NationalLibraryOfScotland/medical-history-of-british-india huggingface dataset:
138
The above remarks dwell principally upon the points wherein
the people were disinclined to accept plague measures ; but as
regards the general attitude of the people, there can be no question
that they have lost their old hostility to the plague officer and all his
works. When plague first broke out, Municipal servants had to face a
storm of disapproval, and not seldom were hustled : later, house-to-
house visitation parties were attended by police, or even by troops
and evacuation was carried out with the assistance of sepoys and
sailors and all the time the office files were crammed with
complaints of every description. During the past year complaints
have been rare; and, except that a few police have occasionally been
asked to be present at the evacuation of large chawls, or for the
protection of property when a room had to be opened, the plague staff
and the Volunteers bave worked steadily on without any display
of force whatever. This change has been due partly to the gradual
education of the people by experience, but in very large measure to
the voluntary co-operation of so many enlightened and public-spirited
men from among them. The institution by leaders of various commu-
nities of private camps and hospitals is mentioned elsewhere; the Farsee
Punchayet also took special steps to encourage inoculation, and to help
those in distress on account of plague. Leaders of the Daivadnya
Community issued a circular pressing upon their co-religionists the
necessity of removal to hospital of plague patients and other measures,
and advising inoculation, and their example was followed by the
Jains and others. It was this public spirit among the natural leaders
of the people which went furthest to reconcile the masses to measures
unavoidably distasteful, and enabled the plague administration to
proceed with so little friction.
The move-
menta of the
people.
Bombay was perhaps fuller than it has ever been before at the
beginning of the past cold weather. The population was estimated
at 9,50,000 ; it had undoubtedly been swelled to some extent by arrivals
from Dharwar and the Southern Maratha country, and reports were
more than once received of the great over-crowding of certain
sections—notably Kumbharwada—by new arrivals. The approximate
number of people in Bombay at the beginning of each month is given
at the commencement of Chapter II of this report. There was a
very large exodus during January, February and March, the returns
furnished by the Collector of Bombay showing that in round numbers
departures exceeded arrivals by 40,000, 77,000 and 82,000 in those
months, respectively. The tide turned in April, and during that and
the following month some 23,000 people came back. In addition to
migration out of Bombay, there was a marked tendency among the
better classes to remove themselves temporarily to the northern parts
of the island. Large numbers from A, B and C Wards, probably
in all some 25,000, took up plots of land in the low-lying fields of
F and G Wards ; the diminution of population was specially
noticeable in Mandvi.
139
Plague
at
Bandora
Slaughter
House*
At the end of July, the Executive Health Officer directed Capt. Lewis,
D. O., F and G Wards, to detail a Medical Officer for the inspection
of the butchers and others residing in the Slaughter House compound.
Dr. Dadi Burjor was told off for this duty. Plague appeared in the
second week of August, and cases occurred for six weeks as shown
below.
Week Ending.
13-8-98
20-8-98
27-8-98
3-9-98
10-9-98
17-9-98
2a-9-98
No. of Attacks.
13
6
5
8
1
2
••
35
No. of Deaths.
6
5
3
8
2
...
24
The daughter of Mr. Saunders, Superintendent of the Slaughter
Houses, was also attacked on the 11th September, but recovered after a
severe illness.
A good deal of difficulty was experienced in getting the but-
chers to move their patients or do anything to stop the spread of
the disease, but eventually matters were settled on a satisfactory
basis, and the following arrangements were made : for the Mhars and
low caste residents hospital accommodation was reserved at the South
end of the Slaughter House. For the butchers and others, 16 rooms
at the end of one of their cliawls were reserved ; 12 for hospital purposes,
and the remaining four rooms were kept open and unoccupied, so
as to divide the hospital quarters from the remainder of the chawl.
