NationalLibraryOfScotland/medical-history-of-british-india huggingface dataset:
341
5. Water Supply—On the ground floor is a large pipe in charge of the cook.
Underneath is a tank from which the hospital is supplied with water. There
are taps on each floor, but they were not utilized.
6. Disinfection—The wards are treated every evening with strong phenyle
solution, and the walls and flooring are lime-washed once every month. When the
hospital closes temporarily, the -District Plague Officer gets the whole building
disinfected.
The linen and clothing are never sent to the Disinfecting Station but disinfected
in the hospital premises. All linen, bedding and clothing, soiled by excreta, are
destroyed by burning. The rest is dipped in a solution of perchloride of mercurry
1 in 2,000 for twenty-four hours and then washed thoroughly by the dhobie on
the premises.
7. Disposal of the Dead—The front verandah of the ground floor is utilized as
a mortuary. A patient dying in the ward is brought down here, dressed and placed
in the coffin, and taken immediately to the cemetery by contacts, and part of the
hospital establishment. Yery little or no time is lost as the Mahomedan religious
rites enjoin early interment. The verandah is. then treated with perchloride
solution and lime-washed. There is no difficulty as regards pauper patients who
receive the same attention when dead as the rich ones.
8. Inoculation.—Nono of the patients treated in this hospital were inoculated
with Haffkine's or any other serum. The Mahomedans in this district have never
taken a favourable view of it.
9. No sickness of any consequence occurred among the Hospital staff or the
contacts who attended as nurses,
M. N. DISANA,
HONY. MEDICAL OFFICER,
KHATRI MAHOMEDAN PLAGUE HOSPITAL.
AND KOLSA MOHLLA M. PLAGUE HOSPITAL.
TABLE No. I.— Total Admissions during the year.
Months.
1899.
February from 15th
March
April
May
June up to 15th
Plague.
1
12
3
Relapsing Fever.
Observation Cases
including all
General Diseases.
1
Total.
1
12
4
The largest number were admitted on the 6th March. 1899, when 3 were ad-
mitted.
342
TABLE No. II.
Plague
...
Relapsing Fever
...
...
...
Observation and other Diseases
Total
...
Admissions.
16
1
17
Deaths.
9
9
Recoveries.
7
1
8
Percentage of
Mortality.
56·2
52·9
TABLE No. III.
Months.
February from 15th
March
April...
May ...
...
June up to 15th
...
Total Ad-
missions.
1
12
4
Died
within
24 Hours.
1
1
Within
48
Hours.
1
Total
Deaths.
8
1
Total
Recoveries.
1
4
3
Percentage
of
Deaths.
66·6
25·00
Remarks—There were no cases of Relapsing Fever.
TABLE No. IV.
Males
Females
...
...
Children (under 12 years)
...
...
Total
Admissions.
10
6
1
Deaths.
7
2
Recoveries.
3
4
1
Percentage
of
Deaths.
70·0
33·3
TABLE No. V.— Table showing Mortality for the year amongst Sexes and Children,
Total Mortality
for the Year.
9
Mortality amongst
the Men.
7
Mortality amongst
Women.
2
Mortality amongst
Children all under
12 Tears of Age.
Nil.
TABLE No. VI.—Table showing the Situation of Buboes.
Situations.
Cervical
R, Parotid
R. Axillary
L. Axillary
R. Femoral
L. Femoral
R. Inguinal
L. Inguinal
···
*··
Other Situations
No. Buboes
Multiple Buboes
···
»*·
·*·
···
...
»· t
···
···
···
Total
No. of
Cases.
1
5
3
5
1
1*
I
Males.
1
1
2
4
1
1
Females.
' "i
1
1
I·.··»
Mortality.
1
2
1
3
1
1
Recoveries.
······ 3
2
2
Percen-
tage of
Mortality.
100
40
33'3
60
100
100
* Left Cervical. Left Femoral. Left Tidls. Left Ankle. Left Cervical, Bight Cervicat.
