38
nary measures of disinfection and segregation were then adopted. Cases
were only isolated where it was possible to secure for the patient a room
of decent size with good ventilation. Endeavours were made to secure
attention to a few essential matters. The number of attendants was
limited to two, disinfectants were supplied and the relatives directed how
to use them ; special instructions being given as to the disinfection and
removal of all secretions and excretions of the patient. The rest of the
house was, if possible, evacuated and visits from friends and neighbours
discouraged. The house was frequently visited by the District Officer,
Sectional Medical Officer or volunteers, to see that these precautions
were adopted, but though the people were ready enough with promises,
it was impossible to rely upon their performance. The number of cases
where the isolation of patients was attended with disastrous consequences
was not very great. Lt. Brackenbury quotes two cases of a little boy
and of a servant who had been tending isolated cases dying of plague
a few days later. In two cases, in B Ward North, the infection spread
to the next floor and there attacked several rooms, and Captain Cuppage
quotes the following case :—
" On 27th August a death occurred in this house from plague. Subsequently
" there was another death from the same cause. On 2nd September the Medical Officer
" was called in to see two people sick in the sanie house. He pronounced them to
" be suffering from pneumonic plague. Not being in a fit condition for removal they
" were allowed to remain in the house. Two of the attendants in these cases died
" subsequently elsewhere of plague. All these people were memb< rs of one firm and
" related to each other. No dead rats had been found in the house."
Segregation of
contacts.
The word "contact" is used to describe persons living with or
' attending a person suffering from plague ; and endeavours were made to
remove such persons, partly to get them away from the infected room,
and partly to reduce the danger of their infecting others. Ordinarily con-
tacts were sent to the accommodation provided at the various hospitals,
public and private, for the friends and relatives of patients, but where
the plague, patient bad died before removal they were sent to one of the
Municipal Health Camps. Contacts were often very difficult to get
hold of ; to avoid going to camp they would leave the house where they
had been living arid find quarters elsewhere. A large number who did this
were followed up, found, and sent to camp, but it cannot be denied that
a great many people coming under the description of contacts managed
to escape being sent to camp. Another difficulty in regard to them
was that the discipline of private hospitals was hardly sufficiently good to
secure that contacts sent to them would reside there. If the patient lived
there was no trouble ; if he died even a few hours after admission there
was practically no control over the contacts, and they could leave the hos-
pital and take up quarters wherever they wished. Endeavours were made
to improve matters in this respect, but without much success; the
managers of various private hospitals were called together, but they
pointed out that it would be impossible to do much in this direction
without making the hospitals unpopular. But though the segregation