46
The first 19 were all inoculated with fluid from one bottle, No. 53 N, the only one of that
number in Dr. Elliot's possession. Very careful enquiries made shortly afterwards proved
that while no body, who had been inoculated with any other brew, suffered any ill-effects, every
person who had been inoculated with fluid from this bottle died of tetanus. The enquiries
also showed that Dr. Elliot had taken every precaution in performing the operations and
there was no room for doubt that although to all appearance pure, the fluid had been con-
taminated with the virus of tetanus.
As soon as the news of the outbreak of tetanus reached the District Plague Medical
Officer, Gujrát, which it did on the morning of November 6th, he and Dr. Elliot went to
Mulkowál and did all that was possible for the unfortunate sufferers, but to no avail. Dr. Elliot
remained at the village almost continuously until the last patient died and did much to
convince the people that the terrible calamity was the result of an accident only and to
prevent any outburst of feeling against Government. The people of Mulkowál bore their
terrible misfortune with great fortitude, though a few were so affected by watching the
sufferings of their relatives who died of tetanus that they imagined that they themselves had
contracted the disease of the symptoms of which they manifested hysterical imitations for
some time.
It so happened that all the sufferers were males, most of them being the bread-winners
of their households, and in order to afford their dependents some compensation for their
loss the Punjab Government awarded a number of these dependents pensions of various
amounts according tó various status and circumstances of each family. One of the victims
was a Lambardár, and a grant of land on the Jhelum Canal was awarded in lieu of a pension
to his family.
A commission was appointed in January 1903 to enquire into the circumstances
connected with the Mulkowál accident, the report of which has not yet been published.
With the occurrence of the Mulkowál disaster and the consequent complete suspen-
sion of operations the inoculation scheme of the Punjab Government may be considered to
have received its death-blow. It was of course realised that the temporary abandonment of
the scheme for extensive inoculation could not fail to shake the confidence of the people in the
measure, but the danger of another such calamity as that which had occurred at Mulkowál
was too great to be faced. Had the accident occurred with the original prophylactic it might
have been possible in view of previous experience of its purity to disregard this danger and
to go on with the scheme, but after so much of the new fluid had been proved to be con-
taminated there was no alternative but to cease operations completely as long as there was
any possibility of any of this fluid being taken into use.
Resumption of operations.
78. As soon as it became certain that no new fluid remained in any district permis-
sion was given for the resumption of inoculation
with such of the original prophylactic as was
still in the Punjab pending the receipt of a further supply of this prophylactic. As, however,
it was anticipated that the supply of fluid prepared by this process could not be obtained
until January instructions were issued directing special attention to other measures for deal-
ing with plague.
District Plague Medical Officers were instructed to arrange in consultation with
Deputy Commissioners for all Medical Officers in their districts to work in those tahsils in
which they would be consequently employed on inoculation duty, in order that they might
become familiar with that part of the district and endeavour to obtain the confidence of its
inhabitants.
The necessity was impressed upon all District Plague Medical Officers of bringing to
light all defects and deficiencies in equipment and for seeing that everybody was thorough-
ly instructed in his duties, in order that when it was possible to re-commence inoculation on
a large scale, everybody and everything might be in readiness.
In the meanwhile not only the people but many officials became distrusted of inocu-
lation. It was common to find officials, who had formerly earnestly advocated the measure,
declare that they could no longer do so, now they themselves so distrusted it that they
would not consent to submit to the operation. It was thus that even after a supply of
prophylactic prepared by the original method and subjected to additional tests as to its
purity was obtained, it was only in those districts of which the officials enjoyed in an excep-
tional degree the confidence of the people or had managed to re-assure themselves of the
safety of the prophylactic that the people came forward at all freely for inoculation. In no
district, however, did the number of inoculations performed approach the number estimated,
and in no large town were more than a few hundred people inoculated. It was in the
towns that the news of the Mulkowál accident produced the greatest distrust of inoculation
as it was here that papers were most read and the manner in which the Mulkowál accident
was referred to by some of the native papers was the reverse of that calculated to re-assure
the public as to the safety of inoculation.