggingface dataset:
190
The incident, however, is of interest, as from the 27th January
little or no disease occurred in this village, which, although considerably
reduced in numbers, was not altogether depopulated; there being never
less than 350 people in the place.
Plans Nos. 12 and 12α are dealt with in a similar manner to Plans
Nos. 11 and 11a, the deaths being grouped Nos. 1, 2 and 3, as shewn on
their respective colours and houses on Plan No. 12a.
With regard to the distribution of the disease, as shewn in Plan
No. 12a, attention may be drawn to the fact that here the disease has not
formed itself into groups, as is almost always the case, and as especially
noticed in Plan No. 11α, but is almost evenly, distributed over the vil-
lage, there being rarely more than one case in a house.
This, then, points apparently to an unusual element in the spread
of the disease, viz., the use of the water mentioned above.
In all 52 cases occurred in Sewree between December 12th and
January 27th, mostly fatal.
There are no drains of any kind in the village.
Plans Nos. 13 and 13a are of the village of Parel, and are simi-
larly dealt with as in the previous two sets of plans.
It will be noticed in Plan No; 13 that up to January 10th two cases-
are recorded as having occurred ; these were probably imported.
Group No. 1 on Plan No. 13a gives two indigenous cases. Group
No. 2, 9 ; and Group No. 3, the epidemic period, 45.
There are 589 houses in Parel village, and many of them well
built and upper-storied.
The village has been drained, but no connections have been made
between the sewers and the houses, and the sewage either flows down on
the surface of the narrow lanes or soaks into the soil. This village is in
an almost hopelessly insanitary condition, and has been a hot bed of fever
for many years.
On the 6th of February a large gang of some 350 coolies were set
to work to thoroughly disinfect and cleanse the village. The whole of the
village was dealt with by the evening of the 11th, but, as will be seen
by Plan No. 13, this had little or no effect, the disease being marked with
greater virulence after February 11th than before, and continuing more-
or less throughout March to be severe.
Plan No. 13α shews the deaths only as far as March 8th. It will
be noticed from, this plan how many evidences of personal infection there
appear to have been.
191
No. 1 in Group 1 lived in house No. 1369, one of the earlier of
Group No. 2 lived in the adjoining house No. 1370, and a member of
Group 3 lived in the same house, thus giving a sequence of infection»
No. 2 of Group 1 lived and died in house No. 1290, a member of
Group 3 did the same ; here there was no possibility of personal infection,
as the usual days of incubation were exceeded. But in other instances in
the plan this probability is pointed to very strongly. House Ko. 1338
contained three of the members of Group 2. House No. 1243 contained
five members of Group 3,-possibly nearly the whole family, and several
others contain two or three. But Plan No. 13 chiefly points to the ab-
sence of good results from disinfecting measures.
Parel is a village in which a number of the houses are very good,
and are well ventilated ; on the other hand there are many overcrowded
hovels of the most insanitary class, situated on sewage-sodden soil and
abutting on narrow lanes ; it was in these houses that the disease chiefly
raged.
Plans Nos. 14 and 14α are plans of a Koliwada (fishing village)
adjoining Moree Road in the District of Mahim. In this village the advent
of the disease. was exceedingly sudden. Previous to the 20th of January
only three cases are recorded, but on the 20th, 21st, and 23rd, three
further cases occurred, and from then almost immediately the whole vil
lage became epidemic.
Like all Koli villages the houses here were of kutcha construc-
tion, with cadjan roofs brought down as low as possible to the verandahs,
and so effectually stopping light and ventilation ; there was likewise a
total absence of drainage.
On the 19th of February a gang of some 300 disinfecting coolies
was sent to the village to supplement the disinfection of individual
infected houses which was already in progress. These coolies completed
their work on the 26th of February. The roofs were stripped from
all the houses, and in many instances burnt, all the houses were
disinfected and limewashed, and the disease was effectually stamped out.
Plan No. 14α teaches the same lesson as the previous plans, viz.,
that the disease attacking several members of the same family or house-
hold points to a strong probability of personal infection.