343
TABLE No. VII.—Table showing Pneumonic Plague (without Buboes).
Males
Females
Children
...
...
...
Admitted.
1
Died.
1
Recovered.
Percentage
of mortality.
100
TABLE No. VIII.
Table showing Cases of Secondary Plague Pneumonia (complicated with Buboes).
Males
Females
Children
...
....
... {
Admitted.
None admitted with
2nd Pneumonia but
all the 3 developed
it in the hospital.
Died.
}
2
1
Recovered.
Percentage of
mortality.
100
100
·· · « -
Notes on the Symptoms, Character and Treatment of
the Disease. (From experience obtained in this
and other Hospitals in my charge, as well as
private practice).
Incubation.—The period of incubation varies from a few hours to a few weeks.
No approximate time could be fixed ; all depends on the vitality of the tissues of a person
to resist the poison. Amongst the ricketty and those whose staple food is "dhall"
and rice alone, such as among the Jains and among the lower order of almost all
communities, the resisting power of the tissue is so low, that the period of incubation is
very short. On the other hand, among the robust and among the higher orders
of all classes who indulge in a mixed food, including vegetables, fruits, &c., the
resisting power of tissues to the plague germs is long.
Cases.—Ismail Hajee Moti, a wood merchant, was living for 2 months in the forest
of Atgaon, about 40 miles away from Bombay. His younger brother in Bombay
having been attacked by Plague, Ismail was telegraphed for. He arrived in Bombay
at 8 p.m. on the 9th February 1898. At 9-30 p.m. he had severe rigor, and I was
sent for to see him. His temperature was found 104° at 7 a. m., the next morning I
again saw him, and found that he had a large bubo in the left Axilla. He was at once
removed to the Kolsa Mohola Hospital, and died four days after. Here the incuba-
tion period was not even two hours.
Cassum Mahomed, aged 30, was nursing his mother who was laid up with
Plague on the 15th February 1899. Cassum himself was attacked on the 13th March
1899, and sent to the hospital lying by the side of his mother. During the interven-
ing period. Cassum, who was usually of a cheerful temper, looked very ill. He
complained of feverish condition at night and occasional vomiting. This is a case in
which the incubation period has been nearly a .month.
348
region ; and so among men who have at one time or the other had venereal or
specific diseases, the common situations are the inguinal and femoral regions. The
following is the order then in which buboes generally occur: —
Among Males—
Inguinal.
Femoral.
Axillary.
Multiple.
Among Females —
Axillary.
Cervical.
Femoral.
Inguinal.
Among Children—
Cervical,
Parotid.
Sub-Maxillary.
Femoral.
Besides these, the rare situations, I noticed, are on the tibse, the outer side of the
chest about 2 inches below the axilla, the pubes, the great toes, the scrotal sac, and
one on the palpebral muscle of the right eye at the situation of the supratrochlear
gland. When buboes are in such unusual situations, the prognosis is most favour-
able ; the most fatal situation is a bubo in the left axilla, and the most fatal form is
the one with blebs. In the case of the former the heart from the very onset is so
very much oppressed that fatal termination is often very sudden.
Buboes mostly appear simultaneously with fever and other symptoms at the
onset, but in some cases they either precede fever by a few hours to few days, or they
appear after it. Sometimos patients undergo treatment for fever, lassitude, &c., at
private dispensaries for about a week, and then a bubo is discovered.
Development.—At the onset they are very small, bat continue to grow in size,
the inflammation extending, until about the fifth day. They then suppurate about
the fifteenth to twenty-fourth day. In the event of an irritant being applied over
them, such as Indian marking nuts or some preparation of arsenic, they soon get
inflamed to an enormous size, often spreading fatal inflammation to other parts. The
peculiarity about suppuration is that, as soon as a slight fluctuation is noticed, the
whole gland gets softened, and bursts open within a day or so. When irritants are
applied, the soft tissues above often get destroyed, and one sees a white mass
protruding from the surrounding redness.