A staff of one lady nurse, one local nurse, 2 ayahs, 2 ward-boys,
2 sweepers, 2 ramosis was engaged : and in addition to Dr. Dadi
Burjor, Dr. DeMonte very kindly gave his services gratuitously in
looking after the health of the people. This staff was dispensed with
ou 10th October. After September the Slaughter Houses were
practically free from plague till the end of the year—one case occurred
in January and one in March 1899.
Railway and
Cause-way In-
spection.
The arrangements in force at the commencement of the year for the
medical inspection of persons entering Bombay by road and rail have
been fully described in Sir J. Campbell's Plague Report. They included
inspection at both the Causeways, and at Sion and Victoria Terminus
on the G. I. P, Railway, and at Bandora and Grant Road on the
B. B. & C. I. Railway. At the beginning of June, plague had greatly
declined in Bombay and Salsette and, with the approval of Government,
inspection at Victoria Terminus, Sion, and Grant Road Stations, and at
both the Causeways was stopped on June 15th. The medical inspection
at Bandora continued, but its management was taken over by the
Collector of Thana, and the inspection there, together with that of up-
passengers at Kalyan, which had been arranged for by Government at
the end of May, was deemed a sufficient protection for Bombay. On July
4th medical inspection of in-coming passengers was re-opened at Sion with
140
a staff of 4 Medical Officers, 8 subordinates and 3 Lady Inspectors,
About this time there was a severe outbreak of plague at Danda, near
Bandora, in the Salsette Taluka ; and in the absence of any Causeway
inspection, the people came into Bombay in numbers on foot. A
considerable number went to Mahim and Parel, but most of these
were collected and sent back over the Causeway. Another party
settled in, and infected Dharavi. The necessity of prompt measures
to protect Bombay from this influx was apparent. The Causeway
Inspections were accordingly reopened on 19th July, with a staff
of 5 Medical Officers, 2 Clerks, 2 peons, 4 police havildars, 26
constables and a bhistie. At first the Causeways were entirely
closed to inward traffic from 9 P.M. to 5 A.M., but in consequence
of petitions from those interested in the green grass market, they
were, on August 23rd, opened between 12 midnight and 2 A.M.
an additional Medical Officer being engaged to enable the inspection,
staff to deal with the extra work. The whole of these inspections,
including that carried out at Bandora under direct Government control,
were discontinued on 13th October. The Officer in charge of the inspec-
tions arranged for by the Municipal Commissioner was, for practically the
whole time, Lieutenant (now Captain) Lewis, D. 0., F and G wards.
General obser-
vations.
There is a general opinion among those engaged in plague
operations, that infection is not, except in pneumonic cases, readily
conveyed from one human being direct to another. The rarity of cases
in hospital supports this belief, and except where people recklessly
handle and embrace the sick, without sanitary precautions of any kind,
it is believed that the disease is more often contracted from infection
lurking in the floors, &c., through some abrasion in the skin, and
frequently through cracks in the skin between the toes. Infection may
undoubtedly be carried in clothes aud the like, and the movements of
people from infected localities must often spread the plague, though
those who take the disease with them may remain free from it
themselves. The Surgeon in charge of one of the Plague Hospitals in
Bombay, lived in pre-eminently healthy quarters. He daily returned to
them, but appears, beyond changing his coat, to have taken very little
precaution. His wife, a pure European, was attacked by a most virulent
form, of plague and died within 3 hours of the disease being definitely
diagnosed. Another case was reported where 4 cases of plague were
traced to mattresses which had been made out of cotton taken from the
bedding of an infected house which had been pressed into a bale and
sold.
The following case is quoted by Dr. Godinho :—
"A large house in Narielwadi was almost vacant, on the ground-floor lived a
Mahoinmedan family which consisted of 6 people, four children and the parents.
One of the children went to a relation from whence he was hrought hack with fever.
As the house was almost vacant and isolated, the child was allowed to remain at
home. Within a week all members of the family took ill and were removed to
hospital. The child was constantly embraced and kissed by the parents."