It will be seen that two members of Group 1 lived and died in
house No. 517, as did also two members of Group 2, and in the rest
of the village almost every family affected lost two or more members.
193
Chapter VIII.
Report by Veterinary-Major J. Mills, A.V.D., 1st Class
Magistrate in Plague Charge, Bandora Slaughter-
House.
Although plague had existed in Bombay in a severe form since September and
at Bandora since the beginning of November 1896, strange to say no cases took
place amongst the inhabitants of the slaughter-house compound until the 14th
February 1897, when a municipal peon, who had served faithfully for 16 years, was
struck down with the disease and succumbed to it on the 16th. This may be due to
the fact that the sanitary arrangements of the place are under strict European
supervision, and that there was not much intercommunication between the employés
and people living in the infected areas. No cases took place for a week after this.
It then broke out in an epidemic form, got a firm hold and spread rapidly till it
reached its climax on the 15th March, when four deaths and three cases took place.
After this it steadily declined and died out in 66 days from its inception.
By order of the Chairman of the Plague Committee I assumed charge
of the slaughter-house and the quarters inhabited by butchers and others in
Bandora on the 12th March 1897.
Previous to this, 9 cases had taken
place, 5 of which had died. Two through fear of being taken to hospital were
lying in a shed in the compound of the mosque just outside the gate of
the slaughter-houses, and one was in a room of a temporary chawl built
for segregation purposes. The rumour that the two cases mentioned above
had been taken into the mosque itself was without foundation. In their panic
their relations had taken them where they thought they would get protection and
be under the care of their own Mullah. Having no hospital ready, I made the shed
they were in, which was well isolated, as comfortable as possible, and gave them
every care in my power, but deatlr claimed them both the day after I assumed
charge and within 48 hours of their being attacked.
From the onset I could plainly see that the task undertaken by me was by no means
an easy one. The majority of the people I had to deal with were fanatical Maho-
medans, and only about 50 out of 700 of them were Hindus. Both sects, however,
were equally opposed to the removal of their sick to the hospital, to treatment, and
to segregation. I, however, at once had a long interview with the heads of both
communities and got them to agree to the following terms :—
(a) Their huts to be evacuated as soon as new temporary ones were erected for
them.
(I) A hospital to be built at a convenient distance from the slaughter-houses
to which they would remove their sick, and to be allowed to adopt
their own modes of treatment by Hakims if they so wished, or to
employ the services of the Medical Officer detailed for duty at the
slaughter-houses.
(c) They agreed to the segregation of those who had been in contact with the
sick.
49
197
only met by stringent and conciliatory measures, e.g., the Mahomedan Mullah was
appointed as superintendent with the following staff :—
Staff.
1 Mahomedan ward-boy
1 Mahomedan ward-woman.
4 Sweepers.
4 Ramoshis.
3 Bigaries.
1 Clerk.
4 Sepoys (supplied by Police
Superintendent, Thana).
Sanitary Measures adopted.
1. Fumigation of rooms.
2. Disinfection of drains.
3. Removal of cattle-troughs.
4. Erection of latrine (and enforcement of its use).
5. Removal (twice daily) of filth.
6. Cleansing of outlying wells.
7. Rigid house-to-house visitation.
8. Segregation of relations in case of patient discovered, with fumigation
and disinfection of premises. Burning of clothes and kutchra.
Compensation being paid in respect of these operations.
Sanitary Measures in Hospital.
1. Provision of hospital clothing.
2. Immediate removal of all discharges from the bed side.
3. Their disinfection or burning.
4. Automatic sprinkler at ward door.
5. Immediate removal of corpses and their dressing and disinfection superin-
tended by the Mullah.
Deaths 34. Of the 34 deaths, the following are the details :—
No.
1
2
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
24
25
26
27
28
29
30
34
36
37
38
41
Sex.
Male
..
...
.
,
.
Female .
Male
»
•
Female .
Male
»
•
Female .
D
»
,,
•
Male
Female .
»
•
Male
»
...
»
*
,,
•
Female .