Complications.
Hoemoptysis, particularly in pneumonia ; aphonia ; difficult deglutition ;
pneumonia, primary or secondary ; endocarditis ; marked bruit with the first
sound ; oedaema of the legs ; diarrhoea, (a fatal symptom,) constipation a favourable
symptom ; tympnitic abdomen, a fatal symptom ; retention of urine ; hemiplegia;
insomnia ; unbearable headache ; deafness, noticeable mostly in primary pneumonic
cases ; muscular tremor ; hemorrhage from the ear, mouth and rectum. Some of
these, such as headache, constipation, tremor, should be classed more as symptoms
of high fever than as complications.
349
Sequelae.
I have just now under treatment a case of heart-disease in a patient, by name
Dewukram, treated for plague by me last year at the Vussonji Tricumji Hospital for
Banias at Mandvie; another of oedsema of the right leg, where a gland existed last
year. Stiff joints, such as the elbow, the shoulder and the hip-joint, are often
come across where a plague gland in former years existed. Phthisis is also met
with, and general debility or breakdown of the constitution is invariably met
with, even if a patient has been discharged from the hospital considerably increased in
weight.
Period of Convalescence.
This varies according to the form and variety of plague. In mild and ordinary
cases it may be roughly taken to a week, and in severe cases a month or even more.
Plague complicated with other Diseases,
Heart-disease and other complications are mentioned above, but plague is
confounded with mumps, traumatic glands and enlarged lymphatics, due to skin
diseases. As regards mumps, the question is, why this disease should appear in large
numbers just about the lime when the plague commences to abate. Why it
is more frequent among children, and whether it should not be taken as a mild
form of plague.
A peculiarity in symptoms at onset among plague-stricken children under
three years of age, as well as among pregnant women, is that they begin invariably
with convulsions, and the latter almost generally abort on the third day.
Treatment.
The treatment of patients varies according to the form of plague with which they
are attacked and their constitution. No hard and fast rule can be laid down in this
respect. Two patients from the same house may have been attacked with the same
symptoms and the same form of the disease, and yet their general condition may
require different treatment. As regards drugs nothing has succeeded to eliminate
the poison and hasten recovery. A drug which may agree in one case may prove
positively harmful in another. The treatment, therefore, is general, and more of a
stimulating and supporting nature than poison eliminating.
Mild Cases.—These generally recover by a judicious dose of purgatives and
followed by moderate doses of Quinine, continued for about a week. Calomel seems to
suit most, but requires to be watched, lest it should set up fatal diarrhoea. This
treatment to a certain extent succeeds in ordinary cases also, but in severe and
other forms the main object for the first four days should be to support the heart. In
most cases it is this organ which fails, even in primary pneumonia, and in secon-
dary. I am inclined to believe that the pneumonic symptoms are due rather to
sudden enfeeblement of the heart owing to a large quantity of poison baving been
poured into its substance than to any lesion in the lung itself.
Symptomatic Treatment.—For the bubo I have found leeches succeed well in
mild cases, but prove, fatal in severe ones. In the latter the following has succeeded
well in lessening pain, as well as in bringing about uninterrupted, speedy suppura-
tion :—
Ext. Belladonna.
Ext. Opii.
Ext. Gannabis Ind.
Red Lead (Plumbi Oxidum).
Hydrarg Oxidi Bubri.
M. ft Pasta.
a,
a.
a 3 I.
a 5 zgs.
351
looked to, not in the decoction, but elsewhere; perhaps previous inoculation has
something to do with it or the early resorting of the people to the hospital for
treatment. Given by the same medical gentleman elsewhere than the Khoja Hospital
it proved useless. 1 would prefer Tincture Warburg to it.
M. N. DISANA,
Hony. Medical Officer, Khatri Mahomedan
Plague Hospital and Kolsa Moholla
Mahommedan Plague Hospital.
