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wood and cowdung were used as fuel. Fifteen seers of cowdung were found sufficient to
raise the temperature to over 200 o Fahr. in half an hour and to maintain it over 122 0 Fahr.
for an hour. Cowdung raised the temperature sooner than wood. No recrudescence
occurred after desiccation.
Infection.
There was no evidence of any recrudescence of last year's epidemic, as in every instance
a distinct history of the importation of a case
in the incubating stage was obtained. The
cases were imported from the Jhang, Gujránwála and Gujrát Districts.
Rats.
Rats were reported to have died in places before the disease became epidemic
amongst human beings.
Type.
In the villages of the Shahpur and Bhera Tahsils the disease was largely of the
pneumonic type ; in the Khusháb Tahsíl it was
mainly bubonic.
The Muhammadans as a class suffered most severely from the disease.
Medical Sfaff and Establishment.
The Medical Officers and subordinates on plague duty were as follows :—Captain
Turner, I. M. S., Dr. M. Doyle, Assistant
Surgeon Jagat Naráin, Assistant Surgeon
Bashárat Ahmad and 3 Compounders.
JHELUM DISTRICT.
Epidemic.
44. This epidemic under report is the first which has visited the Jhelum District.
The disease first appeared in May 1903, and
only 129 cases with 83 deaths occurred. The
epidemic was confined to the jhelum Tahsíl. Only the city and one village were infected.
Preventive measures.
No surveillance over arrivals from infected areas was maintained, and the people
never refused to admit to their villages persons
from infected areas.
Segregation and evacuation were never practised in the town except in the first case
which occurred, which was isolated, but in the village Muftián the inhabitants were very
amenable to advice and evacuated the place, at the same time isolating their sick and segre-
gating all contacts. As a result of this, the epidemic was stopped at Muftián. In all cases
houses and effects were chemically disinfected and the bedding and clothes of most persons
who had died of the disease were burnt.
Disinfection.
309 rooms were chemically disinfected and 267 were desiccated. Ten seers of
charcoal were used for an average-sized room.
One disadvantage observed was that rats left
the desiccated quarters and invaded the neighbouring houses.
Infection.
The infection both of Jhelum City and of the village of Muftián was due to human
agency. The first case in Jhelum City was a
pleader's nephew who had come from Gujrán-
wála. This case did not spread the disease, as it was isolated. The second case, which
was imported into the city, was a peculiar one in that symptoms of the disease did not
develope until 10 days after arrival. The patient, a girl, came from Jalálpur Jattán, an
infected village in the Gujrát District, and during the incubating stage she attended and
infected a school. The village Muftián is on the way to a salt spring at Garat, which is
annually visited by persons from the Siálkot, Gujrát and Gujränwala Districts. It was
probably these people who introduced infection.
After the first imported case in Jhelum City it was noticed that rats were dying in
large numbers in certain streets, in which the disease then assumed an epidemic form
among human beings. Periods varying from 2 to 15 days elapsed between the death of rats
in a house and the appearance of the disease among the occupants. It was remarked that
while the grain market was infected with rats these animals avoided going to certain houses
where kerosine oil was stored.
Type.
The type of plague was mainly bubonic ; pneumonic and septicaemic cases were very-
uncommon and far more fatal.
Medical Staff and Etablishment
The District Medical Staff performed plague duty in addition to their ordinary work,
and only one Hospital Assistant was detailed
to the district for purely plague duty.