»
•
»
•
Male
,,
...
»
•
,,
•
»
•
Female .
»
•
Age.
45
10
13
45
23
27
8
9
30
11
40
7
25
62
18
35
47
9
30
19
17
10
20
23
26
35
23
35
40
59
16
20
Caste.
Hindu
Mahomedan
Hindu
..
Mahomedan
..
,,
...
,,
...
,,
...
,,
•
>
•
>
«
,,
.
»
*
,,
•
,,
...
,,
•
,,
•
,,
•
Hindu
Mahomedan
Hindu
Mahomedan
»
•
>t
*
,,
...
»
•
»
•
,,
•
Hindu
Mahomedan
»
*
»
•
Admission.
14-2-97 ...
21-2-97 ...
23-2-97 ...
23-2-97 ...
3-3-97 ..
11-3-97 ..
11-3-97 ..
11-3-97 ..
13-3-97 ..
13-3-97 ..
13-3-97 .
14-3-97 ..
14-3-97 ..
15-3-97 ..
15-3-97 ..
15-3-97 ..
16-3-97 ..
16-3-97 ..
17-3-97 ..
18-3-97 ..
21-3-97 ..
21-3-97 ..
21-3-97 ..
26-3-97 ..
31-3-97 ..
31-3-97 ..
31-3-97 ..
2-4-97 ..
4-4-97 ..
8-4-97 ..
11-4-97 ...
20-4-97 ...
Date of Death.
16-2-97
22-2-97
25-2-97
24-2-97
10-3-97
13-3-97
13-3-97
12-3-97
14-3-97
16-3-97
15-3-97
15-3-97
15-3-97
16-3-97
16-3-97
17-3-97
17-3-97
21-3-97
24-3-97
24-3-97
21-3-97
21-3-97
22-3 -97
28-3-97
8-4-97
5-4-97
5-4-97
25-4-97
5-4-97
14-4-97
10-5-97
25-4-97
50
198
From this it appears that there died —
Of 35 Mahomedans attacked ...
Of 6 Hindus
„ ...
...
...
... 27
... 5
This hospital bears out the general point observed that the period of life most
vulnerable to attack is between the ages of 20 and 30, though there are 11 deaths
of patients over the age of 30 recorded and 21 below that age.
Ages of Fatal Cases.
From 5 to 10 years
„ 10 to 20 „
„ 20 to 30 „
„ 30 to 40 „
„ 40 to 50 „
„ 50 to 60 „
Above 60 „
... ...
... ...
...
...
...
...
... ...
... ...
... ...
... 5
... 8
... 8
... 6
... 3
... 1
... 1
32
cases.
"
"
"
"
"
cases.
199
Chapter IX.
Foreign Missions.
On the outbreak in Bombay of the epidemic, which had such far-
reaching effect on the commerce and sea traffic of the world, it was
natural that all civilised Powers concerned should, in the interests of
science, despatch Medical Missions to examine and enquire into the
nature and cure of this disease, about which so little was known.
The following Missions presented themselves :—
Egyptian Mission.
Dr. Rogers Pacha, Director-General, Sanitary Department.
Dr. Bitter, Director of the Hygienic Institute, Cairo.
Dr. Ibrahim Pacha, Darsan, Director of the Medical School, Cairo
The German Mission.
1. Geheimer Medicinabrath—Professor Dr. Kock.
2. Geheimer Medicinabrath—Professor Dr. G-affky.
3. Professor Dr. Pfeiffer.
4. Königlich Bayerischer Stratsartz and Dr. Dieudonnè.
5. Privat—O'ocent Dr. Sticker.
The Austrian Mission.
1. Dr. Hermann Franz Müller, M.D., Lecturer for Internal
Medicines (Assistant Professor, Nothnagel).
2. Dr. Heinrich, M.D., Assistant, Patholog. Anatom. Institute.
3. Dr. Anton Ghon, M.D., Assistant, Patholog. Anatom.
Institute.
4. Dr. Rudolph Pock, M.D., Assistant, Clinical, to Professor
Neusser.