Notes by the Special Medical Officer.
I have given Dr. Disana's report in full, as he has had a long experience of this
disease, and his notes are worth perusal.
I am disappointed on the small number of admissions in this hospital.
Kolsa Moholla Hospital No. 32.
Report on the working of the Kolsa Moholla Mahommedan Plague Hospital
for the period 1st January to 15th June 1899.
History.—This was the first hospital started in Bombay in the very locality of
the people for whom it was intended, in April 1897. It is located, like other
Mahommedan hospitals, in the Jamat Khana or dining hall. The following com-
prises the Hospital Board :—
(a) Khan Shab Hajee Ebrahim Hajee Soomar Patel, Chairman.
(b) Sirdar Khan Bahadur Cassum Hajee Mitha, J. P.
(c) Hajee Ebrahim Hajee Ahmed Patel.
(d) Mr. AJli Mahomed Abba Jooina, J. P.
(e) Hajee Oosman Hajee Abba, Secretary»
Hospital Establishment.
(a) Dr. M, N. Disana, L.M.& S., Honorary Medical Officer.
(b) One Hospital Assistant.
(c) Four Ward-boys.
(d) One Cook, one Sweeper, one Dhobie.
Expenses.—The expenses incidental to the working of the hospital are incurred
out of the Jamat Fund, collected by a sort of income tax. No donations have been
received from any one, and the Honorary Medical Officer, besides giving his services
free of charge, supplies medicaments free.
Conservancy.
Building.—It is a three-storied building, open only to the West, and has three
stories with a ground-floor. The last is utilized as a store and cook room, and has
accommodation for servants and contacts. The first storey is utilized as an Obser-
vation Ward; the second, the male ; and the third, the female. No segre-
gation house is provided. The building had had no conservancy arrangement
before. General Gatacre's Committee undertook the construction of water-closets
and erected water-pipes. The expenses amounted to about Es. 1,800, half of
which were paid out of the Jamat Funds and the other half by the Municipality.
There are flushing tanks connected with the latrines.
352
Water-supply.—It is drawn out of pipes erected on each floor by the Plague
Committee in April 1897.
Disinfection.—Whenever there are patients, the -wards are treated with phenyle
solution, and the flooring washed with lime once a fortnight. This year the linen
and clothing, as well as bedding, soiled by patients have been all destroyed. The
rest were treated with strong phenyle solution and washed by the Dhobie.
Disposal of the Dead.—On a patient dying, he or she was taken to the back
of the ward,, and there dressed and put into the coffin and taken to the Burial
Ground.
Inoculation.—·Of the patients admitted none were inoculated.
No sickness occurred among the hospital staff.
General Remarks.—This year only seven patients were admitted into the hospital,
out of which three died, and four were discharged cured. One of the reasons for the
small number of admissions is the retirement of Sirdar Khan Bahadur Cassum Hajee
Mitha from active search-work through ill-health ; but the more notorious one is
apparently the dislike of hospitals, by the Mahommedans in general in this part, no
matter whether it be their own Jamat hospital where friends could attend, and
privacy was respected, or Municipal hospitals ; and, consequently, comparing their
general death-rate, I am inclined to believe plague cases were successfully concealed.
I append herewith the necessary tables called forth in the circular.
As to remarks on clinical experiences, I have included them in my report on
the working of the Khatri Mahommedan Hospital, Bapu Khote Street.
M. N. DISANA,
Hony. Medical Officer, Kolsa Moholla
Mahommedan Plague Hospital and
Khatri Mahommedan Hospital.
Notes by the Special Medical Officer.
The work done by this hospital was very small and unsatisfactory, especially as
the hospital is situated in a very crowded locality, and ought to have been used exten-
sively.
TABLE No. I.— Total Admissions during the year.
January
February
March
April
May
June
Months.
1899
,,
,,
,,
,,
,,
...
...
...
...
...
...
Plague.