141
The following by Dr. Shroff:—
" Dagdoo Laximan aged 8 years used to stay at his relatives somewhere m
Mandvi, and at times used also to stay in this house No. 134-136. On 30th
August this boy got an attack of fever and died on 1st September, the Plague Bubo
developing before death. On the 1st idem other three boys, of nearly the age of
the deceased, were attacked at the same place and removed to A. R. Hospital the
same day. These three boys were sleeping with the deceased in the same room and
almost the same bed and remained the whole time in close contact with the deceased.
On the 2nd September Radhabai (the fifth case who was removed as contact to the
same Hospital on the 2nd September) developed Plague symptoms and died there
on the 4th idem.
"Thus the first case was an infected one and the infection was subsequently
given to the other members of the family."
These are instances where infection seems to have been passed
from person to person ; but speaking generally, experience indicates
that the danger is greater from being in an infected spot than from
contact with an infected person.
The following statement shows, for each district, the number of houses
in which one, two, and three or more cases respectively occurred :—
District.
A Ward
,.
B Ward, South
B Ward, North
CWard
D Ward
E Ward, West
E Ward, Byculla
E Ward, Wari Bandar
F and G Wards
Central District
Total
No. of houses in which
One case.
219
285
93
not
416
343
not
304
not
415
2,075
Two cases.
58
104
32
supplied.
137
154
supplied.
80
supplied.
116
681
Three or more
cases.
58
112
38
187
168
88
155
!
806
The above statement is not complete, but it shows roughly the
proportion of houses in which plague did and did not recur. It is,
however, almost impossible to deduce conclusions.
Each house has a separate population—one may be little more
than a shed with room for 10 people, another will be a chawl
accommodating upwards of 2,000—each house has a separate
individuality in its structure and arrangements, in the matter of
ventilation, water-supply and drainage, every house has a different
sanitary environment, and the customs and manners of the residents vary
according to their caste, class and position in life. Again the record
only refers to cases definitely diagnosed as plague, and leaves out
of count suspicious cases, and those where the cause of death was
successfully misrepresented or the address successfully concealed.
144
House No. 503, Parel Road, UmerJchadi.—This is one of the largest houses
in Parel Road, and is used as a carriage stable. It contains big chawls, all one-
storied, and having lofts for keeping grass stacks. The ground floor is " kutcha,"
filthy and wet. There are so many horses in the stable that it is very hard to
keep it clean. Besides these chawls, there are a number of huts for the sweepers
to live in. The chawls are overcrowded with inmates, men and horses. The
men living in these chawls are generally Ghatis, with a small number of Mussal-
mans with equally filthy habits. They generally sleep on the ground and walk
about bare-footed. They are poor and have to work very hard. There occurred
twelve cases of plague in this stable. But all these cases did not really belong to
the stable. Some of them were brought here from different parts of the City by
their friends living here, while in one or two instances plague deaths occurred
and no trace could be obtained as to where they came from.
There occurred twelve plague cases in the stable from 12th January to 20th
May 1899, as detailed below :—
Date.
12-1-99
23-1-99
24-1-99
27-1-99
14-2-99
Cases.
Date
1
2
1
1
1
6
15-2-99
17-2-99
23-2-99
1-4-99
20-5-99
Cases.
1
2
1
1
1
6
Every room in which a case occurred was disinfected and contacts removed.
The evacuation of the whole stable was hardly possible.
House No. 161, Parel Road, Umerkhadi.—This is a very large house, having
four stories with a very large number of rooms in each. The building is
made of stone and brick, well cemented and properly plastered. The ground
floor is slightly damp, but the upper floors are fairly dry. The rooms are
nicely whitewashed, but with insufficient light and badly ventilated. The popu-
lation of the house is about eight hundred souls. They are all Hindus,
Banias, Marathas and Purdesis. Some are hawkers, others are shopkeepers and
embroiderers. There occurred fourteen plague cases in the house, from 12th
March to 25th May, as detailed below :—
Date.
11-3-99
12-3-99
16-3-99
20-3-99
22-3-99
23-3-99
Cases.