The Russian Mission.
Dr. Vladimir Wysokawiez, Pro-
Dr. Daniel Labolotney.
fessor of the Kien University.
Dr. Eugene Redrew.
In addition to the above, the undermentioned Medical Officers
arrived in Bombay from various ports :—
Monsieur Haffkine, Russian.
„
Y er sin, French.
„
Symonds, „
„
Ladin,
„
Monsieur Lorans, French.
„
Bonneau, ,,
,,
Lustig, Italian.
Under the orders of the Bombay Government, the Missions were
assisted in every way possible. Their instruments and stores were
passed through the Customs free of duty ; laboratories were built
200
or found for them, fitted up and placed at their disposal; hospitals
were thrown open to them ; and, where caste prejudices did not
intervene, means for autopsies were afforded. Owing to the presence
of so many Medical Officers, it was found necessary to determine the
hospitals in which each Mission should work, and the following
arrangement was decided on as likely to meet their wishes :—
The German Mission to work at Parel Hospital.
The Austrian Mission was allotted to the Arthur Road
Hospital.
The Russian Specialists practised at the Grant Road
Hospital.
202
charge of the whole special arrangements to be taken in hand for the suppres-
sion of the plague. Mr. Atkinson, one of the Chief Inspectors of the Bombay
Municipality, who had had great experience of disinfecting work in Bombay, was put
in charge of that work, and the following staff was despatched to the various centres:—
Alibagh.
On the 29th April 150 coolies and three muccadums were sent to Alibagh in
charge of Inspector Stazza, and 151 coolies and two muccadums under Inspector Brady
to Rewadanda, for work there and at Theronda.
Panwell.
On the 4th of May Inspector Jenner and Assistant Surgeon Twells with 25
coolies, two muccadums, and two ward-boys were despatched to Panwell for medical
and disinfecting work ; 50 local coolies were also set to work under Sub-Inspector
Jan Mahommed.
Karanja.
On the 6th of May 50 coolies and Inspector De Sa, two muccadums and
four ward-boys were sent to Karanja for work there and at the villages of Kontri and
Kasola.
Uran.
Sub-Inspector Jan Saheb, two Hospital Assistants, 25 coolies, eight sweepers
and six ward-boys. Ten more sepoys and two Non-Commissioned Officers were sent
afterwards.
Theronda.
Inspector Brady, with one Hospital Assistant, one time-keeper, three ward-boys,
two muccadums, two cooks, 100 coolies, and two sweepers.
The work done by Mr. Atkinson, Disinfecting Inspector, and the staff placed
tinder his orders by the Plague Committee was as follows :—
In all 6,502 houses were disinfected in the following towns : —
Panwell
Uran ...
Karanja
Kondri
Kasaoli
Alibag
Theronda
Sukhur )
Akshi )
Raiwady )
Rewadanda
Choul
Agraon
535
762
50
164
42
1,342
437
310
810
1,000
50
Including flushing down with perchloride of mercury and subsequent lime-
washing, digging up floors of infected houses, clearing houses and compounds of
rubbish and opening out roofs, the cost of the labour for. all this work was only the
value of three coolies' labour for one day per house—a result which must be considered
to reflect considerable credit upon Mr. Atkinson and his Inspectors.
In the larger towns the Municipal hand fire engines were employed for the
disinfecting work ; two American rotary pumps were also purchased. In the island
of Karanja and the village of Theronda small garden hand pumps were employed.
The district officers gave every assistance and the Police in particular made
themselves useful.
206.
Segregation.
As regards the segregation of the healthy from infected houses, I may
mention one instance of its highly beneficial effect. On the 1st June a policeman
was attacked with plague in the police lines at Alibag. He was removed to
hospital and died three days after of a very virulent type of the disease. The
room in which he was attacked was immediately disinfected with perchloride of
mercury and the roof removed, while the whole of the inhabitants of the lines were
promptly removed into a segregation camp, the result being that not a single
case of plague occurred amongst the police at Alibag. All the rooms in the lines
are covered with a common roof, and the partition walls between each quarter do-
not extend quite up to the roof, so that there is a free circulation of air between
the individual rooms. There is not the least doubt that had the quarters not been
immediately vacated, there would have been a general outbreak of plague all through
the lines.