1
4
2
Relapsing Fever.
Observation Cases,
including all
General Diseases.
Total.
1
4
2
ι
353
TABLE No. II.
Plague
Relapsing Fever
Observation and other Diseases,
Total ...
Admissions.
7
.........
7
Deaths.
3
3
Recoveries.
__
····»·
4
Percentage of
Mortality.
42·8
.......
42·8
TABLE No. III.
Months.
1899.
January
February
March
April
May
June
...
Total
Admissions.
1
4
2
..····
... · · .
Died within
24. Hours.
......
1
......
......
Died within
48 Hours.
......
......
......
Total
Deaths,
1
2
······
« · · t · ·
Total
Eecoveries.
.......
2
2
......
Percentage
of Deaths.
100
50
• · · ·· ·
······
TABLE .No. IV.
Males
Females
Children (under 12 years)
Total
Admissions.
3
4
Deaths.
1
2
Recoveries.
2
2
Percentage of
Deaths.
33·3
50
. · · ···
TABLE No. V.—Talle showing the Mortality for the Year amongst Sexes and Children»
Total Mortality for
the Year.
3
Mortality amongst
Men.
1
Mortality amongst
Women.
2
Mortality amongst
Children (all under 12
years of age).
TABLE No. VI.— Table showing the Situation of Buboes.
Situation.
Cervical
R. Parotid
R. Axillary
L. Axillary
R. Femoral ....
L. Femoral
R. Inguinal
L. Inguinal
Other Situations
No Buboes
Multiple Bubces
Total No.
of Gases.
1
.1
1
2
1
1
1
Males.
1
......
1
,
Females.
1
1
1
1
1
Mortality.
··· ·*·
1
......
1
1
Recoveries.
1
1
......
2
··....
Percentage of
Mortality.
......
100
·····»
*··· »·
100
100
I
354
TABLE No. VII.—Table showing Pneumonic Plague (without Buboes).
Males
Females
Children
...
...
...
Admitted.
1
Died.
1
......
Recovered.
... ...
Percentage of
Mortality.
100
······
TABLE No. VIII.
Table showing Cases of Secondary Plague Pneumonia (complicated with Buboes).
Males
Females
Children
·*»
...
...
...
...
...
Admitted.
Died.
Rscovered.
Percentage of
Mortality.
......
No. 33.
Petit Mills Hospital.
Report on the Manechji Petit Mills Hospital, Bombay, from March 1898 to
May 1899.
1. Owing to the plague and house-to-house visitation of the authorities, the mill
hands became nervous, and resolved to bolt away in numbers to their native place. In
time a good many left, and the mill business was hampered.
So the agents of the mills, through the manager, consoled the. mill-hands, and
promised to erect a temporary plague hospital, where they wonld be looked after,
instead of being sent a\vay to the Municipal hospitals if they be attacked with plague.
They heartily approved of this, and abandoned the idea of "going away." The
hospital was opened on 1st March 1898. I was appointed to look after it with one
Hospital Assistant, Mr. J. A. DeSouza, one compounder (Balvant Sakaram Barve),
one ward-boy (Sakaram Bapoo), with other servants.
All the expenses of the Petit Mills Hospital were defrayed by the mills solely.
I should like to note that the mill has got a dispensary of its own for the workmen
(which are nearly five thousand) for the last fifteen years.
2. The hospital was erected on a large plot of ground, in the compound of the
mills.
The hospital was a temporary one, so it was made of matting and cadjan leaves.
We have submitted a plan for permanent hospital to the Municipality on good
sanitary principles, with arrangements for ventilation at bottom and top (just as the
Maratha Hospital).
The temporary hospital was made in two blocks of three rooms each, with
accommodation for six patients.
The mill dispensary was also in the same compound, close by.
One contact camp, with accommodation for about forty people, was erected
along with the hospital.
Servants' quarters were a little away from it.
3. A Bhungy was kept night and day to take away the ejects, and keep the
place clean. Earthen chatties were freely supplied for the same.
