28
At one village two dogs were observed to die within a few hours after suffering front
high fever with glandular swellings in the neck.
Type.
Throughout the district the type was in the main bubonic, though there was also
some pneumonic and septicaemic plague.
Influence of local conditions
Plague was noted to be worst in the least dry parts of the district. As regards
liability, it was noticed that persons living
in the lower floors of houses were more liable
to attack than those living in the upper stories.
Medical Staff and Establishment.
The following Medical Officers and subordinates were employed on plague duty in the
district :—Captain H. Ainsworth, I. M. S., and
Captain P. B. Haig, I. M. S., District Plague
Medical Officers, Dr. Wilkinson, Dr. Douglas, Dr. Gardiner, Dr. Henley, Dr. D. D. Pandya,
Inoculating Medical Officers, Assistant Surgeon Hari Lál Basu, Assistant Surgeon Shiv
Das, 1 Hospital Assistant and 10 Compounders.
AMRITSAR DISTRICT.
Epidemic.
40. The Amritsar District became infected with plague for the second time during the
year under report. During the previous season
there had been 3,145 cases with 1,837 deaths,
60 towns and villages being infected. The present epidemic was of much greater severity :
41,508 plague cases with 27,891 deaths occurred, and 563 towns and villages were
infected. At the beginning of October Amritsar City itself was the only place in the district
infected. Six villages, however, became infected during October, and from thence onwards,
the epidemic gradually spread. The number of attacks and deaths steadily rose week by
week till the last week in December, from which time till the last week in January the
epidemic was almost stationary. During the first week in February there was a sudden
rise in the numbers of plague cases and deaths, and the epidemic then rapidly gathered
strength, reaching its climax in April. After the early part of May the epidemic rapidly
declined, the disease almost disappearing during the first week in August.
The attitude of the people towards all Government measures was at first one of dis-
trust and suspicion, but as the people got to know officials on plague duty they became less
distrustful. They frequently asked for advice as to how best to avoid the disease,
and a small vernacular pamphlet was accordingly distributed to them, briefly detailing what
should be done to combat the epidemic.
Preventive measures.
No attempt was made by the inhabitants of healthy villages to exclude persons
coming from infected places, but the inhabitants,
of one village spontaneously removed an
imported case of plague to a field a mile away from the village, with the result that an
outbreak was prevented.
Information.
The Plague Medical Officer remarks that the reporting of plague occurrences
was at first very defective and cases were
concealed. He attributes this to the people's
fear of Government interference, and adds that as the people realised that their fears were
groundless, reporting gradually improved. This was partly due also to the importance
of their duties in this respect having been impressed upon Patwárís.
Disinfection
Chemical disinfection was not at all popular with the people, and consequently very-
little was done. In many villages the inhabit'
ants took advantage of the advice given
in the pamphlet previously mentioned concerning simple methods of disinfection by fire,
boiling water, exposure to sun, phenyle, &c, and a certain amount of good was probably done
in this way.
Infection.
The majority of villages were infected by human intercourse. A common history-
given was that the first person attacked with
plague had recently returned from an infected
village. The next step was the death of rats in the infected and adjoining houses,
followed by a rapid spread of plague throughout the village. Of 391 villages in which
enquiries were made, 284 reported mortality among rats prior to human beings developing
the disease, 71 reported it to be subsequent to the outbreak among human beings, and
36 reported no rat mortality at all. The District Plague Medical Officer remarks, how-
ever, that these observations do not pretend to any scientific accuracy, as very often the
first human case preceded rat mortality, but was concealed or overlooked by the
villagers. After the first introduction the main factor in the rapid and wide distribution of
the infection throughout the village was the rat. Usually human cases followed rat cases
in about 6 to 7 days. The period varied from 3 to 14 days.