From the commencement of the outbreak up to the present date there
have been recorded 1,405 attacks and 1,175 deaths in Kolaba and Janjira; that is
to say, 83.6 per cent. of the attacks have proved fatal. A chart is appended showing
the progress of the epidemic up to the present date, and a statement showing the
weekly number of attacks and deaths from the commencement of the outbreak.
Statement showing weekly number of attacks and deaths from plague
in Kolaba and Janjira.
Week ending
Cases reported from commencement of outbreak up to 6th March 1897.
March
"
"
April
"
"
"
"
May
"
"
"
June
"
"
"
July
13th
19th
26th
2nd
9th
16th
23rd
30th
7th
14th
21st
28th
4th
11th
18th
25th
2nd
...
Cases.
174
17
23
32
90
135
146
155
138
227
120
125
56
31
18
11
14
3
Deaths.
59
10
10
22
61
129
146
151
133
162
95
89
41
25
15
9
12
6
207
Chapter XL
Report on the Operations carried out at Cutch Mandvi
The town of Mandvi lies some 200 miles north-west of Bombay,
and, being the home of many Bombay traders, in addition to carrying on
a large trade with Karachi, an outbreak of plague might naturally have
been expected there. The rise and progress of the disease is treated at
length in the attached report of Surgeon-Lieutenant-Colonel Wilkins,
D.S.O. As far as the Plague Committee was concerned, the beginning of
events was the receipt of a private telegram by the Chairman from Dr.
Lowson, Special Plague Commissioner, on April 25th. In this he asked
for a European Medical Officer to be sent at once and some Hindu ward-
boys. On the following day another telegram from the same source was
communicated to the Chairman by His Excellency the Governor to the
same effect, namely, that the situation was desperate, the people panic-
stricken and not attending on their sick. On the previous day no less
than 73 deaths had occurred in a population of 25,000.
Dr. Lowson suggested that Dr. Ricketts, who was at Bhuj, the
capital of the Runn of Cutch, on military duty, should be put in charge
of the operations ; the Committee, however, thought that one of their
own medical men, who had acquired familiarity in Bombay both with
the plague itself and the methods adopted for stamping it out, would be
preferable for such an important work. The approval of His Highness
the Rao of Cutch and the consent of the Principal Medical Officer,
Bombay Command, having been obtained, Surgeon-Lieutenant-Colonel
Wilkins, D.S.O., who had been in charge of No. 5 District under the
Plague Committee, was despatched by the boat leaving at 10 o'clock on
the morning of the 27th of April.
There was necessarily much to be done to get together a staff of
nurses, &c., during the night of the 26th. Various officers were detailed
by telephone for this duty, and finally Dr. Wilkins, accompanied by a
native medical practitioner, four nurses, and one hospital assistant, left
by the morning steamer. They took with them six sepoys and one lance
naik from the 21st Bombay Infantry, three ambulances, and four
servants.
Further relays of staff, medical and disinfecting, were sent from
time to time as fast as they could be collected, with two experienced
inspectors and a large staff of Bombay coolies for disinfecting work.
Surgeon-Captain Mason followed on the 11th of May.
212
made themselves temporary booths and huts and lived in them with their families.
A great many cases, I have no doubt, occurred amongst them, but I think it would
have been much better if they could have been persuaded to live in the segregation
huts, where a better watch could have been kept on them and cases removed as they
occurred.
In the city itself all the gates but two were closed, and a watch kept on these
by military sepoys from Bhuj, who were also posted around the city at one time.
On any case being found, the residents of the house were sent out of the city and the
house closed for limewashing, and after cleansing thoroughly and removing tiles to
some extent, the house was sealed, so that it could not be used again for some time.
In this way a good deal of the city was evacuated.
HOSPITALS.