Two water-closets were erected.
355
All the clothing, bedding, &c., of the plague cases were burnt up, if the case
terminated in death. Clothing, &c., of the recovering cases were disinfected by
dipping them in perchloride of mercury lotion.
4. Water-supply was from the Municipal taps, separate for the purpose.
5. Disinfection of wards and surroundings was done by digging up the
ground and freely sprinkling chloride of lime and perchloride of mercury lotion.
6. According to the mill agent's instructions through the manager, the feelings
and the caste prejudices of the mill-hands were much to be respected, and the dead
were immediately earned away by their relatives according to their religious customs.
7. No plague case admitted in our mill hospital was inoculated by Mr.
Haffkine's serum, except our ward-boy who was inoculated by me in March 1898,
but he developed plague this year in the month of March. His name was Sakaram
alias Sitaram Bapoo, a Maratha by caste, aged about 20.
8. Amongst the staff, only this ward-boy developed plague, with bubo in the
left groin. A month before his sickness, he left the mill premises and was-
staying close by the mill in Mr. Noor Mahomed's Chawl, Forjett Street, which was
highly infected at that time. He was attending to our hospital cases up to the last
day of his sickness. So I cannot say, exactly, where he got the infection from.
He was admitted, and died two days after admission, on llth March 1899.
TABLE I.— Total Admissions during the Year.
Months.
15
Plague.
26
Belapsing Fever.
1
Observation Cases.
Total.
27
TABLE II.
Plague
Relapsing Fever
Observation
Total ...
Admissions.
26
1
27
Deaths.
18
**«
**
*
18
Eecovery.
8
1
9
Percentage of
Mortality.
69 per cent.
......
1
69 per cent.
TABLE III.
Months.
15
Total
Admissions.
27
Died
within 24
Hours.
3
Died
within 48
Hours,
6
Total Deaths.
!
18
Eecovery.
8
Percentage
of
Deaths.
69 per cent.
N.B.—One relapsing fever case recovered.
TABLE IV.
Total Admissions.
Males
Females
Children (under 12 years)
Deaths.
16
2
1
Recoveries.
4
1
a
Percentage of Death.
75 per cent.
50
„
N.B.—All cases were of Hindu religion.
356
TABLE V.—Mortality amongst Sexes and Children,
Total Mortality for the
Year.
18
Mortality, Males.
15
Mortality, Females.
2
Mortality, Children
(under 12 Years).
1
TABLE VI.—Situation of Buboes.
Situation.
Cervical
B. Axillary
L. „
E. Inguinal
L. „
Total ...
Total.
4
5
o
6
6
26
Males.
4
4
4
4
5
21
Females.
1
1
2
1
5
Mortality.
3
4
3
4
4
18
Recoveries.
1
1
2
2
2
! 8
TABLE VII.—Pneumonic Plague (without Buboes}.
Nil.
TABLE VIII.—Secondary Pneumonia (with Buboes).
Hales
Females
Children
Died.
4
Recovery.
......
......
Percentage.
100 per cent.
(a] The physical signs of pneumonia were marked. No bacteriological examin-
ation was made.
(6) Pneumonia supervened in two to four days.
Buboes.
They are chiefly in the groins, in the axillas, and in the cervical region. They
appear very irregularly. Sometimes they appear with the rise of temperature and
at times a day or two after it. They are always small in size, but very tender and
painful.
Buboes which suppurate prolong the life of patients. It is a very hopeful sign.
Complications.
Cerebral symptoms are very prominent in the acute stage of the disease.
ARDESHIR HOEMUSJI GHASWALA, L.M.&S.,
In Charge, The Petit Mills Hospital.
Remarks by the Special Medical Officer.
A very useful littlo hospital, situated in open ground and near the mills, and
when completed on the principle adopted by the Marathi Hospital, will do good
work and serve a useful purpose. Contact sheds should also bo erected.