1
1
1
1
1
1
6
Date.
24-3-99
4-4-99
8-4-99
19-4-99
24-4-99
25-5-99
Cases.
1
1
2
1
1
2
8
Disinfection was done in each case immediately after it had occurred. For
every case three rooms were disinfected—one in which the case occurred and
two adjoining rooms. The cases were very widely scattered in the different
floors, and the evacuation of the whole house could not be effected. Therefore
disinfection, removal of contacts and segregation of patients were the only plague
measures adopted.
House No. 85, Kambekar Street, Chuckla.—The house is a " pukka " well built
up and neat building, well ventilated and well lit up. The inmates are well-
154
tances to have their cases treated ; and given a comfortable method of
conveyance, I cannot see why these cases should not be safely brought
to hospitals outside the City, and so possibly save the City from having
these probable centres of infection. When I state that there were 19 of
these possible sources of infection, it will be seen that some steps ought
to be taken to suppress this evil.
My own idea on the subject is that some open space, such as the
Maratha Hospital grounds, or any other convenient site which might be
selected, should be laid out as Large Plague Hospital. Small plots of
ground enough to meet the requirements of each sect, could be handed
over to them to build their own hospitals and contact camps. I need
hardly point out the convenience of this arrangement. A staff of medical
men and nurses could be employed to look after the sick and see that
things are carried on properly. No interference with the prejudices of
caste would be allowed, and the medical attendance and treatment
could be left to the wishes of each caste, and the uncontrolled intercourse
between sick and their friends avoided. The Maratha Hospital had its
vaidya or native doctor. Those who wished it could have this form of
treatment, and they were not interfered with in any way, except that the
general sanitary conditions of these wards were attended to. Under
these circumstances, the infected would be safely removed away from the
City, and possible sources of infection removed. I think the Arthur
Road Hospital should continue, and it is capable of enlargement so as to
meet a larger demand on its resources. So also would, if necessary, the
Modikhana Hospital, where there is plenty of open space for expansion.
The Maratha to me is the ideal place, and if the ground were properly
drained or raised, nearly the whole of the Hindu Hospitals could be
placed comfortably there. I think the compact and well-conducted
hospital, out-buildings and contact camps of the Pathare Parbhu as well
as the Hindu Hospitals, both of which were situated in the Charni Road
Gardens, a model on which these Hospitals should be instituted.
TABLE II.— Total Admissions to all Hospitals Month by Month during the Year.
Month.
June
July
August
September
October
November
December
January
February
March
April May
1893.
... ... ...
1899.
Grand Total
Plague.
69
125
306
480
371
147
381
1,138
2,074
2,465
1,080
429
9,065
Relapsing Fever.
124
120
184
288
278
125
179
183
184
205
141
95
2,106
Observation
Cases, includ-
ing all General
Diseases.
65
98
148
130
134
101
207
295
276
258
210
183
2,105
Total.
258
343
638
898
378
767
1,616
2,534
2,928
1,431
707
13,276
155
The above table is complied from the returns made by 26 hospitals.
Six other hospitals gave totals for 12 months only. If their figures be
added, the grand totals would be :—
Admitted Plague, 9,663 ; Relapsing. Fever, 2,106 ; Observation,
2,142 ; total 13,911.
The months of January, February, March and April have, as usual,
proved the most virulent, and the sudden rise from 381 cases of plague
in December to 1,138 in January, and the sudden decrease from 1,080 in
April to 429 in May, is noticeable.
With regard to relapsing fever, there seems to be a practically uni-
form number of admissions during these months, except in September and
October, and I can see no possible connection between the two diseases.
TABLE III.—Plague (all Hospitals).
Month.
1898.
July
...
...
...
...
August
...
...
...
...
September
...
...
...
...
October
...
...
...
...
November
...
...
...
...
1899.
March
...
...
...
...
April
...
...
...
...
May
...
...
...
...
Grand Total ...
Admissions.