The most important Hospital was the Hindu Hospital, which I have
stated before was in every way suitable for a plague hospital, being fairly isolated,
very airy and commodious and having other facilities. The Hospital was opened on
the 28th April, the day before we arrived here, and there were 53 cases admitted.
The patients had cots of native manufacture made for them and mattresses at first of
cotton but latterly of straw, and as many other requirements as we could obtain.
There were many things which we required, and as these could not be obtained here,
we had to send to Bombay for them, and·carry on as well as we could without. It
was hard work for the nurses·and subordinates, as the cases came in rapidly, and we
were short-handed. At one time I calculated that there was at the rate of one nurse to
about 30 patients. As time went on we were supplied with medicines, many neces-
saries, such as thermometers, waterproof sheets, &c., &c., from Bombay, and most
needed of all, the first batch of nurses and medical attendants were supplied on the
13th May.
The following were the admissions in this Hospital for the nine weeks from 28th
April up to 21st June :—
Date.
From 28th to 30th April
From 1st May to 21st June.
Total
...
{
...
Admitted.
92
738
107
937
Died.
28
511
107
646
Discharged.
...
127
112
239
Remaining.
...
52
52
The largest number in Hospital at one time was 184 on the 24th May.
The largest number of admissions was on the opening day, when we had 53 cases
and on the 4th May, when we had 40 cases come in. The daily average admission
for May was 23.8. The daily average death for May was 16.4.
For June up to date (21st) the daily average admissions was 5.1 and the daily
average death was the same (5.1), or same number of deaths as admissions.
The Brahmapuri Hindu Hospital Returns.
Date.
April 28th ...
„ 29th ...
„ 30th ...
Admitted.
53
27
12
92
Discharged.
0
0
0
0
Died.
4
8
16
28
Remaining.
49
68
64
0
213
The Brahmapuri Hindu Hospital Returns—contd.
Date.
May 1st
„ 2nd
,, 3rd
,, 4th
,, 5th
„ 6th
;, 7th
,, 8th
,, 9th
,, 10th
,, 11th
,, 12th
,, 13th
» 14th
,, 15th
,, 16th
,, 17th
,, 18th
,, 19th
,, 20th
,, 21st
,, 22nd
,, 23rd
,, 24th
,, 25th
,, 26th
;, 27th
., 28th
,, 29th
,, 30th
,, 31st
June 1st
,, 2nd
,, 3rd
,, 4th
,, 5th
» 6th
,, 7th
,, 8th
,, 9th
,, 10th
,, 11th
,, 12th
,, 13th
,, 14th
,, 15th
,, 16th
,, 17th
,, 18th
,, 19th
,, 20th
,, 21st
Admitted.
33
28
36
40
30
18
16
21
28
29
19
26
21
17
20
17
32
35
13
33
15
24
22
15
30
20
24
14
30
14
18
738
15
8
10
12
18
7
2
3
4
4
1
7
1
2
0
3
3
0
1
1
5
107
Discharged.
0
0
0
0
0
0
0
0
7
0
4
4
2
22
0
0
1
7
1
7
1
0
4
8
1
22
12
4
9
5
6
127
0
11
13
2
5
13
10
0
8
13
0
14
3
3
6
0
5
1
0
0
5
112
Died.
24
32
17
24
21
18
13
15
16
15
20
22
10
18
15
13
15
18
23
15
8
11
14
18
14
24
12
8
12
12
14
511
12
11
11
9
8
14
10
7
3
2
5
5
1
2
1
0
2
0
0
2
2
107
Remaining.
73
69
88
104
113
113
116
122
127
141
136
136
145
122
127
131
147
157
146
157
163
176
180
169
184
158
158
160
169
166
164
167
153
139
140
135
125
107
103
96
85
81
69
66
63
56
59
55
54
55
54
52
...
This gives 68 . 9 per cent. of deaths of all cases of admissions, not omitting those
moribund cases which died immediately after admission, or those cases which were
brought in practically convalescent. (Every case suffering from plague in the city was
removed to hospital when found by the search parties.)
54