69
125
306
480
371
147
381
1 138
2 074
2 465
1 080
429
9,065
Deaths.
31
78
181
316
256
101
247
798
1 464
1 777
724
281
6,254
Percentage of
Mortality.
44·9
62·4
59·1
65·8
69·0
68·7
64·8
70·1
70·5
72·80
67·30
65·5
68·9
TABLE IV.—Plague.
Total Admissions to each Hospital during the Year, together with Total Mortality and
Rates of Mortality on Admission.
Name of Hospital.
Arthur Road
...
...
...
...
...
...
Modikhana ...
...
... ... ...
Maratha... ... ... ... ... ...
Jain Hospital, Lall Bag ... ... ... ... ... ...
Bene-Israel
...
...
...
...
...
...
Adamji Peerbhoy Borah Fever Hospital ... ... ...
Thakurdwar Lohana
...
...
...
...
...
...
Kshatriya Fever Hospital Charm Road Gardens ... ...
Vassanji Trikamji
...
...
...
...
...
...
Kolsa Moholla Mahomedan
...
...
...
...
...
...
Pathare Prabhu Hospital... ... ... ... ... ...
Kapole and Lad Joint
...
...
...
...
...
...
Khatri Mahomedan
...
...
...
...
...
...
Ad-
missions.
1,470
1,262
3 104
286
87
147
151
12
18
24
243
7
36
27
92
142
16
Deaths.
1,161
1,028
2 509
200
34
74
113
11
12
18
194
3
26
16
78
116
9
Percentage
of
Mortality.
78·97
81·4
80·8
69·93
39·8
50·3
74·8
91·6
66·6
75·0
79·8
42·8
72·2
59·2
84·7
81·8
56·2
156
Name of Hospital.
Cutchi Memon
Port Trust
Telegu
Hallai Memon
Sunni Mahomedan Jullaha
Hindu Fever Hospital
Parsee Fever Hospital
Bhattia
Petit Mills
Ad-
missions.
24
181
148
145
245
54
804
4
465
250
326
141
17
540
243
22
Deaths.
10
97
108
109
190
35
156
4
210
194
177
100
13
374
174
16
Percentage
of
Mortality,
41·6
53·6
72·9
75·1
77·5
64·8
51·3
100·0
45·1
77·6
54·3
70·8
76·4
69·2
71·6
72·7
If Tables II and III are compared with the general mortality return
of the City of Bombay, the admissions and the rates of mortality will be
found to rise and fall date for date as the general mortality rises and falls.
As noted before, not only does the plague increase during the
months of January, February, March and April, but the tendency seems
to be that the disease is more virulent also during these months.
In comparing this table in the three largest hospitals, viz., Arthur
Road, Maratha and Modikhana, it will be seen that the rates of mortality
varies in the three hospitals, the Arthur Road showing heaviest percen-
tage during September, October, November and January, the Modi-
khana practically agreeing with the Arthur Road, and the Maratha
showing heaviest mortality in November, December, January, February,
March and April.
I have personally watched the rate of mortality during the time I
was in charge of the hospitals, viz., from October to May, and my expe-
rience has been that the type of disease has been virulent all through
this third epidemic, and I am inclined to agree with the results, as shown
by the Arthur Road and Modikhana, which show more or less this heavy
rate of mortality.
TABLE V.—Plague.
Months.
June
1898
July
„
August
„
September
„
October „
November „
December „
January 1899
February „
March
„
April
„
May
„
Total ...
Total Admis-
sions.
69
125
306
480
371
14-7
381
1,138
2,074
2,465
1,080
429
9,065
Died within
24 Hours.
10
31
77
140
110
53
114
S21
561
726
264
129
2,536
Died within
48 Hours.
8
16
41
67
62
18
36
176
337
358
173
44
1,836
Total
Deaths.
31
78
181
316
256
101
247
798
1,464
1,777
724
281
6,254
This table is compiled from the returns given by 26 hospitals.
157
The enormous proportion of the deaths early in the disease is
shown in this table.
TABLE VI.
Total Admissions to Hospitals during the Year, showing also the Effect of
Age and Sex on Mortality.
Males
Females
Children (under 12 years
of age)
Total
Total
Admissions.
7,851
2,557
1,458
11,861
Deaths.
5,488
1,531
704
7,723
Recoveries.
2,363
1,026
749
4,138
Percentage of
Mortality.
69·7
69·4
48·4
65·1
A few hospitals did not give this return. The figures include all diseases.
Table VI is interesting, showing the larger number of attacks of
males as compared with women and children, and also the heavier rate
of mortality amongst them.
Castes.
Admissions and Mortality, all Diseases by Sexes, &c.—Some Hospitals did not give this
information.
TABLE VII.
Total Admissions to Hospitals of each Caste during the Year, showing also the
Effect of Age and Sex on Mortality.
HINDUS.
Males
Females
Children (under 12 years
of age)
Total
Total
Admissions.
6,858
2,129
1,172
10,159
Deaths.
4,283
1,228
524
6,035
Recoveries.
2,575
901
648
4,124
Percentage of
Mortality.
62·4
57·0
44·7
59·3
TABLE VII.—MAHOMEDANS.
Males
Females
Children (under 12 years of
age)
Total
Admissions.
1,132
428
270
1,830
Deaths.
572
157
77
806
Recoveries.
560
271
193
1,024
Percentage of
Mortality .
50·5
36·4
28·5
44
TABLE VII.—NATIVE CHRISTIANS.
Males
Females
Children (under 12 years of
age)
Total
Admissions.
188
43
16
247
Deaths.
122
26
8
156
Recoveries.
66
17
8
91
Percentage of
Mortality.
64·8
62·7
50·0
63·1
158
TABLE VII.—JAINS.
Males
Females
Children ( under 12 years of
age)
Total
Admissions.
476
57
27
560
Deaths.
845
39
18
402
Recoveries.
131
18
9
158
Percentage of
Mortality.
72·4
68·4
66·6
71·7
TABLE—VII. BENE-ISRAEL.
Males
Females
Children ( under 12 years of
age)
Total
Admissions.
31
19
17
67
Deaths.
!
18
i
9
5
i
32
Recoveries.
13
10
12
35
Percentage of
Mortality.
58·06
47·3
29·4
47·7
TABLE VII.—PARSEES.
Males
Females
Children (under 12 years of
age)
Total
Admissions.
205
147
56
408
Deaths.
93
72
15
180
Recoveries.
112
75
41
228
Percentage of
Mortality.
45·3
48·9
26·7
44·1
Table VII is interesting, as giving a general idea of the mortality
amongst the various castes. I am sorry to say some of the hospitals did
not give this information.
The Parsees show the best percentage of mortality. The Hindus
and Jains, who are practically vegetarians, show a high rate of mor-
tality ; The Native Christians, chiefly composed of Goanese, also show a
high rate of mortality ; these men are generally of very poor physique
and are evidently unable to withstand the virulence of the disease.
TABLE VIII.—Table showing the Situation of Buboes.
Situation.
Cervical
Parotid
Right Axillary
Left
„
Right Femoral
Left
„
Right Inguinal
Left
„
Other Situations*
No Buboes
Multiple Buboes †
Total No.
of Cases.
525
133
919
849
1,298
1,266
1,009
931
124
1,515
924
Males.
343
93
631
567
982
950
740
676
79
1,235
564
Females.
156
34
260
262
303
296
250
241
38
264
327
Children
(under 12
Years of
Age).
26
6
28
20
13
20
19
14
7
16
33
Deaths.
264
96
722
667
946
959
681
660
G6
1,318
632
Recov-
eries.
261
37
197
182
352
307
328
271
58
197
292
Percentage
of
Mortality.
50·2
72·1
78·5
78·5
72·1
75·7
67·4
70·8
53·2
86·9
68·3